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Chinese Journal of Traumatology 2011年第3期14卷 183-187页

作者： Ramesh kumar Sen Sujit kumar Tripathy Vibhu Krishnan Tarun goyal Vanyambadi Jagadeesh Department of Orthopedics Postgraduate Institute of Medical Education and Research Chandigarh 160012 India

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracturedislocations of the left hip （Pipkin＇s type IV） and knee （Moore II）joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin＇s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no insta-bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

关键词： Hip dislocation Knee dislocation Fractures bone

Small bowel adenocarcinoma:An overview

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World Journal of Gastrointestinal Oncology 2022年第2期14卷 413-422页

作者： Divya Khosla Treshita Dey Renu Madan Rahul Gupta Shikha goyal Narendra kumar Rakesh Kapoor Department of Radiotherapy and Oncology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of Gastroenterology Shalby Multispeciality HospitalMohali 160062PunjabIndia

Small bowel adenocarcinoma(SBA)is a rare malignancy of the gastrointestinal ***,these tumors are among those with worst *** clinical signs and symptoms and radiological diagnostic challenges often delay treatment,which negatively impacts the prognosis of the ***,recent advances in imaging technology,like multidetector computed tomography,magnetic resonance imaging,and capsule endoscopy,have made earlier and accurate diagnosis *** is the treatment of choice followed by adjuvant ***,there are no strict treatment guidelines available for the management of *** of the available evidence from colorectal and gastric carcinoma has been extrapolated to adequately manage *** for SBA is better than gastric carcinoma but worse than colorectal ***,there is not enough information on the molecular characteristics and tumor *** the incidence of SBA is very low,there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

关键词： Adenocarcinoma Chemotherapy Prognostic factors Small bowel Surgery

CCR5A32 mutation does not influence the susceptibility to HCV infection, severity of liver disease and response to therapy in patients with chronic hepatitis C

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World Journal of Gastroenterology 2006年第29期12卷 4721-4726页

作者： Ankur goyal PV Suneetha GT kumar Deepak K Shukla Naveen Arora Shiv K Sarin Department of Gastroenterology G.B.Pant Hospital New DelhiInstitute of Genomic and Integrative Biology(Formerly CBT)Mall RoadDelhiDr.Ambedkar Center for Biomedical ResearchUniversity of DelhiIndia Department of Gastroenterology G.B.Pant Hospital New DelhiIndia Division of Non-communicable Disease Indian Council of Medical Research Ansari NagarNew DelhiIndia Institute of Genomic and Integrative Biology (Formerly CBT) Mall RoadDelhiIndia

AIM： To study whether CCR5△32 mutation was associated with viral infection and severity of liver disease. METHODS： Two hundred and fifty two histologically proven, chronic HCV patients （mean age： 41±14 years; M/F： 164/88） were genotyped. PCR based genotyping of 32 bp deletion at the CCR5 locus was done. Fourhundred and eight matched healthy controls were studied to assess susceptibility to HCV infection. To assess correlation of immune gene polymorphism with severity of HCV related liver disease, patients with chronic HCV infection were divided into those with a fibrosis score of ≤ 2 （mild） or 〉 2 （severe） and histological activity index （HAI） of ≤ 5 or 〉 5. For correlation between CCR5△32 mutations and response to therapy, 129 patients who completed therapy were evaluated. RESULTS： The majority （89.4%） of the patients were infected with genotype 3. The frequency of homozygous CCR5△32 mutants was comparable to HCV patients as compared to the healthy controls （0.7% vs 0%, P = 0.1）. Further more, the frequency of CCR5△32 mutation was comparable in patients with mild or severe liver disease.（P = NS）. There was also no association observed with response to therapy and CCR5△32 mutation. CONCLUSION： CCR5△32 mutation does not have a role in disease susceptibility, severity or response to therapy in patients with chronic hepatitis C infection.

