Miracle-dz/UniFAR-FTUs huggingface dataset:
Stability-Indicating RP-HPLC Method for the Quantification of Paliperidone in Bulk and Solid Dosage Form to Establish Validation and Stability Indicating Parameters

Objectives: In the present research work, stability indicating reverse phase high performance liquid chromatography method was developed and validated for the quantification of paliperidone in bulk and solid dosage form. Materials and Methods: The chromatographic separation of paliperidone was carried out using Phenomenex, Gemini NX, Octadecyl silane column (150x4.6 mm, 5 μm, particle size) with the mobile phase consisting of methanol: acetonitrile: 0.15% v/v triethylamine in water (pH 6) in the ratio of 50:20:30 v/v, flow rate was determined at 1 ml/min. UV detection wavelength was observed at 237 nm. Method validation and stress testing was carried out as per ICH guidelines Q2 (R1) and Q1A (R2) to demonstrate the suitability and specificity of the method. Results: The developed method had shorter retention time of 3.2 min. The RSD for system, method and intermediate precision in all instrumental condition was found to be less than 2% and the mean recovery was found to be 100.64%. Linearity range was obtained at concentration range of 7.5-150 μg/ml with a regression coefficient (R2) of 0.999. Detection and quantification limits for paliperidone were found to be 0.14 and 0.42 μg/ml, respectively. The developed method could separate the potential degradation products from the analyte peak. Conclusion: The results of validation were found to be satisfactory in all tested validation parameters suggested that the developed method is specific, precise, accurate and robust. Hence, this method would be applied for quantification of paliperidone in bulk and solid dosage form.
THE REASONS ACUTE STROKE PATIENTS NOT RECEIVING THROMBOLYSIS IN AN INDONESIAN REFERRAL HOSPITAL

Objective: The aim of this study was to identify reasons acute stroke patients did not receive thrombolysis despite meeting Code Stroke activation criteria in Cipto Mangunkusumo General Hospital during November 2015 until February 2019. Methods: This study retrospectively collected data of adult (aged>18 y old) acute stroke patients admitted to Cipto Mangunkusumo General Hospital from November 2015 to February 2019 who met criteria for Code Stroke activation but did not undergo thrombolysis. Patient’ data were collected from Code Stroke Registry of Cipto Mangunkusumo General Hospital. Results: There were 518 acute stroke patients who had Code Stroke activated in Cipto Mangunkusumo General Hospital from November 2015 to February 2019. 76.3% of acute stroke patients did not receive thrombolytic therapy (n=395). Hemorrhage on computed tomography (CT) scan was the most common reason patients did not receive thrombolysis. The following most common reasons were low or improved National Institutes of Health Stroke Scale (NIHSS) score, family refusal, and exceedance of time window. Conclusion: Hemorrhage on CT scan was the most common reason patients did not receive thrombolysis following by low or improved NIHSS score, family refusal, and exceedance of time window.
Ultrasound Guided Tunnelled Cuffed Catheter Placement Without Fluoroscopic Guidance By Anatomical Landmarks; Accuracy And Safety.

BACKGROUND Chronic kidney disease is a growing disease with high morbidity and mortality. Haemodialysis remains the most common option available for all those not planning for renal transplantation. Vascular access is the most important aspect of haemodialysis. Though not recommended but central venous catheters remain the most common vascular access in starters on haemodialysis. There is a growing trend towards placement of tunnelled cuffed catheters (TCC). Tunnelled cuffed catheters placement requires fluoroscopic guidance which is not available in all centres. The rationale of this study was to describe safety and accuracy of a catheter placement technique not dependent on fluoroscopic guidance for resource limited settings. METHODS Dialysis dependent patients of a single hospital without long term vascular access were selected over a period of 15 months after getting informed written consent. A new technique was described in which depth of catheter was estimated by superficial anatomical and ultrasound guided measurements for TCC placement which were checked by conventional chest radiography post procedure. RESULTS A total of 209 catheters were placed over a period of 15 months, 189 males and 30 females. Various sites were used predominantly right Internal jugular vein (IJV) (85.6%). Overall success rate was 97.1% (98.3% males, 90% females, p=0.08). Right IJV was successful 98.9%, left IJV 87.5% (p<0.001). Multiple thrombosed/stenosed veins were associated with higher failure rate (p<0.001). CONCLUSIONS Tunnelled cuffed catheters can be placed successfully and safely in right IJV under ultrasound guidance using anatomical landmark measurement technique without fluoroscopic guidance.
Malnutrition and cardiovascular risk in haemodialysis patients with chronic kidney disease

