Terms Of Days Research Articles

Open Radical Cystectomy versus Robot-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion: Early Outcomes of a Single-Center Randomized Controlled Trial.

Radical cystectomy (RC) with urinary diversion (UD) is still considered a complex surgery associated with significant morbidity. Open RC (ORC) remains the reference option of treatment, even if adoption of robot-assisted RC (RARC) is rapidly increasing. To date, all the available randomized controlled trials were characterized by an extracorporeal approach in performing UD, undermining potential benefits of a totally minimally invasive procedure. In this study, we aimed to report perioperative and 6-month outcomes from the first RCT comparing ORC and RARC with totally intracorporeal UD. Patients were eligible for randomization if they had a diagnostic transurethral resection of bladder tumor with cT2-4, cN0, cM0 or recurrent high-grade nonmuscle-invasive bladder cancer and no anesthesiological contraindications to robotic surgery. Patients were enrolled with a covariate adaptive randomization process based on the following variables: body mass index, American Society of Anesthesiologists® score, baseline hemoglobin, planned UD, neoadjuvant chemotherapy and cT stage. The primary end point was to demonstrate the superiority of RARC with intracorporeal UD in terms of a 50% transfusion rate reduction. Overall, 116 consecutive patients (58 RARC, 58 ORC) were enrolled. Among primary endpoint, overall perioperative transfusion rates were significantly lower in the RARC cohort (RARC: 22% vs ORC: 41%; p=0.046). This prospective randomized trial observed 22% and 41% overall perioperative transfusion rates in patients treated by RARC and ORC, respectively, confirming a significant benefit in favor of RARC with intracorporeal UD. However, perioperative complications, hospital stay and 6-month health-related quality of life were largely comparable between groups. Oncologic and functional outcomes will be assessed at longer followup to observe potential differences between arms.

Potential of Gynoecious Line in Generating Superior Heterotic Hybrids in Bitter Gourd (Momordica charantia L.)

An experiment was designed to find out the extent of heterosis in bitter gourd using gynoecious line, KAU- MCGy-101 and three monoecious lines viz., Preethi, Priyanka, and MC133. Hybrids were generated by both direct and reciprocal crosses. All the hybrids exhibited earliness in terms of days to first female flower opening, node bearing first female flower, and days to first harvest. The hybrid KAU-MCGy-101 × Priyanka exhibited significantly higher heterosis with regard to heterobeltiosis (-16.03 %) and standard heterosis (-18.63 %) for days to first female flower opening. All the six hybrids manifested significant standard heterosis for sex ratio in the desirable negative direction, ranged from 44.25 to -55.52 %. The highest yield was recorded in the hybrid KAU-MCGy-101 × Priyanka (22.88 t/ha) and was followed by KAU-MCGy-101 × Preethi (20.42 t/ha) and KAU-MCGy-101 × MC 133 (20.05 t/ha). Heterobeltiosis for yield (t/ha) varied from 14.72 to 57.85 % and the standard heterosis ranged between 37.59 to 89.31 %. The best performing hybrids were KAU-MCGy-101 × Preethi, KAU-MCGy-101 × Priyanka, and KAU-MCGy-101 × MC 133 with respect toearliness, number of fruits per plant, and yield. Thus, the superiority of hybrids having gynoecious line as a maternal parent is prominent in the present study.

