Trends in sexually transmitted infections in general practice 1990-2000: population based study using data from the UK general practice research database

Objective: To describe the contribution of primary care to the diagnosis and management of sexually transmitted infections in the United Kingdom, 1990-2000, in the context of increasing incidence of infections in genitourinary medicine clinics. Design: Population based study. Setting: UK primary care. Participants: Patients registered in the UK general practice research database. Main outcome measures: Incidence of diagnosed sexually transmitted infections in primary care and estimation of the proportion of major such infections diagnosed in primary care. Results: An estimated 23.0% of chlamydia cases in women but only 5.3% in men were diagnosed and treated in primary care during 1998-2000, along with 49.2% cases of non-specific urethritis and urethral discharge in men and 5.7% cases of gonorrhoea in women and 2.9% in men. Rates of diagnosis in primary care rose substantially in the late 1990s. Conclusions: A substantial and increasing number of sexually transmitted infections are diagnosed and treated in primary care in the United Kingdom, with sex ratios differing from those in genitourinary medicine clinics. Large numbers of men are treated in primary care for presumptive sexually transmitted infections

Iatrogenic hypothyroidism and acute psychosis

We present the case of a 39 years old woman who was referred to our day hospital unit because of anxiety. The patient didn\u2019t endorse any past psychiatric symptoms except for an acute psychotic episode in August 2010. In June 2010 she was diagnosed with hypothyroidism (likely due to Hashimoto\u2019s thyroiditis) and was started on Methilmazole 30 mg. Shortly after that she reported persecutory ideation and hallucinations which quickly progressed, until she was hospitalized in a psychiatric facility. Upon admittance her lab work revealed severe hypothyroidism. Methilmazole was suspended, she was started on Haloperidol, and the symptoms went into remission after four days. Despite the fact that she self discontinued Haloperidol shortly after discharge, she showed no sign of psychotic symptoms. While it is widely accepted that hypothyroidism can cause depressive symptoms, to the best of our knowledge very few cases of psychotic symptoms associated with this condition have been described. Based on the patient\u2019s clinical history, on the rapid onset and remission of symptoms, on the lab values and on the doses of medication that were prescribed, we hypothesize that our patient\u2019s psychotic episode was caused by iatrogenic hypothyroidism

Impact of Zinc Supplementation on Subsequent Morbidity and Growth in Bangladeshi Children With Persistent Diarrhoea

This study was conducted to explore whether supplementation of zinc to children during persistent diarrhoea has any subsequent effect on morbidity and growth. A prospective follow-up study was conducted among children, aged 3–24 months, with persistent diarrhoea, who participated earlier in a double-blind randomized placebo-controlled trial. During persistent diarrhoea, children were randomly allocated to receive either zinc in multivitamin syrup or only multivitamin syrup for two weeks. After recovering from diarrhoea, 76 children in the multi-vitamin syrup and 78 children in the zinc plus multivitamin syrup group were followed up for subsequent morbidity and growth. Weekly morbidity and two-weekly anthropometric data were collected for the subsequent 12 weeks. Data showed that episodes and duration of diarrhoea were reduced by 38% and 44% respectively with supplementation of zinc. There was no significant difference in the incidence or duration of respiratory tract infection between the zinc-supplemented and the non-supplemented group. Improved linear growth was observed in underweight children (weight-for-age <70% of the National Center for Health Statistics standard) who received zinc compared to those who did not receive

Wire coating analysis with Oldroyd 8-constant fluid by Optimal Homotopy Asymptotic Method

AbstractIn this study the wire coating in a pressure type die with the bath of Oldroyd 8-constant fluid with pressure gradient is investigated. The non-linear ordinary differential equation in dimensionless form is obtained, which is solved for the velocity profile using the Optimal Homotopy Asymptotic Method (OHAM). The effect of Dilatant constant α, the Psendoplastic constant β, and the pressure gradient on velocity distribution and shear stress is studied. Shear stress is examined under the effect of the viscosity parameter η0. Moreover, the volume flow rate and average velocity is carefully studied with changing the domain (thickness) of the polymer and varying the parameter α,β and the pressure gradient

Atom efficient PtCu bimetallic catalysts and ultra dilute alloys for the selective hydrogenation of furfural

A range of Pt:Cu bimetallic nanoparticles were investigated for the liquid-phase selective hydrogenation of furfural, an important platform biomass feedstock. Alloying of the two metals had a profound effect on the overall catalytic activity, providing superior rates of reaction and achieving the needed high selectivity towards furfuryl alcohol. Furthermore, we investigated the catalytic activity of an Ultra Dilute Alloy (UDA) formed via the galvanic replacement of Cu atoms by Pt atoms on dispersed host Cu nanoparticles (atomic ratio Pt:Cu 1:20). This UDA, after overcoming an induction period, exhibits exceptionally high initial rates of hydrogenation under modest hydrogen pressures of 10 and 20 bar, rivalling the catalytic turnover for the monometallic Pt (containing 12 times more Pt), and outdoing the pure Cu or other compositions of bimetallic nanoparticle alloy catalysts. These atom efficient catalysts are ideal candidates for the valorization of furfural due to their activity and vastly greater economic viability

