bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural Antibacterial and its Use
Authors: Nendissa Sandriana J , Mahendradatta Meta , Zainal  , Bastian Februadi
Published: May 2021

In today’s era, the use of natural antimicrobials such as plant extracts to preserve food processed products has received much attention from researchers. This is related to the increasing public awareness of synthetic chemical preservatives. Various types of plants have been stated to produce extracts that are effective in inhibiting the growth of bacteria that destroy food processed products, such as atung seed ethyl acetate extract (Parinarium glaberrimum Hassk) Bacillus cereus, Bacillus subtilis, Staphylococcus aereus, while pathogenic bacteria are Escherechia coli, Salmonella enternidis; Guava leaf extract has a high tannin compound capable of suppressing the development of Aeromonas hydrophila bacteria in Gurame fish (Osphonemus gouramy Lacepede) with a concentration of 250 ppm-3250 ppm with a diameter of the inhibition zone ranging from 6.5-11.5 mm. The most effective solvent to extract antimicrobial compounds from the bark of Saccoglottis gabonensis is methanol; Rastina, 2015; Rahmawati & Bintari, 2014, extracting methanol from the bark of the bay plant with a concentration of 80% has the ability to inhibit the growth of Escherchia coli bacteria followed by ethanol from Bligo Fruit extract (B. hispida Thunb) which has good inhibitory power at a concentration of 10% against Staphylococcus typhimurium bacteria. 70% ethanol. Among the various types of solvents, ethanol and methanol solvents are most often used for the extraction of antibacterial compounds from plant materials.
The Effect of Ethanol Concentrations as The Extraction Solvent on Antioxidant Activity of Katuk (Sauropus androgynus (L.) Merr.) Leaves Extracts
Authors: Ermi Hikmawanti Ni Putu , Fatmawati Sofia , Asri Anindita Wulan
Published: May 2021

Katuk is widely popular with its benefits for breastfeeding mothers. Katuk is also known as a plant with a high antioxidant content. This study aims to determine the effect of using variations in the ethanol concentration as an extracting solvent in producing Total Phenolics Content (TPC) and Total Flavonoids Content (TFC) and their activities in reducing DPPH free radicals. The dried katuk leaves were extracted by cold maceration method. The solvent used for extraction is ethanol with 3 variations in concentration: 50%, 70%, and 96% (absolute ethanol). TPC and TFC were determined by colorimetric method using a UV-Vis spectrophotometer. TPC was stated to be equivalent to gallic acid, while TFC was stated to be equivalent to quercetin. DPPH free radical scavenging activity was measured based on the IC50 value. The results showed that Katuk leaf extract produced from 50% ethanol solvent was able to produce TPC (42.18 ± 0.30 mg GAE / g), TFC (11.18 ± 0.38 mg QE / g) and reduction activity against DPPH radicals (IC50 = 88.33 ± 3.53 ppm). These were higher than ethanol with other concentrations. However, various things need to be considered when using this solvent given the high water content in the solvent.
The Effect Of Microwave AID Extraction Temperature Of Kedawung Leaves (Parkia biglobosa) On Antioxidant Activity And Flavonoid Leavels
Authors: Indrasari Ferika , Buanasari
Published: May 2021

Parkia biglobosa contains various ingredients such as alkaloids, saponins, tannins, flavonoids, and terpenoids. The flavonoid content in kedawung is thought to have an antioxidant effect. Antioxidants have the ability to provide electrons, bind and have a free radical chain reaction chain. Currently, the microwave-assisted extraction (MAE) method is widely used because extraction using MAE can increase the mass transfer rate of solutes from the sample matrix into the solvent compared to the Soxlet method. One of the factors affecting microwave-assisted extraction is temperature because a higher temperature will increase the solubility of the solute in the solvent. The temperature is limited by the boiling point of the solvent used. This study aims to determine the effect of temperature on the solvent in order to get the best extraction results. This method uses temperature variations to determine the highest levels of flavonoids from microwave-assisted extraction of leaves and bark of kedawung, the temperature used is 30°C, 40°C, 50°C, 60°C with ethanol solvent at a wavelength of 300 W. The results of this study say that there is an effect of temperature on the extraction results. microwave-assisted to the yield of kedawung leaf extract (Parkia biglobosa) at the best temperature of 40°C. Kedawung leaves (parkia biglobosa) have high levels of flavonoids so they have antioxidant activity.
Preparation and Evaluation of Plant Extract Microcapsules Using Chitosan
Authors: Buanasari  , Sugiyo Warlan , Rustaman Heri
Published: May 2021

