bluuebunny/crossref_metadata_2025 huggingface dataset:
Escape into patient safety: bringing human factors to life for medical students
Authors: Backhouse Adam , Malik Myra
Published: March 2019

Background

Patient safety is at the core of the General Medical Council (GMC) standards for undergraduate medical education. It is recognised that patient safety and human factors’ education is necessary for doctors to practice safely. Teaching patient safety to medical students is difficult. Institutions must develop expertise and build curricula while students must also be able to see the subject as relevant to future practice. Consequently graduates may lack confidence in this area.

Method

We used gamification (the application of game design principles to education) to create a patient safety simulation for medical students using game elements. Gamification builds motivation and engagement, whilst developing teamwork and communication. We designed an escape room—a team-based game where learners solve a series of clinical and communication-based tasks in order to treat a fictional patient while avoiding ‘clinician error’. This is followed up with an after action review where students reflect on their experience and identify learning points.

Outcome

Students praised the session’s interactivity and rated it highly for gaining new knowledge and skills and for increasing confidence to apply patient safety concepts to future work.

Conclusion

Our findings are in line with existing evidence demonstrating the success of experiential learning interventions for teaching patient safety to medical students. Where the escape room has potential to add value is the use of game elements to engage learners with the experience being recreated despite its simplicity as a simulation. More thorough evaluation of larger pilots is recommended to continue exploring the effectiveness of escape rooms as a teaching method.
COPD exacerbations: the impact of long versus short courses of oral corticosteroids on mortality and pneumonia: nationwide data on 67 000 patients with COPD followed for 12 months
Authors: Sivapalan Pradeesh , Ingebrigtsen Truls Sylvan , Rasmussen Daniel Bech , Sørensen Rikke , Rasmussen Christian Madelaire , Jensen Camilla Bjørn , Allin Kristine Højgaard , Eklöf Josefin , Seersholm Niels , Vestbo Joergen , Jensen Jens-Ulrik Stæhr
Published: March 2019

Introduction

A large group of patients with chronic obstructive pulmonary disease (COPD) are exposed to an overload of oral corticosteroids (OCS) due to repeated exacerbations. This is associated with potential serious adverse effects. Therefore, we evaluated the impact of a recommended reduction of OCS duration in 2014 on the risk of pneumonia hospitalisation and all-cause mortality in patients with acute exacerbation of COPD (AECOPD).

Methods

This was a nationwide observational cohort study that was based on linked administrative registry data between 1 January 2010 and 31 October 2017. 10 152 outpatients with COPD (median age 70 years) treated with either a short (≤250 mg) or long course (>250 mg) of OCS for AECOPD were included in the study. Cox proportional hazards regression models were used to derive an estimation of multivariable adjusted HRs (aHRs) for pneumonia hospitalisation or all-cause mortality combined and pneumonia hospitalisation and all-cause mortality, separately.

Results

The long course of OCS treatment for AECOPD was associated with an increased 1-year risk of pneumonia hospitalisation or all-cause mortality (aHR 1.3, 95% CI 1.1 to 1.4; p<0.0001), pneumonia hospitalisation (aHR 1.2, 95% CI 1.0 to 1.3; p=0.0110) and all-cause mortality (aHR 1.8, 95% CI 1.5 to 2.2; p<0.0001) as compared with the short course of OCS treatment. These results were confirmed in several sensitivity analyses.

Conclusion

The change of recommendations from long courses to short courses of OCS for AECOPD in 2014 was strongly associated with a decrease in pneumonia admissions and all-cause mortality, in favour of short courses of OCS.
Antithrombotic therapy after femoropopliteal artery stenting: 12-month results from Japan Postmarketing Surveillance
Authors: Kawarada Osami , Nakai Michikazu , Nishimura Kunihiro , Miwa Hideki , Iwasaki Yusuke , Kanno Daitaro , Nakama Tatsuya , Yamamoto Yoshito , Ogata Nobuhiko , Nakamura Masato , Yasuda Satoshi
Published: March 2019

Objective

To investigate the effects of antithrombotic therapy on target lesion revascularisation (TLR) and major adverse cardiovascular and cerebrovascular events (MACCEs) at 12 months after femoropopliteal intervention with second-generation bare metal nitinol stents.

Methods

A total of 277 lesions in 258 limbs of 248 patients with de novo atherosclerosis in the above-the-knee femoropopliteal segment were analysed from the Japan multicentre postmarketing surveillance.

