Propofol Infusion Syndrome: A Retrospective Analysis at a Level 1 Trauma Center

Objectives. The propofol infusion syndrome (PRIS), a rare, often fatal, condition of unknown etiology, is defined by development of lipemic serum, metabolic acidosis, rhabdomyolysis, hepatomegaly, cardiac arrhythmias, and acute renal failure. Methods. To identify risk factors for and biomarkers of PRIS, a retrospective chart review of all possible PRIS cases during a 1-year period was conducted at a level 1 trauma hospital in ICU patients over 18 years of age receiving continuous propofol infusions for ≥3 days. Additional study inclusion criteria included vasopressor support and monitoring of serum triglycerides and creatinine. Results. Seventy-two patients, 61 males (84.7%) and 11 females (15.3%), satisfied study inclusion criteria; and of these, 3 males met the study definition for PRIS, with 1 case fatality. PRIS incidence was 4.1% with a case-fatality rate of 33%. The mean duration of propofol infusion was 6.96 days. A positive linear correlation was observed between increasing triglyceride levels and infusion duration, but no correlation was observed between increasing creatinine levels and infusion duration. Conclusions. Risk factors for PRIS were confirmed as high dose infusions over prolonged periods. Increasing triglyceride levels may serve as reliable biomarkers of impending PRIS, if confirmed in future investigations with larger sample sizes

A window to your smartphone: exploring interaction and communication in immersive VR with augmented virtuality

A major drawback of most Head Mounted Displays (HMDs) used in immersive Virtual Reality (VR) is the visual and social isolation of users from their real-world surroundings while wearing these headsets. This partial isolation of users from the real-world might hinder social interactions with friends and family. To address this issue, we present a new method to allow people wearing VR HMDs to use their smartphones without removing their HMDs. To do this, we augment the scene inside the VR HMD with a view of the user's device so that the user can interact with the device without removing the headset. The idea involves the use of additional cameras, such as the Leap Motion device or a high-resolution RGB camera to capture the user's real-world surrounding and augment the virtual world with the content displayed on the smartphone screen. This setup allows VR users to have a window to their smartphone from within the virtual world and a�ord much of the functionality provided by their smartphones, with the potential to reduce undesirable visual and social isolation users may experience when using immersive VR HMDs. This work has been successfully submitted for presentation as a poster in the Computer and Robot Vision Conference 2017 in Edmonton, Alberta, and is scheduled to appear in the conference proceedings at the IEEE Xplore digital library later this year

The biomechanics of fast prey capture in aquatic bladderworts

Carnivorous plants match their animal prey for speed of movements and hence offer fascinating insights into the evolution of fast movements in plants. Here, we describe the mechanics of prey capture in aquatic bladderworts Utricularia stellaris, which prey on swimming insect larvae or nematodes to supplement their nitrogen intake. The closed Utricularia bladder develops lower-than-ambient internal pressures by pumping out water from the bladder and thus setting up an elastic instability in bladder walls. When the external sensory trigger hairs on their trapdoor are mechanically stimulated by moving prey, the trapdoor opens within 300–700 μs, causing strong inward flows that trap their prey. The opening time of the bladder trapdoor is faster than any recorded motion in carnivorous plants. Thus, Utricularia have evolved a unique biomechanical system to gain an advantage over their animal prey

FEM simulation of three-point bending test of Inconel 718 coating on stainless steel substrate

Three-point bending test is conducted by help of Finite Element Method to find out mechanical properties of Inconel 718 coating on stainless steel. For doing this ANSYS package are employed to visualise exact situation of bending test so that can find out stress field developed during the test. A 3D modelling of coating and substrate material is used. Load versus displacement relationships is compared with reference results. It is noticed that yield stress of substrate material is higher than the tensile stress of substrate and coating. Due to this reason there is initiation of crack at coating-substrate interface and it is propagated which leads to failure with applied load

Documentation of Scent Marking with the Preorbital Gland in Banbakri Antelope (Boselaphus tragocamelus)

Scent marking using the preorbital gland in the Banbakri antelope, also known as the white-footed antelope (Boselaphus tragocamelus), was studied at the Haryana Agriculture Farm, VKS College of Agriculture, Dumraon. This study investigated the behaviour of Banbakri antelopes concerning preorbital gland opening under various conditions, including stress, starvation, and maturity. The research aimed to assess this behaviour as part of a broader investigation into the phenotypic and behavioural characteristics of Banbakri/Nilgai to enhance their well-being and improve resource management. The research is important because it will expand the understanding of this elegant species\u27 behaviour and the functional role of its preorbital gland. Its potential applications in antimicrobial drug development will be explored as well. In mature Banbakri antelopes, the preorbital glands measured approximately 2.1 cm in length and 1.0 cm in width. These exocrine glands, appearing as trench-like slits of dark blue to black coloration, were located beneath the eyes. Under free-roaming conditions, both male and female, B. tragocamelus, rarely exhibited preorbital gland opening. However, the gland was observed to open under stress, particularly when the animal was restrained with a halter for the first time, either at night or occasionally during the day. Preorbital gland opening was also noted during maturity, hunger, and stressful conditions. The findings suggest that this behaviour may serve as a key indicator for differentiating between playful, courtship, and aggressive social behaviours, particularly in stressful situations or stages of maturity. Additionally, the gland may secrete pheromonal substances that facilitate olfactory communication. To the best of our knowledge, no prior studies have reported the opening of the preorbital gland in Banbakri antelopes (B. tragocamelus). This study presents the first recorded observation of this behaviour in captive white-footed antelopes, contributing novel insights into their behavioural ecology