Research on microencapsule formulation and evaluation of ethanol extract by spray drying method was carried out to determine the effect of chitosan addition. It is hoped that from this research, chitosan microcapsule preparations can increase the benefits and stability of the extract. Microcapsule evaluation includes: microcapsule water content test, microcapsule size distribution using a Scanning Electron Microscope (SEM). The microcapsules formed were characterized by antioxidant activity using the 2,2-diphenyl-1-pikrilhidrazil (DPPH) method and total phenol content (folin-ciocalteu method). The results of the morphological evaluation showed that the microcapsules were evenly spherical for all formulas and they had an average moisture content of 4,612 ± 0.02. The anti-oxidant activity of DPPH-SA increased with the increasing concentration of added chitosan. Micro encapsules of the extract without chitosan and with the addition of 0-1% chitosan has antioxidant activity of 85,876 ± 1,897% and 86,014 ±0.570-86,725 ±0.313. In the TPC (Total Phenol Content) test, the results were 5.00 ± 0.01% and 5.49 ± 0.01-8.98 ±0.02%. Based on the research, it could be concluded that the microencapsulation with the addition of chitosan was able to increase the stability of the extract so that the antioxidant activity and total phenolic content could be higher.
Twenty weeks of Centella asiatica improved cognitive function of women elderly with dementia
Authors: Fitriana Lisna Anisa , Anggadiredja Kusnandar , Setiawan  , Adnyana I Ketut
Published: May 2021

Centella asiatica is known to improve cognitive function, but its influence on several domains of cognitive function in dementia women is still limited. This study aimed to determine the effect of Centella asiatica on cognitive function in women elderly with dementia. Screening for dementia used an MMSE questionnaire (Mini-Mental State Examination) with a cut off of 23. The trial comprised the two groups: Centella Asiatica group (CAG) 1x500 mg/day and placebo control group (PCG) 1x500 mg/day. Thirty-nine women were included in this study with mean age 74 ± 10.05. The results showed that the CAG group was effective in increasing the semantic fluency domain (p < 0.001) and visual memory (p < 0.001) compared to PCG. Meanwhile, the phonemic fluency domain and the forward-backward digit span did not show a significant difference compared to the placebo control group. In conclusion, administration of Centella asiatica for 20 weeks is effective in increasing semantic fluency and visual memory in women elderly with dementia.
Material and Life Service of the Septic Tank Have an Influence on the Biological Pollution of Groundwater (Case Study Kelurahan Pademangan Barat, North Jakarta)
Authors: Anggraini Novita , Priadi Cindy Rianti , Herdiansyah Herdis
Published: May 2021

The type of septic tank material used can vary but must be impermeable to water. Septic tanks made of cast concrete but at the bottom are not cast and deliberately made seepage should not be used because they pollute from its seepage. The use of this particular material also directly impacts the service life and affects the performance of the septic tank even though there is no standard regarding its usage time limit. This research aims to identify the use of material and life service of the septic tank in Kelurahan Pademangan Barat, which is the area with the highest biological pollution of groundwater in the study conducted by BPLHD in 2015. The results of this research identified more than half of the respondents, as many as 65.99%, used septic tanks with partially cast concrete, 33.31% usefully cast material, and the rest from other types of materials. The highest yield was 29.60% had septic tanks that were more than ten years old. The rest is as much 22.66% not knowing the service life, 19.16% with service life 5-10 years of use, 11.53% with 3-5 years of use, and 17.06%, which are less than three years old.
The Development Strategy of Conservation for Cacatua sulphurea in Bontomarannu Education Park, Gowa Regency Animal Park
Authors: Novriyani Irny , Syahribulan  , Soekendarsi Eddy
Published: May 2021

Parrot conservation has been carried out since these birds are threatened with extinction due to trade and habitat degradation. One of the conservation efforts to protect the population of fauna is in the form of the establishment of an Animal Park which can be managed by both the government and the private sector. One of the animal parks in South Sulawesi is the Bontomarannu Education Park, Sokkolia Village, Gowa Regency, South Sulawesi. The purpose of this research, (1) To identify the bioecological aspects of the Cacatua sulphurea population and (2) To establish an Ex-situ conservation development strategy for the Cacatua sulphurea to be further carried out by the management of the Bontomarannu Education Park. Based on the results of bioecological studies and conservation development strategies, there was a change in daily behavior after dividing stheir cages, feeding behavior by giving a variety of feed and their breeding by separating each pair of cockatoos in one cage. The conservation development strategy that has been carried out with the result that several pairs of birds have mated and become a reference for best practice in endemic wildlife conservation efforts so that their habitat is similar to life in the wild and is able to survive and reproduce well.
Design and Development of a Geospatial-Based Information Systems for Disaster Management of Adolescent Reproductive Health in Nusa Tenggara Barat Province In 2020
Authors: Sapoan Hadi M. , Hastono Sutanto P. , Prabawa Artha
Published: May 2021

Indonesia is an archipelago country that is very vulnerable to natural disasters, the government has made many efforts to prepare the community to face these risks, either directly or indirectly, although many efforts have been made, there are still many casualties that have occurred so that efforts are needed to prepare a more massive and integrated by involving various related sectors, thus preparedness and mitigation efforts can reach a wider community and facilitate the integration process with various fields by utilizing renewable geospatial technology. With a wide reach, there will be more benefits to the community, especially vulnerable groups, one of which is the youth group, which are vulnerable to experiencing reproductive health problems. The purpose of this study was to design and build a Geospatial Based Adolescent Reproductive Health Disaster Alert Information System in Mataram, West Nusa Tenggara (NTB). To obtain system requirements, data collection had been carried out through in-depth interviews with several stakeholders, followed by the design and development of information systems. The method of designing and developing an information system that was used was the prototyping method where the system was designed and developed in accordance with the identification of system requirements result. Based on the results of this disaster preparedness information system laboratory trial, all components of the information system can be run properly. It is hoped that this system can be tested directly at the field level and can be further developed, especially feature that support community involvement in the use of applications to improve disaster preparedness and mitigation.
Reducing solid waste through waste banks: an empirical study in Kepulauan Riau, Indonesia
Authors: Yudiatmaja W E , Edison  , Samnuzulsari T , Yudithia  , Rezeki S R I , Suyito  , Akbar D , Alfiandri A
Published: May 2021

