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Non-responsive celiac disease in children on a gluten free diet

World Journal of Gastroenterology 2021年第13期27卷 1311-1320页

作者： gopal Veeraraghavan Amelie Therrien Maya Degroote Allison McKeown Paul D Mitchell Jocelyn A Silvester Daniel A Leffler Alan M Leichtner Ciaran P Kelly Dascha C Weir Division of Gastroenterology Hepatology and NutritionBoston Children's HospitalBostonMA 02115United States The Celiac Center Department of Medicine and Division of GastroenterologyBeth Israel Deaconess Medical CenterBostonMA 02215United States Celiac Research Program Harvard Medical SchoolBostonMA 02115United States Institutional Centers for Clinical and Translational Research Boston Children's HospitalBostonMA 02115United States Gastrointestinal Therapeutics Takeda Pharmaceutical International CoCambridgeMA 02139United States

BACKGROUND Non-responsive celiac disease(NRCD) is defined as the persistence of symptoms in individuals with celiac disease(CeD) despite being on a gluten-free diet(GFD). There is scant literature about NRCD in the pediatric *** To determine the incidence, clinical characteristics and underlying causes of NRCD in *** Retrospective cohort study performed at Boston Children’s Hospital(BCH). Children < 18 years diagnosed with CeD by positive serology and duodenal biopsies compatible with Marsh Ⅲ histology between 2008 and 2012 were identified in the BCH’s Celiac Disease Program database. Medical records were longitudinally reviewed from the time of diagnosis through September 2015. NRCD was defined as persistent symptoms at 6 mo after the initiation of a GFD and causes of NRCD as well as symptom evolution were detailed. The children without symptoms at 6 mo(responders) were compared with the NRCD group. Additionally, presenting signs and symptoms at the time of diagnosis of CeD among the responders and NRCD patients were collected and compared to identify any potential predictors for NRCD at 6 mo of GFD *** Six hundred and sixteen children were included. Ninety-one(15%) met criteria for NRCD. Most were female(77%). Abdominal pain [odds ratio(OR) 1.8 95% confidence interval(CI) 1.1-2.9], constipation(OR 3.1 95%CI 1.9-4.9) and absence of abdominal distension(OR for abdominal distension 0.4 95%CI 0.1-0.98) at diagnosis were associated with NRCD. NRCD was attributed to a wide variety of diagnoses with gluten exposure(30%) and constipation(20%) being the most common causes. Other causes for NRCD included lactose intolerance(9%), gastroesophageal reflux(8%), functional abdominal pain(7%), irritable bowel syndrome(3%), depression/anxiety(3%), eosinophilic esophagitis(2%), food allergy(1%), eating disorder(1%), gastric ulcer with Helicobacter pylori(1%), lymphocytic colitis(1%), aerophagia(1%) and undetermined(13%). 64% of children with NRCD

关键词： Celiac disease Non-responsive celiac disease Children Gluten-free diet Constipation Abdominal pain

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An Evaluation of Different Risk Ranking Systems

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Journal of Environmental Protection 2013年第8期4卷 78-86页

作者： Huimei Sha, Ron J. Thiessen gopal Achari Department of Civil Engineering University of Calgary Calgary Canada Department of Civil Engineering University of Calgary Calgary Canada.

A number of risk ranking systems for contaminated sites have been developed by different jurisdictions. While the intent of each of these systems is similar, it is not clear whether they provide results that are comparable. In this paper, 20 contaminated sites are used to assess the United States’ Preliminary Assessment (PA) system, Sweden’s Methods for Inventories of Contaminated Sites (MICS) and New Zealand’s Risk Screening System (RSS) methods. The results were compared with each other and with Canada’s National Classification System for Contaminated Sites (NCSCS) as well as preliminary quantitative risk assessment (PQRA) results. The objectives were to determine if the systems yield similar recommendations regarding further actions, and to assess if there are acceptable correlations between different methods. The study concludes that PA, MICS and NCSCS methods can achieve similar conclusions, although there is a certain degree of inconsistency that is present, RSS can distinguish the very high and very low risk sites and, acceptable correlations exists among the methods except for PA and PQRA.

