bluuebunny/crossref_metadata_2025 huggingface dataset:
Home to Hospital Live Streaming With Virtual Reality Goggles: A Qualitative Study Exploring the Experiences of Hospitalized Children (Preprint)
Authors: Bakker Aafke , Janssen Lindy , Noordam Cees
Published: March 2018

BACKGROUND

Being separated from home and relatives is a major stressor for children and adolescents when hospitalized. Children long for a manner to be distracted, pleasured, and socially connected during hospitalization. Different technological devices have been applied in health care to answer those needs. Both virtual reality (VR) and videoconferencing have proven their value in hospital wards and pediatrics. VisitU combines these 2 technologies innovatively. VisitU is a recently launched VR product enabling users to be virtually at home during hospitalization.

OBJECTIVE

This study aims to explore the experiences of hospitalized patients with the VR intervention of VisitU in addition to standard care.

METHODS

Over a 3-month period, a purposive sample of 10 patients hospitalized in the Radboudumc Amalia Children’s Hospital was included in this qualitative study. Semistructured interviews were performed, one before and one after the use of the VR device. Patients were asked open-ended questions concerning their experiences with VisitU on practical, cognitive, emotional, and social domains. The interviews were audiorecorded and transcribed verbatim. Atlas.ti was used to support the qualitative analysis. Furthermore, the inductive thematic analysis was done according to the 6-step procedure described by Braun and Clarke.

RESULTS

The following 6 main themes were the result of the qualitative analysis: “Being hospitalized,” “Expectations of VisitU,” “VisitU in use,” “VisitU, the benefits,” “The impact of VisitU,” and “Barriers when using VisitU.” The way VisitU was used by patients varied. The main benefits of VisitU were being somewhere else, being at home, and facilitating social connection. Limitations were experienced on the technical abilities, physical side effects, and complexity of use. Despite that, patients were positive about VisitU and unanimous in the view that they would like to use it again and advise other patients to use it.

CONCLUSIONS

This study shows the positive experiences of pediatric patients with VR live streaming. VisitU brings together the needs of patients and possibilities of VR and videoconferencing; it offers patients a way out of the hospital. Nevertheless, practical and technical obstacles must be overcome and side effects are an area of further research.
The Effectiveness of Smartphone Apps for Lifestyle Improvement in Noncommunicable Diseases: Systematic Review and Meta-Analyses (Preprint)
Authors: Lunde Pernille , Nilsson Birgitta Blakstad , Bergland Astrid , Kværner Kari Jorunn , Bye Asta
Published: March 2018

BACKGROUND

Noncommunicable diseases (NCDs) account for 70% of all deaths in a year globally. The four main NCDs are cardiovascular diseases, cancers, chronic pulmonary diseases, and diabetes mellitus. Fifty percent of persons with NCD do not adhere to prescribed treatment; in fact, adherence to lifestyle interventions is especially considered as a major challenge. Smartphone apps permit structured monitoring of health parameters, as well as the opportunity to receive feedback.

OBJECTIVE

The aim of this study was to review and assess the effectiveness of app-based interventions, lasting at least 3 months, to promote lifestyle changes in patients with NCDs.

METHODS

In February 2017, a literature search in five databases (EMBASE, MEDLINE, CINAHL, Academic Research Premier, and Cochrane Reviews and Trials) was conducted. Inclusion criteria was quantitative study designs including randomized and nonrandomized controlled trials that included patients aged 18 years and older diagnosed with any of the four main NCDs. Lifestyle outcomes were physical activity, physical fitness, modification of dietary habits, and quality of life. All included studies were assessed for risk of bias using the Cochrane Collaboration`s risk of bias tool. Meta-analyses were conducted for one of the outcomes (glycated hemoglobin, HbA1c) by using the estimate of effect of mean post treatment with SD or CI. Heterogeneity was tested using the I2 test. All studies included in the meta-analyses were graded.

RESULTS

Of the 1588 records examined, 9 met the predefined criteria. Seven studies included diabetes patients only, one study included heart patients only, and another study included both diabetes and heart patients. Statistical significant effect was shown in HbA1c in 5 of 8 studies, as well in body weight in one of 5 studies and in waist circumference in one of 3 studies evaluating these outcomes. Seven of the included studies were included in the meta-analyses and demonstrated significantly overall effect on HbA1c on a short term (3-6 months; P=.02) with low heterogeneity (I2=41%). In the long term (10-12 months), the overall effect on HbA1c was statistical significant (P=.009) and without heterogeneity (I2=0%). The quality of evidence according to Grading of Recommendations Assessment, Development and Evaluation was low for short term and moderate for long term.