Results

At discharge, dual antiplatelet therapy (DAPT) was prescribed in 68.5% and cilostazol in 30.2% of patients. At 12 months of follow-up, prescriptions of DAPT significantly (p=0.0001) decreased to 51.2% and prescription of cilostazol remained unchanged (p=0.592) at 28.0%. Prescription of warfarin also remained unchanged (14.5% at discharge, 13.3% at 12 months, p=0.70). At 12 months, freedoms from TLR and MACCE were 89.4% and 89.7%, respectively. In a multivariate Cox proportional hazards model, neither DAPT nor cilostazol at discharge was associated with both TLR and MACCE at 12 months. However, warfarin at discharge was only independently associated with TLR at 12 months. Kaplan-Meier estimates demonstrated that warfarin at discharge yielded a significantly (p=0.013) lower freedom from TLR at 12 months than no warfarin at discharge. Freedom from TLR at 12 months by the Kaplan-Meier estimates was 77.8% (95% CI 59.0% to 88.8%) in patients with warfarin at discharge and 91.2% (95% CI 86.3% to 94.3%) in those without warfarin at discharge.

Conclusions

Clinical benefits of DAPT or cilostazol might be small in terms of TLR and MACCE at 12 months. Anticoagulation with warfarin at discharge might increase TLR at 12 months.
Unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation, 2006–2012
Authors: Kenney Anne , Shields Wendy , Hinton Alexandra , Larzelere Francene , Goklish Novalene , Gardner Kyle , Frattaroli Shannon , Barlow Allison
Published: March 2019

This study aims to describe the epidemiology of unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation between 2006 and 2012. Unintentional injury death data were obtained from the Arizona Department of Health Services and death rates were calculated per 100 000 people per year and age adjusted using data obtained from Indian Health Service and the age distribution of the 2010 US Census. Rate ratios were calculated using the comparison data obtained through CDC’s Web-based Injury Statistics Query and Reporting System. The overall unintentional injury mortality rate among American Indians residing on the Fort Apache Indian Reservation between 2006 and 2012 was 107.0 per 100 000. When stratified by age, White Mountain Apache Tribe (WMAT) mortality rates for all unintentional injuries exceed the US all races rate except for ages 10–14 for which there were no deaths due to unintentional injury during this period. The leading causes of unintentional injury deaths were MVCs and poisonings. Unintentional injuries are a significant public health problem in the American Indian and Alaska Native communities. Tribal-specific analyses are critical to inform targeted prevention and priority setting.
Age-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage study
Authors: Young Jesse T , Borschmann Rohan , Preen David B , Spittal Matthew J , Brophy Lisa , Wang Emily A , Heffernan Ed , Kinner Stuart A
Published: March 2019

Background

In population studies, the risk of injury declines after early adulthood. It is unclear if a similar age difference in the risk of injury exists among people released from prison.

Methods

Prerelease survey data collected between 1 August 2008 and 31 July 2010, from a representative cohort of sentenced adults (≥18 years) in Queensland, Australia, were linked prospectively and retrospectively to person-level emergency department, inpatient hospital and correctional records. To ascertain predictors of injury-related hospital contact, we fit a multivariate Andersen-Gill model and tested the interactions between age group (<25 years, ≥25 years) and each variable.

Results

In 1307 adults released from prison, there were 3804 person-years of follow-up. The crude injury rate was 385 (95% CI 364 to 407) per 1000 person-years and did not differ according to age group. Factors associated with increased injury-related hospital contact included a history of mental illness, preincarceration injury, a history of incarceration, release from a short prison sentence (<90 days), being reincarcerated during follow-up and identifying as Indigenous. The effect of mental illness, risky alcohol use, prior incarceration and intellectual disability differed across age group and predicted increased risk of injury among people aged ≥25 years compared with their counterparts without these characteristics.

Conclusions

Unlike in the general population where the risk of injury declines with age, older adults released from prison are at similar risk compared with their younger peers. Adults released from prison with mental illness, a history of injury-related hospital contact and who identify as Indigenous are particularly indicated groups for injury prevention.
Developing drowning prevention strategies for rivers through the use of a modified Delphi process
Authors: Peden Amy E , Franklin Richard C , Leggat Peter A
Published: March 2019

Introduction

Internationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective.

Methods

Using a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios.

Results

An initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills.

Discussion

While all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies.

Conclusion

This Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.
Neighbourhood disadvantage and depressive symptoms among adolescents followed into emerging adulthood
Authors: Goldstein Rise B , Lee Awapuhi K , Haynie Denise L , Luk Jeremy W , Fairman Brian J , Liu Danping , Jeffers Jacob S , Simons-Morton Bruce G , Gilman Stephen E
Published: March 2019

Background

Residents of disadvantaged neighbourhoods report higher levels of depressive symptoms; however, few studies have employed prospective designs during adolescence, when depression tends to emerge. We examined associations of neighbourhood social fragmentation, income inequality and median household income with depressive symptoms in a nationally representative survey of adolescents.

Methods

The NEXT Generation Health Study enrolled 10th-grade students from 81 US high schools in the 2009–2010 school year. Depressive symptoms were assessed with the Modified Depression Scale (wave 1) and the paediatric Patient-Reported Outcome Measurement Information System (waves 2–6). Neighbourhood characteristics at waves 1, 3, 4, and 5 were measured at the census tract level using geolinked data from the American Community Survey 5-year estimates. We used linear mixed models to relate neighbourhood disadvantage to depressive symptoms controlling for neighbourhood and individual sociodemographic factors.

