Development, validation and reliability of a questionnaire to evaluate coaches' and players' perceptions, learning, and resources regarding the ruck in rugby union.

Background: The lack of a reliable research tool for assessing the attitudes, behaviours, and learning resources of rugby coaches and players regarding the ruck event is a significant gap in rugby research. Objectives: This study aimed to adapt an existing questionnaire focused on the tackle event and to validate and establish the reliability of the instrument. The questionnaire explores the attitudes, behaviours, and learning resources of rugby coaches and players, with a focus on the ruck event and its impact on coach and player development, as well as coaching practices. Methods: A seven-step design process was followed to validate the questionnaire's content, construct, clarity, and relevance. A panel of 12 experts evaluated the questionnaire, followed by a test-retest procedure involving 15 coaches and 16 players, highlighting the effectiveness of this questionnaire, and emphasising its potential to generate data that can impact the field of rugby coaching and player development. Results: The questionnaire was deemed appropriate and clear by the expert panel, with an average completion time of 22 minutes. Moderate to good agreement was observed among players (ICC Agreement = 0.71) and coaches (ICC Agreement = 0.88), with high response consistency (ICC Consistency = 0.71 for players and 0.87 for coaches). Significant agreement was also found in Kendall's W scores (players = 0.85, coaches = 0.93, p<0.01). Conclusion: This study presents a developed questionnaire noted for its clarity, reliability, and consistency. It serves as a valuable tool for future rugby research, with the potential to impact coach and player development significantly.

A novel combination of sitagliptin and melatonin ameliorates T2D manifestations: studies on experimental diabetic models.

INTRODUCTION: Type 2 diabetes (T2D) is an endocrine disorder characterized by hyperglycemia, insulin resistance, dysregulated glucose and lipid metabolism, reduced pancreatic ß-cell function and mass, and a reduced incretin effect. Circadian rhythm disruption is associated with increased T2D risk. We have investigated the therapeutic potential of a combination of melatonin (M) and sitagliptin (S), a dipeptidyl peptidase IV (DPP-IV) inhibitor, in the amelioration of T2D manifestations in high-fat diet (HFD) induced T2D mouse model and also on ß-cell proliferation under gluco-lipotoxicity stress in vitro. METHODS: For in vivo study, mice were fed with HFD for 25 weeks to induce T2D and were treated with monotherapies and S + M for four weeks. For the in vitro study, primary mouse islets were exposed to normal glucose and high glucose + palmitate to induce gluco-lipotoxic stress. RESULTS: Our results suggest that monotherapies and S + M improve metabolic parameters and glyco-lipid metabolism in the liver and adipose tissue, respectively, and improve mitochondrial function in the skeletal muscle. Moreover, it increases peripheral insulin sensitivity. Our in vitro and in vivo studies suggest that ß-cell mass was preserved in all the drug-treated groups. CONCLUSION: The combination treatment is superior to monotherapies in the management of T2D.

COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care.

Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in primary care. The association between respiratory disease and methadone prescribing was examined using logistic regression. Models were adjusted for potential effects of clustering by practice. A total of 97.3% of patients prescribed methadone were cigarette smokers, either current (81.2%) or ex-smokers (16.1%). The prevalences of asthma and COPD were higher in methadone patients (14.2% and 12.4%, respectively) compared to non-methadone patients (4.4% and 1.1%, respectively). Methadone was an independent determinant of asthma, adjusting for smoking status (OR 3.21; 95% CI: 2.52, 4.10) or for smoking intensity (3.08; 2.27, 4.19), and of COPD, adjusting for smoking status (6.00; 4.61, 7.80) or for smoking intensity (5.80; 4.12, 8.17). COPD and asthma prevalence were substantially higher in those prescribed methadone compared to those never prescribed methadone. Prescription of methadone was an independent predictor for both COPD and asthma, even after adjustment for smoking status and smoking intensity. Possible explanations include confounding by association with smoking of heroin or crack cocaine, both of which may have a causal association with COPD and asthma.

The association of fever with transfusion-associated circulatory overload.

