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Repurposing Pirfenidone for Nonalcoholic Steatohepatitis-related Cirrhosis:A Case Series

Journal of Clinical and Translational Hepatology 2020年第1期8卷 100-105页

作者： Cyriac Abby Philips Guruprasad Padsalgi Rizwan Ahamed rajaguru paramaguru Sasidharan Rajesh Tom George Pushpa Mahadevan Philip Augustine The Liver Unit and Monarch Liver Lab Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Department of Gastroenterology Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Department of Pathology Al Salam International HospitalBneid Al QarKuwaitIndia Department of Diagnostic and Interventional Radiology Department of Gastroenterology and The Liver UnitCochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Department of Clinical Pathology VPS Lakeshore HospitalKochiKeralaIndia

We repurposed the antifibrotic drug pirfenidone—which is approved for treatment of idiopathic lung fibrosis—in a series of patients with nonalcoholic steatohepatitis-related *** report demonstrates the observed improvements in necroinflammation and regression of cirrhosis with pirfeni-done use for 12-weeks,associated with classical hepatic repair complex features on follow-up liver *** novel work could help stimulate further randomized trials of pirfe-nidone in patients with nonalcoholic steatohepatitis-related liver fibrosis or cirrhosis,for whom no recommended drug treatments exists currently.

关键词： NASH Fibrosis Antifibrotic Hepatitis Pirfenidone

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Application of nonlinear fatigue damage models in power electronic module wirebond structure under various amplitude loadings

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Advances in Manufacturing 2014年第3期2卷 239-250页

作者： Pushparajah rajaguru Hua Lu Chris Bailey Computational Mechanics and Reliability Group University of GreenwichLondonUK

This paper presents mean fatigue lifetime predic- tion of a wire-bond structure model in power electronic module using a failure physics approach that integrates high fidelity modelling and reduced order modelling. Loading current with variable amplitudes is applied to a finite element model of simplified wirebond structures. The resulting accumulated fatigue damage due to random loads is predicted by using reduced order modelling based on failure physics, a cycle counting algorithm, and various nonlinear fatigue damage models widely used in the literature. The reduced order mod- elling approach based on failure physics uses prediction data for the electro-thermo-mechanical behaviour of the wire-bond design of a power module obtained through non-linear transient finite element simulations, in particular for the fatigue life-time of the aluminium wire attached to the silicon chip of the wire in the module. The reduced order models that capture the black box function of the accumulated plastic strain are used in pre- dicting the mean fatigue life time of the wire bond structure under random loads. One of the widely used cycle counting algorithms, rainflow counting algorithm, is used to count cycles of the temperature profile at the specific point of the wire bond structure in a power electronic module. The cycle data from the rainflow algorithm mean life time of the wire bond structure are predicted with various cumulative fatigue models. Non-linear cumulative fatigue models such as damage curve approach （DCA）, double linear damage rule （DLDR）, and double dam- age curve approach （DDCA）, and linear cumulative fatigue damage model such as Palmgren-Miner rule are used to predict the mean fatigue life of the wire bond structure, and the results are compared.

关键词： Reduced order models Power module Kriging Radial basis Damage rule

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Fabrication, characterization, in vitro drug release and glucose uptake activity of 14-deoxy,11, 12-didehydroandrographolide loaded polycaprolactone nanoparticles

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Asian Journal of Pharmaceutical Sciences 2017年第4期12卷 353-362页

作者： Nagalakshmi Kamaraj Pooja Yashwanthi rajaguru Praveen kumar Issac Sujatha Sundaresan Department of Biotechnology School of Bioengineering SRM University

Biodegradable polymer based novel drug delivery systems brought a considerable attention in enhancing the therapeutic efficacy and bioavailability of various drugs. 14-deoxy 11, 12-didehydro andrographolide(poorly water soluble compound) loaded polycaprolactone(nanoDDA) was synthesized using the solvent evaporation technique. Nano-DDA was characterized by scanning electron microscopy(SEM) and dynamic light scattering(DLS) studies. Fourier Transform InfraRed Spectroscopy(FTIR) was used to investigate the structural interaction between the drug and the polymer. Functional characterization of the formulation was determined using drug content, cellular uptake and in vitro drug release. 2-deoxy-D-[1-~3H] glucose uptake assay was carried out to assess the antidiabetic potential of nano-DDA in L6 *** nano-DDA displayed spherical shape with a smooth surface(252.898 nm diameter), zeta potential, encapsulation and loading efficiencies of -38.9 mV, 91.98 ± 0.13% and 15.09 ± 0.18% respectively. No structural alteration between the drug and the polymer was evidenced(FTIR analysis). Confocal microscopy studies with rhodamine 123 loaded polycaprolactone nanoparticles(Rh123-PCL NPs) revealed the internalization of Rh123-PCL NPs in a time dependent manner in L6 myoblasts. A dose dependent increase in glucose uptake was observed for nano-DDA with a maximal uptake of 108.54 ± 1.42% at 100 nM on L6 myotubes, thereby proving its anti-diabetic efficacy. A biphasic pattern of in vitro drug release demonstrated an initial burst release at 24 h followed by a sustained release for up to 11 days. To conclude,our results revealed that nano-DDA formulation can be a potent candidate for antidiabetic drug delivery.

