Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study

© 2015 Published by the BMJ Publishing Group Limited.Objective Urgent care centres (UCCs) hours were developed with the aim of reducing inappropriate emergency department (ED) attendances in England. We aimed to examine the presenting complaint and outcomes of care in 2 general practitioner (GP)-led UCCs with extended opening times. Design Retrospective observational epidemiological study using routinely collected data. Setting 2 GP-led UCCs in London, colocated with a hospital ED. Participants All children aged under 5 years, attending 2 GP-led UCCs over a 3-year period. Outcomes Outcomes of care for the children including: primary diagnosis; registration status with a GP; destination following review within the UCC; and any medication prescribed. Comparison between GP-led UCC visit rates and routine general practices was also made. Results 3% (n=7747/282 947) of all attenders at the GP-led UCCs were children aged under 5 years. The most common reason for attendance was a respiratory illness (27%), followed by infectious illness (17%). 18% (n=1428) were either upper respiratory tract infections or viral infections. The majority (91%) of children attending were registered with a GP, and over two-thirds of attendances were out of hours. Overall 79% were seen and discharged home. Preschool children were more likely to attend their GP (47.0 per 100) than a GP-led UCC (9.4 per 100; 95% CI 8.9 to 10.0). Conclusions Two-thirds of preschool children attending GP-led UCCs do so out of hours, despite the majority being registered with a GP. The case mix is comparable with those presenting to an ED setting, with the majority managed exclusively by the GPs in the UCC before discharge home. Further work is required to understand the benefits of a GP-led urgent system in influencing future use of services especially emergency care

Evaluating virological outcomes in people with HIV on stable antiretroviral therapy with reduced frequency of HIV viral load monitoring during the COVID-19 pandemic

OBJECTIVE: In response to the COVID-19 pandemic, HIV outpatient attendances were restricted from March 2020, resulting in reduced frequency of HIV viral load (VL) monitoring (previously 6-monthly) in clinically stable and virologically suppressed people living with HIV (PLWH). We investigated virological outcomes during this period of reduced monitoring and compared with the previous year, prior to the COVID-19 pandemic. METHODS: People living with HIV with undetectable VL (<200 HIV RNA copies /mL) on antiretroviral therapy (ART) were identified from March 2018 to February 2019. We determined VL outcomes during the pre-COVD-19 period (March 2019–February 2020) and the COVID-19 period (March 2020–February 2021) when monitoring was restricted. Frequency and longest durations between VL tests in each period were evaluated, and virological sequelae in those with detectable VL were determined. RESULTS: Of 2677 PLWH virologically suppressed on ART (March 2018–February 2019), VLs were measured and undetectable in 2571 (96.0%) and 2003 (77.9%) in the pre-COVID and COVID periods, respectively. Mean (SD) numbers of VL tests were 2.3 (1.08) and 1.1 (0.83) and mean longest duration between VL tests was 29.5 weeks (SD 8.25, 3.1% were ≥12 months) and 43.7 weeks (12.64, 28.4% were ≥12 months), in the pre-COVID and COVID periods, respectively. Of 45 individuals with one or more detectable VL during the COVID-19 period, two developed new drug resistance mutations. CONCLUSION: Reduced VL monitoring was not associated with poorer virological outcomes in the majority of stable individuals receiving ART. One in 20 individuals had not returned for VL testing after ≥31 months and the risk of harm in these individuals is unknown

Energy Tunneling Behavior in Geometrically Separated Wave Guides

In this paper, characteristics of energy tunneling channel between the waveguides geometrically separated by a coaxial cable are studied.&nbsp; The novel aspect of design is use of coaxial channel to connect the waveguides while maintaining the energy tunneling phenomena. As anticipated the tunneling frequency depends upon the length of wire inside the waveguide and the length of the coaxial cable. The tunneling frequency also depends upon the dielectric constant of the material inside the waveguide and coaxial cable.&nbsp; At tunneling frequency the field strength (E and H) in the channel is extremely high, making the channel extremely sensitive to small change in permittivity of dielectric occupying the channel.&nbsp; The advantage of the proposed design is, its ability to tune to desired tunneling frequency just by changing the length of the coaxial cable without the need to redesign the waveguide height to accommodate the long tunneling wires. This structure can be used as dielectric sensor both for solid or liquid dielectrics just by placing the sample in coaxial cable cavity, contrary to previously report work where the sample has to be placed inside the waveguide

The effect of quantum memory on quantum games

We study quantum games with correlated noise through a generalized quantization scheme. We investigate the effects of memory on quantum games, such as Prisoner's Dilemma, Battle of the Sexes and Chicken, through three prototype quantum-correlated channels. It is shown that the quantum player enjoys an advantage over the classical player for all nine cases considered in this paper for the maximally entangled case. However, the quantum player can also outperform the classical player for subsequent cases that can be noted in the case of the Battle of the Sexes game. It can be seen that the Nash equilibria do not change for all the three games under the effect of memory.Comment: 26 pages, 7 ps figure

