The management of acne vulgaris in young people in primary care: A retrospective cohort study

BackgroundAcne vulgaris (acne) is common among young persons (YPs). Clinical practice guidelines are available for acne management to minimize their physical and psychological impact. However, evidence of adherence to these guidelines is sparse in primary care practices. The study aimed to determine the demographic profile of YPs who sought primary care consultations for acne, their related prescriptions and referrals to specialists for further management.MethodA retrospective study was conducted using data from a cluster of eight public primary care clinics in Singapore. Demographic, clinical, prescription, and referral data were extracted from the electronic health records of YPs aged 10–29 years with a documented diagnosis of acne (ICD-10 classification) from 1st July 2018 to 30th June 2020. The data were reviewed, audited for eligibility criteria, and de-identified before analysis.ResultsComplete data from 2,700 YPs with acne were analyzed. Male (56.1%) YPs and those of Chinese ethnicity (73.8%) had the most frequent attendances for acne. The mean and median age at presentation was 19.2 (standard deviation = 4.3) and 19 (interquartile range = 16–22) years, respectively. Only 69.7% of YPs received an acne-related medication; 33.5% received antibiotic monotherapy; 53.0% were prescribed oral doxycycline, 35.0% acne cream (combination of sulfur, salicylic acid, and resorcinol), and 28.4% benzoyl peroxide 5% gel; 54.3% of those treated with antibiotics were prescribed with a shorter duration than recommended; 51.3% were referred to a dermatologist on their first visit, and 15.8% had more than one visit.ConclusionAcne management for YPs can be enhanced with refresher training among primary care physicians for better adherence to its clinical practice guidelines

VALUATION OF CREDIT DEFAULT SWAPS

Bachelor'sBACHELOR OF SCIENCE (HONOURS

Swelling behavior and controlled drug release from cross-linked k-carrageenan/ NaCMC hydrogel by diffusion mechanism

We studied a model system of controlled drug release using beta carotene and k-carrageenan/NaCMC hydrogel as a drug and a device, respectively. Electrostatic interactions between beta carotene and k-carrageenan/NaCMC polymer segments are strong, since beta carotene is positively charged, NaCMC is a weak polyelectrolyte which behaves almost neutrally in pH 7.4 and each disaccharide repeating unit of k-carrageenan chains has one sulfate group.Results have shown that the cross-linked beads possess lower swelling ability in all pH conditions (pH 1.2 and 7.4), and swelling ratio decreases with increasing genipin concentration. Beta-carotene was loaded into the hydrogel by combining into blend solution of kappa-carrageenan/NaCMC. Different concentrations of genipin were then added to the hot solution followed by hardening for about 30 minutes to form cross-linked beta carotene loaded beads by using dripping method. Microstructure study shows that cross-linking has enhanced the stability and structure of the beads network. This phenomenon was well explained by our kinetic model studied. Determination of diffusion coefficient for the release of encapsulated beta-carotene indicates less diffusivity when beads are cross-linked. Swelling models using adaptive neuro fuzzy show that using genipin as a cross-linker in the kC/NaCMC hydrogels affects the transport mechanism. The model shows very good agreement with the experimental data which indicates that applying ANFIS modeling is an accurate, rapid and simple way to model in such a case for controlled release applications

Genipin-cross-linked kappa-carrageenan/carboxymethyl cellulose beads and effects on beta-carotene release

Beads of kappa-carrageenan/sodium carboxymethylcellulose were prepared based on different blend formulations using genipin, a natural and non-toxic cross-linking reagent. Different genipin concentrations (0.5, 1.0, 1.5 mM) were used to study the effects on swelling ratio of the beads in different pH values under simulated gastrointestinal tract condition (pH 1.2 and 7.4). Results have shown that the cross-linkedbeads possess lower swelling ability in all pH conditions and swelling ratio decreases with increasing genipin concentration (95.24% in pH 1.2; 100% in pH 7.4 at 0.5 mM genipin; 76.2% in pH 1.2; 85.71% in pH 7.4 at 1.5 mM genipin). It was also found the beads released beta-carotene slower and lesser after being cross-linked. Microstructure study shows that cross-linkedbeads exhibited smoother surface and more spherical shape compared to the native beads. This indicates that cross-linking of genipin has enhanced the beads network stability and their structure to be applied as suitable hydrogel

Effects of board independence and competence on investors' judgments.

This paper uses an experimental approach to examine how corporate governance at the board of director level influences investors' judgments. Drawing on the agency and resource dependence theories of the board, we use board independence and competence as proxies for corporate governance effectiveness

Associations of eating behaviours, fast food purchasing and availability with BMI-for-age z-score among adolescents in Labuan, Malaysia

Introduction: A cross-sectional study was conducted to determine the associations of socio-demographic factors, eating behaviours, fast food purchasing by parents for family meals, and availability of neighbourhood fast-food outlets with BMI-for-age z-score (BAZ) among adolescents. Methods: Through multi-stage stratified cluster sampling method, a total of 420 adolescents from five selected public secondary schools participated in the current study. Data on socio-demographic factors, eating behaviours, and parent’s purchases of fast food were obtained through selfadministered questionnaires. The availability of fast-food outlets was assessed using Geographic Information System (GIS). Body weight and height of the adolescents were measured. Results: The prevalence of overweight, obesity, thinness and severe thinness among adolescents in the present study were 17.6%, 15.5%, 3.1% and 0.7%, respectively. The current findings showed that a higher monthly household income (rs=0.12, p=0.02) and less purchases of fast food by parents for family meals (rs=-0.11, p=0.03) were significantly associated with higher BAZ of the adolescents. However, there were no significant associations between eating outside of home, eating at fast-food restaurants, buying delivery fast food, and availability of neighbourhood fast-food outlets with BAZ. Multiple linear regression showed that less purchases of fast food by parents for family meals significantly contributed towards higher BAZ (β=−0.25, p=0.02). Conclusion: A higher household income and less fast food purchasing by parents were associated with higher BAZ. Fast food purchasing of adolescents were not associated with BAZ. Therefore, an appropriate obesity intervention programme should focus on adolescents and their parents from middle- and high-income households in Labuan

Can carotid artery calcifications on dental radiographs predict adverse vascular events? A systematic review

10.1007/s00784-020-03696-5CLINICAL ORAL INVESTIGATIONS25137-5

Exerting the Appropriate Application of Methylprednisolone in Acute Spinal Cord Injury Based on Time Course Transcriptomics Analysis

Methylprednisolone (MP) is an anti-inflammatory drug approved for the treatment of acute spinal cord injuries (SCIs). However, MP administration for SCIs has become a controversial issue while the molecular effects of MP remain unexplored to date. Therefore, delineating the benefits and side effects of MP and determining what MP cannot cure in SCIs at the molecular level are urgent issues. Here, genomic profiles of the spinal cord in rats with and without injury insults, and those with and without MP treatment, were generated at 0, 2, 4, 6, 8, 12, 24, and 48 h post-injury. A comprehensive analysis was applied to obtain three distinct classes: side effect of MP (SEMP), competence of MP (CPMP), and incapability of MP (ICMP). Functional analysis using these genes suggested that MP exerts its greatest effect at 8~12 h, and the CPMP was reflected in the immune response, while SEMP suggested aspects of metabolism, such as glycolysis, and ICMP was on neurological system processes in acute SCIs. For the first time, we are able to precisely reveal responsive functions of MP in SCIs at the molecular level and provide useful solutions to avoid complications of MP in SCIs before better therapeutic drugs are available