亚热带岩溶区典型常绿和落叶树种的蒸腾特征及其对环境因子的响应

植物蒸腾是水循环的重要组成部分，为了解亚热带岩溶区树木的蒸腾耗水情况，探究气候和水文地质条件对植物蒸腾的影响，运用Granier热耗散探针技术，对亚热带岩溶区次生林内的常绿树种女贞（L.lucidum）和落叶树种刺槐（R.pseudoacacia）的树干液流进行了连续监测，并同步监测了气象因子及土壤含水率（SMC），探讨在不同时间尺度下两种生活型树种的蒸腾特征及其对环境因子的响应。结果表明：（1）在季节尺度下，影响两树种整树蒸腾量（ET）的主要因子为太阳辐射强度（Rs）、气温（T）和水汽压亏缺（VPD）；女贞蒸腾量（ET_L）表现为夏季（1.29 kg/h） > 春季（0.57 kg/h） > 冬季（0.15 kg/h） > 秋季（0.13 kg/h），刺槐蒸腾量（ET_R）表现为夏季（0.90 kg/h） > 春季（0.31 kg/h） > 秋季（0.16 kg/h） > 冬季（0.04 kg/h）。（2）在日尺度下，晴天两树种ET呈现出明显的单峰日变化，且主要影响因子均为T、VPD和Rs；但由于常绿和落叶树种的生理特征差异，降雨时ET_L受到抑制，而ET_R则显著提升。（3）从昼夜层面来看，两树种夜间蒸腾量不足日蒸腾总量的35%。在夜雨现象和树木生理特征的影响下，秋冬季夜间蒸腾量占比明显高于春夏季，刺槐的平均夜间蒸腾量及其占比（1.56 kg，24.1%）高于女贞（1.08 kg，13.9%）。;Plant transpiration is an important part of water cycle in ecosystem, that is, the process of water transfer from soil to atmosphere through plants. It is driven by solar radiation, air temperature, air humidity and wind speed, and also affected by soil water storage capacity. Understanding and quantifying the influence mechanism of transpiration is an important basis to explore the water consumption of vegetation and the water balance of ecosystem. However, although the climate conditions in the subtropical karst area are good, there is a drought period of 4-5 months. At the same time, plants are often affected by water stress because of the thin soil layer and low water holding capacity of soil in karst area. The study of plant transpiration characteristics helps us understand the water consumption of trees in subtropical karst areas, and is also of great significance for exploring the impact of climate and hydro-geological conditions on plant transpiration. Granier's thermal dissipation probe method was used to continuously monitor the trunk sap flow of the evergreen tree species (L.lucidum) and the deciduous tree species (R.pseudoacacia) in the secondary forest in the subtropical karst area. The meteorological factors and soil moisture content (SMC) are also monitored simultaneously. Our purpose is to analyze the transpiration characteristics of two life-form tree species and their responses to environmental factors on different time scales. The results show that:(1) at the seasonal scale, the main factors affecting the whole-tree transpiration (ET) are solar radiation intensity (Rs), air temperature (T) and vapor pressure deficiency (VPD). The transpiration of L.lucidum (ET_L) is shown as summer (1.29 kg/h) > spring (0.57 kg/h) > winter (0.15 kg/h) > autumn (0.13 kg/h), transpiration of R.pseudoacacia (ET_R) is shown as summer (0.90 kg/h) > spring (0.31 kg/h) > autumn (0.16 kg/h) > winter (0.04 kg/h). (2) On the daily scale, the ET of the two tree species shown obvious single peak curve on sunny day, and the main factors affecting transpiration are T, VPD and Rs. However, due to the differences in the physiological characteristics of evergreen and deciduous tree species, ET_L is weakened during rainfall, while ET_R is significantly increased. (3) in terms of day and night, the nocturnal transpiration of the two tree species accounts for less than 35% of the total daily transpiration on average. Affected by the phenomenon of night precipitation and the physiological characteristics of trees, the proportion of nocturnal transpiration in the autumn and winter is significantly higher than that in the spring and summer. At the same time, the average daily nocturnal transpiration and its proportion of R.pseudoacacia (1.56 kg, 24.1%) is higher than that of L.lucidum (1.08 kg, 13.9%).

Clinical-epidemiological changes in patients with non-traumatic acute abdomen during the COVID-19 pandemic: a retrospective study.

we intend to demonstrate the clinical alterations and the postoperative evolution in patients with acute abdomen non-traumatic in conservative or surgical treatment during the pandemic compared to a similar period in the last year. a single-center retrospective study, including patients who received clinical-surgical treatment at Hospital do Trabalhador diagnosed with acute abdomen between March and August 2020 and a similar period in 2019.Variables studied ranged from demographic data to indices of social isolation. 515 patients were included, 291 received treatment in a pre-pandemic period and 224 during. There was not statistical difference in relation to comorbidities (p=0.0685), time to diagnosis and seeking medical help. No statistical differences were observed in terms of days of hospitalization (p = 0.4738) and ICU need (p=0.2320). Regarding in-hospital deaths, there was statistical relevance in the age above 60 years (p=0.002) and there were more deaths during the pandemic period (p=0.032). However, when we analyze the factors associated with the number of days until diagnosis by a physician, there was no statistical difference. the analyzed data showed that the pandemic period and age over 60 years were the variables that increased the odds ratio for the in-hospital death outcome. However, the length of stay, days in intensive care unit and postoperative surgical complications showed no significant difference.

