Predictive modeling of hepatitis B viral dynamics: a caputo derivative-based approach using artificial neural networks.

A fractional model for the kinetics of hepatitis B transmission was developed. The hepatitis B virus significantly affects the world's economic and health systems. Acute and chronic carrier phases play a crucial part in the spread of the HBV infection. The Hepatitis B infection can be spread by chronic carriers even though they show no symptoms. In this article, we looked into the Hepatitis B virus's various stages of infection-related transmission and built a nonlinear epidemic. Then, a fractional hepatitis B virus model using a Caputo derivative and vaccine effects is created. First, we determined the proposed model's essential reproductive value and equilibria. With the aid of Fixed Point Theory, a qualitative analysis of the problem's approximative root has been produced. The Adams-Bashforth predictor-corrector scheme is used to aid in the iterative approximate technique's evaluation of the fractional system under consideration that has the Caputo derivative. In the final section, a graphical representation compares various noninteger orders and displays the discovered scheme findings. In this study, we've utilized Artificial Neural Network (ANN) techniques to partition the dataset into three categories: training, testing, and validation. Our analysis delves deep into each category, comprehensively examining the dataset's characteristics and behaviors within these divisions. The study comprehensively analyzes the fractional HBV transmission model, incorporating both mathematical and computational approaches. The findings contribute to a better understanding of the dynamics of HBV infection and can inform the development of effective public health interventions.

A Systematic Review and Meta-Analysis of Catheter Ablation Versus Anti-arrhythmic Drugs for Treatment of Ventricular Arrhythmia.

Catheter ablation (CA) and anti-arrhythmic drugs (AADs) minimize implanted cardioverter-defibrillator (ICD) shocks in individuals with ischemic cardiomyopathy and an ICD, while the best strategy is still unknown. CA has been proposed as a potentially effective means of reducing the occurrence of ICD events in a number of studies; however, there were insufficient relevant dates from randomized controlled trials. A meta-analysis and systematic review of randomized controlled trials were carried out to evaluate the efficacy of CA for the prevention of VA in patients with ischemic heart disease. Cardiovascular mortality, an unscheduled hospitalization due to increasing heart failure, appropriate ICD shock, or serious treatment-related consequences comprised the composite primary outcome. AADs were examined in six trials (n = 1564; follow-up = 15 ± 8 months), while CA was evaluated in four trials (n = 682; follow-up = 12 ± 6 months). Both CA (odds ratio (OR) 0.65, 95% confidence interval (CI) 0.47-0.82, p = 0.001) and AADs (OR 0.76, 95% CI 0.32-0.84, p = 0.034) significantly reduced the number of suitable ICD interventions, with no discernible difference between the two treatment approaches. AADs were observed to reduce incorrect ICD interventions (OR 0.38, p = 0.001), but CA did not. During follow-up, there was no correlation seen between reduced mortality and either CA or AAD. When compared to AAD, CA decreased the composite endpoint of cardiovascular death, adequate ICD shock, heart failure-related hospitalization, or severe treatment-related consequences in ICD patients with ischemic cardiomyopathy and symptomatic VT.

Asymmetric role of green energy, innovation, and technology in mitigating greenhouse gas emissions: evidence from India.

The primary cause of environmental degradation, which poses a danger to the long-term viability of the ecosystem, is the emission of greenhouse gases (GHG). For this reason, the Glasgow Climate Pact (COP26) established a decarbonization goal in response to this ecological concern, for which all economic players have a responsibility. India is among the participants who have a target set for them to decarbonize their economies by the year 2060 via the use of green energy and the advancement of science and innovation. Nevertheless, the asymmetrical effect of green energy, technology, and innovation on India's decarbonization program was not sufficiently explored in the prior study; hence, this research aims to fill this literature vacuum by considering India's GHG emissions from 1990 to 2020 by leveraging the non-linear autoregressive distributed lag (NARDL) model. The findings reveal the asymmetric influences of variables of interest on GHG emissions during the short and long term and under positive and negative shocks. Regarding the positive shock, long-term findings demonstrate that innovation and technical know-how grow GHG emissions and accelerate environmental degradation. However, a negative shock in innovations and technological know-how is opposed to a positive shock and improving environmental conditions. Further, positive shocks in green energy boost environmental effectiveness by reducing GHG secretions in India. In contrast, the negative shock in green energy deteriorates the environment by triggering GHG releases. These factual findings compel the Indian government to prioritize green technologies in addition to green energy generation to decouple economic growth from greenhouse gas emissions and meet rising energy demands.

