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Shanmugavel Geetha H, Prabhu S, Sekar A, Gogtay M, Singh Y, Mishra AK, Abraham GM, Martin S. Use of inflammatory markers as predictor for mechanical ventilation in COVID-19 patients with stages IIIb-V chronic kidney disease? World J Virol 2023; 12:286-295. [PMID: 38187498 PMCID: PMC10768391 DOI: 10.5501/wjv.v12.i5.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Studies have shown elevated C-reactive protein (CRP) to predict mechanical ventilation (MV) in patients with coronavirus disease 2019 (COVID-19). Its utility is unknown in patients with chronic kidney disease (CKD), who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance. AIM To assess whether an association exists between elevated inflammatory markers and MV rate in patients with stages IIIb-V CKD and COVID-19. METHODS We conducted a retrospective cohort study on patients with COVID-19 and stages IIIb-V CKD. The primary outcome was the rate of invasive MV, the rate of noninvasive MV, and the rate of no MV. Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables. Cutoffs for variables were CRP: 100 mg/L, ferritin: 530 ng/mL, D-dimer: 0.5 mg/L, and lactate dehydrogenase (LDH): 590 U/L. RESULTS 290 were screened, and 118 met the inclusion criteria. CRP, D-dimer, and ferritin were significantly different among the three groups. On univariate analysis for invasive MV (IMV), CRP had an odds ratio (OR)-5.44; ferritin, OR-2.8; LDH, OR-7.7; D-dimer, OR-3.9, (P < 0.05). The admission CRP level had an area under curve-receiver operator characteristic (AUROC): 0.747 for the IMV group (sensitivity-80.8%, specificity-50%) and 0.663 for the non-IMV (NIMV) group (area under the curve, sensitivity-69.2%, specificity-53%). CONCLUSION Our results demonstrate a positive correlation between CRP, ferritin, and D-dimer levels and MV and NIMV rates in CKD patients. The AUROC demonstrates a good sensitivity for CRP levels in detecting the need for MV in patients with stages IIIb-V CKD. This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation and reduced clearance due to CKD alone.
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Affiliation(s)
| | - Sushmita Prabhu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Abinesh Sekar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Maya Gogtay
- Hospice and Palliative Medicine, University of Texas Health-San Antonio, San Antonio, TX 78201, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Ajay K Mishra
- Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - George M Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Suzanne Martin
- Department of Nephrology, Saint Vincent Hospital, Worcester, MA 01608, United States
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Suresh MG, Gogtay M, Singh Y, Yadukumar L, Mishra AK, Abraham GM. Case-control analysis of venous thromboembolism risk in non-alcoholic steatohepatitis diagnosed by transient elastography. World J Clin Cases 2023; 11:8126-8138. [PMID: 38130793 PMCID: PMC10731178 DOI: 10.12998/wjcc.v11.i34.8126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Studies have shown a strong association between non-alcoholic steatohepatitis (NASH) cirrhosis and portal vein thrombosis. Specifically, there is paucity of data on the association of NASH and venous thromboembolism (VTE), with one such study predicting a 2.5-fold increased risk for VTE compared to other liver diseases in hospitalized patients. The mechanism is believed to be a hepatocellular injury, which causes a chronic inflammatory state leading to the unregulated activation of procoagulant factors. There has been no prior analysis of the degree of steatosis and fibrosis (measured using transient elastography, commonly known as FibroScan) in NASH and its association with VTE. AIM To examine the association between the degree of hepatic steatosis and fibrosis, quantified by transient elastography, and the incidence of VTE in patients with NASH. METHODS In our case-control study, we included patients with a documented diagnosis of NASH. We excluded patients with inherited thrombophilia, hemoglobinopathy, malignancy, alcohol use disorder, autoimmune hepatitis, and primary biliary cirrhosis. The collected data included age, demographics, tobacco use, recreational drug use, medical history, and vibration controlled transient elastography scores. VTE-specific data included the location, type of anticoagulant, need for hospital stay, and history of VTE recurrence. Steatosis was categorized as S0-S1 (mild) and S2-S3 (moderate to severe) based on the controlled attenuation parameter score. Fibrosis was classified based on the kilopascal score and graded as F0-F1 (Metavir stage), F2, F3, and F4 (cirrhosis). χ2 and Mann-Whitney U tests were used for the qualitative and quantitative variable analyses, respectively. Furthermore, we performed a logistic regression using VTE as the dependent variable. RESULTS A total of 415 patients were analyzed, and 386 met the inclusion criteria. 51 and 335 patients were included in the VTE and non-VTE groups, respectively. Patients with VTE had a mean age of 60.63 years compared to 55.22 years in the non-VTE group (P < 0.014). Patients with VTE had a higher body mass index (31.14 kg/m² vs 29.30 kg/m²) and a higher prevalence of diabetes mellitus (29.4% vs 13.1%). The history of NASH was significantly higher in the VTE group (45.1% vs 30.4%, P < 0.037). Furthermore, moderate-to-severe steatosis was significantly higher in the VTE group (66.7% vs 47.2%, P < 0.009). Similarly, the F2-F4 fibrosis grade had a prevalence of 58.8% in the VTE group compared to 38.5% in the non-VTE group (P < 0.006). On logistic regression, using VTE as a dependent variable, diabetes mellitus had an odds ratio (OR) =1.702 (P < 0.015), and F2-F4 fibrosis grade had an OR = 1.5 (P < 0.033). CONCLUSION Our analysis shows that NASH is an independent risk factor for VTE, especially deep vein thrombosis. There was a statistically significant association between the incidence of VTE, moderate-to-severe steatosis, and fibrosis. All hospitalized patients should be considered for medical thromboprophylaxis, particularly those with NASH.
