Добірка наукової літератури з теми "362.196 462 4"

Abstract Introduction Febrile neutropenia (FN) is a serious adverse effect of myelosuppressive chemotherapy, which often results in hospitalization and chemotherapy dose modification. FN risk depends on patient characteristics and chemotherapy regimen risk. Understanding the FN risk associated with individual chemotherapy regimens can help guide the use of prophylactic granulocyte colony-stimulating factor (G-CSF) and patient monitoring. To this end, the NCCN has classified regimens into high (≥20%), intermediate (10%-20%), or low (<10%) FN risk based primarily on clinical trial data. However, even for the same regimen, the FN risk is often higher in clinical practice than in clinical trials. In this study, we assessed the FN risk associated with several regimens for which FN risk has not been determined or has shown substantial variability outside of a clinical trial setting, using data from Kaiser Permanente Southern California (KPSC), a large, community-based practice. Methods Included were patients diagnosed with incident non-Hodgkin's lymphoma (NHL), breast cancer (BC), or multiple myeloma (MM) between 2008 and 2013 at KPSC who initiated the following chemotherapy regimens: bendamustine ± rituximab for NHL; docetaxel, carboplatin, and trastuzumab (TCH) or docetaxel and cyclophosphamide (TC) for BC; or Q4W lenalidomide 25 mg/dexamethasone for MM. Bendamustine ± rituximab, TCH, and lenalidomide are not classified by NCCN; TC is classified as intermediate FN risk but has shown considerable variability of FN incidence when used in clinical practice. Data on cancer diagnosis, chemotherapy use, G-CSF use, neutrophil count, and infections were obtained from KPSC's electronic medical records to estimate the incidence proportions of FN and grade 3 and 4 neutropenia. FN was defined as (1) hospitalization with absolute neutrophil count (ANC) <1000/µL or (2) hospitalization with primary or secondary diagnosis codes of neutropenia (ICD-9 288.0x) and fever (ICD-9 780.6), diagnosis code for bacterial/fungal infection, or antibiotic use. Grade 3 neutropenia was defined as ANC ≥500/µL to <1000/µL; grade 4 neutropenia as ANC <500/µL. Patients who received prophylactic G-CSF within 5 days of chemotherapy initiation were excluded from analysis. Results Overall, 40 (12%) NHL patients; 149 (24%) and 340 (28%) BC patients who received TCH and TC, respectively; and 0 (0%) MM patients were excluded due to prophylactic G-CSF. Over the first 6 cycles of bendamustine (median 338.4 mg/m2) ± rituximab for NHL patients (n = 307), 7.2% experienced FN, 4.2% grade 3 neutropenia, and 17.6% grade 4 neutropenia. Over the first 6 cycles of TCH for BC patients (n = 462), 24.2% experienced FN, 10.6% grade 3 neutropenia, and 44.6% grade 4 neutropenia. Over the first 6 cycles of TC for BC patients (n = 859), 20.5% experienced FN, 9.5% grade 3 neutropenia, and 37.5% grade 4 neutropenia. Over the first 4 cycles of lenalidomide/dexamethasone for MM patients (n = 186), 3.8% experienced FN, 5.9% grade 3 neutropenia, and 18.3% grade 4 neutropenia (Table 1). Conclusions Using NCCN criteria, bendamustine ± rituximab for NHL and lenalidomide/dexamethasone for MM would be classified as low-FN-risk regimens (<10%). By contrast, BC regimens TCH and TC would be classified as high-FN-risk regimens (>20%) based on our data. These results could help inform prophylactic G-CSF use for the selected regimens in clinical practice. Table 1. Number and Incidence Proportion of Neutropenic Outcomes Overall and by Cycle Cancer: Regimen Cycle Patients n FN Events n (%) Grade 3 Neutropenia Events n (%) Grade 4 Neutropenia Events n (%) NHL: Bendamustine ± rituximab Overall 307 22 (7.2) 13 (4.2) 54 (17.6) 1 307 12 (3.9) 5 (1.6) 28 (9.1) 2 225 3 (1.3) 4 (1.8) 21 (9.3) 3 173 2 (1.2) 4 (2.3) 15 (8.7) 4 130 2 (1.5) 4 (3.1) 10 (7.7) 5 92 4 (4.4) 4 (4.4) 8 (8.7) 6 69 2 (2.9) 2 (2.9) 0 (0) BC: TCH Overall 462 112 (24.2) 49 (10.6) 206 (44.6) 1 462 70 (15.2) 39 (8.4) 138 (29.9) 2 326 13 (4.0) 15 (4.6) 42 (12.9) 3 282 17 (6.0) 9 (3.2) 39 (13.8) 4 247 6 (2.4) 8 (3.2) 31 (12.6) 5 199 4 (2.0) 6 (3.0) 25 (12.6) 6 169 8 (4.7) 3 (1.8) 12 (7.1) BC: TC Overall 859 176 (20.5) 82 (9.5) 322 (37.5) 1 859 126 (14.7) 51 (5.9) 266 (30.9) 2 649 21 (3.2) 42 (6.5) 82 (12.6) 3 571 19 (3.3) 23 (4.0) 62 (10.9) 4 511 14 (2.7) 22 (4.3) 45 (8.8) 5 94 1 (1.1) 3 (3.2) 9 (9.6) 6 84 2 (2.4) 1 (1.2) 2 (2.4) MM: Lenalidomide / dexamethasone Overall 186 7 (3.8) 11 (5.9) 34 (18.3) 1 186 2 (1.1) 8 (4.3) 17 (9.1) 2 101 3 (3.0) 5 (5.0) 14 (13.9) 3 63 2 (3.2) 2 (3.2) 8 (12.7) 4 37 0 (0) 0 (0) 4 (10.8) Disclosures Family: Amgen Inc.: Research Funding. Klippel:Amgen Inc.: Employment, Equity Ownership. Li:Amgen Inc.: Employment, Equity Ownership. Page:Amgen Inc.: Employment, Equity Ownership.