Effects of a multimodal rehabilitation program in COVID-19 patients admitted to the Intensive Care Unit: A quasi-experimental study

Background: Patients with severe COVID-19 evolve to acute respiratory distress syndrome (ARDS) and require management in Intensive Care Units (ICU) where they are exposed to immobilization, immunosuppression, malnutrition, nosocomial infections; may develop ICU Acquired Weakness (ICUAW), which increases with the stay and use of mechanical ventilation (MV).There is evidence of the use of different modalities in rehabilitation to mitigate these effects. Goal: To determine the efficacy of a Multimodal Rehabilitation Program (MRP) in reducing the number of days of mechanical ventilation and stay in patients hospitalized for COVID-19 in ICU, as well as to describe its clinical and hospital characteristics. Material and Methods: An quasi-experimental study was designed, with sequential sampling and without blinding. A control and intervention group was formed, with 32 participants each. A Multimodal Rehabilitation Program (MRP) based on four therapeutic modalities was applied and the intervention was quantified through the use of proposed indicators. Results: The variation in days of ICU stay and days of MV were similar in both groups. The Multimodal Rehabilitation Index (iMR) ranged from 0.1 to 2.7 (mean = 1.2, SD = 0.7) and had significance for cut-off points ≤ 0.81 and ≤ 0.94 in mortality (p = 0.02) and Ventilator-free days at 28 days (VFDs-28) (p = 0.01). Conclusions: No statistically significant difference was found in favor of the intervention in terms of days of stay in the ICU and days of MV. Explanatorily, it was reported that iMR was related to (VFDs-28) and mortality in patients with severe COVID-19.

The Impact of the Second Wave of COVID-19 on Outcomes in Hip Fracture Patients: An Observational Study

The aim of this work was to measure the healthcare outcomes for patients undergoing surgery for femur fractures during the second wave of the COVID-19 pandemic within a context of orthopaedic surgery units and living with the pandemic and compare them with pre-pandemic outcomes. A retrospective observational study was conducted. The incidence of pressure ulcers and deambulation recovery time were the main outcome. The pre-pandemic group consisted of 108 patients and the second wave pandemic group included 194 patients. The incidence of pressure ulcers increased from 10% in the pre-pandemic period to 21% in the second wave (p = 0.016) and the crude relative risk (RR) was 2.06 (p = 0.023). The recovery of deambulation showed no significant difference in the recovery time in terms of days needed to walk the first time (3 days vs. 2 days; p = 0.44). During the second wave of COVID-19, the risk of pressure ulcers for patients undergoing femur fracture surgery increased significantly. This variation could be explained by the absence of a caregiver for these patients and the increased average complexity of the patients managed in the orthopaedic setting. The hospital management should take into account these aspects when restoring the hospital’s normal surgical activities.

Phenological response to temperature variability and orography in Central Italy

Even if the sensitivity of vegetation phenology to climate change has been accepted on global and continental scales, the correlation between global warming and phenotypic variability shows a modulated answer depending on altitude, latitude, and the local seasonal thermal trend. To connect global patterns of change with local effects, we investigated the impact of the observed signal of warming found in Central Italy on two different willow species, Salix acutifolia and Salix smithiana, growing in three phenological gardens of the International Phenological Gardens’ network (IPG) located in different orographic positions. The time series of temperatures and phenological data for the period 2005–2018 were analysed first to find trends over time in the three gardens and then to correlate the recent local warming and the change in the two species phenology. The results confirmed the correlation between phenological trends and local trend of temperatures. In particular: budburst showed a trend of advancement of 1.4 days/year on average in all three gardens; flowering showed a divergent pattern between the gardens of either advancement of 1.0 days/year on average or delay of 1.1 days/year on average; while senescence showed a delay reaching even 3.3 days/year, although significant in only two gardens for both species. These trends were found to be correlated mainly with the temperatures of the months preceding the occurrence of the phase, with a shift in terms of days of the year (DOY) of the two species. Our conclusion is that the observed warming in Central Italy played a key role in controlling the phenophases occurrences of the two willow species, and that the orographic forcing leads to the different shift in DOY of phenophases (from 5 to 20 days) due to the local thermal forcing of the three phenological gardens.

Does delayed physiotherapy following total knee replacement increase post-operative stiffness? A new angle on knee flexion

Purpose: The NHS continues to adopt ways to safely reduce the length of stay (LOS) following surgery. This audit assesses the impact of the introduction of an innovative pathway for total knee replacement (TKR) allowing early mobilisation and a timely discharge. This followed the success of a similar pathway for unicompartmental knee replacement (UKR) which successfully reduced the LOS with no increase in complications (Jenkins et al., 2019). This new TKR pathway would be compared to previous standard care in terms of day of discharge and post-operative range of movement. In our centre we perform approximately 850 knee replacements a year, so any improvements in LOS would bring significant benefits for patients and the service. We were conscious that increasing our productivity and reducing the LOS would not be at the expense of increased readmission rates or adverse events and these were closely monitored over this period.

