Development and validation of an HPTLC densitometric method for assay of griseofulvin in tablets

A new HPTLC densitometric method for the assay of griseofulvin tablets was developed and validated according to ICH guidelines and USP specifications. The method was developed using a mobile phase prepared with an environmentally friendly solvent system, diethyl ether: toluene (4:1) on pre-coated TLC silica gel 60F254 glass plates with a saturation time of 25 min. Development time of 10 min was required for a migration distance of 70 mm. The best detection wavelength was 299 nm. The Rf value was 0.22 and there were no interferences from the excipients or solvents. With regard to repeatability and intermediate precision, the RSD values were 1.43 and 1.58, respectively. Linearity testing gave the polynomial R2 values, calculated on three consecutive days, of 0.9910, 0.9801 and 0.9840, respectively. The accuracy values tested at 80 %, 100 % and 120 % concentrations were between 98.11-102.66 %. The developed HPTLC densitometric method for the assay of griseofulvin tablets is simple, selective, accurate, reproducible, high throughput, cost-effective and environmentally friendly.Keywords: High Performance Thin Layer Chromatography (HPTLC), griseofulvin, densitometry, validatio

Health-related quality of life of Adolescent and Young Adult Cancer Survivors before and during the COVID-19 pandemic::Longitudinal improvements on social functioning and fatigue

The health-related quality of life (HRQoL) among long-term Adolescent and Young Adult Cancer Survivors (AYACS) and an age- and sex-matched normative population was examined. Although the HRQoL of AYACS was worse compared to the normative population before and during the COVID-19 pandemic, the scores of AYACS improved over time in contrast to the normative population. Presumably, AYACS are used to adjusting their lives to stressful life events. Furthermore, the lockdown may have been beneficial for AYACS who face difficulties fully participating in society due to the impact of cancer. AYACS who encounter HRQoL issues could benefit from support interventions to empower them and build resilience

Differences in Internet use and eHealth needs of adolescent and young adult versus older cancer patients:Results from the PROFILES registry

SIMPLE SUMMARY: The internet has become an important health information source for patients with cancer. AYAs (adolescents and young adults; 18–39 years at time of diagnosis) can be considered as digital natives; they work with the internet and related technologies in their daily lives. It is likely that AYAs are more used to using the internet, while older cancer patients might prefer former ways of information provision to obtain health-related information. The question arises whether internet use and eHealth needs of AYA cancer patients are comparable to those of older ones. By conducting a cross-sectional survey, we evaluated differences in cancer-related internet patterns between AYAs and older cancer patients (40+ years at time of diagnosis). A better understanding of differences between generations will help inform healthcare providers on how to guide cancer patients of different ages regarding cancer-related internet use. ABSTRACT: Background: Our aim was to evaluate differences in cancer-related internet patterns between AYAs (adolescents and young adults; 18–39 years at time of diagnosis) and older adult cancer patients (40+ years). Methods: Cross-sectional surveys were distributed among AYA and older adult cancer patients regarding cancer-related internet use and eHealth needs. Results: 299 AYAs (mean age 31.8 years) and 270 older adults (mean age 55.8 years) participated. AYAs searched significantly more often on the internet on a daily basis just before diagnosis (45% vs. 37%), right after diagnosis (71% vs. 62%) and during treatment (65% vs. 59%) compared to older adults. During follow up, there was a trend that AYAs searched less often on the internet compared to older adults (15% vs. 17%). AYAs searched more often on topics, such as alternative or complementary therapies, treatment guidelines, fertility, end of life, sexuality and intimacy, lifestyle and insurance. AYAs felt significantly better informed (75%) after searching for cancer-related information compared to older adults (65%) and had significantly less unmet needs regarding access to their own medical information (22% vs. 47%). AYAs search more on the internet on a daily basis/several times per week in the diagnosis and treatment phase than older cancer patients. They search on different topics than older adults and seems to have less unmet eHealth needs.It is important that these are easy to find and reliable

The Effects of Ash and Black Carbon (Biochar) on Germination of Different Tree Species