To overcome the solid waste problem, many city governments initiate and facilitate waste banks. Various studies have sought citizen participation in waste banks, but there is little attention to understanding how the coexistence of social capital can encourage waste banks’ practice. This study, therefore, aims at examining the social capital of the urban communities in the business process of waste banks. We looked in-depth at the practice of six waste banks in Tanjungpinang City, Kepulauan Riau, Indonesia. A series of interviews were carried out on the stakeholders of waste banks, such as management, customers, citizens, and households. We suggest that a number of social capitals shape the business process of waste banks, including trust, norms, social networks, and gotong royong. This research has a novel for the study of community-based waste management by considering the urban community’s social capital. Our study also has a worthy recommendation to the local government in managing waste management by corroborating social capital.
The Utilization of Vegetable Waste as a Nutrient Addition in Hydroponic Media for the Growth of Green Mustard (Brassica juncea L.)
Authors: Faruq Hilman , Novelia Elsa , Setyaningsih Maryanti , Nisa Ranti An
Published: May 2021

Waste is a source of environmental pollution because it causes unpleasant odors, polluting water and soil and is seen as aesthetically reducing the beauty of the environment. This study aims to determine the effect of using vegetable waste as a nutrient addition to hydroponic media on the growth of mustard greens (Brassica juncea L.). The method used in this study was an experimental method with a randomized block design (RBD) consisting of 5 treatments with 6 repetitions, namely P0 (control), P1 (20ml POC + 40ml AB mix), P2 (30ml POC + 30ml AB mix), P3 (40 ml POC + 20 AB mix), and P4 (60 ml POC). This research was conducted at the Center for Agricultural Mechanism Development-Tangerang, Banten, and was conducted in March-July 2018. The observation variables were plant height, fresh weight, and plant dry weight. The research data were analyzed using the normality test and homogeneity test as a prerequisite. It was then tested with ANAVA test and the Leastest Significant Difference test 5% (LSD 5%). The results of this study indicated that the application of liquid organic fertilizer from vegetable waste to P2 with a dose of 30 ml POC + 30 ml AB mix gave the best results on plant height parameters with an average of 36.93 cm, fresh weight with an average of 41, 79 grams, and dry weight with an average of 2.34 grams. From this study, it can be concluded that the utilization of vegetable waste as an addition of nutrients to hydroponic media has an effect on the growth of mustard greens (Brassica juncea L.).
A Systematic literature (Impact of Climate Change on Filariasis)
Authors: Roswati  , Santi  , Syafii Ahmad , Mahendra Eke , Tosepu Ramadhan
Published: May 2021

Climate has an impact on the development of mosquito borne diseases, especially lymphatic filariasis. Erratic climate change can certainly cause a bad temperature in the natural environment and disturb human health. In this article, a survey of the impact climate change on filariasis. Materials or methods use review literature search by searching through emerald journals, journal journalists, journal proquests, and Pubmed. The keywords “climate change”, “filariasis disease transmitted through mosquito borne diseases” were searched with various literature or reference articles. Results: From 30 literature collected, 18 articles were excluded because they had no correlation, while 12 articles were included and met the inclusion criteria. The reviewed literature shows that, most of the researchers have been carried out in developed countries, and presumption of the effect of climate metamorphosis on diseases spread by the Aedes Aegypti SP, Anopheles SP, Culex sp and Mansonia. Mosquitoes. Which is due to the following uncertainties: 1. Uncertainty about the spread of disease through climate change and poor environmental sanitation, 2. Uncertainty through behavior between the indirect relationship between climate and human health, 3. Uncertainty about the relationship between climate and disease which is transmitted through the intermediary mosquito borne disease.
Increased Risk of Hepatitis A due to Weather Changes:A Review
Authors: Adibin  , Aisnah  , Indrawati  , Sumriati  , Tosepu Ramadhan
Published: May 2021

The existence of climate change gives great concern to public health problems. In a review kal this, carried out observations on the article discusses the impact of climate change on the increase in cases of hepatitis A disease. Materials and Methods Keyword “Hepatitis A”, “handling of patients and prevention”, “Hepatitis A”, “Hepatitis A due to climate change” is used through a combination of “OR” and “AND” to perform electronic search in Google and Google Scholar and Pubmed. The search was conducted with a publication year limitation between January 2012 and October 2020. Results: 6 articles were collected and met the inclusion criteria. The literature review shows that, most of the research has been done in countries advanced, and is found in the article mentioned that the cases of hepatitis A increases with extreme climate change in each country.
Radio offers view of gravitational waves
Authors: Cartlidge Edwin
Published: May 2021

New limits on the size of primordial gravitational waves have been set that are several orders of magnitude lower than the most sensitive laboratory experiment, as Edwin Cartlidge reports
Space engineer takes over as head of the MIT Media Lab
Authors: Gwynne Peter
Published: May 2021

