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Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients

World Journal of Pediatrics 2018年第4期14卷 364-372页

作者： Parth Bhatt Achint Patel Varun Kumar anusha Lekshminarayanan Viranchi Patel Srilatha Alapati Zeenia Cyrus Billimoria Texas Tech University Health Sciences Center AmarilloTXUSA University of Arkansas for Medical Sciences Little RockARUSA Mt.Sinai St.Luke's Roosevelt Hospital Center New YorkNYUSA Mercy Health CincinnatiOHUSA Tulane University School of Public Health and Tropical Medicine New OrleansLAUSA University of Washington Seattle Children's Hospital4800 Sand Point Way NESeattleWA 98105USA

Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project. Results 6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87,P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89,P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42,P < 0.001) were lower as compared to the 1st tertile of hospital volume. Conclusion Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.

关键词： Atrial septal defect Cardiac catheterization Children

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Exploration of Kras Mutations and Their Potential for Being a Target Molecule in Cancer Chemotherapy

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Journal of Cancer Therapy 2023年第6期14卷 257-276页

作者： anusha Chinthareddy Terry Oroszi Department of Pharmacology and Toxicology Wright State University Dayton USA

The Rat sarcoma virus (RAS) family of proteins, which includes the Kristen Rat sarcoma virus (KRAS), is linked to nearly one-fourth of all human cancers. KRAS mutations, in particular, are associated with Non-Small Cell Lung Carcinoma (NSCLC), colorectal cancer, adenocarcinomas, ovarian carcinoma, and endometrial tumors. KRAS activates 80 different signaling pathways, including Mitogen-activated protein kinases (MAPK) and Phosphoinositide 3-kinase (PI3K), and up-regulates transcription factors such as ETS like Protein (ELK), Jun Proto-Oncogene (JUN), and Myelocytomatosis (MYC), which are involved in cell differentiation, proliferation, transformation, and survival. KRAS mutations are also known to cause autocrine function, which further exacerbates the situation. In NSCLC, KRAS mutations have a strong positive correlation with the disease, particularly in patients with a smoking history. In pancreatic cancer, KRAS mutations are a dominant pathological basis, with most mutations being G12D, G12V, G13D, G13C, G13S, and G13R. These mutations serve as initial markers in tumorigenesis and are associated with poor prognosis and high mortality rates. In colorectal cancer, KRAS mutations contribute to 4/5 of cases, with cellular mechanisms involving the MAPK pathway, which resists anti-epidermal growth factor antibodies. In Low-grade Serous Ovarian Cancer (LGSOC), KRAS mutations are associated with altered signaling in the MAPK pathway and drug resistance. However, treatments such as Selumetinib, a down regulator of RAS/Rapidly Accelerated Fibrosarcoma (RAF)/Mitogen-activated protein kinase (MEK) pathways, and a combination of trametinib and buparlisib have shown promise in managing LGSOC when diagnosed early through KRAS mutation markers. Although KRAS mutations are commonly associated with many types of cancer, their use in clinical practice is limited due to the lack of accurate methods to identify them. It is needed to further isolate the KRAS mutation products and corr

关键词： KRAS Mutations Non-Small Cell Lung Carcinoma (NSCLC) Colorectal Can-cer MAPK Pathway Chemotherapy

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Hippo/Yap signaling controls epithelial progenitor cell proliferation and differentiation in the embryonic and adult lung

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Journal of Molecular Cell Biology 2015年第1期7卷 35-47页

作者： Alexander W.Lange anusha Sridharan Yan Xu Barry R.Stripp Anne-Karina Perl Jeffrey A.Whitsett Division of Pulmonary Biology Cindinnati Children's Hospital Medical Center and the University of Cncinnati Collel ge of MedicineCincinnatiOH 452293039USA Cedars-Sinai Medical Center Los AngelesCA 90048USA

