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Predicting short-term thromboembolic risk following Roux-en-Y gastric bypass using supervised machine learning

World Journal of Gastrointestinal Surgery 2024年第4期16卷 1097-1108页

作者： Hassam Ali Faisal Inayat Vishali Moond Ahtshamullah Chaudhry Arslan afzal Zauraiz Anjum Hamza Tahir muhammad Sajeel Anwar Dushyant Singh Dahiya muhammad sohaib afzal Gul Nawaz Amir H Sohail muhammad Aziz Department of Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Saint Peter's University Hospital and Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine UHS Wilson Medical CenterJohnsonNY 13790United States Division of Gastroenterology Hepatology and MotilityThe University of Kansas School of MedicineKansasKS 66160United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Roux-en-Y gastric bypass(RYGB)is a widely recognized bariatric procedure that is particularly beneficial for patients with class III *** aids in significant weight loss and improves obesity-related medical *** its effectiveness,postoperative care still has *** evidence shows that venous thromboembolism(VTE)is a leading cause of 30-d morbidity and mortality after ***,a clear unmet need exists for a tailored risk assessment tool for VTE in RYGB *** To develop and internally validate a scoring system determining the individualized risk of 30-d VTE in patients undergoing *** Using the 2016–2021 Metabolic and Bariatric Surgery Accreditation Quality Improvement Program,data from 6526 patients(body mass index≥40 kg/m^(2))who underwent RYGB were analyzed.A backward elimination multivariate analysis identified predictors of VTE characterized by pulmonary embolism and/or deep venous thrombosis within 30 d of *** resultant risk scores were derived from the coefficients of statistically significant *** performance of the model was evaluated using receiver operating curves through 5-fold *** Of the 26 initial variables,six predictors were *** included a history of chronic obstructive pulmonary disease with a regression coefficient(Coef)of 2.54(P7%(Coef 1.19,P<0.001),venous stasis history(Coef 1.43,P<0.001),and preoperative anticoagulation use(Coef 1.24,P<0.001).These variables were weighted according to their regression coefficients in an algorithm that was generated for the model predicting 30-d VTE risk *** risk model's area under the curve(AUC)was 0.79[95%confidence interval(CI):0.63-0.81],showing good discriminatory power,achieving a sensitivity of 0.60 and a specificity of *** training,the same model performed satisfactorily

关键词： Roux-en-Y gastric bypass Venous thromboembolism Machine learning Bariatric surgery Predictive modeling

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Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

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World Journal of Transplantation 2024年第2期14卷 62-75页

作者： Faisal Inayat Pratik Patel Hassam Ali Arslan afzal Hamza Tahir Ahtshamullah Chaudhry Rizwan Ishtiaq Attiq Ur Rehman Kishan Darji muhammad sohaib afzal Gul Nawaz Alexa Giammarino Sanjaya K Satapathy Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of Gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Division of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of Internal Medicine Saint Francis Hospital and Medical CenterHartfordCT 06105United States Division of Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine Campbell University and Cape Fear Valley Medical CenterFayettevilleNC 28301United States Department of Internal Medicine North Shore University Hospital and Zucker School of Medicine at Hofstra UniversityManhassetNY 11030United States Division of Hepatology North Shore University Hospital and Zucker School of Medicine at Hofstra UniversityManhassetNY 11030United States

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has posed a major public health concern *** with comorbid conditions are at risk of adverse outcomes following *** organ transplant recipients with concurrent immunosuppression and comorbidities are more susceptible to a severe COVID-19 *** could lead to higher rates of inpatient complications and mortality in this patient ***,studies on COVID-19 outcomes in liver transplant(LT)recipients have yielded inconsistent *** To evaluate the impact of the COVID-19 pandemic on hospital-related outcomes among LT recipients in the United *** We conducted a retrospective cohort study using the 2019–2020 National Inpatient Sample *** with primary LT hospitalizations and a secondary COVID-19 diagnosis were identified using the International Classi-fication of Diseases,Tenth Revision coding *** primary outcomes included trends in LT hospitalizations before and during the COVID-19 *** outcomes included comparative trends in inpatient mortality and transplant rejection in LT *** A total of 15720 hospitalized LT recipients were *** 0.8% of patients had a secondary diagnosis of COVID-19 *** both cohorts,the median admission age was 57 *** linear trends for LT hospitalizations did not differ significantly before and during the pandemic(P=0.84).The frequency of in-hospital mortality for LT recipients increased from 1.7% to 4.4% between January 2019 and December *** to the pre-pandemic period,a higher association was noted between LT recipients and in-hospital mortality during the pandemic,with an odds ratio(OR)of 1.69[95% confidence interval(CI):1.55-1.84),P<0.001].The frequency of transplant rejections among hospitalized LT recipients increased from 0.2%to 3.6% between January 2019 and December *** hospitalizations during the COVID-19 pandemic had a higher associ

