Ophthalmic short- and long-term outcomes for premature infants: Results of an extended follow-up program in Saudi Arabia

Purpose

Study the ophthalmic morbidities for infants born prematurely at a Tertiary care center in Riyadh city.

Methods

Retrospective, longitudinal cohort study at King Fahad Medical City for premature infants born at gestational age (GA) ⩽32 weeks or birth weight (BW) ⩽1500 g during the study period from January 1, 2007, until the end of December 2009 was conducted. Short term outcome was diagnosis with Retinopathy of Prematurity (ROP) and long-term outcome was ophthalmic findings at age 18–24 months.

Results

The cumulative incidence of ROP was 30%. Infants diagnosed with ROP had a mean GA of 27 weeks (23–35 weeks) and mean BW of 907 g (530–1730 g). Risk factors other than GA and BW for ROP, identified in the predictive logistic regression model, were blood transfusion [odds ratio (OR) 1.27] and diagnosis with intraventricular hemorrhage (OR = 2.90). Strabismus was identified in 14% of the study cohort. Diagnosis of hyperopia (spherical equivalent ⩾+0.75 D) was equal in both ROP and no-ROP groups (p = 0.56). Myopia (spherical equivalent ⩾−0.75 D) and astigmatism ⩾1.00 D were diagnosed more frequently in the ROP group (p < 0.0001 and 0.04, respectively).

Conclusions

A higher incidence of ROP was observed in this cohort compared to some Saudi Arabian centers. It is recommended that the screening criteria be maintained and that the effects of further control of blood transfusion be assessed in a prospective study. The authors recommend an extra ophthalmic evaluation at the age of 18–24 months for all premature infants born with GA ⩽ 32 weeks.     

An explanatory mixed methods study on the validity and validation of students’ assessment results in the undergraduate surgery course

Abstract

Background/purpose: There is inadequate evidence of reported validity of the results of assessment instruments used to assess clinical competence. This study aimed at combining multiple lines of quantitative and qualitative evidence to support interpretation and use of assessment results.

Method: This study is a mixed methods explanatory research set in two stages of data collection and analysis (QUAN : qual). Guided by Messick’s conceptual model, quantitative evidences as reliability and correlation coefficients of various validity components were calculated using students’ scores, grades and success rates of the whole population of students in 2012/2013 and 2013/2014 (n=?383; 326). The underlying values that scaffold validity evidences were identified via Focus Group Discussions (FGD) with faculty and students; sampling technique was purposive; and results were analyzed by content analysis.

Results: (1) Themes that resulted from content analysis aligned with quantitative evidences. (2) Assessment results showed: (a) content validity (table of specifications and blueprinting in another study); (b) consequential validity (positive unintended consequences resulted from new assessment approach); (c) relationships to other variables [a statistically significant correlation among various assessment methods; with combined score (0.64–0.86) and between mid and final exam results (r?=?0.672)]; (d) internal consistency (high reliability of MCQ and OSCE: 0.81, 0.80); (3) success rates and grades distribution alone could not provide evidence to advocate an argument on validity of results.

Conclusion: The unified approach pursued in this study created a strong evidential basis for meaningful interpretation of assessment scores that could be applied in clinical assessments.     

Transition metal oxide (NiO,CuO, ZnO)-doped calcium oxide catalysts derived from eggshells for the transesterification of refined waste cooking oil

This paper reports the synthesis of new transition metal oxide-modified CaO catalysts derived from eggshells for the transesterification of refined waste cooking oil. CaO is a well-known base catalyst for transesterification. However, its moderate basicity and low surface area have restricted its catalytic performance. Therefore, a new attempt was made to modify the CaO catalyst with transition metal oxides, including Ni, Cu and Zn oxides, via simple wetness impregnation method. The catalytic performance of the resulting modified CaO-based catalysts was evaluated through the transesterification reaction using refined waste cooking oil. The results showed that the NiO/CaO(10 : 90)(ES) catalyst calcined at 700 °C, demonstrated being highly potential as a catalyst. It gave the highest biodiesel production (97.3%) at the optimum conditions of 1 : 18 oil-to-methanol molar ratio, 6 wt% catalyst loading and 180 minutes reaction time as verified by response surface methodology (RSM). The high catalytic activity of NiO/CaO(10 : 90)(ES)(700 °C) was attributed to its high basicity (8.5867 mmol g⁻¹) and relatively large surface area (7.1 m² g⁻¹). The acid value and free fatty acids of the biodiesel produced under optimal process conditions followed the EN 14214 and ASTM D6751 limit with 0.17 mg KOH per g (AV) and 0.09 mg KOH per g (FFA), respectively.

This paper reports the synthesis of new transition metal oxide-modified CaO catalysts derived from eggshells for the transesterification of refined waste cooking oil.     