Dava Newman, currently professor of astronautics at MIT, will assume the post on 1 July, becoming the first woman to do so.
Scientists face jail over China links
Authors: Gwynne Peter
Published: May 2021

Two US scientists of Asian origin face legal recriminations for allegedly lying about connections with Chinese institutions.
Brexit relief
Authors: Durrani Matin
Published: May 2021

The UK’s deal with the EU means Brexit’s impact on physics won’t be as bad as feared
Protect the scientists of tomorrow
Authors: Green Karel
Published: May 2021

Karel Green says that funders must support all PhD students due to the devastating effects on research caused by the COVID-19 pandemic
Ball proximinality of 𝑀-ideals of compact operators
Authors: Jayanarayanan C. , Siju Sreejith
Published: May 2021

In this article, we prove the proximinality of closed unit ball of

M
M

-ideals of compact operators on Banach spaces. We show that every positive (self-adjoint) operator on a Hilbert space has a positive (self-adjoint) compact approximant from the closed unit ball of space of compact operators. We also show that

K

(

ℓ
1

)

\mathcal {K}(\ell _1)

, the space of compact operators on

ℓ
1

\ell _1

, is ball proximinal in

B

(

ℓ
1

)

\mathcal {B}(\ell _1)

, the space of bounded operators on

ℓ
1

\ell _1

, even though

K

(

ℓ
1

)

\mathcal {K}(\ell _1)

is not an

M
M

-ideal in

B

(

ℓ
1

)

\mathcal {B}(\ell _1)

. Moreover, we prove the ball proximinality of

M
M

-embedded spaces in their biduals.
The discrete spherical maximal function: A new proof of ℓ²-boundedness
Authors: Lyall Neil , Magyar Ákos , Newman Alex , Woolfitt Peter
Published: May 2021

We provide a new direct proof of the

ℓ
2

\ell ^2

-boundedness of the Discrete Spherical Maximal Function that neither relies on abstract transference theorems (and hence Stein’s Spherical Maximal Function Theorem) nor on delicate asymptotics for the Fourier transform of discrete spheres.
Optimal approximants and orthogonal polynomials in several variables II: Families of polynomials in the unit ball
Authors: Sargent Meredith , Sola Alan
Published: May 2021

We obtain closed expressions for weighted orthogonal polynomials and optimal approximants associated with the function

f
(
z
)
=
1
−

1

2

(

z
1

+

z
2

)

f(z)=1-\frac {1}{\sqrt {2}}(z_1+z_2)

and a scale of Hilbert function spaces in the unit

2
2

-ball having reproducing kernel

(
1
−
⟨
z
,
w
⟩

)

−
γ

(1-\langle z,w\rangle )^{-\gamma }

,

γ
>
0

\gamma >0

. Our arguments are elementary but do not rely on reduction to the one-dimensional case.
Effect of a Multicomponent Intervention on Antihypertensive Medication Intensification in Rural South Asia: Post Hoc Analysis of a Cluster RCT
Authors: Feng Liang , Jehan Imtiaz , de Silva H Asita , Naheed Aliya , Khan Aamir H , Kasturiratne Anuradhani , Clemens John D , Lim Ching Wee , Hughes Alun D , Chaturvedi Nish , Jafar Tazeen H
Published: May 2021

Background

Inadequate treatment of hypertension is a widespread problem, especially in South Asian countries where cardiovascular disease mortality rates are high. We aimed to explore the effect of a multicomponent intervention (MCI) on antihypertensive medication intensification among rural South Asians with hypertension.

Methods

A post hoc analysis of a 2-year cluster-randomized controlled trial including 2,645 hypertensives aged ≥40 years from 30 rural communities, 10 each, in Bangladesh, Pakistan, and Sri Lanka. Independent assessors collected information on participants’ self-reports and physical inspection of medications. The main outcomes were the changes from baseline to 24 months in the following: (i) the therapeutic intensity score (TIS) for all (and class-specific) antihypertensive medications; (ii) the number of antihypertensive medications in all trial participants.

Results

At 24 months, the mean increase in the TIS score of all antihypertensive medications was 0.11 in the MCI group and 0.03 in the control group, with a between-group difference in the increase of 0.08 (95% confidence interval (CI, 0.03, 0.12); P = 0.002). In MCI compared with controls, a greater increase in the TIS of renin–angiotensin–aldosterone system blockers (0.05; 95% CI (0.02, 0.07); P < 0.001) and calcium channel blockers (0.03; 95% CI (0.00, 0.05); P = 0.031), and in the number of antihypertensive medications (0.11, 95% CI (0.02, 0.19); P = 0.016) was observed.

Conclusions

In rural communities in Bangladesh, Pakistan, and Sri Lanka, MCI led to a greater increase in antihypertensive medication intensification compared with the usual care among adults with hypertension.

Clinical trials registration

Trial Number NCT02657746.
Estrogen-induced gallstone pancreatitis in a transgender female
Authors: Freier Emily , Kassel Lynn , Rand Joel , Chinnakotla Bhavana
Published: May 2021

Purpose

The case of a transgender female who developed gallstone pancreatitis in the context of estrogen use for gender-affirming hormone therapy is reported.

