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Performance of Non-invasive Blood Parameters for Ruling Out Significant Liver Fibrosis in Patients with Chronic Hepatitis B

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Journal of Clinical and Translational Hepatology 2020年第2期8卷 143-149页

作者： Shivam Khare Anil arora Praveen Sharma Shashi Dhawan Naresh Bansal Vikas Singla ashish Kumar Institute of Liver Gastroenterology&Pancreatico-Biliary SciencesSir Ganga Ram HospitalNew DelhiIndia Department of Histopathology Sir Ganga Ram HospitalNew DelhiIndia

Background and Aims:Evaluation of significant liver fibro-sis is important for treatment decision and treatment re-sponse evaluation in patients with chronic hepatitis B. Since liver biopsy is invasive and transient elastography (TE) has limited availability, various non-invasive blood parameters need evaluation for their capabilities for detection of signifi-cant fibrosis. Methods:In this retrospective study, records of patients who had undergone liver biopsy for treatment-na?ve chronic hepatitis B were evaluated to obtain various non-in-vasive blood parameters (aspartate aminotransferase-to-pla-telet ratio index [referred to as APRI], Fibrosis-4 score [referred to as FIB-4], gamma-glutamyl transpeptidase-to-platelet ratio [referred to as GPR], and gamma-glutamyl transpeptidase-to-albumin ratio [referred to as GAR]), in ad-dition to TE, to assess significant liver fibrosis and compare these to fibrosis stage in liver biopsy. Results:A total of 113 patients were included in the study (median age 33 [inter-quartile range: 11-82 years], 74% males). Most (75%) pa-tients were HBeAg-negative. The liver biopsy revealed significant fibrosis (Ishak ≥3) in 13% of the patients and nil or mild fibrosis (Ishak<3) in 87%of the patients. TE findings were available for 85 patients, APRI and FIB-4 for 95 patients, GPR for 79 patients, and GAR for 78 patients. The median values of all the parameters were significantly higher in pa-tients with significant fibrosis, as compared to patients with non-significant fibrosis, and all the blood parameters as well as TE were able to identify patients with significant fibrosis significantly well (p<0.05). All non-invasive parameters had low positive predictive value but negative predictive value above 92%. Compared to TE, all the non-invasive blood pa-rameters had similar area under the curve for detecting sig-nificant fibrosis, with excellent negative predictive value (≥93%). Conclusions: Non-invasive blood parameters (APRI, FIB-4, GPR, and G

关键词： Hepatitis B Liver fibrosis Cirrhosis Transient elastography APRI FIB-4 GPR GAR

Recent updates on the biological basis of heterogeneity in bone marrow stromal cells/ skeletal stem cells

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Biomaterials Translational 2022年第1期3卷 3-16页

作者： Deepika arora Pamela Gehron Robey National Institute of Dental and Craniofacial Research National Institutes of HealthDepartment of Health and Human ServicesBethesdaMDUSA Biosystems and Biomaterials Division National Institute of Standards and TechnologyDepartment of CommerceGaithersburgMDUSA Department of Biotechnology School of Biological Engineering&Life SciencesShobhit Institute of Engineering&Technology(Deemed-to-be-University)MeerutIndia

Based on studies over the last several decades,the self-renewing skeletal lineages derived from bone marrow stroma could be an ideal source for skeletal tissue ***,the markers for osteogenic precursors;i.e.,bone marrow-derived skeletal stem cells(SSCs),in association with other cells of the marrow stroma(bone marrow stromal cells,BMSCs)and their heterogeneous nature both in vivo and in vitro remain to be *** review aims to highlight:i)the importance of distinguishing BMSCs/SSCs from other“mesenchymal stem/stromal cells”,and ii)factors that are responsible for their heterogeneity,and how these factors impact on the differentiation potential of SSCs towards *** prospective role of SSC enrichment,their expansion and its impact on SSC phenotype is *** has also been given to emerging single cell RNA sequencing approaches in scrutinizing the unique population of SSCs within the BMSC population,along with their committed *** the factors involved in heterogeneity may help researchers to improvise their strategies to isolate,characterize and adopt best culture practices and source identification to develop standard operating protocols for developing reproducible stem cells ***,more scientific understanding of the molecular basis of heterogeneity is warranted that may be obtained from the robust high-throughput functional transcriptomics of single cells or clonal populations.

