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An Autopsy and Histopathology-based Study to Ascertain the Cause of Death of Brought Dead Cases

Journal of Forensic Science and Medicine 2024年第1期10卷 28-33页

作者： chandan Bandyopadhyay Prabir Chandra Paul Prabhas Chandra chakraborty Department of Forensic and State Medicine Medical CollegeKolkataWest BengalIndia Department of Pathology Jagannath Gupta Institute of Medical Science and HospitalKolkataWest BengalIndia Department of Forensic Medicine and Toxicology NRS Medical College and HospitalKolkataand M.G.M Medical College and L S.K HospitalKishanganjBiharIndia

Background and Objectives:The cases of apparent natural deaths are encountered in the hospital casualties who are noted dead at the time of the first medical attention and as such are labeled as“Brought Dead.”These include the cases of sudden death,unexplained death,and unattended death.The cause of such deaths is reported in the literature to emanate principally from the cardiovascular system,though there are some documented geographical,racial,and other variations.In the present study,we endeavored to detect the cause of such natural deaths in terms of the disease and the organ system involved,in the deceased individuals of the contemporary Bengali population,with cases due to obvious unnatural causes being excluded.Materials and Methods:An observational,cross-sectional study with 105(n=105,male:89,female:16)study subjects of age group of 20-80 years,selected by systemic random sampling,from the brought dead subjects coming to the mortuary of the NRS Medical College and Hospital for medicolegal autopsy from April 2011 to March 2012,excluding cases having a history of the obvious unnatural event.Organ system-wise gross examination was done,followed by tissue sampling for histopathological examination.The case-wise findings were tabulated and analyzed for descriptive statistics using SPSS software.Results:In the present study,89 cases were male(84.8%)and 16 cases were female(15.2%),which reflects a male:female ratio of 5.56:1.The dead bodies are mostly recovered from the footpaths(47 cases,44%).Sixty-four(61%)cases are of known identity.In 54 cases out of 105(51.4%),morbid pathology is detected in the respiratory system(RS),lobar pneumonia,and cavitary pulmonary tuberculosis being the most frequent disease entity,in both genders.Fifty-one years-sixty-five years is found to be the most commonly affected age group,in both genders.Interpretation and Conclusions:The present study shows that the most common organ system involved in brought dead cases is the RS,which is supported by a few Indian studies.

关键词： Autopsy brought dead cause of death histopathology

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Exploring the merits of geographical diversification of solar PV power plants for a resilient PV-dominated electricity grid in India

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Clean Energy 2023年第4期7卷 885-910页

作者： Saikat Ghosh Jatindra Nath Roy chandan chakraborty Advanced Technology Development Centre Indian Institute of Technology Kharagpur721302India Department of Electrical Engineering Indian Institute of Technology Kharagpur721302India

India is highly dependent on solar photovoltaics(PV)to harness its vast solar resource potential and combat climate change.However,∼90%of the installed PV capacity in India is concentrated in the top nine states,with the remaining states lagging behind.The research reveals that during monsoons,heavy cloud cover and rain lead to high solar resource variability,intermittency and the risk of very low PV generation,which can result in reliability issues in future PV-dominated electricity grids.Although energy storage can help in overcoming high intermittency,there are multiple challenges associated with it.The novelty of this study lies in demonstrating the benefits of combining multiple PV sites in various regions to mitigate the risks of low PV generation and high variability.The variability of individual sites was found to be up to∼3.5 times higher than the variability of combined generation.During noon,prominent solar park sites like Bhadla and NP Kunta experience a decrease in power generation to values as low as∼10%of the rated PV capacity.However,the minimum generation of the large-scale dispersed PV generation is>30%.Furthermore,the research identifies other benefits of dispersing PV generation across the country,viz.,reduction of seasonal variability by adding PV capacity in the southern region,widening of the PV generation span,more room for PV capacity addition,reduction in storage and ramping needs,utilization of hydroelectric potential of the north-east and PV potential of Ladakh,and creating opportunities for sustainable development in rural agrarian regions through agrivoltaics.

