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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(Pgnificantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

Classification of glaucoma in Retinal Images Using EfficientnetB4 Deep Learning Model

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Computer Systems Science & Engineering 2022年第12期43卷 1041-1055页

作者： A.geetha N.B.prakash National Engineering College Kovilpatti628502India

Today, many eye diseases jeopardize our everyday lives, such as Diabetic Retinopathy (DR), Age-related Macular Degeneration (AMD), and *** is an incurable and unavoidable eye disease that damages the vision ofoptic nerves and quality of life. Classification of glaucoma has been an active fieldof research for the past ten years. Several approaches for glaucoma classification areestablished, beginning with conventional segmentation methods and feature-extraction to deep-learning techniques such as Convolution Neural Networks (CNN). Incontrast, CNN classifies the input images directly using tuned parameters of convolution and pooling layers by extracting features. But, the volume of training datasetsdetermines the performance of the CNN;the model trained with small datasets,overfit issues arise. CNN has therefore developed with transfer learning. The primary aim of this study is to explore the potential of EfficientNet with transfer learning for the classification of glaucoma. The performance of the current workcompares with other models, namely Vgg16, InceptionV3, and Xception usingpublic datasets such as RIM-ONEV2 & V3, ORIgA, DRISHTI-gS1, HRF, andACRIMA. The dataset has split into training, validation, and testing with the ratioof 70:15:15. The assessment of the test dataset shows that the pre-trained EfficientNetB4 has achieved the highest performance value compared to other models listedabove. The proposed method achieved 99.38% accuracy and also better results forother metrics, such as sensitivity, specificity, precision, F1_score, Kappa score, andArea Under Curve (AUC) compared to other models.

关键词： Convolution neural network deep learning fundus image glaucoma image classification

Transitional metal ions induced damage to biomolecules:role of ferryl and perferryl radicals

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Asian Pacific Journal of Tropical Medicine 2010年第1期3卷 32-35页

作者： Mungli prakash Sharmila Upadhya Department of Biochemistry Kasturba Medical College

Objective:To investigate the effect of oxidized transitional metal（ferric and cupric） ions on the amino ***:25 mmol/L hydroxyproline and 25 mmol/L histidine were incubated with 50μL Fe3+ and Cu2+ ions at pH 7.4 and 37℃for 30 mins in separate test *** 500μL of 1% thiobarbituricacid（TBA） was added to the incubated amino acids followed by addition of 500μL of glacial acetic *** resultant mixture was vortexed and heated at 100℃for 30 *** readings were noted after cooling to room *** experiment was repeated in the presence of various reagents,like hydroxyl radical scavengers,antioxidant enzymes,and reducing agents and metal ion ***:The pink chromogen formed with the absorbance maxima at 524 nm,AND shifted to 560 nm in alkaline *** absorbance was expressed as TBAadduct in MDA *** TBA-adduct decreased in the presence of reducing agents and metal ion *** enzymes and hydroxyl radical scavengers did not show any effect. Conclusion:Transitional metal ions in their oxidized state showed significant damage to amino acids,hydroxyproline and *** results indicate the possible role played by high-valent oxo-iron species,ferryl and perferry radicals in damaging biomolecules.

关键词： Transitional metals Oxidative damage Ferryl/perferryl radicals Malondialdehyde Biomolecules Thiobarbituric acid reactive substances

Lethal effect of Streptomyces citreofluorescens against larvae of malaria,filaria and dengue vectors

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Asian Pacific Journal of Tropical Medicine 2012年第8期5卷 594-597页

作者： gavendra Singh Soam prakash Environmental and Advanced Parasitology and Vector Control Biotechnology Laboratories Department of ZoologyDayalbagh Educational InstituteDayalbaghAgra-282 005India

Objective:To investigate lethal effect of culture filtrates of Streptomyces citreofluorescens （***） against Anopheles stephensi（***）,Culex quinquefasciatus（Cx. quinquefasciatus）,and Aedes aegypti（***） larvae vectors for malaria,filarial and dengue. Methods:The culture filtrates obtained from *** 2528 was grown in Potato Dextrose Broth（PDB）,filtrated and used for the bioassay after a growth of 15 ***:The results demonstrated that the *** shows mortalities with LC50,Lg40 values of first instar 46.8μL/mL,79.5μL/mL,second instar 79.0μL/mL,95.6μL/mL,third instar 79.0μL/mL,136.9μL/mL,and fourth instar 122.6μL/mL,174.5μL/mL Whereas,The *** were found effective on first instar 40.0μL/mL,138.03μL/mL,second instar 80.0μL/ml,181.97μL/ mL,third instar 100.0μL/mL,309.2μL/mL,and fourth instar 60.0μL/ml,169.82μL/*** *** were successfully achieved susceptible with higher concentrations in comparisons of *** and *** *** outcomes of the investigations have compared with the Chitinase of Streptomyces griseus（***） C6137 that shows 90%-95% ***:These new findings significantly permitted that the culture filtrates of S. citreofluorescens can be used as bacterial *** is an environmentally safe approach to control the vectors of malaria,dengue and filariasis of tropical areas.

