Evaluating the role and integration of general practice pharmacists in England:a cross-sectional study

Background Since 2015, NHS England has facilitated the recruitment of pharmacists in general practice (GP) to reduce workload of general practitioners. The role of pharmacists is therefore expected to become more clinical and patient oriented. However, little is known about the current roles performed and the integration of GP pharmacists. Objective To assess the role performed by GP pharmacists and their integration into practice exploring facilitators and barriers to integration. Setting A cross-sectional survey of GP pharmacists in England. Method This study used both online and paper-based questionnaires for a period of six months. Survey items included demographics, roles performed, integration including available support and practice environment. Quantitative data were analysed using descriptive statistics and 95% confidence intervals. Open comments were analysed thematically to identify pharmacists’ perceptions of barriers and facilitators to their integration into practice. Main outcome measure Current role and integration of pharmacists into GP. Results 195 participants completed the questionnaire. Three quarters of pharmacists (76%) had only been in GP since 2015. Most pharmacists (81%) were independent prescribers (PIPs). The most reported pharmacists’ roles were medicine reconciliation (95%), telephone support for patients (95%) and face-to-face medication review (91%). 82% (95% CI: 76% to 86.8%) were satisfied with their overall integration into practice. Half of pharmacists (45%) were working in a shared office or at a hot desk and 9% had no designated workspace. PIPs had more access to a convenient workplace (p = 0.016) compared to non-IPs. Conclusion Practice pharmacists are fulfilling a wide range of clinical and non-clinical roles in England. Findings highlight relatively a satisfactory level of pharmacists’ integration into practice and shed the light on their integration issues. These findings could be significant for the development of future roles of pharmacists in GP

Robust and efficient EBG-backed wearable antenna for ISM applications

A structurally compact, semiflexible wearable antenna composed of a distinctively miniaturized electromagnetic band gap (EBG) structure is presented in this work. Designed for body-centric applications in the 5.8 GHz band, the design draws heavily from a novel planar geometry realized on Rogers RT/duroid 5880 laminate with a compact physical footprint spanning lateral dimensions of 0.6 lambda 0 x 0.06 lambda 0. Incorporating a 2 x 2 EBG structure at the rear of the proposed design ensures sufficient isolation between the body and the antenna, doing away with the performance degradation associated with high permittivity of the tissue layer. The peculiar antenna geometry allows for reduced backward radiation and low specific absorption rate (SAR). With the inclusion of EBG, the gain of the antenna undergoes a considerable increase to 7.2 dBi with more than 95% reduction in SAR value. In addition, the front-to-back ratio also amplified to 13 dB. A rigorous analysis detailing the structural robustness is reported for varied bend angle configurations of the proposed antenna. To assess the suitability of the proposed design as a body-worn antenna, an experimental investigation is carried out on different parts of the body. Experimental findings are congruent with computationally obtained results, validating the applicability of the novel antenna structure for body-worn applications

Synthesis and DPPH scavenging assay of reserpine analogues, computational studies and in silico docking studies in AChE and BChE responsible for Alzheimer's disease

A doença de Alzheimer (DA) é uma doença neurodegenerativado sistema nervoso central, em rápido crescimento, e antioxidantes ajudam a suprimir o estresse oxidativo causado por radicais livres, responsávies pela DA. Avaliou-se, biologicamente, série de derivados sintéticos de indol selecionados para identificar novos antioxidantes. A maioria dos compostos avaliados apresentou de significativa a boa propriedade antioxidante (valor de IC50 399,07140.0 ± 50 µM). Eftuaram-se estudos de Teoria do Funcional de Densidade (DFT) com os compostos e os seus correspondentes radicais livres. As diferenças de energia entre os compostos protótipos e os radicais livres correspondentes proporcionaram boa justificativa para a tendência encontrada nos seus valores de IC50. O ancoramento in silico dos compostos com a acetilcolinesterase (AChE) e com a butirilcolinesterase (BChE), que contribuem para a DA, foi, também, realizado para prever o seu potencial anti-DA.Alzheimer's disease (AD) is a fast growing neurodegenerative disorder of the central nervous system and anti-oxidants can be used to help suppress the oxidative stress caused by the free radicals that are responsible for AD. A series of selected synthetic indole derivatives were biologically evaluated to identify potent new antioxidants. Most of the evaluated compounds showed significant to modest antioxidant properties (IC50 value 399.07 140.0±50 µM). Density Functional Theory (DFT) studies were carried out on the compounds and their corresponding free radicals. Differences in the energy of the parent compounds and their corresponding free radicals provided a good justification for the trend found in their IC50 values. In silico, docking of compounds into the proteins acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), which are well known for contributing in AD disease, was also performed to predict anti-AD potential

In Vitro Supplementation of Glycine Improves Quality of Cryopreserved Bull Semen

The extender supplementation of glycine on quality of cryopreserved bull sperm was reported in current study. Three adult Sahiwal bulls was used for semen collection by artificial vagina having 42°C (three weeks) (replicates; n=18)). Collected semen was quickly shifted to laboratory for initial evaluation. Qualified semen ejaculates (>60% motility, >1mL volume, >0.5billion/mL cons.) was diluted in tris extender having 0 (control), 5, 10 and 15 and 20mM of glycine. Cooling of extended semen to (4℃) was done in 2 hours and kept for 4 hours for equilibration. French straws were used for filling at (4℃), liquid nitrogen used for freezing. Highest percentages of post thaw sperm progressive motility and acrosome integrity were observed in extender containing 5mM of glycine compared to other treatments and control (P<0.05). However, glycine supplementation in extender didn’t affect viability, chromatin integrity and plasma membrane integrity of bull sperm. In conclusion, glycine addition at 5 mM in extender improves quality of cryopreserved bull semen

