PRO Group Research Articles

Real-World Effectiveness and Safety of Ibrutinib in Patients with Chronic Lymphocytic Leukemia (CLL) in Belgium after 4 Years

Background: The Belgian ibrutinib Real-world Data (BiRD) study is a multicenter, non-interventional, observational cohort study of adults with confirmed CLL, mantle cell lymphoma, or Waldenström's macroglobulinemia. Aim: To assess the effectiveness and safety of ibrutinib treatment of CLL in routine clinical practice in Belgium. Methods: Eligible patients initiated reimbursed ibrutinib treatment upon or after commercial availability in Belgium (August 1, 2015) or participated in the Medical Need Program and switched to reimbursed ibrutinib with commercial availability. The primary outcome measures were progression-free survival (PFS) and overall response rate (ORR); secondary outcome measures included overall survival (OS) and safety. Data were collected both prospectively (pro) and retrospectively (ret). Pro-collected adverse events (AEs) included all treatment-emergent AEs (TEAEs), whereas ret-collected AEs included only those considered related to ibrutinib; therefore, TEAEs for the pro group and AEs for the ret group are reported separately. To account for patients who could not be included in the ret group as they died before study entry and were therefore unable to provide consent, total population effectiveness results were adjusted with left truncation. We report results from the fourth interim analysis (cutoff: August 20, 2022) for patients with CLL, with a median follow-up of 49.1 months. Results: The effectiveness population included 221 patients (pro, n = 71; ret, n = 150). Median age at ibrutinib initiation was 72 years (range, 38-90); 64.3% were male; median time from diagnosis to ibrutinib initiation was 5.8 years (range, 0-31.4). Del17p/ TP53 mutation was present in 78/132 (59.1%) patients; 22/80 (27.5%) were IGHV-mutated. Nearly one-third of patients (27.4%) were treated first line, 24.2% received 1 prior line of therapy (LOT), 27.9% received 2 prior LOTs, and 20.5% received ≥ 3 LOTs. A history of significant cardiovascular disease was reported by 17.8% patients. Ibrutinib was initiated at 420 mg/day in 88.1% of patients, and 91 (40.3%) patients had ≥ 1 dose modification. Among these patients, who may have had more than 1 modification (increase or decrease), the most common reasons for dose modification were physician preference (59.3%) and toxicity (45.1%). Of the total 226 patients, 58 (25.7%) had ≥ 1 dose increase and 89 (39.4%) had ≥ 1 dose decrease. With ibrutinib treatment, median PFS was 46.0 months in the overall CLL population (Figure), and 49.1/53.6 months in the pro/ret groups. ORR was 90.9% (CR 21.7%, PR 53.4%, PR with lymphocytosis 15.8%). Median OS was 62.3 months (not estimable/91.0 months in pro/ret). Main effectiveness outcomes stratified according to age, prior LOT, and mutation status are listed in the Table. The safety population included 226 patients (pro, n = 73; ret, n = 153). TEAEs/AEs and serious TEAEs/AEs were reported in 100.0/85.6% and 69.9/50.3% in the pro/ret groups, respectively. TEAEs/AEs led to dose reduction, interruption, or withdrawal in 24.7/13.7%, 45.2/28.8%, or 30.1/21.6% of patients in the pro/ret groups, respectively. TEAEs/AEs of interest in the pro/ret groups were major bleeding (5.5/2.6%), infection (76.7/65.4%), hypertension (17.8/11.8%), atrial fibrillation (13.7/9.2%), arthralgia/myalgia (27.4/11.1%), diarrhea (24.7/13.7%), and rash (16.4/9.8%). Ibrutinib was permanently discontinued in 164 (72.6%) patients, most commonly due to disease progression (n = 40). The median duration of treatment was 35.8 months; 32 of the 226 patients discontinued ibrutinib due to toxicity (14.2%), and 27.4% of patients remain on treatment. Conclusions: In this Belgian real-world study, ibrutinib was found to be an effective treatment for patients with CLL, including those with higher risk mutations, several prior LOTs, and older age, with first-line patients who joined the study later responding particularly well. These findings are consistent with those from clinical trials, which support more effective outcomes for ibrutinib when utilized in the frontline (eg, RESONATE-2: Barr PM, et al. Blood Adv. 2022;6:440-3450; RESONATE: Munir T, et al. Am J Hematol. 2019;94:1353-1363). TEAEs/AEs are consistent with the known safety profile of ibrutinib.

