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Bhandoria G, Gadgil A, Khajanchi M, Sarang B, Kizhakke Veetil D, Wadhawan R, Bhandarkar P, Mohan M, Shah P, Bains L, Mishra A, Arora S, Rattan A, Kant R, Sharma N, Bhavishi D, Satoskar RR, Prajapati R, Srivastava KS, Kamble P, Mayadeo NM, Gokhale A, Jaydeep H, Belekar D, Roy N. Effects of the COVID-19 pandemic on delivery of emergency surgical care in India. Br J Surg 2021; 108:e154-e155. [PMID: 33793717 PMCID: PMC7929169 DOI: 10.1093/bjs/znab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022]
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Gonzalez M, Aker M, Manjunath P, Mishra A, Ward N. 508 Conservative Management of Small Bowel Obstruction: A Local Experience. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Post-operative intra-abdominal adhesions remain the leading cause of small bowel obstruction (SBO) representing one of the main diagnoses warranting emergency laparotomies. The National Audit in Small Bowel Obstruction advocates the use of water-soluble contrast agents (WSCA) as initial management of SBO. We aim to assess the role and outcomes of WSCA and its rate in successfully managing SBO non-operatively.
Method
We conducted a 2-year retrospective analysis including all patients admitted with adhesive SBO. Outcomes of patients who received WSCA were compared to those who hadn’t.
Results
118 patients were included, 27(23%) of which required immediate surgery while 91(77%) were initially managed conservatively. From the latter group, 53(58.2%) received WSCA whilst 38(41.8%) didn’t. Of the group that received WSCA, 36(39.5%) were successfully managed non-operatively, compared to 26(28.5%) that didn’t, this however lacked statistical significance. LOS didn’t differ between these two groups (5 days vs. 5.5 days, p = 0.805). 32% of the patients required eventual surgical intervention needing longer LOS regardless of receiving WSCA (6.6 days vs. 13.6 days p < 0.001).
Conclusions
Adhesive SBO can be managed conservatively in up to two-thirds of patients. WSCA usage has a positive impact but needs further assessment in larger studies.
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Jain AK, Mishra A, Singh AP, Patel P, Sheikh AA, Chandraker TR, Vandre R. Effects of different concentration of organic and inorganic trace minerals (zinc, selenium, and chromium) supplementation on expression of chTLR4 gene and humoral immune response in broilers. Vet World 2021; 14:1093-1101. [PMID: 34220108 PMCID: PMC8243660 DOI: 10.14202/vetworld.2021.1093-1101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIM Poultry production is the fastest-growing livestock sector in developing countries. In the poultry diet, trace minerals (zinc [Zn], selenium [Se], and chromium [Cr]) are normally administered in the inorganic form which has been traditionally considered as the most cost-effective and easily available but organic forms of these trace minerals have a higher bioavailability, lower dietary inclusion and cause less environmental pollution as compared to inorganic form. This study aimed to investigate the effect of different concentrations of organic and inorganic forms of trace minerals (Zn, Se, and Cr) supplementation (0-35 days) on expression of chTLR4gene and humoral immune response in broilers. MATERIALS AND METHODS A total of 216 broilers were randomly divided into 12 groups and each group divided into three replicates consisting of six broilers each. T1 (R1, R2, and R3) group was kept as control. T2, T3, and T4 (R1, R2, and R3) groups were supplemented with inorganic form of Zn at 40 mg/kg of feed, organic form of Zn at 40 mg/kg of feed, and 50% organic form of Zn at 20 mg/kg of feed, respectively. T5, T6, and T7 (R1, R2, and R3) groups were supplemented with inorganic form of Se at 0.3 mg/kg of feed, organic form of Se at 0.3 mg/kg of feed, and 50% organic form of Se at 0.15 mg/kg of feed, respectively. T8, T9, and T10 (R1, R2, and R3) groups were supplemented with inorganic form of Cr at 2 mg/kg of feed, organic form of Cr at 2 mg/kg of feed, and 50% organic form of Cr at 1 mg/kg of feed, respectively. T11 and T12 (R1, R2, and R3) groups were supplemented with a combination of all three minerals from inorganic and organic forms, respectively. RESULTS Reverse transcriptase-polymerase chain reaction gene expression analysis revealed that in bursa of Fabricius, maximum upregulation of chTLR4 (3.0214 fold) was observed in T6 group, and in spleen, maximum upregulation of chTLR4 (3.2140 fold) was observed in T3 group as compared to control group. On day 35, the maximum plasma immunoglobulin G concentration was observed in organic trace minerals (OTMs) supplemented, whereas the minimum concentration was recorded in control group. On day 28 and 35, the overall mean heterophil:lymphocyte ratio showed a significant difference (p<0.05) between control and OTM supplemented groups. A significantly higher immune organ weight (spleen and bursa of Fabricius) was recorded in OTM supplemented group as compared to control and other supplemented group. CONCLUSION Supplementation of organic form of Zn, Se, and Cr either alone or in combination increase humoral immune response and upregulation of chTLR4 gene expression in bursa and spleen indicates a beneficial effect of OTM in augmentation of immune system in broilers.
