Physiology, Breast Milk

The production of breast milk initiates in larger amounts between 2 and 4 days after the birth of the baby and the breastmilk is said to have 'come in'. It is the sole best source of nutrition for an infant, providing an adequate amount of nutrients, growth factors, and antibodies required for the nourishment of the baby. Breast milk should be exclusively used for nutrition until 6 months of age after which breastmilk should be used in addition to complementary foods for at least 12 months of age. [1

THE ROLE OF WESTERN MAINSTREAM MEDIA: HOW ISLAM IS BEING BRANDED AS PROMOTER OF VIOLENCE

Whenever we see any terrorist incident committed by a Muslim, happened anywhere in the world, instantly some of the newspapers and TV channels start screaming that it’s a ‘Jihadist’ activity. Jihad has become the synonym of Islamic Terrorism. The western media tries to portray that through Jihad, Islam is encouraging its followers to kill non-believers and people from other religion. This paper is a research on the rise of Islamophobia in the contemporary world and the role of media in spreading it. This wave of anti-Islam sentiment is prevalent in various forms in all the spheres of life but here the ones related with media are emphasized. Here in this paper discussion has been done as to how the media is portraying Islam as the religion which promotes violence and the Muslims as terrorists and ultimately playing a significant role in the global rise of Islamophobia and Xenophobic attack against Muslims. It is important to analyze the role of the media because there is a nexus among Islamophobia-Radicalization-Social marginalization- Security threat. The research contains review of the cases where the media has been biased against Muslims and the further condemnation of this biasedness by the media itself and the views of the expertise thinkers in this field

Is Plaque Removal Efficacy of Toothbrush Related to Bristle Flaring? A 3-month Prospective Parallel Experimental Study

Background: Toothbrushes are over-the-counter products; therefore, no special instruction is given to users when they purchase. There are scarce published studies that have investigated about how often toothbrushes should be replaced. Thus, this study aimed to verify the impact of the Progressive Toothbrush Bristle Flaring on plaque control efficacy of toothbrush.Materials and Methods: Thirty six subjects were randomly selected and underwent complete oral prophylaxis 10 days prior to the Baseline plaque recording. All subjects were provided with new similar toothbrushes and were divided into two groups. New Brush Group changed toothbrush every month and Old month Group used single toothbrush for the whole period of the study. Both groups were assessed for plaque accumulation every month using Turesky et al, (1970) modification of the Quigley and Hein (1962) plaque index. Toothbrush head was photographed and assessed by measuring the brushing surface area on standardized photographs using National Institutes of Health Image Analysis Program (USA).Results: Both groups showed similar plaque scores at the 40th day; progressive increase in the plaque scores in group without changing the toothbrush were recorded at the 70th and 100th days. As toothbrush flaring increased, the plaque scores also increased in the Old Brush Group. Highest plaque accumulation was recorded in Mandibular Lingual aspects in Old Brush Group.Conclusion: Progressive increase was seen in the plaque scores with increase in toothbrush bristle flaring.Keywords: Toothbrush, Efficacy of Toothbrush, Bristle Flaring, Plaque Remova

RTOG 0518: Randomized Phase III Trial to Evaluate Zoledronic Acid for Prevention of Osteoporosis and Associated Fractures in Prostate Cancer Patients