关键词： Risk Ranking System Contaminated Sites Risk Assessment PA MICS RSS NCSCS and PQRA

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Titanasilsesquioxane-Alkylaluminum Catalyst System for Ethylene Polymerization

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Modern Research in Catalysis 2012年第3期1卷 29-42页

作者： Akshay Mehta gopal Tembe Parimal Parikh Girish Mehta Applied Chemistry Department S. V. National Institute of Technology Surat India Chemical Engineering Department S. V. National Institute of Technology Surat India Reliance Technology Group Reliance Industries Limited Vadodara Manufacturing Division Vadodara India

Homogeneous Ti(IV) complexes covalently anchored to Polyhedral Oligomeric Silsesquioxane (POSS) have been synthesized by the stoichiometric reaction between titanium(IV)alkoxide and (iso-Octyl)7Si7O9(OH)3. These catalyst precursors formulated as [Ti(OR)(iso-Octyl)7Si7O12] were characterized by physicochemical and spectroscopic methods. These supported catalysts are found to be active in polymerization of ethylene at high temperatures in presence of ethylaluminum sesquichloride (Et3Al2Cl3, EASC) as co-catalyst. The polyethylene obtained are generally linear, crystalline and display low molecular weight distribution. The microstructure of the polymer was analyzed by NMR and FT-IR spectroscopic methods which indicated a chain transfer reaction to aluminum. The unique molecular properties of PE formed has been compared with commercial micronized PE wax which find industrial applications in surface coating and ink formulations. The effect of reaction conditions on catalytic behaviour is described.

关键词： POSS Titanasilsesquioxane Polyethylene Ethylaluminum Sesquichloride Polymer Microstructure

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Growth and Yield Responses of Switchgrass Ecotypes to Temperature

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American Journal of Plant Sciences 2013年第6期4卷 1173-1180页

作者： Tanka Prasad Kandel Yanqi Wu Vijaya gopal Kakani Department of Plant and Soil Sciences Oklahoma State University Stillwater USA.

Varietal differences of switchgrass in growth and development, biomass yield and partitioning in response to temperature are not well documented. A study was conducted to quantify the effect of temperature on growth, development, and feedstock quality of switchgrass cultivars, and to determine differences between upland and lowland switchgrass. Two lowland (“Alamo” and “Kanlow”) and two upland (“Caddo” and “Cave-in-Rock”) cultivars of switchgrass were grown in pots filled with pure, fine sand in growth chambers. Four different temperature treatments of 23℃/15℃, 28℃/20℃, 33℃/25℃, and 38℃/30℃ with 14/10 hours day/night were imposed at four leaf stage. High temperature significantly decreased the biomass yield across all cultivars. Stem elongation rate (SER) and leaf elongation rate (LER) decreased at the highest temperature treatment but lowland cultivars had significantly higher SER and LER across the temperature treatments. Upland cultivars produced more tillers across the temperature treatment. Both shoot/root and leaf/stem ratios increased under the highest temperature in all cultivars, but upland cultivars partitioned more to the leaf and root at higher temperature. Concentration of cellulose decreased at the highest temperature but temperature had no effect on lignin concentration of leaf and stem biomass. In conclusion, although none of the cultivars studied showed strong tolerance to high temperature, differences were observed for many traits of switchgrass in response to temperature.

关键词： Biomass Partitioning Chemical Composition Growth Response Switchgrass Temperature

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Seismic Performances of Mountainous Continuous Rigid Frame Solid and Hollow Pier Railway Bridges

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Open Journal of Civil Engineering 2018年第4期8卷 489-507页

作者： Akhil Subedi gopal S. Bhandari Paribesh Parajuli Department of Bridge and Tunnel Engineering School of Civil Engineering Southwest Jiaotong University Chengdu China

This paper focuses on the seismic performance of mountainous railway bridges having different pier type i.e. rectangular hollow piers and solid piers. The piers used were of same materials and inertial properties. For this, 3-D FEM models of these bridges were created by ANSYS 15.0. For seismic assessment, Response Spectrum and Dynamic Time-History Analysis methods were adopted. Different types of earthquake waves used were Elcentro, Wenchuan and Nepal earthquakes, all normalized to 0.3 g Peak Ground Acceleration (PGA). The study concluded that even though the hollow pier bridges are susceptible to large displacements, its dealing with internal forces is remarkable compared to solid pier bridges.