Historia nauki polskiej, t. 10: 1944–1989, Cz. 1: Warunki rozwoju nauki polskiej, państwo i społeczeństwo; Cz. 2: Instytucje; Cz. 3: Idee i praktyka, pod red. Leszka Zasztowta i Joanny Schiller- Walickiej, Warszawa: Polska Akademia Nauk, 2015, Cz. 1: ss. 447, Cz. 2: ss. 717, Cz. 3: ss. 445, ISBN 978-83-7545-607-3 (całość) – Agnieszka Chamera-Nowak [355-358] Modlitewnik Olbrachta Gasztołda kanclerza wielkiego litewskiego 1528 r. Facsimile, Wstęp Wiesław Wydra, Libri Precationum Illuminati Poloniae Veteris. Facsimilia, editores: Catharina Krzak-Weiss, Raphael Wójcik, Wiesław Wydra, t. 1, Poznań: Wydawnictwo Naukowe UAM, 2015, ss. 560, ISBN 978-83232- 2774-8 – Karolina Figaszewska [358-360] Katalog inkunabułów Biblioteki Naukowej PAU i PAN w Krakowie, oprac. Teresa Dąbrowa, Elżbieta Knapek, Jacek Wojtowicz, Kraków: Polska Akademia Umiejętności, 2015, ss. 285, ISBN 978-83-7676-223-4 – Agnieszka Chamera-Nowak [360-361] Przyjaźń w kulturze staropolskiej, pod redakcją naukową Agnieszki Czechowicz i Małgorzaty Trębskiej, Lublin: Wydawnictwo Katolickiego Uniwersytetu Lubelskiego, 2013, ss. 331, ISBN: 978-83-7702-798-1 – Magdalena Bejm [362-364] Olaf Kwapis, Do Rzymu, Warszawa: Stowarzyszenie Pro Cultura Litteraria, Instytut Badań Literackich PAN, 2014, ss. 366, ISBN 979-83-61757-54-1 – Magdalena Bejm [365-367] Urszula Paszkiewicz, Cathalogus cathalogorum. Inwentarze i katalogi bibliotek z ziem wschodnich Rzeczypospolitej od XVI wieku do 1939 roku. Spis scalony, poprawiony i uzupełniony, t. 1–2, Warszawa: Ministerstwo Kultury i Dziedzictwa Narodowego, 2015, t. 1: ss. 717, t. 2: ss. 772 ISBN 978-83-62622-41-2 (całość) – Agnieszka Chamera-Nowak [367-369] Zdabytki: dokumental’nyja pomniki na Belarusi, Nacyjanalnaja biblioteka Belarusi; Wypusk 16; Minsk 2013 – Michał Pędracki [369-372] Маteryjały IX Мiżnarodnych knigaznauczych czytannjau „Statut Wjalikaga Knjastwa Litouskaga u gistorii kultury Biełarusi”, Мinsk, 18–19 krasawika 2013 g. – Michał Pędracki [372-376] Kasaty klasztorów na obszarze dawnej Rzeczypospolitej Obojga Narodów i na Śląsku na tle procesów sekularyzacyjnych w Europie, t. 1–4, t. 1: Geneza. Kasaty na ziemiach zaborów austriackiego i rosyjskiego; t. 2: Kasaty na Śląsku Pruskim i na ziemiach zaboru pruskiego; t. 3: Źródła. Skutki kasat XVIII i XIX w. Kasata w latach 1954–1956; t. 4: Dokumentacja, redakcja Marek Derwich, Wrocław: Wrocławskie Towarzystwo Miłośników Historii, 2014, t. 1: ss. 464, t. 2: ss. 474, t. 3: ss. 520, t. 4: ss. 560, ISBN 978-83- 87843-21-2 (całość) – Agnieszka Chamera-Nowak [376-377]