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Franco C, Sawhney R, Burke J, Aruparayil N, Chauhan M, Bolton W, Mishra A, Valdastri P, Jayne D. P15: EVALUATING THE INTERNATIONAL USABILITY OF A LOW-COST LAPAROSCOPIC TRAINER IN LOW- AND HIGH-INCOME SETTINGS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Limited access to equipment and trained personnel restrict the adoption of laparoscopic surgery globally. There are a wide range of laparoscopic trainers available; however, most of these are not affordable. We propose an ultra-low-cost laparoscopic trainer (Lap-Pack), designed for portability, ease of assembly and compatibility with smart devices. The study aims to evaluate the usability of Lap-Pack as a training tool in low- and high-income settings.
Method
An international usability study was conducted in India and the UK in 2019. The participants (n=60), consisting of senior surgeons (n=18), junior trainees (n=20) and medical students (n=22), were asked to complete two tasks using Lap-Pack. Participants then scored Lap-Pack in a 25-point questionnaire, including a pre-established Face-Validity Criteria and four major evaluation categories – Usability, Camera, View, Material.
Result
Lap-Pack scored highly in Face-Validity with a combined mean score of 4.63 (95%CI: 4.31, 4.95, p <0.05) of a possible 6. In both cohorts, the Usability and Camera categories scored highest, with combined values respectively of 6.10 (95%CI: 6.01, 6.19, p <0.05) and 6.09 (95%CI: 5.88, 6.31, p <0.05) of a possible 7. For both centres, the highest-scoring individual criteria were its light weight and portability.
Conclusion
Overall, Lap-Pack was received positively by medical students and consultants alike, suggesting it is a suitable device for development of skills as part of a larger laparoscopic training curriculum. Its ease of assembly, portability and versatility show promise of increasing access to training opportunities worldwide.
Take-home message
Lap-Pack is an ultra-low-cost, portable laparoscopic simulator featuring compatibility with smart devices designed to help increase access to laparoscopic training worldwide. An international usability study found medical students, junior trainees and senior surgeons rated its usability and camera features highly, suggesting its employability as a laparoscopic training tool on a global scale.
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Brahmanand PS, Behera B, Srivastava SK, Singandhupe RB, Mishra A. Cultivated Land Utilization Index Vis-a-Vis Cropping Intensity for Crop Diversification and Water Resource Management in Odisha, India. CURR SCI INDIA 2021. [DOI: 10.18520/cs/v120/i7/1217-1224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jeong J, Kim M, Seo J, Lu H, Ahlawat P, Mishra A, Yang Y, Hope MA, Eickemeyer FT, Kim M, Yoon YJ, Choi IW, Darwich BP, Choi SJ, Jo Y, Lee JH, Walker B, Zakeeruddin SM, Emsley L, Rothlisberger U, Hagfeldt A, Kim DS, Grätzel M, Kim JY. Pseudo-halide anion engineering for α-FAPbI 3 perovskite solar cells. Nature 2021; 592:381-385. [PMID: 33820983 DOI: 10.1038/s41586-021-03406-5] [Citation(s) in RCA: 732] [Impact Index Per Article: 244.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/01/2021] [Indexed: 11/09/2022]
Abstract
Metal halide perovskites of the general formula ABX3-where A is a monovalent cation such as caesium, methylammonium or formamidinium; B is divalent lead, tin or germanium; and X is a halide anion-have shown great potential as light harvesters for thin-film photovoltaics1-5. Among a large number of compositions investigated, the cubic α-phase of formamidinium lead triiodide (FAPbI3) has emerged as the most promising semiconductor for highly efficient and stable perovskite solar cells6-9, and maximizing the performance of this material in such devices is of vital importance for the perovskite research community. Here we introduce an anion engineering concept that uses the pseudo-halide anion formate (HCOO-) to suppress anion-vacancy defects that are present at grain boundaries and at the surface of the perovskite films and to augment the crystallinity of the films. The resulting solar cell devices attain a power conversion efficiency of 25.6 per cent (certified 25.2 per cent), have long-term operational stability (450 hours) and show intense electroluminescence with external quantum efficiencies of more than 10 per cent. Our findings provide a direct route to eliminate the most abundant and deleterious lattice defects present in metal halide perovskites, providing a facile access to solution-processable films with improved optoelectronic performance.
