bluuebunny/crossref_metadata_2025 huggingface dataset:
Hubungan Dukungan Keluarga Dengan Status Imunisasi Dasar Lengkap Pada Bayi : Studi Meta Analisis
Authors: Utomo Benitta Biyantari Eka Putri
Published: March 2022

Salah satu indikator dalam pelaksanaan progam Indonesia Sehat adalah bayi mendapatkan imunisasi dasar lengkap. Namun, cakupan imunisasi dasar lengkap di Indonesia belum mencapai target yang diinginkan. Keluarga memiliki peran penting dalam pemanfaatan pelayanan imunisasi dasar. Tujuan dalam penelitian ini adalah menerapkan meta analisis pada hubungan dukungan keluarga dengan status imunisasi dasar lengkap pada bayi. Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan desain studi meta analisis. Sampel dalam penelitian ini adalah penelitian mengenai hubungan dukungan keluarga dengan status imunisasi dasar lengkap pada bayi. Pengumpulan data dilakukan dengan melakukan penelusuran jurnal secara online menggunakan media elektronik dengan kata kunci yang digunakan adalah dukungan keluarga dan imunisasi dasar lengkap. Analisis menggunakan software JASP (Jeffreys's Amazing Statistics Program). Hasil penelitian menunjukkan summary effect size penelitian sebesar 7,48 dengan nilai p value sebesar < 0,001. Sehingga, terdapat hubungan secara signifikan dukungan keluarga dengan status imunisasi dasar lengkap.
Reporte de casos sobre el uso de ácido tranexámico para reducir el sangrado perioperatorio en liposucción y abdominoplastia
Authors: Fuentes Alzate Juan José , Fuentes Torrado Edgard Augusto , Alzate Granados Juan Pablo
Published: March 2022

Introducción: La liposucción y la abdominoplastia son dos de las cirugías estéticas más realizadas en el mundo. Una de las complicaciones más frecuentes de estos procedimientos es el sangrado perioperatorio, el cual puede conllevar a postoperatorios inadecuados y con mayores complicaciones. Por esta razón, se deben buscar nuevos métodos que permitan reducir las pérdidas sanguíneas en este tipo de cirugías.

Objetivo: Evaluar la efectividad del ácido tranexámico en reducir el sangrado perioperatorio en liposucción y abdominoplastia.

Materiales y métodos: Estudio retrospectivo consistente en un reporte de serie de casos en el que se mencionan un grupo de pacientes a las cuales se aplicó 1 gramo de ácido tranexámico previo a la realización de liposucción y abdominoplastia. En estas pacientes se revisó un hemograma pre quirúrgico y otro post quirúrgico y se comparó la disminución de la hemoglobina y hematocrito. Así mismo, se revisó si las pacientes presentaron la necesidad de transfusión de componentes sanguíneos.

Resultados: Se obtuvo una población de 37 pacientes femeninas. Ninguna de las pacientes presentó una hemoglobina postquirúrgica menor de 8 g/dl ni requirió transfusión de hemoderivados después de la cirugía. Se realizó una correlación de Spearman entre las variables, en las cuales no se evidenció asociación entre el lipoaspirado y la hemoglobina o hematocrito postoperatorio.

Conclusión: El ácido tranexámico es un medicamento que puede ser útil para reducir el sangrado perioperatorio en liposucción y abdominoplastia ya que ninguna de las pacientes que recibió este medicamento requirió transfusión de hemoderivados.  

Palabras clave: Ácido tranexámico, liposucción, abdominoplastia, hemorragia
Lean Manufacturing: Modelos y herramientas
Authors: Muñoz Guevara John Andrés , Zapata Urquijo César Augusto , Medina Varela Pedro Daniel
Published: March 2022

En el libro se hace principal énfasis en la descripción de las herramientas y modelos matemáticos que se requieren aplicar a la hora de implementar Lean Manufacturing en las empresas. El principal aporte y lo que hace que este libro sea diferente a los demás, es la descripción completa sobre aquellos modelos matemáticos que facilitan la toma de decisiones frente a la viabilidad técnica y económica en la aplicación de las herramientas y metodologías Lean. El libro se divide en seis capítulos, en el capítulo uno se realiza una introducción y reseña histórica del Lean Manufacturing. En el capítulo dos se presentan los modelos matemáticos para determinar los niveles de productividad, medición del desperdicio y su relación con los costos de producción. En el capítulo tres se presentan las herramientas para la selección y descripción de un proyecto Lean. En el capítulo cuatro se hace un énfasis en los indicadores claves que se deben aplicar en la implementación del Lean Manufacturing para su correcta gestión. Luego en el capítulo cinco se describen las herramientas y modelos matemáticos aplicados a la gestión de los centros de trabajo, haciendo principal énfasis en los modelos matemáticos para la creación de celdas de manufactura. Por último, en el capítulo seis se describen las herramientas y modelos matemáticos para gestionar el flujo de la producción entre los centros de trabajo. Cada capítulo contiene una serie de preguntas y ejercicios que permiten reforzar los temas estudiados y servir como guía para el aprendizaje y la transferencia del conocimiento.
With controlled animal feeding: Roads Traversing Protected Areas do not affect feeding and foraging behaviour of yellow baboon
Authors: Kitegile Amani , Hawkins Dawn , Hassan Shombe , Norton Guy
Published: March 2022