关键词： Liver transplant recipients Solid organ transplantation COVID-19 Hospitalization Transplant rejection Mortality

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Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis:A propensity-matched analysis

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World Journal of Experimental Medicine 2024年第2期14卷 75-88页

作者： Hassam Ali Faisal Inayat Waqas Rasheed Arslan afzal Ahtshamullah Chaudhry Pratik Patel Attiq Ur Rehman muhammad Sajeel Anwar Gul Nawaz muhammad sohaib afzal Amir H Sohail Subanandhini Subramanium Dushyant Singh Dahiya Deepa Budh Babu P Mohan Douglas G Adler Department of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Texas Tech University Health Sciences CenterLubbockTX 79430United States Department of Internal Medicine St.Dominic’s HospitalJacksonMS 39216United States Department of Gastroenterology Mather Hospital and Hofstra University Zucker School of MedicinePort JeffersonNY 11777United States Department of Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine UHS Wilson Medical CenterJohnson CityNY 13790United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Division of Gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 64108United States Department of Internal Medicine St.Barnabas Hospital and Albert Einstein College of MedicineBronxNY 10457United States Department of Gastroenterology and Hepatology University of Utah School of MedicineSalt Lake CityUT 84132United States Center for Advanced Therapeutic Endoscopy Porter Adventist HospitalCentura HealthDenverCO 80210United States

BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare *** peripancreatic fluid collection(APFC)may negatively impact the clinical course of *** could worsen symptoms and potentially lead to additional ***,clinical evidence regarding the specific association between APFC and early readmission in AP remains *** the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare *** To evaluate the association between APFC and 30-day readmission in patients with *** This retrospective cohort study is based on the Nationwide Readmission Database for *** with a primary diagnosis of AP were *** were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was *** primary outcome was early readmission *** outcomes included the incidence of inpatient complications and healthcare *** analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission *** A total of 673059 patients with the principal diagnosis of AP were *** these,5.1%had APFC on initial *** propensity score matching,each cohort consisted of 33914 *** with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APF

关键词： Acute pancreatitis Acute peripancreatic fluid collections Readmission predictors Inpatient complications Healthcare utilization and costs

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Cold plasma-induced effects on electromagnetic wave scattering in waveguides:a mode-matching analysis

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Communications in Theoretical Physics 2024年第3期76卷 144-156页

作者： Shahana Rizvi muhammad afzal Department of Mathematics Capital University of Science and TechnologyIslamabadPakistan

This article presents advancements in an analytical mode-matching technique for studying electromagnetic wave propagation in a parallel-plate metallic rectangular *** technique involves projecting the solution onto basis functions and solving linear algebraic systems to determine scattering *** accuracy of this method is validated via numerical assessments,which involve the reconstruction of matching conditions and conservation *** study highlights the impact of geometric and material variations on reflection and transmission phenomena in the waveguide.

