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Better Than You Think—Appropriate Use of Implantable Cardioverter-Defi brillators at a Single Academic Center:A Retrospective Review

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Cardiovascular Innovations and Applications 2021年第2期5卷 235-243页

作者： nikhil h.shah Steven J.Ross Steve A.Noutong Njapo Justin Merritt Andrew Kolarich Michael Kaufmann William M.Miles David E.Winchester Thomas A.Burkart Matthew McKillop UF Division of Cardiovascular Medicine 1600 SW Archer RdPO Box 100277GainesvilleFL 32610USA UVA Division of Cardiovascular Medicine PO Box *** Lee St.CharlottesvilleVA 22908-0158USA The Johns hopkins hospital Department of Radiology 601 N Caroline StBaltimore 21287USA The heart Center 930 Franklin Street SEHuntsvilleAL358015USA Intermountain Medical Center 1380 E Medical Center DrSte 1500St.GeorgeUT 847906USA Carolina Cardiology Consultants Prisma Health1005 Grove RoadGreenvilleSC 29605USA

Background:Implantable cardioverter-defi brillators(ICDs)can be life-saving devices,although they are expensive and may cause *** 2013,several professional societies published joint appropriate use criteria(AUC)assessing indications for ICD *** evaluating the clinical application of AUC are *** registry-based studies estimated that 22.5%of primary prevention ICD implantations were“non-evidence-based”*** the basis of AUC,we aimed to determine the prevalence of“rarely appropriate”ICD implantation at our institution for comparison with previous ***:We reviewed 286 patients who underwent ICD implantation between 2013 and *** of each ICD implantation was assessed by independent review and rated on the basis of ***:Of 286 ICD implantations,two independent reviewers found that 89.5%and 89.2%,respectively,were appropriate,5.6%and 7.3%may be appropriate,and 1.8%and 2.1%were rarely *** AUC indication was found for 3.5%and 3.4%of ICD implantations,*** prevention ICD implantations were more likely rarely appropriate(2.6%vs.1.2%and 3.6%vs.1.1%)or unrated(6.0%vs.1.2%and 2.7%vs.0.6%).The reviewers found 3.5%and 3.4%of ICD implantations,respectively,were non-evidence-based *** difference in rates between reviewers was not statistically signifi ***:Compared with prior reports,our prevalence of rarely appropriate ICD implantation was very *** high appropriate use rate could be explained by the fact that AUC are based on current clinical *** AUC could benefi t from additional secondary prevention *** importantly,clinical judgement and individualized care should determine which patients receive ICDs irrespective of guidelines or criteria.

关键词： Appropriate use appropriate use criteria implantable cardioverter-defi brillator

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A Survey and Experimental Review on Data Distribution Strategies for Parallel Spatial Clustering Algorithms

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Journal of Computer Science & Technology 2024年第3期39卷 610-636页

作者： Jagat Sesh Challa Navneet Goyal Amogh Sharma nikhil Sreekumar Sundar Balasubramaniam Poonam Goyal Advanced Data Analytics and Parallel Technologies Laboratory Birla Institute of Technology and Science Pilani 333031India Uber New York 11101U.S.A. Computer Science and Engineering Department University of MinnesotaMinneapolis 55455U.S.A.

The advent of Big Data has led to the rapid growth in the usage of parallel clustering algorithms that work over distributed computing frameworks such as MPI,MapReduce,and *** important step for any parallel clustering algorithm is the distribution of data amongst the cluster *** step governs the methodology and performance of the entire *** typically use random,or a spatial/geometric distribution strategy like kd-tree based partitioning and grid-based partitioning,as per the requirements of the ***,these strategies are generic and are not tailor-made for any specific parallel clustering *** this paper,we give a very comprehensive literature survey of MPI-based parallel clustering algorithms with special reference to the specific data distribution strategies they *** also propose three new data distribution strategies namely Parameterized Dimensional Split for parallel density-based clustering algorithms like DBSCAN and OPTICS,Cell-Based Dimensional Split for dGridSLINK,which is a grid-based hierarchical clustering algorithm that exhibits efficiency for disjoint spatial distribution,and Projection-Based Split,which is a generic distribution *** of these preserve spatial locality,achieve disjoint partitioning,and ensure good data load *** experimental analysis shows the benefits of using the proposed data distribution strategies for algorithms they are designed for,based on which we give appropriate recommendations for their usage.

