Clinical investigation of plethysmographic variability index: A derivative index of pulse oximetry in anesthetized dogs

Plethysmographic Variability Index (PVI) is a derivative index of pulse oximetry that allows evaluating an individual\u27s intravascular volume status. Perfusion Index (PI) represents the strength of pulse signal at the anatomic site of measurement from which PVI is calculated using changes in PI over respiratory cycles. Plethysmographic Variability Index has been used to detect hypovolemia and predict fluid responsiveness in mechanically ventilated human patients however, fewer studies are available in spontaneously breathing patients. The use of PVI has not been explored extensively in dogs so far. The goals of this study were to establish a common range for PVI and assess relationship of the PVI, PI and various clinical variables in the anesthetized spontaneously breathing dogs. Values of PVI and PI derived from Masimo pulse oximetry were obtained at 5, 10, 15 and 20 minutes after anesthetic induction but before surgical stimulation together with cardiorespiratory variables that included heart rate, blood pressures (systolic, mean and diastolic blood pressures), respiratory rate and hemoglobin saturation of oxygen (SpO2) in 73 dogs with ASA 1-3 status admitted to the Purdue Teaching Hospital.^ Other clinical variables like body temperature, anesthetic protocol used, pre-induction packed cell volume (PCV) and total protein (TP) values, recumbency positions (sternal, lateral or dorsal recumbency) and rate of crystalloid fluids administration (5 vs 10 ml/kg/hr) were also obtained. Data were analysed using non-parametric Spearman\u27s rho coefficient and Kruskal Wallis one-way ANOVA by ranks to assess temporal relationship of PVI with all the clinical variables and with significant level set at P\u3c0.05. A common range of PVI was 5-43% with a median 18%. There was no significant correlation found between PVI and PI. Plethysmographic Variability Index positively correlated with the systolic blood pressure (rs=0.25; P\u3c0.001), mean blood pressure (rs=0.26; P\u3c0.001), diastolic blood pressure (rs=0.36; P\u3c0.001) and body temperature (rs=0.166; P=0.004). The other cardiorespiratory variables, recumbency positions, rate of crystalloid fluid administration, pre-operative PCV and TP values had no relationship with PVI. Premedication containing dexmedetomidine resulted in higher PVI (Kruskal-Wallis Test; P=0.001) and lower PI values (Kruskal-Wallis Test; P=0.004) and the opposite was true with protocols that contained acepromazine. It was concluded that while evaluating PVI for fluid response in the anesthetized dogs, various clinical factors should be taken into consideration

Fuzzy Aided Application Layer Semantic Intrusion Detection System - FASIDS

The objective of this is to develop a Fuzzy aided Application layer Semantic Intrusion Detection System (FASIDS) which works in the application layer of the network stack. FASIDS consist of semantic IDS and Fuzzy based IDS. Rule based IDS looks for the specific pattern which is defined as malicious. A non-intrusive regular pattern can be malicious if it occurs several times with a short time interval. For detecting such malicious activities, FASIDS is proposed in this paper. At application layer, HTTP traffic's header and payload are analyzed for possible intrusion. In the proposed misuse detection module, the semantic intrusion detection system works on the basis of rules that define various application layer misuses that are found in the network. An attack identified by the IDS is based on a corresponding rule in the rule-base. An event that doesn't make a 'hit' on the rule-base is given to a Fuzzy Intrusion Detection System (FIDS) for further analysis.Comment: 18 Pages, IJNS

A STABLE CLUSTERING SCHEME WITH NODE PREDICTION IN MANET

The main concern in MANET is increasing network lifetime and security. Clustering is one of the approaches that help in maintaining network stability. Electing an efficient and reliable Cluster Head (CH) is a challenging task. Many approaches are proposed for efficient clustering, weight-based clustering is one among them. This paper proposes a stable clustering scheme which provides network stability and energy efficiency. Proposed Stable Clustering Algorithm with Node Prediction (SCA-NP) computes the weight of the node using a combination of node metrics. Among these metrics, Direct Trust (DT) of the node provides a secure choice of CH and Node Prediction metric based on the minimum estimated time that node stay in the cluster provides the stable clustering. Mobility prediction is considered as the probability that a node stays in the network. This metric helps in electing CH which is available in the network for a longer time. Simulation is done in NS3 to evaluate the performance of SCA-NP in terms of clusters formed, network lifetime, efficiency in packet delivery, detecting malicious nodes and avoiding them in communication

