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Development and validation of multicentre study on novel Artificial Intelligence-based Cardiovascular Risk Score(AICVD)

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Family Medicine and Community Health 2024年第S01期12卷 20-33页

作者： shiv kumar jalepalli Prashant Gupta Andre L A J Dekker Inigo Bermejo Sujoy Kar Apollo Hospitals HyderabadTelanganaIndia Azure Microsoft Research IndiaBengaluruIndia Department of Radiation Oncology(Maastro) Maastricht UniversityMaastrichtNetherlands

Objective Cardiovascular diseases(CVD)are one of the most prevalent diseases in India amounting for nearly 30%of total deaths.A dearth of research on CVD risk scores in Indian population,limited performance of conventional risk scores and inability to reproduce the initial accuracies in randomised clinical trials has led to this study on large-scale patient *** objective is to develop an Artificial Intelligence-based Risk Score(AICVD)to predict CVD event(eg,acute myocardial infarction/acute coronary syndrome)in the next 10 years and compare the model with the Framingham Heart Risk Score(FHRS)and *** Our study included 31599 participants aged 18–91 years from 2009 to 2018 in six Apollo Hospitals in India.A multistep risk factors selection process using Spearman correlation coefficient and propensity score matching yielded 21 risk factors.A deep learning hazards model was built on risk factors to predict event occurrence(classification)and time to event(hazards model)using multilayered neural ***,the model was validated with independent retrospective cohorts of participants from India and the Netherlands and compared with FHRS and *** The deep learning hazards model had a good performance(area under the curve(AUC)0.853).Validation and comparative results showed AUCs between 0.84 and 0.92 with better positive likelihood ratio(AICVD−6.16 to FHRS−2.24 and QRisk3−1.16)and accuracy(AICVD−80.15%to FHRS 59.71%and QRisk351.57%).In the Netherlands cohort,AICVD also outperformed the Framingham Heart Risk Model(AUC−0.737 vs 0.707).Conclusions This study concludes that the novel AI-based CVD Risk Score has a higher predictive performance for cardiac events than conventional risk scores in Indian population.

关键词： AICVD Cardiovascular acute

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The non-coding RNA SVALKA locus produces a cis-natural antisense transcript that negatively regulates the expression of CBF1 and biomass production at normal temperatures

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Plant Communications 2023年第4期4卷 77-87页

作者： Vasiliki Zacharaki shiv kumar Meena Peter Kindgren UmeåPlant Science Centre Department of Forest Genetics and Plant PhysiologySwedish University of Agricultural Sciences90187 Umea°Sweden

Non-coding transcription is present in all eukaryotic genomes,but we lack fundamental knowledge about its importance for an organism’s ability to develop *** plants,emerging evidence highlights the essential biological role of non-coding transcription in the regulation of coding ***,we have few molecular insights into this ***,we show that a long isoform of the long noncoding RNA SVALKA-L(SVK-L)forms a natural antisense transcript to the host gene CBF1 and negatively regulates CBF1 mRNA levels at normal temperatures in the model plant Arabidopsis ***,we show detailed evidence for the specific mode of action of *** pathway includes the formation of double-stranded RNA that is recognized by the DICER proteins and subsequent downregulation of CBF1 mRNA ***,the CBF1-SVK regulatory circuit is not only important for its previously known role in cold temperature acclimation but also for biomass production at normal *** study characterizes the developmental role of SVK-L and offers mechanistic insight into how biologically important overlapping natural antisense transcripts can act on and fine-tune the steady-state levels of their host gene’s mRNA.

关键词： SVALKA cis-natural antisense transcript non-coding transcription CBF1 Arabidopsis

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New treatment options for alcoholic hepatitis

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World Journal of Gastroenterology 2016年第15期22卷 3892-3906页

作者： Saggere Muralikrishna Shasthry shiv kumar Sarin Depart-ment of Hepatology Institute of Liver and Biliary Sciences

The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using “Omics” platforms, newer options for patients with alcoholic hepatitis are expected soon.

关键词： Alcoholic liver disease Alcoholic steatosis Alcoholic hepatitis Gut microbiota Lipopolysaccharide Steroid non-response

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Potent antiviral therapy improves survival in acute on chronic liver failure due to hepatitis B virus reactivation

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World Journal of Gastroenterology 2014年第43期20卷 16037-16052页

作者： Cyriac Abby Philips shiv kumar Sarin Department of Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India

Acute on chronic liver failure(ACLF)is a disease entity with a high mortality *** acute event arises from drugs and toxins,viral infections,bacterial sepsis,interventions(both surgical and non-surgical)and vascular events on top of a known or occult chronic liver *** secondary to reactivation of chronic hepatitis B virus is a distinct condition;the high mortality of which can be managed in the wake of new potent antiviral *** example,lamivudine and entecavir use has shown definite short-term survival benefits,even though drug resistance is a concern in the *** renoprotective effects of telbivudine have been shown in a few studies to be useful in the presence of renal *** with newer agents such as tenofovir and a combination of nucleos(t)ides is promising for improving survival in this special group of liver disease *** review describes the current status of potent antiviral therapy in patient with acute on chronic liver failure due to reactivation of chronic hepatitis B,thereby providing an algorithm in management of such patients.

