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向左走or向右走?--低NIHSS评分的急性大血管闭塞患者应该接受动脉内治疗吗?

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中国卒中杂志 2018年第6期13卷 624-625页

作者： bhogal p BUCKE p GANSLANDT O 李玮不详中国人民解放军陆军军医大学大坪医院ncu 中国卒中学会重症脑血管病分会青年委员会

1背景2015年关于急性卒中动脉内治疗的五项随机对照研究宣告血管内治疗春天的开始。大血管闭塞患者的动脉内治疗方案随即被纳入急性缺血性卒中救治指南,结束了以阿替普酶静脉溶栓为唯一金标准的时代。

关键词：动脉内治疗血管闭塞急性卒中 NIHSS评分患者急性缺血性卒中 or 随机对照研究

Known yet underdiagnosed: Invasive assessment of coronary microvascular disease and its implications

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WORLD JOURNAL OF CARDIOLOGY 2025年第1期17卷 100203页

作者： bhogal, Sukhdeep Batta, Akash Mohan, Bishav Sovah Hlth Dept Cardiol Martinsville VA 24112 USA Dayanand Med Coll & Hosp Dept Cardiol Tagore NagarCivil Lines Ludhiana 141001 Punjab India

Coronary microvascular disease (CMD) is one of the commonest causes of cardiac chest pain. The condition is more prevalent in women, and incidence is known to increase with age, hypertension, and diabetes. The pathophysiological pathways are heterogenous and related to intrinsic vascular and endothelial dysfunction. Furthermore, this entity is known to be associated with adverse cardiovascular outcomes. Despite this, there is inertia amongst cardiologists to further evaluate patients with non-critical coronary artery disease and suspected CMD. With refinement in technology, we have now better understanding of CMD and invasive testing in the catheterization laboratory is a viable option for confirming the diagnosis of CMD. However, despite advances in diagnosing and stratifying this entity, therapeutic options remain limited and poorly defined. In this editorial, we will briefly focus on the pathophysiology and invasive assessment and therapeutic options available for CMD.

关键词： Coronary microvascular disease Endothelial dysfunction Invasive assessment Coronary flow reserve Hyperemic myocardial velocity resistance pressurewire X

Mechanical thrombectomy in children and adolescents:report of five cases and literature review

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Stroke & Vascular Neurology 2018年第4期3卷 245-252页

作者： pervinder bhogal Victoria Hellstern Muhammad AlMatter Oliver Ganslandt Hansjörg Bäzner Marta Aguilar pérez Department of Interventional Neuroradiology Royal London HospitalLondonUK Neuroradiological Clinic NeurocenterKlinikum StuttgartStuttgartGermany Neurosurgical Clinic NeurocenterKlinikum StuttgartStuttgartGermany Medical Faculty University Duisburg-EssenDuisburgGerman

Background paediatric arterial ischaemic stroke is an important cause of morbidity and mortality among ***,there are no recommendations regarding mechanical thrombectomy in children despite overwhelming evidence of improved outcomes in ***,the need for individual case reports and case series is important to highlight potential advantages and disadvantages in this *** descriptions We retrospectively searched our prospectively maintained database of patients undergoing mechanical thrombectomy for ischaemic *** describe five children,aged between 7 and 17,who underwent mechanical thrombectomy for acute ischaemic *** provide an account of their clinical presentations,operative treatment and postoperative *** Mechanical thrombectomy in children,especially older children,can be performed safely and with existing *** a randomised controlled trial would provide compelling evidence of the potential advantages to this technique,the lack of this should not prevent the use of this procedure by trained neurointerventionists.

关键词： maintained throm treatment

Transcatheter aortic valve replacement in low-risk young population:A double edge sword?