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Abstract Treatment intensifications in SCD with HU, TP or SCT are applied in order to reduce SCD related complications but their comparative effects have still to be described. We report our experience concerning the annual check-up performed in SCD pediatric patients. Patients and Methods: Among our cohort of 397 SS/Sb0 pediatric SCD patients, 157 of them were intensified with HU (n= 86), TP (n=104) or SCT (n=36) and some of them received successively HU, TP and SCT. HU was proposed to patients &gt; 3 years of age and having experienced more than 3 VOC/ACS/year or &lt; 7g/dl severe anemia. TP defined as &gt; 4 months program was applied in patients with cerebral vasculopathy defined by an history of stroke or abnormal TCD (&gt; 200 cm/sec). TP was also proposed in patients with HU-failure and in patients with frequent VOC, less than 3 years old. SCT was proposed in patients with an indication of treatment intensification and an available HLA identical sibling donor. Annual check-up were performed in our day-care unit. We analysed 1261 check-ups performed and recorded since 1992 in 341 SS/Sb0 patients (sex: 164 F, 177 M). Median age was 8.8 ± 5.1 years. Mean number of annual check-ups per patient was 3.7 ± 2.8 (range 1 to 13): 816 were performed in non intensified patients, 196 in HU, 123 in TP and 126 in transplanted patients. Categories of age were distinguished: &lt; 2 y of age (n=110), 2–5y (n=244), 5–10y (n=415), 10–15y (n=317) and 15–20y (n=175). Results: Respective follow-up were 4.4 y ± 3.3 in HU, 2.6 y ± 2.6 inTP and 5.8 y ± 4.7 in SCT patients. Comparison with non intensified patients showed that weight was significantly higher in SCT patients &gt; 15 y of age (p=0.001), spleen size was significantly higher in (2–5y) young patients treated with HU (p=0.005) or TP (0.001) and in 5–10 y old patients on HU (p=0.046) but no difference was observed after the age of 10 y. O2 saturation was significantly improved after SCT (p&lt;0.001) (98.8 ± 1.0 vs 97.1 ± 2.6) and was unchanged on HU and TP. Cardiac pulsations were significantly (p&lt;0.001) decreased after all type of intensification. Biological data are shown (table1and 2). Conclusion : Treatment intensifications (TP, HU, SC) reduced the decrease of weight observed with aging in SCD patients and significantly reduced anemia using different mechanisms. SCT was the most effective to correct anemia, supress hemolysis and decrease leucocytosis. Intensif. n Follow-up HbF% Eryht Hb MCV Retic mean (SD) No 816 11.4 (9.2) 3.1 (0.9) 8.1 (1.2) 81.4 (8.9) 268.9 (105.2) HU 196 4.4 y. (3.3) 13.9 (7.0) 2.7 (0.6) 8.5 (1.2) 97.7 (13.7) 188 (83.8) TP 126 2.6 y.(2.7) 3.3 (3.1) 3.1 (0.6) 9.1 (1.4) 86.8 (4.8) 258.2 (126.0) SCT 123 5.8 y.(4.7) 4.6 (6.4) 4.3 (0.9) 11.4 (1.6) 81.5 (8.9) 89.4 (63.4) Intensif. n Tot Bili Conj Bili LDH Ferritin Leucocytes Platelets No 816 49.8 (34.4) 5.7 (3.4) 1016 (312) 192 (322) 13.2 (9.9) 385 (124) HU 196 47.5 (34.4) 5.0 (2.2) 943 (264) 399 (582) 9.7 (3.8) 352 (133) TP 126 58.8 (39.6) 5.6 (2.2) 973 (377) 2238 (6310) 13.1 (4.7) 365 (128) SCT 123 15.6 (13.9) 2.8 (4.2) 493 (200) 1099 (1386) 6.8 (3.3) 295 (109)

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Maddox Dairy, located in Riverdale, CA, USA, is a Holstein herd that milks 3500 cows with a 305-day mature-equivalent milk production of 12 800 kg, and they have been producing high genetic animals by embryo transfer (ET) since the early 1980s. Invivo-derived embryos from Holstein donors were transferred fresh (grade 1 or 2) or frozen (grade 1), at morula (4), early blastocyst (5), or blastocyst (6) stage, to virgin heifers (VH, natural oestrus, 13-15 months old) or lactating cows (LC, Presynch-Ovsynch, 86 days in milk, first or second lactation) 6 to 9 days after oestrus. Pregnancy diagnosis was done by transrectal ultrasonography at 32-46 days in VH and by the IDEXX PAG test at 30 days in LC. June, July, August, September, and October were called critical months (first service AI conception rate drops below 44%) and compared with the other months. The data from 32 503 ETs between January 2008 and December 2018 are summarised on Table 1. Pregnancy rates (PR) are lower for LC recipients than for VH. Embryo transfers performed 7 or 8 days after oestrus had higher PR in both types of recipients and embryos, but Day 6 and 9 oestrus are also used with fair results. The season does not seem to affect PR. There is not enough difference in the combination of stage and days from oestrus for invivo-derived embryos. These numbers do not belong to a planned experiment. Several management changes during the years were made, which make it very difficult to apply statistical methods to analyse the data correctly. They are used as a tool to make decisions in an attempt to improve future results. Table 1.Pregnancy rate (PR) of virgin heifers (top) and lactating cows (bottom)-fresh (SH) and frozen (OZ) invivo-derived embryo transfer1 Heat-months SH-ST4 SH-ST5 SH-ST6 SH-All OZ-ST4 OZ-ST5 OZ-ST6 OZ-All PR% n PR% n PR% n PR% n PR% n PR% n PR% n PR% n Heifers 6 d-CM 62 934 66 243 68 69 63 1246 56 473 58 219 62 42 57 734 6 d-OM 62 1623 67 489 69 211 64 2323 56 600 55 296 48 137 55 1033 6 d-T 62 2557 67 732 69 280 63 3569 56 1073 57 515 51 179 56 1767 7 d-CM 64 1506 68 495 67 221 65 2222 60 822 62 340 63 156 61 1318 7 d-OM 66 2723 68 1021 69 510 67 4254 57 1120 59 581 57 231 58 1932 7 d-T 66 4229 68 1516 69 731 67 6476 58 1942 60 921 60 387 59 3250 8 d-CM 65 1348 64 518 67 322 65 2188 59 595 64 258 63 108 61 961 8 d-OM 66 2166 68 886 70 510 67 3562 61 770 60 364 51 130 60 1264 8 d-T 66 3514 67 1404 69 832 66 5750 60 1365 62 622 56 238 60 2225 9 d-CM 60 109 56 43 70 20 60 172 60 5 33 6 50 4 47 15 9 d-OM 58 129 63 57 60 40 60 226 63 16 50 18 75 4 58 38 9 d-T 59 238 60 100 63 60 60 398 62 21 46 24 63 8 55 53 All-CM 64 3897 66 1299 67 632 65 5828 58 1895 61 823 63 310 60 3028 All-OM 65 6641 67 2453 69 1271 66 10 365 58 2506 58 1259 53 502 58 4267 All-T 65 10 538 67 3752 69 1903 66 16 193 58 4401 60 2082 57 812 59 7295 Lactating cows 6 d-CM 54 265 48 86 50 12 53 363 38 141 31 77 50 10 36 228 6 d-OM 49 463 52 203 45 56 50 723 46 101 48 54 59 27 48 182 6 d-T 51 728 51 289 46 68 51 1086 41 242 38 131 57 37 42 410 7 d-CM 54 755 59 274 56 103 55 1137 43 928 48 450 43 192 45 1570 7 d-OM 55 914 66 367 54 109 58 1393 46 1052 45 564 47 353 46 1969 7 d-T 55 1669 63 641 55 212 57 2530 45 1980 46 1014 46 545 45 3539 8 d-CM 63 252 68 82 76 33 65 368 48 219 56 80 42 33 50 332 8 d-OM 61 257 64 161 53 47 61 466 50 191 53 77 56 16 51 284 8 d-T 62 509 65 243 63 80 63 834 49 410 55 157 47 49 50 616 All-CM 56 1272 58 442 60 148 57 1868 44 1288 47 607 43 235 45 2130 All-OM 55 1634 62 731 51 212 56 2582 47 1344 46 695 48 396 47 2435 All-T 55 2906 60 1173 55 360 57 4450 45 2632 47 1302 46 631 46 4565 1ST=stage; CM=critical months (June, July, August, September, and October); OM=other months.

