Org 25969 (sugammadex), a selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular block

Background. Org 25969 is a cyclodextrin compound designed to reverse a rocuronium-induced neuromuscular block. The aim of this study was to explore the efficacy, dose-response relation and safety of Org 25969 for reversal of a prolonged rocuronium-induced neuromuscular block. Methods. Thirty anaesthetised adult patients received rocuronium 0.6mg kg as an initial dose followed by increments to maintain a deep block at level of

Distribution-based adaptive bounding genetic algorithm for continuous optimisation problems

A new search-space-updating technique for genetic algorithms is proposed for continuous optimisation problems. Other than gradually reducing the search space during the evolution process with a fixed reduction rate set ‘a priori’, the upper and the lower boundaries for each variable in the objective function are dynamically adjusted based on its distribution statistics. To test the effectiveness, the technique is applied to a number of benchmark optimisation problems in comparison with three other techniques, namely the genetic algorithms with parameter space size adjustment (GAPSSA) technique [A.B. Djurišic, Elite genetic algorithms with adaptive mutations for solving continuous optimization problems – application to modeling of the optical constants of solids, Optics Communications 151 (1998) 147–159], successive zooming genetic algorithm (SZGA) [Y. Kwon, S. Kwon, S. Jin, J. Kim, Convergence enhanced genetic algorithm with successive zooming method for solving continuous optimization problems, Computers and Structures 81 (2003) 1715–1725] and a simple GA. The tests show that for well-posed problems, existing search space updating techniques perform well in terms of convergence speed and solution precision however, for some ill-posed problems these techniques are statistically inferior to a simple GA. All the tests show that the proposed new search space update technique is statistically superior to its counterparts.

A meta-analysis of the association between Caesarean section and childhood asthma

Background: Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous studies that have investigated the association between Caesarean section and asthma have been conflicting.

Objective: To review published literature and perform a meta-analysis summarizing the evidence in support of an association between children born by Caesarean section and asthma.

Methods: MEDLINE, Web Science, Google Scholar and PubMed were searched to identify relevant studies. Odds ratio (OR) and 95% confidence interval (CI) were calculated for each study from the reported prevalence of asthma in children born by Caesarean section and in control children. Meta-analysis was then used to derive a combined OR and test for heterogeneity in the findings between studies.

Results: Twenty-three studies were identified. The overall meta-analysis revealed an increase in the risk of asthma in children delivered by Caesarean section (OR=1.22, 95% CI 1.14, 1.29). However, in this analysis, there was evidence of heterogeneity (I2=46%) that was statistically significant (P<0.001). Restricting the analysis to childhood studies, this heterogeneity was markedly decreased (I2=32%) and no longer attained statistical significance (P=0.08). In these studies, there was also evidence of an increase (P<0.001) in the risk of asthma after Caesarean section (OR=1.20, 95% CI 1.14, 12.6).

Conclusion: In this meta-analysis, we found a 20% increase in the subsequent risk of asthma in children who had been delivered by Caesarean section.