Drug utilization pattern in patients of upper respiratory tract infections in pediatrics outpatient department at a tertiary care hospital

Background: Upper respiratory tract infections are the most common and frequently occurring infections in the pediatric population. These infections include conditions like common cold, laryngitis, pharyngitis, tonsillitis, acute rhinitis, acute rhinosinusitis and acute otitis media. Young children have an average of 6-8 colds per year, however 10 -15% of children have at least 12 infections per year. This study concentrates on prescription pattern of Upper Respiratory Tract Infections in children. primary objective was to study the prescription pattern of drugs used in URTI in pediatric outpatient department and the secondary objective was to determine whether the drugs being prescribed comply with those listed in the National list of essential medicines. Methods: This study was a Cross-sectional, observational study conducted at the Pediatric Outpatient Department in a tertiary care hospital, India. The data was collected from patients visiting Pediatrics OPD from June 2021 to December 2021 after taking written informed consent. Sample size was calculated to be 303. Results: Total 943 drugs were prescribed for 303 patients with an average of 3.11±1.15 drugs per prescription. Most common class of drugs prescribed was Antipyretics of which Paracetamol was the most common drug. Antibiotics were prescribed for 19.80% patients & combination of Amoxicillin and Clavulanic acid was the most common antibiotic prescribed. 68.29% drugs were prescribed by generic name. 43.16% drugs were prescribed from National List of Essential Medicines 2015. Conclusions: The study revealed that the majority of children suffering from URTI were below 5 years of age. Our study highlighted the prescribing

Ambient Air Quality of Nashik City 2017 (Maharashtra, India)

Ambient air quality of Nasik city was monitored during the year 2017. Criteria pollutants selected for the monitoring was, sulphur dioxide (SO2) & nitrogen dioxide (NO2) and PM10 (Particulate Matter having aerodynamic diameter less than or equal to 10 µm) for the period of January 2017 to December 2017. Sampling was done for successive periods of about 4 hours for sulphur dioxides (SO2), nitrogen dioxide (NO2) and 8 hours for Respirable suspended particulate matter (PM10) for 24 hours. For Air Quality Monitoring, four representative sites were selected i.e. Industrial-S1-I-VIP, Commercial- S2-R-RTO and Residential-S3-C-NMC and Industrial-S4-I-UB. High volume air sampler were used to measure the concentration of nitrogen dioxide (NO2), sulphur dioxides (SO2) and Respirable suspended particulate matter (PM10). The results reported pertain to an eight hour successive continuous air sampling exercise carried out at each of the four selected locations in Nasik city. The value of PM10 (Particles ≥ 10µ, PM 10µg/m3)  was  noted  to  be  crossing  the  permissible   limit   and  exceeded  the  National Ambient Air Quality Standard (NAAQS) at all locations. The concentration of SO2 and NO2 was within the National Ambient Air Quality Standard (NAAQS, National Ambient Air Quality Standers, November 18, 2009) at all the locations. Keywords: PM10, Ambient Air Quality (AQI), National Ambient Air Quality Standard (NAAQS), Pollutant, Urban air sampling, Transport emissions

Methods of nutrition surveillance in low-income countries

Background In 1974 a joint FAO/UNICEF/WHO Expert Committee met to develop methods for nutrition surveillance. There has been much interest and activity in this topic since then, however there is a lack of guidance for practitioners and confusion exists around the terminology of nutrition surveillance. In this paper we propose a classification of data collection activities, consider the technical issues for each category, and examine the potential applications and challenges related to information and communication technology. Analysis There are three major approaches used to collect primary data for nutrition surveillance: repeated cross-sectional surveys; community-based sentinel monitoring; and the collection of data in schools. There are three major sources of secondary data for surveillance: from feeding centres, health facilities, and community-based data collection, including mass screening for malnutrition in children. Surveillance systems involving repeated surveys are suitable for monitoring and comparing national trends and for planning and policy development. To plan at a local level, surveys at district level or in programme implementation areas are ideal, but given the usually high cost of primary data collection, data obtained from health systems are more appropriate provided they are interpreted with caution and with contextual information. For early warning, data from health systems and sentinel site assessments may be valuable, if consistent in their methods of collection and any systematic bias is deemed to be steady. For evaluation purposes, surveillance systems can only give plausible evidence of whether a programme is effective. However the implementation of programmes can be monitored as long as data are collected on process indicators such as access to, and use of, services. Surveillance systems also have an important role to provide information that can be used for advocacy and for promoting accountability for actions or lack of actions, including service delivery. Conclusion This paper identifies issues that affect the collection of nutrition surveillance data, and proposes definitions of terms to differentiate between diverse sources of data of variable accuracy and validity. Increased interest in nutrition globally has resulted in high level commitments to reduce and prevent undernutrition. This review helps to address the need for accurate and regular data to convert these commitments into practice

Polymerization-Induced Self-Assembly of Block Copolymer Nano-objects via RAFT Aqueous Dispersion Polymerization

In this Perspective, we discuss the recent development of polymerization-induced self-assembly mediated by reversible addition–fragmentation chain transfer (RAFT) aqueous dispersion polymerization. This approach has quickly become a powerful and versatile technique for the synthesis of a wide range of bespoke organic diblock copolymer nano-objects of controllable size, morphology, and surface functionality. Given its potential scalability, such environmentally-friendly formulations are expected to offer many potential applications, such as novel Pickering emulsifiers, efficient microencapsulation vehicles, and sterilizable thermo-responsive hydrogels for the cost-effective long-term storage of mammalian cells