A 24-year-old Caucasian transgender female presented to the emergency department for abdominal pain and vomiting after referral from urgent care for suspected pancreatitis. Her home medications included estradiol, medroxyprogesterone, and spironolactone for gender-affirming hormone therapy and omeprazole for reflux. The patient reported minimal alcohol intake, presented with mildly elevated triglyceride levels, and did not have a family history of pancreatitis or gallstone disease. She underwent a laparoscopic cholecystectomy on hospital day 4 and was given a postoperative diagnosis of chronic cholecystitis, cholelithiasis, and pancreatitis. Given her history and the present illness, the use of estrogen therapy is a likely risk factor for the development of gallstone pancreatitis.

Conclusion

Estrogen is a cornerstone of gender-affirming hormone therapy used by transgender women; however, in addition to its role in gender identity confirmation, estrogen can result in drug-induced pancreatitis.
Russell–Myhill and grounding
Authors: Kment Boris
Published: May 2021

The Russell-Myhill paradox (RMP) puts pressure on the Russellian structured view of propositions (structurism) by showing that it conflicts with certain prima facie attractive ontological and logical principles. I describe several versions of RMP and argue that structurists can appeal to natural assumptions about metaphysical grounding to provide independent reasons for rejecting the ontological principles used in these paradoxes. It remains a task for future work to extend this grounding-based approach to all variants of RMP.
Immune checkpoint inhibitor use in patients with end-stage kidney disease: an analysis of reported cases and literature review
Authors: Kitchlu Abhijat , Jhaveri Kenar D , Sprangers Ben , Yanagita Motoko , Wanchoo Rimda
Published: May 2021

Immune checkpoint inhibitors (ICIs), immunomodulatory antibodies that are used to enhance the immune system, have substantially improved the prognosis of patients with advanced malignancy. As the use of ICI therapy becomes increasingly widespread across different types of cancer, their use in patients receiving dialysis is likely to increase. In this review we summarize the current literature on the use of ICIs in end-stage kidney disease (ESKD) patients and provide aggregate data from reported cases and series. Based on available pharmacological information, ICIs require no dosing adjustment in ESKD patients. Analysis of the reported cases in the literature demonstrates a similar incidence of immune-related adverse events in patients with ESKD receiving dialysis as compared with the general population (49%). Severe reactions graded as 3 and 4 have been seen in 15 patients (16%). As such, it is important that these patients are monitored very closely for immune-related adverse events; however, the risk of these adverse events should not preclude patients on dialysis from receiving these therapies. Cancer remission (complete and partial) was seen in close to 30% of patients, stable disease was seen in 28% and progression of disease in ∼36%. One-third of the patients died. Urothelial and renal cell cancer represented approximately half of all treated cancers and accounted for ∼50% of all deaths reported. Additional data in the dialysis population with the use of ICIs and involvement in prospective studies are needed to better assess outcomes, particularly within specific cancer types.
Quality of care and risk of incident atrial fibrillation in patients with newly diagnosed heart failure: a nationwide cohort study
Authors: Vinter Nicklas , Cordsen Pia , Fenger-Grøn Morten , Lip Gregory Y H , Benjamin Emelia J , Frost Lars , Johnsen Søren Paaske
Published: May 2021

Aims

Incident atrial fibrillation (AF) is an adverse prognostic indicator in heart failure (HF); identifying modifiable targets may be relevant to reduce the incidence and morbidity of AF. Therefore, we examined the association between quality of HF care and risk of AF.

Methods and results

Using the Danish Heart Failure Registry, we conducted a nationwide registry-based cohort study of all incident HF patients diagnosed between 2008 and 2018 and without history of AF. Quality of HF care was assessed by seven process performance measures, including echocardiographic examination, New York Heart Association classification, treatment with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers, and mineralocorticoid antagonists, physical training, and patient education. In the main analysis, we examined adherence with all measures in a cohort of 25 100 patients (mean age 68.5 ± 13.2 years; 33.6% women). The median follow-up was 3.1 years. Cox proportional hazard regressions estimated the hazard ratios (HRs) with 95% confidence intervals (95% CIs) between the number of fulfilled measures and incident AF. In a multivariable-adjusted analysis with 0 fulfilled performance measures as reference, the HRs (95% CIs) were 1: 0.78 (0.61–1.00), 2: 0.63 (0.49–0.80), 3: 0.53 (0.36–0.80), 4: 0.64 (0.44–0.94), 5: 0.56 (0.39–0.82), 6: 0.51 (0.35–0.74), and 7: 0.49 (0.33–0.73), with a significant decreasing linear trend (P < 0.001).

Conclusion

In patients with incident HF, fulfilment of guideline-based process performance measures was associated with decreased long-term risk of AF. This study supports initiatives to improve the quality of care for patients with HF to prevent incident AF.
Low thoracic muscle mass index on computed tomography predicts adverse outcomes following lobectomy via thoracotomy for lung cancer
Authors: Çınar Hüseyin Ulaş , Çelik Burçin , Taşkın Gülten , İnce Özgür
Published: May 2021

OBJECTIVES

The aim of this study was to determine whether the preoperative thoracic muscle mass is associated with postoperative outcomes in patients undergoing lobectomy via thoracotomy for lung cancer.

