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AutorhythmAI: A Hybrid Machine and Deep Learning Approach for Automated Diagnosis of Arrhythmias

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Computers, Materials & Continua 2024年第2期78卷 2137-2158页

作者： S.Jayanthi S.prasanna Devi Department of Computer Science and Engineering SRM Institute of Science and Technology-Vadapalani CampusChennaiTamil NaduIndia

In healthcare,the persistent challenge of arrhythmias,a leading cause of global mortality,has sparked extensive research into the automation of detection using machine learning(ML)algorithms.However,traditional ML and AutoML approaches have revealed their limitations,notably regarding feature generalization and automation efficiency.This glaring research gap has motivated the development of AutorhythmAI,an innovative solution that integrates both machine and deep learning to revolutionize the diagnosis of arrhythmias.Our approach encompasses two distinct pipelines tailored for binary-class and multi-class arrhythmia detection,effectively bridging the gap between data preprocessing and model selection.To validate our system,we have rigorously tested AutorhythmAI using a multimodal dataset,surpassing the accuracy achieved using a single dataset and underscoring the robustness of our methodology.In the first pipeline,we employ signal filtering and ML algorithms for preprocessing,followed by data balancing and split for training.The second pipeline is dedicated to feature extraction and classification,utilizing deep learning models.Notably,we introduce the‘rrI-convoluted trans-former model’as a novel addition for binary-class arrhythmias.An ensemble-based approach then amalgamates all models,considering their respective weights,resulting in an optimal model pipeline.In our study,the VGGres Model achieved impressive results in multi-class arrhythmia detection,with an accuracy of 97.39%and firm performance in precision(82.13%),recall(31.91%),and F1-score(82.61%).In the binary-class task,the proposed model achieved an outstanding accuracy of 96.60%.These results highlight the effectiveness of our approach in improving arrhythmia detection,with notably high accuracy and well-balanced performance metrics.

关键词： Automated machine learning neural networks deep learning arrhythmias

High-throughput computational screening and in vitro evaluation identifies 5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione(C3),as a novel EGFr—HEr2 dual inhibitor in gastric tumors

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Oncology research 2024年第2期32卷 251-259页

作者： MESFEr AL SHAHrANI rEEM GAHTANI MOHAMMAD ABOHASSAN MOHAMMAD ALSHAHrANI YASSEr ALrAEY AYED DErA MOHAMMAD rAJEH ASIrI prasanna rAJAGOPALAN Department of Clinical Laboratory Sciences College of Applied Medical SciencesKing Khalid UniversityAbhaSaudi Arabia

Gastric cancers are caused primarily due to the activation and amplification of the EGFr or HEr2 kinases resulting in cell proliferation,adhesion,angiogenesis,and metastasis.Conventional therapies are ineffective due to the intra-tumoral heterogeneity and concomitant genetic mutations.Hence,dual inhibition strategies are recommended to increase potency and reduce cytotoxicity.In this study,we have conducted computational high-throughput screening of the ChemBridge library followed by in vitro assays and identified novel selective inhibitors that have a dual impediment of EGFr/HEr2 kinase activities.Diversity-based High-throughput Virtual Screening(D-HTVS)was used to screen the whole ChemBridge small molecular library against EGFr and HEr2.The atomistic molecular dynamic simulation was conducted to understand the dynamics and stability of the protein-ligand complexes.EGFr/HEr2 kinase enzymes,KATOIII,and Snu-5 cells were used for in vitro validations.The atomistic Molecular Dynamics simulations followed by solvent-based Gibbs binding free energy calculation of top molecules,identified compound C3(5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione)to have a good affinity for both EGFr and HEr2.The predicted compound,C3,was promising with better binding energy,good binding pose,and optimum interactions with the EGFr and HEr2 residues.C3 inhibited EGFr and HEr2 kinases with IC50 values of 37.24 and 45.83 nM,respectively.The GI50 values of C3 to inhibit KATOIII and Snu-5 cells were 84.76 and 48.26 nM,respectively.Based on these findings,we conclude that the identified compound C3 showed a conceivable dual inhibitory activity on EGFr/HEr2 kinase,and therefore can be considered as a plausible lead-like molecule for treating gastric cancers with minimal side effects,though testing in higher models with pharmacokinetic approach is required.

