Analysis of ABO and RhD blood group detection results among voluntary blood donors in Huainan of Anhui province / 中国基层医药

Objective:To analyze the distributions of ABO and RhD blood groups by analyzing the basic data of blood group detection among voluntary blood donors in Huainan in 2021, to provide data support for blood recruitment, clinical use of blood, and emergency guarantee of rare groups of blood.Methods:ABO and RhD blood groups of 24 484 voluntary blood donors eligible for blood donation in 2021 were detected using the Metis150-8 automatic blood group analyzer, manual saline method, antihuman globulin method, and manual polybrene test. The blood group results were statistically analyzed.Results:Among 24 484 voluntary blood donors in Huainan in 2021, A blood group accounted for the highest proportion (7 463 cases, 30.48%), followed by O blood group (7 444 cases, 30.40%) and B blood group (7 056 cases, 28.82%), and the last was AB blood group (2 521 cases, 10.30%). A total of 143 cases of RhD-negative blood were detected, and the negative frequency of RhD was 0.58% (143/24 484). Among the RhD-negative blood samples, 43 cases of type A, 41 cases of type B, 46 cases of type O, and 13 cases of type AB were RhD-negative, accounting for 30.07%, 28.67%, 32.17%, and 9.09%, respectively. There was no statistical difference in the detection rate of Rh-negative blood among different ABO blood groups in Huainan ( χ2 = 0.36, P = 0.948). The ABO blood group distribution of voluntary blood donors in Huainan in 2021 was not identical to those of voluntary blood donors in Guangzhou, Yueyang, Xinjiang Bozhou, Zhangzhou, and Liuzhou. The proportion of type A blood donors in Yueyang was higher than those in other regions. The proportions of type B blood donors in Huainan, Xinjiang Bozhou, and Zhangzhou were higher than those in other regions. The proportion of type O blood donors in Liuzhou was higher than those in other regions. The proportions of type AB blood donors in Huainan and Xinjiang Bozhou were higher than those in other regions. Conclusion:The distributions of ABO and RhD blood groups among voluntary blood donors in Huainan region have certain regional characteristics. Central blood banks and medical institutions should reasonably store and supply blood according to the blood collection from voluntary blood donations and the needs of clinical transfusion, to prevent the occurrence of situations such as blood expiration and waste.

Comparative study of corneal thickness and thinnest point position of keratoconus measured by Pentacam HR and RTVue OCT / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the difference, correlation, and consistency of corneal thickness and the thinnest point position detected by Pentacam HR corneal topography map and RTVue optical coherence tomography(OCT)in patients with keratoconus.METHODS: Cross-sectional comparative study. The corneal curvature map, corneal thickness map, thinnest point position, and thinnest point thickness were detected by Pentacam HR and RTVue OCT. Paired sample t-test was used for data consistent with normal distribution, and paired sample rank sum test was used for data inconsistent with normal distribution. Spearman correlation analysis and Bland-Altman analysis were used for the correlation and consistency of the two measurement methods.RESULTS: A total of 63 patients(105 eyes)with keratoconus were included in this study, including 49 males(77.8%)and 14 females(22.2%), aged 22.24±6.19 years; among them, relevant data of Pentacam HR topographic map: Km was 47.85±4.73D and Kmax was 55.43±8.72D. In measuring central corneal thickness and the thinnest point thickness of keratoconus, the Pentacam HR was 4.70μm and 19.46μm thicker than the mean value measured by RTVue OCT(P<0.05). There was no significant difference between the horizontal and vertical coordinates of the thinnest points measured by the two devices(P>0.05). The central corneal thickness and the thinnest point thickness measured by the two devices were highly correlated, the horizontal coordinate of the thinnest point was moderately correlated, and the vertical coordinate of the thinnest point was weakly correlated. Bland-Altman analysis showed that the central corneal thickness, the thinnest point thickness, the horizontal coordinate of the thinnest point, and the vertical coordinate of the thinnest point were 95.2%(100/105)and 93.3%(98/105), 95.2%(100/105), 95.2%(100/105)respectively, which were within the 95% consistency limit, while the consistency ranges were -36.00～+26.62μm, -42.27～+3.36μm, -0.80～+0.84mm, and -1.95～+1.06mm, respectively.CONCLUSION: In keratoconus, the central corneal thickness and the thinnest point thickness measured by Pentacam HR were higher than those measured by RTVue OCT. It is not recommended that the central corneal thickness and the thinnest point thickness measured by the two instruments be interchangeable in clinical use because of the wide range of consistency between the two instruments' results. The position of the thinnest corneal point measured by the two instruments is similar and consistent, so it could be considered to replace the measured values of the two instruments in clinical use.

