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The Training and Performance of Emergency Physicians as Anesthetists for International Medical Surgical Response Teams: The Emergency Physician’s General Anesthesia Syllabus (EP GAS)

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Open Journal of Anesthesiology 2014年第2期4卷 53-61页

作者： Richard Skupski Mark Walsh Manar Jbara Donald Zimmer bhavesh M. patel Michael T. McCurdy James Lantry Braxton Fritz Patrick Davis Harsha Musunuru Anne Newbold Art Toth Richard Frechette Tiffany Alexander Madhura Sundararajan John Lovejoy Dan Hottinger Joe Capannari Rachel Kurcz Gerard Bernard Harold Previl Department of Anesthesia and Trauma Services Memorial Hos-pital of South Bend South Bend USA Department of Anesthesia and Trauma Services Memorial Hos-pital of South Bend South Bend USA Sacred Heart Hospital Milot Haiti Department of Anesthesia and Trauma Services Memorial Hos-pital of South Bend South Bend USA St. Damien and St. Luc’s Hospital Port au Prince Haiti Department of Anesthesia and Trauma Services Memorial Hos-pital of South Bend South Bend USA St. Damien and St. Luc’s Hospital Port au Prince Haiti Sacred Heart Hospital Milot Haiti Department of Anesthesia and Trauma Services Memorial Hos-pital of South Bend South Bend USA St. Damien and St. Luc’s Hospital Port au Prince Haiti Mayo Clinic—Emergency Medicine Residency Program Rochester USA Sacred Heart Hospital Milot Haiti St. Damien and St. Luc’s Hospital Port au Prince Haiti St. Damien and St. Luc’s Hospital Port au Prince Haiti University of Maryland School of Medicine Baltimore USA St. Damien and St. Luc’s Hospital Port au Prince Haiti University of Maryland School of Medicine Baltimore USA. St. Damien and St. Luc’s Hospital Port au Prince Haiti Mayo Clinic—Critical Care Medicine Scottsdale USA

Background: The availability of an anesthesiologist is often a limiting factor in the number of operations that can be performed by International Medical Surgical Response Teams (IMSuRT). Because emergency physicians (EPs) possess skills in airway control, management of moderate and deep sedation, and ventilator management, we propose that with proper training in general anesthesia, EPs can serve as anesthetists for IMSuRT with anesthesiologist supervision. Methods: During a 10-week period, a board-certified EP administered general anesthesia to 60 patients prior to a surgical medical mission trip. The breakdown of surgical cases was: 11 orthopedic, 2 genitourinary, 20 ear, nose, and throat, 8 obstetrics and gynecological, 13 general surgery, and 6 vascular. A simplified protocol for induction, maintenance, and emergence was adhered to for all cases. Results: Fourteen orthopedic cases using general anesthesia were performed in a one-week period in Haiti. These cases involved open reduction and internal fixation (ORIF), hemiarthoplasty, hardware removal, tendon transfer and external fixation of fractured bone. Conclusion: We demonstrate the feasibility of a model curriculum to train EPs in the basics of anesthesia. The EP can safely and effectively deliver general anesthesia for major cases on surgical medical mission trips under the auspices of an anesthesiologist in an austere environment.

关键词： Emergency Physicians General Anesthesia Syllabus International Medical Surgical Response Teams Anesthetists Induction Maintenance Emergence Anesthesia

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Evaluation of Google Glass^(■) with Camera Adaptor and GoPro^(■) as Teaching Tools for Endotracheal Intubation in the Austere Medical Environment

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Open Journal of Anesthesiology 2018年第8期8卷 229-239页

作者： Michael Son David Zimmer Ross McCauley Donald Zimmer Joseph Dynako Richard Skupski bhavesh patel Nuha Zackariya Faadil Shariff Lovely Nathalie Colas Gerson Pyram Marc Edson Augustin Carmeline Mathurin Stanley Louis Patricia Saint Louis Stanley Loriston Dan Herbstman Lucio Cervantes Shane Kappler Michael TMcCurdy Jecko Thachil Sarah Greve Mark Walsh University of Notre Dame Notre DameINUSA Memorial Hospital South BendINUSA Indiana University School of Medicine South BendINUSA Mayo Clinic PhoenixAZUSA Indiana University Bloomington BloomingtonINUSA Hospital Saint Luc Port-Au-PrinceHaiti Department of Anesthesiology Hopital Universitaire JustinienCap HaitienHaiti Third Eye Health ChicagoILUSA Adisat Colonia:Condessa Mexico CityMexico 1 University of Maryland School of Medicine BaltimoreMDUSA 1 Department of Haematology Manchester Royal InfirmaryManchesterUK 1 St Joseph Regional Medical Center MishawakaINUSA

