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Gallbladder perforation:A single-center experience in north India and a step-up approach for management

Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 168-174页

作者： Vivek Gupta Abhijit Chandra Vishal Gupta ravi patel Amit Dangi Ajay Pai Department of Surgical Gastroenterology King George’s Medical UniversityLucknowUttar Pradesh 226003India

Background: Spontaneous gallbladder perforation(GBP) is an uncommon diagnosis. This study presented the experience of managing spontaneous GBP over nine years at a large, tertiary care university hospital in north India and investigated the outcomes and treatment strategies. Methods: A retrospective review of prospectively maintained digital database of consecutive patients was performed. All patients received medical and/or surgical treatment for spontaneous GBP in our department between January 2010 and June 2018. Results: We identifed 151 patients(81 females and 70 males) with mean age of 53 years. Most common presenting features were pain(96.7%), fever(54.3%) and jaundice(31.1%). Most common cause was gallbladder stones(84.8%) followed by common bile duct stones(30.5%), xanthogranulomatous cholecystitis(17.9%) and malignancy(11.9%). As per Niemeier classifcation, 8.6% had type 1 GBP(free perforation in peritoneal cavity), 76.2% had type 2 GBP(localized perforation) and 13.2% had type 3 GBP(cholecystoenteric fstula). About 60% of the perforations were diagnosed preoperatively. Type 1 was more common in patients with diabetes and also had the worst prognosis. Surgery was performed in 109 patients(72.2%). Seven patients(4.6%) had a postoperative morbidity of Clavien-Dindo Ⅲ or higher. There were three mortalities in patients who underwent surgery. Conclusions: High index of suspicion is required for preoperative diagnosis of GBP, especially in types 2 and 3. Laparoscopic cholecystectomy can be difficult in these patients and patients may require open or partial cholecystectomy. Early diagnosis and step-up approach for the treatment of GBP is critical.

关键词： Acute calculus cholecystitis Cholecystectomy Cholecysto-enteric fstula Niemeier classifcation

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Filtration of sodium chloride from seawater using carbon hollow tube composed of carbon nanotubes

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International Journal of Smart and Nano Materials 2014年第3期5卷 194-206页

作者： Chaudhary ravi Prakash patel Prashant Tripathi O.N.Srivastava T.P.Yadav Department of Physics(Centre of Advanced Studies) Nanoscience CentreBanaras Hindu UniversityVaranasi 220005India

The present article deals with filtration of seawater to remove sodium chloride(NaCl)using filter made from organized structures of carbon nanotubes(CNTs).The filter consists of hollow carbon cylinder(length~10 cm,diameter~1 cm),which is composed of radially aligned *** carbon hollow cylinder has been synthesized by continuous spray pyrolysis of ferrocene–benzene solution in argon *** hollow cylinder has been turned into a water filter by closing one end and keeping a small funnel at the *** of seawater(Marina Beach,Chennai,India)has been obtained both under the self pressure of seawater column in the hollow cylinder and under the difference of pressure created by enclosing the filter in a vacuum tight *** has been found that the efficiency of filtration is about two times higher under partial vacuum(~10–2 torr)created on the filtrate(water)*** filtration of seawater,a deposit in the inner surface of hollow cylinder has been *** deposit has been characterized by X-ray diffraction,transmission electron microscopy and energy dispersive X-ray analysis,and it has been found that the deposit was *** filtration leads to almost complete removal of NaCl from the seawater.

关键词： carbon nanotube filtration chemical vapor deposition spray pyrolysis

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Predicting the presence of adenomatous polyps during colonoscopy with National Cancer Institute Colorectal Cancer Risk-Assessment Tool

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World Journal of Gastroenterology 2018年第34期24卷 3919-3926页

作者： Hassan Tariq Muhammad Umar Kamal Harish patel ravi patel Muhammad Ameen Shehi Elona Maram Khalifa Sara Azam Aiyi Zhang Kishore Kumar Ahmed Baiomi Danial Shaikh Jasbir Makker Division of Gastroenterology Department of Medicine BronxC are Health system Department of Medicine Bronx Care Health system