Descripción de una población de embarazadas con incompatibilidad Rh (D) / Description of a population of pregnant women with Rh (D) incompatibility

Resumen OBJETIVO: Describir los desenlaces maternos y perinatales en embarazadas con incompatibilidad Rh D. MATERIALES Y MÉTODOS: Estudio de cohorte retrospectiva efectuado en la Unidad Materno Infantil de Medellín, Colombia, en pacientes embarazadas atendidas entre 2013 y 2018 con incompatibilidad Rh. Se realizó un muestreo no probabilístico de casos consecutivos y un análisis univariado. RESULTADOS: Se incluyeron 250 pacientes con mediana de edad de 26 años y tipo de sangre O-, que fue el más prevalente (55.2%). El 49.2% de las pacientes había tenido entre 2 y 3 embarazos previos. El 88% de las pacientes no había tenido ningún evento sensibilizante durante el embarazo. El 65.2% tuvo un reporte negativo del primer Coombs y la media de semanas de embarazo al primer Coombs fue de 28. El 48% de las pacientes recibió la inmunoglobulina G anti-D a una mediana de 28 semanas de gestación. CONCLUSIÓN: El estudio confirma datos clínicos y sociodemográficos y sugiere que se requiere fortalecer la oportunidad en la captación temprana de las pacientes para el seguimiento con el Coombs y para la indicación de la profilaxis.

Abstract OBJECTIVE: To determine the maternal and fetal outcomes in pregnant women with Rh D incompatibility. MATERIALS AND METHODS: A Retrospective cohort study carried out in the Maternal and Child Unit of Medellín, Colombia, in pregnant patients attended between 2013 and 2018. RESULTS: 250 patients were included, in which the median age was 26 years. The O- blood type was the most prevalent in pregnant women with 55.2% and 49.2% of the patients had had between 2 and 3 previous pregnancies, in addition, 88% of the patients had not presented any sensitizing event during her pregnancy. 65.2% had a negative first Coombs result and the mean gestational age of the first Coombs was 28 weeks. 48% of patients received immunoglobulin G anti D at a median gestational age of 28 weeks. CONCLUSION: The present study confirms the clinical and sociodemographic data, however it suggests that it may be necessary to strengthen the opportunity in the early recruitment of patients for follow-up with Coombs and for the indication of prophylaxis.

Comparison of the effectiveness, safety, compliance, and cost of the 6-month isoniazid vs 3-month isoniazid-rifampicin regimen for latent tuberculosis in children

Background@#Tuberculosis remains to be a major cause of morbidity in children and treatment of latent tuberculosis is important to prevent children from developing active tuberculosis. This study aimed to compare the effectiveness, safety, compliance, and cost of the currently available Latent Tuberculosis Infection treatment regimens, 6 months isoniazid (6H) and 3 months isoniazid plus rifampicin (3HR), based on the 2020 Department of Health National Tuberculosis Control Program Tuberculosis Preventive Treatment guidelines for children.@*Methodology@#In this open label randomized controlled trial pilot study, 30 participants were assigned to receive either 6H or 3HR. Medications were administered daily by either participants (with direct supervision of treatment supporters) or treatment supporters (for younger participants). Data on outcome measures in terms of effectiveness, safety, and compliance were obtained. Direct cost of treatment was computed per patient’s weight category. Independent Z-test for proportion (for effectiveness, safety, and compliance) and mean (for cost) at 5% level of significance was used to compare the outcomes for each treatment group.@*Results@#Twelve subjects (67%) in the 6H group completed per-protocol therapy, compared to 10 subjects (87%) in the 3HR group. The proportion of adverse events was higher in the 6H group (22%) compared to the 3HR group (8%), but statistical tests showed no significant difference for both compliance and frequency of adverse events. No participant developed active TB disease in both groups. The cost of the 6H treatment regimen was 2,180.18 Php while the cost of the 3HR treatment regimen was 1,526.41 Php, with a p-value of 0.0470 which was statistically significant.@*Conclusions@#Both 6H and 3HR are effective treatments for latent TB infection in patients 0-18 years old. Both treatments were comparable in terms of safety and ease of compliance, but overall cost was higher in the 6H treatment regimen.