关键词： parallel data mining data distribution parallel clustering spatial locality preservation

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hepatocellular carcinoma immune microenvironment and check point inhibitors-current status

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World Journal of hepatology 2024年第3期16卷 353-365页

作者： Tarana Gupta nikhil Sai Jarpula Division of hepatology Department of MedicinePandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia

hepatocellular carcinoma(hCC)is the most common primary tumor of the liver and has a high mortality *** Barcelona Clinic Liver Cancer staging system in addition to tumor staging also links the modality of treatment available to a particular *** recent description of the tumor microenvironment(TME)in hCC has provided a new concept of immunogenicity within the *** hCC has been shown to be more immunogenic with higher expression of cytotoxic T lymphocytes and decreased elements for immunosuppression such as regulatory T *** immunogenic milieu provides a better response to immunotherapy especially immune checkpoint inhibitors(ICIs).In addition,the recent data on combining locoregional therapies and other strategies may convert the less immunogenic state of the TME towards higher ***,data are emerging on the use of combinations of locoregional therapy and ICIs in unresectable or advanced hCC and has shown better survival outcomes in this difficult population.

关键词： hepatocellular carcinoma Tumor immune microenvironment Immune checkpoint inhibitor Atezolizumab Bevacizumab Pembrolizumab

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Photocatalytic application of magnesium spinel ferrite in wastewater remediation:A review

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Journal of Magnesium and Alloys 2024年第2期12卷 490-505页

作者： Rohit Jasrotia nikhil Jaswal Jyoti Prakash Chan Choon Kit Jagpreet Singh Abhishek Kandwal School of Physics and Materials Science Shoolini UniversityBajholSolanH.P.India himalayan Centre of Excellence in Nanotechnology Shoolini UniversityBajholH.P.India INTI International University Putra NilaiNegeri SembilanMalaysia Department of Chemistry University Centre for Research&Development Chandigarh UniversityMohali140413PunjabIndia Shenzhen Institute of Advanced Technology Chinese Academy of SciencesChina

This review paper explores the efficacy of magnesium ferrite-based catalysts in photocatalytic degradation of organic contaminates(antibiotic and dyes).We report the influence of different doping strategies,synthesis methods,and composite materials on the degradation efficiency of these *** analysis reveals the versatile and promising nature of magnesium ferrite-based catalysts,offering the valuable insights into their practical application for restoring the *** to the smaller band gap and magnetic nature of magnesium ferrite,it holds the benefit of utilising the broader spectrum of light while also being *** in-depth analysis of magnesium ferrites'photocatalytic mechanism could lead to the development of cheap and reliable photocatalyst for the wastewater *** concise review offers a thorough summary of the key advancements in this field,highlighting the pivotal role of the magnesium ferrite based photocatalysts in addressing the pressing global issue of organic pollutants in wastewater.

关键词： Magnesium ferrite Wastewater Dyes Antibiotics Photocatalytic degradation

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Dynamical behaviors of a constant prey refuge ratio-dependent prey-predator model with Allee and fear effects

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International Journal of Biomathematics 2024年第1期17卷 227-250页

作者： Soumitra Pal Pijush Panday nikhil Pal A.K.Misra Joydev Chattopadhyays Department of Mathematics Institute of Science Banaras Hindu University Varanasi 221005India Department of Mathematical and Statistical Sciences University of Alberta EdmontonAB T6G 2G1Canada Department of Mathematics Visva-Bharati Santiniketan 731235India Agricultural and Ecological Research Unit Indian Statistical Institute 203 B.T.RoadKolkata 700108India

In this paper,we consider a nonlinear ratio-dependent prey-predator model with constant prey refuge in the prey *** Allee and fear phenomena are incorporated explicitly in the growth rate of the prey *** qualitative behaviors of the proposed model are investigated around the equilibrium points in *** bifurcation including its direction and stability for the model is also *** observe that fear of predation risk can have both stabilizing and destabilizing effects and induces bubbling phenomenon in the *** is also observed that for a fixed strength of fear,an increase in the Allee parameter makes the system unstable,whereas an increase in prey refuge drives the system toward ***,higher values of both the Allee and prey refuge parameters have negative impacts and the populations go to ***,we explore the variation of densities of the populations in different bi-parameter spaces,where the coexistence equilibrium point remains *** simulations are carried out to explore the dynamical behaviors of the system with the help of MATLAB software.