Effects of Bifidobacterium BL21 and Lacticaseibacillus LRa05 on gut microbiota in type 2 diabetes mellitus mice

Gut dysbiosis causes damage to the intestinal barrier and is associated with type 2 diabetes mellitus (T2DM). We tested the potential protective effects of probiotic BL21 and LRa05 on gut microbiota in type 2 diabetes mellitus mice and determined whether these effects were related to the modulation of gut microbiota.Thirty specific pathogen-free C57BL/6J mice were randomly allocated to three groups—the (CTL) control group, HFD/STZ model (T2DM) group, and HFD/STZ-probiotic intervention (PRO) group—and intragastrically administered strains BL21 and LRa05 for 11 weeks. The administration of strains BL21 and LRa05 significantly regulated blood glucose levels, accompanied by ameliorated oxidative stress in mice. The BL21/LRa05-treated mice were protected from liver, cecal, and colon damage. Microbiota analysis showed that the cecal and fecal microbiota of the mice presented significantly different spatial distributions from one another. Principal coordinate analysis results indicated that both T2DM and the BL21/LRa05 intervention had significant effects on the cecal contents and fecal microbiota structure. In terms of the fecal microbiota, an abundance of Akkermansia and Anaeroplasma was noted in the PRO group. In terms of the cecal content microbiota, enrichment of Akkermansia, Desulfovibrio, Bifidobacterium, Lactobacillus, and Limosilactobacillus was noted in the PRO group. The probiotics BL21 and LRa05 prevent or ameliorate T2DM by regulating the intestinal flora and reducing inflammation and oxidative stress. Our results suggest that BL21 and LRa05 colonize in the cecum. Thus, BL21/LRa05 combined with probiotics having a strong ability to colonize in the colon may achieve better therapeutic effects in T2DM. Our study illustrated the feasibility and benefits of the combined use of probiotics and implied the importance of intervening at multiple intestinal sites in T2DM mice.

Concurrent high-intensity interval training and probiotic supplementation improve associative memory via increase in insulin sensitivity in ovariectomized rats

ObjectivesMetabolic syndrome (MetS) is a serious concern among postmenopausal women which predisposes them to cardiovascular and cognitive disorders. Healthful diet and exercise training have been essential strategies to prevent the progress of MetS. The aim of this study was to evaluate the effect of supplementation with a native potential probiotic and high-intensity interval training (HIIT) for 8 weeks on retention of associative memory in rats with ovariectomy- induced metabolic syndrome.MethodThirty-two female ovariectomized Wistar rats were divided into four groups (n = 8/group): Control (OVX + Veh), exercise (OVX + Exe), probiotic (OVX + Pro), exercise with probiotic (OVX + Exe + Pro). One sham surgery group was included as a control group. Animals received 8 weeks interventions, and then were tested in a step through passive avoidance learning and memory paradigm, to assess long term memory. Then serum levels of adiponectin, insulin and glucose were measured by ELISA and colorimetry respectively. Data were analyzed by Kruskal-Wallis, Mann-Whitney and also One-way analysis of variance (ANOVA).ResultsEight weeks of HIIT and probiotic supplementation caused an increase in step through latency and shortening of total time spent in the dark compartment in OVX + Exe + Pro group compared with OVX + Veh group. Also significant increase in serum adiponectin levels, in parallel with a reduction in glucose, insulin and HOMA-IR were achieved by the group of OVX + Exe + Pro.ConclusionThe present study indicates that HIIT combined with probiotics supplementation for 8 weeks effectively improves associative memory in MetS model of rats partly via improving insulin sensitivity and adiponectin level.

