Kajian Sifat Kuantitatif Galur F2 Tanaman Jagung di Lahan Kering

This study was aimed to determine the average of leaf angle, yield and harvest age of each F2 line compared to the two parents respectively. In addition, we also want to evaluate the coefficient of genetic diversity and heritability of the three traits. The experiment was designed in a randomized block design with a total treatment of 20 populations, namely 16 F2 lines and 4 parents. Each treatment was repeated 3 times, so that 60 experimental units were obtained. The experimental data were analyzed by analysis of variance at the 5 percent significance level and further tests using the Least Significant Difference at the same significance level. The results showed that the F2 P8IS x T1NK7328 (R16), F2 P8IS x T1NK7328 (R18) lines, and the F2 P8IS x NK212 (R4) lines, had leaf angles same as each parent of the first hybrid/hybrid offspring (T1NK7328 and NK212) and smaller than the Sinta Unram. The harvest time of the three F2 lines was classified as super early. Yield (weight of dry seeds per plot) of F2 P8IS x T1NK7328 (R16), F2 P8IS x T1NK7328 (R18) lines, were the same as both parents and F2 P8IS x NK212 (R4) lines, higher than Sinta Unram; but the same as the hybrid parent (NK212). Coefficient of genetic diversity of yield is high; medium for harvest time and low for leaf angle. Heritability in broad sense is classified as high, obtained at harvest time and yield; while the heritability of leaf angle is low. The three F2 lines can be used as basic population material for subsequent breeding activities. Key words: hybridization; Sinta Unram; yield; leaf angle

A Simple Diagnosis-Related Groups-Based Reimbursement System Is Cost Ineffective for Elderly Patients With Displaced Femoral Neck Fracture Undergoing Hemiarthroplasty in Beijing

Displaced femoral neck fractures (FNF) in the elderly are a major public health concern that necessitates hemiarthroplasty (HA) as the mainstay treatment option. Diagnosis-Related Groups (DRG) are a patient classification system that categorizes patients based on the resources expended on them. The first objective of this study was to evaluate if a simplified DRG-based reimbursement system in Beijing would lower total HA treatment costs for elderly patients with displaced FNF. In addition, we aimed to determine how age, gender, year of admission, length of in-hospital stay, and the Charlson index affected total treatment costs. This retrospective study included 513 patients from the Peking Union Medical College Hospital. The patients were diagnosed with unilateral displaced femoral neck fractures and had HA. Medical information was gathered, including baseline demographic and clinical data, as well as treatment costs. Patients were classified into two groups: those who spent more than the predetermined cut-off cost and those who did not. The cost did not include the use of a bipolar prosthesis. Data from the two groups were compared, and multiple regression analysis models were constructed. The median total cost of treatment was ¥49,626 ($7,316). The majority of the patients (89.7%; 460/513) were categorized as exceeding the cost cut-off. Multiple linear regression analysis revealed that total treatment cost was positively correlated with age (p < 0.01) and the duration of in-hospital stay (p < 0.01) but not with gender (p = 0.160) or the Charlson index (p = 0.548). On implementing the DRG-based reimbursement system, the overall treatment costs increased by ¥21,028 ($3,099) (p < 0.01). The implementation of simplified DRG-prospective payment systems did not result in a significant reduction in total treatment costs for elderly patients with FNF who underwent HA in Beijing. The overall cost of treatment was associated with several factors, including age, length of hospitalization, and year of admission.

RHINO-ORBITO-CEREBRAL MUCORMYCOSIS (BLACK FUNGUS) IN COVID 19 PATIENTS

ABSTRACT BACKGROUND Mucormycosis (Black fungus) is a designated as a rare, rapidly progressive fatal disease of immunocompromised caused by saprophytic fungus of family mucorales. Early diagnosis with prompt medical and surgical treatment is the only tool available. Rhino-orbito-cerebral is the most common subtype. In India we saw a sudden rise in mucormycosis cases during second wave of COVID 19. This necessitated a systematic review of epidemic of mucormycosis in COVID 19. METHODS A Retrospective multi-centric study was conducted at various Government and Private Hospitals of Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent COVID19 positive status presenting to us during 14th April 2021- 31st May 2021. RESULT Either Type2 Diabetes Mellitus or history of recent use of steroids in high doses was present in all the patients. Contribution of virulence of the Delta strain B1.617.2 is significant. FESS with sino-nasal debridement contributes significantly towards mortality reduction and cost of total treatment by significantly reducing days of Liposomal Amphotericin B therapy. CONCLUSION Early diagnosis with prompt medical and surgical management along with blood sugar control and avoiding use of high dose of steroids remain to key to mortality and morbidity reduction. Keywords: Black fungus, mucor, mucormycosis, rhino-orbito-cerebral, causes, treatment, covid 19, India, sugar, steroids, steam, oxygen, surgery