关键词： Predator-prey system Allee effect fear effect prey refuge bifurcation population density

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Kiran Nandivada’s Stuck Blade in a Grinder Jar Degenerative Cascade by LSTV at L5-S1

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Open Journal of Orthopedics 2024年第1期14卷 12-21页

作者： Venkata Satya Kumar Kiran Nandivada Nadavinamani Shivanand Raghavendra Nandivada nikhil Bharadwaja Moola Sohith Mahadeva Reddy Ahmed Usama Rizvi Nandivada Ortho Spine Surgeon & Rheumatologist Abu Dhabi United Arab Emirates Senior Orthopedic Surgeon & Rheumatologist Abu Dhabi United Arab Emirates General Practitioner Visakhapatnam India Department of Medicine Kamineni Institute of Medical Sciences Telangana India Department of Medicine Tbilisi State Medical University Tbilisi Georgia

Background: Mario Bertolotti, (1917) described LSTV-Lumbar spinal transitional vertebra as Bertolotti Syndrome a century ago and associated low back pain with it. Yet, it needs to be given significance in general orthopaedic practice even now, and radiologists underreport it. LSTV is a congenital anatomical anomaly that Castellvi classified into four varying types. Purpose: I titled this phenomenon “Kiran Nandivada’s stuck blade in a grinder jar degenerative cascade by LSTV at L5-S1” to clearly explain how an abnormal mega-transverse apophysis with its various variations affects the weight-bearing mechanics as the L5-S1 which is a vital junction where the maximum body weight is directed into both the sacroiliac joints and if a transitional vertebra occurs it becomes detrimental and abnormally redirects the load-bearing forces and leads to a progressive degenerative cascade both proximally and distally. As the L5 vertebral rotations and other movements of flexion, extensions, lateral flexion are stuck like a bent grinder blade, the other areas of the region are damaged progressively as the pelvis, just like the grinder motor tries to move it, resulting in overheating and maybe even a burnout results in the form of facet arthritis, disc degeneration in the normal disc above, the transitional disc at L5-S1, foraminal osteophytes causing radiculopathy, sacroiliac joint arthritis. Material and Methods: Around 200 X-rays of children and adults with this congenital anomaly have been studied between 2020 and 2023. This is a retrospective study. Results: 1) Our study showed an Increased incidence of LSTV at 15%. 2) Patients ranged from asymptomatic, atypical lumbago to classical lumbago with sciatica and claudication. Findings supported facet and sacroiliac joint arthritis and the pain, relieved with physiotherapy, posture corrections, weight reduction, and lifestyle precautions, negating the need for local steroid injections, radiofrequency ablation or surgical excision as

关键词： LSTV Bertolotti Syndrome Transitional Vertebra Facet Tropism Congenital Dysplasia

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Various Aetiologies of Non-Traumatic Coccydynia Cause Pain in the Posterior Sacrococcygeal Leg of the Pelvic Tripod: A Burden on the healthcare Sector

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Open Journal of Orthopedics 2024年第7期14卷 334-353页

作者： Kumar Satya Nandivada Venkata Kiran Nadavinamani Shivanand Raghavendra Oommen Elsy Biju Bharadwaja nikhil Nandivada Nandivada Vaishnavi Rizvi Usama Ahmed Krushi Orthopaedic Welfare Society Research Wing Visakhapatnam India

Introduction: Coccydynia, television disease, and coccygodynia are the different names given to this disabling disease, which can become chronic. It was described by Simson in 1859. Coccydynia means pain at the end of the vertebral column. Non-traumatic coccydynia is a diagnosis, which is never straightforward like traumatic coccydynia because the onset is unclear, and both the patient and the unaware clinician face many challenges in treating it on time and with accuracy. Coccyx was likened to a cuckoo bird’s beak as a curved bone of fused 3 to 5 vertebrae with remnant disc material in some rare cases, unfused segments, linear scoliosis or subluxations and deformities. Stress X-rays of the coccyx in the antero-posterior and lateral views in standing and sitting reveal the “Dynamic Instability” due to congenital coccygeal morphological, pathological and mechanical variations. Material and Methods: This is a complex study having retrograde data collected from online publications from various databases, like PubMed, Embase, and Cochrane Library and also antegrade data collected from 100 patients with their consent from patients in Adam and Eve Specialised Medical Centre-based at Abu Dhabi, UAE and data was processed in the research centre of Krushi Orthopaedic Welfare Society based in India between 2014-2024 following all guidelines of helsinki and approved by the ethics board of Krushi Orthopaedic Welfare Society. Clinical Presentation: The coccyx is painful, with aches, spasms, and an inability to sit. This affects daily activities without any particular date of onset. The onset remains insidious for the non-traumatic variety of coccydynia. Aetiology and Patho Anatomy: Non-traumatic coccydynia can be caused by a myriad of reasons, like congenital morphological variations, acquired dynamic instabilities, and hidden trauma remaining quiescent to re-surface as a strain-induced pain. Radiological Presentations: Unless clarity is focused on these coccygeal views, the err