关键词： β-chemokine receptor 32 bp deletion CCchemokine ligand Human leukocyte antigen Histologicalactivity index

Is prophylactic placement of drains necessary after subtotal gastrectomy?

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World Journal of Gastroenterology 2007年第27期13卷 3738-3741页

作者： Manoj kumarl Seung Bong Yangl Vijay kumar Jaiswall Jay N Shahl manish Shreshthal Rajesh Gongal Department of Surgery Patan Hospital Kathmandu Nepal

AIM： To determine the evidence-based values of prophylactic drainage in gastric cancer surgery. METHODS： One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups. RESULTS： No significant differences were observed between the drain group and no-drain group in terms of operating time （171 ± 42 rain vs 156 ± 39 rain）, number of post-operative days until passage of flatus （3.7 ± 0.5 d vs 3.5 ± 1.0 d）, number of post-operative days until initiation of soft diet （4.9±0.7 d vs 4.8±0.8 d）, length of post-operative hospital stay （9.3±2.2 d vs 8.4±2.4 d）, mortality rate （5.4% vs 3.8%）, and overall postoperative complication rate （21.4% vs 19.2%）. CONCLUSION： Prophylactic drainage placement is not necessary afer subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.

关键词： Prophylactic drainage Subtotal gastrectomy Gastric cancer Post-operative complications Operative outcome

Unleashing the Power of Multi-Agent Reinforcement Learning for Algorithmic Trading in the Digital Financial Frontier and Enterprise Information Systems

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Computers, Materials & Continua 2024年第8期80卷 3123-3138页

作者： Saket Sarin Sunil K.Singh Sudhakar kumar Shivam goyal Brij Bhooshan Gupta Wadee Alhalabi Varsha Arya Chandigarh College of Engineering and Technology Chandigarh160019India Department of Computer Science and Information Engineering Asia UniversityTaichung413Taiwan Symbiosis Centre for Information Technology(SCIT) Symbiosis International UniversityPune411057India Center for Interdisciplinary Research University of Petroleum and Energy Studies(UPES)Dehradun248007India Department of Computer Science Immersive Virtual Reality Research GroupKing Abdulaziz UniversityJeddah21589Saudi Arabia Department of Business Administration Asia UniversityTaichung413Taiwan Department of Electrical and Computer Engineering Lebanese American UniversityBeirut11022801Lebanon UCRD Chandigarh UniversityChandigarh140413India

In the rapidly evolving landscape of today’s digital economy,Financial Technology(Fintech)emerges as a trans-formative force,propelled by the dynamic synergy between Artificial Intelligence(AI)and Algorithmic *** in-depth investigation delves into the intricacies of merging Multi-Agent Reinforcement Learning(MARL)and Explainable AI(XAI)within Fintech,aiming to refine Algorithmic Trading *** meticulous examination,we uncover the nuanced interactions of AI-driven agents as they collaborate and compete within the financial realm,employing sophisticated deep learning techniques to enhance the clarity and adaptability of trading *** AI-infused Fintech platforms harness collective intelligence to unearth trends,mitigate risks,and provide tailored financial guidance,fostering benefits for individuals and enterprises navigating the digital *** research holds the potential to revolutionize finance,opening doors to fresh avenues for investment and asset management in the digital ***,our statistical evaluation yields encouraging results,with metrics such as Accuracy=0.85,Precision=0.88,and F1 Score=0.86,reaffirming the efficacy of our approach within Fintech and emphasizing its reliability and innovative prowess.

关键词： Neurodynamic Fintech multi-agent reinforcement learning algorithmic trading digital financial frontier

Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure

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World Journal of Orthopedics 2017年第5期8卷 385-393页

作者： Saumitra goyal Monappa A Naik Sujit kumar Tripathy Sharath K Rao Department of Orthopedics Kasturba Medical College Manipal University Department of Orthopedics All India Institute of Medical Sciences

AIM To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome(ACS) and to correlate it with functional *** Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale(LEFS)] and complications were *** Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk(10 to 54 wk) and 23.8 ± 9.2 wk(12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness(76%) that caused difficulty in walking,running and squatting. Of 21 patients who had paralysis at diagnosis, 13(62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients(48.3%) with severe disability, 10 patients(34.5%) with moderate disability and 5 patients(17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmH g respectively(P < 0.001).CONCLUSION ACS in tibial fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intracompartmental pressure(ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome.

