Retrospective observational evaluation of postoperative oxygen saturation levels and associated postoperative respiratory complications and hospital resource utilization

The clinical importance of postoperative episodic hypoxemia is still unclear, and therefore largely under-studied. As a result, there is limited understanding of its relationship with early postoperative respiratory complications (PRC, defined as intubation within three days of surgery) and hospital resource utilization.This single center study was performed using a retrospective observational design. We described population based definitions of desaturation from continuous SpO2 monitoring data captured in the post anesthesia care unit (PACU), namely median SpO2 in PACU, duration of desaturation below median, nadir desaturation, and length of oxygen therapy relative to PACU duration. These measures were evaluated against the occurrence of early PRC in logistic regression models. Measures that were independently associated with early PRC were accepted as the primary study exposures. Stratified logistic regression models were planned if significant interaction occurred with high risk surgical procedures. Models were adjusted by including several patient conditions, procedural, and anesthesia risk factors. Propensity matching on desaturation occurrence was planned to evaluate the relationship with postoperative resource utilization.Among 125,740 patients included in the univariate analyses, 351 patients (0.3%) developed early PRC. Nadir desaturation 60 min) to 3.04 (>90 min); p<0.001] were identified as independent predictors of early PRC occurrence. A modest interaction was observed between desaturation and higher surgical risk. Propensity matching for postoperative oxygen requirement was performed in 37,354 matched patients. Matched analysis demonstrated significant increase in day of surgery charges, respiratory charges, total charges, hospital length of stay, reintubation and use of invasive or non-invasive ventilatory support.In summary, we report that prolonged PACU oxygen therapy and nadir desaturation <89% in PACU as captured in a retrospective database are independently associated with early PRC. This study describes resource implications of PACU desaturation in a large academic medical center in North America

Postoperative respiratory complications in patients at risk for obstructive sleep apnea: a single-institution cohort study

Obstructive sleep apnea (OSA) is a prevalent condition that is associated with early postoperative respiratory complications (PRCs). As the majority of patients with OSA are undiagnosed, preoperative screening remains the most efficient method to identify suspected OSA.This retrospective study was performed on patients undergoing anesthesia in a single academic medical center. We assigned OSA risk class retrospectively to all patients in the study by using the Perioperative Sleep Apnea Prediction (PSAP) score. We evaluated the relationship between PSAP categories and early postoperative invasive airway placement after adjusting for several preoperative and intraoperative factors (including surgical risk) previously associated with PRC occurrence.A total of 108,479 patients were included in the final analysis with an incidence of PRC was 0.3% (n = 280). High PSAP score was associated with postoperative intubation (adjusted odds ratio, 2.3; 95% confidence interval, 1.5-3.7). Several risk factors reflecting anesthetic agents, neuromuscular blocking agents, and opioids were also independently associated with early PRC.We report that suspected OSA based on the PSAP score is independently associated with increased risk of early PRC. Specific anesthetic agents are independently associated with early PRC, pointing to the potential for examining risk modification through these exposures in future studies

Case Report: A Rare Case of Sternal Erosion Due to Bronchogenic Carcinoma

Background: Primary sternal malignancy is very uncommon. Secondary sternal malignancy is usually caused by either hematological dissemination or by direct extension due to parasternal lymph node involvement from breast or lung carcinoma.Case Details: A 72 years old smoker presented with a dull aching pain over the sternum. Computed tomography (CT) of the thorax revealed osteolytic erosion of manubrium sterni, along with a mass of lesion in the upper lobe of left lung and left sided mediastinal lymphadenopathy. CT guided fine needle aspiration cytology (FNAC) of the left lung mass showed squamous cell carcinoma and FNAC of the sternal lesion revealed metastatic squamous cell carcinoma.Conclusion: Direct erosion of sternum in case of squamous cell carcinoma of lung is a rarity. We have reported this case to increase the awareness of clinicians regarding the possibility of direct sternal involvement from lung cancer. Moreover, local removal can improve the prognosis.Keywords: Sternal erosion, Lung cancer, Local sprea

Transcriptome analysis of mRNA and miRNA in skeletal muscle indicates an important network for differential Residual Feed Intake in pigs