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Aman Agarwal, Mishra A, Basavarajaiah M, Sharma P, Tanwar S. Dilated Volumetric Network: an Enhanced Fully Convolutional Network for Volumetric Prostate Segmentation from Magnetic Resonance Imaging. PATTERN RECOGNITION AND IMAGE ANALYSIS 2021. [DOI: 10.1134/s1054661821020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Shrestha I, Mishra A, Mishra A, Bista M, Acharya J. Prevalence of Loss of Smell and/or Taste and other Otorhinolaryngology Symptoms in COVID-19 Patients. Kathmandu Univ Med J (KUMJ) 2021; 19:173-179. [PMID: 34819431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Loss of smell and/or taste have been described in COVID-19 patients. Studies have not been conducted to evaluate the loss of smell and/or taste in the context of Nepal. Objective To investigate the prevalence of Ear, Nose and Throat related symptoms and assess smell and taste disorders in laboratory-confirmed SARS-CoV-2 patients. Method This prospective cross-sectional study evaluated patients from September 2020 to March 2021 with preceding COVID-19 diagnosis from a tertiary centre in Kathmandu. COVID-19 positive patients visiting out-patient department, quarantined or admitted were included. Patients were given questionnaire consisting of demographic data, history of smoking and evaluation of presenting symptoms. Loss of smell and taste were subjectively tested and followed up via telephone for ten weeks to evaluate for recovery time and degree of recovery. Result A total of 226 patients participated in the study, 18-92 years old (mean age, 36.77 ± 15.23 years; 53.5% males, 69% non-smokers). Majority of the patients had Myalgia (n = 128, 56.6%) as their presenting symptoms followed by fever (n = 122, 53.9%), loss of smell (n = 117, 51.7%), cough (n = 107, 47.34) and sore throat (n = 102, 45.1%). Loss of sense of smell and taste was reported in 51.8% and 42% respectively. The association between loss of sense of smell and taste was statistically significant (p < .001). All patients had some degree of recovery with 64.1% recovery of smell and 64.2% recovery of taste within 14 days of onset of symptoms. The mean recovery time for sense of smell and taste was 14.34 ± 9.82 days and 15.03 ± 10.06 days, respectively. Conclusion Olfactory and gustatory dysfunctions are cardinal features of COVID-19. They recover spontaneously along with other symptoms within few weeks. The absence of smell or taste in times of pandemic can be suggestive of potential COVID-19 infection and be used as a screening tool for early diagnosis and reduce transmission of the infection.
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Abstract
Filifactor alocis, a fastidious Gram-positive obligate anaerobic bacterium, is a newly appreciated member of the periodontal community that is now proposed to be a diagnostic indicator of periodontal disease. Its pathogenic characteristics are highlighted by its ability to survive in the oxidative stress-rich environment of the periodontal pocket and to significantly alter the microbial community dynamics by forming biofilms and interacting with several oral bacteria. Here, we describe the current understanding of F. alocis virulence attributes, such as its comparative resistance to oxidative stress, production of unique proteases and collagenases that can cause structural damage to host cells, and dysregulation of the immune system, which enable this bacterium to colonize, survive, and outcompete other traditional pathogens in the inflammatory environment of the periodontal pocket. Furthermore, we explore the recent advancements and future directions for F. alocis research, including the potential mechanisms for oxidative stress resistance and our evolving understanding of the interactions and mechanisms of bacterial survival inside neutrophils. We also discuss the current genetic tools and challenges involved in manipulating the F. alocis genome for the functional characterization of the putative virulence genes. Collectively, this information will expedite F. alocis research and should lead to the identification of prime targets for the development of novel therapeutics to aid in the control and prevention of periodontal disease.