关键词： bone marrow stromal cells clonal analysis heterogeneity single cell analysis skeletal stem cells

Correlation of transient elastography with hepatic venous pressure gradient in patients with cirrhotic portal hypertension: A study of 326 patients from India

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World Journal of Gastroenterology 2017年第4期23卷 687-696页

作者： ashish Kumar Noor Muhammad Khan Shrihari Anil Anikhindi Praveen Sharma Naresh Bansal Vikas Singla Anil arora Institute of Liver Gastroenterologyand Pancreatico-Biliary SciencesGanga Ram Institute for Postgraduate Medical Education and ResearchSir Ganga Ram HospitalNew Delhi 110060India

AIM To study the diagnostic accuracy of transient elastography(TE) for detecting clinically significant portal hypertension(CSPH) in Indian patients with cirrhotic portal *** This retrospective study was conducted at the Institute of Liver, Gastroenterology, and Panceatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient(HVPG) and TE from July 2011 to May 2016. Correlation between HVPG and TE was analyzed using the Spearman's correlation test. Receiver operating characteristic ( ROC) curves were prepared for determining the utility of TE in predicting various stages of portal hypertension. The best cut-off value of TE forthe diagnosis of CSPH was obtained using the Youden *** The study included 326 patients [median age 52(range 16-90) years; 81% males]. The most common etiology of cirrhosis was cryptogenic(45%) followed by alcohol(34%). The median HVPG was 16.0(range 1.5 to 30.5) mm Hg. Eighty-five percent of patients had CSPH. A significant positive correlation was noted between TE and HVPG(rho 0.361, P < 0.001). The area under ROC curve for TE in predicting CSPH was 0.740(95%CI: 0.662-0.818)(P < 0.01). A cut-off value of TE of 21.6 k Pa best predicted CSPH with a positive predictive value(PPV) of 93%.CONCLUSION TE has a fair positive correlation with HVPG; thus, TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 21.6 k Pa identifies CSPH with a PPV of 93%.

关键词：门高血压肝硬化临床上重要的门高血压肝僵硬短暂 elastography FibroScan

Association of Overt Diabetes Mellitus with the Non-CC but not the CC Genotype of Interleukin-28B in Hepatitis C Virus Infected Patients

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Journal of Clinical and Translational Hepatology 2016年第1期4卷 26-31页

作者： ashish Kumar Varun Gupta Praveen Sharma Naresh Bansal Vikas Singla Anil arora Institute of Liver Gastroenterology & Panceatico-Biliary Sciences Sir Ganga Ram Hospital New Delhi India

Background:Interleukin-28B (IL-28B) polymorphism is an important predictor for hepatitis C virus (HCV) treatment *** IL-28b genotypes also influence other nontreatment related clinical parameters is ***:Patients with HCV-related chronic liver diseases who attended our department during 2012-2014 were retrospectively *** single nucleotide polymorphisms (SNPs) of rs12979860 (IL-28B) were correlated with various clinical *** also compared these parameters in patients with and without overt diabetes to identify possible ***:A total of 115 patients were included (median age 48,range 15-76 years;70% males).Overall,43/115(37%) patients had chronic hepatitis,while the remaining 72/115 (63%) had *** most common IL-28B genotype was CC,which was found in 53% of patients (61/115),while the remaining 47% were nonCC [CT 42% (48/115) and T-r 5% (6/115)].Clinical and laboratory parameters like Hb,white blood cell (WBC),platelets,bilirubin,transaminases,and albumin were similar in the CC and nonCC *** diabetes mellitus was present in 22% (25/115) of *** with nonCC genotype had significantly higher prevalence of overt diabetes mellitus than patients with CC genotype (31% [17/54] versus 13% [8/61];p < 0.05).When parameters were compared in patients with and without overt diabetes mellitus,only IL-28B and age were significantly associated with overt diabetes mellitus (p < 0.05).Conclusion:In HCV patients,overt diabetes mellitus was more commonly associated with the nonCC genotype of IL-28B than the CC *** of the T-allele of SNP rs12979860 were more likely to have insulin resistance than CC homozygotes,and this finding may explain the higher prevalence of diabetes in non-CC ***,an IL-28B test may be useful in patients of HCV in order to determine their likelihood of developing diabetes mellitus.

