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Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations:A propensity-matched analysis of the United States

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World Journal of Virology 2024年第1期13卷 51-60页

作者： Abdullah Sohail Hassam Ali Pratik Patel Subanandhini Subramanium Dushyant singh Dahiya Amir H Sohail Manesh kumar Gangwani Sanjaya K Satapathy Department of Internal Medicine University of Iowa Roy J and Lucille A Carver College of MedicineIowaIA 52242United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Gastroenterology Mather Hospital/Hofstra University Zucker School of MedicineNY11777United States Department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery University of New MexicoAlbuquerqueNM 87106United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Section on Gastroenterology and Hepatology North Shore University Hospital and Long Island Jewish Medical CenterManhassetNY 11030United States

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United *** with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and ***,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the *** We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and *** primary outcomes included inpatient mortality,length of stay,and hospitalization *** outcomes included the prevalence of systemic *** A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity ***,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD ***,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD *** The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 *** data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been *** will be interesting to see if these trends are

关键词： COVID-19 Metabolic dysfunction-associated steatotic liver disease Prevalence Hospital charges Inpatient resource utilization

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Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

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World Journal of Hepatology 2024年第1期16卷 17-32页

作者： Yash R Shah Hassam Ali Angad Tiwari David Guevara-Lazo Natalia Nombera-Aznaran Bhanu Siva Mohan Pinnam Manesh kumar Gangwani Harishankar Gopakumar Amir H Sohail SriLakshmiDevi Kanumilli Ernesto Calderon-Martinez Geetha Krishnamoorthy Nimish Thakral Dushyant singh Dahiya Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Maharani Laxmi Bai Medical CollegeJhansi 284001India Faculty of Medicine Universidad Peruana Cayetano HerediaLima 15102Peru Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States Department of Surgery University of New MexicoAlbuquerqueNM 87106United States Department of Internal Medicine GSL Medical CollegeRajamahendravaram 533296India Department of Internal Medicine Universidad Nacional Autonoma de MexicoCiudad De Mexico 04510Mexico Department of Digestive Diseases and Nutrition University of KentuckyLexingtonKY 40536United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States

Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut *** prevalence of HE varies with liver disease severity and *** pathogenesis involves ammonia toxicity,gut-brain communication disruption,and *** aims to restore gut microbiota balance,addressing these ***'s efficacy has been explored in various conditions,including *** suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate *** has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver *** include improved liver function,cognitive function,and the slowing of disease ***,larger,controlled studies are needed to validate its effectiveness in these *** have shown cognitive improvements through FMT,with potential benefits in cirrhotic ***,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of *** evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor *** large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and *** FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.

关键词： Hepatic encephalopathy Fecal microbiota transplant Cognitive impairment Liver cirrhosis Chronic liver disease

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Fractionally Delayed Kalman Filter

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IEEE/CAA Journal of Automatica Sinica 2020年第1期7卷 169-177页

作者： Abhinoy kumar singh Discipline of Electrical Engineering Indian Institute of Technology Indore

The conventional Kalman filter is based on the assumption of non-delayed measurements. Several modifications appear to address this problem, but they are constrained by two crucial assumptions: 1) the delay is an integer multiple of the sampling interval, and 2) a stochastic model representing the relationship between delayed measurements and a sequence of possible non-delayed measurements is known. Practical problems often fail to satisfy these assumptions, leading to poor estimation accuracy and frequent track-failure. This paper introduces a new variant of the Kalman filter, which is free from the stochastic model requirement and addresses the problem of fractional *** proposed algorithm fixes the maximum delay(problem specific), which can be tuned by the practitioners for varying delay possibilities. A sequence of hypothetically defined intermediate instants characterizes fractional delays while maximum likelihood based delay identification could preclude the stochastic model requirement. Fractional delay realization could help in improving estimation accuracy. Moreover, precluding the need of a stochastic model could enhance the practical applicability. A comparative analysis with ordinary Kalman filter shows the high estimation accuracy of the proposed method in the presence of delay.

