The Implementation of an Integrated Management System at Qatar Biobank

Qatar Biobank (QBB) is a platform that will make vital health research possible through its collection of samples and information on health and lifestyle from the local population of Qatar. The goal of QBB is to collect, process, store, and finally share high-quality biological samples and associated data for research purposes with the research community. To do this, a series of standardized procedures following evidence-based practices are required, and QBB is achieving this by implementing an integrated management system (IMS) that incorporates ISO 9001: 2015 and ISO 27001: 2013 standards. ISO 9001 is one of the most commonly implemented quality management systems as it is applicable to any size of organization. ISO 27001: 2013 is increasingly popular as organizations look to manage their data and information security, especially in the light of the recent General Data Protection Regulation legislation and an ever-changing digital landscape. QBB has achieved certification in both ISO 9001: 2015 (originally 2008 standard) and ISO 27001: 2013 since 2014. In 2016, during preparations for recertification of both standards in 2017, QBB chose to integrate both of the management systems in preference to running them in parallel, without compromising the goals and objectives of QBB. The IMS has ensured that rigorous processes and controls are implemented to not only manage the quality of internal and external processes and services provided, but the privacy and confidentiality of data collected during a participant visit are consistently protected as well as a proactive approach to identifying and managing risk within the organization. This article will explore the impact of implementing an IMS on the continuous improvement of services within QBB

Impact of Different Cooling Methods on the Stability of Peripheral Blood Mononuclear Cells (PBMCs)

During cryopreservation of peripheral blood mononuclear cells (PBMCs), there are several recognized cooling methods, which include different cooling rates that might influence the stability of the PBMCs. This chapter will focus on three cooling methods trialled and will describe the different principles they are based on and the outcomes. One cooling method is based on repeatable −1°C/min cooling rate that requires only isopropyl alcohol (method A). The second cooling method is based on the cooling rate of −1° C/min solely (method B). The third cooling method is based on a user-predefined programmable controlled rate of freezing (method C). The first method was discontinued for safety reasons. A small comparative study was performed using 12 cell preparation tubes (CPT) using methods B and C. Cell Viability was measured based on the difference between pre-thaw and post-thaw viability percentages that were obtained from the flow cytometry. From our data, we conclude that although there were no significant differences in the outcomes of the comparative study of cooling methods, the use of either method B or C are the most suitable for long-term storage that will preserve the quality of the sample suitable for future research and clinical applications

Consensus Approach for Standardizing the Screening and Classification of Preterm Brain Injury Diagnosed With Cranial Ultrasound: A Canadian Perspective

Acquired brain injury remains common in very preterm infants and is associated with significant risks for short- and long-term morbidities. Cranial ultrasound has been widely adopted as the first-line neuroimaging modality to study the neonatal brain. It can reliably detect clinically significant abnormalities that include germinal matrix and intraventricular hemorrhage, periventricular hemorrhagic infarction, post-hemorrhagic ventricular dilatation, cerebellar hemorrhage, and white matter injury. The purpose of this article is to provide a consensus approach for detecting and classifying preterm brain injury to reduce variability in diagnosis and classification between neonatologists and radiologists. Our overarching goal with this work was to achieve homogeneity between different neonatal intensive care units across a large country (Canada) with regards to classification, timing of brain injury screening and frequency of follow up imaging. We propose an algorithmic approach that can help stratify different grades of germinal matrix-intraventricular hemorrhage, white matter injury, and ventricular dilatation in very preterm infants

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. Funding: UK Medical Research Council, US National Institutes of Health. © 2014 Elsevier Ltd

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

The neural basis of behavioral recovery of chronic visuo-spatial neglect using repetitive transcranial magnetic stimulation

Thesis (Ph.D.)--Boston UniversityHigh frequency repetitive Transcranial Magnetic Stimulation (rTMS) has been used clinically on perilesional cortex to attenuate the neurological consequences of cerebral injuries. Presently the clinical benefits of rTMS remain controversial due to the high level of inter-individual variability in response to treatment. We explored the behavioral efficacy of multisession rTMS and studied the structural and metabolic characteristics underlying the recovery of visuo-spatial functions after unilateral parietal injury. A group of adult cats (n=12) underwent focal lesions in a region of the posterior parietal cortex (pMS, posterior middle suprasylvian area) leading to contralesional visuo-spatial deficits. Two and a half months post-injury, cats were treated with 7 consecutive rounds of 10 daily session of high frequency rTMS applied on an intact perilesional area (aMS, anterior middle suprasylvian area). We characterized two populations of animals: a group of 'Responders' (n=6) displaying significant visual detection improvements in contralesional hemispace and a group of 'Non-responders' (n=6) that did not show significant improvements and suffered unexpected decreases in ipsilesional performance. Detailed lesion analyses revealed no differences between the two groups neither in the amount of total spared cortex nor in the level of residual metabolic bactivity within areas of perilesional tissue. Additionally, we used 14C-2-deoxyglucose (2DG) to measure the metabolic impact of the aMS area on discrete nodes of the visuo-spatial network. When compared individually, none of the 60 regions proved to have significantly higher metabolic uptake in either group. Interestingly however, a cross-correlation analysis of metabolic activity throughout all sampled cortical and subcortical areas revealed that 'Responders' displayed a more metabolically cross-correlated visuo-spatial network than 'Nonresponders'. Furthermore, we found the aMS cortex in the 'Non-responders' group to hold no significant cross-correlations within the visuo-spatial network, indicating that the site of rTMS stimulation held no functional relationship with network regions. We conclude that multisession perilesional rTMS has the potential to induce behavioral ameliorations in chronic brain injury but the ability to consistently induce adaptive outcomes remains highly variable across animals. In addition, functional correlations indicate that rTMS-mediated recovery is dependent on the stimulated aMS cortex and its metabolic coupling with other nodes within visuo-spatial networks

