Mitochondrial Permeability Regulates Cardiac Graft Ischemia-Reperfusion Injury and Allograft Rejection

The clinical relevance of ischemia-reperfusion injury (IRI) in the context of organ transplantation is well-established. IRI is associated with various forms of programmed cell death (PCD), of which necroptosis is particularly significant. Necroptosis is an inflammatory form of PCD that promotes alloimmunity and adversely affects allograft viability and function. We have recently shown the role of cyclophilin D (CypD), a critical mediator of mitochondrial permeability transition pore (mPTP) formation, in necroptosis. In this study, we investigated the downstream mechanism of hypoxia/reoxygenation-induced necroptosis and the effect of CypD inhibition in mitigating IRI-induced allograft injury and the subsequent alloimmune response in a clinically relevant model of cardiac transplantation. Our data indicate that inhibition of caspases during cold hypoxia-reoxygenation injury decreases apoptosis but increases necroptosis and that inhibition of CypD attenuates hypoxia/reoxygenation-induced necroptosis (n=3; p≤0.001). Interestingly, we found that hypoxia/reoxygenation-induced necroptosis involves apoptosis-inducing factor (AIF) translocation to the nucleus and that AIF silencing also attenuates hypoxia/reoxygenation-induced necroptosis (n=3; p≤0.001). Our in vivo studies confirm that CypD deficiency in ischemia-treated donor hearts mitigates IRI and allograft rejection (n=8; p=0.008). Our findings suggest that CypD inhibition following transplantation substantially attenuates necroptosis and mitigates allograft injury and the subsequent alloimmune response. Our data also indicate that AIF may be the downstream effector molecule that executes IRI-induced DNA damage in necroptosis. As such, targeting mitochondrial permeability may be a plausible approach in formulating therapeutic strategies aimed at improving allograft viability and function

DSP Based Transmitter I/Q Imbalance Calibration: Implementation and Performance Measurements

The recent interest in I/Q signal processing based transceivers has resulted in a new domain of research in flexible, low-power, and low-cost radio architectures. The main advantage of complex or I/Q up- and downconversion is that it does not produce any image signal and eliminates the need of expensive RF filters. This greatly simplifies the transceiver front-end and permits single-chip radio transceiver solutions. The analog quadrature modulators and demodulators are, however, sensitive to two kinds of implementation impairments: gain imbalance, and phase imbalance. These impairments originate due to the non-ideal behavior of the electronic components in the I- and Q- channels of the modulators/demodulators. As a result, they compromise the infinite image signal attenuation and adversely affect the performance of a wireless system. Furthermore, new higher order modulated waveforms and wideband signals are especially susceptible to these impairments and achieving sufficient image signal attenuation is a fundamental requirement for future wireless systems. Therefore, digital techniques which enhance the dynamic range of front-end with minimum amount of additional analog hardware are becoming more popular, being also motivated by the constantly increasing number crunching power of digital circuitry. In this thesis, some recently developed algorithms for I/Q imbalance estimation and compensation are studied on the transmitter side. The calibration algorithms use a baseband test signal combined with a feedback loop from I/Q modulator output back to transmitter digital parts to efficiently estimate the modulator I/Q mismatch. In the feedback loop, the RF signal is demodulated and compared with the original test signal to estimate the I/Q imbalance and the needed pre-distortion parameters. The actual digital transmit signal is then properly pre-distorted with the obtained I/Q imbalance knowledge, in order to cancel the effects of modulator I/Q imbalance at the data transmission phase. The performance of the compensation algorithms is first evaluated with computer simulations. A prototype system using laboratory instruments is also developed to illustrate the effects of I/Q imbalance in direct conversion and low-IF transmitters and is used to prove the usability of algorithms in real life front-ends. The results of computer simulations and laboratory measurements prove that the compensation algorithms yield a good calibration performance by suppressing the image signal interference close to or even below the noise floor. /Kir1

Method of Choice for Disphyseal Fracture of Humerus; Closed Intramedullary Interlocking Nail or Functional Brace

Objective: To compare the intramedullary nailing versus functional brace in the cases of disphyseal humeral fractures.Methodology: This was a descriptive comparative analysis study done Shaikh Zayed Hospital from Jan 2016 to March 2018, Pakistan. 60 cases who were presented with the disphyseal fracture of humerus were enrolled. After random allocation in the two different groups viz functional brace and intramedullary nailing. All the patients irrespective of gender and presented with humerus fracture were added. While all other type of fracture cases was excluded.Each patient was treated standardized by a specialist having somewhere around 5 years of experience after post-graduation. All patients were pursued at third week, sixth week and at 3 months to survey the radiological result according to the radiological sign of union i-e formation of callus on the fracture point.Results: Both treatment group in this study were same with non-significant difference with respect to age, gender and history of the smoking. But the union was noted in 45% cases in the intramedullary group and 54% in the functional brace group (p-value>0.05).  But it was observed that at the 6th week there was a significant difference with respect to the union in both operative groups. P-value of the union at 6th week was <0.05 shows that difference is significant.Conclusion: Functional brace method is more effective for the union of the disphyseal humerus fracture

