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Sepsis during short bowel syndrome hospitalizations:Identifying trends,disparities,and clinical outcomes in the United States

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 26-36页

作者： Dushyant Singh Dahiya Jennifer Wachala Shantanu Solanki Dhanshree Solanki asim Kichloo Samantha Holcomb Uvesh Mansuri Khwaja Saad Haq Hassam Ali Manesh kumar Gangwani Yash R Shah Teresa Varghese Hafiz Muzaffar Akbar Khan Simon Peter Horslen Thomas D Schiano Syed-Mohammed Jafri Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Division of Gastroenterology Hepatology&Nutrition The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Medicine Institute for Foreign Medical Graduate EducationHoustonTX 77030United States Department of Internal Medicine MedStar Harbor HospitalBaltimoreMD 21225United States Department of Internal Medicine WellStar Spalding Regional HospitalGriffinGA 30224United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology SUNY Upstate Medical UniversitySyracuseNY 13210United States Department of Pediatrics School of Medicine and UPMC Children’s Hospital of PittsburghUniversity of PittsburghPittsburghPA 15219United States Division of Liver Diseases Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Division of Gastroenterology and Hepatology Henry Ford HospitalDetroitMI 48202United States

BACKGROUND Short bowel syndrome(SBS)hospitalizations are often complicated with *** is a significant paucity of data on adult SBS hospitalizations in the United States and across the *** To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United *** The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between *** study cohort was further divided based on the presence or absence of *** were identified,and hospitalization characteristics and clinical outcomes were *** of mortality for SBS hospitalizations complicated with sepsis were *** Of 247097 SBS hospitalizations,21.7%were complicated by *** SBS hospitalizations had a rising trend of hospitalizations from 20.8%in 2005 to 23.5%in 2014(P trend<0.0001).Compared to non-septic SBS hospitalizations,septic SBS hospitalizations had a higher proportion of males(32.8%vs 29.3%,P<0.0001),patients in the 35-49(45.9%vs 42.5%,P<0.0001)and 50-64(32.1%vs 31.1%,P<0.0001)age groups,and ethnic minorities,i.e.,Blacks(12.4%vs 11.3%,P<0.0001)and Hispanics(6.7%vs 5.5%,P<0.0001).Furthermore,septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation(0.33%vs 0.22%,P<0.0001),inpatient mortality(8.5%vs 1.4%,P<0.0001),and mean length of stay(16.1 d vs 7.7 d,P<0.0001)compared to the non-sepsis cohort.A younger age,female gender,White race,and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS *** Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

关键词： Short bowel syndrome Sepsis Outcomes Mortality Trends

Diabetes among Muslims during Ramadan:A narrative review

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世界临床病例杂志 2023年第26期11卷 6031-6039页

作者： Rohan kumar Ochani asim Shaikh Simran Batra Gauri Pikale Salim Surani Internal Medicine SUNY Upstate Medical University HospitalSyracuseNY 13210United States Medicine Aga Khan UniversitySindhKarachi 74500Pakistan Internal Medicine Dow University of Health SciencesSindhKarachi 74200Pakistan Internal Medicine Chicago Medical School at Rosalind Franklin UniversityChicagoIL 60064United States Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States Medicine Aga Khan UniversityNairobi 00100Kenya

Fasting during the month of Ramadan is one of the five fundamental principles of Islam,and it is obligatory for healthy Muslim adults and *** the fasting month,Muslims usually have two meals a day,suhur(before dawn)and iftar(after dusk).However,diabetic patients may face difficulties when fasting,so it is important for medical staff to educate them on safe fasting *** strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis,but with proper knowledge,careful planning,and medication adjustment,diabetic Muslim patients can fast during *** this review,a literature search was conducted using PubMed and Google Scholar until May *** other than the English language were *** strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition,regular monitoring of blood glucose,medications,and insulin *** therapy can be continued during fasting if properly titrated to the patients’needs,and finger prick blood sugar levels should be assessed *** certain symptoms such as hypoglycemia,hyperglycemia,dehydration,or acute illness occur,or blood glucose levels become too high(>300 mg/dL)or too low(<70 mg/dL),the fast should be *** insulin formulations such as pegylated insulin and medications like tirzepatide,a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors,have shown promise in managing blood sugar levels during ***-insulin dependent medications like sodium-glucose-cotransporter-2 inhibitors,including the Food and Drug Administration-approved ertugliflozin,are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.