Reflection on blood transfusion in a patient with RhC/E gene deletion / 中华检验医学杂志

The patient′s ABO blood type and Rh antigen phenotype were identified by monoclonal antibody serum test tube agglutination, and Rh antigen deletion was confirmed by gene sequencing.The ABO blood type and Rh antigen phenotype of the patient were identified using monoclonal antibody serum in vitro agglutination assay, and Rh antigen deletion was confirmed using gene sequencing. The Rh typing saline method showed that the patient was positive for anti D, but negative for anti E, -C, -c, and -e. The saline method for antibody screening showed negative results for cells I to III, positive results for polyamine and anti human globulin tests, positive results for antibody identification cells 1 to 16, and negative results for themselves. Direct anti globulin tests showed negative results. The sequencing results of RhC/E gene showed that exons 9-10 were normal, while exons 1-8 were missing. The patient had a deletion of exons 1-8 of the RhC/E gene, resulting in a loss of Rh antigen E/e and C/c expression. After the first random matching transfusion, the patient produced antibodies targeting E/e and C/c, resulting in an incompatibility between the main and side matching during the second infusion of red blood cell products and the inability to transfuse. In order to solve this situation, first we need to establish a rare blood group bank for Rh C/E gene deletion. Secondly, during the first blood transfusion, a small amount of RH antigen red blood cells should be injected. Stored autologous blood transfusion should also be considered.

Fetal RHD screening from circulating cell-free DNA in RhD-negative pregnant women / 中华围产医学杂志

Objective:To investigate the RHD genotypes of RhD-negative pregnant women and explore the optimum strategy for fetal RHD screening among this population in the region. Methods:This prospective study recruited 33 cases of RhD-negative singleton pregnancies at ≥12 weeks of gestation in Nanjing Drum Tower Hospital from March to November 2021. On the basis of RHD genotyping, quantitative real-time polymerase chain reaction (PCR) was used to amplify the exons 5 and 10 of RHD gene in the circulating cell-free DNA of RhD-negative pregnant women harboring whole RHD gene deletion and RHD-CE(2-9)- D. High-throughput sequencing was performed to detect chr1:25648453 locus from circulating cell-free DNA in plasma of RhD-negative pregnant women harboring RHD 1227A mutation to screen the fetal RhD blood group. Neonatal umbilical cord blood samples were collected for verifying fetal RHD genotyping. Descriptive statistical analysis was used. Results:Whole RHD gene deletion homozygous genotype ( n=20, 60.6%), RHD-CE(2-9) -D/whole RHD gene deletion heterozygous genotype ( n=5, 21.2%), RHD 1227A/whole RHD gene deletion heterozygous genotype ( n=7, 15.2%) and RHD 711delC/whole RHD gene deletion heterozygous genotype ( n=1) were identified in the 33 RhD-negative pregnant women. In the 25 cases with whole RHD gene deletion homozygous genotype or RHD-CE(2-9)- D/whole RHD gene deletion heterozygous genotype, 22 fetuses were RhD-positive and three were RhD-negative based on prenatal screening, which were confirmed by the neonatal serological test results after birth. In the seven cases carrying RHD 1227A/whole RHD gene deletion heterozygous genotype, all fetuses were RhD-positive, which were consistent with the results of serological detection after delivery. The case harboring RHD 711delC/whole RHD gene deletion heterozygous genotype did not receive fetal RHD screening. Conclusions:This study suggests that whole RHD gene deletion homozygous genotype is the most common allele in RhD-negative population in this area, followed by RHD 1227A/whole RHD gene deletion heterozygous genotype and RHD- CE(2-9)- D/whole RHD gene deletion heterozygous genotype. For women with whole RHD gene deletion homozygous genotype, RHD- CE(2-9)- D, or RHD 1227A mutation, fetal RHD screening with quantitative real-time PCR and high-throughput sequencing are important for the management of RhD-negative pregnant women.

Distribución de virus de papiloma humano de alto riesgo oncogénico y otras infecciones de transmisión sexual en mujeres paraguayas con y sin virus de la inmunodeficiencia humana