Results

None of the models demonstrated evidence for associations of social fragmentation, income inequality or median household income with depressive symptoms.

Conclusion

Despite the prospective design, repeated measures and nationally representative sample, we detected no association between neighbourhood disadvantage and depressive symptoms. This association may not exist or may be too small to detect in a geographically dispersed sample. Given the public health significance of neighbourhood effects, future research should examine the developmental timing of neighbourhood effects across a wider range of ages than in the current sample, consider both objective and subjective measures of neighbourhood conditions, and use spatially informative techniques that account for conditions of nearby neighbourhoods.
Heart rate variability and peripheral nerve conduction velocity in relation to blood lead in newly hired lead workers
Authors: Yu Cai-Guo , Wei Fang-Fei , Yang Wen-Yi , Zhang Zhen-Yu , Mujaj Blerim , Thijs Lutgarde , Feng Ying-Mei , Staessen Jan A
Published: March 2019

Objectives

Previous studies relating nervous activity to blood lead (BL) levels have limited relevance, because over time environmental and occupational exposure substantially dropped. We investigated the association of heart rate variability (HRV) and median nerve conduction velocity (NCV) with BL using the baseline measurements collected in the Study for Promotion of Health in Recycling Lead (NCT02243904).

Methods

In 328 newly hired men (mean age 28.3 years; participation rate 82.7%), we derived HRV measures (power expressed in normalised units (nu) in the high-frequency (HF) and low-frequency (LF) domains, and LF/HF) prior to long-term occupational lead exposure. Five-minute ECG recordings, obtained in the supine and standing positions, were analysed by Fourier transform or autoregressive modelling, using Cardiax software. Motor NCV was measured at the median nerve by a handheld device (Brevio Nerve Conduction Monitoring System, NeuMed, West Trenton, NJ, USA). BL was determined by inductively coupled plasma mass spectrometry.

Results

Mean BL was 4.54 µg/dL (IQR 2.60–8.90 µg/dL). Mean supine and standing values of LF, HF and LF/HF were 50.5 and 21.1 nu and 2.63, and 59.7 and 10.9 nu and 6.31, respectively. Orthostatic stress decreased HF and increased LF (p<0.001). NCV averaged 3.74 m/s. Analyses across thirds of the BL distribution and multivariable-adjusted regression analyses failed to demonstrate any association of HRV or NCV with BL.

Conclusions

At the exposure levels observed in our study, autonomous nervous activity and NCV were not associated with BL.

Trial registration number

NCT02243904
Work participation and working life expectancy after a disabling shoulder lesion
Authors: Sirén Maria , Viikari-Juntura Eira , Arokoski Jari , Solovieva Svetlana
Published: March 2019

Objective

To examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.

Methods

From a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.

Results

During 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.

Conclusions

Working life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.
Falling hospital and postdischarge mortality following CABG in New South Wales from 2000 to 2013
Authors: Brieger David B , Ng Austin C C , Chow Vincent , D'Souza Mario , Hyun Karice , Bannon Paul G , Kritharides Leonard
Published: March 2019

Objectives

To describe changes in mortality among patients undergoing coronary artery bypass grafting (CABG) in New South Wales (NSW) Australia from 2000 to 2013.

Methods

Patients undergoing CABG were identified from the NSW Admission Patient Data Collection (APDC) registry, linked to the NSW state-wide death registry database. Changes in all-cause mortality over time were observed following stratification of the study cohort into two year groups.

Results

We identified 54 767 patients undergoing CABG during the study period. The risk profile of patients increased over time with significant increases in age, comorbidities and concomitant valve surgery (all p < 0.0001). During a median follow-up period of 6 years, a total 12 161 (22.2%) of patients had died. Survival curves and adjusted analyses showed a steady fall in mortality rate: those operated on during 2012–2013 had 40 % lower mortality than those operated on during 2000–2001 (HR 0.61; 95% CI 0.53 to 0.69). This was contributed to both by a fall in mortality both in hospital (HR 0.48, 95% CI 0.37 to 0.62) and postdischarge (HR 0.73; 95% CI 0.61 to 0.86).

Conclusions

We report a consistent reduction in medium-term mortality among a large unselected cohort of NSW patients undergoing CABG between 2000 and 2013. This fall is attributable both to an improvement in outcomes in hospital and in the postdischarge period.
A hundred heart failure deaths: lessons learnt from the Dr Foster heart failure hospital mortality alert
Authors: Tran Patrick , McDonald Michelle , Kunaselan Lleika , Umar Fraz , Banerjee Prithwish
Published: March 2019

Background

Despite advances in evidence-based pharmacotherapy, the latest National Heart Failure Audit (NHFA) has shown that in-hospital mortality of heart failure (HF) remains high with large interhospital variations. University Hospitals Coventry & Warwickshire, a tertiary cardiac centre, received a mortality alert of excess HF deaths based on a high Dr Foster hospital standardised mortality ratio (HSMR). This conflicted with our local NHFA data which showed lower than national average mortality rates.