CONCLUSIONS

Our review demonstrated limited research of the use of smartphone apps for NCDs other than diabetes with a follow-up of at least 3 months. For diabetes, the use of apps seems to improve lifestyle factors, especially to decrease HbA1c. More research with long-term follow-up should be performed to assess the effect of smartphone apps for NCDs other than diabetes.
Mobile Phone and Wearable Sensor-Based mHealth Approaches for Psychiatric Disorders and Symptoms: Systematic Review (Preprint)
Authors: Seppälä Jussi , De Vita Ilaria , Jämsä Timo , Miettunen Jouko , Isohanni Matti , Rubinstein Katya , Feldman Yoram , Grasa Eva , Corripio Iluminada , Berdun Jesus , D'Amico Enrico ,   M-RESIST Group, Bulgheroni Maria
Published: March 2018

BACKGROUND

Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST) is an EU Horizon 2020-funded project aimed at designing and validating an innovative therapeutic program for treatment-resistant schizophrenia. The program exploits information from mobile phones and wearable sensors for behavioral tracking to support intervention administration.

OBJECTIVE

To systematically review original studies on sensor-based mHealth apps aimed at uncovering associations between sensor data and symptoms of psychiatric disorders in order to support the m-RESIST approach to assess effectiveness of behavioral monitoring in therapy.

METHODS

A systematic review of the English-language literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases. Studies published between September 1, 2009, and September 30, 2018, were selected. Boolean search operators with an iterative combination of search terms were applied.

RESULTS

Studies reporting quantitative information on data collected from mobile use and/or wearable sensors, and where that information was associated with clinical outcomes, were included. A total of 35 studies were identified; most of them investigated bipolar disorders, depression, depression symptoms, stress, and symptoms of stress, while only a few studies addressed persons with schizophrenia. The data from sensors were associated with symptoms of schizophrenia, bipolar disorders, and depression.

CONCLUSIONS

Although the data from sensors demonstrated an association with the symptoms of schizophrenia, bipolar disorders, and depression, their usability in clinical settings to support therapeutic intervention is not yet fully assessed and needs to be scrutinized more thoroughly.
Learnability of a Configurator Empowering End Users to Create Mobile Data Collection Instruments: Usability Study (Preprint)
Authors: Schobel Johannes , Pryss Rüdiger , Probst Thomas , Schlee Winfried , Schickler Marc , Reichert Manfred
Published: March 2018

BACKGROUND

Many research domains still heavily rely on paper-based data collection procedures, despite numerous associated drawbacks. The QuestionSys framework is intended to empower researchers as well as clinicians without programming skills to develop their own smart mobile apps in order to collect data for their specific scenarios.

OBJECTIVE

In order to validate the feasibility of this model-driven, end-user programming approach, we conducted a study with 80 participants.

METHODS

Across 2 sessions (7 days between Session 1 and Session 2), participants had to model 10 data collection instruments (5 at each session) with the developed configurator component of the framework. In this context, performance measures like the time and operations needed as well as the resulting errors were evaluated. Participants were separated into two groups (ie, novices vs experts) based on prior knowledge in process modeling, which is one fundamental pillar of the QuestionSys framework.

RESULTS

Statistical analysis (t tests) revealed that novices showed significant learning effects for errors (P=.04), operations (P<.001), and time (P<.001) from the first to the last use of the configurator. Experts showed significant learning effects for operations (P=.001) and time (P<.001), but not for errors as the experts’ errors were already very low at the first modeling of the data collection instrument. Moreover, regarding the time and operations needed, novices got significantly better at the third modeling task than experts were at the first one (t tests; P<.001 for time and P=.002 for operations). Regarding errors, novices did not get significantly better at working with any of the 10 data collection instruments than experts were at the first modeling task, but novices’ error rates for all 5 data collection instruments at Session 2 were not significantly different anymore from those of experts at the first modeling task. After 7 days of not using the configurator (from Session 1 to Session 2), the experts’ learning effect at the end of Session 1 remained stable at the beginning of Session 2, but the novices’ learning effect at the end of Session 1 showed a significant decay at the beginning of Session 2 regarding time and operations (t tests; P<.001 for time and P=.03 for operations).

CONCLUSIONS

In conclusion, novices were able to use the configurator properly and showed fast (but unstable) learning effects, resulting in their performances becoming as good as those of experts (which were already good) after having little experience with the configurator. Following this, researchers and clinicians can use the QuestionSys configurator to develop data collection apps for smart mobile devices on their own.
A Decision Aid to Support Shared Decision Making About Mechanical Ventilation in Severe Chronic Obstructive Pulmonary Disease Patients (InformedTogether): Feasibility Study (Preprint)
Authors: Basile Melissa , Andrews Johanna , Jacome Sonia , Zhang Meng , Kozikowski Andrzej , Hajizadeh Negin
Published: March 2018

BACKGROUND

Severe Chronic Obstructive Pulmonary Disease patients are often unprepared to make decisions about accepting intubation for respiratory failure. We developed a Web-based decision aid, InformedTogether, to facilitate severe Chronic Obstructive Pulmonary Disease patients’ preparation for decision making about whether to accept invasive mechanical ventilation for respiratory failure.

OBJECTIVE

We describe feasibility testing of the InformedTogether decision aid.