关键词： Dual inhibitor Drug discovery EGFr/HEr2 kinase Gastric cancer High-throughput screening

Navigating the intersection of psychiatry and ophthalmology:A comprehensive review of depression and anxiety management in glaucoma patients

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World Journal of Psychiatry 2024年第3期14卷 362-369页

作者： prasanna Venkatesh ramesh Arvind Kumar Morya Ashik Azad Pavithra Pannerselvam Aji Kunnath Devadas Sai Thaejesvi Gopalakrishnan Shruthy Vaishali ramesh Ajanya K Aradhya Department of Glaucoma and research Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Optometry and Visual Science Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Junior resident Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Department of Cataract and refractive Surgery Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia

Glaucoma,a prevalent and debilitating eye disease,has long been associated with vision impairment and blindness.However,recent research has shed light on the often-underestimated psychological dimensions of this condition.Anxiety and depression,two pervasive psychiatric comorbidities,have been increasingly recognized among glaucoma patients.This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology,in the context of managing depression and anxiety in glaucoma patients.By meticulously examining peer-reviewed literature,we synthesize current knowledge on the prevalence,risk factors,and underlying mechanisms of anxiety and depression in glaucoma.The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders.Factors such as progressive vision loss,complex medication regimens,and the fear of further visual deterioration contribute to their vulnerability.Moreover,we delve into the bidirectional relationship between glaucoma and mood disorders,shedding light on the complex interplay between ocular and emotional health.Our review investigates the implications of anxiety and depression on glaucoma management,including their potential impact on treatment adherence,disease progression,and overall quality of life.We also explore the neurobiological pathways linking glaucoma and mood disorders,providing a foundation for future research and potential therapeutic interventions.In conclusion,recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care.This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma.By addressing anxiety and depression in glaucoma care,healthcare providers can enhance the overall quality of life for these patients,ultimately leading to improved outcomes and a brighter future for those affected by this condition.This

关键词： Glaucoma Psychiatry Depression Anxiety risk factors Bidirectional relationship

Unveiling the silent link:Normal-tension glaucoma's enigmatic bond with cardiac blood flow

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World Journal of Cardiology 2024年第1期16卷 10-15页

作者： prasanna Venkatesh ramesh Arvind Kumar Morya Ajanya K Aradhya Pavithra Pannerselvam Sai Thaejesvi Gopalakrishnan Shruthy Vaishali ramesh Aji Kunnath Devadas Navaneeth Krishna Department of Glaucoma and research Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Optometry and Visual Science Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Mahathma Eye Hospital Private Limited Trichy 620017Tamil NaduIndia Department of Cataract and refractive Surgery Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia

This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma(NTG),a condition that continues to baffle clinicians and researchers alike.NTG,characterized by optic nerve damage and visual field loss despite normal intraocular pressure,has long puzzled clinicians.One emerging perspective suggests that alterations in ocular blood flow,particularly within the optic nerve head,may play a pivotal role in its pathogenesis.While NTG shares commonalities with its high-tension counterpart,its unique pathogenesis and potential ties to cardiovascular health make it a fascinating subject of exploration.It navigates through the complex web of vascular dysregulation,blood pressure and perfusion pressure,neurovascular coupling,and oxidative stress,seeking to uncover the hidden threads that tie the heart and eyes together in NTG.This review explores into the intricate mechanisms connecting cardiovascular factors to NTG,shedding light on how cardiac dynamics can influence ocular health,particularly in cases where intraocular pressure remains within the normal range.NTG's enigmatic nature,often characterized by seemingly contradictory risk factors and clinical profiles,underscores the need for a holistic approach to patient care.Drawing parallels to cardiac health,we examine into the shared vascular terrain connecting the heart and the eyes.Cardiovascular factors,including systemic blood flow,endothelial dysfunction,and microcirculatory anomalies,may exert a profound influence on ocular perfusion,impacting the delicate balance within the optic nerve head.By elucidating the subtle clues and potential associations between cardiology and NTG,this review invites clinicians to consider a broader perspective in their evaluation and management of this elusive condition.As the understanding of these connections evolves,so too may the prospects for early diagnosis and tailored interventions,ultimately enhancing the quality of life for those living with NTG.

