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Development of a web-based liver cancer prediction model for type II diabetes patients by using an artificial neural network. - Computer methods and programs in biomedicine
Diabetes mellitus is associated with an increased risk of liver cancer, and these two diseases are among the most common and important causes of morbidity and mortality in Taiwan.To use data mining techniques to develop a model for predicting the development of liver cancer within 6 years of diagnosis with type II diabetes.Data were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan, which covers approximately 22 million people. In this study, we selected patients who were newly diagnosed with type II diabetes during the 2000-2003 periods, with no prior cancer diagnosis. We then used encrypted personal ID to perform data linkage with the cancer registry database to identify whether these patients were diagnosed with liver cancer. Finally, we identified 2060 cases and assigned them to a case group (patients diagnosed with liver cancer after diabetes) and a control group (patients with diabetes but no liver cancer). The risk factors were identified from the literature review and physicians' suggestion, then, chi-square test was conducted on each independent variable (or potential risk factor) for a comparison between patients with liver cancer and those without, those found to be significant were selected as the factors. We subsequently performed data training and testing to construct artificial neural network (ANN) and logistic regression (LR) prediction models. The dataset was randomly divided into 2 groups: a training group and a test group. The training group consisted of 1442 cases (70% of the entire dataset), and the prediction model was developed on the basis of the training group. The remaining 30% (618 cases) were assigned to the test group for model validation.The following 10 variables were used to develop the ANN and LR models: sex, age, alcoholic cirrhosis, nonalcoholic cirrhosis, alcoholic hepatitis, viral hepatitis, other types of chronic hepatitis, alcoholic fatty liver disease, other types of fatty liver disease, and hyperlipidemia. The performance of the ANN was superior to that of LR, according to the sensitivity (0.757), specificity (0.755), and the area under the receiver operating characteristic curve (0.873). After developing the optimal prediction model, we base on this model to construct a web-based application system for liver cancer prediction, which can provide support to physicians during consults with diabetes patients.In the original dataset (n=2060), 33% of diabetes patients were diagnosed with liver cancer (n=515). After using 70% of the original data to training the model and other 30% for testing, the sensitivity and specificity of our model were 0.757 and 0.755, respectively; this means that 75.7% of diabetes patients can be predicted correctly to receive a future liver cancer diagnosis, and 75.5% can be predicted correctly to not be diagnosed with liver cancer. These results reveal that this model can be used as effective predictors of liver cancer for diabetes patients, after discussion with physicians; they also agreed that model can assist physicians to advise potential liver cancer patients and also helpful to decrease the future cost incurred upon cancer treatment.Copyright Â© 2015. Published by Elsevier Ireland Ltd.
Change of strategy is required for malaria elimination: a case study in Purworejo District, Central Java Province, Indonesia. - Malaria journal
Malaria has been targeted for elimination from Indonesia by 2030, with varying timelines for specific geographical areas based on disease endemicity. The regional deadline for malaria elimination for Java island, given the steady decrease of malaria cases, was the end of 2015. Purworejo District, a malaria-endemic area in Java with an annual parasite incidence (API) of 0.05 per 1,000 population in 2009, aims to enter this elimination stage. This study documents factors that affect incidence and spatial distribution of malaria in Purworejo, such as geomorphology, topography, health system issues, and identifies potential constraints and challenges to achieve the elimination stage, such as inter-districts coordination, decentralization policy and allocation of financial resources for the programme.Historical malaria data from 2007 to 2011 were collected through secondary data, in-depth interviews and focus group discussions during study year (2010-2011). Malaria cases were mapped using the village-centroid shape file to visualize its distribution with geomorphologic characteristics overlay and spatial distribution of malaria. API in each village in Purworejo and its surrounding districts from 2007 to 2011 was stratified into high, middle or low case incidence to show the spatiotemporal mapping pattern.The spatiotemporal pattern of malaria cases in Purworejo and the adjacent districts demonstrate repeated concentrated occurrences of malaria in specific areas from 2007 to 2011. District health system issues, i.e., suboptimal coordination between primary care and referral systems, suboptimal inter-district collaboration for malaria surveillance, decentralization policy and the lack of resources, especially district budget allocations for the malaria programme, were major constraints for programme sustainability.A new malaria elimination approach that fits the local disease transmission, intervention and political system is required. These changes include timely measurements of malaria transmission, revision of the decentralized government system and optimizing the use of the district capitation fund followed by an effective technical implementation of the intervention strategy.
Inhibition of hepatitis C virus replication by chalepin and pseudane IX isolated from Ruta angustifolia leaves. - Fitoterapia
Hepatitis C virus (HCV) infection is highly prevalent among global populations, with an estimated number of infected patients being 170 million. Approximately 70-80% of patients acutely infected with HCV will progress to chronic liver disease, such as liver cirrhosis and hepatocellular carcinoma, which is a substantial cause of morbidity and mortality worldwide. New therapies for HCV infection have been developed, however, the therapeutic efficacies still need to be improved. Medicinal plants are promising sources for antivirals against HCV. A variety of plants have been tested and proven to be beneficial as antiviral drug candidates against HCV. In this study, we examined extracts, their subfractions and isolated compounds of Ruta angustifolia leaves for antiviral activities against HCV in cell culture. We isolated six compounds, chalepin, scopoletin, Î³-fagarine, arborinine, kokusaginine and pseudane IX. Among them, chalepin and pseudane IX showed strong anti-HCV activities with 50% inhibitory concentration (ICâ‚…â‚€) of 1.7 Â± 0.5 and 1.4 Â± 0.2 Î¼g/ml, respectively, without apparent cytotoxicity. Their anti-HCV activities were stronger than that of ribavirin (2.8 Â± 0.4 Î¼g/ml), which has been widely used for the treatment of HCV infection. Mode-of-action analyses revealed that chalepin and pseudane IX inhibited HCV at the post-entry step and decreased the levels of HCV RNA replication and viral protein synthesis. We also observed that arborinine, kokusaginine and Î³-fagarine possessed moderate levels of anti-HCV activities with ICâ‚…â‚€ values being 6.4 Â± 0.7, 6.4 Â± 1.6 and 20.4 Â± 0.4 Î¼g/ml, respectively, whereas scopoletin did not exert significant anti-HCV activities at 30 Î¼g/ml.Copyright Â© 2014 Elsevier B.V. All rights reserved.
Trypanosomatid phosphoglycerate mutases have multiple conformational and oligomeric states. - Biochemical and biophysical research communications
Three structurally distinct forms of phosphoglycerate mutase from the trypanosomatid parasite Leishmania mexicana were isolated by standard procedures of bacterial expression and purification. Analytical size-exclusion chromatography coupled to a multi-angle scattering detector detected two monomeric forms of differing hydrodynamic radii, as well as a dimeric form. Structural comparisons of holoenzyme and apoenzyme trypanosomatid cofactor-independent phosphoglycerate mutase (iPGAM) X-ray crystal structures show a large conformational change between the open (apoenzyme) and closed (holoenzyme) forms accounting for the different monomer hydrodynamic radii. Until now iPGAM from trypanosomatids was considered to be only monomeric, but results presented here show the appearance of a dimeric form. Taken together, these observations are important for the choice of screening strategies to identify inhibitors of iPGAM for parasite chemotherapy and highlight the need to select the most biologically or functionally relevant form of the purified enzyme.Copyright Â© 2014. Published by Elsevier Inc.
Early malaria resurgence in pre-elimination areas in Kokap Subdistrict, Kulon Progo, Indonesia. - Malaria journal
Indonesia is among those countries committed to malaria eradication, with a continuously decreasing incidence of malaria. However, at district level the situation is different. This study presents a case of malaria resurgence Kokap Subdistrict of the Kulon Progo District in Yogyakarta Province, Java after five years of low endemicity. This study also aims to describe the community perceptions and health services delivery situation that contribute to this case.All malaria cases (2007-2011) in Kulon Progo District were stratified to annual parasite incidence (API). Two-hundred and twenty-six cases during an outbreak (May 2011 to April 2012) were geocoded by household addresses using a geographic information system (GIS) technique and clusters were identified by SaTScan software analysis (Arc GIS 10.1). Purposive random sampling was conducted on respondents living inside the clusters to identify community perceptions and behaviour related to malaria. Interviews were conducted with malaria health officers to understand the challenges of malaria surveillance and control.After experiencing three consecutive years with API less than 1 per thousand, malaria in Kokap subdistrict increased almost ten times higher than API in the district level and five times higher than national API. Malaria cases were found in all five villages in 2012. One primary and two secondary malaria clusters in Hargotirto and Kalirejo villages were identified during the 2011-2012 outbreak. Most of the respondents were positively aware with malaria signs and activities of health workers to prevent malaria, although some social economic activities could not be hindered. Return transmigrants or migrant workers entering to their villages, reduced numbers of village malaria workers and a surge in malaria cases in the neighbouring district contributed to the resurgence.Community perception, awareness and participation could constitute a solid foundation for malaria elimination in Kokap. However, decreasing number of village malaria workers and ineffective communication between primary health centres (PHCs) within boundary areas with similar malaria problems needs attention. Decentralization policy was allegedly the reason for the less integrated malaria control between districts, especially in the cross border areas. Malaria resurgence needs attention particularly when it occurs in an area that is entering the elimination phase.
Observational study on patient's satisfactions and quality of life (QoL) among cancer patients receiving treatment with palliative care intent in a tertiary hospital in Malaysia. - Asian Pacific journal of cancer prevention : APJCP
The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect (50.6Â±9.07) and the least in General Satisfaction (26.4Â±5.90). The Mental Component Summary (44.9Â±6.84) scored higher when compared with the Physical Component Summary (42.2Â±7.91). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care.
Wavelet packet analysis of EEG signals from dyslexic children with writing disability. - Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
This paper describes Wavelet Packet Analysis of EEG signal of dyslexic children with writing disability. Two activities were carried out during EEG recordings; relax and and writing letters. EEG signals were collected using biosignal gMobilab system and analysed using Wavelet Packet Decomposition to extract alpha and beta brainwave rhythm. Statistical data such as log energy entropy and standard deviation were used to compare the characteristic of EEG signals from dyslexic and normal children. Result showed that the dyslexic children consumed higher energy at left parietal lobe during writing activity especially those who write incorrectly. The alpha band shows higher log energy entropy for dyslexic children compare to normal children at most channel during relax.
Antiviral activities of Indonesian medicinal plants in the East Java region against hepatitis C virus. - Virology journal
Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality worldwide. The overall prevalence of HCV infection is 2%, representing 120 million people worldwide. Current standard treatment using pegylated interferon and ribavirin is effective in only 50% of the patients infected with HCV genotype 1, and is associated with significant side effects. Therefore, it is still of importance to develop new drugs for treatment of HCV. Antiviral substances obtained from natural products, including medicinal plants, are potentially good targets to study. In this study, we evaluated Indonesian medicinal plants for their anti-HCV activities.Ethanol extracts of 21 samples derived from 17 species of medicinal plants explored in the East Java region were tested. Anti-HCV activities were determined by a cell culture method using Huh7.5 cells and HCV strains of 9 different genotypes (1a to 7a, 1b and 2b).Four of the 21 samples tested showed antiviral activities against HCV: Toona sureni leaves (TSL) with 50% inhibitory concentrations (IC50) of 13.9 and 2.0 Î¼g/ml against the HCV J6/JFH1-P47 and -P1 strains, respectively, Melicope latifolia leaves (MLL) with IC50 of 3.5 and 2.1 Î¼g/ml, respectively, Melanolepis multiglandulosa stem (MMS) with IC50 of 17.1 and 6.2 Î¼g/ml, respectively, and Ficus fistulosa leaves (FFL) with IC50 of 15.0 and 5.7 Î¼g/ml, respectively. Time-of-addition experiments revealed that TSL and MLL inhibited both at the entry and post-entry steps while MMS and FFL principally at the entry step. TSL and MLL inhibited all of 11 HCV strains of all the genotypes tested to the same extent. On the other hand, FFL showed significantly weaker inhibitory activities against the HCV genotype 1a strain, and MMS against the HCV strains of genotypes 2b and 7a to a lesser extent, compared to the other HCV genotypes.Ethanol extracts of TSL, MLL, MMS and FFL showed antiviral activities against all the HCV genotypes tested with the exception that some genotype(s) showed significant resistance to FFL and to MMS to a lesser extent. These plant extracts may be good candidates for the development of anti-HCV drugs.
Alumni's perception of public health informatics competencies: lessons from the Graduate Program of Public Health, Faculty of Medicine, Universitas Gadjah Mada, Indonesia. - Studies in health technology and informatics
Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning . Unfortunately, limited reports exist concerning to the capacity building strategies to improve public health informatics workforce in limited-resources setting. In Indonesia, only three universities, including Universitas Gadjah Mada (UGM), offer master degree program on related public health informatics discipline. UGM started a new dedicated master program on Health Management Information Systems in 2005, under the auspice of the Graduate Program of Public Health at the Faculty of Medicine. This is the first tracer study to the alumni aiming to a) identify the gaps between curriculum and the current jobs and b) describe their perception on public health informatics competencies. We distributed questionnaires to 114 alumni with 36.84 % response rate. Despite low response rate, this study provided valuable resources to set up appropriate competencies, curriculum and capacity building strategies of public health informatics workforce in Indonesia.
A simple method to fluorescently label pericytes in the CNS and skeletal muscle. - Microvascular research
Pericytes play important roles in vascular control and may form an important part of the blood brain barrier. Here we introduce a simple method for fluorescently labelling pericytes to enable further studies in live or fixed tissue of rats and mice. Following intraperitoneal injection, the fluorescent tracer Fluorogold was rapidly taken up into vascular endothelial cells, and within 3h in the central nervous system appeared within small perivascular cells with a morphology consistent with pericytes. These Fluorogold labelled cells were pericytes since they displayed immunoreactivity for platelet derived growth factor receptor Î² and were closely associated with isolectin B4 binding to endothelial cells. Pericytes in skeletal muscle were also labelled with this method, but not those within the heart, lungs or kidney. This simple method could therefore be applied for labelling pericytes in a wide variety of studies, including live cell imaging or immunohistochemistry.Copyright Â© 2013 Elsevier Inc. All rights reserved.
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