In vivo antiplasmodial properties of fractions and flavonoids of Pseudarthria hooheri Wight & Arn. (Fabaceae)

Malaria is regarded as one of the most lethal diseases. Resistance to artemisinin and its derivatives jeopardises effective malaria treatment. Finding novel antimalarial chemicals is critical given the existing treatment situation. This work aimed to examine the antiplasmodial capabilities of <i>Pseudarthria hookeri</i> fractions and flavonoids in vivo. The fractions and compounds antiplasmodial activity were evaluated on male Swiss albino mice infected with <i>Plasmodium berghei</i>, and on healthy female Swiss albino mice, the crude extract's acute toxicity was assessed. The EtOAc fraction had significant antiplasmodial activity (32.53 percent suppression at 500 mg/kg BW) and considerably prolonged the survival period of infected mice (9.8 days) compared to control mice (7.8 days). Parasitaemia was dramatically reduced (85.01, 59.41, and 70.39 percent), and the mean survival time extended (11.33, 10.00, and 9.33 days) with 15, 20 and 35 mg/kg of quercetin (<b>1</b>), 7-O-benzyl-6-prenylpinocembrin (<b>6</b>) and 6,8-diprenyleriodictyol (<b>11</b>) (isolates of the EtOAc fraction), respectively. BW loss and PCV reduction were also averted. Moreover, at 2500 mg/kg, the crude extract of <i>P. hookeri</i> showed no acute toxicity in mice. LC-MS analysis of the EtOAc fraction enabled the identification of nine flavonoids, with <b>8</b> and <b>11</b> being the main components. The present investigation confirmed <i>P. hookeri</i>'s antiplasmodial action, substantiating its ethnomedicinal application for malaria treatment.

Impact of the COVID-19 pandemic’s first wave on the care and treatment situation of intravitreal injections in a German metropolitan region

Purpose This study aims to evaluate the impact of the first coronavirus 2019 (COVID-19) wave in 2020 on patients scheduled for intravitreal injections (IVI) in a German metropolitan region. Methods We performed a multicentre prospective survey and retrospective analysis of the records of patients treated with intravitreal injections during the 20-week period from March to July 2020 in all four hospital eye departments in the city of Hamburg using a questionnaire (on treatment adherence, SarsCoV2-related personal, familial and social data) and treatment data. Results A total of 1038 patients (2472 IVI, 1231 eyes) and 818 questionnaires were evaluated. Longer duration of therapy, lower visual acuity (VA) of the treated and higher VA of the fellow untreated eye was were associated with a higher probability of visit cancellation. Every additional year of life posed a 2.6% lower risk of noncompliance. A COVID-19 infection in the family environment displayed a 5.5-fold chance of visit cancellation. Patients treated for neovascular age-related macular degeneration (nAMD) had a 36% reduced risk of visit cancellation compared to patients with diabetic macular oedema (DME). Conclusion A long preceding treatment period, low VA of the treated eye, high VA of the untreated eye, COVID-19 in the family and DME were identified as risk factors for IVI visit cancellations during the COVID-19 pandemic. Compliance to treatment might be improved in the future by taking these risk factors into account when scheduling patients for IVI during the exceptional circumstances of a pandemic.

Innovative Surfactant Chemistry Offers the Performance Advantages to Invert Emulsion Drilling Fluids While Drilling Under Challenging Environments