关键词： Chronic hepatitis C Diabetes mellitus Cirrhosis IL-28B Chronic liver disease Insulin resistance

MCBC-SMOTE:A Majority Clustering Model for Classification of Imbalanced Data

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Computers, Materials & Continua 2022年第12期73卷 4801-4817页

作者： Jyoti arora Meena Tushir Keshav Sharma Lalit Mohan Aman Singh Abdullah Alharbi Wael Alosaimi Department of Information Technology MSITGGSIPUNew Delhi110058India Department of Electrical and Electronic Engineering MSITGGSIPUNew Delhi110058India School of Computer Science and Engineering Lovely Professional University144411PunjabIndia Department of Information Technology College of Computers and Information TechnologyTaif University11099Taif 21944Saudi Arabia

Datasets with the imbalanced class distribution are difficult to handle with the standard classification *** supervised learning,dealing with the problem of class imbalance is still considered to be a challenging research *** machine learning techniques are designed to operate on balanced datasets;therefore,the state of the art,different undersampling,over-sampling and hybrid strategies have been proposed to deal with the problem of imbalanced datasets,but highly skewed datasets still pose the problem of generalization and noise generation during *** overcome these problems,this paper proposes amajority clusteringmodel for classification of imbalanced datasets known as MCBC-SMOTE(Majority Clustering for balanced Classification-SMOTE).The model provides a method to convert the problem of binary classification into a multi-class *** the proposed algorithm,the number of clusters for themajority class is calculated using the elbow method and the minority class is over-sampled as an average of clustered majority classes to generate a symmetrical class *** proposed technique is cost-effective,reduces the problem of noise generation and successfully disables the imbalances present in between and within *** results of the evaluations on diverse real datasets proved to provide better classification results as compared to state of the art existing methodologies based on several performance metrics.

关键词： Imbalance class problem classification SMOTE k-means clustering sampling

Particle Swarm Optimization for Solving Sine-Gordan Equation

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Computer Systems Science & Engineering 2023年第6期45卷 2647-2658页

作者： Geeta arora Pinkey Chauhan Muhammad Imran Asjad Varun Joshi Homan Emadifar Fahd Jarad Lovely Professional University Punjab144118India Jaypee Institute of Information Technology Noida201304India Department of Mathematics University of Management and TechnologyLahore54770Pakistan Department of Mathematics Hamedan BranchIslamic Azad UniversityHamedanIran Department of Mathematics Cankaya UniversityEtimesgutAnkara06790Turkey Department of Mathematics King Abdulaziz UniversitySaudi Arabia Department of Medical Research China Medical University HospitalChina Medical UniversityTaichungTaiwan

The term‘optimization’refers to the process of maximizing the beneficial attributes of a mathematical function or system while minimizing the unfavorable *** majority of real-world situations can be modelled as an optimization *** complex nature of models restricts traditional optimization techniques to obtain a global optimal solution and paves the path for global optimization *** Swarm Optimization is a potential global optimization technique that has been widely used to address problems in a variety of *** idea of this research is to use exponential basis functions and the particle swarm optimization technique to find a numerical solution for the Sine-Gordan equation,whose numerical solutions show the soliton form and has diverse *** implemented optimization technique is employed to determine the involved parameter in the basis functions,which was previously approximated as a random number in the work reported till now in the *** obtained results are comparable with the results obtained in the *** work is presented in the form of figures and tables and is found encouraging.

关键词： Differential quadrature method B-spline particle swarm optimization Sine-Gordan equation

Evaluating factors associated with the risk of hydrothorax following standard supracostal percutaneous nephrolithotomy

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Asian Journal of Urology 2022年第3期9卷 301-306页

作者： Pankaj N.Maheshwari Amandeep arora Mahesh S.Sane Vivek Jadhao Department of Urology Fortis Hospital MulundMumbaiIndia