AIM To evaluate the National Cancer Institute(NCI)Colorectal Cancer(CRC)Risk Assessment Tool as a predictor for the presence of adenomatous polyps(AP) found during screening or surveillance *** This is a retrospective single center observational *** collected data of adenomatous polyps in each colonoscopy and then evaluated the lifetime CRC *** calculated the AP prevalence across risk score quintiles,odds ratios of the prevalence of AP across risk score quintiles,area under curves(AUCs)and Youden’s indexes to assess the optimal risk score cut off value for AP prevalence *** The prevalence of AP gradually increased throughout the five risk score quintiles:i.e.,27.63%in the first and 51.35%in the fifth *** odd ratios of AP prevalence in the fifth quintile compared to the first and second quintile were 2.76[confidence interval(CI):1.71-4.47]and 2.09(CI:1.32-3.30).The AUC for all patients was 0.62(CI:0.58-0.66).Youden’s Index indicated the optimal risk score cutoff value discriminating AP prevalence status was *** Patients with the higher NCI risk score have higher risk of AP and subsequent CRC;therefore,measures to increase the effectiveness of CRC detection in these patients include longer withdrawal time,early surveillance colonoscopy,and choosing flexible colonoscopy over other CRC screening modalities.

关键词： National Cancer Institute Colorectal Cancer Risk-Assessment Tool Colorectal cancer Predictors of colorectal cancer Adenomatous polyps Colonoscopy

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Expiratory Flow Limitation and Its Relation to Dyspnea and Lung Hyperinflation in Patients with Chronic Obstructive Pulmonary Disease: Analysis Using the Forced Expiratory Flow-Volume Curve and Critique

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Open Journal of Respiratory Diseases 2021年第3期11卷 91-104页

作者： Billy Peng Matthew Miller Mark Slootsky ravi patel Ahmet Baydur Division of Pulmonary Critical Care and Sleep Medicine Keck School of Medicine University of Southern California Los Angeles CA USA Los Angeles County + University of Southern California Medical Center Los Angeles CA USA

Background: Tidal expiratory flow limitation (tEFL) is defined as absence of increase in air flow during forced expiration compared to tidal breathing and is related to dyspnea at rest and minimal exertion in patients with chronic airflow limitation (CAL). Tidal EFL has not been expressed as a continuous variable (0% - 100%) in previous analyses. Objective: To relate the magnitude of tEFL to spirometric values and Modified Medical Research Council (MMRC) score and Asthma Control Test (ACT). Methods: Tidal EFL was computed as percent of the tidal volume (0% - 100%) spanned (intersected) by the forced expiratory-volume curve. Results: Of 353 patients screened, 192 (114 M, 78 F) patients (136 with COPD, 56 with asthma) had CAL. Overall characteristics: (mean ± SD) age 59 ± 11 years, BMI 28 ± 7, FVC (% pred) 85 ± 20, FEV1 (% pred) 66 ± 21, FEV1/FVC 55% ± 10%, RV (% pred) 147 ± 42. Tidal EFL in patients with tEFL was 53% ± 39%. Using univariate analysis, strongest correlations were between tEFL and FVC and between tEFL and RV in patients with BMI 2. In patients with nonreversible CAL, tEFL was positively associated with increasing MMRC, negatively with spirometric measurements, and positively with RV/TLC. In asthmatics, ACT scores were higher in patients with mean BMI ≥ 28 kg/m2 (p 40% (p Conclusions: Dy

关键词： Air Trapping Asthma Chronic Obstructive Pulmonary Disease Dyspnea Forced Expiratory Flow-Volume Curve Hyperinflation Tidal Expiratory Flow Limitation

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Exploring nitrogen reduction reaction mechanisms in electrocatalytic ammonia synthesis:A comprehensive review

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Journal of Energy Chemistry 2024年第5期92卷 681-697页

作者： Abhishek Umesh Shetty ravi Sankannavar School of Chemical and Materials Science Indian Institute of Technology GoaFarmagudiPonda 403401GoaIndia Department of Chemical Engineering M.S.Ramaiah Institute of TechnologyMSR NagarMSRIT PostBengaluru 560054KarnatakaIndia

The electrochemical nitrogen reduction reaction(eNRR)holds significant promise as a sustainable alternative to the conventional large-scale Haber Bosch process,offering a carbon footprint-free approach for ammonia *** the process is thermodynamically feasible at ambient temperature and pressure,challenges such as the competing hydrogen evolution reaction,low nitrogen solubility in electrolytes,and the activation of inert dinitrogen(N_(2))gas adversely affect the performance of ammonia *** hurdles result in low Faradaic efficiency and low ammonia production rate,which pose obstacles to the commercialisation of the *** have been actively designing and proposing various electrocatalysts to address these issues,but challenges still need to be resolved.A key strategy in electrocatalyst design lies in understanding the underlying mechanisms that govern the success or failure of the electrocatalyst in driving the electrochemical *** mechanistic studies,we gain valuable insights into the factors affecting the reaction,enabling us to propose optimised designs to overcome the *** review aims to provide a comprehensive understanding of the various mechanisms involved in eNRR on the electrocatalyst *** delves into the various mechanisms such as dissociative,associative,Mars-van Krevelen,lithium-mediated nitrogen reduction and surface hydrogenation mechanisms of nitrogen *** unravelling the intricacies of eNRR mechanisms and exploring promising avenues,we can pave the way for more efficient and commercially viable ammonia synthesis through this sustainable electrochemical process by designing an efficient electrocatalyst.

