Does sex matter? The influence of gender on gastrointestinal physiology and drug delivery.

We all respond differently to drugs. Personalised medicine aims to improve efficacy and reduce side effects, and efforts are being made to understand the physiological differences that underlie responses to drugs. Genetics, diet and disease state can be key; however, gender also plays an important role in pharmacokinetics, pharmacodynamics and drug toxicity. Differences in metabolism and clearance of drugs as a consequence of distinct hepatic and renal processes in males and females are now much better understood but little is known about gender differences in the gastrointestinal tract. As the recipient of all orally administered medications, differences at this level can have a major impact on drug delivery and bioavailability; yet these continue to be ignored and insufficiently studied in the context of drug disposition. The aim of this review is to highlight the known gender differences in gut physiology. Clinical case studies are presented, where possible, to illustrate the influence of these differences on drug disposition and gaps in current knowledge are highlighted to encourage further research in this area

Integrating Green Skills into TVET Curricula in Polytechnics Malaysia

Green skills are very much needed by green industry. Nevertheless, many TVET institutions have not yet embedded green skill elements into the programme’s curriculum because it is still unclear concerning the types of green skills demanded by the green industry. Therefore, this research was conducted to identify the green skills that should be integrated into TVET curricula from the perspective of engineering lecturers in Polytechnics. The nature of this research was descriptive in which the date were collected using self-developed questionnaire. Four Polytechnics located in the East Coast, Northern, Central, and Southern of Malaysia were involved. A total of 332 engineering lecturers from three departments of engineering (Civil, Electrical, and Mechanical Engineering) were invited to participate in this research. The findings revealed that the TVET curricular should contains some of these green skills: problem solving skill related to environmental pollution,  interpretative skill on environmental phenomena, research skill on environmental issues, data collection skill, analytical skill, exploitation skill on green technology, management skill on natural resources, design skill, controlling skill on environment pollution, raw material management skill, energy saving skill, recycling skill, and reuse skill. It is suggested that Polytechnics should embed these green skills into their programme curricula in order to produce graduates who are able to meet the needs of green industry

Predicting two-year mortality from discharge after acute coronary syndrome: An internationally-based risk score.

BACKGROUND: Long-term risk of post-discharge mortality associated with acute coronary syndrome remains a concern. The development of a model to reliably estimate two-year mortality risk from hospital discharge post-acute coronary syndrome will help guide treatment strategies. METHODS: EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients, NCT01171404) and EPICOR Asia (EPICOR Asia, NCT01361386) are prospective observational studies of 23,489 patients hospitalized for an acute coronary syndrome event, who survived to discharge and were then followed up for two years. Patients were enrolled from 28 countries across Europe, Latin America and Asia. Risk scoring for two-year all-cause mortality risk was developed using identified predictive variables and forward stepwise Cox regression. Goodness-of-fit and discriminatory power was estimated. RESULTS: Within two years of discharge 5.5% of patients died. We identified 17 independent mortality predictors: age, low ejection fraction, no coronary revascularization/thrombolysis, elevated serum creatinine, poor EQ-5D score, low haemoglobin, previous cardiac or chronic obstructive pulmonary disease, elevated blood glucose, on diuretics or an aldosterone inhibitor at discharge, male sex, low educational level, in-hospital cardiac complications, low body mass index, ST-segment elevation myocardial infarction diagnosis, and Killip class. Geographic variation in mortality risk was seen following adjustment for other predictive variables. The developed risk-scoring system provided excellent discrimination (c-statistic=0.80, 95% confidence interval=0.79-0.82) with a steep gradient in two-year mortality risk: >25% (top decile) vs. ~1% (bottom quintile). A simplified risk model with 11 predictors gave only slightly weaker discrimination (c-statistic=0.79, 95% confidence interval =0.78-0.81). CONCLUSIONS: This risk score for two-year post-discharge mortality in acute coronary syndrome patients ( www.acsrisk.org ) can facilitate identification of high-risk patients and help guide tailored secondary prevention measures

Actividad microbiana en suelo de agroecosistemas con manejo agroecológico y convencional en la Universidad Autónoma Chapingo

