Duodenal atresia is a common cause of neonatal intestinal obstruction, affecting 1 in 6,000-10,000 births. It has a survival rate of around 95% and is associated with other anomalies in 50% of cases. It results from a failure of recanalization of the duodenum during embryonic development in the 6th week of gestation. Treatment involves NG/OG decompression, IV fluids, and temperature control followed by surgical duodenoduodenostomy once the infant is stabilized.
Short bowel syndrome (SBS) is a devastating condition in which small intestinal length is inadequate and characterized clinically by inability to absorb adequate enteral nutrition to sustain normal growth and development.
Intussusception is the most common acute abdominal disorder of early childhood. In this lecture, we describe the manifests of Intussusception, the diagnosis, and the treatment of this disease.
MECKEL’S DIVERTICULUM- Pediatric Surgery
Dear Viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on Meckel’s diverticulum. This is a great imitator because of its varied ways of presentation. It can present as bleeding per rectum, intestinal obstruction, pain abdomen and fecal umbilical discharge. I have discussed the epidemiology, etiology, embryology, clinical features, investigations, differential diagnosis and treatment of Meckel’s diverticulum in this video. Hope you will enjoy the video. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Short bowel syndrome (SBS) is a devastating condition in which small intestinal length is inadequate and characterized clinically by inability to absorb adequate enteral nutrition to sustain normal growth and development.
Intussusception is the most common acute abdominal disorder of early childhood. In this lecture, we describe the manifests of Intussusception, the diagnosis, and the treatment of this disease.
MECKEL’S DIVERTICULUM- Pediatric Surgery
Dear Viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on Meckel’s diverticulum. This is a great imitator because of its varied ways of presentation. It can present as bleeding per rectum, intestinal obstruction, pain abdomen and fecal umbilical discharge. I have discussed the epidemiology, etiology, embryology, clinical features, investigations, differential diagnosis and treatment of Meckel’s diverticulum in this video. Hope you will enjoy the video. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
This simple lecture was designed as a part of the content of the basic ultrasound workshop held periodically by the department of Obstetrics & gynecology - Faculty of medicine - Mansoura university- Egypt as a part of continuous medical education program.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
The increased availability of biomedical data, particularly in the public domain, offers the opportunity to better understand human health and to develop effective therapeutics for a wide range of unmet medical needs. However, data scientists remain stymied by the fact that data remain hard to find and to productively reuse because data and their metadata i) are wholly inaccessible, ii) are in non-standard or incompatible representations, iii) do not conform to community standards, and iv) have unclear or highly restricted terms and conditions that preclude legitimate reuse. These limitations require a rethink on data can be made machine and AI-ready - the key motivation behind the FAIR Guiding Principles. Concurrently, while recent efforts have explored the use of deep learning to fuse disparate data into predictive models for a wide range of biomedical applications, these models often fail even when the correct answer is already known, and fail to explain individual predictions in terms that data scientists can appreciate. These limitations suggest that new methods to produce practical artificial intelligence are still needed.
In this talk, I will discuss our work in (1) building an integrative knowledge infrastructure to prepare FAIR and "AI-ready" data and services along with (2) neurosymbolic AI methods to improve the quality of predictions and to generate plausible explanations. Attention is given to standards, platforms, and methods to wrangle knowledge into simple, but effective semantic and latent representations, and to make these available into standards-compliant and discoverable interfaces that can be used in model building, validation, and explanation. Our work, and those of others in the field, creates a baseline for building trustworthy and easy to deploy AI models in biomedicine.
Bio
Dr. Michel Dumontier is the Distinguished Professor of Data Science at Maastricht University, founder and executive director of the Institute of Data Science, and co-founder of the FAIR (Findable, Accessible, Interoperable and Reusable) data principles. His research explores socio-technological approaches for responsible discovery science, which includes collaborative multi-modal knowledge graphs, privacy-preserving distributed data mining, and AI methods for drug discovery and personalized medicine. His work is supported through the Dutch National Research Agenda, the Netherlands Organisation for Scientific Research, Horizon Europe, the European Open Science Cloud, the US National Institutes of Health, and a Marie-Curie Innovative Training Network. He is the editor-in-chief for the journal Data Science and is internationally recognized for his contributions in bioinformatics, biomedical informatics, and semantic technologies including ontologies and linked data.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
Professional air quality monitoring systems provide immediate, on-site data for analysis, compliance, and decision-making.
Monitor common gases, weather parameters, particulates.
1. Duodenal atresiaDuodenal atresia
1:6000-1:100001:6000-1:10000
Common site of neonatal intestinalCommon site of neonatal intestinal
obstructionobstruction
Survival ~95%Survival ~95%
Associated anomalies- 50%Associated anomalies- 50%
Down’s synd- 30%Down’s synd- 30%
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2. EmbryologyEmbryology
44thth
week- gut formsweek- gut forms
66thth
week- proliferation of gut epitheliumweek- proliferation of gut epithelium
-- obstruction of lumenobstruction of lumen
Recanalization failureRecanalization failure duodenalduodenal
atresiaatresia
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3. TypesTypes
Complete 80%, incomplete 20%Complete 80%, incomplete 20%
Gray & SkandalakisGray & Skandalakis
– Ty1 - web/ septum- 90%, no muscle/Ty1 - web/ septum- 90%, no muscle/
mesenteric defectmesenteric defect
– Ty 2 – cord connects two blind ends-2%,Ty 2 – cord connects two blind ends-2%,
no mesenteric defectno mesenteric defect
– Ty 3- v shaped mesenteric defectTy 3- v shaped mesenteric defect
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5. Clinical featuresClinical features
Antenatal diag-Antenatal diag-
– ““double bubble”double bubble”
– polyhydramniospolyhydramnios
Post natal-Post natal-
– bilious vomitingbilious vomiting
– Upper abd fullnessUpper abd fullness
– Aspirate> 30 ml , biliousAspirate> 30 ml , bilious
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6. InvestigationInvestigation
X Ray Abd-X Ray Abd-
– double bubbledouble bubble
– +/- distal gas+/- distal gas
Evaluate for Down’s syndEvaluate for Down’s synd
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7. ManagementManagement
NOT a surgical emergencyNOT a surgical emergency
NG/OG aspirationNG/OG aspiration
IV fluidIV fluid
Temperature controlTemperature control
TPNTPN
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14. Jejunoileal atresiaJejunoileal atresia
Atresia- obstruction due to completeAtresia- obstruction due to complete
occlusion of lumen, 95%occlusion of lumen, 95%
Stenosis- partial intestinal obstructionStenosis- partial intestinal obstruction
due to subtotal occlusion of lumen, 5%due to subtotal occlusion of lumen, 5%
Maternal use of psuedoephedrine,Maternal use of psuedoephedrine,
ergot,caffeineergot,caffeine
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15. EmbryologyEmbryology
Mesenteric Vascular accidentsMesenteric Vascular accidents
Late pregnancyLate pregnancy
volvulus, gastroschisis, omphalocele,volvulus, gastroschisis, omphalocele,
internal herniasinternal hernias
Louw & Bernard experimentsLouw & Bernard experiments
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18. InvestigationInvestigation
X ray abd- erect/ supineX ray abd- erect/ supine
– Dilated bowel loopsDilated bowel loops
– AF levelsAF levels
– Paucity of gas beyond obstructionPaucity of gas beyond obstruction
– Abd calcification/ intraluminal calcificationAbd calcification/ intraluminal calcification
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