关键词： Ramadan Fasting Diabetes Complications Insulin therapy Newer advances Hypoglyccemia

Inhibiting Protein Aggregation by Small Molecule-Based Colloidal Nanoparticles

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Accounts of Materials Research 2022年第1期3卷 54-66页

作者： Koushik Debnath Ankan kumar Sarkar Nihar R.jana Nikhil R.jana Department of Pharmacology and Regenerative Medicine College of MedicineUniversity of Illinois at ChicagoChicagoIllinois 60612United States Department of Biomedical Engineering College of MedicineUniversity of Illinois at ChicagoChicagoIllinois 60607United States School of Materials Sciences Indian Association for the Cultivation of ScienceKolkata 700032India

CONSPECTUS:Protein aggregation is associated with different human diseases such as Alzheimer’s,Huntington’s,Parkinson’s,diabetes type II,and *** no effective treatment exists for many of these diseases,particularly for neurological *** research focuses on understanding the origin of protein aggregation,nucleation−growth mechanism of protein aggregation,origin of cytotoxicity of protein aggregates,cellular response of toxic protein aggregates,progress of diseases at intra/extracellular space,and drug developments for respective *** issues are the identification of molecular drugs that can inhibit protein aggregation at early stage,lowering of toxicity due to protein aggregates,delivery of drugs to remote organ and intracellular space,clearing matured protein aggregates from cell/extracellular space/brain,and design of effective therapeutic *** and materials scientists have identified a wide variety of antiamyloidogenic small molecules,macromolecules,and *** is shown that antiamyloidogenic molecules prevent protein oligomerization via binding to protein,masking metal ions(via chelating with metal ions)that are responsible for protein aggregation via generating reactive oxygen species(ROS),and lowering protein−protein interaction via macromolecular crowding ***,nanoscale materials with curved surface and multiple chemical functional groups act as adsorption/binding sites of proteins,modulate nucleation−growth kinetics of protein aggregation,and delay/inhibit protein aggregation in many ***,performance of all these antiamyloidogenic materials needs significant improvement,and proper therapeutic strategies are required for effective drug *** this Account,we describe that the performance of antiamyloidogenic molecules can be greatly improved via appropriate design into colloidal and nanoparticle *** first discuss different human diseases that are linked with protein agg

关键词： integrating Huntington curved

Phosphorus partitioning and recovery of low-phosphorus iron-rich compounds through physical separation of Linz-Donawitz slag

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International Journal of Minerals,Metallurgy and Materials 2016年第7期23卷 751-759页

作者： Dilip Makhija Rajendra kumar Rath Kaushik Chakravarty Abhay Shankar Patra asim kumar Mukherjee Akhilesh kumar Dubey Research and Development Division Tata Steel Ltd. Mineral Processing Division CSIR-National Metallurgical Laboratory Raw Material Blending and Bedding Section Tata Steel Ltd.

The Linz-Donawitz（LD） steelmaking process produces LD slag at a rate of about 125 kg/t. After metallic scrap recovery, the non-metallic LD slag is rejected because its physical/chemical properties are unsuitable for recycling. X-ray diffraction（XRD） studies have indicated that non-metallic LD slag contains a substantial quantity of mineral phases such as di- and tricalcium silicates. The availability of these mineral phases indicates that LD slag can be recycled by iron（Fe）-ore sintering. However, the presence of 1.2wt% phosphorus（P） in the slag renders the material unsuitable for sintering operations. Electron probe microscopic analysis（EPMA） studies indicated concentration of phosphorus in dicalcium silicate phase as calcium phosphate. The Fe-bearing phases（i.e., wustite and dicalcium ferrite） showed comparatively lower concentrations of P compared with other phases in the slag. Attempts were made to lower the P content of LD slag by adopting various beneficiation techniques. Dry high-intensity magnetic separation and jigging were performed on as-received samples with particle sizes of 6 and 3 mm. Spiral separation was conducted using samples ground to sizes of less than 1 and 0.5 mm. Among these studies, grinding to 0.5 mm followed by spiral concentration demonstrated the best results, yielding a concentrate with about 0.75wt% P and 45wt% Fe.

