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Recent advances in new-onset diabetes mellitus after kidney transplantation

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World Journal of Diabetes 2021年第5期12卷 541-555页

作者： Tess Montada-Atin g v ramesh prasad Kidney Transplant Program St.Michael's HospitalToronto M5C 2T2OntarioCanada Department of Medicine University of TorontoToronto M5C 2T2Canada

A common challenge in managing kidney transplant recipients(KTR)is posttransplant diabetes mellitus(PTDM)or diabetes mellitus(DM)newly diagnosed after transplantation,in addition to known pre-existing *** is an important risk factor for post-transplant cardiovascular(Cv)disease,which adversely affects patient survival and quality of *** disease in KTR may manifest as ischemic heart disease,heart failure,and/or left ventricular *** therapies for PTDM include most agents currently used to treat type 2 *** recently,the use of sodium glucose co-transporter 2 inhibitors(SgLT2i),glucagon-like peptide-1 receptor agonists(gLP-1 RA),and dipeptidyl peptidase 4 inhibitors(DPP4i)has cautiously extended to KTR with PTDM,even though KTR are typically excluded from large general population clinical *** evidence from observational studies seems to indicate that SgLT2i,gLP-1 RA,and DPP4i may be safe and effective for glycemic control in KTR,but their benefit in reducing Cv events in this otherwise high-risk population remains *** newer drugs must still be used with care due to the increased propensity of KTR for intravascular volume depletion and acute kidney injury due to diarrhea and their single-kidney status,pre-existing burden of peripheral vascular disease,urinary tract infections due to immunosuppression and a surgically altered urinary tract,erythrocytosis from calcineurin inhibitors,and reduced kidney function from acute or chronic rejection.

关键词： Cardiovascular disease glucagon-like peptide-1 receptor agonists Kidney transplantation Oral antihyperglycemic drugs Post-transplant diabetes mellitus Sodium glucose co-transporter 2 inhibitors Dipeptidyl peptidase-4 inhibitors

Managing cardiovascular disease risk in South Asian kidney transplant recipients

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World Journal of Transplantation 2021年第6期11卷 147-160页

作者： g v ramesh prasad vaishnavi Bhamidi Kidney Transplant Program St.Michael's HospitalToronto M5C 2T2ONCanada

South Asians(SA)are at higher cardiovascular risk than other ethnic groups,and SA kidney transplant recipients(SA KTR)are no *** KTR experience increased major adverse cardiovascular events both early and late *** risk management should therefore begin well before *** candidates may require aggressive screening for pretransplant cardiovascular disease(CvD)due to their ethnicity and *** SA ethnicity during the pre-transplant evaluation may enable programs to better assess cardiovascular risk,thus allowing for earlier targeted periand post-transplant intervention to improve cardiovascular *** remains the most prominent post-transplant cardiovascular risk factor in SA *** also clusters with other metabolic syndrome components including lower high-density lipoprotein cholesterol,higher triglycerides,hypertension,and central obesity in this ***,metabolic syndrome,and obesity are all significant CvD risk factors in SA KTR,and contribute to increased insulin *** biomarkers such as adiponectin,apolipoprotein B,and lipoprotein(a)may be especially important to study in SA *** interventions to improve health behaviors involving diet and exercise may especially benefit SA ***,there are few interventional clinical trials specific to the SA population,and none are specific to SA *** all cases,understanding the nuances of managing SA KTR as a distinct post-transplant group,while still screening for and managing each CvD risk factor individually in all patients may help improve the long-term success of all kidney transplant programs catering to multi-ethnic populations.

关键词： Cardiovascular risk South Asians Diabetes Dyslipidemia Metabolic syndrome Health behavior Novel cardiovascular risk factors

Metabolic syndrome and chronic kidney disease:Current status and future directions

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World Journal of Nephrology 2014年第4期3卷 210-219页

作者： g v ramesh prasad Department of Medicine University of Toronto

Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CvD)-related risk *** the ambiguous definition of Met S,it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate,proteinuria and/or microalbuminuria,and histopathological markers such as tubular atrophy and interstitial ***,the etiological role of Met S in chronic kidney disease(CKD) is less *** relationship between MetS and CKD is complex and bidirectional,and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS,another common disease,may intervene and *** mechanisms of renal injury include insulin resistance and oxidative stress,increased proinflammatory cytokine production,increased connective tissue growth and profibrotic factor production,increased microvascular injury,and renal *** also portends a higher CvD risk at all stages of CKD from early renal insufficiency to end-stage renal *** interventions for MetS in the presence of CKD should include a combination of weight reduction,appropriate dietary modification and increase physical activity,plus targeting of individual CvD-related risk factors such as dysglycemia,hypertension,and dyslipidemia while conforming to relevant national societal guidelines.

