Artigos de revistas sobre o tema "Ri ben shi"

ABSTRACTThis paper assembles three oracle-bone inscriptions divined at the same time from the Wu Yi-Wen Ding period. Two are identical, being a paired divination inquiring into whether the event ri yue you shi was or was not auspicious. The third asks whether, in light of this ri yue you shi, it would be auspicious to sacrifice to Shang Jia.Since 1925, when Wang Xiang , first proposed th at the character yue should be read as xi, his position has been accepted by Liu Chaoyang De Xiaoqian , Chen Mengijia , Zhang Peiyü , Xu Zhentao , the Zhongguo Tianwenxue jianshi bianxiezu , and the Zhongguo Tianwenxueshi zhengli yenjiu xiaozu Yue was first interpreted as yue in 1933 by Shang Chengzuo . Those subscribing to this reading include Dong Zuobin , Chen Zungui , Yü Xingwu Liu Chaoyang, Chen Mengiia, Joseph Needham, Zhao Quemin and Chen Banghuai .Among these scholars Liu Chaoyang holds that “there is no distinction between xi and yue,” while Chen Mengjia believes that the phrase “ri yue you shi” can also be read “ri xi you shi,” hence they accept both interpretations.

In questo saggio si metteranno in mostra, attraverso una prospettiva mediologica e intersemiotica, i meccanismi testuali, intertestuali e performativi con cui il gruppo teatrale-musicale italiano Oblivion ha ri-mediato la prima cantica della Commedia dantesca in un prodotto audiovisivo e performativo ibrido – un mini-musical dal titolo L’Inferno in sei minuti –, che affonda le radici in più immaginari, da quello letterario fino al paesaggio intermediale alimentato dalla popular music italiana. Tale occasione permette anche di riflettere – più in generale – sulle modalità con cui un’opera letteraria ben impressa nell’immaginario nazionale può essere ri-mediata nel contesto postmediale, consentendo nello stesso tempo una riflessione sugli approcci mainstream alla conoscenza di Dante, la quale risulta fortemente vincolata al canone scolastico, come si può notare analizzando i prodotti realizzati dagli Oblivion legati alle opere letterarie.

(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20–24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.

Abstract Fc gamma RIII (CD16) is a hetero-oligomeric receptor composed of a ligand-binding alpha subunit associated with homo- or heterodimers of the TCR zeta- and Fc epsilon RI gamma-chains. We have previously demonstrated that CD16 ligation promotes complex formation between tyrosine-phosphorylated shc and Grb2, leading to activation of ras signaling pathway in human NK cells. Here we report that CD16 engagement induces rapid shc association with the tyrosine-phosphorylated receptor complex in human NK cells. In vitro binding studies demonstrate that this interaction is mediated by the shc-SH2 domain, and immunodepletion experiments indicate that the zeta- but not the gamma-chain has the capability to mediate this association. Jurkat cell clones expressing CD16-zeta or -gamma homodimers have been used to gain more information about the mechanism of shc/CD16 association. Our data show that, while engagement of both receptors induces tyrosine phosphorylation of shc and Grb2 recruitment, shc-SH2/receptor complex association is evident only in CD16-zeta but not in CD16-gamma transfectants. Overall, our data demonstrate that the adaptor protein shc can be recruited to the activated CD16 complex by interaction with tyrosine-phosphorylated zeta-chain in a SH2-dependent manner. These results also provide further support to the notion that zeta- and gamma-chains might couple to different biochemical pathways.

The human Fc gamma RI (CD64) is a high affinity receptor for the Fc portion of immunoglobulin (Ig), and its constitutively low expression on the cell surface of monocyte/macrophage and neutrophils is selectively upregulated by interferon gamma (IFN-gamma) treatment (Perussia, B., E. T. Dayton, R. Lazarus, V. Fanning, and G. Trinchieri. 1983. J. Exp. Med. 158:1092). Three distinct cDNAs have been cloned and code for proteins that predict three extracellular Ig-like domains (Allen, J.M., and B. Seed. 1989. Science [Wash. DC]. 243:378). Several differences in the coding region of these cDNAs suggest that in addition to polymorphic differences a second Fc gamma RI gene could possibly exist. This alternative Fc gamma RI gene (Fc gamma RIb) was defined by the lack of a genomic HindIII restriction site (van der Winkel, J. G. J., L. U. Ernst, C. L. Anderson, and I. M. Chiu. 1991. J. Biol. Chem. 266:13449). We describe the characterization a second gene (Fc gamma RIb) that has a termination codon in the third extracellular domain and therefore predicts a soluble form of a termination codon in the third extracellular domain and therefore predicts a soluble form of the receptor. We also define two distinct IFN-gamma-responsive regions in the 5' flanking sequence of Fc gamma RIb that resemble motifs that have been defined in the class II major histocompatibility complex promoter. The Fc gamma RIb promoter does not possess canonical TATA or CCAAT boxes, but does possess a palindromic motif that closely resembles the initiator sequence identified in the terminal deoxynucleotidyl transferase/human leukocyte IFN/adeno-associated virus type II P5 gene promoters (Smale, S. T., and D. Baltimore. 1989. Cell. 57:103; Seto, E., Y. Shi, and T. Shenk. 1991. Nature [Lond.]. 354:241; Roy, A. L., M. Meisterernst, P. Pognonec, and R. C. Roeder. 1991. Nature [Lond.]. 354:245) virus type II P5 gene promoters raising interesting questions as to its role in the basal and myeloid-specific transcription of this gene.

The flow an heat transfer on the unstea y laminar mixe convection boun ary layer in a micropolar flui past a vertical we ge have been stu ie taking into account the effect of magnetic fiel . We assume that the free stream velocity an surface temperature oscillate in magnitu e but not in the irection of the oncoming flow velocity. The governing equations have been solve numerically by using the straight forwar finite ifference metho . The amplitu es of skin friction an couple stress are foun to be significantly epen ent on the Richar son’s number, Ri, the magnetic parameter, M, an the vortex viscosity parameter, K. We observe that the amplitu es of skin friction an couple stress increases owing to an increase of the Richar son’s number, Ri, while these become lower for the higher value of the magnetic parameter, M, an the vortex viscosity parameter, K. Also the results emonstrate that the effects of the parameters on the amplitu es of heat transfer are rather weak. Dhaka Univ. J. Sci. 64(1): 65-70, 2016 (January)