关键词： Normal tension glaucoma Vascular dysregulation Ocular blood flow Blood pressure Perfusion pressure Oxidative stress

Novel automated non-invasive detection of ocular surface squamous neoplasia using artificial intelligence

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World Journal of Methodology 2024年第2期14卷 51-64页

作者： Sony Sinha prasanna Venkatesh ramesh Prateek Nishant Arvind Kumar Morya ripunjay Prasad Department of Ophthalmology–Vitreo retina Neuro Ophthalmology and OculoplastyAll India Institute of Medical SciencesPatna 801507India Department of Glaucoma and research Mahathma Eye Hospital Private LimitedTrichy 620017India Department of Ophthalmology ESIC Medical CollegePatna 801113India Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126India Department of Ophthalmology RP Eye InstituteDelhi 110001India

Ocular surface squamous neoplasia(OSSN)is a common eye surface tumour,characterized by the growth of abnormal cells on the ocular surface.OSSN includes invasive squamous cell carcinoma(SCC),in which tumour cells penetrate the basement membrane and infiltrate the stroma,as well as non-invasive conjunctival intraepithelial neoplasia,dysplasia,and SCC in-situ thereby presenting a challenge in early detection and diagnosis.Early identification and precise demarcation of the OSSN border leads to straightforward and curative treatments,such as topical medicines,whereas advanced invasive lesions may need orbital exenteration,which carries a risk of death.Artificial intelligence(AI)has emerged as a promising tool in the field of eye care and holds potential for its application in OSSN management.AI algorithms trained on large datasets can analyze ocular surface images to identify suspicious lesions associated with OSSN,aiding ophthalmologists in early detection and diagnosis.AI can also track and monitor lesion progression over time,providing objective measurements to guide treatment decisions.Furthermore,AI can assist in treatment planning by offering personalized recommendations based on patient data and predicting the treatment response.This manuscript highlights the role of AI in OSSN,specifically focusing on its contributions in early detection and diagnosis,assessment of lesion progression,treatment planning,telemedicine and remote monitoring,and research and data analysis.

关键词： Conjunctival neoplasm Early detection of cancer Machine learning Deep neural network Precision medicine

Laparoscopic management of remnant gall bladder with stones: Lessons from a tertiary care centre's experience

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Laparoscopic, Endoscopic and robotic Surgery 2024年第1期7卷 27-33页

作者： Gilbert Samuel Jebakumar Jeevanandham Muthiah Loganathan Jayapal r.Santhosh Kumar Siddhesh Tasgaonkar K.S.Santhosh Anand J.K.A.Jameel Sudeepta Kumar Swain K.J.raghunath prasanna Kumar reddy Tirupporur Govindaswamy Balachandar Department of Surgical Gastroenterology Apollo HospitalsChennai 600006India Department of General Surgery Apollo HospitalsChennai 600006India Department of Minimal Access Surgery Apollo HospitalsChennai 600006India

Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone disease.Despite its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this syndrome.The objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant gallbladders.Methods:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo Hospitals in South India.All patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were included.The following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative outcomes.results:In total,36 patients were included and analysed.The majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 years.The most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open surgery.Cholecystoenteric fistula to the colon was observed in one patient.Choledocholithiasis was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients preoperatively.Conclusion:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and infection.Patients who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain risks.This study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder with cystic duct or bile duct stones.

关键词： remnant gall bladder Stump cholecystitis Subtotal cholecystectomy Laparoscopic completion cholecystectomy

Intraocular lens selection in diabetic patients:How to increase the odds for success

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World Journal of Diabetes 2024年第6期15卷 1199-1211页

作者： Arvind Kumar Morya Prateek Nishant prasanna Venkatesh ramesh Sony Sinha Aarti Heda Sarika Salodia ripunjay Prasad Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Ophthalmology ESIC Medical CollegePatna 801113BiharIndia Department of Glaucoma and research Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Department of Ophthalmology-Vitreo-retina Neuro-Ophthalmology and OculoplastyAll India Institute of Medical SciencesPatnaPatna 801507BiharIndia Department of Ophthalmology National Institute of OphthalmologyPune 411000MaharashtraIndia Department of Safety Global Medical SafetyLundbeckSingapore 307591Singapore Department of Ophthalmology RP Eye InstituteDelhi 110001India