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Affiliation(s)
- Mithil Gowda Suresh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Maya Gogtay
- Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Yuvaraj Singh
- Department of Gastroenterology and Hepatology, University of Massachusetts, Worcester, MA 01605, United States
| | - Lekha Yadukumar
- Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
| | - Ajay Kumar Mishra
- Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - George M Abraham
- Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
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Soni A, Yekula A, Dahiya DS, Sundararajan R, Dutta P, Singh Y, Cheng CI, Abraham G. Influence of nonalcoholic fatty liver disease on inflammatory bowel disease hospitalizations in the United States. Ann Gastroenterol 2023; 36:646-653. [PMID: 38023970 PMCID: PMC10662065 DOI: 10.20524/aog.2023.0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background The reported prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD) is 32%. We assessed the influence of NAFLD on IBD hospitalizations in the United States (US). Methods We utilized the National Inpatient Sample database, from 2016-2019, to identify the total IBD hospitalizations in the US and we further subdivided them according to the presence or absence of NAFLD. Hospitalization characteristics, comorbidities and outcomes were compared. Statistical significance was set at P<0.05. Results There were 1,272,260 IBD hospitalizations in the US, of which 5.04% involved NAFLD. For IBD hospitalizations with NAFLD, the mean age was 50-64 years, and the proportion of males was 46.97%. IBD hospitalizations with NAFLD had a lower proportion of African Americans (8.7% vs. 11.38%, P<0.001). Comorbidities such as hypertension (50.34% vs. 44.04%, P<0.001) and obesity (18.77% vs. 11.81%, P<0.001) were significantly higher in the NAFLD cohort. Overall, based on the Charlson Comorbidity Index, patients with NAFLD had a higher number of comorbidities (52.77% vs. 20.66%, P<0.001). Mortality was higher in the NAFLD compared to the non-NAFLD cohort (3.14% vs. 1.44%, P<0.001). Patients with NAFLD also incurred significantly higher hospital charges ($69,536 vs. $55,467, p<0.001) and had a longer mean length of stay (6.10 vs. 5.27 days, P<0.001) compared to the cohort without NAFLD. Complications and inpatient procedure requirements were also higher in the NAFLD cohort. Conclusion Our study revealed greater mortality, morbidity, and healthcare resource utilization in patients with IBD who were hospitalized with a concomitant diagnosis of NAFLD.