Under the STORMTOOLS initiative, maps of the impact of sea level rise (SLR) (0 to 12 ft), nuisance flooding (1–10 yr), 25, 50, and 100 yr storms, and hindcasts of the four top ranked tropical storms have been developed for the coastal waters of Rhode Island (RI). Estimates of the design elevations, expressed in terms of the Base Flood Elevation (BFE) and thus incorporating surge and associated wave conditions, have also been developed, including the effects of SLR to facilitate structural design. Finally, Coastal Environmental Risk Index (CERI) maps have been developed to estimate the risk to individual structures and infrastructure. CERI employs the BFE maps in concert with damage curves for residential and commercial structures to make estimates of damage to individual structures. All maps are available via an ArcGIS Hub. The objective of this senior design capstone project was to develop STORMTOOLS Design Load maps (SDL) with a goal of estimating the hydrostatic, hydrodynamic, wave, and debris loading, based on ASCE/SEI 7–16 Minimum Design Standards methods, on residential structures in the RI coastal floodplain. The resulting maps display the unitized loads and thus can be scaled for any structure of interest. The goal of the maps is to provide environmental loads that support the design of structures, and reduce the time and cost required in performing the design and the permitting process, while also improving the accuracy and consistency of the designs. SDL maps were generated for all loads, including the effects of SLR for a test case: the Watch Hill/Misquamicut Beach, Westerly, along the southern RI coast. The Autodesk Professional Robot Structural Analysis software, along with SDL loading, was used to evaluate the designs for selected on-grade and pile-elevated residential structures. Damage curves were generated for each and shown to be consistent with the US Army Corps of Engineers empirical damage curves currently used in CERI.

This paper concerns the unsteady mixed convection laminar boundary layer flow past a vertical wedge in the presence of thermal radiation. The governing equations have been solved by the straightforward finite difference method for the entire frequency range. We observe that the Richardson’s number, Ri, strongly affects the skin friction, heat transfer and mass transfer. The effect of the Schmidt number, Sc, on the mass transfer is significant, whereas the skin friction and the heat transfer are almost unaffected by it. Also the heat transfer is considerably dependent on the conduction-radiation parameter, Rd, but the influence of this parameter on the skin friction and the mass transfer is rather weak.Dhaka Univ. J. Sci. 64(1): 59-64, 2016 (January)

The central star of Sh2–71 was observed with the lm telescope using UBV(RI)c photometric system at Konkoly Observatory in the seasons of 1990–92. A period of 68d.06 was found with variable amplitude and/or lightcurve shape. The amplitude is high, close to 1 magnitude. On the basis of old photographic observations (Kohoutek 1979) this period has not changed during the century. No significant colour variation was detected, but the nebular contamination should distort the colour curves. According to the five colour data the central object is a highly reddened B5 dwarf about 1700 pc distant. The nebular properties, however, indicate an evolved, higher mass, lower luminosity exciting source, therefore it is plausible to regard the central object as a binary. The light variation might be caused by obscuration of the B star by outflowing matter from the true nucleus. Bipolar outflow of 3″ dimension has been detected on high dispersion Hα spectra of the central star (Sabbadin et al. 1985; Cuesta et al. 1990). Further spectroscopic observations are highly needed in order to find the exact description of the system.

Background Renal impairment (RI) is one of the cardinal features of newly diagnosed multiple myeloma (NDMM), contributing to dismal outcomes and high risk of early death. Improved renal function is associated with prolonged survival for NDMM. The triplet combination of pomalidomide with bortezomib and dexamethasone (PVD) has been proven to be effective in MM patients with RI [1] (The manuscript in preparation). However, the best renal overall response rate (ORR) was 78.8% and 21.2% of patients had no renal response to PVD. Here we reported an interim analysis to evaluate the renal and hematologic response of SPVD (Selinexor, pomalidomide, bortezomib, dexamethasone) regimen as first-line therapy in NDMM with RI in this prospective, open-label, multicenter, phase 2 study (ChiCTR2200064695). Methods Eligible NDMM with RI (defined as estimated glomerular filtration rate (eGFR) by MDRD < 40ml/min) were enrolled in the study. Sample size was designed to recruit 62 patients. RI caused by other reasons than tubular nephropathy was excluded. Patients received SPVD (Selinexor 40mg on days 1,8,15, pomalidomide 4mg on days1-14, bortezomib 1.3mg/m2 on days 1,4,8,11, and dexamethasone 20mg on day of and after bortezomib, 21days/cycle) for a maximum of 9 cycles. Autologous stem cell transplantation (ASCT) was administrated after 3 to 6 SPVD cycles for transplant-eligible patients. The primary endpoint was renal ORR at 3 months. Secondary endpoints included major renal response (≥partial response) at 3 months, hematological ORR, minimal residual disease (MRD), progression-free survival (PFS), overall survival (OS), and safety. The definition of both hematological response and renal response was according to the International Myeloma Working Group (IMWG) criteria. Results Between Oct 28, 2022 and Jun 23, 2023, 31 patients were enrolled across 17 centers, with a median age of 61 years (range: 45-80). The proportion of R-ISS III was 35.5%. Median serum creatine level and eGFR were 365μmol/L [interquartile range (IQR): 214.5-508] and 14.5 mL/min (IQR: 10.5-22.64), respectively. There were 10/31 (32.3%) patients requiring dialysis at diagnosis and 8 patients with high-risk cytogenetic abnormalities [t(4;14), t(14;16), or del(17p)]. At the data cut-off date of July 11, 2023, the median number of SPVD treatment cycles was 3 (range: 1-8). The median follow-up time was 4 months. Two patients received first-line ASCT after induction therapy. The primary endpoint of renal ORR at 3 months was 74.2%, including 6.5% renal PR, and 25.8% renal CR (Table 1). The ORR of the best hematological response was 70.9% (45.1% ≥VGPR, 16.1% CR)(Table 1). The most common treatment emergent adverse events (TEAEs) (incidence >10%) were infection (45.2%), myelosuppression (45.2%), hepatic impairment (12.9%), nausea (12.9%), and hypokalemia (12.9%) (Table 2). Grade 3 or more hematologic toxicity was seen in 35.5% of the patients, the most common being thrombocytopenia (19.4%)(Table 2). Dose reduction or interruption of pomalidomide occurred in 5 patients due to myelosuppression and infection events. Three patients had dose reduction of selinexor due to nausea or vomiting. Notably, among non-hematologic toxicities, 4 patients developed hepatic impairment, and of those, one patient suffered tumor lysis syndrom, hepatic failure and severe infection and then died. Median PFS and OS were not reached. Conclusion This study demonstrated SPVD is an effective combination in NDMM patients with RI. The toxicity profile was consistent with the reported research, but hepatic impairment during treatment should be noted with caution. Reference [1] JIAN Y, CHANG L, SHI M, et al. Renal Response of Pomalidomide with Bortezomib and Dexamethasone in Newly Diagnosed Multiple Myeloma Patients with Renal Impairment: A Prospective, Open-Label, Multicenter, Phase 2 Study [J]. Blood, 2022, 140(Supplement 1): 10167-9. doi:10.1182/blood-2022-159361.