Demystifying the association between economic development, transportation, tourism, renewable energy, and ecological footprint in Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation region during globalization mode.

The Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) economies have yet to meaningfully contribute to accomplishing Sustainable Development Goals (SDG 7) affordable and clean energy, (SDG 8) decent work and economic growth, and (SDG 13) climate action. Dealing with this issue might require a shift or alteration of policy framework that is the major theme of this study. Consequently, this present research inspects the influence of economic growth, transportation, tourism sector development, and renewable energy on ecological footprint using panel time series from 1990 and 2019 for the BIMSTEC region. To evaluate this dynamic nexus between the mentioned environmental pollution drivers of ecological footprint, this study employed the augumented mean group (AMG) and common correlated effect mean group (CCEMG) regression estimators after detection of cross-sectional dependency. The empirical outcomes denote that economic growth and transportation sector of BIMSTEC countries increase the levels of ecological footprint. Conversely, tourism sector development, globalization, and renewable energy protect the ecological excellence in the region. Moreover, it is observed that a unidirectional causality exists from economic growth to ecological footprint, ecological footprint to transportation, tourism to ecological footprint, and globalization to ecological footprint, while bidirectional causality exists between renewable energy and ecological footprint. By observing the positive function of tourism, green energy, and globalization on sustainable environment progress, central authorities are capable to redesign policies concerning supportable efficient technologies and regulate globalization towards green programs and agenda to reduce global warming.

Environmental cost of natural resources, globalization, and economic policy uncertainty in the G-7 bloc: do human capital and renewable energy matter?

The panel of G-7 economies is considered one of the most prosperous economies, endowed with abundant natural and renewable energy resources. Due to their richness in these resources, most economic development and activities, including environmental and economic aspects, depend on and are determined by energy consumption and natural resource rents. However, the increasing dependence of G-7 economies on energy consumption and natural resources raises questions about their long-term growth and ecological policies towards achieving sustainable development goals (SDGs). Therefore, the main objective of this study is to examine the influence of natural resources, renewable energy, economic policy uncertainty, human capital, and globalization on the ecological footprint in the panel of G-7 economies from 1990 to 2020. After confirming the cross-sectional dependence issue, this study applied second-generation panel data approaches to estimate robust and reliable outcomes. The estimated evidence from this study discovered that natural resources, globalization processes, and economic policy uncertainty significantly increase the level of ecological footprint in the region. In contrast, renewable energy and human capital provide feasible solutions for ecological improvement in the study area. Likewise, the interactive role of renewable energy with economic policy uncertainty significantly protects the environmental quality in the study area. Based on the estimated findings, this study recommends various achievable policy options for policymakers and the governments of these economies to ensure environmental sustainability.

Impact of banking development and renewable energy consumption on environmental sustainability in Germany: Novel findings using the bootstrap ARDL approach.

This study examines the effects of banking development, economic growth and consumption of renewable energy on carbon dioxide (CO2) emissions and load capacity factor (LCF). Previous empirical studies have assessed the interrelationship between banking development and CO2 emissions; however, these studies have ignored supply-side ecological issues. To overcome this issue, this study evaluates the effect of banking development on LCF, which is considered to be one of the most comprehensive ecological proxies to date, including both biocapacity and ecological footprint (EF). Using the bootstrap autoregressive distributed lag model, the study reveals that renewable energy improves ecological quality in Germany. The results of the investigation demonstrate that the environmental Kuznets curve hypothesis is valid in Germany using CO2 emissions and LCF indicators. Furthermore, this study demonstrates that banking growth and renewable energy in Germany correlate with improved environmental quality. These findings provide policymakers with important insights. In this context, the study advises the banking industry and government authorities to leverage banking expansion to support green energy to achieve the national goal of zero CO2 emissions by 2045.

Statistical inferences under step stress partially accelerated life testing based on multiple censoring approaches using simulated and real-life engineering data.