Securing Cognitive Radio Networks using blockchains

Due to the increase in industrial applications of Internet of Things (IoT), number of internet connected devices have been increased accordingly. This has resulted in big challenges in terms of accessibility, scalability, connectivity and adaptability. IoT is capable of creating connections between devices on wireless medium but the utilization of scarce spectrum in efficient manner for the establishment of these connections is the biggest concern. To accommodate spectrum allocation problem different radio technologies are being utilized. One of the most efficient technique being used is cognitive radio, which dynamically allocate the unlicensed spectrum for IoT applications. Spectrum sensing being the fundamental component of Cognitive Radio Network (CRN) is threatened by security attacks. Process of spectrum sensing is disturbed by the malicious user (MU) which attacks the primary signal detection and affects the accuracy of sensing outcome. The presence of such MU in system, sending false sensing data can degrade the performance of cognitive radios. Therefore, in this article a blockchain based method is proposed for the MU detection in network. By using this method an MU can easily be discriminated from a reliable user through cryptographic keys. The efficiency of the proposed mechanism is analyzed through proper simulations using MATLAB. Consequently, this mechanism can be deployed for the validation of participating users in the process of spectrum sensing in CRN for IoTs.publishe

Pre-operative hypoalbuminemia: overlooked prior knee arthroplasty?

Background: Role of preoperative serum albumin on primary total knee arthroplasty.Methods: A total of 1022 patients who underwent primary knee arthroplasty were collected. All patients were divided into the control group (preoperative serum albumin ≥3.5 g/dl) and case group (preoperative serum albumin <3.5 g/dl). The risk factors of preoperative hypoalbuminemia and the postoperative complications were analyzed.Results: Compared to controls, hypoalbuminemia patients were older (p<0.05 ), had higher risk for any complication such as delayed wound healing, pleural effusion, and pneumonia, lower BMI and longer hospital stay (p<0.001).Conclusions: Preoperative hypoalbuminemia is more frequent in patients who are older, have poor nutritional condition, and have more than two concurrent disorders. Hypoalbuminemia before surgery is linked to a higher risk of postoperative problems

Comparison of intra-articular lidocaine versus intravenous sedative and analgesic for reduction of anterior shoulder dislocation in terms of mean pain reduction using vas score

INTRODUCTION: The most common dislocation presenting to emergency department is anterior shoulder dislocation. Posterior dislocations and inferior dislocations are rare. Dislocations of the anterior shoulder mostly occur with the position of the arm is abducted and externally rotated. This results in injury of the humeral head, labrum, capsuloligamentous structures and glenoid. Such patients experience severe pain, therefore prompt reduction is necessary to ameliorate the pain. Intravenous analgesia combined with sedation or intra-articular lidocaine injection can be used for closed reduction of anterior shoulder dislocation. Due to its side effects, Intra-articular lidocaine (IAL) is recommended for use as a probable alternative to intravenous sedation-analgesia especially for patients with contraindication to intravenous sedation-analgesia. OBJECTIVE: To compare intra-articular lidocaine versus intravenous sedative and analgesic for management of anterior shoulder dislocation in terms of mean pain using VAS during reduction of shoulder joint. STUDT DESIGN:   Randomized controlled trial (RCT). SETTING: Removed for blind review DURATION: 6 months (November 22nd, 2017 to May 21st, 2018) SAMPLE SIZE: 60 patients (30 in each group) RESULTS: We included sixty patients in my study. 19 (31.7%) were females and 41 (68.3%) were male patients. Out of all the patients 38 (63.3%) had right sided shoulder dislocation, while the rest 22 (36.7%) patients had left sided shoulder dislocation. Patients mean age was 33.27±10.535 years and mean pain score of all the patients was 4.966±1.930. The mean pain score in Group A was 4.200±1.648, while the mean pain score in Group B was 5.733±1.910 (p value = 0.002. Stratification was done according to gender and age group of the patients, and post-stratification t-test was applied. CONCLUSION:   Intra-articular lidocaine is better option in pain control during reduction of anterior shoulder dislocation. KEY WORDS: Intra venous analgesia, Intra-articular lidocaine, shoulder dislocation