关键词： Anopheles stephensi Culex quinquefasciatus Aedes aegypti Soil bacteria Mosquito larvicides

Assessing anthropogenic pressure and threats on Paeonia emodi *** Royle habitats in garhwal Himalaya

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Journal of Mountain Science 2023年第3期20卷 810-820页

作者： Praveen JOSHI Prem prakash Vijay Kant PUROHIT Department of Botany Govt.M.B.P.G.CollegeHaldwani 263641Indial High Altitude Plant Physiology Research Centre H.N.B.Garhwal Central UniversitySrinagar Garhwal 263671India

The garhwal Himalaya is among the major repositories of immensely valuable wild edible plants and provides food security to the local *** the valuable plant species that grow in this region,Paeonia emodi(family Paeoniaceae)is an important wild edible species that found in temperate regions with an altitude range between 1800 and 2800 *** species is facing a severe threat to its sustainability due to overharvesting,habitat disturbances,and a lack of effort regarding *** the first time,this study investigated anthropogenic pressure,population decline perceptions in the natural habitat,and vulnerability assessment of *** under selected study sites(n=23 villages).A semi structured questionnaire was used to interview approximately 45%of the local inhabitants,including herbal practitioners(Vaidhyas or Dais)of each *** the basis of demographic characteristics,the perceptions and responses of 464 local people were documented regarding potential causes of deterioration and feasible options for sustainable *** the weight survey method,we estimated the actual amount of collection based on personal interaction and direct *** order to determine the threats status,a rapid vulnerability assessment(RVA)was performed and were used based on the current exploitation and *** present study revealed that leaf(100%)was the most frequently harvested part,followed by stem(95.65%),seed(26.09%),root(21.74%)and flower(13.04%).The village Triyuginarayan and Pothivasa recorded the highest collection scores while the purpose of the collection was mostly edible(100%),medicinal(100%),and least commercial(8.70%).According to the literature review and the present survey,the RVA(total=21)is categorized as category II(intermediate side of the RVA index),indicating a degree of *** study revealed that *** faces extinction in the garhwal *** this species through agro-production techniques may alleviate th

关键词： Anthropogenic pressure Conservational strategies garhwal Himalaya Paeonia emodi Rapid vulnerability assessment Wild edibles

Benevolent behavior of Kleinia grandiflora leaf extract as a green corrosion inhibitor for mild steel in sulfuric acid solution

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International Journal of Minerals,Metallurgy and Materials 2014年第11期21卷 1083-1095页

作者： Muthukrishnan Pitchaipillai Karthik Raj Jeyaprabha Balasubramanian prakash Periakaruppan Department of Chemistry Faculty of Engineering Karpagam UniversityCoimbatore-641021 Tamil Nadu India Department of Chemistry Thiagarajar CollegeMadurai-625009 Tamil Nadu India Department of Civil Engineering Fatima Michael College of Engineering & TechnologyMadurai-625020 Tamil Nadu India

The ethanolic extract of Kleinia grandiflora leaves was characterized and tested for its potential anticorrosion properties on mild steel in 1 M H2SO4 medium using mass-loss analysis, potentiodynamic polarization measurements, electrochemical impedance spectroscopy, Fourier-transform infrared spectroscopy, scanning electron microscopy, UV–visible spectroscopy, and X-ray diffraction analysis. The effect of temperature on the corrosion behavior of mild steel was studied in the range of 308 to 328 K. The inhibition efficiency was observed to increase with increasing concentration of the extract. Polarization curves revealed that the Kleinia grandiflora leaf extract is a mixed inhibitor. Impedance diagrams revealed that an increase of Kleinia grandiflora leaf extract concentration increased the charge transfer resistance and decreased the double-layer capacitance. The adsorption process obeys Langmuir＇s model, with a standard free energy of adsorption（Δgads） of-18.62 k J/mol. The obtained results indicate that the Kleinia grandiflora leaf extract can serve as an effective inhibitor for the corrosion of mild steel in a sulfuric acid medium.

