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In vivo and ex vivo confocal endomicroscopy of pancreatic cystic lesions: A prospective study

World Journal of Gastroenterology 2017年第18期23卷 3338-3348页

作者： Somashekar G Krishna rohan m modi Amrit K Kamboj Benjamin J Swanson Phil A Hart mary E Dillhoff Andrei manilchuk Carl R Schmidt Darwin L Conwell Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical Center Department of Internal medicine The Ohio State University Wexner Medical Center College of medicine The Ohio State University Wexner Medical Center Department of Pathology The Ohio State University Wexner Medical Center Division of Surgical Oncology The Ohio State University Wexner Medical Center Deparment of General Surgery The Ohio State University Wexner Medical Center

To investigate the reproducibility of the in vivo endoscopic ultrasound (EUS) - guided needle based confocal endomicroscopy (nCLE) image patterns in an ex vivo setting and compare these to surgical histopathology for characterizing pancreatic cystic lesions (PCLs).mETHODSIn a prospective study evaluating EUS-nCLE for evaluation of PCLs, 10 subjects underwent an in vivo nCLE (AQ-Flex nCLE miniprobe; Cellvizio, maunaKea, Paris, France) during EUS and ex vivo probe based CLE (pCLE) of the PCL (Gastroflex ultrahigh definition probe, Cellvizio) after surgical resection. Biopsies were obtained from ex vivo CLE-imaged areas for comparative histopathology. All subjects received intravenous fluorescein prior to EUS and pancreatic surgery for in vivo and ex vivo CLE imaging *** total of 10 subjects (mean age 53 ± 12 years; 5 female) with a mean PCL size of 34.8 ± 14.3 mm were enrolled. Surgical histopathology confirmed 2 intraductal papillary mucinous neoplasms (IPmNs), 3 mucinous cystic neoplasms (mCNs), 2 cystic neuroendocrine tumors (cystic-NETs), 1 serous cystadenoma (SCA), and 2 squamous lined PCLs. Characteristic in vivo nCLE image patterns included papillary projections for IPmNs, horizon-type epithelial bands for mCNs, nests and trabeculae of cells for cystic-NETs, and a “fern pattern” of vascularity for SCA. Identical image patterns were observed during ex vivo pCLE imaging of the surgically resected PCLs. Both in vivo and ex vivo CLE imaging findings correlated with surgical *** vivo nCLE patterns are reproducible in ex vivo pCLE for all major neoplastic PCLs. These findings add further support the application of EUS-nCLE as an imaging biomarker in the diagnosis of PCLs.

关键词： Confocal laser endomicroscopy Serous cystadenoma Pancreatic neuroendocrine tumor Intraductal papillary mucinous neoplasm Pancreatic cystic neoplasm

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Two types of uranium mineralization in Gulcheru quartzite:Fracture-controlled in Ambakapalle area and litho-controlled in Tummalapalle area,Cuddapah Basin,Andhra Pradesh,India

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China Geology 2019年第2期2卷 142-156页

作者： Sukanta goswami Pradeep Kumar Upadhyay Bhaskaran Saravanan V Natarajan mohan Babu Verma Atomic minerals Directorate for Exploration and Research Department of Atomic EnergyBangalore 560072India Atomic minerals Directorate for Exploration and Research Department of Atomic Energy BegumpetHyderabad 500016India