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Affiliation(s)
- Aakriti Soni
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA (Aakriti Soni, Anuroop Yekula, Yuvaraj Singh, George Abraham)
| | - Anuroop Yekula
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA (Aakriti Soni, Anuroop Yekula, Yuvaraj Singh, George Abraham)
| | - Dushyant Singh Dahiya
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI (Dushyant Singh Dahiya)
| | - Ramaswamy Sundararajan
- Department of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (Ramaswamy Sundararajan)
| | - Priyata Dutta
- Department of Internal Medicine, Trinity Health, Ann Arbor, MI (Priyata Dutta)
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA (Aakriti Soni, Anuroop Yekula, Yuvaraj Singh, George Abraham)
| | - Chin-I Cheng
- Department of Statistics, Actuarial, and Data Science, Central Michigan University, Mt. Pleasant, MI (Chin-I Cheng)
| | - George Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA (Aakriti Soni, Anuroop Yekula, Yuvaraj Singh, George Abraham)
- Department of Infectious Diseases, Saint Vincent Hospital, Worcester, MA (George Abraham), USA
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Singh Y, Castillo-Mancilla J, Madimabe R, Jennings L, Ferraris CM, Robbins RN, Anderson PL, Remien RH, Orrell C. Tenofovir diphosphate in dried blood spots and HIV-1 resistance in South Africa. AIDS Res Ther 2023; 20:67. [PMID: 37705102 PMCID: PMC10500931 DOI: 10.1186/s12981-023-00552-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/29/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Suboptimal antiretroviral (ART) adherence can lead to virologic failure with consequent HIV-1 resistance. Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a powerful biomarker of cumulative adherence, predictive of future viremia. It has been associated with resistance in Persons With HIV (PWH) in South Africa and the US. We explored the relationship of TFV-DP concentrations with antiretroviral drug resistance at the time of treatment failure in SA. METHODS Adult PWH from health clinics in Cape Town, South Africa on efavirenz-based first-line ART containing tenofovir disoproxil fumarate (TDF) with an undetectable (< 50 copies/mL) HIV-1 viral load (VL) were prospectively enrolled in an observational cohort for 12 months. Monthly study visits included blood collection for HIV-1 VL and DBS for TFV-DP. The first confirmed viral breakthrough (VB) > 400 copies/mL triggered HIV-1 genotyping at the subsequent visit. An electronic adherence (EA) device monitored ART adherence in real-time, estimated as a percent for the 30-days prior to VB. Wilcoxon rank sum test was used to compare median [IQR] TFV-DP by genotype outcome. RESULTS Of 250 individuals, (n = 195, 78% women), 21 experienced VB, with a median of 5 [4;7] months on study, and a median EA of 33.3 [13.3;53.3]%. Demographic characteristics between those with and without VB were similar. Median VL at VB was 4.0 [3.2;4.5] log copies/mL. TFV-DP concentrations trended down towards the VB visit. Median TFV-DP concentrations were significantly higher in those HIV-1 genotype did not amplify due to being virally suppressed at the subsequent visit (n = 10; 380 [227-661] fmol/punch, p = 0.035; EA 45 [24.9; 59.2]%); than in those who were successfully genotyped with evidence of drug resistance (n = 5, 241 [150-247] fmol/punch, EA 20 [6.7;36.7]%) and in individuals who did not have resistance (n = 3, 39.9 [16.6; 93.9] fmol/punch; EA 33.3 [16-38]%). Three genotype collections were not done. Only non-nucleoside reverse transcriptase inhibitor-associated mutations were identified on resistance testing. (K103N, E138K, Y118H). CONCLUSION TFV-DP in DBS showed a step-wise inverse relationship with VB and drug resistance, with evidence of low cumulative ART adherence in PWH who developed antiretroviral resistance. Monitoring TFV-DP concentrations could be a valuable tool for predicting future VB and future resistance.
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Affiliation(s)
- Y Singh
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | | | - R Madimabe
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - L Jennings
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - C M Ferraris
- New York State Psychiatric Institute, New York, USA
| | - R N Robbins
- New York State Psychiatric Institute, New York, USA
- Columbia University Irving Medical Center, New York, USA
| | | | - R H Remien
- New York State Psychiatric Institute, New York, USA
- Columbia University Irving Medical Center, New York, USA
| | - C Orrell
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa
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Yukselen Z, Singh Y, Malempati S, Dasari M, Arun Kumar P, Ramsaran E. Virtual patient education for hypertension: The truth about behavioral change. World J Cardiol 2023; 15:324-327. [PMID: 37397829 PMCID: PMC10308268 DOI: 10.4330/wjc.v15.i6.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/11/2023] [Accepted: 05/22/2023] [Indexed: 06/26/2023] Open
Abstract
Anti-hypertensive education is an important public health intervention to decrease the mortality and burden of the disease. Using digital technologies for education as a part of preventive measures for hypertension is a cost-effective approach and helps low-income communities and vulnerable populations overcome barriers to healthcare access. The coronavirus disease 19 pandemic further highlighted the need of new health interventions to address health inequalities. Virtual education is helpful to improve awareness, knowledge, and attitude toward hypertension. However, given the complexity of behavioral change, educational approaches do not always provide a change in behavior. Some of the obstacles in online hypertensive education could be time limitations, not being tailored to individual needs and not including the different elements of behavioral models to enhance behavior change. Studies regarding virtual education should be encouraged and involve lifestyle modifications emphasizing the importance of Dietary Approaches to Stop Hypertension diet, salt restriction, and exercise and should be used adjunct to in-person visits for the management of hypertension. Additionally, to stratify patients according to hypertension type (essential or secondary) would be useful to create specific educational materials. Virtual hypertension education is promising to increase awareness regarding risk factors and most importantly motivate patients to be more compliant with management helping to decrease hypertension related complications and hospitalizations.
