by the renowned pediatrician, Dr Satish Deopujari,
National Chairperson (Ex)
Intensive Care Chapter I A P
Founder Chairman.....
National conference on pediatric critical care
Professor of pediatrics ( Hon ) JNMC:Wardha
Nagpur : INDIA
by the renowned pediatrician, Dr Satish Deopujari,
National Chairperson (Ex)
Intensive Care Chapter I A P
Founder Chairman.....
National conference on pediatric critical care
Professor of pediatrics ( Hon ) JNMC:Wardha
Nagpur : INDIA
Oxidative stress is described as the imbalance between pro-oxidants (Reactive oxygen species) and antioxidants levels commonly called redox imbalance. It occurs in a discrete step-wise process of initiation, propagation, and termination stages via the generation of free radicals. These steps bring about effects that have contributed to hypertension through endothelial dysfunction, reduced bioavailability of Nitric oxide, atherosclerotic plaque formation, and reduction of toxic oxidants. Hence, oxidative stress mechanism is implicated in hypertension and thus, the daily intake of antioxidants-containing foods and products to supplement depleted endogenous antioxidants is recommended.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Pride Month Slides 2024 David Douglas School District
09 ir injury
1. Dept. of PathologyDept. of Pathology
Medical CollegeMedical College
Hunan Normal UniversityHunan Normal University
(( 湖南 范大学医学院病理学教研室师湖南 范大学医学院病理学教研室师 )) 1
Chapter 9Chapter 9
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
(缺血(缺血 -- 再灌注 )损伤再灌注 )损伤
2. 22
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
a.a. OverviewOverview
b.b. EtiologyEtiology
c.c. PathogenesisPathogenesis
d.d. Alterations of Metabolism andAlterations of Metabolism and
FunctionFunction
e.e. Pathophysiological Basis ofPathophysiological Basis of
Prevention and TreatmentPrevention and Treatment
3. Ischemia
Concept
Injury More injury
Reperfusion
“A paradox”
After prolonged ischemia, reestablishment
of blood flow (reperfusion) does not relieve
ischemic injury; On the contrary, it aggravates
the tissue injury.
4. 1955 Sewell1955 Sewell
Ligation of dog coronary artery → restoreLigation of dog coronary artery → restore
blood flow → ventricular fibrillation → deathblood flow → ventricular fibrillation → death
1960 Jennings1960 Jennings Myocardial IRIMyocardial IRI (first to name IRI)
1968 Ames1968 Ames Brain IRIBrain IRI
1972 Flore1972 Flore Kidney IRIKidney IRI
1978 Modry Lung IRI1978 Modry Lung IRI
1981 Greenberg Intestine IRI1981 Greenberg Intestine IRI
History of Ischemia-Reperfusion Injury (IRI)
Research
7. pH Paradox
Acidosis Tissue injury
Correction of
Acidosis
Tissue injury ↑
Perfusion
Paradoxes During IR Injury
8. 88
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
a.a. OverviewOverview
b.b. EtiologyEtiology
c.c. PathogenesisPathogenesis
d.d. Alterations of Metabolism andAlterations of Metabolism and
FunctionFunction
e.e. Pathophysiological Basis ofPathophysiological Basis of
Prevention and TreatmentPrevention and Treatment
12. Factors Influencing IR Injury
a.a. Duration of ischemiaDuration of ischemia
b.b. Collateral circulationCollateral circulation
c.c. Dependency on oxygen supplyDependency on oxygen supply
d.d. Condition of reperfusionCondition of reperfusion
13. 1313
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
a.a. OverviewOverview
b.b. EtiologyEtiology
c.c. PathogenesisPathogenesis
d.d. Alterations of Metabolism andAlterations of Metabolism and
FunctionFunction
e.e. Pathophysiological Basis ofPathophysiological Basis of
Prevention and TreatmentPrevention and Treatment
14. Apoptosis Oxygen Society Education Program Tome & Briehl 14
Pathogenesis of IR Injury
a.a. Role of OFR/ROSRole of OFR/ROS
b.b. Calcium overloadCalcium overload
c.c. Activation of neutrophilsActivation of neutrophils
15. Free Radicals
Highly reactive group of atoms, molecules
or radicals, which carry unpaired electron
in the outer orbit.