El virus de papiloma humano de alto riesgo oncogénico (VPH-AR) es causa necesaria pero no suficiente para la ocurrencia de cáncer de cuello uterino (CCU). Mujeres portadoras del virus de inmunodeficiencia humana (VIH) presentan mayor riesgo de desarrollar lesiones precursoras del cáncer de cuello de útero, por ello, el objetivo del presente trabajo prospectivo de corte transversal fue determinar la frecuencia de VPH-AR y otras infecciones de transmisión sexual-ITS (condilomas, sífilis, virus del herpes simple, gonorrea, citomegalovirus, hepatitis B) en 218 mujeres con y sin VIH que acudieron al Programa Nacional de Lucha contra el SIDA (PRONASIDA) desde julio 2017 hasta marzo 2021. Se encontró que 16/54 (29,6%) mujeres VIH-positivas presentaron infección por VPH-AR en comparación a 41/164 (25%) mujeres VIH-negativas (p>0,05). En relación a la edad, mujeres VIH positivas presentaron una frecuencia comparable de infección por VPH-AR (30 años 30,2%), a diferencia de mujeres VIH negativas donde hubo una disminución significativa de la infección por VPH-AR luego de los 30 años (30 años 18,8%, p= 0,028). Esto podría explicarse por la inmunosupresión observada en mujeres VIH positivas que podría favorecer infecciones persistentes, sugiriendo que deben ser controladas más cercanamente. Además, se observó mayor frecuencia de otras ITS en mujeres VIH positivas (29,6% vs 15,8%, p=0,026), lo cual sugiere que aparte del monitoreo más cercano, es fundamental fortalecer la educación sobre factores de riesgo para la ITS sobre todo VPH y VIH, así como la realización de prevención primaria por vacunación contra el VPH.

High-risk human papillomavirus (HPV-HR) is a necessary but not sufficient cause for cervical cancer (CC). Women carriers of human immunodeficiency virus (HIV) present an increased risk for the development of cervical cancer precursor lesions, therefore, the objective of the present prospective cross-sectional study was to determine the frequency of HPV-HR and other sexually transmitted infections-STIs (condylomas, syphilis, herpes simplex virus, gonorrhoea, cytomegalovirus, hepatitis B) in 218 women with and without HIV who attended the Ministry of Health from July 2017 to March 2021. It was found that 16/54 (29.6%) HIV-positive women had HPV infection compared to 41/164 (25%) HIV-negative women (p>0.05). In relation to age, HIV-positive women had a comparable frequency of HPV infection (30 years 30.2%), unlike HIV-negative women whom above 30 years of age presented a significant decrease in HPV-AR infection (30 years 18.8%, p:0.028). This could be explained by the immunosuppression observed in HIV-positive women which could favour persistent infections, suggesting that they should be controlled more closely. In addition, other STIs were observed to be more frequent in HIV-positive women (29.6% vs 15.8%, p:0.026), which suggests that apart from closer monitoring, it is essential to strengthen education on risk factors for STIs, especially HPV and HIV, as well as the implementation of primary prevention by vaccination against HPV.

Comparison Of Oral Midazolam,Oral Dexmedetomidine And Oral Midazolam Ketamine Combination For Premedication In Paediatric Surgery

Background: Children especially age group <10years undergoing operation may experience preoperative anxiety & may be uncooperative. This uncooperative behavior of children may be observed at the time of separation from parents, venipuncture or mask application. Untreated anxiety may lead to difficult induction, greater rescue analgesic needs, emergence delirium (ED), behavioural & postoperative psychological effects. An atraumatic premedication, calm separation from parents can minimize these problems and a smooth induction of anaesthesia can be achieved.Method : Prospective randomized double blind active controlled study was conducted in Government medical college & hospital, Aurangabad from 2018 to 2020 after Institution Ethics Committee approval. 75 ASA I & II subjects aged between 2 to 5 year weighing less than 15 Kg posted for elective paediatric surgery under general anaesthesia at tertiary care centre were selected. They were randomly allocated into 3 groups Group M ,Group M K & Group D with 25 subjects in each group using computer generated randomization list. Oral premedication was given in each group 30 minutes before surgery. Baseline heart rate, SBP and RR measured before administering premedication and at 10 minutes intervals up to 30 to 45 minutes after premedication. Sedation & anxiolysis score at induction[S1] was significant higher inResults: Group M K& Group D [p Value <0.05] compared to Group M. Sedation at the time of separation from parents [S2] was better in Group M K & Group D compared to Group M[p Value <0.05]. Sedation during Mask Acceptance[S3] was better in Group M K & Group D compared to Group M[p Value <0.05].Wake up Behaviour [when the patient recovers from anaesthesia at end of surgery [S4] ] was assessed & Subjects were more Sedated[post anaesthesia] in Group D when compared to Group m & Group M K[p Value <0.05]. Time taken for maximum change in vital parameters was more in Group D followed by Group M K and Group M respectively p Value 0.001].There was significant changes in Vital parameters in Group D compared to Group M & Group M K .Bradycardia p Value 0.00044] & Hypotension [p Value 0.01]was more significant in Group D when compared to Group MK &Group M Oral Midazolam (0.2mg/kg)Conclusion: & Ketamine (2mg/kg) combination & oral Dexmedetomidine (0.5 g/kg) both provide satisfactory sedation levels & offers significant ease of separation from parents with satisfactory mask acceptance in children<10 years compared to oral Midazolam alone.