Objective

To review various systemic and individual processes of care in patients admitted with HF and examine the validity of HSMR in HF.

Design, setting, patients

A retrospective case note analysis was performed on a random sample of 100 HF deaths identified by Dr Foster from 2010 to 2016.

Measures

Case record reviews were performed on the following aspects of care: admission to appropriate wards, resuscitation status, palliative care input and National Confidential Enquiry into Patient Outcome and Death classification. Primary diagnosis coding, diagnostic accuracy and actual causes of death were examined to assess limitations of HSMR.

Results

Despite evidence of lower mortality on cardiology wards, only 28% of patients with acute HF were admitted to a cardiology-ward. Sixty four per cent were considered palliative but only 4.6% were referred to palliative care. The Do Not Attempt Resuscitation order was appropriate in 91% patients but only 74% had this in place. The primary diagnosis of HF was incorrectly coded in 34% while three cases were misdiagnosed.

Conclusion

HF may be coded as a cause of death in some cases where the cause is uncertain and misdiagnosed. Although HSMR has many limitations, it is a smoke alarm that should not be ignored.
Neural networks for automatic scoring of arthritis disease activity on ultrasound images
Authors: Andersen Jakob Kristian Holm , Pedersen Jannik Skyttegaard , Laursen Martin Sundahl , Holtz Kathrine , Grauslund Jakob , Savarimuthu Thiusius Rajeeth , Just Søren Andreas
Published: March 2019

Background

The development of standardised methods for ultrasound (US) scanning and evaluation of synovitis activity by the OMERACT-EULAR Synovitis Scoring (OESS) system is a major step forward in the use of US in the diagnosis and monitoring of patients with inflammatory arthritis. The variation in interpretation of disease activity on US images can affect diagnosis, treatment and outcomes in clinical trials. We, therefore, set out to investigate if we could utilise neural network architecture for the interpretation of disease activity on Doppler US images, using the OESS scoring system.

Methods

Two state-of-the-art neural networks were used to extract information from 1342 Doppler US images from patients with rheumatoid arthritis (RA). One neural network divided images as either healthy (Doppler OESS score 0 or 1) or diseased (Doppler OESS score 2 or 3). The other to score images across all four of the OESS systems Doppler US scores (0–3). The neural networks were hereafter tested on a new set of RA Doppler US images (n=176). Agreement between rheumatologist’s scores and network scores was measured with the kappa statistic.

Results

For the neural network assessing healthy/diseased score, the highest accuracies compared with an expert rheumatologist were 86.4% and 86.9% with a sensitivity of 0.864 and 0.875 and specificity of 0.864 and 0.864, respectively. The other neural network developed to four class Doppler OESS scoring achieved an average per class accuracy of 75.0% and a quadratically weighted kappa score of 0.84.

Conclusion

This study is the first to show that neural network technology can be used in the scoring of disease activity on Doppler US images according to the OESS system.
Unveiling the Vascular Mechanisms Behind Long‐Term Effects of Coarctation Treatment Using Pulse Wave Dynamics
Authors: Hametner Bernhard , Bauer Andreas , Wassertheurer Siegfried
Published: March 2019

See Article by
Martins et al
and
Kowalski et al
Strength of association between the Five-Times-Sit-to-Stand Test and balance, knee extensor strength and lower limb power in community-dwelling older adults
Authors: Tiwari Devashish , Talley Susan Ann , Alsalaheen Bara , Goldberg Allon
Published: March 2019

Background/Aims

Although strength, power and balance are associated with the Five-Times-Sit-to-Stand Test in older adults, the relative contribution of each to sit-to-stand performance is unclear. This study compared the strength of association between the Five-Times-Sit-to-Stand Test and measures of balance, knee extensor strength, and lower limb power in older adults.

Methods

A total of 41 community-dwelling older adults completed the Five-Times-Sit-to-Stand Test and tests of balance, knee extensor strength, and lower limb power.

Results

The strongest association observed was between the Five-Times-Sit-to-Stand Test and dynamic balance (rs= −0.61, P<0.001), with a moderate association observed between the Five-Times-Sit-to-Stand Test and power (rs= −0.52, P=0.001).

Conclusions

Dynamic balance and lower limb power are determinants of, and play roles in the Five-Times-Sit-to-Stand Test performance in community-dwelling older adults. Dynamic balance was the strongest determinant of Five-Times-Sit-to-Stand Test performance, suggesting that the Five-Times-Sit-to-Stand Test should not be viewed solely as a proxy measure of knee extensor strength in community-dwelling older adults.
Original kinesio tape application for temporary diastasis recti reduction: a single case study
Authors: Ammendolia Antonio , d’Esposito Oriana , Inzitari Maria Teresa , Manti Francesco , Caridi Adele De , Iocco Maurizio
Published: March 2019

Background/Aims

The person in this case study was a man with prostatic cancer and diastasis rectus abdominis. Perineal rehabilitation was needed to prevent urinary incontinence, before and after a radical prostatectomy. This study reports on an original application of kinesio tape to reduce the diastasis rectus abdominis so that he could carry out the rehabilitation programme.

