Effects of institutional quality on foreign direct investment inflow in lower-middle income countries.

The intention of this study is to look into the effect of institutional quality on Foreign Direct Investment (FDI) inflow in lower-middle income countries. To accomplish this goal, we use a panel data set of 28 lower-middle income countries in six different regions that span the period from 2002 to 2018. This analysis is conducted by using dynamic panel estimation (two-step system GMM). Later, we use threshold analysis to capture how the reaction of institutional quality varies in terms of GDP per capita. The empirical outcomes suggest that control of corruption and regulatory quality enhance FDI inflow while high rule of law and voice and accountability mitigate it in lower-middle income countries. On the contrary, government effectiveness, and political stability do not have any significant impact on FDI. Regulatory quality has the greatest impact on foreign investment inflows of all the metrics. Similarly, threshold analysis reveals that regulatory quality has a positive impact on FDI when per capita GDP of FDI recipient nations exceeds the threshold value of 7.197, while voice and accountability have a positive impact on FDI when per capita GDP exceeds the threshold value of 7.776. In terms of the size of the impact of institutional factors in attracting FDI, lower middle incoutries were quite different from that high and low income countries, though the outcome is largely similar in the three subgroups. According to the regional findings, each of the institutional quality measures is only effective in the East Asia and Pacific region. In addition, threshold analysis reveals how institutions respond to the impact of per capita GDP.

Comparison of traditional and upper thoracic epidural analgesia after off-pump coronary artery bypass graft surgery: A Quasi-experimental study.

Background and Aims: Surgical trauma initiates changes in central and peripheral nervous systems that need to be treated therapeutically to facilitate postoperative pain. The quality of postoperative analgesia is expected to affect clinical outcomes positively. Albeit optimal pain relief following cardiac surgery is often complex, researchers have tried to explore several techniques other than conventional ones during the last decade to find a unique analgesic method for postcardiac surgical patients. This study aims to find a unique analgesic approach that maximizes patient satisfaction after off-pump coronary artery bypass graft (OPCABG) surgery. Methods: The current study will compare the analgesic effect of upper thoracic epidural analgesia (TEA) with conventional analgesia after OPCAB graft surgery. For this, we will use a Quasi-experimental study design. Patients admitted for coronary artery bypass graft (CABG) surgery will be assigned into two groups. The control group (conventional) will receive intravenous opioids and nonsteroidal anti-inflammatory medications, and the study (case) group (TEA) will receive Inj. Bupivacaine 0.25% as an infusion through the epidural catheter. Physiologic parameters like hemodynamic and respiratory variables and pain scores will be recorded in predesigned format periodically. Results: We expect to analyze a total of 130 consecutive off-pump CABG surgery patients in Group A (Case, 65 patients) and Group B (Control, 65 patients). Study variables will be the visual analog scale score, hemodynamic parameters (heart rate, mean arterial pressure, and respiratory parameters (respiratory rate, PaO2, PaCO2, PEFR, FEV1). After data collection, the result will be analyzed and published in the public domain and in journals. Conclusion: We expect thoracic epidural analgesia with local anesthetics will be a reliable postoperative analgesic option.

Performance of EuroSCORE II and logistic EuroSCORE in Bangladeshi population undergoing off-pump coronary artery bypass surgery: A prospective cohort study.

INTRODUCTION: European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to identify patients who may have a greater postoperative risk for adverse effects following adult cardiac surgery. This study evaluated the discriminatory potential of using the EuroSCORE system in predicting the early, as well as late, postoperative outcomes following coronary artery bypass graft surgery in Bangladesh. METHODS: A total of 865 patients who underwent isolated coronary artery bypass graft surgery were evaluated with the EuroSCORE risk scoring system. Moreover, we also compared the discriminatory potentials between the EuroSCORE II and the original logistic EuroSCORE. RESULTS: Operative mortality was best predicted by EuroSCORE II (area under the curve (AUC) 0.863, Brier score 0.030) compared to the original logistic EuroSCORE (AUC 0.849, Brier score 0.033). However, the overall expected-to-observed mortality ratio for EuroSCORE II was 1.1, whereas the observed ratio for the original logistic EuroSCORE was 1.7. EuroSCORE II was predictive of an intensive care unit stay of five days or more (AUC 0.786), prolonged inotropes use (AUC 0.746), stroke (AUC 0.646), de novo dialysis (AUC 0.810), and low output syndrome (AUC 0.715). Moreover, a high EuroSCORE II quintile significantly predicted the risk for late mortality (p < 0.0001). CONCLUSIONS: EuroSCORE has an important role in predicting the early, as well as late, postoperative outcomes following coronary artery bypass surgery. However, the performance of EuroSCORE II is significantly better than the original logistic EuroSCORE in predicting postoperative morbidity and mortality after isolated coronary artery bypass graft surgery among Bangladeshi patients.

Impact of prosthetic heart valves on pregnancy in Bangladeshi women.

BACKGROUND: This study evaluated pregnancy outcome in women with a prosthetic heart valve, especially with the oral anticoagulation therapy that must be weighed against the risk of intracardiac thrombosis. METHODS: This multicenter, retrospective, cohort study was undertaken between January 2012 and June 2017. The principal maternal outcome variables included bleeding and thromboembolic complications, infective endocarditis, prosthetic valve thrombosis and heart failure. However, the main foetal outcome variables included miscarriage, mortality, preterm baby, warfarin embryopathy, low birthweight and the mode of delivery. RESULTS: A total of 265 pregnancies in women with prosthetic heart valves were evaluated in two groups: Group I (n = 182) covers a mechanical valve, while Group II (n = 82) covers a bioprosthetic valve. The mean age of the patients was 25.2 ± 2.5 years and 24.5 ± 5.2 years in Group I and Group II, respectively. Approximately 80% of the patients had normal echocardiography findings. However, Group I (mechanical prostheses) has a higher incidence (11.54%) of thrombus formation in comparison with the bioprostheses. Hemorrhagic complications and spontaneous miscarriage were statistically significant (p⩽0.05) between the study groups. However, normal pregnancy outcome (91.57%) was significantly higher (p⩽0.05) in Group II compared to Group I (61.54%). Mean birthweight and mean APGAR score were found normal in both study groups. Only 2.75% of patients have warfarin embryopathy in Group I. Furthermore, comparison of SF-36 scores for HRQOL (Health-Related Quality of Life) before and after pregnancy were statistically insignificant among the study population. CONCLUSION: Proper antenatal care and early risk stratification are the fundamental measures to improve the maternal and foetal outcomes in a patient with a prosthetic heart valve.

Strand-biased gene distribution, purine assymetry and environmental factors influence protein evolution in Bacillus.

A strong purine asymmetry, along with strand-biased gene distribution and the presence of PolC, prevails in Bacillus and some other members of Firmicutes, Fusobacteria and Tenericutes. The analysis of protein features in 21 Bacillus species of diverse metabolic, virulence and ecological traits revealed that purine asymmetry in conjunction with lineage/niche specific constraints significantly influences protein evolution in Bacillus. All Bacillus species, except for Se-respiring Bacillus selenitireducens, display distinct strand-specific biases in amino acid usage, which may affect the isoelectric point or surface charge distribution of proteins with prevalence of acidic and basic residues in the leading and lagging strand proteins, respectively.

Association of purine asymmetry, strand-biased gene distribution and PolC within Firmicutes and beyond: a new appraisal.

BACKGROUND: The Firmicutes often possess three conspicuous genome features: marked Purine Asymmetry (PAS) across two strands of replication, Strand-biased Gene Distribution (SGD) and presence of two isoforms of DNA polymerase III alpha subunit, PolC and DnaE. Despite considerable research efforts, it is not clear whether the co-existence of PAS, PolC and/or SGD is an essential and exclusive characteristic of the Firmicutes. The nature of correlations, if any, between these three features within and beyond the lineages of Firmicutes has also remained elusive. The present study has been designed to address these issues. RESULTS: A large-scale analysis of diverse bacterial genomes indicates that PAS, PolC and SGD are neither essential nor exclusive features of the Firmicutes. PolC prevails in four bacterial phyla: Firmicutes, Fusobacteria, Tenericutes and Thermotogae, while PAS occurs only in subsets of Firmicutes, Fusobacteria and Tenericutes. There are five major compositional trends in Firmicutes: (I) an explicit PAS or G + A-dominance along the entire leading strand (II) only G-dominance in the leading strand, (III) alternate stretches of purine-rich and pyrimidine-rich sequences, (IV) G + T dominance along the leading strand, and (V) no identifiable patterns in base usage. Presence of strong SGD has been observed not only in genomes having PAS, but also in genomes with G-dominance along their leading strands - an observation that defies the notion of co-occurrence of PAS and SGD in Firmicutes. The PolC-containing non-Firmicutes organisms often have alternate stretches of R-dominant and Y-dominant sequences along their genomes and most of them show relatively weak, but significant SGD. Firmicutes having G + A-dominance or G-dominance along LeS usually show distinct base usage patterns in three codon sites of genes. Probable molecular mechanisms that might have incurred such usage patterns have been proposed. CONCLUSION: Co-occurrence of PAS, strong SGD and PolC should not be regarded as a genome signature of the Firmicutes. Presence of PAS in a species may warrant PolC and strong SGD, but PolC and/or SGD not necessarily implies PAS.

A hierarchical approach for speech-instrumental-song classification.

Audio classification acts as the fundamental step for lots of applications like content based audio retrieval and audio indexing. In this work, we have presented a novel scheme for classifying audio signal into three categories namely, speech, music without voice (instrumental) and music with voice (song). A hierarchical approach has been adopted to classify the signals. At the first stage, signals are categorized as speech and music using audio texture derived from simple features like ZCR and STE. Proposed audio texture captures contextual information and summarizes the frame level features. At the second stage, music is further classified as instrumental/song based on Mel frequency cepstral co-efficient (MFCC). A classifier based on Random Sample and Consensus (RANSAC), capable of handling wide variety of data has been utilized. Experimental result indicates the effectiveness of the proposed scheme.

Evaluation of myocardial protection in off-pump vs. on-pump coronary bypass surgery by troponin I estimation.

BACKGROUND: This prospective non-randomized clinical study was done to compare Off-pump and On-pump myocardial revascularization by Troponin I release in patients undergoing first elective coronary artery bypass graft used to evaluate myocardial injury. METHODS: One hundred an twenty patients were non-randomly assigned to a Off-pump or On-pump myocardial revascularization group. Cardiac Troponin I (CTnI) were measured in serial venous blood samples drawn preoperatively in both groups. In On-pump group after aortic unclamping at 12 and 24 hours and in Off-pump group after the last distal anastomosis at 12 and 24 hours. RESULTS: The total amount of CTnI release were significantly higher in On-pump group than in Off-pump group. In On-pump group it was 2.1 +/- 1.9 (mean +/- SD) ng/ml vs in Off-pump group it was 1.0 +/- 1.7 (mean +/- SD) ng/ml at 12 hours and in On-pump group it was 1.6 +/- 1.6 (mean +/- SD) ng/ml vs. in Off-pump group it was .9 +/- 1.6 (mean +/- SD) ng/ml at 24 hours (P < 0.0001 for the pattern). CONCLUSION: The lower release of CTnI in the Off-pump myocardial revascularization group indicates that the arrested heart coronary revascularization group causes more damage to the heart due to cardiopulmonary bypass than Off-pump myocardial revascularization group.

Comparative codon and amino acid composition analysis of Tritryps-conspicuous features of Leishmania major.

Comparative analyses of codon/amino acid usage in Leishmania major, Trypanosoma brucei and Trypanosoma cruzi reveal that gene expressivity and GC-bias play key roles in shaping the gene composition of all three parasites, and protein composition of L. major only. In T. brucei and T. cruzi, the major contributors to the variation in protein composition are hydropathy and/or aromaticity. Principle of Cost Minimization is followed by T. brucei, disregarded by T. cruzi and opposed by L. major. Slowly evolving highly expressed gene-products of L. major bear signatures of relatively AT-rich ancestor, while faster evolution under GC-bias has characterized the lowly expressed genes of the species by higher GC12-content.