The Tanzania-Zambia (TANZAM) Highway traversing Mikumi National Park
(MINAPA) has been a concern for wildlife managers since it was first
paved in 1973-74. After its upgrade in 1989-90, researchers have
documented increasing traffic resulting in considerable animal injuries
and mortalities. Yellow baboons in MINAPA are known to use the road as
their bridge to and from foraging areas, therefore in addition to the
risk of mortality; road use could potentially have significant influence
on their feeding behaviour. However, knowledge on the influences of the
TANZAM highway in the feeding behaviour of the baboons is sparse. Using
focal animal sampling techniques, we collected data on feeding and
foraging behaviour of two habituated troops of yellow baboons to examine
to what extent the TANZAM highway is important in their feeding and
foraging behaviour. Results showed that in relation to habitat
availability, visitation to habitat types reflect actual habitat choice
of baboons. In general, baboons less frequently visit and spent less
time in the highway compared to natural habitats. Whenever they were on
the highway, adult females and subadult males engage more into feeding,
resting and socializing, while adult males were more vigilant. The major
dietary compositions were fruits, seeds, leaves, sap and invertebrates,
almost exclusively collected from natural habitats, foods from the
highway were opportunistically consumed. This study provides empirical
evidence and concludes that yellow baboons do not directly depend on the
highway for food, rather they use the TANZAM highway as normal part of
their home range. The TANZAM highway is used because it improves
visibility and reduces the perceived predation risk compared to natural
habitats. However, its location near sleeping sites may have significant
impact on baboons’ activity budget. With these findings, we recommend
strict implementation of rules against park littering and animal feeding
in protected areas traversed by highways.
Wilms Tumor: An Institutional Experience with Rupture
Authors: Radu Stephanie , Nacharaju Deepthi , Edwards Emily , Winsnes Katrina , Fialkowski Elizabeth
Published: March 2022

Background: While patients with Wilms tumor (WT) have an overall
survival greater than 90%, tumor rupture is associated with worse
outcomes and can increase risk of abdominal recurrence to 20%1. Because
our institutional rate of rupture is at least 2.5x higher than that
found in literature, we conducted a retrospective chart review to
understand the differences between our patient population and the
population in literature2. Our aims were to 1) compare our patient
demographics and outcomes, 2) describe correlations between
preoperative, intraoperative, and pathologic diagnosis of rupture, and
3) compare our outcomes between upfront resection and neoadjuvant
chemotherapy. Procedures: We reviewed charts from 2015 to 2019 and
assessed: details of presentation, chemotherapy, operative and
pathological findings, complications, and outcomes between patients with
and without rupture. Results: Of 29 patients with WT, 9 had preoperative
rupture by imaging and 8, all females, were confirmed surgically. Our
rupture prevalence of 27.6% is higher than that in literature
(11-13%.) Despite patients with rupture having more positive margins
(50% vs. 19% non-ruptured), they had lower recurrence rates at one
year (0 vs 19% non-ruptured) and improved survival mortality (100% vs.
90.5% non-ruptured). Neoadjuvant therapy and flank radiation compared
to whole abdominal radiation did not change complication rates or
outcomes. Conclusions: The high percentage of ruptured WT at our
institution allowed for comprehensive review and revealed variations
from literature. Patients with rupture had better outcomes than patients
without rupture, with no difference comparing neoadjuvant chemotherapy
to upfront resection and flank vs whole abdomen radiation.
Early application of non-invasive ventilation for children with pulmonary edema after drowning
Authors: Şık Nihan , Şenol Hüseyin Bahadır , caglar aykut , Yılmaz Durgül , Duman Murat
Published: March 2022

Background: The present study aimed to assess the efficacy of
non-invasive ventilation (NIV) on the clinical course, oxygenation, need
for invasive mechanical ventilation (IMV), and outcomes for children
with pulmonary edema after drowning. Methods: We conducted a
retrospective chart review. Children who were referred to the pediatric
emergency department due to drowning-related pulmonary edema and
underwent NIV between May 2014 and October 2020 were included.
Demographics, vital signs, clinical findings, and results of laboratory
and radiologic investigations were recorded. Patients were divided into
6 groups using the Szpilman classification system. The need for IMV, the
need for pediatric intensive care unit (PICU) admission, and the length
of NIV treatment and stay in the PICU were recorded for each patient.
Results: Twenty-five patients were enrolled. According to the Szpilman
classification, 13 (52.0%) patients were evaluated as grade 3 and 12
(48.0%) as grade 4. All patients were treated with bi-level positive
airway pressure in the spontaneous/timed mode. A significant increase in
oxygen saturation (SpO₂) and SpO₂/fraction of inspired oxygen ratios was
observed from the beginning of NIV treatment and this increase was also
observed for the 2nd and 4th hours. There was a decrease in respiratory
rate at the 4th hour of NIV treatment. No patient subsequently
deteriorated to IMV. Conclusion: We have reported a favorable clinical
course of drowning patients who underwent early use of NIV in the
pediatric emergency department. Management of drowning patients with
pulmonary edema by NIV with close follow-up can be successfully applied
in selected cases.
Low phenotypic plasticity as a driver of species decline under eutrophication
Authors: Baattrup-Pedersen Annette , Cavalli Giulia , Larsen Søren , Johansson Liselotte , Riis Tenna
Published: March 2022

The number of extinct or urgently threatened species rapidly accelerates
and almost one-third of freshwater biodiversity face extinction.
Consequently, the need to identify means to help protect and conserve
species is paramount. Here, we explore mechanistic links between
eutrophication and species declines. Specifically, we hypothesised that
declining species within the plant genus Potamogetonaceae exhibit a low
degree of ecophysiological trait plasticity and a suboptimal trait
expression under enhanced levels of nutrients rendering these species
prone to extinction under eutrophication. Individuals of five species
including common species (S. pectinatus, P. perfoliatus and P. crispus)
and declining species (P. compressus and P. gramineus) were transplanted
into three replicate lakes along a gradient in nutrient availability.
After four weeks, ecophysiological traits were measured and the
phenotypic plasticity was assessed. We found that declining species were
unable to convert increased nutrients availability into enhanced rates
of growth. Additionally, we found that the ecophysiological plasticity
was lower both regarding nutrient acquisition and the ability to adjust
physiologically to maximise growth under the prevailing nutrient regime.
We conclude that the mechanisms behind species declines link to
inappropriate ecophysiological adjustments under nutrient enrichment
that have severe consequences for their competitive capabilities,
eventually leading to local extinction.
Dominance of honey bees is negatively associated with wild bee diversity in commercial apple orchards regardless of management practices Short title : Honey bees affect wild bees in apple orchards
Authors: Weekers Timothy , Marshall Leon , Leclercq Nicolas , Wood Thomas , Acuna Diego Cejas , Drepper Bianca , Hutchinson Louise , Michez Denis , Molenberg Jean-Marc , Smagghe Guy , Vandamme Peter , Vereecken Nicolas
Published: March 2022

Commercial apple production relies on managed honey bees for
pollination, and on intensive management for pest control. Previous
studies revealed the detrimental effects of these factors on wild bee
diversity in agroecosystems, and the pollination services they provide.
However, the extent to which honey bee dominance and management interact
under field-realistic conditions to shape wild communities has never
been investigated. We measured the species richness and functional and
phylogenetic diversity of wild bees associated with apple blossoms, in
46 organic and non-organic orchards, and along a climatic gradient
across Western Europe and Morocco. Our results consistently show a
strong and negative association between honey bee dominance and all
diversity indices, regardless of local practices and surrounding
landscape cover. Collectively, we show that wild bee diversity decreases
with increasing honey bee density, with alternative management practices
(i.e., organic) having no significant influence on wild bee communities
in commercial apple orchards.
Broad adaptive genetic differentiation in forage quality traits but similar phenotypic plasticity in Tunisian populations of Brachypodium hybridum in response to phosphorus deficiency
Authors: Neji Mohamed , Tlahig Samir , Abdelly Chedly
Published: March 2022

Facing to the harsh environmental constraints, natural populations of
widespread plant species may express plastic response, evolve local
adaptation or combine both mechanisms in order to maintain their genetic
variation and pervasiveness across a wide ecological niche. Here, 79
lines representing height Tunisian populations of Brachypodium hybridum
were cultivated in two contrasting phosphorus (P) availability levels
and their genetic variation was investigated using forage quality traits
to identify the main mechanisms governing their genetic variation. Our
results revealed large variation among populations for most traits. PCA
analysis showed the separation between coastal and inland populations in
both P levels. Importantly, all traits revealed high heritability in
both P treatments and the response of most of them to P deficiency was
highly influenced by the population effect, which accounted 52.38% of
the total variation, indicating strong population differentiation.
However, although significant for most traits, only 18.13% of variation
was attributed to P treatment, suggesting little plastic response to P
deficiency. Importantly, as revealed by the lack of population*treatment
effect for most traits, the plastic response was probably common to all
populations. Moreover, we found that 56.99% of variation was attributed
to environmental factors with distance to coastline, precipitation
seasonality, and annual precipitation being the most important factors,
suggesting that the strong population differentiation likely reflects
local adaptation to specific environmental conditions. Contrary to the
coastal populations, which were characterized by high levels of
fiber-related traits levels, the inland ones displayed the high values
of most energy-related traits, suggesting that these latter were
characterized by relatively higher forage quality. Overall, our results
suggested that the effect of local adaptation overrides the effect of
phenotypic plasticity in explaining the variation of forage quality
traits, which indicate a broad adaptive genetic differentiation among
the Tunisian populations of B. hybridum in response to P deficiency.
Exogenously applied phthalanilic acid regulates photosynthetic and antioxidant capacity and improves yield in Vigna unguiculata under field conditions
Authors: Ma Ting , Wu Qiong , Liu Na , Zhang Rong , Ma Zhiqing , Zhang Xing
Published: March 2022

Phthalanilic acid (PPA), a promising plant growth regulator, has been
increasingly applied to fruit and vegetable production. However, its
regulation on growth and development of cowpea (Vigna unguiculata)
plants is still unclear. In this study, the physiological and
biochemical effects of PPA on cowpea plants were investigated under
field conditions by using brassinolide as the positive control. Here,
the results showed that PPA treatments exhibited positive effects on
photosynthesis. Meanwhile, antioxidant enzymes including superoxide
dismutase (SOD), peroxidase (POD) and catalase (CAT) were enhanced post
PPA application. In addition, free proline in cowpea leaves were
increased, while the relative electrical conductivity and
malondialdehyde (MDA) content were decreased. Furthermore, the length,
width, single pod weight of cowpea were increased, and vitamin C,
soluble protein and soluble sugar content were also improved by 200
mg·L-1 PPA. Moreover, PPA treatment increased yield by 16% when applied
at 200 mg·L-1. Our findings demonstrate that PPA regulates the growth
and development of cowpea plants, improving the yield and quality,
especially at the concentration of 200 mg·L-1. This study indicates that
PPA has an application prospect in cowpea production.
Existence of solitary waves in a perturbed KdV-mKdV equation
Authors: junning cai , Wei Minzhi
Published: March 2022

In this paper, we establish the existence of solitary wave in some
KdV-mKdV equation with dissipative perturbation by applying geometric
singular perturbation technique and Melnikov function. The distance of
the stable manifold and unstable manifold are computed to show the
existence of the homoclinic loop for the related ordinary differential
equation systems on the slow manifold, which implies the existence of a
solitary wave for the KdVmKdV equation with dissipative perturbation
Nuchal cord – aetiological factors, perinatal outcome, and its relation with amniotic fluid: A case-control study
Authors: Walawalkar Sonal , Almelkar Shahdab
Published: March 2022

Objectives: To search into aetiological factors of nuchal cord (NC). To
understand its relation with amniotic fluid levels and perinatal
outcome. Design: A prospective case-control study. Setting: Shree
Hospital and Research Institute (SHRI), Kolhapur, India. Population of
sample: 95 non-complimented singleton pregnant women. Method: Maternal
age, socioeconomic status, education level, and parity were noted. They
underwent ultrasonography at 34 weeks onwards. NC, if present, along
with amniotic fluid index were reported. They were followed until
parturition. Intrapartum assessment of liquor, APGAR, fetal need for
oxygen, Neonatal Intensive Care Unit (NICU), gender, and birth weight
were noted. Participants were divided into nuchal cord at birth (NCB)
and the no-nuchal cord (NNCB) groups. Parameters were analysed. Result:
NC incidence is highest in young (≤ 24 yrs), low socioeconomic status,
higher education, primigravida, excess liquor, and male fetus. It causes
reduction in liquor level, low fetal birth weight, low 1 min APGAR,
extended oxygen (> 30 min), and NICU support. Conclusion:
The epidemiological factors and excess liquor play an essential role in
NC. It may be related to maternal stress. However, NC results in
oligohydramnios, low birth weight, and fetal distress. The nuchal cord
is not a physiological condition.
Diaminopimelic acid is mineralized and recycled mainly by Proteobacteria in the ocean
Authors: zheng liyuan , Chen Xiu-Lan , Liu Ning-Hua , Zhong Shuai , Yu Yang , Qin Qi-Long , Fu Huihui , Zhang Xi-Ying , Zhang Yu-Zhong
Published: March 2022

Diaminopimelic acid (DAP) is a characteristic component of peptidoglycan
in Gram negative bacterial cell walls, and is an important component of
organic matters in the ocean. Microbes play a vital role in promoting
the recycling of marine DAP. However, neither the DAP content nor the
DAP-utilizing microbes in the ocean have been investigated. Here, we
measured the DAP contents in seawaters and investigated the diversity of
marine DAP-utilizing microbes and their mechanism for DAP metabolism.
The DAP contents are from 0.590 μM to 0.948 μM in the Western Pacific
seawater from surface to 5000 m depth. DAP-utilizing bacteria of 20
families from 4 phyla were recovered from the Western Pacific seawater,
and 14 strains were further isolated, which showed that Proteobacteria
are the dominant group to utilize DAP. Based on genomic and
transcriptional analyses combined with in vitro activity detection, DAP
decarboxylase (LysA) is a key enzyme involved in DAP metabolism in the
isolated Proteobacteria strains, which catalyzes the decarboxylation of
DAP to form lysine. MurE and MurF are also two key enzymes for DAP
metabolism, which are responsible for the incorporation of DAP into
peptidoglycan for cell wall construction. Investigation in the TARA and
GOS databases showed that microbes containing LysA-like sequences, which
are predominantly Proteobacteria, are widely distributed in multiple
habitats in the ocean, suggesting that DAP-utilizing microbes are widely
spread in the ocean. This study provides the first insight into
bacteria-driven DAP mineralization and recycling in the ocean.
5-HT1A receptors in the reinforcing effects of methylphenidate and its modulation with buspirone
Authors: Haleem Darakhshan , Salman Tabinda , Nawaz Shazia
Published: March 2022

Accumulating studies consistently show that methylphenidate (MPD), the
first line drug for treating Attention-Deficit Hyperactivity Disorder
(ADHD), is abused by patients to whom the drug is prescribed. Like other
psychostimulants, only low doses of MPD improve cognitive performance
while higher doses can impair it. Preventing the use of high doses of
MPD is important for preventing its overuse and for retaining its
therapeutic efficacy. Previously, we have shown that performance in
Morris water test was improved in rats treated, orally, with MPD in
doses of 2.5 mg/kg; but higher doses (5 mg/kg) impaired it. The present
study concerns rewarding/reinforcing effects of 2.5 mg/kg MPD in
conditioned place preference (CPP) paradigm and its modulation with
buspirone. Our results show that rewarding effects of MPD in CPP test
are prevented in rats co-treated with buspirone in doses of 0.1 and 0.3
mg/kg. Animals treated with MPD exhibit a down regulation of 5-HT1A
receptor in the nucleus accumbens which is reversed in rats co-treated
with 0.1 an 0.3 mg/kg buspirone. Administration of buspirone in these
doses is not rewarding in CPP test and produces an upregulation of
5-HT1A receptor in the nucleus accumbens. The findings suggesting an
important role of 5-HT1A receptor in the rewarding effects of MPD, open
a gateway for improving therapeutic use of MPD.
Assessment of Anxiety, Pain and Quality of Life Among Patients Undergoing Nail Surgery
Authors: Manav Vildan , Karaali Müge Göre , Erdem Ozan , Polat Asude Kara , Erdil Duygu , Aksu Ayşe Esra Koku
Published: March 2022

Aims: Nail surgery is a part of dermatological surgery and can cause a
lot of anxiety in patients. The aims of this study is to determine the
anxiety and pain levels of the patients before, during and after nail
surgery and to determine their effects on their lives. Methods: Patients
aged> 14 years who were admitted to our outpatient clinic
between April 2019-2020 and scheduled for nail surgery were included in
the study. Anxiety (Instant and Trait Anxiety Scale (STAI)),
dermatological quality of life (Skindex-16) and pain (Visual analogue
scale (VAS 0–10)) were recorded before, during and after nail surgery.
Results: The patients were most worried about the recurrence of their
disease after the procedure (54.17%). Skindex-16 scores in the 31-50
age group were statistically significantly higher than the other age
groups. Preoperative anxiety scores were higher in male patients
compared to females (p = 0.021). Preoperative anxiety was significantly
lower in patients who had previous nail surgery (p = 0.018).
Preoperative pain scores were negatively correlated with preoperative
anxiety (p = 0.048). Conclusion: Nail surgery is a procedure that can
cause anxiety and stress for patients. Being aware of the anxiety and
pain of patients due to surgery and the factors affecting them by the
dermatologic surgeon can change the attitudes and behaviors towards
patients and the measures to be taken for anxiety and pain can
accelerate the recovery of patients.
DcPI2 combine DcNAC56 promoter contributes to petal development based on ABCE MADS box gene expression patterns in Dianthus chinensis
Authors: Zhang Xiaoni , Wang Qijian , Lin Shengnan , Wu Quanshu , Li Dandan , Zhang Zhen , Li Mouliang , Tembrock Luke , Wu Zhiqiang , Wang Caiyun , Bendahmane Mohammed , Bao Manzhu , Fu Xiaopeng
Published: March 2022

Dianthus chinensis is a widely used landscaping plant with high
commercial value. Understanding the molecular mechanisms responsible for
floral organ formation can help to improve the traits (e.g.,, petal
size, floral organ shape, etc.) of D. chinensis. However, there has no
comprehensive study of ABCE MADS-box genes in D. chinensis. In this
study, we identified 15 ABCE MADS-box genes of D. chinensis. The
expression and interactions patterns among ABCE MADS-box genes were
analysis by in situ, qRT-PCT, Yeast two‐hybrid and bimolecular
fluorescent complimentary experiments. In different stages of petal
development, the expression of DcNAC56 changes with DcPI2. The
overexpression of DcPI2 in D. chinensis resulted in high expression
levels of DcNAC56. 35S: DcPI2 transgenic plants had a larger petal size
with petals expansion. Furthermore, we observed that the DcPI2 protein
can bind to the DcNAC56 promoter in D. chinensis. On the basis of these
results, we propose that spatiotemporal expression of class ABCE genes
and different combinations between class ABCE proteins might regulate
floral organ specification. And DcPI2 can regulate the expansion of
petals by binding to DcNAC56 involved in cell proliferation and
differentiation. These results provide new insights into the improving
cultivars of Dianthus by change floral traits.
Absolute monocyte count（AEC）may be one of the most optimal peripheral blood markers to identify risk of immune-related events in advanced malignant tumors treated with PD-1/PD-L1 inhibitors.
Authors: Ma Yan , Ma Xiao , Wu Jingting , Wu Shanshan , Wang Jing , Cao Bangwei
Published: March 2022

Purpose To investigate the predictive value of serum biomarkers such as
AEC、Neutrophil- lymphocyte ratio (NLR) and platelets - lymphocyte
ratio(PLR) on immune-related adverse events (irAEs) during the
PD-1/PD-L1 inhibitors treatment in advanced malignant tumors. Methods We
retrospectively analyzed 95 advanced cancer patients treated with
PD-1/PD-L1 inhibitor from January 1, 2017 to May 1, 2020 in our cancer
center. Then, the associations between irAEs and PD-1/PD-L1 inhibitors
respond was analyzed and the predictive value of serum biomarkers on
irAEs occurrence risk was evaluated. Results The incidence of irAEs was
55.8%. There were no statistically significant differences between the
irAEs group and the no-irAEs group in Objective response rate (ORR) and
Disease control rate (DCR), but the Landmark analysis showed that the
irAEs group had better survival after 120 days compared with the
no-irAEs group. The incidence of irAEs in the high-AEC and low-NLR
groups was greater than that in the low-AEC and high-NLR
groups.Univariate logistic analysis results showed that low-NLR, ECOG
(0-1) and High-AEC were risk factors for irAEs. However, multivariate
logistic analysis not only shows that AEC is an independent factor of
irAEs , but also suggests that good ECOG may be more prone to irAEs .
Conclusions IrAEs may show a survival benefit to a certain extent.
Baseline AEC is a strong predictor of irAEs in the treatment of
PD-1/PD-L1 inhibitors.
AUTOTRANSPLANTATION OF A MAXILLARY PREMOLAR REPLACING A CENTRAL INCISOR: SEVEN YEARS FOLLOW-UP
Authors: Yetkiner Enver , Arıkan Fatih , çelik handan , pamuk ceren , ERSİN NAZAN
Published: March 2022

This case report aims to summarize the seven-years follow-up period of
an upper premolar transplantation for a maxillary central incisor. A
maxillary central that had been avulsed and reimplanted elsewhere was
diagnosed with progressive external root resorption. Transplantation of
teeth 1.5 was planned as the case presented with increased overjet.
Grazing decouples the plant-soil microbe linkage in fragile grasslands
Authors: Kong Weidong , Chen Hao , Wu Jianshuang , Zhou Tianqi , Jia Hongzeng , Yue Linayn , Liang Chao , Makhalanyane Thulani , Cowan Donald , Zhang Xianzhuo , Wang Tao , Zhu Yong-guan
Published: March 2022

Plant-soil microbe linkage is theoretically positive, but rarely
observed in natural ecosystems. We hypothesized that animal grazing
decouples this linkage, for plant removal usually decreases plant
influences on soil microbiota. We tested the hypothesis by exploring
plant and soil microbial diversity in grazed versus non-grazed
grasslands along a gradient of plant diversity. Grazing slightly
decreased the diversity of plants and soil microbes in high-diversity
sites, but increased them in low-diversity sites. Plant and microbial
diversity positively correlated in non-grazed grasslands (P <
0.001), but not in grazed grasslands, indicating that grazing decoupled
the biodiversity linkage. The decoupling was attributed to the change of
the principal driver of soil microbiota from plant variables in
non-grazed grasslands to soil variables in grazed grasslands. The
diversity decoupling was also characterized by reduced plant-microbe
interactions and lower heterogeneity in grazed grasslands. Our findings
provide significant insights into the cross-biota linkages in grassland
ecosystems.
SLOSS analysis does not show several small patches contain more species than expected
Authors: Deane David C.
Published: March 2022

Overlap in species-accumulation curves ordered from small-large and
large-small (aka SLOSS analysis) is an important line of evidence
inferring weak positive diversity effects of fragmentation per se. Yet
combining patches in small-large order maximises the probability of
encountering new species for every patch, invalidating comparison with
large-small order. Controlling for this using simulated null
communities, I test species accumulation against a random expectation
for 201 published datasets from islands, habitat islands and fragments
and compare inference using both methods. SLOSS analysis found 67%
positive, 7% negative and 26% no response among datasets. Using
simulation, analogous values were 4%, 12% and 40% respectively with
no clear outcome in the remainder. SLOSS analysis provides unreliable
inference on the diversity effects of habitat subdivision. Accumulation
of species in small-large patch size order is more likely to result in
fewer than expected species than more, with no effect being the most
probable result.
Pediatric Patients with Sickle Cell Disease at a Public Hospital and Early Experience with L-Glutamine Therapy
Authors: Gotesman Moran , Elgar Guy , Hernandez-Santiago Laura , Alvarez Abigail , Pak Youngju , Lin Henry , III Joseph Lasky , Panosyan Eduard
Published: March 2022

Background. Hydration and hydroxyurea (HU) can modify sickle cell
disease (SCD) severity. Optimal nutrition and L-glutamine (Gln) may
provide further amelioration. Procedures. EMR reviews and nutrition
surveys were used to investigate pediatric SCD severity in relation to
nutrition, growth, hematologic parameters, and disease-modifying agents.
Results. Among 25 females and 25 males, mean age was 9.1±7 years, and
mean BMI percentile was 56.4±32.6. Hemoglobinopathies were: HbSS/Sß0,
60%; HbSC, 32%; HbSß+, 8%. Annual pain crises rose with age (APC
mean, 0.97±1.1 hospital visits or admissions per patient). HbF dropped
to <10% in teenagers, while APC increased ≥2-fold. Proper
hydration and nutrition correlated with younger ages and fewer APCs.
Height and weight Z-scores were ≤ -1SD in 20% of 35 surveyed patients
(12±7.8 years) with more APCs (2.5±2.5 vs. 1±1.3, p=0.03). Prealbumin
was low overall. Twenty-two of 28 patients on HU reported ≥90%
adherence – with higher MCVs (92±9.6 vs. 74±10 f/L, p<0.01)
and HbF%, and younger ages. Most children aged ≥5 years were prescribed
Gln (70% dispensed). A quarter of patients reported <50% Gln
intake due to abdominal pain or taste. Gln compliance over 23 months was
≥70% in 12 patients, including 2 on chronic transfusion. Of 10
evaluable patients, 6 (8.8 ±2.2 years) had fewer APCs on Gln (mean 0.2
vs. 0.9, p=0.016), with higher prealbumin (14.1 to 15.8 mg/dL, p=0.1).
Conclusions. Young, well-nourished/hydrated patients have a milder
clinic course. Severe disease occurred in undernourished teenagers with
suboptimal compliance. L-Glutamine should be further evaluated in
pediatric SCD along with prealbumin measurements.
Clinical Pharmacist and Clinical Pharmacologist Opinion of Narrow Therapeutic Index (NTI) Drugs
Authors: Habet Sam
Published: March 2022

Purpose: If the drugs are routinely required for therapeutic drug
monitoring (TDM), they may be considered NTI drugs. By basing some
criteria that affect the degree of separation of the concentrations that
elicit the therapeutic and the adverse effects, an attempted to avoid
the vagaries inherent in preparing a list of individual drugs
themselves. Methods: I reviewed over 200 commonly prescribed drugs in
the retail and hospital pharmacies in the US. As the Food and Drugs
Administration (FDA) clinical pharmacologist and as practicing clinical
pharmacist in hospitals for 25 years, there are no drugs that of concern
than the Narrow Therapeutic Index (NTI) drugs. Results: NTI drugs are
very dangerous in that any small change in the dose or concentration or
interaction with any drugs, may end up with major consequences. That is
why in hospitals, NTI drugs are routinely monitor such as vancomycin and
gentamicin. Similarly, at the FDA, it is essential that labels specify
the drug levels for certain conditions or diseases that are being
monitoring. Conclusions: The plasma levels sometimes are required for
in-patient and out-patient for drugs such as valproic acid, digoxin, and
theophylline. It is essential that NTI must be monitored in-patient and
out-patient.
Will evidence-based medicine be acupuncture's nemesis?
Authors: Wang Qi , Zhang Kai
Published: March 2022

Abstract: Evidence-based medicine (EBM) is an excellent reference for
the guide of clinical decisions, through which medical practice can be
improved. As an important part of Traditional Chinese medicine,
acupuncture functions as a complex treatment system instead of rigid,
linear or mechanical organizations, and its complexity is exactly the
source of innovation. How does EBM affect acupuncture innovation? EBM
helps acupuncture research to be under control, while it may be the
great excuse to put barriers to the innovation for acupuncture
treatment.
Population Pharmacokinetics of Oxcarbazepine: A Systematic Review
Authors: Chen Yue-ting , wang chenyu , Yin Yi-wei , Li Ziran , Lin Wei-wei , Zhu Min , Jiao Zheng
Published: March 2022

Aim This is the first review to summarize the population pharmacokinetic
studies of oxcarbazepine and explored the significant covariates that
may have an impact on the dosage regimen and clinical use of
oxcarbazepine. Methods PubMed and Embase databases were searched before
31 October 2020, and references of all selected studies were further
screened to identify the pertinent population pharmacokinetic studies of
oxcarbazepine. Relevant information about the identified population
pharmacokinetic studies was summarised, and the quality of the reports
was evaluated. Moreover, studies among infant, children, and adult
patients were compared. Results Twelve studies were included: seven
studies enrolled paediatric patients only; two enrolled both paediatric
and adult patients; and two enrolled adult patients only. The apparent
clearance per weight for children (median: 0.0505 L/h/kg, range:
0.016-0.084) and infants (0.078 L/h/kg) were higher than that for adults
(median: 0.036 L/h/kg, range: 0.029-0.06). Furthermore, children had a
larger variation on clearance compared to adults. Weight,
co-administration with enzyme-inducing antiepileptic drugs, and renal
function were found to significantly affect clearance of
10-hydroxycarbazepine. Conclusion The oxcarbazepine dose regimen was
dependent on weight, co-administration with enzyme-inducing medications,
and renal function. Further study is essential to explore the
pharmacodynamics in epilepsy patients and pharmacokinetics of
oxcarbazepine in infants.
Dispensing Patterns of Drugs used for neuropathic pain in Lebanon: An observational study from community pharmacies
Authors: Chahine Bahia
Published: March 2022

Background: Neuropathic pain is a common chronic ailment that can be
challenging to treat, because of the heterogeneity of its etiologies,
symptoms, and underlying mechanisms. Drugs to treat neuropathic pain are
highly prescribed; however, limited data exist on the rates and patterns
of dispensing in Lebanon. Aim: This study was conducted to assess the
patterns of dispensing neuropathic pain drugs in the Lebanese adult
population. Methods: An observational study was conducted at 30
community pharmacies over a period of 10 months. Adults presenting to
the community pharmacy diagnosed with a neuropathic pain disorder, and
taking at least one pain medication were interviewed using a
questionnaire that included socio-demographic characteristics of
patients, comorbidities, neuropathic pain disorder type, physicians’
specialty, class, and number of medications prescribed. Results: A total
of 360 patients diagnosed with painful neuropathy were enrolled in our
study. The mean patients’ age was 50.2 years. Guideline-recommended
first-line agents (serotonin-norepinephrine reuptake inhibitors,
tricyclic antidepressants, and gabapentinoids) were prescribed to 278
patients (77.2%) with pregabalin being the most used drug (60.5%),
nonsteroidal anti‐inflammatory drugs (46.8%), opioids (15.8%), and
topical agents (5.5%). Combination treatment for neuropathic pain was
prescribed to 78.3% of patients. Conclusion: Our study revealed that
the Lebanese community is following international guidelines in treating
neuropathic pain disorders.
Pregnancy health and perinatal outcomes among Pacific Islander women in the United States and U.S. Affiliated Pacific Islands: a scoping review
Authors: Suss Rachel , Mahoney Madison , Arslanian Kendall , Nyhan Kate , Hawley Nicola
Published: March 2022

Background: This scoping review examines the existing literature on
pregnancy and perinatal outcomes among Pacific Islander women in the
United States (U.S.) and U.S.-affiliated Pacific Islands. Objective:
Specifically, we aimed to identify research that disaggregated Pacific
Islanders from any other population group. Search Strategy: We conducted
a systematic search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO),
and PsycINFO (Ovid) electronic databases, and hand searched grey
literature. Data collection and analysis: We extracted and synthesized
data on the study characteristics and pregnancy and perinatal health
outcomes. Main results: Forty-eight articles published between January
2010 and June 2020 were included in the review. The majority of studies
utilized clinical record data were conducted in Hawaii. Infant outcomes
(preterm birth, birth weight) were more commonly reported than maternal
outcomes related to either pregnancy health or the perinatal period. Our
findings highlight several limitations of the existing literature,
including continued aggregation of Pacific Islanders with Asian
Americans and other ethnic groups, little comparison between Pacific
Islander sub-groups, lack of definition of the nationality/ethnic
composition of Pacific Islander groups, a lack of hypothesis-driven
primary data collection and clinical trials, and underrepresentation in
population-based studies. Conclusion: Researchers and policymakers
should aim to address these limitations to better understand pregnancy
and perinatal outcomes among Pacific Islanders.
MANAGEMENT OF SPONTANEOUS PNEUMOTHORAX IN PATIENTS WITH COVID-19
Authors: ULUTAS HAKKI , Celik Muhammet , Gulcek Ilham , Kalkan Muhammed , Agar Mehmet , KILIC TALAT , Gulcek Emine
Published: March 2022

The coronavirus diseases 2019 (COVID-19) pneumonia may cause cystic
features of lung parenchyma which can resolve or progress to larger
blebs. Spontaneous pneumothorax (SP) was reported as a complication of
COVID-19 with an incidence of 1% in hospitalized patients, in 3% of
patients hospitalized with pneumonia, in 6% mechanically ventilated
patients and in 1% of decased patients. Pneumothorax was more likely in
patients with neutrophilia, severe lung injury and a prolonged clinical
course. We present 11 cases of SP managed with chest tube thoracostomy
(CTT) or high dose oxygen therapy. Isolated SP was detected in all
cases. Eight cases were male and three cases were female. There were
bilateral ground-glass opacities or pulmonary infiltrates in the
parenchyma of the ten cases. We detected neutrophilia, lymphopenia and
increased CRP, Ferritin, LDH, D-Dimer, IL-6 levels in almost all cases.
CTT was sufficient to treat pneumothorax in our nine of case. In two
cases, pneumothorax healed with high dose oxygen therapy. Favipiravir
and antibiotic treatment were given to different ten patients. In our
institution, all patients with COVID-19 infection were placed on
prophylactic or therapeutic anticoagulation, unless contraindicated. The
treatments of patients diagnosed with secondary spontaneous pneumothorax
during the pandemic period and those diagnosed with secondary
spontaneous pneumothorax in the previous three years were compared with
the durations of tube thoracostomy performed in both groups. The
increased number of cases of pneumothorax suggests that pneumothorax may
be a complication of covid-19 infection. During medical treatment of
covid-19, pneumothorax may be the only reason for hospitalization.
Although tube thoracostomy is a sufficient treatment option in most
cases, clinicians should be aware of the difficulties that may arise in
diagnosis and treatment.
Effectiveness of mepolizumab in severe asthma in Japan: A real-world study using claims data
Authors: Nagase Hiroyuki , Tamaoki Jun , Suzuki Takeo , Nezu Yasuko , Katsumata Masayuki , Komatsubara Masaki , Mu George , Yang Shibing , Cole Ashley , Alfonso-Cristancho Rafael
Published: March 2022

Background: Mepolizumab reduces exacerbations and oral corticosteroid
(OCS) use in randomized controlled trials of patients with severe
eosinophilic asthma. This study evaluated the effectiveness of
mepolizumab in patients with severe asthma in real-world clinical
practice in Japan. Methods: This was a retrospective, observational,
self-controlled study (GSK ID: 213221) of patients (aged ≥12 years) with
asthma from the JMDC Claims Database. Data were gathered for 12 months
prior to (baseline) and 12 months following (follow-up) index
(mepolizumab initiation date). Outcomes (compared annually or quarterly
during baseline and follow-up) included the rate of exacerbations, the
proportions of patients experiencing an asthma exacerbation, receiving
maintenance OCS, and achieving a ≥50% reduction from baseline in daily
OCS dose, and median daily OCS dose. Results: Sixty-one patients were
included. During follow-up versus baseline, exacerbation incidence was
significantly reduced by 43% (incidence rate ratio: 0.57 [95%
confidence interval: 0.43, 0.74]) and the proportion of patients with
any exacerbation fell from 89% to 62%. In the final quarter of
follow-up, the proportion of patients receiving OCS maintenance therapy
decreased to 16% (from 26% in the 3 months prior to index), 60% of
patients achieved a ≥50% reduction from baseline in daily OCS dose, and
median (interquartile range) prednisone-equivalent OCS dose reached 3
(1–5) mg/day, a 55% reduction from baseline dose (8 [7–11]
mg/day). Conclusions: Patients with asthma receiving mepolizumab
treatment in routine clinical practice in Japan experienced clinically
significant reductions in asthma exacerbations and maintenance OCS use,
supporting the effectiveness of mepolizumab in real-world settings.
Pelagic calcifiers face increased mortality and habitat loss with warming and ocean acidification
Authors: Bednarsek Nina , Carter Brendan , McCabe Ryan , Feely RICHARD Allen , Howard Evan , Chavez Francisco , Elliott Meredith , Fisher Jennifer , Jahncke Jaime , Siegrist Zach
Published: March 2022

Global change is impacting the oceans in an unprecedented way with
resulting changes in species distributions or species loss. There is
increasing evidence that multiple environmental stressors act together
to constrain species habitat more than expected from single stressor.
Here, we conducted a comprehensive study of the combined impact of ocean
warming and acidification (OWA) on a global distribution of pteropods,
ecologically important pelagic calcifiers and an indicator species for
ocean change. We co-validated three different approaches to evaluate the
impact of OWA on pteropod survival and distribution. First, we used
co-located physical, chemical, and biological data from oceanographic
cruises and regional time-series; second, we conducted multifactorial
experimental incubations using OWA to evaluate survival; and third, we
validated pteropod distributions using global carbonate chemistry and
observation datasets. Habitat suitability indices and global
distributions suggest that a multi-stressor framework is essential for
understanding distributions of this pelagic calcifier.