Case study: Anaesthetic management of an achondroplastic dwarf undergoing radical nephrectomy

A three feet two inch (96 cm) tall achondroplastic patient with urothelial cell carcinoma involving renal pelvis was scheduled for a radical nephrectomy. Radial artery cannulation and central venous access were securedin the pre-induction period. After induction, the airway was secured using a flexible fibreoptic scope. General anaesthesia was maintained with oxygen-nitrous-oxide and continuous propofol infusion. The total duration of anaesthesia was three hours and 50 minutes. To the best of the authors’ knowledge, this is the shortest adult achondroplastic patient ever reported to undergo such major abdominal surgery under general anaesthesia. The anaesthetic implications in patients with achondroplasia are reviewed in this case report

Relation between Stochastic Resonance and Synchronization of Passages in a Double-Well System

We calculate, numerically, the residence times (and their distribution) of a Brownian particle in a two-well system under the action of a periodic, saw-tooth type, external field. We define hysteresis in the system. The hysteresis loop area is shown to be a good measure of synchronization of passages from one well to the other. We establish connection between this stochastic synchronization and stochastic resonance in the system.Comment: To appear in PRE May 1997, figures available on reques

Brownian rectifiers in the presence of temporally asymmetric unbiased forces

The efficiency of energy transduction in a temporally asymmetric rocked ratchet is studied. Time asymmetry favours current in one direction and suppresses it in the opposite direction due to which large efficiency ~ 50% is readily obtained. The spatial asymmetry in the potential together with system inhomogeneity may help in further enhancing the efficiency. Fine tuning of system parameters considered leads to multiple current reversals even in the adiabatic regime

A Case Report on Longitudinal Collection of Tumour Biopsies for Gene Expression-Based Tumour Microenvironment Analysis from Pancreatic Cancer Patients Treated with Endoscopic Ultrasound Guided Radiofrequency Ablation.

BACKGROUND: Most patients with pancreatic ductal adenocarcinoma (PDAC) are metastatic at presentation with dismal prognosis warranting improved systemic therapy options. Longitudinal sampling for the assessment of treatment response poses a challenge for validating novel therapies. In this case study, we evaluate the feasibility of collecting endoscopic ultrasound (EUS)-guided longitudinal fine-needle aspiration biopsies (FNABs) from two PDAC patients and conduct gene expression studies associated with tumour microenvironment changes associated with radiofrequency ablation (RFA). METHODS: EUS-guided serial/longitudinal FNABs of tumour were collected before and after treatment from two stage III inoperable gemcitabine-treated PDAC patients treated with targeted RFA three times. Biopsies were analysed using a custom NanoString panel (144 genes) consisting of cancer and cancer-associated fibroblast (CAFs) subtypes and immune changes. CAF culture was established from one FNAB and characterised by immunofluorescence and immunoblotting. RESULTS: Two-course RFA led to the upregulation of the CD1E gene (involved in antigen presentation) in both patients 1 and 2 (4.5 and 3.9-fold changes) compared to baseline. Patient 1 showed increased T cell genes (CD4-8.7-fold change, CD8-35.7-fold change), cytolytic function (6.4-fold change) and inflammatory response (8-fold change). A greater than 2-fold upregulation of immune checkpoint genes was observed post-second RFA in both patients. Further, two-course RFA led to increased PDGFRα (4.5-fold change) and CAF subtypes B and C genes in patient 1 and subtypes A, B and D genes in patient 2. Patient 2-derived CAFs post-first RFA showed expression of PDGFRα, POSTN and MYH11 proteins. Finally, RFA led to the downregulation of classical PDAC subtype-specific genes in both patients. CONCLUSIONS: This case study suggests longitudinal EUS-FNAB as a potential resource to study tumour and microenvironmental changes associated with RFA treatment. A large sample size is required in the future to assess the efficacy and safety of the treatment and perform comprehensive statistical analysis of EUS-RFA-based molecular changes in PDAC

Asymmetric motion in a double-well under the action of zero-mean Gaussian white noise and periodic forcing

Residence times of a particle in both the wells of a double-well system, under the action of zero-mean Gaussian white noise and zero-averaged but temporally asymmetric periodic forcings, are recorded in a numerical simulation. The difference between the relative mean residence times in the two wells shows monotonic variation as a function of asymmetry in the periodic forcing and for a given asymmetry the difference becomes largest at an optimum value of the noise strength. Moreover, the passages from one well to the other become less synchronous at small noise strength as the asymmetry parameter (defined below) differs from zero, but at relatively larger noise strengths the passages become more synchronous with asymmetry in the field sweep. We propose that asymmetric periodic forcing (with zero mean) could provide a simple but sensible physical model for unidirectional motion in a symmetric periodic system aided by a symmetric Gaussian white noise.Comment: Appeared in PRE March 1997, figures available on reques

Medicinal plants used in the treatment of snakebite and scorpion sting by the tribesof Shahapur and Jawhar forest division