METHODS

Consecutive patients undergoing lobectomy were retrospectively reviewed. The thoracic muscle mass index (TMMI) was obtained at the level of the fifth thoracic vertebra on preoperative thoracic computed tomography (CT). Patients were analysed comparatively by being dividing into low and high muscle index groups by the median of sex-specific TMMI. The primary outcomes were the incidence of any or postoperative pulmonary complications. The secondary outcomes were postoperative intensive care unit (ICU) admission, length of stay (LOS) in the ICU, total hospital LOS, readmission and mortality.

RESULTS

The study population consisted of 120 patients (63.6 ± 9.8 years; 74% male). Each groups included 60 patients. Major complications occurred in 28.3% (34/120) and readmission in 18.3% (22/120) of patients. The adjusted multivariable analysis showed that each unit increase in TMMI (cm2/m2) was independently associated with the rates of less any complications [odds ratio (OR) 0.92, P = 0.014], pulmonary complications (OR 0.27, P = 0.019), ICU admission (OR 0.76, P = 0.031), hospitalization for >6 days (OR 0.90, P = 0.008) and readmission (OR 0.93, P = 0.029).

CONCLUSIONS

Low TMMI obtained from the preoperative thoracic CT is an independent predictor of postoperative adverse outcomes in patients following lobectomy via thoracotomy for lung cancer. TMMI measurements may contribute to the development of preoperative risk stratification studies in the future.
Alternative and Improved Stability-Indicating HPLC Method for the Assay of Eprinomectin and Determination of Its Related Compounds in Bulk Batches of Eprinomectin Drug Substance
Authors: Padivitage Nilusha , Tian Jingzhi , Rustum Abu
Published: May 2021

Background

Eprinomectin is used as an active pharmaceutical ingredient (API) in various drug products by the animal health industry. Several major related impurities of eprinomectin API are not separated and coelute by the current United States Pharmacopeia (USP) method for eprinomectin.

Objective

The aim was to develop and validate a true and reliable stability-indicating reversed-phase (RP) HPLC method for assay and determination of related substances of eprinomectin in bulk batches of eprinomectin API.

Method

HPLC analysis is carried out using a Kinetex C8 column (100 mm × 4.6 mm i.d. , 2.6 μm particle size) maintained at 30°C with water–acetonitrile–isopropanol (48 + 42 + 10, v/v/v) as mobile phase A and 100% acetonitrile as mobile phase B. Analytes are separated by gradient elution at a flow rate of 0.7 mL/min and detected by UV at 252 nm. The total run time of the method is 30 min. Eprinomectin assay and estimation of all eprinomectin-related substances are obtained in a single HPLC run.

Results

The HPLC method was able to separate all analytes of interest by gradient elution. The new method was successfully validated according to current The Internal Council for Hamonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) and International Cooperation on Hamonisation of Technical Requirements for Registration of Veterinary Medicinal Products (VICH) guidelines and was found to be specific, linear, accurate, precise, robust, and sensitive.

Conclusions

An HPLC method for assay of eprinomectin and estimation of its related substances was successfully developed, validated, and demonstrated to be accurate, robust, specific, and stability-indicating.

Highlights

The HPLC method presented in this paper is more desirable as compared to USP and suitable for routine analysis of bulk batches of eprinomectin API and stability samples in QC laboratories.
Biology, Ecology, and Management of Hemipteran Pests in Almond Orchards in the United States
Authors: Rijal Jhalendra P , Joyce Andrea L , Gyawaly Sudan
Published: May 2021

Almond, Prunus dulcis (Miller) D. A. Webb, is an important tree nut crop cultivated primarily in the Mediterranean climatic regions. However, the United States, specifically the state of California, is the largest producer and exporter of almond nuts in the world. At least 60 species of insect pests attack almonds worldwide. Hemipterans can be important pests in almond orchards. Some hemipteran insect pests in almonds include lace bugs, plant bugs, stink bugs, and leaffooted bugs. These pests use needle-like mouthparts to pierce and feed upon fruits or other parts of the plant, causing direct or indirect crop damage. Nonetheless, the biology, life history, and management practices for many hemipteran pests of almonds are not available in the literature or come from research of these insects on other crops and host plants. In this article, we discuss the current understanding of biology, ecology, and management of hemipteran pests of almonds and outline future research to advance the integrated pest management of these pests in almond orchard systems.
Influenza Immunization of Adults During Outpatient Pediatric Visits
Authors: Mishra Aakriti , Dehority Walter
Published: May 2021

The American Academy of Pediatrics suggests pediatricians may provide influenza immunization to adults accompanying children to outpatient appointments. Analysis of the IBM Watson MarketScan database demonstrated that of 1 546 340 encounters for pediatric influenza immunization in 2016, only 1.5% of encounters with a pediatrician resulted in immunization of an accompanying adult.
Implantable cardiac pacemaker failure by cumulative dose effects of flattening filter free beams
Authors: Nakamura Kazuhiko , Aoyama Takahiro , Kaneda Naoki , Otsuji Masashi , Minami Yoshitaka , Sakuragi Ami , Nakamura Masaru
Published: May 2021

