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This brief note addresses the comparison between conventional ELISA and a slightly newer, equally sensitive, specific, less time consuming and cost effective version of its “Paper based ELISA,” which have a few major benefits on the conventional ELISA.

In this paper a review of Foam mat drying process for fruits and vegetables is discussed to develop quality powders Foam mat drying is a new drying technique for foods which are highly heat sensitive and very sticky to dry Foods contain a lot of compounds which are very sensitive to high temperature for long time By using this drying technique product is dried in a very short time with minimum quality changes Fruits and vegetables pastes are mixed with different foaming agents egg albumin soy protein egg white Lecithin etc and foam stabilizers carboxymethyl cellulose pectin etc in different concentration to introduce stable foams Foams are dried in trays by application of hot air and milled to develop free flowing powders Powders developed by this drying technique have maximum preservation of the compounds which are very heat sensitive

The study aimed at the development of a method for obtaining biodiesel by transesterification by via methylic from castor oil using biocatalysts. Seven varieties of lipase (PPL, Candida rugosa, OS cepacea, OS cepacea immobilized on diatomaceous earth, Novozyme 435, Lipozyme and Lipozyme RM) and seven enzymatic sources from a vegetable origin (latex of the species Ficus benjamina, Manihot glaziovii Muell. Arg., Calotropis procera, Jatropha curcas L., Ficus pumila, Euphorbia tirucalli L.) were tested. Enzymatic sources of plant origin were submitted, initially, the hydrolytic activity tests to evaluate their potential as biocatalysts and, from the results obtained, two samples were selected for the experiments further synthesis of biodiesel. Validation of the method of production of biodiesel evaluated linearity, reproducibility (precision), recovery (accuracy) and the limits of detection and quantification. Among the sources of enzymes used in the synthesis of biodiesel presented the best result was the commercial enzyme Novozym 435 with 55.33% conversion yield of biodiesel in initial tests. Were conducted new tests for optimization of reactional parameters co-solvent, alcohol: oil ratio, amount of enzyme and solvent for recovery of the enzyme, which enabled a maximum yield of biodiesel to 98.84%.

A cost minimization concept of heat and and energy consumption for direct dyeing process of cotton fabric coloration was experimented with triethanolamine instead of sodium carbonate in the dyebath of direct dyeing with low temperature at C medium temperature at Cand high temperature at Cand compared with the conventional method of direct dyeing with high temperature at Cwhere an acceptable range of increasing color strength K S and color difference were observed for low temperature dyeing with triethanolamine TEA method comparing to the conventional dyeing process of high temperature with sodium carbonate SC method Considering heat and energy consumption in direct dyeing of cotton fabric coloration with triethanolamine method the low temperature dyeing cost was minimized Rs comparing to high temperature sodium carbonate method dyeing cost

Morinda citrifolia popularly known as noni has had its cultivation and consumption rapidly spread all over the Brazilian territory due to its phytotherapeutic properties The biotechnological and pharmacological potential of noni were investigated herein Testing was performed to determine hemagglutinating antitriptic and cheliprotic activity and the phenolic compounds present in both pulp and seed Raw noni pulp and seeds extracts from three different buffers were tested Noni samples presented protease inhibitors low phenolic compound content and hemagglutination of papain and trypsin treated type A blood The inhibitory activities found in noni fruit both for trypsin and chymotrypsin point towards a great potential for the purification of bioactive molecules Lectins manifest a number of exploitable biological activities such as antiproliferative antitumor and immunomodulatory Thus it is stated that exotic fruit extracts are of interest to the food industry due to their biotechnological and pharmaceutical potential

This work presents the effective optimum parameters of one rotary dryer such as energy consumption, optimum drying time, color and size distribution of outlet sodium chloride crystals from dryer and the amount of distilled water. The experimental results show, the maximum deviation between salt production in 12 minutes as drying time and production of dried saline crystals in 15.2 minutes is only 8% but since of the quality of outlet dried saline crystals is optimized in 15.2 minutes so this drying time is introduced as optimized time for drying. Also, the moisture content (kg) per dried salt (kg) in this condition is 0.005. According to the literature, this amount of moisture content in outlet dried saline crystals is very suitable.

This “short but sweet” clinical paper is about a next generation “uptick” nanotechnology that demonstrates a unique, real time imaging inventive art enabling a different kind of look at the brain, actually, to see inside neuronal and glial circuitry in the brain and spinal cord of the living human being and animal. “Lewy body dementia is characterized by the abnormal buildup of proteins into masses known as Lewy bodies. This protein is also associated with Parkinson’s disease. People who have Lewy bodies in their brains also have the plaques and tangles associated with Alzheimer's disease. Apr 26, 2019, Mayo clinic”.1 This is the problem and thus far, the problem is addressed primarily after autopsy, called post mortem, also problematic. Therefore, the purpose of this paper is to introduce the online and real time and spatial sensitive voltaic image of the Tau peptide complex video-tracked by the BRODERICK PROBE® biomedical sensors in striatum of the living Parkinson subject. This nanoprobe enables studies of the striking consequences among intensities of phosphorylated Tau. Identifying Tau on line is unmistakably relevant to longevity, both individual and societal and this relevance is inexorably critical to and on behalf of humanity per se.

