Pediatric cardiac surgery without homologous blood transfusion, using a miniaturized bypass system in infants with lower body weight

ObjectiveWe have established a low–priming volume cardiopulmonary bypass system for pediatric heart surgery to avoid homologous blood transfusion. The priming volume of our system is down to 140 mL for patients weighing less than 7 kg. We can prime the bypass circuits without blood products for patients weighing more than 4 kg.MethodsSeventy consecutive patients weighing 4 to 7 kg underwent heart surgery with a bloodless prime from October 2003 to September 2006. The type of procedures (Risk Adjustment in Congenital Heart Surgery category) included the following: category 1: atrial septal defect (n = 3); category 2: ventricular septal defect, tetralogy of Fallot, bidirectional Glenn shunt, and others (n = 55); category 3: atrioventricular septal defect, double-outlet right ventricle, and others (n = 8); category 4: Rastelli procedure for transposition of the great arteries (n = 3); and category 6, Damus–Kaye–Stansel procedure (n = 1). Transfusion criteria were hematocrit less than 20%, mixed venous oxygen saturation less than 70%, regional cerebral oxygenation less than 50%, and plasma lactate level greater than 4.0 mmol/L during bypass.ResultsThe mean age and body weight were 7.3 ± 5.4 months and 5.4 ± 0.8 kg, respectively. Forty-five patients (64%) underwent transfusion-free procedures. Preoperative hematocrit, age, body weight, complexity of procedure and cardiopulmonary bypass time were compared between patients with and without transfusion. Bypass time and Risk Adjustment in Congenital Heart Surgery risk category in patients with transfusion were significantly greater than those in patients without (P < .0001, and P < .05, respectively). Body weight in patients without transfusion was significantly greater than that in patients with (P < .01). In multiple regression analysis, the determinants of blood transfusion were the bypass time and body weight (odds ratio 1.026, 95% confidence interval 1.011–.040, P < .0001, and odds ratio 0.366, 95% confidence interval 0.171–0.785, P < .01).ConclusionsIt is possible to do complex transfusion-free procedures safely for patients weighing more than 4 kg by using the low–priming volume circuit. The limiting factors of bloodless heart surgery are not preoperative hematocrit and complexity of procedure but the cardiopulmonary bypass time and the patient’s body weight

Scanning SQUID microscope system for geological samples: system integration and initial evaluation

We have developed a high-resolution scanning superconducting quantum interference device (SQUID) microscope for imaging the magnetic field of geological samples at room temperature. In this paper, we provide details about the scanning SQUID microscope system, including the magnetically shielded box (MSB), the XYZ stage, data acquisition by the system, and initial evaluation of the system. The background noise in a two-layered PC permalloy MSB is approximately 40–50 pT. The long-term drift of the system is approximately ≥1 nT, which can be reduced by drift correction for each measurement line. The stroke of the XYZ stage is 100 mm × 100 mm with an accuracy of ~10 µm, which was confirmed by laser interferometry. A SQUID chip has a pick-up area of 200 µm × 200 µm with an inner hole of 30 µm × 30 µm. The sensitivity is 722.6 nT/V. The flux-locked loop has four gains, i.e., ×1, ×10, ×100, and ×500. An analog-to-digital converter allows analog voltage input in the range of about ±7.5 V in 0.6-mV steps. The maximum dynamic range is approximately ±5400 nT, and the minimum digitizable magnetic field is ~0.9 pT. The sensor-to-sample distance is measured with a precision line current, which gives the minimum of ~200 µm. Considering the size of pick-up coil, sensor-to-sample distance, and the accuracy of XYZ stage, spacial resolution of the system is ~200 µm. We developed the software used to measure the sensor-to-sample distance with line scan data, and the software to acquire data and control the XYZ stage for scanning. We also demonstrate the registration of the magnetic image relative to the optical image by using a pair of point sources placed on the corners of a sample holder outside of a thin section placed in the middle of the sample holder. Considering the minimum noise estimate of the current system, the theoretical detection limit of a single magnetic dipole is ~1 × 10-14 Am2. The new instrument is a powerful tool that could be used in various applications in paleomagnetism such as ultrafine-scale magnetostratigraphy and single-crystal paleomagnetism

Antibiotic-dependent instability of homeostatic plasticity for growth and environmental load

