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Characterization of tumors of jaw:Additive value of contrast enhancement and dual-energy computed tomography

World Journal of Radiology 2024年第4期16卷 82-93页

作者： deepak Justine Viswanathan Ashu Seith Bhalla Smita Manchanda Ajoy Roychoudhury Deepika Mishra Asit Ranjan Mridha Department of Radiodiagnosis and Interventional Radiology All India Institute of Medical SciencesNew Delhi 110029India Department of Oral and Maxillofacial Surgery All India Institute of Medical SciencesNew Delhi 110029India Department of Oral Pathology and Microbiology All India Institute of Medical SciencesNew Delhi 110029India Department of Pathology All India Institute of Medical SciencesAnsari NagarNew Delhi 110029India

BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the *** is a paucity of literature on the enhancement characteristics of jaw *** is mainly because,even though computed tomography(CT)is used to evaluate these lesions,they are often imaged without intravenous *** study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT,therefore improving the ability to differentiate between various *** To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw *** Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy *** analysis of the tumor,including the enhancing solid component,was done,followed by quantitative analysis of iodine concentration(IC),water concentration(WC),HU,and normalized *** study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma(CGCG),ameloblastoma,odontogenic keratocyst(OKC),and other jaw tumors.A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for nonparametric variables were *** significant differences were found,a series of independent t-tests or Mann-Whitney U tests were *** Ameloblastoma was the most common pathology(n=20),followed by CGCG(n=11)and *** showed a higher mean concentration of all quantitative parameters than ameloblastomas(P<0.05).An IC threshold of 31.35×100μg/cm^(3) had the maximum sensitivity(81.8%)and specificity(65%).Between ameloblastomas and OKC,the former showed a higher mean concentration of all quantitative parameters(P<0.001),however when comparing unilocular ameloblastomas with OKCs,the latter showed

关键词： Jaw neoplasms Ameloblastomas Dual-energy computed tomography Iodine quantification Mandibular neoplasms Maxillary neoplasms

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Evaluation of Rainfall Tendency for the Twentieth Century over Indira Sagar Region in Central India

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American Journal of Climate Change 2024年第1期13卷 47-68页

作者： Rituraj Shukla deepak Khare Ramesh P. Rudra Priti Tiwari Himanshu Sharma Prasad Daggupati Pradeep Goel School of Engineering University of Guelph Guelph Canada Department of Water Resources Development and Management Indian Institute of Technology Roorkee India Indira Gandhi Agricultural University Raipur India Department of Civil Engineering Institute of Infrastructure Technology Research and Management (IITRAM) Ahmedabad India

The study investigates long-term changes in annual and seasonal rainfall patterns in the Indira Sagar Region of Madhya Pradesh, India, from 1901 to 2010. Agriculture sustainability, food supply, natural resource development, and hydropower system reliability in the region rely heavily on monsoon rainfall. Monthly rainfall data from three stations (East Nimar, Barwani, and West Nimar) were analyzed. Initially, the pre-whitening method was applied to eliminate serial correlation effects from the rainfall data series. Subsequently, statistical trends in annual and seasonal rainfall were assessed using both parametric (student-t test) and non-parametric tests [Mann-Kendall, Sen’s slope estimator, and Cumulative Sum (CUSUM)]. The magnitude of the rainfall trend was determined using Theil-Sen’s slope estimator. Spatial analysis of the Mann-Kendall test on an annual basis revealed a statistically insignificant decreasing trend for Barwani and East Nimar and an increasing trend for West Nimar. On a seasonal basis, the monsoon season contributes a significant percentage (88.33%) to the total annual rainfall. The CUSUM test results indicated a shift change detection in annual rainfall data for Barwani in 1997, while shifts were observed in West and East Nimar stations in 1929. These findings offer valuable insights into regional rainfall behavior, aiding in the planning and management of water resources and ecological systems.