Effect of Systematic Holistic Nursing Combined with the MDT Teaching Method in the Nursing of Neonatal Jaundice and Its Impact on the Recovery of the Newborns’ Physiological Function

The application effect of systematic holistic nursing combined with the multidisciplinary team (MDT) in the nursing of neonatal jaundice was explored. This study was a retrospective control study. 90 cases of neonatal jaundice admitted to our hospital (February 2020–February 2021) were equally split into group P treated with routine nursing and group Q treated with systematic holistic nursing combined with MDT. The application effect of the two nursing programs was compared and analyzed. Groups P and Q showed no statistical difference in general data ( P > 0.05 ). Compared with group P, the jaundice regression time, hospitalization time, time of first defecation, and time of meconium turning yellow of group Q were notably shorter, and the body weight and total treatment efficiency of group Q were notably higher ( P < 0.05 ). From the third day, the daily jaundice indexes between the two groups were different; that is, the indexes of group Q were notably lower compared with group P ( P < 0.05 ). The scores of environmental nursing, special nursing, basic nursing, and service attitude in group Q were notably higher compared with group P ( P < 0.05 ). In the nursing process of neonatal jaundice, the combination of systematic holistic nursing and MDT can effectively shorten the time of first defecation and meconium turning yellow, reduce jaundice indexes, promote the recovery of the physiological function, and improve the clinical efficacy and nursing quality.

Cost-effectiveness of using stone cone, balloon dilator, stone basket, and entrapment device in ureteroscopic laser lithotripsy for ureteric stones

Objective To evaluate the costs and stone-free rates of ureteroscopic laser lithotripsy (ULL) performed with and without auxiliary equipment and to compare first-time ULL with total treatment. Methods One hundred patients who underwent first-time ULL without the use of auxiliary equipment because its unavailability comprised the no-device ULL (ndULL) group. Additionally, 100 patients who underwent first-time ULL with the use of auxiliary equipment when necessary comprised the device ULL (dULL) group. Results In the ndULL and dULL groups, the stone-free rates after first-time ULL were 72% and 94% and the mean cost was US $1037 ± 15.10 and US $1452 ± 19.80 per case, respectively, with a statistically significant difference. The stone-free rates at the end of treatment were 98% and 99%, respectively, without a statistically significant difference. When secondary treatment costs were added to the first ULL costs after failed treatment, the mean total cost was US $1625 ± 12.60 in the ndULL group and US $1566 ± 11.01 in the dULL group without a statistically significant difference. Conclusions The stone-free rates and costs after first-time ULL were significantly different between the groups. However, after total treatment, there was no statistically significant difference between the two groups.

A Personal and Practical Answer from A Clinical Perspective

Restoring sodium and fluid homeostasis in hemodialysis (HD) patients is a crucial aim to reduce cardiovascular burden and improve global outcome. This crucial target is achieved at maximum in one quarter of HD patients according to a recent study. Sodium and fluid balance relies on a multitarget approach involving dietary salt restriction, dialysis salt mass removal and eventually residual kidney function. Salt mass removal in hemodialysis relies on ultrafiltration (convective sodium), the dialysate–plasma sodium gradient (diffusive sodium) and total treatment time. Manual dialysate sodium prescription has three major aims: dialysate–plasma sodium gradient; sodium mass removal target; hemodialysis tolerance and patient risks. In the future, automated dialysate sodium adjustment by HD machine will facilitate this aim.

Rhino-orbito-Cerebral mucormycosis during COVID 19 pandemic in western Uttar Pradesh India

Mucormycosis (Black fungus) is a designated as a rare, rapidly progressive fatal disease of immunocompromised caused by saprophytic fungus of family mucorales. Early diagnosis with prompt medical and surgical treatment is the only tool available. Rhino-orbito-cerebral is the most common subtype. In India we saw a sudden rise in mucormycosis cases during second wave of COVID 19. This necessitated a systematic review of epidemic of mucormycosis in COVID 19.A Retrospective multi-centric study was conducted comprising of 51 cases of Rhino-orbito-cerebral mucormycosis with present or recent COVID19 in Western Uttar Pradesh positive status presenting to us during 14 April 2021- 31 May 2021.Either Type2 Diabetes Mellitus or history of recent use of steroids in high doses was present in all the patients. Contribution of virulence of the Delta strain B1.617.2 is significant. FESS with sino-nasal debridement contributes significantly towards mortality reduction and cost of total treatment by significantly reducing days of Liposomal Amphotericin B therapy.Early diagnosis with prompt medical and surgical management along with blood sugar control and avoiding use of high dose of steroids remain to key to mortality and morbidity reduction.