Methods

Three green-coloured Y-type tapes (width 5 cm and length 15 cm) were positioned to form an X, orthogonally at the linea alba, separating the tape half in width and two-thirds of a grid in length into 2 ends, under 75% pulling force (above and below the navel), and two green-coloured I-type tapes (width 5 cm and length 30 cm) positioned in parallel at the rectus abdominis, from the external face of the 5th, 6th and 7th costal cartilage and by the xiphoid process to the upper part of the pubis tubercle and pubic symphysis under 50% pulling force. Kinesio tapes were applied daily before every session of the perineum rehabilitation.

Findings

A significant reduction of the diastasis was observed by ultrasound, after the kinesio tape was applied.

Conclusions

This case demonstrates that it was possible to perform a pre- and post-operative perineal rehabilitation programme after the application of kinesio tape, which efficiently reduced the diastasis rectus while performing exercises, with the aim to prevent urinary incontinence.
Cross-cultural psychometric properties of the Persian version of the Measure of Processes of Care for Service Providers questionnaire
Authors: Riyahi Azade , Rassafiani Mehdi , Abdolrazaghi Hosseinali , Rafiei Fatemeh , Mohammadbeigi Abolfazl
Published: March 2019

Background

The Measure of Processes of Care is the most widely used tool for measuring family-centredness and perceptions of the care process. This study assessed the psychometric properties of the Persian language version of the Measure of Processes of Care for Service Providers questionnaire.

Methods

In a cross-sectional study, the Measure of Processes of Care for Service Providers questionnaire was translated three times based on a backward–forward method. The Persian version of the Measure of Processes of Care for Service Providers was used with 150 health providers in Iran. The Pearson correlation coefficient, Cronbach alpha and interclass correlation coefficient were used for reliability analysis. Content validity index and content validity ratio and confirmatory factor analysis was used for validity assessments.

Results

The test-retest correlation was higher than 0.95 and the interclass correlation coefficient was higher than 0.8 in all domains. The consistency coefficient was calculated as r=0.989 and the Cronbach alpha calculated as 0.994, which varied from 0.978 to 0.994. The content validity index average was 0.97, which varied from 0.90 to 0.99. Moreover, the content validity ratio average calculated 0.726 and ranged from 0.60 to 0.95. The goodness of fit index was acceptable as CMIN =χ2: 411.52, df; 280, P<0.001, CMIN/df; 1.47, root mean square error of approximation: 0.056; P value: 0.19, goodness of fit index and Tucker–Lewis index was 0.951 and 0.938 respectively.

Conclusion

The Persian translation of the Measure of Processes of Care for Service Providers questionnaire is a standard tool for assessing family-centred care with acceptable reliable and valid. It could be used in all health, clinical and rehabilitation centres to assess family-centred care in health care providers and can be an incentive to improve the quality of family-related services.
Review on Pharmacology of Cisplatin: Clinical Use, Toxicity and Mechanism of Resistance of Cisplatin
Authors: Aldossary Sara A.
Published: March 2019

Cisplatin is a chemotherapeutic drug that has been used in the treatment of various types of human cancers such as ovarian, lung, head and neck, testicular and bladder. Cisplatin has demonstrated efficacy against various types of cancers such as germ cell tumors, sarcomas, carcinomas as well as lymphomas. The current study presents a pharmacological review on the drug including its mechanism of action, resistance mechanism, and toxicity as well as its clinical applications. The mechanism of action of cisplatin has been associated with ability to crosslink with the urine bases on the DNA to form DNA adducts, preventing repair of the DNA leading to DNA damage and subsequently induces apoptosis within cancer cells. However, the drug exhibits certain level of resistance including increased repair of the damaged DNA, reduction in the accumulation of the drug intracellular and cytosolic inactivation of cisplatin. The drug is also characterized by various toxic side effects including nausea, nephrotoxicity, Cardiotoxicity, hepatotoxicity and neurotoxicity. Due various side effects as well as drug resistance, other anti-cancer drugs that contain platinum such as carboplatin and oxaliplatin among others have been used in combination with cisplatin in chemotherapeutic treatment of cancer. Strong evidence from research has demonstrated higher efficacy of combination of chemotherapies of cisplatin together with other drugs in overcoming drug resistance and in reducing toxic effects as well. Future studies that explore combinational techniques that target various mechanisms such as reduction in the uptake of cisplatin as well as inflammation could enhance efficacy of cisplatin.
Management of Factors for Improving Antigen–Antibody Interaction in Lateral flow Immunoassay of Tetracycline in Human Serum Samples
Authors: Berlina Anna N. , Bartosh Anastasia V. , Zherdev Anatoly V. , Eremin Sergei A. , Dzantiev Boris B.
Published: March 2019

