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Safety of tranexamic acid in surgically treated isolated spine trauma

World Journal of Orthopedics 2024年第4期15卷 346-354页

作者： Wajiha Zahra Sandeep Krishan Nayar ashwin bhadresha Vinay Jasani Syed Aftab Trauma and Orthopedics Department University Hospital of North Midlands NHS TrustStoke-on-Trent ST46QGUnited Kingdom Trauma and Orthopedics Department Royal London HospitalBarts Health InstituteLondon E11BBUnited Kingdom Craniospinal Services University Hospital of North Midlands NHS TrustStokeon-Trent ST46QGUnited Kingdom Spine Department Royal London HospitalBarts Health InstituteLondon E11BBUnited Kingdom

BACKGROUND Tranexamic acid(TXA),a synthetic antifibrinolytic drug,effectively reduces blood loss by inhibiting plasmin-induced fibrin *** is the first study in the United Kingdom to investigate the effectiveness of TXA in the surgical management of isolated spine *** To assess the safety of TXA in isolated spine *** primary and secondary outcomes are to assess the rate of thromboembolic events and to evaluate blood loss and the incidence of blood transfusion,*** This prospective observational study included patients aged≥17 years with isolated spine trauma requiring surgical intervention over a 6-month period at two major trauma centers in the United *** We identified 67 patients:26(39%)and 41(61%)received and did not receive TXA,*** groups were matched in terms of age,gender,American Society of Anesthesiologists grade,and mechanism of injury.A higher proportion of patients who received TXA had a subaxial cervical spine injury classification or thoracolumbar injury classification score>4(74%vs 56%).All patients in the TXA group underwent an open approach with a mean of 5 spinal levels involved and an average operative time of 203 min,compared with 24 patients(58%)in the non TXA group who underwent an open approach with an average of 3 spinal levels involved and a mean operative time of 159 *** patients who received TXA,blood loss was<150 and 150–300 mL in 8(31%)and 15(58%)patients,*** were no cases of thromboembolic events in any patient who received *** Our study demonstrated that TXA is safe for isolated spine *** is challenging to determine whether TXA effectively reduces blood loss because most surgeons prefer TXA for open or multilevel ***,larger studies are necessary to explore the rate,dosage,and mode of administration of TXA.

关键词： Tranexamic acid Infection Trauma Thromboembolic disease Minimally invasive Percutaneous

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Role of renin-angiotensin system/angiotensin converting enzyme-2 mechanism and enhanced COVID-19 susceptibility in type 2 diabetes mellitus

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World Journal of Diabetes 2024年第4期15卷 606-622页

作者： ashwin Kumar Shukla Komal Awasthi Kauser Usman Monisha Banerjee Molecular and Human Genetics Laboratory Department of ZoologyUniversity of LucknowLucknow 226007Uttar PradeshIndia Department of Medicine King Georges’Medical UniversityLucknow 226003Uttar PradeshIndia Institute of Advanced Molecular Genetics and Infectious Diseases(IAMGID)University of LucknowLucknow 226007Uttar PradeshIndia

Coronavirus disease 2019(COVID-19)is a disease that caused a global pandemic and is caused by infection of severe acute respiratory syndrome coronavirus 2 *** has affected over 768 million people worldwide,resulting in approx-imately 6900000 ***-risk groups,identified by the Centers for Disease Control and Prevention,include individuals with conditions like type 2 diabetes mellitus(T2DM),obesity,chronic lung disease,serious heart conditions,and chronic kidney *** indicates that those with T2DM face a hei-ghtened susceptibility to COVID-19 and increased mortality compared to non-diabetic *** the renin-angiotensin system(RAS),a vital regulator of blood pressure and pulmonary stability,reveals the significance of the angiotensin-converting enzyme(ACE)and ACE2 *** converts angiotensin-I to the vasoconstrictor angiotensin-II,while ACE2 counters this by converting angiotensin-II to angiotensin 1-7,a *** ACE2 exp-ression,common in diabetes,intensifies RAS activity,contributing to conditions like inflammation and *** ACE inhibitors and angiotensin receptor blockers can be therapeutically beneficial by increasing ACE2 levels,concerns arise regarding the potential elevation of ACE2 receptors on cell membranes,potentially facilitating COVID-19 *** review explored the role of the RAS/ACE2 mechanism in amplifying severe acute respiratory syndrome cor-onavirus 2 infection and associated complications in *** treatment strategies,including recombinant human ACE2 therapy,broad-spectrum antiviral drugs,and epigenetic signature detection,are discussed as promising avenues in the battle against this pandemic.

