scholarly journals Development of an Ultrasensitive Impedimetric Immunosensor Platform for Detection of Plasmodium Lactate Dehydrogenase

Sensors ◽  
2019 ◽  
Vol 19 (11) ◽  
pp. 2446 ◽  
Author(s):  
Yu Kong Low ◽  
Jianxiong Chan ◽  
Gita V. Soraya ◽  
Christelle Buffet ◽  
Chathurika D. Abeyrathne ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Best Practice ◽  
Asymptomatic Carrier ◽  
Diagnostic Tools ◽  
Asymptomatic Carriers ◽  
Before And After ◽  
Sample Application ◽  
Impedimetric Biosensor ◽  
Receive Treatment ◽  
Impedance Magnitude

Elimination of malaria is a global health priority. Detecting an asymptomatic carrier of Plasmodium parasites to receive treatment is an important step in achieving this goal. Current available tools for detection of malaria parasites are either expensive, lacking in sensitivity for asymptomatic carriers, or low in throughput. We investigated the sensitivity of an impedimetric biosensor targeting the malaria biomarker Plasmodium lactate dehydrogenase (pLDH). Following optimization of the detection protocol, sensor performance was tested using phosphate-buffered saline (PBS), and then saliva samples spiked with pLDH at various concentrations. The presence of pLDH was determined by analyzing the sensor electrical properties before and after sample application. Through comparing percentage changes in impedance magnitude, the sensors distinguished pLDH-spiked PBS from non-spiked PBS at concentrations as low as 250 pg/mL (p = 0.0008). Percentage changes in impedance magnitude from saliva spiked with 2.5 ng/mL pLDH trended higher than those from non-spiked saliva. These results suggest that these biosensors have the potential to detect concentrations of pLDH up to two logs lower than currently available best-practice diagnostic tools. Successful optimization of this sensor platform would enable more efficient diagnosis of asymptomatic carriers, who can be targeted for treatment, contributing to the elimination of malaria.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

KETIDAKEFEKTIFAN KEBIJAKAN ANTI-DUMPING PRODUK IMPOR BAJA INDONESIA: SEBUAH ANALISIS AWAL

2017 ◽  
Vol 11 (2) ◽  
pp. 143-168
Author(s):  
Aditya Paramita Alhayat
Keyword(s):  
Government Regulation ◽  
Best Practice ◽  
Secondary Data ◽  
Information Services ◽  
Global Trade ◽  
Trade Patterns ◽  
Safeguard Measures ◽  
The Us ◽  
Before And After ◽  
The Government

Meskipun Indonesia telah mengenakan tindakan anti-dumping terhadap beberapa jenis produk baja, namun impor produk tersebut masih meningkat. Salah satu kemungkinan penyebabnya adalah importasi melalui produk yang dimodifikasi secara tidak substansial atau melalui negara ketiga yang tidak dikenakan tindakan anti-dumping, yang dalam perdagangan internasional umum disebut sebagai praktik circumvention. Studi ini ditujukan untuk membuktikan bahwa circumvention mengakibatkan tindakan anti-dumping atas impor produk baja Indonesia tidak efektif dan untuk memberikan masukan berdasarkan praktik di negara lain supaya kebijakan anti-dumping Indonesia lebih efektif. Circumvention dianalisis dengan membandingkan pola perdagangan antara sebelum dan setelah pengenaan bea masuk anti-dumping (BMAD) menggunakan data sekunder dari Badan Pusat Statistik (BPS) maupun Global Trade Information Services (GTIS). Hasil analisis menunjukkan adanya indikasi kuat bahwa circumvention mengkibatkan pengenaan tindakan anti-dumping impor produk baja di Indonesia menjadi tidak efektif. Oleh karena itu, sangat penting bagi Pemerintah Indonesia untuk segera melakukan penyempurnaan terhadap Peraturan Pemerintah No. 34/2011 tentang Tindakan Antidumping, Tindakan Imbalan, dan Tindakan Pengamanan Perdagangan dengan memasukkan klausul tindakan anti-circumvention yang setidaknya mencakup bentuk-bentuk dan prosedur tindakan, sebagaimana yang telah dilakukan beberapa negara seperti: AS, EU, Australia, dan India. Although Indonesia has imposed anti-dumping measures on several types of steel products, the import of steel products is still increasing. One possible cause is that imports are made by non-substantial modification of product or through a third country which is not subject to anti-dumping measures, which is generally referred as circumvention practice. This study is aimed to prove that circumvention made Indonesian anti-dumping actions on the steel products ineffective. This also study provides recommendation for a best practice for other countries so that Indonesia's anti-dumping policy can be more effective. Circumvention was analyzed by comparing trade patterns between before and after the imposition of anti-dumping duty using secondary data from the Central Bureau of Statistics (BPS) and the Global Trade Information Services (GTIS). The results of the analysis indicate that circumvention became the reason why Indonesian anti-dumping measures on imported steel products are ineffective. Therefore, it is very important for the Government of Indonesia to immediately make amendments to the Government Regulation No. 34/2011 on Antidumping, Countervailing, and Safeguard Measures by adopting clauses of anti-circumvention. This can be done bycovering the forms/types and procedures of action, as has been implemented by several countries such as the US, EU, Australia, and India.

