On the synthesis of fused thiazolo[5,4- d]isoxazoles and a novel rearrangement involving conversion of 5(4H)-isoxazolones to 4(5H)-isoxazolones

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Do primary care placements influence career choice: What is the evidence?

BACKGROUND: The NHS is struggling with GP recruitment. The Health Education England (HEE) Wass Report (By Choice not by Chance), among its recommendations to boost GP numbers, highlighted undergraduate (UG) GP placement experience as an important influence on future career choice. AIM: To explore the UG influences on GP career choice. METHODS: Two junior doctors produced a pragmatic rapid appraisal of the literature on the UG influences on GP career choice for the Wass Report. The search strategy was supported by librarians and focused on rapidly accessing and summarising relevant literature. Databases searched, including Medline, EMBASE, HMIC & grey literature, revealed 294 items. Data extraction and synthesis was pragmatic. RESULTS: The international evidence suggests that UG GP experience can positively influence students towards a primary care career. Longitudinal placements are more influential than traditional blocks. UK literature is limited, but there are consistencies with the international evidence. The relevant studies identified are observational with risk of bias, but this is unavoidable within this research context. DISCUSSION: The implications of these results for medical school curricula are discussed with particular reference to Government plans to expand medical student numbers and establish new medical schools with explicit aims to produce more GPs

Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population

Enhancing phosphorus use efficiency and soil quality indicators in lowland paddy ecosystem through Azolla, rice straw, and NPKS fertilizers

PurposeThis study investigates the influence of incorporating Azolla, rice straw, and NPKS fertilizers on phosphorus use efficiency (PUE) and rice productivity in lowland paddy fields. Despite Azolla’s well-known role as a nitrogen-fixing aquatic fern in rice production, its specific impact on PUE remains unclear. The primary objective is to explore diverse treatment combinations to identify synergies that enhance both PUE and overall rice productivity.MethodsThe study was conducted at Mkula Irrigation Scheme in the Kilombero Valley, Tanzania; the field experiment employed a randomized complete block design with 13 treatments and three replications. Treatments comprised various combinations of Azolla, rice straw, and chemical fertilizers, incorporating 50% and 100% rates of nitrogen (N) applied with phosphorus (P), potassium (K), and sulfur (S).ResultsThe study reveals the substantial impact of Azolla application on total nitrogen, available phosphorus, and exchangeable potassium levels in the soil. Particularly noteworthy were treatment combinations involving Azolla, rice straw, and reduced rates of synthetic nitrogen, along with specific P, K, and S applications, which exhibited the highest phosphorus uptake and PUE. Specifically, combining rice straw and Azolla with reduced N rates, alongside 30 kg P ha−1 + 30 kg K ha−1 + 20 kg S ha−1, resulted in the highest phosphorus uptake (73.57 kg/ha) and PUE (46.24%).ConclusionIntegrated nutrient management, incorporating rice straw and Azolla alongside synthetic fertilizers, demonstrates synergistic effects on phosphorus uptake and efficiency while maintaining soil quality. The study underscores the potential of such integrated strategies to optimize PUE and contribute to sustainable rice production in lowland paddy fields

Assortative Mating on Ancestry-Variant Traits in Admixed Latin American Populations

Assortative mating is a universal feature of human societies, and individuals from ethnically diverse populations are known to mate assortatively based on similarities in genetic ancestry. However, little is currently known regarding the exact phenotypic cues, or their underlying genetic architecture, which inform ancestry-based assortative mating. We developed a novel approach, using genome-wide analysis of ancestry-specific haplotypes, to evaluate ancestry-based assortative mating on traits whose expression varies among the three continental population groups – African, European, and Native American – that admixed to form modern Latin American populations. Application of this method to genome sequences sampled from Colombia, Mexico, Peru, and Puerto Rico revealed widespread ancestry-based assortative mating. We discovered a number of anthropometric traits (body mass, height, and facial development) and neurological attributes (educational attainment and schizophrenia) that serve as phenotypic cues for ancestry-based assortative mating. Major histocompatibility complex (MHC) loci show population-specific patterns of both assortative and disassortative mating in Latin America. Ancestry-based assortative mating in the populations analyzed here appears to be driven primarily by African ancestry. This study serves as an example of how population genomic analyses can yield novel insights into human behavior

Evaluation of Xpert® MTB/RIF and ustar easyNAT™ TB IAD for diagnosis of tuberculous lymphadenitis of children in Tanzania : a prospective descriptive study

