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Hybrid Mobile Cloud Computing Architecture with Load Balancing for Healthcare Systems

Computers, Materials & Continua 2023年第1期74卷 435-452页

作者： Ahyoung Lee Jui Mhatre rupak kumar das Min Hong Department of Computer Science Kennesaw State UniversityMariettaGAUSA Department of Computer Science University of Minnesota DuluthDuluthMNUSA Department of Computer Software Engineering Soonchunhyang UniversityAsanKorea

Healthcare is a fundamental part of every individual’s *** healthcare industry is developing very rapidly with the help of advanced *** researchers are trying to build cloud-based healthcare applications that can be accessed by healthcare professionals from their premises,as well as by patients from their mobile devices through communication *** systems promote reliable and remote interactions between patients and healthcare ***,there are several limitations to these innovative cloud computing-based systems,namely network availability,latency,battery life and resource *** propose a hybrid mobile cloud computing(HMCC)architecture to address these ***,we also evaluate the performance of heuristic and dynamic machine learning based task scheduling and load balancing algorithms on our proposed *** compare them,to identify the strengths and weaknesses of each algorithm;and provide their comparative results,to show latency and energy consumption *** issues for cloudbased healthcare systems are discussed in detail.

关键词： Mobile cloud computing hybrid mobile cloud computing load balancing healthcare solution

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In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity:Insights from national inpatient sample 2020

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World Journal of Hepatology 2024年第6期16卷 912-919页

作者： Sashwath Srikanth Vibhor Garg Lakshmi Subramanian Jyoti Verma Hansika Sharma Harroop Singh Klair Shrenil A Kavathia Jithin Kolli Teja Nikhil Sai Vasireddy kumar Anmol Dhanush Kolli Shruti Sanjay Bodhankar Sobya Hashmi Shaylika Chauhan rupak Desai Department of Medicine ECU Health Medical CenterGreenvilleNC 27834United States Department of Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Department of Medicine North Alabama Medical CentreFlorenceAL 35630United States Department of General Medicine Gandhi Medical CollegeSecunderabad 500003TelanganaIndia Department of Medicine Government Medical CollegePatiala 147001PunjabIndia Department of Medicine B.J.Medical CollegeAhmedabad 380016GujaratIndia Department of Medicine JSS Medical CollegeMysore 570015KarnatakaIndia Department of Internal Medicine Gandhi Medical CollegeSecunderabad 500003TelanganaIndia Department of Medicine Kasturba Medical CollegeManipal 575001KarnatakaIndia Clinical Extern Department of Internal MedicineBeaumont HospitalDearbornMI 48124United States Department of Internal Medicine Geisinger Health SystemWilkes-BarrePA 18702United States Independent Researcher AtlantaGA 30079United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular diseases independently of other risk ***,data on its effect on cardiovascular outcomes in coronavirus disease 2019(COVID-19)hospitalizations with varied obesity levels is *** management and patient care depend on understanding COVID-19 admission results in NAFLD patients with varying obesity *** To study the in-hospital outcomes in COVID-19 patients with NAFLD by severity of *** COVID-19 hospitalizations with NAFLD were identified using International Classification of Disease-10 CM codes in the 2020 National Inpatient Sample *** and Obesity Classes Ⅰ,Ⅱ,and Ⅲ(body mass index 30-40)were *** adverse cardiac and cerebrovascular events(MACCE)(all-cause mortality,acute myocardial infarction,cardiac arrest,and stroke)were compared between *** regression analyses adjusted for sociodemographic,hospitalization features,and *** Our analysis comprised 13260 hospitalizations,7.3% of which were overweight,24.3% Class Ⅰ,24.1% Class Ⅱ,and 44.3% Class Ⅲ.Class Ⅲ obesity includes younger patients,blacks,females,diabetics,and hypertensive *** multivariable logistic analysis,Class Ⅲ obese patients had higher risks of MACCE,inpatient mortality,and respiratory failure than Class Ⅰ obese *** Ⅱ obesity showed increased risks of MACCE,inpatient mortality,and respiratory failure than Class I,but not *** obesity classes had non-significant risks of MACCE,inpatient mortality,and respiratory failure compared to the overweight *** Class Ⅲ obese NAFLD COVID-19 patients had a greater risk of adverse outcomes than class Ⅰ.Using the overweight group as the reference,unfavorable outcomes were not significantly *** obesity had a greater risk of MACCE regardless of the referent group(overweight or Class Ⅰ obese)compared to overweight NAFLD patients admitte

