Warfarin is used in paediatric populations, but dosing algorithms incorporating pharmacogenetic data have not been developed for children. Previous studies have produced estimates of the effect of polymorphisms in CYP2C9 and VKORC1 on stable warfarin dosing, but data on time in therapeutic range, initial dosing and adverse effects are limited. Participants (n=97) were recruited, and routine clinical data and salivary DNA samples were collected from all participants, and analysed for CYP2C9*2, *3 and VKORC1-1639 polymorphisms.VKORC1 -1639 was associated with a greater proportion of the first six months’ treatment time spent within the target INR range, accounting for an additional 9.5% of the variance in the proportion of time. CYP2C9*2 was associated with a greater likelihood of INR values exceeding the target range during the initiation of treatment (OR [per additional copy] 4.18, 95% CI 1.42, 12.34). CYP2C9*2 and VKORC1-1639 were associated with a lower dose requirement, and accounted for almost 12% of the variance in stable dose. VKORC1-1639 was associated with an increased likelihood of mild bleeding complications (OR [heterozygotes vs homozygotes] 4.53, 95% CI 1.59, 12.93). These data show novel associations between VKORC1-1639 and CYP2C9*2 and INR values in children taking warfarin, as well as replicating previous findings with regard to stable dose requirements. The development of pharmacogenomic dosing algorithms for children using warfarin has the potential to improve clinical care in this population.

Background Magnetic resonance imaging (MRI) safety screening is a crucial procedure for patient preparation before entering into MRI room. Many hospitals in Malaysia are still using the MRI safety checklist printed form. Besides, clinicians will not get a definite conclusion about whether the patient is contraindicated for MRI or not. Hence, we have created one mobile application named MagnetoSafe to overcome this issue. The application will provide an instant decision on whether the patient has no contraindication, relative contraindication, or absolute contraindicated for MRI. We need to check for acceptability and user experience for any newly created mobile application. Objective This study was designed to check the validity of the adapted Technology Acceptance Model (TAM) and System Usability Scale (SUS) Questionnaire. Method The validity and reliability of the questionnaire were investigated. Subsequently, 52 fully completed responses were collected. Results Face and content validity of the questionnaires are considered acceptable with only minor changes to Item 10 of SUS. The Cronbach's alpha for the SUS questionnaire (10 questions) is −0.49, which is not acceptable. The Cronbach's alpha for TAM questionnaire (3 domains; 14 questions) is acceptable, which is 0.910 for perceived usefulness, 0.843 for perceived ease of use, and 0.915 for intention to use. Conclusion Face validity of the adapted SUS and modified TAM questionnaires is acceptable with only minor changes to Item 10 in SUS. Content validity with experts is good. However, the reliability of the SUS questionnaire is not acceptable and therefore adapted SUS will not be used for assessing user experience. The reliability of the modified TAM questionnaire with the original three-factor structure is considered acceptable and can be used to evaluate the user's acceptability of MagnetoSafe.

No abstract

Background: Silicone or foreign materials injection is widely used for aesthetic breast augmentation and reconstructions in many countries. Once injected, it will stimulate a foreign body reaction between body tissues and silicone. This reaction can cause the formation of a granuloma known as siliconoma, which represent by the lumping at the breast. This symptom usually mimics breast cancer and sometimes be the origin of breast cancer. This paper is focused on the discussion on radiographic appearance of silicone and a case study of breast siliconoma. Case Study: A 66-year-old Chinese female with a family history of cancer presents with palpable painless lumps in her breasts. The lumps were present in both breasts without any mobility and other inflammatory processes. Mammographic examination demonstrated a dense bilateral mass towards the chest wall and asymmetrical rounded densities in both breasts. There are no breast cancer indications were reported. The pathology demonstrated a siliconoma.

Study findings revealed some similarities and differences in current evaluation practice (timeline and requirements) for biosimilar versus novel BTPs. The findings of this research also provide an insight on current evaluation practice on biosimilar product labeling.