关键词： electromagnetic waves scattering cold plasma metallic conducting mode-matching technique

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AI-Driven Learning Management Systems:Modern Developments, Challenges and Future Trends during theAge of ChatGPT

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Computers, Materials & Continua 2024年第8期80卷 3289-3314页

作者： Sameer Qazi muhammad Bilal Kadri muhammad Naveed Bilal AKhawaja sohaib Zia Khan muhammad Mansoor Alam Mazliham Mohd Su’ud Department of Computer Science Faculty of EngineeringScience and TechnologyIQRA UniversityKarachi75500Pakistan College of Computer and Information Sciences Prince Sultan UniversityRiyadh11586Saudi Arabia Faculty of Engineering Department of Electrical EngineeringIslamic University of MadinahP.O.BOX 170Madinah41411Saudi Arabia Faculty of Engineering Department of Mechanical EngineeringIslamic University of MadinahP.O.BOX 170Madinah41411Saudi Arabia Faculty of Computing Riphah International UniversityIslamabad46000Pakistan Faculty of Computing and Informatics(FCI)Multimedia University Cyberjaya63100Malaysia Faculty of Engineering and Information Technology School of Computer ScienceUniversity of Technology SydneySydneyNSW 2007Australia

COVID-19 pandemic restrictions limited all social activities to curtail the spread of the *** foremost and most prime sector among those affected were schools,colleges,and *** education system of entire nations had shifted to online education during this *** shortcomings of Learning Management Systems(LMSs)were detected to support education in an online mode that spawned the research in Artificial Intelligence(AI)based tools that are being developed by the research community to improve the effectiveness of *** paper presents a detailed survey of the different enhancements to LMSs,which are led by key advances in the area of AI to enhance the real-time and non-real-time user *** AI-based enhancements proposed to the LMSs start from the Application layer and Presentation layer in the form of flipped classroom models for the efficient learning environment and appropriately designed UI/UX for efficient utilization of LMS utilities and resources,including AI-based *** layer enhancements are also required,such as AI-based online proctoring and user authentication using *** extend to the Transport layer to support real-time and rate adaptive encrypted video transmission for user security/privacy and satisfactory working of *** also needs the support of the Networking layer for IP-based geolocation features,the Virtual Private Network(VPN)feature,and the support of Software-Defined Networks(SDN)for optimum Quality of Service(QoS).Finally,in addition to these,non-real-time user experience is enhanced by other AI-based enhancements such as Plagiarism detection algorithms and Data Analytics.

关键词： Learning management systems chatbots ChatGPT online education Internet of Things(IoT) artificial intelligence(AI) convolutional neural networks natural language processing

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Association between alcohol-associated cirrhosis and inpatient complications among COVID-19 patients:A propensity-matched analysis from the United

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World Journal of Virology 2023年第4期12卷 221-232页

作者： Faisal Inayat Hassam Ali Pratik Patel Rubaid Dhillon Arslan afzal Attiq Ur Rehman muhammad sohaib afzal Laraib Zulfiqar Gul Nawaz muhammad Hassan Naeem Goraya Subanandhini Subramanium Saurabh Agrawal Sanjaya K Satapathy Department of Internal Medicine Allama Iqbal Medical CollegeLahore 54550PunjabPakistan Department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of Gastroenterology Cleveland Clinic FoundationClevelandOH 44195United States Department of Hepatology Mercy Medical CenterBaltimoreMD 21202United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Internal Medicine Quaid-e-Azam Medical CollegeBahawalpur 63100PunjabPakistan Department of Hepatology Tampa General Medical Group and University of South FloridaTampaFL 33606United States Department of Hepatology North Shore University Hospital and Zucker School of Medicine at Hofstra UniversityManhassetNY 11030United States