The Cuddapah Basin in southern India has a potential for uranium mineralization due to some favorable factors such as its temporal, stratigraphic and tectonic settings. Systematic exploration program conducted by the Atomic minerals Directorate for Exploration and Research (AmD) within the Cuddapah Basin resulting in the recognition of distinct types of uranium mineralization, viz., strata bound type, fracture/shear-controlled type and tabular type. The Gulcheru Formation which is the lowermost unit of the Cuddapah Basin is dominantly arenitic in nature. During the exploration works, a number of uranium anomalies were identified with dimensions ranging from 1 m to 1.5 km. Gulcheru quartzite hosted uranium mineralization is intermittent and inconsistent in nature. The anomalous outcrops are distributed over a strike length of ca. 60 km between Gandi in the SE and Ambakapallein the NW. Presently, two different types of uranium mineralization are characterized on the basis of field observations, mapping and structural interpretation, petro-mineralogy and geochemistry. Although the host rock is same for both types, the mechanism of uranium enrichment is totally different. The Ambakapalle uranium mineralization is controlled by fault zone and associated hydrothermal activity. Whereas, the Tummalapalle uranium mineralization is litho-controlled in nature influenced by suitable four ‘P’ factors, i.e., provenance, porositypermeability, precipitation and preservation. The geochemical characterization of Gulcheru quartzite suggest a passive margin type of provenance setting. Petro-mineralogically the quartz arenite suggests enough textural as well as mineralogical maturity. Ambakapalle quartzite is slightly strained and deformed due to faulting. Analysis of selected samples recorded 0.01% to 0.048% U3O8 and malies were appeared due to secondary uranium minerals occurring as surficial encrustations, fracture filling an

关键词： Uranium mineralization Fracture-controlled mineralization Litho-contralled mineralization Gulcheru quartzite Hydrothermal alteration Andhra Pradesh India

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microwave based reversible unfolding and refolding of alcohol oxidase protein probed by fluorescence and circular dichroism spectroscopy

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Journal of Biophysical Chemistry 2012年第4期3卷 317-323页

作者： Soma Sekhar R. Chinnadayyala m. Santhosh Pranab goswami Department of Biotechnology Indian Institute of Technology Guwahati Guwahati India

The reversible effect of microwave mediated denaturation of protein at low exposure time of 10 s has been demonstrated for the first time. The effect of microwave (2.45 GHz and 900 W) was confirmed in a homo-octameric alcohol oxidase in aqueous solution of pH 7.5. The unfolding events did not transverse through any intermediate states and no subunits of the protein were detached during the process. The refolding of the protein achieved at 4℃ for 24 h had regenerated the native enzyme. This reversible refolding approach excludes any chemical reagent and therefore established as simple technique for protein unfolding-folding studies.

关键词： microwave Alcohol Oxidase Protein Unfolding Protein Refolding Pichia Pastoris Protein structure

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Impact of transjugular intrahepatic porto-systemic shunt on post liver transplantation outcomes: Study based on the United Network for Organ Sharing database

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World Journal of Hepatology 2017年第2期9卷 99-105页

作者： Khalid mumtaz Sherif metwally rohan m modi Nishi Patel Dmitry Tumin Anthony J michaels James Hanje Ashraf El-Hinnawi Don Hayes Jr Sylvester m Black Wexner medical Center Gastroenterology Hepatology and Nutrition Division the Ohio State University Department of Internal medicine the Ohio State University Department of Pediatrics the Ohio State University Department of Surgery the Ohio State University Section of Pulmonary medicine the Ohio State University

AImTo determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. mETHODSUtilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ2 tests for categorical measures. We estimated the impact of TIPS on each of the outcome measures. multivariate analyses were conducted on the study population to explore the effect of TIPS on 30-d mortality post-LT, need for re-LT and LOS. All covariates were included in logistic regression analysis. RESULTSWe included adult patients (age ≥ 18 years) who underwent LT from may 2002 to September 2013. Only those undergoing TIPS after listing and before liver transplant were included in the TIPS group. We excluded patients with variceal bleeding within two weeks of listing for LT and those listed for acute liver failure or hepatocellular carcinoma. Of 114770 LT in the UNOS database, 32783 (28.5%) met inclusion criteria. Of these 1366 (4.2%) had TIPS between the time of listing and LT. We found that TIPS increased the days on waitlist (408 ± 553 d) as compared to those without TIPS (183 ± 330 d), P P P = 0.001) by TIPS to LOS. CONCLUSIONTIPS did increase time on waitlist for LT. more importantly, TIPS was not associated with 30-d mortality and re-LT, but it did lengthen hospital LOS after transplantation.

