104 research outputs found

    Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients

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    Keywords:anesthesia;cognitive function;complications;postoperative period;regional anesthesia;surgery Background: Postoperative cognitive dysfunction (POCD) is a common complication after cardiac and major non-cardiac surgery with general anaesthesia in the elderly. We hypothesized that the incidence of POCD would be less with regional anaesthesia rather than general. Methods: We included patients aged over 60 years undergoing major non-cardiac surgery. After giving written informed consent, patients were randomly allocated to general or regional anaesthesia. Cognitive function was assessed using four neuropsychological tests undertaken preoperatively and at 7 days and 3 months postoperatively. POCD was defined as a combined Z score >1.96 or a Z score >1.96 in two or more test parameters. Results: At 7 days, POCD was found in 37/188 patients (19.7%, [14.3–26.1%]) after general anaesthesia and in 22/176 (12.5%, [8.0–18.3%]) after regional anaesthesia, P = 0.06. After 3 months, POCD was present in 25/175 patients (14.3%, [9.5–20.4%]) after general anaesthesia vs. 23/165 (13.9%, [9.0–20.2%]) after regional anaesthesia, P = 0.93. The incidence of POCD after 1 week was significantly greater after general anaesthesia when we excluded patients who did not receive the allocated anaesthetic: 33/156 (21.2%[15.0–28.4%]) vs. 20/158 (12.7%[7.9–18.9%]) (P = 0.04). Mortality was significantly greater after general anaesthesia (4/217 vs. 0/211 (P <0.05)). Conclusion: No significant difference was found in the incidence of cognitive dysfunction 3 months after either general or regional anaesthesia in elderly patients. Thus, there seems to be no causative relationship between general anaesthesia and long-term POCD. Regional anaesthesia may decrease mortality and the incidence of POCD early after surgery

    Whole-genome sequencing reveals host factors underlying critical COVID-19

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    Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

    Biotechnology, the gene revolution, and proprietary technology in agriculture: a strategic note for the World Bank

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    The world economy experienced significant growth and transformation, with increases in productivity, product quality, and export base diversification in the 1990s. These advances were mainly driven by the growth of traditional agricultural and industrial sectors, including the natural resource-based sectors. This article outlines how application that New Science offers an opportunity for equitable growth that will assist in further poverty alleviation throughout the world. New Science will impact all poverty areas such as income, nutrition and environmental enhancement. The principal objective of this document was to provide a textual report on the topic of innovation in science and technology, and in particular the way that new science such as biotechnology and information technology serve as factors for increasing the competitiveness of developing nations in the global context. Interwoven into this subject matter the report provides clear positions to consider adopting in the critical areas of Intellectual Property Rights, Biotechnology Biosafety, Trade and Environmental Protection

    青枯病 (Pseudomonas solanacearum) 抵抗性付与のための抗細菌性遺伝子のAgrobacterium法による4倍体バレイショ品種への形質転換

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    Seven tetraploid potato genotypes were employed to put artificial antibacterial genes against bacterial wilt (Pseudomonas solanacearum) . The antibacterial genes derived from giant silk moth (Hyalophora cecropia). These genes are associated with the antibacterial peptides, cecropin, attacin, lysozyme or shiva. These genes were constructed with either cauliflower mosaic virus (CaMV35S) or wound-inducible (WI) promoter, and with franking gene markers in a binary vector pBI121. Agrobacterium rhizogenes (R1000) which contains the binary vector was used to transform the potato genotypes. Hairy roots obtained were cultured in MS medium with Claforan then, in a regeneration medium containing 100ppm kanamycin. Regenerated plantlets were evaluated for the expression of flanking marker genes: kanamycin resistance and GUS reaction. After selection, those plantlets were used for Southern hybridization to confirm the presence of the target gene(s) for antibacteria. Phenotypic resistance evaluation on them was made using Pseudomonas solanacearum, Race 3 , Biovar II, CIP isolate 204 at greenhouse. Some improvement on the level of resistance was seen on regenerates from three original genotypes, while there was variation on the level of resistance among regenerates from the same original genotype. RT-PCR revealed substantial level of gene expression, however, the amount of resulting lytic peptides was not detected well by ELISA. Thus, it was speculated that a post-transcriptional degradation and/or a post-translational degeneration by endogenious xenobiotic metabolizing mechanisms or endogenous proteinases.  (和文)  バレイショ品種における青枯病 (Pseudomonas solanacearum)に対する抵抗性を飛躍的に向上させるため、カイコ由来の溶細菌性タンパクを生産する遺伝子群を用いた。溶細菌性遺伝子を含むbinary vectorをそれぞれ導入した、Agrobacterium rhizogenes, R1000を用いて、バレイショ品種に遺伝子の導入・発現を試みた。組み換えバレイショ系統は多数得られたものの、閉鎖系温室での抵抗性の程度は組み換え個体問で大きな違いがあり、遺伝子構築や発現様式の調整が今後必要であることが解った。継続後誌:近畿大学先端技術総合研究所紀要 = Memoirs of Institute of Advanced Technology, Kinki Universit
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