关键词： Gaussian likelihood Kalman filter optimal Kalman gain randomly delayed measurements

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Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant singh Dahiya Muhammad Nadeem Yousaf Brinda Basida Bhanu Siva Mohan Pinnam Manesh kumar Gangwani Hassam Ali Sahib singh Yash R Shah Daksh Ahluwalia Mihir Prakash Shah Saurabh Chandan Neil R Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of Rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related *** To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National Readmission *** aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Major Development Under Gaussian Filtering Since Unscented Kalman Filter

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IEEE/CAA Journal of Automatica Sinica 2020年第5期7卷 1308-1325页

作者： Abhinoy kumar singh IEEE Department of Electrical Engineering Indian Institute of Technology Indore

Filtering is a recursive estimation of hidden states of a dynamic system from noisy *** problems appear in several branches of science and technology,ranging from target tracking to biomedical monitoring.A commonly practiced approach of filtering with nonlinear systems is Gaussian *** early Gaussian filters used a derivative-based implementation,and suffered from several drawbacks,such as the smoothness requirements of system models and poor stability.A derivative-free numerical approximation-based Gaussian filter,named the unscented Kalman filter(UKF),was introduced in the nineties,which offered several advantages over the derivativebased Gaussian *** the proposition of UKF,derivativefree Gaussian filtering has been a highly active research *** paper reviews significant developments made under Gaussian filtering since the proposition of *** review is particularly focused on three categories of developments:i)advancing the numerical approximation methods;ii)modifying the conventional Gaussian approach to further improve the filtering performance;and iii)constrained filtering to address the problem of discrete-time formulation of process *** review highlights the computational aspect of recent developments in all three *** performance of various filters are analyzed by simulating them with real-life target tracking problems.

关键词： Bayesian framework cubature rule-based filtering Gaussian filters Gaussian sum and square-root filtering nonlinear filtering quadrature rule-based filtering unscented transformation

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Global trends in hepatitis C-related hepatocellular carcinoma mortality:A public database analysis(1999-2019)

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World Journal of Virology 2024年第1期13卷 69-83页

作者： Hassam Ali Fnu Vikash Vishali Moond Fatima Khalid Abdur Rehman Jamil Dushyant singh Dahiya Amir Humza Sohail Manesh kumar Gangwani Pratik Patel Sanjaya K Satapathy Department of Internal Medicine/Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Department of Internal Medicine Saint Peter's University Hospital/Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine Quaid-e-Azam Medical CollegeBahawalpur 63100PunjabPakistan Department of Internal Medicine Samaritan Medical CentreWatertownMA 13601United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery New York University Winthrop HospitalNew YorkMineloaNY 11501United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology Mather Hospital/Hofstra University Zucker School of MedicineNY 11777United States Division of Hepatology Department of MedicineNorth Shore University HospitalManhassetNY 11030United States

BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical *** the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis ***,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global *** some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender *** gap in knowledge hinders the development of targeted interventions and resource allocation *** The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two ***,females exhibited a remarkable decrease in mortality compared to ***,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward *** America and the Caribbean also experienced an increase in mortality ***,no significant difference was observed in the Middle East and North *** America exhibited a notable upward *** Asia and Sub-Saharan Africa significantly declined throughout the study *** raises the hope of identifying areas for implementing more targeted *** some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].

关键词： Carcinoma Hepatocellular Antiviral agents Global Burden of Disease Quality indicators Health care Liver neoplasms Hepatitis C Chronic hepatitis C

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Anterior resection for rectal carcinoma-risk factors for anastomotic leaks and strictures

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World Journal of Gastroenterology 2011年第11期17卷 1475-1479页

作者： Ashok kumar Ram Daga Paari Vijayaragavan Anand Prakash Rajneesh kumar singh Anu Behari vinay K Kapoor Rajan Saxena Department of Surgical Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow 226014India

AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent ***:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and ***:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were *** median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic *** these,11 patients required reexploration and five were managed *** anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for ***(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal *** multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic ***:Advance age is a risk factor for an anastomotic *** anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.

关键词： Rectal carcinoma Anterior resection Anastomotic leak Stricture

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Derated Mode of Power Generation in PV System Using Modified Perturb and Observe MPPT Algorithm

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Journal of Modern Power Systems and Clean Energy 2021年第5期9卷 1183-1192页

作者： Vinit kumar Mukesh singh Thapar Institute of Engineering and Technology PatialaPunjabIndia