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Natanasabapathy V, Arul B, Mishra A, Varghese A, Padmanaban S, Elango S, Arockiam S. Ultrasound imaging for the differential diagnosis of periapical lesions of endodontic origin in comparison with histopathology - a systematic review and meta-analysis. Int Endod J 2021; 54:693-711. [PMID: 33368404 DOI: 10.1111/iej.13465] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Differentiating periapical lesions is important for treatment planning and subsequent treatment outcome. OBJECTIVE To assess the diagnostic accuracy of ultrasound imaging for the differentiation of periapical lesions in comparison with histopathology. METHODS PubMed, Scopus, Embase, Web of Science and ProQuest databases were searched for clinical studies published until June 2020 that evaluated the use of ultrasound (US) imaging for differential diagnosis of periapical lesions and used histopathology as the reference standard. Animal studies, laboratory-based studies, reviews and clinical studies not using a reference standard were excluded. Risk of bias (RoB) assessment was performed using a modified Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The random effects model was used for quantitative analysis of the data, and the Deeks test was used for calculating publication bias. Quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twelve articles were included in the systematic review, out of which ten articles were quantitatively assessed. All the articles had a high RoB and concerns regarding applicability in the patient selection domain. For the index test domain, seven articles had low and the remaining five had unclear RoB and concerns regarding applicability. In the reference standard domain, low RoB and concerns regarding applicability were observed for all the articles. The RoB was low in flow and timing domains in all the articles except for one, where it was high. Summary estimates of sensitivity and specificity of US to diagnose periapical granulomas were 0.94 and 0.98, whereas for periapical cysts it was 0.98 and 0.99, respectively. Area under the curve for diagnosis of both periapical granulomas and periapical cysts was 0.99. All the included articles had inherent publication bias. Quality of evidence using GRADE, for sensitivity, was moderate for periapical granulomas and high for periapical cysts, whereas for specificity, it was high for periapical granulomas and low for periapical cysts. DISCUSSION The available evidence is considered to be of low quality due to the observational nature of the studies and inherent publication bias. CONCLUSION Although the sensitivity and specificity for differentiating periapical cysts and periapical granulomas using US were high, taking the quality of evidence into consideration, it can serve as an additional tool in differential diagnosis of periapical lesions.
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Hope MA, Nakamura T, Ahlawat P, Mishra A, Cordova M, Jahanbakhshi F, Mladenović M, Runjhun R, Merten L, Hinderhofer A, Carlsen BI, Kubicki DJ, Gershoni-Poranne R, Schneeberger T, Carbone LC, Liu Y, Zakeeruddin SM, Lewinski J, Hagfeldt A, Schreiber F, Rothlisberger U, Grätzel M, Milić JV, Emsley L. Nanoscale Phase Segregation in Supramolecular π-Templating for Hybrid Perovskite Photovoltaics from NMR Crystallography. J Am Chem Soc 2021; 143:1529-1538. [DOI: 10.1021/jacs.0c11563] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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88
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Su TS, Eickemeyer FT, Hope MA, Jahanbakhshi F, Mladenović M, Li J, Zhou Z, Mishra A, Yum JH, Ren D, Krishna A, Ouellette O, Wei TC, Zhou H, Huang HH, Mensi MD, Sivula K, Zakeeruddin SM, Milić JV, Hagfeldt A, Rothlisberger U, Emsley L, Zhang H, Grätzel M. Crown Ether Modulation Enables over 23% Efficient Formamidinium-Based Perovskite Solar Cells. J Am Chem Soc 2020; 142:19980-19991. [PMID: 33170007 DOI: 10.1021/jacs.0c08592] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The use of molecular modulators to reduce the defect density at the surface and grain boundaries of perovskite materials has been demonstrated to be an effective approach to enhance the photovoltaic performance and device stability of perovskite solar cells. Herein, we employ crown ethers to modulate perovskite films, affording passivation of undercoordinated surface defects. This interaction has been elucidated by solid-state nuclear magnetic resonance and density functional theory calculations. The crown ether hosts induce the formation of host-guest complexes on the surface of the perovskite films, which reduces the concentration of surface electronic defects and suppresses nonradiative recombination by 40%, while minimizing moisture permeation. As a result, we achieved substantially improved photovoltaic performance with power conversion efficiencies exceeding 23%, accompanied by enhanced stability under ambient and operational conditions. This work opens a new avenue to improve the performance and stability of perovskite-based optoelectronic devices through supramolecular chemistry.
