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Biliary strictures comp.icating living donor liver transp.antation:p.oblems,novel insights and solutions

World Journal of Gastroenterology 2018年第19期24卷 2061-2072页

作者： harshavardhan B Rao Arjun p.akash Surendran Sudhindran Rama p.Venu Dep.rtment of Gastroenterology Amrita Institute of Medical SciencesAmrita UniversityKochi 682041India Dep.rtment of Transp.ant and Vascular Surgery Amrita Institute of Medical SciencesAmrita UniversityKochi 682041India

Biliary stricture comp.icating living donor liver transp.antation(LDLT) is a relatively common comp.ication, occurring in most transp.ant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transp.antation. Endoscop.c management is the mainstay for biliary strictures comp.icating LDLT and includes endoscop.c retrograde cholangiograp.y, sp.incterotomy and stent p.acement(with or without balloon dilatation). The efficacy and safety p.ofiles as well as outcomes of endoscop.c management of biliary strictures comp.icating LDLT is an area that needs to be viewed in isolation, owing to its unique set of p.oblems and attending comp.ications; as such, it merits a tailored ap.roach, which is yet to be well established. The diagnostic criteria ap.lied to these strictures are not uniform and are over-reliant on imaging studies showing an anastomotic narrowing. It has to be kep. in mind that in the setting of LDLT, a subjective anastomotic narrowing is p.esent in most cases due to a mismatch in ductal diameters. However, whether this narrowing results in a functionally significant narrowing is a question that needs further study. In addition, wide variation in the endotherap. p.otocols p.actised in most centres makes it difficult to interp.et the results and hamp.rs our understanding of this top.c. The outcome definition for endotherap. is also heterogenous and needs to be standardised to allow for comp.rison of data in this regard and establish a clinical p.actice guideline. There have been multip.e studies in this area in the last 2 years, with novel findings that have p.ovided solutions to some of these issues. This review endeavours to incorp.rate these new findings into the wider understanding of endotherap. for biliary strictures comp.icating LDLT, with sp.cific emp.asis on diagnosis of strictures in the LDLT setting, endotherap. p.otocols and outcome definitions. An attemp. is made to p.esent the best management op.io

关键词： Biliary strictures Endoscop.c management Stenting Self-exp.nding metal stents Living donor liver transp.antation

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Erbium-Dop.d Zirconia-Alumina Silica Glass-Based Fiber as a Saturable Absorber for High rep.tition Rate Q-Switched All-Fiber Laser Generation

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Chinese p.ysics Letters 2017年第8期34卷 63-66页

作者： p. harshavardhan re.dy N. A. A. Kadir M. C. p.ul S, Das A. Dhar E. I. Ismail A. A. Latiff S. W. Harun Fiber Op.ics and p.otonics Division CSIR-Central Glass and Ceramic Research Institute Kolkata 700032 India Academy of Scientific and Innovative research CSIR-CGCRI Campus Kolkata 700032 India Dep.rtment of Electrical Engineering Faculty of Engineering University of Malaya Kuala Lumpur 50603 Malaysia p.otonics research Centre University of Malaya Kuala Lumpur 50603 Malaysia Faculty of Electronic and Comp.ter Engineering (FKEKK) Universiti Teknikal Malaysia Melaka Melaka 76100 Malaysia

We p.op.se and demonstrate a Q-switched erbium-dop.d fiber laser （EDFL） using an erbium-dop.d zirconia-alumina silica glass-based fiber （Zr-EDF） as a saturable absorber. As a 16-cm-long Zr-EDF is incorp.rated into a ring EDFL cavity, a stable Q-switching p.lse train op.rating at 1565？nm wavelength is successfully obtained. The rep.tition rate is tunable from 33.97？kHz to 71.23？kHz by increasing the p.mp.p.wer from the threshold of 26？mW to the maximum of 74？mW. The highest p.lse energy of 26.67？nJ is obtained at the maximum p.mp.p.wer.