AbstractObjectiveTo identify generational differences in the dietary patterns of Brazilian adults born between 1934 and 1975.DesignA cross-sectional study from the baseline of the multicentre Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Year of birth was categorized into three birth generations: Traditionalists (born between 1934 and 1945); Baby Boomers (born between 1946 and 1964); and Generation X (born between 1965 and 1975). Food consumption was investigated using an FFQ. Latent class analysis (LCA) was used to identify data-driven dietary patterns.SettingBrazil.SubjectsIndividuals (n 15 069) aged 35–74 years.ResultsA three-class model was generated from the LCA for each birth generation. Generation X presented higher energy intakes (kJ/kcal) from soft drinks (377·4/90·2) and sweets (1262·3/301·7) and lower energy intakes from fruit (1502·5/359·1) and vegetables (311·3/74·4) than Baby Boomers (283·7/67·8, 1047·7/250·4, 1756·0/419·7 and 365·3/87·3, respectively) and Traditionalists (186·2/44·5, 518·8/124·0, 1947·7/465·5 and 404·6/96·7, respectively). For Baby Boomers and Generation X, we found food patterns with similar structures: mixed pattern (22·7 and 29·7 %, respectively), prudent pattern (43·5 and 34·9 %, respectively) and processed pattern (33·8 and 35·4 %, respectively). Among Traditionalists, we could also identify mixed (30·9 %) and prudent (21·8 %) patterns, and a third pattern, named restricted dietary pattern (47·3 %).ConclusionsThe younger generation presented higher frequencies of consuming a pattern characterized by a low nutritional diet, compared with other generations, indicating that they may age with a greater burden of chronic diseases. It is important to develop public health interventions promoting healthy foods, focusing on the youngest generations.

