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Biliary strictures complicating living donor liver transplantation:problems,novel insights and solutions

World Journal of Gastroenterology 2018年第19期24卷 2061-2072页

作者： Harshavardhan B Rao Arjun prakash Surendran Sudhindran rama p venu Department of Gastroenterology Amrita Institute of Medical SciencesAmrita UniversityKochi 682041India Department of Transplant and Vascular Surgery Amrita Institute of Medical SciencesAmrita UniversityKochi 682041India

Biliary stricture complicating living donor liver transplantation(LDLT) is a relatively common complication, occurring in most transplant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transplantation. Endoscopic management is the mainstay for biliary strictures complicating LDLT and includes endoscopic retrograde cholangiography, sphincterotomy and stent placement(with or without balloon dilatation). The efficacy and safety profiles as well as outcomes of endoscopic management of biliary strictures complicating LDLT is an area that needs to be viewed in isolation, owing to its unique set of problems and attending complications; as such, it merits a tailored approach, which is yet to be well established. The diagnostic criteria applied to these strictures are not uniform and are over-reliant on imaging studies showing an anastomotic narrowing. It has to be kept in mind that in the setting of LDLT, a subjective anastomotic narrowing is present in most cases due to a mismatch in ductal diameters. However, whether this narrowing results in a functionally significant narrowing is a question that needs further study. In addition, wide variation in the endotherapy protocols practised in most centres makes it difficult to interpret the results and hampers our understanding of this topic. The outcome definition for endotherapy is also heterogenous and needs to be standardised to allow for comparison of data in this regard and establish a clinical practice guideline. There have been multiple studies in this area in the last 2 years, with novel findings that have provided solutions to some of these issues. This review endeavours to incorporate these new findings into the wider understanding of endotherapy for biliary strictures complicating LDLT, with specific emphasis on diagnosis of strictures in the LDLT setting, endotherapy protocols and outcome definitions. An attempt is made to present the best management optio

关键词： Biliary strictures Endoscopic management Stenting Self-expanding metal stents Living donor liver transplantation

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Artificial intelligence in endoscopy: More than what meets the eye in screening colonoscopy and endosonographic evaluation of pancreatic lesions

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Artificial Intelligence in Gastrointestinal Endoscopy 2022年第3期3卷 16-30页

作者： Harshavardhan Rao B Judy A Trieu priya Nair Gilad Gressel Mukund venu rama p venu Department of Gastroenterology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Internal Medicine-Gastroenterology Loyola University Medical CenterMaywoodIL 60153United States Center for Cyber Security Systems and Networks Amrita VishwavidyapeethamKollam 690546KeralaIndia

Artificial intelligence(AI)-based tools have ushered in a new era of innovation in the field of gastrointestinal(GI)*** vast improvements in endoscopic techniques and equipment,diagnostic endoscopy remains heavily operator-dependent,in particular,colonoscopy and endoscopic ultrasound(EUS).Recent reports have shown that as much as 25%of colonic adenomas may be missed at *** can result in an increased incidence of interval colon ***,EUS has been shown to have high inter-observer variability,overlap in diagnoses with a relatively low specificity for pancreatic *** understanding of Machine-learning(ML)techniques in AI have evolved over the last decade and its application in AI–based tools for endoscopic detection and diagnosis is being actively investigated at several *** is an aspect of AI that is based on neural networks,and is widely used for image classification,object detection,and semantic segmentation which are key functional aspects of AI-related computer aided diagnostic *** this review,current status and limitations of ML,specifically for adenoma detection and endosonographic diagnosis of pancreatic lesions,will be summarized from existing *** will help to better understand its role as viewed through the prism of real world application in the field of GI endoscopy.

关键词： Artificial intelligence Artificial Machine Colonoscopy polyp Endosonography pancreas

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Endoscopic therapy for biliary strictures complicating living donor liver transplantation: Factors predicting better outcome

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World Journal of Gastrointestinal pathophysiology 2017年第2期8卷 77-86页

作者： Harshavardhan B Rao Hasim Ahamed Suprabha panicker Surendran Sudhindran rama p venu Department of Gastroenterology Amrita Institute of Medical Sciences Department of Gastrointestinal Surgery Amrita Institute of Medical Sciences

