Value of Oxygenation Index in Selecting Neonates for Thoracoscopic Repair of Congenital Diaphragmatic Hernia

Introduction: The major obstacles for routine application of thoracoscopic repair for congenital diaphragmatic hernia (CHH) in neonates include intraoperative hypercarbia, acidosis and conversion to open surgery. Therefore, strict preoperative selection criteria should be followed for successful primary thoracoscopic repair of the diaphragm and achievement of minimal conversion rate. Materials and Methods: A prospective study was conducted from April 2016 to March 2018, where all neonates confirmed to have CDH were assessed by a specialized anaesthesia team for the possibility of undergoing thoracoscopic repair. In order to assess the severity of persistent pulmonary hypertension (PPH), oxygenation index (OI) was used and babies who had OI <5 were considered to have mild pulmonary hypertension; and consequently underwent thoracoscopic repair. Results: Twenty nine CDH cases met the selection criteria; hence, they underwent thoracoscopic repair. Primary diaphragmatic repair was successfully performed thoracoscopically in all neonates without perioperative complication. Conversion to open repair occurred in 3 cases, with causes related to surgical factors. Recurrence was discovered in 1 case only. Conclusion: While choosing candidates for thoracoscopic CDH repair in neonates, OI is a reliable indicator as it clarifies neonates who have good preoperative pulmonary functio

RADIATION PREPARATION OF SMART HYDROGEL HAS ANTIMICROBIAL PROPERTIES FOR CONTROLLED RELEASE OF CIPROFLOXACIN IN DRUG DELIVERY SYSTEMS

The objective of the present work was to synthesize copolymer hydrogel composed of poly acrylic acid (PAAc) and PAAc/pectin, which are verysensitive to environmental stimulus, this feature is important for their application in biomedical applications, due to its unique properties, whichcan resemble human living organs, wound dressing, drug delivery systems. Gamma radiation induces synthesis and modification of monomer topolymer hydrogel was studied. The effect of different parameter onto preparation of smart hydrogel such as monomer concentration, radiation doseon to swelling percent of the prepared copolymer hydrogel have been studied, gel fraction have been studied as a function of swelling ratio. Structurecharacterization of the prepared copolymer hydrogel have been investigated using Fourier transform infrared spectroscopy, The morphologicalstructure using X-ray diffraction analysis and scanning electron microscopy have been studied. The swelling properties of the prepared copolymershave been studied at different time and pH. It was found that the swelling percent increases as the time increase and increases as pH increase and themaximum swelling occurs at pH 6 with the value of 19,000% for PAAc hydrogel and 10,000% for PAAc/pectin hydrogels after 24 hrs. Drug loadingmeasurements using ciprofloxacin (CPFX) drug at pH 7 for PAAc hydrogel after 24 hrs and at pH 11 for PAAc/pectin hydrogels. Studies of drugreleasingof CPFX as drug model have been investigated, at different time and pH and it was found that the drug release incases as pH increase and themaximum release occurs at pH 4 for PAAc and pH (3,8) for PAAc/pectin hydrogels, the antimicrobial activity of the synthesized copolymeric hydrogelunder study was evaluated based on the diameters of clear zone surrounding the polymeric substance (disk diffusion test) this proved that polymerichydrogel can be used as antibacterial agent.Keywords: Radiation, Copolymerization, Pectin, Acrylic monomers, Drug release

Do public health services in Egypt help young married women exercise their reproductive rights?

AbstractObjectiveTo assess supply and demand of family planning services from a reproductive rights perspective among young married women (YMW) in Egypt.MethodsData sources related to family planning included structured interviews with service providers (n=216); an inventory of equipment and supplies (n=40); exit interviews with YMW (n=147); and focus group discussions (n=12) with YMW, husbands, and mothers and/or mothers in law. YMW, husbands and mothers in law were not necessarily related.ResultsAlthough family planning services were readily available and affordable, YMW had limited access to information and services. Shortfalls were noted regarding respect for privacy, choice of family planning method, access to fertility services, and premarital counseling. Few YMW had sufficient autonomy to make informed reproductive decisions. Effective accountability mechanisms and processes for redress were also lacking.ConclusionImplementation of a rights-based approach and structural changes to family planning service delivery are recommended to empower YMW in Egypt to demand and exercise their reproductive rights

The Effectiveness Of Non Invasive Hemodynamic Parameters In Detection Of Spinal Anesthesia Induced Hypotension During Cesarean Section