Evaluating gladiolus varieties for off-season planting using agro-meteorological indices

Commercial floriculture is an emerging profitable agro industry in the world with great demand of cut flowers but with a constraint to regulate the supply for longer duration in the markets. The off-season plucked flowers get better price, as glut during peak season affects the profits. This could be achieved by cultivating varieties over a wide range of planting times which demands evaluation of varietal performance under different sowing windows. The present study was conducted with five gladiolus varieties viz. Punjab glance, Punjab lemon delight, Novalux, Rose supreme and Alexander the great planted at six sowing dates starting from 5thJuly to 20th September at 15 days interval. All the varieties gave best performance in terms of days to flowering, plant height, spike length, number of florets per spike, vase life and number of corms per corm when planted on 20th September (nearest to normal planting season).The growth of all varieties was affected under early plantings as they produced taller plants with shorter spikes, reduced number of florets per spike and vase life; took more number of days to flower, accumulated more growing degree days (GDD), helio thermal units (HTU) and photothermal units (PTU). All the varieties under early plantings produced spikes of comparable quality that depicts their tolerance to unfavourable temperature and photoperiod. This characteristic could be used in breeding programmes for development of varieties that could efficiently channelize their accumulated heat units for spike production and could be grown in diverse agro climatic zones. The performance of early planted Punjab glance and Punjab lemon delight was at par to their respective normal plantings. Thus, early planting of these varieties will lead to spike production in September and at this time farmers can fetch good price.

THE GENDER PAY GAP IN NON-PROCEDURAL CARDIOLOGY - EVIDENCE FROM A POPULATION-BASED STUDY

<h3>BACKGROUND</h3> The gender pay gap in medicine is well documented. Frequently cited drivers of gender-based billings disparities are women entering lower-remunerated specialties and fewer hours worked. To date, there has not been a population-based analysis of the gender pay gap and gender-based practice differences in a highly remunerated specialty like cardiology in a fee-for-service system (FFS). Our objectives were to assess differences in billings, practice patterns, and patient outcomes between male and female non-procedural cardiologists in a FFS system. <h3>METHODS AND RESULTS</h3> We used linked population-based administrative health databases to conduct a retrospective cohort study of cardiologists practicing in Ontario, Canada between April 2011 and March 2016. All cardiologists submitting outpatient claims during the study period were included, with cardiologists practicing interventional cardiology or electrophysiology being excluded. Outpatients of study cardiologists were identified and followed as a patient cohort. Our primary outcome was overall annual physician billings. We assessed practice patterns by identifying days worked and volumes billed for outpatient visits, inpatient visits, and diagnostic test interpretation. Patient outcomes included healthcare utilization, all-cause mortality, all-cause hospital admission, and emergency department visit or hospitalization for cardiovascular cause. We developed multivariable regression models to estimate the effect of gender on billings and each patient outcome. We identified 394 cardiologists, of whom 20% were women. The patient cohort included 818,122 patients. Unadjusted annual billings were significantly higher among male cardiologists than female ($769,371 vs. $515,997 p < 0.0001). Men billed more annual outpatient visits (1,808 vs. 1,169, p < 0.0001) and outpatient visits per day (11 patients per day vs. 9, p = 0.0004) than women. Male cardiologists billed more days for diagnostic test interpretation than women (for echocardiograms, 172 vs. 146, p = 0.016) though the numbers of echocardiograms billed per day were similar. Billings were significantly associated with outpatient practice size and echocardiogram reading, but not cardiologist gender after adjustment for patient and provider factors. There were no differences by cardiologist gender for patient outcomes after adjustment for cardiologist and patient factors. <h3>CONCLUSION</h3> Our results demonstrate substantial gender-based billings disparity, which may be driven by practice styles in terms of days worked and patients seen per day in outpatient cardiology and diagnostic test interpretation. Our findings contribute to the growing body of evidence on the gender pay gap in medicine, as well as discussion of the equity of FFS remuneration. Further research is needed to understand what drives these differences in practice choices.

Assessment of genetic diversity among the maintainer and restorer inbreds of sunflower (Helianthus annuus L.)

