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Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

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World Journal of Hepatology 2024年第1期16卷 17-32页

作者： Yash R Shah Hassam Ali Angad Tiwari David Guevara-Lazo Natalia Nombera-Aznaran Bhanu siva Mohan pinnam Manesh kumar Gangwani Harishankar Gopakumar Amir H Sohail SriLakshmiDevi Kanumilli Ernesto Calderon-Martinez Geetha Krishnamoorthy Nimish Thakral Dushyant Singh Dahiya Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Maharani Laxmi Bai Medical CollegeJhansi 284001India Faculty of Medicine Universidad Peruana Cayetano HerediaLima 15102Peru Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States Department of Surgery University of New MexicoAlbuquerqueNM 87106United States Department of Internal Medicine GSL Medical CollegeRajamahendravaram 533296India Department of Internal Medicine Universidad Nacional Autonoma de MexicoCiudad De Mexico 04510Mexico Department of Digestive Diseases and Nutrition University of KentuckyLexingtonKY 40536United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States

Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut *** prevalence of HE varies with liver disease severity and *** pathogenesis involves ammonia toxicity,gut-brain communication disruption,and *** aims to restore gut microbiota balance,addressing these ***'s efficacy has been explored in various conditions,including *** suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate *** has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver *** include improved liver function,cognitive function,and the slowing of disease ***,larger,controlled studies are needed to validate its effectiveness in these *** have shown cognitive improvements through FMT,with potential benefits in cirrhotic ***,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of *** evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor *** large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and *** FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.

关键词： Hepatic encephalopathy Fecal microbiota transplant Cognitive impairment Liver cirrhosis Chronic liver disease

Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh kumar Syeda parsa Manesh kumar Gangwani Hassam Ali Amir Humza Sohail Saqr Alsakarneh Umar Hayat Sheza Malik Yash R Shah Bhanu siva Mohan pinnam Sahib Singh Islam Mohamed Adishwar Rao Saurabh Chandan Mohammad Al-Haddad Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States Department of Internal Medicine Chandka Medical CollegeSindh 77280Pakistan Department of Gastroenterology and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Department of Internal Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Sinai hospitalBaltimoreMD 21215United States Department of Hepatology University of MissouriColumbiaMO 65211United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)*** is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural *** has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug *** also has satisfactory efficacy and has achieved high rates of successful sedation in GI ***,studies have demonstrated that the efficacy of Remimazolam is non-inferior to propofol,which is currently a gold standard for procedural sedation in most parts of the ***,the use of propofol is associated with hemodynamic instability and respiratory *** contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to propofol in procedural *** this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural *** also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

关键词： Remimazolam Endoscopy Sedation Outcomes Efficacy Safety pharmacokinetics

Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant Singh Dahiya Muhammad Nadeem Yousaf Brinda Basida Bhanu siva Mohan pinnam Manesh kumar Gangwani Hassam Ali Sahib Singh Yash R Shah Daksh Ahluwalia Mihir prakash Shah Saurabh Chandan Neil R Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of Rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCp)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCp-related *** To investigate outcomes of ERCp in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National Readmission *** aged≥90 were identified who underwent ERCp,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ERCp were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,p=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,p=0.67),accidental punctures/lacerations(aOR=0.77,p=0.5),and mechanical ventilation rates(aOR=1.19,p=0.6).post-ERCp complication rate was similar for bleeding(aOR=0.72,p=0.41)and post-ERCp pancreatitis(aOR=1.4,p=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(ppatients were similar(p=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCp compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

User Centric Block-Level Attribute Based Encryption in Cloud Using Blockchains

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Computer Systems Science & Engineering 2022年第8期42卷 605-618页

作者： S.Godfrey Winster A.siva kumar R.Ramesh Department of Computer Science and Engineering School of ComputingCollege of Engineering and TechnologySRM Institute of Science and TechnologyChengalpattu603203India Department of Information Technology Sri Sai Ram Engineering CollegeChennai600044India Department of Electronics and Communication Engineering Saveetha Engineering CollegeChennai602105India