ABSTRACT Objective To verify the association between nutritional status and traditional and non-traditional cardiovascular risk factors in haemodialysis patients. Methods A cross-sectional study with 132 patients over 18 years of age on haemodialysis to evaluate nutritional status through Subjective Global Assessment. Information on traditional and non-traditional cardiovascular disease risk factors were obtained using a structured questionnaire; the Framingham score was also used to assess cardiovascular risk. Data analysis was performed using the Chi-square Test or Fischer Exact Test and a Log-binomial Regression Model. Results Malnutrition affected 31.1% of patients. Among them, a higher percentage of smokers (p=0.016), former smokers (p=0.034) and diabetes Mellitus patients (p=0.001) were detected. Malnutrition was found to be 4.53 times more prevalent in diabetic individuals (95%CI: 1.99-10.27) and 2.26 times more prevalent among former smokers (95%CI: 1.04-4.95). Malnourished individuals exhibited a 4.03 times prevalence of moderate to severe cardiovascular risk. Conclusion A high prevalence of malnutrition and of other risk factors for cardiovascular disease were observed. Such factors included diabetes Mellitus, smoking and former smoker conditions and were associated with malnutrition. Inaddition, it was found that malnourished individuals were more likely to develop cardiovascular disease within 10 years.
Protocol for an observational study evaluating new approaches to modelling diagnostic information from large administrative hospital datasets

The Charlson and Elixhauser indices define sets of conditions used to adjust for patients’ comorbidities in administrative hospital data. A strength of these indices is the parsimony that results from including only 19 and 30 conditions respectively, but the conditions included may not be the ones most relevant to a specific outcome and population. Our objectives are to: (1) test an approach to developing parsimonious indices for the specific outcome and populations being studied, while comparing performance to the Charlson and Elixhauser indices; and (2) evaluate several approaches that involve models with more diagnosis-related terms and aim to improve prediction performance by capturing more of the information in large datasets.This is a modelling study using a linked national dataset of administrative hospital records and death records. The study populations are patients admitted to hospital for acute myocardial infarction, hip fracture, or major surgery for colorectal cancer in England between 1 January 2015 and 31 December 2017. The outcome is death within 365 days of the date of admission (acute myocardial infarction and hip fracture) or procedure (colorectal surgery). In the ‘First analysis’, prognostic indices will be developed based on the presence/absence of individual ICD-10 codes in patients’ medical histories. Logistic regression will be used to estimate associations with a full set of sociodemographic and diagnostic predictors from which reduced models (with fewer diagnostic predictors) will be produced using a step-down approach. In the ‘Second analysis’, models will also account for the timing that each ICD-10 code was last recorded and allow for non-linear relationships and interactions between conditions and the timings of records. Validation will include an overall measure of performance (scaled Brier score) and measures of discrimination (c-statistic) and calibration (such as the Integrated Calibration Index) in bootstrap or cross-validation samples. Sensitivity analyses will include varying the length of medical history analysed, using a comparator that combines the Charlson and Elixhauser sets of conditions, and aggregating ICD-10 codes into clinical groups.
Sleep Instability in Adults with NonRefractory Temporal Lobe Epilepsy

Temporal Lobe Epilepsy (TLE) is characterized by a number of clinical conditions or epileptic syndromes with partial complex seizures [1]. TLE is the most common epileptic syndrome in adults [2], and approximately 30% to 40% of these patients exhibit refractory seizures [3]. A relationship between refractory seizures and changes in the organization of sleep has been described in patients with TLE compared to normal controls [4,5]. Sleep and epilepsy exert a reciprocal effect [6-9]. Sleep stages modulate interictal and ictal epileptic phenomena: NREM sleep facilitates these phenomena, whereas REM sleep inhibits them [10]. Sleep may also cause important changes in interictal EEGs, particularly in terms of frequency, morphology, spatial distribution of epileptic discharges and seizure occurrence, also the thalamocortical and corticothalamic projections mediate a complex pattern of reciprocal interactions between thalamus and the cortex [11]. Interictal manifestations in the form of sharp-waves recorded in EEGs result from the depolarization and hyper polarization of cortical neurons [12]. In addition, processes relating to slow-wave sleep, including the progressive hyper polarization of thalamocortical neuronal projections may contribute to the activation of interictal epileptogenic discharges in partial epilepsy [13].
Current paradigms in the prehospital care of exertional heat illness: A review

