A REPORT ON DIABETES AND RISK FOR CARDIOVASCULAR DISEASE

Patients with diabetes mellitus are at high risk of cardiovascular disease and the risk is further increased when they are complicated with nephropathy, neuropathy or Retinopathy. 33 patients were recruited into the study (patient group) along with 33 healthy individuals (control group). The control group was recruited from the people attending the master health checkup program of the hospital and staff of the department. In the present study we have evaluated the diabetes and risk for CVD in rural population of India. We found increased fasting glucose and total cholesterol in test subjects compared to control, but these are statistically not significant. An increase in glucose and lipid profile they are well with in the normal range. But these finding are crucial because they are at the higher normal range. This could be due to due to small number of population and age factor of the participants. Further studies which include more number of subjects from rural area will through more light on Prevalence of diabetes and risk for cardiovascular disease. &nbsp

Glycerol conversion to 1, 3-Propanediol is enhanced by the expression of a heterologous alcohol dehydrogenase gene in Lactobacillus reuteri

In this work, Lactobacillus reuteri has been metabolically engineered for improving 1, 3-propanediol (1, 3-PD) production by the expression of an Escherichia coli alcohol dehydrogenase, yqhD, that is known to efficiently convert the precursor 3-hydroxypropionaldehyde (3-HPA) to 1, 3-PD. The engineered strain exhibited significantly altered formation rates for the product and other metabolites during the fermentation. An increase in the 1, 3-PD specific productivity of 34% and molar yield by 13% was achieved in the clone, relative to the native strain. A concomitant decrease in the levels of toxic intermediate, 3-HPA, was observed, with the specific productivity levels being 25% lesser than that of the native strain. Interestingly, the recombinant strain exhibited elevated rates of lactate and ethanol formation as well as reduced rate of acetate production, compared to the native strain. The preferential utilization of NADPH by YqhD with a possible decrease in the native 1, 3-PD oxidoreductase (NADH-dependent) activity, could have resulted in the diversion of surplus NADH towards increased lactate and ethanol productivities

Utjecaj pojačane ekspresije gena biosintetskog puta za 3-hidroksipropionsku kiselinu na njezin prinos u bakteriji Lactobacillus reuteri

3-Hydroxypropionic acid (3-HP) is a novel antimicrobial agent against foodborne pathogens like Salmonella and Staphylococcus species. Lactobacillus reuteri converts glycerol into 3-HP using a coenzyme A-dependent pathway, which is encoded by propanediol utilization operon (pdu) subjected to catabolite repression. In a catabolite repression-deregulated L. reuteri RPRB3007, quantitative PCR revealed a 2.5-fold increase in the transcripts of the genes pduP, pduW and pduL during the mid-log phase of growth. The production of 3-HP was tested in resting cells in phosphate buff er and growing batch cultures in MRS broth of various glucose/glycerol ratios. Due to the upregulation of pathway genes, specific formation rate of 3-HP in the mutant strain was found to be enhanced from 0.167 to 0.257 g per g of cell dry mass per h. Furthermore, formation of 3-HP in resting cells was limited due to the substrate inhibition by reuterin at a concentration of (30±5) mM. In batch cultures, the formation of 3-HP was not observed during the logarithmic and stationary phases of growth of wild-type and mutant strains, which was confi rmed by NMR spectroscopy. However, the cells collected in these phases were found to produce 3-HP aft er washing and converting them to resting cells. Lactate and acetate, the primary end products of glucose catabolism, might be the inhibiting elements for 3-HP formation in batch cultures. This was confirmed when lactate (25±5 mM) or acetate (20±5 mM) were added to biotransformation medium, which prevented the 3-HP formation. Moreover, the removal of sodium acetate and glucose (carbon source for lactic acid production) was found to restore 3-HP formation in the MRS broth in a similar manner to that of the phosphate buff er. Even though the genetic repression was circumvented by the up-regulation of pathway genes using a mutant strain, 3-HP formation was further limited by the substrate and catabolite inhibition.3-Hidroksipropionska kiselina je novi antimikrobni agens koji se može upotrijebiti za suzbijanje patogenih bakterija u hrani, kao što su vrste iz rodova Salmonella i Staphylococcus. Bakterija Lactobacillus reuteri iz glicerola sintetizira 3-hidroksipropionsku kiselinu biosintetskim putem ovisnim o koenzimu A, kodiranim operonom za korištenje propandiola koji je reguliran kataboličkom represijom. U mutantu L. reuteri RPRB3007 u kojem nema kataboličke represije, ispitanom pomoću metode PCR, primijećeno je 2,5 puta više transkripata gena pduP, pduW i pduL, i to tijekom logaritamske faze rasta bakterije. Proizvodnja 3-hidroksipropionske kiseline određena je u stanicama koje se ne dijele, a bile su resuspendirane u fosfatnom puferu, te u šaržnim kulturama uzgojenim u podlozi MRS s različitim omjerima glukoze i glicerola. Utvrđeno je da se u mutantu zbog pojačane ekspresije gena biosintetskog puta povećala specifična brzina nastajanja 3-hidroksipropionske kiseline, i to s 0,167 na 0,257 g po gramu suhe biomase po satu. Osim toga, sinteza je 3-hidroksipropionske kiseline u stanicama koje se ne dijele bila usporena nakon dodatka reuterina u koncentraciji od (30±5) mM. U šaržnom uzgoju nije utvrđena prisutnost 3-hidroksipropionske kiseline tijekom logaritamske i stacionarne faze rasta divljeg soja i mutanta, što je potvrđeno i NMR spektroskopijom. Međutim, nakon ispiranja i povratka u stanje mirovanja ove su stanice ponovno proizvodile 3-hidroksipropionsku kiselinu. Zaključeno je da laktat i acetat, primarni produkti katabolizma glukoze, vjerojatno inhibiraju sintezu 3-hidroksipropionske kiseline u šaržnim kulturama, što je potvrđeno činjenicom da dodatak laktata u koncentraciji od (25±5) mM ili acetata u koncentraciji od (20±5) mM podlozi sprečava sintezu 3-hidroksipropionske kiseline. Osim toga, uklanjanjem je natrijevog acetata i glukoze (izvora ugljika za proizvodnju mliječne kiseline) potaknuta proizvodnja 3-hiroksipropionske kiseline u hranjivoj podlozi MRS na sličan način kao i uporabom fosfatnog pufera. Iako je genetička represija u mutantu izbjegnuta pojačanom ekspresijom gena biosintetskog puta, proizvodnja je 3-hidroksipropionske kiseline i dalje bila ograničena supstratom i kataboličkom inhibicijom