ISLAM NUSANTARA: AMBIGUITY, CULTURAL STRATEGY OR ORIGINALITY

Islam Nusantara is a new term in Indonesia. The opposing group views it as a form of Islamic division, and the pro group considers it a strategy for Islamic da'wah with a slogan of moderation and a cultural approach. Islam Nusantara is defined as Islam that is friendly, inclusive, dynamic, and friendly with a diverse cultural, sub-cultural and religious environment. From this meaning, the question arises from this ambiguity: "does the Islam brought by the Prophet not have the characteristics mentioned above, so it needs a discourse on Islam Nusantara? Or did it just happen because of the problem of syncretism and local cultural infiltration? It is a fundamental question that needs to be cleared. This study uses a social and historical approach to analyze the origin, meaning, and purpose of Islam Nusantara from the perspective of Indonesian society. Islam Nusantara is not a new issue. The identity of Islam has been popular since Islamization. The researcher concludes that the terminology of Nusantara Islam has political and theological content. That is the discourse of certain Islamic rulers and organizations dealing with the current epidemic of radicalism and extremism in religion. Originality is the primordial value of Islam that is not bound by time and place; inclusive, dynamic, and moderate. At the same time, the cultural strategy is a dialogue effort between Islam and time and place. Islam Nusantara needed to develop and change according to the demands of the times.

Evaluation of Facial Trauma Scars After Treating by Refining Plastic Surgery Techniques: A Follow-Up Study.

Although early debridement and refining plastic surgery techniques have been shown to be effective in the treatment of facial scars after trauma, their postoperative outcomes have not been quantitatively evaluated by the relevant Scar Cosmesis Assessment and Rating (SCAR) Scale. This study was designed to provide a fair assessment of the appearance and local symptoms of scars after treatment by refining plastic surgery techniques and to share the operational skills of surgical repairs. Patients who received refining plastic surgery techniques were followed up, and facial scars were taken as high-definition photos, which were presented to 6 professional observers, 6 lay observers, and patients themselves to score the facial scars, including: scar spread, erythema, dyspigmentation, track marks or suture marks, hypertrophy/atrophy, itch and pain according to the SCAR. There were 56 patients who met the inclusion criteria and 25 agreed to participate in the study. No hypertrophic scar was found, and all patients were satisfied with the scar control effect. The scores showed that the treatment was achieved good results in scar spread (pro group: 0.85±0.55, lay group: 0.96±0.68, patients: 0.92±0.64), erythema (pro group: 0.34±0.26, lay group: 0.45±0.37, patients: 0.32±0.48), hypertrophy/atrophy (pro group: 0.21±0.27, lay group: 0.21±0.31, patients: 0.32±0.48), and there was no significant difference in the scores of the 3 observation groups ( P >0.05). However, it is difficult to eliminate dyspigmentation (pro group: 0.29±0.26, lay group: 0.30±0.30, patients: 0.40±0.50), track marks or suture marks (pro group: 0.45±0.33, lay group: 0.59±0.30, patients: 0.36±0.49). Two (8%) patients complained of itch and 1 (4%) patient complained of both itch and pain in the past 24 hours. The appearance of facial scars is satisfactory, the local symptoms are mild, and the evaluation among different aesthetics is affirmative after receiving refining plastic surgery techniques, which is just in line with the purpose of seeking beauty for the patients, and meanwhile can provide a good foundation for the comprehensive treatment of late scars, so that the treatment plan should be promoted.

