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Why are we performing fewer cholecystectomies for mild acute biliary pancreatitis?Trends and predictors of cholecystectomy from the National Readmissions Database(2010–2014)

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Gastroenterology Report 2019年第5期7卷 331-337,I0002页

作者： sushil kumar garg Fateh Bazerbachi Shashank Sarvepalli Shounak Majumder Shanthi Swaroop Vege Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Massachusetts General HospitalBostonMAUSA Department of Hospital Medicine Cleveland ClinicClevelandOHUSA

Background:Current guidelines recommend cholecystectomy for patients with mild acute biliary pancreatitis(MABP)during the index admission because it is associated with better *** this study,we aimed to assess national trends in cholecystectomy during index admissions for MABP and to identify factors associated with cholecystectomy completion and 30-day ***:Using diagnostic codes and the National Readmissions Database,we identified patients admitted with MABP between 2010 and *** in cholecystectomy rates were computed on the basis of various *** conducted a multivariable analysis to identify factors associated with 30-day readmission and cholecystectomy during the same ***:We identified 255,695 unique index MABP cases(41.3%male)and the 30-day readmission rate was 12.6%.Overall,43.8%underwent cholecystectomy and 25%underwent endoscopic retrograde cholangiopancreatography(ERCP)with *** observed a decreasing trend in both procedures during the study period(P<0.001).In multivariate analysis,odds of 30-day readmission were reduced for patients undergoing ERCP with sphincterotomy(odds ratio,0.78;95%confidence interval,0.74–0.84)or cholecystectomy(odds ratio,0.37;95%confidence interval,0.35–0.39).Conclusions:For patients with MABP,cholecystectomy or ERCP with sphincterotomy during the index admission decreased the risk of 30-day *** this benefit and national guidelines recommending cholecystectomy during the index MABP admission,the rate of cholecystectomies performed nationally decreased during the study *** research is needed to understand the implications and reasons underlying this deviation from guidelines.

关键词： cholecystectomy mild acute biliary pancreatitis National Readmissions Database endoscopic retrograde cholangiopancreatography

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Genome-wide gene expression analysis for target genes to differentiate patients with intestinal tuberculosis and Crohn’s disease and discriminative value of FOXP3 mRNA expression

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Gastroenterology Report 2016年第1期4卷 59-67,I0003页

作者： Vineet Ahuja Swati Subodh Amit Tuteja Veena Mishra sushil kumar garg Neha Gupta Govind Makharia SK Acharya Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew DelhiIndia The Centre for Genomic Application(An IGIB–IMM collaboration) New DelhiIndia

Background and aims:Crohn’s disease(CD)and intestinal tuberculosis(ITB)are both chronic granulomatous conditions with similar phenotypic ***,there is need for a biomarker to differentiate between both these two *** study aimed at genome-wide gene expression analysis of colonic biopsies from confirmed cases of ITB and CD in comparison with *** evaluate the role of T regulatory cells,forkhead box P3(FOXP3)mRNA expression was quantified in serum as well as in colonic biopsies from patients with ITB and with the ***:Paired samples,including serum and colonic biopsies,were taken from 33 study subjects(CD,ITB and controls),and total RNA was *** whole genome gene expression microarray analysis was performed using the Illumina HumanWG-6 BeadChip Kit with six total RNA samples of the three groups in ***-time PCR for FOXP3 mRNA expression was analyzed in serum samples and colonic biopsy samples(4-CD,5-ITB,4-controls).Results:In CD and ITB there was 1.5-fold upregulation of 92 and 382 genes and 1.5-fold downregulation of 91 and 256 genes,*** proliferators via the PPARc pathway were most significantly downregulated(P2-fold *** ITB,the complement activation pathway,specifically the classical pathway,was the most significantly ***3 mRNA expression was significantly elevated in colonic biopsies obtained from ITB patients as compared with CD cases(4.7062.21 vs 1.4860.31,P=0.016).Conclusions:FOXP3 mRNA expression in colonic mucosa could be a discriminatory marker between ITB and *** of the complement activation pathway in ITB suggests that pathogenetic mechanisms for ITB are similar to those of pulmonary *** CD,downregulation of PPARc was seen in colonic tissue,suggesting that restoratio

