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Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant Singh Dahiya Muhammad Nadeem Yousaf Brinda Basida Bhanu Siva mohan Pinnam Manesh kumar Gangwani Hassam Ali Sahib Singh Yash R Shah Daksh Ahluwalia Mihir Prakash Shah Saurabh Chandan Neil R Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of Rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related *** To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National Readmission *** aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Soft Computing Based Discriminator Model for Glaucoma Diagnosis

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Computer Systems Science & Engineering 2022年第9期42卷 867-880页

作者： Anisha Rebinth S.mohan kumar Department of Information Science and Engineering NHCEVisvesvaraya Technological UniversityBangaloreIndia Department of Computer Science and Engineering Nagarjuna College of Engineering and TechnologyBangaloreIndia

In this study, a Discriminator Model for Glaucoma Diagnosis (DMGD)using soft computing techniques is presented. As the biomedical images such asfundus images are often acquired in high resolution, the Region of Interest (ROI)for glaucoma diagnosis must be selected at first to reduce the complexity of anysystem. The DMGD system uses a series of pre-processing;initial cropping by thegreen channel’s intensity, Spatially Weighted Fuzzy C Means (SWFCM), bloodvessel detection and removal by Gaussian Derivative Filters (GDF) and inpaintingalgorithms. Once the ROI has been selected, the numerical features such as colour, spatial domain features from Local Binary Pattern (LBP) and frequencydomain features from LAWS are generated from the corresponding ROI forfurther classification using kernel based Support Vector Machine (SVM). TheDMGD system performances are validated using four fundus image databases;ORIGA, RIM-ONE, DRISHTI-GS1, and HRF with four different kernels;LinearKernel (LK), Polynomial Kernel (PK), Radial Basis Function (RBFK) kernel,Quadratic Kernel (QK) based SVM classifiers. Results show that the DMGD system classifies the fundus images accurately using the multiple features and kernelbased classifies from the properly segmented ROI.

关键词： Glaucoma support vector classification clustering technique spatial domain and frequency domain features

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Optimal and Effective Resource Management in Edge Computing

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Computer Systems Science & Engineering 2023年第2期44卷 1201-1217页

作者： Darpan Majumder S.mohan kumar Department of Information Science and Engineering New Horizon College of Engineering Research CentreVisvesvaraya Technological University(VTU)BangaloreIndia Department of CSE Nagarjuna College of Engineering and TechnologyBangaloreIndia

Edge computing is a cloud computing extension where physical compu-ters are installed closer to the device to minimize *** task of edge data cen-ters is to include a growing abundance of applications with a small capability in comparison to conventional data *** this framework,Federated Learning was suggested to offer distributed data training strategies by the coordination of many mobile devices for the training of a popular Artiﬁcial Intelligence(AI)model without actually revealing the underlying data,which is signiﬁcantly enhanced in terms of *** learning(FL)is a recently developed decentralized profound learning methodology,where customers train their localized neural network models independently using private data,and then combine a global model on the core server *** models on the edge server use very little time since the edge server is highly *** the amount of time it takes to download data from smartphone users on the edge server has a signiﬁcant impact on the time it takes to complete a single cycle of FL operations.A machine learning strategic planning system that uses FL in conjunction to minimise model training time and total time utilisation,while recognising mobile appliance energy restrictions,is the focus of this *** further speed up integration and reduce the amount of data,it implements an optimization agent for the establishment of optimal aggregation policy and asylum architecture with several employees’shared *** main solutions and lessons learnt along with the prospects are *** show that our method is superior in terms of the effective and elastic use of resources.

关键词： Federated learning machine learning edge computing resource management

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Skin Lesion Classification System Using Shearlets

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Computer Systems Science & Engineering 2023年第1期44卷 833-844页

作者： S.mohan kumar T.Kumanan Department of Computer Science and Engineering Meenakshi Academy of Higher Education and ResearchChennai600078Tamil NaduIndia

The main cause of skin cancer is the ultraviolet radiation of the *** spreads quickly to other body ***,early diagnosis is required to decrease the mortality rate due to skin *** this study,an automatic system for Skin Lesion Classification(SLC)using Non-Subsampled Shearlet Transform(NSST)based energy features and Support Vector Machine(SVM)classifier is ***,the NSST is used for the decomposition of input skin lesion images with different directions like 2,4,8 and *** the NSST’s sub-bands,energy fea-tures are extracted and stored in the feature database for *** classifier is used for the classification of skin lesion *** dermoscopic skin images are obtained from PH^(2) database which comprises of 200 dermoscopic color images with melanocytic *** performances of the SLC system are evaluated using the confusion matrix and Receiver Operating Characteristic(ROC)*** SLC system achieves 96%classification accuracy using NSST’s energy fea-tures obtained from 3^(rd) level with 8-directions.