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Affiliation(s)
- Zeynep Yukselen
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Sarat Malempati
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Mahati Dasari
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Pramukh Arun Kumar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Eddison Ramsaran
- Department of Cardiovascular Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
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Dasari M, Arun Kumar P, Singh Y, Ramsaran E. New scoring system for acute chest pain risk stratification: Is it worth SVEAT-ing it? World J Cardiol 2023; 15:200-204. [PMID: 37124978 PMCID: PMC10130892 DOI: 10.4330/wjc.v15.i4.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 04/20/2023] Open
Abstract
The emergency room is a very potent environment in the hospital. With the growing demands of the population, improved accessibility to health resources, and the onslaught of the triple pandemic, it is extremely crucial to triage patients at presentation. In the spectrum of complaints, chest pain is the commonest. Despite it being a daily ailment, chest pain brings concern to every physician at first. Chest pain could span from acute coronary syndrome, pulmonary embolism, and aortic dissection (all potentially fatal) to reflux, zoster, or musculoskeletal causes that do not need rapid interventions. We often employ scoring systems such as GRACE/PURSUIT/TIMI to assist in clinical decision-making. Over the years, the HEART score became a popular and effective tool for predicting the risk of 30-d major adverse cardiovascular events. Recently, a new scoring system called SVEAT was developed and compared to the HEART score. We have attempted to summarize how these scoring systems differ and their generalizability. With an increasing number of scoring systems being introduced, one must also prevent anchorage bias; i.e., tools such as these are only diagnosis-specific and not organ-specific, and other emergent differential diagnoses must also be kept in mind before discharging the patient home without additional workup.
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Affiliation(s)
- Mahati Dasari
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Pramukh Arun Kumar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Eddison Ramsaran
- Department of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
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Geetha HS, Singh G, Sekar A, Gogtay M, Singh Y, Abraham GM, Trivedi N. Hyperglycemia in COVID-19 infection without diabetes mellitus: Association with inflammatory markers. World J Clin Cases 2023; 11:1287-1298. [PMID: 36926123 PMCID: PMC10013116 DOI: 10.12998/wjcc.v11.i6.1287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/17/2022] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019 (COVID-19) infection. Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia, but factors like direct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced pancreatic β-cell failure have also been postulated to play a role.
AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infection-induced hyperglycemia, particularly the rationale of the cytokine-induced hyperglycemia hypothesis, by evaluating the association between inflammatory markers and new onset hyperglycemia in non-diabetic patients with COVID-19 infection.
METHODS We conducted a retrospective case-control study on adults without diabetes mellitus hospitalized for COVID-19 infection. The serum levels of glucose and inflammatory markers at presentation before initiation of corticosteroid were collected. Hyperglycemia was defined as glucose levels ≥ 140 mg/dL. C-Reactive protein (CRP) ≥ 100 mg/L, ferritin ≥ 530 ng/mL, lactate dehydrogenase (LDH) ≥ 590 U/L, and D-dimer ≥ 0.5 mg/L were considered elevated. We used the χ2 test for categorical variables and the Mann-Whitney U test for continuous variables and calculated the logistic regression for hyperglycemia.
RESULTS Of the 520 patients screened, 248 met the inclusion criteria. Baseline demographics were equally distributed between patients with hyperglycemia and those who were normoglycemic. Serum inflammatory markers in patients with or without new-onset hyperglycemia were elevated as follows: CRP (58.1% vs 65.6%, P = 0.29), ferritin (48.4% vs 34.9%, P = 0.14), D-dimer (37.1% vs 37.1%, P = 0.76) and LDH (19.4% vs 11.8%, P = 0.02). Logistic regression analysis showed LDH odds ratio (OR) = 1.623 (P = 0.256). We observed significantly higher mortality (24.2% vs 9.1%, P = 0.001; OR = 2.528, P = 0.024) and length of stay (8.89 vs 6.69, P = 0.026) in patients with hyperglycemia.
CONCLUSION Our study showed no association between CRP, ferritin, LDH, D-dimer levels, and new-onset hyperglycemia in non-diabetic patients with COVID-19 infection. It also shows an increased mortality risk and length of stay in patients with hyperglycemia. With new-onset hyperglycemia being closely associated with poor prognostic indices, it becomes pivotal to understand the underlying pathophysiological mechanisms behind the SARS-CoV-2 infection-induced hyperglycemia. We conclude that the stress hyperglycemia hypothesis is not the only mechanism of SARS-CoV-2 infection-induced hyperglycemia but rather a multicausal pathogenesis leading to hyperglycemia that requires further research and understanding. This would help us improve not only the clinical outcomes of COVID-19 disease and inpatient hyperglycemia management but also understand the long-term effects of SARS-CoV-2 infection and further management.