关键词： Compartment syndrome Leg Tibial fracture Deep posterior compartment Intracompartmental pressure Functional outcome

Atomic Energy as well as Gravitational Energy is Another form of Electrical Energy

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Journal of Mathematics and System Science 2017年第2期7卷 56-61页

作者： manish kumar Department of Electrical Engineering lndian Institute of Technology (Banaras Hindu University) Varanasi-22100 5 U.P. INDIA

Atomic energy is the source of power which is another form of electrical energy. This electrical energy is basically the fundamental energy which is the source of all other energy known to world. We can say that from the prediction of genius Albert Einstein for the unification of forces it is the electrical force that is the root cause of all other forces. When a charge particle moves it produces magnetic force i.e. electrical energy is converted to magnetic energy and charge particle has only electrical energy only. It is the movement of electrical energy that leads to generation of magnetic energy according to the Maxwell＇s law. Since these forces are long range forces so when they follow the Maxwell＇s law leads to generation of electromagnetic radiation. The weak and strong nuclear forces discovered which is the cause for binding sub-atomic particles into the nucleus is nothing but the electrical energy being converted into sub-atomic particles due to the conversion of electrical energy into mass with the electrical charge of positive and negative character depending upon the orientation of electrical energy into clockwise or anticlockwise direction. The packing of electrical energy into mass is governed by the anti-law that leads the conversion of mass into energy in the atomic energy given by Einstein＇s famous relation E = mc2.

关键词：电能转化原子能能量亚原子粒子引力爱因斯坦电能质量电磁辐射

Field evidences showing rapid frontal degeneration of the Kangriz glacier,western Himalayas,Jammu&Kashmir

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Journal of Mountain Science 2018年第6期15卷 1199-1208页

作者： GARG Siddhi SHUKLA Aparna MEHTA manish kumar Vinit SAMUEL Shruti Anna BARTARYA S.K. SHUKLA Uma Kant Wadia Institute o/Himalayan Geology 33 GMS Road Dehradun 248001 India Department of Geology Banaras Hindu University Varanasi 221005 India

Life cycle of glaciers in the Himalayan region has notably changed due to the climatic variability since last few decades. Glaciers across the world and specially the Himalayan glaciers have shown large scale degeneration in the last few decades. Himalayan glaciers serve as an important fresh water resource for the downstream communities, who are dependent on this water for domestic and other purposes. Therefore, glacier shrinkage and the associated hydrological changes pose a significant problem for regional-scale water budgets and resource management. These issues necessitate the regular and rigorous monitoring of the wastage pattern of the Himalayan glaciers in field and using satellite remote sensing data. In this work, we report rapid and enhanced degeneration of the frontal part of the Kangriz glacier, Jammu and Kashmir(J & K), in terms of surface melting, debris cover, snout characteristics and meltwater discharge. Ablation data acquired during 2016-2017 shows the average lowering of the frontal part of the glacier to be ~148 ± 34 cm, one-third of which was found to have occurred within a 13 day time period in September, 2017. Also, the quantum of ice melt was found to be inversely influenced(r =-0.84) by the debris thickness. 15 day meltwater discharge measurement revealed its strong relationship with snout disintegration pattern, evidenced twice during the said time period. Volume of water discharged from the glacier was estimated to be 7.91×10~6 m^3 for the measurement duration. Also, mean daily discharge estimated for the 15 days interval showed good positive correction(r = 0.78) with temperature indicating the direct dependency of the former on land surface temperature conditions of the region. Besides the lowering and discharge observations, the frequent ice-block break-offs at the glacier snout further enhance its overall drastic degeneration. The study suggests that, being the largest glacier in the Suru basin, the Kangriz glacier needs to be continuo