Fine needle aspiration biopsy has become a standard approach for diagnosis of peripheral tuberculous lymphadenitis. The aim of this study was to compare the performance of Xpert MTB/RIF and Ustar EasyNAT TB IAD nucleic acid amplification assays, against acid-fast bacilli microscopy, cytology and mycobacterial culture for the diagnosis of TB lymphadenitis in children from a TB-endemic setting in Tanzania.; Children of 8 weeks to 16 years of age, suspected of having TB lymphadenitis, were recruited at a district hospital in Tanzania. Fine needle aspirates of lymph nodes were analysed using acid-fast bacilli microscopy, liquid TB culture, cytology, Xpert MTB/RIF and EasyNAT. Latent class analysis and comparison against a composite reference standard comprising "culture and/or cytology" was done, to assess the performance of Xpert MTB/RIF and EasyNAT for the diagnosis of TB lymphadenitis.; Seventy-nine children were recruited; 4 were excluded from analysis. Against a composite reference standard of culture and/or cytology, Xpert MTB/RIF and EasyNAT had a sensitivity and specificity of 58 % and 93 %; and 19 % and 100 % respectively. Relative to latent class definitions, cytology had a sensitivity of 100 % and specificity of 94.7 %.; Combining clinical assessment, cytology and Xpert MTB/RIF may allow for a rapid and accurate diagnosis of childhood TB lymphadenitis. Larger diagnostic evaluation studies are recommended to validate these findings and on Xpert MTB/RIF to assess its use as a solitary initial test for TB lymphadenitis in children

Drivers of millet consumption among school aged children in central Tanzania

Open Access Journal; Published online: 06 Aug 2021Background: Iron and zinc deficiency are common public health problems in low-income countries largely due to poor consumption of iron and zinc rich foods. It has previously been observed that 57% of school aged children (SAC) in Tanzania suffer from anemia. In addition, estimates indicate that over 25% of the population have inadequate zinc intake. Pearlmillet is an example of a nutrient dense, resilient cereal crop, that can be promoted to diversify diets and combat iron and zinc deficiency. This study overall aim was to increase pearl millet consumption among school aged (5 – 12 years) children. As part of the study, we investigated, the drivers of food choice relating to pearl millet consumption. Methods: The study was a cross-sectional study of randomly selected households in Kongwa district, Dodoma region of Tanzania. In total, 128 women of reproductive age (20 – 49 years) were randomly selected for the study. A study questionnaire consisting of 66 items, was developed and validated. The constructs in the questionnaire were categorized in two groups: internal and external factors. Respondents were asked to indicate their level of agreement or disagreement with statements read to them by interviewers. The scores on intention and behavior constructs were based on the number of times caregivers intended to, or had fed their school going children with pearl millet in the referent month. Intention was considered high if it was higher than the median intention score of the group, and low if it was equal to or lower than the median scores. Correlations and multiple linear regressions were performed to measure association between constructs and to identify predictive constructs. The Mann-Whitney U test was used for score comparison. Results: There was a significant difference between intention and behavior among those who did not consume pearl millet (P = 0.003), and those who consumed pearl millet two or more times a week, in the same month (P = 0.01). Knowledge was significantly correlated with behavior identity (r = 0.58, P = 0.001), while health behavior identity was significantly correlated with intention (r = 0.31, P = 0.001). Intention of caregivers was significantly and positively correlated (r = 0.44, P = 0.001) with and predicted consumption of pearl millet (r = 0.87, P = 0.067). Conclusion: Increasing knowledge or awareness on nutritional benefits of pearl millet among caregivers may increase consumption of pearl millet by children of school going age

Medical Management Following Surgical Therapy in Inflammatory Bowel Disease: Evidence from Cochrane Reviews

The Cochrane Inflammatory Bowel Diseases Group presented a symposium at Digestive Diseases Week 2019 entitled “Medical Management Following Surgical Therapy in Inflammatory Bowel Disease: Evidence from Cochrane Reviews”. This article summarizes the data presented at this symposium

Case Report The Solitary Variant of Mandibular Intraosseous Neurofibroma: Report of a Rare Entity

Neurofibroma (NF) is a benign neoplasm derived from peripheral nerve cells. NF may extend either as a solitary lesion or as part of a generalized syndrome of neurofibromatosis. Intraorally, the intraosseous variant of neurofibroma is a very rare tumor. The literature provides only few cases of solitary intraosseous neurofibroma of the mandible. We report a case of 28-year-old female who was diagnosed with a solitary intraosseous neurofibroma involving the lower left quadrant of the mandible. The present case is rare in regard to its dimensions and its location