关键词： Green ammonia synthesis Electrolysis Electrocatalysis Nitrogen reductionreaction Electrochemical reaction pathways Reactionmechanism

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Relation of Indices of Lung Hyperinflation to Dyspnea in Patients with Chronic Obstructive Pulmonary Disease: A Physiologic Assessment and Discussion

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Open Journal of Respiratory Diseases 2019年第3期9卷 75-88页

作者： Matthew Miller Mark Slootsky ravi A. patel Melissa Mert Ahmet Baydur Divisions of Geriatric Hospital Palliative and General Internal Medicine University of Southern California Los Angeles California USA Department of Biostatistics School of Preventive Medicine University of Southern California Los Angeles California USA Pulmonary Critical Care and Sleep Medicine Keck School of Medicine University of Southern California Los Angeles California USA

Background: The severity of COPD is commonly assessed by the reduction in forced expiratory volume at one second (FEV1), although more recently prognostic factors influencing survival have also incorporated functional capacity, degree of breathlessness on exertion, and body mass index. Increasingly, the reliability of physiological parameters such as FEV1 to predict patient-centered outcomes has been brought into question. Objectives: To evaluate the relationship between dyspnea as assessed by the Modified Medical Council Dyspnea (MMRC) scale, the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2014) staging and indices of lung hyperinflation and spirometry. Methods: Data were retrospectively analyzed at a 600-bed tertiary care center including spirometry, plethysmographic lung volumes, single breath carbon monoxide diffusion capacity and dyspnea graded according to MMRC, and GOLD staging. Results: Data for 331 patients were analyzed. Differences amongst FEV1, IC, IC/TLC, FRC and RV/TLC were significant between GOLD I/II and GOLD III/IV groups. The closest relationship to GOLD staging was seen with FEV1, FVC and slow vital capacity (SVC). FEV1/FVC, IC, and IC/TLC were inversely associated with MMRC score, while RV/TLC exhibited a positive relation with MMRC score. Conclusions: Indices of lung hyperinflation are closely associated, with dyspnea as assessed by MMRC grading with TLC, RV/TLC and IC exhibiting the closest relations, more so than FEV1. GOLD staging also shows strong correlations with lung volume subdivisions (weakly with TLC), more so than with FEV1. That TLC changed little between GOLD stages can be explained by the presence of collateral interalveolar channels and population characteristics different from those of other studies. These findings further support the concept that more than a reduction in FEV1, lung hyperinflation contributes to the sensation of dyspnea in airflow limitation.

关键词： Chronic Obstructive Pulmonary Disease Dyspnea Expiratory Flow Limitation Hyperinflation Inspiratory Capacity

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Federated Approach for Privacy-Preserving Traffic Prediction Using Graph Convolutional Network

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Journal of Shanghai Jiaotong university(Science) 2024年第3期29卷 509-517页

作者： LONARE Savita BHRAMARAMBA ravi Pimpri Chinchwad College of Engineering Pune 411044India Department of Computer Science and Engineering GITAMViskhapatnam 530045India

Existing traffic flow prediction frameworks have already achieved enormous success due to large traffic datasets and capability of deep learning ***,data privacy and security are always a challenge in every field where data need to be uploaded to the *** learning(FL)is an emerging trend for distributed training of *** primary goal of FL is to train an efficient communication model without compromising data *** traffic data have a robust spatio-temporal correlation,but various approaches proposed earlier have not considered spatial correlation of the traffic *** paper presents FL-based traffic flow prediction with spatio-temporal *** work uses a differential privacy(DP)scheme for privacy preservation of participant's *** the best of our knowledge,this is the first time that FL is used for vehicular traffic prediction while considering the spatio-temporal correlation of traffic data with DP *** proposed framework trains the data locally at the client-side with *** then uses the model aggregation mechanism federated graph convolutional network(FedGCN)at the server-side to find the average of locally trained *** results of the proposed work show that the FedGCN model accurately predicts the *** scheme at client-side helps clients to set a budget for privacy loss.