Sunflower (Helianthus annuus L.) is one of the most important oilseed crops grown worldwide because of its supreme oil quality and commercial importance. Assessment of diversity among inbreds is a vital prerequisite to select parents for a hybridization programme. Hence, in the present investigation, the genetic divergence of 29 genotypes consisting of both maintainer and restorer inbreds was studied using Mahalanobis (D2) analysis. Genotypes were grouped into eight clusters, in which cluster I was the largest with 13 genotypes. Clusters IV, VI, VII and VIII were the smallest, with one genotype each. The maximum intracluster distance was observed in cluster I followed by II. Maximum inter cluster distance was recorded between clusters II and V followed by clusters II and VII. Days to 50% flowering had the maximum contribution (32.76%) for genetic divergence. Superior mean performance for head diameter, 100 - seed weight, seed yield per plant and oil content was observed in cluster VI whereas earliness in terms of days to 50% flowering and days to maturity was observed in cluster II. Cluster VIII recorded superior mean performance for volume weight and the lowest mean plant height was observed in cluster VII. Hence, hybridization between cluster II (CMS 10B, HA 89B, RHA-1-1) and cluster V (CMS 519B, HA 430B) could create more variability in the segregating generations. Key words: Sunflower, genetic diversity, inbreds, maintainer, restorer.

Pericardiectomy for Constrictive Tuberculous Pericarditis: A Systematic Review and Meta-analysis on the Etiology, Patients' Characteristics, and the Outcomes.

Tuberculosis (TB) is the most common etiology of constrictive pericarditis in the developing world. In this study, we collected currently available data to evaluate the outcomes following pericardiectomy in patients with constrictive tuberculous pericarditis. We retrieved electrical databases, including PubMed and PubMed Central, from 1985 AD and onwards. We included articles that had more than 80% TB as the etiology and articles with mixed etiologies. Pooled analysis was done in Review Manager (RevMan) version 5.2 (The Nordic Cochrane Centre, Copenhagen). and Stata Statistical Software, Release 16 ( StataCorp LLC, College Station, TX). We compared the mortality in patients after pericardiectomy due to TB with other etiologies. In-hospital mortality versus one-year mortality was analyzed in studies with constrictive pericarditis of mixed etiologies. We also compared pre-operative New York Heart Association (NYHA) grade to post-operative NYHA grade one year after pericardiectomy. We calculated the pooled mean of postoperative hospital stay, postoperative intensive care unit (ICU) stay, and in-hospital mortality.A total of 12 articles and 859 patients were included in the final analysis. Pericardiectomy was performed mostly on middle-aged men with or without previous comorbidity. Total pericardiectomy was the preferred surgical procedure performed on a mean of 93% of patients. The pooled analysis shows a significant decrease in all-cause mortality in patients with TB as compared to other etiologies (pooled risk ratios (RR) 0.34 CI [0.12,1.01] I2 = 61%) and a lower but insignificant in-hospital mortality in comparison to one-year mortality in studies with mixed etiologies (RR 0.59 [0.11,3.11] I2= 61%). There was a significant improvement in the NYHA grade of the patients one year following pericardiectomy (RR 8.04, CI [5.20,12.45], I2= 0%). The mean postoperative hospital stay and the postoperative ICU stay were calculated and reported in terms of days. The mean postoperative hospital stays in studies with more than 80% of TB cases is 13.34 (10.21, 16.47) with a mean standard deviation of 4.46 (2.87, 6.05). The mean postoperative ICU stay is 1.93 (1.47, 2.39), with a mean standard deviation of 3.26 (2.51, 4.00), and the mean in-hospital mortality is 0.07 (0.02, 0.12). Similarly, the mean postoperative hospital stay in studies with mixed etiologies is 19.40 (11.93, 26.87) with a mean standard deviation of 8.26 (4.21, 12.52). The mean postoperative ICU stay is 3.52 (1.93, 5.10) with a mean standard deviation of 2.34 (1.36, 3.32). The mean in-hospital mortality is 0.06 (0.04, 0.08). There is significant heterogeneity along with a number of methodological concerns, and therefore, generalization of the data should be done with caution, and a randomized controlled trial in the future may be beneficial.

Influence of Natural Liquid Organics on Morphology and Growth Attributes of Blackgram (Vigna mungo L.)