Cloud computing is a collection of distributed storage Network which can provide various services and store the data in the efficient *** advantages of cloud computing is its remote access where data can accessed in real time using Remote Method Innovation(RMI).The problem of data security in cloud environment is a major concern since the data can be accessed by any time by any *** to the lack of providing the efficient security the cloud computing they fail to achieve higher performance in providing the efficient *** improve the performance in data security,the block chains are used for securing the data in the cloud ***,the traditional block chain technique are not suitable to provide efficient security to the cloud data stored in the *** this paper,an efficient user centric block level Attribute Based Encryption(UCBL-ABE)scheme is presented to provide the efficient security of cloud data in cloud *** proposed approach performs data transaction by employing the block *** proposed system provides efficient privacy with access control to the user access according to the behavior of cloud user using Data Level Access Trust(DLAT).Based on DLAT,the user access has been restricted in the cloud *** proposed protocol is implemented in real time using Java programming language and uses IBM *** implementation results justifies that the proposed system can able to provide efficient security to the data present in and cloud and also enhances the cloud performance.

关键词： Cloud blockchain data security ABE block-level

Deep Learning for Wind Speed Forecasting Using Bi-LSTM with Selected Features

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Intelligent Automation & Soft Computing 2023年第3期35卷 3829-3844页

作者： siva Sankari Subbiah Senthil kumar paramasivan Karmel Arockiasamy Saminathan Senthivel Muthamilselvan Thangavel Department of Computer Science and Engineering Sreenivasa Institute of Technology and Management StudiesChittoor517127India School of Information Technology&Engineering Vellore Institute of TechnologyVellore632014India School of Computer Science and Engineering Vellore Institute of TechnologyChennai600127India School of Computing College of Engineering and TechnologySRM Institute of Science and TechnologyKattankulathur603203India

Wind speed forecasting is important for wind energy *** the modern era,the increase in energy demand can be managed effectively by fore-casting the wind speed *** main objective of this research is to improve the performance of wind speed forecasting by handling uncertainty,the curse of dimensionality,overﬁtting and non-linearity *** curse of dimensionality and overﬁtting issues are handled by using Boruta feature *** uncertainty and the non-linearity issues are addressed by using the deep learning based Bi-directional Long Short Term Memory(Bi-LSTM).In this paper,Bi-LSTM with Boruta feature selection named BFS-Bi-LSTM is proposed to improve the performance of wind speed *** model identiﬁes relevant features for wind speed forecasting from the meteorological features using Boruta wrapper feature selection(BFS).Followed by Bi-LSTM predicts the wind speed by considering the wind speed from the past and future time *** proposed BFS-Bi-LSTM model is compared against Multilayer perceptron(MLp),MLp with Boruta(BFS-MLp),Long Short Term Memory(LSTM),LSTM with Boruta(BFS-LSTM)and Bi-LSTM in terms of Root Mean Square Error(RMSE),Mean Absolute Error(MAE),Mean Square Error(MSE)and *** BFS-Bi-LSTM surpassed other models by producing RMSE of 0.784,MAE of 0.530,MSE of 0.615 and R2 of *** experimental result shows that the BFS-Bi-LSTM produced better forecasting results compared to others.

关键词： Bi-directional long short term memory boruta feature selection deep learning machine learning wind speed forecasting

Impact of Living Donor Liver Transplantation on COVID-19 Clinical Outcomes from a Quaternary Care Centre in Delhi

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Journal of Clinical and Translational Hepatology 2022年第4期10卷 770-777页

作者： Imtiakum Jamir Niteen kumar Gaurav Sood Ashish George pankaj Lohia Samba siva Rao pasupuleti Amrish Sahney Manav Wadhawan Ajay kumar Abhideep Chaudhary Department of HpB Surgery and Liver Transplantation BLK Super Speciality HospitalNew DelhiIndia Department of Critical Care BLK Super Speciality HospitalNew DelhiIndia Department of Statistics Mizoram University(A Central University)Pachhunga University College CampusAizawlMizoramIndia Institute of Digestive and Liver Diseases BLK Super Speciality HospitalNew DelhiIndia

Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services *** aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(1 year)post-transplant ***:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February ***:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of *** overall median interval between transplantation and COVID-19 diagnosis was 816.00 *** and malaise were the common presenting *** most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe *** for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe ***(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft *** recipients with early *** post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and ***:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.