关键词： Metabolic syndrome Cardiovascular disease Diabetes Dialysis Hyperlipidemia Hypertension Microalbuminuria Obesity Progression

Determining the Checkpoint of Transition from Thin to Thick Periodontal Phenotypes in the Maxillary and Mandibular Anterior Regions of South Indian Population

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Journal of Forensic Science and Medicine 2024年第1期10卷 55-61页

作者： Mohan Kumar Pasupuleti Rasagna Chowdary g gautami SPenmetsa vivek Bypalli ramesh S.v.Konathala Sruthima N.v.S.gottumukkala Department of Periodontics and Implantology Vishnu Dental CollegeBhimavaramAndhra PradeshIndia2Vishnu Dental CollegeBhimavaramAndhra PradeshIndia

Aim:The aim of this study was to compare and investigate the tissue thickness at the maxillary and mandibular central incisors utilizing the probe visibility method and traditional way of measuring gingival thickness(gT)by endodontic ***:In 200 selected patients,the gT was measured at both the maxillary and mandibular anterior using an endodontic file after local infiltration at the mid-distance from the gingival margin to the mucogingival *** checkpoint of transition from thin to thick periodontal phenotype was determined by probe visibility method in the following age groups:group A:21-30 years;group B:31-40 years;group C:41-50 years;and group D:51-60 ***:gT varied from 0.3 to 1.9 *** translucency was observed up to the thickness of 0.7 *** 0.8 mm of gT,there was no probe ***:According to the present research,the gingiva appears transparent up to a thickness of around 0.7 *** checkpoint of transition between thin and thick periodontal phenotypes at both the maxillary and mandibular anterior was associated with a gT of 0.8 mm.

关键词： gingiva periodontal phenotype probe visibility

Screening for cardiovascular disease before kidney transplantation

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World Journal of Transplantation 2015年第4期5卷 276-286页

作者： Sneha Palepu g v ramesh prasad Renal Transplant Program St.Michael’s HospitalUniversity of Toronto Division of Nephrology Department of MedicineUniversity of Toronto

Pre-kidney transplant cardiac screening has garnered particular attention from guideline committees as an approach to improving post-transplant success. Screening serves two major purposes: To more accurately inform transplant candidates of their risk for a cardiac event before and after the transplant, thereby informing decisions about proceeding with transplantation, and to guide pre-transplant management so that posttransplant success can be maximized. Transplant candidates on dialysis are more likely to be screened for coronary artery disease than those not being considered for transplantation. Thorough history and physical examination taking, resting electrocardiography and echocardiography, exercise stress testing, myocardial perfusion scintigraphy, dobutamine stress echocardiography, cardiac computed tomography, cardiac biomarker measurement, and cardiac magnetic resonance imaging all play contributory roles towards screening for cardiovascular disease before kidney transplantation. In this review, the importance of each of these screening procedures for both coronary artery disease and other forms of cardiac disease are discussed.

关键词： Dobutamine stress echocardiography Myocardial perfusion scanning Chronic kidney disease Coronary angiography Magnetic resonance imaging

Post-transplant dyslipidemia: Mechanisms, diagnosis and management

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World Journal of Transplantation 2016年第1期6卷 125-134页

作者： Arnav Agarwal g v ramesh prasad Division of Nephrology Department of Medicine University of Toronto Renal Transplant Program St. Michael’s Hospital

Post-transplant dyslipidemia is highly prevalent and presents unique management challenges to the clinician. The two major outcomes to considerwith post-transplant therapies for dyslipidemia are preserving or improving allograft function, and reducing cardiovascular risk. Although there are other cardiovascular risk factors such as graft dysfunction, hypertension, and diabetes, attention to dyslipidemia is warranted because interventions for dyslipidemia have an impact on reducing cardiac events in clinical trials specific to the transplant population. Dyslipidemia is not synonymous with hyperlipidemia. Numerous mechanisms exist for the occurrence of posttransplant dyslipidemia, including those mediated by immunosuppressive drug therapy. Statin therapy has received the most attention in all solid organ transplant recipient populations, although the effect of proper dietary advice and adjuvant pharmacological and nonpharmacological agents should not be dismissed. At all stages of treatment appropriate monitoring strategies for side effects should be implemented so that the benefits from these therapies can be achieved. Clinicians have a choice when there is a conflict between various transplant society and lipid society guidelines for therapy and targets.

关键词： Cholesterol Dyslipidemia Triglycerides Statins Immunosuppression

New-onset diabetes mellitus after kidney transplantation:Current status and future directions

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世界糖尿病杂志：英文版（电子版） 2015年第3期6卷 445-455页

作者： Sneha Palepu g v ramesh prasad Division of Nephrology University of TorontoSt.Michael’s Hospital

A diagnosis of new-onset diabetes after transplantation(NODAT) carries with it a threat to the renal allograft,as well as the same short-and long-term implications of type 2 diabetes seen in the general *** usually occurs early after transplantation,and is usually diagnosed according to general population ***-modifiable risk factors for NODAT include advancing age,African American,Hispanic,or South Asian ethnicity,genetic background,a positive family history for diabetes mellitus,polycystic kidney disease,and previously diagnosed glucose *** risk factors for NODAT include obesity and the metabolic syndrome,hepatitis C virus and cytomegalovirus infection,corticosteroids,calcineurin inhibitor drugs(especially tacrolimus),and *** affects graft and patient survival,and increases the incidence of post-transplant cardiovascular *** incidence and impact of NODAT can be minimized through pre-and post-transplant screening to identify patients at higher risk,including by oral glucose tolerance tests,as well as multi-disciplinary care,lifestyle modification,and the use of modified immunosuppressive regimens coupled with glucose-lowering therapies including oral hypoglycemic agents and *** NODAT is a major cause of post-transplant morbidity and mortality,measures to reduce its incidence and impact have the potential to greatly improve overall transplant success.