Mutational signatures in esophageal adenocarcinoma define etiologically distinct subgroups with therapeutic relevance

Esophageal adenocarcinoma (EAC) has a poor outcome, and targeted therapy trials have thus far been disappointing owing to a lack of robust stratification methods. Whole-genome sequencing (WGS) analysis of 129 cases demonstrated that this is a heterogeneous cancer dominated by copy number alterations with frequent large-scale rearrangements. Co-amplification of receptor tyrosine kinases (RTKs) and/or downstream mitogenic activation is almost ubiquitous; thus tailored combination RTK inhibitor (RTKi) therapy might be required, as we demonstrate in vitro. However, mutational signatures showed three distinct molecular subtypes with potential therapeutic relevance, which we verified in an independent cohort (n = 87): (i) enrichment for BRCA signature with prevalent defects in the homologous recombination pathway; (ii) dominant T>G mutational pattern associated with a high mutational load and neoantigen burden; and (iii) C>A/T mutational pattern with evidence of an aging imprint. These subtypes could be ascertained using a clinically applicable sequencing strategy (low coverage) as a basis for therapy selection

Reusability of filtering facepiece respirators after decontamination through drying and germicidal UV irradiation.

During pandemics, such as the SARS-CoV-2, filtering facepiece respirators plays an essential role in protecting healthcare personnel. The recycling of respirators is possible in case of critical shortage, but it raises the question of the effectiveness of decontamination as well as the performance of the reused respirators. Disposable respirators were subjected to ultraviolet germicidal irradiation (UVGI) treatment at single or successive doses of 60 mJ/cm <sup>2</sup> after a short drying cycle (30 min, 70°C). The germicidal efficacy of this treatment was tested by spiking respirators with two staphylococcal bacteriophages (vB_HSa_2002 and P66 phages). The respirator performance was investigated by the following parameters: particle penetration (NaCl aerosol, 10-300 nm), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), differential scanning calorimetry and mechanical tensile tests. No viable phage particles were recovered from any of the respirators after decontamination (log reduction in virus titre >3), and no reduction in chemical or physical properties (SEM, particle penetrations <5%-6%) were observed. Increasing the UVGI dose 10-fold led to chemical alterations of the respirator filtration media (FTIR) but did not affect the physical properties (particle penetration), which was unaltered even at 3000 mJ/cm <sup>2</sup> (50 cycles). When respirators had been used by healthcare workers and undergone decontamination, they had particle penetration significantly greater than never donned respirators. This decontamination procedure is an attractive method for respirators in case of shortages during a SARS pandemic. A successful implementation requires a careful design and particle penetration performance control tests over the successive reuse cycles

Improving resilience management for critical infrastructures\u2014strategies and practices across air traffic management and healthcare

Recent natural and man-made disasters highlight that a more resilient approach to preparing for and dealing with such events is needed. To address this challenge, the main objective of the research and innovation H2020 project DARWIN is the development of European resilience management guidelines for Critical Infrastructures (CI). Based on a systematic literature survey with a world-wide scope and prioritization of resilience concepts, the guidelines have been developed taking into account everyday operations, contingency plans, training, etc. This paper describes insights gained from the adaptation of these guidelines in the domains of Air Traffic Management (ATM) and Healthcare (HC). A collaborative and iterative process has been defined involving relevant experts and practitioners. To ensure transnational, cross-sector applicability and uptake, a Community of Crisis and Resilience Practitioners (DARWIN DCoP) has been involved. The preliminary results indicate that a big step has been taken in moving from the resilience theory to practice. organization in the creation, assessment or improvement of its own reference guidelines, procedures and practices

Insensitivity of place cells to the value of spatial goals in a two-choice flexible navigation task

Hippocampal place cells show position-specific activity, thought to reflect a self-localization signal. Several reports also point to some form of goal encoding by place cells. We investigated this by asking whether they also encode the value of spatial goals, which is a crucial information for optimizing goal-directed navigation. We used a continuous place navigation task in which male rats navigate to one of two (freely chosen) unmarked locations and wait, triggering the release of reward which is then located and consumed elsewhere. This allows sampling of place fields, and dissociates spatial goal from reward consumption. The two goals varied in the amount of reward provided, allowing assessment of whether the rats factored goal value into their navigational choice, and of possible neural correlates of this value. Rats successfully learned the task, indicating goal localization, and they preferred higher-value goals, indicating processing of goal value. Replicating previous findings, there was goal-related activity in the out-of-field firing of CA1 place cells, with a ramping-up of firing rate during the waiting period, but no general over-representation of goals by place fields, an observation that we extended to CA3 place cells. Importantly, place cells were not modulated by goal value. This suggests that dorsal hippocampal place cells encode space independently of its associated value, despite the effect of that value on spatial behavior. Our findings are consistent with a model of place cells in which they provide a spontaneously constructed value-free spatial representation, rather than encoding other navigationally relevant, but non-spatial, information

Neutral Bystander, Intrusive Micromanager, or Useful Catalyst?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73380/1/j.1541-0072.1995.tb01746.x.pd

Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries.

OBJECTIVE:To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs). DESIGN:Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. DATA SOURCES:We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. ELIGIBILITY CRITERIA FOR SELECTING STUDIES:Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. ANALYSES:Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses. RESULTS:We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs. CONCLUSIONS:Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children