METHODS

Mixed methods, pre- and postintervention feasibility study in outpatient pulmonary and geriatric clinics. Clinicians used InformedTogether with severe Chronic Obstructive Pulmonary Disease patients. Patient-participants completed pre- and postassessments about InformedTogether use. The outcomes measured were the following: feasibility/acceptability, communication (Combined Outcome Measure for Risk Communication [COMRADE], Medical Communication Competency Scale [MCCS], Observing Patient Involvement [OPTION] scales), and effectiveness of InformedTogether on changing patients' knowledge, Decisional Conflict Scale, and motivation.

RESULTS

We enrolled 11 clinicians and 38 Chronic Obstructive Pulmonary Disease patients at six sites. Feasibility/acceptability: Clinicians and patients gave positive responses to acceptability questions (mean 74.1/89 max [SD 7.24] and mean 59.63/61 [SD 4.49], respectively). Communication: 96% of clinicians stated InformedTogether improved communication (modified MCCS mean 44.54/49 [SD 2.97]; mean OPTION score 32.03/48 [SD 9.27]; mean COMRADE Satisfaction 4.31/5.0 [SD 0.58]; and COMRADE Confidence 4.18/5.0 [SD 0.56]). Preference: Eighty percent of patients discussed preferences with their surrogates by 1-month. Effectiveness: Knowledge scores increased significantly after using InformedTogether (mean difference 3.61 [SD 3. 44], P=.001) and Decisional Conflict decreased (mean difference Decisional Conflict Scale pre/post -13.76 [SD 20.39], P=.006). Motivation increased after viewing the decision aid.

CONCLUSIONS

InformedTogether supports high-quality communication and shared decision making among Chronic Obstructive Pulmonary Disease patients, clinicians, and surrogates. The increased knowledge and opportunity to deliberate and discuss treatment choices after using InformedTogether should lead to improved decision making at the time of critical illness.
Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Davis Deborah , Davey Rachel , Williams Lauren T. , Foureur Maralyn , Nohr Ellen , Knight-Agarwal Catherine , Lawlis Tanya , Oats Jeremy , Skouteris Helen , Fuller-Tyszkiewicz Matthew
Published: March 2018

BACKGROUND

Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.

OBJECTIVE

The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.

METHODS

This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women’s weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.

RESULTS

Recruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign.

CONCLUSION

Feasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy.

CLINICALTRIAL

Australian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo)

REGISTERED REPORT IDENTIFIER

RR1-10.2196/9920
Differences in the Use and Opinions About New eHealth Technologies Among Patients With Psychosis: Structured Questionnaire (Preprint)
Authors: Bonet Lucia , Llácer Blanca , Hernandez-Viadel Miguel , Arce David , Blanquer Ignacio , Cañete Carlos , Escartí Maria , González-Pinto Ana M , Sanjuán Julio
Published: March 2018

BACKGROUND

Despite a growing interest in the use of technology in order to support the treatment of psychotic disorders, limited knowledge exists about the viability and acceptability of these eHealth interventions in relation to the clinical characteristics of patients.

OBJECTIVE

The objective of this study was to assess the access and use of, as well as experiences and interest in, new technologies using a survey of patients diagnosed with early psychosis compared with a survey of patients diagnosed with chronic psychotic disorders.

METHODS

We designed a structured questionnaire. This questionnaire was divided into five parts: (1) clinical and demographic information, (2) access and use of the internet, (3) use of the internet in relation to mental health, (4) experiences with technology, and (5) patients’ interest in eHealth services. In total, 105 patients were recruited from early psychosis units (n=65) and recovery units (n=40).

RESULTS

In this study, 84.8% (89/105) of the patients had access to the internet and 88.6% (93/105) owned an electronic internet device. In total, 71.3% (57/80) of patients who owned a mobile phone were interested in eHealth systems and 38.2% (37/97) reported negative experiences related to the internet usage. We observed differences between the groups in terms of device ownership (P=.02), the frequency of internet access (P<.001), the use of social media (P=.01), and seeking health information (P=.04); the differences were found to be higher in the early psychosis group. No differences were found between the groups in terms of the use of internet in relation to mental health, experiences and opinions about the internet, or interest in eHealth interventions (P=.43).

CONCLUSIONS

The availability and use of technology for the participants in our survey were equivalent to those for the general population. The differences found between the groups in relation to the access or use of technology seemed to due to age-related factors. The use of technology involving mental health and the interest in eHealth interventions were mainly positive and equivalent between the groups. Accordingly, this group of patients is a potential target for the emerging eHealth interventions, regardless of their clinical status. However, 28.7% (23/80) of the studied patients rejected the use of internet interventions and 38.2% (37/97) had unpleasant experiences related to its usage; thus, more in-depth studies are needed to better define the profile of patients with psychosis who may benefit from eHealth treatments.
Challenges and Potential Opportunities of Mobile Phone Call Detail Records in Health Research: Review (Preprint)
Authors: Jones Kerina Helen , Daniels Helen , Heys Sharon , Ford David Vincent
Published: March 2018

BACKGROUND

Call detail records (CDRs) are collected by mobile network operators in the course of providing their service. CDRs are increasingly being used in research along with other forms of big data and represent an emerging data type with potential for public good. Many jurisdictions have infrastructures for health data research that could benefit from the integration of CDRs with health data.

