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Determinants and Outcomes of Pregnancies among Booked versus Unbooked Patients in a Tertiary Hospital South East, Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 144-161页

作者： Chijioke S. Anyigor-Ogah john O. Egede Chijioke O. Ogeh Chika C. Agunanne Alphosus i. Ozioko Chinyere C. Duru Department of Family Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Paediatrics Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria

Background: inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. in a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. Chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% Ci = 1.24 - 32.59), educational status (OR = 36.40, 95% Ci = 5.26-152.83), place of residence (OR = 0.15, 95% Ci = 0.06 - 0.41), partner’s support (OR = 0.05, 95% Ci = 0.01 - 0.37), family support (OR = 0.03, 95% Ci = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% Ci = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% Ci = 2.45 - 14.83) and NBiCU admission (OR = 3.75, 95% Ci = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. Conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.

关键词： Socio-Demographic Characteristics Booking Status Antenatal Delivery

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Anja Schuffer is Stronger than Your

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城市漫步（GBA版） 2024年第2期 31-33页

作者： Kirby john Carney 不详

"i cannot imagine a life without being able to deadlift,"confesses Anja Schuffner,a sentiment that resonates within the strength training *** echoes the legendary words of Jon Pall Sigmarsson,the first four-time winner of the World's Strongest Man,who famously stated,"There is no point in being alive if you cannot do the deadlift."

关键词： Strong words Your

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New markers of fibrosis in hepatitis C:A step towards the Holy Grail?

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World Journal of Hepatology 2024年第2期16卷 112-114页

作者： Konstantinos john Dabos Department of Hepatology St Hohn's HospitalLivingston EH546PPWest LothianUnited Kingdom

in the present issue of the World Journal of Hepatology,Ferrassi et al examine the problem of liver fibrosis staging in chronic hepatitis *** identify novel biomarkers in an effort to predict accurate fibrosis staging with the aid of the metabolome of Hepatitis C *** i think Ferrassi et al took a different approach in identifying fibrosis biomarkers,by looking at the patients’*** biomarkers clearly separate patients from *** can also separate out,patients with minimal fibrosis(F0-F1 stage)and patients with cirrhosis(F4 stage).Obviously,if these biomarkers were to be widely used,tests for all the important metabolites would need to be readily available for use in hospitals or outpatient setting and that may prove difficult and above all,***,this step could eventually lead to a metabolomic approach for novel biomarkers of ***,it would need to be validated,but could represent a step towards the Holy Grail of Hepatology.

关键词： Hepatitis C metabolomics Fibrosis Non invasive markers Metavir

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Results of the Second Life Metabolism Travel Awards 2024

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Life Metabolism 2024年第3期3卷 1-2页

作者： john R.Speakman Shenzhen Key Laboratory of Metabolic Health Center for Energy Metabolism and ReproductionShenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenGuangdong 518055China State Key Laboratory of Molecular Developmental Biology Institute of Genetics and Developmental BiologyChinese Academy of SciencesBeijing 100101China institute of Biological and Environmental Sciences University of AberdeenAberdeenAB242TZScotlandUnited Kingdom

This year is the second year of the Life Metabolism Travel Prize Awards for PhD students and *** three 700 US$awards are generously sponsored by Sable Systems-Promethion(China)who manufacture metabolic *** i announce the winners and their interesting projects,i will just reiterate how the judging of the awards *** first remove anything from the submission that would identify the sex,affiliation,or ethnicity of the applicant.

关键词： remove Travel Awards

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Adjuvant Rectal Diclofenac for Post Operative Analgesia after Caesarean Section—A Randomized Controlled Study

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 591-609页

作者： Eziaha Eric S. Ede Ayodele A. Olaleye john C. irechukwu Uchenna Nelson Nwaedu Borniface N. Ejikeme Vincent Chidiebere Ali Bartholomew i. Olinya Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAiD that can be used for postoperative analgesia. it is available and affordable. OBJECTiVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P CONCLUSiON: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.

关键词： Pain Caesarean Section Diclofenac Placebo Suppository

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RiGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir john Potter Christopher i Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NiHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RiGHT-2).Methods RiGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[iQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%Ci 0.85 to 1.54),death or global analysis(MWD 0.00,95%Ci-0.10 to 0.09).in subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** in patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** iS ALREADY KNOWN ON THiS TOPiC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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Adaptive strategies of high and low nucleic acid prokaryotes in response to declining resource availability and selective grazing by protozoa

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Science China Earth Sciences 2024年第6期67卷 1872-1884页

