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Non-alcoholic fatty liver disease may not be a severe disease at presentation among Asian Indians

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World Journal of Gastroenterology 2006年第21期12卷 3400-3405页

作者： Kaushal Madan Yogesh Batra S Datta Gupta Bal Chander K D anand rajan M S Tewatia S K Panda S K Acharya Department of Gastroenterology All India Institute of Medical Sciences New DelhiIndia Department of Gastroenterology All India Institute of Medical Sciences New DelhiIndia Department of PathologyAll India Institute of Medical SciencesNew DelhiIndia Department of Pathology All India Institute of Medical Sciences New DelhiIndia

AIM： To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease （NAFLD） and to assess their histological severity at ***： Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences （AIIMS） with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied. RESULTS： Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34（17-58） years and 26.7（21.3-32.5） kg/m^2 respectively and 46 （90.1%） were males. The majority of the patients had mild inflammation, either grade 1 [32 （63%）] or grade 2 [16 （31%）] and only 3 （6%） patients had severe （grade 3） inflammation. Twenty-three （45%）, 19 （37%）, 8（16%） and 1（2%） patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % （OR = 7.1; 95% CI： 1.6-31.5, P = 0.002） and AST ALT ratio 〉 1 （OR = 14.3; 95% CI： 1.4-678.5, P = 0.008） were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia 〉150 mg% was the only factor independently associated with presence of high grade of inflammation （OR = 1.6; 95% CI： 1.3-22.7, P =0.02）, while none was associated with advanced fibrosis. Triglyceride levels correlated positively with inflammatory grade （r = 0.412; P = 0.003）. CONCLUSION： NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation.

关键词： Inflammation Fibrosis Triglycerides Non alcoholic steatohepatitis

Machine learning models compared to existing criteria for noninvasive prediction of endoscopic retrograde cholangiopancreatography-confirmed choledocholithiasis

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Liver Research 2021年第4期5卷 224-231页

作者： Camellia Dalai John M Azizian Harry Trieu anand rajan Formosa C Chen Tien Dong Simon W Beaven James H.Tabibian UCLA-Olive View Internal Medicine Residency Program Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA Keck School of Medicine University of Southern CaliforniaLos AngelesCAUSA Department of Surgery David Geffen School of Medicine at UCLALos AngelesCAUSA Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesCAUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance *** aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained *** logistic regression was used to identify predictors of ERCP-confirmed *** were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to ***:We identified 270 patients(mean age 46 years,62.2%female,73.7%Hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed *** regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed *** the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,*** high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD di

关键词： Machine learning models(MLMs) Endoscopic retrograde cholangiopancreatography(ERCP) Noninvasive imaging Bile duct disorders Common bile duct stones Gallstones

Assessing the yield and safety of endoscopy in acute graft-vs-host disease after hematopoietic stem cell transplant

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World Journal of Gastrointestinal Endoscopy 2020年第10期12卷 341-354页

作者： anand V rajan Harry Trieu Peiguo Chu James Lin Trilokesh Dey Kidambi Department of Medicine City of Hope Medical CenterDuarteCA 91010United States Department of Medicine UCLA-Olive View Medical CenterSylmarCA 91342United States Keck School of Medicine University of Southern CaliforniaLos AngelesCA 90089United States Department of Gastroenterology City of HopeDuarteCA 91010United States

