CONTINUOUS SPINAL ANAESTHESIA WITH POPLITEAL SCIATIC NERVE BLOCK FOR BELOW KNEE AMPUTATION IN A PATIENT WITH MULTIPLE COMORBIDITIES FOR EARLY REHABILITATION

A male patient in his late fifties, with a history of coronary artery disease, chronic kidney disease, and sepsis, required below knee amputation under tourniquet. Due to a heart rate of 110/minute, blood pressure of 90/60 mm Hg, and noradrenaline support, along with elevated creatinine levels and moderate systolic dysfunction, the patient\u27s perioperative management was challenging. To decrease risks, continuous spinal anaesthesia (CSA) at a low dose (0.5ml of bupivacaine) was combined with a popliteal sciatic nerve block. CSA provided effective anaesthesia with minimal hemodynamic fluctuations, ensuring a stable intraoperative course. The addition of a popliteal sciatic nerve block aimed to enhance early postoperative pain management. The patient maintained hemodynamic stability without anaesthesia-related complications. However, postoperatively, after two days recurrent pulmonary oedema ensued, necessitating dialysis, diuretics, and non-invasive ventilation. CSA demonstrated superiority over general anaesthesia for high-risk patients, offering improved cardiovascular stability and faster recovery. This faster recovery ensured early rehabilitation and physiotherap

Tumor Progression Locus 2 (TPL2) Regulates Obesity-Associated Inflammation and Insulin Resistance

OBJECTIVE Obesity-associated low-grade systemic inflammation resulting from increased adipose mass is strongly related to the development of insulin resistance and type 2 diabetes as well as other metabolic complications. Recent studies have demonstrated that the obese metabolic state can be improved by ablating certain inflammatory signaling pathways. Tumor progression locus 2 (TPL2), a kinase that integrates signals from Toll receptors, cytokine receptors, and inhibitor of κ-B kinase-β is an important regulator of inflammatory pathways. We used TPL2 knockout (KO) mice to investigate the role of TPL2 in mediating obesity-associated inflammation and insulin resistance. RESEARCH DESIGN AND METHODS Male TPL2KO and wild-type (WT) littermates were fed a low-fat diet or a high-fat diet to investigate the effect of TPL2 deletion on obesity, inflammation, and insulin sensitivity. RESULTS We demonstrate that TPL2 deletion does not alter body weight gain or adipose depot weight. However, hyperinsulinemic euglycemic clamp studies revealed improved insulin sensitivity with enhanced glucose uptake in skeletal muscle and increased suppression of hepatic glucose output in obese TPL2KO mice compared with obese WT mice. Consistent with an improved metabolic phenotype, immune cell infiltration and inflammation was attenuated in the adipose tissue of obese TPL2KO mice coincident with reduced hepatic inflammatory gene expression and lipid accumulation. CONCLUSIONS Our results provide the first in vivo demonstration that TPL2 ablation attenuates obesity-associated metabolic dysfunction. These data suggest TPL2 is a novel target for improving the metabolic state associated with obesity. </jats:sec

Registration of ‘ALR 2’ Peanut

'ALR 2' Spanish peanut (Arachis hypogaea L. subsp. fastigiata Waldron var. vulgaris Hartz) (Reg. no. CV-61, P1 599975) is a pure-line selection from an advanced breeding line, ICGV 86011, developed at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), ICRISAT Asia Center (IAC), Patancheru, AP, India. The original population of ICGV 86011 was supplied to the Agricultural Research Station, Aliyarnagar, Tamil Nadu, India, in 1984. It was tested during the rainy (Chitrai season: April sowing, no irrigation), postrainy (Margazhi season: October sowing, irrigated), and summer (Adi season: June sowing, irrigated) seasons of 1986 to 1993 in various yield trials in Tamil Nadu. After 8 yr of evaluation, ALR 2 was released in 1994 by the state varietal release subcommittee of the Tamil Nadu Agricultural University, Coimbatore, for cultivation in the rainy and irrigated postrainy and summer seasons in the Pollachi tract of Tamil Nadu (3)

Moving Beyond Mimicry: Developing Hybrid Spaces in Indian Business Schools

This article analyses the identity work of Indian management educators and scholars as they seek to establish, maintain and revise a sense of self in the context of business school globalization. We show how globalization, combined with the historical legacy of colonialism, renders Indian scholars precarious in their interactions with Western business schools. Based on a qualitative interview study, we explore how Indian business school scholars perform their identities in the context of neo-colonial relations, which are characterised by the dominance of English language and a pressure to conform to research norms set by globally-ranked journals. Drawing on postcolonial theory, our argument focuses on mimicry as a distinctive form of identity work that involves maintaining difference between Western and non-Western identities by 'Othering' Indian scholars, while simultaneously seeking to transform them. We draw attention to ambivalence within participants' accounts, which we suggest arises because the authority of Western scholarship relies on maintaining non-Western scholars in a position of alterity or 'not quite-ness'. We suggest that hybridity offers an opportunity to disrupt and question current practices of business school globalization and facilitate scholarly engagement that reflects more diverse philosophical positions and worldviews