关键词： steel corrosion mild steel sulfuric acid corrosion inhibitors

Influence of lubrication,tool steel composition,and topography on the high temperature tribological behaviour of aluminium

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Friction 2021年第1期9卷 155-168页

作者： Justine DECROZANT-TRIQUENAUX Leonardo PELCASTRE Braham prakash Jens HARDELL Machine Elements Lulea University of TechnologyLulea SE-97187Sweden Department of Mechanical Engineering Tsinghua UniversityBeijing 100084China

The use of high strength aluminium alloys,such as 6 XXX and 7 XXX series,is continuously increasing for automotive applications in view of their good strength-to-weight *** formability at room temperature is limited and they are thus often formed at high temperatures to enable production of complex *** challenges during hot forming of aluminium are the occurrence of severe adhesion and material transfer onto the forming *** negatively affects the tool life and the quality of the produced *** general,the main mechanisms involved in the occurrence of material transfer of aluminium alloys at high temperature are still not clearly ***,this study is focussed on understanding of the friction and wear behaviour during interaction of Al6016 alloy and three different tool steels in as-received and polished *** tribotests were carried out under dry and lubricated conditions,with two distinct lubricants,using a reciprocating friction and wear *** worn surfaces were analysed using scanning electron microscopy(SEM)and energy dispersive X-ray spectroscopy(EDS).The results showed a high dependence of friction and wear behaviour on the tool steel roughness as well as on the stability of the lubricant *** were found to develop in the contact zone and their capacity to improve the tribological behaviour is seen to be drastically impacted by the surface roughness of the tool *** the tribolayers failed,severe adhesion took place and led to high and unstable friction as well as material transfer to the tool steel.

关键词： friction wear high temperature tribology aluminium lubrication tribolayer

Tribological characteristics of friction stir processed graphite and tin/LM24 surface composites

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Friction 2021年第3期9卷 569-582页

作者： Vipin SHARMA Ujjwal prakash B.Venkata MANOJ KUMAR Department of Metallurgical and Materials Engineering Indian Institute of Technology RoorkeeRoorkee 247667India

Friction stir processing(FSP)is an emerging solid-state technique for preparing surface composites using various *** and metallic particles are easily reinforced in a matrix by this *** composites made from an LM24 alloy reinforced with graphite and tin,with good wettability and material flow owing to the low melting point of tin,were fabricated by FSP at two rotational speeds of 1,400 and 1,000 *** its low hardness,the graphite/LM24 surface composite fabricated at a higher rotational speed of 1,400 rpm exhibited better wear ***,its frictional behavior was not significantly affected by the *** fabricated surface composites with graphite and tin reinforcement as well as graphite-only reinforcement exhibited contradicting behaviors under sliding wear *** post wear analysis indicated that abrasion,adhesion,layer formation,and delamination occurred on the composite surfaces.

关键词： composites friction stir processing graphite tin Al-Si alloy wear

The biochemical pathways of central nervous system neural degeneration in niacin deficiency

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Neural Regeneration Research 2014年第16期9卷 1509-1513页

作者： Linshan Fu Venkatesh Doreswamy Ravi prakash Department of Neurosurgery the First People’s Hospital of Yancheng Department of Physiology M.S.Ramaiah Medical College

Neural degeneration is a very complicated process. In spite of all the advancements in the molecular chemistry, there are many unknown aspects of the phenomena of neurodegeneration which need to be put together. It is a common sequela of the conditions of niacin deficiency. Neural degeneration in Pellagra manifests as chromatolysis mainly in pyramidal followed by other neurons and glial cells. However, there is a gross lack of understanding of biochemi- cal mechanisms of neurodegeneration in niacin deficiency states. Because of the necessity of niacin or its amide derivative NAD in a number of biochemical pathways, it is understandable that several of these pathways may be involved in the common outcome of neural degener- ation. Here, we highlight five pathways that could be involved in the neuraldegeneration for which evidence has accumulated through several studies. These pathways are： 1） the trypto- phan-kyneurenic acid pathway, 2） the mitochondrial ATP generation related pathways, 3） the poly （ADP-ibose） polymerase （PARP） pathway, 4） the BDNF-TRKB Axis abnormalities, 5） the genetic influences of niacin deficiency.

关键词： Niacin deficiency neural degeneration chromatolysis biochemical pathways ofdegeneration kyneurenic acid BDNF- TRKB pathway