Polarization on the Polemic of the Job Creation Law

The Omnibus Law on the Job Creation Law (UU Cipta Kerja) which was authorized in October 2020 amid the COVID-19 outbreak has raised pros and cons among the public, policymakers, investors, and workers in Indonesia. It is considered to be detrimental to the lower middle class while benefiting certain entities. Consequently, there was a polarization of public discourse in cyberspace. Therefore, this study aimed to map polarization trends in the internet community regarding the polemic on the Job Creation Law. This research used mixed methods with the Corpus-Assisted Discourse Study (CADS) framework. The trend amongst the cyber community indicated that there was group polarization in perceiving these issues, where both pro and con groups have different arguments and justifications in addressing the matter. The research data was in the form of tweets corpus totaling 12,224 tokens related to the Job Creation Law. The Natural Language Toolkit (NLTK) package built into Python 3.9.2 was used for tokenization and stopword removal. Lancsbox 6.0 was used to compute keywords and determine concordances. Furthermore, the significance of the keyword frequency was calculated using the Log-Likelihood test. This study identified three main topics in the controversial debate on the Job Creation Law, namely 1) State financial and economic policies; 2) Employment, length of service, and income; and 3) Environment and sustainability.
 Keywords: Corpus-Assisted Discourse Study (CADS), Cyberspace, Job Creation Law, Omnibus Law, Polarization.

Gut microbial shifts by synbiotic combination of Pediococcus acidilactici and lactulose in weaned piglets challenged with Shiga toxin-producing Escherichia coli.

Development of alternatives to in-feed antibiotics in the swine industry have been the focused of many pig gut microbiota studies to improve animal health. In this study, we evaluated the effects of probiotic Pediococcus acidilactici (PRO), prebiotic lactulose (PRE), and their synbiotic combination (SYN) on gut microbiota using 16S rRNA gene sequencing in weaned piglets challenged with Shiga-toxin producing Escherichia coli (STEC). Our data showed that prebiotics, probiotics and synbiotics improved the intestinal health in weaned piglets. No significant differences were observed in species richness and species diversity in weaned piglets fed prebiotics, probiotics and their synbiotic combination. However, beta diversity analysis revealed distinct clustering of the microbiota of according to dietary treatment and by oral challenge of STEC. At the phylum level, Firmicutes to Bacteroidetes ratio was lower in the dietary treatment groups than the control group. Oral supplementation of prebiotics, probiotics and synbiotics enriched the abundance of Prevotella and Roseburia. Succinivibrio was elevated in PRO group; however, Phascolarctobacterium was depleted with STEC challenge regardless of dietary treatment. Overall, our data showed that administration of synbiotics in piglets improved intestinal health through gut microbiota modulation. Our data indicated that prebiotics, probiotics and their synbiotic combination could promote intestinal health through gut microbiota modulation in weaned piglets.

Comparison of Dexmedetomidine and Propofol on Serum Neutrophil Gelatinase-associated Lipocalin Levels of Patients after Thoracotomy

BACKGROUND: Acute kidney injury (AKI) is a well-known complication of surgery that increases the death rate and the side costs of postoperative care and treatment. Neutrophil gelatinase-associated lipocalin (NGAL) is a protein that is emerging as a new marker in the early detection of kidney damage. AIM AND OBJECTIVE: In this study, we try to compare the effect of propofol (Pro) and dexmedetomidine (Dex) on activity in patients undergoing thoracotomy by evaluating and measuring the amount of renal function evaluation factors similar to blood urea nitrogen (BUN), creatinine, and NGAL. MATERIALS AND METHODS: All patients who underwent thoracotomy (with two types of anesthetics Dex and Pro) in the first 6 months of 2019 (April–September) in Masih Daneshvari Hospital were included in this study and the information obtained from all of them was based on a questionnaire design. RESULTS: The BUN index in patients of the two groups was significantly different in three time periods before surgery, 2 h after surgery, and 24 h. Based on the available results, the NGAL index as a factor in assessing renal function was significantly different in the two groups of patients. However, the mean numerical values in all three intervals of NGAL levels were much lower in the patients of the Pro group. However, other indicators in the study did not show significant changes in terms of mean values in the two groups of patients. CONCLUSION: Pro significantly reduced NGAL compared with Dex for thoracotomy surgery.

