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Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of Anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru Deepak Mishra Nitin Pahuja Akash Ray Mohapatra Jyotsna sharma Om Bahadur Thapa Manjot Multani Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care Military Hospital Bhopal India

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema Pleural effusion Lung ultrasound (LUS) Pneumothorax

Comprehensive analysis of uncertainty quantification for the^(58)Ni(n,p)^(58)Co reaction cross section

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Chinese Physics C 2024年第9期48卷 170-175页

作者： Mahesh Choudhary Aman sharma Namrata Singh Mahima Upadhyay Punit Dubey A.Gandhi Akash Hingu G Mishra Sukanya De L.S.Danu Ajay Kumar R.G.Thomas Saurav Sood Sajin Prasad S.Mukherjee I.N.Ruskov Yu.N.Kopatch A.Kumar Department of Physics Banaras Hindu UniversityVaranasi 221005India Horia Hulubei National Institute of Physics and Nuclear Engineering-IFIN-HH Bucharest 077125Romania Department of Physics The Maharaja Sayajirao University of BarodaVadodara 390002India Nuclear Physics Division Bhabha Atomic Research CentreMumbai 400085India Health Physics Division Bhabha Atomic Research CentreMumbai 400085India Department of Electrical Power Engineering Brno University of TechnologyBrno 61600Czech Republic Institute for Nuclear Research and Nuclear Energy Bulgarian Academy of SciencesSofia 1784Bulgaria Joint Institute for Nuclear Research(JINR) Dubna 141980Russia

In this study,we measured the^(58)Ni(n,p)^(58)Co reaction cross section with neutron energies of 1.06,1.86,and 2.85 *** cross section was measured using neutron activation techniques andγ-ray spectroscopy,and it was compared with cross section data available in the ***,we calculated the covariance matrix of the measured cross section for the aforementioned nuclear *** uncertainties of the theoretical calculation for^(58)Ni(n,p)^(58)Co reaction cross section were calculated via Monte Carlo *** this study,we used uncertainties in the optical model and level density parameters to calculate uncertainties in the theoretical cross *** theoretical calculations were performed by using *** this study,we aim to analyze the effect of uncertainties of the nuclear model input as well as different experimental variables used to obtain the values of reaction cross section.

关键词： ^(58)Ni(n p)^(58)Co reaction γ-ray spectroscopy uncertainty quantification of cross section covariance analysis

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莫迪终于认识到了炒作的作用不过如此

商业周刊（中文版） 2024年第9期 28-29页

作者： Mihir sharma 逸思(译) 不详

这位长期执政的印度领导人将开启第三个任期。但选民们已经证明,政治定律依然有效。印度变幻莫测。这是不争的事实,但过去十年来,印度人自已似乎都把这给忘了。自从2014年纳伦德拉·莫迪(Narendra Modi)出人意料以前所未有的绝对多数赢... 详细信息

这位长期执政的印度领导人将开启第三个任期。但选民们已经证明,政治定律依然有效。印度变幻莫测。这是不争的事实,但过去十年来,印度人自已似乎都把这给忘了。自从2014年纳伦德拉·莫迪(Narendra Modi)出人意料以前所未有的绝对多数赢得议会席位上台执政以来,很多人都认为印度的政治格局已经永远改变了。联盟时代结束了,印度似乎正不可逆转地走向一党独大局面。

关键词：莫迪长期执政一党独大政治格局绝对多数印度人选民伦德拉

PARAMETER AND INTERACTION STUDY OF EDGE CRACK PROBLEM USING MESHFREE METHOD

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International Journal of Modeling, Simulation, and Scientific Computing 2012年第4期3卷 58-76页

作者： KAMAL sharma vivek BHASIN I.V.SINGH B.K.MISHRA K.K.VAZE Reactor Safety Division BARC TrombayMumbaiMaharastraIndia MIED IIT RoorkeeRoorkeeUttarakhandIndia

In this work,element free Galerkin method(EFGM)has been used to obtain the solution of edge crack problem under mechanical loads as it provides a versatile technique to model static as well as moving crack problems without any requirement of *** first,some techniques are presented for enriching the EFG approximations near the crack tip such as extrinsic and intrinsic *** enrichment involves the addition of solution form to the trial function,whereas the EFG basis is expanded to include few terms from crack tip solution in intrinsic *** from enrichment techniques,four basic techniques of smoothing meshless approximations near nonconvex boundaries are also presented such as diffraction,transparency,see through and wedge *** techniques are then used for the parameteric analysis of an edge crack problem under mode-1 loading and results obtained using different approaches are compared with each other as well as with exact *** these techniques,the extrinsic PU enrichment technique was found to be more accurate as compared to other *** PU enrichment technique has also been used for the analysis of a shear edge crack *** all these techniques,the value of mode-1 stress intensity factor and mode-2 stress intensity factor has been evaluated by interaction integral *** of crack orientation is also studied for different cases.

关键词： EFGM edge crack enrichment techniques meshfree.