Stable invert emulsion with oil wet solids is achieved using invert emulsifiers and wetting agents. This paper reviews the chemistry and performance criteria of traditional invert emulsifiers and wetting agents utilized in formulating stable invert emulsion drilling fluids. However, occasionally such stable invert emulsion drilling fluids can be destabilized due to various hostile conditions encountered during drilling operation, and can adversely impact the drilling cost. Extreme preventive measures cannot avoid such hostile conditions such as sudden water influx, excessive solids and salt contaminations during drilling. Upon solids becoming extremely water wet with "flipped emulsion", it becomes impossible to fix the drilling fluid, resulting in expensive maneuver. Often situation cannot be corrected with traditional wetting agents and emulsifiers even at high level of treatments. New innovative chemistry addresses the severe water-wetting and emulsion instability of invert emulsion under extreme challenging and hostile situations. The unique water soluble oil mud conditioner (OMC) synergistically enhances the performances of traditional oil-wetting agents and emulsifiers at very low, as little as 0.5 ppb levels of treatment. This OMC improves and extends the efficacy of the traditional invert emulsifiers and oil wetting agents resulting in reduced usage of these additives with excellent economic advantages. The 15.0 ppg, invert emulsion drilling fluids were prepared using 2-3 ppb of primary and secondary emulsifiers, and these fluids were destabilized using high shear mixer for 7-8 hours. The destabilized fluids had severe water wet solids and ES value of less than 5. These destabilized fluids, upon treating with 0.5 ppb of newly developed OMC instantly became oil-wet and shiny and ES was increased to greater than 500. To demonstrate the effectiveness of OMC in pre-treatment situation, the base fluids treated with 0.5 −1.0 ppb of OMC showed superior mud stability compared to base fluid when contaminated with sea water, fine solids, barite and high salt contaminations. The OMC is flexible in its application and can be used as pre-treatment to improve the overall performance of drilling fluids and can also be used for post-treatment to recover the drilling fluids, which have been rendered unusable.

Redesigning the Municipal Solid Waste Supply Chain Considering the Classified Collection and Disposal: A Case Study of Incinerable Waste in Beijing

The output of municipal solid waste is growing rapidly, which has brought tremendous pressure to urban development. The supply chain of municipal solid waste (MSW) in China mainly contains three processes: collection, transportation, and disposal. The waste is sorted at the collection and disposed of according to the classification. However, it is mixed at the transportation stage. Mixed transportation remixes the separately collected waste, which seriously affects the disposal effect. The supply chain of MSW urgently needs to be redesigned to improve the MSW disposal effect. First of all, on the ground of the waste treatment situation, we redesigned the supply chain of MSW in China. Secondly, combined with the redesign of the MSW supply chain, this paper established the function allocation model for collection stations, making a collection station only gather one type of waste, and built the transportation path planning model for vehicles, reducing the impact of waste storage on residents. Finally, based on the data of Xuanwu District in Beijing, the supply chain redesigning practical example of incinerable waste was given. The supply chain redesigning model in this paper not only makes full use of the existing infrastructure but also improves the disposal effect of waste. The supply chain redesigning model has practical application value.

Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và tình hình điều trị của bệnh nhân viêm khớp dạng thấp tại Bệnh viện Hữu nghị Đa khoa Nghệ An