关键词： Angiotensin-converting enzyme 2 Angiotensin-converting enzyme inhibitors Angiotensin-II receptor blockers Complex diseases COVID-19 Type 2 diabetes

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Combined hepatocellular cholangiocarcinoma: A clinicopathological update

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World Journal of Hepatology 2024年第5期16卷 766-775页

作者： Mukul Vij Fadl H Veerankutty ashwin Rammohan Mohamed Rela Department of Pathology Institute of Liver Disease and TransplantationChennai 600044India Comprehensive Liver Care Institute VPS LakeshoreCochin 682040India Institute of Liver Disease and Transplantation Dr.Rela Institute and Medical CentreChennai 600044India

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a rare primary liver cancer associated with an appalling *** diagnosis and manage-ment of this entity have been challenging to physicians,radiologists,surgeons,pathologists,and oncologists *** diagnostic and prognostic value of biomarkers such as the immunohistochemical expression of nestin,a progenitor cell marker,have been explored *** a better understanding of biology and the clinical course of cHCC-CCA,newer treatment modalities like immune checkpoint inhibitors are being tried to improve the survival of patients with this rare *** this review,we give an account of the recent developments in the pathology,diagnostic approach,and management of cHCC-CCA.

关键词： Combined hepatocellular-cholangiocarcinoma Immunotherapy Nestin Hepatocellular carcinoma Cholangiocarcinoma Liver cancer Biomarker Immune checkpoint inhibitors Pathology Genomic landscape

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Effect of KiwiBiotic on functional constipation and related symptoms:A prospective,single-center,randomized,comparative,crossover study

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2024年第5期15卷 40-49页

作者： ashwin D Porwal Paresh M Gandhi Deepak K Kulkarni Gajanan B Bhagwat Pravin P Kamble Department of Proctology Healing Hands ClinicMahārāshtraPune 411001India R&D Center Healing Hands and Herbs Pvt.Ltd.MahārāshtraPune 411002India

BACKGROUND Functional constipation(FC)is a common gastrointestinal disorder characterized by abdominal pain and bloating,which can greatly affect the quality of life of *** treatments often yield suboptimal results,leading to the exploration of alternative therapeutic *** To evaluate the efficacy of KiwiBiotic in the management of FC and related *** This prospective,interventional,single-center,crossover study compared the safety and effectiveness of KiwiBiotic®vs psyllium husk in managing FC,abdominal pain,and *** diagnosed with FC were randomly assigned to receive KiwiBiotic or psyllium husk during the two treatment periods,with a 14-day washout period between *** Seventy participants were enrolled,32 of whom received KiwiBiotic followed by psyllium husk,and 33 received *** showed superiority over psyllium husk in alleviating abdominal pain and bloating,as evidenced by significantly lower mean ***,KiwiBiotic resulted in more than 90.0%of patients experiencing relief from various constipation symptoms,while psyllium husk showed comparatively lower *** KiwiBiotic is an effective treatment option for FC,abdominal pain,and bloating,highlighting its potential as a promising alternative therapy for patients with FC and its associated symptoms.

关键词： KiwiBiotic Psyllium husk Constipation Abdominal pain Bloating

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Scalable and Practical Nonblocking Switching Networks

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Journal of Computer Science & Technology 2006年第4期21卷 466-475页

作者：郑斯清 ashwin Gumastet Department of Computer Science University of Texas at Dallas U.S.A. School of Information Technology Indian Institute of Technology Bombay India

Large-scale strictly nonblocking （SNB） and wide-sense nonblocking （WSNB） networks may be infeasible due to their high cost. In contrast, rearrangeable nonblocking （RNB） networks are more scalable because of their much lower cost. However, RNB networks are not suitable for circuit switching. In this paper, the concept of virtual nonblockingness is introduced. It is shown that a virtual nonblocking （VNB） network functions like an SNB or WSNB network, but it is constructed with the cost of an RNB network. The results indicate that for large-scale circuit switching applications, it is only needed to build VNB networks.