关键词： Nanoencapsulation Polycaprolactone 14-deoxy 11,12-didehydro andrographolide Glucose uptake In vitro drug release Cellular uptake

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Understanding surgical care delivery in Sub-Saharan Africa:a cross-sectional analysis of surgical volume,operations,and financing at a tertiary referral hospital in rural Tanzania

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Global Health Research and Policy 2019年第1期4卷 78-86页

作者： Praveen Paul rajaguru Mubashir Alavi Jusabani Honest Massawe Rogers Temu Neil Perry Sheth Center for Public Health Initiatives University of PennsylvaniaPhiladelphiaPAUSA Department of Orthopaedic Surgery Kilimanjaro Christian Medical CenterMoshiTanzania Department of Orthopaedic Surgery University of PennsylvaniaPhiladelphiaPAUSA

Background:Access to surgical care in Low-and Middle-Income Countries(LMICs)such as Tanzania is extremely *** Tanzania is served by a single tertiary referral hospital,Kilimanjaro Christian Medical Centre(KCMC).The surgical volumes,workflow,and payment mechanisms in this region have not been *** these factors is critical in expanding access to *** authors sought to evaluate the operations and financing of the main operating theaters at KCMC in Sub-Saharan ***:The 2018 case volume and specialty distribution(general,orthopaedic,and gynecology)in the main operating theaters at KCMC was retrieved through retrospective review of operating report *** workflow(*** and cancelled cases,lengths of procedures,lengths of operating days)and financing data(patient payment methods)from the five KCMC operating theater logs were retrospectively reviewed for the available fivemonth period of March 2018 to July *** statistics and statistical analysis were ***:In 2018,the main operating theaters at KCMC performed 3817 total procedures,with elective procedures(2385)outnumbering emergency procedures(1432).General surgery(1927)was the most operated specialty,followed by orthopaedics(1371)and gynecology(519).In the five-month subset analysis period,just 54.6%of planned operating days were fully *** were 238 cancellations(20.8%of planned operations).Time constraints(31.1%,74 cases)was the largest reason;lack of patient payment accounted for as many cancellations as unavailable equipment(6.3%,15 cases each).Financing for elective theater cases included insurance 45.5%(418 patients),and cash 48.4%(445 patients).Conclusion:While surgical volume is high,there are non-physical inefficiencies in the system that can be addressed to reduce cancellations and improve *** physical resources is not enough to improve access to care in this region,and likely in many LMIC set

关键词： Global health systems Global surgery delivery Capacity building Universal health coverage Access to healthcare Low-and middle-income countries Financing healthcare Systems and operations

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A Unique Approach to Epilepsy Classification from EEG Signals Using Dimensionality Reduction and Neural Networks

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Circuits and Systems 2016年第8期7卷 1455-1464页

作者： Harikumar rajaguru Sunil Kumar Prabhakar Department of ECE Bannari Amman Institute of Technology Sathyamangalam India

Characterized by recurrent and rapid seizures, epilepsy is a great threat to the livelihood of the human beings. Abnormal transient behaviour of neurons in the cortical regions of the brain leads to a seizure which characterizes epilepsy. The physical and mental activities of the patient are totally dampened with this epileptic seizure. A significant clinical tool for the study, analysis and diagnosis of the epilepsy is electroencephalogram (EEG). To detect such seizures, EEG signals aids greatly to the clinical experts and it is used as an important tool for the analysis of brain disorders, especially epilepsy. In this paper, the high dimensional EEG data are reduced to a low dimension by incorporating techniques such as Fuzzy Mutual Information (FMI), Independent Component Analysis (ICA), Linear Graph Embedding (LGE), Linear Discriminant Analysis (LDA) and Variational Bayesian Matrix Factorization (VBMF). After employing them as dimensionality reduction techniques, the Neural Networks (NN) such as Cascaded Feed Forward Neural Network (CFFNN), Time Delay Neural Network (TDNN) and Generalized Regression Neural Network (GRNN) are used as Post Classifiers for the Classification of Epilepsy Risk Levels from EEG signals. The bench mark parameters used here are Performance Index (PI), Quality Values (QV), Time Delay, Accuracy, Specificity and Sensitivity.

关键词： LDA FMI ICA LGE VBMF NN

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