Increased Risk of Meconium-Related Ileus in Extremely Premature Infants Exposed to Antenatal Magnesium Sulfate

<b><i>Introduction:</i></b> We experienced an increased incidence of meconium-related ileus (MRI) in extremely premature infants (EPIs) while adopting the antenatal magnesium sulfate (MgSO₄) protocol for fetal neuroprotection in our neonatal intensive care unit. This study aimed to test whether antenatal MgSO₄ use was associated with increased risk of MRI in EPIs. <b><i>Methods:</i></b> The incidences of complicated MRI requiring aggressive enema or surgical intervention and other intestinal complications were compared among period 1 (January 2012–December 2013, <i>n</i> = 79), before adoption of the antenatal MgSO₄ protocol for fetal neuroprotection; period 2 (January 2014–March 2016, <i>n</i> = 72), when the protocol was adopted; and period 3 (April 2016–September 2018, <i>n</i> = 75), when the protocol was temporarily withdrawn due to concern regarding intestinal complications in EPIs. <b><i>Results:</i></b> Despite similar baseline clinical characteristics among infants across the study periods, the MRI and MRI with surgical treatment incidences were higher in period 2 than those in periods 1 and 3 (13% vs. 8% and 6%, <i>p</i> = 0.391, and 11% vs. 0% and 1%, <i>p</i> = 0.001, respectively). In multivariable analysis, exposure to antenatal MgSO₄ independently increased the risk of MRI (adjusted odds ratio, 3.8; 95% confidence interval, 1.4, 10.6). <b><i>Conclusion:</i></b> Antenatal MgSO₄ may increase the risk of MRI, frequently requiring surgical intervention, in EPIs with a gestational age of 25 weeks or less.

Obstetric and neonatal outcomes of gestational diabetes mellitus in twin pregnancies according to changes in its diagnostic criteria from National Diabetes Data Group criteria to Carpenter and Coustan criteria: a retrospective cohort study

Background To compare obstetric and neonatal outcomes in twin pregnancies with or without gestational diabetes mellitus (GDM) before and after changes in GDM diagnostic criteria. Methods This was a retrospective cohort study of 1,764 twin pregnancies including 130 women with GDM (GDM group) and 1,634 women without GDM (non-GDM group). Patients with pregestational diabetes, unknown GDM status, and fetal death at < 24 gestational weeks were excluded. Obstetric and neonatal outcomes were compared between the two groups by two periods: period 1 (1995–2005) and period 2 (2005–2018) when National Diabetes Data Group criteria and Carpenter and Coustan criteria were used for diagnosis of GDM, respectively. Results The incidence of GDM in twin pregnancies increased from 4.0% in period 1 to 9.3% in period 2. Composite obstetric complications rate was significantly higher in the GDM group than that in the non-GDM group during period 1 (72.0% vs. 45.5%, P = 0.009). However, it became comparable during period 2 (60.0% vs. 57.4%, P = 0.601). Interaction between GDM and period indicated a significant differential effect of GDM by period on the rate of composite obstetric complications. The rate of composite neonatal complications was similar between the two groups during both periods. The interaction between GDM and period was not significant. Conclusion After changes of GDM diagnostic criteria, the incidence of GDM increased more than twice, and the rate of composite obstetric complications decreased, but the rate of composite neonatal complications did not change significantly.

VARIATIONS IN PRECIPITABLE WATER CONTENT IN LOWER TROPOSPHERE AT PUNE DURING SUMMER MONSOON

Variation. in Precipitable Water Content (pWC) at Pune (lse32'N. 73·S1'E..ssg m u 1)duri ngIUmmer mon aoon aealOM of 1980 and 1981. have been studied. Spectrum of PWC values in layen 9OQ..650 bPashowed peals at period. 2-3 and '·8 days. The periodicities observed in PWC ~comparable with these observed. in other mckorolOlical parameters.