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

Ciliated hepatic foregut cyst:an increasingly diagnosed condition

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Hepatobiliary & Pancreatic Diseases International 2008年第6期7卷 581-589页

作者： Sharad sharma Amanda G.Dean Ayumi Corn vivek Kohli Harlan I Wright Anthony Sebastian Nicolas Jabbour Methodist University Hospital Transplant Institute 1265 Union Avenue Nazih Zuhdi Transplant Institute 3300 North West Expressway

BACKGROUND:Ciliated foregut cysts of the liver are rare, with only 96 cases diagnosed since the first description in *** are being increasingly diagnosed recently;the majority of the cases have been reported in the last 15 years. Although they bear a close resemblance to the simple cyst of the liver which has essentially a benign course,ciliated hepatic foregut cysts(CHFCs)can progress to malignancy with devastating *** is imperative that this group of conditions be diagnosed and treated adequately. DATA SOURCES:This review includes discussion of the data from all the 96 reported cases from English and non-English *** of the incidence rates, embryogenesis,growth,clinical features,risk of malignancy and the prognosis are highlighted *** roles of various diagnostic modalities including ultrasound, CT,MRI,fine needle aspiration cytology(FNAC), immunohistochemistry and surgery are further discussed. RESULTS:The mean age of patients with CHFC was 48± 12 *** male/female ratio was 1.1∶*** majority of patients with CHFC(62%)were asymptomatic,and the common mode of presentation was right upper abdominal *** cysts occurred in the left lobe in 51 patients, with sole location in segmentⅣin 44,and in the right lobe in *** average size of the cysts was 3.6±2.12 cm. The majority of the cysts were unilocular,and only 7 cases were *** contents were described as viscous or mucinous in 73 patients,whereas bilious fluid was noted in *** cysts having squamous carcinoma were cited in 3 patients,and 2 had extensive squamous metaplasia without *** had benign histopathology. CONCLUSIONS:Clinicians have become increasingly aware of *** alone is not diagnostic per se, but when considered in the context of the global picture does provide important clues to the *** is diagnostic by the presence of the ciliated columnar aspirate but lacks *** presentation is usua

关键词： ciliated hepatic foregut cyst squamous cell carcinoma cystic liver disease

Chemical, mechanical, and thermal expansion properties of a carbon nanotube-reinforced aluminum nanocomposite

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International Journal of Minerals,Metallurgy and Materials 2016年第2期23卷 222-233页

作者： Manjula sharma Vimal sharma Department of Physics National Institute of Technology Hamirpur

In the present study,the chemical and mechanical properties and the thermal expansion of a carbon nanotube（CNT）-based crystalline nano-aluminum（nano Al） composite were *** properties of nanocomposites were tailored by incorporating CNTs into the nano Al matrix using a physical mixing *** elastic moduli and the coefficient of thermal expansion（CTE） of the nanocomposites were also estimated to understand the effects of CNT reinforcement in the Al *** characterization of the nanocomposite reveals that the CNTs are dispersed and embedded in the Al *** experimental results indicate that the incorporation of CNTs into the nano Al matrix results in the increase in hardness and elastic modulus along with a concomitant decrease in the coefficient of thermal expansion The hardness and elastic modulus of the nanocomposite increase by 21%and 20%,respectively,upon CNT *** CTE of CNT/A1 nanocomposite decreases to 70%compared with that of nano Al.

关键词： metal matrix composites carbon nanotubes nanocomposites chemical properties thermal expansion mechanical properties

Siponimod exerts neuroprotective effects on the retina and higher visual pathway through neuronal S1PR1 in experimental glaucoma

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Neural Regeneration Research 2023年第4期18卷 840-848页

作者： Devaraj Basavarajappa vivek Gupta Nitin Chitranshi Roshana Vander Wall Rashi Rajput Kanishka Pushpitha Samridhi sharma Mehdi Mirzaei Alexander Klistorner Stuart L.Graham Department of Clinical Medicine Faculty of MedicineHealth and Human SciencesMacquarie UniversityNorth RydeSydneyNSWAustralia

Sphingosine-1-phosphate receptor(S1PR)signaling regulates diverse pathophysiological processes in the central nervous *** role of S1PR signaling in neurodegenerative conditions is still largely *** is a specific modulator of S1P1 and S1P5 receptors,an immunosuppressant drug for managing secondary progressive multiple *** investigated its neuroprotective properties in vivo on the retina and the brain in an optic nerve injury model induced by a chronic increase in intraocular pressure or acute N-methyl-D-aspartate ***-specific deletion of sphingosine-1-phosphate receptor(S1PR1)was carried out by expressing ***-Cre recombinase under Syn1 promoter in S1PR1mice to define the role of S1PR1 in *** retinal electrophysiological responses,along with histological and immunofluorescence analysis of the retina and optic nerve tissues,indicated significant neuroprotective effects of siponimod when administered orally via diet in chronic and acute optic nerve injury ***,siponimod treatment showed significant protection against trans-neuronal degenerative changes in the higher visual center of the brain induced by optic nerve *** treatment also reduced microglial activation and reactive gliosis along the visual *** results showed that siponimod markedly upregulated neuroprotective Akt and Erk1/2 activation in the retina and the ***-specific deletion of S1PR1 enhanced retinal and dorsolateral geniculate nucleus degenerative changes in a chronic optic nerve injury condition and attenuated protective effects of *** summary,our data demonstrated that S1PR1signaling plays a vital role in the retinal ganglion cell and dorsolateral geniculate nucleus neuronal survival in experimental glaucoma,and siponimod exerts direct neuroprotective effects through S1PR1 in neurons in the central nervous system independent of its peripheral immuno-modulatory *** findings s

关键词： glaucoma intraocular pressure neurodegeneration neuroprotection optic nerve injury retinal ganglion cells siponimod sphingosine-1-phosphate

Effect of Climate Change on Lung Cancer

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