Ventilator induced lung injury (VILI) in acute respiratory distress syndrome (Ards). “barotrauma” to “biotrauma”: case report

Acute respiratory distress syndrome is the most severe manifestation of acute lung injury and it is associated with high mortality rate. ARDS is characterized by the acute onset of diffuse neutrophilic alveolar infiltrates protein-rich edema due to enhanced alveolar-capillary permeability and hypoxemic respiratory failure. Mechanical ventilation is the main ARDS supportive treatment. However, mechanical ventilation is a non-physiologic process and complications are associated with its application. Mechanical ventilation may induce lung injury; referred to as ventilator-induced lung injury (VILI) and it is in form of alveolar rupture due to over distension of alveoli due to positive pressure ventilation i.e.Volutrauma, Barotrauma, Biotrauma. The Biotrauma is a form of VILI is the ability of inflation volume to disrupt the alveolarcapillary interface and promote proinflammatory cytokine released from the lungs and trigger the systemic inflammatory response syndrome, and can lead to inflammatory injury in the lung as well in other organs. The biotrauma is the leading cause of mortality in patient with ARDS. The lung protective ventilation strategy- Low tidal volume ventilation has shown some reduction in mortality in patients with ARDS but mortality is still high in patient with severe ARDS secondary to Pneumocystis jiroveci pneumonia (PJP) despite of lung protective ventilation strategy. In patients with Severe ARDS due to PJP, the outcome can be improved with the use of Extracorporeal life support (ECLS) techniques, such as extracorporeal membrane oxygenation (ECMO) or extracorporealCO2 removal (ECCO2R), because with such technique the patient can be given very low tidal volume 2-4ml/kg/PBW and risk of VILI can be avoided

Managing Access to Biobanks:How Can We Reconcile Privacy and Public Interests in Genetic Research?

This article is concerned with the ultimate objectives of genetic biobanks set up to promote the public interest—being the sharing of samples and data for medical research—and the consequences for personal privacy of realising them. Our aim is to chart the values, interests and principles in play, to consider the challenges of realizing biobanking objectives on a global scale, and to propose viable ways forward that ensure, as far as possible, that access provisions remain fit for purpose throughout the entire life of a biobank, while adequately protecting the privacy interests at stake. It is argued that key features in any robust access model must include mechanisms to (a) maintain participant trust in management of the resource and to measure and respond to participants’ expectations, (b) facilitate and promote the sharing of benefits, and (c) respond timeously and effectively to new challenges

Hepatitis A, B and C viral co-infections among HIV-infected adults presenting for care and treatment at Muhimbili National Hospital in Dar es Salaam, Tanzania

<p>Abstract</p> <p>Background</p> <p>Tanzania is currently scaling-up access to anti-retro viral therapy (ART) to reach as many eligible persons as possible. Hepatitis viral co-infections are known to influence progression, management as well as outcome of HIV infection. However, information is scarce regarding the prevalence and predictors of viral hepatitis co-infection among HIV-infected individuals presenting at the HIV care and treatment clinics in the country.</p> <p>Methods</p> <p>A cross-sectional study conducted between April and September 2006 enrolled 260 HIV-1 infected, HAART naïve patients aged ≥18 years presenting at the HIV care and treatment clinic (CTC) of the Muhimbili National Hospital (MNH). The evaluation included clinical assessment and determination of CD4+ T-lymphocyte count, serum transaminases and serology for Hepatitis A, B and C markers by ELISA.</p> <p>Results</p> <p>The prevalence of anti HAV IgM, HBsAg, anti-HBc IgM and anti-HCV IgG antibodies were 3.1%, 17.3%, 2.3% and 18.1%, respectively. Dual co-infection with HBV and HCV occurred in 10 individuals (3.9%), while that of HAV and HBV was detected in two subjects (0.8%). None of the patients had all the three hepatitis viruses. Most patients (81.1%) with hepatitis co-infection neither had specific clinical features nor raised serum transaminases. History of blood transfusion and jaundice were independent predictors for HBsAg and anti-HBc IgM positivity, respectively.</p> <p>Conclusion</p> <p>There is high prevalence of markers for hepatitis B and C infections among HIV infected patients seeking care and treatment at MNH. Clinical features and a raise in serum alanine aminotransferase were of limited predictive values for the viral co-infections. Efforts to scale up HAART should also address co-infections with Hepatitis B and C viruses.</p

A reference map of the human binary protein interactome.

Global insights into cellular organization and genome function require comprehensive understanding of the interactome networks that mediate genotype-phenotype relationships(1,2). Here we present a human 'all-by-all' reference interactome map of human binary protein interactions, or 'HuRI'. With approximately 53,000 protein-protein interactions, HuRI has approximately four times as many such interactions as there are high-quality curated interactions from small-scale studies. The integration of HuRI with genome(3), transcriptome(4) and proteome(5) data enables cellular function to be studied within most physiological or pathological cellular contexts. We demonstrate the utility of HuRI in identifying the specific subcellular roles of protein-protein interactions. Inferred tissue-specific networks reveal general principles for the formation of cellular context-specific functions and elucidate potential molecular mechanisms that might underlie tissue-specific phenotypes of Mendelian diseases. HuRI is a systematic proteome-wide reference that links genomic variation to phenotypic outcomes

Pengetahuan Keuangan, Pengalaman Investasi, dan Iklan Proyek Berpengaruhkah pada Minat Investasi Mahasiswa pada Crowdfunding Syariah?