scholarly journals Cooperation & Liaison between Universities & Editors (CLUE): recommendations on best practice

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Elizabeth Wager ◽  
◽  
Sabine Kleinert
Keyword(s):  
Peer Review ◽  
Best Practice ◽  
Research Integrity ◽  
Decision Makers ◽  
Publication Ethics ◽  
List Type ◽  
Research Institutions ◽  
Academic Journals ◽  
Before And After ◽  
Published Research

Abstract Background Inaccurate, false or incomplete research publications may mislead readers including researchers and decision-makers. It is therefore important that such problems are identified and rectified promptly. This usually involves collaboration between the research institutions and academic journals involved, but these interactions can be problematic. Methods These recommendations were developed following discussions at World Conferences on Research Integrity in 2013 and 2017, and at a specially convened 3-day workshop in 2016 involving participants from 7 countries with expertise in publication ethics and research integrity. The recommendations aim to address issues surrounding cooperation and liaison between institutions (e.g. universities) and journals about possible and actual problems with the integrity of reported research arising before and after publication. Results The main recommendations are that research institutions should: develop mechanisms for assessing the integrity of reported research (if concerns are raised) that are distinct from processes to determine whether individual researchers have committed misconduct; release relevant sections of reports of research integrity or misconduct investigations to all journals that have published research that was investigated; take responsibility for research performed under their auspices regardless of whether the researcher still works at that institution or how long ago the work was done; work with funders to ensure essential research data is retained for at least 10 years. Journals should: respond to institutions about research integrity cases in a timely manner; have criteria for determining whether, and what type of, information and evidence relating to the integrity of research reports should be passed on to institutions; pass on research integrity concerns to institutions, regardless of whether they intend to accept the work for publication; retain peer review records for at least 10 years to enable the investigation of peer review manipulation or other inappropriate behaviour by authors or reviewers. Conclusions Various difficulties can prevent effective cooperation between academic journals and research institutions about research integrity concerns and hinder the correction of the research record if problems are discovered. While the issues and their solutions may vary across different settings, we encourage research institutions, journals and funders to consider how they might improve future collaboration and cooperation on research integrity cases.

scholarly journals Impact of the 2017 Child and Adult Care Food Program Meal Pattern Requirement Change on Menu Quality in Tribal Early Care Environments: The Food Resource Equity and Sustainability for Health Study

2019 ◽  
Vol 4 (Supplement_1) ◽  
pp. 12-22 ◽  
Author(s):  
Susan B Sisson ◽  
Kaysha Sleet ◽  
Rachel Rickman ◽  
Charlotte Love ◽  
Alexandria Bledsoe ◽  
...  
Keyword(s):  
Native American ◽  
Best Practice ◽  
Food Resource ◽  
Saturated Fat ◽  
Health Study ◽  
Healthy Weight ◽  
Early Care ◽  
Adult Care ◽  
Nutrient Analysis ◽  
Before And After