Objective: Endotracheal intubation (ETI) is a life-saving emergency procedure, but it is a complex skill that is difficult to teach. Recent studies have shown that video laryngoscopy is effective in teaching ETI to learners at various levels of medical expertise;however, it has proven to be costly and provides images of inconsistent quality. In this educational proof of concept feasibility convenience sample pilot study, we aim to explore and compare the effectiveness of using modified Google Glass? (GG) and GoPro? (GP) technologies to visualize and teach ETI to critical care physicians in the austere medical environment of a low-income country. We propose, based on our findings, that this inexpensive technology could teach lifesaving ETI to pre-hospital providers in the austere medical environment, medical students, rural emergency physicians, critical care physicians in low-income countries, far forward military medical providers, and other learners. Methods: A case series of twenty-five patients, five in the United States (US) at Memorial Hospital in South Bend, IN and twenty at Saint Luc’s Hospital in Port Au Prince, Haiti, is presented. These patients were collected from November 1st 2015 through February 1st of 2016. The anesthesiologist and the emergency physicians in the United States utilized GG to intubate five patients in the US prior to the twenty patients intubated during two separate trips to Haiti. On the two separate trips to Haiti, the GG was trialed and modified to obtain better exposure. These adaptations resulted in the final collection of twenty patients studied with the adapted GG system and GP. Physicians graded airway visualization based on LEMON and Cormack-Lehane scores. Previously published parameters for the assessment of failed intubation risk and passage of the cords were used as data points for analysis using a Likert-Scale analysis for each parameter. The data were analyzed by averages of Likert-Scale scoring with their respective sta

关键词： Endotracheal Intubation Google Glass^(■) GoPro^(■) Cord Visualization Military Medicine Austere Medical Environment Low Income Country Rural Prehospital

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Utilizing Anesthesiologists, Emergency and Critical Care Physicians with Telemedicine Monitoring to Develop Intubation and Ventilation Services in an Intensive Care Unit in the Austere Medical Environment: A Case Series. Expansion of the EP/CC GAS Project

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Open Journal of Anesthesiology 2018年第6期8卷 183-197页

作者： Richard Skupski Arthur Toth Michael T. McCurdy Shane Kappler James Lantry Gerson Pyran Donald Zimmer Joseph Dynako Anne Grisoli David Zimmer John Wilson bhavesh M. patel Hannelisa Callisen Alyssa Chapital Lovely Nathalie Colas Marc Edson Augustin Nathalie Edema Enzo Del Brocco Richard Frechette Mark Thompson James Corcoran Michael Mazowiecki Mark Walsh Memorial Hospital Trauma Center South Bend IN USA University of Maryland School of Medicine Baltimore MD USA Indiana University School of Medicine South Bend Campus South Bend IN USA Mayo Clinic Rochester MN USA Mayo Clinic Phoenix AZ USA Hô spital Saint Luc Port-Au-Prince Haiti Excela Health Westmoreland Hospital Greensburg PA USA Saint Joseph Regional Medical Center Mishawaka IN USA

Background: Significant resource constraints and critical care training gaps are responsible for the limited development of intensive care units (ICUs) in resource limited settings. We describe the implementation of an ICU in Haiti and report the successes and difficulties encountered throughout the process. We present a consecutive case series investigating an anesthesiologist, emergency, and critical care physician implemented endotracheal intubation and mechanical ventilation protocol in an austere environment with the assistance of telemedicine. Methods: A consecutive case series of fifteen patients admitted to an ICU at St. Luc Hospital located in Portau-Prince, Haiti, between the months of February 2012 to April 2014 is reported. Causes of respiratory failure and the clinical course are presented. Patients were followed to either death or discharge. Results: Fifteen patients (eight women and seven men) were included in the study with an average age of 37.7 years. The mean duration of ventilation was three days. Of the fifteen patients intubated, five patients (33.3%) survived and were discharged from the ICU. Of the five surviving patients, two were intubated for status epilepticus, one for status asthmaticus and one for hyperosmolar coma associated with intracerebral hemorrhage. Of the patients dying on the ventilator, four patients died from pneumonia, two from renal failure, and one from tetanus. The remaining three died from strokes and cardiac arrests. Conclusions: Mortality of mechanically ventilated patients in a resource-limited country is significant. Focused training in core critical care skills aimed at increasing the endotracheal intubation and ventilatory management capacity of local medical staff should be a priority in order to continue to develop ICUs in these austere environments. Collaborative educational and training efforts directed by anesthesiologists, emergency, and critical care physicians, and aided by telemedicine can facilitate reali