Associations between blood sex steroid concentrations and risk of major adverse cardiovascular events in healthy older women in Australia: a prospective cohort substudy of the ASPREE trial

Background: Blood testosterone concentrations in women decline during the reproductive years and reach a nadir in the seventh decade, after which concentrations increase and are restored to those of reproductive-aged women early in the eighth decade. We aimed to establish the association between the concentration of testosterone in the blood and risk of major adverse cardiovascular events (MACE) and all-cause mortality in healthy older women. Methods: SHOW was a prospective cohort substudy of the longitudinal randomised ASPREE trial. Eligible participants were women aged at least 70 years from Australia with unimpaired cognition, no previous MACE, and a life expectancy of at least 5 years. Participants who were receiving hormonal or steroid therapy were ineligible for inclusion. We measured serum concentrations of sex steroids with liquid chromatography–tandem mass spectrometry and of SHBG with immunoassay. We compared lower concentrations of sex hormones with higher concentrations using four quartiles. Primary endpoints were risk of MACE and all-cause mortality, the associations of which with sex steroid concentrations were assessed using Cox proportional hazards regression that included age, body-mass index, smoking status, alcohol consumption, diabetes, hypertension, dyslipidaemia, impaired renal function, and treatment allocation in the ASPREE trial (aspirin vs placebo). ASPREE is registered with ClinicalTrials.gov, NCT01038583. Findings: Of the 9180 women recruited to the ASPREE trial between March 10, 2010, and Dec 31 2014, 6358 participants provided sufficient biobank samples at baseline and 5535 were included in the final analysis. Median age at entry was 74·0 years (IQR 71·7–77·7). During a median 4·4 years of follow-up (24 553 person-years), 144 (2·6%) women had a first MACE (incidence 5·9 per 1000 person-years). During a median 4·6 years of follow-up (3·8–5·6), 200 women died (7·9 per 1000 person-years). In the fully adjusted models, higher concentrations of testosterone were associated with a lower incidence of MACE (quartile 4 vs quartile 1: hazard ratio 0·57 [95% CI 0·36–0·91]; p=0·02), as were higher concentrations of DHEA (quartile 4 vs quartile 1: 0·61 [0·38–0·97]; p=0·04). For oestrone, a lower risk of MACE was seen for concentrations in quartile 2 only, compared with quartile 1 (0·55 [0·33–0·92]; p=0·02). In fully adjusted models, no association was seen between SHBG and MACE, or between any hormone or SHBG and all-cause mortality. Interpretation: Blood concentrations of testosterone and DHEA above the lowest quartile in older women were associated with a reduced risk of a first-ever MACE. Given that the physiological effects of DHEA are mediated through its steroid metabolites, if the current findings were to be replicated, trials investigating testosterone therapy for the primary prevention of ischaemic cardiovascular disease events in older women would be warranted. Funding: The National Health and Medical Research Council of Australia, US National Institute on Aging, the Victorian Cancer Agency, the Commonwealth Scientific and Industrial Research Organisation, and Monash University