The maxillary molars especially the third molars have the most complicated root canal system in permanent dentition There are many variations in root canal number system and configuration in maxillary molars It is imperative and paramount for the clinician to seek out every possible aberration of root canal anatomy for all teeth undergoing treatment This paper relates a case of a maxillary right third molar with a canal configuration rarely reported in the literature The tooth had four roots with four root canals two separate palatal roots mesiopalatal and distopalatal with their own distinct canals and orifices The mesiobuccal and distobuccal roots had normal anatomy This paper escalates the complexity of maxillary molar variation and is intended to brace clinician rsquo s awareness of the rare morphology of root canal system

Cocaine is amongst the most highly addictive drugs used worldwide and its expanding demand in the UK is causing it to become an increasingly, problematic drug.1 Cannabis abuse is a large scale phenomenon and its growth and cultivation within the UK has developed greatly throughout the years.2 Both cocaine and cannabis since their first use and identification, have both been found to have many different effects and long term risks to health, which is the reason for their illegality. This paper views aspects of their history and origin and their psychological effects on a user, both short-term and long-term. Using relevant statistics, this paper also considers how age, sex, environments and social situations can cause different levels of abuse of these drugs. A thorough understanding of the effects and prevalence of these two major illicit drugs, can allow treatment and prevention programmes to be constructed with a clearer understanding of their target groups.3 This review pursues a conclusion on whether these programmes can be sufficient in not only reducing the abuse of these illicit drugs, but to also bring about social change and to prevent subsequent divesting effects including homelessness and suicide from occurring as frequently as they do today.

COVID is a severe acute respiratory syndrome caused by the SARS CoV virus and is currently at pandemic levels worldwide This opinion paper considers what evidence there is for a fungal connection between the aetiology of illness and the role of climate and the local environment The paper focuses mainly on China Five themes are explored beginning with social media reports of potential water damage at emergency healthcare buildings This builds on the premise that damp indoor environments can promote elevated microbial growth from fungi bacteria and yeasts causing occupant infection or exposure or sensitivity reactions to spores cellular debris allergens or to a range of inflammatory mycotoxins The second theme looks at seasonal variations in key climate factors like temperature and humidity and are examined from the perspective of controlling virus transmission based on known epidemiological data trends Thirdly large cities like Wuhan exploit the sponge city concept where water is controlled using engineering controls Since excess water is a hallmark of mould growth in the built environment the role of this particular planning effort is discussed The fourth theme discusses the emerging literature that severe and adverse COVID complications may be caused by fungal co infections The evidence for this builds on emerging clinical reports relating procalcitonin interleukins and lung opacities with signs of severe illness and or sepsis The paper concludes with a review of several non pharmacological infection control interventions that may help in controlling the spread of this virus in other countries and regions

Objective Mean arterial pressure MAP and pulse pressure PP are important parameters that predict cardiovascular risk both in diabetics and non diabetic population in both genders Data on this subject area in Nigeria Africa and worldwide are few The aim of this paper is to examine the pattern of MAP and PP in a diabetic male population compared to a general population of males in Africans Is the pattern of MAP and PP the same in both diabetic and non diabetic Does any significant disparity exist Methods This is a preliminary prospective study Randomly the blood pressure of men from the general Lagos population was taken at heart level using a mercurial sphygmomanometer during a free medical screening exercise in surlier Similarly the blood pressure of consecutive known diabetic men was taken at heart level using a mercurial sphygmomanometer The diabetic patients were recruited from the endocrinology clinic of the Lagos State University Teaching Hospital Ikeja and Lagos Nigeria Individual consent was obtained from both groups of participants The PP of each individual was computed by subtracting the diastolic blood pressure from the systolic blood pressure The MAP of each individual was computed by adding one third of the PP to the diastolic blood pressure The limitation of this study includes the very small size of the study population and Africans are not well represented in the sample size Results or case presentation The age range of the non diabetic was to years while the age range of the diabetics was to years The mean average pulse pressure among the non diabetic was mmHg while the average pulse pressure among the diabetics was mmHg Among the non diabetic the mean of the MAP was mmHg while among the diabetics it was mmHg The highest MAP among the diabetic group was mmHg while the highest among the non diabetic was mmHg Discussion This paper shows that the average MAP is higher in the general African male population than among diabetic male Africans This supports autopsy finding in literature that hemorrhagic cerebra vascular accident occurs slightly more commonly in non diabetic compared to diabetics while cerebral infarction occurs more in diabetic subjects compared to non diabetics Similarly it was noticed in the study that African male diabetics tend to have higher pulse pressure than the general African population Conclusion MAP is lower in male African diabetics compared to the general African male population Conversely PP is higher among male African diabetics compared to the general African male population

The paper describes a patient with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS). The features of the course and therapy of epilepsy in MELAS are discussed. The disease is known for its late diagnosis when years elapse from the onset of the clinical manifestations to diagnosis. The paper presents clinical criteria for the diagnosis of MELAS and the specific features of brain neuroimaging changes that allow identification of the disease at an early stage.

Objective: Review the publications (2007–2017) generated by physical therapy staff members’ associated with Saudi Universities. Methods: Following the identification of those universities offering Physical Therapy/Physiotherapy programmes, a PRISMA strategy was used to search for the peer-reviewed publications using four electronic database (Scopus; ScienceDirect; Web of Science; and Google Scholar). Full-length papers were included if they were generated by an affiliated staff member and published in English in peer-reviewed papers. The bibliometric characteristics of the journals were documented. Results: A total of 1127 titles were generated by the 14 Physical Therapy programmes. Following screening, 245 were determined to meet the inclusion criteria and were retained for analysis. There has been a systematic increase in the number of publications over the study timeframe. The “Journal of Physical Therapy Science” was the most the frequently (14.69 %) recorded publication. Publications were recorded in 107 journals. The bibliometric characteristics varied considerably. Conclusion: There was evidence of a systematic increase in research publications indicating a greater commitment to conducting research among physical/physiotherapy programmes in Saudi Arabia universities.

