The human body at cellular resolution: the NIH Human Biomolecular Atlas Program

Abstract: Transformative technologies are enabling the construction of three-dimensional maps of tissues with unprecedented spatial and molecular resolution. Over the next seven years, the NIH Common Fund Human Biomolecular Atlas Program (HuBMAP) intends to develop a widely accessible framework for comprehensively mapping the human body at single-cell resolution by supporting technology development, data acquisition, and detailed spatial mapping. HuBMAP will integrate its efforts with other funding agencies, programs, consortia, and the biomedical research community at large towards the shared vision of a comprehensive, accessible three-dimensional molecular and cellular atlas of the human body, in health and under various disease conditions

Real World Learning and Authentic Assessment

As students increasingly adopt a consumerist lifestyle academics are under pressure to assess and mark more students’ assignments in quicker turn around periods. In no other area is the marketisation shift between student and academic more apparent in the accountability that academics now need to demonstrate to students in their grading and feedback (Boud & Molloy, 2013). When evaluating their higher education experience students are most likely to complain about their grading or feedback (Boud & Molloy, 2013) and National Student Survey results consistently indicate that this category, more than any other, has the highest student dissatisfaction rates (Race, 2014)

Real World Learning: Simulation and Gaming

Simulations and games are being used across a variety of subject areas as a means to provide insight into real world situations within a classroom setting; they offer many of the benefits of real world learning but without some of the associated risks and costs. Lean, Moizer, Derham, Strachan and Bhuiyan aim to evaluate the role of simulations and games in real world learning. The nature of simulations and games is discussed with reference to a variety of examples in Higher Education. Their role in real world learning is evaluated with reference to the benefits and challenges of their use for teaching and learning in Higher Education. Three case studies from diverse subject contexts are reported to illustrate the use of simulations and games and some of the associated issues

PEMBUATAN BRIKET KULIT DURIAN DENGAN PROSES KARBONISASI

Biomassa dari limbah kulit durian selama ini belum banyak dimanfaatkan secara maksimal sehingga perlu adanya alternatif pengolahan agar menjadi bahan yang lebih bermanfaat, salah satunya sebagai bahan bakar alternatif briket. Tujuan dari penelitian ini adalah membuat briket dari kulit durian dengan proses karbonisasi, mengetahui pengaruh briket terhadap ukuran bahan, suhu, dan waktu karbonisasi, serta mengetahui spesifikasi briket dari kulit durian. Metode penelitian dilakukan dengan melakukan proses karbonisasi selama 4 dan 7 jam dan melakukan analisa proksimat pada briket. Hasil penelitian menunjukkan bahwa nilai kalor kulit durian sebasar 4.569,54 kcal/kg, kadar air 12%, kadar abu 15%. Kata kunci: briket, nilai kalor, kulit durian, karbonisas

Post-operative pulmonary complications in patients undergoing transoral odontoidectomy and posterior fixation for craniovertebral junction anomalies

Background: In patients with craniovertebral junction (CVJ) anomalies, the respiratory system is adversely affected in many ways. The sub-clinical manifestations may get aggravated in the postoperative period owing to anesthetic or surgical reasons. However, there is limited data on the incidence of postoperative pulmonary complications (PPCs) and associated risk factors in such patients, who undergo transoral odontoidectomy (TOO) and posterior fixation (PF) in the same sitting. Materials and Methods: Five years data of 178 patients with CVJ anomaly who underwent TOO and PF in the same sitting were analyzed retrospectively. Preoperative status, intraoperative variables, and PPCs were recorded. Patients were divided into two groups depending on the presence or absence of PPCs. Bivariate analysis was done to find out association between various risk factors and PPCs. Multivariate analysis was done to detect relative contribution of the factors shown to be significant in bivariate analysis. P < 0.05 was considered as significant. Results: The incidence of PPCs was found to be 15.7%. Factors significantly associated with PPCs were American Society of Anesthesiologists grade higher than II, preoperative lower cranial nerves palsy and respiratory involvement, duration of surgery, and intraoperative blood transfusion. In multivariate analysis, blood transfusion was found to be the sole contributing factor. The patients who developed PPCs had significantly prolonged stay in ICU and hospital. Conclusion: Patients with CVJ anomaly are at increased risk of developing PPCs. There is a strong association between intraoperative blood transfusion and PPCs. Patients with PPCs stay in the ICU and hospital for a longer period of time