关键词： Precipitation Parametric Non-Parametric Tests Trend Analysis Serial Correlations

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A Comparative Study between Landmark Based and Real Time Ultrasound Guided Sub Arachnoid Block

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Open Journal of Anesthesiology 2024年第4期14卷 118-125页

作者： Kunal Tewari Om Bahadur Thapa deepak Mishra Manjot Multani Jyotsna Sharma Akash Ray Mohapatra Sandhya Khwaunju Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care AFMC Pune India

Background: Sub arachnoid block (SAB) performed by traditional landmark palpation technique can be inaccurate. This problem is exacerbated by altered patient anatomy due to obesity and age-related changes. A pre-procedural ultrasound scan of the lumbar spine has been shown to be of benefit in guiding lumbar epidural insertion in obstetric patients. Information on the use of real-time ultrasound (RUS) guided SAB, to date, been limited. This study compared RUS guided SAB to traditional landmark guided technique in patients undergoing spinal anesthesia for different surgical procedures. Methods: This was a prospective, single center, comparative observational study conducted in the department of anesthesiology at our center. 560 patients who underwent spinal anesthesia either by landmark based technique or real-time ultrasound-guided methods. The primary outcome was the first attempt success rate of dural puncture when employing the two methods. Results: Baseline characteristics were similar in the two study groups. The first attempt success rate of dural puncture in landmark guided group was 64.3% compared to 72.6% in the ultrasound guided group. This difference was not statistically significant. The procedure performance time was significantly shorter with landmark palpation compared to use of real-time ultrasound guided method. Conclusion: Use of RUS-guided technique does not significantly improve the first attempt success rate of SAB dural puncture during spinal anesthesia compared to the traditional landmark-guided technique.

关键词： Sub Arachnoid Block (SAB) Real Time Ultrasound (RUS)

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Handgrip strength in type 2 diabetics and nondiabetics:A comparative cross-sectional study among adults in rural Mysore

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Journal of Integrative Nursing 2024年第3期6卷 150-154页

作者： deepak ANIL M.RAKESH Shabeena AKBAR Vijaylakshmi Rao VADAGA D.Sunil KUMAR Department of Community Medicine JSS Medical CollegeJSS Academy of Higher Education and ResearchMysoreKarnatakaIndia

Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and HGS among diabetic *** and Methods:A community-based cross-sectional study was conducted in rural Mysore,India,for 4 ***-eight clinically diagnosed type 2 diabetics and 58 nondiabetics participated in the *** handheld dynamometer was used to test the HGS of all subjects in their dominant *** t-test was used to analyze the differences in HGS between patients with and without ***:The mean dynamometer reading among diabetics was 19.08±7.51,whereas that in nondiabetics was 27.474±*** was a significant difference in HGSs between diabetics and nondiabetics(P<0.01).Conclusion:Decreased muscle strength and quality in the upper extremities are associated with type 2 diabetes and can lead to functional and physical *** patients’HGS should be evaluated promptly to identify any disabilities and plan for appropriate therapy.

关键词： Diabetics dynamometer handgrip muscle strength

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Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of Anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru deepak Mishra Nitin Pahuja Akash Ray Mohapatra Jyotsna Sharma Om Bahadur Thapa Manjot Multani Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care Military Hospital Bhopal India

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema Pleural effusion Lung ultrasound (LUS) Pneumothorax

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Sedation reversal trends at outpatient ambulatory endoscopic center vs in-hospital ambulatory procedure center using a triage protocol

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 413-423页

作者： Saqib Walayat Peter Stadmeyer Azfar Hameed Minahil Sarfaraz Paul Estrada Mark Benson Anurag Soni Patrick Pfau Paul Hayes Brittney Kile Toni Cruz deepak Gopal Department of Gastroenterology University of IllinoisPeoriaIL 61605United States Department of Gastroenterology University of WisconsinMadisonWI 53792United States Department of Internal Medicine Texas Health DentonDentonTX 76201United States Department of Internal Medicine Allama Iqbal Medical CollegeLahore 042Pakistan Department of Gastroenterology Texas Tech University Health Services CenterEl PasoTX 79911United States Department of Gastroenterology and Hepatology University of WisconsinMadisonWI 53705United States Finance Business Partners UW Health University of WisconsinMadisonWI 53792United States UW Health Digestive Health Center Endoscopy University of WisconsinMadisonWI 53792United States Division of Gastroenterology and Hepatology Department of MedicineUniversity of Wisconsin Hospitals and ClinicsMadisonWI 53705United States