Background: Globally, an estimated 528,000 women develop cervical cancer (CC) each year, 266,000 of whom die from the disease. CC is the fourth most-common cancer in women worldwide and fourteenth in the UK, where 3,200 cases are diagnosed each year. In England CC is more common among White females and more common among women in deprived areas. In 1989, the NHS Cervical Screening Programme (NHSCSP) developed a screening programme aimed at identifying women who may be at risk of developing CC. However, incidence rates for CC are projected to rise by 43% in the UK between 2014 and 2035, to 17 cases per 100,000 females by 2035, which suggests that there are ongoing barriers that may be preventing women from attending cervical cancer screening (CCS). The primary goal of this extended literature review, it to examine these barriers, with particular emphasis on the extent to which they are shaped by ethnicity. Methodology: The research question and selection of relevant keywords were formulated using the PICO(S) framework. Six databases were used to search for relevant literature. Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline and SCOPUS provided literature specific to the nursing and allied health perspectives while PsycINFO and Applied Social Sciences Index and Abstract (ASSIA) were used to find studies focused on sociological and psychological aspects of the research question. The use of the Cochrane database provided previous research papers relevant to the topic. All papers were screened for eligibility against the inclusion and exclusion criteria and critically appraised, and quality assessed using the Joanna Briggs Institute (JBI) checklist for systematic reviews, with reference to the Boland, Cherry & Dickson3 theories of methodology. Results: Thematic analysis of the eight studies was carried out in line with the process outlined by Braun & Clark4 to identify recurring themes and barriers to CCS access: (1) Psychological and emotional barriers (2) Financial barriers (3) Perceptions and previous experiences. Discussion: The barriers are applicable to women from all ethnicities, to varying degrees. However, females from marginalized, educationally deprived or underserved groups are less likely to attend CCS screening due to the barriers identified. This has immense implications for CC policy and practice.

Cardiac surgeons perform a number of procedures in the aortic outflow tract the so named ldquo aortic annulus rdquo and the surrounding structures This region has many structures related to the conduction system like the atrioventricular node the His bundle and its branches plus the vascular supply of these elements There are several ldquo dogmas rdquo regarding valve replacement procedures that preclude any stitch from going ldquo near rdquo ldquo under rdquo ldquo beneath rdquo etc some specific zones most of the time this dogmas are followed without reaching comprehensive understanding of the milimetric nature of the ldquo play field rdquo when performing an aortic or mitral procedure The detailed anatomy of the subaortic outflow tract is clearly illustrated by the pictures accompanying this paper There are not ldquo schematic drawings rdquo in this paper All of the pictures are photographs of human hearts where dissection of the conduction system and its blood supply was performed Some of the hearts were subjected to true cardiac procedures in vivo and the dissection of the His bundle was performed postmortem This study reveals the precise location of the subaortic structures evidencing the real manoeuvre margin that the surgeon has in stented valve nostented valve Bentall and homografts procedures

Fil: Levin, Luciano G. Universidad Nacional de Río Negro. Centro de Estudios en Ciencia, Tecnología y Desarrollo. Río Negro; Argentina. Fil: Levin, Luciano G. Universidad Nacional de La Pampa; Argentina. This paper describes and analyzes various ways in which drug addiction has been constructed from different cognitive perspectives, each of which has been conceptualized in terms of: a.The knowledge invoked for its theoretical demarcation and the knowledge produced as a result of that approach. b.The framing of drug addiction in the theoretical body and the representations that govern the so-called ?deviant behaviors? c.The particularization in the subset of problems known as ?medicalized behaviors? d.The historicization of the agents through which these problems materialize in actions and concrete institutions at the Argentine local state level. In this work we assume that the emergence of a problem of these characteristics, contingent decisions about how addiction is treated, what types of medical treatments should be implemented, where and by whom, are decisions that result from the interaction between different social actors that mobilize institutional mechanisms and knowledge that shape the interests of the parties involved and public opinion. Then we systematized each of the elements that have been identified in the respective conceptualizations, to show how the analysis of these dimensions allows us to explain the current structuring of the problem - social, public and knowledge. This paper describes and analyzes various ways in which drug addiction has been constructed from different cognitive perspectives, each of which has been conceptualized in terms of: a.The knowledge invoked for its theoretical demarcation and the knowledge produced as a result of that approach. b.The framing of drug addiction in the theoretical body and the representations that govern the so-called ?deviant behaviors? c.The particularization in the subset of problems known as ?medicalized behaviors? d.The historicization of the agents through which these problems materialize in actions and concrete institutions at the Argentine local state level. In this work we assume that the emergence of a problem of these characteristics, contingent decisions about how addiction is treated, what types of medical treatments should be implemented, where and by whom, are decisions that result from the interaction between different social actors that mobilize institutional mechanisms and knowledge that shape the interests of the parties involved and public opinion. Then we systematized each of the elements that have been identified in the respective conceptualizations, to show how the analysis of these dimensions allows us to explain the current structuring of the problem - social, public and knowledge.