Evaluating the lifespan distribution of highly reliable commodities under regular use is exceedingly difficult, time consuming, and extremely expensive. As a result of its ability to provide more failure data faster and at a lower experimental cost, accelerated life testing has become increasingly important in life testing studies. In this article, we concentrate on parametric inference for step stress partially life testing utilizing multiple censored data based on the Tampered Random Variable model. Under normal stress circumstances, the lifespan of the experimental units is assumed to follow the Nadarajah-Haghighi distribution, with and being the shape and scale parameters, respectively. Maximum likelihood estimates for model parameters and acceleration factor are developed using multiple censored data. We build asymptotic confidence intervals for the unknown parameters using the observed Fisher information matrix. To demonstrate the applicability of the different methodologies, an actual data set based on the timings of subsequent failures of consecutive air conditioning system failures for each member of a Boeing 720 jet aircraft fleet is investigated. Finally, thorough simulation studies utilizing various censoring strategies are performed to evaluate the estimate procedure performance. Several sample sizes were studied in order to investigate the finite sample features of the considered estimators. According to our numerical findings, the values of mean squared errors and average asymptotic confidence intervals lengths drop as sample size increases. Furthermore, when the censoring level is reduced, the considered estimates of the parameters approach their genuine values.

The role of monetary and fiscal policies in determining environmental pollution: Revisiting the N-shaped EKC hypothesis for China.

The equilibrium between environmental quality and economic growth is one of the contemporary objectives of fiscal and monetary policies in the case of China. In this study, we investigate the extent of the existence of the N-shaped environmental Kuznets curve (EKC) hypothesis and measure the collision of fiscal and monetary policy on carbon emissions within the economic growth perspectives that China is witnessing. This study examines the dynamic nexus between monetary supply, government expenditure, and carbon emissions in China over the spanning from 1980 to 2019. The findings demonstrate that the money supply reduces carbon emissions in the short- and long-run. Precisely, a 1-unit augmentation in monetary policy tool (money supply) will significantly reduce the pressure on the environment by 0.29332 unit in the long-run and 0.79311 unit in the short-run. In contrast, the fiscal policy instrument (government expenditure) contributes to the increase in carbon emissions. Specifically, a 1-unit increase in government expenditure will increase the carbon emission by 0.17835 and 0.48247 units in the long-run and short-run, respectively. Additionally, the result also confirmed the N-shaped EKC hypothesis. Particularly, at the initial stage of economic growth, there are 1.58659 and 4.29197 unit increas in carbon emission in the long-run and short-run, respectively. However, after taking the square of economic growth, this reduces the environmental pollution by 0.3018 and 0.81665 units in the long-run and short-run, respectively. Finally, the cubic form of economic growth shows the 0.01755 and 0.04747 units increase in the pollution level in the long-run and short-run, respectively. Moreover, the study also found the presence of a causality link between government expenditure, economic growth, and carbon emissions. These findings will aid policymakers in implementing fiscal and monetary policies that promote long-term development while lowering carbon emissions.

MTHFR promoter methylation might mitigate the effect of smoking at the level of LINE-1 in cleft lip tissues: A preliminary study.

BACKGROUND: The medial and maxillary aspects of the upper lip originate at separate embryonic stages and therefore may experience different maternal exposure patterns which may affect methylation. Based on this hypothesis, we investigated the level of methylation of the methylene tetrahydrofolate reductase promoter gene (mMTHFR) in tissues from cleft lip, and mMTHFR levels by MTHFR c.677C > T genotype. We further investigated whether mMTHFR mitigates the effect of smoking on long interspersed nuclear element (LINE-1) methylation in these tissues. METHODS: DNA extracted from medial and lateral tissues of 26 infants with nonsyndromic cleft lip with or without cleft palate (nsCL/P) was bisulfite converted and mMTHFR was measured on a pyrosequenser. LINE-1 methylation and MTHFR c.677C > T genotype data were obtained in our previous study. RESULTS: There was no substantial difference in mMTHFR (p = .733) and LINE-1 (p = .148) between the two tissues. mMTHFR was not influenced by MTHFR c.677C > T genotype, but there was suggestive evidence that the difference was larger among infants exposed to maternal smoking compared to nonexposed. LINE-1 methylation differences were significant (p = .025) in infants born to nonsmoking mothers, but this was not apparent (p = .872) in infants born to mothers who smoked. Our Pearson's correlation analysis suggested a weak inverse association between mMTHFR and LINE-1 (r = -.179, p = .381). CONCLUSION: Our preliminary observation of differences in patterns of mMTHFR levels in lip tissue suggests the interplay of gene and environment in the establishment of methylation in tissues at both sides of cleft lip. This requires investigation in a larger cohort, integrated with metabolic assessment.