关键词： Glacier shrinkage Western Himalayas Surface lowering Degeneration Meltwater discharge

Effect of recombinant and native buffalo OVGP1 on sperm functions and in vitro embryo development: a comparative study

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Journal of Animal Science and Biotechnology 2018年第1期9卷 99-110页

作者： Suman Choudhary A.kumaresan manish kumar Shivani Chhillar Hrudananda Malik Sudarshan kumar Jai K.Kaushik Tirtha K.Datta Ashok K.Mohanty Animal Biotechnology Centre National Dairy Research Institute Livestock and Production Management Section National Dairy Research Institute

Background： An oviduct-specific glycoprotein, OVGP1, is synthesized and secreted by non-ciliated epithelial cells of the mammalian oviduct which provides an essential milieu for reproductive functions. The present study reports the effects of recombinant buffalo OVGP1 that lacks post-translational modifications, and native Buffalo OVGP1 isolated from oviductal tissue, on frozen-thawed sperm functions and in vitro embryo ***： The proportion of viable sperms was greater（P 〈 0.05） in the recombinant OVGP1-treated group compared to the native OVGP1-treated group at 2 h, 3 h, and 4 h of incubation. The proportion of motile sperms at3 h and 4 h of incubation; and membrane-intact sperms at 4 h was greater（P 〈 0.05） in the native OVGP1-treated group compared to the control and recombinant OVGP1-treated groups. The proportion of capacitated and acrosome-reacted sperms was greater（P 〈 0.05） in the native OVGP1-treated group compared to the recombinant OVGP1 group at 4 h. The rates of cleavage of embryos and their development to the blastocyst stage were greater（P 〈 0.05） in the presence of either native or recombinant OVGP1 in comparison to control at 10 μg/mL concentration as compared to 5 or 20 μg/***： The study suggests that both native and recombinant OVGP1 impart a positive effect on various sperm features and in vitro embryo development. However, native OVGP1 was found to have a more pronounced effect in comparison to recombinant non-glycosylated OVGP1 on various sperm functions except viability. Hence,our current findings infer that glycosylation of OVGP1 might be essential in sustaining the sperm functions but not the in vitro embryo development.

关键词： Blastocyst Capacitation Fertilization Glycoprotein In vitro fertilization Oestrus Semen Sperm

Atrial fibrillation in older adults with cancer

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Journal of Geriatric Cardiology 2022年第1期19卷 1-8页

作者： manish kumar Nerea Lopetegui-Lia Christina Al Malouf Mansour Almnajam Patrick P.Coll Agnes S.Kim Department of Medicine Pat and Jim Calhoun Cardiology CenterUniversity of Connecticut School of MedicineFarmingtonCT 06030USA Department of Hematology and Oncology Cleveland ClinicOhio 44195USA De-partment of Cardiology Mount Sinai Hospital/Icahn School of MedicineNew York 10029USA Department of Fam-ily Medicine UConn Center of AgingUniversity of ConnecticutSchool of MedicineFarmingtonCT 06030USA

Cancer and atrial fibrillation(AF)are common co-morbid conditions in older *** cancer and cancer treatment increase the risk of developing new AF which increases morbidity and *** rate and rhythm control along with anticoagulation therapy remain the mainstay of treatment of AF in older adults with both cancer and *** to the treatment may be necessary because of drug interactions with concurrent *** and old age increase the risk of both,thromboembolism and *** risk of these complications is further enhanced by concomitant cancer therapy,frailty,poor nutrition status and,coexisting geriatric ***,careful attention needs to be given to the risks and benefits of using anticoagulant *** review focuses on the management of AF in older patients with cancer,including at the end-of-life care.

关键词： fibrillation Cancer chemotherapy