The present numerical study has been accomplished remembering the true objective to explore the low Reynolds number flow with heat exchange behaviors inside a double lid driven square shaped cavity loaded with fluids such as air and water. Specifically, this work explores laminar, steady, incompressible mixed convection flow inside the cavity which has been done numerically by applying Finite Difference Method (FDM). In this analysis, top wall is treated as the heated wall and remaining walls are considered as cold walls. In addition, vertical side walls are moving at a relentless speed in its own particular plane along with the positive direction. Moreover, the numerical simulation is being conveyed out to observe the behavior of flow and thermal fields for variation of low Reynolds Number (Re), Richardson number (Ri) and Prandtl number(Pr). Also, the results have been validated through a comparison with other research works and a good agreement is observed. Also, results show that the above mentioned dimensionless parameters have significant effects on the flow and heat exchange attributes. Moreover, the effects of these parameters on average Nusselt number (Nu) have been analyzed and presented. Dhaka Univ. J. Sci. 66(2): 95-101, 2018 (July)

Heavy metal contents in road dust have been an important indicator of heavy metal pollution arising from traffic-related activities. In this study, 108 road dust samples were collected from four locations of Hong Kong, namely Kwai Hing (industrial area), Sau Mau Ping (residential area), Sai Kung and Tai Lam (rural area), over a one-year period and analysed for zinc (Zn), nickel (Ni), copper (Cu), lead (Pb), chromium (Cr), cadmium (Cd), and arsenic (As). The geo-accumulation indices (Igeo) and contamination factors indicated zinc, copper, chromium, to a lesser extent, nickel, and cadmium pollution of road dust in industrial and residential areas. The potential ecological risks of Cu were found to be particularly high in both areas. Residential and industrial areas are prone to considerable and very high risks, respectively, based on the risk indices (RI). The sources of heavy metals may vary slightly between the areas based on Pearson's correlation analysis. It was found that the metal contents in the road dust samples vary differently between the dry and wet seasons. The concentrations of Zn were higher in the dry season while those of Cu, Cr and Ni were generally higher in the wet season.

Background:The relationship between the pathological findings and disease relapse has not been well established.Objectives:We aim to investigate the clinical and pathological manifestations in relation with disease relapse in IgG4-RD, as well as identify prognostic factors in predicting relapsed disease.Methods:This study enrolled 71 patients newly diagnosed with IgG4-RD between Jan 2011 and April 2020, all of whom had received pathological examinations. Their pathological manifestations and clinical data were collected. Multivariate Cox regression and AUC (area under curve) were used to identify predictors for relapsed disease and assess the predictive value of these predictors, respectively.Results:During a follow-up period of 26 (range, 6-123) months, 4.2% (3/71) patients died. The remaining 68 patients were all treated with glucocorticoids with or without immunosuppressor continuously. By the end of follow-up, 47 (69.1%) patients sustained clinical remission, and 21 (30.9%) patients suffered relapsed disease with a median relapse time at 10 (6-30) months. We found that IgG4 ≥ 6.5g/L (OR 1.52-11.06), IgG ≥ 20.8g/L (OR 1.11-7.23), IgG4-RD responder index (RI) ≥ 9 (OR 1.28-11.37), and more IgG4+ plasma cell infiltration (≥ 60 / HPF in visceral organs, or ≥ 200 / HPF in head and neck organs) (OR 1.79-22.41) were all independent predictive factors for disease relapse. A prognostic score was explored for predicting recurrence in IgG4-RD, including three predictive factors (IgG ≥ 20.8g/L, IgG4-RD RI ≥9, and more IgG4+ plasma cell infiltration). The three-year relapse rate for the patients with no, one, two, and three risk factors were 0%, 27.3%, 66.7%, and 100%, respectively.Conclusion:Patients’ earlier IgG4 ≥ 6.5g/L, IgG ≥ 20.8g/L, IgG4-RD RI ≥9, and more IgG4+ plasma cell infiltration independently predicted disease relapse. We explored a prognostic score for predicting recurrence in IgG4-RD include three predictive factors (IgG ≥ 20.8g/L, IgG4-RD RI ≥9, and more IgG4+ plasma cell infiltration), which might be used to evaluate the risk of recurrence in IgG4-RD.References:[1]DESHPANDE V, ZEN Y, CHAN J K, et al. Consensus statement on the pathology of IgG4-related disease[J]. Mod Pathol,2012,25(9): 1181-1192.[2]JENNETTE J C, FALK R J, BACON P A, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides[J]. Arthritis Rheum,2013,65(1): 1-11.[3]OKAZAKI K, UMEHARA H. Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan[J]. Int J Rheumatol,2012,2012: 357071.[4]SHIMOSEGAWA T, CHARI S T, FRULLONI L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology[J]. Pancreas,2011,40(3): 352-358.[5]OHARA H, OKAZAKI K, TSUBOUCHI H, et al. Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012[J]. J Hepatobiliary Pancreat Sci,2012,19(5): 536-542.[6]KAWANO M, SAEKI T, NAKASHIMA H, et al. Proposal for diagnostic criteria for IgG4-related kidney disease[J]. Clin Exp Nephrol,2011,15(5): 615-626.[7]GOTO H, TAKAHIRA M, AZUMI A. Diagnostic criteria for IgG4-related ophthalmic disease[J]. Jpn J Ophthalmol,2015,59(1): 1-7.[8]MATSUI S, YAMAMOTO H, MINAMOTO S, et al. Proposed diagnostic criteria for IgG4-related respiratory disease[J]. Respir Investig,2016,54(2): 130-132.[9]WEN ZHANG J H S. Management of IgG4-related disease[J]. Lancet Rheumatol,2019,1: e55-e65.[10]EBBO M, DANIEL L, PAVIC M, et al. IgG4-related systemic disease: features and treatment response in a French cohort: results of a multicenter registry[J]. Medicine (Baltimore),2012,91(1): 49-56.Disclosure of Interests:None declared

Understanding how reef-associated sharks use coastal waters through their ontogeny is important for their effective conservation and management. This study used the horizontal movements of acoustically tagged Caribbean reef sharks (Carcharhinus perezi) to examine their use of coastal space around the Cayman Islands between 2009 and 2019. A total of 39 (59.1%) tagged sharks (male = 22, female = 17, immature = 18, mature = 21) were detected on the islands wide network of acoustic receivers. The detection data were used to calculate values of Residency Index (RI), Site-Fidelity Index (SFI) and minimum linear displacement (MLD), as well as for network analysis of individual shark movements to test for differences between demographics, seasons, and diel periods. Sharks were detected for up to 1,598 days post-tagging and some individuals showed resident behaviour but the majority of tagged individuals appear to have been one-off or only occasional transient visitors to the area. Generally, individuals showed strong site-fidelity to different areas displaying linear home ranges of < 20 km. The evidence indicates that there was no pattern of diel behaviour. Tagged sharks generally showed increased movements within and between islands during the summer (April–September), which may be related to breeding activity. Some individuals even made occasional excursions across 110 km of open water > 2,000 m deep between Grand Cayman and Little Cayman. One mature female shark showed a displacement of 148.21 km, the greatest distance reported for this species. The data shows that the distances over which some sharks moved, greatly exceeded the extent of any one of the islands’ marine protected areas indicating that this species may be more mobile and dispersive than previously thought. This study provides support for the blanket protection to all sharks throughout Cayman waters, which was incorporated within the National Conservation Act in 2015.