SPEECH ACT ANALYSIS: DISCUSSION ON COVID-19 VACCINE SIDE EFFECTS IN A FORUM

Vaccines have been an important topic in recent years due to the prevalence of COVID-19. Discussions were mainly conducted online during this period, which makes COVID-19 discussion forums a great place to start examining the discourse surrounding this topic. The objective of this study is to examine the speech act strategies performed by participants in an online forum on their perception of COVID-19 vaccine side effects and how they promote or influence others with their viewpoints. The study extracted 7 pages or 105 posts, from a forum called Veda (Vestibular [inner-ear and brain balance] Disorder Association) as the data. Participants of different beliefs in the forum shared their thoughts upon taking the vaccine through the forum’s “Covid-19 Vaccine Side Effects” tab. Using Searle’s Speech Act Theory, the study first identified the types of speech acts performed. Then, each of the posts were categorised into three groups (pro, anti and vaccine-hesitant groups) based on the content and previous posts made by the same participant. Findings revealed that assertives (46.9%) were the most prominent speech act, amongst all three groups. The pro and anti groups who had a firmer position on vaccination used more assertives as compared to vaccine-hesitant groups who used slightly more directives to request answers or clarifications. Declaration (1.9%) speech acts were used the least frequently since participants did not possess a special institutional role to bring about changes in real-life other than possibly influencing the perceptions of other participants.Keywords: speech act theory, online forum, COVID-19, vaccines, computer-mediated communication, synchronous discussions

Comparison among U-17, U-20, and Professional Female Soccer in the GPS Profiles during Brazilian Championships

The purpose of this study was to compare and characterize the physical demand of official matches among under-17 (U-17), under-20 (U-20), and professional (Pro) female soccer players. All matches were from the U-17, U-20, and Pro National Brazilian Championships. Fourteen Pro matches, nine U-20 matches, and four U-17 matches were analyzed. The external load was measured by the global positioning system (GPS) and the internal workload was assessed by the ratings of perceived exertion (RPE) multiplied by the duration of the match. The activity profiles measured were total distance covered (km), total sprint distance (m) (speed > 18 km·h-1), number of accelerations and decelerations (between 1 and 2 m·s-2 and >3 m·s-2), and top speed (km·h-1). For the analysis, we standardized all the metrics (except the top speed) by the time (in minutes) played. The Pro group presented higher sprint distances, number of accelerations and decelerations, and top speeds, compared to U-20 and U-17. There was no difference in the total distance among groups, and there was no difference in any GPS metrics between U-20 and U-17. The RPE was higher in Pro and U-17, compared to U-20; however, the workload-RPE was higher in Pro, compared to both U-17 and U-20 groups. These findings provide important information for the evolution of physical performance according to age categories in elite female soccer players.

KAJIAN YURIDIS PERPANJANGAN JABATAN PRESIDEN DI INDONESIA

The issue of the extension of the term of position of Joko Widodo as President has caused a polemic in the community. The existence of pro community groups through declaring their wishes in various cities in Indonesia to do change of rules. The demands of course based on the results of the work leadership president by Joko Widodo which is felt by the community to be quite real and the realization of government performance is in the interest of the community. However, this is certainly not agreed upon by various parties and opposes the opinion of extending the term of position of the president by the opposing groups. The extension of the term of position of the president is considered a setback for democracy, violates the 1945 Constitution (UUD 1945), is unconstitutional and injures the 1998 Reformation struggle. In other that, Author interested to do research uses a qualitative method in collecting and managing research data. The data that has been obtained by the Author is analyzed and summarized in descriptive form