Free radicals that contain oxygen.
Properties of free radicalsProperties of free radicals
Chemically activeChemically active
Highly oxidativeHighly oxidative
Short half-lifeShort half-life
Oxygen Free Radicals (OFR)
16. Reactive Oxygen Species (ROS)
A group of chemically reactive molecules
containing oxygen.
Oxygen free radicals: O2
., OH ., LO .
Non-free radicals:
1
O2 , H2O2
Classification of ROS
17. Free Radicals
Oxygen Free
Radicals
Reactive Oxygen
Species
Non-Free
Radicals
(Oxygen-
containing)
Non-Oxygen
Free Radicals
O2
.
OH .
LO .
1
O2
H2O2
OONO-
L .
Cl .
CH3
.
The Relationship Between
Free radicals and Reactive Oxygen Species
18. RReactive specieseactive species Half-lifeHalf-lifeHalf-lifeHalf-life
Hydroxyl radical (Hydroxyl radical (••
OH)OH)
Alcoxyl radical (ROAlcoxyl radical (RO••
))
Singlet oxygen (Singlet oxygen (11
OO22))
Peroxynitrite anion (ONOOPeroxynitrite anion (ONOO--
))
Peroxyl radical (ROOPeroxyl radical (ROO••
))
Nitric oxide (Nitric oxide (••
NO)NO)
Hydrogen peroxide (HHydrogen peroxide (H22OO22))
Superoxide anion (OSuperoxide anion (O22
••
))
1010-9-9
ss
1010-6-6
ss
1010-5-5
ss
00..05 – 105 – 1..00 ss
77 ss
1 – 101 – 10 ss
hours/hours/daysdays
hours/hours/daysdays
18
Half-life ofHalf-life of Some ROSSome ROS
19. Apoptosis Oxygen Society Education Program Tome & Briehl 19
Mechanism of ROS Increase During IR InjuryMechanism of ROS Increase During IR Injury
a.a. Increased ROS productionIncreased ROS production
b.b. Decreased ROS clearanceDecreased ROS clearance
Role of ORF/ROS
Injurious Effects of ROSInjurious Effects of ROS
28. Apoptosis Oxygen Society Education Program Tome & Briehl 28
Mechanism of ROS Increase During IR InjuryMechanism of ROS Increase During IR Injury
a.a. Increased ROS productionIncreased ROS production
b.b. Decreased ROS clearanceDecreased ROS clearance
Role of ORF/ROS
Injurious Effects of ROSInjurious Effects of ROS
33. Apoptosis Oxygen Society Education Program Tome & Briehl 33
Mechanism of ROS Increase During IR InjuryMechanism of ROS Increase During IR Injury
a.a. Increased ROS productionIncreased ROS production
b.b. Decreased ROS clearanceDecreased ROS clearance
Role of ORF/ROS
Injurious Effects of ROSInjurious Effects of ROS
39. Apoptosis Oxygen Society Education Program Tome & Briehl 39
Pathogenesis of IR Injury
a.a. Role of ORF/ROSRole of ORF/ROS
b.b. Calcium overloadCalcium overload
c.c. Activation of neutrophilsActivation of neutrophils
40. Calcium Overload
During IR, the concentration of cytosolic CaDuring IR, the concentration of cytosolic Ca2+2+
increases obviously, causing cell damage andincreases obviously, causing cell damage and
dysfunction. This phenomenon is called “Calciumdysfunction. This phenomenon is called “Calcium
Overload”.Overload”.