Abstract Abstract 3050 Background. Allogeneic hematopoietic stem cell transplantation (HSCT) is the treatment of choice for the majority of hematological malignancies. Early and successful immunologic reconstitution after HSCT reduces morbidity and mortality due to infection complications and improves survival. Aim of the study. We analyzed immune recovery after HSCT in 444 patients according to donor source. Patients and Methods. From January 2005 to June 2011 176 patients were grafted from HLA identical siblings (MSD), 125 from alternative donors (1 antigen mismatched family or unrelated donors) (ALT), 103 from unrelated cord blood grafted intra bone (CBIB) and 40 from haplo-identical mismatched family donors (HAPLO). All patients received unmanipulated bone marrow: 283 after a myeloablative (MA) conditioning regimen (CY-TBI or BU-CY) and 161 after a fludarabine based reduced intensity regimen (RIC). Graft versus host disease (GvHD) prophylaxis was cyclosporin methotrexate (CyA+MTX) for all patients except for CBIB (CyA and mycophenolate, MMF) and for HAPLO transplants which consisted of CyA+MMF and post-transplant high dose cyclophosphamide (HDCY) according to the Baltimore protocol (Lutznik et al BBMT 2008). Anti-thymocyte globulin (ATG) was used only for ALT transplants. Results. We compared immune reconstitution in MA and RIC transplants according to donor type at different time points post BMT. CD3+ absolute median counts/μl in MA conditioning on day+30, +90, +180 were respectively in MSD 477, 565, 700; in ALT donors were 146, 404, 470; in CBIB were 30, 57, 196; for HAPLO transplants they were 195, 182, 499. CD3+ absolute median counts/μl in RIC conditioning on day+30, +90, +180 were respectively in MSD 301, 660, 700; in ALT donors were 506, 186, 721; in CBIB 234, 399, 522; in HAPLO were 178, 276, 1300. CD4+ absolute median counts/μl in MA conditioning on day+30, +90, +180 were respectively in MSD 166, 170, 198; in ALT donors were 36, 86, 111; in CBIB 7, 36, 106; for HAPLO transplants they were 45, 127, 211. CD4+ absolute median counts/μl in RIC conditioning on day+30, +90, +180 were respectively in MSD 89, 189, 274; in ALT donors were 131, 210, 220; in CBIB 52, 110, 130; for HAPLO transplants they were 41, 205, 385. CD8+ absolute median counts/μl in MA conditioning on day+30, +90, +180 were respectively in MSD 280, 389, 500; in ALT donors were 102, 278, 413; in CBIB 42, 16, 51; in HAPLO transplants were 73, 424, 408. CD8+ absolute median counts/μl in RIC conditioning on day+30, +90, +180 were respectively in MSD 196, 432, 300; in ALT donors were 366, 65, 494; in CBIB 71, 167, 199; for HAPLO transplants they were 137, 129, 900. CD3, CD8, and CD4 counts in HAPLO transplants were not statistically different from MSD with the only exception of day +30, both for MA and RIC conditioning. Platelet median counts/μl on day+30, +90, +180 in MA conditioning were in MSD 142, 129, 180, in ALT 75, 101, 147, in CBIB were 19, 77, 128 and for HAPLO transplants were 67, 126, 128; in RIC conditioning platelets counts were in MSD 137, 156, 168, in ALT 33, 134, 142, in HAPLO were 77, 95, 188. Acute GvHD II-IV developed in 29% (MSD) 38% (ALT) 16% (CBIB) and 12% (HAPLO) (p=0.004) in MA conditioning and 40% (MSD) 18% (ALT) 25% (CBIB) and 10% (HAPLO) (p=0.07). Overall Cumulative Incidence of Non-Relapse Mortality (CI-NRM) was respectively 18% (MSD), 35% (ALT), 34% (CBIB), 22% (HAPLO) (p=0.02) in MA conditioning (p=0.02) and was 30% (MSD), 33% (ALT), 45% (CBIB), 0% (HAPLO) (p=0.02) in RIC conditioning (p=0.02). Day+100 CI-NRM was respectively 10% (MSD), 21% (ALT), 19% (CBIB), 12% (HAPLO) in MA conditioning (p=0.01) and 11% (MSD), 19% (ALT), 26% (CBIB), 0% (HAPLO) in RIC conditioning (p=0.02). Death due to infections were respectively 6% (MSD), 26% (ALT), 30% (IBCB), 17% (HAPLO) in MA conditioning and for RIC were 15 (MSD), 36% (ALT), 32% (IBCB), 0% (HAPLO). Conclusions. HAPLO transplant with HDCY post transplant as proposed by the Baltimore group, is associated with (1) rapid immunologic (CD3, CD4, CD8) recovery (2) low infectious death rate, (3) low overall and Day+100 CI-NRM, (4) rapid hematologic recovery. These results are comparable with those achieved with MSD and warrant further studies with HDCY post transplant as a GvHD prophylaxis. Figure: absolute CD4+ counts/μl on day+30, +90, +180, according to donor type in MA conditioning regimen. Disclosures: No relevant conflicts of interest to declare.

Background: COVID-19 is an emerging infectious disease which has created a global health emergency status. It is now super spreading in the community of Bangladeshi population causing morbidity and mortality amongst masses. Objectives: The aim of this study is to find out the knowledge, attitude and practices of medical college students and their family members towards the Covid-19. Materials & Methods: This online cross sectional study was conducted from the 15 April to 30 April 2020 during the lockdown period in Bangladesh. Collected data was analyzed by using SPSS IBM version 22.0. Results: A total of 517 responses were obtained. The majority of the population 326 (63.06%) were female and 352 (68.09%) belonged to an age group of 21-30 years. This study has revealed that 412(79.69%) believe COVID-19 affect all age group, 311(60.15%) thinks that it affect the elder people seriously, 215(41.59%) thinks specific treatment is not available for COBID-19, Greater part of respondents 256(49.52%) says COVID-19 infection is preventable, 452(87.43%) gives positive opinion about government lockdown to avoid further spread of infection and 402(77.76%) believes physical distancing is helpful to prevent spread of this disease. Regarding 14 days quarantine period 375(72.53%) give positive answer, 425(82.20%) says COVID-19 affects world economy badly, 298(57.64%) thinks the situation may be controlled soon. Conclusion: Since prevention is better that cure, hence an increasing need of awareness amongst the local population regarding COVID-19 is required. Further extensive survey studies are required in future that can provide supportive data in developing and implementing public health policies regarding COVID-19 pandemic in our country. KYAMC Journal Vol. 11, No.-4, January 2021, Page 166-170