Detection of antibiotics in the blood is necessary for characterizing their common or individual pharmacokinetics. This has increased the need in rapid detection techniques, such as lateral flow immunoassay, for the on-site control of antibiotics. The present study characterized factors influencing the analytical parameters of lateral flow immunoassay to increase its sensitivity for detecting tetracycline in human serum samples. Assay sensitivity was increased by altering the concentrations of immunoreagents and surfactant and the number of interaction stages in the assay with indirect labeling a specific antibody. The optimal assay conditions reduced the limit of visual detection of tetracycline from 100 to 10 ng/mL. The developed assay allowed us to detect tetracycline in both two-fold diluted and undiluted human serum samples within 15 min. Our results suggest that the developed assay can be used to screen patients under antibiotic treatment.
Age of Laboratory Hamster and Human: Drawing the Connexion
Authors: Dutta Sulagna , Sengupta Pallav
Published: March 2019

Hamsters have unique physiological characteristics rendering them well-suited for biomedical research as experimental model. They match beneficial traits of both smaller rodents and larger mammals that make them suitable for laboratory use, such as availability, breeding ease, greater tissue proportions and the like. In experimental design, it is inevitable to select laboratory animals of accurate age that can mimic the target human age in a specific research. In this article, we have calculated that one human year equals 13.67 hamster days, considering their entire lifespan. This simplistic calculation may not find universal relevance in biomedical research, given the accelerated non-uniform life stages of hamsters when matched with human. To resolve this issue, this is the first ever article where we have provided a concise perception of hamster days in human years by correlating their age at every major life stage. This article will aid precision in biomedical research via selection of laboratory hamster of accurate age corresponding to human age, which is the most primary and essential criteria in animal based research.
Life Span of the Chondrocytes from Human Umbilical Cord Derived-Mesenchymal Stem Cell Differentiation
Authors: Kumara Wati Ketut Dewi , Dhyanti Pratiwi Endah , Dirgantara Yanni , Retna Sartika Cynthia , Dhamayanti Meita , Setiabudiawan Budi , Parwati Ida
Published: March 2019

Problem in growth might need to be sought deeper inside the cells to enhance better management. There was a lack of study done in chondrocytes to determine growth problem mechanism. We sought to see the chondrocyte’s life span by observing the cells characteristic in a small container over long period. Human mesenchymal stem cell-derived MSC underwent chondrocyte differentiation procedure in a 96 wells-plate using chondrocyte/osteocyte differentiation medium followed by basal medium. A morphological observation and MTT assay was done to observe apoptosis in chondrocyte in the different wells. MTT assay absorbance was used to determine number of apoptosis. Statistical analysis was done to assess the different of mean absorbance values on different days of observation using Anova folowed by post hoc analysis in SPSS IBM package version 24 , with significance determined at P<0.05. Chondrocytes was confirmed with 1% Alcian blue staining and showed characteristic larger then its parent MSC. The MTT assay showed that chondrocyte absorbance reduce from day 3 through day 14, which was different significantly (anova, P=0.03) and day 14 was the most differed compared to day 7 and day 10 (P=0.02, P=0.017 and P=0.013, respectively). The 2D monolayer chondrocyte underwent total apoptosis on day 14 which can set the limit for observation in further long-term observational cell study.
Melanoma Detection in Dermoscopic Images using Color Features
Authors: Pathan Sameena , Aggarwal Vatsal , Prabhu K. Gopalakrishna , Siddalingaswamy P. C.
Published: March 2019

Color is considered to be a major characteristic feature that is used for distinguishing benign and malignant melanocytic lesions. Most of malignant melanomas are characterized by the presence of six suspicious colors inspired from the ABCD dermoscopic rule. The presence of these suspicious colors histopathologically indicates the presence of melanin in the deeper layers of the epidermis and dermis. The objective of the proposed work is to evaluate the role of color features, a set of fifteen color features have been extracted from the region of interest to determine the role of color in malignancy detection. Further, a set of ensemble classifiers with dynamic selection techniques are used for classification of the extracted features, yielding an average accuracy of 87.5% for classifying benign and malignant lesions.
Place and Possibilities of the Robotic System Lokomat in the Rehabilitation of Patients After Ischemic Stroke
Authors: I. N. Medvedev
Published: March 2019