Efficacy and prognosis following combined cinepazaide maleate/nimodipine therapy in cerebral vasospasm patients after hemorrhage

Purpose: To investigate the efficacy and prognosis following treatment of cerebral vasospasm (CVS) patients with a combination of cinnarizide maleate and nimodipine after subarachnoid hemorrhage (SAH).Methods: Eighty-eight patients with CVS after SAH were selected and divided into control group (CG) and study group (EG), each with 44 patients (n = 44). Patients in CG were treated with intravenous infusion of cinnarizide maleate, while those in EG received intravenous infusion of cinnarizide maleate together, and their clinical efficacy and prognosis were compared.Results: Compared with CG, total treatment effectiveness (response) in EG was significantly higher, while levels of inflammatory factors were lower (p < 0.05). Serum protein levels of S100 β and ET-1, and MCA blood flow velocity in EG were notably lower (p < 0.05), but GCS scores were highercompared with CG (p < 0.05). The NIHSS scores were lower and BI indices were higher in EG than in CG (p < 0.05).Conclusion: Treatment of CVS patients after SAH using a combination of cinnarizide maleate and nimodipine effectively reduces the levels of inflammatory factors, improves quality of prognosis, and relieves symptoms of CVS, when compared with administration of cinnarizide maleate only. Therefore, the combination treatment is recommended for the management of CVS after SAH.

Assessing the dose rate delivery of helical TomoTherapy prostate and head & neck treatments

The dose rate distributions delivered to 55 prostate and head & neck (H&N) cancer patients treated with a helical TomoTherapy (HT) system were resolved and assessed with regard to pitch and field width defined during treatment planning. Statistical analysis of the studied cases showed that the median treatment delivery time was 4.4 min and 6.3 min for the prostate and H&N cases, respectively. Dose rate volume histogram data for the studied cases showed that the 25% and 12% of the volume of the planning target volumes of the prostate and H&N cases are irradiated with a dose rate of greater or equal to 1 Gy/min. Quartile dose rate (QDR) data confirmed that in HT, where the target is irradiated in slices, most of the dose is delivered to each voxel of the target when it travels within the beam. Analysis of the planning data from all cases showed that this lasts for 68 s (median value). QDRs results showed that using the 2.5 cm field width, 75% of the prescribed dose is delivered to target voxels with a median dose rate of at least 3.2 Gy/min and 4.5 Gy/min, for the prostate and H&N cases, respectively. Systematically higher dose rates were observed for the H&N cases due to the shallower depths of the lesions in this anatomical site. Delivered dose rates were also found to increase with field width and pitch setting, due to the higher output of the system which, in general, results in accordingly decreased total treatment time. The biological effect of the dose rate findings of this work needs to be further investigated using in-vitro studies and clinical treatment data.

Cost per Responder Analysis to Assess the Value of CAR-T Therapy for Relapsed or Refractory Multiple Myeloma

