RSII rapid-sequence induction of anaesthesia and intubation of the trachea

Rapid sequence induction and intubation (RSII) is the preferred method of tracheal intubation in emergen­cy situations for patients presenting with a full stomach. The aim of RSII is to intubate the trachea within 60 seconds, without having to use bag-valve-mask ventilation to avoid air insufflation into the stomach. After preoxygenation and while cricoid pressure is applied, an induction dose of intravenous anaesthetic agent is administered and rapidly followed by a fast-acting muscle relaxant, and after 60 seconds tracheal intubation is performed. Preoxygention increases apnoea tolerance. This is particularly important for infants and young children, and in patients who are in critical condition, obese or pregnant. Cricoid pressure (the Sellick manouver) is recommended to prevent regurgitation of the gastric contents to the throat. Propofol or thiopental are routinely used for induction. Ketamine or etomidate may be used if propofol or thiopental administration is contraindicated. Succinylcholine or rocuronium are used to facilitate tracheal intubation. Poor jaw relaxation, patient resistance to a laryngoscope, closed or closing vocal cords, vigorous limb movements or sustained coughing after tube insertion are not clinically acceptable. Modified rapid sequence induction, used in patients at risk of rapid development of hypoxaemia, allows gentle positive pressure ventilation after administration of the induction agent and muscle relaxant, but before the tracheal intubation. If the attempt of intubation fails, sugammadex, 16 mg/kg body weight is recommended for the immediate reversal of the neuromuscular block produced by rocuronium, but not for other muscle relaxants

Skill-Intensity of Occupations, Labor Market Polarization, and Occupational Allocation of College Graduates

Skill-intensity of occupations, labor market polarization, and occupational allocation of college graduates. Barbara Pertold-Gebicka Abstrakt První část disertace je motivovaná výraznou expanzí vyššího vzdělávání ve Střední Evropě, kde university jsou převážně financované z veřejných zdrojů a poskytovaní vyššího vzdělání je tak součástí rozhodování ve veřejné politice. V této části disertace zkoumám indikátor použití vysokoškolsky vzdělané pracovní síly - podíl absolventů vysokých škol ve "vysokoškolských" pozicích. Gottschalk a Hansen (2003) navrhují identifikovat "vysokoškolské" pozice na základě mzdové prémie, kterou dostanou na této pozici vysokoškolsky vzdělaní lidé. Navazuji na jejich práci a studuji lokální vztah mezi podílem vysokoškolsky vzdělaných lidí v populaci a využitím vysokoškolsky vzdělané pracovní síly. Empirické výsledky založené na analýze individuálních dat z českých regionů na úrovní NUTS-4 naznačují existenci pozitivního vztahu, tudíž potvrzují přítomnost endogenního vlivu počtu vzdělané pracovní síly na poptávku po ní. Z těchto závěru vyplývá, že v dlouhém období regiony by měly být schopny pozitivně stimulovat lokální trh práce pomocí poskytování vyššího vzdělání většímu podílu populace. V druhé části navrhuji jak odhadnout na základě modelu míru kvalifikační náročnosti zaměstnání....Skill-intensity of occupations, labor market polarization, and occupational allocation of college graduates. Barbara Pertold-Gebicka Abstract The first chapter is motivated by a rapid expansion of higher education systems in Central European countries, where universities are largely state-funded and provision of higher education is a public policy decision. In this paper, I investigate an indicator of college skills usage - the fraction of college graduates employed in "college" occupations. Gottschalk and Hansen (2003) propose to identify "college" occupations based on within-occupation college wage premia; I build on their strategy to study the local-labor-market relationship between the share of college graduates in the population and the use of college skills. Empirical results based on worker-level data from Czech NUTS-4 districts suggest a positive relationship, thus supporting the presence of an endogenous influence of the number of skilled workers on the demand for them. Thus, the findings of this paper suggest that, in the long run, districts should be able to positively stimulate their labor markets by providing higher education to a larger fraction of their population. In the second chapter, I propose a model-based measure of occupational skill-intensity -- a measure allowing to consistently...CERGEFaculty of Social SciencesFakulta sociálních vě

Biologically Relevant Small Radicals

Biologically relevant small radicals are at the focus of the working group 4 (WG4) of the COST Action CM0603 (Free Radicals in Chemical Biology, CHEMBIORADICAL). This article surveys the areas of research being undertaken by the partners in WG4. The character of the radicals is described together with experimental techniques utilized to follow their structure and reactivity. Specifically, C-, S-, N- and O-centered radicals of small size, and their interaction with different biomolecules are described. Processes at the molecular level exemplifying important biological signaling and damaging pathways are introduced

Reaction intermediates and molecular mechanism of Peroxynitrite activation by NO synthases

The activation of peroxynitrite (PN) by hemoproteins, which leads to its detoxification or on the contrary to the enhancement of its cytotoxic activity, is a reaction of physiological importance that is still poorly understood. It has been known for some years that the reaction of hemoproteins, notably cytochrome P450, with PN leads to the build-up of an intermediate species with a Soret band at ~435 nm (I435). The nature of this intermediate is however debated. On the one hand, I435 has been presented as a Compound-II species that can be photo-activated to Compound I. A competing alternative involves the assignment of I435 to a ferric-nitrosyl species. Alike the cytochromes P450, the build-up of I435 occurs in NO-synthases (NOSs) upon their reaction with excess PN. Interestingly, the NOS isoforms vary in their capacity to detoxify/activate PN although they all show the build-up of I435. To better understand PN activation/detoxification by heme proteins, a definitive assignment of I435 is needed. Here we used a combination of fine kinetic analysis under specific conditions (pH, PN concentrations and PN/NOSs ratios) to probe the formation of I435. These studies revealed that I435 is not formed upon homolytic cleavage of the O-O bond of PN but that it arises from side-reactions associated with excess PN. Characterization of I435 by resonance Raman spectroscopy allowed its identification as a ferric iron-nitrosyl complex. Together, our study indicates that the model used so far to depict PN interactions with hemo-thiolate proteins, i.e. leading to the formation and accumulation of Compound II, needs to be reconsidered