关键词： Transjugular intrahepatic porto-systemic shunt Shunt Liver Transplantation Ascites model for end-stage liver disease mortality Transjugular

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Paracentesis in cirrhotics is associated with increased risk of 30-day readmission

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World Journal of Hepatology 2018年第6期10卷 425-432页

作者： Lindsay A Sobotka rohan m modi Akshay Vijayaraman A James Hanje Anthony J michaels Lanla F Conteh Alice Hinton Ashraf El-Hinnawi Khalid mumtaz Department of Internal medicine the Ohio State University Wexner Medical Center Division of Gastroenterology Hepatology and Nutrition the Ohio State Wexner Medical Center Division of Biostatistics College of Public Health the Ohio State University Department of Surgery the Ohio State Wexner Medical Center

AIm To determine the readmission rate, its reasons, predictors, and cost of 30-d readmission in patients with cirrhosis and *** A retrospective analysis of the nationwide readmission database(NRD) was performed during the calendar year 2013. All adults cirrhotics with a diagnosis of ascites,spontaneous bacterial peritonitis, or hepatic encephalopathy were identified by ICD-9 codes. multivariate analysis was performed to assess predictors of 30-d readmission and cost of *** Of the 59597 patients included in this study, 18319(31%) were readmitted within 30 d. majority(58%) of readmissions were for liver related reasons. Paracentesis was performed in 29832(50%) patients on index admission. Independent predictors of 30-d readmission included age medicaid(OR: 1.21; CI: 1.04-1.41) and medicare coverage(OR: 1.13; CI: 1.02-1.26), > 3 Elixhauser comorbidity(OR: 1.13; CI: 1.05-1.22), nonalcoholic cirrhosis(OR: 1.16; CI: 1.10-1.23), paracentesis on index admission(OR: 1.28; CI: 1.21-1.36) and having hepatocellular carcinoma(OR: 1.21; CI: 1.05; 1.39). Cost of index admission was similar in patients readmitted and not readmitted(P-value: 0.34); however cost of care was significantly more on 30 d readmission($30959 ± 762) as compared to index admission($12403 ± 378), P-value: mission within 30-d. Younger patients, with public insurance, nonalcoholic cirrhosis and increased comorbidity who underwent paracentesis are at increased risk of readmission. Risk factors for unplanned readmission should be targeted given these patients have higher healthcare utilization.

关键词： Cirrhosis Readmission rates Paracentesis Ascites

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Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation

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World Journal of Hepatology 2018年第1期10卷 134-141页

作者： rohan m modi Dmitry Tumin Andrew J Kruger Eliza W Beal Don Hayes Jr James Hanje Anthony J michaels Kenneth Washburn Lanla F Conteh Sylvester m Black Khalid mumtaz Department of Internal medicine Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Anesthesiology and Pain medicine Nationwide Children’s HospitalColumbusOH 43205United States Department of General Surgery Division of TransplantationOhio State University Wexner Medical CenterColumbusOH 43210United States Comprehensive Transplant Center Ohio State University Wexner Medical CenterColumbusOH 43210United States Section of Pulmonary medicine Nationwide Children’s HospitalColumbusOH 43205United States Department of Internal medicine Division of GastroenterologyHepatology and NutritionOhio State University Wexner Medical CenterColumbusOH 43210United States

AIm To examine the effect of center size on survival differences between simultaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed *** The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Posttransplant survival was evaluated using stratified Cox regression with interaction between transplant type(LTA vs SLKT) and center *** During the study period, 393 of 4580 patients(9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients(180/393, 46%) than SLKT recipients(1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio(HR) = 2.85; 95%CI: 2.21, 3.66; P ming 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction(HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs *** In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes.

