Identification of the critical enablers for perishable food supply chain using deterministic assessment models

Today’s perishable food supply chains must be resilient to handle volatile demands, environmental restrictions, and disruptions in order to meet customers’ requirements. The enablers of the perishable food supply chain have not yet been explored. In this paper, a bibliometric systematic literature review has been conducted to identify the articles related to the perishable food supply chain. Next, with these identified articles, a map is created with bibliographic data using Vosviewer network visualization software, and then the enablers were identified by conducting keyword co-occurrence analysis. Later, a total interpretive structural modeling (TISM) is employed to analyze the interrelationships among enablers and then determine each enabler’s hierarchies, further representing them in a diagraph. Finally, the identified enablers are classified using cross-impact matrix multiplication applied to classification (MICMAC) analysis, and the graph is plotted. The results obtained from the deterministic assessment model provide the critical enablers for the perishable food supply chain. The obtained critical enablers and their hierarchies provide valuable insights for researchers in the context of perishable food supply chain for further study.The authors are grateful to FCT - Fundação para a Ciência e Tecnologia who financially supported this work through the RD Units Project Scope: UIDP/04077/2020 and UIDB/04077/2020

Maternal tissue perfusion and altered expression of hypoxia regulated genes in pre-eclampsia

Pre-eclampsia is an enigmatic multisystem disorder of the second half of pregnancy. Placental hypoxia and generalised endothelial dysfunction are features of this syndrome and the clinical manifestations of this disease are suggestive of reduced maternal tissue perfusion. There is convincing evidence that the hypoxic placenta released as yet unknown circulating factor(s), which rsult in the generalised endothelial dysfunction. The hypothesis of this study is that, altered expression of hypoxia regulated genes occurs in the placenta and vascular endothelium in pregnancies complicated by pre-eclampsia which accounts for the clinical manifestations of the syndrome including the reduced blood flow. There is an ongoing debate regarding the shared and disparate components of the pathophysiology of pre-eclampsia and Intra uterine growth restriction (IUGR) hence women with IUGR pregnancy were also included in this study. The primary aim of this research was to identify, through bioinformatics a set of hypoxia regulated genes in pre-eclamptic placenta and then to validate the results through RT-qPCR from the placenta and also in edothelial cells exposed to the plasma from three groups of women (pre-eclampsia, IUGR and normal pregnancy) recruited for the study. First, Strain gauge plethysmography was used to measure maternal tissue blood flow in the claf, which was compared to tissue oxygen saturation measured using pulse oximetry in the three groups of women. Second, using bioinformatics, a set of novel potential hypoxia regulated genes namely angiogenein inhibitor, apolipoprotein E, growth differentiating factor (GDF15), HS19, KISS1, NAD-Ubiquinone oxidoreductase 1 (NDUFAB1) and ROBO$ were identified and RT-qPCR was used to study their expression in the placenta and also in the two endothelial cell lines, (Human umbilical vein endothelial cells and Myometrial uterine microvascular endothelial cells) exposed to hypoxic conditions and plasma from the threee groups of women. Calf blood flow was significantly decreased in women with pre-eclampsia however the difference was not statistically significant in women with IUGR pregnancy compared to normal pregnancy. Notably, tissue oxygen saturation was not significantly different between the three groups of women and there was no correlation between tissue blood flow and oxygen saturation in all the three groups. Overall, the expression of the novel hypoxia regulated genes was increased in pre-eclamptic placenta compared to placenta from normal pregnancy. There was an overall reduction in the expression of the hypoxia regulated genes by HUVEC exposed to plasma from women with pathological pregnancies. However there was no change in expression of the hypoxia regulated genes by UtMVEC when exposed to similar conditions. The study findings suggest that in pre-eclampsia there is compensatory up-regulation of hypoxia regulated genes in the placenta probably in response to uteroplacental ischemia. In both pre-eclampsia and IUGR, there is a failure of up- regulation of hypoxia regulated genes in maternal endothelial cells cultured in vivo in response to circulating factor(s) released by the hypoxic placenta and this may explain the clinical manifestation of impaired tissue perfusion

5.5 Successful insilico discovery of novel hypoxia regulated genes in pre-eclampsia.

DDD identified a total of 32 gene clusters to be differentially expressed and six of them were found to be hypoxia regulated. Angiogenin inhibitor, apolipoprotein E, NADH dehydrogenase (ubiquinone) 1, alpha/beta subcomplex, 1 (NDUFAB1) and round about homolog 4 (ROBO4) were the upregulated genes and H19 and growth differentiating factor (GDF15) were the down regulated genes. Rt-QPCR studies showed similar results thus providing a proof that insilico techniques can be used as tools for novel gene discovery in gestational diseases like pre-eclampsia

Hypoxia in pre-eclampsia: cause or effect?

Pre-eclampsia is a pregnancy specific multi-system disorder associated with increased maternal and perinatal morbidity and mortality. In spite of intensive research for several decades into its pathophysiology, the aetiology remains unexplained. There is evidence that maternal tissue blood flow is reduced in pregnancies complicated by this disease, which precedes clinical onset, and persists after delivery. It is however unclear whether the reduced maternal tissue blood flow is associated with changes in tissue oxygenation and/or abnormal tissue oxygen homeostasis and whether this precedes or follows pre-eclampsia. This review examines the cause and effect relationship between hypoxia and pre-eclampsia and possible underlying mechanism(s) of impairment in oxygen regulation

Simultaneous Bilateral Carotid Stenting in High-risk Patients: A Single-center Experience with Review of Literature

Background: The aim of the present study is to determine the role of simultaneous carotid artery stenting in high-risk patients with triple vessel coronary artery disease and to determine the safety and efficacy of the procedure in these cases. Materials and Methods: The present study is a retrospective analysis of 33 patients who underwent carotid artery stenting in the same setting in our institution from 2009 to 2016. There were 22 male and 11 females with a mean age of 65 years (53–76 years). Demographic factors clinical characteristics and atherosclerosis risk factors were documented. Results: Technical success was 100% in our series. Intraprocedural and postprocedural events in the form of hypotension and bradycardia due to hemodynamic depression were seen in 11 patients. We did not encounter hyperperfusion syndrome in any of our patients. Twenty-nine patients underwent cardiac bypass surgery after 3 weeks, and 4 patients were kept on medical management for coronary artery disease. No deaths or major strokes occurred in our series. Conclusion: Simultaneous bilateral carotid artery stenting is a safe treatment option even in patients with high-risk factors and can be considered as the therapeutic option in patients with significant bilateral carotid artery disease