IMPROVING ENGLISH VOCABULARIES THROUGH DERIVATIONAL MORPHEME

This research aims to improve students' vocabulary acquisition through the strategy of deriving suffixes. The populations of this study are students from Politeknik Ganesha Medan in second semester. This research was conducted through Applied Classroom Action Research (CAR), born in two cycles (cycle 1 and cycle 2), and each process consisted of four meetings. The vocabulary test results showed that the average improvement score of the pre-test was 34.66, the post-test of period 1 was 93.46, and the post-test of period 2 was 97.33. In the first cycle, the nominal comparison rate was 88.83%, the verb nature was 77.46%, the adjective nature was 40.74%, and the adverbial heart was 84.14%. In cycle 2, the nominal comparison rate was 100%, the verb nature was 95.45%, the adjective nature was 65.84%, and the adverbial nature was 94.91%. The proportion of students who passed Minimal Criterion Mastery in each cycle was 100%, cycle 1 increased by 169.64%, and cycle 2 increased by 180.81%. These indicate that there is a significant improvement of the students’ vocabulary mastery through derivational morpheme strategy of the students of Politeknik Ganesha Medan.

Spontaneous Recovery of Circadian Organization in Mice Lacking a Core Component of the Molecular Clockwork

Circadian rhythms are generated by interlocked transcriptional-translational feedback loops of circadian clock genes and their protein products. Mice homozygous for a functional deletion in the Period-2 gene ( Per2m/m mice) exhibit short free-running circadian periods and eventually lose behavioral circadian rhythmicity in constant darkness (DD). We investigated Per2m/m mice in DD for several months and identified a categorical sex difference in the dependence on Per2 for maintenance of circadian rhythms. Nearly all female Per2m/m mice became circadian arrhythmic in DD, whereas free-running rhythms persisted in 37% of males. Remarkably, with extended testing, Per2m/m mice did not remain arrhythmic in DD, but after varying intervals spontaneously recovered robust, free-running circadian rhythms, with periods shorter than those expressed prior to arrhythmia. Spontaneous recovery was strikingly sex-biased, occurring in 95% of females and 33% of males. Castration in adulthood resulted in male Per2m/m mice exhibiting female-like levels of arrhythmia in DD, but did not affect spontaneous recovery. The circadian pacemaker of many gonad-intact males, but not females, can persist in DD for long intervals without a functional PER2 protein; their circadian clocks may be in an unstable equilibrium, incapable of sustaining persistent coherent circadian organization, resulting in transient cycles of circadian organization and arrhythmia.

Stripe order enhanced superconductivity in the Hubbard model

Unidirectional (“stripe”) charge density wave order has now been established as a ubiquitous feature in the phase diagram of the cuprate high-temperature superconductors, where it generally competes with superconductivity. Nonetheless, on theoretical grounds it has been conjectured that stripe order (or other forms of “optimal” inhomogeneity) may play an essential positive role in the mechanism of high-temperature superconductivity. Here, we report density matrix renormalization group studies of the Hubbard model on long four- and six-leg cylinders, where the hopping matrix elements transverse to the long direction are periodically modulated—mimicking the effect of putative period 2 stripe order. We find that even modest amplitude modulations can enhance the long-distance superconducting correlations by many orders of magnitude and drive the system into a phase with a substantial spin gap and superconducting quasi–long-range order with a Luttinger exponent, Ksc∼1.

Retrospective analysis of the emergence of antibiotic-resistant Salmonella enterica infections in a level IV hospital from Lima, Peru