OBJECTIVE

The objective of this study was to review how CDRs have been used in health research and to identify challenges and potential opportunities for their wider use in conjunction with health data.

METHODS

A literature review was conducted using structured search terms making use of major search engines. Initially, 4066 items were identified. Following screening, 46 full text articles were included in the qualitative synthesis. Information extracted included research topic area, population of study, datasets used, information governance and ethical considerations, study findings, and data limitations.

RESULTS

The majority of published studies were focused on low-income and middle-income countries. Making use of the location element in CDRs, studies often modeled the transmission of infectious diseases or estimated population movement following natural disasters with a view to implementing interventions. CDRs were used in anonymized or aggregated form, and the process of gaining regulatory approvals varied with data provider and by jurisdiction. None included public views on the use of CDRs in health research.

CONCLUSIONS

Despite various challenges and limitations, anonymized mobile phone CDRs have been used successfully in health research. The use of aggregated data is a safeguard but also a further limitation. Greater opportunities could be gained if validated anonymized CDRs were integrated with routine health records at an individual level, provided that permissions and safeguards could be put in place. Further work is needed, including gaining public views, to develop an ethically founded framework for the use of CDRs in health research.
How New and Expecting Fathers Engage With an App-Based Online Forum: Qualitative Analysis (Preprint)
Authors: White Becky K , Giglia Roslyn C , Scott Jane A , Burns Sharyn K
Published: March 2018

BACKGROUND

Breastfeeding is important for infants, and fathers are influential in supporting their partner in their decision to breastfeed and how long they breastfeed for. Fathers can feel excluded from traditional antenatal education and support opportunities but highly value social support from peers. Online health forums can be a useful source of social support, yet little is known about how fathers would use a conversation forum embedded in a breastfeeding-focused app. Milk Man is a mobile app that aimed to increase paternal support for breastfeeding using a range of strategies, including a conversation forum.

OBJECTIVE

The aim of this study was to examine how fathers used a breastfeeding-focused conversation forum contained within a mobile app throughout the perinatal period.

METHODS

A qualitative analysis of comments posted by users in the online forum contained within the Milk Man app was conducted. The app contained a library of information for fathers, as well as a conversation forum. Thematic analysis was used to organize and understand the data. The NVivo 11 software package was used to code comments into common nodes, which were then organized into key themes.

RESULTS

In all, 208 contributors (35.5% [208/586] of those who had access to the app) posted at least once within the forum. In total, 1497 comments were included for analysis. These comments were coded to 3799 individual nodes and then summarized to 54 tree nodes from which four themes emerged to describe how fathers used the app. Themes included seek and offer support, social connection, informational support provision, and sharing experiences. Posting in the forum was concentrated in the antenatal period and up to approximately 6 weeks postpartum.

CONCLUSIONS

These data show that fathers are prepared to use a breastfeeding-focused online forum in a variety of ways to facilitate social support. Fathers can be difficult to reach in the perinatal period, yet engaging them and increasing social support is important. This research demonstrates the acceptability of an innovative way of engaging new and expecting fathers.
β-Blocker Dialyzability in Maintenance Hemodialysis Patients
Authors: Tieu Alvin , Velenosi Thomas J. , Kucey Andrew S. , Weir Matthew A. , Urquhart Bradley L.
Published: March 2018

Background and objectives

There is a paucity of data available to describe drug dialyzability. Of the available information, most was obtained before implementation of modern hemodialysis membranes. Our study characterized dialyzability of the most commonly prescribedβ-blockers in patients undergoing high-flux hemodialysis.

Design, setting, participants, & measurements

Patients on hemodialysis (n=8) were recruited to an open label, pharmacokinetic, four-way crossover trial. Single doses of atenolol, metoprolol, bisoprolol, and carvedilol were administered on separate days in random order to each patient. Plasma and dialysate drug concentrations were measured, and dialyzability was determined by the recovery clearance and arterial venous difference methods.

Results

Using the recovery clearance method, the dialytic clearance values for atenolol, metoprolol, bisoprolol, and carvedilol were 72, 87, 44, and 0.2 ml/min, respectively (P<0.001). Applying the arterial venous difference method, the dialytic clearance values of atenolol, metoprolol, bisoprolol, and carvedilol were 167, 114, 96, and 24 ml/min, respectively (P<0.001).