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Affiliation(s)
| | - Garima Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Abinesh Sekar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Maya Gogtay
- Department of Hospice and Palliative Medicine, University of Texas Health, San Antonio, TX 78229, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - George M Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
- Department of Internal Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, United States
| | - Nitin Trivedi
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
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Gogtay M, Singh Y, Yekula A, Abraham GM. Calculator for detection of colorectal adenomas by using artificial intelligence models in patients with chronic hepatitis C. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
70 Background: Hepatitis C virus (HCV) is known for its oncogenic potential, especially in hepatocellular carcinoma and non-Hodgkin lymphoma. On review, several studies have indicated that patients with chronic hepatitis C (CHC) have an increased risk of developing colorectal cancer (CRC). We developed an artificial intelligence (AI) based tool using machine learning (ML) algorithms to help stratify these patients into a higher risk of CRC/adenomas. Methods: The study was approved by the institutional review board. We developed an AI automated calculator uploaded to a graphical user interface (GUI), and we applied ML to train models to predict the probability and the number of adenomas detected on colonoscopy. Data collected were age, smoking history, significant alcohol consumption, aspirin intake, ethnicity, HCV status, gender, body mass index (BMI), and colonoscopy findings. The models can operate either in the presence or absence of the above parameters. Data sets were split into 70:30 ratios for training and internal validation. Scikit-learn StandardScaler was used to scale values of continuous variables. We used the colonoscopy findings as the gold standard and applied a deep learning architecture to train six ML models for prediction. The ML models used were Support Vector Classifier, Random Forest, Bernoulli Naïve Bayes (BNB), Gradient Boosting Classifier (GBC), Logistic Regression, and Deep Neural Networks. Additional regression models were trained and tested to predict the number of polyps. A Flask (customizable python framework) application programming interface (API) was used to deploy the trained ML model with the highest accuracy as a web application. Finally, Heroku was used for the deployment of the web-based API to https://adenomadetection.herokuapp.com. Results: Data was collected for 415 patients, of which only 206 had colonoscopy results. On internal validation with the remaining patients, BNB predicted the probability of adenoma detection with the highest accuracy of 56%, precision of 55%, recall of 55%, and F1 measure of 54%. Support Vector Regressor (SVR) predicted the number of adenomas with the least mean absolute error (MAE) of 0.905. Conclusions: Our AI-based tool shows an association between CHC and colorectal adenomas. This tool can help providers stratify patients with CHC for early referral for screening colonoscopy. Along with giving a numerical percentage, the calculator can also comment on the number of adenomatous polyps a gastroenterologist can expect while doing a colonoscopy, thus prompting a higher adenoma detection rate.
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Affiliation(s)
- Maya Gogtay
- Hospice and Palliative Medicine, University of Texas Health Science Center, San Antonio, TX
| | - Yuvaraj Singh
- Internal Medicine, St. Vincent Hospital, Worcester, MA
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Soni A, Yekula A, Singh Y, Sood N, Dahiya DS, Bansal K, Abraham GM. Influence of non-alcoholic fatty liver disease on non-variceal upper gastrointestinal bleeding: A nationwide analysis. World J Hepatol 2023; 15:79-88. [PMID: 36744164 PMCID: PMC9896500 DOI: 10.4254/wjh.v15.i1.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease globally with an estimated prevalence of 25%, with the clinical and economic burden expected to continue to increase. In the United States, non-variceal upper gastrointestinal bleeding (NVUGIB) has an estimated incidence of 61-78 cases per 100000 people with a mortality rate of 2%-15% based on co-morbidity burden.
AIM To identify the outcomes of NVUGIB in NAFLD hospitalizations in the United States.
METHODS We utilized the National Inpatient Sample from 2016-2019 to identify all NVUGIB hospitalizations in the United States. This population was divided based on the presence and absence of NAFLD. Hospitalization characteristics, outcomes and complications were compared.