Exertional heat illness, including muscle cramps, heat syncope, heat exhaustion, and heat stroke, occur each year in athletes and military soldiers. Exertional heat stroke, the most concerning type of exertional heat illness, is a life-threatening condition defined clinically by a core body temperature greater than 104° F (40°C) and central nervous system dysfunction. Heat stroke may lead to multiorgan failure and death and is one of the leading causes of nontraumatic death in athletes participating in outdoor activities. Current recommendations are discussed regarding prehospital and first responder care of exertional heat illness, particularly heat stroke, with an emphasis on rapid recognition, assessment, and implementation of cooling and advanced care strategies. This overview is of particular interest to orthopaedic team physicians who often are first responders on the field.
Detailing postoperative pain and opioid utilization after periacetabular osteotomy with automated mobile messaging

Abstract In the setting of periacetabular osteotomy (PAO), this investigation sought to (i) describe patient-reported pain scores and opioid utilization in the first 6 weeks following surgery and (ii) evaluate the effectiveness of postoperative communication using a robotic mobile messaging platform. Subjects indicated for PAO were enrolled from a young adult hip clinic. For the first 2 weeks after surgery, subjects received daily mobile messages inquiring about pain level on a 0–10 scale and the number of opioid pain medication tablets they consumed in the previous 24 h. Messaging frequency decreased to 3 per week in Weeks 3–6. Pain scores, opioid utilization and response rates with our mobile messaging platform were quantified for the 6-week postoperative period. Twenty-nine subjects underwent PAO. Twenty-one had concurrent hip arthroscopy. Average daily pain scores decreased over the first four postoperative days. Average pain scores reported were 5.9 ± 1.9, 4.1 ± 3.3 and 3.0 ± 3.5 on Day 1, Day 14 and Week 6, respectively. Reported opioid tablet utilization was 5.0 ± 3.2, 2.2 ± 2.0 and 0.0 ± 0.0 on Days 1 and 14 and at 6 weeks. Response rate for participants completing the 6-week messaging protocol was 84.1%. Patient-reported pain scores decreased over the first two postoperative weeks following PAO before plateauing in weeks 3–6. Opioid pain medication utilization increased in the first postoperative week before gradually declining to no tabs consumed at 6 weeks after PAO. Automated mobile messaging is an effective method of perioperative communication for the collection of pain scores and opioid utilization in patients undergoing PAO.
Analyzing the Role of DNA Hydroxymethylation in BDNF Gene in case of Type 2 Diabetic Retinopathy

confluency; cells were treated by different concentration of DMOG at different time intervals. 5hmc level was examined using oligo primers in BDNF gene region. Positive results were found in at DMOG concentration (75µM-12h, 100 µM-12h and 75µM-24h) in Type 2 Diabetic Retinopathy Patient retinal sample & at DMOG concentration (75µM-12h and 75µM-24h) in Type 2 Diabetic Mellitus Patients retinal sample.
Prevalencia del síndrome de burnout y su relación con el afrontamiento en profesionales de la salud de la zona 7

Este trabajo de investigación estuvo en función determinar la prevalencia del síndrome de burnout y su relación con estrategias afrontamiento con una muestra de 142 médicos. Los instrumentos utilizados fueron: Cuestionario sociodemográfico [Ad hoc], Maslach Burnout Inventory [MBI] Maslach y Jackson (1986); y COPE-28 [Brief COPE] Carver (1997). En relación con la prevalencia del síndrome de burnout se identificó un 2.8%. Los altos niveles de agotamiento emocional fueron 25.8%, en despersonalización el puntaje alto fue de 17.6% y con una baja realización personal de 61.2%. Las estrategias de afrontamiento que presentaron una media mayor a 4.5 y una desviación estándar 1.9 fueron, replanteamiento positivo, aceptación, planificación y apoyo instrumental en cuanto a la correlación entre las estrategias de afrontamiento y el burnout existe un nivel de significancia alto con: autodistracción r(142)= -. 147 p< 0.001, afrontamiento activo r( 142)= -. 313 p< 0.001 desahogo r(142)= . 208 p= 0.011, replanteamiento positivo r(142)= - . 313 p< 0.001 y culpa r(142)=. 179 p=0.029.
Estimates of the global burden of Japanese encephalitis and the impact of vaccination from 2000-2015