Conclusions

Atenolol and metoprolol are extensively cleared by hemodialysis compared with the negligible dialytic clearance of carvedilol. Contrary to estimates of dialyzability on the basis of previous literature, our data indicate that bisoprolol is also dialyzable. This finding highlights the importance of conducting dialyzability studies to definitively characterize drug dialytic clearance.
Fibroblast Growth Factor 23 Associates with Death in Critically Ill Patients
Authors: Leaf David E. , Siew Edward D. , Eisenga Michele F. , Singh Karandeep , Mc Causland Finnian R. , Srivastava Anand , Alp Ikizler T. , Ware Lorraine B. , Ginde Adit A. , Kellum John A. , Palevsky Paul M. , Wolf Myles , Waikar Sushrut S.
Published: March 2018

Background and objectives

Dysregulated mineral metabolism is a common and potentially maladaptive feature of critical illness, especially in patients with AKI, but its association with death has not been comprehensively investigated. We sought to determine whether elevated plasma levels of the osteocyte-derived, vitamin D–regulating hormone, fibroblast growth factor 23 (FGF23), are prospectively associated with death in critically ill patients with AKI requiring RRT, and in a general cohort of critically ill patients with and without AKI.

Design, setting, participants, & measurements

We measured plasma FGF23 and other mineral metabolite levels in two cohorts of critically ill patients (n=1527). We included 817 patients with AKI requiring RRT who enrolled in the ARF Trial Network (ATN) study, and 710 patients with and without AKI who enrolled in the Validating Acute Lung Injury biomarkers for Diagnosis (VALID) study. We hypothesized that higher FGF23 levels at enrollment are independently associated with higher 60-day mortality.

Results

In the ATN study, patients in the highest compared with lowest quartiles of C-terminal (cFGF23) and intact FGF23 (iFGF23) had 3.84 (95% confidence interval, 2.31 to 6.41) and 2.08 (95% confidence interval, 1.03 to 4.21) fold higher odds of death, respectively, after adjustment for demographics, comorbidities, and severity of illness. In contrast, plasma/serum levels of parathyroid hormone, vitamin D metabolites, calcium, and phosphate were not associated with 60-day mortality. In the VALID study, patients in the highest compared with lowest quartiles of cFGF23 and iFGF23 had 3.52 (95% confidence interval, 1.96 to 6.33) and 1.93 (95% confidence interval, 1.12 to 3.33) fold higher adjusted odds of death.

Conclusions

Higher FGF23 levels are independently associated with greater mortality in critically ill patients.
REMOVAL OF FLUORIDE USING NEEM LEAVES BATCH REACTOR: KINETICS AND EQUILIBRIUM STUDIES
Authors: Singh Tej Pratap , Cb Majumder
Published: March 2018

Objective: The aim of this paper is to study the fluoride removal efficiency of the neem leaves low-cost biosorbent for defluoridation of sewage wastewater.Methods: For finding the best operating condition for maximum removal of fluoride, batchwise experiments were performed at different contact times and keeping other parameters to be constant such as pH, initial fluoride concentration, and adsorbent dose. Various kinetic models such as intraparticle diffusion model, Bangham’s model, and Elovich model had been investigated for determining the suitable adsorption mechanism. The rate of adsorption of fluoride on neem leaves has been determined by pseudo-first-order and pseudo-second-order rate models.Results: The adsorption kinetics rate and mechanism was best described by the pseudo-second-order model and Bangham’s model, respectively. The optimum pH, initial concentration, adsorbent dose, and contact time were found to be 7, 20 mg/L, 10 g/L, and 40 min, respectively, for which there was maximum fluoride removal.Conclusion: The result obtained from the experiments show that the neem leaves have been proved to be a low-cost biosorbent for the defluoridation of the sewage wastewater and have high fluoride removal efficiency.
A COMPARISON BETWEEN BIOSORPTION AND BIOACCUMULATION OF FLUORIDE FROM WASTE WATER.
Authors: Singh Tej Pratap , Cb Majumder
Published: March 2018

Objective: The comparison between the properties of two removal methods viz. adsorptive removal (biosorption) and simultaneous adsorption and bioaccumulation (SAB) of fluoride from waste water was investigated.Methods: In the present study, bioaccumulation study was done on Sweet Lemon peel. Acinetobacter baumannii (Mtcc no-11451) is a water living microorganism which survives in waste water. Microorganism (Acinetobacter baumannii (Mtcc no-11451)) immobilized on the surface of Sweet Lemon peel. The size of microorganism is greater than the pore size of adsorbent. Active sites of the adsorbent are blocked due to immobilization of microorganism on the surface of adsorbent. Different optimizing parameters are studied during the experiments like adsorbent dose, pH, initial concentration and contact time for bio bioaccumulation process.Results: It was observed that adsorption and bioaccumulation process execute simultaneously but mainly bioaccumulation is responsible for removal of fluoride. The removal efficiency of fluoride sees a drastic increase from 59.59 % to 99.49 % in optimum conditions. It is to be noted that simple adsorption process removal efficiency was 95.795 % at optimum time (60 min), pH 4.0 and dose 10 g/l. Adsorption isotherm parameters are well fitted for Freundlich whereas simple adsorption follow Langmuir isotherm model.Conclusion: The removal of fluoride occurred due to the accumulation by bacteria. Kinetic result revealed that bioaccumulation is a slower process. Bioaccumulation process increase the removal efficiency but it is very time consuming and costly as compare to the simple adsorption process.
PERCEIVED RISK AND ABILITIES FOR HEALTH PRACTICES RELATED TO PREVENTION OF TYPE II DIABETES MELLITUS AMONG POSTNATAL MOTHERS WITH GESTATIONAL DIABETES MELLITUS
Authors: Bhasy Bency , Varghese Linda , Krishnan Aswathy , Viswanath Lekha
Published: March 2018