The Hippo/Yap pathwayis a wll-conserved signaling cascade that regulates cell proliferation and dfferentiationto control organsize and stem/progenitor cell *** airway injury,Yap was dynamically regulated in regenerating airway epithelial *** *** the role ofHippo signaling in the lung,the mammalian Hippo kinases,Mst1 and Mst2,were deleted in epithelial cells ofthe embry-onic and mature mouse ***1/2 deletion in the fetal lung enhanced proliferation and inhibited sacculation and epithelial cell *** transcriptional inhibition of cell proliferation and activation of differentiation during normal perinatal lung maturation were inversely regulated followving embryonic Mst1/2 *** of Mst1/2 from bronchiolar epithelial cells in the adult lung caused airway hyperplasia and altered *** Yap phosphorylation was decreased and Yap nuclear localization and transcriptional targets were increased after Mst1/2 deletion,consistent with canonical Hippo/Yap *** potentiated cell prolif-eration and inhibited dfferentiation of human bronchial epithelial cells in *** of Mst1/2 and expression ofYAP regulated transcrip-tional targets controlling cell proliferation and diferentiation,including Ajuba LIM *** was required forthe effects ofYAP oncell proliferation in ***/Yapsignaling regulates Ajuba and controls proliferation and diferentiation oflung epithelial progenitor cells.

关键词： Hippo/Yap pathway lung Ajuba proliferation dfferetiation

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Optical Spectroscopy of Classical Be Stars in Old Open Clusters

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Research in Astronomy and Astrophysics 2023年第3期23卷 16-24页

作者： Madhu Kashyap Jagadeesh Blesson Mathew K.T.Paul Gourav Banerjee Suman Bhattacharyya R.anusha Pramod Kumar S. Department of Physics and Electronics CHRIST(Deemed to be University)Hosur Main RoadBengaluruIndia Department of Physics and Astronomy University of Western OntarioON N6A 3K7Canada Indian Institute of Astrophysics KoramangalaBengaluruIndia

We performed the optical spectroscopy of 16 classical Be stars in 11 open clusters older than 100 *** is the first spectroscopic study of classical Be stars in open clusters older than 100 *** found that the Hαemission strength of most of the stars is less than 40?,in agreement with previous *** analysis further suggests that one of the stars,[KW97]35–12,might be a weak Hαemitter in nature,showing Hαequivalent width of-0.5?.Interestingly,we also found that the newly detected classical Be star LSⅢ+4737b might be a component of the possible visual binary system LSⅢ+4737,where the other companion is also a classical Be ***,the present study indicates the possible detection of a binary Be ***,it is observed that all 16 stars exhibit a lesser number of emission lines compared to classical Be stars younger than 100 ***,the spectral type distribution analysis of B-type and classical Be stars for the selected clusters points out that the existence of CBe stars can depend on the spectral type distribution of B-type stars present in these clusters.

关键词： clusters showing spectroscopic

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A comprehensive evaluation of brain derived neurotropic growth factor gene on Bharatnatyam dancers

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Precision Medicine Research 2022年第2期4卷 1-6页

作者： Nithyakalyani Mohan anusha Sunder Transplant department Apollo HospitalsChennai 600006India Apollo Hospitals and Research Foundation Apollo HospitalsChennai 600006India

Research significance:Dance symbolizes rhythmic body movements to music intending expression of an idea or emotion that delights the ***,an imperative form of Indian Classical dance,has therapeutic implications including enhancement of cognitive *** belonging to the nerve growth factor family essentially regulate neuronal growth,development and *** Brain-Derived Neurotrophic Factor(BDNF)is a member of this ***-term memory and learning are vitally influenced by *** Bharatanatyam,new movements are learntand they are practiced until *** newly learntmovement initially stays in short-term memory and with practice,it reaches the long-term *** thus,a favorableincrease in plasma BDNF levels can be associated with *** the BDNF gene,rs6265 is a common single nucleotide polymorphism,which results in a valine(Val)being substituted with methionine(Met)in the prodomainat codon 66(Val66Met).This genetic variation affects the BDNF protein’s activity-dependent *** methods:With an intention to delve into the link between BDNF gene variants and Bharatanatyam,we conducted an observational research study on 93 participants with their due *** study group included 45 dancers and 48 *** anddiscussion:Genotype suggesting optimal BDNF production was proportionately higher in dancers(40%)than *** of the dancers with optimal BDNF genotype expressed a feeling of happiness as their mental status after one hour of dancing and also took up other exercises(like skating/badminton/basketball player etc)as *** amongst dancers with sub-optimal BDNF genotype,most of them did not take up any other exercise(like skating/badminton/basketball player etc)andalso expressed a blank feeling as their mental status after one hour of ***,BDNF has an evident role in the formation of new learning and memory.