In the eastern United States, Monilinia laxa (Aderh. & Ruhl.) Honey has only been reported on tart cherry in New York (NY) (1). As a result of considerable rain in May of 2009 and 2011, an ornamental planting of Kwanzan cherries in Middletown, Rhode Island (RI), a planting of sweet cherry cvs. Ulster, Hedelfingen, Sam, and Lapins in Lanesboro, Massachusetts (MA), and plantings of apricot cvs. Harcot and Hargrande in Albion, Aurora, and Geneva, NY, and Harogem in Lanesboro, MA developed severe shoot blight (>15 to 100% of first-year shoots). Blighted shoots were wilted with the blight encompassing the distal end and often extending into second-year tissue with a distinct sunken margin. Leaves on symptomatic shoots had flushed, but were blighted and light brown. Blossom spurs were often blighted and gummosis was frequently observed at the base. In these same years, sweet cherry cv. Black Gold in Walworth, NY and plum cv. Stanley in Olcott, NY developed severe fruit rot (35 to 70% incidence). Plantings suffering from fruit rot had fruit lesions that began as pale brown, soft lesions with indiscriminant margins that covered 15 to 85% of the fruit surface area. Many blighted spurs, shoot tissues, and infected fruit were sporulating with tan-to-buff colored conidia produced in chains. From each planting with shoot blight, shoot tips were removed for pathogen isolation. Sections of symptomatic shoots (5 cm long) were surface sterilized in 0.6% NaOCl for 1 min and rinsed in sterile dH20. From plantings displaying blighted spurs or fruit rot, isolation was attempted directly from sporulating tissue. Cross sections of sterilized shoot tissue (3 mm thick) or tufts of sporulation from fruit and spurs were placed on potato dextrose agar amended with 50 μg/ml of streptomycin sulfate. After incubation at 24°C for 5 days, colonies with lobed margins, commonly described for M. laxa (4), were obtained. Several colonies resembling M. fructicola were isolated from all locations, but the majority of isolates from spurs and shoots resembled M. laxa. Conidia from both colony morphotypes were lemon shaped, but as expected, those from putative M. laxa isolates were smaller (10.75 × 12.0 μm) compared with those from putative M. fructicola isolates (15.75 × 18.25 μm) (4). Confirmation of M. laxa was further achieved by PCR amplification of the β-tubulin gene using M. laxa-specific primers as previously described (3). Pathogenicity of M. laxa isolates was proven by inoculating fruit of the stone fruit crop from which they were isolated as previously described (2). Fruit inoculated with M. laxa developed brown, soft sporulating lesions identical to the original observations, while those inoculated with water remained healthy. M. laxa was reisolated from symptomatic shoots and spurs, but not from water-inoculated tissues. The presence of M. laxa has been reported on tart cherries in NY (1), but to our knowledge, this is the first instance of economically devastating shoot blight on apricot in NY and MA, ornamental cherry in RI, and sweet cherry in MA and fruit rot on sweet cherry and plum in NY caused by M. laxa. In wet seasons, stone fruit growers may need to revise their chemical management programs to better prepare for M. laxa epidemics on several stone fruit species. References: (1) K. D. Cox and S. M. Villani. Plant Dis. 94:783, 2010. (2) K. D. Cox and S. M. Villani. Plant Dis. 95:828, 2011. (3) Z. Ma et al. Pest Manag. Sci. 61:449, 2005. J.M. (4) G. C. M. van Leeuwen and H. A. van Kesteren. Can. J. Bot. 76:2042, 1998.

Nghiên cứu này nhằm đánh giá ảnh hưởng của việc bổ sung cao chiết củ nén (CPN) vào trong nước uống đối với đáp ứng miễn dịch dịch thể chống lại virus Newcastle và năng suất sinh trưởng của gà thịt. Tổng số 180 gà trống Ri lai được úm cùng nhau đến 7 ngày tuổi. Sau khi được chủng vaccine Newcastle vào ngày 7, gà được phân bố ngẫu nhiên vào 04 nghiệm thức với 03 lần lặp lại. Gà ở các nghiệm thức T1, T2 và T3 được bổ sung 0,3, 0,5 và 0,7% CPN vào nước uống, liên tục từ ngày 7 đến ngày 42 tuổi và nghiệm thức đối chứng (ĐC - không sử dụng CPN). Vaccine Newcastle được tiêm lặp lại vào ngày 28. Hiệu giá kháng thể (GMT) trong huyết thanh chống lại bệnh Newcastle được xác định bằng cách sử dụng xét nghiệm ngăn trở ngưng kết hồng cầu (HI) lúc 21, 35 và 42 ngày tuổi. Kết quả cho thấy lượng ăn vào, tăng trọng, hệ số chuyển hóa thức ăn (FCR) và tỉ lệ chết khi kết thúc thí nghiệm không sai khác giữa 04 nghiệm thức. Tuy nhiên, hiệu giá kháng thể và tỷ lệ khối lượng cơ quan của hệ miễn dịch so với khối lượng cơ thể cao hơn (P<0,05) ở T2 và T3 so với đối chứng. Như vậy, việc bổ sung CPN trong nước uống không ảnh hưởng đến sinh trưởng; tuy nhiên, bổ sung CPN ở mức 0,5% và 0,7% đã làm tăng hiệu giá kháng thể dịch thể chống lại virus Newcastle ở gà thịt. ABSTRACT This study was conducted to investigate the effect of various levels of fresh chive’s bulb (Allium schoenoprasum) supplementation (CBE) in drinking water on immune status against Newcastle disease (ND) virus and productive performance of broiler chicken. A total of 180 Ri roosters were brooded at the same bath until 7 days of age. After chickens had been vaccinated the Newcastle on day 7, they were randomly allocated into four treatments with 03 replicates as namely Control (no CBE), and T1, T2 and T3. While a control group received no CBE, birds in groups T1, T2 and T3 received 0,3, 0,5 and 0,7 (w/v) CBE, respectively, continuously from day 7 to 42 years old. Newcastle vaccine was repeated on day 28. The geometric mean titer (GMT) against Newcastle disease virus was determined using the haemagglutination inhibition (HI) assay at 21, 35 and 42 days of age. The results showed that at the end of the experiment, the feed intake, average daily gain, feed conversion ratio (FCR) and overall mortality rate did not significantly differ among 04 treatments. Whereas, in general the antibody titer and the ratio of organ mass of the immune system to the body weight were significantly higher (P <0,05) in T2 and T3 than in the Control. Therefore, the supplementation of CBE in drinking water did not affect the growth performance. However, the supplement of 0,5% and 0,7% increased the antibody titre against Newcastle virus in broiler chicken.