BACKGROUND Alcohol-associated cirrhosis(AC)contributes to significant liver-related mortality in the United *** is known to cause immune dysfunction and coagulation *** with comorbid conditions like AC are at risk of worse clinical outcomes from coronavirus disease 2019(COVID-19).The specific association between AC and COVID-19 mortality remains inconclusive,given the lack of robust clinical evi-dence from prior *** To study the predictors of mortality and the outcomes of AC in patients hospitalized with COVID-19 in the United *** We conducted a retrospective cohort study using the National Inpatient Sample(NIS)database *** were identified with primary COVID-19 hospitalizations based on an underlying diagnosis of AC.A matched comparison cohort of COVID-19 patients without AC was identified after 1:N propensity score matching based on baseline sociodemographic characteristics and Elixhauser *** outcomes included median length of stay,median inpatient charges,and in-hospital *** outcomes included a prevalence of systemic *** A total of 1325 COVID-19 patients with AC were matched to 1135 patients without *** was no difference in median length of stay and hospital charges in COVID-19 patients with AC compared to non-AC(P>0.05).There was an increased prevalence of septic shock(5.7%vs 4.1%),ventricular fibrillation/ventricular flutter(0.4%vs 0%),atrial fibrillation(13.2%vs 8.8%),atrial flutter(8.7%vs 4.4%),first-degree atrioventricular nodal block(0.8%vs 0%),upper extremity venous thromboembolism(1.5%vs 0%),and variceal bleeding(3.8%vs 0%)in the AC cohort compared to the non-AC cohort(P<0.05).There was no difference in inpatient mortality in COVID-19 patients with non-AC compared to AC,with an odds ratio of 0.97(95%confidence interval:0.78-1.22,P=0.85).Predictors of mortality included advanced age,cardiac arrhythmias,coagulopathy,protein-calorie malnutrition,flui

关键词： Alcoholic cirrhosis COVID-19 Chronic liver disease Mortality predictors Inpatient complications

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Unraveling the complex landscape of endocrine resistance in breast cancer: Emerging role of long noncoding RNA AGPG and beyond

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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 19页

作者： Khawar muhammad Babar Yu Shiyi afzal Ali Sun Haibo Institute of Translational Medicine Medical College Yangzhou University Yangzhou Jiangsu China Jiangsu Key Laboratory of Experimental & Translational Non-Coding RNA Research Yangzhou University Yangzhou Jiangsu China Applied Molecular Biology and Biomedicine Lab Department of Zoology University of Narowal Narowal Pakistan Molecular Medicine and Cancer Therapeutics Lab Department of Zoology Faculty of Sciences Technology University of Central Punjab Lahore Pakistan

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Long-term outcomes of titanium-nitride-oxide coated stents and drug-eluting stents in acute coronary syndrome:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第5期16卷 293-305页

作者： muhammad Ahmed Ali Fahim Afia Salman Hira Anas Khan Syed muhammad Hasan Muskan FatimaBhojani Sarah Aslam Amna Zia Ul Haq Vishal Reddy Bejugam Beena Muntaha Nasir Wajiha Gul Abdul Moeed Abdelrahman S Abdalla muhammad Majid muhammad sohaib Asghar Md Al Hasibuzzaman Department of Internal Medicine Dow University of Health SciencesKarachi 74200Pakistan Department of Internal Medicine North Central Bronx HospitalBronxNY 10467United States Department of Urology Center for Academic MedicineStanford University School of MedicinePalo AltoCA 33872United States Department of Cardiovascular Imaging Cleveland ClinicClevelandOH 44195United States Division of Nephrology and Hypertension Mayo Clinic RochesterRochesterMN 55905United States Institute of Nutrition and Food Science University of DhakaDhaka 1000Bangladesh

BACKGROUND In severe cases of coronary artery disease,percutaneous coronary intervention provide promising *** stent used could be a drug-eluting stent(DES)or a titanium-nitride-oxide coated stent(TiNOS).AIM To compare the 5-year effectiveness and safety of the two stent *** The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines,and PubMed/MEDLINE,Scopus,and Cochrane Central were searched from inception till August *** outcomes were major adverse cardiac events(MACE),cardiac death,myocardial infarction(MI),cardiac death or MI,and ischemia-driven total lesion revascularization(ID-TLR).RESULTS Four randomized controlled trials(RCT),which analyzed a sum total of 3045 patients with acute coronary syndrome(ACS)after a median follow-up time of 5 years were *** statistically insignificant,an increase in the ID-TLR was observed in patients receiving TiNOSs vs *** addition,MI,cardiac death and MI,and definite stent thrombosis(DST)were significantly decreased in the TiNOS *** analysis revealed no significant results with meta-regression presenting non-ST elevated MI(NSTEMI)as a statistically significant covariate in the outcome of *** TiNOS was found to be superior to DES in terms of MI,cardiac death or MI,and DST outcomes,however,the effect of the two stent types on ID-TLR and MACE was not significant.A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.