关键词： BDNF Bharatanatyam gene genotype SNP rs6265 memory cognition

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Metamaterial Inspired Radar Absorbers:Emergence,Trends and Challenges

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Computers, Materials & Continua 2016年第6期 143-158页

作者： anusha Eldo Balamati Choudhury CSIR-NAL BangaloreIndia

The advances in metamaterial science and technology have raised the expectations of camouflage or stealth researchers to one order higher in terms of absorption *** metamaterial inspired radar absorbing structures are proving themselves as a good candidate with near unity absorption,feasibility towards hardware realization is *** an extensive literature survey of metamaterial inspired radar absorbing structure has been carried out and reported in this paper along with the challenges and material *** various types of metamaterial structures that can be used as absorber have been provided along with simulation *** make the review more useful,graphene and carbon nanotube(CNT)based radar absorbing structures are also included along with their simulation and fabrication techniques.

关键词： Metamaterial radar absorbers graphene CNT fishnet structures.

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Intelligent Virtual Assistant System(IVAS) for Air Traffic Controllers

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Instrumentation 2021年第1期8卷 43-50页

作者： anusha DILHANI Ruminda J WIMALASIRI Department of Mechanical Engineering The Open University Sri LankaNawalaNugegodaSri Lanka

Air traffic control is an essential obligation in the aviation industry to have safe and efficient air *** by year,the workload and on-job-stress of the air traffic controllers are rapidly increasing due to the rapid growth of air *** are usually dealing with multiple aircrafts at a time and must make quick and accurate decisions to ensure the safety of *** workload and high responsibilities create air traffic control a stressful job that sometimes could be error-prone and time-consuming,since controlling and decision-making are solely dependent on human *** provide effective solutions for the mentioned on the job challenges of the controllers,this study proposed an intelligent virtual assistant system(IVAS)to assist the controllers thereby to reduce the controllers’*** of four main parts,which are voice recognition,display conversation on screen,task execution,and text to speech,the proposed system is developed with the aid of artificial intelligence(AI)techniques to make speedy decisions and be free of human *** is a computer-based system that can be activated by the voice of the air traffic controller and then appropriately assist to control the *** identifies the words spoken by the controller and then a virtual assistant navigates to collect the data requested from the controllers,which allows additional or free time to the controllers to contemplate more on the work or could assist to another *** Google speech application programming interface(API)converts audio to text to recognize *** agent is trained using the Hidden marko model(HMM)algorithm such that it could learn the characteristics of the distinct voices of the *** this stage,the proposed IVAS can be used to provide training for novice air traffic controllers *** system is to be developed as a real-time system which could be used at the air traffic controlling base fo

关键词： Artificial Intelligence Air Traffic Controller Intelligent Virtual Assistant

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Acute coagulopathy of trauma: Mechanism, monitoring, management

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World Journal of Anesthesiology 2014年第1期3卷 111-118页

作者： anusha Cherian Bidkar Prasanna Udupi Department of Anaesthesiology and Critical Care Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry 605006India