关键词： Intensive Care Unit (ICU) Critical Care Mechanical Ventilation Endotracheal Ventilation Anesthesiologist Low and Moderate-Income Country Austere Environment Telemedicine

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Artificial intelligence:New age of transformation in petroleum upstream

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Petroleum Research 2022年第1期7卷 106-114页

作者： Parth Solanki Dhruv Baldaniya Dhruvikkumar Jogani bhavesh Chaudhary Manan Shah Ameya Kshirsagar School of Petroleum Technology Pandit Deendayal Petroleum UniversityGandhinagar382007GujaratIndia Department of Chemical Engineering School of TechnologyPandit Deendayal Petroleum UniversityGandhinagar382007GujaratIndia Department of Information Technology Symbiosis Institute of TechnologyPuneMaharashtraIndia

In the Oil and Gas industry,the implementation of artificial intelligence techniques gives advantages of better use of existing *** provides better future outcomes,which makes it an essential technology in the operations of the *** this paper,the implementation of artificial intelligence techniques for good planning,determination of reservoir rock properties,drilling optimization and production facilities are *** precise knowledge of permeability and porosity,reservoir engineers can develop robust reservoir development plan and manage hydrocarbon recovery *** porosity prediction,wire-line log data and seismic attributes are used in artificial intelligence-based *** prediction has been discussed by considering the different types of well-log data in the modeling of artificial intelligence techniques to predict single-phase *** of specific developed problems during the determination of permeability in the actual experiment is also *** intelligence techniques are used in the design and accurate analysis of the drilling *** assists in the selection of drill bit and drilling-related *** a reservoir cannot produce naturally,we can select a suitable artificial lift and design the production system using Artificial intelligence *** EOR methods,SADA and NAVA knowledge base systems are *** intelligence can help in optimizing production,improve production efficiency and recovery of hydrocarbons.

关键词： Artificial neural network Enhanced oil recovery Fuzzy logic system Artificial lift Permeability Porosity

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Improving the charge kinetics through in-situ growth of NiSe nanoparticles on g-C_(3)N_(4)nanosheets for efficient hybrid supercapacitors

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Journal of Energy Chemistry 2023年第12期87卷 304-313,I0008页

作者： Somnath R.Khaladkar Oshnik Maurya Girish Gund bhavesh Sinha Deepak Dubal R.R.Deshmukh Archana Kalekar Department of Physics Institute of Chemical Technology(ICT)MatungaMumbai 400019MaharashtraIndia Department of Physics Mahatma Phule ArtsScience and Commerce CollegePanvel 410206MaharashtraIndia National Center for Nanoscience and Nanotechnology University of MumbaiMumbai 400032MaharashtraIndia Centre for Materials Science School of Chemistry and PhysicsQueensland University of TechnologyBrisbane QLD 4000Australia

Nickel selenide(NiSe)has been a promising positive electrode for hybrid supercapacitors due to its multiple oxidation states,tunability,and high specific ***,sluggish ion transfers and particle agglomeration hamper its electrochemical *** the present study,we have grown NiSe nanoparticles on two-dimensional(2D)graphitic carbon nitride(g-C_(3)N_(4))nanosheets to realize three-dimensional(3D)*** 2D support,high nitrogen content,and features of g-C_(3)N_(4)enhanced the specific capacity of the NiSe/g-C_(3)N_(4)nanocomposite *** resulting nanocomposite shows a specific capacity of 320 mA h g^(-1)at a current density of 1 A g^(-1),which is considerably higher than pristine ***,the hybrid supercapacitor(HSC)device was fabricated using NiSe/g-C_(3)N_(4)composite as positive and activated carbon(AC)as negative *** cell delivered an energy density of 52.5 Wh kg^(-1)at a power density of 1488 W kg^(-1)with excellent cyclic stability of 84.9%over 8000 *** electrochemical performance enhancement corresponds to a 3D structure,high electrochemical active sites,and improved charge transportation at the electrode/electrolyte ***,the present work offers an easy approach and architectural design for high-performance HSC.

