Variations in anesthetic requirements with body mass index in patients undergoing trans vaginal oocyte retrieval

Background: Various techniques have been described for ultrasound guided trans-vaginal oocyte retrieval (TVOR). No single technique has been found to be superior to others. In many centers, paracervical block (PCB) is used, either alone or in conjunction with sedation for pain relief during TVOR. This aim of this study is to evaluate the variations in anaesthetic requirements with body mass index (BMI) in patients undergoing transvaginal oocyte retrieval (TVOR).Methods: This study comprised of 70 women aged between 20 to 40 years. All patients were classified according to WHO classification into four groups on the basis of their BMI. Parameters like effectiveness of paracervical block (PCB), requirement of additional anesthetic drug (propofol), time required for surgery and numbers of oocytes retrieved were studied for each group. The correlation of all these parameters with BMI was noted and statistically evaluated.Results: PCB alone was not sufficient and all patients required additional propofol for successfully completing the procedure. The requirement of propofol increased with increase in BMI of the patients. The amount of rescue propofol required in patients with BMI>30 was significantly higher as compared to females with BMI<30, irrespective of the time taken during the procedure or the oocyte retrieved. A positive correlation was also observed between number of oocyte retrieved and time taken for surgery.Conclusions: PCB is quite useful in patients with normal BMI, but it proved to be totally ineffective in obese patients (BMI>30) undergoing TVOR. The requirement of additional propofol and time taken to successfully conduct the procedure is significantly high in patients with high BMI. These alterations in anesthetic parameters with change in BMI have vital implications and they should be taken into consideration while managing obese patients undergoing TVOR

EphA2 is a functional receptor for the growth factor progranulin.

Although the growth factor progranulin was discovered more than two decades ago, the functional receptor remains elusive. Here, we discovered that EphA2, a member of the large family of Ephrin receptor tyrosine kinases, is a functional signaling receptor for progranulin. Recombinant progranulin bound with high affinity to EphA2 in both solid phase and solution. Interaction of progranulin with EphA2 caused prolonged activation of the receptor, downstream stimulation of mitogen-activated protein kinase and Akt, and promotion of capillary morphogenesis. Furthermore, we found an autoregulatory mechanism of progranulin whereby a feed-forward loop occurred in an EphA2-dependent manner that was independent of the endocytic receptor sortilin. The discovery of a functional signaling receptor for progranulin offers a new avenue for understanding the underlying mode of action of progranulin in cancer progression, tumor angiogenesis, and perhaps neurodegenerative diseases

The CMS Outer Hadron Calorimeter

The CMS hadron calorimeter is a sampling calorimeter with brass absorber and plastic scintillator tiles with wavelength shifting fibres for carrying the light to the readout device. The barrel hadron calorimeter is complemented with a outer calorimeter to ensure high energy shower containment in CMS and thus working as a tail catcher. Fabrication, testing and calibrations of the outer hadron calorimeter are carried out keeping in mind its importance in the energy measurement of jets in view of linearity and resolution. It will provide a net improvement in missing \et measurements at LHC energies. The outer hadron calorimeter has a very good signal to background ratio even for a minimum ionising particle and can hence be used in coincidence with the Resistive Plate Chambers of the CMS detector for the muon trigger

Observation of the Production of Three Massive Gauge Bosons at root s=13 TeV

The first observation is reported of the combined production of three massive gauge bosons (VVV with V = W, Z) in proton-proton collisions at a center-of-mass energy of 13 TeV. The analysis is based on a data sample recorded by the CMS experiment at the CERN LHC corresponding to an integrated luminosity of 137 fb(-1). The searches for individualWWW, WWZ, WZZ, and ZZZ production are performed in final states with three, four, five, and six leptons (electrons or muons), or with two same-sign leptons plus one or two jets. The observed (expected) significance of the combinedVVV production signal is 5.7 (5.9) standard deviations and the corresponding measured cross section relative to the standard model prediction is 1.02(-0.23)(+0.26). The significances of the individual WWW and WWZ production are 3.3 and 3.4 standard deviations, respectively. Measured production cross sections for the individual triboson processes are also reported

Search for a light pseudoscalar Higgs boson in the boosted mu mu tau tau final state in proton-proton collisions at root s=13 TeV

A search for a light pseudoscalar Higgs boson (a) decaying from the 125 GeV (or a heavier) scalar Higgs boson (H) is performed using the 2016 LHC proton-proton collision data at root s = 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), collected by the CMS experiment. The analysis considers gluon fusion and vector boson fusion production of the H, followed by the decay H -> aa -> mu mu tau tau, and considers pseudoscalar masses in the range 3.6 aa -> mu mu tau tau, down to 1.5 (2.0)x10(-4) for m(H) = 125 (300) GeV. Model-dependent limits on B(H -> aa) are set within the context of two Higgs doublets plus singlet models, with the most stringent results obtained for Type-III models. These results extend current LHC searches for heavier a bosons that decay to resolved lepton pairs and provide the first such bounds for an H boson with a mass above 125 GeV.Peer reviewe

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Revenue Management with Bargaining

Static game-theoretic models of bilateral bargaining assume that the seller knows his valuation for the item that is up for sale; that is, how the seller may determine this quantity is exogenous to these models. In this paper, we develop and analyze a stylized Markov decision process that endogenizes the seller's computation of his marginal inventory valuation in an infinite horizon revenue management setting when each sale occurs according to a given bilateral bargaining mechanism. We use this model to compare, both analytically and numerically, the seller's performance under four basic bilateral bargaining mechanisms with a tractable information structure. These comparisons provide insights on the seller's performance under the following trading arrangements: buyer and seller posted pricing, negotiated pricing, and rule based pricing

Relation between oral stereognosis and masticatory efficiency in complete denture wearers: an in vivo study

Aim: The purpose of the present study was to evaluate the possible association between the oral stereognostic ability and masticatory efficiency at the time of denture insertion and after 6 months in complete denture wearers. Methods: Sixty edentulous patients were selected. The study was conducted in two parts. First, on the day of denture fit-in oral stereognostic ability test was conducted, followed by masticatory efficiency was carried out. The patients were recalled for check up after 6 months and the same test was performed again. Data were tabulated and analyzed statistically by paired t-test and Pearson&apos;s correlation coefficient. Results: There was weak correlation between oral stereognosis and masticatory efficiency. Many opinions have been presented in the literature in the past regarding oral stereognosis. The issue whether oral stereognosis also helps in patients&apos; adaptation towards complete denture prosthesis is still ambiguous. No consensus has been reached. This study is further an attempt to understand the basic physiology of oral stereognosis and whether there is any possible relation between oral stereognosis and masticatory efficiency. Conclusions: Within the limitation of this study, it can be concluded that oral stereognostic ability improves with time, which might be due to adaptation to the denture. As adaptation towards denture improves masticatory efficiency improves as well. This study showed that there might be a weak association between oral stereognosis and masticatory efficiency