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Prehabilitation in elderly patients scheduled for liver resection and protocol for Recovery Of Surgery in Elderly

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Hepatoma Research 2020年第3期6卷 50-59页

作者： ramkumar mohan Cheong Wei Terence Huey Sameer Junnarkar Jee Keem Low Vishal G.Shelat Yong Loo Lin School of Medicine National University of SingaporeSingapore Senior Consultant Hepatopancreaticobiliary SurgeryTan Tock Seng HospitalSingapore

Ageing population of first world economies pose unique challenges to surgical *** recovery after surgery protocols and pathways do not attempt to optimize or enhance physical function of patients by customized program of physical ***,prehabilitation programs(PP)have gained momentum in orthopaedics,urology,colorectal surgery and hepatopancreaticobiliary *** evidence of PP in various elective surgical procedures have shown improved outcomes with minimal to none drawback or *** is emerging evidence of role of PP in elective liver *** aim of this paper is to review the basis of PP and share local multidisciplinary team protocol specifically customized to frail and elderly population-Recovery Of Surgery in Elderly.

关键词： Prehabilitation liver resection hepatocellular carcinoma pre-operative exercise ageing

Elderly patients(≥80 years)with acute calculous cholangitis have similar outcomes as non-elderly patients(<80 years):Propensity score-matched analysis

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World Journal of Hepatology 2021年第4期13卷 456-471页

作者： Kai Siang Chan ramkumar mohan Jee Keem Low Sameer P Junnarkar Cheong Wei Terence Huey Vishal G Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore MOH Holdings Singapore 099253Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore

BACKGROUND Acute cholangitis(AC)is a disease spectrum with varying extent of ***≥75 years forms part of the criteria for moderate(Grade II)severity in both the Tokyo Guidelines(TG13 and TG18).Aging is associated with reduced physiological reserves,frailty,and ***,there is evidence that age itself is not the determinant of inferior outcomes in elective and emergency biliary *** is a paucity of reports comparing clinical outcomes amongst elderly patients vs non-elderly patients with *** To investigate the effect of age(≥80 years)on AC's morbidity and mortality using propensity score matching(PSM).METHODS This is a single-center retrospective cohort study of all patients diagnosed with calculous AC(January 2016 to December 2016)and≥80 years old(January 2012 to December 2016)at a tertiary university-affiliated teaching *** criteria were patients who were treated for suspected or confirmed AC secondary to biliary *** with AC on a background of hepatobiliary malignancy,indwelling permanent metallic biliary stents,or concomitant pancreatitis were *** patients were defined as≥80 years old in our study.A 1:1 PSM analysis was performed to reduce selection bias and address confounding *** variables include comorbidities,vital parameters,laboratory and radiological investigations,and type of biliary decompression,including the time for endoscopic retrograde cholangiopancreatography(ERCP).Primary outcomes include in-hospital mortality,30-d and 90-d *** of hospital stay(LOS)was the secondary *** Four hundred fifty-seven patients with AC were included in this study(318 elderly,139 non-elderly).PSM analysis resulted in a total of 224 patients(112 elderly,112 non-elderly).The adoption of ERCP between elderly and non-elderly was similar in both the unmatched(elderly 64.8%,non-elderly 61.9%,P=0.551)and matched cohorts(elderly 68.8%and non-elderly 58%,P=0.096).The overall in

关键词： Cholangitis Choledocholithiasis Cholelithiasis Aged 80 and over Geriatrics Cholangiopancreatography Endoscopic retrograde

A Blockchain Based Framework for Information System Integrity

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China Communications 2019年第6期16卷 1-17页

作者： Mahalingam ramkumar Department of Computer Science and Engineering Mississippi State University

A blockchain based system integrity(BCSI)framework for assuring the integrity of information system processes is *** is well suited for a broad class of large scale real-world information *** the BCSI framework,the integrity of any information system I is assured by executing the finite state machine model for system I processes in a blockchain *** BCSI framework is compared and contrasted with the Clark-Wilson(CW)system integrity model,and existing blockchain based frameworks like Ethereum.

