Multidimensional Symptom Burden among Patients with Hemodialysis in Indonesia

Background: Patients with hemodialysis commonly experience multiple symptoms. Most of the previous studies analyzed the symptoms as one dimension such as the severity dimension. Conducting the comprehensive symptom assessment among patients with hemodialysis is necessary to gain a better understanding of the symptom burden. Purpose: The aim of this study was to identify symptom burden among patients with hemodialysis comprehensively. Methods: This study was a descriptive study. A convenience sample of 320 patients undergoing hemodialysis was recruited from the dialysis units at two referral hospitals in Indonesia (Fatmawati Hospital and Cipto Mangunkusumo National Hospital). Indonesian Version of Chronic Kidney Disease - Symptom Burden Index (CKD-SBI) was used. For the data analysis, descriptive analysis was used. Results: Total 320 subjects were collected. This study found that lack of energy was the highest physical symptom burden under 4 dimensions: occurrence 269 (84.0%), severity (mean = 4.28, SD = 3.08), distress (mean = 4.42, SD = 3.09), and frequency (mean = 4.41, SD = 3.27). Furthermore, decreased interest in sex was the highest psychological symptom burden under for dimensions: occurrence 210 (65.6%), severity (mean = 3.39, SD = 3.38), distress (mean = 2.92, SD = 2.99), frequency (mean = 3.70, SD = 3.65). Conclusion: Lack of energy and decreased interest in sex were consistently the highest symptom burden among patients with hemodialysis. Creating appropriate interventions and managing the symptoms experienced by patients with hemodialysis comprehensively is very important to improve their quality of life.

Translation and psychometric testing of Indonesian Version of Chronic Kidney Disease– Symptom Burden Index

Introduction: Chronic Kidney Disease Symptom Burden Index (CKD-SBI) is an instrument measuring symptom burden developed by Almutary and colleagues in 2015 to refine the identification of symptom burden in chronic kidney disease population. This instrument has not been tested for Indonesian language, thus, the aim of study was to translate and psychometrically testing the Indonesian version of CKD-SBI. Methods: This study design was cross-sectional study. The study methods were divided into translation and psychometric testing. The translation was conducted by adapting Guillemin and Beaton's guidelines. The psychometric properties determined 320 hemodialysis patients with several inclusion criteria such as above 18 years old, regularly receiving hemodialysis for more than 3 months. Patients with cognitive impairment, psychiatric patients, and in critical condition were excluded. Results: The item content validity index of the Indonesian version was 0.92, and the subscale content validity was 0.78. The instrument demonstrated convergent validity with the Kidney Disease Quality of Life. Excellent internal consistency was demonstrated based on a Cronbach’s alpha coefficient of .91 and a subscale ranging from 0.86 to 0.92. The confirmatory factor analysis showed that the five factors of English Version did not fit the Indonesian version.  Conclusions: Translated Indonesian versions of CKD-SBI can be used as instruments to assess symptom burden among patients with hemodialysis. By assessing symptom burden, we hope nurses in the hospital are able to decide effective symptom management to increase the health-related quality of life among these populations

The risk of false inclusion of a relative in parentage testing – an in silico population study

Aim To investigate the potential of false inclusion of a close genetic relative in paternity testing by using computer generated families. Methods 10 000 computer-simulated families over three generations were generated based on genotypes using 15 short tandem repeat loci. These data were used in assessing the probability of inclusion or exclusion of paternity when the father is actually a sibling, grandparent, uncle, half sibling, cousin, or a random male. Further, we considered a duo case where the mother’s DNA type was not available and a trio case including the mother’s profile. Results The data showed that the duo scenario had the highest and lowest false inclusion rates when considering a sibling (19.03 ± 0.77%) and a cousin (0.51 ± 0.14%) as the father, respectively; and the rate when considering a random male was much lower (0.04 ± 0.04%). The situation altered slightly with a trio case where the highest rate (0.56 ± 0.15%) occurred when a paternal uncle was considered as the father, and the lowest rate (0.03 ± 0.03%) occurred when a cousin was considered as the father. We also report on the distribution of the numbers for non-conformity (non-matching loci) where the father is a close genetic relative. Conclusions The results highlight the risk of false inclusion in parentage testing. These data provide a valuable reference when incorporating either a mutation in the father’s DNA type or if a close relative is included as being the father; particularly when there are varying numbers of non-matching loci

A novel strategy for sibship determination in trio sibling model

Aim To use a virtually simulated population, generated from published allele frequencies based on 15 short tandem repeats (STR), to evaluate the efficacy of trio sibship testing and sibling assignment for forensic purposes. Methods Virtual populations were generated using 15 STR loci to create a large number of related and unrelated genotypes (10 000 trio combinations). Using these virtual populations, the probability of related and unrelated profiles can be compared to determine the chance of inclusions of being siblings if they are true siblings and the chance of inclusion if they are unrelated. Two specific relationships were tested – two reference siblings were compared to a third true sibling (3S trio, sibling trio) and two reference siblings were compared to an unrelated individual (2S1U trio, non-sibling trio). Results When the likelihood ratio was greater than 1, 99.87% of siblings in the 3S trio population were considered as siblings (sensitivity); 99.88% of non-siblings in the 2S1U trio population were considered as non-siblings (specificity); 99.9% of both populations were identified correctly as siblings and non-siblings; and the accuracy of the test was 99.88%. Conclusions The high sensitivity and specificity figures when using two known siblings compared to a putative sibling are significantly greater than when using only one known relative. The data also support the use of increasing number of loci allowing for greater confidence in genetic identification. The system established in this study could be used as the model for evaluating and simulating the cases with multiple relatives