CLINICAL PRESENTATION AND LIFESTYLE RELATED RISK FACTORS OF BREAST CANCER AMONG DIFFERENT AGE AND ETHNIC GROUPS

Breast cancer (BC) is one of the most frequent and leading cause of malignancies in females globally. In Pakistan, breast cancer is most frequently found in younger individuals and late stage presentation is the key feature for clinical diagnosis. Numbers of genetic factors are reported to be significantly associated with the manifestation of breast cancer. A number of factors including gender, age, genetic predisposition, familial vertical history, ethnicity and life style eventually leading to the development of the cancer. Therefore, we identified the role of biochemical characteristics of all participants in the development of breast cancer. 50 breast cancer patients were enrolled in this study. A written informed consent was taken from each of the patients prior to data collection through questionnaire. People belonging to different ethnic groups: Pashtoon was found to be the highest noteworthy figure of breast cancer patients with an overall of 14 (28%) followed by Afghani ethnic group with 7 (14%), Baloch 15 (30%), Hazara 8 (16%), Punjabi 3 (6%) and Sindhi 3 (6%). Key words: Breast cancer, Ethnic groups, Cenar Hospital, Balochistan

Mitigation of water scarcity with sustained growth of Rice by plant growth promoting bacteria

Climate change augments the risk to food security by inducing drought stress and a drastic decline in global rice production. Plant growth-promoting bacteria (PGPB) have been known to improve plant growth under drought stress. Here in the present study, we isolated, identified, and well-characterized eight drought-tolerant bacteria from the rice rhizosphere that are tolerant to 20% PEG-8000. These strains exhibited multiple plant growth-promoting traits, i.e., 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase activity, exopolysaccharide production, phosphate (P)-solubilizing activity (51–356 µg ml-1), indole-3 acetic acid (IAA) production (14.3–46.2 µg ml-1), and production of organic acids (72–178 µg ml-1). Inoculation of bacterial consortium (Bacillus subtilis NM-2, Brucella haematophilum NM-4, and Bacillus cereus NM-6) significantly improved seedling growth and vigor index (1009.2-1100) as compared to non-inoculated stressed plants (630-957). Through rhizoscanning, efficiency of the consortium was validated by improved root parameters such as root length (17%), diameter, and surface area (18%) of all tested genotypes as compared with respective non-inoculated stressed treatments. Furthermore, the response of consortium inoculation on three rice genotypes was positively correlated with improved plant growth and drought stress ameliorating traits by the accumulation of osmoprotectant, i.e., proline (85.8%–122%), relative water content (51%), membrane stability index (64%), and production of antioxidant enzymes to reduce oxidative damage by reactive oxygen species. A decrease in temperature and improved chlorophyll content of inoculated plants were found using infrared thermal imaging and soil plant analyzer development (SPAD), respectively. The key supporting role of inoculation toward stress responses was validated using robust techniques like infrared thermal imaging and an infrared gas analyzer. Furthermore, principal component analysis depicts the contribution of inoculation on stress responses and yield of tested rice genotypes under water stress. The integration of drought-tolerant rice genotype (NIBGE-DT02) and potential bacterial strains, i.e., NM-2, NM-4, and NM-6, can serve as an effective bioinoculant to cope with water scarcity under current alarming issues related to food security in fluctuating climate

Dietary betaine supplementation increases Fgf21 levels to improve glucose homeostasis and reduce hepatic lipid accumulation in mice

Identifying markers of human insulin resistance may permit development of new approaches for treatment and prevention of type 2 diabetes. To this end, we analyzed the fasting plasma metabolome in metabolically characterized human volunteers across a spectrum of insulin resistance. We demonstrate that plasma betaine levels are reduced in insulin-resistant humans and correlate closely with insulin sensitivity. Moreover, betaine administration to mice with diet-induced obesity prevents the development of impaired glucose homeostasis, reduces hepatic lipid accumulation, increases white adipose oxidative capacity, and enhances whole-body energy expenditure. In parallel with these beneficial metabolic effects, betaine supplementation robustly increased hepatic and circulating fibroblast growth factor (Fgf)21 levels. Betaine administration failed to improve glucose homeostasis and liver fat content in Fgf21(-/-) mice, demonstrating that Fgf21 is necessary for betaine's beneficial effects. Together, these data indicate that dietary betaine increases Fgf21 levels to improve metabolic health in mice and suggest that betaine supplementation merits further investigation as a supplement for treatment or prevention of type 2 diabetes in humans

Maternal mortality and morbidity burden in the Eastern Mediterranean region : findings from the Global Burden of Disease 2015 study

Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life

Neonatal, infant, and under-5 mortality and morbidity burden in the Eastern Mediterranean region: findings from the Global Burden of Disease 2015 study

Objectives Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. Methods We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. Results In 2015, 755,844 (95% uncertainty interval (UI) 712,064–801,565) children under 5 died in the EMR. In the early neonatal category, deaths in the EMR decreased by 22.4%, compared to 42.4% globally. The rate of years of life lost per 100,000 population under 5 decreased 54.38% from 177,537 (173,812–181,463) in 1990 to 80,985 (76,308–85,876) in 2015; the rate of years lived with disability decreased by 0.57% in the EMR compared to 9.97% globally. Conclusions Our findings call for accelerated action to decrease child morbidity and mortality in the EMR. Governments and organizations should coordinate efforts to address this burden. Political commitment is needed to ensure that child health receives the resources needed to end preventable deaths