Transforming HR practices with Behavioral Economics

Behaviors Economics is presently a thriving field of research for many researchers. It offers a descriptive model of decision making which is entirely different from the traditional decision making models of economics. This research paper is an attempt to bring insights from Behavioral Economics which can help Human Resource personnel to address the issues like Dynamic Inconsistency and incentive design strategies. The author argues that the insight from Behavioral Economics can transform HR practices. HR managers and leaders stand to benefit from the emerging evidence from the lab and field of behavioral economics that calls for s rethinking of traditional decision making model

Management of human epidermal growth factor receptor 2杗egative metastatic breast cancer: Role of poly adenosine diphosphate (ADP?ribose) polymerase inhibitors

Human epidermal growth factor receptor 2 (HER2)?negative subset is the most heterogeneous group of metastatic breast cancers (MBCs) as it includes both hormone receptor (HR)?positive and HR?negative breast cancer (or TNBC), which have different therapies and treatment challenges. Though endocrine therapy (ET) remains the treatment backbone in HR?positive HER2?negative cases, about 40% of the patients show intrinsic or acquired resistance to ET due to multiple mechanisms. Combining different therapies such as ET and other targeted therapies with or without chemotherapy fails to give continued benefit, unlike cyclin?dependent kinase (CDK) 4/6 inhibitors that have shown a great benefit. TNBC has conventionally been treated ineffectively with systemic chemotherapy. Recently, poly (ADP?ribose) polymerase inhibitors (PARPi) have emerged for HER2?negative breast cancer (BC) patients, including TNBC. Olaparib and talazoparib have recently been approved in germline BRCA?mutated (gBRCAm) HER2?negative MBC. Additionally, ongoing trials of PARPi in combination with various therapies are expected to provide more and better treatment options for gBRCAm HER2?negative breast cancer.

Effects of different bladder filling volumes on target area and organs at risk during three-dimensional brachytherapy of postoperative early cervical cancer / 中华放射医学与防护杂志

Objective:To investigate the optimal bladder filling volume in the 3D brachytherapy of postoperative cervical cancer.Methods:Totally 111 early cervical cancer patients with positive incisal margins or insufficient safety boundaries were included. The normal saline 50, 60, 70, 80, 90, and 100 ml were filled into their bladders, and accordingly six groups were determined, and 66, 69, 66, 69, 72, 56 person-times in each group, respectively. The CT-based simulation positioning was performed. According to the ICRU 89 report, high-risk clinical target volume and organs at risk such as bladder and rectum were delineated. The Oncentra planning system was used to prepare the treatment program. The high-risk clinical target volume (HR-CTV), D90, and the D2 cm 3 and D1 cm 3 of organs at risk under different volumes were recorded. Results:Compared to the 60 ml group, the volume and dosage of HR-CTV in the groups of 50, 70, 80, 90, and 100 ml had no significant difference ( P>0.05). The D2 cm 3 and D1 cm 3 of the bladder and rectum of patients in these groups significantly decreased, and the difference was statistically significant ( tbladder = 3.21, 5.83, 2.89, 12.95, 7.96, Pbladder = 0.031, 0.010, 0.041, 0.000, 0.001; trectum = 2.94, 4.66, 2.53, 5.89, 4.13, Prectum = 0.037, 0.024, 0.049, 0.005, 0.028). The pairwise comparison among these groups except for the 60 ml group showed that the volume and dosage of HR-CTV and the D2 cm 3 and D1 cm 3 of bladder and rectum had no significant difference ( P > 0.05). Moreover, the D2 cm 3 and D1 cm 3 of sigmoid colon and small intestine of these groups had no significant difference ( P > 0.05). Conclusions:In the 3D brachytherapy of postoperative early cervical cancer, a bladder filling volume of 60 ml can ensure the volume and dose of HR-CTV and can protect the bladder and rectum compared with other filling volumes.