The Relationship of the Anthropometric Variables to the Infusion Rate of Rocuronium in the Elderly

We have determined the infusion rates of rocuronium in the elderly and young adult patients during sevoflurane and nitrous oxide anesthesia. The correlation of some anthropometric predictors with infusion rate of rocuronium was also investigated for both elderly and young adult. Participating patients were assigned to one of two groups: 1) young adult patients aged 20 to 50 years (n = 30); 2) elderly patients aged over 65 years (n = 30). The anthropometric variables such as height, weight, ratio of weight to body surface area, subscapularis and suprailiac skin folds, body surface area, body mass index and % ideal body weight were evaluated as predictors for infusion rate. The infusion rate in elderly patients was significantly less compared with that in young adult patients (p < 0.05). In elderly patients, no anthropometric predictor was related to the infusion rate of rocuronium. This suggests that the infusion rate of rocuronium for an elderly patient needs to be individualized by monitoring neuromuscular transmission to avoid excessive dose

Existing environmental management approaches relevant to deep-sea mining

Deep-sea mining (DSM) may become a significant stressor on the marine environment. The DSM industry should demonstrate transparently its commitment to preventing serious harm to the environment by complying with legal requirements, using environmental good practice, and minimizing environmental impacts. Here existing environmental management approaches relevant to DSM that can be used to improve performance are identified and detailed. DSM is still predominantly in the planning stage and will face some unique challenges but there is considerable environmental management experience in existing related industries. International good practice has been suggested for DSM by bodies such as the Pacific Community and the International Marine Minerals Society. The inherent uncertainty in DSM presents challenges, but it can be addressed by collection of environmental information, area-based/spatial management, the precautionary approach and adaptive management. Tools exist for regional and strategic management, which have already begun to be introduced by the International Seabed Authority, for example in the Clarion-Clipperton Zone. Project specific environmental management, through environmental impact assessment, baseline assessment, monitoring, mitigation and environmental management planning, will be critical to identify and reduce potential impacts. In addition, extractive companies’ internal management may be optimised to improve performance by emphasising sustainability at a high level in the company, improving transparency and reporting and introducing environmental management systems. The DSM industry and its regulators have the potential to select and optimize recognised and documented effective practices and adapt them, greatly improving the environmental performance of this new industry

A Review on Direct Electrochemistry of Catalase for Electrochemical Sensors

Catalase (CAT) is a heme enzyme with a Fe(III/II) prosthetic group at its redox centre. CAT is present in almost all aerobic living organisms, where it catalyzes the disproportionation of H2O2 into oxygen and water without forming free radicals. In order to study this catalytic mechanism in detail, the direct electrochemistry of CAT has been investigated at various modified electrode surfaces with and without nanomaterials. The results show that CAT immobilized on nanomaterial modified electrodes shows excellent catalytic activity, high sensitivity and the lowest detection limit for H2O2 determination. In the presence of nanomaterials, the direct electron transfer between the heme group of the enzyme and the electrode surface improved significantly. Moreover, the immobilized CAT is highly biocompatible and remains extremely stable within the nanomaterial matrices. This review discusses about the versatile approaches carried out in CAT immobilization for direct electrochemistry and electrochemical sensor development aimed as efficient H2O2 determination. The benefits of immobilizing CAT in nanomaterial matrices have also been highlighted

Zymographic assay of plant diamine oxidase on entrapped peroxidase polyacrylamide gel electrophoresis. A study of stability to proteolysis

A zymographic assay of diamine oxidase (DAO, histaminase, EC 1.4.3.6), based on a coupled peroxidase reaction, and its behavior at proteolysis in simulated gastric and intestinal conditions, are described. The DAO activity from a vegetal extract of Lathyrus sativus seedlings was directly determined on sodium dodecyl sulfate polyacrylamide electrophoretic gels containing entrapped horseradish peroxidase, with putrescine as substrate of histaminase and ortho-phenylenediamine as co-substrate of peroxidase. The accumulation of azo-aniline, as peroxidase-catalyzed oxidation product, led to well-defined yellow-brown bands on gels, with intensities corresponding to the enzymatic activity of DAO. After image analysis of gels, a linear dependency of DAO content (Coomassie-stained protein bands) and of its enzymatic activity (zymographic bands) with the concentration of the vegetal extract was obtained. In simulated gastric conditions (pH 1.2, 37 °C), the DAO from the vegetal extract lost its enzymatic activity before 15 min of incubation, either in the presence or absence of pepsin. The protein pattern (Coomassie-stained) revealed that the DAO content from the vegetal extract was kept almost constant in the simulated intestinal fluid (containing pancreatin or not), with a slight diminution in the presence of pancreatic proteases. After 10 h of incubation at 37 °C, the DAO enzymatic activity from the vegetal extract was 44.7% in media without pancreatin and 13.6% in the presence of pancreatin, whereas the purified DAO retained only 4.65% of its initial enzymatic activity in the presence of pancreatin