41. Mechanisms of Calcium Overload
NaNa++
-Ca-Ca2+2+
exchanger dysfunctionexchanger dysfunction
Damage in cell membraneDamage in cell membrane
Damage in organelle (Mito or SR) membraneDamage in organelle (Mito or SR) membrane
Na+
-Ca2+
Exchanger
Ca2+
Pump
Ca2+
[Ca2+
]e : 10-3
M [Ca2+
]i : 10-7
M
Ca2+
channel
Mito
SR
Ca2+
Na +
Ca 2+
Ca 2+
SR: Sarcoplasmic reticulum
43. Mitochondrial dysfunction
Formation of Calcium Phosphate
precipitation → Mito oxidation↓
Increased ROS production
Activation of Calcium-dependent proteinases
→ Destruction of cell structure
Membrane
Cytoskeleton
Consequences of Calcium Overload
44. Apoptosis Oxygen Society Education Program Tome & Briehl 44
Pathogenesis of IR Injury
a.a. Role of ORF/ROSRole of ORF/ROS
b.b. Calcium overloadCalcium overload
c.c. Activation of neutrophilsActivation of neutrophils
45. IR injuryIR injury
Activation of
Neutrophils
Chemokines
(LTs, PAF, Kinin)
Adhesion molecules ↑↑
(integrin, ICAM-1)(integrin, ICAM-1)
Activation of Neutrophils
Granzymes
(elastase,
collagenase)
ROS Cytokines
47. 4747
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
a.a. OverviewOverview
b.b. EtiologyEtiology
c.c. PathogenesisPathogenesis
d.d. Alterations of Metabolism andAlterations of Metabolism and
FunctionFunction
e.e. Pathophysiological Basis ofPathophysiological Basis of
Prevention and TreatmentPrevention and Treatment
49. ArrhythmiaArrhythmia
Ventricular fibrillationVentricular fibrillation
Ventricular TachycardiaVentricular Tachycardia
Myocardial dysfunctionMyocardial dysfunction
COCO ↓↓
Myocardial stunningMyocardial stunning
Reversible reduction of the function of heartReversible reduction of the function of heart
contraction after reperfusion.contraction after reperfusion.
Restored after a few hours or days.Restored after a few hours or days.
Myocardial IR Injury
50. 5050
Ischemia-Reperfusion InjuryIschemia-Reperfusion Injury
a.a. OverviewOverview
b.b. EtiologyEtiology
c.c. PathogenesisPathogenesis
d.d. Alterations of Metabolism andAlterations of Metabolism and
FunctionFunction
e.e. Pathophysiological Basis ofPathophysiological Basis of
Prevention and TreatmentPrevention and Treatment
51. Reduce ischemia
Control reperfusion conditions
Scavenge ROS
Relieve Ca2+
overload
Improve metabolism
- Energy supplementation
- Cell protectors
Prevention and Treatment of IR Injury
52. Lower pressureLower pressure
Lower flow speedLower flow speed
Lower temperatureLower temperature
Lower pHLower pH
Lower CaLower Ca2+2+
and Naand Na++
↓↓ OFR and edemaOFR and edema
↓↓ CaCa2+2+
overloadoverload
↓↓ metabolism →↓ energymetabolism →↓ energy
consumptionconsumption
Control Reperfusion ConditionsControl Reperfusion Conditions
During ischemia, ROS generation is reduced. However, during reperfusion, ROS production is greatly increased (one of the major mechanisms of IR injury).
CABG: 冠状动脉旁路搭桥术
PTCA: 经皮冠状动脉扩张术
CABG: 冠状动脉旁路搭桥术
PTCA: 经皮腔内冠状动脉成型术
用球囊或支架 (stent: stand, support)。
1977 first case in the world.
Abundance in collateral circulation (侧枝循环), not easy for IR injury.
ROS, 活性氧簇
1O2,singlet oxygen (单线态氧)
ONOO-: 过氧亚硝基阴离子
The sodium-calcium exchanger (often denoted Na+/Ca2+ exchanger, NCX, or exchange protein) is an antiporter membrane protein that removes calcium from cells. It uses the energy that is stored in the electrochemical gradient of sodium (Na+) by allowing Na+ to flow down its gradient across the plasma membrane in exchange for the countertransport of calcium ions (Ca2+). The NCX removes a single calcium ion in exchange for the import of three sodium ions.[1] The exchanger exists in many different cell types and animal species.[2] The NCX is considered one of the most important cellular mechanisms for removing Ca2+.[2]
Should be intracellular calcium.