PRO-KONTRA ATAS PUTUSAN MAHKAMAH KONSTITUSI NOMOR 46/PUU-VIII/2010 TENTANG KEDUDUKAN DAN HAK ANAK LUAR KAWIN

This research uses qualitative methods, while the type of research is library research which is contextual interpretation by explaining: (1) What is the position and rights of children out of wedlock after the decision of the constitutional court number 46/PUU-VIII/2010 (2) What are the arguments of the pro and contra groups of people over the decision of the constitutional court number 46/PUU-VIII/2010. This study concluded that (1) illegitimate children can get the position and rights that exist in themselves, such as civil relations, maintenance rights, subsistence rights, and educational financing rights from their biological fathers as long as they can be proven based on science and technology or other tools. Other evidence as for the inheritance of the father, the child can only get it in the form of a will or a grant. (2) The arguments of the pro group are more in terms of the interests of the child in giving an opinion where the child should be given legal protection against acts of discrimination or things that threaten the safety of the child and confirms guarantess of constitutional rights such as the right to life and rights private. Meanwhile the opposing group gave an argument that looked more from a religious perspective on the validity of their parents marriage, because how could a child resulting from a relationship outside of marriage have the same position and rights as a legitimate child so that it would have a bad impact and facilitate moral depravity, prostitution and the existence of a decision. This is considered to have violated Islamic theachings and even changed the order of life of Muslims which had been in effect and made it difficult for inheritance to be distributed. Key Word: Pros-Cons, The Position and Rights of Children Out of Wedlock, Constitutional Court Decision.

Sevoflurane alleviates lung injury and inflammatory response compared with propofol in a rat model of VV ECMO.

Although venovenous extracorporeal membrane oxygenation (VV ECMO) is a reasonable salvage treatment for acute respiratory distress syndrome (ARDS), it requires sedating the patient. Sevoflurane and propofol have pulmonary protective and immunomodulatory properties. This study aimed to compare the effectiveness of sevoflurane and propofol on rats with induced ARDS undergoing VV ECMO. Fifteen sprague-dawley (SD) rats were randomly divided into three groups: Con group, sevoflurane (Sevo) group and propofol (Pro) group. Arterial blood gas tests were performed at time pointsT0 (baseline), T1 (the time to ARDS), and T2 (weaning from ECMO). Oxygenation index (PaO2/FiO2) was calculated, and lung edema assessed by determining the lung wet:dry ratio. The protein concentration in bronchial alveolar lavage fluid (BALF) was determined by using bicinchoninic acid assay. Haematoxylin and eosin staining was used to evaluate the lung pathological scores in each group. IL-1β and TNF-α were also measured in the BALF, serum and lung. Oxygenation index showed improvement in the Sevo group versus Pro group. The wet:dry ratio was reduced in the Sevo group compared with propofol-treated rats. Lung pathological scores were substantially lower in the Sevo group versus the Pro group. Protein concentrations in the BALF and levels of IL-1β and TNF-α in the Sevo group were substantially lower versus Pro group. This study demonstrates that compared with propofol, sevoflurane was more efficacious in improving oxygenation and decreasing inflammatory response in rat models with ARDS subject to VV ECMO treatment.

Comparison of clinical safety and efficacy of dexmedetomidine, remifentanil, and propofol in patients who cannot tolerate non-invasive mechanical ventilation: A prospective, randomized, cohort study.

Background and objectivesNon-invasive ventilation (NIV) is used in intensive care units (ICUs) to treat of respiratory failure. Sedation and analgesia are effective and safe for improving compliance in patients intolerant to NIV. Our study aimed to evaluate the effects of dexmedetomidine, remifentanil, and propofol on the clinical outcomes in NIV intolerant patients.MethodsThis prospective randomized cohort study was conducted in a tertiary ICU, between December 2018 and December 2019. We divided a total of 120 patients into five groups (DEXL, DEXH, REML, REMH, PRO). IBM SPSS Statistics 20 (IBM Corporation, Armonk, New York, USA) was used to conduct the statistical analyses.ResultsThe DEXL, DEXH, REML, and REMH groups consisted of 23 patients each while the PRO group consisted of 28 patients. Seventy-five patients (62.5%) became tolerant of NIV after starting the drugs. The NIV time, IMV time, ICU LOS, hospital LOS, intubation rate, side effects, and mortality were significantly different among the five groups (P = 0.05). In the groups that were given dexmedetomidine (DEXL, and DEXH), NIV failure, mortality, ICU LOS, and hospital LOS were lower than in the other groups.ConclusionIn this prospective study, we compared the results of three drugs (propofol, dexmedetomidine, and remifentanil) in patients with NIV intolerance. The use of sedation increased NIV success in patients with NIV intolerance. NIV failure, mortality, ICU LOS, IMV time, and hospital LOS were found to be lower with dexmedetomidine.

