Evaluation of efficacy of priming dose of propofol in reducing induction dose requirements in patients undergoing elective surgeries under general anaesthesia

Background: Priming principle refers to administration of a subanaestheic dose of an agent prior to its actual anaesthetic dose. Propofol is an effective substitute to thiopentone for intravenous induction. The objectives of the study were to evaluate whether priming with propofol would reduce induction of dose, reduce the peri-intubation haemodynamic changes, influence the severity of side effects and influence recall phenomenon.Methods: Sixty patients of ASA Grade 1 and 2, between 18-55 years of age group, of both sexes, were selected on the basis of eligibility criteria and scheduled for elective surgery under general anaesthesia were divided into study and control groups of 30 patients each. The total dose of propofol including the priming (25% of total) dose of propofol, heart rate and blood pressure, baseline (before induction), immediately after intubation, 1 min, 3 min, 5 min after induction, SPO2 (% of oxygen saturation), recall phenomenon and other side effects post operatively were studied.Results: The demographic data were comparable for age, weight and sex in both the groups. Total patients were divided into two groups with 30 patients each. It was observed that total induction dose of propofol was significantly decreased in the study group 72.33±9.53mg compared to control group 115.83±9.00mg. Heart rate was better maintained in study group with minimal post-intubation response. The values of systolic, diastolic and mean blood pressure observed at 1 min after induction also showed significant decrease in control group compared to study group.Conclusions: Propofol produces smooth, rapid, pleasant and safe induction. Priming with propofol can be practiced due to its cost effectiveness and better haemodynamic profile and safety

Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients

Introduction: Close monitoring and repeated risk assessment of sepsis patients in the intensive care unit (ICU) is important for decisions regarding care intensification or early discharge to the ward. We studied whether considering plasma kinetics of procalcitonin, a biomarker of systemic bacterial infection, over the first 72 critical care hours improved mortality prognostication of septic patients from two US settings. Methods: This retrospective analysis included consecutively treated eligible adults with a diagnosis of sepsis from critical care units in two independent institutions in Clearwater, FL and Chicago, IL. Cohorts were used for derivation or validation to study the association between procalcitonin change over the first 72 critical care hours and mortality. Results: ICU/in-hospital mortality rates were 29.2%/31.8% in the derivation cohort (n = 154) and 17.6%/29.4% in the validation cohort (n = 102). In logistic regression analysis of both cohorts, procalcitonin change was strongly associated with ICU and in-hospital mortality independent of clinical risk scores (Acute Physiology, Age and Chronic Health Evaluation IV or Simplified Acute Physiology Score II), with area under the curve (AUC) from 0.67 to 0.71. When procalcitonin decreased by at least 80%, the negative predictive value for ICU/in-hospital mortality was 90%/90% in the derivation cohort, and 91%/79% in the validation cohort. When procalcitonin showed no decrease or increased, the respective positive predictive values were 48%/48% and 36%/52%. Discussion In septic patients, procalcitonin kinetics over the first 72 critical care hours provide prognostic information beyond that available from clinical risk scores. If these observations are confirmed, procalcitonin monitoring may assist physician decision-making regarding care intensification or early transfer from the ICU to the floor

On the Complexity of Newman's Community Finding Approach for Biological and Social Networks

Given a graph of interactions, a module (also called a community or cluster) is a subset of nodes whose fitness is a function of the statistical significance of the pairwise interactions of nodes in the module. The topic of this paper is a model-based community finding approach, commonly referred to as modularity clustering, that was originally proposed by Newman and has subsequently been extremely popular in practice. Various heuristic methods are currently employed for finding the optimal solution. However, the exact computational complexity of this approach is still largely unknown. To this end, we initiate a systematic study of the computational complexity of modularity clustering. Due to the specific quadratic nature of the modularity function, it is necessary to study its value on sparse graphs and dense graphs separately. Our main results include a (1+\eps)-inapproximability for dense graphs and a logarithmic approximation for sparse graphs. We make use of several combinatorial properties of modularity to get these results. These are the first non-trivial approximability results beyond the previously known NP-hardness results.Comment: Journal of Computer and System Sciences, 201

Habitat 3.0: A Co-Habitat for Humans, Avatars and Robots

We present Habitat 3.0: a simulation platform for studying collaborative human-robot tasks in home environments. Habitat 3.0 offers contributions across three dimensions: (1) Accurate humanoid simulation: addressing challenges in modeling complex deformable bodies and diversity in appearance and motion, all while ensuring high simulation speed. (2) Human-in-the-loop infrastructure: enabling real human interaction with simulated robots via mouse/keyboard or a VR interface, facilitating evaluation of robot policies with human input. (3) Collaborative tasks: studying two collaborative tasks, Social Navigation and Social Rearrangement. Social Navigation investigates a robot's ability to locate and follow humanoid avatars in unseen environments, whereas Social Rearrangement addresses collaboration between a humanoid and robot while rearranging a scene. These contributions allow us to study end-to-end learned and heuristic baselines for human-robot collaboration in-depth, as well as evaluate them with humans in the loop. Our experiments demonstrate that learned robot policies lead to efficient task completion when collaborating with unseen humanoid agents and human partners that might exhibit behaviors that the robot has not seen before. Additionally, we observe emergent behaviors during collaborative task execution, such as the robot yielding space when obstructing a humanoid agent, thereby allowing the effective completion of the task by the humanoid agent. Furthermore, our experiments using the human-in-the-loop tool demonstrate that our automated evaluation with humanoids can provide an indication of the relative ordering of different policies when evaluated with real human collaborators. Habitat 3.0 unlocks interesting new features in simulators for Embodied AI, and we hope it paves the way for a new frontier of embodied human-AI interaction capabilities.Comment: Project page: http://aihabitat.org/habitat

Use of thiopurines in inflammatory bowel disease : an update

Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.Peer reviewe

A bibliography of parasites and diseases of marine and freshwater fishes of India

With the increasing demand for fish as human food, aquaculture both in freshwater and salt water is rapidly developing over the world. In the developing countries, fishes are being raised as food. In many countries fish farming is a very important economic activity. The most recent branch, mariculture, has shown advances in raising fishes in brackish, estuarine and bay waters, in which marine, anadromous and catadromous fishes have successfully been grown and maintained