关键词： Skin lesion classification non-subsampled shearlet transform sub-band coefficients energy feature support vector machine

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Impact of Land-Use Change on Soil Microbial Community Composition and Organic Carbon Content in the Dry Tropics

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Pedosphere 2017年第5期27卷 974-977页

作者： Chandra mohan kumar Nandita GHOSHAL Centre of Advanced Study in Botany Department of Botany Institute of Science Banaras Hindu University

Restoration of forests poses a major challenge globally, particularly in the tropics, as the forests in these regions are more vulnerable to land-use change. We studied land-use change from natural forest(NF) to degraded forest(DF), and subsequently to either Jatropha curcas plantation(JP) or agroecosystem(AG), in the dry tropics of Uttar Pradesh, India, with respect to its impacts on soil microbial community composition as indicated by phospholipid fatty acid(PLFA) biomarkers and soil organic carbon(SOC) content. The trend of bacterial PLFAs across all land-use types was in the order: NF > JP > DF> AG. In NF, there was dominance of gram-negative bacterial(G^-) PLFAs over the corresponding gram-positive bacterial(G^+) PLFAs. The levels of G^- PLFAs in AG and JP differed significantly from those in DF, whereas those of G^+ PLFAs were relatively similar in these three land-use types. Fungal PLFAs,however, followed a different trend: NF > JP > DF = AG. Total PLFAs, fungal/bacterial(F/B) PLFA ratio, and SOC content followed trends similar to that of bacterial PLFAs. Across all land-use types, there were strong positive relationships between SOC content and G-, bacterial, fungal, and total microbial PLFAs and F/B PLFA ratio. Compared with bacterial PLFAs, fungal PLFAs appeared to be more responsive to land-use change. The F/B PLFA ratio, fungal PLFAs, and bacterial PLFAs explained 91%, 94%,and 73% of the variability in SOC content, respectively. The higher F/B PLFA ratio in JP favored more soil C storage, leading to faster ecosystem recovery compared to either AG or DF. The F/B PLFA ratio could be used as an early indicator of ecosystem recovery in response to disturbance, particularly in relation to land-use change.

关键词： ecosystem recovery fungal/bacterial ratio natural forest phospholipid fatty acid (PLFA) plantation

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An Ophthalmic Evaluation of Central Serous Chorioretinopathy

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Computer Systems Science & Engineering 2023年第1期44卷 613-628页

作者： L.K.Shoba P.mohan kumar Department of Information Technology Jeppiaar Engineering CollegeChennai600119India Department of Computer Science and Engineering Sri Krishna College of Engineering and TechnologyCoimbatore641008India

Nowadays in the medicalfield,imaging techniques such as Optical Coherence Tomography(OCT)are mainly used to identify retinal *** this paper,the Central Serous Chorio Retinopathy(CSCR)image is analyzed for various stages and then compares the difference between CSCR before as well as after treatment using different application *** approach,which was focused on image quality,improves medical image *** enhancement algorithm was implemented to improve the OCT image contrast and denoise purpose called Boosted Anisotropic Diffusion with an Unsharp Masking Filter(BADWUMF).The classifier used here is tofigure out whether the OCT image is a CSCR case or not.150 images are checked for this research work(75 abnormal from Optical Coherence Tomography Image Retinal Database,in-house clinical database,and 75 normal images).This article explicitly decides that the approaches suggested aid the ophthalmologist with the precise retinal analysis and hence the risk factors to be *** total precision is 90 percent obtained from the Two Class Support Vector Machine(TCSVM)classifier and 93.3 percent is obtained from Shallow Neural Network with the Powell-Beale(SNNWPB)classifier using the MATLAB 2019a program.

关键词： OCT CSCR macula segmentation boosted anisotropic diffusion with unsharp maskingfilter two class support vector machine classifier and shallow neural network with powell-beale classifier

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Climate change and finger millet: Perception, trend and impact on yield in different ecological regions in Central Nepal

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Journal of Mountain Science 2019年第4期16卷 821-835页

作者： Dol Raj LUITEL mohan SIWAKOTI Pramod kumar JHA Central Department of Botany Tribhuvan University Department of Environment Ministry of Forests and Environment

The views of local people on climate change along different ecological regions are relatively unexplored in Nepal. This study was conducted in 13 villages in central Nepal at different altitudes to document the views of small holder farmers and compare their perception with trends of climatic variables, finger millet yield, natural disasters, plant phenology(flowering and fruiting), status of forest and wild life, as well as the spread of diseases and pests. Analysis on the climatic data of stations for 36-41 years between 1975 and 2016 showed significant increases in the minimum temperature in lower tropical climatic region(<500 m), upper tropical to subtropical climatic region(500-2000 m) and temperate climatic region(2000-3000 m) by 0.01, 0.026 and 0.054℃/year, respectively, and an increase of maximum temperature by 0.008, 0.018, and 0.019℃/year, respectively. Rainfall showed a strongly significant decreasing trend in all elevation regions. This result matches with the views of respondents except 38% respondent from temperate climatic region. People from the temperate climatic region also mentioned that current onset of snowfall is delayed but amount of snowfall remained the same. From the documented records, except events of wild fire, frequency of natural disasters events have increased in the recent years, which was in harmony with the views of local people. Multi-linear regression analysis showed that contribution of climatic variables on finger millet yield in lower tropical climatic region and upper tropical to subtropical regions was 23% and 57.3%, respectively, which was supported by increasing trend on average growing degree day(GDD) temperature at the rate of 0.01℃ in upper tropical to subtropical region and 0.007℃ in lower tropical climatic region yearly. Finger millet yield has been increasing at the rate of 7.39 and 36.9 kg/ha yearly in lower tropical climatic region and upper tropical to subtropical climatic region, respectively. This result provide