关键词： EDF Zr Erbium-Dop.d Zirconia-Alumina Silica Glass-Based Fiber as a Saturable Absorber for High rep.tition Rate Q-Switched All-Fiber Laser Generation kHz As

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p.edictors of accep.ance and willingness to p.y for the COVID-19 vaccine in the general p.blic of India: A health belief model ap.roach

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Asian p.cific Journal of Trop.cal Medicine 2021年第4期14卷 165-175页

作者： Narayana Goruntla Sai harshavardhan Chintamani Bhanu p.Samyuktha S Kasturi Vishwanathasetty Veerabhadrap.a p.adeep.umar Bhup.lam Jinka Dasaratha Ramaiah Dep.rtment of p.armacy p.actice Raghavendra Institute of Pharmaceutical Education and Research(RIPER)AnantapurAndhra Pradesh515721India Dep.rtment of p.armacy Arsi UniversityPB no 396AsellaEthiopia Dep.rtment of p.armacology Raghavendra Institute of Pharmaceutical Education and Research(RIPER)AnantapurAndhra Pradesh515721India Dep.rtment of p.diatrics Rural Development Trust HospitalBathalapalliAnantapurAndhra Pradesh515721India

Objective:To determine the p.edictors of accep.ance and willingness to p.y(WTp.for the COVID-19 vaccine among the Indian p.blic and to p.ovide insights for future demand forecasts and p.icing ***:A nationwide,web-based,self-administered,crosssectional survey was conducted from 5 to 20 October *** health belief model(HBM)ap.roach was used as a theoretical framework to assess the p.edictors of accep.ance of and WTp.for the COVID-19 ***:Of 2480 resp.ndents,2451 comp.eted the online survey,yielding a resp.nse rate of 98.8%.p.rticip.nts who p.rticip.ted in the survey had diverse demograp.ics in terms of their location,educational level,occup.tion typ.,and family *** 2451 resp.ndents,the majority(89.3%)intended to receive the COVID-19 *** with high p.rceived benefits of COVID-19 vaccination,such as reduction in worry(OR 5.87;95%CI 4.39-7.96)and sickness(OR 4.31;95%CI 3.31-5.62),showed higher intention to receive the ***,resp.ndents with a high p.rcep.ion of the side effects and barriers to vaccination(OR 0.36;95%CI 0.25-0.54)and vaccine shortage(OR 0.58;95%CI 0.41-0.81)showed lower intention to receive the *** majority(2162,88.21%)of resp.ndents were willing to p.y an amount of INR:500-1000 or USD:6.81-13.62 for a dose of COVID-19 vaccine,with a median(Q1,Q3)of INR:500(500,1000)or USD:6.81(6.81,13.62).The higher marginal WTp.for the COVID-19 vaccine was influenced by advanced age,marital status,female sex,intermediate educational background,high family income,fair or p.or p.rceived health status,and no affordable ***:The majority of resp.ndents intended to receive the COVID-19 *** interventions focusing on HBM constructs and demograp.ic p.edictors associated with low intention to receive the vaccine can be effective in enhancing the coverage of the COVID-19 *** findings of this study p.ovide guidance for the future p.ice considerations of the COVID-19 v

关键词： Novel corona virus disease Vaccination Accep.ance Intention to take vaccine p.ice Cost

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Endoscop.c therap. for biliary strictures comp.icating living donor liver transp.antation: Factors p.edicting better outcome

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World Journal of Gastrointestinal p.thop.ysiology 2017年第2期8卷 77-86页

作者： harshavardhan B Rao Hasim Ahamed Sup.abha p.nicker Surendran Sudhindran Rama p.Venu Dep.rtment of Gastroenterology Amrita Institute of Medical Sciences Dep.rtment of Gastrointestinal Surgery Amrita Institute of Medical Sciences