BACKGROUND Routine outpatient endoscopy is performed across a variety of outpatient settings.A known risk of performing endoscopy under moderate sedation is the potential for over-sedation,requiring the use of reversal *** needs to be reported on rates of reversal across different outpatient *** academic tertiary care center utilizes a triage tool that directs higher-risk patients to the in-hospital ambulatory procedure center(APC)for their ***,we report data on outpatient sedation reversal rates for endoscopy performed at an inhospital APC vs at a free-standing ambulatory endoscopy digestive health center(AEC-DHC)following risk stratification with a triage *** To observe the effect of risk stratification using a triage tool on patient outcomes,primarily sedation reversal *** We observed all outpatient endoscopy procedures performed at AEC-DHC and APC from April 2013 to September *** were stratified to their respective sites using a triage *** evaluated each procedure for which sedation reversal with flumazenil and naloxone was *** and characteristics recorded include patient age,gender,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,procedure type,and reason for sedation *** There were 97366 endoscopic procedures performed at AEC-DHC and 22494 at the APC during the study *** these,17 patients at AEC-DHC and 9 at the APC underwent sedation reversals(0.017%vs 0.04%;P=0.06).Demographics recorded for those requiring reversal at AEC-DHC vs APC included mean age(53.5±21 vs 60.4±17.42 years;P=0.23),ASA class(1.66±0.48 vs 2.22±0.83;P=0.20),BMI(27.7±6.7 kg/m^(2) vs 23.7±4.03 kg/m^(2);P=0.06),and female gender(64.7%vs 22%;P=0.04).The mean doses of sedative agents and reversal drugs used at AEC-DHC vs APC were midazolam(5.9±1.7 mg vs 8.9±3.5 mg;P=0.01),fentanyl(147.1±49.9μg vs 188.9±74.1μg;P=0.10),flumazenil(0.3±0.18μg vs 0.17±0.17μg;P=0.13)and naloxo

关键词： Ambulatory care Conscious sedation Endoscopy Colonoscopy Risk assessment Risk factors

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Comprehensive G?bner Basis Theory for a Parametric Polynomial Ideal and the Associated Completion Algorithm

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Journal of Systems Science & Complexity 2017年第1期30卷 196-233页

作者： KAPUR deepak Department of Computer Science University of New Mexico Albuquerque NM USA.

Groebner basis theory for parametric polynomial ideals is explored with the main objec- tive of nfinicking the Groebner basis theory for ideals. Given a parametric polynomial ideal, its basis is a comprehensive GrSbner basis if and only if for every specialization of its parameters in a given field, the specialization of the basis is a GrSbnerbasis of the associated specialized polynomial ideal. For various specializations of parameters, structure of specialized ideals becomes qualitatively different even though there are significant relationships as well because of finiteness properties. Key concepts foundational to GrSbner basis theory are reexamined and/or further developed for the parametric case：（i） Definition of a comprehensive Groebner basis, （ii） test for a comprehensive GrSbner basis, （iii） parameterized rewriting, （iv） S-polynomials among parametric polynomials, （v） completion algorithm for directly computing a comprehensive Groebner basis from a given basis of a parametric ideal. Elegant properties of Groebner bases in the classical ideal theory, such as for a fixed admissible term ordering, a unique GrSbner basis can be associated with every polynomial ideal as well as that such a basis can be computed from any Groebner basis of an ideal, turn out to be a major challenge to generalize for parametric ideals; issues related to these investigations are explored. A prototype implementation of the algorithm has been successfully tried on many examples from the literature.

关键词： Comprehensive GrSbner basis minimal comprehensive GrSbner basis parametric polyno-mial system parametric S-polynomial redundancy.