关键词： Kidney transplantation Center volume mortality Liver transplantation United network for organ sharing

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Evolving paradigm of thrombolysis in pulmonary embolism:Comprehensive review of clinical manifestations,indications,recent advances and guideline

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World Journal of Clinical Cases 2023年第8期11卷 1702-1711页

作者： rohan Kumar Ochani Rafi Aibani Hafsa Nazir Jatoi masroor Anwar Syed Anjum Khan Iqbal Ratnani Salim Surani Department of Internal medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of Internal medicine Khyber Teaching HospitalPeshawar 00000Pakistan Department of Critical Care medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Anesthesiology&Critical Care Houston Methodist HospitalHoustonTX 77030United States Department of medicine Texas A&M UniversityCollege StationTX 77843United States Department of medicine Aga Khan UniversityNairobiKenya

Thrombolytic therapy has been the mainstay for patients with pulmonary embolism(PE).Despite being linked to a higher risk of significant bleeding,clinical trials demonstrate that thrombolytic therapy should be used in patients with moderate to high-risk PE,in addition to hemodynamic instability *** prevents the progression of right heart failure and impending hemodynamic *** PE can be challenging due to the variety of presentations;therefore,guidelines and scoring systems have been established to guide physicians to correctly identify and manage the ***,systemic thrombolysis has been utilized to lyse the emboli in ***,newer techniques for thrombolysis have been developed,such as endovascular ultrasound-assisted catheter-directed thrombolysis for massive and intermediatehigh submassive risk *** newer techniques explored are the use of extracorporeal membrane oxygenation,direct aspiration,or fragmentation with *** of the constantly changing therapeutic options and the scarcity of randomized controlled trials,choosing the best course of treatment for a given patient may be *** help,the Pulmonary Embolism Reaction Team is a multidisciplinary,rapid response team that has been developed and is used at many *** to bridge the knowledge gap,our review highlights various indications of thrombolysis in addition to the recent advances and management guidelines.

关键词： Pulmonary embolism Thrombolytics Systemic Catheter-directed Pulmonary embolism reaction team Guidelines

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Design of a CmOS Optical Receiver Front-End Using 0.18 μm Technology

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Wireless Engineering and Technology 2013年第1期4卷 46-53页

作者： Ajay Shukla Radheshyam Gamad rohan Raikwar Department of Electronics & Instrumentation Engineering S. G. S. Institute of Technology and Science Indore India

This paper reports design of a CmOS optical receiver front-end using 0.18 μm technology. Design process is current associated with photodiode using trans-impedance amplifier (TIA) for wide bandwidth, high gain, low input referred noise and wide dynamic range. The Automated Gain Control (AGC) voltage is used to provide variable gain for multilevel signals. This design is simulated in 0.18 μm UmC technology for the performance analysis. The best simulation results are reported the maximum TIA gain of 67.26 dB? at 0 V AGC followed by a post amplifier gain of 86.70 dB?. The bandwidth range is 7.03 GHz to 11.5 GHz corresponding to 0 - 3 V AGC respectively. The input referred noise level value is 43.86 pA/√Hz up to 10 GHz frequency. In addition authors have obtained the common mode rejection ratio (CmRR) is 72.42 dB and rectified group delay is 144.48 ps. Verification of the design, reported results are compared with earlier published work and improvements obtained in the present results.

关键词： Component Formatting Style Styling Insert

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Comparison of Different Classification methods on Glass Identification for Forensic Research

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Journal of Statistical Science and Application 2016年第2期4卷 65-84页

作者： Suchismita goswami Edward J. Wegman Computational and Data Science George Mason University Fairfax VA 22030