Design and Analysis of Self-Healing Tree-Based Hybrid Spectral Amplitude Coding OCDMA System

This paper presents an efficient tree-based hybrid spectral amplitude coding optical code division multiple access (SAC-OCDMA) system that is able to provide high capacity transmission along with fault detection and restoration throughout the passive optical network (PON). Enhanced multidiagonal (EMD) code is adapted to elevate system’s performance, which negates multiple access interference and associated phase induced intensity noise through efficient two-matrix structure. Moreover, system connection availability is enhanced through an efficient protection architecture with tree and star-ring topology at the feeder and distribution level, respectively. The proposed hybrid architecture aims to provide seamless transmission of information at minimum cost. Mathematical model based on Gaussian approximation is developed to analyze performance of the proposed setup, followed by simulation analysis for validation. It is observed that the proposed system supports 64 subscribers, operating at the data rates of 2.5 Gbps and above. Moreover, survivability and cost analysis in comparison with existing schemes show that the proposed tree-based hybrid SAC-OCDMA system provides the required redundancy at minimum cost of infrastructure and operation

Calcium levels and metabolic disturbance in renal disease patients receiving hemodialysis: a cross sectional study highlighting its association in dialysis patients

Background: The aim of this study was to determine the disturbances in Calcium and other mineral levels in patients on hemodialysis at Tabba Kidney Institute, Karachi, Sindh, Pakistan.Methods: A cross sectional observational study through convenient sampling technique was conducted from January 2017 to August 2017 at Tabba Kidney Institute, Karachi after obtaining ethical approval. 255 patients, all above 18 years of age and on hemodialysis were included in the study. Multi-organ failure patients on dialysis, other systemic diseased patients on hemodialysis were excluded. Demographic variables, mineral levels, symptoms and supplementations were recorded. SPSS version 20.0 was used for data analysis.Results: A total of 255 patients on hemodialysis were selected and divided into groups depending upon median years of hemodialysis below and above 5 years of hemodialysis. Median and IQR of calcium were 8.8 and 8.2-9.1 mg/dl for below 5 years, 8.6 and 8.1-9.1 mg/dl for above 5 years (P value=0.44). Median and IQR of phosphate were 4.9 and 3.9-5.7 mg/dl for below 5 years and 4.6 and 3.7-5.5 mg/dl for above 5 years (P value=0.21). Median and IQR of parathyroid hormone were 393 and 212-699 pg/ml for below 5 years and 329 and 128-657 pg/ml for above 5 years. (P value=0.13) Median and IQR of albumin were 4.0 and 3.6-4.2 mg/dl for below 5 years and 4.0 and 3.8-4.3 for above 5 years (P value=0.30). Total of 18 (10.9%) had para thyroidectomy.Conclusions: Present study showed that significant difference in mineral levels did not exist in patients on hemodialysis as regards to the duration of dialysis. However clinical features had a tendency to decrease as duration of dialysis increased to above 5 years. Para thyroidectomy and itching were two main significant findings in this study

Renal bone disease in patients on hemodialysis: an observational study focusing on the variation of calcium metabolism

Background: The aim of this study was to determine the disturbances in the levels of mineral in the body due to hemodialysis at different levels of parathormone levels and to assess its association with the calcium levels.Methods: Study was a cross sectional for the period of 6 months taking ethical approval. Total 255 cases were registered in this study after taking their informed consent. The cases were divided into three groups according to PTH level. Group 1 has 87 subjects with PTH level <250, group 2 has 102 subjects with PTH level 250-650 and group 3 has 66 cases with PTH level >650. The cases were taking hemodialysis for greater than 6 months and have the ages more than 18 years were included in this study. The demographic data includes age, sex dialysis related data like duration of hemodialysis, levels of calcium, phosphorus, albumin, PTH, ALP were observed.Results: Hemodialysis duration were recorded in respective three groups as 7.28±5.71, 6.26±5.56 and 6.15±4.30 days respectively  (P=0.319). Calcium was found in group 1, 8.70±0.81, in group 2, 8.39±0.89 and in group 3, 8.76±0.82 (P=0.01). PTH level in three respective group were recorded to be 123.46±74.15, 418.47±115.49 and 1314.67±1188.63 (P <0.001).Conclusions: Present study showed that significant difference was found in mineral levels in patients on hemodialysis with PTH level as well as with alkaline phosphatase level. Nevertheless, no significant difference was found with duration of dialysis and with parameter of albumin