BACKGROUND: Fever is described in transfusion-associated circulatory overload (TACO), reflecting either comprehensive haemovigilance or an inflammatory pathobiology (such as congestion-associated atheroma disruptions). METHODS: Hospital haemovigilance data (1/1/2010-31/12/2012) were reviewed for TACO cases (frequency and mode of referral). TACO with or without fever (TACO+F/-F) was examined for its association with patient age (as a surrogate for atheroma burden) and product age (as a surrogate for storage-related pyrogens). Fever in allergic transfusion reactions was also compared. RESULTS: Of 972 reactions, 107 suspected cases of TACO (11%) were seen. TACO+F vs. TACO-F occurred in 42·1 vs. 57·9%, respectively. TACO+F cases were discovered in referrals to investigate either a fever (in 47·1%) or dyspnoea (in 52·9%). Among TACO+F cases, 24·4% had already been febrile, whereas 75·6% exhibited a new reaction-associated fever. After excluding preexisting fevers, TACO+F occurred in 31·8% of TACO, compared with 8·2% of allergic reactions with fever, for an odds ratio of 5·2 (2·9-9·4 [95% CI]), P < 0·001. TACO+F/TACO-F showed no difference in median host age (69 vs. 64 years, P = 0·3), RBC age (22 days +F/-F, P = 0·9) or severity. CONCLUSION: Transfusion-associated circulatory overload disproportionately exhibits fever compared with allergic reactions. However, TACO+F did not associate with patient or product age, nor reflect severity. To better understand TACO+F, the fever-congestion sequence merits attention. Further study is needed to see whether TACO+F occurs as reproducibly elsewhere, and in association with atherosclerosis in a better characterized cohort.

TIPS to manipulate myogenesis: retention of myoblast differentiation capacity using microsphere culture.

Cell therapy is an emerging option for regenerating skeletal muscle. Improved delivery methods for anchorage-dependent myoblasts are likely to improve integration and function of transplanted muscle cells. Highly porous microspheres, produced using thermally induced phase separation (TIPS), have features ideally suited for minimally invasive cell delivery. The purpose of this study was to investigate, for the first time, the use of TIPS microspheres as highly porous microcarriers for manipulation of human skeletal muscle myoblasts (HSMM) under defined culture conditions. HSMM cells readily attached to the surface of poly (DL-lactide-co-glycolide) (PLGA) TIPS microcarriers, where they were induced to continue proliferating or to be driven towards differentiation whilst under static-dynamic culture conditions for 7 days. Switching from proliferation medium to differentiation medium for 7 days, resulted in increased protein expression of skeletal muscle cell contractile apparatus components, MyoD and skeletal muscle myosin heavy chain, compared with cells cultured on conventional culture plasticware for the same duration (p < 0.001). Growth of myoblasts on the surface of the microcarriers and their migration following simulated delivery, caused no change to the proliferative capacity of cells over 7 days. Results from this study demonstrate that TIPS microspheres provide an ideal vehicle for the expansion and delivery of myoblasts for therapeutic applications. Transplantation of myoblasts anchored to a substrate, rather than in suspension, will reduce the amount of ex vivo manipulation required during preparation of the product and allows cells to be delivered in a more natural state. This will improve the ability to control cell dosage and increase the likelihood of efficacy.

Colonisation of dentures by Staphylococcus aureus and MRSA in out-patient and in-patient populations.

Methicillin-resistant Staphylococcus aureus (MRSA) is an important human pathogen, and colonisation with this organism can result in localised or systemic infections which may be fatal. One hundred in-patients admitted to a London teaching hospital and 100 out-patients attending prosthetic dentistry clinics were recruited into this study. Of the 100 out-patients, 27 % harboured S. aureus on their dentures, compared to 33 % of in-patients. Only one out-patient had MRSA colonising their dentures whereas 12 % of the in-patients harboured MRSA. The median total bacterial count of the denture plaque samples was 6.2 × 10(7) cfu/sample and 6.9 × 10(7) cfu/sample for the out-patient and in-patient populations, respectively. In most instances, where present, S. aureus comprised less than 1 % of the total viable denture microbiota. Phage typing demonstrated that EMRSA-15 and non-typeable strains were harboured on dentures. The results of this study have revealed that dentures are a potential reservoir of MRSA and so account should be taken of these findings when planning decontamination procedures for elimination of this pathogen.

Kindler syndrome with severe mucosal involvement in childhood.

Kindler syndrome (KS) is an inherited dermatosis linked to the FERMT1 gene, and is characterized clinically by trauma-induced acral skin blisters in infancy and childhood, photosensitivity, and progressive poikiloderma. We report a case of KS in a 7-year-old Indian girl with severe mucosal involvement of the oral cavity and genitourinary tract. Mutation analysis in the girl showed a homozygous FERMT1 mutation, c.862C>T, p.R288*. The clinical manifestations in patients with KS show significant inter individual variation, even with the same type of mutations and within members of the same family. Our case highlights the role of environmental modifiers in regulating the clinical features of KS.

Draft Genome Sequence of Petroleum Hydrocarbon-Degrading Pseudomonas aeruginosa Strain PK6, Isolated from the Saurashtra Region of Gujarat, India.