关键词： Non-alcoholic fatty liver disease Obesity Obese Body mass index Major adverse cardiac and cerebrovascular events Mortality Acute myocardial infarction Cardiac arrest Stroke

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Intracoronary brachytherapy for the treatment of recurrent drugeluting stent in-stent restenosis:A systematic review and metaanalysis

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World Journal of Cardiology 2021年第4期13卷 95-102页

作者： Irtqa Ilyas Ashish kumar Devina Adalja Mariam Shariff rupak Desai Yasar Sattar Saraschandra Vallabhajosyula Nageshwara Gullapalli Rajkumar Doshi Department ofInternal Medicine University of Nevada Reno School of MedicineRenoNV 89509United States Department of Critical Care Medicine Saint John's Medical College HospitalBangalore 560034KarnatakaIndia Department of Internal Medicine GMERS Gotri Medical CollegeVadodara 380021GujaratIndia Department of Cardiology Atlanta VA Medical CenterDecaturGA 30033United States Department of Internal Medicine Icahn School of Medicine at Mount Sinai ElmhurstNew YorkNY 11373United States Interventional Cardiology Emory UniversityAtlantaGA 30322United States

BACKGROUND We performed a meta-analysis on observational studies since randomized control trials are not *** studied intracoronary brachytherapy(ICBT)and recurrent drug eluting stent in-stent restenosis(DES-ISR)to evaluate the procedural success,target lesion revascularization(TLR),incidence of myocardial infarction(MI)and all-cause mortality at 2 years *** To perform meta-analysis for patients undergoing ICBT for recurrent *** We performed a systematic search of the PubMed/MEDLINE,Cochrane and DARE databases to identify relevant *** were excluded if intracoronary brachytherapy was used as a treatment modality for initial ISR and studies with bare metal *** used a random-effect model with DerSimonian&Laird method to calculate summary *** was assessed using I2 *** A total of 6 observational studies were included in the final *** angiographic success following intra-coronary brachytherapy was 99.8%.Incidence of MI at 1-year was 2%and 4.1%at 2-years,*** incidence of TLR 14.1%at 1-year and 22.7%at 2-years,***-cause mortality at 1-and 2-year follow-up was 3%and 7.5%,*** Given the observational nature of the studies included in the analysis,heterogeneity was significantly higher for *** there are no randomized controlled trials or definitive guidelines available for recurrent ISR associated with DES,this analysis suggests that brachytherapy might be the alternative approach for recurrent *** controlled trials are required to confirm results from this study.

关键词： Intracoronary brachytherapy In-stent restenosis Meta-analysis Drug eluting stent Systematic review Brachytherapy

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Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample

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World Journal of Cardiology 2019年第5期11卷 137-148页

作者： rupak Desai Tarang Parekh Hemant Goyal Hee Kong Fong Dipen Zalavadia Nanush Damarlapally Rajkumar Doshi Sejal Savani Gautam kumar Rajesh Sachdeva Division of Cardiology Atlanta VA Medical Center Decatur GA 30033 United States Division of Cardiology Morehouse School of Medicine Atlanta GA 30310 United States Department of Health Administration and Policy George Mason University Fairfax VA 22030 United States Department of Internal Medicine Macon University School of Medicine Macon GA 31207 United States Department of Internal Medicine University of Missouri-Columbia Columbia MO 65212 United States Department of Internal Medicine The Wright Center for Graduate Medical Education Scranton PA 18503 United States Department of Health Sciences Coleman College of Health Sciences Houston TX 77030 United States Department of Internal Medicine University of Nevada School of Medicine Reno NV 89557 United States Public Health New York University New York NY 10010 United States Division of Cardiology Emory University School of Medicine Atlanta GA 30322 United States

BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS We used the national inpatient sample (2010-2014) to identify the ACS and goutrelated hospitalizations, relevant comorbidities, revascularization and postrevascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACSgout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17- 1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization inhospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, postoperative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION Although gout was not independently associated with an increased risk of postrevas

关键词： Gout Serum uric acid Acute coronary syndrome Unstable angina Myocardial infarction Revascularization Percutaneous coronary intervention Coronary artery bypass grafting In-hospital outcomes

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