Forest fires generate large amounts of ash and biochar, or black carbon (BC), that cover the soil surface, interacting with the soil’s constituents and its seedbank. This study concerns reproductive ecology assessments supported by molecular characterisation to improve our understanding of the effects of fire and fire residues on the germination behaviour of 12 arboreal species with a wide geographic distribution. For this purpose, we analysed the effects of three ash and one BC concentration on the germination of Acacia dealbata Link, A. longifolia (Andrews) Willd., A. mearnsii De Wild., A. melanoxylon R. Br., Pinus nigra Arnold, P. pinaster Aiton, P. radiata D. Don, P. sylvestris L., Quercus ilex L., Q. pyrenaica Willd., Q. robur L., and Q. rubra L. Each tree species was exposed to ash and BC created from its foliage or twigs (except for Q. rubra, which was exposed to ash and BC of Ulex europaeus L.). We monitored germination percentage, the T50 parameter, and tracked the development of germination over time (up to 1 yr). The BC of A. dealbata, P. pinaster, and Q. robur was analysed by pyrolysis-gas chromatography-mass spectrometry (PY-GC-MS) to assess the molecular composition. In six species, ash inhibited the germination, while in another five species, germination was not affected by ash or by BC. In Q. rubra, ash and BC stimulated its germination. This stimulating effect of the BC on Q. rubra is likely to be related to the chemical composition of the ash and BC obtained from Ulex feedstock. The BC of U. europaeus has a very different molecular composition than the other BC samples analysed, which, together with other factors, probably allowed for its germination stimulating effects.This study was carried out within the Project 10MDS200007PR, financed by the Xunta de Galicia; the Project AGL2013-48189-C2-2-R, financed by the Ministerio de Economía y Competitividad, Spain; and FEDERS

Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study)

Background: Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.Methods: A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician’s diagnosis with the reference diagnosis.Results: We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).Conclusions: ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.Trial registration: Netherlands Trial Register, NTR6268.</p

Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study)

Background: Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.Methods: A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician’s diagnosis with the reference diagnosis.Results: We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).Conclusions: ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.Trial registration: Netherlands Trial Register, NTR6268.</p

Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study)

Background: Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.Methods: A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician’s diagnosis with the reference diagnosis.Results: We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).Conclusions: ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.Trial registration: Netherlands Trial Register, NTR6268.</p

Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behaviour and their parents

Background: An adaptation of multisystemic therapy (MST) was piloted to find out whether it would yield better outcomes than standard MST in families where the adolescent not only shows antisocial or delinquent behaviour, but also has an intel‐ lectual disability. Method: To establish the comparative effectiveness of MST‐ID (n = 55) versus stand‐ ard MST (n = 73), treatment outcomes were compared at the end of treatment and at 6‐month follow‐up. Pre‐treatment differences were controlled for using the propen‐ sity score method. Results: Multisystemic therapy‐ID resulted in reduced police contact and reduced rule breaking behaviour that lasted up to 6 months post‐treatment. Compared to standard MST, MST‐ID more frequently resulted in improvements in parenting skills, family relations, social support, involvement with pro‐social peers and sustained pos‐ itive behavioural changes. At follow‐up, more adolescents who had received MST‐ID were still living at home. Conclusions: These results support further development of and research into the MST‐ID adaptation

Genome-wide analyses of platinum-induced ototoxicity in childhood cancer patients: Results of GO-CAT and United Kingdom MAGIC consortia

: Hearing loss (ototoxicity) is a major adverse effect of cisplatin and carboplatin chemotherapy. The aim of this study is to identify novel genetic variants that play a role in platinum-induced ototoxicity. Therefore, a genome-wide association study was performed in the Genetics of Childhood Cancer Treatment (GO-CAT) cohort (n = 261) and the United Kingdom Molecular Genetics of Adverse Drug Reactions in Children Study (United Kingdom MAGIC) cohort (n = 248). Results of both cohorts were combined in a meta-analysis. In primary analysis, patients with SIOP Boston Ototoxicity Scale grade ≥1 were considered cases, and patients with grade 0 were controls. Variants with a p-value &lt;10-5 were replicated in previously published data by the PanCareLIFE cohort (n = 390). No genome-wide significant associations were found, but variants in TSPAN5, RBBP4P5, AC010090.1 and RNU6-38P were suggestively associated with platinum-induced ototoxicity. The lowest p-value was found for rs7671702 in TSPAN5 (odds ratio 2.0 (95% confidence interval 1.5-2.7), p-value 5.0 × 10-7). None of the associations were significant in the replication cohort, although the effect directions were consistent among all cohorts. Validation and functional understanding of these genetic variants could lead to more insights in the development of platinum-induced ototoxicity