Anaesthetic management in patients with glucose-6-phosphate dehydrogenase deficiency undergoing neurosurgical procedures

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is an X-linked recessive enzymopathy responsible for acute haemolysis following exposure to oxidative stress. Drugs which induce haemolysis in these patients are often used in anaesthesia and perioperative pain management. Neurosurgery and few drugs routinely used during these procedures are known to cause stress situations. Associated infection and certain foodstuffs are also responsible for oxidative stress. Here, we present two patients with G-6-PD deficiency who underwent uneventful neurosurgical procedures. The anaesthetic management in such patients should focus on avoiding the drugs implicated in haemolysis, reducing the surgical stress with adequate analgesia, and monitoring for and treating the haemolysis, should it occur

Intensive care management of patients with acute intermittent porphyria: Clinical report of four cases and review of literature

Acute intermittent porphyria (AIP), the most common and the most severe form of acute hepatic porphyria, is an autosomal dominant condition. It results from lower-than-normal levels (less than 50%) of porphobilinogen (PBG) deaminase. Patients may present commonly with gastrointestinal complaints and neuropsychiatric manifestations. Diagnosis may be confirmed with the presence of intermediary metabolites of haem synthesis, amino levulinic acid (ALA) and PBG in urine or with specific enzyme assays. Abdominal pain is the most common symptom (90%). Peripheral polyneuropathy, primarily motor with flaccid paresis of proximal musculature, with or without autonomic involvement, is characteristic. Respiratory failure necessitates ventilator and intensive care support. Avoidance of precipitating factors and the use of haem preparations and intravenous dextrose form the basis of management. Gabapentin and propofol, rather than the conventional antiepileptics appear to be the appropriate choice for seizure control. Here, we present intensive care management of four cases of AIP with varying clinical presentation

Effects of Phenytoin Therapy on Bispectral Index and Haemodynamic Changes Following Induction and Tracheal Intubation

Laryngoscopy and tracheal intubation (LTI) increase blood pressure and heart rate (HR). Intensity of these changes is influenced by the anaesthetic depth assessed by the bispectral index (BIS). We determined the effect of phenytoin on anaesthetic depth and its influence on haemodynamics following LTI. Fifty patients of ASA grades I and II on oral phenytoin 200 to 300mg per day for more than one week were compared with 48 control patients. Standard anaesthesia technique was followed. BIS, non invasive mean blood pressure (MBP) and HR were recorded 30, 60, 90 and 120 sec after LTI. Phenytoin group needed lesser thiopentone for induction, 5 mg (1.1) vs. 4.3 mg (0.7) [p=0.036]. BIS was significantly lower in the phenytoin group vs. the control 30, 60, 90 and 120 sec after LTI [43.1 (16.0) vs. 48.9 (14.9), p=0.068, 56.3 (16.7) vs. 64.3 (14.4), p=0.013, 59.8 (15.8) vs. 67.5 (12.1), p=0.008, 62.6 (14) vs. 68.9 (11.2), p=0.017, and 64.2 (11.3) vs. 69 (11.7), p=0.033], respectively. MBP was also lower in the phenytoin group 30, 60, 90 and 120 sec after LTI [112.8 mmHg (13.8), vs. 117.9 mmHg (18) p=0.013, 108.6 (12.8) vs. 117.5 (16) p=0.003, 106.1 mmHg (14.1) vs. 113.2 mmHg (14.9), p=0.017, 101.8 mmHg (13.8) vs. 109.5 mmHg (14.1), p=0.007], respectively. HR was lower in phenytoin group at 30 sec. (p=0.027), 60 sec (p=0.219), and again at 120 sec (p=0.022). Oral phenytoin therapy for over a week results in greater anaesthetic depth as observed using BIS, which also attenuated haemodynamic response of LTI