Human CD4+ Memory T Cells Can Become CD4+IL-9+ T Cells

Background: IL-9 is a growth factor for T- and mast-cells that is secreted by human Th2 cells. We recently reported that IL-4+TGF-β directs mouse CD4+CD25−CD62L+ T cells to commit to inflammatory IL-9 producing CD4+ T cells. Methodology/Principal Findings: Here we show that human inducible regulatory T cells (iTregs) also express IL-9. IL-4+TGF-β induced higher levels of IL-9 expression in plate bound-anti-CD3 mAb (pbCD3)/soluble-anti-CD28 mAb (sCD28) activated human resting memory CD4+CD25−CD45RO+ T cells as compared to naïve CD4+CD25−CD45RA+ T cells. In addition, as compared to pbCD3/sCD28 plus TGF-β stimulation, IL-4+TGF-β stimulated memory CD4+CD25−CD45RO+ T cells expressed reduced FOXP3 protein. As analyzed by pre-amplification boosted single-cell real-time PCR, human CD4+IL-9+ T cells expressed GATA3 and RORC, but not IL-10, IL-13, IFNγ or IL-17A/F. Attempts to optimize IL-9 production by pbCD3/sCD28 and IL-4+TGF-β stimulated resting memory CD4+ T cells demonstrated that the addition of IL-1β, IL-12, and IL-21 further enhance IL-9 production. Conclusions/Significance: Taken together these data show both the differences and similarities between mouse and human CD4+IL9+ T cells and reaffirm the powerful influence of inflammatory cytokines to shape the response of activated CD4+ T cells to antigen

Burden of anxiety in Adolescent: A community-based study in Western Uttar Pradesh

Background: Anxiety is a prevalent issue among adolescents and can adversely affect their academic performance and everyday functioning. Aims & Objectives: To estimate the prevalence of anxiety among adolescents in urban and rural areas and to study the socio-demographic correlates of anxiety among adolescents in urban and rural areas. Methods: A comprehensive survey was conducted in the field practice area of Department of Community Medicine of a Medical College in western district of Uttar Pradesh. The survey was aimed at young people between the ages of 10 and 19 who lived in the practice area of the medical college. Result: The burden of anxiety was observed to be 19.6 % (n=92). Female gender, urban residence, early adolescent age-group (10-13 yr), nuclear family, day-time somnolence and family history of mental illness were factors having statistical significance. Poor education level of parents was also statistically significant. Physical activity and substance abuse did not have significant contribution in burden of anxiety. Conclusion: Anxiety in adolescents is a significant issue influenced by various factors. Early intervention and support are crucial

Twelfth rib syndrome: role of intercostal blocks: case series of 10 patients

Twelfth rib syndrome (TRS) is a rare condition that causes severe pain in the loin. It is often misdiagnosed, leading to unnecessary investigations and treatments. Intercostal blocks in the 11th and 12th rib often resolve the pain for these patients. In this research paper, we aim to explore the role of intercostal block in the management of TRS based on our experience with 10 patients. Data of patients who were diagnosed with TRS were studied retrospectively from our hospital records who have been given intercostal block injection from the period of Jan 2022 to August 2023 as an audit.  Four patients underwent intercostal blocks. VAS scores were measured in follow-up for 1 and 3 months. 4 patients were lost to follow up and hence not considered in this study. The male to female ratio was 7:3. There was a statistically significant reduction in VAS score at 1 month and 3 months compared to pre-injection times. Patients who have failed conservative management for TRS can be effectively managed with intercostal block injections

Mechanisms underlying age-associated exacerbation of pulmonary veno-occlusive disease

Pulmonary veno-occlusive disease (PVOD) is a rare but severe form of pulmonary hypertension characterized by the obstruction of pulmonary arteries and veins, causing increased pulmonary artery pressure and leading to right ventricular (RV) heart failure. PVOD is often resistant to conventional pulmonary arterial hypertension (PAH) treatments and has a poor prognosis, with a median survival time of 2-3 years after diagnosis. We previously showed that the administration of a chemotherapy agent mitomycin C (MMC) in rats mediates PVOD through the activation of the eukaryotic initiation factor 2 (eIF2) kinase protein kinase R (PKR) and the integrated stress response (ISR), resulting in the impairment of vascular endothelial junctional structure and barrier function. Here, we demonstrate that aged rats over 1 year exhibit more severe vascular remodeling and RV hypertrophy than young adult rats following MMC treatment. This is attributed to an age-associated elevation of basal ISR activity and depletion of protein phosphatase 1, leading to prolonged eIF2 phosphorylation and sustained ISR activation. Pharmacological blockade of PKR or ISR mitigates PVOD phenotypes in both age groups, suggesting that targeting the PKR/ISR axis could be a potential therapeutic strategy for PVOD

Cost benefit analysis of intralesional injections in keloids using Luer lock and non-locking syringes

Background: For keloid scarring, intralesional corticosteroid injections continue to be the most often utilised first therapeutic option. This is a common procedure done on an outpatient basis by surgeons and orthopaedists. Luer lock syringes which lock the needle with syringe prevent any leakage or spillage of drug while pushing it near the keloid compared to normal syringes. Methods: We intend to do a cost benefit analysis based on the retrospective data of intralesional steroid injections done by the authors (AP and SK) in their private practice. Results: The time between 2021 to 2022, 200 injection data was retrieved, 100 each using non locking syringes and Luer lock syringes. The spillage rate with non-Luer lock syringes was 14%. Conclusions: We found that luer lock syringes prove to be cost effective after giving more than 200 injections in keloids than non-locking syringes.