关键词： Cyclosporine graft Kidney New-onsetdiabetes Tacrolimus Transplantation

Laboratory evaluation of toxicity of selected insecticides against egg and larval stages of cotton pink bollworm, Pectinophora gossypiella (Saunders) (Lepidoptera: gelechiidae)

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Journal of Cotton Research 2024年第1期7卷 15-28页

作者： BUSNOOR Abhishek v. WADASKAR R.M. FAND Babasaheb B. TAMBE v.J. PILLAI T. MAHULE D.J. NAgRARE v.S. prasad Y.g. Entomology Section College of Agriculture(Dr.Panjabrao Deshmukh Krishi Vidyapeeth)Nagpur 440001MaharashtraIndia Indian Council of Agricultural Research-Central Institute for Cotton Research Nagpur 441108MaharashtraIndia

Background The cryptic nature of pink bollworm Pectinophora gossypiella(Saunders)larvae enables its reduced vul-nerability to insecticidal ***,the development of resistance against Bacillus thuringiensis(Bt)toxins posed a serious threat to transgenic cotton *** necessitated determining the critical timing of spray applications on the control *** study assessed the influence of egg age(freshly laid ***-day-old)and the loca-tion of larvae(directly exposed to the insecticide residues on the boll rind *** inside the bolls)on insecticide control *** The results revealed a significant decrease in the ovicidal activity of tested insecticides with an increase in the age of eggs from one day old to three days old(paired t-test,Pvae directly exposed to the insec-ticide residues on the boll rind were more susceptible(>80%mortality)than the larvae exposed after they had bur-rowed inside the bolls(velopmental biology were more pronounced in the experiment on pre-larval release insecticide treatment compared with insecticide treatment given post-larval release and entry inside the *** Egg age influences the insecticide susceptibility,as does the larval location,directly exposed vs bur-rowed inside the *** eggs and the larvae that had burrowed inside the green bolls of cotton were relatively less susceptible to the insecticide *** toxic effects of insecticides on egg and larval stages were primar-ily *** findings are significant for devising a comprehensive strategy for pink bollworm management on a sustainable basis.

关键词： Bioefficacy Cotton Insecticides Pink bollworm Pectinophora gossypiella Timings of spray

Bio-Inspired Intelligent Routing in WSN: Integrating Mayfly Optimization and Enhanced Ant Colony Optimization for Energy-Efficient Cluster Formation and Maintenance

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Computer Modeling in Engineering & Sciences 2024年第10期141卷 127-150页

作者： v.g.Saranya S.Karthik Department of Electronics and Communication Engineering Faculty of Engineering&TechnologySRM Institute of Science and TechnologyVadapalani CampusChennai600026India

Wireless Sensor Networks(WSNs)are a collection of sensor nodes distributed in space and connected through wireless *** sensor nodes gather and store data about the real world around ***,the nodes that are dependent on batteries will ultimately suffer an energy loss with time,which affects the lifetime of the *** research proposes to achieve its primary goal by reducing energy consumption and increasing the network’s lifetime and *** present technique employs the hybrid Mayfly Optimization Algorithm-Enhanced Ant Colony Optimization(MFOA-EACO),where the Mayfly Optimization Algorithm(MFOA)is used to select the best cluster head(CH)from a set of nodes,and the Enhanced Ant Colony Optimization(EACO)technique is used to determine an optimal route between the cluster head and base *** performance evaluation of our suggested hybrid approach is based on many parameters,including the number of active and dead nodes,node degree,distance,and energy *** objective is to integrate MFOA-EACO to enhance energy efficiency and extend the network life of the WSN in the *** proposed method outcomes proved to be better than traditional approaches such as Hybrid Squirrel-Flying Fox Optimization Algorithm(HSFLBOA),Hybrid Social Reindeer Optimization and Differential Evolution-Firefly Algorithm(HSRODE-FFA),Social Spider Distance Sensitive-Iterative Antlion Butterfly Cockroach Algorithm(SADSS-IABCA),and Energy Efficient Clustering Hierarchy Strategy-Improved Social Spider Algorithm Differential Evolution(EECHS-ISSADE).

关键词： Enhanced ant colony optimization mayfly optimization algorithm wireless sensor networks cluster head base station(BS)