The types, incidence and demographic distribution of benign oral and maxillofacial neoplasms among patients attending Muhimbili National Hospital in Tanzania, 2008-2013

Background: Pathological processes of oral and maxillofacial region are generally classified as benign or malignant based on specific histological criteria, including the presence or absence of necrosis, mitotic figures as well as basic understanding of the entity. The objective of this study was to determine the types, prevalence and demographic distribution of benign oral and maxillofacial tumours among patients treated at Muhimbili National Hospital in Tanzania.Methods: In this retrospective study, data on histological results of lesions of the oral and maxillofacial region were retrieved from the archives at the Department of Oral and Maxillofacial Surgery of Muhimbili National Hospital were analysed. The tumour type, age, sex, file number and histopathological diagnosis of the patient were recorded. The study covered a period of from January 2008 to December 2013. The top ten lesions with higher frequency of occurrence from January to were picked for analysis.Results: A total of 897 (males=388; females=509) histological results of patients with benign oral and maxillofacial lesions were obtained during the period under review. The age ranged from 0 to 88 years, mean age being 32.63 ± 17.1 while the age group of 20-29 and 30-39 were the most affected. A total of 136 different types of benign lesions were reported and ameloblastoma was the most common benign lesion (27.4%) followed by ossifying fibroma (18.7%), pyogenic granuloma (11.4%), pleomorphic adenoma (10.0%), and fibrous dysplasia (9.6%). Females were more affected than males, with a male to female ratio of 1:1.4 however the difference was statistically insignificant (p= 0.055).Conclusion: Ameloblastoma and ossifying fibroma were the most common oral and maxillo-facia neoplasms at Muhimbili National Hospital. The young age groups were the most affected by these lesions

Fine Structure of the Fibrillar Flight Muscles in the Housefly, Musca domestica (Diptera)

Insects of the orders Hemiptera, Hymenoptera, Coleoptera and Diptera have developed an asynchronous flight mechanism. The frequency of the muscle contraction is not directly related to the rate of nervous stimulation (Pringle 1965). An initial nervous stimulus produces an active state in the flight muscle during which a variable number of oscillatory contractions take place. Consequently, insects like the house-fly can maintain a very high frequency of wing beat (180-200 per second). Asynchronous flight muscles differ from the vertebrate skeletal muscles and insect synchronous flight muscles; in the latter each nerve impulse produces a single contraction of the innervated fibres. The asynchronous flight muscles are usually referred to as \u27 fibrillar muscles because of the easy dissociability of their large myofibrils. The existing information on the cytology of the fibrillar muscles is quite meagre as compared to the vertebrate striated muscles. The present report is concerned with the ultrastructural organization of the fibrillar flight muscles of the common house-fly, Musca domestica

A Novel Shared Protection Scheme Based on Aggregate Wavelength in High Speed Networks

We propose novel analytical model of dynamic link cost evaluation in IP over WDM networks. We suggest disjoint path algorithm for the primary and backup path based on wavelength aggregate information, to provide shared backup. We show the optimality of pair selected because of joint optimization of the pair paths. The shareable capacity factor is introduced to establish the effect of load balancing on resources. We compared our simulation results with that of separate protection at connection and showed improvement on resource utilization performance of the network. We also study the blocking probability of proposed scheme

Zinc modulates several transcription-factor regulated pathways in mouse skeletal muscle cells

Zinc is an essential metal ion involved in many biological processes. Studies have shown that zinc can activate several molecules in the insulin signalling pathway and the concomitant uptake of glucose in skeletal muscle cells. However, there is limited information on other potential pathways that zinc can activate in skeletal muscle. Accordingly, this study aimed to identify other zinc-activating pathways in skeletal muscle cells to further delineate the role of this metal ion in cellular processes. Mouse C2C12 skeletal muscle cells were treated with insulin (10 nM), zinc (20 µM), and the zinc chelator TPEN (various concentrations) over 60 min. Western blots were performed for the zinc-activation of pAkt, pErk, and pCreb. A Cignal 45-Reporter Array that targets 45 signalling pathways was utilised to test the ability of zinc to activate pathways that have not yet been described. Zinc and insulin activated pAkt over 60 min as expected. Moreover, the treatment of C2C12 skeletal muscle cells with TPEN reduced the ability of zinc to activate pAkt and pErk. Zinc also activated several associated novel transcription factor pathways including Nrf1/Nrf2, ATF6, CREB, EGR1, STAT1, AP-1, PPAR, and TCF/LEF, and pCREB protein over 120 min of zinc treatment. These studies have shown that zinc’s activity extends beyond that of insulin signalling and plays a role in modulating novel transcription factor activated pathways. Further studies to determine the exact role of zinc in the activation of transcription factor pathways will provide novel insights into this metal ion actions

Improving the healthcare response to domestic violence and abuse in UK primary care: interrupted time series evaluation of a system-level training and support programme.

BACKGROUND: It is unknown whether interventions known to improve the healthcare response to domestic violence and abuse (DVA)-a global health concern-are effective outside of a trial. METHODS: An observational interrupted time series study in general practice. All registered women aged 16 and above were eligible for inclusion. In four implementation boroughs' general practices, there was face-to-face, practice-based, clinically relevant DVA training, a prompt in the electronic medical record, reminding clinicians to consider DVA, a simple referral pathway to a named advocate, ensuring direct access for women to specialist services, overseen by a national, health-focused DVA organisation, fostering best practice. The fifth comparator borough had only a session delivered by a local DVA specialist agency at community venues conveying information to clinicians. The primary outcome was the daily number of referrals received by DVA workers per 1000 women registered in a general practice, from 205 general practices, in all five northeast London boroughs. The secondary outcome was recorded new DVA cases in the electronic medical record in two boroughs. Data was analysed using an interrupted time series with a mixed effects Poisson regression model. RESULTS: In the 144 general practices in the four implementation boroughs, there was a significant increase in referrals received by DVA workers-global incidence rate ratio of 30.24 (95% CI 20.55 to 44.77, p < 0.001). There was no increase in the 61 general practices in the other comparator borough (incidence rate ratio of 0.95, 95% CI 0.13 to 6.84, p = 0.959). New DVA cases recorded significantly increased with an incident rate ratio of 1.27 (95% CI 1.09 to 1.48, p < 0.002) in the implementation borough but not in the comparator borough (incidence rate ratio of 1.05, 95% CI 0.82 to 1.34, p = 0.699). CONCLUSIONS: Implementing integrated referral routes, training and system-level support, guided by a national health-focused DVA organisation, outside of a trial setting, was effective and sustainable at scale, over four years (2012 to 2017) increasing referrals to DVA workers and new DVA cases recorded in electronic medical records

Implementing lean management/Six Sigma in hospitals: beyond empowerment or work intensification?

This article analyses a process improvement project based on Lean Six Sigma (LSS) techniques in the emergency department (ED) of a large Australian hospital. We consider perspectives of the clinical and managerial staff involved in the project implementation, its implications for empowerment and work intensification. We find that the project appeared to improve patient flow from the ED to the wards and to have positive implications for some staff. However, these achievements tended to be the result of senior staff using the project to leverage resources and create desirable outcomes, rather than the result of the use of LSS, in particular. We found some evidence of work intensification, but this was attributable to wider systemic issues and budget constraints, rather than being a direct consequence of the use of LSS. We argue that translating LSS from a manufacturing context into the politicised and professionalised context of healthcare changes the usual questions about empowerment or work intensification to questions about the influences of powerful stakeholders