Experimental investigation of tribological properties of laser textured tungsten doped diamond like carbon coating under dry sliding conditions at various loads

Laser micro texturing technique has shown its potential in reducing friction and wear at various mechanical interfaces such as automotive and cutting tools etc. Automotive parts are coated with Diamond-like Carbon (DLC) coatings to enhance their performance. Due to stringent condition at the automotive contacts and demand for performance enhancement, increase in performance of DLC coatings is required. In this study laser micro texturing is being combined with tungsten doped DLC coating. In order to analyze the benefits of laser micro texturing on tungsten doped DLC coating. Tribological testing was conducted on a reciprocating test rig at various loading conditions. The results indicated that laser textured tungsten doped DLC coating showed the lower coefficient of friction compared to un-textured tungsten doped DLC coating at a load of 15 N, 25 N and 35 N. Higher graphitization was observed in the case of un-textured coating at 35 N load

System differentiation in England: the imposition of supply and demand

This chapter describes changing state and sector policy in relation to differentiation and how it has emerged in the English HE context: specifically, the attempts to concentrate the highest qualified applicants and the most prestigious institutions in a 'premium' market segment; the significance of the growing involvement of private providers; and the rise of the ‘student-as-consumer’ and 'value for money' in recent government policy discourse (e.g. the White Papers Students at the Heart of the System (DBIS 2011a) and Success as a Knowledge Economy (DBIS 2016). The chapter situates the development of a market hierarchy (in the form of a vertical differentiation of institutions, Archer 2007) following the demise of the university-polytechnic binary system in 1992 (Further and Higher Education Act, HMSO 1992). This co-existed for several years with the institutional diversity often celebrated by the Higher Education Funding Council for England (e.g. HEFCE 1994; 2000) that can be conceptualised as the horizontal differentiation of valued types of higher education provision and provider (e.g. part-time or vocationally orientated). The introduction of market mechanisms, in various stages beginning with the 2004 Higher Education Act (DfES 2004) and the introduction of variable tuition fees, coincided with the publication of institutional league tables from 2005. Taken together, these have reinforced a hierarchical system in which all institutions and courses are henceforth differentiated only by reference to a set of criteria dominated by the entry requirements demanded, and the amount of research carried out by the institution. Given the implications of the most recent legislation – the Higher Education and Research Act (HMSO 2017) this hierarchy is likely to be matched by one signalled by tuition fee levels, as new cheaper 'challenger' institutions come to the market

Quantitative proteomics analysis of an ethanol- and a lactate-producing mutant strain of Synechocystis sp. PCC6803

BACKGROUND: This study aimed at exploring the molecular physiological consequences of a major redirection of carbon flow in so-called cyanobacterial cell factories: quantitative whole-cell proteomics analyses were carried out on two (14)N-labelled Synechocystis mutant strains, relative to their (15)N-labelled wild-type counterpart. Each mutant strain overproduced one specific commodity product, i.e. ethanol or lactic acid, to such an extent that the majority of the incoming CO2 in the organism was directly converted into the product. RESULTS: In total, 267 proteins have been identified with a significantly up- or down-regulated expression level. In the ethanol-producing mutant, which had the highest relative direct flux of carbon-to-product (>65%), significant up-regulation of several components involved in the initial stages of CO2 fixation for cellular metabolism was detected. Also a general decrease in abundance of the protein synthesizing machinery of the cells and a specific induction of an oxidative stress response were observed in this mutant. In the lactic acid overproducing mutant, that expresses part of the heterologous l-lactate dehydrogenase from a self-replicating plasmid, specific activation of two CRISPR associated proteins, encoded on the endogenous pSYSA plasmid, was observed. RT-qPCR was used to measure, of nine of the genes identified in the proteomics studies, also the adjustment of the corresponding mRNA level. CONCLUSION: The most striking adjustments detected in the proteome of the engineered cells were dependent on the specific product formed, with, e.g. more stress caused by lactic acid- than by ethanol production. Up-regulation of the total capacity for CO2 fixation in the ethanol-producing strain was due to hierarchical- rather than metabolic regulation. Furthermore, plasmid-based expression of heterologous gene(s) may induce genetic instability. For selected, limited, number of genes a striking correlation between the respective mRNA- and the corresponding protein expression level was observed, suggesting that for the expression of these genes regulation takes place primarily at the level of gene transcription