The choice of old people rsquo s home is due to the falling traditional family system as children are in search for greener pasture Hence the concept of old people rsquo s homes has been viewed as an abuse of institutionalizing the older population The paper is a review of the concept of old peoples homes conception of old peoples homes around the world and Nigeria in particular and also the misconception attached to old peoples homes in Nigeria The paper x rayed the emerging roles of social workers in providing long term care The paper recommended that old peoples home should not be seen as an elder abuse but as an alternative to provide long term care for the elderly in a gradually falling African family traditional system

Clinical procedures encourage exercises and activities for Non-specific Low Back Pain (NSLBP). However, the relationship between the levels of physical exercise and their results is still unclear. Therefore, this review explains the relationships between the level of free living activity following Low Back Pain (LBP) and the levels of pain. It also describes impairment in patients with NSLBP. The paper used AMED, OVID, Biomed, CINAHL, Medline, Embase, Google scholar PubMed-National Library of Medicine, Proquest Directories, and manual reference lists searches to locate relevant literature. Only studies that examined statistical relationship between activities of free living Physical Activity (PA) in subjects with LBP and LBP outcome procedures were included in this review. Altogether, twelve studies, consisting of seven cohorts and five cross-sectional studies were included in this review. Out of the twelve studies, only one showed statistically significant relationship between increased leisure time activity and improved LBP outcomes. Another study reported reduced levels of sporting activity to be linked with higher levels of discomfort and disability. The rest (n=10) demonstrated no connection between activity levels and pain. The studies also demonstrated that NSLBP patient’s activity levels are neither connected with nor predictive of the pain levels. This paper recommends prospective research to thoroughly determine the relationships between PA, LBP and activity levels.

Commonly used household chemicals and pharmaceuticals agents which may range from pain killer remedies to anticonvulsant medications hair dye up to toilet cleaners all agents poses a potentially fatal poisoning tendency The most vulnerable groups in a household are children below years of age to accidental poisoning and young adults to intentional self harm although no age is barred from being poisoned by these agents Children are most at risk for poison exposures from household products as they do not have the ability to distinguish between safe and unsafe things that look very similar This is an issue that can affect anyone where children are at most risk This paper reviewed the present trend of household poisoning and observed that there is a striking increase in the number of household poisoning cases in the recent past The primary aim of the present paper is to review the existing burden of lsquo household poisons rsquo and to recommend appropriate preventive measures against such poisoning occurrences

For four decades clinicians have used scaffolds composed of extracellular matrices ECMs as replacements for a variety of tissues These scaffolds contain collagen from different subfamilies and to a first approximation mimic the structure of the host tissue To avoid problems such as intimal hyperplasia and stress shielding it is important that the mechanical properties of the host and implant materials be matched We have reported that the use of optical cohesion tomography OCT in concert with vibrational analysis is a useful tool to evaluate mechanical properties of scaffolds to replace extracellular matrices in animals and humans as well to study the onset and pathogenesis of diseases In this paper we compare the mechanical properties of a number of ECMs to establish the mechanical requirements for scaffolding materials The results presented in this paper suggest that the moduli of elastic tissue fibrous collagen and subchondral bone are characteristic finger prints of structural components of ECMs that can be non invasively and non destructive measured using OCT and vibrational analysis

Objectives The aim of this paper is to review recent literature on the effects of orthodontic premolar extractions contributing to obstructive sleep apnea The paper also reviews the literature regarding effects of extractions on dental arch length total tongue space changes and upper airway changes Methods The PubMed database was systematically searched to obtain all the current eligible papers covering the period from Exclusion criteria included papers not published in the English language Searches included reference key words including obstructive sleep apnea orthodontic treatment premolar extraction and airway space Results After assessing the available articles a total of articles were chosen in the correct time frame to be considered a current analysis of the data Conclusion To date there is no evidence that orthodontic premolar extractions directly cause obstructive sleep apnea

Brain tumors in children are life threatening and deserve more research to improve patient care In recent years multivariate analysis has been increasingly used in tumor classification segmentation and survival outcome assessment in childhood brain tumors This paper reviewed the studies that applied multivariate analysis to tumor classification segmentation and survival outcome assessment in pediatric brain tumors Large variations in the tumor classification results were observed in the studies of tumor classification even in similar patient populations Moderate error rate in the multivariate survival analysis model was also observed which could lead to inaccurate survival estimates and misidentification of prognostic factors To address these problems this paper analyzed the data processing chains in these multivariate analyses in detail It seems that optimizing and standardizing these data processing chains may improve tumor classification and survival analysis reduce variations and errors in classification results and survival estimates As multivariate analytic approaches data processing technologies and imaging techniques advance in the Big Data era of the st century it is anticipated that the challenges in complex imaging data processing in tumor classification will be overcome and complex data processing will be revolutionized This will make accurate automatic tumor classification segmentation for each tumor type and grade possible to early detect and treat tumors guide treatment planning monitor tumor progression and treatment effects together with advanced accurate survival assessment to guide life saving rescue and recovery planning revolutionize patient care and truly benefit children with brain tumors

There are so many studies of occurrence of microorganisms specially the parasitical ova isolation from the banknotes and coins and causing serious health hazard to the community. Parasitical ova are usually associated with spoilage in foods, but they may also produce toxins and adult parasite after mature can make serious illness and thus their presence on banknotes and on coins is also undesirable and causing serious illness especially the respiratory disease, diarrhea and the itching wound of anal area to children and parasitic infection .Modern bank notes are made up of special blend of 75% cotton and 25% are of linen with small segment of fiber so paper money is something of a in isomer, this formation is of paper money is the potential source ,substrate for the survival of the parasitical ova. While from different locations we buy day to day commodities we transfer these microorganisms from one location to another location and transferring diseases specially to the depilated patients and immunocompromized patients who are at high risk and vulnerable to get disease. The average life span of low denomination paper banknotes is about 24 months. Study is designed to provide the first insight to add to the limited body of literature on microbial contamination of currency (Pakistan currency circulating in country, papers as well as coins currency) and to address growing community concerns about the risk associated with microbial contamination and handling of money in the country. Objectives: a. To identify the common pathogens residual on circulating Pakistan’s currency. b. The microbial contamination of currency to enrich in global information bank on subject as the issue is becoming a major public health concern worldwide. c. To take the effective measure regarding bio-safety in Pakistan currency circulating in Pakistan. Methodology: In this total study 720 samples were taken from different locations i.e. from Bank counter243 samples, TM Machine 50 samples, Food seller 94 samples Medical store 35 samples, Milk seller 92 samples, Grocery shop 63 samples, Meat shop 80 samples, Road side mechanic 36 samples, Bus conductor 4 samples and from Beggars’ 23 sample while study period was from 4.32010 to 31.12011 all the specimens were processed according to standard methods. Material and Method: As Per Criteria.

Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumulative psychological traumatization in childhood. It is characterized by a marked disturbance of identity due to the presence of distinct personality states and repetitive dissociative amnesias which interfere with the continuity of the affected persons autobiography. These personality states [alter personalities] recurrently take control of or influence the individual undermining one’s sense of self and agency. Although working with alter personalities is the hallmark of psychotherapy in DID, a detailed and specific clinical and theoretical psychopathology of alter personalities do not exist yet. Hence, the present paper addresses the formation and functions of alter personalitiesin DID. The hypotheses, proposals, andassumptions developed in this paper have been derived from experiences inintensive treatment of a very large number of patients with DID over more than two decades. The authors propose that the reconciliation between diverse perspectives about one’s internal world and external reality carried by various personalities is necessary for successful treatment of DID. The hallmark of dealing with alter and host personalities constitutes of the elimination of misperceptions of themabout each other personality state and even about themselves.This requires an analysis of the missions and functions of alter personalities which are usually different thanthe perceived conceptualizations.This recognition usually increases the therapeutic alliance and even consent between the therapist, and alter and host personalities and decreases the duration of treatment. The present paper is a preliminary one on this subject and may serve as a basis both for further theoretical elaborations as well as for development of hypotheses in empirical research devoted to understanding operations of human mind when exposed to stress in particular as well as the mechanisms of effective therapeutic interventions in those conditions.

A person’s quality of life (QoL) can be affected with poor oral health.1 Measurement of oral health related quality of life (OHRQoL) helps professionals clarify the role of oral health status on the overall quality of life.2 It also assists in clinical decisions taking into account patients’ needs and serves as an effective communication mechanism with policy makers.3,4 Consequently modern healthcare systems should address patient’s health complaints, taking into consideration the impact of patients’ illness on quality of life.5 Modern dental procedures endeavour to improve patients’ quality of life. Orthodontic treatment based on purely clinical and functional perceptions may not fully address patients’ concerns. Patients and their parents have been shown to share similar treatment expectations, although parents reported more realistic prospects. Ethnicity significantly influences expectations for orthodontic treatment, and this may relate to differences in the patients’ and parents’ assessment of the clinical outcome. In the previous paper (part 1), the impact of fixed and Twin block appliances on. OHRQoL was assessed, both groups demonstrated significant improvement toward the end of the treatment. However, in the current paper the economic analysis for Twin block and fixed appliances was performed. Economic evaluation is widely used and well accepted in the appraisal of health care. However in the field of orthodontics, there have been relatively few economic analyses performed., peer-reviewed

The human body when subjected to heavy loads of physical training suffers numerous modifications to adapt to stress. Various systems are directly and indirectly affected, we can mention the cardio respiratory system as the one that suffers the most modifications when we are facing an intense physical load. Another system that modifies and of which we will explain in this paper is the endocrine system, specifically the thyroid gland who suffers some changes. This paper aims to demonstrate and exemplify the changes in the thyroid gland during physical activity, such as the release of pro-and anti-inflammatory cytokines, and the alteration occurred in the release of thyroid hormones. All these changes suffer direct influence on the athlete's performance being a limiting factor for a good performance. Through this paper, we exemplify the changes in the thyroid gland during exercise in order to seek an intervention for these transformations, aiming ultimately a good performance of the athlete.

The presentation of any psychiatric patient to a general hospital Emergency Department is at best a potential for disruption of the routine and requiring special care, special attention and precautions and definitely needing special logistics. The Emergency physician intervention is an emergency measure: IE life or limb saving intervention, so medical stabilization is a major goal. When it comes to well and seemingly healthy presentation with psychiatric symptoms or behavioral disturbances, the referral is made directly to the psychiatrist with little history of the current presentation and usually it is filed to consultation as “Abnormal Behavior”. We looked into this group to see what is hidden behind the blanket that label. Our results were congruent with many other published papers as to the frequency of non-psychiatric cases referred to psychiatry. A practical recommendation was derived from the experience in this paper we are discussing the results and the recommendations.

Background: The first requirement of this concept paper is proper understanding of homoeopathy, which throws a tough challenge before science. How do high potency (beyond 12c) homoeo-medicines, which are devoid of original medicinal substances, differ from one another and how such medicines cure diseases- these two mysteries of homoeopathy are yet to be solved to the satisfaction of scientists in general. Many investigators are seriously trying to solve these two-century-old mysteries. Method: This paper examines the works which are logically consistent and promising in nature. In this process it does not consider the works which try to explain the homoeo- mysteries in terms of presence of starting material in some form or other. It also examines the mechanism of action of main stream medicines. Result: Analysis of various works on homoeopathy fulfilling the above criteria suggests that structures of water or chemicals can serve as medicines. Further, finding a strong parallelism between mechanisms of action of homoeopathy and main stream medicines this article arrives at the structural model as a generalized concept of medicines stated as: A substance is to be recognized as a medicine if it has the capability of curing disease(s) while its medicinal property is to be attributed to molecular structure of vehicle like water or of distinct chemical substance when it exists. Conclusion: The structural model of medicines seems to have a general validity for all kinds of medicines - homoeopathy and non-homoeopathy.

The goal of this research paper is to propose an approach to uncovering important and previously unknown indicators that could prevent suicide by analyzing data released by the Centers for Disease Control and Prevention (CDC). The CDC data includes 75 variables that identify characteristics and demographics of the deceased. This paper describes the process of exploring data science methods to build a predictive model that could lead to prevention of suicide rate in USA. The data was explored with the Python programming language, R scripting language, RStudio and in the Tableau environment. Preliminary analysis of the CDC 2013 deaths by suicide data indicate that education was one of the important factors that lead to suicide; further analysis of this and other data may provide a new set of objective risk factors from one or more of the variables in this data set.

Policy makers and governments often pay little attention to support cancer registries and cancer research in Africa and mainly in East Africa. This paper demonstrates that an updated cancer registry data could be one of the main factors to control and treat cancer cases. The approach of the paper is situated in the broader studies of cancer registry and epidemiology and its effects on cancer control and treatment. The paper also shows why the findings of this study are significant. The paper makes recommendations that will hopefully help policy makers in understanding the problems and obstacles facing cancer registries and cancer genomics research in East Africa. The current study conducted a field research survey to assess the cancer registries, cancer epidemiology and cancer genomics research capabilities in five East African countries including Ethiopia, Eritrea, Sudan, Uganda and Kenya. Uganda and Kenya were included as cancer registry controls in order to compare the best practices and lessons learnt from the existing cancer registries. This will facilitate the formulation of appropriate policies and recommendations for improved cancer care and prevention in this region. The current study provided the baseline information for conducting cancer genome analyses in the near future in this region. The study also addressed the challenges facing these countries to have up-to-date cancer registries. The study adopted questionnaire and interviewing approach to conduct the field research survey. The questionnaire assessed the cancer registries, cancer epidemiology and cancer genomics research capabilities in these countries.

Nutritionists, health and food professionals need to be skilled in recognizing the various sources of calories in consumed foods and the implications of excessive caloric intake. Such skills are necessary in order to effectively counsel consumers and patients on food choices & weight management, or to advise food manufacturers to make and market products for better health. This paper will address the growing concern on overweight and obesity epidemic and the risks of excessive consumption of calories from various sources in our food supply, especially obvious and hidden calories. The paper will define what is meant by obvious and hidden sources of calories, with real life examples. Using data from published studies, the paper will discuss how caloric consumption impacts weight gain, obesity, health and wellness. Strategies for recognizing and reducing excessive caloric intake especially from hidden calories will be suggested. Such strategies would include lifestyle changes, dietary habits, physical activity, behavior modification, reading food labels, proper food selection & preparation, food substitution, food processing & consumption among others. A joint action by food consumers and regulators, food manufacturers & marketers, nutritionists, food and healthcare professionals will help consumers in managing weight and in fighting the overweight and obesity epidemic in many populations.

The purpose of my research paper is to analyze the proposed bill called the Healthy Teens Act. This bill would provide grant funding for comprehensive sexual education programs in New York State. The Healthy Teens Act would also establish standards for all programs receiving funding including medical accuracy, providing culturally appropriate and unbiased information, family communication, and healthy decision-making skills. The Healthy Teens Act would award grants to programs that exemplify these standards and would set high-need communities as a priority. Currently, there is no legal mandate for schools to teach sexual education in public schools in New York State, with the exception of HIV/AIDS education. The only incentive given to schools is federal funding for abstinence-only sexual education programs. In my paper, I compare the two different types of programs and their approaches to providing sexual education. I ultimately hope to show how a comprehensive sexual education program would ultimately be more effective in reducing teen pregnancy rates.

This paper reports on the favorable results obtained in patients with differing illnesses who were treated with Enercel reg homeopathic formulations The range of treatable illnesses does not support the homeopathic ldquo Laws of Similars rdquo with the implied specificity of action of each homeopathic remedy As summarized in this paper Enercel can provide clinical improvements to cancer patients as well as to patients with various infectious allergic and neurological illnesses Each of these illnesses is explainable as an insufficiency of cellular energy ICE required for normal biological functioning In addition to cellular energy obtained from food metabolism an environmental force termed KELEA kinetic energy limiting electrostatic attraction provides an alternative cellular energy ACE to the body This energy is expressed as a dynamic kinetic energy of the body fluids in support of various biological activities Enercel is prepared by progressively diluting various herbal compounds in water plus ethanol using facilities approved for Good Manufacturing Practices GMP Enercel attracts KELEA from the environment as can other formulations of KELEA activated water Upon administration to humans these solutions can potentially transfer the energy to the body and thereby enhance the ACE pathway Continuing clinical experience gained from using Enercel will help in the evaluation of other KELEA activated water based products as well as in the assessment of various ACE pathway enhancing technologies

culture experiments, almost all papers pass quickly over some steps description and leave the reader who wants to reconduct that experiment or a one based on it, unable to know necessary essential information, such as using a syringes or pipette tips to discard the medium, the time between adding a reagent and the plate reading, how the initial aliquots of a drug were prepared and how long they were stored and at what temperature before being utilized. In addition, many papers do not mention the purity percentage of the drug tested and how long it was prepared with the culture medium before being given to the seeded cells and this makes the reader unclear about essential information. Another example is western blotting experiment description; where many of the papers about this experiment steps neglect the clarification of the dilution method of the primary and secondary antibodies; being done in skimmed milk or a special solution for this process, and the specifications of all the reagents used in this experiment, such as those for preparing the loading buffer, etc. These steps are widely overlooked, but they are important to provide the reader with a precise description of the experiment, which is vital in scientific writing. This precision and comprehensiveness allow the experimenter reading the paper to be able to reconduct it with certitude. Particularly, for instance, the purity of a compound; if not mentioned could make great troubles for the reader, since impurities may influence the therapeutic and the toxic effect of the tested drug.