关键词： federated learning(FL) traffic flow prediction data privacy graph convolutional network(GCN) differential privacy(DP)

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Unsupervised intrusion detection system for in-vehicle communication networks

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Journal of Safety Science and Resilience 2024年第2期5卷 119-129页

作者： Kabilan N Vinayakumar ravi V Sowmya Center for Computational Engineering and Networking(CEN) Amrita School of Artificial InteligenceAmrita Vishwa VidyapeethamCoimbatoreIndia Center for Artificial Intlligence Prince Mohammad Bin Fahd UniversityKhobarSaudi Arabia

In-vehicle communication has been optimized day to day to keep updated of the *** area network(CAN)is used as a standard communication method because of its efficient and reliable ***,CAN is prone to several network level attacks because of its lack in security *** methods have been introduced to incorporate this in *** proposed an unsupervised method of intrusion detection for in-vehicle communication networks by combining the optimal feature extracting ability of autoencoders and more precise clustering using fuzzy C-means(FCM).The proposed method is light weight and requires less computation *** performed an extensive experiment and achieved an accuracy of 75.51%with the ML35o in-vehicle intrusion *** experimental result,the proposed method also works better for other intrusion detection problems like wireless intrusion detection datasets such as WNS-DS with accuracy of 84.05%and network intrusion detection datasets such as KDDCup with accuracy 60.63%,UNSW_NB15 with accuracy 73.62%and Information Security Center of Excellence(Iscx)with accuracy 74.83%.Overall,the proposed method outperforms the existing methods and avoids labeled datasets when training an in-vehicle intrusion detection *** results of the experiment of our proposed method performed on various intru-sion detection datasets indicate that the proposed approach is generalized and robust in detecting intrusions and can be effectively deployed in real time to monitor CAN traffic in vehicles and proactively alert during attacks.

关键词： Controlarea network Intrusiondetection Unsupervised learning Autoencoders Fuzzy C-means

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Dynamics of some new solutions to the coupled DSW equations traveling horizontally on the seabed

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Journal of Ocean Engineering and Science 2024年第2期9卷 154-163页

作者： Raj Kumar ravi Shankar Verma Department of Mathematics Faculty of Engineering&TechnologyVeer Bahadur Singh Purvanchal UniversityJaunpur 222003India

The system of(1+1)-coupled Drinfel’d-Sokolov-Wilson equations describes the surface gravity waves travelling horizontally on the *** objective of the present research is to construct a new variety of analytical solutions for the *** invariants are derived with the aid of Killing form by using the optimal algebra classification via Lie symmetry *** invariant solutions involve time,space variables,and arbitrary *** adequate constraints on arbitrary constants,solutions are represented graphically to make them more applicable in designing sea *** behavior of solutions shows asymptotic,bell-shaped,bright and dark soliton,bright soliton,parabolic,bright and kink,kink,and periodic *** constructed results are novel as the reported results[26,28,29,30,33,38,42,49]can be deduced from the results derived in this *** remaining solutions derived in this study,are absolutely different from the earlier *** this study,the physical character of analytical solutions of the system could aid coastal engineers in creating models of beaches and ports.

关键词： Coupled Drinfel’d-Sokolov-Wilson model Invariants Killing form Optimal sub algebra Lie symmetry reductions

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An Interactive Operating Demand Response Approach for Hybrid Power Systems Integrating Renewable Energy Sources

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Protection and Control of Modern Power Systems 2024年第3期9卷 174-194页

作者： Abhishek Saxena ravi Shankar IEEE the Department of Electrical Engineering National Institute of Technology PatnaIndia

The increased deployment of renewable energy in existing power networks has jeopardized rotational inertia,resulting in system degradation and *** address the issue,this paper proposes a demand response strategy for ensuring the future reliability of the electrical power *** addition,a modified fuzzy logic control topology-based two-degree-of-freedom(fractional order proportional integral)-tilt derivative controller is designed to regulate the frequency within a demand response framework of a hybrid two-area deregulated power *** test system includes thermal power plants,renewable energy sources(such as wind,parabolic trough solar thermal plant,biogas),and electric vehicle *** adaptively tune the controller’s coefficients,a quasi-opposition-based harris hawks optimization(QOHHO)algorithm is *** effectiveness of this algorithm is compared to other optimization algorithms,and the stability of the system is *** results demonstrate that the designed control algorithm significantly enhances system frequency stability in various scenarios,including uncertainties,physical constraints,and high penetration of renewables,compared to existing ***,an experimental assessment through OPAL-RT is conducted to verify the practicality of the proposed strategy,considering source and load intermittencies.

关键词： Area control error demand response energy storage vertically integrated utility

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