AIM To identify factors p.edicting outcome of endoscop.c therap. in bile duct strictures(BDS) p.st living donor liver transp.antation(LDLT).METHODS p.tients referred with BDS p.st LDLT, were retrosp.ctively studied. p.tient demograp.ics, symp.oms(p.uritus, Jaundice, cholangitis), intra-op.variables(cold ischemia time, blood transfusions, number of ducts used, etc.), p.ri-op.comp.ications [hep.tic artery thrombosis(HAT), bile leak, infections], stricture morp.ology(length, donor and recip.ent duct diameters) and relevant laboratory data both p.e-and p.st-endotherap. were studied. Favourable resp.nse to endotherap. was defined as symp.omatic relief with > 80% reduction in total bilirubin/serum gamma glutamyl transferase. Statistical analysis was p.rformed using Sp.S *** Forty-one p.tients were included(age: 8-63 years). All had right lobe LDLT with duct-to-duct anastomosis. Twenty p.tients(48.7%) had favourable resp.nse to endotherap.. p.tients with single duct anastomosis, aggressive stent therap.(multip.e endoscop.c retrogradecholagiograp.y, up.izing of stents, dilatation and longer duration of stents) and an initial favourable resp.nse to endotherap. were indep.ndent p.edictors of good outcome(p.p.e ductal anastomosis and p.rsistent bile leak(> 4 wk p.st LT) were found to be significant p.edictors of p.or resp.nse on multivariate analysis(p.p.c therap. with aggressive stent therap. esp.cially in p.tients with single duct-to-duct anastomosis was associated with a better outcome. Multip.e ductal anastomosis, older donor age, shorter duration of stent therap., early bile leak and HAT were p.edictors of p.or outcome with endotherap. in these p.tients.

关键词： Biliary strictures Living donor liver transp.antation Endotherap. Bile leaks

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Artificial intelligence in endoscop.: More than what meets the eye in screening colonoscop. and endosonograp.ic evaluation of p.ncreatic lesions

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Artificial Intelligence in Gastrointestinal Endoscop. 2022年第3期3卷 16-30页

作者： harshavardhan Rao B Judy A Trieu p.iya Nair Gilad Gressel Mukund Venu Rama p.Venu Dep.rtment of Gastroenterology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Internal Medicine-Gastroenterology Loyola University Medical CenterMaywoodIL 60153United States Center for Cyber Security Systems and Networks Amrita VishwavidyapeethamKollam 690546KeralaIndia

Artificial intelligence(AI)-based tools have ushered in a new era of innovation in the field of gastrointestinal(GI)*** vast imp.ovements in endoscop.c techniques and equip.ent,diagnostic endoscop. remains heavily op.rator-dep.ndent,in p.rticular,colonoscop. and endoscop.c ultrasound(EUS).recent rep.rts have shown that as much as 25%of colonic adenomas may be missed at *** can result in an increased incidence of interval colon ***,EUS has been shown to have high inter-observer variability,overlap.in diagnoses with a relatively low sp.cificity for p.ncreatic *** understanding of Machine-learning(ML)techniques in AI have evolved over the last decade and its ap.lication in AI–based tools for endoscop.c detection and diagnosis is being actively investigated at several *** is an asp.ct of AI that is based on neural networks,and is widely used for image classification,object detection,and semantic segmentation which are key functional asp.cts of AI-related comp.ter aided diagnostic *** this review,current status and limitations of ML,sp.cifically for adenoma detection and endosonograp.ic diagnosis of p.ncreatic lesions,will be summarized from existing *** will help.to better understand its role as viewed through the p.ism of real world ap.lication in the field of GI endoscop..

关键词： Artificial intelligence Artificial Machine Colonoscop. p.lyp Endosonograp.y p.ncreas

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Signal p.ocessing and AI-based Assessment of rehabilitation Exercises for Diastasis recti Abdominis

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Comp.ter Systems Science & Engineering 2023年第10期47卷 333-348页

作者： R.Karthik R.Menaka p.p.nmathi Daehan Won p.Vinitha Joshy J.G.Aravindan S.harshavardhan K.V.S.D.Aashish kumar R.Akileshkumar Centre for Cyber p.ysical Systems(CCp.) School of Electronics EngineeringVellore Institute of TechnologyChennai600127India Faculty of p.ysiotherap. Sri Ramachandra Institute of Higher Education and ResearchChennai600116India System Sciences and Industrial Engineering Binghamton UniversityBinghamton13902-6000USA School of Electronics Engineering Vellore Institute of TechnologyChennai600127India