TÓM TẮT Mục tiêu: Mô tả đặc điểm lâm sàng, cận lâm sàng và tình hình điều trị bệnh nhân viêm khớp dạng thấp tại khoa Cơ xương khớp Bệnh viện Hữu nghị Đa khoa Nghệ An. Phương pháp: Phương pháp nghiên cứu mô tả cắt ngang được thực hiện trên 103 bệnh nhân viêm khớp dạng thấp tại khoa cơ xương khớp Bệnh viện hữu nghị đa khoa Nghệ An. Kết quả: Nữ giới chiếm 89,32% và 45,63% có độ tuổi từ 30 - 59 tuổi; Vị trí khớp khởi phát viêm hay gặp là khớp cổ bàn ngón tay (47,57%); 85,44%có thời gian cứng khớp buổi sáng ≥ 1h; 87,38%bệnh ở mức độ hoạt động mạnh; 91,26% có tốc độ máu lắng tăng và 97,07% có CRP dương tính; 54,37% có thiếu máu; 87,38 % có RF dương tính và 91,67% có anti-CCP dương tính cao; 53,40% số bệnh nhân có tổn thương gai đoạn 2 trên x-quang; 46,22% số bệnh nhân không tuân thủ điều trị thường xuyên tại thời điểm nghiên cứu và chỉ có 8,74% số bệnh nhân được điều trị bằng thuốc sinh học. Kết luận: Nghiên cứu đã cho thấy một số đặc điểm lâm sàng và cận lâm sàng của bệnh nhân viêm khớp dạng thấp điều trị tại khoa cơ xương khớp bệnh viện hữu nghị đa khoa Nghệ An. Có 87,38% số bệnh nhân bệnh có mức độ hoạt động mạnh theo thang điểm DAS. Có 46,22% số bệnh nhân không tuân thủ điều trị thường xuyên và chỉ có 8,74% số bệnh nhân được điều trị bằng thuốc sinh học. Từ khóa: Lâm sàng, cận lâm sàng, điều trị, viêm khớp dạng thấp ABSTRACT CLINICAL, SUBCLINICAL FEATURES AND TREATMENT SITUATION OF RHEUMATOID ARTHRITIS PATIENTS AT NGHE AN FRIENDSHIP GENERAL HOSPITAL Objective: To describe the clinical, subclinical features and treatment situation of patientswith rheumatoid arthritis at the rheumatology Department of Nghe An friendshipgeneral Hospital. Methods: The cross-sectional, descriptive study was conducted on 103 patients with rheumatoid arthritis at the rheumatology Department of Nghe An friendshipgeneralHospital. Results: Females account for 89,32% and 45,63% of patients are aged from 30 to 59 years old; The most common joint site of inflammation onset is the wrist, hand and finger joints (47,57%); 85,44% of patients have morning joint stiffness that was greater than 1h; 87,38% of the patients had a strong level of disease activity; 91,26% of patients had an increased erythrocyte sedimentation rate and 97,07% of patients had a positive CRP; 54.37% of patients have anemia; 87,38% of patients have positive RF test and 91.67% have high positive anti-CCP test; 53.40% of patients have stage 2 lesions on x-ray; 46,22% of patients did not adhere to regular treatment and only 8,74% of patients were treated with biologic drugs. Conclusion: The study showed some clinical and subclinical characteristics of patients with rheumatoid arthritis at the rheumatology Department of Nghe An friendshipgeneral Hospital. There are 87,38% of patients who had the strong level of disease activity according to DAS scale. There were 46,22% of patients who did not adhere to regular treatment and only 8,74% of patients were treated with biological drugs. Keywords: Clinical, subclinical, treatment, rheumatoid arthritis

Examining the Use of Radiation Therapy for Cholangiocarcinoma: Benefits through Modern Techniques

<b><i>Background:</i></b> Cholangiocarcinoma (CCA) is a rare malignant tumor of the bile duct epithelium. At first diagnosis, only a minority of patients are eligible for surgery, which is regarded as the only curative treatment. This study examines the role of radiation therapy (RT) and chemoradiotherapy (CRT) in the definitive and adjuvant treatment situation. <b><i>Methods:</i></b> The monocentric, retrospective analysis included 39 patients with CCA undergoing 53 RT courses. Data were collected from January 2005 to September 2018. There were 11 cases of CRT, 6 of which were definitive. Surgery was either palliative (<i>n</i> = 6) or radical (<i>n</i> = 15). <b><i>Results:</i></b> After RT, the median overall survival (OS) was 10.4 months (m), median progression-free survival was 5.6 m, and median duration of local control (DOLC) was 8.9 m. There was a significant difference in survival between patients with and without locoregional lymph node metastasis (OS: 4.3 vs. 15.4 m, <i>p</i> = 0.031). After treatment of a primary tumor, DOLC was about twice as long as in the recurrent situation (10.4 vs. 5.4 m, <i>p</i> = 0.032). Conservative therapy significantly elevated the risk of local recurrence compared to radical surgery in univariate and multivariate analyses. Side effects were mostly classified as mild to moderate. Termination of RT and increased alanine aminotransferase were significantly less frequent after stereotactic body radiation therapy and hypofractionation. <b><i>Conclusion:</i></b> RT can achieve local control in patients with CCA. Toxicities of RT are manageable but require close clinical and laboratory follow-up.

O-035 Searching for the perfect country - mapping out differences in fertility treatments and access to treatments across Europe

text Fertility Europe has established a working group that is examining secondary data on legislation, regulation and funding of fertility treatment across Europe. The data has been mapped in order to easily visualize the “perfect country” in terms of fertility treatments[Vi1] . The map will be updated every two years in order to show progress towards more countries reaching the status of “perfect country”. As the map provides a clear picture on the differences in access to treatments[Vi2] across Europe, it is expected to be a useful advocacy tool for patient[Vi3] associations working to influence the current treatment situation in their country. This talk focuses on the work that has been done by the Fertility Europe working group to date, to create the map of the “perfect country”, and the possibilities that such a map represents from a patient advocacy perspective. treatmentS [Vi1] [Vi1] treatmentS [Vi2] [Vi2] patient associations’ [Vi3] [Vi3]