Necrosis Factor-α (TNF-α) and the Presence of Macrophage M2 and T Regulatory Cells in Nasopharyngeal Carcinoma

Objective:To investigate the correlation between TLR3 and pro-inflammatory cytokines (TNFα, IL6) expression with the distribution of macrophage M2 and Treg on Epstein Barr virus-encoded RNAs (EBER+) nasopharyngeal carcinoma (NPC) tissues. Methods:A total of 23 FFPE NPC tissue samples were obtained from patients in Dr. Sardjito General Hospital, Yogyakarta, Indonesia in 2008–2010, which expressed EBER was collected. The expressions of TLR3, TNFα, and IL6 were examined using immunofluorescence assay. The distribution of macrophage M2 and Treg were examined by immunohistochemistry with anti-CD163 and -FOXP3 antibodies, respectively. The quantification of fluorescence intensity was analyzed by the RGB space method using ImageJ software. The M2 interpretation was done by the eyeballing method and the M2 scores were divided into 0 (negative), 1 (scant), 2 (focal), 3 (abundant). The average number of Treg FOXP3+ cells in five high power fields was counted. The relationship between variables were tested by the Spearman correlation test, and the coefficient correlation was used to see the correlation between variables. Results:All EBER+ NPC specimens showed TLR3 expression intracellularly. The expression of TNFα could be observed in the cell membranes and secreted extracellularly, while IL6 was secreted to the extracellular area. The expression of TNFα was two times higher than IL6. Most specimens showed low M2 score (56.52%) and high Treg (52.17%). A positive correlation was found between TLR3 and IL6 (12.9%). TNFα was positively correlated with the M2 distribution of 13.7% and Treg distribution of 12.9%, while the rest were explained by other factors. Conclusion:TNFα has a positive correlation with M2 and Treg distribution,but mostly through a different mechanism other than EBER-TLR3 interaction. Possibly, other pro-inflammatory and anti-inflammatory cytokines are involved in the formation of the NPC microenvironment, especially related to the presence of M2 and Treg, which provide immunosuppressive effects in NPC tumors. Key Words: Epstein Barr virus, encoded RNAs, TLR3, pro-inflammatory cytokines, M2, Treg     

Phenotypic and Functional Characterization of Mesenchymal Stem Cells from Chorionic Villi of Human Term Placenta

Background

Bone marrow derived mesenchymal stem cells (BM-MSCs) are used extensively in transplantation but their use is associated with many problems including low abundance in BM, low overall number, decreased differentiation potential with age and the invasive isolation procedures needed to obtain BM. We report a novel method of isolating placental MSCs (pMSCs) from chorionic villi, which exhibit the phenotypic and functional characteristics that will make them an attractive source of MSCs for cell-based therapy.

Methods

A novel explant approach was used to isolate pMSCs from chorionic villi of human placentae. These pMSCs were characterized by flow cytometry and were differentiated into adipocytes, osteocytes and chondrocytes using differentiation medium as demonstrated by cytochemical staining. The gene and protein expression profiles of pMSCs were also characterized using real time polymerase chain reaction (PCR) and flow cytometry, respectively. In addition, cytokine secretion by pMSCs was also analysed using sandwich enzyme-linked immunosorbent assay (ELISA) technique. Moreover, the migration and proliferation potentials of pMSCs were also determined.

Results

pMSCs were isolated from fetal part of the chorionic villi and these pMSCs expressed CD44, CD90, CD105, CD146, CD166 and HLA-ABC but not CD14, CD19, CD40, CD45, CD80, CD83, CD86 and HLA-DR. In addition, these pMSCs differentiated into osteocytes, chondrocytes and adipocytes and they also expressed several adhesion molecules, chemokines/receptors, growth factor receptors and cytokines/receptors. Moreover, they secreted many cytokines (IL-1Ra, IL6, IL8, IL10, IL11 and IL15) and they were able to proliferate. Furthermore, they migrated in response to chemotactic factors including stromal cell-derived factor-1 (SDF-1), platelet derived growth factor (PDGF), hepatocyte growth factor (HGF), and monocyte chemotactic protein-1 (MCP-1).

Conclusions

We devised a novel explant method of isolating pMSCs that expressed many biological factors responsible for mediating cellular processes such as migration/homing, immune modulation and angiogenesis. Therefore, we suggest that pMSCs prepared from human term placental chorionic villous explants are an attractive source of MSCs for cell therapy.     

Music and Sound-Based Intervention in Autism Spectrum Disorder: A Scoping Review

To map the evidence from the relevant studies regarding the use of music and sound-based intervention for autism spectrum disorder (ASD) using a scoping review study design. Scoping review was conducted according to the inclusion criteria using Google Scholar, PubMed, CINAHL, MEDLINE, and Scopus. The review was accomplished in five steps: 1) identify the inclusion criteria, 2) search for relevant studies, 3) studies selection, 4) data extraction and charting, and 5) data analysis and presentation. Four major themes emerged from 39 studies that matched the inclusion criteria as follows: 1) forms of sound therapy discussing methods of sound therapy and stimulus used, 2) duration of the intervention explain in terms of listening time and total listening sessions, 3) clinical characteristics of the intervention exploring the main interest of sound therapy study in ASD, and 4) evidence for the intervention effectiveness looking into the positive, negative, and mixed findings of previous studies. Each theme was explored to identify the knowledge gaps in sound-intervention therapy. This review demonstrated the need for further studies to address several issues including identifying the effectiveness of sound-therapy intervention for ASD according to the individual sound types, the minimum duration for ASD sound-therapy intervention and more details on the use of technology, and clinical features of the sound-therapy intervention. These elements are important to further demonstrate the effectiveness of sound therapy intervention for ASD children.