ABSTRACT Background Native American (NA) children have a high prevalence of obesity contributing to lifespan health disparities. Dietary intake is important to promote healthy weight gain, growth, and development. In 2017, the USDA enforced changes to the Child and Adult Care Food Program (CACFP). The CACFP provides reimbursement to qualifying Early Care and Education (ECE) programs that serve foods that uphold the program's nutrition requirements. Objective This study had the following 2 objectives: 1) Describe a novel index to evaluate ECE menus based on revised CACFP requirements (accounting for food substitutions) and best practices for 3- to-5-y-old children, and 2) analyze CACFP requirement and best practice compliance and nutrient changes in 9 NA ECE programs before and after enforcement of the revised CACFP requirements. Methods This longitudinal study is within a larger community-based participatory research study. Menus and meals served were evaluated for 1 wk at each of 9 programs before and after enforcement of the revised meal patterns. Nutrient analysis, CACFP requirement and best practice compliance, and substitution quality were evaluated. Differences were determined using a paired t-test or Wilcoxon matched test. This trial was registered at clinicaltrials.gov as NCT03251950. Results Total grams of fiber consumed increased (5.0 ± 1.2 compared with 5.9 ± 0.8 g, P = 0.04) and total grams of sugar consumed decreased (53.8 ± 12.6 compared with 48.4 ± 7.9 g, P = 0.024), although room for further improvement exists. Although total grams of fat remained unchanged, grams of saturated fat significantly increased (7.8 ± 1.4 compared with 10.5 ± 3.4, P = 0.041). Other nutrients remained unchanged. Overall CACFP requirement and best practice compliance scores improved, although this finding was not statistically significant. No significant changes in food quality associated with substitutions occurred. Conclusions This study provides early evidence to support the beneficial impact of the revised CACFP requirements. Understanding barriers to compliance within rural NA communities would be an important next step in enhancing the health of vulnerable children.

scholarly journals Myocardial infarction, ischaemic stroke and pulmonary embolism before and after breast cancer hospitalisation

2011 ◽  
Vol 106 (07) ◽  
pp. 149-155 ◽  
Author(s):  
Sumitra Shantakumar ◽  
Pieter W. Kamphuisen ◽  
Fernie J. A. Penning-van Beest ◽  
Ron M. C. Herings ◽  
Myrthe P. P. van Herk-Sukel
Keyword(s):  
Breast Cancer ◽  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Ischaemic Stroke ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Before And After ◽  
Receive Treatment ◽  
Free Women

SummaryWe studied the occurrence of myocardial infarction (MI), ischaemic stroke (IS) and pulmonary embolism (PE) before and after breast cancer hospitalisation compared with cancer-free controls. For this, women with a first breast cancer hospitalisation during 2000–2007 were selected from the PHARMO Record Linkage System, including drug use and hospitalisations of three million inhabitants in the Netherlands, and matched 1:10 by age to cancer-free women. The occurrence of MI, IS and PE were assessed in the 12 months before and after breast cancer hospitalisation. The study included 11,473 breast cancer patients, with a mean (± SD) age of 59 (± 14) years. Breast cancer patients were two to three times as likely as their cancer-free controls to have had a hospitalisation for PE, MI or IS in the 12 months before diagnosis, though prevalence was <1% in all groups. Breast cancer patients experienced an extreme high risk of PE in the first six months after diag- nosis (hazard ratio [HR] 23.5, 95% confidence interval [CI] 11.1–49.7 compared to controls), which declined gradually to a four times increased risk (HR 3.6, 95%CI 2.4–5.5) more than 12 months after breast cancer hospitalisation. However, incidence was low: less than five events per 1,000 person years during all time periods. For MI and IS we did not observe significant increased HRs after breast cancer hospitalisation compared to controls. Breast cancer patients seem to have a higher risk profile to develop MI and IS, and receive treatment that increases the risk of PE compared to cancer-free controls, although the frequency of hospitalisations was low.

scholarly journals A Successful Strategy to Reduce Hospital-Onset Clostridium difficile

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S406-S406
Author(s):  
Lou Ann Bruno-Murtha ◽  
Rebecca Osgood ◽  
Casey Alexandre ◽  
Rumel Mahmood
Keyword(s):  
Best Practice ◽  
Teaching Hospitals ◽  
Incentive Payment ◽  
Contact Precautions ◽  
Testing Protocol ◽  
Antigen Assay ◽  
Before And After ◽  
Practice Advisory ◽  
Community Onset ◽  
Community Teaching