关键词： Hollow Pier Mountainous Bridge Solid Pier Mountainous Bridge Response Spectrum Analysis Modal Analysis Time-History Analysis

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Reconfigurable metasurface-based 1×2 waveguide switch

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Photonics Research 2021年第10期9卷 2104-2115页

作者： AMGED ALQULIAH MOHAMED ELKABBASH JINLUO CHENG gopal VERMA CHAUDRY SAJED SARAJ WEI LI CHUNLEI GUO GPL Changchun Institute of OpticsFine Mechanics and PhysicsChinese Academy of SciencesChangchun 130033China University of Chinese Academy of Sciences Beijing 100049China The Institute of Optics University of RochesterRochesterNew York 14627USA Current address:The Research Laboratory of Electronics Massachusetts Institute of TechnologyCambridgeMassachusetts 02139USA

Reconfigurable nanophotonic components are essential elements in realizing complex and highly integrated photonic *** we report a novel concept for devices with functionality to dynamically control guided light in the near-visible spectral range,which is illustrated by a reconfigurable and non-volatile(1×2)switch using an ultracompact active *** switch is made of two sets of nanorod arrays of TiO_(2) and antimony trisulfide(Sb_(2)S_(3)),a low-loss phase-change material(PCM),patterned on a silicon nitride *** metasurface creates an effective multimode interferometer that forms an image of the input mode at the end of the stem waveguide and routes this image toward one of the output ports depending on the phase of PCM ***,our metasurface-based 1×2 switch enjoys an ultracompact coupling length of 5.5μm and a record high bandwidth(22.6 THz)compared to other PCM-based ***,our device exhibits low losses in the near-visible region(∼1 dB)and low cross talk(−11.24 dB)over a wide bandwidth(22.6 THz).Our pro-posed device paves the way toward realizing compact and efficient waveguide routers and switches for applications in quantum computing,neuromorphic photonic networking,and biomedical sensing and optogenetics.

关键词： waveguide interferometer surface

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Geographically distributed hybrid testing & collaboration between geotechnical centrifuge and structures laboratories

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Earthquake Engineering and Engineering Vibration 2018年第1期17卷 53-71页

作者： Mobin Ojaghi Ignacio Lamata Martínez Matt S.Dietz Martin S.Williams Anthony Blakeborough Adam J.Crewe Colin A.Taylor S.P.gopal Madabhushi Stuart K.Haigh Department of Engineering Science University of Oxford Department of Civil Engineering University of Bristol Department of Engineering University of Cambridge

Distributed Hybrid Testing（DHT） is an experimental technique designed to capitalise on advances in modern networking infrastructure to overcome traditional laboratory capacity limitations. By coupling the heterogeneous test apparatus and computational resources of geographically distributed laboratories, DHT provides the means to take on complex, multi-disciplinary challenges with new forms of communication and collaboration. To introduce the opportunity and practicability afforded by DHT, here an exemplar multi-site test is addressed in which a dedicated fibre network and suite of custom software is used to connect the geotechnical centrifuge at the University of Cambridge with a variety of structural dynamics loading apparatus at the University of Oxford and the University of Bristol. While centrifuge time-scaling prevents real-time rates of loading in this test, such experiments may be used to gain valuable insights into physical phenomena, test procedure and accuracy. These and other related experiments have led to the development of the real-time DHT technique and the creation of a flexible framework that aims to facilitate future distributed tests within the UK and beyond. As a further example, a real-time DHT experiment between structural labs using this framework for testing across the Internet is also presented.

关键词： centrifuge distributed dynamics geotechnical hardware-in-the-loop real-time hybrid testing

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Modified Multiple Scale/Segment Entropy （MMPE） Analysis of Heart Rate Variability of NHH, CHF ＆ AF Subjects

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Journal of Life Sciences 2011年第8期5卷 593-597页

作者： Chodavarapu Renu Madhavi Alevoor gopal Krishnachar Ananth Rastreeya Vidyalaya. College of Engineering Bangalore Karnataka 560059 India

Nonlinear analysis of heart rate variability （HRV） has become important as heart behaves as a complex system. In this work, the approximate entropy （ApEn） has been used as a nonlinear measure. A new concept of estimating the ApEn in different segments of long length of the recorded data called modified multiple scale （segment） entropy （MMPE） is introduced. The idea of estimating the approximate entropy in different segments is useful to detect the nonlinear dynamics of the heart present in the entire length of data. The present work has been carried out for three cases namely the normal healthy heart （NHH） data, congestive heart failure （CHF） data and Atrial fibrillation （AF） data and the data are analyzed using MMPE techniques. It is observed that the mean value of ApEn for NHH data is much higher than the mean values for CHF data and AF data. The ApEn profiles of CHF, AF and NHH data for different segments obtained using MPE profiles measures the heart dynamism for the three different cases. Also the power spectral density is obtained using fast fourier transform （FFT） analysis and the ratio of LF/HF （low frequency/high frequency） power are computed on multiple scales/segments namely MPLH （multiple scale low frequency to high frequency） for the NHH data, CHF data and AF data and analyzed using MPLH techniques. The results are presented and discussed in the paper.