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Mishra A. The Intricacies of Trust in Technology. JOURNAL OF CASES ON INFORMATION TECHNOLOGY 2020. [DOI: 10.4018/jcit.2020100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this paper is to demonstrate the intricacies of trust in an institutional setting with the help of a case entailing a clash between Apple and the FBI in a situation that was both politically and emotionally complex. The review of literature covers an extensive amount of academic papers to encapsulate each and every aspect of trust ranging from simple characterization of the concept to the deep-seated complexities of the matter like the effect of ethnicity on trust or the neurological effects during a breach of trust. Finally, it identifies serious gaps in research that are needed to be worked upon by other researchers to further our understanding of the matter.
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Lu H, Liu Y, Ahlawat P, Mishra A, Tress WR, Eickemeyer FT, Yang Y, Fu F, Wang Z, Avalos CE, Carlsen BI, Agarwalla A, Zhang X, Li X, Zhan Y, Zakeeruddin SM, Emsley L, Rothlisberger U, Zheng L, Hagfeldt A, Grätzel M. Vapor-assisted deposition of highly efficient, stable black-phase FAPbI3 perovskite solar cells. Science 2020; 370:370/6512/eabb8985. [DOI: 10.1126/science.abb8985] [Citation(s) in RCA: 307] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
Mixtures of cations or halides with FAPbI3 (where FA is formamidinium) lead to high efficiency in perovskite solar cells (PSCs) but also to blue-shifted absorption and long-term stability issues caused by loss of volatile methylammonium (MA) and phase segregation. We report a deposition method using MA thiocyanate (MASCN) or FASCN vapor treatment to convert yellow δ-FAPbI3 perovskite films to the desired pure α-phase. NMR quantifies MA incorporation into the framework. Molecular dynamics simulations show that SCN– anions promote the formation and stabilization of α-FAPbI3 below the thermodynamic phase-transition temperature. We used these low-defect-density α-FAPbI3 films to make PSCs with >23% power-conversion efficiency and long-term operational and thermal stability, as well as a low (330 millivolts) open-circuit voltage loss and a low (0.75 volt) turn-on voltage of electroluminescence.
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Sharma AR, Batra G, Kumar M, Mishra A, Singla R, Singh A, Singh RS, Medhi B. BCG as a game-changer to prevent the infection and severity of COVID-19 pandemic? Allergol Immunopathol (Madr) 2020; 48:507-517. [PMID: 32653224 PMCID: PMC7332934 DOI: 10.1016/j.aller.2020.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/24/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023]
Abstract
The impact of COVID-19 is changing with country wise and depend on universal immunization policies. COVID-19 badly affects countries that did not have universal immunization policies or having them only for the selective population of countries (highly prominent population) like Italy, USA, UK, Netherland, etc. Universal immunization of BCG can provide great protection against the COVID-19 infection because the BCG vaccine gives broad protection against respiratory infections. BCG vaccine induces expressions of the gene that are involved in the antiviral innate immune response against viral infections with long-term maintenance of BCG vaccine-induced cellular immunity. COVID-19 cases are reported very much less in the countries with universal BCG vaccination policies such as India, Afghanistan, Nepal, Bhutan, Bangladesh, Israel, Japan, etc. as compared to without BCG implemented countries such as the USA, Italy, Spain, Canada, UK, etc. BCG vaccine provides protection for 50–60 years of immunization, so the elderly population needs to be revaccinated with BCG. Several countries started clinical trials of the BCG vaccine for health care workers and elderly people. BCG can be uses as a prophylactic treatment until the availability of the COVID-19 vaccine.
