The role of the respiratory microbiome in asthma

Asthma is a common airways disease and the human microbiome plays an increasingly recognised role in asthma pathogenesis. Furthermore, the respiratory microbiome varies with asthma phenotype, endotype and disease severity. Consequently, asthma therapies have a direct effect on the respiratory microbiome. Newer biological therapies have led to a significant paradigm shift in how we treat refractory Type 2 high asthma. While airway inflammation is the generally accepted mechanism of action of all asthma therapies, including both inhaled and systemic therapies, there is evidence to suggest that they may also alter the microbiome to create a more functionally balanced airway microenvironment while also influencing airway inflammation directly. This downregulated inflammatory cascade seen biochemically, and reflected in improved clinical outcomes, supports the hypothesis that biological therapies may in fact affect the microbiome-host immune system dynamic and thus represent a therapeutic target for exacerbations and disease control

Synthesis and characterisation of TiO based catalyst for the production of FAME from the esterfication of PFAD / Muhammad Imran Sulaiman

TiO based catalyst mixed oxides solid catalysts were prepared and evaluated in the esterification of palm fatty acid distillate (PFAD) to produce fatty acid methyl ester (FAME). Esterification was conducted in a batch reactor at 100-170OC temperature ranges. The catalysts were characterized by several techniques such as BET and FTIR. The effect of catalyst preparation condition (catalyst ratio) and the influence of reaction conditions (methanol/PFAD ratio, temperature) were studied. The prepared catalyst with formula TiCr (calcined at 500OC for 2h) gave the maximum FAME conversion at best reaction conditions (160OC, 2h, 4:1 methanol/PFAD molar ratio, 1.5 wt% catalyst dosage). Thus, TiCr has shown promising potentials as heterogeneous catalyst for FAME synthesis from high acid value oils

Tailored metabolic workup for urolithiasis – the debate continues

Abstract Urolithiasis is one of the commonest afflictions of the urinary tract. Stones are of various chemical compositions, some share some common etiology; but most are specific to the structure and composition of stone. In view of highly recurrent nature of this condition, it is logical to have strategies for prevention. However, due to multiple factors most patients receive no or fragmented information on prevention. The current controversy is to the extent of metabolic workup in adult first time stone former. This requires longitudinal studies to show benefit in prevention strategies. Patients at high risk can have recurrence in weeks to years, depending upon the composition and attending risk factor. They should be targeted with concentric and tailored prevention protocols. The major urological guidelines (EAU and AUA) recommend basic stone workup for all patients. However, indication for detailed workup are less well documented, so one potential solution is to tailor metaphylaxis strategies for individual patient

Social incentives, delivery agents, and the effectiveness of development interventions

There has been a rise in the use of the local delivery model for development interventions, where local agents are hired as intermediaries to target benefits to potential beneficiaries. We study this model in the context of a standard agricultural extension intervention in Uganda. We document a trade-off between coverage and targeting: delivery agents treat more farmers when they have a greater number of social ties, but they are significantly more likely to target their nonpoor ties. We conclude by discussing the implications of our findings for the design of the local delivery model for antipoverty interventions

Malnutrition and dietary pattern of children age below 12 years old living in Mukim Kemumin, Kota Bharu, Kelantan.

A study to assess household food insecurity was carried out among 150 n=150) households in Mukim Kemumin, Kota Bharu, Kelantan. Apart from this study, an assessment of nutritional status and dietary pattern of children of the selected household aged below 12 years old was implemented, where a total of 150 households were selected through proportion sampling

Use of social media sites by Malaysian universities and its impact on university ranking

Social Media is not just for photo sharing and status update, it can also be used by students for university selection. In the current era of high competition among higher educational institutes, many universities are focusing on online marketing. Most of the students are using social media sites to select their university which shows the importance of online presence for the universities. It is very much important for the universities to decide their marketing strategy to attract more and more international students. Good promotional marketing activities through social media, social networking sites by universities is associated with the ranking of the university. In this article we review the importance of social media marketing through social networking sites like Facebook and the capability of Malaysian universities to use social networking sites and its impact on university ranking and its Facebook engagement rank