BACKGROUND Acute gastrointestinal(GI)graft-vs-host disease(aGVHD)is the most complication of hematopoietic stem cell transplant(HSCT)in patients with hematologic *** data exists on endoscopic evaluation of GVHD in post-HSCT patients with differing GI ***,the diagnostic value of gross endoscopic findings as well as the safety of endoscopy in this commonly thrombocytopenic and neutropenic patient population remains *** To understand the diagnostic value of symptoms and gross endoscopic findings as well as safety of endoscopy in aGVHD *** We analyzed 195 endoscopies performed at City of Hope in patients who underwent allogeneic HSCT less than 100 d prior for hematologic malignancy and were subsequently evaluated for aGVHD via *** yield,sensitivity,and specificity of diagnosing aGVHD were calculated for upper and lower endoscopy,various GI tract locations,and presenting *** Combined esophagogastroduodenoscopy(EGD)and flexible sigmoidoscopy(FS)demonstrated a greater diagnostic yield for aGVHD(83.1%)compared to EGD(66.7%)or FS(77.2%)alone with any presenting *** upper and lower GI tract demonstrated similar yields regardless of whether patients presented with diarrhea(95.7%vs 99.1%)or nausea/vomiting(97.5%vs 96.8%).Normalappearing mucosa was generally as specific(91.3%)as abnormal mucosa(58.7%-97.8%)for the presence of *** events such as bleeding(1.0%),infection(1.0%),and perforation(0.5%)only occurred in a small proportion of patients,with no significant differences in those with underlying thrombocytopenia(P=1.000)and neutropenia(P=0.425).CONCLUSION Combined EGD and FS with biopsies of normal and inflamed mucosa demonstrated the greatest diagnostic yield regardless of presenting symptom and appears to be safe in this population of patients.

关键词： Graft-vs-host disease Esophagogastroduodenoscopy Colonoscopy Endoscopy Flexible sigmoidoscopy Stem cell transplant Hematopoietic stem cell transplant Thrombocytopenia Neutropenia Malignancy

Review of MXenes as a component in smart textiles and an adsorbent for textile wastewater remediation

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Chinese Chemical Letters 2024年第2期35卷 208-222页

作者： Kaniz Farhana Kumaran Kadirgama Abu Shadate Faisal Mahamude rajan Jose Department of Apparel Engineering Bangladesh University of TextilesDhaka 1208Bangladesh Faculty of Mechanical and Automotive Engineering Technology Universiti Malaysia Pahang26600 PekanPahangMalaysia Center of Automotive Engineering Universiti Malaysia PahangMalaysia College of Engineering Universiti Malaysia Pahang26300 GambangPahangMalaysia Faculty of Industrial Sciences & Technology Universiti Malaysia Pahang26300 KuantanMalaysia Center of Intelligent Materials Universiti Malaysia Pahang26300 KuantanMalaysia

Two-dimensional(2D)MXenes have emerged as an archetypical layered material combining the properties of an organic-inorganic hybrid offering materials sustainability for a range of *** surface functional groups and the associated chemical properties'tailorability through functionalizing MXenes with other materials as well as hydrophilicity and high conductivity enable them to be the best successor for various applications in textile industries,especially in the advancement of smart textiles and remediation of textile ***-based textile composite performs superb smartness in high-performance wearables as well as in the reduction of textile dyes from *** article critically reviews the significance of MXenes in two sectors of the textile ***,we review the improvement of textile raw materials such as fiber,yarn,and fabric by using MXene as electrodes in supercapacitors,pressure ***,we review advancements in the removal of dyes from textile wastewater utilizing MXene as an absorbent by the adsorption ***-based textiles demonstrated superior strength through the strong bonding between MXene and textile structures as well as the treatment of adsorbate by adsorbent(MXene in the adsorption process).We identify critical gaps for further research to enable their real-life applications.

关键词： Textile fibers Industrial wastewater treatment MAX phases Hybrid electrodes Adsorption

Limited impacts of occasional tillage on dry aggregate size distribution and soil carbon and nitrogen fractions in semi-arid drylands

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International Soil and Water Conservation Research 2024年第1期12卷 96-106页

作者： Wooiklee S.Paye Vesh R.Thapa rajan Ghimire New Mexico State University Agricultural Science CenterClovisNM88101USA New Mexico State University Department of Plant and Environmental SciencesLas CrucesNM88003USA