Objectives: The study is aimed to assess the perceived risk and abilities for health practices related to prevention of Type II diabetes mellitus (DM) among postnatal mothers with gestational DM (GDM).Methods: This is a descriptive study involving 60 postnatal mothers at Amrita Institute of Medical Sciences, Kochi. Non-probability convenience sampling technique was used for the study, data collected through semi-structured questionnaire, risk perception survey for developing diabetes is used to assess the perceived risks and self-rated abilities for health practice scale is used to assess abilities for health practices.Result: Most of the postnatal mothers 55% with GDM had an average personal control and 53% of postnatal mother with GDM were high optimistic that they will not develop Type II DM. In case of diabetes risk knowledge, more than half of the mothers 54% with GDM had average perception. Based on health practices, majority of the postnatal mothers 63 % with GDM have average abilities for health practices related to prevention of Type II DM.Conclusion: Strategies should be designed to care for the postnatal mothers with GDM such as early detection and postpartum screening are mandatory to detect future DM.
FORMULATION AND EVALUATION OF METFORMIN HYDROCHLORIDE SUSTAINED-RELEASE ORAL MATRIX TABLETS
Authors: Bookya Padmaja , Raparla Ramakrishna , Raparla Ramakrishna , Sriramula Harikishan Prasad , Raparla Ramakrishna , Tarrigopula Sunitha , Sriramula Harikishan Prasad , Vanga Sridhar , Raparla Ramakrishna , Sriramula Harikishan Prasad , Tarrigopula Sunitha , Sriramula Harikishan Prasad , Vanga Sridhar , Tarrigopula Sunitha , Tarrigopula Sunitha , Vanga Sridhar , Vanga Sridhar
Published: March 2018

Objective: The aim of this investigation was to develop and optimize metformin hydrochloride matrix tablets for sustained release application. The sustained release matrix tablet of metformin hydrochloride was prepared by wet granulation technique using chitosan, xanthan gum, and hydroxypropyl methylcellulose at varying concentrations.Material and Methods: Extended release of metformin hydrochloride matrix tablets was prepared by wet granulation method. The influence of varying the polymer ratios was evaluated. The excipients used in this study did not alter physicochemical properties of the drug.Results: All the batches were evaluated for thickness, weight variation, hardness, and drug content uniformity. The in vitro drug dissolution study was carried out using USP apparatus Type II, paddle method, and the release mechanisms were explored. Mean dissolution time is used to characterize drug release rate from a dosage form and indicates the drug release is retarding efficiency of the polymer. This study revealed that as the concentration of matrix material increased, drug release from matrices decreased. This may be due to slower penetration of the dissolution medium into the matrices.Conclusion: Formulation with chitosan MS1 drug release was 86%, xanthan gum MS489%, and finally MS7 with hydroxypropyl methyl cellulose which exhibited the highest drug release retardation also had the lowest matrix concentration. Hence, lower concentration of polymers is suitable to prepare metformin hydrochloride tablets compared to higher concentrations.
MORIN PREVENTS ULTRAVIOLET-B RADIATION-INDUCED PHOTOCARCINOGENESIS THROUGH ACTIVATING THROMBOSPONDIN-1 IN THE MOUSE SKIN
Authors: C Anjugam , M Sridevi , N Rajendra Prasad , Balupillai Agilan
Published: March 2018

Objective: In this study, we investigated whether morin, a natural flavonoid, could able to inhibit ultraviolet B (UVB)-induced carcinogenesis in the skin of Swiss albino mice.Methods: The mice were exposed to UVB radiation (180 mJ/cm2) on weekly thrice for 30 weeks, and morin was administered intraperitoneal and topical application 1 h before UVB exposure. UVB radiation induces the overexpression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and Bcl-2 genes.Results: Morin significantly prevented UVB-induced activation of COX-2, iNOS, VEGF, TGF-β, and Bcl-2 expression in mouse skin. Thrombospondin-1 (TSP), a novel endogenous factor, inhibits angiogenesis and inflammation.Conclusion: The present study illustrates that the protective effect of morin against UVB-induced carcinogenesis may be modulated through activation of TSP-1 in UVB-exposed Swiss albino mice.
NUTRITIONAL PROFILE, ANTIOXIDANT, ANTIMICROBIAL POTENTIAL, AND BIOACTIVES PROFILE OF CHLORELLA EMERSONII KJ725233
Authors: Sawant Sneha Sunil , Kelkar Mane Varsha
Published: March 2018