关键词： Stents Drug-eluting Major adverse cardiac events All-cause death Meta-analysis

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The Influence of Depression on Different Age and Gender Groups in Bahawalpur

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Journal of Clinical and Nursing Research 2024年第7期8卷 196-207页

作者： Mehran Khan muhammad Shahbaz Tooba Waris Shoaib Yaseen Iqra afzal Emaan Khadim Sawera Usman muhammad Ismail Shah Sulaiman Aslam Zafar Iqbal Bahawalpur College of Pharmacy BMDC Complex63100PunjabPakistan

In Bahawalpur,a cross-sectional study assessed depression prevalence across age and gender groups,involving 442 participants from diverse socioeconomic backgrounds and *** the PHQ9 questionnaire,84%were found to meet depression *** findings revealed a higher incidence in females(88%)than males(79%),with the greatest disparity among young adults,particularly young women,due to factors like academic pressure and financial *** children had the lowest depression rates(68%),possibly due to better *** individuals exhibited more severe depression,likely related to aging and domestic *** study’s findings highlight a significant variation in depression severity across different demographic groups,with an overall higher incidence in *** research underscores the necessity for targeted mental health resources and interventions tailored to the specific needs of each demographic *** also points to the importance of addressing academic and socioeconomic stressors to mitigate depression,particularly among young *** the study provides valuable insights,it relies on self-reported data,which may introduce ***,future research should include clinical assessments to validate these findings and ensure a more accurate representation of depression within the community.

关键词： Influence Depression Different age Gender groups Bahawalpur

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Early versus delayed necrosectomy in pancreatic necrosis:A population-based cohort study on readmission,healthcare utilization,and in-hospital mortality

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World Journal of Methodology 2024年第3期14卷 55-67页

作者： Hassam Ali Faisal Inayat Vinay Jahagirdar Fouad Jaber Arslan afzal Pratik Patel Hamza Tahir muhammad Sajeel Anwar Attiq Ur Rehman muhammad Sarfraz Ahtshamullah Chaudhry Gul Nawaz Dushyant Singh Dahiya Amir H Sohail muhammad Aziz Division of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Division of Gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine UHS Wilson Medical CenterJohnson CityNY 13790United States Division of Gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Division of Gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Division of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Acute necrotizing pancreatitis is a severe and life-threatening *** poses a considerable challenge for clinicians due to its complex nature and the high risk of *** minimally invasive and open necrosectomy procedures have been *** advancements in treatment modalities,the optimal timing to perform necrosectomy lacks *** To evaluate the impact of necrosectomy timing on patients with pancreatic necrosis in the United *** A national retrospective cohort study was conducted using the 2016-2019 Nationwide Readmissions *** with non-elective admissions for pancreatic necrosis were *** participants were divided into two groups based on the necrosectomy timing:The early group received intervention within 48 hours,whereas the delayed group underwent the procedure after 48 *** various intervention techniques included endoscopic,percutaneous,or surgical *** major outcomes of interest were 30-day readmission rates,healthcare utilization,and inpatient *** A total of 1309 patients with pancreatic necrosis were *** propensity score matching,349 cases treated with early necrosectomy were matched to 375 controls who received delayed *** early cohort had a 30-day readmission rate of 8.6% compared to 4.8%in the delayed cohort(P=0.040).Early necrosectomy had lower rates of mechanical ventilation(2.9%vs 10.9%,P<0.001),septic shock(8%vs 19.5%,P<0.001),and in-hospital mortality(1.1%vs 4.3%,P=0.01).Patients in the early intervention group incurred lower healthcare costs,with median total charges of $52202 compared to$147418 in the delayed *** in the early cohort also had a relatively shorter median length of stay(6 vs 16 days,P<0.001).The timing of necrosectomy did not significantly influence the risk of 30-day readmission,with a hazard ratio of 0.56(95%confidence interval:0.31-1.02,P=0.06).CONCLUSION Our findings show that

关键词： Acute necrotizing pancreatitis Pancreatic necrosis Early necrosectomy Delayed necrosectomy Readmission,Healthcare costs Mortality

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