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Conditional Congruence Closure over Uninterpreted and Interpreted Symbols

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Journal of Systems Science & Complexity 2019年第1期32卷 317-355页

作者： KAPUR deepak Department of Computer Science University of New Mexico

A framework for generating congruence closure and conditional congruence closure of ground terms over uninterpreted as well as interpreted symbols satisfying various properties is proposed. It is based on some of the key concepts from Kapur's congruence closure algorithm(RTA97)for ground equations based on introducing new symbols for all nonconstant subterms appearing in the equation set and using ground completion on uninterpreted constants and puri?ed equalities over interpreted symbols belonging to different theories. In the original signature, the resulting rewrite systems may be nonterminating but they still generate canonical forms. A byproduct of this framework is a constant Horn completion algorithm using which ground canonical Horn rewrite systems can be generated for conditional ground *** effcient algorithms for generating congruence closure of conditional and unconditional equations on ground terms over uninterpreted symbols are presented. The complexity of the conditional congruence closure is shown to be O(n*log(n)), which is the same as for unconditional ground *** proposed algorithm is motivated by our attempts to generate effcient and succinct interpolants for the quanti?er-free theory of equality over uninterpreted function symbols which are often a conjunction of conditional equations and need additional simpli?cation. A completion algorithm to generate a canonical conditional rewrite system from ground conditional equations is also presented. The framework is general and ?exible and is used later to develop congruence closure algorithms for cases when function symbols satisfy simple properties such as commutativity, nilpotency, idempotency and identity as well as their combinations. Interesting outcomes include algorithms for canonical rewrite systems for ground equational and conditional theories on uninterpreted and interpreted symbols leading to generation of canonical forms for ground terms, constrained terms and Horn equat

关键词： Completion congruence closure conditional congruence closure intepreted symbols rewrit-ing uninterpreted symbols

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Impact of surface Albedo on Martian photochemistry

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Earth and Planetary Physics 2020年第3期4卷 206-211页

作者： deepak Singh Physical Research Laboratory AhmedabadIndia

Solar energy is the primary driving force behind a planet’s climate system,and surface albedo plays a key role in determining the energy budget of the *** the Snow,Ice,and Aerosol Radiation(SNICAR)with the Laboratoire de Météorologie Dynamique(LMD)Mars General Circulation Model(MGCM)to create a new coupled model leads to an approximately 4%drop in the net CO2 ice deposition on *** simulated surface albedo affects the concentration of gaseous species in the Martian atmosphere(condensation-sublimation cycle).The new set-up also impacts the solar energy available in the *** two effects together lead to subsequent and significant changes in other chemical species in the Martian *** with results of the MGCM model alone,in the new coupled model CO2(gas)and O3 show a drop of about 1.17%and 8.59%in their respective concentrations,while H2O(vapor)and CO show an increase of about 13.63%and 0.56%in their respective *** trace species,OH shows a maximum increase of about 29.44%,while the maximum drop of 11.5%is observed in the O *** neutral species such as Ar and N2 remain unaffected by the albedo changes.

关键词： Mars Albedo snow photochemistry climate modelling

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Effectiveness of state incentives for promoting wind energy： A panel data examination

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Frontiers in Energy 2015年第3期9卷 247-258页

作者： deepak SANGROYA Jogendra NAYAK Department of Management Studies Indian Institute of Technology IIT Roorkee Roorkee 247667 India

Over the last decade, India has started to concentrate earnestly on renewable energy. The Indian government, as well as different state governments, are adopting policy instruments such as feed in tariff, captive consumption, renewable purchase obligation and genera- tion based incentive etc. aimed at renewable energy development. This paper evaluates the effectiveness of state level incentives for the development of wind energy in India. Fixed effect panel data modelling technique of econometric analysis is used to analyse the data of 26 Indian states in 11 years. The results show that feed in tariff and captive consumption are the significant predictors of wind energy development. However, renewable purchase obligation does not affect wind energy significantly.

关键词： India wind energy development state incen-tives econometric analysis panel data

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