6,7-Dihydro-3H-1,4-diazepino[1,2,3,4-lmn][1,10]phenanthroline-3,9(5H)-dione

In the title compound, C15H12N2O2, the seven-membered ring bearing the three methyl­ene C atoms displays a puckered conformation, with the methyl­ene C atoms deviating from the plane of the benzene ring by 0.05 (1), 0.98 (1) and 1.04 (1) Å. The phenanthroline unit is not planar; the dihedral angles between this benzene ring and the other pyridyl rings are 9.62 (4) and 9.31 (4)°. The crystal packing is stabilized by π–π inter­actions between two phenanthroline ring systems, forming a centrosymmetric dimer with a centroid–centroid distance of 3.656 (1) Å

N,N′-Bis(4-methoxy­benzyl­idene)-4,4′-(m-phenyl­enedi­oxy)dianiline

Mol­ecules of the title compound, C34H28N2O4, a Schiff base precursor for macrocycles, are located on a mirror plane. The C=N double bond is trans configured. Inter­molecular C—H⋯O inter­actions stabilize the crystal packing

Role of Modern Technologies in Tissue Engineering

Nanotechnology is a rapidly developing field with numerous applications spread in different fields, especially medicine. It plays a role in tissue engineering, tissue regeneration, drug delivery, and regenerative medicine. The present brief review summarizes the role of nanotechnology in tissue engineering and tissue regeneration. The CRISPR/Cas9 system in tissue engineering is playing an important role, as CRISPR is a revolutionary genome-editing technology that is being used for tissue engineering where it emphasizes to address tissue architecture formation, immune response circumvention, cell differentiation, and disease model development. Moreover, the development and research expenses for tissue engineering and regenerative medicine are too high and there is a need for making these systems cost-effective. Thus, the advanced approach of applications of nanotechnology to regenerative medicine and CRISPR will definitely revolutionize the basis of treatment, prevention, and diagnosis of various diseases

Clinical evaluation of patients suffering from breast cancer and determination of evolving treatment therapies and better strategies related to breast cancer

Abstract: Breast cancer is basically the lesion of female breast that may create from the connective tissue or epithelial cells of breast.Primary objective: The objective of study was to conduct a survey about the prevailing of rate of breast cancer in community of Rawalakot, Islamabad and local community and to find out strategies used for the diagnosis, treatment and prevention of breast cancer. Methods/Design: A well structure questionnaire including 35 questions about the history, sociodemograhic characteristics, diagnostic tools, treatment plans and prevention methods has been prepared and circulated among the patients of breast cancer through survey. Setting: Study was conducted in Rawalakot and Islamabad Pakistan Participants: 50 participants were involved Intervention: The study was also conducted to communicate with larger community of breast cancer patients and to give them awareness related to initial diagnosis of this harmful disease. Primary Outcome Measures: This study was very very helpful in educated and non-educated community of the specific cities . Results: While conducting the research based on studies, it was found that about 68.84% patients has been report with the reoccurrence of breast cancer after surgery, 70% patients have been diagnosed with invasive type and 30% non-invasive type and 50% have been treated with hormonal therapy as continued treatment after surgery. Conclusion : Breast cancer variation among population or regional differences in the types have been attribute to the prevalence of major risk factors, availability and use of medical practices such as cancer screening, availability and quality of treatment, completeness of reporting and age structure.

2,9-Dichloro-1,10-phenanthroline

The title mol­ecule, C12H6Cl2N2, is almost planar (the r.m.s. deviation of C atoms is 0.04 Å). The C—N and C—C distances indicate delocalization of the π-electrons in the aromatic fused-ring system

Epidemiology of respiratory infections among adults in Qatar (2012-2017).

Limited data is available about the etiology of influenza like illnesses (ILIs) in Qatar. This study aimed at providing preliminary estimates of influenza and other respiratory infections circulating among adults in Qatar. We retrospectively collected data of about 44,000 patients who visited Hamad General Hospital clinics, sentinel sites, and all primary healthcare centers in Qatar between 2012 and 2017. All samples were tested for influenza viruses, whereas about 38,000 samples were tested for influenza and a panel of respiratory viruses using Fast Track Diagnostics (FTD) RT-PCR kit. Among all ILIs cases, 20,278 (46.5%) tested positive for at least one respiratory pathogen. Influenza virus was predominating (22.6%), followed by human rhinoviruses (HRVs) (9.5%), and human coronaviruses (HCoVs) (5%). A detection rate of 2-3% was recorded for mycoplasma pneumonia, adenoviruses, human parainfluenza viruses (HPIVs), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ILIs cases were reported throughout the year, however, influenza, RSV, and HMPV exhibited strong seasonal peaks in the winter, while HRVs circulated more during fall and spring. Elderly (>50 years) had the lowest rates of influenza A (13.9%) and B (4.2%), while presenting the highest rates of RSV (3.4%) and HMPV (3.3%). While males had higher rates of HRVs (11.9%), enteroviruses (1.1%) and MERS CoV (0.2%), females had higher proportions of influenza (26.3%), HPIVs (3.2%) and RSV (3.6%) infections. This report provides a comprehensive insight about the epidemiology of ILIs among adults in the Qatar, as a representative of Gulf States. These results would help in improvement and optimization of diagnostic procedures, as well as control and prevention of the respiratory infections.This study was supported by funds from Hamad Medical Corporation (grant # 16335/16) and Qatar University (grant # QUCG-BRC-2018/2019-1)

Analytical approach for entropy generation and heat transfer in CNT-nanofluid dynamics through a ciliated porous medium

The transportation of biological and industrial nanofluids by natural propulsion like cilia movement and self-generated contraction-relaxation of flexible walls has significant applications in numerous emerging technologies. Inspired by multi-disciplinary progress and innovation in this direction, a thermo-fluid mechanical model is proposed to study the entropy generation and convective heat transfer of nanofluids fabricated by the dispersion of single-wall carbon nanotubes (SWCNT) nanoparticles in water as the base fluid. The regime studied comprises heat transfer and steady, viscous, incompressible flow, induced by metachronal wave propulsion due to beating cilia, through a cylindrical tube containing a sparse (i.e. high permeability) homogenous porous medium. The flow is of the creeping type and is restricted under the low Reynolds number and long wavelength approximations. Slip effects at the wall are incorporated and the generalized Darcy drag-force model is utilized to mimic porous media effects. Cilia boundary conditions for velocity components are employed to determine analytical solutions to the resulting non-dimensionalized boundary value problem. The influence of pertinent physical parameters on temperature, axial velocity, pressure rise and pressure gradient, entropy generation function, Bejan number and stream-line distributions are computed numerically. A comparative study between SWCNT nanofluids and pure water is also computed. The computations demonstrate that axial flow is accelerated with increasing slip parameter and Darcy number and is greater for SWCNT- nanofluids than for pure water. Furthermore the size of the bolus for SWCNT-nanofluids is larger than that of the pure water. The study is applicable in designing and fabricating nanoscale and microfluidics devices, artificial cilia and biomimetic micro-pump

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety

The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training