This paper examines the role of clinical decision support systems (CDSS) as a critical and increasingly prevalent tool in improving clinical practice. Using findings from previously published reference papers, books and other related studies, the paper demonstrates how clinical decision support systems are repeatedly being used in clinical practice to enhance quality of care, improve safety, reduce healthcare costs and heighten efficiency. Although findings from the reference papers, books and studies vary in how clinical decision support systems can advance clinical practice, they strongly identify improvements made in clinical practice as they relate to patient safety, medication errors, clinical workflows and processes, diagnostic processes, compliance with regulatory guidelines, disease management, patient outcomes, genomic and personalized medicine and cost of care.

Motivation Problem Statement nbsp This paper is critically evaluates a study that discusses the preferred infant cardiopulmonary resuscitation technique Confusion regarding infant cardiopulmonary resuscitation techniques is a common phenomenon that can result in life threatening situations Cardiopulmonary resuscitation techniques today are based on evidence gleaned from different studies and guidelines however few studies have discussed the superiority of one technique to another Therefore the aim of this paper is to identify the most effective cardiopulmonary resuscitation technique for infants Approach Method nbsp Research databases were searched for a study regarding cardiopulmonary resuscitation techniques in infants The search was limited to randomised control studies published in English within the last ten years conducted on humans A framework devised by Ingham Broomfield was used to critically analyse and review the article Results nbsp After critically appraising a study by Huynh et al the result was that the TT technique using a raised table should be the preferred technique to teach infant CPR to individuals Additionally the two thumb TT technique is preferable for infants less than one year old however if the rescuer s cannot physically encircle the victim rsquo s chest then the two finger TF technique would be more appropriate to achieve effective chest compressions Conclusion nbsp In conclusion it is difficult to ascertain the best method for infant cardiopulmonary resuscitation and there is a need for more studies to investigate the best infant cardiopulmonary resuscitation technique Future studies will help to improve current practice and will add to the evidence base of practice

This research paper examines the critical use of public health information systems in enhancing health outcomes research on populations. As a systematic review, the paper will explore five published articles on studies that address the ever-increasing application of public health information systems to public health outcomes research within the domain framework of population-level health quality measures, related health measures, and efficiency measures. The studies were conducted using different information systems as data sources such as the Nationwide Inpatient Sample (NIS), the Pediatric Health Information Systems Database, the Discharge Abstract Database (DAD) of the Canadian Institute for Health Information (CIHI), Geographic Information Systems (GIS), and CDC’s National Center for Health Statistics (NCHS). The systematic review found that those systems were successfully used in population-based studies in collecting, evaluating, interpreting, assessing, and investigating health data outcomes from which findings will later be used for improved public health planning.

Hand surgery is very much a psychomotor dominant specialty requiring the need for predictable, reliable and cost effective means of transferring and developing surgical skills. The need for a high quality simulations model to acquire skills is important in skill training. In this paper we identified real world problems of skill gaps in hand surgery and used the theories of instructional design (ID) to analyse the instructional needs in the problems and then generated solutions using the principles of ID. Based on the individual needs of the learners and entry behavior and characteristics, the framework developed instructional activities and materials and used the concept of the flipped classroom, allowing for effective and efficient transfer of information and skills allowing for adequate feedback and assessment to achieve the stated objectives of the instructions. It included generation of appropriate tools to evaluate the effectiveness of the whole ID framework. Trainees may be trusted to perform a professional task with sufficient independence. This professional activity that is required in the community is called a Entrustable Professional Activities (EPAs). EPAs are entrusted when a supervisor is confident the trainee can demonstrate the knowledge, skills and attitude required of the task, knows when to ask for additional help and can be trusted to seek assistance in a timely manner. The authors developed the EPA for trainees in hand surgery care based on prior unpublished research. 4 skill acquisition workshops were conceptualized and developed based on the ADDIE (Analyse, Design, Develop, Implement, and Evaluate) framework of Instructional Design. The 4 workshops were: Injured Hand Assessment; Flexor Tendon Workshop; Hand Fracture Fixation; Micro-neural repair workshop. The ADDIE and Gagnes 9 events of instruction framework was used to analyse the instructional goals and needs and formulated strategies to bridge the gap by developing the instructional events for delivery of the learning in the form of an intensive course to transfer knowledge and skills using a high fidelity simulated models. Using Gagnes 9 events of instruction, the curriculum, pedagogy, and assessment were developed and the resource materials were posted on an open online learning management system. (www.handsurgeryedu.com). This formed the basis of the flipped workshop to maximizing resources during the face to face skill acquisition workshops. This paper shows that the use of the Instructional Design models like ADDIE and Gagne’s nine events and the use of open educational resources hosted on an open learning management system is a useful strategy in designing surgical skill workshops and is a reliable and predictable tool in producing learning programs for surgeons in a cost effective manner.

This paper examines the critical application of image analysis in improving the diagnosis and management of breast cancer using techniques such as mammography, dedicated breast computed tomography (DBCT), background parenchymal enhancement (BPE), positron emission tomography, optical imaging, molecular imaging, automated whole breast ultrasound (AWBU), mechanical imaging, and optical coherence tomography (OCT). The paper performs a review of previously published studies and research on various imaging techniques currently used in the overall screening and assessment of breasts’ size, volume, composition, and density. Using findings from those studies, the paper demonstrates that such methods have been successfully applied into clinical practice to ameliorate health conditions of breast cancer patients and reduce mortality rate.