Objective:To report our experience with supracostal percutaneous nephrolithotomy(SC-PNL)and evaluate factors which could predict the risk of hydrothorax following ***:We reviewed 347 patients who underwent SC-PNL from January 2011 to December *** were assessed for demographic characteristics,indication for the supracostal access,level of supracostal access,anatomy of the kidney(normal or malrotated),site of the puncture in relation to the mid-scapular line(medial or lateral),and whether another subcostal tract for stone clearance was required or *** were assessed for the incidence of hydrothorax and requirement of intercostal drain depending on the level of percutaneous *** addition,a multivariable logistic regression analysis model was developed to identify factors which could predict the occurrence of hydrothorax following ***:Of the 347 patients with SC-PNL,248(71.5%)underwent a supra-12th rib approach,while the rest needed a supra-11th(n=85;24.5%)or a supra-10th(n=14;4.0%)rib ***,17(4.9%)patients developed a hydrothorax,while an intercostal-drain was required in seven of these 17 patients for 48 *** of the patients with a supra-12th rib puncture required an *** than a third of the patients with a supra-10th puncture developed a hydrothorax(35.7%)and all of them required an intercostal *** such as anteriorly malrotated kidney(odds ratio[OR]=2.722;95%confidence interval[CI]=1.042-5.617,p=0.03),puncture medial to the mid-scapular line(OR=1.669;CI=0.542-1.578,p=0.03),and an access higher than the supra-12th level(OR=5.265;CI=1.292-9.342,p<0.001)proved to be independent predictors of hydrothorax following a SC-PCNL on multivariable ***:Incidence of clinically significant hydrothorax requiring an intercostal-drain after SC-PNL is very *** of the predicting factors will help to anticipate the risk of hydrothorax in a particular patient and take necessary p

关键词： Calculous disease Stone Supracostal Percutaneous nephrolithotomy Hydrothorax

Preventable iatrogenic cause of foot-drop in knee injuries with literature review

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Chinese Journal of Traumatology 2022年第4期25卷 224-231页

作者： Anant Krishna Sumit arora Rakesh Goyal Manish Kumar Nirup Naik Manoj Kumar Department of Orthopaedics All India Institute of Medical SciencesAnsari NagarNew Delhi110029India Department of Orthopaedic Surgery Maulana Azad Medical College&Associated Lok Nayak HospitalNew Delhi110002India

Purpose Common peroneal nerve palsy is quite disabling and every effort should be made to prevent its injury during the *** We retrospectively reviewed the prospectively collected data of 7 cases of tibial plateau fractures in association with proximal fibula fracture from January 2019 to September 2019 who presented to emergency room of our *** In addition to fibular neck fracture,the first case had type 6 tibial plateau displaced fracture and the second case had displaced acetabular fracture with instability of knee with tibial tuberosity *** peroneal nerve palsy developed following application of distal tibial skeletal traction in both the *** 6 such cases remained neurologically intact as traction was not applied to *** Such iatrogenic complication could have been prevented if the injury pattern of"concomitant medial and lateral columns"of the proximal leg is kept in mind by the treating surgeon before applying skeletal traction.

关键词： Common peroneal neuropathies Tibial plateau fractures Proximal fibula fractures Traction palsy

Currencies of greater interest for central Asian economies:an analysis of exchange market pressure amid global and regional interdependence

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Financial Innovation 2023年第1期9卷 1275-1292页

作者： Devendra Kumar Jain Naqeeb Ur‑Rehman Omonjon Ganiev Kapil arora Flame School of Business Flame UniversityPuneIndia School of Economics Westminster International UniversityTashkentUzbekistan School of Business&Economics Westminster International University in TashkentTashkentUzbekistan Alliance School of Business Alliance UniversityBangaloreIndia

Central Asian Economies(CAEs)have diverse exchange rate *** have recorded higher volatility in the foreign exchange market since *** volatility of the transition era has drifted these economies towards partial *** authorities in CAEs,(already have a challenge of maintaining monetary policy autonomy)have a gigantic task of price stability and stopping the spread of *** study is directed towards assessing the drivers and the determinants of foreign exchange market pressure in *** results,based on panel data analysis and the System GMM model,have provided useful insights about the exchange market pressure determinants particularly USD,Euro,Ruble,and *** results show that China and Russia exchange market pressure has a negative effect on the exchange market pressure of *** the dollar index shows a positive impact on the exchange market pressure of ***,the findings imply that China and Russia currency appreciation results in a trade deficit across *** policy implication suggests that the floating exchange rate regime(inflation targeting regime)is not in favor of CAEs,and they must use managed-float to reduce their trade deficits.

关键词： Exchange market pressures Central Asian economies Exchange markets Financial market Interdependence Transition economies