Introduction: Hypotension is the most frequent consequence of spinal anesthesia in cesarean section. It results in harmful effects on mother and newborn.Aim: This study aim was to evaluate the correlation of positional changes in hemodynamic (heart rate and blood pressure) measured before spinal anesthesia in anticipation of occurrence of hypotension throughout cesarean delivery.Methods: 100 ASA grade I parturient were selected for this prospective observational study. Preoperative sociodemographic data, parity, and hemodynamic parameters were recorded including changes in systolic, diastolic, mean arterial blood pressure, and heart rate after positional shift from supine to lateral and sitting positions. Intraoperative, occurrence of hypotension was noted.Results: With hypotension as the dependent variable, the age, parity, heart rate at supine position, and changes in (heart rate, systolic, diastolic and mean arterial blood pressure) from supine to lateral position, and from supine to sitting position had high statistical significant negative correlation with blood pressure as P value <.05. Multivariate logistic analysis to assess predictors of hypotension concluded that changes in hemodynamic variable from supine to lateral position only significant predictor were (Δ heart rate, Δ diastolic and Δ mean blood pressure), and changes in hemodynamic variable from supine to sitting position only significant predictor were (Δheart rate and Δ diastolic blood pressure).Discussion: Elevated sympathetic activity before neuraxial anesthesia was associated with higher risk for post-spinal hypotension. The great variability in hemodynamic after positional change indicates higher sympathetic activity to blood vessels. The high rise in the autonomic activity, the higher the risk for post-spinal hypotensionConclusion: Age, parity, and positional changes in hemodynamic were correlated with blood pressure reading after spinal anesthesia during cesarean delivery

Zelluläre Regulation von Plättchen Glykoprotein VI : in vivo und in vitro Studien in der Maus

Platelet interaction with the subendothelium is essential to limit blood loss after tissue injury. However, upon rupture of atherosclerotic plaques, this interaction may result in blood vessel occlusion leading to life threatening diseases such as myocardial infarction or stroke. Among the subendothelial matrix proteins, collagen is considered to be the most thrombogenic component as it directly activates platelets. Platelets interact with collagen, either indirectly through glycoprotein (GP) Ib-V-IX receptor complex, or directly through the major collagen receptor on the platelet surface, GPVI. The work presented here focused on studying the cellular regulation of GPVI. In addition, a possible role for GPVI in thrombus formation induced by atherosclerotic plaque material was investigated and it was found that GPVI plays an important role in this process. Using a recently published mitochondrial injury model, it was found that GPVI contains a cleavage site for a platelet-expressed metalloproteinase. Further studies showed that platelet activation by CRP, or thrombin induced down-regulation of GPIb, but not GPVI. In parallel, cellular regulation of GPV was studied and it was found that GPV is cleaved in vitro by the metalloproteinase ADAM17. In previous studies it was shown that injection of mice with the anti-GPVI mAb, JAQ1, induces GPVI down-regulation, which is associated with a strong, but transient, thrombocytopenia. Using new anti-GPVI mAbs, which bind different epitopes on the receptor, it is shown in this study that GPVI down-regulation occurs in an epitope-independent manner. Further experiments showed that antibody treatment induces a transient, but significant increase in bleeding time. Using different genetically modified mice, it is shown that, upon antibody injection, GPVI is both, shed from the platelet surface and internalized into the platelet. Signaling through the immunoreceptor tyrosine-based activation motif (ITAM) of the FcR chain is essential for both processes, while LAT and PLC2 are essential for the shedding process only. Antibody-induced increase in bleeding time and thrombocytopenia were absent in LAT deficient mice, showing that it is possible to uncouple the associated side effects from the down-regulation process. As antibody-induced GPVI internalization still occurs in LAT and PLC2 deficient mice, this suggests a novel signaling pathway downstream of GPVI that has not been described so far.Plättchen Interaktion mit dem Subendothel ist für die Blutstillung essentiell. Dies kann jedoch nach dem Aufbrechen atherosklerotischer Plaques zu lebensbedrohlicher Erkrankungen wie Infarkt oder Schlaganfall führen. Kollagen, welches die Plättchen dirket aktiviert, ist der thrombogenste Bestandteil der Extrazellularmatrix (EZM). Die Bindung zwischen Plättchen und Kollagen wird sowohl indirekt durch den Glykoprotein (GP) Ib-V-IX Rezeptorkomplex, als auch direkt durch den Kollagenrezeptor GPVI, auf der Plättchenoberfläche vermittelt. In der vorliegenden Arbeit wurde die zelluläre Regulation von GPVI untersucht. Des Weiteren wurde die Rolle von GPVI in durch atheroklerotisches Plaquematerial induzierter Thrombusbildung studiert. Hierbei wurde festgestellt, dass GPVI eine wichtige Funktion in diesem Prozess spielt. Mittels eines jüngst publizierten mitochondrialen Verletzungsmodels, konnte gezeigt werden, dass GPVI eine Erkennungsstelle für eine in den Plättchen exprimierte Metalloproteinase besitzt. Mehrere Versuche haben gezeigt, dass Plättchenaktivierung durch CRP, und Thrombin zur Runterregulierung von GPIb aber nicht von GPVI führt. Parallellaufende Untersuchungen zeigten, dass GPV durch die Metalloproteinase ADAM17 in vitro abgespalten wird. Vorherige Studien ergaben, dass die in vivo Behandlung von Mäusen mit dem anti-GPVI Antikörper, JAQ1, zur Runterregulierung des Rezeptors führt. Dieses ist mit einer starken, transienten Thrombozytopenie assoziiert. Mittels neu generierte anti-GPVI Antikörper (JAQ2, 3), die unterschiedliche Bindungsstellen auf GPVI erkennen, konnte demonstriert werden, dass die Antikörper vermittele GPVI Runterregulierung Epitop unabhängig ist. Weitere Untersuchungen ergaben, dass Anitkörperinjektion eine transiente Erhöhung der Blutungszeit verursacht. Mittels genetisch modifizierter Mäuse konnte dargestellt werden, dass die Antikörpergabe GPVI sowohl von der Plättchenoberfläche abgespalten, als auch internalisiert wird. Während die Signaltransduktion durch das ITAM Motif der FcR Kette essentiell für beide Prozesse ist, sind LAT und PLC2 nur für das Abspalten wichtig. Antikörper induzierte Erhöhung der Blutungszeit und Thrombozytopenie sind abwesend in LAT-defizienten Mäuse, was zeigt, dass möglicherweise die GPVI Runterregulierung von den assoziierten Nebenwirkungen zu trennen ist. Da die GPVI Runterregulierung in LAT und –PLC2 defizienten Mäusen weiterhin stattfindet, zeigt dies einen neuen GPVI Signalweg, der bisher noch nicht beschrieben wurde

