Mitochondrial dysfunction in Autism Spectrum Disorders

Autism spectrum disorders (ASD) are classified as neurodevelopmental disorders characterised by diminished social communication and interaction. Recently, evidence has accrued that a significant proportion of individuals with autism have concomitant diseases such as mitochondrial disease and abnormalities of energy generation. This has therefore led to the hypothesis that autism may be linked to mitochondrial dysfunction. We review such studies reporting decreased activity of mitochondrial electron transport chain (ETC) complexes and reduced gene expression of mitochondrial genes, in particular genes of respiratory chain complexes, in individuals with autism. Overall, the findings support the hypothesis that there is an association of ASD with impaired mitochondrial function; however, many of the studies have small sample sizes and there is variability in the techniques utilised. There is therefore a vital need to utilise novel imaging techniques, such as near-infrared spectroscopy, that will allow noninvasive measurement of metabolic markers for neuronal activity such as cytochrome c oxidase, in order to better establish the link between autism and mitochondrial dysfunction

Non-invasive measurement of a metabolic marker of infant brain function

While near-infrared spectroscopy (NIRS) haemodynamic measures have proven to be vastly useful in investigating human brain development, the haemodynamic response function (HRF) in infants is not yet fully understood. NIRS measurements of the oxidation state of mitochondrial enzyme cytochrome-c-oxidase (oxCCO) have the potential to yield key information about cellular oxygen utilisation and therefore energy metabolism. We used a broadband NIRS system to measure changes in oxCCO, in addition to haemodynamic changes, during functional activation in a group of 33 typically developing infants aged between 4 and 6 months. The responses were recorded over the right temporal lobe while the infants were presented with engaging videos containing social content. A significant increase in oxCCO was found in response to the social stimuli, with maximum increase of 0.238 ± 0.13 μM. These results are the first reported significant change in oxCCO in response to stimulus-evoked activation in human infants and open new vistas for investigating human infant brain function and its energy metabolism

Electro-osmotic flow of couple stress fluids in a microchannel propagated by peristalsis

A mathematical model is developed for electro-osmotic peristaltic pumping of a non-Newtonian liquid in a deformable micro-channel. Stokes’ couple stress fluid model is deployed to represent realistic working liquids. The Poisson-Boltzmann equation for electric potential distribution is implemented owing to the presence of an electrical double layer (EDL) in the micro-channel. Using long wavelength, lubrication theory and Debye-Huckel approximations, the linearized transformed dimensionless boundary value problem is solved analytically. The influence of electro-osmotic parameter (inversely proportional to Debye length), maximum electro-osmotic velocity (a function of external applied electrical field) and couple stress parameter on axial velocity, volumetric flow rate, pressure gradient, local wall shear stress and stream function distributions is evaluated in detail with the aid of graphs. The Newtonian fluid case is retrieved as a special case with vanishing couple stress effects. With increasing couple stress parameter there is a significant elevation in axial pressure gradient whereas the core axial velocity is reduced. An increase in electro-osmotic parameter induces both flow acceleration in the core region (around the channel centreline) and also enhances axial pressure gradient substantially. The study is relevant to simulation of novel smart bio-inspired space pumps, chromatography and medical microscale devices

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Not Available

Not AvailableThe investigation was carried out with 200 dairy farmers of Jalgaon district of Maharashtra. Ten villages of Jalgaon district of Maharashtra were selected and from each village 20 respondents were selected randomly. The information on socioeconomic status and knowledge of improved management practices were collected through personal interviews of the respondents. It was found that, 29 percent of farmers were medium category followed by (27 percent) small category, (23 percent) marginal, (14.5 percent) large and only (6.5 percent) farmers belonged to landless, categorie. Middle age group farmers were highest followed by young age and older age group. It was observed that majority of the farmers were educated upto primary school level. Correlation of socio-economic characteristic with knowledge revealed that age of dairy farmers, family size and annual income was positive but non-significant. Education, land holding, social participation and source of information of dairy farmers were positively and significantly correlated. Animal herd size of the farmer had very weak and non-significant correlation with knowledge of improved animal management practices. Risk orientationattitude had negatively and non-significant correlation with level of knowledge of improved dairy cattle managementpractice. Socio-economic profile of the dairy farmer influences the knowledge of improved animal management practicesNot Availabl

Effective Transmission Congestion Management via Optimal DG Capacity using Hybrid Swarm Optimization for Contemporary Power System Operations

Publisher Copyright: AuthorManaging transmission congestion had been a major problem with growing competition in the power networks. Accordingly, competitiveness emerges through the network's reconfiguration and the proliferation of secondary facilities. Congestion of transmission lines is a critical issue, and their regulation poses a technical challenge as the power system is deregulated. Therefore, the present research illustrates a multi-objective strategy for reaching the optimal capabilities of distributed generators (DG) like wind power plants and geothermal power-producing plants to alleviate congestion throughout the transmission network. Goals such as congestion management during power delivery, power loss reduction, power flow improvement with the enhancement of voltage profile, and investment expenditure minimization are considered to boost the network's technological and economic reliability. The congestion management is achieved using the locational marginal price (LMP) and calculation of transmission congestion cost (TCC) for the optimal location of DG. After identification of congested lines, DG is optimally sized by particle swarm optimization (PSO) and a newly proposed technique that combines the features of modified IL-SHADE and PSO called hybrid swarm optimization (HSO) which employs linear population size reduction technique which improves its performance greatly by reducing the population size by elimination of least fit individuals at every generation giving far better results than those obtained with PSO. In addition, optimal rescheduling of generations from generators has been done to fulfill the load demand resulting in alleviation of congested lines thereby enhancing the performance of the network under investigation. Furthermore, the performance of the proposed methodology of HSO and PSO has been tested successfully on standard benchmark IEEE-30 & IEEE-57 bus configurations in a MATLAB environment with the application of MATPOWER power system package.Peer reviewe