Cumulative dose effects, which are one of the main causes of errors that occur when an implantable cardiac pacemaker (ICP) is irradiated with ionizing radiation, induce permanent failure in ICPs. Although flattening filter free (FFF) beams, which are often used in stereotactic radiotherapy, are known to have different characteristics from conventional (with flattening filter [WFF]) beams, the cumulative dose effects on ICPs with FFF beams have been under-investigated. This study investigates ICP failure induced by cumulative dose effects of FFF beams. When the ICP placed in the center of the irradiation field was irradiated with 10 MV-FFF at 24 Gy/min, the cumulative dose at which failure occurred was evaluated on the basis of the failure criteria associated with high cumulative dose as described in the American Association of Physicists in Medicine Task Group 203. The ICP failures such as a mild battery depletion at a cumulative dose of 10 Gy, pacing-output voltage change >25% at a cumulative dose of 122 Gy, and the loss of telemetry capability at cumulative dose 134 Gy were induced by cumulative dose effects. The cumulative doses by which the cumulative dose effects of FFF beams induced ICP failure were not very different from those reported in previous studies with WFF beams. Therefore, radiotherapy with FFF beams (and WFF beams) for patients with ICP requires appropriate management for minimizing the cumulative dose effects.
The Politics of Uncertainty: Producing, Reinforcing, and Mediating (Legal) Uncertainty in Local Refugee Reception—Introduction to the Special Issue
Authors: Maas Felix , Münch Sybille , Schader Miriam , Schammann Hannes
Published: May 2021

Even though a migration-uncertainty nexus has been widely acknowledged, several of its dimensions are strikingly understudied and under-theorised. This special issue contributes to the debate by focussing on migration movements that are linked to an extraordinary degree of uncertainty: refugee and forced migration. This introductory article highlights key points arising from the contributions. The articles look at both the migrants’ perspective and the perspective of local organisations dealing with refugee and forced migration, including the state. The special issue puts into sharper focus the relevance of further theorisation of uncertainty in migration processes at the local level, as it reveals several dimensions of uncertainty, namely as a fundamental experience, a challenge as well as a governing tool. Furthermore, we are able to bring together the micro- and meso-levels and to substantiate our theoretical contribution with ample empirical material.
Multidrug-resistant tuberculosis imported into low-incidence countries—a GeoSentinel analysis, 2008–2020
Authors: Eimer Johannes , Patimeteeporn Calvin , Jensenius Mogens , Gkrania-Klotsas Effrossyni , Duvignaud Alexandre , Barnett Elizabeth D , Hochberg Natasha S , Chen Lin H , Trigo-Esteban Elena , Gertler Maximilian , Greenaway Christina , Grobusch Martin P , Angelo Kristina M , Hamer Davidson H , Caumes Eric , Asgeirsson Hilmir
Published: May 2021

Background

Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travellers and migrants with MDR-TB.

Methods

Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin.

Results

Of 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%) and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154 days (interquartile range [IQR]: 10–751 days); 34.3% of patients presented within 1 month after immigration, 30.9% between 1 and 12 months and 34.9% after ≥1 year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26 days [IQR: 8–522] vs. 369 days [IQR: 84–827]), while patients from Georgia presented very early, irrespective of the level of resistance (8 days [IQR: 2–18] vs. 2 days [IQR: 1–17]).

Conclusions

MDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration.
Achy Shoulder After Sunset
Authors: Cruz-Jimenez Maricarmen
Published: May 2021

Bicipital tendinopathies encompass a spectrum of clinical manifestations, expanding from acute inflammation to chronic degenerative changes in the tendon structure that impact the biomechanics and function of the shoulder. Although bicipital tendonitis can manifest as a primary isolated disorder, this is less common; it is more common to see bicipital tendon injuries in association with injuries to other nearby structures, more commonly the rotator cuff. Pain is the mainstay of the clinical symptoms, but other manifestations can accompany the presentation, including impingement and instability. A comprehensive history and physical examination enhance the ability to identify the functional impairments and the identification of all potential contributors. Treatment modalities vary depending on the stage of injury, expanding from pharmacotherapy to surgical interventions.
Burning and Twitching in the Shoulder
Authors: Robinson Matthew , Pham Quynh Giao
Published: May 2021

Lesions to the brachial plexus may lead to significant pain and disability. These tend to be difficult to diagnose. Radiation-induced brachial plexopathy (RBP) is a known complication of radiation to the chest, neck, or axillary region. The average onset of symptoms post-radiation has been reported as 6 years, and it is most commonly reported following radiation for breast cancer (up to 40–75% of patients), followed by lung cancer and lymphoma. RBP has also been described following radiation to treat nasopharyngeal carcinoma with lower cervical lymph node metastases. This chapter discusses the signs, symptoms, differential diagnosis, and management of conditions affecting the brachial plexus, comparing and contrasting RBP with idiopathic brachial neuritis and neoplastic brachial plexopathy.
A Very Strong Woman with an Achy Forearm and Weak Grip
Authors: Pham Quynh Giao
Published: May 2021

Median nerve compression neuropathy is most commonly seen at the carpal tunnel, but proximal median nerve compression can also occur. This chapter describes the signs and symptoms of median nerve entrapment syndrome and discusses the various forms of this condition, including anterior interosseous syndrome, pronator teres syndrome, and carpal tunnel syndrome. Anterior interosseous syndrome presents with pure motor deficits. Pronator teres syndrome presents with both pain and weakness in the forearm and sensory abnormalities. A rare site of median nerve compression (ligament of Struthers and bicipital aponeurosis/lacertus fibrosus) can occur and may be confused with medial epicondylitis. The chapter delineates the differential diagnoses, diagnostic work-up, and treatment options related to proximal median nerve entrapment syndromes.
Can’t Sleep While Hands Are Taking a Nap
Authors: Cuevas-Trisan Ramon
Published: May 2021