Objective: This paper is an examination of the experiences of a selected group of older Brazilians people which aims to analyse how they have been impacted by COVID-19 and, particularly, how they have been affected by protective social isolation measures. Methodology: 42 older residents of Sao Jose do Rio Preto were interviewed by phone. The applied script question was developed by International Longevity Centre the Netherlands, based at the Leyden Academy on Vitality and Aging. The data collection instrument consisted of five categories of analysis: social activities, social contacts and connectivity, well-being, vitality and health, and COVID-19 news and reports. Results: All in-person social activity ceased with the implementation of the isolation measures. Most of the interviewees pointed out to be suffering do to absence of their children, grand-children, other relatives and close friends from whom they have being apart since the beginning of the Corona virus pandemic. A large number of the interviewees recognized a worsening of their health condition and attributed it to the suspension of the physical activities and the social life that they had before isolation. Conclusion: The interviewed showed some insight about the experiences of older Brazilian adults during the COVID-19 pandemic. They all revealed a strong awareness of their physical vulnerability regarding corona virus. Most accepted the need to protect themselves through isolation or any other measures. However, there are barriers that difficulty the elderly people isolation as they live with of member of the family with different ages and in poor financial situations.

Objective: The aim of this paper is to illustrate the main points of interest regarding the way treatment of infertility impacts the life of couples who struggle with this condition in Romania. The unique aspects and specific challenges regarding social, financial and psychological implications that affect Romanian couples who access specialized treatment for infertility will be thoroughly discussed. Methods: This study is a descriptive cross-sectional research. The sample population included patients who attended specialized infertility treatment (Assisted Reproductive Techniques - ART) in Fertility Clinics from Romania. The study was conducted between 2017 and 2019 and data was gathered through two infertility questionnaires. Results: The questionnaire for women was filled in by 829 female participants who struggled with infertility and resorted to ART and the questionnaire for men was completed by 227 male participants, as partners of the women, some of them as well with fertility issues. We analysed the results regarding all aspects surrounding infertility and ART, such as: psychological implications, impact of stress, access to specialized treatment, costs for treatment. Conclusion: The results showed that couples who struggle with infertility have to deal with high costs for specialized infertility treatments, in addition to stress related to treatment, creating a combination which negatively impacts their future chances of getting a pregnancy.

Food and agriculture are playing key roles for many of the global challenges such as poverty, under-nutrition, obesity, climate change, and biodiversity loss which impacts the health of the population of the country thus also impacts the economy of both developed and developing countries differently. Many changes are already implemented from food production to consumptions from various sectors but the efforts are still not enough and in infancy. The food system is a complicated network of tasks involving various steps from production, to consumption. The food system includes other factors of sociological factors like governance, the economics of food production, culture, health, sustainability, and its effect on the natural environment. This research paper will propose the primary changes required in the food system, policies, and dietary perspective to construct an integrated methodology of intervention, after evaluating web of interconnected different indicator variable and analyzing the previous methods of intervention responsible for food sustainability directly and indirect, at two different levels local and global. I will address the root cause of a problem in food system which impacts the health which includes various sectors such as socially, economically and politically channel at various levels in the food system to help the United Nations’ Sustainable Development Goals (SDGs). Apart from this, the study also evaluates the economical burden from health issues resulting from the failing food system in developed and developing countries

A systematic review was carried out of the literature especially in humans reporting the origin, functions and neural changes of the subplate zone and the relationships with neurodevelopmental disorders and stress or nociceptive reaction in neonates. Thirty-two articles with established criteria were identified. Academic Google, SciElo, PubMed, Scopus, Cochraine Library and Web of Science databases were searched until January 2020 for scientific papers written in any language. Subplate neurons are present during embryogenesis of the nervous system and shortly after birth. Through them, the brain forms the first connections between the thalamus and the cortex originating sensory and cognitive capacities. Because of this, disorders involving migration and apoptosis failures or tissue injury can lead to psychiatric disorders, such as autism and schizophrenia, and to morphological alterations that may alter cognitive functions, modify the perception of pain in fetuses and neonates and have repercussions in adult life. Accumulative evidences reveal the importance of subplate neurons for neurodevelopment, previously ignored because they are transient cells. The elucidation of some morphological aspects of the cerebral cortex may explain mental disorders, the beginning of the perception of nociceptive stimuli and their implication in the long term.

An active ankle-foot orthosis (AAFO) was developed with the intent of providing propulsive ground reaction force to individuals at risk of experiencing fall. The device makes use of one double-acting cylinder per leg, and a lever arm system to transfer propulsive force to the ground, and potentially assist in fall prevention and rehabilitation. Preliminary tests have been shown to improve ground reaction forces in walking. In this paper, the design and construction of the device is included as well as the control algorithm used and testing procedure. This research may be used to advance the field of gait assistance and fall prevention through use of active foot orthotics.

Myasthenia Gravis (MG) and Neuromyelitis Optica Spectrum Disorder (NMOSD) are antibody-mediated channelopathies caused by complex immunological mechanisms, which are thus associated with multiple autoimmune diseases. This paper describes the case of a Colombian male patient with a history of seropositive MG that required thymectomy. After four years, he had an Optic Neuritis event and 30 years later, due to suspected autoimmune comorbidities, further investigations were performed, confirming the coexistence of NMOSD with presence of Anti-Aquaporin 4 (AQP4) antibodies (Abs). Several reports in the literature show that the coexistence of these two pathologies is more common than expected by chance. Few cases have been reported in Latin America, which makes this report meaningful. In contrast to our case, the literature shows a higher incidence among women, but, on the other hand, it is consistent with an onset with mild or moderate MG symptoms at the clinical presentation, most of which led to thymectomy, followed by manifestations of NMOSD. Timely diagnosis and the consequent therapeutic adjustment may have a significant impact on the disability of these patients. There is a need for more reports in order to extend the statistical information and to improve the characterization of these patients, primarily in our Latin American region.