TAB182 promotes DNA homologous recombination repair by stabilizing RPA2 mRNA / 中华放射医学与防护杂志

Objective:To investigate the regulating molecules and acting mechanism of TAB182 in HR pathway.Methods:TAB182 in human breast cancer MCF-7 cells was knocked down by shRNA strategy, the TAB182 knockdown MCF-7 as the TAB182 knockdown group, and the MCF-7 cell using the shRNA negative control as the TAB182 negative control group. RNA sequencing and qRT-PCR were performed to screen and verify the differentially expressed genes of HR pathway related to TAB182 depression. Western blot was used to detect protein expression. Immunofluorescence staining of nuclear RAD51 and BrdU was used to check the 3′ ssDNA formation by the end resection. The cell cycle arrest and apoptosis were measured by flow cytometry. Cloning formation assay was used to evaluate the sensitivity TAB182-knockdown cells to radiation.Results:Both quantitative RNA sequencing and qRT-PCR assays showed that TAB182-knockdown significantly decreased the mRNA expression of RPA2( t=17.97, P<0.05). Compared with the TAB182 negative control group, the protein level of RPA2, the number of RAD51 foci, and the 3′ ssDNA-binding nuclear protein marker BrdU in TAB182-knockdown cells were significantly reduced. At 4, 8, and 12 h after actinomycin D treatment, the attenuation of RPA2 mRNA in the TAB182-knockdown cells was accelerated ( t=5.37, 3.79, 3.69, P<0.05). Compared with the TAB182 negative control group, the radiosensitivity and radiation-induced apoptosis in the TAB182-knockdown group were increased ( t=3.48, 11.05, P<0.05), and at 24 h after irradiation, the cell cycle block time was prolonged ( t=8.40, P<0.01). Conclusions:TAB182 plays a role in maintaining RPA2 mRNA stability, thereby promoting HR repair. TAB182 knockdown cells are highly sensitive to ionizing radiation.

Hemolytic disease in a neonate caused by anti-c antibody / 中华围产医学杂志

We report a case of hemolytic disease of the newborn (HDN) caused by anti-c antibody. The baby boy presented progressive jaundice on his face and trunk one hour after birth. Total bilirubin of 168.1 μmol/L was detected six hours after birth and positive results of direct antiglobulin test, serum free antibody test, and erythrocyte releasing antibody test were obtained. His blood type was O and RhDCcEe, while his mother was A and RhDCCee. IgG anti-c antibodies were identified in the maternal blood serum with the titer of 1∶4. After phototherapy, immunoglobulin infusion, and medication, the boy was recovered and discharged from the hospital. The boy was normal in both physical and neurobehavioral development at one and three months after discharge.

Research progress in endocrine clinical treatment of HR +/HER2 - metastatic breast cancer / 国际生物医学工程杂志

Breast cancer, as a heterogeneous disease, has different molecular subtypes. The most common molecular subtype is hormone receptor positive (HR +). Endocrine therapy is the predominant treatment for this subtype. The main treatment modality for HR +/human epidermal growth factor receptor 2-negative (HER2 -) metastatic breast cancer (MBC) is novel targeted agents combined with endocrine therapy. In this review, researches in endocrine clinical treatment of HR +/HER2 - MBC was reviewed to provide a new targeted therapy, including CDK4/6 inhibitors combined with endocrine therapy, the debate between CDK4/6 inhibitors combined with endocrine therapy and chemotherapy, new directions of CDK4/6 inhibitor combination, exploration of multiple treatment strategies after CDK4/6 inhibitor therapy progresses, histone deacetylase inhibitor combined with endocrine therapy, PI3K/Akt/mTOR pathway targeting drugs in combination with endocrine therapy, polyadenosine diphosphate ribose polymerase (PARP) inhibitors for gBRCA1/2 mutated breast cancer, novel targeted drugs, and multi-target/multi-combination therapy model.

Comparsion of corneal astigmatism measurement among iTrace, IOL Master 700 and Pentacam HR in cataract eyes / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the difference and consistency among iTrace, IOL Master 700 and Pentacam HR in measuring corneal astigmatism before cataract surgery.<p>METHODS: Across-sectional study. From May 2020 to May 2021, a total of 149 cataract patients(181 eyes)were collected in our hospital. Presurgery, steep keratometry(Ks), flat keratometry(Kf), mean keratometry(Km), astigmatism magnitude(Cyl), and steep astigmatic axis values measured by the three instruments of the iTrace, IOL Master 700 and the Pentacam HR. The difference and consistency of the measurement indexes of the three instruments were analyzed.<p>RESULTS: Statistical differences existed in Ks, Kf, Km among the three instruments(<i>F</i>=4.912, 3.514, 4.873, all <i>P</i><0.05)and there was no difference in Cyl and Axis(<i>F</i>=0.523, 0.128, all <i>P</i>>0.05). Bland-Altman analysis showed the outcomes revealed that the Ks and Kf measured by iTrace and the other two instruments have poor consistency, and the consistency of Cyl and Axis was good. But the difference of Axis is not clinically acceptable. There were no statistically differences between the iTrace and the other two devices among the low astigmatism(50 eyes), moderate astigmatism(34 eyes)and high astigmatism(18 eyes)groups(all <i>P</i>>0.05). <p>CONCLUSION: In the preoperative measurement of cataract patients except for the good consistency of astigmatism, the iTrace, IOL Master 700 and Pentacam HR showed different Ks and Kf, and the Axis difference exceeded the clinically acceptable range, especially in the highly astigmatism group. The measurement of corneal astigmatism before cataract surgery should be evaluated by multiple measurement methods and make comprehensive planning for the surgical plan.