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in adults, affecting females more than males. Symptoms are generally reported to gradually worsen after insidious onset. Common conditions that cause systemic neuropathies (diabetes and hypothyroidism) or edema (pregnancy and renal insufficiency) are risk factors for developing this condition. In addition, obesity has also been described as a risk factor, along with occupations in which there is repetitive wrist motion (secretarial work) and use of vibrating tools (some construction jobs). Patients with mild CTS will usually present symptoms with either no signs or relatively minor signs on examination. Electrodiagnostic testing is the only ancillary test that will be useful in confirming the diagnosis, providing also information about the degree of nerve compromise, thus helping guide possible interventions. Conservative followed by more invasive management methods may be used for management in a stepwise manner.
Wrist Pain After Slip and Fall
Authors: Spielman Amanda , Lessard Anne-Sophie , Sankaranarayanan Sriram
Published: May 2021

The wrist is a very complex structure, and its radiographic evaluation requires very specific views. This chapter discusses the classical findings associated with injuries to ligaments of the wrist. It reviews three common wrist sprains: triangular fibrocartilage complex sprains, scapholunate ligament injuries, and lunotriquetral ligament injuries. The chapter describes the anatomy and common mechanisms of injury to the region, associated with each main class of sprains, as well as patient symptoms. It reviews the steps to follow to allow for appropriate diagnosis, including imaging studies and classification guides. The chapter also provides information for management of patients’ conditions and counseling advice for patients in the outpatient setting.
The High-Risk Obstetric Patient
Authors: Curbelo Jacqueline
Published: May 2021

“The high-risk obstetric patient: pregnancy-induced conditions” focuses on maternal pathophysiological conditions which develop only in the pregnancy state. Gestational diabetes mellitus (GDM) is discussed, including the role of progressive insulin resistance, maternal risk factors for GDM, diagnostic criteria, recommendations for managing hyperglycemia, maternal and fetal complications, recommendations for obstetric management, and anesthetic implications and management. The chapter focuses on hypertensive disorders of pregnancy, including gestational hypertension (GHTN), preeclampsia, the syndrome of hemolysis, elevated liver enzymes, low platelets (HELLP), and eclampsia. Emphasis is placed on the significant maternal morbidity and mortality related to hypertension in pregnancy and the importance of recognizing and responding to ominous, multisystemic manifestations associated with hypertensive disorders of pregnancy. Recommendations for obstetric management are reviewed, and anesthetic implications and recommendations are discussed. Intrauterine fetal demise (IUFD) is introduced, including causes of fetal demise, obstetric management, and anesthetic implications.
Cesarean Delivery
Authors: dos Santos Thais Franklin , Ghosh Arina , Zbeidy Reine
Published: May 2021

Severe postoperative pain is reported in 20% of patients in the initial period following the cesarean delivery, and multimodal analgesic regimens provide better analgesia and allow for reducing total neuraxial and systemic opioid use, thus reducing the risk of side effects. Inadequately treated pain is associated with increased risk of developing chronic pain, postpartum depression, difficulty with breastfeeding, increased healthcare cost, and other complications. Neuraxial opioids are considered the main component of multimodal analgesia after cesarean since they provide better pain control than systemic opioids, non-neuraxial regional techniques, and oral analgesics. Neuraxial morphine is the gold-standard option for postcesarean analgesia. Systemic opioids, nonopioid adjuvants, and peripheral nerve blocks have an important role as part of a multimodal regimen for postcesarean analgesia.
Trauma and Critical Care During Pregnancy
Authors: Best Gavin T. , Nikolaidis Melissa A. , Deng Yi
Published: May 2021

Trauma is the leading nonobstetric cause of death in pregnant patients, and parturient women have unique physiologies, pathologies, and considerations. The aim of this chapter is to discuss these differences and address ways to treat these patients immediately following trauma and in the critical care setting. The chapter addresses blunt, penetrating, and burn trauma in the pregnant patient. Additionally, it will highlight several common critical pathologies seen in pregnancy such as eclampsia; hemolysis, elevated liver enzymes, and low platelets syndrome; and acute respiratory distress syndrome, as well as some pre-existing conditions made more complicated by the pregnant state.
Axon and Myelin
Authors: Benarroch Eduardo E.
Published: May 2021

Axons allow the initiation and conduction of the action potential and neurotransmitter release and have unique structure and physiology. Myelin has a unique composition of lipids and proteins. Each compartment of myelinated axons expresses a unique repertoire of ion channels, adaptor molecules, and adhesion molecules. There is a reciprocal interaction between the axons and myelinating cells. Axons are also vulnerable structures, as they may extend for long distances away from the cell body, which renders them highly dependent on mitochondrial energy metabolism, cytoskeletal integrity, and axonal transport for their maintenance and response to injury. Immune, metabolic, or degenerative disorders affecting these interactions result in a wide variety of peripheral neuropathies and leukoencephalopathies.