Microstructure of non-polar GaN on LiGaO2 grown by plasma-assisted MBE

We have investigated the structure of non-polar GaN, both on the M - and A-plane, grown on LiGaO2 by plasma-assisted molecular beam epitaxy. The epitaxial relationship and the microstructure of the GaN films are investigated by transmission electron microscopy (TEM). The already reported epi-taxial relationship and for M -plane GaN is confirmed. The main defects are threading dislocations and stacking faults in both samples. For the M -plane sample, the density of threading dislocations is around 1 × 1011 cm-2 and the stacking fault density amounts to approximately 2 × 105 cm-1. In the A-plane sample, a threading dislocation density in the same order was found, while the stacking fault density is much lower than in the M -plane sample

Survivin counteracts the therapeutic effect of microtubule de-stabilizers by stabilizing tubulin polymers

<p>Abstract</p> <p>Background</p> <p>Survivin is a dual function protein. It inhibits the apoptosis of cells by inhibiting caspases, and also promotes cell growth by stabilizing microtubules during mitosis. Over-expression of survivin has been demonstrated to induce drug-resistance to various chemo-therapeutic agents such as cisplatin (DNA damaging agent) and paclitaxel (microtubule stabilizer) in cancers. However, survivin-induced resistance to microtubule de-stabilizers such as <it>Vinca </it>alkaloids and Combretastatin A-4 (CA-4)-related compounds were seldom demonstrated in the past. Furthermore, the question remains as to whether survivin plays a dominant role in processing cytokinesis or inhibiting caspases activity in cells treated with anti-mitotic compounds. The purpose of this study is to evaluate the effect of survivin on the resistance and susceptibility of human cancer cells to microtubule de-stabilizer-induced cell death.</p> <p>Results</p> <p>BPR0L075 is a CA-4 analog that induces microtubule de-polymerization and subsequent caspase-dependent apoptosis. To study the relationship between the expression of survivin and the resistance to microtubule de-stabilizers, a KB-derived BPR0L075-resistant cancer cell line, KB-<it>L30</it>, was generated for this study. Here, we found that survivin was over-expressed in the KB-<it>L30 </it>cells. Down-regulation of survivin by siRNA induced hyper-sensitivity to BPR0L075 in KB cells and partially re-stored sensitivity to BPR0L075 in KB-<it>L30 </it>cells. Western blot analysis revealed that down-regulation of survivin induced microtubule de-stabilization in both KB and KB-<it>L30 </it>cells. However, the same treatment did not enhance the down-stream caspase-3/-7 activities in BPR0L075-treated KB cells. Translocation of a caspase-independent apoptosis-related molecule, apoptosis-inducing factor (AIF), from cytoplasm to the nucleus was observed in survivin-targeted KB cells under BPR0L075 treatment.</p> <p>Conclusion</p> <p>In this study, survivin plays an important role in the stability of microtubules, but not with caspases inhibition. Over-expression of survivin counteracts the therapeutic effect of microtubule de-stabilizer BPR0L075 probably by stabilizing tubulin polymers, instead of the inhibition of caspase activity in cancer cells. Besides microtubule-related caspase-dependent cell death, caspase-independent mitotic cell death could be initiated in survivin/BPR0L075 combination treatments. We suggest that combining microtubule de-stabilizers with a survivin inhibitor may attribute to a better clinical outcome than the use of anti-mitotic monotherapy in clinical situations.</p

The risk of false inclusion of a relative in parentage testing - an in silico population study FORENSIC SCIENCE

Aim To investigate the potential of false inclusion of a close genetic relative in paternity testing by using computer generated families. Methods 10 000 computer-simulated families over three generations were generated based on genotypes using 15 short tandem repeat loci. These data were used in assessing the probability of inclusion or exclusion of paternity when the father is actually a sibling, grandparent, uncle, half sibling, cousin, or a random male. Further, we considered a duo case where the mother&apos;s DNA type was not available and a trio case including the mother&apos;s profile. Results The data showed that the duo scenario had the highest and lowest false inclusion rates when considering a sibling (19.03 ± 0.77%) and a cousin (0.51 ± 0.14%) as the father, respectively; and the rate when considering a random male was much lower (0.04 ± 0.04%). The situation altered slightly with a trio case where the highest rate (0.56 ± 0.15%) occurred when a paternal uncle was considered as the father, and the lowest rate (0.03 ± 0.03%) occurred when a cousin was considered as the father. We also report on the distribution of the numbers for non-conformity (non-matching loci) where the father is a close genetic relative. Conclusions The results highlight the risk of false inclusion in parentage testing. These data provide a valuable reference when incorporating either a mutation in the father&apos;s DNA type or if a close relative is included as being the father; particularly when there are varying numbers of non-matching loci