This study retrospectively analysed the emergence of multidrug-resistant Salmonella enterica in a level IV hospital in Lima, Peru. A total of 64 S. enterica from January 2009 to June 2010 (Period 1, 24 isolates) and January 2012 to December 2014 (Period 2, 40 isolates) were included. Some 25 were from non-hospitalized and 39 from hospitalized patients. Antimicrobial susceptibility to 15 antimicrobial agents was established by automated methods. Most of the isolates were from blood (46.9%), urine (21.9%) and faeces (14.1%). There was a reduction in blood isolates in Period 2, while all the faecal isolates were from this period. In Period 1, only 3/24 (12.5%) isolates showed antibiotic resistance, whereas 25/39 isolates (64.1%) from Period 2 were antibiotic-resistant, with multidrug-resistant and extensively drug-resistant rates of 17.9% and 20.5%, respectively. Multidrug-resistant/extensively drug-resistant Salmonella isolates were introduced in the hospital in 2013, with Salmonella recovered from faeces from non-hospitalized patients suggested an increase in community-acquired multidrug-resistant/extensively drug-resistant Salmonella infections.

The sleep-wake distribution contributes to the peripheral rhythms in PERIOD-2

In the mouse, Period-2 (Per2) expression in tissues peripheral to the suprachiasmatic nuclei (SCN) increases during sleep deprivation and at times of the day when animals are predominantly awake spontaneously, suggesting that the circadian sleep-wake distribution directly contributes to the daily rhythms in Per2. We found support for this hypothesis by recording sleep-wake state alongside PER2 bioluminescence in freely behaving mice, demonstrating that PER2 bioluminescence increases during spontaneous waking and decreases during sleep. The temporary reinstatement of PER2-bioluminescence rhythmicity in behaviorally arrhythmic SCN-lesioned mice submitted to daily recurring sleep deprivations substantiates our hypothesis. Mathematical modelling revealed that PER2 dynamics can be described by a damped harmonic oscillator driven by two forces: a sleep-wake-dependent force and a SCN-independent circadian force. Our work underscores the notion that in peripheral tissues the clock gene circuitry integrates sleep-wake information and could thereby contribute to behavioral adaptability to respond to homeostatic requirements.

The impact of COVID-19 on surgical volume and surgical training at a high-volume pelvic oncology centre

Introduction: The coronavirus (COVID-19) pandemic has overwhelmed most health services. As a result, many surgeries have been deferred and diagnoses delayed. The aim of this study was to assess the effect of the COVID-19 pandemic at a high-volume pelvic oncology centre. Methods: A retrospective review was performed of clinical activity from 2017 to 2020. We compared caseload for index procedures 2017–2019 (period 1) versus 2020 (period 2) to see the effect of the COVID pandemic. We then compared the activity during the first lockdown (March 23rd) to the rest of the year when we increased our theatre access by utilising a ‘clean’ site. Results: The average annual number of robotic assisted radical cystectomy (RARC) and robotic assisted radical prostatectomy (RARP) performed during period 1 was 82 and 352 respectively. This reduced to 68 (17.1% reduction) and 262 (25.6% reduction) during period 2. The number of patients who underwent prostate brachytherapy decreased from 308 to 243 (21% reduction). The number of prostate biopsies decreased from 420 to 234 (44.3% reduction). The number of radical orchidectomies decreased from 18 to 11 (39% reduction). The mean number of RARC and RARP per month during period 2 was 5.5 and 22. This decreased to 4 and 9 per month during the first national lockdown but was maintained thereafter despite two further lockdowns. Conclusion: There has been a substantial decrease in urological oncology caseload during the COVID pandemic. The use of alternate pathways such as ‘clean’ sites can ensure continuity of care for cancer surgery and training needs.

Quality Awareness of Indonesian Higher Education During the Covid-19 Pandemic: A Google Trend Analysis

This study aims to determine the trend of society on the quality of higher education and the factors that influence it during COVID-19. Data was collected through the google search engine in the period March 2020 to November 2021. Bibliometric analysis techniques based on Google Trend big data were used. The results of the study found that 1) the community trend regarding the quality of higher education was quite good with a range of information retrieval above 10% and a sharp increase during the July period; 2) two main factors influence the trend of awareness of the quality of higher education, namely the acceptance of new students, and monitoring of accreditation ratings by BAN-PT. Therefore, higher education institutions must continue to improve binding quality services through accreditation instruments, especially on websites or online media owned by universities.