LINE-1 methylation in cleft lip tissues: Influence of infant MTHFR c.677C>T genotype.

OBJECTIVE: To investigate the influence of MTHFR c.677C>T genotype on LINE-1 methylation in lateral and medial tissues from cleft lip (CL). METHODS: Forty-five consecutive non-syndromic cleft lip with or without cleft palate (nsCL/P) cases were included in the study. Genomic DNA was extracted from tissues at both sides of cleft lip, and LINE-1 methylation was detected by bisulfite conversion and pyrosequencing. MTHFR c.677C>T genotyping was carried out using the TaqMan genotyping assay. RESULTS: LINE-1 methylation level was significantly higher on medial side of cleft lip compared with lateral side (p = 0.001). This difference was not significantly influenced by the case's sex or cleft type. However, MTHFR c.677C>T genotyping revealed that the difference in LINE-1 methylation across cleft lip was restricted to carriers of C allele of MTHFR c.677C>T and was not apparent in TT homozygous cases (p = 0.027). CONCLUSION: This integrated analysis supports the previous finding of differences in DNA methylation across the two sides of cleft lip and further suggests a possible role of MTHFR c.677C>T genotype in establishing this difference.

Ultrastructural analysis of collagen fibril diameter distribution in cleft lip.

OBJECTIVE: A preliminary study to determine collagen fibril diameter (CF-ED) distribution on medial and lateral sides of cleft lip (CL). MATERIAL AND METHODS: Tissue samples from medial and lateral sides of CL were fixed in 2.5% glutaraldehyde and 1% osmium tetroxide and embedded in Araldite CY212 resin for transmission electron microscopy. The analysis of CF-ED was performed using the ImageJ program. To characterize the packaging of collagen fibrils (CFs) in the two tissues, we estimated the collagen number density (CF-ND) and fibril-area-fraction (FAF). Differences in measurements across the two sides were calculated using Wilcoxon signed-rank test. RESULTS: The CF-ED was statistically significantly (p < 0.001) smaller on the medial side (45.69 ± 7.89 nm) than on the lateral side (54.18 ± 7.62 nm). The medial side had a higher CF-ND and a higher percentage of FAF than the lateral side. CONCLUSION: Our finding of a smaller CF-ED and higher CF-ND and FAF for the medial side suggests possible differences in size and distribution of CFs between medial and lateral sides of CL. This finding provides knowledge toward underlying tissue biomechanics that may help reconstruction of perioral tissue scaffolds, ultimately resulting in better treatment of patients with oral clefts.

Association between a common missense variant in LOXL3 gene and the risk of non-syndromic cleft palate.

To investigate possible association between functional common variants in the lysyl oxidase like 3 gene and non-syndromic cleft palate we selected a common missense variant p.Ile615Phe (rs17010021), which was predicted to have a probably damaging effect on the lysyl oxidase like 3 enzyme. We genotyped 258 non-syndromic cleft palate case-parent triads of European origin and tested genetic association using the transmission disequilibrium test and log-linear regression analyses of genotypic relative risks and of parent-of-origin effects. The observed genotype frequency in parents was in Hardy-Weinberg equilibrium. Compared with wild-type Ile/Ile homozygotes, the relative risks for Phe/Phe homozygote infants was 6.87 (P value 3.0 × 10-3 ), while that for Ile/Phe heterozygotes was not significant. Assuming an autosomal recessive model, the relative risks for Phe/Phe genotype resulted 10.54 (P value 2.9 × 10-5 ), with a 3.6% population attributable risk. No parent-of-origin effect was observed. The identification in lysyl oxidase like 3 of a missense variant which under a recessive model associates with 10-fold increased risk of non-syndromic cleft palate supports the hypothesis that the genetic etiology of this congenital anomaly includes relatively uncommon recessive variants with moderate penetrance and located in genes which are also involved in syndromes that include cleft palate as part of the phenotype. Our findings require functional validation and replication in a larger independent genetic association study.

