Comparative study between LMA supreme with I-gel in anaesthetised adult patient on effectiveness and safety

Background: Supreme laryngeal mask airway (SLMA) and I-gel airway devices are second generation supraglottic airway devices (SAD) and are good alternatives to intubation during surgeries. The study was conducted with the objective to compare two supraglottic airway devices for ease of insertion, number of attempts of insertion, hemodynamic changes, incidence of adverse effects like regurgitation, lip and dental trauma and post-operative sore throat, dysphagia or hoarseness.Methods: This study was conducted at Topiwala National Medical College and BYL Nair hospital, Mumbai. 80 patients of ASA class 1 and 2 with Mallampati grading 1 and 2, between age group of 18-60 years and with BMI 0.05). Postoperatively no significant complications were observed in terms of dental injury, laryngospasm. Complication like sore throat after 1 hour and after 24 hours was comparatively more in I-gel group but difference was not significant at 1 hr (p>0.05). Dysphagia was reported more in SLMA group (8 cases) than I-gel group (1 case) at one hour and the difference was statistically significant (p=0.013).Conclusions: SLMA and I-GEL are better airway management option for patients undergoing short surgical procedures under general anaesthesia

Peran Pendidikan Agama Kristen Dalam Mengatasi Masalah Moderasi Beragama Terkait Penyalahgunaan Media Sosial (Hoax)

Konflik antar umat beragama pada dasarnya bukan lagi hal yang baru. Tindakan diskriminasi terhadap kaum minoritas juga merupakan alasan mengapa konflik antar umat beragama itu terjadi. Untuk mencegah terjadinya maka dibuatlah moderasi antar umat beragama. Tujuan adanya moderasi beragama ini ialah untuk membuat setiap umat beragama dapat saling menghargai antar umat beragama dengan cara hidup bertoleransi. Akan tetapi dalam kehidupan moderasi beragama tidak bisa terlepas dari yang namanya masalah. Salah satunya ialah masalah hoax. hoax merupakan berita palsu yang gampang sekali beredar dimedia sosial dan membawa dampak yang buruk terutama bagi kehidupan beragama, karena dapat mengakibatkan konflik dalam beragama. Untuk mengatasi hal ini pendidikan agama Kristen mempunyai peranan yang sangat penting dalam kehidupan bersama ditengah – tengah perbedaan dengan menekankan pada kehidupan kasih, dengan cara mengasihi sesama sebagai bentuk dari moderasi beragama. Selain tujuan  pendidikan agama Kristen juga membantu agar manusia dapat bijak dalam menggunakan IPTEK, dan dapat menganalisis informasi – informasi dengan benar serta dapat menyampaikan informasi yang sudah terbukti keabsahannya. Dengan demikian, hoax dapat dihindari dan kehidupan umat beragama dapat rukun

Faktor-Faktor yang Mempengaruhi Profitabilitas dan Nilai Perusahaan

This study aims to analyze and test the significance of the effect of capital structure, the growth of the company to profitability and corporate value in the telecommunications industry companies listed on the Indonesia Stock Exchange. Value of the company is investor perception of the level of success that is often associated with the company\u27s stock price. The sampling method using purposive sampling, with some predetermined criteria, the number of samples is as much as 6 telecom industry companies. Secondary data obtained from the Indonesian Capital Market Directory (ICMD) in 2008-2012. The model is used to answer the research problem and hypothesis testing research used path analysis technique (path analysis), with the application tool SPSS version 20.0. The results showed that: 1) the capital structure and significant effect on profitability negatiff, 2) the company\u27s growth and a significant positive effect on profitability, 3) capital structure and significant positive effect on firm value, 4) the company\u27s growth and a significant positive effect on the value 5 companies) profitability and significant positive effect on the value enterprise.And 6) indirectly influence the capital structure, the company\u27s growth to company value through profitability and significant positive effect

An ORC/Cdc6/MCM2-7 Complex Is Formed in a Multistep Reaction to Serve as a Platform for MCM Double-Hexamer Assembly

In Saccharomyces cerevisiae and higher eukaryotes, the loading of the replicative helicase MCM2-7 onto DNA requires the combined activities of ORC, Cdc6, and Cdt1. These proteins load MCM2-7 in an unknown way into a double hexamer around DNA. Here we show that MCM2-7 recruitment by ORC/Cdc6 is blocked by an autoinhibitory domain in the C terminus of Mcm6. Interestingly, Cdt1 can overcome this inhibitory activity, and consequently the Cdt1-MCM2-7 complex activates ORC/Cdc6 ATP-hydrolysis to promote helicase loading. While Cdc6 ATPase activity is known to facilitate Cdt1 release and MCM2-7 loading, we discovered that Orc1 ATP-hydrolysis is equally important in this process. Moreover, we found that Orc1/Cdc6 ATP-hydrolysis promotes the formation of the ORC/Cdc6/MCM2-7 (OCM) complex, which functions in MCM2-7 double-hexamer assembly. Importantly, CDK-dependent phosphorylation of ORC inhibits OCM establishment to ensure once per cell cycle replication. In summary, this work reveals multiple critical mechanisms that redefine our understanding of DNA licensing

A unique DNA entry gate serves for regulated loading of the eukaryotic replicative helicase MCM2-7 onto DNA.