Ischemic stroke is still a very common disease with quite serious consequences. Modern medicine considers in this regard its main task in the curation of such patients, the maximum possible restoration of the functions of the affected brain and the volume of its control over the body. Due to the rapid development of medicine associated with the emergence of innovative technologies in the field of rehabilitation, hardware methods of rehabilitation today have gone far ahead and have in their arsenal a lot of high-tech tools. For this purpose, a search is being made for means of increasing the activity of brain cells located in the affected area. Of particular importance in this regard are the methods of rehabilitation in the early recovery period after ischemic stroke using robotic methods of mechanotherapy, one of which is the use of the Lokomat system. Among them, a prominent place is occupied by the walking training system - Lokomat, consisting of robotic orthoses and a body support device, which are combined with a treadmill. Information about the successful use of Lokomat during the rehabilitation of patients with movement disorders is still scattered, and this required their generalization and understanding. The main advantage of this system is the ability to effectively control and ensure high intensity, repeatability (reproducibility) and purposefulness of the trained movements. The convincing advantages of automated training on the Lokomat system compared to traditional rehabilitation in terms of various clinical indicators in patients with post-stroke hemiparesis have been identified. It was shown that in patients trained on the Lokomat system, a single support on the paretic leg intensified, which contributed to a more symmetrical gait. This system is more than other devices and technologies designed for learning to walk, in line with the modern approach to the restoration of impaired motor functions. The inclusion of training sessions on the Lokomat robotic system in the comprehensive treatment of patients with post-stroke hemiparesis leads to a marked improvement in movement skills. This is associated with a pronounced restructuring against the background of its use of the motor stereotype of walking, which makes it possible to increase the effectiveness of recreational activities in post-stroke patients.
A Modified Goldblatt 2K1C Kidney Arterial Ligation Method and Salt Consumption: Which one is Best for Hypertensive Mouse Model?
Authors: Feinisa Khairani Astrid , Afif Auliya Muhammad , Adipurna Syamsunarno Mas Rizky Anggun , Pamela Yunisa , Wahyudi Kurnia , Oktavia Nandina , Iqbal Mohammad
Published: March 2019

The Goldblatt method is one of several methods that can be used in making mouse model of hypertension. The principle of the Goldblatt method itself aims to cause renovascular hypertension by constricting renal blood vessels that results in hypoxic injury and consequently affects the RAAS (Renin-Angiotensin-Aldosterone System). This study aims to determine whether a modification to the Goldblatt method and an additional high salt consumption could be a more effective method in developing a mouse model of hypertension. This study was done on DDY strain mice with 4 weeks of age and 25-30 grams of weight. A simple ligation to constrict renal blood vessel was used as modification from the original Goldblatt 2K1C (two-kidney, one-clip) method. A total of 32 mice were randomized to receive either a modified Goldblatt, modified Goldblatt with salt diet, sham surgery only, or sham with salt diet. Blood pressure was measured at baseline, first week after intervention, and second week after intervention. The data was then analysed by repeated ANOVA method. Hematoxylin and eosin staining was used to analyse histology appearance. This study showed that using a high salt diet only-method generated a hypertensive state faster compared to the modified Goldblatt method, while the modified Goldblatt method produced a steadier increase of blood pressure. Statistically, there was a significant difference of blood pressure between the sham and salt diet group compared to the other three groups at the first week after intervention (p<0,05). The resulting blood pressure from all the methods used in this study was influenced by time. From all four interventions, it is concluded that the modified Goldblatt 2K1C arterial ligation method with an additional high salt consumption had an effect on mice blood pressure. It is prospective to use the salt intervention method for study of hypertension with a short-time period because its acute effect on the rise of diastolic blood pressure was more rapid than the other three groups. On the other hand, the ligation group produced a steadier increase in diastolic blood pressure, therefore might be effective to be used for study of hypertension in a long-time period.
Evaluation of Anti-Propionibacterium Acnes and Anti-Inflammatory Effects of Polyphenolic Extracts of Medicinal Herbs in Jordan
Authors: Abu-Qatouseh Luay , Mallah Eyad , Mansour Kenza
Published: March 2019

Acne vulgaris is one of the most common health problem where medical treatment is sought in adults worldwide. It has been long described the integral role of Propionibacterium acnes in the pathogenesis of this disease. In this study, a group of local herbs known for their antimicrobial effects were selected for the evaluation of potential anti-acnes effects in vitro. Phenolics and flavonoid contents of methanolic extracts of Eucalyptus globulus, Mentha rotundifolia, Inula viscosa, Utrica dioica, Malva sylvestris, Quercus calliprinos, Arum palaestinum and Achille aodorata collected from different regions in Jordan during 2016-2017 were screened for antimicrobial activity against Propionibacterium acnes by disc diffusion and by broth microdilution method. Measurement of release of interleukin 1 alpha from human skin explants by ELISA was used for the evaluation of anti-inflammatory effects of the herbal preparations and extracts. M. rotundifolia and E. globulus, showed the highest phenolic and flavonoid contents in contrast to M. sylvestris which showed the least phenolic contents. Moreover, polyphenolic fractions exhibited modest anti-acne activity of herbal extracts of E. globulus and A. palaestinum (MIC 0.125 mg/ml), U. dioica (0.25 mg/ml) and I. viscosa (0.5 mg/ml), compared to not significant antimicrobial activity for others (MIC >1mg/ml). Regarding anti-inflammatory effects of the tested fractions, E. globulus and A. palaestinum extracts showed inhibition of interleukin 1 alpha release by more than 60 % for concentrations of 0.5 mg/ml respectively. The presence of anti-inflammatory and anti-acne activities in the polyphenolic extracts of local medicinal plants would increase the potential of using these herbs in the control of Acne vulgaris.
Correlation between Hasford Score with Early Molecular Response in Patients with Chronic Myeloid Leukemia in Chronic Phase Treated with Imatinib
Authors: Widi Hersana I. Dewa Made , Yudho Bintoro Ugroseno , Ashariati Ami , Putra Sedana Made
Published: March 2019