Comparative Evaluation Between Two NiTi Rotary Files Using CBCT

AIM: The aim of the study was to evaluate and compare the effects of WaveOne and Protaper Next on volume of dentin removed, centering ability and dentin thickness using CBCT on human mandibular molars. MATERIALS AND METHOD: Methodology: 50 recently extracted human mandibular molars were taken and divided into two groups i.e. Group 1- Pro taper next and Group -2 Wave One. The distal root was discarded and the mesiobuccal root canals were selected. Further the selected root canals were scanned to standardize the mesial root canal ranging from 15o to 45o followed by root canal preparation. Here CBCT a non invasive technique was used for assessment. The data extracted were tabulated and subjected to statistical analysis for pair wise comparison. RESULTS: It was seen that Protaper Next showed statistically significant centric ability where as dentin thickness at cervical, middle and apical level and showed no significant differences. Even mean of volume of removed dentin also showed no significant difference (p>0.05) between the groups. CONCLUSION: The inventive method of NiTi rotary system is having better-quality shaping ability in curved canals that results more centered instruments and less canal errors.

An Epidemic Model with Pro and Anti-vaccine Groups.

Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx to the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective.

Comparison of mean Postoperative Inguinodynia in patients undergoing open Inguinal Hernia Surgery with use of standard Polypropylene Heavy Weight Mesh v/s Ultra Pro light Weight Mesh

Background: Various types of meshes for inguinal hernias have been discovered to combat with chronic groin pain related problems. The data regarding these findings was variable due to difference in the cut off values used in the past in different studies to label inguinodynia and local data was scarce where HWM is still highly practiced. Aim: To compare the mean postoperative inguinodynia in patients undergoing open inguinal hernia surgery with use of standard polypropylene heavy weight mesh (HWM) v/s Ultra Pro lightweight mesh (LWM). Methodology: This is a prospective randomized controlled trail conducted at department of surgery, Services Institute of Medical Sciences, from July 2019 to June 2020. Cases were divided in two groups by using radio opaque sealed envelopes labeled as A and B. Group-A underwent Lichtenstein mesh repair by Ultra Pro LWM and group B had polypropylene heavy weight mesh (HWM). Lichtenstein mesh repair was done under spinal or general anesthesia by the experienced surgeon. Duration of surgery was also calculated (from incision to closure). Patient was followed in outpatient department at 3 months where the outcome was seen and inguinodynia was assessed. Results: The mean age was in group A was 40.66±10.52 years and 40.53 ±12.56 years in group B. The mean pain Score in group A was 2.024±0.88 and in Group-B it was 2.97 ±0.85. Conclusion: Ultra Pro LWM is more effective in terms of less postoperative pain as compared to standard polypropylene heavy weight mesh in patients undergoing open inguinal hernia surgery Keywords: Postoperative, Inguinodynia, Inguinal hernia, Standard, Polypropylene heavy weight mesh, Ultra Pro light

Kepentingan Ideologis Negara dan Nahdlatul Ulama dalam Pembubaran Hizbut Tahrir Indonesia

This article discussed the contestation of ideological interests between the state, Hizbut Tahrir Indonesia (HTI), and Nahdlatul Ulama (NU) in the case of the disbandment of HTI in 2017. The disbandment of HTI explained the existence of pro and contra groups and the attraction of ideological interests. This research was qualitative research with observation and interview methods. The research results proved that there were conflicting and conflicting interests between the interests of the state, HTI, and NU. The state interests were the interests of the Pancasila ideology and public security. NU rejected the caliphate because it was interested in defending the "Islam Nusantara" ideology. NU's success in encouraging the government was influenced by the issues' relevance and the condition of the political structure of Joko Widodo's government for the 2014-2019 period. The polarized condition of the government's political structure in the Jokowi versus Prabowo group influenced the decision to disband HTI because NU was identified with moderate Islam that supported Jokowi. Hence, NU's bargaining power with the Jokowi government was more substantial than HTI.