Background: RTOG 0518 evaluated the potential benefit of zoledronic acid therapy in preventing bone fractures for patients with high grade and/or locally advanced, non-metastatic prostate adenocarcinoma receiving luteinizing hormone-releasing hormone (LHRH) agonist and radiotherapy (RT). Methods: Eligible patients with T-scores of the hip ( −2.5 vs. > −1.0) and negative bone scans were prospectively randomized to either zoledronic acid, 4 mg, concurrently with the start of RT and then every six months for a total of 6 infusions (Arm 1) or observation (Arm 2). Vitamin D and calcium supplements were given to all patients. Secondary objectives included quality of life (QOL) and bone mineral density (BMD) changes over a period of three years. Results: Of 109 patients accrued before early closure, 96 were eligible. Median follow-up was 36.3 months for Arm I and 34.8 months for Arm 2. Only two patients experienced a bone fracture (1 in each arm) resulting in no difference in freedom from any bone fracture (p=0.95), nor in QOL. BMD percent changes from baseline to 36 months were statistically improved with the use of zoledronic acid compared to observation for the lumbar spine (6% vs. −5%, p<0.0001), left total hip (1% vs. −8%, p=0.0002), and left femoral neck (3% vs. −8%, p=0.0007). Conclusions: For patients with advanced, non-metastatic prostate cancer receiving LHRH agonist and RT, the use of zoledronic acid was associated with statistically improved BMD percent changes. The small number of accrued patients resulted in decreased statistical power to detect any differences in the incidence of bone fractures or QOL

“It’s hard to tell”. The challenges of scoring patients on standardised outcome measures by multidisciplinary teams: a case study of Neurorehabilitation

Background Interest is increasing in the application of standardised outcome measures in clinical practice. Measures designed for use in research may not be sufficiently precise to be used in monitoring individual patients. However, little is known about how clinicians and in particular, multidisciplinary teams, score patients using these measures. This paper explores the challenges faced by multidisciplinary teams in allocating scores on standardised outcome measures in clinical practice. Methods Qualitative case study of an inpatient neurorehabilitation team who routinely collected standardised outcome measures on their patients. Data were collected using non participant observation, fieldnotes and tape recordings of 16 multidisciplinary team meetings during which the measures were recited and scored. Eleven clinicians from a range of different professions were also interviewed. Data were analysed used grounded theory techniques. Results We identified a number of instances where scoring the patient was 'problematic'. In 'problematic' scoring, the scores were uncertain and subject to revision and adjustment. They sometimes required negotiation to agree on a shared understanding of concepts to be measured and the guidelines for scoring. Several factors gave rise to this problematic scoring. Team members' knowledge about patients' problems changed over time so that initial scores had to be revised or dismissed, creating an impression of deterioration when none had occurred. Patients had complex problems which could not easily be distinguished from each other and patients themselves varied in their ability to perform tasks over time and across different settings. Team members from different professions worked with patients in different ways and had different perspectives on patients' problems. This was particularly an issue in the scoring of concepts such as anxiety, depression, orientation, social integration and cognitive problems. Conclusion From a psychometric perspective these problems would raise questions about the validity, reliability and responsiveness of the scores. However, from a clinical perspective, such characteristics are an inherent part of clinical judgement and reasoning. It is important to highlight the challenges faced by multidisciplinary teams in scoring patients on standardised outcome measures but it would be unwarranted to conclude that such challenges imply that these measures should not be used in clinical practice for decision making about individual patients. However, our findings do raise some concerns about the use of such measures for performance management

Effect of polygenic risk for schizophrenia on cardiac structure and function: a UK Biobank observational study