The aim of the study is to to determine correlation Hasford score and early molecular response in chronic phase BCR-ABL-Positive CML patients treated with imatinib. This is an longitudinal observational study in newly diagnosed patients of CML chronic phase BCR-ABL-Positive treated imatinib from Januari 2017 to September 2017. Patients were stratified according to Hasford score at diagnosis. Q-PCR(Quantitative RT-PCR) were used to monitor BCR-ABL transcription levels after 3 months of imatinib treatment. Correlation between Hasford score with early molecular response were analyzed using Koefisien Kontingensi’s correlation test. Results: Thirty five patients were enrolled in this study consist of 13 male and 22 female. After 3 months of imatinib treatment, EMR were 5 patients (83.3%), 11 patients (61.1%) and 2 patients (18.2%) in low, intermediate, and high risk group patients, respectively. Koefisien kontigensi test showed that there was significant correlation between Hasford score and EMR (p=0.018; r=0.431). The Hasford score correlated to early molecular response in chronic phase BCR-ABL-positive CML patients received imatinib.
Amelioration of Cyclophosphamide Induced Immunosupression by the Hydro-Alcoholic Extract of Gymnema Sylvestre Leaves in Albino Rats
Authors: Priyadarshini Kar Padmaja , Rath Bandana , Ramani Y. Roja , Maharana C. S.
Published: March 2019

Cyclophosphamide (CP), the most commonly used anti-neoplastic agent causes immunosuppression and toxic effects on various organs that are the limiting factors of cancer treatment. It can be hypothesized that addition of new immunopotentiating agents with detoxification properties would have beneficial role in cancer therapy. Many researchers have proved that, if certain plant products are combined with cancer chemotherapeutic agents, reduce toxicities and improve tumour response. In Ayurveda, Gymnema sylvestre is commonly used for diabetes, obesity and asthma. Also it possesses anti-inflammatory, astringent and digestive properties. Reports on the immunostimulatory activity of Gymnema sylvestre leaves are available from some in vitro and in vivo experiments. With this background the present study was undertaken to evaluate the potential beneficial role of hydro-alcoholic extract of Gymnema sylvestre leaves (GSE) on cyclophosphamide induced immunnosupression in rats. In this experiment, five groups (n=6 in each) of wistar albino rats were randomly divided to receive drugs and vehicle orally for 21 days. Gr I and II received vehicle. Gr III, IV and V were administered with Levamisole 50 mg/kg, GSE 25mg/kg and GSE 50 mg/kg respectively. Except Gr I rats, all rats were injected intraperitoneally with Cyclophosphamide (100mg/kg) on day 9th and 16th of drug treatment. The effects on various organ weights, rise in Haemagglutination titre to Sheep RBC Antigen, delayed type of hypersensitivity (DTH) response to Sheep RBC, percentage of neutrophil adhesion to nylon fibre and phagocytic index from carbon clearance test were evaluated. Humoral and cellular immunity were measured from HA titre and DTH response respectively. It has been observed that, GSE 50 mg/kg significantly increased the antibody titre, percentage neutrophil adhesion and phagocytic index in CP induced immunosuppressed rats. It also restored the CP induced changes in organ weights and the DTH response at 24 and 48 hours of antigen challenge. But these effects were not comparable to that of Levamisole. Our study shows that Gymnema sylvestre reduced the CP induced immunotoxicities and therefore, it could be a safe supplement to cyclophosphamide chemotherapy.
Fully Automated Coronal and Sagittal Chest Segmentation using Colour Features and Fuzzy C-Means Clustering in CT Images
Authors: Khan Z. Faizal
Published: March 2019

In this article, a Combination of Fuzzy logic and color features based segmentation approach for parenchyma of lung from the Coronal and Sagittal Chest CT images is proposed. This approach employs a modified method of segmenting lung parenchyma which is considered as the Region of Interest (ROI) from the Coronal and Sagittal Chest CT images. The first step is the pre-processing of CT lung image in for the process of removing the noise and artefacts present in it. The border detection process is carried out as a Second step where all the regions including the tissue and lung parenchyma is separated by a border detection algorithm. Third step is the color formation process in which the image along with its border is formed in magenta color. Then, the color features extracted from the image border and are given as input to the Improved Fuzzy C Means clustering (IFCM) method to produce the lung Parenchyma. Experimental results reveal that the proposed methodology provides better segmentation results of 97.8 % accuracy in segmenting the parenchyma from Coronal and Sagittal Chest CT images.