关键词： Coccydynia Coccygodynia Pelvic Floor Chordoma Pilonidal Sinus Fused Sacrococcygeal Segment Non-Traumatic Coccydynia Entrapment of Coccygeal Nerves Dural Syndrome

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In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity:Insights from national inpatient sample 2020

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World Journal of hepatology 2024年第6期16卷 912-919页

作者： Sashwath Srikanth Vibhor Garg Lakshmi Subramanian Jyoti Verma hansika Sharma harroop Singh Klair Shrenil A Kavathia Jithin Kolli Teja nikhil Sai Vasireddy Kumar Anmol Dhanush Kolli Shruti Sanjay Bodhankar Sobya hashmi Shaylika Chauhan Rupak Desai Department of Medicine ECU Health Medical CenterGreenvilleNC 27834United States Department of Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Department of Medicine North Alabama Medical CentreFlorenceAL 35630United States Department of General Medicine Gandhi Medical CollegeSecunderabad 500003TelanganaIndia Department of Medicine Government Medical CollegePatiala 147001PunjabIndia Department of Medicine B.J.Medical CollegeAhmedabad 380016GujaratIndia Department of Medicine JSS Medical CollegeMysore 570015KarnatakaIndia Department of Internal Medicine Gandhi Medical CollegeSecunderabad 500003TelanganaIndia Department of Medicine Kasturba Medical CollegeManipal 575001KarnatakaIndia Clinical Extern Department of Internal MedicineBeaumont HospitalDearbornMI 48124United States Department of Internal Medicine Geisinger Health SystemWilkes-BarrePA 18702United States Independent Researcher AtlantaGA 30079United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular diseases independently of other risk ***,data on its effect on cardiovascular outcomes in coronavirus disease 2019(COVID-19)hospitalizations with varied obesity levels is *** management and patient care depend on understanding COVID-19 admission results in NAFLD patients with varying obesity *** To study the in-hospital outcomes in COVID-19 patients with NAFLD by severity of *** COVID-19 hospitalizations with NAFLD were identified using International Classification of Disease-10 CM codes in the 2020 National Inpatient Sample *** and Obesity Classes Ⅰ,Ⅱ,and Ⅲ(body mass index 30-40)were *** adverse cardiac and cerebrovascular events(MACCE)(all-cause mortality,acute myocardial infarction,cardiac arrest,and stroke)were compared between *** regression analyses adjusted for sociodemographic,hospitalization features,and *** Our analysis comprised 13260 hospitalizations,7.3% of which were overweight,24.3% Class Ⅰ,24.1% Class Ⅱ,and 44.3% Class Ⅲ.Class Ⅲ obesity includes younger patients,blacks,females,diabetics,and hypertensive *** multivariable logistic analysis,Class Ⅲ obese patients had higher risks of MACCE,inpatient mortality,and respiratory failure than Class Ⅰ obese *** Ⅱ obesity showed increased risks of MACCE,inpatient mortality,and respiratory failure than Class I,but not *** obesity classes had non-significant risks of MACCE,inpatient mortality,and respiratory failure compared to the overweight *** Class Ⅲ obese NAFLD COVID-19 patients had a greater risk of adverse outcomes than class Ⅰ.Using the overweight group as the reference,unfavorable outcomes were not significantly *** obesity had a greater risk of MACCE regardless of the referent group(overweight or Class Ⅰ obese)compared to overweight NAFLD patients admitte

关键词： Non-alcoholic fatty liver disease Obesity Obese Body mass index Major adverse cardiac and cerebrovascular events Mortality Acute myocardial infarction Cardiac arrest Stroke

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Evaluation of graphite depressants in a poly-metallic sulfide flotation circuit

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International Journal of Mining Science and Technology 2017年第2期27卷 285-292页

作者： nikhil Gupta Department of Mining and Minerals Engineering Virginia Polytechnic Institute and State UniversityBlacksburgVA 24061USA