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Mishra A, Speers RA. Wort Boil Time and Trub Effects on Fermentability. JOURNAL OF THE AMERICAN SOCIETY OF BREWING CHEMISTS 2020. [DOI: 10.1080/03610470.2020.1795782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liao J, Wang R, Mishra A, Emanuel E, Zhu J, Cousins D, Navathe A. Spillover Effects of the Comprehensive Care for Joint Replacement Program Among Non‐Medicare Patients. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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94
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Chapman SJ, Lee MJ, Blackwell S, Arnott R, Ten Broek RPG, Delaney CP, Dudi-Venkata NN, Hind D, Jayne DG, Mellor K, Mishra A, O'Grady G, Sammour T, Thorpe G, Wells CI, Wolthuis AM, Fearnhead NS. Establishing core outcome sets for gastrointestinal recovery in studies of postoperative ileus and small bowel obstruction: protocol for a nested methodological study. Colorectal Dis 2020; 22:459-464. [PMID: 31701620 DOI: 10.1111/codi.14899] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Gastrointestinal recovery describes the restoration of normal bowel function in patients with bowel disease. This may be prolonged in two common clinical settings: postoperative ileus and small bowel obstruction. Improving gastrointestinal recovery is a research priority but researchers are limited by variation in outcome reporting across clinical studies. This protocol describes the development of core outcome sets for gastrointestinal recovery in the contexts of postoperative ileus and small bowel obstruction. METHOD An international Steering Group consisting of patient and clinician representatives has been established. As overlap between clinical contexts is anticipated, both outcome sets will be co-developed and may be combined to form a common output with disease-specific domains. The development process will comprise three phases, including definition of outcomes relevant to postoperative ileus and small bowel obstruction from systematic literature reviews and nominal-group stakeholder discussions; online-facilitated Delphi surveys via international networks; and a consensus meeting to ratify the final output. A nested study will explore if the development of overlapping outcome sets can be rationalized. DISSEMINATION AND IMPLEMENTATION The final output will be registered with the Core Outcome Measures in Effectiveness Trials initiative. A multi-faceted, quality improvement campaign for the reporting of gastrointestinal recovery in clinical studies will be launched, targeting international professional and patient groups, charitable organizations and editorial committees. Success will be explored via an updated systematic review of outcomes 5 years after registration of the core outcome set.
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Saiada F, Eldemery F, Zegpi RA, Gulley SL, Mishra A, Santen VLV, Toro H. Early Vaccination of Chickens Induces Suboptimal Immunity Against Infectious Bronchitis Virus. Avian Dis 2020; 63:38-47. [PMID: 31251518 DOI: 10.1637/11951-081418-reg.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/28/2018] [Indexed: 11/05/2022]
Abstract
Infectious bronchitis virus (IBV) is highly prevalent in broiler chickens despite extensive vaccination commonly conducted early after hatch. The effects of early vaccination on immune responses were further investigated in chickens primed at increasing ages, followed by booster vaccination with an attenuated Arkansas (Ark) Delmarva Poultry Industry-type vaccine. Results show that vaccination on day 1 of age elicits significantly lower systemic and mucosal antibody responses compared with vaccination at later time points in the life of the chicken. The increase of IBV antibodies in serum from secondary responses after booster vaccination was more dramatic and significantly higher when measured by an Ark spike subunit 1 protein ELISA compared with measuring by non-Ark serotype whole-virus ELISA, which underlines the immunogenic importance of the virus spike at inducing antibodies. However, the levels achieved following boosting did not differ significantly between ages of priming. Thus, it seems that the booster vaccination mitigated the differences detected after prime immunization. In contrast to the continued rise of systemic antibodies after booster vaccination, the levels of mucosal IBV-specific immunoglobulin A decreased after booster vaccination. The recruitment or expansion of cluster of differentiation (CD)4+, CD8+, and CD4+/CD8+ T-cell populations in different immune effector sites was increased with age, but remained unaltered by IBV vaccination. In contrast, peripheral blood CD4+ cells showed a significant increase in IBV-vaccinated chickens compared with nonvaccinated age-matched controls both after primary and booster immunization. The results of the current study confirm that IBV vaccination on the day of hatch induces suboptimal IBV immune responses both in the systemic and mucosal compartments. This routine practice may be contributing to the immunologic escape of the virus and increased persistence of vaccine virus in vaccinated chickens. However, booster vaccination seems to overcome poor initial responses.