RESULTS The total number of hospitalizations for NVUGIB was 799785, of which 6% were found to have NAFLD. NAFLD and GIB was, on average, more common in younger patients, females, and Hispanics than GIB without NAFLD. Interestingly, GIB was less common amongst blacks with NAFLD. Multivariate logistic regression analysis was conducted, controlling for the multiple covariates. The primary outcome of interest, mortality, was found to be significantly higher in patients with NAFLD and GIB [adjusted odds ratio (aOR) = 1.018 (1.013-1.022)]. Secondary outcomes of interest, shock [aOR = 1.015 (1.008-1.022)], acute respiratory failure [aOR = 1.01 (1.005-1.015)] and acute liver failure [aOR = 1.016 (1.013-1.019)] were all more likely to occur in this cohort. Patients with NAFLD were also more likely to incur higher total hospital charges (THC) [$2148 ($1677-$2618)]; however, were less likely to have a longer length of stay [0.27 d (0.17-0.38)]. Interestingly, in our study, the patients with NAFLD were less likely to suffer from acute myocardial infarction [aOR = 0.992 (0.989-0.995)]. Patients with NAFLD were not more likely to suffer acute kidney injury, sepsis, blood transfusion, intubation, or dialysis.
CONCLUSION NVUGIB in NAFLD hospitalizations had higher inpatient mortality, THC, and complications such as shock, acute respiratory failure, and acute liver failure compared to those without NAFLD.
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Affiliation(s)
- Aakriti Soni
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Anuroop Yekula
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Nitish Sood
- Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States
| | - Dushyant Singh Dahiya
- Department of Internal Medicine, Central Michigan University, Saginaw, MI 48602, United States
| | - Kannu Bansal
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - GM Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
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10
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Singh Y, Gogtay M, Yekula A, Soni A, Mishra AK, Tripathi K, Abraham GM. Detection of colorectal adenomas using artificial intelligence models in patients with chronic hepatitis C. World J Hepatol 2023; 15:107-115. [PMID: 36744168 PMCID: PMC9896503 DOI: 10.4254/wjh.v15.i1.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/21/2022] [Accepted: 11/14/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Hepatitis C virus is known for its oncogenic potential, especially in hepatocellular carcinoma and non-Hodgkin lymphoma. Several studies have shown that chronic hepatitis C (CHC) has an increased risk of the development of colorectal cancer (CRC).
AIM To analyze this positive relationship and develop an artificial intelligence (AI)-based tool using machine learning (ML) algorithms to stratify these patient populations into risk groups for CRC/adenoma detection.
METHODS To develop the AI automated calculator, we applied ML to train models to predict the probability and the number of adenomas detected on colonoscopy. Data sets were split into 70:30 ratios for training and internal validation. The Scikit-learn standard scaler was used to scale values of continuous variables. Colonoscopy findings were used as the gold standard and deep learning architecture was used to train six ML models for prediction. A Flask (customizable Python framework) application programming interface (API) was used to deploy the trained ML model with the highest accuracy as a web application. Finally, Heroku was used for the deployment of the web-based API to https://adenomadetection.herokuapp.com.
RESULTS Of 415 patients, 206 had colonoscopy results. On internal validation, the Bernoulli naive Bayes model predicted the probability of adenoma detection with the highest accuracy of 56%, precision of 55%, recall of 55%, and F1 measure of 54%. Support vector regressor predicted the number of adenomas with the least mean absolute error of 0.905.
CONCLUSION Our AI-based tool can help providers stratify patients with CHC for early referral for screening colonoscopy. Along with providing a numerical percentage, the calculator can also comment on the number of adenomatous polyps a gastroenterologist can expect, prompting a higher adenoma detection rate.
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Affiliation(s)
- Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Maya Gogtay
- Hospice and Palliative Medicine, University of Texas Health-San Antonio, San Antonio, TX 78201, United States
| | - Anuroop Yekula
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Aakriti Soni
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Ajay Kumar Mishra
- Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Kartikeya Tripathi
- Division of Gastroenterology and Hepatology, UMass Chan School-Baystate Medical Center, Springfield, MA 01199, United States
| | - GM Abraham
- Division of Infectious Disease, Chief of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
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11
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Mushtaq S, Kumar N, Singh P, Singh Y. Vision and Audio-Based Methods for First Impression Recognition Using Machine Learning Algorithms: A Review. INT J ARTIF INTELL T 2022. [DOI: 10.1142/s0218213023400109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Zitek T, Pagano K, Singh Y, Mechanic O, Farcy D. 283 Trauma Team Activation Fees Vary Widely Based on Region and Hospital Type. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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13
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Gogtay M, Singh Y, Bullappa A, Yekula A, Abraham G. 330P Does hepatitis C independently increase the risk of colorectal adenoma? Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Dalle Zotte A, Singh Y, Gerencsér Z, Matics Z, Szendrő Z, Cappellozza S, Cullere M. Feeding silkworm (Bombyx mori L.) oil to growing rabbits improves the fatty acid composition of meat, liver and perirenal fat. Meat Sci 2022; 193:108944. [PMID: 35969976 DOI: 10.1016/j.meatsci.2022.108944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/05/2022] [Accepted: 08/04/2022] [Indexed: 10/31/2022]
Abstract
Silkworm oil was used in a rabbit diet to evaluate its benefit on the fatty acid (FA) profile of different carcass portions. Two experimental diets were prepared: a control diet (commercial diet with 13 g/kg sunflower oil) and a silkworm oil diet (SWO) (commercial diet with 13 g/kg silkworm oil). Rabbits received the experimental diets the last three weeks before slaughter, which occurred at 10 weeks of age. At slaughter, hind leg meat, liver, and perirenal fat were sampled for FA profile analysis. The SWO diet significantly increased the n-3 FA of all three sampling sites and halved the n-6/n-3 ratio of hind leg meat and perirenal fat. Furthermore, the liver of SWO rabbits was also richer in C22:6 n-3 compared to that of control rabbits. In conclusion, this study demonstrated that the total dietary replacement of sunflower oil with silkworm oil in fattening rabbits positively changed the FA profile of the considered carcass tissues.
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Affiliation(s)
- A Dalle Zotte
- Department of Animal Medicine, Production and Health, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy.
| | - Y Singh
- Department of Animal Medicine, Production and Health, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy.
| | - Zs Gerencsér
- Hungarian University of Agriculture and Life Sciences, Kaposvár Campus, H-7400 Kaposvár, Guba Sándor u. 40, Hungary.
| | - Zs Matics
- Hungarian University of Agriculture and Life Sciences, Kaposvár Campus, H-7400 Kaposvár, Guba Sándor u. 40, Hungary.
| | - Zs Szendrő
- Hungarian University of Agriculture and Life Sciences, Kaposvár Campus, H-7400 Kaposvár, Guba Sándor u. 40, Hungary.
| | - S Cappellozza
- Council for Agricultural Research and Economics, Research Centre for Agriculture and Environment (CREA - AA), Sericulture Laboratory of Padova, Via Eulero 6a, 35143 Padova, Italy.
| | - M Cullere
- Department of Animal Medicine, Production and Health, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy.
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15
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Tripathi A, Ranjan MR, Verma DK, Singh Y, Shukla SK, Rajput VD, Minkina T, Mishra PK, Garg MC. Author Correction: ANN-GA based biosorption of As(III) from water through chemo-tailored and iron impregnated fungal biofilter system. Sci Rep 2022; 12:13228. [PMID: 35918382 PMCID: PMC9345897 DOI: 10.1038/s41598-022-17593-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Tripathi
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India.
| | - M R Ranjan
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India
| | - D K Verma
- School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, U.P., 221005, India
| | - Y Singh
- School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, U.P., 221005, India
| | - S K Shukla
- Department of Transport Science and Technology, School of Engineering and Technology, Central University of Jharkhand, Ranchi, Jharkhand, 835222, India
| | - Vishnu D Rajput
- Academy of Biology and Biotechnology, Southern Federal University, Rostov-on-Don, Russia, 344090
| | - Tatiana Minkina
- Academy of Biology and Biotechnology, Southern Federal University, Rostov-on-Don, Russia, 344090
| | - P K Mishra
- Department of Chemical Engineering, IIT BHU, Varanasi, U.P., 221005, India
| | - M C Garg
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India
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16
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Tripathi A, Ranjan MR, Verma DK, Singh Y, Shukla SK, Rajput VD, Minkina T, Mishra PK, Garg MC. ANN-GA based biosorption of As(III) from water through chemo-tailored and iron impregnated fungal biofilter system. Sci Rep 2022; 12:12414. [PMID: 35858932 PMCID: PMC9300712 DOI: 10.1038/s41598-022-14802-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
The iron impregnated fungal bio-filter (IIFB) discs of luffa sponge containing Phanerochaete chrysosporium mycelia have been used for the removal of As(III) from water. Two different forms of same biomass viz. free fungal biomass (FFB) and modified free fungal biomass (chemically modified and iron impregnated; CFB and IIFB) have been simultaneously investigated to compare the performance of immobilization, chemo-tailoring and iron impregnation for remediation of As(III). IIFB showed highest uptake capacity and percentage removal of As(III), 1.32 mg/g and 92.4% respectively among FFB, CFB and IIFB. Further, the application of RSM and ANN-GA based mathematical model showed a substantial increase in removal i.e. 99.2% of As(III) was filtered out from water at optimised conditions i.e. biomass dose 0.72 g/L, pH 7.31, temperature 42 °C, and initial As(III) concentration 1.1 mg/L. Isotherm, kinetic and thermodynamic studies proved that the process followed monolayer sorption pattern in spontaneous and endothermic way through pseudo-second order kinetic pathway. Continuous mode of As(III) removal in IIFB packed bed bioreactor, revealed increased removal of As(III) from 76.40 to 88.23% with increased column height from 5 to 25 cm whereas the removal decreased from 88.23 to 69.45% while increasing flow rate from 1.66 to 8.30 mL/min. Moreover, the IIFB discs was regenerated by using 10% NaOH as eluting agent and evaluated for As(III) removal for four sorption–desorption cycles, showing slight decrease of their efficiency by 1–2%. SEM–EDX, pHzpc, and FTIR analysis, revealed the involvement of hydroxyl and amino surface groups following a non-electrostatic legend exchange sorption mechanism during removal of As(III).