Adaptive-neighbourhood and iterative methods for image restoration

Bibliography: p. 104-110

Animat vision, active vision in artificial animals

grantor: University of TorontoWe propose and demonstrate a new paradigm for active vision research which draws upon recent advances in the fields of artificial life and computer graphics. A software alternative to the prevailing hardware vision mindset, ' animat vision' prescribes artificial animals, or animats, situated in physics-based virtual worlds as autonomous virtual robots with active perception systems. To be operative in its world, an animat must autonomously control its eyes and actuated body. Computer vision algorithms continuously analyze the retinal image streams acquired by the animat's eyes, enabling it to locomote purposefully through its world. We describe an initial animat vision implementation within lifelike artificial fishes inhabiting a physics-based, virtual marine world. Emulating the appearance, motion, and behavior of real fishes in their natural habitats, these animats are capable of spatially nonuniform retinal imaging, foveation, retinal image stabilization, color object recognition, color stereo obstacle avoidance, and perceptually-guided navigation. These capabilities allow them to foveate and pursue moving targets of interest, such as other artificial fishes, while exercising the sensorimotor control necessary to avoid collisions and predators. We demonstrate that the animat vision paradigm extends to virtual environments inhabited by virtual humans. Animat vision offers a fertile approach to the development, implementation, and evaluation of computational theories that profess sensorimotor competence for animal or robotic situated agents.Ph.D

Impaired hypoxic response in senescent mouse brain

'This is the author's version of a work that was accepted for publication in International Journal of Developmental Neuroscience. Changes resulting from the publishing process, such as structural formatting and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Developmental Neuroscience, 29 (6) (2011) 10.1016/j.ijdevneu.2011.06.003'Tissue hypoxia leads to activation of endogenous adaptive responses that involve a family of prolyl hydroxylase domain proteins (PHD1-3) with oxygen sensing properties, hypoxia inducible transcription factors (HIFs), and cytoprotective HIF target genes such as erythropoietin (EPO) and vascular endothelial growth factor (VEGF). The hypoxic induction of these genes is regulated by oxygen-dependent hydroxylation of HIF alpha subunits by PHDs, which signals their proteasomal degradation. In this study, mice of different age were exposed to hypoxia or subjected to cerebral ischemia after hypoxic pre-conditioning. We found an impaired hypoxic response in the brain, characterized by elevated levels and impaired downregulation of PHD1. Furthermore, an attenuated hypoxic activation of VEGF and EPO, as well as of other HIF-target genes such glucose transporter-1 and carbonic anhydrase 9 was found in senescent brain. Finally, we observed a loss of the protective effect of hypoxic pre-conditioning on subsequent cerebral ischemia with increasing age. Thus, the impaired hypoxic adaptation, resulting in compromised hypoxic activation of neuroprotective factors, could contribute to neurodegenerative processes with increasing age, and might have implications for treating age-related disorders.Peer reviewedFinal Accepted Versio