Tackling youth unemployment: evidence from a labor market experiment in Uganda

We design a labor market experiment to compare demand- and supply-side policies to tackle youth unemployment, a key issue in low-income countries. The experiment tracks 1700 workers and 1500 firms over four years to compare the effect of offering workers either vocational training (VT) or firm-provided training (FT) for six months in a common setting where youth unemployment is above 60%. Relative to control workers we find that averaged over three post-intervention years, FT and VT workers: (i) enjoy large and similar upticks in sector-specific skills, (ii) significantly improve their employment rates, and, (iii) experience marked improvements in an index of labor market outcomes. These averages, however, mask differences in dynamics: FT gains materialize quickly but fade over time, while VT gains emerge slowly but are long-lasting, leading VT worker employment and earning profiles to rise above those of FT workers. Estimating a job ladder model of worker search reveals the key reason for this: VT workers receive significantly higher rates of job offers when unemployed thus hastening their movement back into work. This likely stems from the fact that the skills of VT workers are certified and therefore can be demonstrated to potential employers. Tackling youth unemployment by skilling youth using vocational training pre-labor market entry, therefore appears to be more effective than incentivizing firms through wage subsidies to hire and train young labor market entrants

A qualitative evaluation of patients understanding, expectations and experiences with HIV/AIDS treatment

Background: Treatment understanding and experiences are vital to determine HIV patients’ adherence and retention to care. Methods: In-depth patient interviews were audio-recorded, with a prior verbal and written consent and subjected to a thematic content analysis framework for data analysis. Results: Though majority of participants believed in Antiretroviral Therapy (ART) as the most effective way of treatment, they were greatly worried about its toxicities. Disease understanding and peer influence were regarded as the main reasons for treatment initiation; whereas, perceived side effects and lack of support system were among the main reasons associated with treatment delay. Almost all the patients experienced toxicities due to ARTs and viewed it negatively impacting their quality of life. Conclusion: It is vital for People Living with HIV/AIDS (PLWHA) to be retained in care; hence, the provision of optimal care with greater support to overcome treatment challenges must be focused in any HIV program

Investigating the relationship between peak inspiratory flow rate and volume of inhalation from a Diskus™ Inhaler and baseline spirometric parameters: a cross-sectional study

Drug delivery from a Dry Powder Inhaler (DPI) is dependent on the peak inspiratory flow rate (PIFR) generated. Currently available methods for estimating PIFR from most DPIs are limited and mainly rely on subjective assessment. We aim to show that spirometric and Diskus™ PIFR and Inspiratory Vital Capacity (IVC) are related to the underlying respiratory condition and that spirometric PIFR can be used to assess whether Diskus™ PIFR will be adequate when using this DPI. Healthy volunteers and patients with asthma, COPD, neuromuscular disease and non-respiratory disorders were recruited (n = 85). Demographics and baseline lung function by spirometry were recorded. Flow and volume readings were taken while patients used a Diskus™ DPI, housed in an airtight container connected to a spirometer. T-tests were performed to compare mean spirometric and Diskus™ PIFR/ IVC between groups. Stepwise regression analysis of Diskus™ PIFR versus spirometric PIFR, spirometric IVC, age, gender, condition, BMI, FEV1 and FVC was performed. The Diskus™ PIFR for the COPD and Neuromuscular Disease group was more than 10 L/min lower than the Healthy or Asthma groups (p \u3c 0.05). The mean spirometric and Diskus™ IVC of the Healthy group was significantly (\u3e0.75 L) higher than the mean for the other three groups (p \u3c 0.05). Diskus™ PIFR was moderately correlated with spirometric PIFR and age (Adjusted R2 = 0.58, p \u3c 0.0001). PIFR generated using a Diskus™ DPI is dependent on the underlying disease and age. A spirometric PIFR of less than 196 L/min should prompt further investigation into the suitability of a patient for a Diskus™ DPI, with possible consideration of alternate devices

Predicting asthma exacerbations employing remotely monitored adherence

This Letter investigated the efficacy of a decision-support system, designed for respiratory medicine, at predicting asthma exacerbations in a multi-site longitudinal randomised control trial. Adherence to inhaler medication was acquired over 3 months from patients with asthma employing a dose counter and a remote monitoring adherence device which recorded participant\u27s inhaler use: n = 184 (23,656 audio files), 61% women, age (mean ± sd) 49.3 ± 16.4. Data on occurrence of exacerbations was collected at three clinical visits, 1 month apart. The relative risk of an asthma exacerbation for those with good and poor adherence was examined employing a univariate and multivariate modified Poisson regression approach; adjusting for age, gender and body mass index. For all months dose counter adherence was significantly (p \u3c 0.01) higher than remote monitoring adherence. Overall, those with poor adherence had a 1.38 ± 0.34 and 1.42 ± 0.39 (remotely monitored) and 1.25 ± 0.32 and 1.18 ± 0.31 (dose counter) higher relative risk of an exacerbation in model 1 and model 2, respectively. However, this was not found to be statistically significantly different. Remotely monitored adherence holds important clinical information and future research should focus on refining adherence and exacerbation measures. Decision-support systems based on remote monitoring may enhance patient-physician communication, possibly reducing preventable adverse events