Rose balsam (Impatiens balsamina L.) is an ornamental species frequently cultivated in China and the red flower is often used as nail polish in rural regions. The phytoplasmas previously reported with rose balsam phyllody in China have been classified as aster yellows group (16SrI) (1). In August 2012, some rose balsams were observed with typical phytoplasma symptoms in Handan City, Hebei Province, China, with an incidence of about 70% in the fields. The flowers turned green and petals fascicled. The new leaves wrinkled and deformed and internodes shortened. Infected plants were stunted, matured prematurely, and failed to produce seeds. To confirm phytoplasma infection, 100 mg of plant tissue (leaves, petals) was collected from five symptomatic and four asymptomatic plants and total DNA was extracted using a modified cetyltrimethylammonium bromide (CTAB) method (2). The 16S rDNA gene was amplified by nested PCR using primer pair P1/P7 followed by R16F2n/R16R2 (3). No amplicons were generated with DNA from asymptomatic samples, but amplicons of approximately 1.2 kb were obtained with DNA from five symptomatic samples. The amplified products were purified with aTIANgel midi purification kit (Tiangen, Beijing) and sequenced at the Sangon Biotech facility (Shanghai, China). The sequences of the amplicons were 100% identical and deposited in NCBI GenBank (Accession No. KC993832). The 16S rDNA gene sequence from this phytoplasma was 99% similar to Jujube witches broom phytoplasma (JQ675716), Puna chicory flat stem phytoplasma (JN582266), Plum yellows phytoplasma (FJ459914), and other elm yellows group phytoplasmas by BLAST search of the NCBI database. Restriction fragment length polymorphism (RFLP) analyses were carried out by digesting the 1.2-kb R16F2n/R16R2 nested PCR product with restriction enzymes AluI, RsaI, HhaI, HpaI, Eco RI, TaqI, HaeIII, HinfI, and KpnI (Takara, Dalian). The 16S rDNA RFLP patterns matched that of Jujube witches broom phytoplasma (JWB, subgroup 16SrV-B) (4). Nucleotide sequences of rose balsam phyllody were analyzed by iPhyClassifier software, which revealed that it had maximum similarity to the reference pattern of 16Sr group V, subgroup B (AB052876). All samples were detected with transmission electron microscopy. The results showed phytoplasma-like cells in phloem sieve element of symptomatic plants, while no phytoplasma-like cells were observed in healthy phloem tissues. The phytoplasma cells ranged from 230 to 470 nm in diameter and were ellipsoidal or orbicular with visible membranes. Combining the RFLP pattern and sequence analysis by iPhyClassifier, we classified the phytoplasma causing rose balsam phyllody into subgroup 16SrV-B. To our knowledge, this is the first report of 16SrV-B group phytoplasmas infecting rose balsam in China. References: (1) Z. N. Li et al. J. Phytopathol. 159:799, 2011. (2) M. A. Saghai-Maroof et al. Proc. Natl. Acad. Sci. 81:8014, 1984. (3) I. M. Lee et al. Phytopathology 83:834, 1993. (4) I. M. Lee et al. Int. J. Syst. Bacteriol. 48:1153, 1998.

BackgroundAnti-CTLA-4 antibodies have brought about limited clinical benefit because severe toxicity limits dosing levels and/or duration. We used CTLA-4 knockin mice to screen for antibodies with higher anti-tumor activity but lower autoimmunity. We have revealed that the key for better safety and preclinical efficacy is preservation of CTLA-4 for immune tolerance and intratumorial Treg depletion. Our work established that, independent of blocking activities, mAbs that preserve CTLA-4 recycling maintain the physiological immune tolerance checkpoint function while allowing more efficient and selective elimination of tumor-infiltrating regulatory T cells, resulting in highest efficacy and lowest toxicity and was thus developed for clinical testing of all antibodies tested.1–6 The antibody with best safety and efficacy profile, ONC-392 was developed for clinical testing. The first-in human studies showed that ONC-392 is safe and well tolerated. Remarkably, no irAE has been reported among patients who has received repeated dosing of 3.0 mg/kg and 10.0 mg/kg of ONC-392. The molecular and cellular characterization of ONC-392 will be presented.MethodsIn vitro binding and disassociation assay were determined between pH 4.0–7.0. The intracellular traffic of both antibodies and CTLA-4 molecules were visualized by confocal microscopy. The binding to human and mouse FcgRI, IIA, IIB, and III (A), FcRn as well as mouse FcgRIV were evaluated by surface plasmon resonance (SPR). Depletion of regulatory T cells in tumor and lymphoid tissues were determined by flow cytometry.ResultsONC-392 is a pH-sensitive antibody that preserves CTLA-4 recycling. By preserving cell surface CTLA-4, Onco-392 preserves immune tolerance. Preserving CTLA-4 on tumor-infiltrating Treg contribute to more effective immunotherapy. In addition to its unique feature of pH sensitive binding, OncoC4 also have several important features in Fc. ONC-392 shown comparable binding to human FcgRI and IIIA as wild-type IgG1s. As expected from the mutations introduced, ONC-392 show about 6 fold higher affinity for FcRn than wild-type IgG1. Interestingly, ONC-392 has shown 7–10-fold reduction to FcgRIIB, which is generally considered to be a negative signaling FcR. ONC-392 binding to mouse FcgRI-IV was lower that WT IgG1.ConclusionsUnlike other clinical anti-CTLA-4 antibodies, ONC-392 preserves CTLA-4 recycling and thus Treg function in the peripheral tissues. The higher cell surface CTLA-4 allows more efficient Treg depletion in the tumor microenvironment. In addition, despite reduced binding to mouse activating Fc?RI, III/IV, ONC-392 was more effective in intratumor Treg depletion in the mice. Therefore, lacking negative signaling from Fc?RIIB may also contribute to its anti-tumor activity.Trial RegistrationNCT04140526ReferencesDu X, et al. Uncoupling therapeutic from immunotherapy-related adverse effects for safer andeffective anti-CTLA-4 antibodies in CTLA4 humanized mice. Cell Res 2018;28:433–447.Du X, et al. A reappraisal of CTLA-4 checkpoint blockade in cancer immunotherapy. Cell Res 2018;28:416–432.Liu Y, Zheng P. How does an anti-CTLA-4 antibody promote cancer immunity? Trends Immunol 2018;39:953–956.Zhang Y, et al. Hijacking antibody-induced CTLA-4 lysosomal degradation for safer and more effective cancer immunotherapy. Cell Res 2019;29:609–627.Liu Y, Zheng P. Preserving the CTLA-4 checkpoint for safer and more effective cancer immunotherapy. Trends Pharmacol Sci 2020;41(1):4–12.Zhang P, et al. Mechanism- and immune landscape-based ranking of therapeutic responsiveness of 22 major human cancers to next generation anti-CTLA-4 antibodies. Cancers 2020;12:284.