关键词： switching network rearrangeable nonblocking network wide-sense nonblocking network strictly nonblockingnetwork circuit switching optical switching

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Post-transplant immunosuppression and COVID-19:From a double whammy to a mixed blessing

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World Journal of Transplantation 2020年第9期10卷 267-276页

作者： ashwin Rammohan The Institute of Liver Disease and Transplantation Dr.Rela Institute and Medical CentreChennai 600044India

The coronavirus pandemic(COVID-19)has had an unprecedented effect on various disease processes and their ***-19 is likely to have a complex pathophysiological interplay with the post-transplant patients;one affecting the clinical course and outcome of the *** the absence of validated data from trials,there is strong dependence on experience based on previous similar epidemics(SARS/MERS),and from consensus based on expert *** the fact that our knowledge is rapidly evolving with time,there still is relatively limited objective data on the effect of COVID-19 on the human *** questions remain unanswered,one of which involves the management of immunosuppression in the post-transplant recipient during this *** core tenet of which continues to be that of establishing an equipoise between infection and *** review summarises the current knowledge on immune interactions of the virus,the immunomodulatory effects that may be at play,and its relation to the art of immunosuppression.

关键词： COVID-19 Post-transplant immunosuppression Immunity Review

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Automotive Visible-Light Communication: Alternative Devices and Systems

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清华大学学报:自然科学版(英文版) 2023年第4期28卷 719-728页

作者： Lin Cheng Yue Wu Chenren Xu Khadija Ashraf ashwin Ashok Department of Engineering Trinity CollegeHartfordCT 06106USA Department of Computer Science Yale UniversityNew HavenCT 06520USA Department of Computer Science and Technology Peking UniversityBeijing 100084China Department of Computer Science Georgia State UniversityAtlantaGA 30302USA

Continuous advancements in visible-light communication(VLC)technology have paved the way for future high-capacity communication links that can simultaneously provide data transmission and *** is being accepted as a potential complementary technology in 5G networks,and standardization efforts through IEEE 802.15.7 are on their ***,vehicular networking applications have become increasingly complex with tight power and performance ***,devices and systems that can meet diverse vehicular networking applications are in great *** this article,we discuss three alternatives for vehicular networking applications in(1)LED–photodiode-based active VLC,(2)VLC with a multicamera array receiver,and(3)passive VLC based on decoding information from optical *** also present our recent experimental and modeling work using our camera-based and passive VLC prototype implementations.

关键词： visible-light communications automobile camera communications

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Robotic donor hepatectomy:Are we there yet?

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 668-677页

作者： ashwin Rammohan Mohamed Rela Institute of Liver Disease&Transplantation Dr.Rela Institute&Medical CentreBharath Institute of Higher Education&ResearchChennai 600044India

In living donor liver transplantation(LDLT)the safety of the live donor(LD)is of paramount *** all efforts,the morbidity rates approach 25%-40%with conventional open donor hepatectomy(DH)***,most of these complications are related to the operative wound and despite increased selfesteem and satisfaction in various quality of life analyses on LD,the most common grievance is that of the *** safe and precise DH through a conventional laparoscopic approach is a formidable task with a precipitous learning curve for the whole *** to the ramifications the donor operation carries for the donor,the recipient,the transplant team and for the LDLT program in general,the development and acceptance of minimally invasive DH(MIDH)has been *** robotic surgical system overcomes the reduced visualization,restricted range of motion and physiological tremor associated with laparoscopic surgery and allows for a comparatively easier transition from technical feasibility to ***,many questions especially with regards to standardization of surgical technique,comparison of outcomes,understanding of the learning curve,*** *** aim of this review is to provide insights into the evolution of MIDH and highlight the current status of robotic DH,appreciating the existing challenges and its future role.