Se evaluó la producción de CO2 en suelos de agroecosistemas con manejo convencional y agroecológico para determinar si hay influencia de la forma de manejo con la actividad microbiana. Se estudiaron dos agroecosistemas con manejo convencional, cultivados con alfalfa (Medicago sativa) y con avena (Avena sativa) y un sistema agroforestal con manejo agroecológico, donde se analizó la asociación durazno (Prunus persica) y avena. Para la determinación de CO2, se usó el método de incubación en medio cerrado descrito por Anderson (1982). Otros parámetros evaluados fueron pH, contenido de materia orgánica (MO) y humedad del suelo. Los niveles de dióxido de carbono se analizaron mediante el programa estadístico SPSS, con la prueba no paramétrica de Mann Whitney. Se presentaron diferencias significativas en la producción de CO2 en los tres sistemas de manejo. El agroecosistema durazno-avena fue el que produjo la mayor cantidad de dióxido de carbono lo que es atribuible al tipo de manejo implementado.In order to determinate the influence of conventional and agroecological management on soil microbial activity, the production of CO2 was evaluated. There were studied two agroecosystems with conventional management, grown with alfalfa (Medicago sativa) and oat (Avena sativa). In the third agro ecosystem it was analyzed the association of peach (Prunus persica) and oat. For the determination of CO2 in the laboratory, an incubation method described by Anderson (1982) was used. Some of the others parameters evaluated were pH, organic matter (MO) and moisture. The levels of carbon dioxide were analyzed with Mann Withney’s nonparametric test through the statistic program SPSS. The results indicated that the agro-ecosystem of peach and oats was the one who produced the highest level of carbon dioxide and this is because of the management that was used.Eje: A1 Sistemas de producción de base agroecológica (Trabajos científicos)Facultad de Ciencias Agrarias y Forestale

Actividad microbiana en suelo de agroecosistemas con manejo agroecológico y convencional en la Universidad Autónoma Chapingo

Se evaluó la producción de CO2 en suelos de agroecosistemas con manejo convencional y agroecológico para determinar si hay influencia de la forma de manejo con la actividad microbiana. Se estudiaron dos agroecosistemas con manejo convencional, cultivados con alfalfa (Medicago sativa) y con avena (Avena sativa) y un sistema agroforestal con manejo agroecológico, donde se analizó la asociación durazno (Prunus persica) y avena. Para la determinación de CO2, se usó el método de incubación en medio cerrado descrito por Anderson (1982). Otros parámetros evaluados fueron pH, contenido de materia orgánica (MO) y humedad del suelo. Los niveles de dióxido de carbono se analizaron mediante el programa estadístico SPSS, con la prueba no paramétrica de Mann Whitney. Se presentaron diferencias significativas en la producción de CO2 en los tres sistemas de manejo. El agroecosistema durazno-avena fue el que produjo la mayor cantidad de dióxido de carbono lo que es atribuible al tipo de manejo implementado.In order to determinate the influence of conventional and agroecological management on soil microbial activity, the production of CO2 was evaluated. There were studied two agroecosystems with conventional management, grown with alfalfa (Medicago sativa) and oat (Avena sativa). In the third agro ecosystem it was analyzed the association of peach (Prunus persica) and oat. For the determination of CO2 in the laboratory, an incubation method described by Anderson (1982) was used. Some of the others parameters evaluated were pH, organic matter (MO) and moisture. The levels of carbon dioxide were analyzed with Mann Withney’s nonparametric test through the statistic program SPSS. The results indicated that the agro-ecosystem of peach and oats was the one who produced the highest level of carbon dioxide and this is because of the management that was used.Eje: A1 Sistemas de producción de base agroecológica (Trabajos científicos)Facultad de Ciencias Agrarias y Forestale

Global geographical variations in ST-segment elevation myocardial infarction management and post-discharge mortality.

BACKGROUND: There is a shortage of information on regional variations in ST-segment elevation myocardial infarction (STEMI) management and prognosis at a global level. We aimed to compare patient profiles, in-hospital management and post-discharge mortality across several world regions. METHODS: In total, 11,559 patients with STEMI were enrolled in two prospective studies of acute coronary syndrome survivors: EPICOR (4943 patients from 555 hospitals in 20 countries in Europe and Latin America recruited between September 2010 and March 2011) and EPICOR Asia (6616 patients from 218 hospitals in eight Asian countries recruited between June 2011 and May 2012). Comparisons were performed by eight pre-defined regions: Northern Europe (NE), Southern Europe (SE), Eastern Europe (EE), Latin America (LA), China (CN), India (IN), Southeast Asia (SA), and South Korea/Hong Kong/Singapore (KS). RESULTS: Reperfusion therapy rates ranged between 53.9% (IN) and 81.2% (SE), primary percutaneous coronary intervention (PCI) between 24.8% (IN) and 65.6% (NE) and fibrinolysis between 8.1% (CN) and 34.2% (SA). Median time to primary PCI (h) ranged from 3.9 (NE) to 20.9 (IN) and to fibrinolysis from 2.4 (SE) to 6.3 (IN). Two-year mortality ranged between 2.5% in NE and 7.4% in LA. Regional variations in mortality persisted after adjustment for reperfusion therapy and known prognostic factors. CONCLUSIONS: Among patients with STEMI, there is a wide regional variation in clinical profiles, hospital care and mortality. Substantial room for improvement remains at a global level for increasing reperfusion rates, reducing delays and post-discharge mortality in patients with STEMI