Objective: The present study revolved around the nutritional evaluation of Chlorella emersonii KJ725233, a novel non-fastidious Chlorella strain that was isolated from the Western regions of Maharashtra, India, for a probable use as a food supplement.Methods: The nutritional composition of C. emersonii KJ725233 was evaluated in terms of total protein, total lipids, and total carbohydrates content along with its mineral composition. Furthermore, the effect of different solvents on the extraction of the bioactives and hence the antioxidant and antimicrobial activity of C. emersonii KJ725233 was also analyzed. The bioactives extracted in the organic solvents were further identified by gas chromatography–high-resolution mass spectrometry (GC-HRMS).Results: As reported in the literature for commercial Chlorella powder, C. emersonii KJ725233 was found to contain an equivalent concentration of protein, three-fold lipid content, i.e. 36.48±0.52% and 43.58±0.72%, respectively; along with 17.17±0.91% carbohydrates and 6.62±0.16% mineral content. Methanolic content was not only found to contain the highest antioxidant, radical scavenging potential as well as total phenolic content but also exhibited a strong antimicrobial potential against the tested Gram-positive, Gram-negative bacterial and fungal strains. Moreover, sterols, hydrocarbons, and fatty acid methyl esters known antimicrobials and antioxidants were identified when the organic extracts of the microalgae dried biomass were subjected to GC-HRMS analysis.Conclusion: With a well-balanced nutritional composition together with the reservoir of antioxidants and antimicrobials, this native novel isolate of Chlorella thus emerges as a potential food supplement whose consumption would not only enhance the dietary value along with providing antiaging benefits.
IN SILICO IDENTIFICATION OF NOVEL DRUG TARGETS IN ACINETOBACTER BAUMANNII BY SUBTRACTIVE GENOMIC APPROACH
Authors: Goyal Meenu , Citu Citu , Singh Nidhi
Published: March 2018

Objective: Multiple drug resistance (MDR) in bacteria, particularly Gram-negative bacilli, has significantly hindered the treatment of infections caused by these bacteria. This results in the need for identifying new drugs and drug targets for these bacteria. The objective of this study was to identify novel drug targets in Acinetobacter baumannii which has emerged as a medically important pathogen due to an increasing number of infections caused by it and its MDR property.Methods: In our study, we implemented in silico subtractive genomics approach to identify novel drug targets in A. baumannii American type culture collection 17978. Various databases and online software were used to build a systematic workflow involving comparative genomics, metabolic pathways analysis, and drug target prioritization to identify pathogen-specific novel drug targets.Results: First, 458 essential proteins were retrieved from a database of essential genes, and by performing BLASTp against Homo sapiens, 246 human non-homologous essential proteins were selected of 458 proteins. Metabolic pathway analysis performed by Kyoto Encyclopedia of Genes and Genomes–Kyoto Automatic Annotation Server revealed that these 246 essential non-homologous proteins were involved in 66 metabolic pathways. Among these metabolic pathways, 12 pathways were found to be unique to Acinetobacter that involved 37 non-homologous essential proteins. Of these essential non-homologous proteins, 19 proteins were found in common as well as unique metabolic pathways and only 18 proteins were unique to Acinetobacter. Finally, these target proteins were filtered to 9 potential targets, based on subcellular localization and assessment of druggability using Drug bank, ChEMBL, and literature.Conclusion: Our study identified nine potential drug targets which are novel targets in A. baumannii and can be used for designing drugs against these proteins. These drugs will be pathogen specific with no side effects on human host, as the potential drug targets are human non-homologous.
THERAPEUTIC EFFICACY OF LEVONORGESTREL INTRAUTERINE SYSTEM AS AN ALTERNATIVE TO HYSTERECTOMY FOR MANAGEMENT OF HEAVY MENSTRUAL BLEEDING IN PERIMENOPAUSAL WOMEN
Authors: Dash Sudershan , Mishra Jagannath , Shankar Behera Shashis , Rout Subhashree
Published: March 2018

Objective: This prospective observational study has been conducted to find out the efficacy and patient satisfaction of levonorgestrel intrauterine system (LNG-IUS), and it was compared with results of hysterectomy in perimenopausal Indian women with heavy menstrual bleeding (HMB).Methods: It was a prospective study conducted on 135 cases after taking consent. Patients were inserted with LNG-IUS, and the outcome in terms of further bleeding and quality of life was compared to that of hysterectomy.Results and Conclusion: Levonogestrol containing-IUS is a highly effective treatment of HMB in perimenopausal women. It is a safe, effective, and quality of life after treatment makes it a good alternative to hysterectomy for HMB.
A NEW METHOD OF EPISTAXIS MANAGEMENT USING NASAL GEL: A SINGLE CENTER, RANDOMIZED CLINICAL TRIAL
Authors: Torabi Mehdi , Roughani Esfahani Ava , Moeinaddini Shiva , Baneshi Mohammad Reza
Published: March 2018