Sistemas de informação na gestão de recursos humanos em saúde da Secretaria de Estado de Saúde do Rio de Janeiro / Information systems in the administration of human resources in health at the Rio de Janeiro State Department of Health

Este estudo aborda o tema de sistemas de informação utilizados na gestão de recursos humanos em saúde na Secretaria de Estado de Saúde do Rio de Janeiro (SES/RJ), órgão da Administração Direta do Poder Executivo do Estado. A SES/RJ é responsável por definir políticas de saúde no Estado, a qual utiliza vários sistemas de informação para gestão de sua força de trabalho, com evidências de fragmentação dos dados, dificuldade na gestão das informações e prejuízo na definição de estratégias. Nesse sentido, este trabalho tem como objetivo descrever os sistemas de informação de recursos humanos em uso na SES/RJ, no contexto dos modelos de gestão adotados em suas unidades de saúde, e contribuir para melhorar a gestão de recursos humanos e das informações geradas no âmbito da instituição, fornecendo subsídios para o processo de tomada de decisão. Para tanto, fez-se, primeiramente, uma revisão bibliográfica sobre o tema desde o ano de 1995, período da Reforma do Estado, e uma pesquisa documental em portais e legislações, tanto da SES/RJ como de outros órgãos estaduais, assim como das esferas federal e municipal. Em seguida, o trabalho discute as possibilidades e os subsídios que possam favorecer a interoperabilidade desses sistemas e, assim, facilitar a gestão da força de trabalho na instituição.

This study investigates the use of information systems in the administration of human resources in health at the Rio de Janeiro State Department of Health (SES/RJ), which is part of the Direct Administration of the State Government. SES/RJ oversees establishing state health policies and managing its staff using a variety of information systems, with evidence of data fragmentation, information management challenges, and strategy development impairment. In this sense, this study aims to describe the human resources information systems in use at SES/RJ in relation to the management models used in its health units, as well as to contribute to improving human resources management and the information generated within the institution by providing decision-making inputs. To that end, we conducted a bibliographic review of the topic dating back to 1995, during the State Reform period, as well as document search in the portals and legislation of SES/RJ and other state agencies, as well as federal and municipal domains. The study then moves on to the possibilities and advantages that may encourage system interoperability and, as a result, make labor management in the institution easier.

Human resource practices and employee wellbeing from a gender perspective: The role of organizational justice / Prácticas de recursos humanos y bienestar de los empleados desde una perspectiva de género: el papel de la justicia organizacional

Abstract Introduction/objective: HR practices have been widely studied in the literature. However, critical research gaps remain unexplored. Little attention has been paid to the relationship between HR practices and well-being, or the mechanisms that explain the effect of HR on employees' wellbeing, and the role of gender in this relationship. Hence, this study aims to examine the relationship between HR practices and well-being (eudemonic and hedonic) through organizational justice, taking into account gender. Method: A convenience sampling technique was used in a correlational design. The sample was composed of 1647 employees from 42 Spanish organizations. Our measures were HR practices, organizational justice, and hedonic and eudemonic wellbeing. Multi-group structural equation models were computed. Results: The results supported our hypothesis, which mainly stated that (1) organizational justice (distributive, procedural and interactional justice) mediated the relationship between HR practices and eudemonic and hedonic well-being; (2) there were differences between men and women in this mediation. Conclusions: Human resource practices and organizational justice offer tools to HR managers in order to maintain and improve employees' well-being levels within their organizations.