关键词： Climate change Growing degree days (GDD) Natural disaster Phenology Precipitation Small holder farmers

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Stability Analysis of an Underactuated Autonomous Underwater Vehicle Using Extended-Routh's Stability Method

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International Journal of Automation and computing 2018年第3期15卷 299-309页

作者： Basant kumar Sahu Bidyadhar Subudhi Madan mohan Gupta Department of Electrical Engineering National Institute of Science and TechnologyBerhampur Department of Electrical Engineering National Institute of TechnologyRourkela Intelligent Systems Research Laboratory College of Engineering University of Saskatchewan

In this paper, a new approach to stability analysis of nonlinear dynamics of an underactuated autonomous underwater vehicle（AUV） is presented. AUV is a highly nonlinear robotic system whose dynamic model includes coupled terms due to the hydrodynamic damping factors. It is difficult to analyze the stability of a nonlinear dynamical system through Routh＇s stability approach because it contains nonlinear dynamic parameters owing to hydrodynamic damping coefficients. It is also difficult to analyze the stability of AUVs using Lyapunov＇s criterion and LaSalle＇s invariance principle. In this paper, we proposed the extended-Routh＇s stability approach to verify the stability of such nonlinear dynamic systems. This extended-Routh＇s stability approach is much easier as compared to the other existing methods. Numerical simulations are presented to demonstrate the efficacy of the proposed stability verification of the nonlinear dynamic systems, e.g., an AUV system dynamics.

关键词： Routh's stability extended-Routh's stability autonomous underwater vehicle (AUV) underactuated system underwaterrobots.

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Evolutionary dynamics of solitary wave profiles and abundant analytical solutions to a(3+1)-dimensional burgers system in ocean physics and hydrodynamics

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Journal of Ocean Engineering and Science 2023年第1期8卷 1-14页

作者： Sachin kumar Amit kumar Brij mohan Department of Mathematics Faculty of Mathematical SciencesUniversity of DelhiDelhi 110007India Department of Mathematics Sri Vankateswara CollegeUniversity of DelhiDelhi 110021India Department of Mathematics Hansraj CollegeUniversity of DelhiDelhi 110007India

In the fields of oceanography,hydrodynamics,and marine engineering,many mathematicians and physi-cists are interested in Burgers-type equations to show the different dynamics of nonlinear wave phenom-ena,one of which is a(3+1)-dimensional Burgers system that is currently being *** this paper,we apply two different analytical methods,namely the generalized Kudryashov(GK)method,and the generalized exponential rational function method,to derive abundant novel analytic exact solitary wave solutions,including multi-wave solitons,multi-wave peakon solitons,kink-wave profiles,stripe solitons,wave-wave interaction profiles,and periodic oscillating wave profiles for a(3+1)-dimensional Burgers sys-tem with the assistance of symbolic *** employing the generalized Kudryashov method,we obtain some new families of exact solitary wave solutions for the Burgers ***,we applied the generalized exponential rational function method to obtain a large number of soliton solutions in the forms of trigonometric and hyperbolic function solutions,exponential rational function solutions,peri-odic breather-wave soliton solutions,dark and bright solitons,singular periodic oscillating wave soliton solutions,and complex multi-wave solutions under various family *** on soft computing via Wolfram Mathematica,all the newly established solutions are verified by back substituting them into the considered Burgers ***,the dynamical behaviors of some established results are exhibited graphically through three-and two-dimensional wave profiles via numerical simulation.

关键词： Dynamical structures Burger system GERF Method Generalized kudryashov method Closed-form solutions Solitary waves

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Structural, Thermal, Linear and Nonlinear Optical Studies on New NLO Crystal∶DL-Threonium Trichloroacetate

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Journal of Rare Earths 2006年第Z1期24卷 249-252页

作者： Gubendiran Ramesh kumar Srinivasan Gokul Raj Rajagopal mohan Ramasamy Jayave Department of Physics Presidency college Chennai-600 005 India Department of Physics Presidency college Chennai-600 005 India Department of Physics Presidency college Chennai-600 005 India Department of Physics Presidency college Chennai-600 005 India Crystal Growth Centre Anna University Chennai-600 025 India

Crystals of DL-threonium trichloroacetate (DLTTCA) was synthesized from an aqueous solution by slow evaporation technique. The grown crystals were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, UV-Vis-NIR and SHG measurements. Vibrational structure of the crystal was elucidated from FTIR analysis and the hydrogen bond interactions were discussed in detail. The ultraviolet transparent cutoff falls at 212 nm. Thermal stability of the compound was also studied. The powder SHG efficiency of the compound was measured as 0.62 times to that of KDP.

关键词： growth from solution nonlinear optical materials

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