关键词： Acute on chronic liver failure Chronic hepatitis B infection Reactivation of hepatitis B Flare of hepatitis B Anti-viral therapy Nucleoside analogue Nucleotide analogue

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Dynamic properties and liquefaction behaviour of cohesive soil in northeast India under staged cyclic loading

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Journal of Rock Mechanics and Geotechnical Engineering 2018年第5期10卷 958-967页

作者： shiv Shankar kumar A.Murali Krishna Arindam Dey Department of Civil Engineering Indian Institute of Technology Guwahati

Estimation of strain-dependent dynamic soil properties, e.g. the shear modulus and damping ratio, along with the liquefaction potential parameters, is extremely important for the assessment and analysis of almost all geotechnical problems involving dynamic loading. This paper presents the dynamic properties and liquefaction behaviour of cohesive soil subjected to staged cyclic loading, which may be caused by main shocks of earthquakes preceded or followed by minor foreshocks or aftershocks, respectively. Cyclic triaxial tests were conducted on the specimens prepared at different dry densities （1.5 g/cm3 and 1.75 g/cm3） and different water contents ranging from 8% to 25%. The results indicated that the shear modulus reduction （G/Gmax） and damping ratio of the specimen remain unaffected due to the changes in the initial dry density and water content. Damping ratio is significantly affected by confining pressure, whereas G/Gmax is affected marginally. It was seen that the liquefaction criterion of cohesive soils based on single-amplitude shear strain （3.75% or the strain at which excess pore water pressure ratio becomes equal to 1, whichever is lower） depends on the initial state of soils and applied stresses. The dynamic model of the regional soil, obtained as an outcome of the cyclic triaxial tests, can be successfully used for ground response analysis of the region.

关键词： Cohesive soil Dynamic soil properties Liquefaction potential Cyclic triaxial tests Staged cyclic loading

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Antitubercular therapy in patients with cirrhosis:Challenges and options

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World Journal of Gastroenterology 2014年第19期20卷 5760-5772页

作者： Naveen kumar Chandan kumar Kedarishetty Sachin kumar Vikas Khillan shiv kumar Sarin Departments of Hepatology Institute of Liver and Biliary SciencesVasant KunjNew Delhi 110070India Departments of Pulmonology Institute of Liver and Biliary SciencesVasant KunjNew Delhi-110070India Departments of Microbiology Institute of Liver and Biliary SciencesVasant KunjNew Delhi-110070India

Tuberculosis(TB)has been a human disease for *** frequency is increased manyfold in patients with liver *** gold standard of TB management is a 6-mo course of isoniazid,rifampicin,pyrazinamide and *** good results are seen with this treatment in general,the management of patients with underlying cirrhosis is a *** underlying depressed immune response results in alterations in many diagnostic *** tests used for latent TB have many flaws in this group of *** of four first-line antitubercular drugs are hepatotoxic and baseline liver function is often disrupted in patients with underlying *** of hepatotoxicity is increased in patients with liver cirrhosis,frequently leading to severe liver *** are no established guidelines for the treatment of TB in relation to the severity of liver *** is no consensus on the frequency of liver function tests required or the cutoff used to define *** specific treatment exists for prevention or treatment of hepatotoxicity,making monitoring even more important.A high risk of multidrug-resistant TB is another major worry due to prolonged and interrupted treatment.

关键词： Antitubercular therapy Drug hepatotoxicity Multidrug-resistant tuberculosis Immune dysfunction

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A randomized controlled trial of peeling and aspiration of Elschnig pearls and neodymium: yttrium-aluminiumgarnet laser capsulotomy

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International Journal of Ophthalmology(English edition) 2015年第3期8卷 590-596页

作者： Rahul Bhargava Prachi kumar shiv kumar Sharma Avinash Kaur Department of Ophthalmology Laser Eye Clinic Department of Pathology Santosh Medical College and Hospital Department of Ophthalmology Rotary Eye Hospital Department of Ophthalmology Santosh Medical College and Hospital

AIM: To compare surgical peeling and aspiration and neodymium yttrium garnet laser capsulotomy for pearl form of posterior capsule opacification(PCO).METHODS: A prospective, randomized, double blind,study was done at Rotary Eye Hospital, Maranda,Palampur, India, Santosh Medical College Hospital,Ghaziabad, India and Laser Eye Clinic, Noida *** patients with pearl form of PCO following surgery, phacoemulsification, manual small incision cataract surgery and conventional extracapsular cataract extraction(ECCE) for age related cataract, were randomized to have peeling and aspiration or neodymium yttrium garnet laser capsulotomy. Corrected distance visual acuity(CDVA), intra-operative and postoperative complications were ***: A total of 634 patients participated in the study, and 314(49.5%) patients were randomized to surgical peeling and aspiration group and 320(50.5%) to the Nd:YAG laser group. The mean pre-procedural log MAR CDVA in peeling and neodymium: yttrium-aluminium-garnet(Nd:YAG) laser group was 0.80 ±0.25 and 0.86 ±0.22, respectively. The mean final CDVA in peeling group(0.22 ±0.23) was comparable to Nd:YAG group(0.24 ±0.28; t-test, P =0.240). There was a significant improvement in vision after both the procedures(P <0.001). A slightly higher percentage of patients in Nd:YAG laser group(283/88.3%) than in peeling group(262/83.4%) had a CDVA of 0.5(20/63) or better at 9mo(P <0.001). On the contrary, patients havingCDVA worse than 1.00(20/200) was also significantly higher in Nd:YAG laser group as compared to peeling group(25/7.7% vs 15/4.7%, respectively). On application of ANCOVA, there was less than 0.001% risk that PCO thickness and total laser energy had no effect on rate of complications in Nd:YAG laser group and less than 0.001% risk that PCO thickness had no effect on complications in peeling group respectively. Sum of square analysis suggests that in the Nd:YAG laser group,thick PCO had a stronger impact on complication