In a grid-integrated photovoltaic system(GIPVS),there exist issues such as surplus active power and inadequate performance of maximum power point tracking(MPPT).A surplus active power causes the overvoltage problem at the point of common coupling in low-or medium-voltage grid during the peak hours of power ***,the inadequate performance of the MPPT algorithm results in power loss due to high settling time during the sudden change of ***,to solve the surplus power problem,the curtailment of active power is suggested with improved MPPT algorithm under variable irradiance *** this paper,a derated power generation mode(DPGM)control strategy is presented for the curtailment of active ***,a drift-free(named as modified)perturb and observe(P&O)technique is also proposed to improve the performance of the MPPT ***,the DPGM control scheme with the intermediate boost converter shaves the surplus active power during the peak hours of power ***,the modified MPPT algorithm deals with the fluctuation of irradiance during non-peak ***,the proposed control scheme delivers in a more efficient system during the peak hours of power *** addition,it reduces the power loss and settling time during the change of irradiance for non-peak *** on the proposed control scheme,a 30 kW system has been simulated in MATLAB/Simulink using Simpower tools under different environmental conditions.

关键词： Derated power generation mode(DPGM) gridintegrated photovoltaic system intermediate boost converter modified perturb and observe voltage source inverter

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Investigation of structural, morphological and electrochemical properties of mesoporous La2CuCoO6 rods fabricated by facile hydrothermal route

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International Journal of Minerals,Metallurgy and Materials 2020年第7期27卷 987-995页

作者： Jashandeep singh Ashok kumar Department of Physics National Institute of Technology KurukhsetraHaryana 136119India Department of Applied Sciences National Institute of Technical Teachers Training and ResearchChandigarh 160019India

This work introduces the facile hydrothermal synthesis of double perovskite La2CuCoO6.X-ray diffraction pattern confirmed the formation of a monoclinic phase with P121/c1 *** electron microscopy results revealed that the self-assembled porous rods were composed of nanocrystallite *** estimated specific surface area of these mesoporous rods with an average pore diameter of 6 nm was^41 m^2·g^–*** presence of ions with oxidation states of La^3+,Cu^2+,and Co^2+/Co^3+on the surface of the mesoporous La2CuCoO6 rods was confirmed by X-ray photoelectron spectroscopic *** cyclicvoltammetry and chronopotentiometry,the electrode fabricated from the mesoporous La2CuCoO6 rods were found to exhibit pseudocapacitive behavior with a specific capacitance of 259.4 F·g^–1 at a current density of 0.5 A·g^–***^89%retention in specific capacitance was achieved after 1000 charge/discharge cycles at a constant current density of4 A·g^–1.

关键词： rare earth double perovskites oxide materials hydrothermal electrochemical

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Multi-Objective Optimization of Fused Deposition Modeling for Mechanical Properties of Biopolymer Parts Using the Grey-Taguchi Method

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Chinese Journal of Mechanical Engineering 2023年第1期36卷 51-64页

作者： Kapil kumar Hari singh Department of Mechanical Engineering National Institute of TechnologyKurukshetra136119India

The urgent need to develop customized functional products only possible by 3D printing had realized when faced with the unavailability of medical devices like surgical instruments during the coronavirus-19 disease and the ondemand necessity to perform surgery during space *** have recently been the most appropriate option for fabricating surgical instruments via 3D printing in terms of cheaper and faster *** all 3D printing techniques,fused deposition modelling(FDM)is a low-cost and more rapid printing *** article proposes the fabrication of surgical instruments,namely,forceps and hemostat using the fused deposition modeling(FDM)*** mechanical properties are the only indicator to judge the quality of the functional *** mechanical properties of FDM-processed parts depend on various process *** parameters are layer height,infill pattern,top/bottom pattern,number of top/bottom layers,infill density,flow,number of shells,printing temperature,build plate temperature,printing speed,and fan *** strength and modulus of elasticity are chosen as evaluation indexes to ascertain the mechanical properties of polylactic acid(PLA)parts printed by *** experiments have performed through Taguchi’s L27orthogonal array(OA).Variance analysis(ANOVA)ascertains the significance of the process parameters and their percent contributions to the evaluation ***,as a multiobjective optimization technique,grey relational analysis(GRA)obtains an optimal set of FDM process parameters to fabricate the best parts with comprehensive mechanical *** electron microscopy(SEM)examines the types of defects and strong bonding between *** proposed research ensures the successful fabrication of functional surgical tools with substantial ultimate tensile strength(42.6 MPa)and modulus of elasticity(3274 MPa).

关键词： Fused deposition modeling Mechanical properties Taguchi method ANOVA Grey relational analysis SEM

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