AbstrakPre-eklampsia berat, salah satu penyebab utama kematian ibu di Indonesia dan di RSUD Dr. H. Abdul Moeloek Lampung, merupakan penyebab kematian ibu nomor satu (47,25%). Penelitian ini bertujuan untuk mengetahui hubungan prediktor pre-eklampsi berat (PEB) yang dinilai dari tekanan darah sistolik, tekanan darah diastolik, proteiunuria, eklampsia, sindrom hemolysis, elevated liver enzymes, low platelets count (HELLP) dengan kematian ibu di RSUD Dr. H. Abdul Moeloek. Penelitian ini menggunakan desain kasus kontrol dengan jumlah sampel 60 kasus dan 120 kontrol. Data diolah dari rekam medis rumah sakit selama periode lima tahun (2010 – 2014). Hasil penelitian ini memperlihatkan bahwa sindrom HELLP memiliki risiko kematian ibu 12 kali lebih tinggi (95%CI 2,9 – 53,7) dan eklampsia memiliki risiko 12,1 kali lebih tinggi (95%CI 3,8 – 38,6). Tekanan darah diastolik 110 – 119 mmHg memiliki risiko 7,4 kali lebih tinggi (95%CI 1,8 – 29,2), tekanan darah diastolik ≥ 120 mmHg memiliki risiko 5,5 kali lebih tinggi (95%CI 1,1 – 23,1), tekanan darah sistolik > 190 mmHg memiliki risiko 2,1 kali lebih tinggi (95%CI 0,5 – 7,4), tekanan darah sistolik 170 – 190 mmHg memiliki risiko 1,6 kali lebih tinggi (95%CI 0,5 – 4,5), proteinuria +3 memiliki risiko 4,2 kali lebih tinggi (95%CI 0,3 – 27,4), proteinuria +4 memiliki risiko 3,2 kali lebih tinggi (95%CI 0,5 – 31,7) setelah dikontrol oleh usia ibu, gravida, usia kehamilan, metode persalinan, pemberian diasepam, pendidikan, tempat tinggal, dan pekerjaan. Oleh karena itu, perlu meningkatkan deteksi dini komplikasi kehamilan dan penanganan yang baik kasus preeklampsia untuk mencegah kematian ibu akibat eklampsia dan sindrom HELLP.AbstractSevere preeclampsia, one of main causes of maternal death in Indonesiaand at Dr. H. Abdul Moeloek Lampung Public Hospital, is the leading cause of maternal death (47.25%). This study aimed to determine relation of severe preeclampsia predictor as assessed from systolic blood pressure, diastolic blood pressure, proteiunuria, eclampsia and HELLP syndrome withmaternal death at Dr. H. Abdul Moeloek Public Hospital. This study usedcase control design with 60 cases and 120 control total of sample. Data was managed from hospital medical records during five years period (2010 – 2014). Results of study showed HELLP syndrome had risk of maternaldeath 12 times higher (95%CI 2.9 – 53.7) and eclampsia had the risk 12.1 times higher (95%CI 3.8 – 38.6). Then diastolic blood pressure 110 – 119 mmHg had the risk 7.4 times higher (95%CI 1.8 – 29.2), diastolic blood pressure ≥ 120 mmHg had the risk 5.5 times higher (95%CI 1.1 – 23.1), sistolic blood pressure > 190 mmHg had the risk 2.1 times higher (95%CI 0.5 – 7.4), sistolic blood pressure 170 – 190 mmHg had the risk 1.6 times higher (95%CI 0.5 – 4.5), proteinuria +3 had the risk 4.2 times higher (95%CI 0.3 – 27.4), proteinuria +4 had the risk 3.2 times higher (95%CI 0.5 – 31.7) after controlled by maternal age, gravida, pregnancy age, delivery method, diazepam provision, education, domicile and employment. Therefore, it needs to improve early detection of pregnancy complication and good management of preeclampsia case to prevent maternal death due to eclampsia and HELLP syndrome.

Article 4(21) (Definition of a supervisory authority); Article 28(8) (Adoption of processors’ standard contractual clauses); Article 36(2) (Prior consultation) (see too recitals 84 and 94); Articles 40(1), (5) and 41(3) (Codes of conduct) (see too recital 98); Article 42(1), (5), (7) and 43(1) (Certification) (see too recital 100); Article 46(2)(d), (3) and (4) (Standard data protection clauses for data transfers) (see too recitals 108–109); Article 47 (Approval of binding corporate rules); Article 50 (International cooperation for the protection of personal data) (see too recitals 104 and 116); Article 58 (Powers) (see too recitals 129, 148 and 150); Article 59 (Activity reports); Article 60 (Cooperation between supervisory authorities); Article 61 (Mutual assistance between supervisory authorities); Article 62 (Joint operations of supervisory authorities); Article 70 (Tasks of the Board, including promotion of cooperation between supervisory authorities; contribution to activities of the Board); Article 77 (Complaint handling and investigations) (see too recital 141); Article 83 (Administrative fines) (see too recital 148).

One of the first structures explored at Dura in 1920, this temple (or perhaps better, sanctuary: Buchmann 2016, 116) was subsequently completely excavated but never fully published. Preliminary accounts were written by the excavators (Cumont 1926, 29–41; PR 2, 11–12, 67–9 (Pillet), PR 4, 16–19 (Pillet); Rostovtzeff 1938, 68–75 and pl. VI) and it has been much discussed since (Downey 1988, 105–10 for overview and references; Dirven 1999, 326–49 for the Palmyrene evidence; Leriche et al. 2011, 28). It remained a temple through the Roman period, apparently no part of it other than, presumably, the upper levels of city wall Tower 1 being used for secular military purposes. However, its continued existence in the farthest corner of the military base, and its attested use for worship by the Roman military community, demand discussion here. Indeed one of the very first military discoveries was the Terentius wall painting on the N wall of the temple’s room A, depicting a Roman military sacrifice by cohors XX Palmyrenorum before a triad of its national deities and the Tychai of Dura and Palmyra (Pl. I; Breasted 1922; Cumont 1923; Breasted 1924, 94–101, pl. XXI). Cumont consequently called the sanctuary the ‘Temple of the Palmyrene Gods’ (Cumont 1926, 29). In recent decades it has been more usually known as the ‘Temple of (i.e. Palmyrene) Bêl’, following Rostovtzeff (1938, 51), although in Parthian times it was probably dedicated to Zeus (Welles 1969, 63; Millar 1998, 482; Kaizer 2002, 122). No evidence indicates Palmyrene worship in the Parthian-era temple (Dirven 1999, 327–8). There is no consensus on the name for the sanctuary, so I follow MFSED’s ‘Temple of Bêl’ (Leriche et al. 2011, 28; also now Kaizer 2016b, 37–41). Described as laying in ‘J3/5’ by the Yale expedition, it actually lies N of these blocks in an area MFSED has labelled J9 (Leriche et al. 2011, 28–30). During the third century when the temple lay within the Roman base area, it did become the focus of Palmyrene cults, likely ‘related to Palmyrene soldiers or people associated with them’ (Dirven 1999, 328).