Nutrition: Basis for Healthy Children and Mothers in Bangladesh

Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourished, and almost 90% of these children are from developing countries. Bangladesh is one of the countries with the highest rate of malnutrition. The recent baseline survey by the National Nutrition Programme (NNP) showed high rates of stunting, underweight, and wasting. However, data from the nutrition surveillance at the ICDDR, B hospital showed that the proportion of children with stunting, underweight, and wasting has actually reduced during 1984–2005. Inappropriate infant and young child-feeding practices (breastfeeding and complementary feeding) have been identified as a major cause of malnutrition. In Bangladesh, although the median duration of breastfeeding is about 30 months, the rate of exclusive breastfeeding until the first six months of life is low, and practice of appropriate complementary feeding is not satisfactory. Different surveys done by the Bangladesh Demographic and Health Survey, United Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding Foundation (BBF) showed a rate of exclusive breastfeeding to be around 32-52%, which have actually remained same or declined over time. The NNP baseline survey using a strict definition of exclusive breastfeeding showed a rate of exclusive breastfeeding (12.8%) until six months of age. Another study from the Abhoynagar field site of ICDDR, B reported the prevalence of exclusive breastfeeding to be 15% only. Considerable efforts have been made to improve the rates of exclusive breastfeeding. Nationally, initiation of breastfeeding within one hour of birth, feeding colostrum, and exclusive breastfeeding have been promoted through the Baby-Friendly Hospital Initiative (BFHI) implemented and supported by BBF and UNICEF respectively. Since most (87-91%) deliveries take place in home, the BFHI has a limited impact on the breastfeeding practices. Results of a few studies done at ICDDR, B and elsewhere in developing countries showed that the breastfeeding peer-counselling method could substantially increase the rates of exclusive breastfeeding. Results of a study in urban Dhaka showed that the rate of exclusive breastfeeding was 70% among mothers who were counselled compared to only 6% who were not counselled. Results of another study in rural Bangladesh showed that peer-counselling given either individually or in a group improved the rate of exclusive breastfeeding from 89% to 81% compared to those mothers who received regular health messages only. This implies that scaling up peer-counselling methods and incorporation of breastfeeding counselling in the existing maternal and child heath programme is needed to achieve the Millennium Development Goal of improving child survival. The recent data showed that the prevalence of starting complementary food among infants aged 6-9 months had increased substantially with 76% in the current dataset. However, the adequacy, frequency, and energy density of the complementary food are in question. Remarkable advances have been made in the hospital management of severely-malnourished children. The protocolized management of severe protein-energy malnutrition at the Dhaka hospital of ICDDR, B has reduced the rate of hospital mortality by 50%. A recent study at ICDDR, B has also documented that home-based management of severe protein-energy malnutrition without follow-up was comparable with a hospital-based protocolized management. Although the community nutrition centres of the NNP have been providing food supplementation and performing growth monitoring of children with protein-energy malnutrition, the referral system and management of complicated severely-malnourished children are still not in place

Zeamatin-like protein (ZLP) gene is associated with resistance against A. Niger in maize (Zea mays L.)

Maize (Zea mays L.) constitutes one of the most important crops worldwide with multi-billion dollar annual revenue. The plant is however a good substrate for growth, development and activity of filamentous fungi. A large number of fungal species causes spoilage and accumulation of mycotoxins. Plants restrict the hyphal growth by producing pathogenesis related proteins. So far 17 groups of such proteins are identified. PR-5 group comprises of the thaumatin-like proteins (TLPs), which have diverse modes of actions and act at various stages of fungal attack. Zeamatin-like protein (ZLP) is a member of TLPs, which is basically localized in seeds with enhanced expression during physiological growth and cellular differentiation. However a basal quantity is found in the leaves of many crop plants. Here we report the response of maize plant tissues against A. niger inoculation by measuring the variation in expression profile of a zeamatin-like gene. Conventional PCR coupled with RT-qPCR identifies a significant change in the expression magnitude of ZLP in pre- and post-inoculated plant samples. SDS-PAGE, followed by antimicrobial activities against A. niger, E.coli, P. aeruginosa, B. cereus, S. aureus and S. typhimurium, however, do not register a direct relationship with enhancement in gene expression. It is in line with the fact that response to pathogenesis in plants is a multigenic activity involving a series of responsible/induced genes. The assay developed is useful in primary sorting out of the maize hybrids with respect to their resistance against Aspergillus spp., especially in areas with high rate of incidence of fungal pathogenesis

Evolution of supermassive black holes

Supermassive black holes (SMBHs) are nowadays believed to reside in most local galaxies, and the available data show an empirical correlation between bulge luminosity - or stellar velocity dispersion - and black hole mass, suggesting a single mechanism for assembling black holes and forming spheroids in galaxy halos. The evidence is therefore in favour of a co-evolution between galaxies, black holes and quasars. In cold dark matter cosmogonies, small-mass subgalactic systems form first to merge later into larger and larger structures. In this paradigm galaxy halos experience multiple mergers during their lifetime. If every galaxy with a bulge hosts a SMBH in its center, and a local galaxy has been made up by multiple mergers, then a black hole binary is a natural evolutionary stage. The evolution of the supermassive black hole population clearly has to be investigated taking into account both the cosmological framework and the dynamical evolution of SMBHs and their hosts. The seeds of SMBHs have to be looked for in the early Universe, as very luminous quasars are detected up to redshift higher than z=6. These black holes evolve then in a hierarchical fashion, following the merger hierarchy of their host halos. Accretion of gas, traced by quasar activity, plays a fundamental role in determining the two parameters defining a black hole: mass and spin. A particularly intriguing epoch is the initial phase of SMBH growth. It is very challenging to meet the observational constraints at z=6 if BHs are not fed at very high rates in their infancy.Comment: Extended version of the invited paper to appear in the Proceedings of the Conference "Relativistic Astrophysics and Cosmology - Einstein's Legacy