关键词： steelmaking slag dephosphorization recycling

Effect of Sintering Temperature and Heating Rate on Crystallite Size,Densification Behaviour and Mechanical Properties of Al-MWCNT Nanocomposite Consolidated via Spark Plasma Sintering

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Acta Metallurgica Sinica(English Letters) 2018年第10期31卷 1019-1030页

作者： Lavish kumar Singh Alok Bhadauria Subhodeep jana Tapas Laha Department of Metallurgical and Materials Engineering Indian Institute of Technology Kharagpur Kharagpur India Centre for Healthcare Science and Technology Indian Institute of Engineering Science and Technology Shibpur India

Powder mixture of ball-milled aluminium and functionalized multi-walled carbon nanotubes was compacted via spark plasma sintering （SPS） to study effects of sintering temperature and heating rate. An increase in sintering temperature led to an increase in crystallite size and density, whereas an increase in heating rate exerted the opposite effect. The crystallite size and relative density increased by 85.0% and 14.3%, respectively, upon increasing the sintering temperature from 400 to 600℃, whereas increasing the heating rate from 25 to 100 ℃/min led to respective reduction by 30.0% of crystallite size and 1.8% of relative density. The total punch displacement during SPS for the nanocomposite sintered at 600 ℃ （1.96 mm） was much higher than that of the sample sintered at 400 ℃ （1.02 mm） confirming positive impact of high sintering temperature on densification behaviour. The maximum improvement in mechanical properties was exhibited by the nanocomposite sintered at 600 ℃ at a heating rate of 50℃/min displaying microhardness of 81 4- 3.6 VHN and elastic modulus of 89 4- 5.3 GPa. The nanocomposites consolidated at 400 ℃ and 100 ℃/min, in spite of having relatively smaller crystallite size, exhibited poor mechanical properties indicating the detrimental effect of porosity on the mechanical properties.

关键词： Al nanocomposite Multi-walled carbon nanotubes Ball milling Spark plasma sintering Densification behaviour Mechanical properties

In-depth investigation on physicochemical and thermal properties of magnesium(Ⅱ) gluconate using spectroscopic and thermoanalytical techniques

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Journal of Pharmaceutical Analysis 2017年第5期7卷 332-337页

作者： Mahendra kumar Trivedi Neena Dixit Parthasarathi Panda Kalyan kumar Sethi Snehasis jana Trivedi Global Inc. National Institute of Technology Trivedi Science Research Laboratory Pvt.Ltd.

Magnesium gluconate is a classical organometallic pharmaceutical compound used for the prevention and treatment of hypomagnesemia as a source of magnesium ion. The present research described the in-depth study on solid state properties viz. physicochemical and thermal properties of magnesium gluconate using sophisticated analytical techniques like Powder X-ray diffraction(PXRD), particle size analysis(PSA),Fourier transform infrared(FT-IR) spectrometry, ultraviolet–visible(UV–Vis) spectroscopy, thermogravimetric analysis(TGA)/differential thermogravimetric analysis(DTG), and differential scanning calorimetry(DSC).Magnesium gluconate was found to be crystalline in nature along with the crystallite size ranging from 14.10 to47.35 nm. The particle size distribution was at d(0.1)=6.552 μm, d(0.5)=38.299 μm, d(0.9)=173.712 μm and D(4,3)=67.122 μm along with the specific surface area of 0.372 m^2/g. The wavelength for the maximum absorbance was at 198.0 nm. Magnesium gluconate exhibited 88.51% weight loss with three stages of thermal degradation process up to 895.18 °C from room temperature. The TGA/DTG thermograms of the analyte indicated that magnesium gluconate was thermally stable up to around 165 °C. Consequently, the melting temperature of magnesium gluconate was found to be 169.90 °C along with the enthalpy of fusion of 308.7 J/***, the authors conclude that the achieved results from this study are very useful in pharmaceutical and nutraceutical industries for the identification, characterization and qualitative analysis of magnesium gluconate for preformulation studies and also for developing magnesium gluconate based novel formulation.

关键词： Magnesium gluconate Solid state properties Particle size analysis Thermal analysis Spectroscopic analysis

Overview of milling techniques for improving the solubility of poorly water-soluble drugs

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Asian Journal of Pharmaceutical Sciences 2015年第4期10卷 255-274页

作者： Zhi Hui Loh asim kumar Samanta Paul Wan Sia Heng GEANUS Pharmaceutical Processing Research Laboratory Department of PharmacyNational University of Singapore18 Science Drive 4Singapore 117543Singapore Janssen India Department of PDMS-SMMD-ADJohnson&Johnson Ltd.Higi HouseOpp Ralli WolfLBS MargMulund(W)Mumbai 400080India

Milling involves the application of mechanical energy to physically break down coarse particles to finer ones and is regarded as a“topedown”approach in the production of fine *** drug particulates are especially desired in formulations designed for parenteral,respiratory and transdermal *** drugs after crystallization may have to be comminuted and this physical transformation is required to various extents,often to enhance processability or solubility especially for drugs with limited aqueous *** mechanisms by which milling enhances drug dissolution and solubility include alterations in the size,specific surface area and shape of the drug particles as well as millinginduced amorphization and/or structural disordering of the drug crystal(mechanochemical activation).Technology advancements in milling now enable the production of drug micro-and nano-particles on a commercial scale with relative *** review will provide a background on milling followed by the introduction of common milling techniques employed for the micronization and nanonization of *** information contained in the cited examples are further extracted and summarized for ease of reference by researchers keen on employing these techniques for drug solubility and bioavailability enhancement.