Shared memory machines typically have relatively few processors, say 2–128. An intrinsic characteristic of these machines is a strategy for memory coherence and a fast tightly coupled network for distributing data from a commonly accessible memory system. Our test examples were run on two HP Superdome clusters: Stardust is a production machine with 64 PA-8700 processors, and Pegasus is a 32 CPU machine with the same kind of processors. The HP9000 is grouped into cells, each with 4 CPUs, a common memory/cell, and connected to a CCNUMA crossbar network. The network consists of sets of 4×4 crossbars and is shown in Figure 4.2. An effective bandwidth test, the EFF_BW benchmark [116], groups processors into two equally sized sets. Arbitrary pairings are made between elements from each group, Figure 4.3, and the cross-sectional bandwidth of the network is measured for a fixed number of processors and varying message sizes. The results from the HP9000 machine Stardust are shown in Figure 4.4. It is clear from this figure that the cross-sectional bandwidth of the network is quite high. Although not apparent from Figure 4.4, the latency for this test (the intercept near Message Size = 0) is not high. Due to the low incremental resolution of MPI_Wtime, multiple test runs must be done to quantify the latency. Dr Byrde’s tests show that minimum latency is ≳ 1.5μs. A clearer example of a shared memory architecture is the Cray X1 machine, shown in Figures 4.5 and 4.6. In Figure 4.6, the shared memory design is obvious. Each multi-streaming processor (MSP) shown in Figure 4.5 has 4 processors (custom designed processor chips forged by IBM), and 4 corresponding caches. Although not clear from available diagrams, vector memory access apparently permits cache by-pass; hence the term streaming in MSP. That is, vector registers are loaded directly from memory: see, for example, Figure 3.4. On each board (called nodes) are 4 such MSPs and 16 memory modules which share a common (coherent) memory view. Coherence is only maintained on each board, but not across multiple board systems.

BACKGROUND Gender-incongruent (GI) youth have high rates of mental health problems. Although gender-affirming medical care (GAMC) provides psychological benefit, some GI youth present to care at older ages. Whether a relationship exists between age of presentation to GAMC and mental health difficulties warrants study. METHODS A cross-sectional chart review of patients presenting to GAMC. Subjects were classified a priori as younger presenting youth (YPY) (&lt;15 years of age at presentation) or older presenting youth (OPY) (≥15 years of age). Self-reported rates of mental health problems and medication use were compared between groups. Binary logistic regression analysis was used to identify determinants of mental health problems. Covariates included pubertal stage at presentation, social transition status, and assigned sex. RESULTS Of 300 youth, there were 116 YPY and 184 OPY. After presentation, more OPY than YPY reported a diagnosis of depression (46% vs 30%), had self-harmed (40% vs 28%), had considered suicide (52% vs 40%), had attempted suicide (17% vs 9%), and required psychoactive medications (36% vs 23%), with all P &lt; .05. After controlling for covariates, late puberty (Tanner stage 4 or 5) was associated with depressive disorders (odds ratio 5.49; 95% confidence interval [CI]: 1.14–26.32) and anxiety disorders (odds ratio 4.18 [95% CI: 1.22–14.49]), whereas older age remained associated only with psychoactive medication use (odd ratio 1.31 [95% CI: 1.05–1.63]). CONCLUSIONS Late pubertal stage and older age are associated with worse mental health among GI youth presenting to GAMC, suggesting that this group may be particularly vulnerable and in need of appropriate care.

Chronic mountain sickness (CMS), syndrome with manifestations of hypoventilation, hypoxemia, hyperviscosity, polycythemia, pulmonary hypertension, and right ventricular hypertrophy, is a recent history inthe western Himalyas (42675888 m asl). Six well defined subjects studied revealed: significant increasein fibrinogen (400±37 vs normal 275 ± 33 mg/dl), Hct(74.3±3.1 vs 45.2±3.2%) and Hb (23.1±2.6 vs 17.9±0.8g/dl); significant decrease in APTT (27.1±5.2 vs 54.6±7.9 sec), platelets (177.8±10.9 vs 197.4±19.3 thous/cmm), ELT (165±75 vs 399±48 min) and ESR (3.5±2.5 vs 6.0±3.5 mm/1 hr); and absolute eosinophil counts (465±69 vs 384±106). An accelerated Cell mediated immunity (CMI), in them, was evident by 'Spontaneous Flare', 4 + DNCB (di-nitro-chloroben- zene)-phenomenon and profuse lymphocyte recruitment in dermis.Theseresults indicate a state of hypercoagulability inCMS. Muscularisation and thrombosis of pulmonary arteris do occur in CMS. Accelerated CMI and augmented fibrinolytic activity in CMS account for its protracted course (8-25 months) to develop. Yogic breathing, acetazolamide, aspirin and evacuation to low heightshave a salutary effect. Steroids, medroxyprogesterone and phlebotomy bring reflief to these subjuects. Oxygen therapy, in CMS, has no role.