AIM To identify factors predicting outcome of endoscopic therapy in bile duct strictures(BDS) post living donor liver transplantation(LDLT).METHODS patients referred with BDS post LDLT, were retrospectively studied. patient demographics, symptoms(pruritus, Jaundice, cholangitis), intra-op variables(cold ischemia time, blood transfusions, number of ducts used, etc.), peri-op complications [hepatic artery thrombosis(HAT), bile leak, infections], stricture morphology(length, donor and recipient duct diameters) and relevant laboratory data both pre-and post-endotherapy were studied. Favourable response to endotherapy was defined as symptomatic relief with > 80% reduction in total bilirubin/serum gamma glutamyl transferase. Statistical analysis was performed using SpSS *** Forty-one patients were included(age: 8-63 years). All had right lobe LDLT with duct-to-duct anastomosis. Twenty patients(48.7%) had favourable response to endotherapy. patients with single duct anastomosis, aggressive stent therapy(multiple endoscopic retrogradecholagiography, upsizing of stents, dilatation and longer duration of stents) and an initial favourable response to endotherapy were independent predictors of good outcome(p ple ductal anastomosis and persistent bile leak(> 4 wk post LT) were found to be significant predictors of poor response on multivariate analysis(p pic therapy with aggressive stent therapy especially in patients with single duct-to-duct anastomosis was associated with a better outcome. Multiple ductal anastomosis, older donor age, shorter duration of stent therapy, early bile leak and HAT were predictors of poor outcome with endotherapy in these patients.

关键词： Biliary strictures Living donor liver transplantation Endotherapy Bile leaks

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Role of endoscopic ultrasound guided fine needle aspiration/biopsy in the evaluation of intra-abdominal lymphadenopathy due to tuberculosis

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World Journal of Gastrointestinal Endoscopy 2021年第12期13卷 649-658页

作者： Harshavardhan Rao B priya Nair S Krishna priya Archana George Vallonthaiel Dipu T Sathyapalan Anoop K Koshy rama p venu Department of Gastroenterology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Department of pathology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Department of Internal Medicine Amrita Institute of Medical Sciences and Research CentreKochi 682041KeralaIndia

BACKGROUND Intra-abdominal lymphadenopathy due to tuberculosis(TB)poses a diagnostic challenge due to difficulty in tissue *** endoscopic ultrasound guided fine needle aspiration/biopsy(EUS-FNA/B)has shown promise in the evaluation of mediastinal lymph nodes,its role in the evaluation of intra-abdominal lymphadenopathy is not *** To assess the role of EUS-FNA/B in the evaluation of intra-abdominal lymphadenopathy due to *** This was a retrospective study where patients with intra-abdominal lymphadenopathy who underwent evaluation with EUS-FNA/B were *** was diagnosed if the patient had any one of the following:(1)positive acid fast bacilli(AFB)stain/TB GeneXpert/TB-polymerase chain reaction/AFB culture of tissue sample;and(2)positive Mantoux test and response to anti-tubercular ***-FNA reports,clinical reports and imaging characteristics of patients were recorded for a detailed analysis of patients with *** A total of 149 patients underwent an EUS-FNA/B from lymph nodes(mean age 51±17 years,M:F=1.2).Benign inflammatory reactive changes were seen in 45 patients(30.2%),while 54 patients(36.2%)showed granulomatous inflammation with/without *** these,51 patients(94.4%)were confirmed to have TB as per pre-defined *** with TB were more likely to have hypoechoic and matted nodes[40 patients(67.7%)].EUS-FNA/B was found to have a sensitivity and specificity of 86%and 93%respectively,with a diagnostic accuracy of 88%in the evaluation of intra-abdominal lymphadenopathy due to *** EUS-FNA/B has a high diagnostic yield with a good sensitivity and specificity in the evaluation of intra-abdominal lymphadenopathy due to ***,the validity of these findings in populations with low prevalence of TB needs further evaluation.

关键词： Endoscopic ultrasound Lymph nodes Tuberculosis Mesenteric Intraabdominal

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Velocity Form Calculations of Generalized Oscillator Strengths for 3s→ (3p, 4p, 5p, 6p) Dipole Transitions of Atomic Sodium in Debye plasma

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Open Journal of Applied Sciences 2024年第6期14卷 1512-1529页

作者： Louis Gomis Clement Diatta Moustapha Sadibou Tall Ibrahima Gueye Faye rama Gomis Yande Diouf Mamadou Coulibaly Laboratoire de physique des plasmas et de Recherches Interdisciplinaires Departement de Physique Universite Cheikh Anta Diop Dakar Senegal