Background: Heavy use of chemicals in agriculture has weakened the ecological base and caused the degradation of soil, water resources and quality of the food. The increasing cost and unavailability of fertilizers, growing ecological concern has forced us to try new methods of application of nutrients. Natural farming is the new method introduced as a holistic alternative to the present chemical input based agriculture. There has been increasing interest in the use of panchagavya, beejamrutha, jeevamrutha and other liquid organic formulations during the recent years. Therefore, there is a need to compare the efficiency of natural liquid organics and the regular chemical fertilizers. Hence, the present investigation is taken up with the aim to study the effect of different foliar spray of organics on growth of blackgram. Methods: A field experiment was conducted at the dryland farm, S.V. Agricultural College, Tirupati during Kharif, 2017 to study the effect of foliar sprays of different natural liquid organics on morphological and growth attributes of blackgram. Result: The results indicated that RDF (recommended dose of fertilizers) recorded significantly maximum plant height, leaf area, dry matter, seed yield and other yield attributes over the foliar spray of liquid organics. Results further revealed that significantly lower plant height, dry matter were recorded in the treatment receiving seed treatment with beejamrutha. No significant difference in terms of days to 50% flowering was observed among the treatments. Significantly higher emergence index was recorded in the treatments receiving seed treatment with beejamrutha and water. Integrated use of organics has recorded significantly more number of root nodules compared to other treatments. Jeevamrutha foliar spray recorded to be superior over panchagavya foliar spray which was attributed to the presence of micronutrients in jeevamrutha.

HOUSEHOLDS’ HEALTH EXPENDITURES ON ACUTE GASTROENTERITIS IN MALAYSIA

Acute gastroenteritis (AGE) causes significant health and economic burden on society. The aim of this study is to estimate households’ direct and indirect expenditures on AGE and its predicted factors. This cross-sectional study was conducted between December 2019 and March 2020 using a bilingual proforma distributed using Survey Monkey among individuals with self-reported AGE in all 14 states of Malaysia. The finding revealed the average expenditure for a single episode of AGE was RM395.58 (± SD 798.02). The mean indirect expenditure was higher at RM259.14 (± SD 379.92) vs. direct expenditure of RM136.44 (± SD 596.47). The highest expenditure was seen among those who obtained inpatient care. The multiple linear regression analysis showed that household income (RM0.13; 95% CI: 0.01, 0.27; p=0.043) and type of healthcare facility (private vs government) (RM1842.05; 95% CI: 395.13, 3288.98; p=0.014) had a significant association with households’ total health expenditure on AGE. Acute gastroenteritis incurred substantial costs on all affected households regardless of care-seeking modalities. Interestingly, the main economic burden of AGE was the indirect cost of productivity loss; interpreted in terms of days away from work. In conclusion, AGE instigated an economic burden on both households and employers. The household income and type of facility were found to be significant factors associated with the households’ health expenditures due to AGE. This study recommends food safety awareness among the public and enforcement of safe food handling practices among food vendors and industries.

Short versus long feeding interval for bolus feedings in very preterm infants.

There is presently no certainty about the ideal feeding intervals for preterm infants. Shorter feeding intervals of, for example, two hours, have the theoretical advantage of allowing smaller volumes of milk. This may have the potential to reduce the incidence and severity of gastro-oesophageal reflux. Longer feeding intervals have the theoretical advantage of allowing more gastric emptying between two feeds. This potentially provides periods of rest (and thus less hyperaemia) for an immature digestive tract. To determine the safety of shorter feeding intervals (two hours or shorter) versus longer feeding intervals (three hours or more) and to compare the effects in terms of days taken to regain birth weight and to achieve full feeding. We used the standard search strategy of Cochrane Neonatal to run comprehensive searches in CENTRAL (2020, Issue 6) and Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions, and CINAHL on 25 June 2020. We searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs. We included RCTs and quasi-RCTs comparing short (e.g. one or two hours) versus long (e.g. three or four hours) feeding intervals in preterm infants of any birth weight, all or most of whom were less than 32 weeks' gestation. Infants could be of any postnatal age at trial entry, but eligible infants should not have received feeds before study entry, with the exception of minimal enteral feeding. We included studies of nasogastric or orogastric bolus feeding, breast milk or formula, in which the feeding interval is the intervention. We used standard methodological procedures expected by Cochrane. We used the GRADE approach to assess the certainty of evidence. Our primary outcomes were days taken to achieve full enteral feeding and days to regain birth weight. Our other outcomes were duration of hospital stay, episodes of necrotising enterocolitis (NEC) and growth during hospital stay (weight, length and head circumference). We included four RCTs, involving 417 infants in the review. One study involving 350 infants is awaiting classification. All studies compared two-hourly versus three-hourly feeding interval. The risk of bias of the included studies was generally low, but all studies had high risk of performance bias due to lack of blinding of the intervention. Three studies were included in meta-analysis for the number of days taken to achieve full enteral feeding (351 participants). The mean days to achieve full feeds was between eight and 11 days. There was little or no difference in days taken to achieve full enteral feeding between two-hourly and three-hourly feeding, but this finding was of low certainty (mean difference (MD) ‒0.62, 95% confidence interval (CI) ‒1.60 to 0.36). There was low-certainty evidence that the days taken to regain birth weight may be slightly longer in infants receiving two-hourly feeding than in those receiving three-hourly feeding (MD 1.15, 95% CI 0.11 to 2.20; 3 studies, 350 participants). We are uncertain whether shorter feeding intervals have any effect on any of our secondary outcomes including the duration of hospital stay (MD ‒3.36, 95% CI ‒9.18 to 2.46; 2 studies, 207 participants; very low-certainty evidence) and the risk of NEC (typical risk ratio 1.07, 95% CI 0.54 to 2.11; 4 studies, 417 participants; low-certainty evidence). No study reported growth during hospital stay. The low-certainty evidence we found in this review suggests that there may be no clinically important differences between two- and three-hourly feeding intervals. There is insufficient information about potential feeding complications and in particular NEC. No studies have looked at the effect of other feeding intervals and there is no long-term data on neurodevelopment or growth.