Resumen Introducción/objetivo: Las prácticas de recursos humanos (RRHH) han sido ampliamente estudiadas en la literatura. Sin embargo, existen importantes carencias de investigación al respecto. Por ejemplo, se ha prestado poca atención a la relación entre las prácticas de RRHH y el bienestar, al mecanismo que explica el efecto de los RRHH en los empleados, y se ha pasado por alto el papel del género en las prácticas de RRHH. Por tanto, este estudio se dirige a examinar la relación entre las prácticas de RRHH y el bienestar (eudemónico y hedónico) por medio de la justicia organizacional, teniendo en cuenta el género. Método: Se utilizó un muestreo por conveniencia en un diseño correlacional. La muestra se compuso de 1647 trabajadores de 42 organizaciones españolas. Los instrumentos utilizados midieron prácticas de RRHH, justicia organizacional, y bienestar hedónico y eudemonico. Se realizaron modelos de ecuaciones estructurales multigrupo. Resultados: Los resultados confirmaron nuestras hipótesis, que afirmaban principalmente que (1) la justicia organizacional (justicia distributiva, de procedimiento e interactiva) mediaba la relación entre las prácticas de RRHH y el bienestar eudemónico y hedónico; (2) hay diferencias entre hombres y mujeres en esta mediación. Conclusiones: Las prácticas de RRHH y la justicia organizacional ofrecen herramientas a los directores de RRHH sobre cómo actuar para mantener y mejorar los niveles de bienestar de los empleados dentro de sus organizaciones.

Evaluation of soil contamination by heavy metals at public cemeteries in the municipality of Lages, southern Brazil / Avaliação da contaminação de solos por metais tóxicos em cemitérios públicos do município de Lages, Sul do Brasil

ABSTRACT The burial of bodies is a potentially polluting activity. Taking this into consideration, the aim of the present study was to verify the compliance of two cemeteries with environmental legislation and to quantify the concentrations of heavy metals in soils affected by burial activities. Physicochemical characterization of the soil was performed by analyzing control samples from areas near the cemeteries. Concentrations of cadmium, lead, chromium, nickel, zinc and copper were determined using high-resolution continuum source atomic absorption spectrometry. The two cemeteries had unsatisfactory properties for the retention of metal cations, with clay percentages ranging from 15.40 to 41.40% and sand percentages ranging from 28.75 to 66.85%. The control samples presented low cation exchange capacity (12.27 to 22.73 cmolc/dm³) and high aluminum (Al3+) saturation (66.74 to 90.16%). Although neither of the two cemeteries had concentrations above the limits established for the metals analyzed by Resolution No. 420/2009 of the National Environment Council, the contaminants may be leaching to groundwater due to inadequate soil characteristics.

RESUMO O sepultamento de corpos é uma atividade potencialmente poluidora. Este trabalho teve como objetivo verificar a adequação das áreas de dois cemitérios públicos à legislação ambiental e à atividade cemiterial e quantificar a concentração de metais pesados nos solos que estão sob influência desses empreendimentos. Realizou-se a caracterização físico-química do solo, com a análise de amostras testemunha de solo de cada cemitério. Também foram determinadas as concentrações dos metais pesados: cádmio, chumbo, cromo, níquel, zinco e cobre, por meio de espectrometria de absorção atômica de alta resolução com fonte contínua. As áreas dos cemitérios apresentam condições insatisfatórias para a retenção de íons catiônicos metálicos, com percentuais de argila variando entre 15,40 e 41,40% e de areia entre 28,75 e 66,85%. Os solos testemunha apresentaram reduzida capacidade de troca de cátions entre 12,27 e 22,73 cmolc/dm³) e elevada saturação por alumínio entre 66,74 e 90,16%. Apesar de nenhum dos cemitérios apresentar concentrações dos metais analisados acima dos limites de prevenção estabelecidos pela Resolução nº 420/2009 do Conselho Nacional do Meio Ambiente, em função das características dos solos, os contaminantes podem estar sendo lixiviados para os recursos hídricos subjacentes.

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

Research progress on fetal RHD genotype screening in RhD-negative pregnant women in Asia / 中华围产医学杂志

RhD-negative pregnant women with an RhD-positive fetus are at risk of hemolytic disease of the fetus and newborn (HDFN), which may lead to fetal/neonatal death. While these would not affect those RhD-negative fetuses. With the advancement of technology in genetics, the administration of anti-D immunoglobulin to women with an RhD-positive fetus could reduce the risk of HDFN. Therefore, non-invasive prenatal testing on fetal RHD genotype plays an important role in the management of RhD-negative pregnant women. Selective usage of anti-D immunoglobulin is important in perinatal management in these women. The non-invasive prenatal screening for fetal RHD gene which has been carried out in Caucasian is not applicable to Asians because of the difference in RHD genotype. In addition to complete or partial RHD gene deletion, point mutations are also common RHD genotypes among Asians. This enlightens us to establish a non-invasive prenatal screening method for Asians. This article reviews the progress of fetal RHD screening in Asian RhD-negative pregnant women.