Nonsyndromic cleft palate: An association study at GWAS candidate loci in a multiethnic sample.

BACKGROUND: Nonsyndromic cleft palate only (nsCPO) is a common and multifactorial form of orofacial clefting. In contrast to successes achieved for the other common form of orofacial clefting, that is, nonsyndromic cleft lip with/without cleft palate (nsCL/P), genome wide association studies (GWAS) of nsCPO have identified only one genome wide significant locus. Aim of the present study was to investigate whether common variants contribute to nsCPO and, if so, to identify novel risk loci. METHODS: We genotyped 33 SNPs at 27 candidate loci from 2 previously published nsCPO GWAS in an independent multiethnic sample. It included: (i) a family-based sample of European ancestry (n = 212); and (ii) two case/control samples of Central European (n = 94/339) and Arabian ancestry (n = 38/231), respectively. A separate association analysis was performed for each genotyped dataset, and meta-analyses were performed. RESULTS: After association analysis and meta-analyses, none of the 33 SNPs showed genome-wide significance. Two variants showed nominally significant association in the imputed GWAS dataset and exhibited a further decrease in p-value in a European and an overall meta-analysis including imputed GWAS data, respectively (rs395572: PMetaEU = 3.16 × 10-4 ; rs6809420: PMetaAll = 2.80 × 10-4 ). CONCLUSION: Our findings suggest that there is a limited contribution of common variants to nsCPO. However, the individual effect sizes might be too small for detection of further associations in the present sample sizes. Rare variants may play a more substantial role in nsCPO than in nsCL/P, for which GWAS of smaller sample sizes have identified genome-wide significant loci. Whole-exome/genome sequencing studies of nsCPO are now warranted.

Evaluating LINE-1 methylation in cleft lip tissues and its association with early pregnancy exposures.

AIM: To pilot investigation of methylation of long interspersed nucleotide element-1 in lip tissues from infants with nonsyndromic cleft lip, and its association with maternal periconceptional exposures. METHODS: The lateral and medial sides of the cleft lips of 23 affected infants were analyzed for long interspersed nucleotide element-1 methylation by bisulfite conversion and pyrosequencing. RESULTS: The medial side showed 1.8% higher methylation compared with the lateral side; p = 0.031, particularly in male infants (2.7% difference; p = 0.011) or when the mothers did not take folic acid during periconceptional period (2.4% difference; p = 0.011). These results were not statistically significant when Bonferroni adjustment was used. CONCLUSION: The observed differences in DNA methylation, although nonsignificant after correction for multiple comparisons, suggest that differential regulation of the two sides may impact lip fusion and warrant larger-scale replication.

A new method of detecting changes in corneal health in response to toxic insults.

The size and arrangement of stromal collagen fibrils (CFs) influence the optical properties of the cornea and hence its function. The spatial arrangement of the collagen is still questionable in relation to the diameter of collagen fibril. In the present study, we introduce a new parameter, edge-fibrillar distance (EFD) to measure how two collagen fibrils are spaced with respect to their closest edges and their spatial distribution through normalized standard deviation of EFD (NSDEFD) accessed through the application of two commercially available multipurpose solutions (MPS): ReNu and Hippia. The corneal buttons were soaked separately in ReNu and Hippia MPS for five hours, fixed overnight in 2.5% glutaraldehyde containing cuprolinic blue and processed for transmission electron microscopy. The electron micrographs were processed using ImageJ user-coded plugin. Statistical analysis was performed to compare the image processed equivalent diameter (ED), inter-fibrillar distance (IFD), and EFD of the CFs of treated versus normal corneas. The ReNu-soaked cornea resulted in partly degenerated epithelium with loose hemidesmosomes and Bowman's collagen. In contrast, the epithelium of the cornea soaked in Hippia was degenerated or lost but showed closely packed Bowman's collagen. Soaking the corneas in both MPS caused a statistically significant decrease in the anterior collagen fibril, ED and a significant change in IFD, and EFD than those of the untreated corneas (p<0.05, for all comparisons). The introduction of EFD measurement in the study directly provided a sense of gap between periphery of the collagen bundles, their spatial distribution; and in combination with ED, they showed how the corneal collagen bundles are spaced in relation to their diameters. The spatial distribution parameter NSDEFD indicated that ReNu treated cornea fibrils were uniformly distributed spatially, followed by normal and Hippia. The EFD measurement with relatively lower standard deviation and NSDEFD, a characteristic of uniform CFs distribution, can be an additional parameter used in evaluating collagen organization and accessing the effects of various treatments on corneal health and transparency.