Abstract Background Our goal was to reduce the rate of hospital-onset (HO) C. difficile (CD) by prompt testing in patients with diarrhea on hospital day (HD) 1–3 using a nurse-driven testing protocol (NTP) with PCR and improve identification of disease after HD 3 using a combined toxin/antigen assay (TAA). Methods An automated best practice advisory/NTP was developed in Epic, triggered by documentation of diarrhea during HD 1–3, to facilitate prompt stool collection, testing and initiation of contact precautions. Education was provided. The NTP was fully implemented at 2 community-teaching hospitals mid-February 2016. The TAA was adopted 7/27/16 for testing after HD 3. Results In 2016, the standardized infection ratio (SIR) at Cambridge and Everett was 0.43 (P = 0.009) and 0.5 (P = 0.017), respectively, reflecting a 48–61% decrease from 2015. There was a 14–28% improvement in identifying cases as community-onset. The TAA led to a further decline in HO-CD by 10–61%. Refer to the graph for quarterly SIRs before and after implementation. Despite a 26% increase in testing volume, costs are less with the current strategy. Conclusion Prompt identification of CD improves care and prevents inflation of HO-CD. This strategy has enhanced our efforts to reduce our SIR (observed/expected cases) and resulted in a substantial incentive payment for CHA. Disclosures All authors: No reported disclosures.

scholarly journals 2345. Reduction in Testing and Change in Testing Algorithm Associated with Decrease in Number of Nosocomial Clostridium difficile Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S806-S806
Author(s):  
Susan Nichols ◽  
Michelle D Jordan ◽  
Michael Coogan ◽  
Jackie Opera ◽  
Paul P Cook
Keyword(s):  
Clostridium Difficile ◽  
Best Practice ◽  
Medical Center ◽  
Nucleic Acid Amplification ◽  
Antimicrobial Use ◽  
Continuous Variables ◽  
Laxative Use ◽  
Days Of Therapy ◽  
Before And After ◽  
Testing Algorithm

Abstract Background Previous data at our facility indicated 37% of patients with Clostridium difficile infection (CDI) were receiving at least one laxative at the time of testing, suggesting the possibility of false-positive results. Nucleic acid amplification testing (NAAT) does not distinguish between colonization and infection with C. difficile. We implemented two interventions to address these issues and evaluated our rates of nosocomial CDI before and after these changes. Methods This was a retrospective study of all positive test results for adult patients with nosocomial C. difficile from October 1, 2017 through March 31, 2019 at Vidant Medical Center, a 911-bed hospital. In June, 2018, we implemented a best practice advisory (BPA) in our electronic health record to recommend against testing for CDI in patients receiving laxatives. We reviewed the number of C. difficile tests ordered before and after initiating the BPA. In December, 2018, we removed NAAT and replaced it with a cell cytotoxicity assay (CCA) for specimens that were enzyme immunoassay (EIA) negative and glutamate dehydrogenase (GDH) positive. Antimicrobial use was measured in days of therapy (DOT) per 10,000 patient-days (PD). Mann–Whitney U test was used for continuous variables. Linear regression was used to monitor antimicrobial use. Results The number of C. difficile tests ordered per month decreased 19.5% after implementing the BPA (P < 0.0001). There was a 44% reduction in the number of EIA+/GDH+ specimens per month after the BPA intervention (P = 0.003). Following substitution of CCA for NAAT for EIA-/GDH+ specimens, there was a 61% reduction in the rate of nosocomial CDI (8.6 cases/10,000 PD to 3.3 cases/10,000 PD; P = 0.005). Total antimicrobial use was unchanged over the course of the study (673 to 677 DOT/10,000 PD). Carbapenem use decreased 56% (P = 0.009); cefepime use increased 85%(p = 0.002); quinolone and clindamycin use were unchanged. Conclusion Laxative use in hospitalized patients is common and likely contributes to a false elevation in the CDI rate by identifying carriers in addition to those who have true infection. Implementing a BPA to reduce inappropriate testing and changing our testing algorithm for Clostridium difficile by substituting CCA for NAAT has resulted in a lower rate of nosocomial CDI. Disclosures All authors: No reported disclosures.

scholarly journals The descriptive epidemiology of coronavirus disease 2019 during the epidemic period in Lu'an, China: achieving limited community transmission using proactive response strategies