HT_FED2004-56432 Mechanical Degradation Effects on Turbulent Flows with Macro- Molecular Polymer Structures

ABSTRACT Macro-molecular polymer structures due to either the entanglement of polymer molecules or the ionic character of the polymer, have been shown in the literature to enhance the drag reducing abilities of polymer solutions in internal water flows. The purpose of this study is to contrast the performance of an ionic and a non-ionic polymer as drag reduction agents with and without the presence of such macro molecular polymer structures. The endurance of such polymer structures to mechanical degradation is also assessed and documented herein. It will also be shown that special attention needs to be paid to the design of optimum polymer delivery systems since they can contribute to the formation or to further enhancing the drag reducing abilities of homogeneous polymer solutions

Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia.

BACKGROUND: The EPICOR Asia (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients in Asia) study (NCT01361386) was an observational study of patients hospitalized for acute coronary syndromes (ACS) enrolled in 218 hospitals in eight countries/regions in Asia. This study examined costs, length of stay and the predictors of high costs during an ACS hospitalization. METHODS AND RESULTS: Data for patients hospitalized for an ACS (n = 12,922) were collected on demographics, medical history, event characteristics, socioeconomic and insurance status at discharge. Patients were followed up at 6 weeks' post-hospitalization for an ACS event to assess associated treatment costs from a health sector perspective. Primary outcome was the incurring of costs in the highest quintile by country and index event diagnosis, and identification of associated predictors. Cost data were available for 10,819 patients. Mean length of stay was 10.1 days. The highest-cost countries were China, Singapore, and South Korea. Significant predictors of high-cost care were age, male sex, income, country, prior disease history, hospitalization in 3 months before index event, no dependency before index event, having an invasive procedure, hospital type and length of stay. CONCLUSIONS: Substantial variability exists in healthcare costs for hospitalized ACS patients across Asia. Of concern is the observation that the highest costs were reported in China, given the rapidly increasing numbers of procedures in recent years. TRIAL REGISTRATION: NCT01361386

Prevalensi Labioschisis Di Rsup. Prof. Dr. R. D. Kandou Manado Periode Januari 2011 – Oktober 2012

: Cleft lip or labioschisis is an inherited disorder that can occur on the lips to the ceiling. Cleft lip is a disruption in the face of growth since the fourth week of embryonic life. Method: This research in retrospection description research for knowning prevalence cleft lip or labioschisis in surgical department RSUP. Prof. Dr. R. D. Kandou Manado, period of Januari 2011 – October 2012. Output: Prevalence of Labioschisis and Labiopalatochisis on Januari 2011 – October 2012 is 57% and 43%. Presentation for each of kind harelipped are : unilateral labioschisis 47%, bilateral labioschisis 5%, unilateral palatum of labioshisis 28%, and bilateral palatum of labioschisis 12%, submucosa 1%, and cleft palate lips 7%. Presentation according to the place of defect : right 18%, left 57%, bilateral 25%, and status not complete 54%. Presentation according to age for doing operation : 0-4 years 73%, 5-9 years 10%, 10-14 years 7%, and >15 years 10%. Presentation labioschisis according to sex : Man 58%, and women 42%. Presentation labioschisis according to etiology : genetic factor 25%, environment factor 62%, and unknown factor 13%. Presentation of labioschisis that be surgery 93%, and not surgery 7%. Presentation of labioschisis according to complication surgery : bleeding post surgery 1%, secunder infection 4%, dehisensi/establish scar 4%, and not complication 91%. Conclusion: Prevalence labioschisis still decrease in each year, kind of labioschisis that large is unilateral labioschisis and localization defect is often on left edge. Labioschisis is happen more to man. Factor that to cause labioschisis between : genetic factor, environment factor and unknown factor. Labioschisis is often more to surgery 0-4 years old