关键词： blockchains finite state machine model ordered merkle tree

Utilization of chemical looping strategy in coal gasification processes

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Particuology 2008年第3期6卷 131-142页

作者： Liangshih Fan Shwetha ramkumar Department of Chemical and Biomolecular Engineering The Ohio State UniversityUnited States

Three chemical looping gasification processes, i.e. Syngas Chemical Looping （SCL） process, Coal Direct Chemical Looping （CDCL） process, and Calcium Looping process （CLP）, are being developed at the Ohio State University （OSU）. These processes utilize simple reaction schemes to convert carbonaceous fuels into products such as hydrogen, electricity, and synthetic fuels through the transformation of a highly reactive, highly recyclable chemical intermediate. In this paper, these novel chemical looping gasification processes are described and their advantages and potential challenges for commercialization are discussed.

关键词： Chemical looping Gasification process Combustion Hydrogen

Distribution of clay minerals in marine sediments off Chennai,Bay of Bengal,India:Indicators of sediment sources and transport processes

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International Journal of Sediment Research 2014年第1期29卷 11-23页

作者： Subramanian VEERASINGAM Ramdoss VENKATACHALAPATHY Thirunavukkarasu ramkumar CSIR-National Institute of Oceanography Department of Physics Annamalai University Centre of Advanced Study in Marine Biology Faculty of Marine SciencesAnnamalai University Department of Earth Sciences Annamalai University

Clay mineralogy,texture size and statistical analyses were carried out on surface sediments from the continental shelf of Chennai,Bay of Bengal,*** purpose of this study is to characterize the clay mineral distribution and its relation to the hydrodynamics off Chennai to identify the sources and transport pathways of the marine *** of clay minerals in coastal sediments by Fourier Transform Infrared(FTIR)spectroscopy has provided the association of quartz,feldspar,kaolinite,chlorite,illite and iron oxides(magnetite and hematite) derived from river catchments and coastal ***,chlorite,illite,iron oxides,and organic matter are the dominant minerals in Cooum,and Adayar *** quartz and feldspar zones were identified in Marina,which are being confined the sand zone and paralleling the *** strong relationships among the wave energy density,sand,quartz and carbonate revealed that wave induced littoral drift system play a dominant role in transportation and deposition of sediments in the Chennai *** sediment texture and minerals data are in agreement well with the previous results of hydrodynamics and littoral drift models in this *** statistical analyses(correlation,cluster and factor analyses) were carried out and obtained results suggested that clay minerals and organic matter are trapped in silt and clay particles,whereas quartz,feldspar and carbonate are associated with sand *** of sediment sources and transport processes from this study will be useful to predict the fate of the pollutants released from land or the potential change in sediment delivery to coastal areas.

关键词： Clay minerals Texture size Marine sediment Hydrodynamics Multivariate statistics

Key Management Using Chebyshev Polynomials for Mobile Ad Hoc Networks

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China Communications 2017年第11期14卷 237-246页

作者： K.R.ramkumar Raman Singh Chitkara University Chandigarh - Patiala National Highways (NH 64)Patiala - 140401 Punjab India Thapar University Patiala- 147004 Punjab India

A dedicated key server cannot be instituted to manage keys for MANETs since they are dynamic and unstable. The Lagrange's polynomial and curve fitting are being used to implement hierarchical key management for Mobile Ad hoc Networks(MANETs). The polynomial interpolation by Lagrange and curve fitting requires high computational efforts for higher order polynomials and moreover they are susceptible to Runge's phenomenon. The Chebyshev polynomials are secure, accurate, and stable and there is no limit to the degree of the polynomials. The distributed key management is a big challenge in these time varying networks. In this work, the Chebyshev polynomials are used to perform key management and tested in various conditions. The secret key shares generation, symmetric key construction and key distribution by using Chebyshev polynomials are the main elements of this projected work. The significance property of Chebyshev polynomials is its recursive nature. The mobile nodes usually have less computational power and less memory, the key management by using Chebyshev polynomials reduces the burden of mobile nodes to implement the overall system.