LBT4 increase is because of breakdown of membrane lipid leading to increase of AA.
Usually it denotes the release of these chemicals from immune cells, e.g., neutrophils and monocytes, as they come into contact with different bacteria or fungi. Two enzymes are involved, NADPH oxidase and MPO.
It plays an important role in immune response. OONO-: Peroxynitrite anion.
Hypochlorous acid (NaOCl or CaOCl) is used as bleach or disinfectant.
O2-: superoxide anion; OH-: hydroxyl radical.
O2. is the basis for production of other ROS; OH. is the most active and potent endogenous ROS.
Catalase (CAT) makes H2O2 to become H2O and O2.
Mn (Manganese) (锰) [‘mæŋɡəniːz] (not to confuse with Mg (Magnesium)(镁) [mæɡ’niːziəm] ). Cu (Copper) ['kɑːpər]
Hawking (physicist and cosmologist from U of Cambridge) suffers from a rare early-onset, slow-progressing form of amyotrophic lateral sclerosis (ALS,肌萎缩性脊髓侧索硬化征), also known as motor neuron disease or Lou Gehrig's disease, that has gradually paralysed him over the decades.[20] He now communicates using a single cheek muscle attached to a speech-generating device. Hawking married twice and has three children.全身关节不能活动,不能说话。
Allopurinol inhibit the transformation from xanthine dehydrogenase to xanthine oxidase.
Reaction of GSH to GSSG requires GSH-Px (glutathione peroxidase).
Lipids, proteins, and DNA can be oxidized.
Lipid peroxidation refers to the oxidative degradation of lipids. It is the process in which free radicals "steal" electrons from the lipids in cell membranes, resulting in cell damage. This process proceeds by a free radical chain reaction mechanism. It most often affects polyunsaturated fatty acids, because they contain multiple double bonds in between which lie methylene bridges (-CH2-) that possess especially reactive hydrogens. As with any radical reaction, the reaction consists of three major steps: initiation, propagation, and termination.
DNA breakage, crosslinking will occur. 80% of DNA ROS damage is caused by .OH.
Lead to gene mutation.
Calcium overload (a pathological process) does not equal to calcium increase.
Two types of calcium channel: VOCC: Voltage-operated Ca2+ channel; ROCC: Receptor-operated Ca2+ channel.
Mito contains 500-fold more calcium than cytosol.
Intracellular IP3 increases, calcium is released from ER to the cytoplasm.
Na-Ca exchanger is not a pump, does not need energy. It depends on Na-Ca concentration. (exchange of Na vs. Ca at 3:1). This
[Ca2+]e:10-3 ~ 10-2M; [Ca2+]i:10-8 ~10-7M
Calcium overload (a pathological process) does not equal to calcium increase.
Two types of calcium channel: VOCC: Voltage-operated Ca2+ channel; ROCC: Receptor-operated Ca2+ channel.
Mito contains 500-fold more calcium than cytosol.
Intracellular IP3 increases, calcium is released from ER to the cytoplasm.
Na-Ca exchanger is not a pump, does not need energy. It depends on Na-Ca concentration. (exchange of Na vs. Ca at 3:1). This
[Ca2+]e:10-3 ~ 10-2M; [Ca2+]i:10-8 ~10-7M
Increased ROS production is because blocking Mito oxidation. (1-2 single electron reduction increases producing more ROS).
Stunning (心肌顿抑) is a protective mechanism, leading to decreased oxygen consumption.
Cell protectors: metallothionein, taurate (牛磺酸)
Lower pH to decrease the difference between extracellular and intracellular [H+], reducing Na-Ca exchange.
Lower Na will reduce the activation of Na-Ca exchanger.