Dynamics of multipartite quantum correlations under decoherence

Quantum discord is an optimal resource for the quantification of classical and non-classical correlations as compared to other related measures. Geometric measure of quantum discord is another measure of quantum correlations. Recently, the geometric quantum discord for multipartite states has been introduced by Jianwei Xu [arxiv:quant/ph.1205.0330]. Motivated from the recent study [Ann. Phys. 327 (2012) 851] for the bipartite systems, I have investigated global quantum discord (QD) and geometric quantum discord (GQD) under the influence of external environments for different multipartite states. Werner-GHZ type three-qubit and six-qubit states are considered in inertial and non-inertial settings. The dynamics of QD and GQD is investigated under amplitude damping, phase damping, depolarizing and flipping channels. It is seen that the quantum discord vanishes for p>0.75 in case of three-qubit GHZ states and for p>0.5 for six qubit GHZ states. This implies that multipartite states are more fragile to decoherence for higher values of N. Surprisingly, a rapid sudden death of discord occurs in case of phase flip channel. However, for bit flip channel, no sudden death happens for the six-qubit states. On the other hand, depolarizing channel heavily influences the QD and GQD as compared to the amplitude damping channel. It means that the depolarizing channel has the most destructive influence on the discords for multipartite states. From the perspective of accelerated observers, it is seen that effect of environment on QD and GQD is much stronger than that of the acceleration of non-inertial frames. The degradation of QD and GQD happens due to Unruh effect. Furthermore, QD exhibits more robustness than GQD when the multipartite systems are exposed to environment.Comment: 15 pages, 4 figures, 4 table

Comparative nutritional analysis between Vigna radiata and Vigna mungo of Pakistan

Vigna radiata (mung bean) and Vigna mungo (mash bean) of the family Fabaceae are among staple food in Pakistan. The experiments were conducted on these beans to determine the proximate composition such as moisture, ash, fibre, fat and protein content. The protein isolates from V. radiata and V. mungo was prepared and their functional properties (foaming, nitrogen solubility index and SDS gel electrophoresis) were also analyzed. All biochemical constituents were analyzed using official methods of analysis of the Association of Official Agricultural Chemists (2005). Results show that they have high protein content and play significant role in human nutrition. These beans have high nitrogen solubility and less fat content; which is a characteristic generally needed for healthy food. This research concluded that V. radiata has high percentage of moisture (9.74 ± 0.19), fat (1.35 ± 0.048) and protein content (22.5 ± 0.24) as compared to V. mungo (7.9 ± 0.06, 1.01 ± 0.01, 21.3 ± 0.24, respectively). 54 and 33% of protein isolates were made from V. radiata and V. mungo, respectively. The functional properties analysis enhances their acceptability in food industry.Key words: Vigna radiata, Vigna mungo, protein isolate, foam stability

ONLINE NEWSPAPER EXPOSURE BY ACADEMICS IN THE FACULTY OF SOCIAL SCIENCES, UNIVERSITY

ABSTRAC

Biological impact of nanodiamond particles – label free, high-resolution methods for nanotoxicity assessment

Current methods for the assessment of nanoparticle safety that are based on 2D cell culture models and fluorescence-based assays show limited sensitivity and they lack biomimicry. Consequently, the health risks associated with the use of many nanoparticles have not yet been established. There is a need to develop in vitro models that mimic physiology more accurately and enable high throughput assessment. There is also a need to set up new assays that offer high sensitivity and are label-free. Here we developed ‘mini-liver’ models using scaffold-free bioprinting and used these models together with label-free nanoscale techniques for the assessment of toxicity of nanodiamond produced by laser-assisted technology. Results showed that NDs induced cytotoxicity in a concentration and exposure-time dependent manner. The loss of cell function was confirmed by increased cell stiffness, decreased cell membrane barrier integrity and reduced cells mobility. We further showed that NDs elevated the production of reactive oxygen species and reduced cell viability. Our approach that combined mini-liver models with label-free high-resolution techniques showed improved sensitivity in toxicity assessment. Notably, this approach allowed for label-free semi-high throughput measurements of nanoparticle-cell interactions, thus could be considered as a complementary approach to currently used methods

Heterogeneous clinical spectrum of DNAJC12-deficient hyperphenylalaninemia:From attention deficit to severe dystonia and intellectual disability

BACKGROUND: Autosomal recessive mutations in DNAJC12, encoding a cochaperone of HSP70 with hitherto unknown function, were recently described to lead to hyperphenylalaninemia, central monoamine neurotransmitter (dopamine and serotonin) deficiency, dystonia and intellectual disability in six subjects affected by homozygous variants. OBJECTIVE: Patients exhibiting hyperphenylalaninemia in whom deficiencies in hepatic phenylalanine hydroxylase and tetrahydrobiopterin cofactor metabolism had been excluded were subsequently analysed for DNAJC12 variants. METHODS: To analyse DNAJC12, genomic DNA from peripheral blood (Sanger sequencing), as well as quantitative messenger RNA (Real Time Quantitative Polymerase Chain Reaction (RT-qPCR)) and protein expression (Western blot) from primary skin fibroblasts were performed. RESULTS: We describe five additional patients from three unrelated families with homozygosity/compound heterozygosity in DNAJC12 with three novel variants: c.85delC/p.Gln29Lysfs*38, c.596G>T/p.*199Leuext*42 and c.214C>T/p.(Arg72*). In contrast to previously reported DNAJC12-deficient patients, all five cases showed a very mild neurological phenotype. In two subjects, cerebrospinal fluid and primary skin fibroblasts were analysed showing similarly low 5-hydroxyindolacetic acid and homovanillic acid concentrations but more reduced expressions of mRNA and DNAJC12 compared with previously described patients. All patients responded to tetrahydrobiopterin challenge by lowering blood phenylalanine levels. CONCLUSIONS: DNAJC12 deficiency appears to result in a more heterogeneous neurological phenotype than originally described. While early identification and institution of treatment with tetrahydrobiopterin and neurotransmitter precursors is crucial to ensure optimal neurological outcome in DNAJC12-deficient patients with a severe phenotype, optimal treatment for patients with a milder phenotype remains to be defined