Crowdfunding Syariah merupakan salah satu bentuk fintech dengan mengumpulkan dana dari masyarakat untuk diberikan kepada pihak atau proyek yang membutuhkan bantuan dana dengan menerapkan prinsip syariah didalamnya. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh dari pengetahuan keuangan, pengalaman investasi mahasiswa dan iklan proyek terhadap minat investasi mahasiswa pada situs crowdfunding syariah di Indonesia. Pada penelitian ini digunakan metode kuantitatif dengan teknik analisis PLS-SEM. Dari hasil penelitian ditemukan bahwa pengetahuan keuangan dan iklan proyek berpengaruh signifikan terhadap minat investasi mahasiswa pada situs crowdfunding syariah, sedangkan pengalaman investasi mahasiswa memiliki pengaruh yang tidak signifikan pada minat investasi mahasiswa pada situs crowdfunding syariah di Indonesia. Kata Kunci: Pengetahuan Keuangan, Pengalaman Investasi, Iklan Proyek, Investasi Mahasiswa, Crowdfunding Syariah

Prevalence of hepatitis A, B, C and human immunodeficiency virus seropositivity among patients with acute icteric hepatitis at the Kenyatta National Hospital, Nairobi

Objective: To determine the prevalence of hepatitis A, B, C and HIV seropositivity among patients with acute icteric hepatitis. Design: Cross-sectional descriptive survey. Setting: Kenyatta National Hospital, Nairobi. Subjects: Eighty four patients aged above six months with a history of jaundice not exceeding six months were recruited. There were 47 males and 17 females with an age range of eight months to 67 years and a median age of 25 years. Methods: History was obtained physical examination done and blood taken for determination of bilirubin, ALT, AST and ALP levels. Sera that had disproportionately greater transaminase than ALP elevation were assayed for IgM anti-HAV, IgM anti- HBc, HbsAg, anti-HCV and anti-HlV antibodies. Results: Evidence of hepatitis A, B, and C was round in 41.7%, 26.2%, and 7.1% of the patients respectively, 13.1% of the patients were HBsAg carriers while 30.1% of all patients were HIV positive. Thirty two patients did not have evidence of hepatitis A, B, or C infection and this group was significantly associated with HIV infection (p=0.003). Conclusion: Hepatitis A was the commonest overall type of acute icteric hepatitis seen at the KNH, and among patients aged 15 years and below. Hepatitis B was the leading identified cause of acute hepatitis among those aged over 15 years. Hepatitis C accounted for 7.1% of acute icteric hepatitis 30.1% of all patients and 50% of those admitted with acute hepatitis were also HIV positive. East African Medical Journal Vol. 81 No. 4 April 2004: 183-18

BEBERAPA ALGORITMA PELABELAN GRACEFUL UNTUK GRAF CATERPILLAR

Graceful labeling, first introduced by Rosa as β-labeling. A graceful labeling (or β-labeling) on a graph G involves assigning labels to its set of vertices, forming an injective function f that maps each vertex to the set of non-negative integers {0, 1, 2, ..., |E(G)|}, where |E(G)| denotes the number of edges in G. This induces a bijective function f* that maps the edges of G to the set of positive integers {1,2,...,|E(G)|} which the edges label obtained by absolute number of the subtraction between 2 neighboring vertex labels. One renowned conjecture proposed by Kotzig-Ringel-Rosa, known as the Graceful Tree Conjecture (GTC), posits that all trees are graceful. To this day, this remains an open problem, challenging researchers to substantiate its validity. The quest for graceful labeling, particularly for specific types of trees, continues to be an active zona of research. Notably, caterpillar graphs have been established as graceful. It is worth noting that not all graphs possess a unique labeling. For instance, in the case of graceful labeling for caterpillar graphs, there exist four distinct methods, which will be elucidated algorithmically in this article. By demonstrating various approaches to labeling caterpillar graphs, it is hoped that this concept can be extended to other graceful labelings, ultimately contributing to the identification of more graceful tree

Managing Access to Biobanks: How Can We Reconcile Individual Privacy and Public Interests in Genetic Research?

This article is concerned with the ultimate objectives of genetic biobanks set up to promote the public interest—being the sharing of samples and data for medical research—and the consequences for personal privacy of realising them. Our aim is to chart the values, interests and principles in play, to consider the challenges of realizing biobanking objectives on a global scale, and to propose viable ways forward that ensure, as far as possible, that access provisions remain fit for purpose throughout the entire life of a biobank, while adequately protecting the privacy interests at stake. It is argued that key features in any robust access model must include mechanisms to (a) maintain participant trust in management of the resource and to measure and respond to participants’ expectations, (b) facilitate and promote the sharing of benefits, and (c) respond timeously and effectively to new challenges