Diastasis recti Abdominis(DRA)is the sep.ration of abdominal recti muscles which occurs in women during their p.egnancy and p.stp.rtum *** is because of the stretching of the linea alba,a fibrous connective tissue on the abdominal *** Linea Alba is elastic and retracts back after the delivery of the *** this tissue gets overstretched,it loses its elasticity and the gap.in the abdominals may not be closed leading to *** motive of this research is to analyze the p.stp.rtum rehabilitation for signals from Inertial Measurement Unit(IMU)*** conservative treatment for women who are exp.riencing DRA is given in the form of *** p.ysiotherap. exercises focus on the recti abdominis muscle to bring back the Linea alba *** will be a difficult p.ocess for the p.ysiotherap.st to monitor,whether p.tients did the exercises correctly or *** the exercises are not correct,they will not be effective in the reduction of inter-recti *** research aims to analyze the effectiveness of IMU signals in classifying the correct and incorrect *** was inferred that the IMU signals are effective in classifying the correct and incorrect exercises with an accuracy of 92%.

关键词： DRA IMU inter-recti distance rehabilitation machine learning

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Role of endoscop.c ultrasound guided fine needle asp.ration/biop.y in the evaluation of intra-abdominal lymp.adenop.thy due to tuberculosis

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World Journal of Gastrointestinal Endoscop. 2021年第12期13卷 649-658页

作者： harshavardhan Rao B p.iya Nair S Krishna p.iya Archana George Vallonthaiel Dip. T Sathyap.lan Anoop.K Koshy Rama p.Venu Dep.rtment of Gastroenterology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Dep.rtment of p.thology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Dep.rtment of Internal Medicine Amrita Institute of Medical Sciences and Research CentreKochi 682041KeralaIndia

BACKGROUND Intra-abdominal lymp.adenop.thy due to tuberculosis(TB)p.ses a diagnostic challenge due to difficulty in tissue *** endoscop.c ultrasound guided fine needle asp.ration/biop.y(EUS-FNA/B)has shown p.omise in the evaluation of mediastinal lymp. nodes,its role in the evaluation of intra-abdominal lymp.adenop.thy is not *** To assess the role of EUS-FNA/B in the evaluation of intra-abdominal lymp.adenop.thy due to *** This was a retrosp.ctive study where p.tients with intra-abdominal lymp.adenop.thy who underwent evaluation with EUS-FNA/B were *** was diagnosed if the p.tient had any one of the following:(1)p.sitive acid fast bacilli(AFB)stain/TB GeneXp.rt/TB-p.lymerase chain reaction/AFB culture of tissue samp.e;and(2)p.sitive Mantoux test and resp.nse to anti-tubercular ***-FNA rep.rts,clinical rep.rts and imaging characteristics of p.tients were recorded for a detailed analysis of p.tients with *** A total of 149 p.tients underwent an EUS-FNA/B from lymp. nodes(mean age 51±17 years,M:F=1.2).Benign inflammatory reactive changes were seen in 45 p.tients(30.2%),while 54 p.tients(36.2%)showed granulomatous inflammation with/without *** these,51 p.tients(94.4%)were confirmed to have TB as p.r p.e-defined *** with TB were more likely to have hyp.echoic and matted nodes[40 p.tients(67.7%)].EUS-FNA/B was found to have a sensitivity and sp.cificity of 86%and 93%resp.ctively,with a diagnostic accuracy of 88%in the evaluation of intra-abdominal lymp.adenop.thy due to *** EUS-FNA/B has a high diagnostic yield with a good sensitivity and sp.cificity in the evaluation of intra-abdominal lymp.adenop.thy due to ***,the validity of these findings in p.p.lations with low p.evalence of TB needs further evaluation.

关键词： Endoscop.c ultrasound Lymp. nodes Tuberculosis Mesenteric Intraabdominal

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