作者： Chen HU Liuqian YU Xiaowei CHEN Jihua LiU Yao ZHANG john BATT Xilin XiAO Qiang SHi Rui ZHANG Tingwei LUO Nianzhi JiAO Dapeng XU College of the Environment and Ecology Xiamen UniversityXiamen 361102China State Key Laboratory of Marine Environmental Science College of Ocean and Earth SciencesFujian Key Laboratory of Marine Carbon SequestrationXiamen UniversityXiamen 361102China Joint Lab for Ocean Research and Education(LORE)of Dalhousie University Canadaand Shandong University and Xiamen UniversityXiamen 361102China Earth Ocean and Atmospheric Sciences ThrustThe Hong Kong University of Science and Technology(Guangzhou)Guangzhou 510000China institute of Marine Science and Technology Shandong UniversityQingdao 266237China Department of Oceanography Dalhousie UniversityHalifaxNova Scotia B3H 4R2Canada institute for Advanced Study Shenzhen UniversityShenzhen 518060China Carbon Neutral innovation Research Center Xiamen UniversityXiamen 361102China

Prokaryotes play a fundamental role in global ocean biogeochemical ***,how the abundance and metabolic activity of ecologically distinct subgroups(i.e.,high nucleic acid(HNA)and low nucleic acid(LNA)cells),and their regulating factors,change in response to changing marine environmental conditions remains poorly ***,we delved into the time-evolving dynamic responses of the HNA and LNA prokaryotic subgroups to declining resource availability and selective grazing by protozoa by conducting a 73-day incubation experiment in a large-volume(117,000 L)macrocosm that facilitates community-level *** found that the metabolic activity of the HNA subgroup was higher than that of the LNA subgroup when the macrocosm was resource replete but that the HNA subgroup declined more rapidly than the LNA subgroup as the resources became increasingly scarce,leading to a steadily increasing contribution of LNA cells to prokaryotic ***,as resources in the macrocosm became limited,protozoan grazing preference shifted from the HNA to the LNA subgroup and the contributions of the LNA subgroup to the carbon flow within the macrocosm *** findings highlight the resilience of LNA cells in resource-limited environments,illuminate the critical role of selective grazing by protozoa in balancing distinct prokaryotic subgroups under changing resource conditions,and demonstrate the complex and adaptive interactions between protozoa and prokaryotes across diverse environmental contexts.

关键词： Microbial loop Macrocosm experiment Prokaryote Top-down and bottom-up controls Carbon flow

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Land use and river-lake connectivity: Biodiversity determinants of lake ecosystems

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Environmental Science and Ecotechnology 2024年第5期21卷 329-340页

作者： Huiyu Xie Yu Ma Xiaowei Jin Shiqi Jia Xu Zhao Xianfu Zhao Yongjiu Cai Jian Xu Fengchang Wu john P.Giesy State Key Laboratory of Environmental Criteria and Risk Assessment Chinese Research Academy of Environmental SciencesBeijing100012China College of Water Sciences Beijing Normal UniversityBeijing100875China China National Environmental Monitoring Centre Beijing100012China Key Laboratory of Ecological impacts of Hydraulic-Projects and Restoration of Aquatic Ecosystem of Ministry of Water Resources Institute of HydroecologyMinistry of Water Resources and Chinese Academy of SciencesWuhan430079China Nanjing institute of Geography and Limnology Chinese Academy of SciencesNanjing210008China Department of integrative Biology Michigan State UniversityEast LansingMI48895USA Department of Veterinary Biomedical Sciences and Toxicology Centre University of SaskatchewanSaskatoonSaskatchewanS7N 5B3Canada Toxicology Centre and Department of Veterinary Biomedical Sciences University of Saskatchewan44 Campus DriveSaskatoonSKS7N 5B3SaskatoonSKCanada

Lake ecosystems confront escalating challenges to their stability and resilience,most intuitively leading to biodiversity loss,necessitating effective preservation strategies to safeguard aquatic ***,the complexity of ecological processes governing lake biodiversity under multi-stressor interactions remains an ongoing concern,primarily due to insufficient long-term bioindicator data,particularly concerning macroinvertebrate *** we utilize a unique,continuous,and in situ biomonitoring dataset spanning from 2011 to 2019 to investigate the spatio-temporal variation of macroinvertebrate *** assess the impact of four crucial environmental parameters on Lake Dongting and Lake Taihu,i.e.,water quality,hydrology,climate change,and land *** two systems are representative of lakes with Yangtze-connected and disconnected subtropical floodplains in *** find an alarming trend of declining taxonomic and functional diversities among macroinvertebrate communities despite improvements in water *** contributing factors to this decline include persistent anthropogenic pressures,particularly alterations in human land use around the lakes,including intensified nutrient loads and reduced habitat ***,river-lake connectivity is pivotal in shaping differential responses to multiple *** results highlight a strong correlation between biodiversity alterations and land use within a 2e5 km radius and 0.05e2.5 km from the shorelines of Lakes Dongting and Taihu,*** findings highlight the importance of implementing land buffer zones with specific spatial scales to enhance taxonomic and functional diversity,securing essential ecosystem services and enhancing the resilience of crucial lake ecosystems.