A Novel Lyophilized PRP-Loaded Gel Based on Chitosan and PEG with Hemostatic and Antibacterial Properties

A dynamic gel loaded with lyophilized platelet-rich plasma-chitosan/difunctionalized polyethylene glycol (LPRP-CP) was prepared to investigate its hemostatic antibacterial and promoting wound healing of scald wounds through in vitro and in vivo experiments. In this study, normal gauze/blank tablet (Ctrl), LPRP-CP, Chitosan HUCHUANG Powder(Chito P)and ChitoGauze XP PRO group (Chito G group) were set. The hemostatic effect and promoting healing effect of the four groups of materials were evaluated by establishing rabbit ear artery hemorrhage model and superficial Ⅱ° scalded model of skin on the back. The hemostatic time and bleeding amount were calculated and the gross and histological results of scald healing were observed. The antibacterial effect of the four groups of materials was evaluated by antibacterial test in vitro. In the rabbit ear arterial hemorrhage model, the hemostasis of all materials was successful. The hemostatic time of Ctrl, Chito P, LPRP-CP and Chito G groups was 213.33±38.30, 118.33±24.01, 115.00±8.37 and 111.67±11.69 s, respectively. The blood loss was 1233.83±992.27, 346.67±176.00, 193.33±121.47 and 147.50±80.66 mg, respectively. Compared with Ctrl, the hemostasis time of LPRP-CP, Chito P and Chito G group was significantly shorter (P<0.001), and the amount of blood loss of LPRP-CP and Chito G group was decreased (P<0.05). Compared with LPRP-CP, there were no significant differences in hemostatic time and blood loss between Chito P and Chito G group (P>0.05). In the model of superficial Ⅱ° scalded on the back of rabbit, the wound healing rate of LPRP-CP was faster than that of the other three groups at the same time, and the healing effect was perfect. In the antibacterial test in vitro, only LPRP-CP had better anti-S. aureus effect, and all groups had no anti-E. coli effect. LPRP-CP is an excellent hemostatic material for superficial wounds, and has certain antibacterial and wound healing effects, which has a wide academic value and research prospects.

Dexmedetomidine versus propofol for prevention of emergence delirium in pediatric cataract surgery: Double blinded randomized study

ABSTRACT Background Emergence delirium (ED) is a common complication after general anesthesia in pediatrics, as reported by pediatric anesthesiologists. Multiple drugs have been suggested to prevent the incidence of this problem. Herein, we compared dexmedetomidine and propofol in the prevention of ED in pediatric patients undergoing cataract surgery under general anesthesia. Patients and methods: This prospective study included 80 children who were randomly allocated into two groups; the Dex group, which received dexmedetomidine, and the Pro group, which received propofol. All operations were performed under general anesthesia, and both drugs were administered 20 minutes before the end of surgery. Our primary outcome was to compare between the incidence of ED in both groups, while secondary outcomes included hemodynamic changes, pain scores, and other complications. Results Age, gender, and the duration of PACU stay showed no significant difference between the two groups. ED was encountered in 5% and 27.5% of patients in the Dex and Pro groups, respectively, with a significant decline in association with dexmedetomidine. Delirium and pain scores were significantly decreased in the Dex group throughout all times of measurement. The same group expressed a significant decrease in most heart rate and arterial pressure measurements. Hypotension was encountered in 15% of patients in the Dex group versus no cases in the Pro group. Conclusion Dexmedetomidine is superior to propofol in the prevention of ED in pediatrics. It is also associated with better post-operative pain scores.