Japanese encephalitis (JE) is a mosquito-borne disease, known for its high mortality and disability rate among symptomatic cases. Many effective vaccines are available for JE, and the use of a recently developed and inexpensive vaccine, SA 14-14-2, has been increasing over the recent years particularly with Gavi support. Estimates of the local burden and the past impact of vaccination are therefore increasingly needed, but difficult due to the limitations of JE surveillance. In this study, we implemented a mathematical modelling method (catalytic model) combined with age-stratifed case data from our systematic review which can overcome some of these limitations. We estimate in 2015 JEV infections caused 100,308 JE cases (95% CI: 61,720–157,522) and 25,125 deaths (95% CI: 14,550–46,031) globally, and that between 2000 and 2015 307,774 JE cases (95% CI: 167,442–509,583) were averted due to vaccination globally. Our results highlight areas that could have the greatest benefit from starting vaccination or from scaling up existing programs and will be of use to support local and international policymakers in making vaccine allocation decisions.
Recent Advancements in Spectrophotometric pKa Determinations: A Review

The pKa value is a key feature in Absorption, Distribution, Metabolism and Excretion (ADME) of drugs, thus knowing this value is critical in drug development. In this review,pKa values determined in the past decade, using UV-Vis spectrometry, are discussed. To determine the pKa, four methods were applied; Henderson-Hasselbach, Albert-Serjeant,Bates- chwarzenbach and Spectrometric titrations. This review will show the value of this aged but well-established technique in the past decade, due to its simplicity,accuracy, cost efficiency and reproducibility
Impact of mutations in epigenetic modifiers in acute myeloid leukemia: A systematic review and meta-analysis

This is a systematic review and meta-analysis evaluating the prognostic significance of epigenetic mutations on the overall survival (OS) in Acute Myeloid Leukemia (AML). We searched for studies evaluating epigenetic mutations in AML (up to November 2018) in PubMed, Trip database and Cochrane library. Hazard ratio (HR) of outcomes were extracted, and random-effects model was used to pool the results. A total of 10,002 citations were retrieved from the search strategy; 42 articles were identified for the meta-analysis (ASXL1 = 7, TET2 = 8, DNMT3A = 12, IDH =15), with fair to good-quality studies. The pooled HR was 1.88 (95% CI: 1.49−2.36) for ASXL1 mutation, 1.39 (95% CI: 1.18−1.63) for TET2 mutation, 1.35 (95% CI 1.16-1.56) for DNMT3a and 1.54 (95% CI: 1.15-2.06) for IDH mutation. However, there was a substantial heterogeneity in the DNMT3a and IDH studies. In conclusion epigenetic mutations in ASXL1, TET2, DNMT3a and IDH adversely impact OS in patients with AML albeit with considerable heterogeneity and possibly publication bias. Further studies are required to address these limitations.
Bacterial Reduction of Hand Contamination: Hand Rubbing with Alcohol-Based Solution or Handing Washing with Soap and Water?

Health care-associated infections (HAIs) occur worldwide and affect both developed and developing countries. Hand hygiene, including hand washing (washing hands with plain soap), hygienic hand washing (washing hands with medicated soap) and hygienic hand rubbing (use of antiseptic rubs or solutions) had been recommended as effective in preventing and controlling HAIs. Thus a mini-review was conducted to answer the question is alcohol-based hand sanitizer more effective than standard hand washing with soap and water in bacterial reduction during patient care? Two studies were reviewed which showed statistically significant difference between before and after hand rubbing with alcohol-based and hand washing with soap and water. However bacterial reduction in alcohol-based solution was higher than that of soap and water (0.85 vs 0.58). Keywords: hand hygiene, hand washing, hand rubbing, bacterial reduction DOI : 10.7176/JHMN/67-09 Publication date :October 31 st 2019
Sustainability in critical care practice: A grounded theory study.