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World Journal of Cardiology 2024年第4期16卷 177-180页

作者： Sukhdeep bhogal Akash Batta Department of Cardiology Sovah HealthMartinsvilleVA 24112United States Department of Cardiology Dayanand Medical College and HospitalLudhiana 141001India

Since the advent of transcatheter aortic valve replacement(TAVR)in 2002,it has now become the default interventional strategy for symptomatic patients presenting with severe aortic stenosis,particularly in intermediate to highsurgical risk *** 2019,the United States Food and Drug Administration approved TAVR in low-risk patients based on two randomized ***,these breakthrough trials excluded patients with certain unfavorable anatomies and odd *** currently there is no randomized study of TAVR in young patients,it may be preferred by the young population given the benefits of early discharge,shorter hospital stay,and expedite ***,it is important to ruminate various factors including lifetime expectancy,risk of pacemaker implantation,and the need for future valve or coronary interventions in young cohorts before considering TAVR in these ***,the data on long-term durability(>10 years)of TAVR is still unknown given most of the procedures were initially performed in the high or prohibitive surgical risk ***,this editorial aims to highlight the importance of considering an individualized approach in young patients with consideration of various factors including lifetime expectancy while choosing TAVR against surgical aortic valve replacement.

关键词： Transcatheter aortic valve replacement Surgical aortic valve replacement pacemaker implantation Coronary re-access Structural deterioration

Action Recognition for Multiview Skeleton 3D Data Using NTURGB+D Dataset

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Computer Systems Science & Engineering 2023年第12期47卷 2759-2772页

作者： Rosepreet Kaur bhogal V.Devendran School of Electronics and Electrical Engineering Lovely Professional UniversityPhagwara144411India School of Computer Science Engineering Lovely Professional UniversityPhagwara144411India

Human activity recognition is a recent area of research for *** recognition has many applications in smart homes to observe and track toddlers or oldsters for their safety,monitor indoor and outdoor activities,develop Tele immersion systems,or detect abnormal activity *** dimensions(3D)skeleton data is robust and somehow *** to this,it is one of the popular choices for human action *** paper proposed using a transversal tree from 3D skeleton data to represent videos in a *** proposed two neural networks:convolutional neural network recurrent neural network_1(CNN_RNN_1),used to find the optimal features and convolutional neural network recurrent neural network network_2(CNN_RNN_2),used to classify *** deep neural network-based model proposed CNN_RNN_1 and CNN_RNN_2 that uses a convolutional neural network(CNN),Long short-term memory(LSTM)and Bidirectional Long shortterm memory(BiLSTM)*** systemefficiently achieves the desired accuracy over state-of-the-art models,i.e.,88.89%.The performance of the proposed model compared with the existing state-of-the-art *** NTURGB+D dataset uses for analyzing experimental *** is one of the large benchmark datasets for human activity ***,the comparison results show that the proposed model outperformed the state-ofthe-art models.

关键词： Activity recognition multiview LSTM BiLSTM NTURGB+D

Stereotactic radiotherapy for intrahepatic cholangiocarcinoma

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World Journal of Gastrointestinal Oncology 2022年第8期14卷 1478-1489页

作者： Aditya Borakati Farid Froghi Ricky H bhogal Vasileios K Mavroeidis Department of Surgery The Royal London HospitalBarts Health NHS TrustLondon E11FRUnited Kingdom Department of HpB and Liver Transplantation Surgery Royal Free Hospital NHS Foundation TrustLondon NW32QGUnited Kingdom Department of Academic Surgery The Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

Intrahepatic cholangiocarcinoma(iCCA)is an aggressive malignancy with an increasing incidence worldwide and poor prognosis,despite several advances and continuous efforts to develop effective *** surgical resection is the mainstay of treatment and offers a potentially curative option,but is only possible in less than a third of patients,owing to advanced *** is a well-established treatment in the adjuvant and palliative setting,however,confers limited *** radiotherapy is challenging due to local *** recent advances in stereotactic ablative radiotherapy(SABR),it is now possible to focus ablative beams of radiotherapy precisely aimed at tumours to minimise damage to surrounding *** review details the history,technical background and application of SABR to iCCA,with directions for future research suggested.

关键词： Cholangiocarcinoma Intrahepatic Stereotactic ablative radiotherapy Stereotactic body radiotherapy Radiotherapy Liver cancer Hepatectomy

Liver transplantation in the management of cholangiocarcinoma:Evolution and contemporary advances

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World Journal of Gastroenterology 2023年第13期29卷 1969-1981页

作者： Aditya Borakati Farid Froghi Ricky H bhogal Vasileios K Mavroeidis Department of HpB and Liver Transplantation Surgery Royal Free Hospital NHS Foundation TrustLondon NW32QGUnited Kingdom Department of Academic Surgery The Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

Cholangiocarcinoma(CCA)is an aggressive malignancy arising from the biliary *** may occur at any location along the biliary tree with the perihilar area being the most *** is poor with 5-year overall survival at less than 10%,typically due to unresectable disease at *** surgical resection with clear margins offers a chance of cure in patients with resectable tumours,but is frequently not possible due to locally advanced *** the other hand,orthotopic liver transplantation(LT)allows for a radical and potentially curative resection for these patients,but has been historically controversial due to the limited supply of donor grafts and previously poor *** patients with perihilar CCA,within specific criteria and following the implementation of a protocol combining neoadjuvant chemoradiation and LT,excellent results have been achieved in the last decades,resulting in its increasing acceptance as an indication for LT and the standard of care in several centres with significant ***,in intrahepatic CCA,the role of LT remains controversial and owing to dismal previous results it is not an accepted ***,more recent studies have demonstrated favourable results with LT in early intrahepatic CCA,indicating that,under defined criteria,its role may increase in the *** review highlights the history and contemporary advances of LT in CCA,with particular focus on the improving outcomes of LT in intrahepatic and perihilar CCA and future perspectives.

关键词： Cholangiocarcinoma Klatskin tumor Liver transplantation Liver cancer Liver resection Neoadjuvant therapy

Responding to fire in an intensive care unit: Management and lessons learned

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World Journal of Emergency Medicine 2018年第2期9卷 154-156页

作者： Navneet Dhaliwal Ranjitpal Singh bhogal Ashok Kumar Anil Kumar Gupta Department of Hospital Administration Postgraduate Institute of MedicalEducation and Research

Healthcare institutions are vulnerable to disruptionfrom events such as earthquakes, fires, and floods, andthe damage incurred can endanger the lives of patientsin the hospital.[1] In this type of scenario hospital staffhave primary responsibility for the hospitalized patients＇safety, since patients are neither fit to respond to sucha disaster, nor do they know how to respond.[2,3] Thesituation becomes more difficult and challenging if thedisaster occurs in critical care areas such as intensivecare units （ICUs） and operating rooms.

关键词： Responding to fire an intensive care unit:Management lessons learned

Impact of psychosocial comorbidities on clinical outcomes after liver transplantation: Stratification of a high-risk population

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World Journal of Hepatology 2019年第8期11卷 638-645页

作者： Neil bhogal Amaninder Dhaliwal Elizabeth Lyden Fedja Rochling Marco Olivera-Martinez Department of Internal Medicine Division of Gastroenterology and Hepatology University of Nebraska Medical Center Omaha NE 68198 United States Department of Biostatistics Division of Public Health University of Nebraska Medical Center Omaha NE 68198 United States

BACKGROUND Liver transplantation is the accepted standard of care for end-stage liver disease due to a variety of etiologies including decompensated cirrhosis, fulminant hepatic failure, and primary hepatic malignancy. There are currently over 13000 candidates on the liver transplant waiting list emphasizing the importance of rigorous patient selection. There are few studies regarding the impact of additional psychosocial barriers to liver transplant including financial hardship, lack of caregiver support, polysubstance abuse, and issues with medical noncompliance. We hypothesized that patients with certain psychosocial comorbidities experienced worse outcomes after liver transplantation. AIM To assess the impact of certain pre-transplant psychosocial comorbidities on outcomes after liver transplantation. METHODS A retrospective analysis was performed on all adult patients from 2012-2016. psychosocial comorbidities including documented medical non-compliance, polysubstance abuse, financial issues, and lack of caregiver support were collected. The primary outcome assessed post-transplantation was survival. Secondary outcomes measured included graft failure, episodes of acute rejection, psychiatric decompensation, number of readmissions, presence of infection, recidivism for alcohol and other substances, and documented caregiver support *** For the primary outcome, there were no differences in survival. patients with a history of psychiatric disease had a higher incidence of psychiatric decompensation after liver transplantation (19% vs 10%, p = 0.013). Treatment of psychiatric disorders resulted in a reduction of the incidence of psychiatric decompensation (21% vs 11%, p = 0.022). patients with a history of polysubstance abuse in the transplant evaluation had a higher incidence of substance abuse after transplantation (5.8% vs 1.2%, p = 0.05). In this cohort, 15 patients (3.8%) were found to have medical compliance issues in the transplant evaluation. Of

关键词： Liver transplantation Recidivism psychosocial decompensation Noncompliance Transplant psychiatry