关键词： Taxonomic richness Functional diversity Biotic homogenization River-lake connectivity Multiple stressors

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Promises and pitfalls of targeted agents in chronic lymphocytic leukemia

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Cancer Drug Resistance 2020年第3期3卷 415-444页

作者： Thomas E.lew Mary Ann Anderson john F.Seymour Department of Clinical Haematology The Royal Melbourne Hospital and Peter MacCallum Cancer CentreParkville 3050Australia. Blood Cells and Blood Cancer Division Walter and Eliza Hall Institute of Medical ResearchParkville 3050Australia. Faculty of Medicine Dentistry and Health SciencesThe University of MelbourneParkville 3050Australia.

Targeted agents have significantly improved outcomes for patients with chronic lymphocytic leukemia,particularly high-risk subgroups for whom chemoimmunotherapy previously offered limited *** classes of agent in particular,the Bruton tyrosine kinase inhibitors(e.g.,ibrutinib)and the B-cell lymphoma 2 inhibitor,venetoclax,induce high response rates and durable remissions in the relapsed/refractory and frontline ***,maturing clinical data have revealed promises and pitfalls for both *** drugs induce remissions and disease control in the majority of patients,often in situations where modest efficacy would be expected with traditional chemoimmunotherapy ***,in the relapsed and refractory setting,both agents appear to be associated with an inevitable risk of disease relapse and *** patterns of resistance are being described for both agents but a common theme appears to be multiple sub-clonal drivers of disease *** these mechanisms and developing effective and safe methods to circumvent the emergence of resistance will determine the longer-term utility of these agents to improve patients’quality and length of *** drug combinations,optimised scheduling and sequencing of therapy will likely hold the key to achieving these important goals.

关键词： Chronic lymphocytic leukemia drug resistance venetoclax B-cell lymphoma 2 ibrutinib bruton tyrosine kinase idelalisib phosphatidylinositol 3-kinase

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integrative genomic and transcriptomic profiling of pulmonary sarcomatoid carcinoma identifies molecular subtypes associated with distinct immune features and clinical outcomes

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Cancer innovation 2024年第3期3卷 81-94页

作者： Sahil Seth Runzhe Chen Yang Liu Junya Fujimoto Lingzhi Hong Alexandre Reuben Susan Varghese Carmen Behrens Tina McDowell Luisa Solis Soto Cara Haymaker Annikka Weissferdt Neda Kalhor Jia Wu Xiuning Le Natalie i Vokes Chao Cheng john V.Heymach Don L.Gibbons P.Andrew Futreal ignacio iWistuba Humam Kadara Jianhua Zhang Cesar Moran Jianjun Zhang Department of Genomic Medicine The University of Texas MD Anderson Cancer CenterHoustonTexasUSA TRACTiON The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Graduate School of Biomedical Sciences The University of Texas MD Anderson and the University of Texas Health Science CenterHoustonTexasUSA Department of Thoracic/Head and Neck Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Epidemiology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Pathology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of imaging Physics The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Medicine Baylor College of MedicineHoustonTexasUSA

Background:Pulmonary sarcomatoid carcinoma(PSC)is a rare and aggressive subtype of non-small cell lung cancer(NSCLC),characterized by the presence of epithelial and sarcoma-like *** molecular and immune landscape of PSC has not been well ***:Multiomics profiling of 21 pairs of PSCs with matched normal lung tissues was performed through targeted high-depth DNA panel,whole-exome,and RNA *** describe molecular and immune features that define subgroups of PSC with disparate genomic and immunogenic features as well as distinct clinical ***:in total,27 canonical cancer gene mutations were identified,with TP53 the most frequently mutated gene,followed by ***,most TP53 and KRAS mutations were earlier genomic events mapped to the trunks of the tumors,suggesting branching evolution in most PSC *** identified two distinct molecular subtypes of PSC,driven primarily by immune infiltration and *** immune High(iM-H)subtype was associated with superior survival,highlighting the impact of immune infiltration on the biological and clinical features of localized ***:We provided detailed insight into the mutational landscape of PSC and identified two molecular subtypes associated with ***-H tumors were associated with favorable recurrence-free survival and overall survival,highlighting the importance of tumor immune infiltration in the biological and clinical features of PSCs.

关键词： genomic immune pulmonary sarcomatoid carcinoma survival

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