BACKGROUND Sustaining high-quality, critical care practice is challenging because of current limits to financial, environmental, and social resources. The National Health Service in England intends to be more sustainable, although there is minimal research into what sustainability means to people working in critical care, and a theoretical framework is lacking that explains the social processes influencing sustainability in critical care. AIMS AND OBJECTIVES This study aimed to explain the concept of sustainability from the perspective of practitioners caring for critically ill patients. DESIGN The qualitative research followed a Charmazian constructivist grounded theory approach, including concurrent data collection and interpretation through constant comparison analysis. METHODS In-depth interviews were conducted online or by telephone with 11 health care professionals working in critical care in the South of England (8 nurses, 2 physiotherapists, and 1 technician). Schatzman's dimensional analysis and Straussian grounded theory techniques supplemented the data analysis. RESULTS Sustainability was defined as maintaining financial, environmental, and social resources throughout the micro, meso, and macro systems of critical care practice. The most pertinent social process enabling sustainability of critical care was satisficing (satisfaction of achieving a goal of quality care while sufficing within the limits of available resources). Increased satisficing enabled practitioners to fulfil their sense of normative, responsible, sustainable, and flourishing practice. Satisficing was bounded by the cognitive and environmental influences on decisions and an ethical imperative to ensure resources were used wisely through stewarding. CONCLUSIONS An explanation of the concept of sustainability and significant social processes, in relation to critical care, are presented in a theoretical framework, with implications for how financial, environmental, and social resources for critical care practice can be maintained. RELEVANCE TO CLINICAL PRACTICE This theory offers clinicians, managers, educators, and researchers a definition of sustainability in critical care practice and provides a structured approach to addressing critical care sustainability issues.
Management of hyperparathyroid‐induced hypercalcaemic crisis with intracardiac thrombi

A 29‐year‐old previously healthy patient presented with a hyperparathyroid‐induced hypercalcaemic crisis refractory to conventional therapy. The patient developed ventricular fibrillation and subsequently required emergency parathyroidectomy and extracorporeal membrane oxygenation support. Extensive intracardiac and pulmonary trunk thrombi were identified soon after the commencement of extracorporeal membrane oxygenation, despite full anticoagulation. In this report we highlight the non‐specific presentations of hypercalcaemia which may lead to delayed diagnosis, and discuss the incidence, risk factors and treatment of a hyperparathyroid‐induced hypercalcaemic crisis. We emphasise the role of emergency parathyroidectomy as a salvage therapy in medically refractory We consider the likely factors leading to intracardiac thrombi formation in this case, including how hypercalcaemia may have been a contributing factor.
Cathepsin L interacts with CDK2-AP1 as a potential predictor of prognosis in patients with breast cancer

Cathepsin L (CTSL) is a lysosomal acid cysteine protease that has been implicated in tumorigenesis and malignant progression. In the present study, the role of CTSL in tumorigenesis and prognosis of breast cancer was evaluated. The prognostic value of CTSL was analyzed using immunohistochemistry in patients with breast cancer, as well as online microarray datasets. CTSL expression was knocked down in the breast cancer cell line T-47D using RNA interference. MTT and colony formation assays were performed to assess the role of CTSL in the proliferation of breast cancer cells. Cell cycle progression and apoptosis were measured using flow cytometry. A physical interaction of CTSL and cyclin dependent kinase 2 associated protein 1 (CDK2-AP1) was determined using a glutathione S-transferase pull-down assay. Endogenous CTSL expression was high in breast cancer cells and exhibited an inverse association with CDK2-AP1 expression; aberrant expression of CTSL in breast cancer tissues predicted an improved clinical outcome and prognosis. In addition, CTSL knockdown decelerated the progression of breast cancer cells by arresting cell cycle progression and increasing apoptosis. Thus, CTSL may be a potential therapeutic target for treating patients with breast cancer.
문서 자동요약 기술을 적용한 클라우드 스토리지 기반 지능적 아카이빙 시스템

제로 클라이언트 체제는 기업의 문서 중앙화를 위해 제시된 최신의 방법이며, 이를 기업의 현실에 보다 적합하도록 토착화시키는 작업은 필수적이다. 본 연구는 제로 클라이언트 체제의 잘 알려진 보안 및 프라이버시 상의 문제점을 제외한, 사용 상의 문제점을 보완하고자 고안되었다. 즉, 작업자가 작업한 문서를 기업 클라우드 스토리지에 저장하고자 저장 카테고리를 검색하는 과정의 부담과 정확성을 향상시키기 위하여, 작업 문서의 주제어를 자동으로 파악하고, 이를 바탕으로 해당 문서가 저장되어야 하는 카테고리를 자동으로 검색하여 작업자의 확인을 통 해 자동 저장되도록 하는, 지능적 아카이빙 방식을 제시한다. 본 연구에서 제시하는 주제어 자동 파악 및 자동 아카이빙을 위한 방법론과 프로토타입 시스템은 기업 환경에 적용이 가능할 정도로 정확성과 확장성을 갖추고 있다.