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Association of initial assessment variables and mortality in severe pediatric traumatic brain injury

World Journal of Pediatric surgery 2024年第2期7卷 125-133页

作者： Katherine C Bergus Kelli N Patterson Lindsey Asti Josh Bricker Tariku J Beyene Lauren N schulz Dana M schwartz Rajan K thakkar Eric A sribnick Pediatric surgery Nationwide Children's HospitalColumbusOhioUSA Centerforsurgical Outcomes Research Nationwide Children's HospitalColumbusOhioUSA Neurologic surgery The Ohio State UniversityColumbusOhioUSA Neurologic surgery Nationwide Children's HospitalColumbusOhioUSA

Background Predictive scales have been used to prognosticate long-term outcomes of traumatic brain injury(TBI),but gaps remain in predicting mortality using initial trauma resuscitation *** sought to evaluate the association of clinical variables collected during the initial resuscitation of intubated pediatric severe patients with TBI with in-hospital *** Intubated pediatric trauma patientss with severe TBI(Glasgow coma scale(GCs)score≤8)from January 2011 to December 2020 were *** between initial trauma resuscitation variables(temperature,pulse,mean arterial blood pressure,GCs score,hemoglobin,international normalized ratio(INR),platelet count,oxygen saturation,end tidal carbon dioxide,blood glucose and pupillary response)and mortality were evaluated with multivariable logistic *** Among 314 patients,median age was 5.5 years(interquartile range(IQR):2.2-12.8),GCs score was 3(IQR:3-6),Head Abbreviated Injury score(hAIs)was 4(IQR:3-5),and most had a severe(25-49)Injury severity score(Iss)(48.7%,153/314).Overall mortality was 26.8%.GCs score,hAIs,Iss,INR,platelet count,and blood glucose were associated with in-hospital mortality(all ps age and GCs score increased,the odds of mortality *** 1-point increase in GCs score was associated with a 35%decrease in odds of *** hAIs,INR,and blood glucose increased,the odds of mortality *** each 1.0 unit increase in INR,the odds of mortality increased by 1427%.Conclusions Pediatric patients with severe TBI are at substantial risk for in-hospital *** are needed to examine whether earlier interventions targeting specific parameters of INR and blood glucose impact mortality.

关键词： mortality pediatric traumatic

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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(Pse readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUsION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Integrating algae building technology in the built environment:A cost and benefit perspective

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Frontiers of Architectural Research 2020年第2期9卷 370-384页

作者： Nimish Biloria Yashkumar thakkar Faculty of Design Architecture and Building University of Technology SydneySydneyAustralia Faculty of Engineering and IT University of Technology SydneySydneyAustralia

Energy consumption rates have been rising globally at an escalating pace since the last three *** exploration of new renewable and clean sources of energy globally is thus gaining prime *** Australia,coal is still the primary source of energy,which,during the process of energy production,generates greenhouse gases,subsequently resulting in environmental *** this context,the paper compares the economic and environmental benefits of utilizing two renewable energy production sources:algae building technology(ABT)and solar PV panels.A case study site for retrofitting a specified area on the front facade of a multi-storied building at the University of Technology sydney,City Campus,Australia was thus chosen for the study.A cost and benefit analysis model using the following performance indicators;return on investment,payback period as well as net present value of the two systems,was thus *** revenue generation of both systems which included tangible and intangible benefits of both systems were simultaneously *** investment and operation and maintenance costs of both systems were calculated based on market research as well as quantitative data adapted from our literature *** conclusions show that closed tubular photobioreactor systems have more benefit than solar panel system from an environmental impact perspective considering Australia’s current struggle with water scarcity,drought,air pollution and carbon emission reduction goals.

关键词： Algae Architectural retrofitting Cost and benefit analysis Built environment

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Waste fly ash-ZnO as a novel sunlight-responsive photocatalyst for dye discoloration

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Water science and Engineering 2023年第1期16卷 76-82页

作者： Leena V.Bora sonal P.thakkar Kevin s.Vadaliya Nisha V.Bora Nirma University AhmedabadGujarat 382481India Government Engineering College ModasaGujarat 383315India