New classes of therapies have emerged for treating Relapsed or Refractory Multiple Myeloma (RRMM) patients, including chimeric antigen receptor T-cell (CAR-T) therapies targeting the B-cell maturation antigen. While CAR-T therapies are expected to be a more expensive class of treatment compared to chemotherapy, 1 they have been shown to have a high overall response rate (ORR) and progression-free survival (PFS). 2,3 As newer, more innovative RRMM therapies are developed and brought to market, payers will need to balance their higher efficacy and total treatment costs when assessing potential value. To assess the value of RRMM CAR-T therapies (ciltacabtagene autoleucel [cilta-cel] and idecabtagene vicleucel [ide-cel]), we developed a cost per responder (CPR) model that incorporates efficacy and total cost of treatment. In the absence of head-to-head trial data for CAR-T therapies, indirect treatment comparisons (ITCs) can be used to evaluate comparative efficacy, and the results can be used to inform a CPR model. Matching-adjusted indirect comparisons (MAIC) is a form of ITC that involves matching and adjusting a treatment group from a clinical study with individual patient-level data (IPD) available to a comparator for which only summary-level data are available. This method mitigates potential bias arising from differences in patient characteristics between trials and is widely used and accepted in comparative effectiveness research. Unanchored matching adjusted indirect comparison (MAIC) analyses were used to inform the comparative efficacy of cilta-cel versus ide-cel in our CPR model. MAIC results indicated that cilta-cel was associated with statistically significantly improved ORR (odds ratio [OR]: 87.99 [95% confidence interval [CI]: 20.32, 381.01; p &lt; .0001]), complete response or better (≥CR) rate (OR: 5.96 [95% CI: 2.76, 12.88; p &lt; .0001]) and PFS (hazard ratio [HR]: 0.36 [95% CI: 0.22, 0.59; p &lt; .0001]) when compared with ide-cel. 4 To adequately capture total treatment costs for each treatment of interest, CPR models should include all costs related to acquisition and delivery of treatment. Relevant costs of CAR-T therapy for RRMM include the cost of apheresis, bridging therapy, costs of CAR-T acquisition and administration, supportive care and monitoring costs, adverse event management costs, and any costs associated with delivery of inpatient or outpatient clinical services. Preliminary results of the CPR analysis indicate that ide-cel is associated with a cost per ORR of approximately $743,000, a cost per CR or better of $1.66 million and a cost per month in PFS of approximately $55,000. Corresponding results for cilta-cel will be generated after the PDUFA date (November 29, 2021), and presented at ASH 2021. In conclusion, CPR models have significant potential to assist payers in evaluating the value of newer, more innovative RRMM therapies by integrating information on both total costs and efficacy. References 1 Pagliarulo N. FDA approves first CAR-T cell therapy for multiple myeloma. https://www.biopharmadive.com/news/fda-car-t-multiple-myeloma-approval-bristol-myersbluebird/597438/#:~:text=The%20pharma%2C%20which%20licensed%20the,other%20approve d%20CAR%2DT%20therapies. Published 27 March 2021. Accessed 22 June 2021. 2 Munshi NC, Anderson Jr LD, Shah N, et al. Idecabtagene vicleucel in relapsed and refractory multiple myeloma. N Engl J Med. 2021;384(8):705-16. 3 Madduri D, Berdeja JG, Usmani SZ, et al. CARTITUDE-1: phase 1b/2 study of ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy, in relapsed/refractory multiple myeloma [abstract]. Blood. 2020;136(1 supplement). Abstract 177. 4 Martin T, Usmani SZ, Schecter JM, Vogel M, Jackson CC et al. (2021) Matching-adjusted indirect comparison of efficacy outcomes for ciltacabtagene autoleucel in CARTITUDE-1 versus idecabtagene vicleucel in KarMMa for the treatment of patients with relapsed or refractory multiple myeloma. Curr Med Res Opin 1-10. Disclosures Martin: Sanofi: Research Funding; Oncopeptides: Consultancy; Janssen: Research Funding; Amgen: Research Funding; GlaxoSmithKline: Consultancy. Usmani: Pharmacyclics: Consultancy, Research Funding; Seattle Genetics: Consultancy, Research Funding; Merck: Consultancy, Research Funding; SkylineDX: Consultancy, Research Funding; Bristol-Myers Squibb: Research Funding; Takeda: Consultancy, Research Funding, Speakers Bureau; Janssen Oncology: Consultancy, Research Funding; Abbvie: Consultancy; Array BioPharma: Consultancy, Research Funding; Sanofi: Consultancy, Research Funding, Speakers Bureau; Celgene/BMS: Consultancy, Research Funding, Speakers Bureau; GSK: Consultancy, Research Funding; EdoPharma: Consultancy; Janssen: Consultancy, Research Funding, Speakers Bureau; Amgen: Consultancy, Research Funding, Speakers Bureau. Joseph: Johnson and Johnson: Current Employment, Current equity holder in publicly-traded company. Crivera: Johnson & Johnson: Current Employment, Current equity holder in publicly-traded company. Valluri: Janssen: Current Employment, Current equity holder in publicly-traded company. Jackson: Memorial Sloan Kettering Cancer Center: Consultancy; Janssen: Current Employment. Cohen: Eversana Life Science Services: Current Employment, Other: Eversana Life Science Services was contracted by Janssen to work on this project.. Singh: Eversana Life Science Services: Current Employment, Other: Eversana Life Science Services was contracted by Janssen to work on this project..