关键词： Crohn’s disease intestinal tuberculosis microarray gene expression profiling signaling pathway FOXP3 mRNA

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Acute pancreatitis associated with intravenous administration of propofol:evaluation of causality in a systematic review of the literature

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Gastroenterology Report 2019年第1期7卷 13-23,I0001页

作者： Samir Haffar Ravinder Jeet Kaur sushil kumar garg Joseph A.Hyder M.Hassan Murad Barham K.Abu Dayyeh Fateh Bazerbachi Digestive Center for Diagnosis&Treatment 29 Ayar StreetDamascusSyrian Arab Republic Division of Gastroenterology and Hepatology Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Anesthesiology and Perioperative Medicine Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Health Care Policy and Research Mayo Clinic200 First Street SWRochesterMN 55905USA

Acute pancreatitis(AP)associated with intravenous administration of propofol has been described with unknown causal *** therefore assessed this causality in a systematic *** databases were searched on 16 August 2017;studies were appraised and selected by two reviewers based on a priori *** causality was evaluated with the Naranjo scale and Badalov *** identified 18 studies from 11 countries with a total of 21 patients,and the majority had adequate methodological *** median age was 35 years(range,4–77)and 10(48%)were ***,propofol was administrated in 8 patients as sedative along with induction/maintenance of anesthesia in 13 patients;median dose was 200 mg,with intermediate latency(1–30 days)in 14(67%).Serum triglycerides were>1000 mg/dL in four *** AP was observed in four patients(19%).AP recurrence occurred in one out of two patients who underwent *** related to AP was 3/21(14%).Propofol was the probable cause of AP according to the Naranjo scale in 19 patients(89%).Propofol-induced AP has a probable causal relation and evidence supports Badalov class *** is not the only mechanism by which propofol illicit ***-induced AP was severe in 19%of patients with a mortality rate related to AP of 14%.Future research is needed to delineate whether this risk is higher if combined with other procedures that portend inherent risk of pancreatitis such as endoscopic retrograde cholangiopancreatography.

关键词： Acute pancreatitis drug-induced pancreatitis propofol systematic review

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Ameta-analysis on efficacy and safety:single-balloon ***-balloon enteroscopy

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Gastroenterology Report 2015年第2期3卷 148-155页

作者： Vaibhav Wadhwa Saurabh Sethi Sumeet Tewani sushil kumar garg Douglas K.Pleskow Ram Chuttani Tyler M.Berzin Nidhi Sethi Mandeep S.Sawhney Department of Internal Medicine Fairview HospitalCleveland ClinicClevelandOHUSA Division of Gastroenterology Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMAUSA Division of Basic and Translational Research Department of SurgeryUniversity of MinnesotaMinneapolisMNUSA

Background and aim:Double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)are new techniques capable of providing deep *** of individual studies comparing these techniques have not been able to identify a superior *** aim was to systematically pool all available studies to compare the efficacy and safety of DBE with SBE for evaluation of the small ***:Databases were searched,including PubMed,Embase,and the Cochrane Central Register of Controlled *** main outcome measures were complete small-bowel visualization,diagnostic yield,therapeutic yield,and complication *** analysis was performed using Review Manager(RevMan version 5.2).Meta-analysis was performed using fixed-effect or random-effect methods,depending on the absence or presence of significant *** used the v2 and I2 test to assess heterogeneity between *** were expressed as risk ratios(RR)or mean differences with 95%confidence intervals(CI).Results:Four prospective,randomized,controlled trials with a total of 375 patients were *** was superior to SBE for visualization of the entire small bowel[pooled RR=0.37(95%CI:0.19–0.73;P=0.004)].DBE and SBE were similar in ability to provide diagnosis[pooled RR=0.95(95%CI:0.77–1.17;P=0.62)].There was no significant difference between DBE and SBE in therapeutic yield[pooled RR=0.78(95%CI:0.59–1.04;P=0.09)]and complication rate[pooled RR=1.08(95%CI:0.28–4.22);P=0.91].Conclusions:DBE was superior to SBE with regard to complete small bowel *** was similar to SBE with regard to diagnostic yield,ability to provide treatment and complication rate,but these results should be interpreted with caution as they is based on very few studies and the overall quality of the evidence was rated as low tomoderate,due to the small sample size.