关键词： Nickel selenide Graphitic carbon nitride Nanocomposite Specific capacity Hybrid supercapacitor

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Evaluation of Modified Vector Space Representation Using ADFA-LD and ADFA-WD Datasets

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Journal of Information Security 2015年第3期6卷 250-264页

作者： bhavesh Borisaniya Dhiren patel Computer Engineering Department NIT Surat India

Predicting anomalous behaviour of a running process using system call trace is a common practice among security community and it is still an active research area. It is a typical pattern recognition problem and can be dealt with machine learning algorithms. Standard system call datasets were employed to train these algorithms. However, advancements in operating systems made these datasets outdated and un-relevant. Australian Defence Force Academy Linux Dataset (ADFA-LD) and Australian Defence Force Academy Windows Dataset (ADFA-WD) are new generation system calls datasets that contain labelled system call traces for modern exploits and attacks on various applications. In this paper, we evaluate performance of Modified Vector Space Representation technique on ADFA-LD and ADFA-WD datasets using various classification algorithms. Our experimental results show that our method performs well and it helps accurately distinguishing process behaviour through system calls.

关键词： System Call Trace Vector Space Model Modified Vector Space Representation ADFA-LD ADFA-WD

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Montmorillonite/Poly(L-Lactide)microcomposite spheres as reservoirs of antidepressant drugs and their controlled release property

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Asian Journal of Pharmaceutical Sciences 2015年第5期10卷 452-458页

作者： Shalini Rajkumar bhavesh D.Kevadiya Hari C.Bajaj Institute of Science Nirma UniversityAhmedabad 382481GujaratIndia Discipline of Inorganic Materials and Catalysis Central Salt and Marine Chemicals Research InstituteCouncil of Scientific and Industrial Research(CSIR)Gijubhai Badheka MargBhavnagar 364021GujaratIndia

This work evaluates intercalation of Nortriptyline(NT)and Venlafaxine(VFX)in an interlayer gallery of Na^(+)-MMT(Montmorillonite),which was further compounded with Poly(LLactide)(PLLA)to form microcomposite spheres(MPs)for oral controlled drug *** XRD patterns,thermal and spectroscopic analyses indicated intercalation of drugs into the MMT interlayer that was stabilized by electrostatic *** significant changes in structural and functional properties of drugs were found in the MMT *** vitro drug release studies showed controlled release pattern.

关键词： Nortriptyline Venlafaxine Poly(L-Lactide) Montmorillonite Antidepressant

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Quantitation of tadalafil in human plasma using a sensitive and rapid LC-MS/MS method for a bioequivalence study

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Journal of Pharmaceutical Analysis 2018年第4期8卷 271-276页

作者： Abhaysingh Bhadoriya bhavesh Dasandi Dharmesh Parmar Priyanka A. Shah Pranav S. Shrivastav Bioanalytical Department Synchron Research Services Pvt. Ltd. Department of Chemistry School of Sciences Gujarat University

A highly sensitive liquid chromatography-tandem mass spectrometry（LC-MS/MS） method was developed for the determination of tadalafil（TAD） in human plasma. TAD and its deuterated internal standard（IS）, tadalafil-d3, were extracted from 200 mL plasma using Phenomenex Strata-X-C 33 m extraction cartridges. Chromatographic analysis was carried out on Synergi Hydro-RP C18（100 mm × 4.6 mm, 4 mm）column with a mobile phase consisting of methanol and 10 m M ammonium formate, p H 4.0（90：10, v/v）,delivered at a flow rate of 0.9 m L/min. Quantitation of the protonated analyte was done on a triple quadrupole mass spectrometer using multiple reaction monitoring via electrospray ionization. The precursor to product ions transitions monitored for TAD and TAD-d3 were m/z 390.3-268.2 and m/z393.1-271.2, respectively. The calibration curve was linear over the concentration range of 0.50–500 ng/m L with correlation coefficient, r2 Z 0.9994. Acceptable intra-batch and inter-batch precision（r3.7%） and accuracy（97.8% to 104.1%） were obtained at five concentration levels. The recovery of TAD from spiked plasma was highly precise and quantitative（98.95% to 100.61%）. Further, the effect of endogenous matrix components was minimal. TAD was found to be stable under different storage conditions in human plasma and also in whole blood samples. The validated method was successfully used to determine TAD plasma concentration in a bioequivalence study with 20 mg TAD tablets in 24 healthy volunteers. Method performance was evaluated by reanalyzing 115 study samples.