关键词： decarbonization PV-based resilient grid PV variability and intermittency solar PV power plants

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Urbanization Impact on Regional Climate and Extreme Weather:Current Understanding,Uncertainties,and Future Research Directions

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Advances in Atmospheric Sciences 2022年第6期39卷 819-860页

作者： Yun QIAN TC chakraborty Jianfeng LI Dan LI Cenlin HE chandan SARANGI Fei CHEN Xuchao YANG L.Ruby LEUNG Pacific Northwest National Laboratory RichlandWA 99354USA Yale University New HavenCT 06520USA Department of Earth and Environment Boston UniversityMA 02215USA National Center for Atmospheric Research BoulderCO 80301USA Indian Institute of Technology MadrasChennaiTamil Nadu 600036India Zhejiang University Hangzhou 310027China

Urban environments lie at the confluence of social,cultural,and economic activities and have unique biophysical characteristics due to continued infrastructure development that generally replaces natural landscapes with built-up structures.The vast majority of studies on urban perturbation of local weather and climate have been centered on the urban heat island(UHI)effect,referring to the higher temperature in cities compared to their natural surroundings.Besides the UHI effect and heat waves,urbanization also impacts atmospheric moisture,wind,boundary layer structure,cloud formation,dispersion of air pollutants,precipitation,and storms.In this review article,we first introduce the datasets and methods used in studying urban areas and their impacts through both observation and modeling and then summarize the scientific insights on the impact of urbanization on various aspects of regional climate and extreme weather based on more than 500 studies.We also highlight the major research gaps and challenges in our understanding of the impacts of urbanization and provide our perspective and recommendations for future research priorities and directions.

关键词： urbanization regional climate extreme weather urban heat island urban flooding

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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 diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications 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 to non-frail.Larger studies are warranted to in

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Decaying items inventory models with partial linked-to-order upstream trade credit and downstream full trade credit

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Journal of Management Analytics 2022年第1期9卷 137-168页

作者： chandan Mahato Gour Chandra Mahata Department of Mathematics Sidho-Kanho-Birsha UniversityPuruliaIndia

In practice,any member of supply chain may offer full or partial trade credit contract to his downstream level.Full trade credit is the case that the latter is allowed to defer whole payment to the end of credit period.In partial trade credit,however,the downstream supply chain member must pay for a proportion of the purchased goods at first,and can delay paying for the rest until the end of credit period.This paper considers a two-level trade credit,where the supplier offers order-quantity-dependent partial trade credit to a retailer,who suggests full trade credit to his customers.An economic order quantity(EOQ)inventory model of a deteriorating item with expiration dates is formulated here.Theoretical results are developed to obtain the optimal solutions to the problem.Numerical examples and sensitivity analysis are performed to justify the proposed models and theoretical results and managerial insights are provided.

关键词： Inventory two-level trade credit partial trade credit order-quantitydependent trade credit deterioration

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Modeling the gene delivery process of the needle array-based tissue nanotransfection

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Nano Research 2022年第4期15卷 3409-3421页

作者： Zhigang Li Yi Xuan Subhadip Ghatak Poornachander RGuda Sashwati Roy chandan K.Sen Indiana Center for Regenerative Medicine and Engineering Indiana University Health Comprehensive Wound CenterDepartment of SurgeryIndiana University School of MedicineIndianapolisIN 46202USA Birck Nanotechnology Center and Weldon School of Biomedical Engineering Purdue UniversityWest LafayetteIN 47907USA

Hollow needle array-based tissue nanotransfection(TNT)presents an in vivo transfection approach that directly translocate exogeneous genes to target tissues by using electric pulses.In this work,the gene delivery process of TNT was simulated and experimentally validated.We adopted the asymptotic method and cell-array-based model to investigate the electroporation behaviors of cells within the skin structure.The distribution of nonuniform electric field across the skin results in various electroporation behavior for each cell.Cells underneath the hollow microchannels of the needle exhibited the highest total pore numbers compared to others due to the stronger localized electric field.The percentage of electroporated cells within the skin structure,with pore radius over 10 nm,increases from 25%to 82%as the applied voltage increases from 100 to 150 V/mm.Furthermore,the gene delivery behavior across the skin tissue was investigated through the multilayer-stack-based model.The delivery distance increased nonlinearly as the applied voltage and pulse number increased,which mainly depends on the diffusion characteristics and electric conductivity of each layer.It was also found that the skin is required to be exfoliated prior to the TNT procedure to enhance the delivery depth.This work provides the foundation for transition from the study of murine skin to translation use in large animals and human settings.