Expression of Leukocyte Inhibitory Immunoglobulin-like Transcript 3 Receptors by Ovarian Tumors in Laying Hen Model of Spontaneous Ovarian Cancer.

Attempts to enhance a patient's immune response and ameliorate the poor prognosis of ovarian cancer (OVCA) have largely been unsuccessful owing to the suppressive tumor microenvironment. Leukocyte immunoglobulin-like transcript 3 (ILT3) inhibitory receptors have been implicated in immunosuppression in several malignancies. The expression and role of ILT3 in the progression of ovarian tumors are unknown. This study examined the expression and association of ILT3 in ovarian tumors in laying hens, a spontaneous preclinical model of human OVCA. White Leghorn laying hens were selected by transvaginal ultrasound scanning. Serum and normal ovaries or ovarian tumors were collected. The presence of tumors and the expression of ILT3 were examined by routine histology, immunohistochemistry, Western blot analysis, and reverse transcription-polymerase chain reaction. In addition to stromal immune cell-like cells, the epithelium of the ovarian tumors also expressed ILT3 with significantly high intensity than normal ovaries. Among different subtypes of ovarian carcinomas, serous OVCA showed the highest ILT3 staining intensity, whereas endometrioid OVCA had the lowest intensity. Similar to humans, an immunoreactive protein band of approximately 55 kDa for ILT3 was detected in the ovarian tumors in hens. The patterns of ILT3 protein and messenger RNA expression by ovarian tumors in different subtypes and stages were similar to those of immunohistochemical staining. The results of this study suggest that laying hens may be useful to generate information on ILT3-associated immunosuppression in OVCA. This animal model also offers the opportunity to develop and test anti-ILT3 immunotherapy to enhance antitumor immunity against OVCA in humans.

Swelling studies of camel and bovine corneal stroma.

In the present study we investigated the swelling characteristics of fresh camel and bovine cornea in sodium salt solutions. Swelling studies were carried out at 20 minutes, 14 hours, and 46 hours on five fresh camel and 5 five fresh bovine corneas. During the 20-minute hydration of fresh corneal stroma was investigated using sodium chloride (NaCl), sodium bicarbonate (NaHCO(3)), sodium acetate (CH(3)COONa), sodium thiocyanate (NaSCN), and sodium floride (NaF) at 2-minute time intervals. During a 46-hour time period, the hydration study was carried out using NaCl (150, 300 mM) and NaF (150 mM) at random intervals. The 14-hour study was carried out to assess the rehydration of corneal stroma after 6 hours of drying. During the 20-minute swelling studies in the first 2 minutes the rate of hydration in both camel and bovine corneas was high but gradually reduced in the 2-20-minute period. The rates and levels of hydration of camel and bovine cornea were not significantly different from each other in all the strengths of solutions. During the 46-hour swelling studies, the initial rate of hydration (0-2 hours) of camel and bovine stroma, in all solutions was significantly higher (Z = 0.056) compared to hydration during later hours (2-46 hours). Camel stromal hydration (high) in 150 mM NaCl was significantly higher compared to bovine stromal hydration in the same solution during the 10-24, and 24-46-hour time periods. Rehydration in camel stroma was significantly lower than bovine in 150 mM NaF. The 20-minute study showed that there was no selective affinity for particular ions in camel or bovine corneal stroma. Initial swelling in both corneal and bovine stroma is faster and more prominant compared to later swelling. The swelling in camel cornea is more prominant compared to bovine corneal stroma. This could be due to higher negatively charged keratin sulfate-proteoglycans in the stroma. Lower rehydration in camel cornea suggests stronger leaching of proteoglycans from stroma in NaF.

Tracheal stenosis mimicking severe acute asthma.

Post-intubation tracheal stenosis is a rare but serious clinical entity that rarely develops when intubation is less than a week. These patients may remain asymptomatic for a variable period and are often misdiagnosed as asthmatic. The authors report a case of a middle-aged lady who was initially misdiagnosed as having acute asthma after brief tracheal intubation.