Abdominal sacrohysteropexy versus vaginal hysterectomy for pelvic organ prolapse in young women

Background: Pelvic organ prolapse (POP) is the descent of the pelvic organs beyond their anatomical confines. The definitive treatment of symptomatic prolapse is surgery but its management in young is unique due to various considerations. Aim of this study was to evaluate anatomical and functional outcome after abdominal sacrohysteropexy and vaginal hysterectomy for pelvic organ prolapse in young women.Methods: A total 27 women less than 35 years of age with pelvic organ prolapse underwent either abdominal sacrohysteropexy or vaginal hysterectomy with repair. In all women, pre-op and post-op POP-Q was done for evaluation of anatomical defect and a validated questionnaire was given for subjective outcome.Results: Anatomical outcome was significant in both groups as per POP-Q grading but the symptomatic outcome was better for sacrohysteropexy with regard to surgical time, bleeding, ovarian conservation, urinary symptoms, sexual function.Conclusions: Sacrohysteropexy is a better option

FACTORS INFLUENCING JOB REJECTIONS IN CLOUD ENVIRONMENT

The IT organizations invests heavy capital by consuming large scale infrastructure and advanced operating platforms. The advances in technology has resulted in emergence of cloud computing, which is promising technology to achieve the aforementioned objective. At the peak hours, the jobs arriving to the cloud system are normally high demanding efficient execution and dispatch. An observation that has been carried out in this paper by capturing a job arriving pattern from a monitoring system explains that most of the jobs get rejected because of lack of efficient technology. The job rejections can be controlled by certain factors such as job scheduling and load balancing. Therefore, in this paper the efficiency of Round Robin (RR) scheduling strategy used for job scheduling and Shortest Job First Scheduling (SJFS) technique used for load balancing in reducing the job rejections are analyzed. Further, a proposal for an effective load balancing approach to avoid deadlocks has been discussed

Design and Development of Sustainable Construction Strategy for Residential Buildings: A Case Study for Composite Climate

Developing cities in India like Nagpur are growing exponentially in population due to industrialization. The ever increasing demand of the natural resources leads to depletion of limited resources and also affects local environment in terms of increasing pollution emissions especially carbon emission. With recourse to composite climatic condition (Nagpur, India) the sustainable construction strategy is developed in the present paper. The developed strategy includes conservation of soil, energy, resources, material and water. It provides a systematic approach towards sustainability of building through quantification of energy consumption. Analysis of conventional and non-conventional material and technology on cost, energy consumption and carbon emission parameters helps in highlighting suitable options for sustainable construction. Strategy is validated through a case study of new construction of the residential buildings for enhanced environmental performance. The amount of excavated soil and its reutilization on site is taken into consideration. Locally available sustainable construction materials are compared for material cost, and embodied energy for selection of appropriate construction material. In order to conserve the ground water various options for the low flow devices, roof top rainwater harvesting and gray water recycling and reuse are suggested. Application of sustainable construction strategy to case study building revealed that 97% of natural soil is conserved through backfilling. Estimated carbon emission reduction due to recommended construction materials (sustainable bricks, cement, and steel) with respect to conventional options is of the order of 60%. Recommended water conservation options resulted in 57% reduction in ground water demand.  However suggested sustainable construction strategy options estimated in increase in project cost by 13% whose effect can subsequently be reduced over the design life span computations. The developed strategy can further be applied to the larger residential township areas with varying building types for conserving the natural resources as well as reducing the impact of environmental pollution

Performance of four cardiac output monitoring techniques vs. intermittent pulmonary artery thermodilution during a modified passive leg raise maneuver in isoflurane-anesthetized dogs