Several researches have been conducted about "Analysis of Heavy Metal Content Mercury (Hg) On Whitening Face Cream Circulating On Percut Sei Tuan Sampali area with Atomic Absorption Spectrophotometer (AAS)". The research study was run at the Health Central Laboratory of North Sumatra. This study aimed to determine the levels of mercury (Hg) in the whitening face creams that ciirculating in the Percut Sei Tuan Sampali district. It also need to determine the levels of mercury (Hg) from Percut Sei Tuan Sampali area that accordance with the Regulation No. HK.03.1.23.07.11.6662 POM. However, this was an experiment study with a random of 5 samples among the whitening face cream at Percut Sei Tuan Sampali area. Thus, this area presented that the heavy metal mercury (Hg) from 5 samples were obtained the results that samples 1A was 1.5429 mg / L, samples 2A is 1.5334 mg / L, samples 3A is 1.4851 mg / L, samples 4A is 1.4916 mg / L, the sample 5A is 1, 5180 mg / L. However, the results showed that the mercury (Hg) value was above the levels was determined by BPOM RI, (the permission terms of heavy metal contamination Mercury (Hg) 1 mg / L No. HK.03.1.23.07.11.6662 in 2011). Thus, it was necessary to supervise the facial whitening cream in the Percut Sei Tuan Sampali society.

Several researches have been conducted about "Analysis of Heavy Metal Content Mercury (Hg) On Whitening Face Cream Circulating On Percut Sei Tuan Sampali area with Atomic Absorption Spectrophotometer (AAS)". The research study was run at the Health Central Laboratory of North Sumatra. This study aimed to determine the levels of mercury (Hg) in the whitening face creams that ciirculating in the Percut Sei Tuan Sampali district. It also need to determine the levels of mercury (Hg) from Percut Sei Tuan Sampali area that accordance with the Regulation No. HK.03.1.23.07.11.6662 POM. However, this was an experiment study with a random of 5 samples among the whitening face cream at Percut Sei Tuan Sampali area. Thus, this area presented that the heavy metal mercury (Hg) from 5 samples were obtained the results that samples 1A was 1.5429 mg / L, samples 2A is 1.5334 mg / L, samples 3A is 1.4851 mg / L, samples 4A is 1.4916 mg / L, the sample 5A is 1, 5180 mg / L. However, the results showed that the mercury (Hg) value was above the levels was determined by BPOM RI, (the permission terms of heavy metal contamination Mercury (Hg) 1 mg / L No. HK.03.1.23.07.11.6662 in 2011). Thus, it was necessary to supervise the facial whitening cream in the Percut Sei Tuan Sampali society.

Objective: Coffee is frequently (one or two cups/day) consumed throughout pregnancy. Although there are a few studies evaluating caffeine effects on pregnancy; however, a diuretic effect of caffeine on fetal kidneys has not been reported. Therefore, after drinking coffee whether changing of amniotic fluid index (AFI) and fetal renal artery blood flow (FRABF, RI, Resistive index; PI, Pulsatility index) were evaluated in this study. Methods: This clinical study was performed with two groups. For the study group, 63 participants with isolated borderline oligohydramnios who agreed to drink one cup of instant coffee were included in this study while 63 participants with isolated borderline oligohydramnios who did not drink one cup of instant coffee formed the control group. AFI, RI and PI were evaluated both before and after coffee intake.Results: Maternal characteristics of all study population were homogenous. FRABF indices were similar in both before and after coffee consumption. AFI was increased significantly six hours after drinking coffee (p<0.001). Conclusions: The coffee consumption increased the amniotic fluid volume. However it does not seem to affect on FRABF. According to our study findings, coffee consumption may offer a new opportunity to improve amniotic fluid volume for pregnant women with oligohydramnios. doi: https://doi.org/10.12669/pjms.36.4.1690 How to cite this:Madendag IC, Sahin ME, Aydin E, Madendag Y. Effect of coffee consumption on fetal renal artery blood flow and amniotic fluid volume in third trimester of pregnancy. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1690 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background Medicinal plants have been used countless times for curing diseases mainly in developing countries. They are easily available with little to no side effects when compared to modern medicine. This manuscript encompasses information on ethnomedicinal plants in Champhai district, located in the North East Region (NER) of India. The region lies within Indo-Burma biodiversity hotspot. This study will be the first quantitative report on the ethnomedicinal plants used by the local tribes of this region. Knowledge of medicinal plants is mostly acquired by word of mouth, and the knowledge is dying among the local youths with the prevalence of modern medicine. Hence, there is urgency in deciphering and recording such information. Methods Information was gathered through interviews with 200 informants across 15 villages of the Champhai district. From the data obtained, we evaluate indices such as used report (UR), frequency of citation (FC), informant consensus factor (Fic), cultural values (CVs) and relative importance (RI) for all the plant species. Secondary data were obtained from scientific databases such as Pubmed, Sci Finder and Science Direct. The scientific name of the plants was matched and arranged in consultation with the working list of all plant species (http://www.theplantlist.org). Results Totally, 93 plant species from 53 families and 85 genera were recorded. The most common families are Euphorbiaceae and Asteraceae with six and five species representatives, respectively. Leaves were the most frequently used part of a plant and were usually used in the form of decoction. Curcuma longa has the most cultural value (27.28 CVs) with the highest used report (136 FC), and the highest RI value was Phyllanthus emblica. The main illness categories as per Frequency of citation were muscle/bone problem (0.962 Fic), gastro-intestinal disease (0.956 Fic) and skin care (0.953 Fic). Conclusion The people of Mizoram living in the Champhai district have an immense knowledge of ethnomedicinal plants. There were no side effects recorded for consuming ethnomedicinal plants. We observed that there is a scope of scientific validation of 10 plant species for their pharmacological activity and 13 species for the phytochemical characterisation or isolation of the phytochemicals. This might pave the path for developing a scientifically validated botanical or lead to semisyntheic derivatives intended for modern medicine.