Pseudomonas aeruginosa strain PK6, a potential petroleum hydrocarbon-degrading soil bacterium, was isolated from a site contaminated by a petroleum hydrocarbon spill from an automobile service station in Junagadh, Gujarat, India. Here, we provide the 6.04-Mb draft genome sequence of strain PK6, which has genes encoding enzymes for potential and related metabolic pathways of the strain.

Draft Genome Sequence of Textile Azo Dye-Decolorizing and -Degrading Pseudomonas aeruginosa Strain PFK10, Isolated from the Common Effluent Treatment Plant of the Ankleshwar Industrial Area of Gujarat, India.

Here, we report the draft genome sequence of Pseudomonas aeruginosa strain PFK10, isolated from the common effluent treatment plant (CETP) of the Ankleshwar industrial area of Gujarat, India. The 6.04-Mb draft genome sequence of strain PFK10 provides information about the genes encoding enzymes that enable the strain to decolorize and degrade textile azo dye.

Bacterial diversity associated with feeding dry forage at different dietary concentrations in the rumen contents of Mehshana buffalo (Bubalus bubalis) using 16S pyrotags.

Pyrosequencing of 16S rRNA gene targeting bacteria was applied to identify diet-induced shifts in the microbiome of both solid and liquid ruminal fractions retrieved from water buffalo fed different diets. The depth of coverage of metabolically active bacteria in a community using different primer pairs was also investigated. To assess reproducibility, animal to animal variation was considered in all phylogenetic and community comparisons. The experiment included four non-lactating water buffaloes fed three different diets for six weeks each; diets were M1 (50% concentrate: 50% dry roughage), M2 (25% concentrate: 75% dry roughage) and M3 (100% dry roughage). A total of 333, 851 pyrotags were analyzed in this study. Phylogenetic analysis revealed significant differences in the rumen microbiome mediated by primer and diet (P < 0.05). Differences in community composition due to primer, diet, fraction and animal were compared using unweighted and weighted UniFrac analysis. Clustering of communities was largely explained by primer differences in both weighted and unweighted UniFrac analyses (P < 0.001). In the weighted analysis, communities clustered by diets (P < 0.05) and fractions (P < 0.08) while no inter-animal variation was observed. The identified repertoire of bacterial populations was dependent on the primer pair, as targeting the V4-V5 region resulted in greater diversity profiles of the microbiome. Within each primer pair, dietary changes altered the community composition with noticeable shifts at genus level. Genera such as Ruminococcus and Fibrobacter (P < 0.05) were higher in abundance on M3 diet while Prevotella dominated (P < 0.05) on M1 diet.

Metagenomic analysis of buffalo rumen microbiome: Effect of roughage diet on Dormancy and Sporulation genes.

Buffalo rumen microbiome experiences a variety of diet stress and represents reservoir of Dormancy and Sporulation genes. However, the information on genomic responses to such conditions is very limited. The Ion Torrent PGM next generation sequencing technology was used to characterize general microbial diversity and the repertoire of microbial genes present, including genes associated with Dormancy and Sporulation in Mehsani buffalo rumen metagenome. The research findings revealed the abundance of bacteria at the domain level and presence of Dormancy and Sporulation genes which were predominantly associated with the Clostridia and Bacilli taxa belonging to the phyla Firmicutes. Genes associated with Sporulation cluster and Sporulation orphans were increased from 50% to 100% roughage treatment, thereby promoting sporulation all along the treatments. The spore germination is observed to be the highest in the 75% roughage treatment both in the liquid and solid rumen fraction samples with respect to the decrease in the values of the genes associated with spore core dehydration, thereby facilitating spore core hydration which is necessary for spore germination.

Complete Genome Sequence of Escherichia Phage ADB-2 Isolated from a Fecal Sample of Poultry.

Escherichia phage ADB-2 was isolated from a chicken fecal sample. It is a virulent phage and shows effective inhibition of Escherichia coli strains. Here we announce the completely sequenced genome of Escherichia phage ADB-2, and major findings from its annotation are described.

Whole-genome shotgun sequencing of the extremophile Alkalibacillus haloalkaliphilus C-5, of Indian origin.

Alkalibacillus haloalkaliphilus C-5 is a haloalkaliphilic bacterium that was isolated from a soil sample from the salty Sambhar Lake, Rajasthan, India. The organism is capable of alkaline protease production under conditions of pH 10 and 10% (wt/vol) salt. We sequenced and have reported the whole genome of Alkalibacillus haloalkaliphilus C-5, of Indian origin, for the first time.