关键词： small bowel enteroscopy single-balloon enteroscopy double-balloon enteroscopy meta-analysis outcomes

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An emerging threat Fileless malware:a survey and research challenges

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Cybersecurity 2018年第1期1卷 668-679页

作者： Sudhakar sushil kumar School of Computer&Systems Sciences Jawaharlal Nehru University110067New DelhiIndia Indian Computer Emergency Response Team Ministry of Electronics&Information Technology110003New DelhiIndia

With the evolution of cybersecurity countermeasures,the threat landscape has also evolved,especially in malware from traditional file-based malware to sophisticated and multifarious fileless *** malware does not use traditional executables to carry-out its ***,it does not use the file system,thereby evading signature-based detection *** fileless malware attack is catastrophic for any enterprise because of its persistence,and power to evade any anti-virus *** malware leverages the power of operating systems,trusted tools to accomplish its malicious *** analyze such malware,security professionals use forensic tools to trace the attacker,whereas the attacker might use anti-forensics tools to erase their *** survey makes a comprehensive analysis of fileless malware and their detection techniques that are available in the *** present a process model to handle fileless malware attacks in the incident response *** the end,the specific research gaps present in the proposed process model are identified,and associated challenges are highlighted.

关键词： Fileless malware Botnet Incident response Memory forensics Incident investigation Memory resident malware Rootkit

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Morphological, Optical and DC Conduction Properties of a-GaSe Semiconductor Nanoparticle Thin Films

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Journal of Materials Science & Technology 2013年第12期29卷 1151-1155页

作者： sushil kumar M.A. Majeed Khan Materials Science Lab. Department of Physics Chaudhary Devi Lal University Sirsa 125 055 India King Abdullah Institute for Nanotechnology King Saud University Riyadh 11451 Saudi Arabia

Amorphous gallium selenide （a-GaSe） semiconductor nanoparticle thin films were deposited onto well cleaned glass substrates by inert gas condensation （IGC） technique under a vacuum of 400 x 10-6 Pa （3 x 10-6 Torr）. The films were characterized by different structural and optical techniques, including X-ray diffraction, field emission scanning electron microscopy （FESEM）, field emission transmission electron microscopy （FETEM）, UV-visible absorption spectroscopy and I-V measurements. The particle size and size distribution were determined by TEM images which show the presence of spherical particles in the range of 5-50 nm in size. SEM images indicate that the a-GaSe film grown on glass substrate is almost smooth and dense. The optical properties of a-GaSe nanoparticle thin films were determined by optical absorption spectra. The optical bandgap of the film was estimated to be 2.19 eV and the transitions are allowed direct type. The electrical conductivity of the deposited films has been studied as a function of temperature. In the higher temperature range the dominance of thermally activated band conduction was observed; whereas in the low temperature ranqe the hoppinQ conduction in the band tails of localized states was found to be dominated.

关键词： Nanoparticles Thin film Optical bandgap Electrical conductivity

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An efficient algorithm to clip a 2D-polygon against a rectangular clip window

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Applied Mathematics(A Journal of Chinese Universities) 2022年第1期37卷 147-158页

作者： sushil Chandra Dimri Umesh kumar Tiwari Mangey Ram Department of Computer Science and Engineering Graphic Era(Deemed to be University)DehradunUttarakhandIndia

Polygon clipping is of great importance in computer *** of the popular algorithms to clip a polygon is Cohan–Sutherland Hodgeman algorithm which is based on line ***–Sutherland Hodgeman algorithm clips the polygon against the given rectangular clip window with the help of line clipping ***–Sutherland algorithm requires traversing the polygon in anti clockwise direction(positive orientation).In this work we propose an efficient polygon clipping algorithm against a rectangular clip *** algorithm uses parametric representation of polygon *** the concept of point clipping,we can find required intersection points of edges of polygon with clip window *** suited numerical illustrations are used to explain the proposed polygon clipping *** proposed algorithm is computationally less expensive and comprehensive.