Tujuan dari penelitan ini adalah untuk menganalisis (1) perkembangan ROA, CAR dan OER pada bank umum syariah devisa di Indonesia. (2) CAR dan OER terhadap ROA pada bank umum syariah devisa di Indonesia periode 2009-2014. Data yang digunakan adalah data time series dari Laporan Keuangan tahunan Bank Umum Syariah Devisa di Indonesia periode 2009-2014, yaitu Bank BNI Syariah, Bank Mega Syariah, Bank Muamalat Indonesia, dan Bank Mandiri Syariah. Alat analisis yang digunakan adalah analisis deskriptif dan regresi berganda. Hasil analisis menemukan bahwa: 1) Rata-rata perkembangan ROA pertahun untuk Bank BNI Syariah sebesar 0.20%, Bank Mega Syariah sebesar 0.98%, Bank Muamalat Indonesia sebesar 0.19 % dan Bank Mandiri Syariah sebesar 0.62%; 2) Rata-rata perkembangan CAR pertahun untuk Bank BNI Syariah sebesar 18.42%, Bank Mega Syariah sebesar 13.18 %, Bank Muamalat Indonesia sebesar 12.65%, dan Bank Syariah Mandiri sebesar 12.57 %; 3) Rata-rata perkembangan OER pertahun untuk Bank BNI Syariah sebesar sebesar 85.1%, Bank Mega Syariah sebesar 87.12%, Bank Muamalat Indonesia sebesar 86.91% dan Bank Mandiri Syariah sebesar 80.87%; 4) Secara simultan, CAR dan OER berpengaruh signifikan terhadap ROA Bank Umum Syariah Devisa di Indonesia, sedangkan secara parsial OER berpengaruh negatif signifikan dan CAR tidak memiliki pengaruh yang signifikan. Kata Kunci : Keuangan, Bank Umum, Syariah, Devisa REFERENCES Desfian, B, 2005. Analisis Faktor-faktor Yang Berpengaruh terhadap Kinerja Bank Umum di Indonesia Tahun 2001-2003, TESIS Program pascasarjana Magister Manajemen UNDIP Diana,P, 2009, Analisis Pengaruh CAR, NPL, PDN, NIM,BOPO, LDR, Dan Suku Bunga Sbi Terhadap ROA (Studi Pada Bank Devisa Di Indonesia Periode 2003-2007), TESIS Program pascasarjana Magister Manajemen UNDIP Faisol, A (2007). Analisis Kinerja Keuangan Bank Pada PT. Bank Muamalat Indonesia Tbk. Jurnal Bisnis Managemen, 3(2), 1411-9366 Febryani, A, dan Zulfadin, R. 2003. Analisis Kinerja Bank Devisa dan Bank Non Devisa di Indonesia. Kajian Ekonomi dan Keuangan, Vol.7 no. 4. [online] (http://bi.go.id/, diakses tanggal 10 April 2010) Ghozali, I, 2006, Aplikasi Analisis Multivariate Dengan Program SPSS, Badan Penerbit Universitas Diponegoro, Semarang. Hafidhuddin, D,2003. “Islam Aplikatif”, Jakarta: Gema Insani Press, Cet. I Husnan, S dan Pudjiastuti, E . 2004. Dasar-dasar Manajemen Keuangan. UPP-AMP YKPN, Yogyakarta. Johanes, et all, 2014. Pedoman Penulisan dan Bimbingan Skripsi, Cetakan : 3. Jambi : Fakultas Ekonomi dan Bisnis UNJA Kasmir, 2003. Manajemen Perbankan. Jakarta : PT. Raja Grafindo Persada. Luciana, A, dan Herdiningtyas,W. 2005, Analisis Rasio CAMEL Terhadap Prediksi Kondisi Bermasalah Pada Lembaga Perbankan Perioda 2000-2002, Jurnal Akuntansi dan Keuangan, Vol.7, No. 2. Mahardian, P,2008. Analisis Pengaruh Rasio CAR, BOPO, NPL, NIM Dan LDR Terhadap Kinerja Keuangan Perbankan (Studi Kasus Perusahaan Perbankan Yang Tercatat Di Bej Periode Juni 2002 – Juni 2007) TESIS Program pascasarjana Magister Manajemen UNDIP Meriewaty, D. 2005.“Analisis Rasio Keuangan terhadap Perubahan Kinerja pada Perusahaan di Industry food and beverages yang Terdaftar di BEI”. Skripsi Universitas Kristen Duta Kencana. Mawardi,W, 2005. Analisis Faktor-faktor yang Mempengaruhi Kinerja Keuangan Bank Umum di Indonesia (Studi Kasus Pada Bank umum dengan Total Assets Kurang dari 1 Trilliun), Jurnal bisnis Strategi, Vol. 14, No. 1. Muhammad,2005. Manajemen Bank Syariah. Yogyakarta: UPP AMP YKPN Muharam,H dan Pusvitasari,R. 2007. Analisis Perbandingan Eefiisiensi Bank Syariah di Indonesia dengan Metode Data Envelopment Analysis Periode Tahun 2005. Jurnal Fakultas Ekonomi Universitas Diponegoro, Vol.11 No.03, Desember 2007 Munawir,S. 2002. Analisis Laporan Keuangan. Yogyakarta : Liberty. Ponttie, P, 2007. Analisis Pengaruh Rasio-rasio Keuangan Terhadap Kinerja Bank Umum di Indonesia (Studi Empiris Bank-bank Umum yang Beroperasi di Indonesia). Program Studi Magister Sains Akuntansi Program Pascasarjana Universitas Diponegoro. Prastiyaningtyas, F, 2010. Faktor yang Mempengaruhi Profitabilitas Bank go public di Indonesia (Studi pada Bank Umum Go Public Yang Listed di Bursa Efek Indonesia Tahun 2005-2008) SKRIPSI Program Sarjana Fakultas Ekonomi UNDIP Prasetya,B; Tan,S; Delis, A. (2015). Faktor-Faktor yang Mempengaruhi Penghimpunan Dana Pihak Ketiga Perbankan Syariah di Indonesia. Jurnal Perspektif Pembiayaan dan Pembangunan Daerah; 3(2): 91-100. Safitri, N, 2012. Analisis pengaruh Capital Adequacy Ratio (CAR), Non Performing Loan (NPL), BOPO (Biaya Operasional/Pendapatan Operasional BOPO), Non Performing Loan (NPL), dan Loan to Deposit Ratio (LDR), terhadap Return On Asset (ROA). Skripsi Jurusan Manajemen Fakultas Ekonomi Dan Bisnis Universitas Hasanuddin Makassar Siamat,D, 2005. Manajemen Lembaga Keuangan,“Kebijakan Moneter dan Perbankan”. Jakarta : Fakultas Ekonomi Universitas Indonesia, edisi kesatu. Surat Edaran Bank Indonesia No.6/ 23./DPNP tanggal 31 Mei 2004 Perihal Pedoman Sistem Penilaian Tingkat Kesehatan Bank Umum (CAMELS Rating), Bank Indonesia, Jakarta Syofyan, S, 2002, “Pengaruh Struktur Pasar terhadap Kinerja Perbankan di Indonesia“, Media Riset Bisnis & Manajemen, Vol.2, No3, Desember, pp.194-219. Undang-Undang RI No 7 tahun 1992 Undang-Undang RI No. 10 Tahun 1998 Undang-Undang No.21 Tahun 2008 Usman, B , 2003, Analisis Rasio Keuangan Dalam Memprediksi Perubahan Laba Pada Bank-Bank di Indonesia, Media riset Bisnis dan manajemen, Vol. 3, No. 1. Veitzhal, R, 2007. Credit Management Handbook : Teori, Konsep, Prosedur, dan Aplikasi Panduan Praktis Mahasiswa, Bankir, Dan Nasabah. Jakarta : PT. RajaGrafindo Persada.