Reducing antibiotic usage in livestock animals has become an urgent issue worldwide to prevent antimicrobial resistance. Here, abuse of chlortetracycline (CTC), a versatile antibacterial agent, on the performance, blood components, fecal microbiota, and organic acid concentration in calves was investigated. Japanese Black calves were fed milk replacer containing CTC at 10 g/kg (CON) or 0 g/kg (EXP). Growth performance was not affected by CTC administration. However, CTC administration altered the correlation between fecal organic acids and bacterial genera. Machine learning methods such as association analysis, linear discriminant analysis, and energy landscape analysis revealed that CTC administration affected according to certain rules the population of various types of fecal bacteria. It is particularly interesting that the population of several methane-producing bacteria was high in the CON, and that of Lachnospiraceae, a butyrate-producing bacteria, was high in the EXP at 60 d of age. Furthermore, statistical causal inference based on machine learning data estimated that CTC treatment affects the entire intestinal environment, inhibiting butyrate production for growth and biological defense, which may be attributed to methanogens in feces. Thus, these observations highlight the multiple harmful impacts of antibiotics on intestinal health and the potential production of greenhouse gas in the calves

Identification of RNF213 as a Susceptibility Gene for Moyamoya Disease and Its Possible Role in Vascular Development

もやもや病感受性遺伝子の特定とその機能についての発見. 京都大学プレスリリース. 2011-7-21.Background Moyamoya disease is an idiopathic vascular disorder of intracranial arteries. Its susceptibility locus has been mapped to 17q25.3 in Japanese families, but the susceptibility gene is unknown. Methodology/Principal Findings Genome-wide linkage analysis in eight three-generation families with moyamoya disease revealed linkage to 17q25.3 (P<10-4). Fine mapping demonstrated a 1.5-Mb disease locus bounded by D17S1806 and rs2280147. We conducted exome analysis of the eight index cases in these families, with results filtered through Ng criteria. There was a variant of p.N321S in PCMTD1 and p.R4810K in RNF213 in the 1.5-Mb locus of the eight index cases. The p.N321S variant in PCMTD1 could not be confirmed by the Sanger method. Sequencing RNF213 in 42 index cases confirmed p.R4810K and revealed it to be the only unregistered variant. Genotyping 39 SNPs around RNF213 revealed a founder haplotype transmitted in 42 families. Sequencing the 260-kb region covering the founder haplotype in one index case did not show any coding variants except p.R4810K. A case-control study demonstrated strong association of p.R4810K with moyamoya disease in East Asian populations (251 cases and 707 controls) with an odds ratio of 111.8 (P = 10−119). Sequencing of RNF213 in East Asian cases revealed additional novel variants: p.D4863N, p.E4950D, p.A5021V, p.D5160E, and p.E5176G. Among Caucasian cases, variants p.N3962D, p.D4013N, p.R4062Q and p.P4608S were identified. RNF213 encodes a 591-kDa cytosolic protein that possesses two functional domains: a Walker motif and a RING finger domain. These exhibit ATPase and ubiquitin ligase activities. Although the mutant alleles (p.R4810K or p.D4013N in the RING domain) did not affect transcription levels or ubiquitination activity, knockdown of RNF213 in zebrafish caused irregular wall formation in trunk arteries and abnormal sprouting vessels. Conclusions/Significance We provide evidence suggesting, for the first time, the involvement of RNF213 in genetic susceptibility to moyamoya disease

Heat_stress

This file contains the raw data utilized in the following study: Growth under heat-stress conditions; Metabolomics under the conditions; and faecl bacterial population under the conditions. No other conditions were described.</p

An evaluation of homeostatic plasticity for ecosystems using an analytical data science approach

The natural world is constantly changing, and planetary boundaries are issuing severe warnings about biodiversity and cycles of carbon, nitrogen, and phosphorus. In other views, social problems such as global warming and food shortages are spreading to various fields. These seemingly unrelated issues are closely related, but it can be said that understanding them in an integrated manner is still a step away. However, progress in analytical technologies has been recognized in various fields and, from a microscopic perspective, with the development of instruments including next-generation sequencers (NGS), nuclear magnetic resonance (NMR), gas chromatography-mass spectrometry (GC/MS), and liquid chromatography-mass spectrometry (LC/MS), various forms of molecular information such as genome data, microflora structure, metabolome, proteome, and lipidome can be obtained. The development of new technology has made it possible to obtain molecular information in a variety of forms. From a macroscopic perspective, the development of environmental analytical instruments and environmental measurement facilities such as satellites, drones, observation ships, and semiconductor censors has increased the data availability for various environmental factors. Based on these background, the role of computational science is to provide a mechanism for integrating and understanding these seemingly disparate data sets. This review describes machine learning and the need for structural equations and statistical causal inference of these data to solve these problems. In addition to introducing actual examples of how these technologies can be utilized, we will discuss how to use these technologies to implement environmentally friendly technologies in society

Highly efficient and switchable electron-transfer system realised by peptide-assisted J-type assembly of porphyrin

We propose a new strategy for fabrication of a phase-separated bicontinuous system composed of low-molecular donor and acceptor that is built up through coordination-based orientation of pyridylated fullerene on a π-conjugated zinc-porphyrin J-type assembly. This complex system exhibits extremely efficient and switchable fluorescence quenching