Inappropriate Use of Hospital Beds in a Tertiary Care Service Hospital.

BACKGROUND: The cost of medical care is continuing to rise and cost containment measures need to focus on inappropriate hospitalization. Armed Forces Medical Services ensure universal access to its consumers but continuous increase in patient load is stretching the capability of service hospitals. The present study was undertaken to determine the rate of inappropriate hospitalization in a large tertiary care service hospital. METHODS: Appropriateness Evaluation Protocol (AEP) was used to assess the appropriateness of hospital days, the study being carried out in the acute medical and acute surgical wards of the hospital on randomly selected days over a period of three months. RESULTS: Inappropriate patient days were found to be 29.48% during the study period, with 34% of acute surgical patient days and 24.4% of acute medical patient days found to be inappropriate. No statistically significant difference was observed in the rate of inappropriate hospital stay between serving personnel and ex-servicemen. 31.25% non local patients as compared to 25.81% of local patients were found to have inappropriate hospital stays, though the difference was not found to be statistically significant. 60.71% of inappropriate stays were found in the initial period of admission (1-5 days), the phenomenon being observed both in the acute surgical and acute medical wards. CONCLUSION: The study shows that the rate of inappropriate patient days is quite high among the study population and regular utilization reviews need to be carried out to conserve health care resources available with the service hospitals.

Attenuation mapping for monitoring thermal therapy using ultrasound transmission imaging.

The use of an ultrasound (US) transmission imaging system to monitor attenuation changes during tissue heating was investigated. This work presents preliminary results of images obtained from an acoustic camera before, during and after heating tissue phantoms using a heated needle. Two types of tissue-mimicking phantoms were used, agar and polyacrylamide-based. Regions of interests were chosen in images obtained from the real-time imaging system, and the pixel intensity values before, during and after heating were compared. In both phantoms, a decrease in image intensities was observed during heating, indicating an increase in tissue attenuation. Additionally, an irreversible change in image intensity was observed in regions close to the heat source. The reversibility of the intensity change was shown to be a function of the distance from the heating needle to the selected region. Initial results indicate that US transmission imaging can be used to monitor thermal therapy.

Antiasthmatic property of polyherbal preparation E-721 B.

E-721B and its aqueous extract were studied for its antiasthmatic effect in various experimental models using rats and guinea pigs. E-721B produced significant and dose-dependent inhibition of peritoneal mast-cell degranulation induced by compound 48/80 and egg-albumin in sensitised rats. The inhibition was comparable to that with disodium cromoglycate, ketotifen, and prednisolone. E-721B administered 2 h before the experiment and once daily for seven days significantly increased the preconvulsion time of acetylcholine and histamine aerosol-induced bronchospasm. It also significantly reduced mortality in guineapigs produced by egg albumin-induced anaphylactic shock and also reduced bronchoalveolar fluid eosinophil count in the same animals. E-721B significantly inhibited the acetylcholine and histamine-induced contraction of different isolated smooth muscle preparations from rats and guinea pigs. Contrary to these findings E-721B produced dose-dependent contraction of the rat anococcygeus muscle which was blocked by prazosin. Thus our observations establish the antiasthmatic potential of this herbal formulation.

Enzyme treatment to reduce solids and improve settling of sewage sludge.

The effect of microbial enzymes in reducing the disposable solid content of sludge was investigated. A mixture of industrial cellulase, protease, and lipase, in equal proportion by weight, reduced total suspended solids (TSS) by 30-50% and improved settling of solids. An increase in solid reduction was observed with increasing enzyme concentration. The effect of combinations of enzyme treatments indicated that two-enzyme combinations of protease and cellulase produced better solid reduction than individual enzymes and that lipase further augmented this effect. Among the individual enzymes, protease produced a more settleable sludge as compared to cellulase and lipase. Adjustment of the pH of the enzymatically treated sludge to the acidic range (pH 2-4) further improved solid reduction, and adjustment to the alkaline range (pH 10-12) improved settleability.

TOTAL QUALITY MANAGEMENT - THE NEW PARADIGM IN HEALTH CARE MANAGEMENT.

Hospitals are by nature complex organisations and the complexity is compounded in service hospitals with perceived notion of service deficiencies. Quality has emerged as a major issue in health care sector and TQM has been accepted as a major long-term strategic initiative towards continuously improving quality of health care. Key concepts of TQM start with top management leadership with emphasis on process and customer focus. Implementation of TQM in service hospitals will require Quality Management awareness, training and framework development as well as development of customer awareness. TQM has been widely applied in clinical field with successful outcome. TQM is not a short-term solution, it has to be understood and practised as a long-term strategic commitment.