BACKGROUND: Cardiovascular disease is a major cause of excess mortality in people with schizophrenia. Several factors are responsible, including lifestyle and metabolic effects of antipsychotics. However, variations in cardiac structure and function are seen in people with schizophrenia in the absence of cardiovascular disease risk factors and after accounting for lifestyle and medication. Therefore, we aimed to explore whether shared genetic causes contribute to these cardiac variations. METHODS: For this observational study, we used data from the UK Biobank and included White British or Irish individuals without diagnosed schizophrenia with variable polygenic risk scores for the condition. To test the association between polygenic risk score for schizophrenia and cardiac phenotype, we used principal component analysis and regression. Robust regression was then used to explore the association between the polygenic risk score for schizophrenia and individual cardiac phenotypes. We repeated analyses with fibro-inflammatory pathway-specific polygenic risk scores for schizophrenia. Last, we investigated genome-wide sharing of common variants between schizophrenia and cardiac phenotypes using linkage disequilibrium score regression. The primary outcome was principal component regression. FINDINGS: Of 33 353 individuals recruited, 32 279 participants had complete cardiac MRI data and were included in the analysis, of whom 16 625 (51·5%) were female and 15 654 (48·5%) were male. 1074 participants were excluded on the basis of incomplete cardiac MRI data (for all phenotypes). A model regressing polygenic risk scores for schizophrenia onto the first five cardiac principal components of the principal components analysis was significant (F=5·09; p=0·00012). Principal component 1 captured a pattern of increased cardiac volumes, increased absolute peak diastolic strain rates, and reduced ejection fractions; polygenic risk scores for schizophrenia and principal component 1 were negatively associated (β=-0·01 [SE 0·003]; p=0·017). Similar to the principal component analysis results, for individual cardiac phenotypes, we observed negative associations between polygenic risk scores for schizophrenia and indexed right ventricular end-systolic volume (β=-0·14 [0·04]; p=0·0013, pFDR=0·015), indexed right ventricular end-diastolic volume (β=-0·17 [0·08]); p=0·025; pFDR=0·082), and absolute longitudinal peak diastolic strain rates (β=-0·01 [0·003]; p=0·0024, pFDR=0·015), and a positive association between polygenic risk scores for schizophrenia and right ventricular ejection fraction (β=0·09 [0·03]; p=0·0041, pFDR=0·015). Models examining the transforming growth factor-β (TGF-β)-specific and acute inflammation-specific polygenic risk scores for schizophrenia found significant associations with the first five principal components (F=2·62, p=0·022; F=2·54, p=0·026). Using linkage disequilibrium score regression, we observed genetic overlap with schizophrenia for right ventricular end-systolic volume and right ventricular ejection fraction (p=0·0090, p=0·0077). INTERPRETATION: High polygenic risk scores for schizophrenia are associated with decreased cardiac volumes, increased ejection fractions, and decreased absolute peak diastolic strain rates. TGF-β and inflammatory pathways might be implicated, and there is evidence of genetic overlap for some cardiac phenotypes. Reduced absolute peak diastolic strain rates indicate increased myocardial stiffness and diastolic dysfunction, which increases risk of cardiac disease. Thus, genetic risk for schizophrenia is associated with cardiac structural changes that can worsen cardiac outcomes. Further work is required to determine whether these associations are specific to schizophrenia or are also seen in other psychiatric conditions. FUNDING: National Institute for Health Research, Maudsley Charity, Wellcome Trust, Medical Research Council, Academy of Medical Sciences, Edmond J Safra Foundation, British Heart Foundation

Triglyceride-containing lipoprotein sub-fractions and risk of coronary heart disease and stroke: A prospective analysis in 11,560 adults

AIMS: Elevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease; however, there is uncertainty about the role of total triglycerides and the individual triglyceride-containing lipoprotein sub-fractions. We measured 14 triglyceride-containing lipoprotein sub-fractions using nuclear magnetic resonance and examined associations with coronary heart disease and stroke. METHODS: Triglyceride-containing sub-fraction measures were available in 11,560 participants from the three UK cohorts free of coronary heart disease and stroke at baseline. Multivariable logistic regression was used to estimate the association of each sub-fraction with coronary heart disease and stroke expressed as the odds ratio per standard deviation increment in the corresponding measure. RESULTS: The 14 triglyceride-containing sub-fractions were positively correlated with one another and with total triglycerides, and inversely correlated with high-density lipoprotein cholesterol (HDL-C). Thirteen sub-fractions were positively associated with coronary heart disease (odds ratio in the range 1.12 to 1.22), with the effect estimates for coronary heart disease being comparable in subgroup analysis of participants with and without type 2 diabetes, and were attenuated after adjustment for HDL-C and LDL-C. There was no evidence for a clear association of any triglyceride lipoprotein sub-fraction with stroke. CONCLUSIONS: Triglyceride sub-fractions are associated with increased risk of coronary heart disease but not stroke, with attenuation of effects on adjustment for HDL-C and LDL-C

Congenital anomalies in low- and middle-income countries: the unborn child of global surgery.

Surgically correctable congenital anomalies cause a substantial burden of global morbidity and mortality. These anomalies disproportionately affect children in low- and middle-income countries (LMICs) due to sociocultural, economic, and structural factors that limit the accessibility and quality of pediatric surgery. While data from LMICs are sparse, available evidence suggests that the true human and financial cost of congenital anomalies is grossly underestimated and that pediatric surgery is a cost-effective intervention with the potential to avert significant premature mortality and lifelong disability

Life cycle assessment of bacterial cellulose production

Purpose Bacterial cellulose (BC), obtained by fermentation, is an innovative and promising material with a broad spectrum of potential applications. Despite the increasing efforts towards its industrialization, a deeper understanding of the environmental impact related to the BC production process is still required. This work aimed at quantifying the environmental, health, and resource depletion impacts related to a production of BC. Methods An attributional life cycle assessment (LCA) was applied to a process design of production of BC, by static culture, following a cradle-to-gate approach. The LCA was modeled with GaBi Pro Software using the ReCiPe 2016 (H) methodology with environmental impact indicators at midpoint level. The functional unit was defined as 1 kg of BC (dry mass), in 138.8 kg of water. Results From the total used resources (38.9 ton/kg of BC), water is the main one (36.1 ton/kg of BC), most of which (98%) is returned to fresh waters after treatment. The production of raw materials consumed 17.8 ton of water/kg of BC, 13.8 ton/kg of BC of which was for the production of carton packaging, culture medium raw materials, and sodium hydroxide (for the washing of BC). The remaining consumed water was mainly for the fermentation (3.9 ton/kg) and downstream process (7.7 ton/kg). From the identified potential environmental impacts, the production of raw materials had the highest impact, mainly on Climate change, Fossil depletion, Human toxicity, non-cancer, and Terrestrial toxicity. The sodium dihydrogen phosphate production, used in the culture medium, showed the highest environmental impacts in Human toxicity, non-cancer and Terrestrial ecotoxicity, followed by corn syrup and carton production. The static culture fermentation and downstream process showed impact in Climate change and Fossil depletion. Conclusions Per se, the BC production process had a small contribution to the consumption of resources and environmental impact of the BC global life cycle.This study was supported by the Portuguese Foundation for Science and Technology (FCT) within the scope of the strate gic funding of UIDB/04469/2020 and UIDB/00511/2020 units and MultiBiorefinery project (SAICTPAC/0040/2015-POCI-01-0145- FEDER-016403). This study was also supported by The Navigator Company through the I&D no. 21874, “Inpactus-–Produtos e Tecno logias Inovadores a partir do Eucalipto”, funded through the European Regional Development Fund (ERDF) and the Programa Operacional Competitividade e Internacionalização (POCI) is greatly acknowl edged. The work by Belmira Neto was fnancially supported by Base Funding—UIDB/00511/2020 of the Laboratory for Process Engineer ing, Environment, Biotechnology and Energy—LEPABE—funded by national funds through the FCT/MCTES (PIDDAC).info:eu-repo/semantics/publishedVersio

Validation of lipid-related therapeutic targets for coronary heart disease prevention using human genetics

Drug target Mendelian randomization (MR) studies use DNA sequence variants in or near a gene encoding a drug target, that alter the target's expression or function, as a tool to anticipate the effect of drug action on the same target. Here we apply MR to prioritize drug targets for their causal relevance for coronary heart disease (CHD). The targets are further prioritized using independent replication, co-localization, protein expression profiles and data from the British National Formulary and clinicaltrials.gov. Out of the 341 drug targets identified through their association with blood lipids (HDL-C, LDL-C and triglycerides), we robustly prioritize 30 targets that might elicit beneficial effects in the prevention or treatment of CHD, including NPC1L1 and PCSK9, the targets of drugs used in CHD prevention. We discuss how this approach can be generalized to other targets, disease biomarkers and endpoints to help prioritize and validate targets during the drug development process