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Abdul Halim M, Pincus M, Mishra A. 053 Long Term Outcomes of Catheter-based Renal Denervation Therapy: A Single Centre Experience. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kallani M, Mishra A, Himanshu D. Glycemic Gap as a Prognostic Marker for Critically Ill Patients in ICU. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2020; 68:51. [PMID: 31979572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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LeClair H, Purohit A, Mishra A, Mohan A. Effects of Drying, Lactic Acid, and an Antimicrobial Marinade on the Survival of Generic Escherichia coli on Biltong. MEAT AND MUSCLE BIOLOGY 2019. [DOI: 10.22175/mmb.10766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objective of the experiment was to evaluate the effects of drying, lactic acid spray, and a certain marinade application on the survival of generic Escherichia coli on biltong.Materials and MethodsFrozen eyes of round (IMPS #171C) were obtained from a local beef purveyor. The eyes of round were thawed (at 4°C), trimmed of extra fat and connective tissues, and cut into strips (L × W × T; 6 in × 2 in × 0.75 in). The experiment was divided into 2 groups and replicated once. Experiment 1 was further sub-grouped into 3 treatments: (1) negative control (NC), (2) negative control for dip treatment (NCD), and (3) inoculated group (I). Experiment 2 was sub-grouped into 6 treatments: (1) negative control (NC), (2) negative control for dip treatment (NCD), (3) positive inoculated control (PIC), and inoculated treatments (4) marinated (M), (5) 2% lactic acid spray (LA), and (6) marinated and lactic acid spray (MLA). For both experiments 1 and 2, 12 strips of biltong were randomly selected for each treatment (n = 36 for experiment 1; n = 72 for experiment 2). The inoculated samples were dipped for 30 s in a cocktail (5-log) of 4 different strains of nalidixic adapted Escherichia coli (beef isolates) and allowed 2 h for attachment at 4°C. The lactic acid was sprayed to each side of the respective biltong and allowed a 10-min resting period. Marinade was applied to respective treatment groups by dipping, rubbing, and incubating overnight (at 4°C). All samples were kept in a smokehouse in a controlled environment with drying cycle at 78°F and 60% relative humidity. Experiment 1 was incubated in the smokehouse for a total of 12 d and experiment 2 was incubated for 9 d total. Samples from each treatment group were removed on Days 0, 2, 5, 7, 9, and 12 (experiment 1 only) for microbiological sampling and analysis. Samples were homogenized, serially diluted, enumerated on TSA plus 200 ppm nalidixic acid, and incubated at 35°C for 18–24 h. Colonies were counted after 24 h and colony counts were transformed into log10 CFU for reporting.ResultsThe data for experiment 2 showed that the treatments LA, M, MLA, and PIC were able to achieve a 2.5–3 log10 CFU reduction after 9 d of drying. The M and MLA treatments exhibited a 2–3 log10 CFU reduction after 2 d of drying as compared with LA and PIC that showed a similar reduction in microbial counts after 9 d of incubation. The NC and NCD treatment groups resulted in no microbial growth from Day 0 till Day 9 of incubation. The data for experiment 1 showed that there was a 1 log10 CFU reduction of E. coli in treatment group I. The NC and NCD groups did not show microbial growth from Day 0 till Day 9 of incubation. The water activity decreased overtime to 0.722 for experiment 1 and 0.711 for experiment 2. Overall, the M and the MLA samples appeared to have the greatest and quickest killing effect on generic E. coli.ConclusionResults from these experiments suggest that the combination of drying with a lactic acid spray and marinade application causes a decrease in the E. coli population on Biltong during incubation for 9 or 12 d. While the results show that there may be a small decrease from drying alone, the greatest decreasing effect appears to be the combination of the drying, lactic acid, and marinade. Future work will include additional replicates and experiments with pathogens such as E. coli O157:H7.
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Patel N, Mishra A. Clinical and Coronary Angiographic Profile of ST-Elevation Myocardial Infarction in Patients with Failed Thrombolysis versus Successful Thrombolysis. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ramakant P, Rana C, Singh KR, Mishra A. Primary adrenal teratoma: An unusual tumor - Challenges in diagnosis and surgical management. J Postgrad Med 2019; 64:112-114. [PMID: 29067922 PMCID: PMC5954807 DOI: 10.4103/jpgm.jpgm_588_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We report a rare case of a 25-year-old lady who presented with right hypochondriac pain associated with weakness for 3 months. Her hormonal evaluation was normal. Computed tomography scan revealed an adrenal mass for which a right open transperitoneal adrenalectomy was performed, and the lesion was diagnosed as mature teratoma on histopathological examination. Teratoma is an unusual neoplasm which arises from one or all the three germ layers. Extragonadal teratomas are rare in adults as compared to children and are mostly retroperitoneal in location, constituting only 4% of all primary teratomas. Primary adrenal teratomas are even rarer and to the best of our knowledge, only eight cases have been reported in adults in the past 10 years. Adrenal teratoma can pose a diagnostic challenge because radiologically it mimics myelolipoma, angiomyolipoma, liposarcoma, or pheochromocytoma. Mature teratomas are usually benign but may possess malignant potential, the chances of which are greater in adults as compared to children, making it an important entity requiring a proper diagnosis and management.
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