Analisis penerapan sistem bagi hasil dan perakuan akuntansi pembiayaan mudharabah pada BMT Maslahah Capem Pagelaran Malang

INDONESIA: Sistem bagi hasil merupakan landasan operasional untuk menentukan besarnya bagi hasil di Bank Syariah. Tujuan utama penelitian ini adalah untuk mengetahui penerapan sistem bagi hasil pada BMT-Maslahah dan menilai kesesuaian antara perlakuan akuntansi pembiayaaan mudharabah dengan ketentuan menurut PSAK 105. Jenis penelitian ini adalah penelitian kualitatif dengan pendekatan deskriptif, yang dilakukan di BMT-Maslahah Pagelaran Malang, Teknik pengumpulan data dalam peneletian ini adalah dengan wawancara dan dokumentasi. Analisis data yang dilakukan adalah analisis deskriptif yaitu dengan bagaimana mengetahui penerapan sistem bagi hasil dan membandingkan perlakuan akuntansi pembiayaan mudharabah yang diterapkan BMT-Maslahah dengan PSAK 105. Hasil penelitian ini menunjukan bahwa sistem perhitungan bagi hasil pembiayaan mudharabah di BMT – Maslahah Pagelaran Malang menerapkan sistem bagi hasil Revenue sharing. Dalam PSAK 105 dijelaskan bahwa metode ini menjadikan laba bruto sebagai dasar dalam pendistribusian hasil usaha. Perlakuan akuntansi untuk pembiayaan BMT – Maslahah Pagelaran Malang dengan akad mudharabah mengenai pengakuan akuntansi pembiayaan mudharabah belum sepenuhnya sesuai dengan PSAK 105. Pengakuan keuntungan, pengakuan kerugian, pengakuan piutang dan pengakuan beban di BMT-Maslahah telah sesuai dengan PSAK 105.Namun terdapat ketidaksesuaian dalam hal pengakuan investasi. ENGLISH: The system was the Foundation for the results of operations to determine the magnitude of the result in the Islamic Bank. The main goal of this research is to know the implementation system for the results on the BMT-Maslahah and assess suitability between the accounting treatment of the cost mudharabah with the provisions according to PSAK 105. This type of research is qualitative research with a descriptive approach, carried out in Poor performance of BMT -Maslahah, techniques of data collection in the peneletian this is by interview and documentation. The data analysis done is a descriptive analysis of the application of the system for how to know the result and compare the treatment applied mudharabah financing accounting BMT-Maslahah with PSAK 105.The results of this study showed that the calculation system for the results of the mudharabah financing applied in BMT – Maslahah Unfortunate Performances using the method of Revenue sharing. In PSAK 105 explained that this method makes the gross profit as a basis in the distribution of business results. The accounting treatment for financing the Poor performance of BMT – Maslahah with the approval of the accounting recognition on mudharabah financing mudharabah is not fully in accordance with PSAK 105. Recognition of the profit, loss recognition, recognition of receivables and the recognition of the burden on the BMT-Maslahah were in accordance with PSAK 105. But there is a mismatch in terms of recognition of investment

Benefit of multiple sessions of perilesional repetitive transcranial magnetic stimulation for an effective rehabilitation of visuospatial function

Noninvasive neurostimulation techniques have been used alone or in conjunction with rehabilitation therapy to treat the neurological sequelae of brain damage with rather variable therapeutic outcomes. One potential factor limiting a consistent success for such techniques may be the limited number of sessions carried out in patients, despite reports that their accrual may play a key role in alleviating neurological deficits long-term. In this study, we tested the effects of seventy consecutive sessions of perilesional high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic neglect deficits in a well-established feline model of visuospatial neglect. Under identical rTMS parameters and visuospatial testing regimes, half of the subjects improved in visuospatial orienting performance. The other half experienced either none or extremely moderate ameliorations in the neglected hemispace and displayed transient patterns of maladaptive visuospatial behavior. Detailed analyses suggest that lesion location and extent did not account for the behavioral differences observed between these two groups of animals. We conclude that multi-session perilesional rTMS regimes have the potential to induce functional ameliorations following focal chronic brain injury, and that behavioral performance prior to the onset of the rTMS treatment is the factor that best predicts positive outcomes for noninvasive neurostimulation treatments in visuospatial neglect. Non-invasive neurostimulation techniques have been used alone or in conjunction with rehabilitation therapy to treat the neurological sequelae of brain damage with rather variable therapeutic outcomes. One potential factor limiting a consistent success for such techniques may be the few sessions carried out in patients, despite reports that their accrual may play a key role in alleviating neurological deficits long-term

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann-Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P \u3c 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students\u27 perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools