Difference In Days Research Articles

Cardiac Implantable Electronic Devices In Advanced Heart Failure Patients On Palliative Inotropes

Inotrope therapy can be utilized as palliation for patients with end stage heart failure who are not candidates for durable devices or transplant. We aim to compare survival and outcomes between patients with and without defibrillators who received palliative inotropes. We retrospectively analyzed 220 patients with American Heart Association Stage D heart failure discharged on palliative inotropes after January 1, 2010. Patients who underwent durable device support or transplant were excluded. Those with a permanent pacemaker (PPM), bi-ventricular pacemaker (BiV-P), or no device were assigned to the Pacer/None group. Patients with an implantable cardioverter defibrillator (ICD), BiV-defibrillator (BiV-D), or LifeVest (Zoll, Chelmsford, MA) were assigned to the Defibrillator group. Primary outcome was 2-year survival. Secondary outcomes were clinic visits and hospitalizations, complications such as infection or arrhythmia, and number of treated tachyarrhythmia episodes. Of 220 patients, 54 were in the Pacer/None group and 168 were in the Defibrillator group. We found no difference in age or gender. In both groups, more patients were placed on milrinone compared to dobutamine, but no difference in days on therapy was seen. Patients in the Defibrillator group were more likely to have hypertension. Patients in the Pacer/None group were more likely to have pulmonary hypertension (see Figure). We found no significant difference in our primary outcome of survival at 2-years post-discharge with 25.8% in the Pacer/None group compared to 26.3% in the Defibrillator group (see Kaplan-Meyer curve). No difference was found in PICC line infections and arrhythmias, number of hospitalizations, and clinic visits within 2-years. No difference was seen in the number of treated arrhythmic episodes within in the Defibrillator group. Those who expired or entered hospice, however, were found to have more treated episodes than those who survived to 2-years. Patients undergoing evaluation for defibrillator implantation are required to meet guidelines on indications and expected survival. As patients with palliative inotropes are living longer, consideration for protection against arrhythmic events is fundamental. Further studies with larger populations are needed to understand the utility of defibrillators in this population. Inotrope therapy can be utilized as palliation for patients with end stage heart failure who are not candidates for durable devices or transplant. We aim to compare survival and outcomes between patients with and without defibrillators who received palliative inotropes. We retrospectively analyzed 220 patients with American Heart Association Stage D heart failure discharged on palliative inotropes after January 1, 2010. Patients who underwent durable device support or transplant were excluded. Those with a permanent pacemaker (PPM), bi-ventricular pacemaker (BiV-P), or no device were assigned to the Pacer/None group. Patients with an implantable cardioverter defibrillator (ICD), BiV-defibrillator (BiV-D), or LifeVest (Zoll, Chelmsford, MA) were assigned to the Defibrillator group. Primary outcome was 2-year survival. Secondary outcomes were clinic visits and hospitalizations, complications such as infection or arrhythmia, and number of treated tachyarrhythmia episodes. Of 220 patients, 54 were in the Pacer/None group and 168 were in the Defibrillator group. We found no difference in age or gender. In both groups, more patients were placed on milrinone compared to dobutamine, but no difference in days on therapy was seen. Patients in the Defibrillator group were more likely to have hypertension. Patients in the Pacer/None group were more likely to have pulmonary hypertension (see Figure). We found no significant difference in our primary outcome of survival at 2-years post-discharge with 25.8% in the Pacer/None group compared to 26.3% in the Defibrillator group (see Kaplan-Meyer curve). No difference was found in PICC line infections and arrhythmias, number of hospitalizations, and clinic visits within 2-years. No difference was seen in the number of treated arrhythmic episodes within in the Defibrillator group. Those who expired or entered hospice, however, were found to have more treated episodes than those who survived to 2-years. Patients undergoing evaluation for defibrillator implantation are required to meet guidelines on indications and expected survival. As patients with palliative inotropes are living longer, consideration for protection against arrhythmic events is fundamental. Further studies with larger populations are needed to understand the utility of defibrillators in this population.

Update on Association of Fried's Frailty Score and Sarcopenia After Left Ventricular Assist Device Implantation

<h3>Purpose</h3> While Fried's Frailty Assessment (FFA) is well-validated, it does include subjective components in its frailty assessment. The assessment of skeletal muscle density has recently emerged as an objective biomarker for frailty in patients with left ventricular assist device (LVAD) placement. The additive value of sarcopenia to existing frailty assessments and its association with outcomes in patients undergoing LVAD implantation requires further clarification. <h3>Methods</h3> We evaluated 43 patients who underwent LVAD implantation at our medical center between January 2018 and July 2021. Perioperative FFA score ≥ 3 was defined as frail. Skeletal muscle indexes were measured using preoperative computed tomography imaging of the psoas and pectoralis muscles areas. Sarcopenia was defined per the lowest skeletal muscle tertile with total psoas area index ≤4.45 or pectoralis muscle index ≤4.50. All time to event analysis excluded patients who died during their admission for LVAD. <h3>Results</h3> Of the 43 patients who had LVAD placement, eight patients met criteria for frailty based on FFA. When combined with frailty based on sarcopenia, 13 additional patients met criteria. The frail group had significantly lower albumin (3.33 vs. 3.78, p=0.046). There were no differences in age (54.1 vs 53.6 years, p=0.54) or BMI (27.6 vs. 31.1, p=0.15) between the frail and non-frail groups. Although the frail group had a greater proportion of patients with major bleed after discharge (38.1% vs. 13.6%), there was no significant difference in days to major bleed between both groups (log-rank p=0.112). The frail group had significantly higher rates of composite outcome of 30-day readmission and all-cause mortality (log-rank p=0.042), (Figure 1). <h3>Conclusion</h3> While FFA is a commonly used tool with subjective components for assessing frailty in patients with heart failure, the addition of objective sarcopenia biomarkers identifies additional patients with frailty, who are at risk for worse outcomes.

Mixture × Genotype Effects in Cereal/Legume Intercropping.

Cropping system diversification through annual intercropping provides a pathway for agricultural production with reduced inputs of fertilizer and pesticides. While several studies have shown that intercrop performance depends on the genotypes used, the available evidence has not been synthesized in an overarching analysis. Here, we review the effects of genotypes in cereal/legume intercropping systems, showing how genotype choice affects mixture performance. Furthermore, we discuss the mechanisms underlying the interactions between genotype and cropping system (i.e., sole cropping vs. intercropping). Data from 69 articles fulfilling inclusion criteria were analyzed, out of which 35 articles reported land equivalent ratio (LER), yielding 262 LER data points to be extracted. The mean and median LER were 1.26 and 1.24, respectively. The extracted genotype × cropping system interaction effects on yield were reported in 71% out of 69 publications. Out of this, genotype × cropping system interaction effects were significant in 75%, of the studies, whereas 25% reported non-significant interactions. The remaining studies did not report the effects of genotype × cropping system. Phenological and morphological traits, such as differences in days to maturity, plant height, or growth habit, explained variations in the performance of mixtures with different genotypes. However, the relevant genotype traits were not described sufficiently in most of the studies to allow for a detailed analysis. A tendency toward higher intercropping performance with short cereal genotypes was observed. The results show the importance of genotype selection for better in cereal/legume intercropping. This study highlights the hitherto unrevealed aspects of genotype evaluation for intercropping systems that need to be tackled. Future research on genotype effects in intercropping should consider phenology, root growth, and soil nutrient and water acquisition timing, as well as the effects of weeds and diseases, to improve our understanding of how genotype combination and breeding may help to optimize intercropping systems.

Augmented analysis for yield performance and agronomic characteristics of upland rice lines grown under coconut plantation

Establishment of shade-tolerant rice varieties aims to utilize the dry land under tree stands. A field experiment on rice yield under coconut plantation was conducted at farmer field in Calincing Tegalbuleud Sukabumi, West Java, Indonesia. The experiment involved 307 upland promising lines, 42 of which were selected in comparison to four check varieties, namely Jatiluhur, Batutugi, Limboto and Situpatenggang. The experiment was conducted according to augmented design with four replications. The analysis of variance indicated significant difference in yield per ha between blocks and no significant differences in days to flowering, plant height and number of productive tiller between blocks. Meanwhile, significant differences were observed in plant height and number of productive tillers between all check varieties. Under shade of coconut plantation, some lines could perform better and had higher performance than check varieties. Four lines ofB11957SR* 232182SI2MR2PN21, B12743MR18232PN1111, B13498D9, and B12743MR18235PN1031 had significantly higher yield compared to the check variety with the highest yield, which is Limboto. The utperforming lines can be proposed as promising rice lines for shading tolerance. However, most of the lines were proved to be underperforming for yield and its components in prevailing conditions.

516 Phosphorus Requirements in Patients with Severe Thermal Injuries Requiring High-Volume Hemofiltration

IntroductionPatients with thermal injuries have increased metabolic demands, requiring increased phosphate supplementation. Evidence is scant depicting incidence of hypophosphatemia and repletion requirements in patients with thermal injuries treated with high-volume hemofiltration (HVHF) and a high-flux membrane. The objective of this study was to determine the incidence of hypophosphatemia and characterize repletion requirements in this population.MethodsThis study was a case-control, retrospective chart review. Patients were included if sustained at least 20% total body surface area (TBSA) thermal injuries and required continuous HVHF (prescribed doses ≥ 35 mL/kg/hr). A randomly selected cohort (matched to age, TBSA, and inhalation injury) without acute kidney injury (AKI) was used to compare phosphorus requirements over an initial 14 day period. An a priori sample size was calculated (n = 26) to detect a minimum difference of 0.3 mmol/kg/day. Repeated measures ANOVA was used to compare requirements and concentrations. Demographics, diet, and variables affecting phosphorus concentrations were compared utilizing Fisher's exact, Student's t-test, or Mann-Whitney test depending on type and distribution.ResultsOne thousand sixty-six patients were screened. Most were excluded from the HVHF group for TBSA < 20% (58%) or not a burn injury (29%). Sixteen patients were included in each group. The average age was 60.2 ± 15.1 vs 53.3 ± 16.4 (p = 0.22) with median TBSA (p = 0.73) of 30% (23.4, 56.3) vs 29% (26.4, 33.9). All patients in the study group were started on HVHF for AKI, utilizing a 1.6m2 polyethersulfone membrane (mean delivered prefilter dose of 54.7 ± 1.5 ml/kg/hr), and had statistically higher potassium and phosphorous laboratory values at baseline. Parenteral phosphorus replacements were 2 fold higher in the HVHF group (p = 0.02), but not statistically different after accounting for estimated enteral intake. Despite providing 0.75 mmol/kg/day of phosphorous supplementation (vs 0.66 mmol/kg/day in control, p = 0.45), the HVHF group experienced more days with hypophosphatemia (49.6 ± 12.4 % vs 29.3 ± 16.3 %, p = 0.012). By 72h, every HVHF patient experienced at least one episode of hypophosphatemia. Patients on longer durations of therapy had increasing risk of hypophosphatemia. There was a significant difference in days requiring mechanical ventilation (p < 0.001)ConclusionsThis study demonstrates thermally injured patients receiving HVHF for AKI are at increased risk for hypophosphatemia and require higher phosphate supplementation to maintain lower average serum concentrations, as compared to the controls with similar burns but without acute kidney injury.

The importance of diaphragmatic surgery, chemical pleurodesis and postoperative hormonal therapy in preventing recurrence in catamenial pneumothorax: a retrospective cohort study.

Catamenial pneumothorax (CP) is defined as a recurrent, spontaneous pneumothorax occurring within a day before or 72h after the onset of menstruation. Most first episodes go undiagnosed and treated as primary spontaneous pneumothorax, and only after recurrence is the clinical suspicion of CP raised. No gold-standard management approach exists, especially in terms of managing diaphragmatic involvement. This study is a single-centre cohort retrospective study of 24 female patients who underwent surgery for pneumothorax due to diaphragmatic endometriosis between January 2008 and December 2016. Two groups were compared: a group that underwent pleurodesis alone (8 patients) and a group that underwent diaphragmatic surgery and pleurodesis (16 patients). There were differences in BMI and smoking habits between the two groups. The right diaphragm was involved more often (6vs15, p = 0.190). VATS was the preferred surgical approach and only one conversion occurred in the diaphragmatic surgery group (p = 0.470). Diaphragmatic abnormalities were present in all the patients, brown/violet spots (100%) in the pleurodesis group and perforations (100%) in the diaphragmatic surgery group (p < 0.001). There were no differences in days of chest tube removal and length of stay. The recurrence rate was 100% in the pleurodesis alone group while it was only 12.5% in the diaphragmatic surgery group (< 0.001). In our experience, diaphragmatic surgery and pleurodesis followed by hormonal therapy was an effective approach in preventing recurrence in patients with catamenial pneumothorax and diaphragmatic involvement.

Gut hormones profile after an Ivor Lewis gastro-esophagectomy and its relationship to delayed gastric emptying.

Delayed gastric emptying (DGE) is common after an Ivor Lewis gastro-esophagectomy (ILGO). The risk of a dilated conduit is the much-feared anastomotic leak. Therefore, prompt management of DGE is required. However, the pathophysiology of DGE is unclear. We proposed that post-ILGO patients with/without DGE have different gut hormone profiles (GHP). Consecutive patients undergoing an ILGO from 1 December 2017 to 31 November 2019 were recruited. Blood sampling was conducted on either day 4, 5, or 6 with baseline sample taken prior to a 193-kcal meal and after every 30minutes for 2hours. If patients received pyloric dilatation, a repeat profile was performed post-dilatation and were designated as had DGE. Analyses were conducted on the following groups: patient without dilatation (non-dilated) versus dilatation (dilated); and pre-dilatation versus post-dilatation. Gut hormone profiles analyzed were glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY) using radioimmunoassay. Of 65 patients, 24 (36.9%) had dilatation and 41 (63.1%) did not. For the non-dilated and dilated groups, there were no differences in day 4, 5, or 6 GLP-1 (P = 0.499) (95% confidence interval for non-dilated [2822.64, 4416.40] and dilated [2519.91, 3162.32]). However, PYY levels were raised in the non-dilated group (P = 0.021) (95% confidence interval for non-dilated [1620.38, 3005.75] and dilated [821.53, 1606.18]). Additionally, after pyloric dilatation, paired analysis showed no differences in GLP-1, but PYY levels were different at all time points and had an exaggerated post-prandial response. We conclude that DGE is associated with an obtunded PYY response. However, the exact nature of the association is not yet established.

Is early patent ductus arteriosus ligation helpful in premature neonates? A 10-year retrospective study.

To compare short and long outcomes between early (≤ 28days) (EL) and late ligation (LL) groups. To explore factors predicting early extubation (≤ 7days) after patent ductus arteriosus (PDA) ligation. We conducted a single center, retrospective cohort study of preterm infants < 32weeks who underwent surgical ligation over a 10-year period (2009-2019). A total of 133 infants underwent PDA ligation, in the study period. Both groups had similar short-term outcome such as bronchopulmonary dysplasia (BPD) or death (96% vs. 98%, P = 0.64) and long-term clinical outcomes including Bayley's assessment at 2 years corrected age. Fewer infants in the EL group developed severe BPD (63% vs. 81%, P = 0.02). Age at ligation had adjusted odds ratio of 1.04 with over lapping confidence interval (95% CI 1.0-1.1, P = 0.02) for severe BPD/death. There was no difference in day of extubation between the EL and LL group (8days vs. 7days, P = 0.85). Left atrium/aortic root ratio of ≥ 1.75 would give sensitivity of 41% and 80% specificity for early extubation (area under the curve of 0.61). There was marginal reduction of hospital stay in the EL group [113 (105-121) days vs. 115 (107-123) days; log rank P = 0.026]. EL can be delivered safely with a clinically important lower incidence of severe BPD and shorter duration of hospital stay compared to LL.

Quantitative and Qualitative Analysis of Emergency Physician Performed Biparietal Diameter Estimate for Gestational Age.

An accurate estimation of fetal gestational age is essential for the management of pregnant patients who present to the emergency department (ED). Point-of-care-ultrasound (POCUS) is an integral part of emergency medicine training and includes measurement of fetal gestational age by the biparietal diameter (BPD) method. In this study we performed a quantitative assessment of emergency physician (EP)-performed BPD estimate of gestational age to identify the percentage of studies performed in our department that had an estimated gestational age within 14 days of an adjusted radiological or obstetrical estimation. We performed a chart review of our ED ultrasound database and electronic medical records for cases where a BPD measurement was performed by an EP. We recorded the ED gestational age estimate in days and the radiological or obstetrical estimate of gestational age in days. We then calculated the difference in days between the two examinations. We used a normal binomial approximation to calculate 95% confidence intervals. A secondary analysis looked at the quality of the images based on measurement placement and the view obtained. Seventy-four cases met eligibility criteria; of those, 67 (91%) had a gestational age estimation within 14 days of the adjusted radiological or obstetrical estimate (95% confidence interval 81-96%). This study shows that EP-performed BPD measurements for gestational age are quantitatively accurate, with 91% of estimates within 14 days of a standard radiological or obstetrical estimation.

Differences in Administration of Methotrexate and Impact on Outcome in Low-Risk Gestational Trophoblastic Neoplasia.

Simple SummaryLow-risk gestational trophoblastic neoplasia is a rare but highly curable malignancy. The most common first line treatment is methotrexate, which can be administered in different forms. In order to investigate the impact of route of administration on methotrexate resistance, toxicity demanding treatment switch, complete remission and relapse, we performed an observational study including women with low-risk gestational trophoblastic neoplasia in a population-based setting in Sweden and Denmark. We found that oral compared to intra-muscular administration of methotrexate gives a higher rate of drug resistance, but does not affect rates of complete remission, recurrence or overall survival. Intra-muscular treatment was associated with more toxicity leading to switch of treatment. We conclude that, although a larger proportion of women develop drug resistance, oral methotrexate, which is easy to administer and highly tolerable, could be an option for well-informed and motivated women.Methotrexate (MTX) is frequently used as first-line treatment for low-risk gestational trophoblastic neoplasia (GTN). Intravenous and intramuscular (im) routes of administration are the most common methods, although oral administration is used by some Scandinavian centers. The primary aim of this study was to assess the impact of form of administration (im/oral) on resistance to methotrexate (MTX-R) treatment in low-risk GTN. Secondary aims were time to hCG normalization, rates of toxicity-induced treatment switch, and rates of complete remission and recurrence. In total, 170 women treated at Karolinska University Hospital in Sweden and Aarhus University Hospital in Denmark between 1994 and 2018 were included, of whom 107 were given im and 63 oral MTX. MTX-R developed in 35% and 54% in the im and oral groups, respectively (p = 0.01). There was no difference in days to hCG normalization (42 vs. 41 days, p = 0.50) for MTX-sensitive women. Toxicity-induced treatment switch was only seen in the im group. Complete remission was obtained in 99.1% and 100% (p = 0.44), and recurrence rate within one year was 2.8% and 1.6% (p = 0.29). The form of administration of MTX had a significant impact on development of MTX-R and treatment-associated toxicity, but does not affect rates of complete remission, recurrence or survival.

Longer Healing Times, Higher Recurrence Rates, And Increased Incidence Of Dvt Following Cyanoacrylate Ablation For Active Venous Ulcerations

INTRODUCTION Venous leg ulcerations are a common ailment with increasing prevalence in older populations, 5% of those over age 65, and cost approximately half a billion dollars per year. With an aging population, venous ulcers represent an increasing burden. Treatment of superficial venous reflux with ablation has been demonstrated to decrease ulcer recurrence, but the relationship between healing active ulcers and ablation remains uncertain, particularly between different modalities of ablation. METHODS Data was collected retrospectively on 146 patients at a single institution, tertiary-referral center, with an active venous ulcer who underwent ablation therapy via cyanoacrylate (Venaseal™), radiofrequency (RFA), or endovenous laser ablation (EVLT) from 2010-2020. The primary outcome was the time to ulcer healing. Secondary outcomes were the rate of recurrence, compliance with compression, and participation in a wound clinic. RESULTS The study showed a non-significant difference in days to ulcer healing post-intervention between ablative techniques, with 80.8 days for cyanoacrylate (n=15), 70.07 for RFA (n=44), and 67.04 days for EVLT (n=79). A similar, non-significant trend was observed for ulcer recurrence, with a rate of 35.7% (5/14) for cyanoacrylate, 26.7% (20/75) for EVLT, and 23.1% (9/39) for RFA. Few local and systemic complications occurred. The most common complication was DVT after procedure (n=13). The same non-significant trend occurred with DVT following procedure, being observed in 12.5% (2/16) of cyanoacrylate, 9.5% (8/84) of EVLT, and 6.5% (3/46) of RFA cases. Logistic regression to predict wound healing was significant for compliance with compression therapy and was not influenced by smoking, diabetes mellitus, or participation in a wound clinic. CONCLUSIONS There is a consistent trend towards longer rates of healing, higher ulcer recurrence, and increased incidence of DVT after cyanoacrylate ablation as compared to RFA and EVLT. Compliance with compression therapy is predictive of ulcer healing for all ablation modalities. Venous leg ulcerations are a common ailment with increasing prevalence in older populations, 5% of those over age 65, and cost approximately half a billion dollars per year. With an aging population, venous ulcers represent an increasing burden. Treatment of superficial venous reflux with ablation has been demonstrated to decrease ulcer recurrence, but the relationship between healing active ulcers and ablation remains uncertain, particularly between different modalities of ablation. Data was collected retrospectively on 146 patients at a single institution, tertiary-referral center, with an active venous ulcer who underwent ablation therapy via cyanoacrylate (Venaseal™), radiofrequency (RFA), or endovenous laser ablation (EVLT) from 2010-2020. The primary outcome was the time to ulcer healing. Secondary outcomes were the rate of recurrence, compliance with compression, and participation in a wound clinic. The study showed a non-significant difference in days to ulcer healing post-intervention between ablative techniques, with 80.8 days for cyanoacrylate (n=15), 70.07 for RFA (n=44), and 67.04 days for EVLT (n=79). A similar, non-significant trend was observed for ulcer recurrence, with a rate of 35.7% (5/14) for cyanoacrylate, 26.7% (20/75) for EVLT, and 23.1% (9/39) for RFA. Few local and systemic complications occurred. The most common complication was DVT after procedure (n=13). The same non-significant trend occurred with DVT following procedure, being observed in 12.5% (2/16) of cyanoacrylate, 9.5% (8/84) of EVLT, and 6.5% (3/46) of RFA cases. Logistic regression to predict wound healing was significant for compliance with compression therapy and was not influenced by smoking, diabetes mellitus, or participation in a wound clinic. There is a consistent trend towards longer rates of healing, higher ulcer recurrence, and increased incidence of DVT after cyanoacrylate ablation as compared to RFA and EVLT. Compliance with compression therapy is predictive of ulcer healing for all ablation modalities.

Moderating Effects of Smoking Status on the Relationships Between Mental Health Problems and Poor Sleep

A dearth of research exists on the effects of smoking on the relationship between sleep and mental illnesses. To examine the association of mental health problems with days of poor sleep based on whether participants smoked. A secondary analysis of the 2015 Behavioral Risk Factor Surveillance System ( N = 16,253) was conducted using linear regressions models. The study found that the associations between mental health and sleep quality, measured as days of poor sleep, varied by the respondents’ smoker status among those who reported having less than 20 days of mental health problems. The difference in days of poor sleep between smokers and non-smokers were greatest among those who experienced 10 to 19 days of mental health problems. Of those with 10 to 19 days of mental health problems in the past 30 days, an average of 8.5 days of poor sleep was estimated among smokers, which was 3 more days than that of non-smokers ( p = .001). The differences in days of poor sleep were not significantly different between smokers and non-smokers among those who reported 20 or more days of mental health problems. Days of mental health problems were directly related to days of poor sleep. This relationship was moderated by smoking status. Special attention needs to be paid to those who have comparably moderate levels of mental illnesses because non-smoking status can significantly improve sleep quality. Further research is needed to confirm the impact of smoking on the associations of mental illnesses with poor sleep.

Effect of liquid and carrier based biofertilizers on flowering attributes, days to harvest and benefit-cost ratio in Tomato

The experiment conducted at Horticultural Research Station, Dr. YSR Horticultural University, Venkataramannagudem, West Godavari with nine treatment combinations and three replications showed no significant difference in days to first flowering, days to 50 per cent flowering and days to first harvest in all the treatment combinations. Whereas, the application of 100 per cent RDF along with liquid formulations of NFB, PSB and KSB showed significant difference in days to final harvest as compared to other treatment combinations. The application of 80 per cent RDF along with liquid formulations of NFB, PSB and KSB recorded in significantly higher number of flowers per plant, number of clusters per plant, yield ha-1 and the benefit-cost ratio.

Identifying Soil Freeze/Thaw States Using Scattering and Coherence Time Series of High-Resolution C-Band Synthetic Aperture Radar in the Qinghai-Tibet Plateau

The soil freeze/thaw (F/T) cycles play an important role in the climate system and human activities. However, the harsh environment in the Qinghai-Tibet Plateau (QTP) poses great challenges for both in-situ observation and remote-sensing monitoring of the soil F/T process. In this article, the time series of scattering and coherence of the high-resolution Sentinel-1 <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">C-</i> band synthetic aperture radar (SAR) is analyzed to identify the soil F/T state. The time series of scattering, including intensity and decomposition parameters, and coherence, are analyzed based on three typical landcover types (i.e., desert, grassland, and meadow) in the QTP. They are given the mathematical description by second-order and fourth-order Fourier functions, respectively. Based on Fourier functions, the initial F/T time points of the soil are detected in each pixel to draw the F/T map of the entire study area. The experiment results are cross-validated with the initial F/T time points of the soil calculated from the MODIS land surface temperatures, showing that the differences in days are less than one revisit cycle of Sentinel-1 (i.e., 12 days). Furthermore, the possible impacts of environmental factors acquired from the Wudaoliang meteorological station, including air temperature, ground surface temperature, snow depth, and precipitation, on scattering and coherence are discussed. This study explores that Sentinel-1 has great potential for soil F/T monitoring in the QTP, which can indicate F/T states of the surface soil as well as F/T information of the deeper soil with a high spatial–temporal resolution.

Anosmia e ageusia em pessoas após a COVID-19: análise entre tipo e tempo de hospitalização

ABSTRACT Purpose: to analyze the type and length of hospital stay in people who reported anosmia and ageusia after COVID-19. Methods: a cross-sectional study with patients who were referred by the hospital after medical discharge. They answered a standardized in-person questionnaire on age, sex, anthropometry, need for hospitalization, anosmia, and ageusia. Nonparametric statistics were calculated to analyze the data. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups. Significance was set at p&lt;0.05. Results: the responses of 201 participants with a mean age of 44.7 ± 12.7 years were analyzed, 52.2% (n = 105) were males, 67.7% had been hospitalized (n = 136), 60.2% (n = 121) reported ageusia, and 55.7% (n = 112) reported anosmia. There was a difference in days spent in the Intensive Care Unit (ICU) for the Ageusia group (p = 0.004), which had a shorter length of stay. As for those who reported anosmia, there was a difference and shorter length of stay for both the ward (p = 0.001) and ICU (p = 0.004). Categorical data showed that anosmia was associated with hospitalization (yes or no) (p = 0.018; phi = -0.167). Among those who were not hospitalized, 67% (n = 44) reported anosmia. Conclusion: those who reported anosmia and ageusia had shorter hospital stays, when necessary.

ESTIMATING VARIABILITY, HERITABILITY, AND GENETIC ADVANCE OF RICE GENOTYPES IN MID-HILLS OF NEPAL

&lt;p&gt;Rice is an essential staple food in Nepal but researches and varietal improvement programs are rarely carried out due to inadequate variability study. The field study was carried to diagnose the influence of genetic and environmental factors on yield traits to aid future rice breeding programs. Twelve genotypes were arranged in randomized complete block design with three replications from July to November 2019 at the research field of the Institute of Agriculture and Animal Science, Tribhuvan University, in the hilly area of Nepal. Analysis of variance showed significant difference for days to 50% booting, days to 50% flowering, plant height, panicle length, flag leaf area, filled grains per panicle, unfilled grains per panicle, fertility percentage, effective tillers m&lt;sup&gt;-2&lt;/sup&gt;, straw yield, grain yield, 1000-grain weight, and harvesting index indicating the presence of variation in genotypes. LPN BR-1615 was the most promising genotype in grain yield. The values of Phenotypic Coefficient of Variation (PCV) were higher than Genotypic Coefficient of Variation (GCV) for each trait and low difference between them was found for days to 50% booting, days to 50% flowering, plant height, panicle length, grain yield, thousand-grain weight, fertility percentage, and harvesting index. Plant height, effective tillers m&lt;sup&gt;-2&lt;/sup&gt;, and grain yield showed high heritability (i.e. 93.2%, 60.5% and 92.6%, respectively) and higher genetic advance as percentage of mean (i.e. 46.5, 34.6 and 50.1, respectively) . Thus, the experiment revealed that selections favoring plant height, effective tillers m&lt;sup&gt;-2&lt;/sup&gt;, and grain yield would help in effective breeding programs of rice in future.&lt;/p&gt;

Oropharyngeal colostrum immunotherapy and nutrition in preterm newborns: meta-analysis.

ABSTRACTOBJECTIVE To investigated the effect of oropharyngeal colostrum immunotherapy in reducing the time required for very low birth weight preterm newborns (VLBW-PTNB: < 1,500g and < 37 weeks) to achieve full enteral nutrition.METHODS Literature search was conducted using four databases, including gray literature, with additional manual search of the references of selected articles. Eligibility criteria consisted of randomized clinical trials, without restriction regarding the date or language of the publication. Two independent reviewers performed the article selection and data extraction. The random-effects meta-analysis used a non-standard technique to assess the mean difference in days to achieve full enteral nutrition, carried out by the Stata 15 statistic program.RESULTS The systematic review comprised 10 studies, and five were selected for meta-analysis, with a population of 764 VLBW-PTNB and gestational age of birth between 25 and 32 weeks. The studies were conducted between 2011 and 2018 in North America, Asia and Africa, with only one conducted in South America. Altogether, they reported the number of days it took 708 VLBW-PTNB to achieve full enteral nutrition, with newborns treated with immunotherapy showing a shorter time in only three studies. Meta-analysis showed a mean difference of -4.26 days, (95% CI -7.44; -1.08d), with high heterogeneity (I2 = 83.1%).CONCLUSION The use of oropharyngeal colostrum immunotherapy can reduce the time for VLBW-PTNB to achieve full nutrition when compared to those who used a placebo or received routine care.

The impact of COVID-19 on chronic therapies: the Pescara (ASL) Local Health Authority experience in Italy

Introduction At this time in history fraught with restrictions and issues stemming from the COVID-19 pandemic, the care and management of chronic therapies is a major concern for society. The objective of the following study was to assess whether adherence and persistence in patients treated with hypoglycaemic drugs and statins during 2020 changed in comparison with pre-pandemic years. Materials and methods A retrospective study was conducted, taking into account the drugs dispensed at pharmacies in the territory of the ASL (Local Heath Authority) of Pescara from January 1, 2011 to December 2020 of all patients treated with ATC A10B (hypoglycaemic group) and ATC C10A (statin group). Adherence was calculated using the Proportion of days covered (PDC) method. Persistence to treatment was calculated as the difference in days between the start and end of therapy. Results A total of 12030 patients treated with hypoglycaemic drugs and 19699 with statins were analysed. Adherence data ranged from values of 0.79 and 0.75 in 2012 to 0.92 and 0.79 in 2020 for the hypoglycaemic group and statin group, respectively. Persistence curves stratified by year showed a statistically significant difference for both groups under analysis (p < 0.0001). Conclusions The adherence figure did not change much, unlike the persistence figure. In fact, during 2020, the great impact that COVID-19 had on follow-up visits, on the availability of drugs, and on the difficulty of access to health facilities resulted in chronic patients abandoning therapy.

Inventory Management at the Enterprise in the Field of Probability Models

The inventory management system is designed to continuously ensure the production activities of the enterprise with all necessary resources. The purpose of this study is to build a probabilistic model that can be proposed as a new inventory model, which establishes the relationship of period factors between the purchase of parts and the duration of their suitability, which affect inventory management. The research methods are based on a probabilistic approach using continuous distributions. Using the statistical method, point estimates were found for the studied parameters: mean and standard deviation. The histograms of relative frequencies between dates of two next purchases, volume of purchases of details and days of replacement of the fulfilled details are constructed. The critical areas for the studied parameters are illustrated. The values of the difference in days between the purchases of parts and the values of purchases of parts that meet the normal distribution of random variables with the appropriate parameters, as well as the critical values of the need for parts in the production process. The size of the part reserve, which corresponds to Erlang distribution, was found, depending on the established risk factor. For different values of this factor, the value of the difference in days between the purchases of parts, the size of purchases and the reserve of parts that correspond to the distributions of random variables, as well as the critical value of the need for parts in the production process to avoid downtime. Using the central limit theorem, it is shown that the purchase volume of parts and the volume of used parts are distributed according to the normal law. The study concludes that the probabilistic approach is the basis for forecasting inventory management in the enterprise, taking into account the risks associated with determining the optimal demand for raw materials in the enterprise

Minimal clinically important difference in days at home up to 30 days after surgery.

Patient-centred outcomes are increasingly recognised as crucial measures of healthcare quality. Days alive and at home up to 30 days after surgery (DAH30 ) is a validated and readily obtainable patient-centred outcome measure that integrates much of the peri-operative patient journey. However, the minimal difference in DAH30 that is clinically important to patients is unknown. We designed and administered a 28-item survey to evaluate the minimal clinically important difference in DAH30 among adult patients undergoing inpatient surgery. Patients were approached pre-operatively or within 2 days postoperatively. We did not study patients undergoing day surgery or nursing home residents. Patients ranked their opinions on the importance of discharge home using a Likert scale (from 1, not important at all to 6, extremely important) and the minimum number of extra days at home that would be meaningful using this scale. We recruited 104 patients; the survey was administered pre-operatively to 45 patients and postoperatively to 59 patients. The mean (SD) age was 53.5 (16.5) years, and 51 (49%) patients were male. Patients underwent a broad range of surgery of mainly intermediate (55%) to major (33%) severity. The median minimal clinically important difference for DAH30 was 3 days; this was consistent across a broad range of scenarios, including earlier discharge home, complications delaying hospital discharge and the requirement for admission to a rehabilitation unit. Discharge home earlier than anticipated and discharge home rather than to a rehabilitation facility were both rated as important (median score = 5). Empirical data on the minimal clinically important difference for DAH30 may be useful to determine sample size and to guide the non-inferiority margin for future clinical trials.