Osteogenic Differentiation Potential of Human Bone Marrow and Amniotic Fluid-Derived Mesenchymal Stem Cells in Vitro & in Vivo

BACKGROUND: Cell therapies offer a promising potential in promoting bone regeneration. Stem cell therapy presents attractive care modality in treating degenerative conditions or tissue injuries. The rationale behind this is both the expansion potential of stem cells into a large cell population size and its differentiation abilities into a wide variety of tissue types, when given the proper stimuli. A progenitor stem cell is a promising source of cell therapy in regenerative medicine and bone tissue engineering. AIM: This study aimed to compare the osteogenic differentiation and regenerative potentials of human mesenchymal stem cells derived from human bone marrow (hBM-MSCs) or amniotic fluid (hAF-MSCs), both in vitro and in vivo studies. SUBJECTS AND METHODS: Human MSCs, used in this study, were successfully isolated from two human sources; the bone marrow (BM) and amniotic fluid (AF) collected at the gestational ages of second or third trimesters. RESULTS: The stem cells derived from amniotic fluid seemed to be the most promising type of progenitor cells for clinical applications. In a pre-clinical experiment, attempting to explore the therapeutic application of MSCs in bone regeneration, Rat lumbar spines defects were surgically created and treated with undifferentiated and osteogenically differentiated MSCs, derived from BM and second trimester AF. Cells were loaded on gel-foam scaffolds, inserted and fixed in the area of the surgical defect. X-Ray radiography follows up, and histopathological analysis was done three-four months post- operation. The transplantation of AF-MSCs or BM-MSCs into induced bony defects showed promising results. The AF-MSCs are offering a better healing effect increasing the likelihood of achieving successful spinal fusion. Some bone changes were observed in rats transplanted with osteoblasts differentiated cells but not in rats transplanted with undifferentiated MSCs. Longer observational periods are required to evaluate a true bone formation. The findings of this study suggested that the different sources; hBM-MSCs or hAF-MSCs exhibited remarkably different signature regarding the cell morphology, proliferation capacity and osteogenic differentiation potential CONCLUSIONS: AF-MSCs have a better performance in vivo bone healing than that of BM-MSCs. Hence, AF derived MSCs is highly recommended as an alternative source to BM-MSCs in bone regeneration and spine fusion surgeries. Moreover, the usage of gel-foam as a scaffold proved as an efficient cell carrier that showed bio-compatibility with cells, bio-degradability and osteoinductivity in vivo

Barriers and Motivators of Appropriate Antibiotic Prescription at PHCC in Qatar: Perspective of Physicians and Pharmacists

Antimicrobial resistance (AMR) is a serious public health problem of global concern. The Ministry of Public Health (MOPH) developed the NAP (National Action Plan) to combat AMR in Qatar in collaboration with WHO/EMRO. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized in this study to tailor behavior change in relation to antimicrobial use. This study explores barriers and motivators of appropriate antibiotic prescription from the physicians’ and pharmacists’ perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs; 30 physicians and 20 pharmacists. Two different interview guides were constructed; one for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. Each transcript was coded, and new themes were added to the codebook as they emerged. The analysis revealed that factors influencing the prescription of antibiotics in PHCC were embedded within the individual, community, and organizational levels. Participants explained that patients’ demographics and practitioners’ practices in prescribing AB were among the major barriers. On the other hand, patient’s education and engagement regarding appropriate antibiotic use, physician’s ability to make the right decision, and build rapport with the patient to gain trust were among the motivators. In addition, auditing AB prescription and the enhancement and utilization of clinical diagnostic tools could play a positive role in changing behavior. The findings would help develop and pilot a behavior change intervention among physicians and pharmacists in the selected PHCCs with the aim of optimizing appropriate antibiotic prescription, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual, community, and organizational factors to optimize appropriate antibiotic prescription, thus decrease the prevalence and burden of antibiotic resistance

Barriers and motivators of appropriate antibiotic prescription at PHCC in Qatar: perspective of physicians and pharmacists

Antimicrobial resistance (AMR) is a serious public health problem of global concern. The Ministry of Public Health (MOPH) developed the NAP (National Action Plan) to combat AMR in Qatar in collaboration with WHO/EMRO. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized in this study to tailor behavior change in relation to antimicrobial use. The study explores barriers and motivators of appropriate antibiotic prescription from the physicians' and pharmacists' perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs; 30 physicians and 20 pharmacists. Two different interview guides were constructed; one for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. Each transcript was coded, and new themes were added to the codebook as they emerged. The analysis revealed that the factors influencing the prescription of antibiotics in PHCC were embedded within the individual, community, and organizational levels. Participants explained that patients' demographics and practitioners' practices in prescribing AB were among the major barriers. On the other hand, patient's education and engagement regarding appropriate antibiotic use, physician's ability to make the right decision, and build rapport with the patient to gain trust were among the motivators. In addition, auditing AB prescription and the enhancement and utilization of clinical diagnostic tools could play a positive role in changing behavior. The findings would help develop and pilot a behavior change intervention among physicians and pharmacists in the selected PHCCs with the aim of optimizing appropriate antibiotic prescription, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual, community, and organizational factors to optimize appropriate antibiotic prescription, thus decrease the prevalence and burden of antibiotic resistance

Barriers of Appropriate Antibiotic Prescription at PHCC in Qatar: Perspective of Physicians and Pharmacists.

The Ministry of Public Health in Qatar developed the NAP (National Action Plan to combat Antimicrobial Resistance (AMR) in collaboration with WHO Regional Office for the Eastern Mediterranean (WHO/EMRO). Among the major factors shaping AMR is antimicrobial prescribing and use. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized to adapt behavior change in relation to antimicrobial use. This study explores barriers of appropriate antibiotic (AB) prescription from the physicians’ and pharmacists’ perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs: 30 physicians and 20 pharmacists. Two different interview guides were constructed: One for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. The Major themes arose from the analysis revealed that patients, practitioners mainly physicians, and the organization itself, played a role in shaping these barriers in the two primary healthcare centers. The findings would help develop and pilot behavior change interventions among patients, physicians and pharmacists with the aim of optimizing appropriate antibiotic prescription and use, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual and organizational factors to optimize appropriate antibiotic prescription