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection.&#x0D; Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate.&#x0D; Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source.&#x0D; Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group.&#x0D; Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

Calibration and validation of InfoCrop model for phenology, LAI, dry matter and yield of wheat

Present experiment was conducted (2015-16 and 2016-17) comprising different levels of water stress and environmental conditions for the model parametrization and validation of Info Crop-wheat v2.1 model. The model was calibrated and validated for popular wheat variety HD-2967 under semi-arid environmental conditions. The important genetic coefficients were generated and model fine-tuned for simulating phenology, leaf area index (LAI), dry matter and yield of wheat crop. The result showed that the model simulated the phenology in terms of days to 50% anthesis and days to physiological maturity very accurately with root mean squared error of 2.26 and 1.36 days, respectively. The model could also able to simulate temporal course of LAI and biomass very satisfactorily. The errors in simulating final biomass and yield were also within the acceptable limit of 10%. We conclude that InfoCrop model is reasonably suitable to simulate the developmental stages, leaf area expansion, dry matter and yield of wheat crop in semi-arid environment hence it can be utilized for undertaking various crop management applications.

Characterization of Oilseed Crop Noug (Guizotia abyssinica) Using Agro-Morphological Traits

Noug (Guizotia abyssinica) is an outcrossing oilseed crop that serves as a source of edible oil and other nutrients although its seed yield is generally low. The analysis of agro-morphological traits in relation to seed and oil yields is important for improving the productivity of this crop. The present study aimed at assessing the variation and heritability of quantitative (10) and qualitative (6) traits in noug based on 60 landrace accessions collected from wide geographic area in Ethiopia. The field trial was conducted at two sites in Ethiopia using a square lattice design. The analysis of variance revealed significant variation (p &lt; 0.05) among these accessions. The highest broad-sense heritability (H2) was recorded for days to 10% flowering (DTF10; 85.4%), whereas number of capitula per plant (NCPP) and number of seeds per capitulum (NSPC) showed medium heritability (H2 = 38.5% and 31.6%, respectively). NCPP and NSPC showed a highly significant (p &lt; 0.01) positive and negative genotypic correlation with days to flowering, respectively. These three traits showed very low genotypic coefficient of variation (&lt;1%). In the case of qualitative traits, small capitulum, large flower, green leaf, green stem and course leaf margin showed significant association with higher number of seeds per plant (NSPP). Euclidean distance-based cluster analysis revealed that the clustering pattern of the accessions poorly correlates with the geographic distance between sample collecting sites. Similarly, no clear clustering pattern of accessions was revealed by principal component analysis (PCA) that explained 66.3% and 53.6% of the total variation of quantitative traits and qualitative traits, respectively. The oil content of these accessions was previously investigated and accessions with high oil content show large differences in terms of days to flowering, NSPP and thousand seed weight (TSW). Among the accessions included in this research, Hr_B21; Gj_C17, Sh_I4 and Gr_F15 Gj_G18 and Tg-R13 are top ranking, as they have at least one the following highly desirable traits: early maturity, high oil content, NSPP and TSW. Hence, crossbreeding of their selected genotypes would lead to the development of new cultivars that combine early maturity and both high seed and oil yields.