关键词： Drug solubility Fluid energy milling Ball milling Media milling High pressure homogenization Cryomilling

Clinical outcome of orbital apex syndrome in COVID associated mucormycosis patients in a tertiary care hospital

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International Journal of Ophthalmology(English edition) 2022年第4期15卷 527-532页

作者： Smiti Rani Srivastava Purban Ganguly Debasis Barman Sudip Das Manimoy Bandyopadhyay asim kumar Ghosh Subhra Sarkar Amitabha Sengupta Sarbari Swaika Pritam Chatterjee Amit kumar Gupta Alok Ranjan Mondal Soumyajit Guha Sinjita Dutta Souvik Adhikari Aditi Kaushik Partha Sundar Biswas Asif Ayub Department of Ophthalmology Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial HospitalKolkata 999008India

AIM: To share clinical pattern of presentation, the modalities of surgical intervention and the one month postsurgical outcome of rhino-orbito-mucormycosis(ROCM) ***: All COVID associated mucormycosis(CAM) patients underwent comprehensive multidisciplinar y examination by ophthalmologist, otorhinolaryngologist and physician. Patients with clinical and radiological evidence of orbital apex involvement were included in the study. Appropriate medical and surgical intervention were done to each patient. Patients were followed up one-month post intervention. RESULTS: Out of 89 CAM patients, 31(34.8%) had orbital apex syndrome. Sixty-six(74.2%) of such patients had pre-existing diabetes mellitus, 18(58%) patients had prior documented use of steroid use, and 55(61.8%) had no light perception(LP) presenting vision. Blepharoptosis, proptosis, complete ophthalmoplegia were common clinical findings. Seventeen(19.1%) of such patients had variable amount of cavernous sinus involvement. Endoscopic debridement of paranasal sinuses and orbit with or without eyelid sparing limited orbital exenteration was done in most cases, 34(38.2%) patients could retain vision in the affected eye. CONCLUSION: Orbital apex involvement in CAM patients occur very fast. It not only leads to loss of vision but also sacrifice of the eyeball, orbital contents and eyelids. Early diagnosis and prompt intervention can preserve life, vision and spare mutilating surgeries.

关键词： rhino-orbito-cerebral mucormycosis COVID associated mucormycosis orbital exenteration endoscopic paranasal sinus debridement orbital apex syndrome

A nonautonomous mat hematical model to assess the impact of algae on the abatement of atmospheric carbon dioxide

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International Journal of Biomathematics 2021年第7期14卷 227-264页

作者： Pankaj kumar Tiwari Rajesh kumar Singh Debaldev jana Yun Kang Arvind kumar Misra Department of Basic Science and Humanities Indian Institute of Information Technology Bhagalpur 813210 India Government Shahid Kedamath P.G.College Mauganj Rewa 486331India Department of Mathematics&SRM Research Institute SRM Institute of Science and Technology Kattankulathur 603203 Tamil NaduIndia Science and Mathematics Faculty Arizona State University Mesa AZ 85212USA Department of Mathematics Institute of Science Banaras Hindu UniversityVaranasi 221005India

The world's oceans have played an important role in sequestering atmospheric carbon dioxide through solubility and the action of *** of atmospheric carbon dioxide by photoautotrophic algal cultures has the potential to diminish the release of carbon dioxide into the atmosphere,thereby helping to alleviate the trend toward global *** work investigates the role of algae in controlling the level of atmospheric carbon *** Rank Correlation Coefficients(PRCCs)technique is used to address how the concentration of atmospheric carbon dioxide is affected by changes in a specific parameter disregarding the uncertainty over the rest of the model *** related to algal growth are shown to significantly reduce the level of atmospheric CO_(2).Further,we explore the dynamics of nonautonomous system by incorporating the seasonal variations of sonic ecologically important model *** nonautonomous system exhibits globally attractive positive periodic solution,and also the appearance of double periodic solution is ***,by letting the seasonally forced parameters as almost periodic functions of time,we show almost periodic behavior of the *** findings suggest that the policy makers should focus on continuous addition of nutrients in the ocean to accelerate the algal growth thereby reducing the level of carbon dioxide in the atmosphere.

关键词： Mathematical model algae atmospheric CO2 sensitivity analysis:seasonality periodic solution