Many tribal communities living in the forest area deals with emergency cases of snakebite, scorpion sting by using traditional knowledge of medicinal plants. They possess Traditional and authentic information gained from their elders about the antidote for poisonous bites.  The present study was conducted in the tribal pockets of Shahapur and Jawhar forest division of Thane forest circle, Maharashtra. Data was collected by interviews with folk healers and informers by using specially design open and close-ended proforma. Collected data have been verified from the classical text of Ayurveda, books and available articles. This medico-ethno-botanical survey reveals the detail information on 27 plants belonging to 19 families. Total 17 and 10 claims have been reported for the treatment of snakebite and scorpion sting, respectively. Only 1 plant is claimed for veterinary use.  Tribal has been using flower, fruit, pod, root, stem, stem bark, leaf, etc. as an antidote in the form of fresh juice, powder for internal use and paste for local application. They also are administering medicine via Nasya (nasal administration) and Dhumapan (smoke). The observation generated by this article create scientific curiosity regarding further studies to evaluate the efficacy and develop antidote from medicinal plants based on tribal knowledg

Genetic Progress in 50 Years of Potato Breeding in India: Where Do We Stand?

Although the potato is a crop that was introduced in India, it has become a staple food and is grown in both the hills and plains. Potato breeding started in India in the 1950s’ and has contributed significantly to improving production. However, it is important to ascertain genetic progress in terms of changes in its yield over time. This study used the ‘Era trial’ methodology, wherein 22 potato varieties released in different decades ranging from 1968-2012 were evaluated in replicated multi-location trials for three consecutive years (2014-15, 2015-16 and 2016-17) in four potato growing zones of the country. The traits recorded were total tuber yield, marketable tuber yield and tuber dry matter content. Mixed model REML analysis showed significant differences among varieties and environments. Tuber dry matter content showed the least variation among varieties. The highest tuber yields were observed in the West-Central plains (WCP), while mean tuber yields were high in the North-Western plains (NWP). The zone-wise entry mean based broad-sense heritability estimates for all the three traits were high, although individual environment estimates observed low and moderate heritability too. Genetic gain results showed a positive trend for total and marketable tuber yields in NWP, WCP and Hill region (HR), while no gain was observed in the Eastern plains (EP) zone. The maximum annual rate of genetic gain for total tuber yield was 0.4%, 0.3% and 0.2% in WCP, HR and NWP. Positive genetic gain for tuber dry matter content was 0.2% in HR and 0.08% in WCP, while the other two zones had negative genetic gain for the trait. The annual rate of genetic gain for tuber yields and dry matter in potatoes does not commensurate with the future demand for the crop, underlining the need for holistic modern breeding techniques to boost genetic gains in potato breeding in India

Investigation of structural and optical properties of Ag nanoclusters formed in Si(100) after multiple implantations of low energies Ag ions and post-thermal annealing at a temperature below the Ag-Si eutectic point

This paper investigates the synthesis of Ag NCs in Si(100) substrate by implanting multiple energies and fluences of Ag ions and subsequent thermal annealing

Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults with nonhypoxic ischaemic acute brain injuries and conditions in the intensive care unit (Mega-ROX Brains)

Background: The effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults who have nonhypoxic ischaemic encephalopathy acute brain injuries and conditions and are receiving invasive mechanical ventilation in the intensive care unit (ICU) is uncertain. Objective: The objective of this study was to summarise the protocol and statistical analysis plan for the Mega-ROX Brains trial. Design, setting, and participants: Mega-ROX Brains is an international randomised clinical trial, which will be conducted within an overarching 40,000-participant, registry-embedded clinical trial comparing conservative and liberal ICU oxygen therapy regimens. We expect to enrol between 7500 and 9500 participants with nonhypoxic ischaemic encephalopathy acute brain injuries and conditions who are receiving unplanned invasive mechanical ventilation in the ICU. Main outcome measures: The primary outcome is in-hospital all-cause mortality up to 90 d from the date of randomisation. Secondary outcomes include duration of survival, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and the proportion of participants discharged home. Results and conclusions: Mega-ROX Brains will compare the effect of conservative vs. liberal oxygen therapy regimens on 90-day in-hospital mortality in adults in the ICU with acute brain injuries and conditions. The protocol and planned analyses are reported here to mitigate analysis bias. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN 12620000391976)

Origin of early maturing pigeonpea germplasm and its impact on adaptation and cropping systems

Pigeonpea breeding activities started about a century ago and for decades only late maturing cultivars dominated the global cultivation. Historically, no early maturing cultivar was available for a very long time and breeding of such varieties started in the third quarter of 20th century but at a low key. From these efforts, some pigeonpea varieties maturing in 90–150 days were bred. Information gathered from various sources revealed that the first few early maturing genotypes originated through spontaneous mutations in the late maturing field‐grown landraces. In other cases, transgressive segregation and induced mutations also produced early maturing varieties. At present, the high yielding early maturing cultivars are contributing significantly towards widening the adaption barriers and in the diversification of some age‐old cropping systems. In this paper, the authors, besides discussing the importance of early maturing cultivars in present agricultural systems, also summarize information related to the origin of primary sources of earliness