Tillage management that minimizes the frequency and intensity of soil disturbance can increase soil carbon(C)and nitrogen(N)sequestration and improve the resilience of dryland cropping systems,yet the impact of occasional disturbance on soil aggregate formation and the soil organic carbon(SOC)storage within aggregates has not been studied *** evaluated the effect of four tillage management practices on soil dry aggregate size distribution,aggregate-protected C and N,mineral-associated organic matter carbon(MAOM-C),particulate organic matter carbon(POM-C),and corn(Zea mays L.)and sorghum(Sorghum bicolor(L.)Moench)yields in a semi-arid dryland cropping *** included conventional tillage(CT),strip-tillage(ST),no-tillage(NT),and occasional tillage(OT)management in a corn-sorghum *** macro-aggregates were 51-54%greater under ST,NT,and OT,while small and micro-aggregates were greater in *** tillage reduced soil aggregate-associated C by 28-31%in macro-aggregates and 47-53%in small aggregates at 26 months(M)sampling compared to ST,NT,and *** clay+silt fraction,CT had 14-16%,21-26%,and 36-43%less SOC at 7,14,and 26M samplings,respectively,than ST,NT,and *** associated N was generally similar under ST,NT,and OT,which was greater on average than *** MOAM-C and POM-C under ST,NT,and OT were generally greater than respective SOC fractions under CT at 19 and 26 M after OT *** and sorghum yields were similar among tillage systems in 2020,but greater under ST,NT,and OT than CT in *** results suggest that while frequent intensive tillage can lower SOC and N storage,a single stubble mulch occasional tillage after several years of NT does not lead to soil C and N losses and soil structural instability in semi-arid drylands.

关键词： Conventional tillage Occasional tillage Aggregate associated carbon Mineral associated organic matter carbon(MAOM-C) Particulate organic matter carbon(POM-C)

Direct Pointwise Comparison of FE Predictions to StereoDIC Measurements:Developments and Validation Using Double Edge-Notched Tensile Specimen

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Computer Modeling in Engineering & Sciences 2024年第8期140卷 1263-1298页

作者： Troy Myers Michael A.Sutton Hubert Schreier Alistair Tofts Sreehari rajan Kattil Department of Mechanical Engineering University of South CarolinaColumbiaSC29208USA Correlated Solutions Incorporated 121 Dutchman BlvdColumbiaSC29063USA

To compare finite element analysis(FEA)predictions and stereovision digital image correlation(StereoDIC)strain measurements at the same spatial positions throughout a region of interest,a field comparison procedure is *** procedure includes(a)conversion of the finite element data into a triangular mesh,(b)selection of a common coordinate system,(c)determination of the rigid body transformation to place both measurements and FEA data in the same system and(d)interpolation of the FEA nodal information to the same spatial locations as the StereoDIC measurements using barycentric *** an aluminum Al-6061 double edge notched tensile specimen,FEA results are obtained using both the von Mises isotropic yield criterion and Hill’s quadratic anisotropic yield criterion,with the unknown Hill model parameters determined using full-field specimen strain measurements for the nominally plane stress *** Hill’s quadratic anisotropic yield criterion,the point-by-point comparison of experimentally based full-field strains and stresses to finite element predictions are shown to be in excellent agreement,confirming the effectiveness of the field comparison process.

关键词： StereoDIC spatial co-registration data transformation finite element simulations point-wise comparison of measurements and FEA predictions double edge notch specimen model validation

Diagnosing upper tract urothelial carcinoma: A review of the role of diagnostic ureteroscopy and novel developments over last two decades

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Asian Journal of Urology 2024年第2期11卷 242-252页

作者： Paul Gravestock Daniel Cullum Bhaskar Somani rajan Veeratterapillay Urology Department Freeman HospitalNewcastle Upon TyneUK Department of Urology University Hospital SouthamptonSouthamptonUK

Objective: The role of ureteroscopy in the diagnosis of upper tract urothelial carcinoma is yet to be fully determined. We aimed to provide an up to date evaluation of its role and the emerging technologies in the ***: A literature search of the last two decades (from 24th May, 2001 to 24th May, 2021) was carried out identifying 147 papers for potential inclusion within this narrative ***: Diagnostic ureteroscopy is undeniably useful in its ability to visualise and biopsy indeterminate lesions, and to risk stratify malignant lesions that may be suitable for kidney sparing surgery. However, an increased risk of intravesical recurrence following nephroureterectomy when a prior diagnostic ureteroscopy has been performed, inadequate sampling at biopsy, complications from the procedure, and difficult ureteric access are all potential drawbacks. Furthermore, whilst generally an accurate diagnostic procedure, it risks missing carcinoma in-situ lesions. Despite this, evidence shows that routine use of ureteroscopy changes the management of patients in a large proportion of cases, preventing unnecessary surgery or facilitating kidney sparing surgery. The overall rate of complications is low, and improved biopsy techniques and the use of tissue biomarkers for improved staging and grading are encouraging. The risks of delays to definitive management and post-ureteroscopy intravesical recurrence do not seem to affect survival, and trials are in progress to determine whether intravesical therapy can mitigate the latter. Further promising techniques are being investigated to improve shortcomings, particularly in relation to improved diagnosis of carcinoma in situ and preoperative ***: Ureteroscopy has a role in the diagnosis of upper tract malignancy, though whether it should be used routinely is yet to be determined.

关键词： Ureteroscopy Carcinoma Transitional cell Ureteralneoplasms Urinary bladder neoplasms Carcinomainsitu Biopsy

Minimally invasive management of parapharyngeal space tumors:Introducing a decision-making algorithm and radiologic tool

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第3期7卷 97-101页

作者： Manuel Schoch Gunesh rajan Grzegorz Karwacki Department of Otolaryngology and Head-Neck Surgery Hospital of St.GallSt.GallenSwitzerland Department of Otolaryngology and Head-Neck Surgery Hospital of LucerneLuzernSwitzerland Department of Radiology and Nuclear Medicine Hospital of LucerneLuzernSwitzerland

Objective Traditionally tumors of the parapharyngeal space(PPS)are resected through transcervical *** recent approaches include endoscopic approaches or transoral robotic surgery(TORS)without directions on when to use which *** objective was to find objective parameters to choose the most suitable *** It is a retrospective study containing 6 patients from May 2019 to May 2021 with tumors of the PPS treated in the Department of Otolaryngology and Head-Neck Surgery at the Hospital of Lucerne,*** The data was analysed in average 53 months after *** resection was completed with TORS in 3 patients and endoscopically in 3 *** operation time was 114 *** major complications *** evidence of tumor was found in magnetic resonance imaging studies postoperatively in all *** We conclude that a resection via TORS or endoscopic technique is safe and ***,we postulate that the further a tumor is located in the upper lateral area of the PPS,an approach via TORS is less possible.

关键词： Oto-rhino-laryngology Endoscopic surgery Robotic surgery Parapharyngeal space tumors

Type 2 diabetes in children and adolescents:Exploring the disease heterogeneity and research gaps to optimum management

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World Journal of Clinical Pediatrics 2024年第2期13卷 80-99页

作者： Subhodip Pramanik Sunetra Mondal rajan Palui Sayantan Ray Department of Endocrinology Neotia Getwel Multi-specialty hospitalSiliguri 734010West BengalIndia Department of Endocrinology NRS Medical College and HospitalKolkata 700014West BengalIndia Department of Endocrinology All India Institute of Medical SciencesBhubaneswarBhubaneswar 751019OdishaIndia

Over the past 20 years,the incidence and prevalence of type 2 diabetes mellitus(T2DM)in children and adolescents have increased,particularly in racial and ethnic *** the rise in T2DM in children and adolescents,the pathophysiology and progression of disease in this population are not clearly ***-onset T2DM has a more adverse clinical course than is seen in those who develop T2DM in adulthood or those with ***,the available therapeutic options are more limited for children and adolescents with T2DM compared to adult patients,mostly due to the challenges of implementing clinical trials.A better understanding of the mechanisms underlying the development and aggressive disease phenotype of T2DM in youth is important to finding effective prevention and management *** review highlights the key evidence about T2DM in children and adolescents and its current burden and challenges both in clinical care and research activities.

关键词： Type 2 diabetes mellitus Children and adolescents Pathophysiology Heterogeneity Complications Treatment options Barriers