关键词： Liver transplantation Donor hepatectomy Minimal invasive surgery Robotic surgery Outcomes

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FedRec:Trusted rank-based recommender scheme for service provisioning in federated cloud environment

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Digital Communications and Networks 2023年第1期9卷 33-46页

作者： ashwin Verma Pronaya Bhattacharya Umesh Bodkhe Deepti Saraswat Sudeep Tanwar Kapal Dev Department of Computer Science and Engineering Institute of TechnologyNirma UniversityAhmedabadGujarat382481India Department of Institute of Intelligent Systems University of JohannesburgPO Box 524South Africa

The emergence of on-demand service provisioning by Federated Cloud Providers(FCPs)to Cloud Users(CU)has fuelled significant innovations in cloud provisioning *** to the massive traffic,massive CU resource requests are sent to FCPs,and appropriate service recommendations are sent by ***,the FourthGeneration(4G)-Long Term Evolution(LTE)network faces bottlenecks that affect end-user throughput and ***,the data is exchanged among heterogeneous stakeholders,and thus trust is a prime *** address these limitations,the paper proposes a Blockchain(BC)-leveraged rank-based recommender scheme,FedRec,to expedite secure and trusted Cloud Service Provisioning(CSP)to the CU through the FCP at the backdrop of base 5G communication *** scheme operates in three *** the first phase,a BCintegrated request-response broker model is formulated between the CU,Cloud Brokers(BR),and the FCP,where a CU service request is forwarded through the BR to different *** service requests,Anything-as-aService(XaaS)is supported by 5G-enhanced Mobile Broadband(eMBB)*** the next phase,a weighted matching recommender model is proposed at the FCP sites based on a novel Ranking-Based Recommender(RBR)model based on the CU *** the final phase,based on the matching recommendations between the CU and the FCP,Smart Contracts(SC)are executed,and resource provisioning data is stored in the Interplanetary File Systems(IPFS)that expedite the block *** proposed scheme FedRec is compared in terms of SC evaluation and formal *** simulation,FedRec achieves a reduction of 27.55%in chain storage and a transaction throughput of 43.5074 Mbps at 150 *** the IPFS,we have achieved a bandwidth improvement of 17.91%.In the RBR models,the maximum obtained hit ratio is 0.9314 at 200 million CU requests,showing an improvement of 1.2%in average servicing latency over non-RBR models and a maximization trade-off of QoE index of 2.76

关键词： Blockchain 5G-enhanced mobile broadband Federated clouds Rank-based recommender model Smart contracts

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“以需定供”:2024—2050年托育需求与供给规模预测——以上海市为例

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人口与发展 2024年第4期30卷 104-118页

作者：王雅楠高传胜刘竞龙 [印度]阿什温·库马尔·古拉詹南京中医药大学卫生经济管理学院江苏南京210023 南京大学政府管理学院江苏南京210023 加泰罗尼亚理工大学信号理论与通讯学院西班牙巴塞罗那08034 加泰罗尼亚理工大学超级计算机中心西班牙巴塞罗那08034

少子化形势客观上要求以需求为导向推动托育服务供给。基于Bootstrapping改进的ARIMA-LSTM模型测算2024—2050年上海市人口规模与出生率,进而考察在动态变化的入托率下幼儿园、托育机构的托育需求与供给规模。结果显示:托位缺口大,且供... 详细信息

少子化形势客观上要求以需求为导向推动托育服务供给。基于Bootstrapping改进的ARIMA-LSTM模型测算2024—2050年上海市人口规模与出生率,进而考察在动态变化的入托率下幼儿园、托育机构的托育需求与供给规模。结果显示:托位缺口大,且供需缺口经历了“起步-快速增长-稳定回落”过程。起步期(2024—2032年)幼儿园、托育机构的平均供需缺口分别为0.62万、3.58万个,应供给310个幼儿园托班与298所托育机构。快速增长期(2033—2042年)幼儿园、机构的供需缺口为2.42万、10.24万个。在第一阶段的基础上,还需供给900个托班与619所机构。稳定回落期(2043—2050年)幼儿园、机构的供需缺口回落至2.36万、10.94万个。若第二阶段已经补足缺口,则无需再增加供给。学前教育学位的持续释放为幼儿园下设托班提供了基础,但是其师资与财政经费的短缺,以及托育机构规模增长的压力是制约托育服务有效供给的关键。

关键词：人口预测托育需求托育服务供给托育机构学前教育

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