2020 ◽  
Vol 148 ◽  
Author(s):  
Wei Qin ◽  
Jie Sun ◽  
Pengpeng Xu ◽  
Tianqi Gong ◽  
Xiude Li ◽  
...  
Keyword(s):  
Early Stage ◽  
Asymptomatic Carrier ◽  
Hubei Province ◽  
Initial Symptom ◽  
Asymptomatic Carriers ◽  
Epidemic Period ◽  
Imported Cases ◽  
Community Transmission ◽  
The Mean ◽  
The Impact

Abstract Hubei province in China has had the most confirmed coronavirus disease 2019 (COVID-19) cases and has reported sustained transmission of the disease. Although Lu'an city is adjacent to Hubei province, its community transmission was blocked at the early stage, and the impact of the epidemic was limited. Therefore, we summarised the overall characteristics of the entire epidemic course in Lu'an to help cities with a few imported cases better contain the epidemic. A total of 69 confirmed COVID-19 cases and 11 asymptomatic carriers were identified in Lu'an during the epidemic from 12 January to 21 February 2020. Fifty-two (65.0%) cases were male, and the median age was 40 years. On admission, 56.5% of cases had a fever as the initial symptom, and pneumonia was present in 89.9% of cases. The mean serial interval and the mean duration of hospitalisation were 6.5 days (95% CI: 4.8–8.2) and 18.2 days (95% CI: 16.8–19.5), respectively. A total of 16 clusters involving 60 cases (17 first-generation cases and 43 secondary cases) were reported during the epidemic. We observed that only 18.9% (7/37) index cases resulted in community transmission during the epidemic in Lu'an, indicating that the scale of the epidemic was limited to a low level in Lu'an city. An asymptomatic carrier caused the largest cluster, involving 13 cases. Spread of COVID-19 by asymptomatic carriers represents an enormous challenge for countries responding to the pandemic.

“Months, not years”: Impact of clinical discussions of advanced cancer life-expectancy on patient illness understanding.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 30-30
Author(s):  
Andrew S. Epstein ◽  
Holly Gwen Prigerson ◽  
Leonard Saltz ◽  
Eileen Mary O'Reilly ◽  
Manish A. Shah ◽  
...  
Keyword(s):  
Life Expectancy ◽  
End Of Life ◽  
Advanced Cancer ◽  
Best Practice ◽  
Chemotherapy Regimen ◽  
Advanced Cancer Patients ◽  
Coping With Cancer ◽  
Before And After ◽  
Observational Cohort ◽  
Upper Gastrointestinal

30 Background: Patients’ understanding of their illness often guides best practice, and this is no less true at the end of life. Data showing the influence of patients’ acknowledgment of prognostic discussions on the accuracy of patients’ illness understanding could inform the debate regarding how to engage in these difficult discussions. Methods: To evaluate the effects of recent and past oncologist-patient discussions about prognosis/life-expectancy (P/LE) on changes in advanced cancer patents’ illness understanding (acknowledgement of their illness as 1. terminal; 2. incurable; 3. advance staged; and 4. associated with an estimated life-expectancy in months, not years), 208 patients (with advanced lung or upper gastrointestinal cancers that progressed on 1 chemotherapy regimen, or advanced colorectal cancers that progressed on 2) from Coping with Cancer II, a prospective observational cohort study, were interviewed before and after a visit with their oncologists who discussed scan results regarding potential additional progression. Results: Median time between pre- and post-scan interviews was 38 days. Controlling for potential confounds (i.e., patients’ race) and adjusting for patients’ pre-scan illness understanding, patients who acknowledged ever having discussions of P/LE with their oncologists were more likely to recognize that their disease was incurable (Adjusted Odds Ratio [AOR] = 2.97, p = 0.009) than those who did not. Compared to patients who denied ever having a discussion of P/LE, those who reported having both recent and past discussions of P/LE were more likely to recognize that their disease was at an advanced stage (AOR = 4.88, p = 0.012), and those who reported having only recent discussions, or both recent and past discussions, of P/LE were more likely to estimate their life-expectancy in terms of months as opposed to years (AOR = 10.1, p = 0.050, and AOR = 17.5, p = 0.006, respectively). Conclusions: Advanced cancer patients who acknowledge having discussions of P/LE with their oncologists have a better understanding of the terminal nature of their illnesses as compared to those who do not, and thus may be better prepared to make informed end-of-life care decisions.

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