Objective: Epistaxis is one of the common causes of patients’ referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding.Methods: In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients’ satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups.Results: The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients’ satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group.Conclusion: In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.
ANTITUBERCULOSIS ACTIVITY OF EXTRACT AND FRACTIONS OF TINOSPORA CRISPA AGAINST MYCOBACTERIUM TUBERCULOSIS H37RV USING MYCOBACTERIA GROWTH INDICATOR TUBE AND AGAR PROPORTION METHOD
Authors: Wahyuningrum Retno , Ritmaleni Ritmaleni , Irianti Tatang , Wahyuono Subagus , Kaneko Takushi
Published: March 2018

Objective: The increasing incidence of multidrug-resistant tuberculosis (TB) has created a need to discover a new anti-TB drug candidates. The aim of this study was to screen extract and fractions of Tinospora crispa for activity against Mycobacterium tuberculosis H37Rv.Methods: The dried and pulverized T. crispa stem was extracted by maceration method using ethanol (96%). The anti-TB activity was carried out using mycobacteria growth indicator tube (MGIT) system and agar proportion method with Lowenstein–Jensen (LJ) medium.Result: The result of this study showed that ethanolic extract and fractions of T. Crispa did not exhibit anti-TB activity in the range of 100–1000 μg/ml with MGIT method, while with agar proportion method, there were M. tuberculosis colonies growth on the LJ containing 1000 μg/ml extract slants.Conclusion: The tested extract and fractions of T. crispa have no anti-TB activity against M. tuberculosis until 1000 μg/ml.
SCREENING ANTIMICROBIAL POTENTIAL FOR MALAYSIAN ORIGINATED TAMARINDUS INDICA ETHANOLIC LEAVES EXTRACT
Authors: Chigurupati Sridevi , Kwang Yiik Eric Wong , Islam Mohammad Jahidul , Vijayabalan Shantini , Krishnan Selvarajan Kesavanarayanan , Ramana Reddy M Venkata , Sekhar Nanda Sitansu
Published: March 2018

Objective: The aim of the research is to study the antimicrobial potential of Tamarindus indica leaves extract (Malaysian origin).Methods: T. indica leaves extraction was carried out by maceration (TIME) and Soxhlet extraction methods (TISE). The phytochemical test was conducted for the confirmation of various phytoconstituents present in the leaves extract. Antimicrobial assays were carried out by minimum bactericidal concentration (MBC), minimum inhibitory concentration (MIC), and agar well diffusion method against ATCC bacterial strains.Results: Ethanolic extraction of T. indica leaves by maceration method showed better yield (70.38%) compared to Soxhlet extraction method (60.55%). The qualitative phytochemical test on TISE and TIME were confirmed the presence of alkaloids, flavonoids, phenols, mucilage, tannins, steroids, proteins, and carbohydrates. TIME was selected for antimicrobial studies, and it was found to have MBC value of 500 μg/mL and MIC value of 250 μg/mL among various test bacteria, and it was also found to exhibit good zone of inhibition against Gram-negative bacteria such as Escherichia coli and Neisseria gonorrhoeae. Conclusion: These findings deduced that T. indica leaves have various phytochemical constituents which could be responsible for their natural antibacterial activity especially against Gram-negative bacteria.
NECK CIRCUMFERENCE AS AN INDICATOR OF OBESITY IN YOUNG ADULTS
Authors: Vm Vinodhini , Ganesan Vinothkumar
Published: March 2018

Objective: Neck circumference (NC) is considered to be an indicator of upper-body subcutaneous adipose tissue distribution. An upper body distribution of fat, especially with increased visceral adipose tissue, is considered to be predictive of cardiometabolic outcomes. Therefore, in this study, we have studied the relationship between NC and the conventional marker of obesity, namely, body mass index (BMI) and also the triglyceride levels in a group of young adults.Methods: There were 60 participants in this study in the age group of 18-42 years of both genders with no known major medical conditions (viz., diabetes, coronary artery disease, hypertension, thyroid diseases, or malignancy) NC was measured at mid-neck height. The analysis of serum triglycerides was carried out after an overnight fast using Beckman Coulter autoanalyzer.Results: A significantly positive correlation was found between NC and BMI (r=0.8154, p<0.0001). A positive correlation was found between NC and triglyceride levels (r=0.0316, p=0.9934).Measurement of NC may be more useful in morbidly obese people, bedridden patients, and pregnant women. NC is found to have a positive correlation with insulin resistance and various components of the metabolic syndrome.Conclusion: NC can be considered as a simple, useful, and reliable tool to identify overweight and obesity. This can be used as an alternative method to assess the fat distribution in health-care centers and also in population studies.