Neural tube defects (NTDs), such as spinal cord and brain defects, are due to abnormal embryonic development of the neural tube and associated with increased fetal and infant mortality, morbidity, lifelong disability, and high economic costs. Globally, more than 260,000 pregnancies are estimated to be affected by NTDs, and 75% of the NTD live births result in under-5 deaths.1 Majority of NTDs are folic acid-sensitive; with much of the NTD burden preventable through consumption of folic acid before and during early pregnancy (periconception). An association between low folate status of women of reproductive age (WRA) and risk of NTD-affected pregnancy was first proposed in 1965 by Hibbard et al.2 and was subsequently substantiated in several randomized controlled trials which demonstrated the effectiveness of folic acid supplementation during periconception in preventing the first occurrence of NTDs.3 These findings resulted in a recommendation in 1992 by the U.S. Public Health Service that WTA consume 400 μg of folic acid daily to prevent occurrence of an NTD-affected pregnancy.4 This recommendation together with other large-scale, global intervention studies demonstrated the efficacy of a daily periconceptional supplement of 400 μg in preventing a large percentage of NTDs.5 Folic acid is a synthetic, oxidized form of folate that acts as a coenzyme in the biosynthesis of DNA and RNA. With 4 mg folic acid daily, it may take 20 weeks to reach red-blood-cell folate levels between 1050 and 1340 nmol/L, which is optimal for reduction of the neural tube defect risk. Therefore, folic acid supplementation should be started 5–6 months before conception. The residual risk with optimal red-blood-cell folate levels is reportedly 4.5 per 10,000 total births whereas the residual risk in pooled data from countries with mandatory folic acid fortification is 7.5 per 10,000 pregnancies, regardless of pre-fortification rates.6 In one study, the optimal RBC folate level was achieved in 80.4% of women who started FA 400 μg 4–8 weeks before their last menstrual period (LMP) compared to only 53.6% in women who started 4–8 weeks after their LMP (P < 0.001). 7 A worldwide survey of folic acid supplementation in WRA showed inadequate compliance to folic acid intake.8 A systematic review and meta-analysis of pooled prevalence estimates of folic acid compliance showed 32–51% in North America, 9–78% in Europe, 21–46% in Asia, 4–34% in the Middle East, 32–39% in Australia/New Zealand, and 0% in Africa. Poor compliance was secondary to many factors. In the United States, the recommendation of 400 μg supplemental intake of folic acid daily has limitations as many pregnancies, including up to 50% of all pregnancies are unplanned.9 In many countries, particularly among low- and middle-income countries, many barriers exist for the access of WRA to folic acid supplements, such as procurement of the micronutrients in a relatively costly prepackaged form and ineffective distribution system. An evaluation of NTD trends in multiple countries indicated that, regardless of form, timing, or intended target, issuing recommendations on folic acid use alone, in the absence of fortification, had no detectable impact on NTD incidence. Thus, food fortification with folic acid has been a component of national public health strategies; in particular, where folate status is insufficient and a fortifiable food vehicle, processed by a centralized industry is consumed regularly by WRA.10,11 Other factors associated with poor compliance in folic acid intake include low income, smoking during pregnancy, alcohol consumption, multiple pregnancy, geographic location, and religious beliefs. On the other hand, preconception counselling, previous infertility therapy, multivitamin intake before pregnancy, older age planned pregnancy, previous infertility therapy, and multivitamin intake before pregnancy increased compliance.12-16 Women who also believed that they had good general and obstetric health (e.g., no history of illness or miscarriage) had attitudes of not being susceptible to the health consequences of not taking folic acid supplements and were the low users of folic acid supplement.17 In the Philippines, although WRA are advised to consume 320 ug dietary folate equivalent per day,18 about 0.9 % (around 1 in 5) are folate-deficient based on red cell folate count, while 38.7% (around 2 in 5) are folate-deficient based on serum folate.19 Congenital malformations including NTDs remain in the top ten leading causes of infant mortality from 1960 to 2005.20 In the index paper of Bernardo21 a cross-sectional, cluster sampling survey of 184 healthy, pregnant women, of age 15–49 years was conducted in the Batangas province from May to July 2017 to assess the level of knowledge, attitude, and perceived practice among the subjects on the importance of folate periconceptionally. A pretested interview questionnaire was used. The mean scores were 77% (moderate level) for knowledge, 82% for positive attitude, and 71% for positive perceived practice. The scores in the survey were related to patient’s age, civil status and to some extent, education. The study suggested that while respondents knew about folate (70%), they had low knowledge of the effect of its deficiency especially as it can lead to infant death. Knowledge had significant and positive moderate correlation with attitude (r = 0.7) and perceived practice (r = 0.5), but there was a weak positive correlation between attitude and perceived practice (r = 0.4). This likely indicates failure to emphasize the translation of knowledge and awareness properly and sufficiently into actual practice. As recommended by the author, education is the principal means to achieve the desired outcome. However, it is not clear in the study whether some amount of educational intervention besides determination of prevalence was included. As in any prevalence study, the golden opportunity to improve health outcomes is to accompany the survey with educational intervention, which in many instances, is required by the institutional board review. Some regression analysis of the data may also have been useful to determine which factors contributed most to the outcome measures. Enrique M. Ostrea, Jr., MD Wayne State University Hutzel Women’s Hospital Children’s Hospital of Michigan Detroit, Michigan, United States of America; National Institutes of Health University of the Philippines, Manila REFERENCES Blencowe H, Kancherla V, Moorthie S, Darlison D, Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Ann NY Acad Sci. 2018; 1414:31-46. Hibbard B, Hibbard E, Jeffcoate J. Folic acid and reproduction. 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