关键词： point clipping polygon clipping clip window line segment computational complexity

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OTS Scheme Based Secure Architecture for Energy-Efficient IoT in Edge Infrastructure

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Computers, Materials & Continua 2021年第3期66卷 2905-2922页

作者： sushil kumar Singh Yi Pan Jong Hyuk Park Department of Computer Science and Engineering Seoul National University of Science and TechnologySeoul01811South Korea Department of Computer Science Georgia State UniversityAtlantaGA30302-5060USA

For the past few decades,the Internet of Things(IoT)has been one of the main pillars wielding significant impact on various advanced industrial applications,including smart energy,smart manufacturing,and *** applications are related to industrial plants,automation,and e-healthcare *** applications have several issues related to developing,planning,and managing the ***,IoT is transforming into G-IoT(Green Internet of Things),which realizes energy *** provides high power efficiency,enhances communication and ***,this paradigm did not resolve all smart applications’challenges in edge infrastructure,such as communication bandwidth,centralization,security,and *** this paper,we propose the OTS Scheme based Secure Architecture for Energy-Efficient IoT in Edge Infrastructure to resolve these *** OTS-based Blockchain-enabled distributed network is used at the fog layer for security and *** evaluated our proposed architecture’s performance quantitatively as well as security and *** conducted a comparative analysis with existing studies with different measures,including computing cost time and communication *** a result of the evaluation,our proposed architecture showed better performance.

关键词： Blockchain energy-efficient IoT ots scheme edge infrastructure security and privacy

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Quantum cascade lasers operating from 1.4 to 4 THz

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Chinese Optics Letters 2011年第11期9卷 9-15页

作者： sushil kumar Department of Electrical and Computer Engineering and Center for Optical Technologies Lehigh University

The development of teranertz （THz） quantum cascade lasers （QCLs） has progressed considerably since their advent almost a decade *** QCLs operating in a frequency range from 1.4 to 4 THz with electron-phonon scattering mediated depopulation schemes are *** different types of GaAs/AlGaAs superlattice designs are *** of the best temperature performances are obtained by the so-called resonant-phonon designs that are *** above a temperature of 160 K has been obtained across the spectrum for THz QCLs operating at ν 〉 1.8 *** maximum operating temperature of previously reported THz QCLs has empirically been limited to a value of ～ω/k B.A new design scheme for THz QCLs with scattering-assisted injection is shown to surpass this empirical temperature barrier,and is promising to improve the maximum operating temperatures of THz QCLs even further.

关键词： Quantum cascade lasers operating from 1.4 to 4 THz QCL

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Morphological phylogeny among 15 accessions of bamboos growing in Kokrajhar district of the Bodoland Territorial Area Districts,Assam

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Journal of Forestry Research 2018年第5期29卷 1379-1386页

作者： Anusriti Basumatary sushil kumar Middha Talambedu Usha Samik Bhattacharya Birendra kumar Brahma Arvind kumar Goyal Centre for Bamboo Studies and Department of Biotechnology Bodoland University DBT-BIF Centre Department of BiotechnologyPG Research CentreMaharani Lakshmi Ammanni College for Women Department of Biochemistry Maharani Lakshmi Ammanni College for Women Department of Molecular Ecology Max Planck Institute of Chemical Ecology

Bamboo is nature＇s wonderful gift historically associated with the rural population of the Bodoland Territorial Area ***,indiscriminate use of the resource and the ambiguity in the identification of bamboos in the absence of flowering characters pose a potential risk to the bamboo ***,we considered revising the taxonomic positions and phylogenetic relationships among 15 tropical bamboo species using 35 key morphological descriptors（MD） to assess the reliability of vegetative characters in identifying *** phylogenetic tree constructed from the similarity matrix,derived from an unweighted pair group method of analysis（UPGMA） of the 35 MDs,marginally deviated from the conventional taxonomic positions of the bamboo *** the two varieties,one forma of Bambusa vulgaris（***,***,***） and two species of the genus Dendrocalamus（*** and ***）clustered together in a single clade,and *** was distantly placed from their *** discrepancy with the conventional classification might have ensued since only vegetative characters such as culm anatomy,culm sheath,leaf,and leaf sheath were considered in the present *** the phylogenetic relationship among the 15 tropical bamboos（computed from exhaustive MDs）grossly corroborate the conventional taxonomic grouping,a molecular-marker-based multidisciplinary approach should resolve the remaining conflicts in bamboo identification.

关键词： Bamboo Bodoland Culm Culm-sheath Leaf-sheath Phylogenetic relationship conflict

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