Dental Care of Patients With Dementia: A Survey on Practice Equipment, Training, and Dental Treatment

For patients with dementia, dental care can pose a considerable challenge due to cognitive impairment, behavioral, and psychological symptoms, and (often subsequently) limited autonomous oral care. In this study, we aimed to assess the proficiency of dentists in general practice in the outpatient dental care of these patients. A total of 119 dentists from private practices in Lower Saxony, Germany, participated in this study. Concerning treatment of patients with dementia, they provided details about (1) practice equipment/consultation, (2) training/expertise, and (3) special circumstances of dental treatment. Participating dentists predominantly reported to use medical aids (e.g., positioning cushions) to improve the treatment situation for patients with dementia. Over two thirds (68.6%) offered consultations in nursing homes, and at the patients' homes (47.0%). The training rate was remarkably low in the field of gerodontology for dentists and their practice staff (&lt;10%), however, 54.5% expressed interest in such training. The majority of dentists reportedly adapted their treatment strategy to the needs of patients with dementia (e.g., communication, inclusion of caregivers, time management). Furthermore, most participants adapted dental treatment adequately (e.g., strict indication for tooth extraction, simple design of dental prostheses). In summary, even though training in the field of gerodontology must be considered insufficient, most dentists in this study showed an adequate adaptation of their treatment strategy as well as consideration of dental characteristics in patients with dementia, along with interest in trainings. We conclude that dementia-specific training should be expanded in the field of dentistry, preferably already at university level.

Dental care of patients with dementia: A survey on practice equipment, training, and dental treatment

For patients with dementia, dental care can pose a considerable challenge due to cognitive impairment, behavioral, and psychological symptoms, and (often subsequently) limited autonomous oral care. In this study, we aimed to assess the proficiency of dentists in general practice in the outpatient dental care of these patients. A total of 119 dentists from private practices in Lower Saxony, Germany, participated in this study. Concerning treatment of patients with dementia, they provided details about (1) practice equipment/consultation, (2) training/ expertise, and (3) special circumstances of dental treatment.Participating dentists predominantly reported to use medical aids (e.g., positioning cushions) to improve the treatment situation for patients with dementia. Over two thirds (68.6%) offered consultations in nursing homes, and at the patients’ homes (47.0%). The training rate was remarkably low in the field of gerodontology for dentists and their practice staff (< 10%), however, 54.5% expressed interest in such training. The majority of dentists reportedly adapted their treatment strategy to the needs of patients with dementia (e.g., communication, inclusion of caregivers, time management). Furthermore, most participants adapted dental treatment adequately (e.g., strict indication for tooth extraction, simple design of dental prostheses).In summary, even though training in the field of gerodontology must be considered insufficient, most dentists in this study showed an adequate adaptation of their treatment strategy as well as consideration of dental characteristics in patients with dementia, along with interest in trainings. We conclude that dementia-specific training should be expanded in the field of dentistry, preferably already at university level.

PD (L) 1-Inhibitors and Radiation: A Good Combination for Local and Systemic Effects?

Radiation therapy is an important component in treatment of solid tumours, in a locally advanced situation and also in a metastatic situation. Indications for using PD- (L) -1 inhibitors increase especially in the metastatic situation, but also in locally advanced solid tumours. Preclinical data show local and systemically effective synergies between local irradiation and an application of checkpoint inhibitors. In the metastatic situation, a possible abscopal effect is of particular interest. This abscopal effect can be achieved especially in concurrent approaches of PD-(L)-1-inhibitors and stereotactic radiation with higher single doses like 3 x 8 Gy or 4 x 12,5 Gy. In locally advanced tumours a local enhancement of the radiation effect, and also an abscopal effect to eliminate potential micrometastases to is of great interest to achieve healing. In this treatment situation promising results are seen in the application of PD-(L)-1-inhibitors as maintenance after concurrent chemoradiation especially in non-small cell lung cancer, as well as in concurrent applications of conventionally fractionated radiotherapy and PD-(L)-1 inhibitors. These approaches and results are considered from the clinician’s point of view.