关键词： tissue nanotransfection silicon needle array hollow needle array electroporation electrophoresis gene delivery

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The portrayal of hearing loss information in online Mandarin videos

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Journal of Otology 2023年第3期18卷 152-159页

作者： chandan H.Suresh Kiara Leng Nilesh J.Washnik Satyabrata Parida Department of Communication Disorders California State UniversityLos AngelesUSA Department of Communication Sciences and Disorders Ohio UniversityAthensOHUSA Department of Neurobiology University of PittsburghPittsburghPA15261USA

Background/purpose:With increasing accessibility to the Internet,patients frequently use the Internet for hearing healthcare information.No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms.The study’s primary purpose is to investigate the content,source,understandability,and actionability of hearing loss information in the Mandarin language’s one hundred most popular online videos.Method:In this project,publicly accessible online videos were analyzed.One hundred of the most popular Mandarin-language videos about hearing loss were identified(51 videos on YouTube and 49 on the Bilibili video-sharing platform).They were manually coded for different popularity metrics,sources,and content.Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials(PEMAT-AV)to measure the understandability and actionability scores.Results:The video sources were classified as either media(n=36),professional(n=39),or consumer(n=25).The videos covered various topics,including symptoms,consequences,and treatment of hearing loss.Overall,videos attained adequate understandability scores(mean=73.6%)but low(mean=43.4%)actionability scores.Conclusions:While existing online content related to hearing loss is quite diverse and largely understandable,those videos provide limited actionable information.Hearing healthcare professionals,media,and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.

关键词： Hearing loss YouTube BiliBili Internet health information Social media

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Sarcopenia in hepatocellular carcinoma:Current knowledge and future directions

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World Journal of Gastroenterology 2022年第4期28卷 432-448页

作者： Abhilash Perisetti Hemant Goyal Rachana Yendala Saurabh chandan Benjamin Tharian Ragesh BabuThandassery Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Interventional Oncology and Surgical Endoscopy Parkview HealthFort WayneIN 46825United States Department of Internal Medicine The Wright Center for Graduate Medical EducationThe Wright Center for Graduate Medical EducationScrantonPA 18501United States Department of Hematology and Oncology Conway Regional Medical CenterConwayAR 72034United States Department of Internal Medicine Gastroenterology and Hepatology DivisionCHI Creighton University Medical CenterOmahaNE 68107United States Department of Medicine Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States

Liver cancer is the second most occurring cancer worldwide and is one of the leading causes of cancer-related deaths.Hepatocellular carcinoma(HCC)is the most common(80%-90%)type among malignant liver cancers.Sarcopenia occurs very early in HCC and can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant management.Multiple prognostic stating systems have been developed in HCC,such as Barcelona Clinic Liver Cancer,Child-Pugh score and Albumin-Bilirubin grade.However,the evaluation of patients’performance status is a major limitation of these scoring systems.In this review,we aim to summarize the current knowledge and recent advances about the role of sarcopenia in cirrhosis in general,while focusing specifically on HCC.Additionally,the role of sarcopenia in predicting clinical outcomes and prognostication in HCC patients undergoing loco-regional therapies,liver resection,liver transplantation and systematic therapy has been discussed.A literature review was performed using databases PubMed/MEDLINE,EMBASE,Cochrane,Web of Science,and CINAHL on April 1,2021,to identify published reports on sarcopenia in HCC.Sarcopenia can independently predict HCC-related mortality especially in patients undergoing treatments such as loco-regional,surgical liver transplantation and systemic therapies.Basic research is focused on evaluating a balance of anabolic and catabolic pathways responsible for muscle health.Early clinical studies have shown promising results in methods to improve sarcopenia in HCC which can potentially increase prognosis in these patients.As sarcopenia occurs very early in HCC,it can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant management.Further,sarcopenia measurement can obviate the confounding caused by the abdominal ascites in these patients.The use of sarcopenia can add to the existing scoring systems to better pr