关键词： COVID-19 SARS-CoV-2 Living donor liver transplantation,LDLT Mortality perioperative

Efficient Resource Allocation in Fog Computing Using QTCS Model

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Computers, Materials & Continua 2022年第2期70卷 2225-2239页

作者： M.Iyapparaja Naif Khalaf Alshammari M.Sathish kumar S.siva Rama Krishnan Chiranji Lal Chowdhary School of Information Technology and Engineering Vellore Institute of TechnologyVellore632014India Mechanical Engineering University of HailSaudi Arabia

Infrastructure of fog is a complex system due to the large number of heterogeneous resources that need to be *** embedded devices deployed with the Internet of Things(IoT)technology have increased since the past few years,and these devices generate huge amount of *** devices in IoT can be remotely connected and might be placed in different locations which add to the network *** time applications require high bandwidth with reduced latency to ensure Quality of Service(QoS).To achieve this,fog computing plays a vital role in processing the request locally with the nearest available resources by reduced *** of themajor issues to focus on in a fog service is managing and allocating *** theory is one of the most popular mechanisms for task *** this work,an efficient model is designed to improve QoS with the efficacy of resource allocation based on a Queuing Theory based Cuckoo Search(QTCS)model which will optimize the overall resource management process.

关键词： Queuing theory Cuckoo search QoS resource allocation energy efficiency

purcell's Swimmer Revisited

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International Journal of Automation and computing 2012年第3期9卷 325-330页

作者： M. siva kumar p. philominathan Faculty Oman Dental College P.O. Box 835 Postal Code 116 Sultanate of Oman Research and pG Department of physics AVVM Sri Pushpam College

purcell’s swimmer was proposed by E. M. purcell to explain bacterial swimming motions. It has been proved experimentally that a swimmer of this kind is possible under inertial-less and high viscous environment. But we could not investigate all the aspects of this mechanism through experiments due to practical difficulties. The computational fluid dynamics (CFD) provides complementary methods to experimental fluid dynamics. In particular, these methods offer the means of testing theoretical advances for conditions unavailable experimentally. Using such methodology, we have investigated the fluid dynamics of force production associated with the purcell’s swimmer. By employing dynamic mesh and user-defined functions, we have computed the transient flow around the swimmer for various stroke angles. Our simulations capture the bidirectional swimming property successfully and are in agreement with existing theoretical and experimental results. To our knowledge, this is the first CFD study which shows the fact that swimming direction depends on stroke angle. We also prove that for small flapping frequencies, swimming direction can also be altered by changing frequency-showing breakdown of Stokes law with inertia.

关键词： Very low Reynolds number flow swimming motion of bacteria dynamic mesh purcell’s swimmer Stokes flow

Optimization of AWJM process parameters on 3D-printed Onyx-Glass Fiber Hybrid Composite

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哈尔滨工业大学学报:英文版 2023年第2期30卷 84-98页

作者： Dharmalingam G Arun prasad M Deepak panghal Sachin Salunkhe siva kumar M Rathinasuriyan C Department of Mechanical Engineering Vel Tech Rangarajan Dr.Sagunthala R&D Institute of Science and TechnologyAvadiChennai-600062Tamil NaduIndia Department of Fashion Technology National Institute of Fashion TechnologyNew Delhi-11016India

Compared with conventional manufacturing methods, the additive manufacturing technique enhances mechanical properties. The present investigation of additive manufacturing technique is focused on delamination studies of Onyx-Glass Fiber Hybrid polymer Composite(OGFHpC) along with surface roughness properties during machining(drilling) of composites through abrasive water jet machining(AWJM). However, delamination is a major issue during machining of OGFHpC. In order to overcome these drawbacks, the fabrication of OGFHpC was carried out using fused deposition modeling(FDM) technology which is an additive manufacturing method with Mark forged Mark Two 3D-composite printer. The machinability studies were conducted for drilling operation through AWJM process with different abrasive mass flow rates, drilling diameters and traverse speeds. These drilling machinability process parameters were optimized through the design of experiments-Taguchi analysis followed by the analysis of variance(ANOVA) and validated through the Harmony Search Algorithm(HSA), Whale Optimization Algorithm(WOA) and Grey Wolf Optimization Algorithm(GWO). It was observed that minimum delamination and surface roughness of OGFHpC were optimized for AWJM at abrasive mass flow rates(450 g/min), drilling diameters(12 mm) and traverse speed rate(30 mm/min).

关键词： Onyx-Glass composite fused deposition modeling AWJM delamination surface roughness Taguchi analysis