Dexamethasone Pharmacokinetics Following Standard and Short Dosing Schedules in Patients on the UKALL2011 Trial

Dexamethasone (Dex) is a key component of ALL therapy, with glucocorticoid sensitivity strongly linked to prognosis. However, it also contributes to both short and long term toxicities. The UKALL 2011 trial (ISRCTN64515327) investigated a shorter schedule of Dex as part of randomisation 1 (R1) (10mg/m2 x 14 days vs 6mg/m2 x 28 days), in an attempt to bring about a more rapid cytoreduction whilst limiting toxicities associated with long term steroid exposure. There are limited data regarding Dex pharmacokinetics, however large variability has been reported in children being treated for ALL (Yang et al. 2008).To investigate Dex pharmacokinetics in the context of the UKALL2011 randomised dex dosing and scheduling, blood samples were collected up to 8h post oral administration of Dex on one of the first three days, and one of the last three days of induction chemotherapy. Plasma Dex levels were analysed using a fully validated tandem reverse phase LC-MS method, and non-compartmental pharmacokinetic analysis was performed using Pheonix WinNonlin.Pharmacokinetic parameters from day one sampling are shown in the table below. Exposure, as defined by AUC0-12h, and Cmax were significantly higher on the short arm (n=72) compared to the standard arm (n=53) (p=<0.0001 for both). However, there was substantial overlap between the two arms, with a number of patients on the standard arm exhibiting higher exposures than those on short therapy, despite having a longer duration of treatment, and vice versa. This variation is displayed in the greater than 20-fold variation in AUC0-12h values observed on the two arms (short: 69.1-1,606; standard: 38.3-1,009 hr*ng/mL). When AUC values were extrapolated to the duration of Dex therapy on short and standard arms, patients on the standard arm had a significantly larger overall exposure compared to those on the short arm (short: 16,318 (14,177-19,568) vs. standard: 22,570 (18,012-25,550) hr*ng/mL, median (95% CI) p=0.01).Early response data would indicate a trend towards a higher Dex exposure (AUC) in patients with a day 8 bone marrow blast count <5% versus those patients with a day 8 blast count >5 % (595.3 (458.5-843.7) vs 441.7 (387.5-552.1) hr*ng/mL, median (95% CI) p=0.0006). However, there was no statistical difference between the two randomisation arms in terms of day 8 blast count (p=0.2). Pharmacokinetic profiles also differed between the two days of treatment, with AUC0-12h being significantly higher at the end of induction chemotherapy (n=52, study day 1: 562.5 (435.7-756.5); study day 2:794.5 (648.7-1041) hr*ng/mL, (median (95% CI) p=0.0003).The UKALL 2011 R1 found no statistical difference in terms of steroid related toxicity or MRD response between short and standard Dex dosing. The data generated from patients recruited to the pharmacology sub-study shows considerable variation in Dex pharmacokinetics and suggest that pharmacokinetic variability may be a more important factor than variation in dosing regimen on the two arms of the randomisation. Furthermore, a significantly higher cumulative exposure of patients on the standard arm suggests that in a drug treatment with markedly variable pharmacokinetics, duration of therapy may be more important in terms of the likely impact on clinical response and toxicity. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Effects of Home-Based Physical Exercise on Days at Home, Health Care Utilization, and Functional Independence Among Patients With Hip Fractures: A Randomized Controlled Trial

ObjectiveTo evaluate the effects of a physical exercise program on days lived at home, the use and costs of health care and social services, mortality, and functional independence among patients with hip fractures. DesignRandomized controlled trial with a parallel 2-group design consisting of a 12-month intervention and 12-month registry follow-up. SettingHome-based intervention. ParticipantsPatients aged ≥60 years (N=121) with operated hip fracture and who were living at home were randomized into physical exercise (n=61) and usual care (n=60) groups. InterventionsSupervised physical exercise twice a week. Main Outcome MeasuresThe primary outcome was the number of days lived at home over 24 months. Secondary outcomes were the use and costs of health care and social services, mortality over 24 months, and Functional Independence Measure (FIM) over 12 months. ResultsOver 24 months, there was no significant difference between the groups in terms of days lived at home (incidence rate ratio, 1.01; 95% confidence interval [CI], 0.90-1.14) or mortality (hazard ratio, 1.01; 95% CI, 0.42-2.43). The mean total costs of health care and social services did not differ between the groups. The costs per person-year were 1.26-fold (95% CI, 0.87-1.86) greater in the physical exercise group than in the usual care group over 12 months and 1.08-fold (95% CI, 0.77-1.70) over 24 months. The mean difference between the change in FIM of the groups over 12 months was 4.5 points (95% CI, 0.5-8.5; P=.029) in favor of the physical exercise group. ConclusionsLong-term home-based physical exercise had no effect on the number of days lived at home over 24 months among patients with hip fractures. The intervention was cost neutral over these 24 months. The FIM scores improved in both groups over 12 months, but the improvement was significantly greater in the physical exercise group than in the usual care group.