关键词： Multiple scale/segment heart rate variability approximate entropy congestive heart failure atrial fibrillations.

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Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux

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World Journal of Gastroenterology 2007年第11期13卷 1706-1710页

作者： Bhavneesh Sharma Manisha Sharma Mradul Kumar Daga gopal Krishan Sachdev Elliott Bondi Brookdale University Hospital and Medical Center Division of Pulmonary and Critical Care Medicine State University of New York Brooklyn New York 11212 United States University of Delhi Maulana Azad Medical College Divisions of Pulmonary Medicine and Gastroenterology New Delhi 110002 India

AIM： To study the effect of combined omeprazole（Ome） and domperidone（Dom） therapy on asthma symptoms and pulmonary function in asthmatics with gastroesoph- ageal reflux. METHODS： We selected 198 asthmatics with gastro- esophageal reflux diagnosed by 24-h esophageal pH moni- toring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk （1：1 double-blind randomization）. Spirometry was done at baseline and after 16 wk of treatment. The primary outcome measures were： mean daily daytime and nighttime asthma symptom scores. Mean daily reflux symptom scores, albuterol use as rescue medication （number of puffs）, daytime and nighttime peak expiratory flow rate （PEFR）, postbronchodilator forced expiratory volume in 1 second （FEVl） and postbronchodilator forced vital capacity （FVC） were secondary outcome measures. RESULTS： Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score （17.4% vs 8.9 %）, nighttime asthma symptom score （19.6% vs 5.4%）, reflux symptom score （8.7% vs 1.6%） and rescue medication use （23.2% vs 3.1%） after antireflux therapy compared to mean change in placebo group （P 〈 0.001）. There was significant improvement in morning PEFR （7.9% vs 0.2%）, evening PEFR （9.8% vs 0.5%）, FEW （11.1% vs 3.78%） and FVC （9.3%vs 1.52%） in the antireflux therapy group compared to placebo on comparng the mean change from baseline after 16 wk （P 〈 0.01） CONCLUSION： Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medi- cation use, and improving pulmonary function.

关键词： Asthma Reflux Gastroesophageal reflux disease Antireflux therapy Prokinetic Omeprazole

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锁骨钩钢板与双Endobutton技术治疗肩锁关节脱位的比较研究

锁骨钩钢板与双Endobutton技术治疗肩锁关节脱位的比较研究

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作者： gopal Prasad Yadav（亚德）东南大学

学位级别：硕士

背景:多种手术技术被用于治疗肩锁关节脱位,但最佳的治疗方法仍不清楚。目的:比较双Endobutton钢板内固定术与锁骨钩钢板内固定术治疗肩锁关节脱位的疗效。方法:对2013年1月至2016年2月在东南大学附属中大医院就诊接受手术治疗的34例肩... 详细信息

背景:多种手术技术被用于治疗肩锁关节脱位,但最佳的治疗方法仍不清楚。目的:比较双Endobutton钢板内固定术与锁骨钩钢板内固定术治疗肩锁关节脱位的疗效。方法:对2013年1月至2016年2月在东南大学附属中大医院就诊接受手术治疗的34例肩锁关节脱位患者进行回顾性研究。根据手术方式不同分为2组:锁骨钩钢板内固定术组(组1,20例),双Endobutton钢板内固定术组(组2,14例),术后随访时间为14-16周。疗效评价指标包括Constant-Murley评分、VAS疼痛评分、住院时间、手术时长、术后并发症及术中出血量等。所有的数据以平均值士标准偏差表示。使用SPSS v.20进行数据分析。采用T检验或Mann-Whi tney非参数检验对组间变量进行比较。结果:随访末期,组1的平均Constant-Murley评分为80.5 ± 9.7明显低于组2(92.2 ± 7.2),两组差异有统计学意义(p<0.05,p=0.01)。组1和组2的平均VAS评分分别为1.6 ± 1.1和0.4 ± 0.6,两组差异有统计学意义(p<0.05,p=0.02)。组2术前术后功能和疼痛改善程度也明显优于组1。组1术中出血量明显高于组2(P=0.01),而在住院时间(p=0.2)和手术时长(p=0.5)上两组间无明显差异。结论:肩锁钩钢板固定和双Endobutton技术治疗肩锁关节脱位均能获得比较满意的临床结果。相对于肩锁钩钢板固定技术,双Endobutton技术能够获得更好的疼痛缓解和功能恢复。

关键词：肩锁关节 endobutton 钩板脱位

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