Synthetic dyes are commonly used for graphite depression in poly-metallic flotation circuits; however,these dyes can be very expensive. The aim of this study is to evaluate performance of certain low-cost alternative depressants for a complex lead-zinc(Pb-Zn) ore rich in graphite(Gr-C) on a conventional mini pilot-scale flotation circuit. The reagents used were commercial and industrial grade starch; agro-based waste-sugarcane bagasse and charred(burnt) bagasse powder. The primary evaluation criteria were quality(grades) of lead and zinc concentrates, their recoveries(%), and graphite rejection(%) in the *** tests using nigrosine as graphite depressant showed 94.3% rejection of Gr-C. The results with commercial starch were found as effective with 93.8% graphite rejection. Furthermore, bagasse powder showed potential in improving product quality(36.4% and 65.6% Pb grade and recovery) with an intermediate effectiveness in graphite rejection(85.6%). The order of effectiveness in Gr-C rejection follows nigrosine % commercial starch > bagasse > industrial starch > charred bagasse. In addition, the effect these depressants on silver(byproduct) grade and recovery was also investigated.

关键词： Graphite depressants Sulfide flotation Dyes Starch Bagasse hydrophobic impurities

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Knowledge and attitude on childhood cancer survivorship among healthcare trainees:a multicentre study from India

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Family Medicine and Community health 2024年第S2期12卷 34-43页

作者： Amritesh Grewal Bhavik Bansal Chetanya Mittal hardik Gupta Archana Sasi Prasanth Ganesan Aashima Dabas Puneet Sahi Lakshmi Ramamoorthy hmar Thiak Lalthanthuami Jaikumar Ramamoorthy Arwachi Sindhu Suyash Arora Anumeha Bhukya Muthumani hepzibah Kanchana Devi Karthick Krishnamurthy Sanjeet K Rai nikhil Mehta Komal Antil Sameer Bakhshi Shuvadeep Ganguly Medical Student All India Institute of Medical SciencesNew DelhiDelhiIndia Department of Medical Oncology Dr.B.R.A.Institute Rotary Cancer HospitalAll India Institute of Medical SciencesNew DelhiDelhiIndia Department of Medical Oncology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryPuducherryIndia Department of Pediatrics Lok Nayak HospitalNew DelhiDelhiIndia Department of Pediatrics Maulana Azad Medical CollegeNew DelhiDelhiIndia College of Nursing Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryPuducherryIndia Department of Pediatrics Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryPuducherryIndia Medical Student Maulana Azad Medical CollegeNew DelhiDelhiIndia Department of Surgical Disciplines All India Institute of Medical SciencesNew DelhiDelhiIndia Department of Dermatology and Venereology All India Institute of Medical SciencesNew DelhiDelhiIndia College of Nursing All India Institute of Medical SciencesNew DelhiDelhiIndia

Background The proportion of childhood cancer survivors(CCS)in low/middle-income countries(LMICs)is *** often develop several physical and psycho-social long-term adverse effects,with unique healthcare *** healthcare providers(primary care physicians(PCPs)),especially in LMICs,are often not equipped to handle survivorship *** study aimed to assess knowledge,and attitude among trainee healthcare providers concerning major issues of paediatric survivorship *** A multi-centre,cross-sectional,questionnaire-based study was conducted among nursing and medical undergraduate students,and postgraduate medical residents across three tertiary-care teaching hospitals in India—All India Institute of Medical Sciences,New Delhi;Jawaharlal Institute of Postgraduate Medical Education and Research,Puducherry;and Maulana Azad Medical College,New Delhi.A questionnaire with total of 24 questions(14 knowledge-based and 10 attitude-based)was finalised after validation by expert review and *** major domains covered in the questionnaire included knowledge and attitude regarding long-term adverse effects and psychosocial,employment-related issues faced by the *** was administered to the study participants *** knowledge-based questions had true/false responses(scored as 0 or 1 if incorrect or correct,respectively).Attitude-based questions were scored as 5-point Likert *** Total 898 responses were collected(median age:21 years,64%(576/898)female).Among the respondents,44%were undergraduate medical students,42%were nursing students and 14%were postgraduate medical *** mean(SD)of knowledge score was 8.72(2.04)(out of 14).On multivariable analysis,only discipline of training predicted knowledge scores regarding survivorship *** medical residents(9.08)as well as undergraduate medical students(8.85),had significantly higher mean knowledge scores than nursing students(8.47)(p=0.004).Two questions were

关键词： centre handle false

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