Treating waste with a waste material using freely available solar energy is the most effective way towards sustainable *** this study,a novel photocatalyst,partly derived from waste material from the coal industry,was *** ash hybridized with ZnO(FAeZn)was synthesized as a potential photocatalyst for dye *** synthesized photocatalyst was characterized by X-ray diffraction,scanning electron microscopy,transmission electron microscopy,and ultravioletevisible/near infra-red *** photocatalytic activity was examined with the discoloration of methylene blue used as synthetic dye *** the experiments were performed in direct *** photocatalytic performance of FAeZn was found to be better than that of ZnO and the conventionally popular *** LangmuireHinshelwood model rate constant values of ZnO,TiO2,and FAeZn were found to be 0.016 min1,0.017 min1,and 0.020 min1,*** were two reasons for this:(1)FAeZn was able to utilize both ultraviolet and visible parts of the solar spectrum,and(2)its BrunauereEmmetteTeller surface area and porosity were significantly *** led to increased photon absorption and dye adsorption,thus exhibiting an energy-efficient ***,FAeZn,partly derived from waste,can serve as a suitable material for environmental remediation and practical solar energy applications.

关键词： Photocatalyst ZnO Fly ash Geopolymer Wastewater treatment Methylene blue

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Electromagnetic transition properties of→Nγ in a hypercentral scheme

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Chinese Physics C 2012年第5期36卷 385-389页

作者： Kaushal thakkar Ajay Majethiya P.C.Vinodkumar Department of Applied Physics S.V.National Institute of Technology Department of Physics Sardar Patel University Kalol Institute of Technology and Research Centre

The electromagnetic transition properties of the decuplet to octet baryon （→ Nγ） is studied within the framework of a hypercentral quark *** confinement potential is assumed as a hypercentral coloumb plus linear *** transition magnetic moment and transition amplitude f M 1 for the → Nγ are in agreement with other theoretical *** present result of the radiative decay width is found to be in excellent agreement with the experimental values reported by the particle data group over other theoretical model predictions.

关键词： light flavour baryons transition magnetic moment radiative decay width

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Application of statistically Based Experimental Designs to Optimize Cellulase Production and Identification of Gene

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Natural Products and Bioprospecting 2014年第6期4卷 341-351页

作者： Aarti thakkar Meenu saraf Department of Microbiology University School of ScienceGujarat UniversityAhmedabad 380009GujaratIndia

A natural bacterial strain identified as Bacillus amyloliquefaciens MBAA3 using 16s rDNA partial genome sequencing has been studied for optimization of cellulase *** screening of media components for production of cellulase by *** MBAA3 was carried out by Plackett–Burman ***–Burman design showed CMC,MgsO4 and pH as significant components influencing the cellulase production from the media components screened by Plackett-Burman fractional factorial *** optimum concentrations of these significant parameters were determined employing the response surface central composite design,involving three factors and five levels was adopted to acquire the best medium for the production of cellulase enzyme revealed concentration of CMC(1.84 g),MgsO4(0.275 g),and pH(8.5)in media for highest enzyme *** surface counter plots revealed that middle level of MgsO4 and middle level of CMC,higher level of CMC and lower level of pH and higher level of MgsO4 with lower level of pH increase the production of *** optimization cellulase activity increased by 6.81 *** of cellulase gene in MBAA3 was conformed by the amplification of genomic DNA of MBAA3.A PCR product of cellulase gene of 1500 bp was successfully *** amplified gene was conformed by sequencing the amplified product and sequence was deposited in the gene bank under the accession number KF929416.

关键词： Bacillus amyloliquefaciens Cellulase gene Optimization Plackett-Burman design Response surface methodology

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Review of abdominal solid organ transplantation in Jehovah’s Witness patients

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World Journal of Transplantation 2019年第5期9卷 94-102页

作者： Rodrigo s Figueiredo Rohan G thakkar Paul R Ainley Colin H Wilson Department of Hepatopancreatico-biliary and Transplant surgery Freeman Hospital

Managing blood loss in Jehovah’s Witness(JW)patients is a matter of *** patients will not accept transfusions of red blood cells,white blood cells,platelets or plasma,even if that is required to save their *** are many discussions regarding safety of operating upon JW patients in general surgical procedures,but in solid organ transplantation there is a paucity of literature on this *** have reviewed individual case reports and small series documenting on experience with solid organ transplantation in JW patients and the strategies adopted to facilitate *** is clear that such patients require the surgical team to dedicate more time to ensure their safe *** begins with a thorough,detailed consent of exactly which products and interventions they will or will not *** must begin weeks before surgery if *** case must be assessed individually,but provided they meet fitness requirements,there are no absolute contraindications to abdominal organ transplantation.