Coagulopathy is a well-known consequence of trauma and is the most common cause of mortality in the young. However, its cause and management is still controversial. A new concept in the understanding of coagulopathy in trauma is the occurrence of Acute coagulopathy of trauma(ACo T). ACo T is associated with hypo perfusion and tissue trauma as seen in massive injury. The incidence of coagulopathy increases with injury scores and is associated with higher number of ventilator days, higher morbidity and mortality. The process of coagulation is better described by the cell based model with a central role for platelets rather than the older plasma based model. This shift in our understanding supports the theory that ACo T results from the endothelial release of thrombomodulin and activated protein C in the presence of hypoperfusion. This in turn leads on to a hyperfibrinolytic and hypocoagulable state. Viscoelastic hemostatic assays are replacing the older tests like prothrombin time in the assessment of coagulopathy. These tests are accurate, determine the need for transfusion and can be performed at the point of care. Damage control resuscitation includes newer concepts like permissive hypotension, increased use of plasma as a part of massive transfusion protocols and damage control surgery.

关键词： Trauma Coagulopathy Massive transfusion Bleeding Thromboelastography

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Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects

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World Journal of Clinical Cases 2022年第24期10卷 8450-8462页

作者： Amanina Ahmad Safri Che Mohd Nasril Che Mohd Nassir Ismail Nurul Iman Nur Hartini Mohd Taib anusha Achuthan Muzaimi Mustapha Department of Neurosciences School of Medical SciencesUniversiti Sains MalaysiaHealth CampusKubang Kerian 16150KelantanMalaysia Department of Radiology School of Medical SciencesUniversiti Sains MalaysiaHealth CampusKubang Kerian 16150KelantanMalaysia School of Computer Sciences Universiti Sains Malaysia11800 USMPenangMalaysia Department of Neurosciences Hospital Universiti Sains MalaysiaKubang Kerian 16150KelantanMalaysia

Cerebral small vessel disease(CSVD)is a leading cause of age-related microvascular cognitive decline,resulting in significant morbidity and decreased quality of *** a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging(MRI),key questions on CSVD remain *** relationships and reliable lesion studies,such as white matter tractography using diffusion-based MRI(dMRI)are necessary in order to improve the assessment of white matter architecture and connectivity in *** tensor imaging(DTI)and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter ***,due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting,interpreting the findings remain contentious,especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical *** this minireview,we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD,even for subclinical CSVD in at-risk individuals.

关键词： Diffusion tensor imaging White matter Cerebral small vessel disease Pipeline processing Tractography

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The Role of Efferent Reduction of Cochlear Compression in the Detection of Tones in Noise

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Open Journal of Acoustics 2017年第3期7卷 69-82页

作者： Shaum P. Bhagat anusha Yellamsetty School of Communication Sciences and Disorders The University of Memphis Memphis TN USA

Stimulation of medial olivocochlear (MOC) efferent neurons reduces basilar membrane (BM) sensitivity and increases the slope of BM input-output (I/O) functions in animal models. Decreased compression of I/O functions associated with activation of MOC efferent neurons may assist in extending the neural response to the tone above that of noise, leading to an improvement in masked thresholds. To evaluate this hypothesis, the distortion-product otoacoustic emission (DPOAE) I/O function, a proxy measure of BM compression, was examined in conditions with presentation of contralateral noise. DPOAE I/O functions were measured at f2 frequencies of 1000 and 2000 Hz in 16 normal-hearing adults. In each subject, estimation of masked thresholds at 1000 and 2000 Hz was provided by a two-interval forced-choice procedure. There were statistically significant associations between DPOAE I/O function slopes and masked tone thresholds at both 1000 and 2000 Hz. At 1000 Hz, individuals with higher DPOAE I/O function slopes exhibited lower masked thresholds. Data at 2000 Hz indicated that individuals with higher masked thresholds exhibited higher DPOAE I/O function slopes. When measured with contralateral noise, DPOAE I/O function slopes were linked to masked thresholds at both frequencies examined in this study. Linearized DPOAE I/O functions presumably reflect linearized BM growth functions under conditions of MOC efferent activation, and this process may have extended the neural response to the signal tone so that it could be more easily heard in the presence of masking noise under certain conditions examined in this study.

关键词： Cochlea Masking Otoacoustic Emissions Suppression Humans

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