Feed efficiency (FE) can be measured by feed conversion ratio (FCR) or residual feed intake (RFI). In this study, we measured the FE related phenotypes of 236 castrated purebred Yorkshire boars, and selected 10 extreme individuals with high and low RFI for transcriptome analysis. We used RNA-seq analyses to determine the differential expression of genes and miRNAs in skeletal muscle. There were 99 differentially expressed genes identified (q ≤ 0.05). The down-regulated genes were mainly involved in mitochondrial energy metabolism, including FABP3, RCAN, PPARGC1 (PGC-1A), HK2 and PRKAG2. The up-regulated genes were mainly involved in skeletal muscle differentiation and proliferation, including IGF2, PDE7A, CEBPD, PIK3R1 and MYH6. Moreover, 15 differentially expressed miRNAs (|log2FC| ≥ 1, total reads count ≥ 20, p ≤ 0.05) were identified. Among them, miR-136, miR-30e-5p, miR-1, miR-208b, miR-199a, miR-101 and miR-29c were up-regulated, while miR-215, miR-365-5p, miR-486, miR-1271, miR-145, miR-99b, miR-191 and miR-10b were down-regulated in low RFI pigs. We conclude that decreasing mitochondrial energy metabolism, possibly through AMPK - PGC-1A pathways, and increasing muscle growth, through IGF-1/2 and TGF-β signaling pathways, are potential strategies for the improvement of FE in pigs (and possibly other livestock). This study provides new insights into the molecular mechanisms that determine RFI and FE in pigs

Novel Modeling of Combinatorial miRNA Targeting Identifies SNP with Potential Role in Bone Density

MicroRNAs (miRNAs) are post-transcriptional regulators that bind to their target mRNAs through base complementarity. Predicting miRNA targets is a challenging task and various studies showed that existing algorithms suffer from high number of false predictions and low to moderate overlap in their predictions. Until recently, very few algorithms considered the dynamic nature of the interactions, including the effect of less specific interactions, the miRNA expression level, and the effect of combinatorial miRNA binding. Addressing these issues can result in a more accurate miRNA:mRNA modeling with many applications, including efficient miRNA-related SNP evaluation. We present a novel thermodynamic model based on the Fermi-Dirac equation that incorporates miRNA expression in the prediction of target occupancy and we show that it improves the performance of two popular single miRNA target finders. Modeling combinatorial miRNA targeting is a natural extension of this model. Two other algorithms show improved prediction efficiency when combinatorial binding models were considered. ComiR (Combinatorial miRNA targeting), a novel algorithm we developed, incorporates the improved predictions of the four target finders into a single probabilistic score using ensemble learning. Combining target scores of multiple miRNAs using ComiR improves predictions over the naïve method for target combination. ComiR scoring scheme can be used for identification of SNPs affecting miRNA binding. As proof of principle, ComiR identified rs17737058 as disruptive to the miR-488-5p:NCOA1 interaction, which we confirmed in vitro. We also found rs17737058 to be significantly associated with decreased bone mineral density (BMD) in two independent cohorts indicating that the miR-488-5p/NCOA1 regulatory axis is likely critical in maintaining BMD in women. With increasing availability of comprehensive high-throughput datasets from patients ComiR is expected to become an essential tool for miRNA-related studies. © 2012 Coronnello et al