关键词： Sarcopenia Skeletal muscle Hepatocellular carcinoma Cirrhosis Outcomes Liver cancer

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慢性荨麻疹患者焦虑状况发生的影响因素分析及nomogram预测模型构建

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全科医学临床与教育 2024年第1期22卷 20-23,F0003页

作者：吴婵丹胡晶晶陈鲜玉曹毅永康市中医院皮肤科浙江永康321300

目的探讨慢性荨麻疹患者焦虑状况发生的影响因素并构建nomogram预测模型。方法选取200例慢性荨麻疹患者为研究对象,采用焦虑自评量表(SAS)对慢性荨麻疹患者焦虑情况进行评估,将SAS评分≥50分的患者纳入焦虑组(n=78),SAS评分2年)、发... 详细信息

目的探讨慢性荨麻疹患者焦虑状况发生的影响因素并构建nomogram预测模型。方法选取200例慢性荨麻疹患者为研究对象,采用焦虑自评量表(SAS)对慢性荨麻疹患者焦虑情况进行评估,将SAS评分≥50分的患者纳入焦虑组(n=78),SAS评分2年)、发作频率(>4次/周)、发病部位(全身)、风团持续时间(>4 h)是影响慢性荨麻疹患者焦虑状况发生的独立危险因素(OR分别=1.53、1.72、1.63、1.97、1.49、2.36,P均0.18时,可提供临床净收益。结论性别(女性)、文化程度(高中及以下)、病程(>2年)、发作频率(>4次/周)、发病部位(全身)、风团持续时间(>4 h)是影响慢性荨麻疹患者焦虑状况发生的独立危险因素,基于此构建的nomogram预测模型具有重要的临床参考意义。

关键词：慢性荨麻疹焦虑影响因素 nomogram预测模型

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Impact of utilization of hepatitis C positive organs in liver transplant:Analysis of united network for organ sharing database

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World Journal of Hepatology 2022年第5期14卷 984-991页

作者： Amaninder Dhaliwal Banreet Dhindsa Daryl Ramai Harlan Sayles Saurabh chandan Rajani Rangray Department of Gastroenterology and Hepatology Moffitt Cancer CenterTampaFL 33612United States Department of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNE 68198United States Department of Internal Medicine The Brooklyn Hospital CenterBrooklynNY 11201United States Department of Biostatistics University of Nebraska Medical CenterOmahaNE 68198United States Department of Gastroenterology and Hepatology Creighton University Medical CenterOmahaNE 68124United States

BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV treatment.The efficacy of DAA in treating HCV is nearly 100%.AIM To analyze the United Network for Organ Sharing(UNOS)database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and recipients.METHODS We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December 2017.The primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status:(Group 1)Both donor and recipient negative for HCV(Group 2)Negative donor and positive recipient for HCV(Group 3)Positive donor and negative recipient for HCV(Group 4)Both positive donor and recipient for HCV.SAS 9.4 software was used for the data analysis.Kaplan Meier log rank test was used to analyze the estimated survival rates among the four groups.RESULTS A total of 24512 patients were included:Group 1:16436,Group 2:6174,Group 3:253 and Group 4:1649.The 1-year(Group 1:91.8%,Group 2:92.12%,Group 3:87%,Group 4:92.8%),2-year(Group 1:88.4%,Group 2:88.1%,Group 3:84.3%,Group 4:87.5%),3-year(Group 1:84.9%,Group 2:84.3%,Group 3:75.9%,Group 4:83.2%)survival rates showed no statistical significance among the four groups.Kaplan Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other groups.CONCLUSION The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and recipients.This could be due to the use of DAA therapy with cure rates of nearly 100%.This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV infection.Further long-term studies are needed to further validate these findings.

关键词： Hepatitis C Liver transplant Survival United Network for Organ Sharing Direct acting antiviral

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