Introdução: A sífilis congênita, embora seja um agravo possível de ser prevenido, ainda é considerada um grave problema de saúde pública. Objetivo: Analisar a conclusão e as vulnerabilidades dos casos de sífilis congênita residentes em Niterói (RJ) diagnosticados em 2018 e 2019. Métodos: Realizou-se análise dos casos de sífilis congênita residentes, exceto abortos, diagnosticados em 2018 e 2019, por fichas do Sistema de Informação de Agravos de Notificação e questionários de investigação. Resultados: Dos 46 casos de 2018 e 107 de 2019, respectivamente, 8 (17,4%) e 4 (4%) não fizeram pré-natal, 2 (4,4%) e 4 (4%) não fizeram triagem para sífilis congênita no pré-natal, 3 (6,52%) e 13 (12%) fizeram triagem porém não trataram, outros 11 (23,9%) e 17 (16%) não fizeram o tratamento adequado, 10 (21,7%) e 23 (21%) foram reagentes na triagem, tratamento adequado, porém reinfectaram, 9 (19,6%) e 32 (30%) foram reagentes na triagem, tratamento adequado, porém confirmaram sífilis congênita por outros critérios, 3 (6,52%) e 12 (11%) foram não reagentes no pré-natal porém foram reagentes no parto e 0 (0%) e 2 (2%) foram reagentes, considerados cicatriz sorológica, não tratada, e confirmaram por outros critérios. As principais vulnerabilidades identificadas foram família de baixa renda, 21 casos (45,7%) em 2018 e 50 casos (46,7%) em 2019, usuária de álcool e/ou outras drogas, 18 (39,1%) em 2018 e 34 (31,8%) em 2019. Conclusão: Investigar os casos de sífilis congênita com a atenção básica leva a identificar os casos que se referem a crianças expostas à sífilis materna e aos que de fato possuem critérios para sífilis congênita. A investigação dos casos de sífilis congênita é fundamental para qualificação da vigilância, aprimorando dados e apontando ações de educação permanente relacionadas à clínica e à avaliação das vulnerabilidades para pensar em estratégias intra e intersetoriais.

The effectiveness of the British Gas elastic wave in-line inspection tool for finding and characterizing cracks along DSAW seams was clearly demonstrated by its use in 42 miles (67.59 km) of Colonial Pipeline Company’s 32-inch (812.8-mm) OD Line 4. Fourteen crack-like anomalies were located and characterized. Subsequent cut outs of the anomalies revealed these to be cracks along and at the toe of the longitudinal seam. All initiated at the OD surface. Some apparently were transit fatigue cracks with no indication of growth in service. Others showed evidence of having been extended by fatigue from service-pressure cycles. The sizes of the defects were such that they were too small to have failed if the pipeline had been subjected to a hydrostatic test to 100% of SMYS. This was demonstrated not only by calculations for the cutout anomalies, but by the hard evidence of burst test results in which the failures occurred at levels of 126% of SMYS and higher. The results show unequivocally that the elastic wave tool provides a significantly greater validation of pipeline integrity (assuming the located anomalies are removed or repaired) than a hydrostatic test to 100% of SMYS. The results suggest that the reinspection interval for the elastic wave tool could be significantly longer than the hydrostatic retest interval on an equivalent-risk basis.

Introdução: A Organização Mundial da Saúde (OMS) define mortalidade materna como a morte de uma mulher gestante ou em até 42 dias após o término da gestação, independentemente da sua duração ou localização. Ocorre por causa relacionada com ou agravada pela gravidez ou por medidas tomadas em relação a ela, não incluindo causas acidentais ou incidentais, e constitui grave violação dos direitos da mulher à saúde. Ainda nesse contexto, a mortalidade materna pode ser influenciada por fatores sociais, como idade, raça, escolaridade, padrão socioeconômico e estado civil, e, por isso, reflete a qualidade de vida de uma região. A mortalidade materna reflete a qualidade dos serviços de saúde prestados às mães e aos recém-nascidos, justificando a importância de uma análise profunda de suas variáveis. Objetivo: Analisar o número de óbitos maternos em Goiás durante o período de 2007 a 2017, correlacionando com a idade, cor/raça e escolaridade maternas, e grupo CID-10. Material e Métodos: Trata-se de um estudo observacional, descritivo, longitudinal e retrospectivo, de análise do número de óbitos maternos e suas variáveis no estado de Goiás em um período de dez anos. Os dados foram obtidos na plataforma on-line Tabnet/DATASUS do Ministério da Saúde em fevereiro de 2020 e são referentes às estatísticas vitais. Não foi necessária a aprovação do Comitê de Ética em Pesquisa, pois são dados públicos. As variáveis escolhidas e utilizadas para análise foram “idade materna”, “cor/raça materna”, “escolaridade materna” e “grupo CID-10”. Esses constituem indicadores de saúde para avaliar a qualidade dos serviços prestados à saúde materno-infantil. Os dados incluídos e analisados se referem somente aos óbitos maternos no estado de Goiás durante o período de 2007 a 2017. Os cálculos foram realizados no Excel. Resultados e Conclusão: No período de 2007 a 2017, totalizaram-se 512 óbitos maternos em Goiás, sendo 55 em adolescentes (10 a 19 anos), 233 em mulheres de 20 a 29 anos, 188 entre 30 e 39 anos, e 36 acima de 40 anos de idade. Mulheres brancas contabilizaram 154 óbitos; mulheres pretas, 62; pardas, 264; amarelas, 2; e ignorado, 30. Em relação à escolaridade, 48 mulheres não tinham nenhuma ou tinham apenas 1 a 3 anos; 106 possuíam 4 a 7 anos, e 212, mais de 8 anos, sendo ignorado 146 casos. Os grupos CID-10 com mais prevalência foram hipertensão relacionada à gravidez (120), complicações do trabalho de parto (105) e complicações relacionadas ao puerpério (53). A mortalidade materna constitui um dos indicadores de saúde mais adequados para avaliar a cobertura e a qualidade dos serviços de saúde de forma integral, pois reflete a realidade da desigualdade social do país. Os índices epidemiológicos analisados contribuem para o planejamento de ações e políticas públicas de saúde do estado de Goiás, que promovam atenção integral à gestante e ao seu filho.