In this paper, the generalized oscillator strengths (GOSs) of excitations of atomic sodium from ground state to 2p63s0 (3p, 4p, 5p, 6p) states, immersed in Debye plasma, were calculated by using wavefunctions which were obtained numerically from the restricted Hartree-Fock (RHF) equation. This RHF equation employs the local density approach for exchange interactions including plasma Debye screening. Theoretical RHF and random phase approximation with exchange (RpAE) velocity calculations have shown that the GOSs for excitations to 3 s0(3 p,4 p,5 p,6 p)depend on the plasma Debye screening effects, as shown by the reduction in the GOS amplitude with decreasing Debye length λD. The agreement between the present RpAE V results for the transitions 3 s→3 s0(3 p,4 p,5 p)and the length calculations of Martínez-Flores was satisfactory. Correlation effects were found quite to be significant in the vicinity of the maxima of the GOS of the 3 s→3 s0(4 p,5 p,6 p)excitations by using the RpAE V approach. We note the poor influence of many electron correlations on the GOS of (3 s→3 p)transition with the same principal quantum number. Finally, we comment that the RpAE V calculations are useful in investigating electron correlation effects on the transition GOS of atomic sodium planted in Debye plasma. The present velocity results also reveal that the 3 s→3 s0(5p, 6p)transition GOSs tend to be delocalized due to more significant screening effects at Debye lengths λD=20and 30 a.u. for excited subshells 5p and 6p, respectively. We report here novel results of GOS for 3 s→3 s06ptransition obtained from different Debye lengths.

关键词： plasma Screening Effect Correlation Effect Sodium Atomic Velocity Form GOS Restricted Hatree-Fock Random phase Approximation with Exchange

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Tumor microenvironment pathways:Cross regulation in breast cancer metastasis

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Genes & Diseases 2022年第2期9卷 310-324页

作者： rama Rao Malla p.Kiran Cancer Biology Lab Department of Biochemistry and BioinformaticsInstitute of ScienceGITAM(Deemed to be University)Visakhapatnam 530045India

The tumor microenvironment(TME)is heterogeneous and contains a multiple cell population with surrounded immune cells,which plays a major role in regulating *** multifunctional pathways,Hedgehog(Hh),Wnt,Notch,and NF-kB,cross-regulates metas-tasis in breast *** review presents substantial evidence for cross-regulation of TME components and signaling pathways,which makes breast TME more heterogeneous and com-plex,promoting breast cancer progression and metastasis as a highly aggressive *** discoursed the importance of stromal and immune cells as well as their crosstalk in bridging the *** also discussed the role of Hh and Notch pathways in the intervention be-tween breast cancer cells and macrophages to support TME;Notch signaling in the bidirec-tional communication between cancer cells and components of TME;Wnt signal pathway in controlling the factors responsible for EMT and NF-kB pathway in the regulation of genes con-trolling the inflammatory *** also present the role of exosomes and their miRNAs in the cross-regulation of TME cells as well as pathways in the reprogramming of breast TME to support ***,we examined and discussed the targeted small molecule inhibitors and natural compounds targeting developmental pathways and proposed small molecule nat-ural compounds as potential therapeutics of TME based on the multitargeting *** conclu-sion,the understanding of the molecular basis of the cross-regulation of TME pathways and their inhibitors helps identify molecular targets for rational drug discovery to treat breast can-cers.

关键词： Breast cancer Cross-regulation Hedgehog NF-kB Notch Tumor microenvironment Wnt

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Low velocity impact studies of E-glass/epoxy composite laminates at different thicknesses and temperatures

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Defence Technology（防务技术） 2019年第6期15卷 897-904页

作者： T.Sreekantha Reddy p.rama Subba Reddy Vemuri Madhu Defence Metallurgical Research Laboratory

Low velocity impact experiments were carried out on E-glass/epoxy composite laminates having varying thicknesses at sub zero and elevated temperatures using hemi spherical steel impactor of 16 mm diameter with impact energies in the rage of 50-150 *** performance of the laminates was assessed in terms of energy absorption,maximum displacement,peak force and failure *** indicated that the effect of temperature on energy absorption of the laminate is negligible although the laminates are embrittling at sub zero *** it has influence on failure behaviour and *** force has increased linearly with increase in laminate thickness from 5 to 10 *** it got reduced by 25% when temperature was increased from-20℃ to 100℃,Based on experimental results,laminate perforation energies were predicted using curve fitting *** analysis was carried out using Taguchi method to identify the global effects of various parameters on laminate performance and confirmed that the laminate thickness has significant influence as compared to temperature,for the studied range.

关键词： Laminates Glass fibres Impact behaviour Delamination

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Structural Tuning of Low Band Gap Intermolecular push/pull Side-chain polymers for Organic photovoltaic Applications

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Chinese Journal of polymer Science 2017年第9期35卷 1073-1085页

作者： Ansuman Nayak p.S. rama Sreekanth Santosh Kumar Sahu Duryodhan Sahu Department of Chemistry National Institute of Science and Technology Palur Hills Berhampur Odisha India 761008 Department of Chemistry Gandhi Institute of Engineering and Technology Gunpur Odisha India Department of Mechanical Engineering National Institute of Science and Technology Palur Hills Berhampur Odisha India 761008