关键词： Anaemia Blood transfusion Informed consent Jehovah's Witness Transplantation

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successful Percutaneous Treatment of Coronary Artery Ectasia with Drug-Eluting stent

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International Journal of Clinical Medicine 2014年第20期5卷 1265-1268页

作者： Bhupesh Rajanikant shah Ashok s. thakkar Department of Cardiology NHL Municipal Medical College Ahmedabad India Department of Clinical Trials Sahajanand Medical Technologies Pvt. Ltd. Surat India

Coronary artery ectasia is well-known but relatively uncommon finding with prevalence ranging from 1.2% to 5.3%. Coronary artery ectasia has been associated with atherosclerosis in approximately half of the cases. Here, we are presenting a case of male patient who experienced myocardial infarction and was diagnosed with coronary artery ectasia in proximal-mid junction of left anterior descending artery with stenotic lesion. The patient was successfully treated with percutaneous transluminal coronary angioplasty.

关键词： Coronary Artery Ectasia Drug Eluting stent Percutaneous Coronary Intervention

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Oldest Asian Record of snapping shrimps(Malacostraca:Alpheidae)from the Kutch Basin,Western India and Associated Biota:Biostratigraphic,Paleoenvironmental and Paleoecological significance

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Acta Geologica sinica(English Edition) 2022年第6期96卷 1867-1883页

作者： Vivesh V.KAPUR Kamlesh KUMAR Pranav J.PANDYA Amit KGHOsH Arindam CHAKRABORTY Anupam sHARMA Gaurav CHAUHAN M.G.thakkar Birbal sahni Institute of Palaeosciences 53University RoadLucknow 226007India Department of Biology Shri R.R.Lalan CollegeBhujKachchh DistrictGujaratIndia Institute of Earth sciences Academia SinicaTaipeiTaiwan 11529China Department of Earth and Environmental science K.S.K.V.Kachchh UniversityBhujKachchh DistrictGujaratIndia

The oldest Asian record of alpheid shrimps,assigned to genus Alpheus,based on snapping claw fingertips from the Miocene Khari Nadi Formation in the Kutch Basin,western India reported herein,extends the fossil record of the family Alpheidae from Asia by~22 million *** early Miocene(Aquitanian)age is estimated based on the associated assemblage of calcareous nannofossils,sphenolithus disbelemnos,Cyclicargolithus floridanus,and Reticulofenestra *** co-occurring microbiota includes bony fish otolith remains,identified as“genus Gobiidarum”,isolated teeth of Dasyatis rays,sphyrna sharks,and teleosts,ctenoid and placoid scales,ostracods,belonging to the genera Paractinocythereis,Alocopocythere,Ruggieria,Aglaiocypris,Bairdoppilata,and echinoid *** together,the microfossil assemblage and data from chemical analyses using Energy Dispersive spectroscopy,X-Ray Diffraction and Wavelength Dispersive X-Ray Fluorescence of host and associated lithologies suggests prevalence of a shallow(neritic)to coastal marine(intertidal)depositional *** present investigation also provides the oldest fossil evidence on the co-occurrence of Alpheus and gobiids(based on otoliths)that strongly advocates that the mutualistic association between these animal groups had developed by the Aquitanian.

关键词： biostratigraphy Crustacea Caridea Elasmobranchs Gobiidae invertebrate and vertebrate paleontology nannofossils Oligocene-Miocene Indian subcontinent

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A case of type Ⅰ variant Kounis syndrome with samter-Beer triad

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World Journal of Cardiology 2013年第4期5卷 112-114页

作者： Jayesh s Prajapati Kapil M Virpariya Ashok s thakkar Atul D Abhyankar Department of Cardiology UN Mehta Institute of Cardiology and Research CenterAhmedabad 380016GujaratIndia Department of Clinical Trials Sahajanand Medical Technologies Pvt.Ltd.Surat 395004India Department of Cardiology Shree BD Mehta Mahavir Heart InstituteAthwagateSurat 395001India

Kounis syndrome is defined as the coexistence of acute coronary syndromes with situations associated with allergy or hypersensitivity,as well as anaphylactic or anaphylactoid reactions,to a variety of medical conditions,environmental and medication *** report a case of Kounis-Zavras syndrome type Ⅰ variant in the setting of aspirin-induced asthma,or the samter-Beer triad of asthma,nasal polyps and aspirin *** there is a young individual with no predisposing factors of atherosclerosis and apparent coronary lesion,with or without electrocardiography and biochemical markers of infarction,the possibility of Kounis syndrome should be kept in mind.

关键词： Kounis syndrome samter-Beer triad Nasal polyps Coronary spasm Aspirin allergy

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