ObjectiveThis study investigated the performance among four cardiac output (CO) monitoring techniques in comparison with the reference method intermittent pulmonary artery thermodilution (iPATD) and their ability to diagnose fluid responsiveness (FR) during a modified passive leg raise (PLRM) maneuver in isoflurane-anesthetized dogs undergoing acute blood volume manipulations. The study also examined the simultaneous effect of performing the PLRM on dynamic variables such as stroke distance variation (SDV), peak velocity variation (PVV), and stroke volume variation (SVV).Study designProspective, nonrandomized, crossover design.Study animalsSix healthy male Beagle dogs.MethodsThe dogs were anesthetized with propofol and isoflurane and mechanically ventilated under neuromuscular blockade. After instrumentation, they underwent a series of sequential, nonrandomized steps: Step 1: baseline data collection; Step 2: removal of 33 mL kg−1 of circulating blood volume; Step 3: blood re-transfusion; and Step 4: infusion of 20 mL kg−1 colloid solution. Following a 10-min stabilization period after each step, CO measurements were recorded using esophageal Doppler (EDCO), transesophageal echocardiography (TEECO), arterial pressure waveform analysis (APWACO), and electrical cardiometry (ECCO). Additionally, SDV, PVV, and SVV were recorded. Intermittent pulmonary artery thermodilution (iPATDCO) measurements were also recorded before, during, and after the PLRM maneuver. A successful FR diagnosis made using a specific test indicated that CO increased by more than 15% during the PLRM maneuver. Statistical analysis was performed using one-way analysis of variance for repeated measures with post hoc Tukey test, linear regression, Lin’s concordance correlation coefficient (ρc), and Bland–Altman analysis. Statistical significance was set at p < 0.05.ResultsAll techniques detected a reduction in CO (p < 0.001) during hemorrhage and an increase in CO after blood re-transfusion and colloid infusion (p < 0.001) compared with baseline. During hemorrhage, CO increases with the PLRM maneuver were as follows: 33% for iPATD (p < 0.001), 19% for EC (p = 0.03), 7% for APWA (p = 0.97), 39% for TEE (p < 0.001), and 17% for ED (p = 0.02). Concurrently, decreases in SVV, SDV, and PVV values (p < 0.001) were also observed. The percentage error for TEE, ED, and EC was less than 30% but exceeded 55% for APWA. While TEECO and ECCO slightly underestimated iPATDCO values, EDCO and APWACO significantly overestimated iPATDCO values. TEE and EC exhibited good and acceptable agreement with iPATD. However, CO measurements using all four techniques and iPATD did not differ before, during, and after PLRM at baseline, blood re-transfusion, and colloid infusion.Conclusion and clinical relevanceiPATD, EC, TEE, and ED effectively assessed FR in hypovolemic dogs during the PLRM maneuver, while the performance of APWA was unacceptable and not recommended. SVV, SDV, and PVV could be used to monitor CO changes during PLRM and acute blood volume manipulations, suggesting their potential clinical utility

The genetic landscape of dural marginal zone lymphomas

The dura is a rare site of involvement by marginal zone lymphoma (MZL) and the biology of dural MZL is not well understood. We performed genome-wide DNA copy number and targeted mutational analysis of 14 dural MZL to determine the genetic landscape of this entity. Monoallelic and biallelic inactivation of TNFAIP3 by mutation (n=5) or loss (n=1) was observed in 6/9 (67%) dural MZL exhibiting plasmacytic differentiation, including 3 IgG4+ cases. In contrast, activating NOTCH2 mutations were detected in 4/5 (80%) dural MZL displaying variable monocytoid morphology. Inactivating TBL1XR1 mutations were identified in all NOTCH2 mutated cases. Recurrent mutations in KLHL6 (n=2) and MLL2 (n=2) were also detected. Gains at 6p25.3 (n=2) and losses at 1p36.32 (n=3) were common chromosomal imbalances, with loss of heterozygosity (LOH) of these loci observed in a subset of cases. Translocations involving the IGH or MALT1 genes were not identified. Our results indicate genetic similarities between dural MZL and other MZL subtypes. However, recurrent and mutually exclusive genetic alterations of TNFAIP3 and NOTCH2 appear to be associated with distinct disease phenotypes in dural MZL