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Not AvailableSoils of large areas of the globe are affected by deficiency or toxicity of iron (Fe), making it one of the major limitations to higher productivity of rice. Deficiency of Fe, an essential micronutrient for growth and development of rice, produces grain with low Fe-content. Consumption of low-Fe rice causes malnutrition affecting human health. Biofortification is an easy and low-cost way to enhance Fe content in rice, the staple food of more than half of the global population. Identification of relevant quantitative trait loci (QTLs) and genes controlling the stresses are needed for developing tolerant genotype(s). Fe deficiency is commonly observed in alkaline and aerobic soils, while toxicity is seen in low pH soils of lowland rice ecology. Rice plants cope up under deficiency or toxicity conditions through various morphological, physiological and differential gene expression strategies.Rice plant uses various transporter genes like OsNAS1, OsNAS2, OsIRT1, OsIRT2, OsNRAMP1, OsYSL15 and OsYSL16 under deficiency stress while OsIRT1, OsFRO2, OsVIT1, OsVIT2, OsNRAMP6, OsNAAT1, OsNAS3, OsNAC4, OsNAC5 and OsNAC6 under toxicity condition are involved for Fe homeostasis. Several QTLs including qFe3:1, qFe3:2, qFe7:1, qFe9:1, qFe9:2, qFe10:1, Fe11:1, qFe3.3 and qFe7.3 associated with grain-Fe content have been identified. Many Fe binding and transporters genes like OsZIP1, OsHMA4, OsACA2, OsZIP2, OsCNGC, OsZIP3, OsZIP5, OsZIP9, OsHma2, ABC transporter, OsNAS3, heavy metal transporter, Chy zinc finger and OsACA9 have been identified to improve grain-Fe content. Donor lines for grain-Fe content have been identified from rice germplasms showing even up to 147 μg g−1 in brown rice. Fe content in rice grain has been enhanced to many folds using ferritin genes of soybean and common bean, NAS gene and mugineic acid synthase genes (HvNAS1 and HvNAAT-A,-B or IDS3) of barley, nicotianamine transporter gene (OsYSL2) and nicotinamine synthase genes (OsNAS1, OsNAS2 and OsNAS3) through transgenic approach. The paper analyses the mechanisms of tolerance to Fe-deficiency and toxicity, identification of genes/QTLs responsible for tolerance under the stresses and helping for biofortification, assesses the stress affected symptoms, reviews the screening and summarizes the efforts for breeding programs for improving tolerance to Fe-deficiency and toxicity in rice.Not Availabl

A novel deep learning-based technique for detecting prostate cancer in MRI images

AbstractIn the western world,the prostate cancer is major cause of death in males. Magnetic Resonance Imaging (MRI) is widely used for the detection of prostate cancer due to which it is an open area of research. The proposed method uses deep learning framework for the detection of prostate cancer using the concept of Gleason grading of the historical images. A3D convolutional neural network has been used to observe the affected region and predicting the affected region with the help of Epithelial and the Gleason grading network. The proposed model has performed the state-of-art while detecting epithelial and the Gleason score simultaneously. The performance has been measured by considering all the slices of MRI, volumes of MRI with the test fold, and segmenting prostate cancer with help of Endorectal Coil for collecting the images of MRI of the prostate 3D CNN network. Experimentally, it was observed that the proposed deep learning approach has achieved overall specificity of 85% with an accuracy of 87% and sensitivity 89% over the patient-level for the different targeted MRI images of the challenge of the SPIE-AAPM-NCI Prostate dataset.</jats:p

The evolutionary significance of polyploidy

Polyploidy, or the duplication of entire genomes, has been observed in prokaryotic and eukaryotic organisms, and in somatic and germ cells. The consequences of polyploidization are complex and variable, and they differ greatly between systems (clonal or non-clonal) and species, but the process has often been considered to be an evolutionary 'dead end'. Here, we review the accumulating evidence that correlates polyploidization with environmental change or stress, and that has led to an increased recognition of its short-term adaptive potential. In addition, we discuss how, once polyploidy has been established, the unique retention profile of duplicated genes following whole-genome duplication might explain key longer-term evolutionary transitions and a general increase in biological complexity

Azimuthal Charged-Particle Correlations and Possible Local Strong Parity Violation

Parity-odd domains, corresponding to nontrivial topological solutions of the QCD vacuum, might be created during relativistic heavy-ion collisions. These domains are predicted to lead to charge separation of quarks along the system’s orbital momentum axis. We investigate a three-particle azimuthal correlator which is a P even observable, but directly sensitive to the charge separation effect. We report measurements of charged hadrons near center-of-mass rapidity with this observable in Au+Au and Cu+Cu collisions at √sNN=200  GeV using the STAR detector. A signal consistent with several expectations from the theory is detected. We discuss possible contributions from other effects that are not related to parity violation

Long range transport of soil dust and smoke pollution in the South Asian Region.

Transboundary transport of air pollution in the South Asian region has been an issue of increasing importance over the past several decades. Long–range transport of anthropogenic pollution is contrasted with that of pollution produced by natural processes such as dust storms or natural forest fires. Airborne particulate matter datasets covering the period from 2002 to 2007 from the neighboring countries like Bangladesh, India, Pakistan and Sri Lanka were used to find the source areas that are primarily responsible for long range transported pollutants. All four countries collected samples with the same type of sampler and follow the same technique for mass and BC measurements. It was found that high fine soil contributions were from dust storms. On the other hand, smoke in this region mainly comes from northern India where agricultural waste is often burned. © Elsevier B.V