关键词： posterior capsule neodymium Elschnig pearls yttrium-aluminium-garnet capsulotomy

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Phacoemulsification versus small incision cataract surgery in patients with uveitis

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International Journal of Ophthalmology(English edition) 2015年第5期8卷 965-970页

作者： Rahul Bhargava Prachi kumar shiv kumar Sharma Manoj kumar Avinash Kaur Department of Ophthalmology Laser Eye Clinic Department of Pathology Santosh medical College and Hospital Department of Ophthalmology Rotary Eye Hospital

AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic *** a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically *** hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance

关键词： small incision cataract surgery phacoemulsification uveitis corrected distance visual acuity uncorrected distance visual acuity

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Role of Pathogen-Related Protein 10 (PR 10) under Abiotic and Biotic Stresses in Plants

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Phyton-International Journal of Experimental Botany 2020年第2期89卷 167-182页

作者： Rakesh kumar Sinha shiv Shankar Verma Anshu Rastogi Department of Plant Biophysics&Biochemistry Biology Center of the Czech Academy of SciencesInstitute of PlantMolecular BiologyCeskeBudejovice37005Czech Republic School of Medicine Case Western Reserve UniversityCleveland44106USA Department of Ecology and Environmental Protection Laboratory of BioclimatologyPoznan University of Life SciencesPoznan60-649Poland

Members of the Pathogenesis Related(PR)10 protein family have been identified in a variety of plant species and a wide range of functions ranging from defense to growth and development has been attributed to ***10 protein possesses ribonuclease(RNase)activity,interacts with phytohormones,involved in hormone-mediated signalling,afforded protection against various phytopathogenic fungi,bacteria,and viruses particularly in response to biotic and abiotic *** resistance mechanism of PR10 protein may include activation of defense signalling pathways through possible interacting proteins involved in mediating responses to pathogens,degradation of RNA of the invading ***,several morphological changes have been shown to accompany the enhanced abiotic stress *** this review,the possible mechanism of action of PR10 protein against biotic and abiotic stress has been ***,our findings also confirmed that the in vivo Nitric oxide(NO)is essential for most of environmental abiotic stresses and disease resistance against pathogen *** proper level of NO may be necessary and beneficial,not only in plant response to the environmental abiotic stress,but also to biotic *** updated information on this interesting group of proteins will be useful in future research to develop multiple stress tolerance in plants.

关键词： Pathogenesis-related(PR) PR10 abiotic stress biotic stress ribonuclease stress tolerance nitric oxide

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Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 27-32页

作者： Praveen Sharma Barjesh Chander Sharma shiv kumar Sarin Department of Gastroenterology G.B.Pant Hospital

BACKGROUND:Minimal hepatic encephalopathy (MHE) impairs quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic *** of MHE requires cumbersome *** is effective in the treatment of *** study aimed to evaluate the use of critical flicker frequency (CFF) for the diagnosis of MHE in cirrhotic patients after ***:One hundred and ten patients were evaluated by psychometry (number connection tests A,B or figure connection tests A,B),P300 auditory event related potential (P300ERP),venous ammonia,and CFF for *** was diagnosed by abnormal psychometry (>2SD age matched controls) and *** patients were treated with lactulose for one *** was defined by normalization (<2SD of matched controls) of both psychometry and ***:Of the 110 patients [Child Turcott Pugh score A:B:C 39:42:29,(age 41.6±11.6 years,M:F 82:28)],75 (68%) had abnormal results of psychometric tests,and 74 (67%) had prolonged *** (20%) patients with abnormal results of psychometric tests had normal *** sixty (54.5%) patients were diagnosed as having *** treatment for one month,34 (57%) recovered while 26 (43%) continued to have abnormal resents of psychometric or P300ERP *** was <39 Hz in 72 (65.4%) patients before treatment and in 20 (33.3%) after *** sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy for the assessment of recovery of MHE were 65%,91%,85%,77% and 80%,***:CFF is a simple,relatively reliable,and accurate test without any dependence on age or literacy in the diagnosis and assessment of recovery of patients with MHE.

关键词： minimal hepatic encephalopathy critical flicker frequency lactulose

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