A series of novel low band gap donor-acceptor （D-A） type organic co-polymers （BT-F-TpA, BT-CZ-TpA and BT-SI-TpA） consisting of electron-deficient acceptor blocks both in main chains （M1） and at the pendant （M2） were polymerized with different electron rich donor （M3-M5） blocks, i.e., 9,9-dihexyl-9H-fluorene, N-alkyl-2,7-carbazole, and 2,6-dithinosilole, respectively, via Suzuki method. These polymers exhibited relatively low band gaps （1.65-1.88 eV） and broad absorption ranges （680-740 nm）. Bulk heterojunction （BHJ） solar cells incorporating these polymers as electron donors, blended with [6,6]-phenyl-C61-butyric acid methyl ester （pC61BM） or [6,6]-phenyl-Cvl-butyric acid methyl ester （pC71BM） as electron-acceptors in different weight ratios were fabricated and tested under 100 mW/cm2 of AM 1.5 with white-light illumination. The photovoltaic device containing donor BT-SI-TpA and acceptor pC71BM in 1：2 weight ratio showed the best power conversion efficiency （pCE） value of 1.88%, with open circuit voltage （Voc） = 0.75 V, short circuit current density （Jsc） = 7.60 mA/cm2, and fill factor （FF） = 33.0%.

关键词： polymer solar cells Low band gap Conducting polymers Charge transfer Donor-acceptor Bulk heterojunctionsolar cell

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Emissions analysis on second generation biodiesel

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Frontiers of Environmental Science & Engineering 2017年第1期11卷 53-58页

作者： Yuvarajan Devarajan Ravi kumar Jayabal Devanathan Ragupathy Harish venu Department of Mechanical Engineering Vel Tech Dr. RR & Dr. SR Technical University Chennai 600062 India Department of Mechanical Engineering Jeppiaar Institute of Technology Chennai 631604 India Department of Mechanical Engineering Anna University Chennai 600025 India

This work investigates the effect of adding pentanol with biodiesel derived from cashew nut shell on its emissions characteristics is conducted in stationery diesel engine. The main purpose of this work is intended to reduce the emissions by fuelling biodiesel derived from cashew nut shell and the pentanol blends. Cashew nut shell biodiesel is prepared by transesterification process. Oxygenated additive used in the work is pentanol. The experiment is con-ducted using four test fuels such-as, biodiesel derived from cashew nut shell （CNSBD）, a fuel containing 90% cashew nut shell biodiesel and 10% pentanol （CNSBD90p 10）, a fuel containing 80% cashew nut shell biodiesel and 20% pentanol （CNSBDSOp20） and neat diesel. Experimental work concluded that by adding 10% of pentanol to cashew nut shell biodiesel 10.1%, 2.6%, 5.1% and 2.1%reduction in CO, HC, NOx and Smoke emissions were observed respectively. Further by fueling with these blends, no modifications in engines were required.

关键词： pentanol Biodiesel Emissions

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A Collaborative Approach for Secured Routing in Mobile Ad-Hoc Network

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Intelligent Automation & Soft Computing 2023年第2期35卷 1337-1351页

作者： W.Gracy Theresa A.Gayathri p.rama Department of Computer Science and Engineering Panimalar Institute of TechnologyChennai600123Tamil NaduIndia Department of Information Technology Vellore Institute of TechnologyVellore632014Tamil NaduIndia Department of Computer Science and Engineering Loyola Institute of TechnologyChennai600123Tamil NaduIndia

Mobile computing is the most powerful application for network com-munication and connectivity,given recent breakthroughs in theﬁeld of wireless networks or Mobile Ad-hoc networks(MANETs).There are several obstacles that effective networks confront and the networks must be able to transport data from one system to another with adequate *** most applications,a frame-work must ensure that the retrieved data reﬂects the transmitted *** driv-ing to other nodes,if the frame between the two nodes is deformed in the data-link layer,it must be *** link-layer protocols immediately disregard the frame and enable the high-layer protocols to transmit it *** other words,because of asset information must be secured from threats,information is a valu-able *** MANETs,some applications necessitate the use of a network method for detecting and blocking these *** a secure intrusion detection system in the network,which provides security to the nodes and route paths in the network,is a major difﬁculty in *** on the network can jeopardize security issues discovered by the intrusion detection system engine,which are then blocked by the network’s intrusion prevention *** bringing the Secure Intrusion Detection System(S-IDS)into the network,a new technique for implementing security goals and preventing attacks will be *** Secure Energy Routing(SER)protocol for MANETs is introduced in this *** protocol addresses the issue of network security by detecting and preventing attacks in the *** data transmission in the MANET is forwarded using Elliptical Curve Cryptography(ECC)with an objective to improve the level of *** Simulator–2 is used to simulate the network and experiments are compared with existing methods.

关键词： Mobile ad-hoc network(MANET) intrusion detection system secure energy routing(SER) elliptical curve cryptography(ECC) security

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