The incidence of cataracts is significantly higher in diabetic individuals,particularly in younger age groups,with rates quadrupled in those under 65 and doubled in those over 65 compared to non-diabetics.Cataract surgery in diabetic patients poses many challenges:Poor epithelial healing,decreased corneal sensitivity,increased central corneal thickness,decreased endothelial cell count,variable topography,poor pupillary dilatation,anterior capsular phimosis,posterior capsular opacification(PCO),chances of progression of diabetic retinopathy(Dr),zonular weakness,and vitreous prolapse and diabetic macular edema.Selection of an appropriate intraocular lens(IOL)is crucial for visual rehabilitation and monitoring Dr.The choice of IOL in diabetic cataract patients is a challenging scenario.Square-edge IOLs are favored for their capacity to mitigate PCO,whereas hydrophilic counterparts may incur calcification in the setting of proliferative Dr.The advisability of premium IOLs for achieving spectacle independence warrants judicious evaluation,particularly in the presence of advanced retinopathy.Optimal IOL placement within the capsular bag is advocated to minimize postoperative complications.rigorous preoperative assessment and informed patient counseling regarding IOL options are indispensable for optimizing surgical outcomes.This review article covers various aspects regarding the choice of IOLs in different case scenarios and complications in the diabetic population.

关键词： Diabetics Cataract Intraocular lens Diabetic retinopathy Diabetes mellitus

Analysis and Optimization of Operational and Pollutant Attributes of Diesel Engine with CNT-Infused Orange Peel Biodiesel-Diesel Blend Fuel

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Journal of Thermal Science 2024年第2期33卷 761-778页

作者： ranjeet rAI r.r.SAHOO Mechanical Engineering Department GLA UniversityMathura281406India Mechanical Engineering Department IIT(BHU)Varanasi221005India

The current study is performed to find sustainable solutions for the future of transportation and environmental well-being.Both conventional methods and experimental design table(L16 Orthogonal Array)techniques have been employed to examine and optimize a diesel-powered engine's operational and pollutant parameters.The L16 Orthogonal Array is obtained through Taguchi's experimental design approach using Minitab 16 software.The experimental design incorporated three control variables,namely engine speed,fuel type,and engine load,each with four levels.The operational parameters,namely brake thermal efficiency(BTE)and brake specific fuel consumption(BSFC),as well as the emission characteristics,including hydrocarbon(HC),carbon monoxide(CO),nitrogen oxide(NO),and smoke emissions,were acquired using the L16 orthogonal array(OA) and subsequently examined.The utilization of methodologies such as signal-to-noise(S/N) ratio and grey analysis was employed to determine the optimal operational state of the engine to achieve maximum performance while minimizing emissions.The engine's ideal state of operation,in terms of BTE and BSFC,was determined to be at 75% engine load,1000 r/min engine speed,and using 10^(-4)(in vol) carbon nanotube incorporated 20% orange peel biodiesel(OPB20CNT100) blended fuel(A3-B1-C4).The study indicated that engine load significantly influenced BTE and BSFC,with 84.05% and 87.79% contribution factors,respectively.At 25% engine load,1000 r/min,and OPB20CNT100 fuel(A1-B1-C4) CO,smoke,NO,and HC emissions were the lowest.Engine load affects emissions the most.Engine BSFC increased 3.10% and NO emissions 1.77%.BTE,CO,smoke,and HC emissions decreased by 1.9%,12.29%,47.05%,and 47.22%,respectively,at optimal operating conditions concerning diesel fuel.This study shows that Taguchi-Grey's experimental design optimizes diesel engine operational and pollutant attributes.The outcomes revealed that orange peel biodiesel infused with CNT can replace diesel fuel in an environmentally friendly way.This alternative

关键词： Taguchi-Grey method OPB20CNT100 transesterification S/N ratio GrG HC CO and NO

Treat to target in Crohn’s disease:A practical guide for clinicians

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World Journal of Gastroenterology 2024年第1期30卷 50-69页

作者： Ashish r Srinivasan Department of Gastroenterology Austin HealthVictoriaMelbourne 3083Australia Department of Gastroenterology Eastern HealthVictoriaMelbourne 3128Australia Department of Medicine University of MelbourneVictoriaMelbourne 3052Australia

A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's disease.The Selecting Therapeutic Targets in Inflammatory Bowel Disease(STrIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these timepoints.Scheduled appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or modified.Consensus treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic healing.Although the STrIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all patients.This underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment targets.The use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural healing.Two randomised clinical trials,namely,CALM and STArDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s disease.Findings from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be clarified.Moreover,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world studies.Despite the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its uptake.This highlights the need to describe strategies,processes,and models of care capable of

关键词： Treat to target Inflammatory bowel disease Crohn’s disease Treatment targets Endoscopic remission Transmural healing Time to response Intestinal ultrasound