关键词： chebyshev polynomials interpolation secret sharing key management

Characterization of Microstructure, Strength, and Toughness of Dissimilar Weldments of Inconel 625 and Duplex Stainless Steel SAF 2205

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Acta Metallurgica Sinica(English Letters) 2014年第6期27卷 1018-1030页

作者： R. Sridhar K. Devendranath ramkumar N. Arivazhagan School of Mechanical & Building Sciences VIT University Saraswathy Velu College of Engineering

The dissimilar combinations of Inconel 625 and duplex stainless steel SAF 2205 obtained from manual GTA welding process employing ER2209 and ERNi CrMo-3 filler metals have been investigated. Formation of secondary phases at the HAZ of Inconel 625 and grain coarsening at the HAZ of SAF 2205 were witnessed while using these filler wires. The average hardness of ER2209 weldments was found to be greater than ERNi CrMo-3 weld. Tensile fracture was observed at the weld zones for both the fillers. Impact test trials showed brittle mode of fracture on employing ER2209 filler and mixed（ductile–brittle） mode of fracture while using ERNi CrMo-3 filler. Further optical microscopy and SEM/EDS analysis were carried out across the weldments to investigate the structure–property relationships.

关键词： Inconel 625 Duplex stainless steel SAF 2205 Dissimilar metal welding Microstructure Mechanical characterization

Application of remote sensing and GIS analysis for identifying groundwater potential zone in parts of Kodaikanal Taluk, South India

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Frontiers of Earth Science 2013年第1期7卷 65-75页

作者： Murugesan BAGYARAJ Thirunavukkarasu ramkumar Senapathi VENKATRAMANAN Balasubramanian GURUGNANAM Department of Earth Sciences Annamalai University Annamalai Nagar 608002 India Department of Geology Gandhigram Rural Institute Deemed University Gandhigarm 624302 India

Groundwater potential zones were demarcated with the help of remote sensing and Geographic Informa- tion System （GIS） techniques. The study area is composed rocks of Archaean age and chamockite dominated over others. The parameters considered for identifying the groundwater potential zone of geology slope, drainage density, geomorphic units and lineament density were generated using the resource sat （IRS P6 LISS IV MX） data and survey of India （SO1） toposheets of scale 1：50000 and integrated them with an inverse distance weighted （IDW） model based on GIS data to identify the ground- water potential of the study area. Suitable weightage factors were assigned for each category of these para- meters. For the various geomorphic units, weightage factors were assigned based on their capability to store ground-water. This procedure was repeated for all the other layers and resultant layers were reclassified. The reclassi- fied layers were then combined to demarcate zones as very good, good, moderate, low, and poor. This groundwater potentiality information could be used for effective identification of suitable locations for extraction of potable water for rural populations.

关键词： remote sensing GIS slope geomorphic lineament Kodaikanal

Variations in texture of beach sediments in the vicinity of the Tirumalairajanar river mouth of India

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International Journal of Sediment Research 2011年第4期26卷 460-470页

作者： Senapathi VENKATRAMANAN Thirunavukkarasu ramkumar Irudhayanathan ANITHAMARY Govindaraj RAMESH Research scholar Department of Earth SciencesAnnamalai UniversityAnnamalainagar608002.TamilnaduIndia Department of Earth Sciences Annamalai University

The distribution of grain size parameters along 11 km stretch of the beach sediments between Karikal and Nagore,reveals that the mean grain size exhibits a marked decreasing trend on either side of the mouth of the Tirumalairajanar River which flow from west to *** sediments are mainly of medium to coarse grained,moderately sorted,near-symmetrical skewed to fine skewed and leptokurtic to mesokurtic in *** of various parameters shows bimodal nature of sediments having dominance of medium to coarse *** major part of the sediment fall in a coarse to fine grained category(sand and silt).Based on the CM(Coarser one percentile value in micron) pattern,the sediment fall in rolling and suspension *** factors includes the sediments discharged from the river mixes with offshore sediments and with the sediments eroded from a source *** effect of wave sorting, and the northward drifting of sediments by littoral current are *** indicate that the Tirumalairajanar River is the most important source for modern sediments in the study *** agitation by waves is an important sorting mechanism in the study area,and the net sediment transport in the study area is *** findings are based on the grain sizes and also corroborated by shortterm observations of the beach sediment dynamics and transport during the monsoon and summer seasons between Karaikal and Nagore region.

关键词： Grain size analysis Beach sediments Tirumalairajanr East coast