Classification methods play an important role in investigating crime in forensic research. Here we assess the relative performance of several classification methods, such as Logistic Regression （LR）, Linear Discriminant Analysis （LDA）, Quadratic Discriminant Analysis （QDA）, mixture Discriminant Analysis （mDA） and Classification Tree （CT） on glass identification data. We present a different approach to investigate the relative performance of the classifiers by invoking the tests of statistical significance and the receiver operating characteristic （ROC） curves in addition to estimating the probabilities of correct classification （PCC）. The area under the receiver operating characteristic curve （AUC）, the error rate and its 95% confidence interval are used to measure predictive power of these algorithms. Dimensionality reduction of data has been conducted using principal component analysis （PCA） and Fisher＇s linear discriminant analysis （FDA） and two major components were identified. Among all the classification methods mentioned above, the LDA and the QDA are observed to be statistically significant. The Box＇s m test （P〈0.0001）, which is used to test the homogeneity of covariance matrices, showed that the homogeneity of covariance could not be assumed for LDA. This suggests that for glass types, window and non-window, the QDA is superior to all methods. The CT, however, has been found to outperform FDA when all six categories of glass are considered.

关键词： Forensic Research PCA LDA QDA CT

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Using compositional data analysis to explore accumulation of sedentary behavior,physical activity and youth health

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Journal of Sport and Health Science 2022年第2期11卷 234-243页

作者： Simone J.J.m.Verswijveren Karen E.Lamb Josep A.martín-Fernández Elisabeth Winkler Rebecca m.Leech Anna Timperio Jo Salmon Robin m.Daly Ester Cerin David W.Dunstan rohan m.Telford Richard D.Telford Lisa S.Olive Nicola D.Ridgers Institute for Physical Activity and Nutrition School of Exercise and Nutrition SciencesDeakin UniversityGeelongVIC 3216Australia melbourne School of Population and Global Health University of MelbourneParkvilleVIC 3053Australia Department of Computer Science Applied Mathematics and StatisticsUniversity of GironaGirona 17003Spain School of Public Health University of QueenslandHerstonQLD 4006Australia mary macKillop Institute for Health Research Australian Catholic UniversityFitzroyVIC 3065Australia School of Public Health University of Hong KongHong KongChina Baker Heart and Diabetes Institute MelbourneVIC 3004Australia Research Institute for Sport and Exercise University of CanberraBruceACT 2617Australia School of Psychology Deakin UniversityBurwoodVIC 3125Australia ImPACT Research Institute Deakin UniversityBurwoodVIC 3125Australia ANU medical School Australian National UniversityGarranACT 2605Australia

Purpose:The study aimed to describe youth time-use compositions,focusing on time spent in shorter and longer bouts of sedentary behavior and physical activity(PA),and to examine associations of these time-use compositions with cardiometabolic ***:Accelerometer and cardiometabolic biomarker data from 2 Australian studies involving youths 7-13 years old were pooled(complete cases with accelerometry and adiposity marker data,n=782).A 9-component time-use composition was formed using compositional data analysis:time in shorter and longer bouts of sedentary behavior;time in shorter and longer bouts of light-,moderate-,or vigorous-intensity PA;and"other time"(i.e.,non-wear/sleep).Shorter and longer bouts of sedentary time were defined asmin and>5 min,*** bouts of light-,moderate-,and vigorous-intensity PA were defined asmin;longer bouts were defined as≥1 *** models examined associations between overall time-use composition and cardiometabolic ***,associations were derived between ratios of longer activity patterns relative to shorter activity patterns,and of each intensity level relative to the other intensity levels and"other time",and cardiometabolic ***:Confounder-adjusted models showed that the overall time-use composition was associated with adiposity,blood pressure,lipids,and the summary ***,more time in longer bouts of light-intensity PA relative to shorter bouts of light-intensity PA was significantly associated with greater body mass index z-score(zBmI)(β=1.79;SE=0.68)and waist circumference(β=18.35,SE=4.78).When each activity intensity was considered relative to all higher intensities and"other time",more time in light-and vigorous-intensity PA,and less time in sedentary behavior and moderate-intensity PA,were associated with lower waist ***:Accumulating PA,particularly light-intensity PA,in frequent short bursts may be more beneficial for limiting adi

关键词： Accumulation patterns Cardiometabolic health Children Compositional data analysis Time-use

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