The regulated loading of the replicative helicase minichromosome maintenance proteins 2–7 (MCM2–7) onto replication origins is a prerequisite for replication fork establishment and genomic stability. Origin recognition complex (ORC), Cdc6, and Cdt1 assemble two MCM2–7 hexamers into one double hexamer around dsDNA. Although the MCM2–7 hexamer can adopt a ring shape with a gap between Mcm2 and Mcm5, it is unknown which Mcm interface functions as the DNA entry gate during regulated helicase loading. Here, we establish that the Saccharomyces cerevisiae MCM2–7 hexamer assumes a closed ring structure, suggesting that helicase loading requires active ring opening. Using a chemical biology approach, we show that ORC–Cdc6–Cdt1-dependent helicase loading occurs through a unique DNA entry gate comprised of the Mcm2 and Mcm5 subunits. Controlled inhibition of DNA insertion triggers ATPase-driven complex disassembly in vitro, while in vivo analysis establishes that Mcm2/Mcm5 gate opening is essential for both helicase loading onto chromatin and cell cycle progression. Importantly, we demonstrate that the MCM2–7 helicase becomes loaded onto DNA as a single hexamer during ORC/Cdc6/Cdt1/MCM2–7 complex formation prior to MCM2–7 double hexamer formation. Our study establishes the existence of a unique DNA entry gate for regulated helicase loading, revealing key mechanisms in helicase loading, which has important implications for helicase activation

Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo – a new animal model

BACKGROUND: Existing animal models provide only indirect information about the pathogenesis of infections caused by indigenous gastrointestinal microflora and the kinetics of bacterial translocation. The aim of this study was to develop a novel animal model to assess bacterial translocation and intestinal barrier function in vivo. METHODS: In anaesthetized male Wistar rats, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli was administered by intraluminal injection in a model of small bowel obstruction. Animals were randomly subjected to non-ischemic or ischemic bowel obstruction. Ischemia was induced by selective clamping of the terminal mesenteric vessels feeding the obstructed bowel loop. Time intervals necessary for translocation of E. coli into the submucosal stroma and the muscularis propria was assessed using intravital microscopy. RESULTS: Bacterial translocation into the submucosa and muscularis propria took a mean of 36 ± 8 min and 80 ± 10 min, respectively, in small bowel obstruction. Intestinal ischemia significantly accelerated bacterial translocation into the submucosa (11 ± 5 min, p < 0.0001) and muscularis (66 ± 7 min; p = 0.004). Green fluorescent protein-transfected E. coli were visible in frozen sections of small bowel, mesentery, liver and spleen taken two hours after E. coli administration. CONCLUSIONS: Intravital microscopy of fluorescent bacteria is a novel approach to study bacterial translocation in vivo. We have applied this technique to define minimal bacterial transit time as a functional parameter of intestinal barrier function

Cryo-EM structure of a helicase loading intermediate containing ORC-Cdc6-Cdt1-MCM2-7 bound to DNA

In eukaryotes, the Cdt1-bound replicative helicase core MCM2-7 is loaded onto DNA by the ORC-Cdc6 ATPase to form a prereplicative complex (pre-RC) with an MCM2-7 double hexamer encircling DNA. Using purified components in the presence of ATP-γS, we have captured in vitro an intermediate in pre-RC assembly that contains a complex between the ORC-Cdc6 and Cdt1-MCM2-7 heteroheptamers called the OCCM. Cryo-EM studies of this 14-subunit complex reveal that the two separate heptameric complexes are engaged extensively, with the ORC-Cdc6 N-terminal AAA+ domains latching onto the C-terminal AAA+ motor domains of the MCM2-7 hexamer. The conformation of ORC-Cdc6 undergoes a concerted change into a right-handed spiral with helical symmetry that is identical to that of the DNA double helix. The resulting ORC-Cdc6 helicase loader shows a notable structural similarity to the replication factor C clamp loader, suggesting a conserved mechanism of action

Mechanism and timing of Mcm2–7 ring closure during DNA replication origin licensing

The opening and closing of two ring-shaped Mcm2-7 DNA helicases is necessary to license eukaryotic origins of replication, although the mechanisms controlling these events are unclear. The origin-recognition complex (ORC), Cdc6 and Cdt1 facilitate this process by establishing a topological link between each Mcm2-7 hexamer and origin DNA. Using colocalization single-molecule spectroscopy and single-molecule Förster resonance energy transfer (FRET), we monitored ring opening and closing of Saccharomyces cerevisiae Mcm2-7 during origin licensing. The two Mcm2-7 rings were open during initial DNA association and closed sequentially, concomitant with the release of their associated Cdt1. We observed that ATP hydrolysis by Mcm2-7 was coupled to ring closure and Cdt1 release, and failure to load the first Mcm2-7 prevented recruitment of the second Mcm2-7. Our findings identify key mechanisms controlling the Mcm2-7 DNA-entry gate during origin licensing, and reveal that the two Mcm2-7 complexes are loaded via a coordinated series of events with implications for bidirectional replication initiation and quality control.National Institutes of Health (U.S.) (Grant R01 GM52339)National Institutes of Health (U.S.) (Pre-Doctoral Training Grant GM007287)National Cancer Institute (U.S.) (Koch Institute Support Grant P30-CA14051