关键词： Tadalafil Tadalafil-d3 LC-MS/MS Sensitive Bioequivalence study Human plasma

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Sensitive and rapid determination of amantadine without derivatization in human plasma by LC–MS/MS for a bioequivalence study

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Journal of Pharmaceutical Analysis 2018年第3期8卷 202-207页

作者： Abhaysingh Bhadoriya Shivprakash Rathnam bhavesh DasANDi Dharmesh Parmar Mallika Sanyal Pranav S.Shrivastav Bioanalytical Department Synchron Research Services Pvt.Ltd Department of Chemistry St.Xavier's College Department of Chemistry School of Sciences Gujarat University

A highly sensitive, rapid and rugged liquid chromatography-tandem mass spectrometw （LC-ESI-MS/MS） method was developed for reliable estimation of amantadine （AMD）, an antiviral drug in human plasma. The analyte and internal standard （IS）, amantadine-d6 （AMD-d6）, were extracted from 200μL plasma by solid phase extraction on Phenomenex Strata-X-C 33 ~t cartridges. Chromatography was performed on Synergi^TM Hydro-RP C18 （150 mm×4.6 mm, 4 μm） analytical column using a mixture of acetonitrile and 10 mM ammonium formate, pH 3.0 （80：20, v/v） as the mobile phase. Detection and quantitation was done by multiple reaction monitoring in the positive ionization mode for AMD （m/z 152.1→ 135.1 ） and IS （m/z 158.0 → 141.1） on a triple quadrupole mass spectrometer. The assay was linear in the concentration range of 0.50-500 ng/mL with correlation coefficient （r^2）〉 0.9969. The limit of detection of the method was 0.18 ng/mL The intra-batch and inter-batch precisions were 〈 5.42% and the accuracy varied from 98.47% to 105.72%. The extraction recovery of amantadine was precise and quantitative in the range of 97.89%-100.28%. IS-normalized matrix factors for amantadine varied from 0.981 to 1.012. The stability of AMD in whole blood and plasma was evaluated under different conditions. The developed method was successfully applied for a bioequivalence study with 100 mg of AMD in 32 healthy volunteers. The reproducibility of the assay was determined by reanalysis of 134 subject samples.

关键词： Amantadine Amantadine-d6 LC-ESI-MS/MS Sensitive Bioequivalence study Human plasma

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Phoenix phylogeny, and analysis of genetic variation in a diverse collection of date palm(Phoenix dactylifera) and related species

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Plant Diversity 2019年第5期41卷 330-339页

作者： Srinivasa R.Chaluvadi Porter Young Kentrez Thompson Bochra Amina Bahri bhavesh Gajera Subhash Narayanan Robert Krueger Jeffrey L.Bennetzen Department of Genetics University of GeorgiaAthensGAUSA Institute of Plant Breeding Genetics and Genomics(Department of Crop and Soil Sciences)and Department of Plant BiologyUniversity of GeorgiaAthensGA 30602USA Laboratory of Bioaggressors and Integrated Protection in Agriculture The National Agronomic Institute of TunisiaUniversity of Carthage43 Avenue Charles-NicolleTunis 1082Tunisia Anand Agricultural University AnandIndia USDA-ARS National Clonal Germplasm Repository for Citrus and Dates RiversideCAUSA

Date palm(Phoenix dactylifera),one of the most ancient crops,is grown commercially in>30 *** whole plastome assemblies,phylogenetic analyses revealed that cultivated date palm accessions share the same clade with Phoenix sylvestris,Phoenix pusilla and Phoenix acaulis,which are native to the Indian subcontinent,and Phoenix caespitosa that is native to the Arabian Peninsula and the deserts of *** of genetic diversity and genetic relationships among date palm accessions from 13 producing countries involved 195 date palm accessions that were genotyped at 19 microsatellite *** genetic diversity was observed,with many accessions heterozygous for most markers in this clonally propagated *** average number of alleles per locus(42.1),expected heterozygosity(0.8),observed heterozygosity(0.47)and fixation indices(FST=0.42)demonstrated substantial genetic diversity and population *** accessions were found to have the richest allelic diversity,and the most private *** model-based Bayesian method indicated that these accessions could be broadly divided into two structure groups,one group with predominantly African accessions and another predominantly *** germplasm,especially from Tunisia and Iraq,deviated from this *** accessions in the STRUCTURE-derived groups were found to be genetic admixtures,with gene flow between Asian and African *** and Pakistani date palms were found to be most closely related to North African germplasm.

关键词： Date palm improvement Germplasm dissemination Plastome Simple sequence repeats

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