A Study to Assess the Level of Softskill Practices Among Nursing Students in Selected Colleges

Soft skills are the habits and traits that determine how a person operates in the workplace like communicating with others. Students are in a position to prove themselves in different aspects, which is not possible by technology. The soft skills identified as important in the workplace include communication, teamwork, motivation, problem-solving, enthusiasm, and trust. A quantitative, descriptive cross-sectional approach was used to assess the knowledge and practice of soft skills among nursing students at selected nursing colleges in Chennai. The target population was B. Sc Nursing Basic students in Chennai. There was a total of 305 students in the study. Data was collected using my 3s 5 point rating scale questionnaire, which Data developed was analyzed using SPSS version 23. The highest mean score (20.47 with SD 4.38) was observed in the soft skill domain of management and the lowest score was in writing and communication skills (20.23 with SD4.38). There was a statistically significant association found in soft skill domains of writing skill and management skill with fathers’ educational status and mothers’ occupational status at p<0.05 level. Soft skills are an internal part of the nursing profession. It reflects on approaches that would enable nursing students to grow in their profession

Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): A California Cancer Registry analysis

BackgroundNon-small cell lung cancer (NSCLC) is uncommonly diagnosed in patients younger than 50 years of age. We analyzed the California Cancer Registry (CCR) to describe epidemiologic characteristics and outcomes in this patient subset and to identify factors prognostic for cause-specific survival (CSS).MethodsPatients diagnosed with NSCLC between 1/1/98 through 12/31/09 and reported to the (CCR) as of October 2011 were included. The primary outcome measure was CSS. Cox regression models were used to evaluate predictors of CSS in young patients with NSCLC, adjusted for potential confounders. Interaction analysis was performed between age groups (&lt;50 vs. ≥50) and specific demographic and tumor covariates.ResultsWe identified 132,671 lung cancer cases, of which 114,451 (86.3%) had NSCLC. Of these, 6389 (5.6%) were&lt;50 years of age (median, 46 years). The most common histology was adenocarcinoma (3697, 57.9%). Most patients had stage III (1522, 23.8%) or IV (3655, 57.2%) disease. Fewer young patients were diagnosed in recent years (n, % of total NSCLC population of that era): 1998-2001 (2355, 6.0), 2002-2005 (2182, 5.7), and 2006-2009 (1852, 5.0), P&lt;0.001. Multivariate analysis showed that age &lt;50 years was an independent predictor of improved CSS (HR 0.827, P&lt;0.001). Significant predictors of better CSS in patients &lt;50 years included female sex, Asian or Hispanic ethnicity, lower stage, later year of diagnosis, and higher socioeconomic status, among others. Adenocarcinoma histology was not associated with improved CSS in this patient subset (HR 0.987, P=0.78). Interaction analysis revealed that Hispanic race and bronchioloalveolar histology had differential CSS outcomes dependent on age group.ConclusionsThis large registry study found that age &lt;50 years is an independent predictor of improved CSS. Variables prognostic for CSS differed somewhat from those in older patients

Policy Experimentation and Innovation as a Response to Complexity in China’s Management of Health Reforms

There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China’s reforms; this article argues that these processes have been important in rebuilding China’s health system. While China’s current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China’s management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which ‘what works’ is not knowable in advance. The article situates China’s use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China’s approaches to managing complexity in development of health systems for the benefit of the poor

Global burden of cardiovascular diseases and risk factors, 1990-2019 : Update from the GBD 2019 Study

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases