301 research outputs found
Asthma diagnosis and treatment - 1012. The efficacy of budesonide in the treatmetn of acute asthma in children: a double-blind, randomized, controlled trial.
Background
Current evidence suggests that inhaled glucocorticoids (IGC) have a more profound topical none genomic effect on bronchial airways as compared to systemic glucocorticoids. The value of adding IGC to current therapy of acute asthma is not well established.
Methods
We conducted a double-blind, randomized, two-arm, parallel groups, controlled clinical trial to compare the addition of budesonide 1500 mcg or placebo (normal saline) to standard acute asthma treatment (albuterol and ipratropium bromide) administered in 3 divided mixed doses within 1 hour in the emergency department (ED). Children 2-12 years of age with moderate or severe acute asthma, scoring 8-15/15 on a well-validated scoring system were included. Both groups received a single dose of prednisone 2 mg/kg/day (max. 60 mg) at the beginning of therapy. The primary outcome was admission rate within 2-4 hours from starting therapy.
Results
A total of 723 children were enrolled in the study over 17 months duration, of whom 139 were allowed to re-enroll and be randomized to constitute 906 randomization assignments (458 on the treatment group and 448 on the control group); with baseline mean + SD asthma score of 10.63 + 1.73; age 5.52 + 2.76 years; 35% girls; 30.8% (16.5%) with baseline severe asthma score of ≥12 (≥ 13). Statistical Analysis plan allowed for the potential dependency in response due to reenrollments of a subset of children, using Generalized Linear Mixed Modeling (GLMM) techniques. Baseline demographic and clinical characteristics were not significantly different between the two randomized groups. Seventy-five out of 458 (16.4%) of the treatment group vs. 82/448 (18.3%) of the control group were admitted, (OR 0.85, CI: 0.59-1.23, p-value=0.39). Among the severe asthmatics with baseline score ≥13, treatment vs. placebo group, GLMM adjusted admission rate was 30% vs. 47%, indicating a 17% difference in admission rate in favor of the treatment group (adjusted OR of 0.49, CI: 0.25-0.95; p-value= 0.035) that indicated a 51% reduction in the risk of admission for the treatment vs. control group.
Conclusions
Children with baseline severe asthma score ≥13 who were treated with budesonide had a significant reduction in their admission rate
Implementation of Crumb Rubber Modified Binder for Qatar Local Roads Construction Projects
The continuous increase in the pile up of used vehicle tires in Qatar poses a challenge
contributing to potential environmental pollution problems. The magnitude of this problem
can be drastically reduced by processing and recycling these tire wastes into crumb
rubber, obtained from grinding up whole scrap tires, and incorporating into conventional
asphalt binder to produce Crumb Rubber Modified Binder (CRMB) for asphalt mixes
used in pavement construction. Asphalt mixtures which incorporates crumb rubber have
been used in different parts of the world, notably USA since the 1960s, ostensibly to
solve the associated environmental problems, but with added advantages of improving
the overall performance of the asphalt pavement in terms of rutting and crack resistance,
increased flexibility and durability. In 2018, the Roads Project Department (RPD)
in collaboration with the Quality and Safety Department (QSD) of the Public Works
Authority (PWA) in Qatar, undertook a demonstration project which utilized CRMB
in the wearing course, in lieu of Polymer Modified Binder (PMB) originally proposed.
Preliminary results from this project showed an encouraging prospect for adopting
Crumb Rubber Modified Binder technology on local road projects, and eventually on
all other roads in Qatar. Consequently, it became imperative for a tentative specification
to be quickly put together for use by suppliers and contractors to achieve this goal. The
preliminary results of this demonstration project are promising and the ensuing crumb
rubber and CRMB guidelines have been useful
Evaluation on Cooling Energy Load with Varied Envelope Design for High-Rise Residential Buildings in Malaysia
With the development of the economy in the recent years, Malaysia is maintaining a high economic growth and therefore, its energy consumption increases dramatically. Residential buildings are characterized by being envelope-load dominated buildings, hence are greatly influenced by the outside climatic conditions. Due to the hot humid climate of Malaysia, air conditioning system accounts for more than 45% of the total electricity used in the residential sector which is required to remove substantial amount of gained heat due to poor thermal envelope performance. This paper uses Ecotect software to analyze the impact of building envelope design on energy cooling load for residential building in Penang, Malaysia, which include area ratio of window to floor, exterior wall thermal insulation, and several kinds of shading system. This paper describes an integrated passive design approach to reduce the cooling requirement for high-rise apartments through an improved building envelope design. Comparing with the other passive strategies investigated in this paper, the results indicated that exterior wall thermal insulation is the best strategy to decrease both annual cooling energy load and peak cooling load which achieved a reduction of 10.2% and 26.3% respectively. However, the other passive strategies applied also have some marginal effect on decreasing the cooling load
A Comparison Study in the Management of Ectopic Pregnancy between State of Qatar and Kingdom of Bahrain
Ectopic pregnancy is of increasing concern to gynecologists since it is a major cause of maternal mortality and morbidity in reproductive age women. It occurs when the conceptus implants in an abnormal position other than the uterus. Although the incidence of ectopic pregnancy during the 20 years studied increased five-folds, the risk of death from ectopic pregnancy declined by 90%. This decline might be related to the increase awareness of this condition that accompanied improved diagnostic technology and thus improved management and care. However, ectopic pregnancy remains the leading cause of maternal mortality in first trimenster. This study was to evaluate the management of ectopic pregnancy in the State of Qatar and the Kingdom of Bahrain in a time period from January I, 2000 to August 31, 2003. Statistical analysis showed high incidence of ectopic pregnancy with increase in age and abortion. Etiological factors including contraceptive usage, infertility treatment and previous ectopic pregnancy were shown to increases ectopic pregnancy rates. In the Kingdom of Bahrain, management of ectopic pregnancy was carried by surgical salpingectomy and Laparoctomy and to a lesser extend medical Methotrexate management was also carried on. While in the State of Qatar it was the opposite as Methotrexate was mainly used rather than the surgical treatment. It is recommended that further investigations are needed to enhance this data and to prove the benefits of medical management over the surgical management.qscienc
Culpability, blame, and stigma after pregnancy loss in Qatar
Background: Following a miscarriage many women report feeling guilty and culpable for what has happened
particularly when aspects of societal blame and stigma are involved. This research investigated the impact of
cultural context on the experience of miscarriage. In particular, it focused on how elements of stigma and blame
are linked to notions of miscarriage etiology and risk among Qatari women.
Methods: The research used an ethnographic approach. The data was collected over 18 months of fieldwork in
Qatar, using semi-structured face to face interviews, and participant observation. A purposive sample of 40 women
(primary participants) who had recently miscarried, participated in the study. Potential subjects were initially
identified in the Women’s Hospital and were consented, and then interviewed in Arabic either in the hospital or at
their preferred location. The interviews were audio recorded, transcribed and translated into English. Additional key
interviews were performed with 20 secondary participants related to the miscarriage cohort including family
members and husbands. Inductive thematic analysis of content was performed manually to extract themes.
Results: Two main themes emerged from the material looking specifically at miscarriage aftermaths: rhetorics of
blame, self-blame and feelings of guilt; and miscarriage attitudes. Overall society is sympathetic and miscarriage is
seen as normal and not particularly worrying, but understood to be upsetting to women. However, findings
suggest there is some ambivalence around blame, culpability and stigma applied to miscarriage; some participants
perceived miscarriage as a relatively normal and common event, whereas, others felt that miscarriage is resounding
stigma and shame.
Conclusion: Miscarriage aftermaths are embedded in social, cultural and religious frameworks in relation to notions
of risk and causation. Attention should be paid to ensure women and those around them are given appropriate
and robust information about miscarriage causation to deflect discourses of blame that may be employed and
reduce harm to women who suffer miscarriage
Calm Vessels: Cultural Expectations of Pregnant Women in Qatar
This article explores emerging themes from the first stage of
ethnographic research investigating pregnancy and loss in Qatar. Issues around
the development of foetal personhood, the medical management of the pregnant
body and the social role of the pregnant woman are explored. Findings suggest that
Qatari women are expected to be calm vessels for their growing baby and should
avoid certain foods and behaviours. These ideas of risk avoidance are linked to
indigenous knowledge around a mother’s influence on a child’s health and traits.
Motherhood holds a particularly important place in Qatari culture and in Islam,
and women are ultimately responsible for protecting and promoting fertility and
for producing healthy children
Salinity tolerance loci revealed in rice using high-throughput non-invasive phenotyping
High-throughput phenotyping produces multiple measurements over time, which require new methods of analyses that are flexible in their quantification of plant growth and transpiration, yet are computationally economic. Here we develop such analyses and apply this to a rice population genotyped with a 700k SNP high-density array. Two rice diversity panels, indica and aus, containing a total of 553 genotypes, are phenotyped in waterlogged conditions. Using cubic smoothing splines to estimate plant growth and transpiration, we identify four time intervals that characterize the early responses of rice to salinity. Relative growth rate, transpiration rate and transpiration use efficiency (TUE) are analysed using a new association model that takes into account the interaction between treatment (control and salt) and genetic marker. This model allows the identification of previously undetected loci affecting TUE on chromosome 11, providing insights into the early responses of rice to salinity, in particular into the effects of salinity on plant growth and transpiration.Nadia Al-Tamimi, Chris Brien, Helena Oakey, Bettina Berger, Stephanie Saade, Yung Shwen Ho, Sandra M. Schmöckel, Mark Tester and Sónia Negrã
Application of Gaussia luciferase in bicistronic and non-conventional secretion reporter constructs
Background: Secreted luciferases are highly useful bioluminescent reporters for cell-based assays and drug discovery. A variety of secreted luciferases from marine organisms have been described that harbor an N-terminal signal peptide for release along the classical secretory pathway. Here, we have characterized the secretion of Gaussia luciferase in more detail. / Results: We describe three basic mechanisms by which GLUC can be released from cells: first, classical secretion by virtue of the N-terminal signal peptide; second, internal signal peptide-mediated secretion and third, non-conventional secretion in the absence of an N-terminal signal peptide. Non-conventional release of dNGLUC is not stress-induced, does not require autophagy and can be enhanced by growth factor stimulation. Furthermore, we have identified the golgi-associated, gamma adaptin ear containing, ARF binding protein 1 (GGA1) as a suppressor of release of dNGLUC. / Conclusions: Due to its secretion via multiple secretion pathways GLUC can find multiple applications as a research tool to study classical and non-conventional secretion. As GLUC can also be released from a reporter construct by internal signal peptide-mediated secretion it can be incorporated in a novel bicistronic secretion system
P04.74 Preclinical evaluation of combinations targeting the DNA damage response in 2D and 3D models of glioblastoma stem cells
Background Despite surgical resection followed by DNA-damaging adjuvant therapies, glioblastoma remain incurable. Increasing evidence demonstrates that aberrations within the DNA damage response (DDR) of cancer stem cells contribute to treatment resistance. We have previously shown that the Fanconi Anaemia (FA) pathway, a key DDR process, remains inactive in normal brain but is re-activated in glioblastoma, making it an appealing foundational target for cancer-specific combination therapies. Since intratumoural heterogeneity in glioblastoma and inherent capacity for functional redundancy within DDR networks are established concepts - we aimed to determine whether combined and hypothesis-driven targeting of the FA pathway along with interconnected DDR processes could form a basis for effective multimodal therapies. Material and Methods Bioinformatic analysis of mRNA expression data (REMBRANDT database) was used to confirm the relevance of FA pathway activity in glioma. Subsequently, immunofluorescence and cell viability assays were used to validate and establish the therapeutic potential of novel FA pathway inhibitors (nFAPi) and inhibition of related DDR targets in established cell models. Finally, combinations targeting the DDR were optimised using immunoblotting, and assessed using clonogenic survival in 2D and novel 3D patient-derived glioblastoma stem cell models. Results High expression of downstream FA pathway genes is strongly associated with poor survival (-17.1% 5-year OS, n=329, Log-rank, P Conclusion Simultaneously targeting the FA pathway and interconnected DDR processes in glioblastoma represents a promising therapeutic strategy. Early mechanistic studies suggest this approach augments DNA damage and enhances IR-induced cell cycle arrest in G2/M, however further preclinical evaluation is ongoing
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Survival analysis modeling with hidden censoring
There are well-established survival analysis methodologies for data sets that are complete, with accurate information on censoring. But what if they are not complete? In this article we consider how to analyze cases where “hidden censoring” occurs, where individuals have effectively left the study but the hospital is unaware of this. We develop a new Markov chain-based methodology for generating survival curves and hazard functions, and demonstrate this using a breast cancer data set from the Kurdistan region of Iraq
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