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Affiliation(s)
- A Tripathi
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India.
| | - M R Ranjan
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India
| | - D K Verma
- School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, U.P., 221005, India
| | - Y Singh
- School of Biochemical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, U.P., 221005, India
| | - S K Shukla
- Department of Transport Science and Technology, School of Engineering and Technology, Central University of Jharkhand, Ranchi, Jharkhand, 835222, India
| | - Vishnu D Rajput
- Academy of Biology and Biotechnology, Southern Federal University, Rostov-on-Don, Russia, 344090
| | - Tatiana Minkina
- Academy of Biology and Biotechnology, Southern Federal University, Rostov-on-Don, Russia, 344090
| | - P K Mishra
- Department of Chemical Engineering, IIT BHU, Varanasi, U.P., 221005, India
| | - M C Garg
- Amity Institute of Environmental Sciences, Amity University Uttar Pradesh, Noida-125, Gautam Buddha Nagar, U.P., 201303, India
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Singh Y, Bharti J, Chaoudhary G. ONCOCYTIC ADRENOCORTICAL CARCINOMA IN A YOUNG PATIENT. Acta Endocrinol (Buchar) 2022; 18:383-386. [PMID: 36699174 PMCID: PMC9867804 DOI: 10.4183/aeb.2022.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Context Adrenocortical carcinoma (ACC) is a rare neoplasm with an aggressive course and poor prognosis. The worldwide incidence is about 0.5 to 2 cases per million population per year. Oncocytic adrenocortical carcinoma is a rare histopathological variant of ACC with only a few reported cases in the literature. Case report We report a case of an oncocytic variant of adrenocortical carcinoma in a 21-year-old male patient who presented with a left adrenal mass. Imaging studies confirmed a large left adrenal mass with involvement of the left renal vein and inferior vena cava. Endocrine workup showed mildly elevated serum cortisol levels. Discussion Oncocytic AAC is a rare histopathological variant of ACC, as well as a rare subgroup of oncocytic adrenal neoplasms Hormonally active or functioning adrenocortical carcinomas most commonly secrete cortisol whereas co-secretion of multiple steroid hormones is a rare phenomenon. Conclusions Surgery remains the mainstay of treatment, but most of the patients present late with large masses and eventually become unsuitable for curative resection.
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Affiliation(s)
- Y. Singh
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
| | - J.N. Bharti
- Correspondence to: Jyotsna Naresh Bharti, All India Institute of Medical Sciences, Department of Pathology, Mangalagiri, Guntur,India, E-mail:
| | - G.R. Chaoudhary
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, India
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18
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Thomas D, Molan A, Singh Y, Ravindran V. Influence of green tea powder on the performance, nutrient utilisation, caecal microbiota profile and meat quality of broiler chickens. Journal of Applied Animal Nutrition 2022. [DOI: 10.3920/jaan2022.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study assessed the influence of green tea powder diet supplementation on performance, nutrient utilisation, caecal microbiota profile and meat quality in broiler chickens. A total of 144, one-day-old broiler (Ross 308) chicks were allocated to 18 cages (eight broilers/cage) which were randomly assigned to one of three dietary treatments: a wheat-based basal diet or supplemented with one of two types of green tea; normal (N-GT) or selenium-rich (Se-GT) tea, at an inclusion rate of 1%. Bird performance, nitrogen-corrected apparent metabolisable energy (AMEn), and total tract digestibility of fat and starch were measured on d 7, 21 and 35. Effects on microbiota profile on d 7, 21 and 35 were determined in a cohort study. Green tea supplementation reduced (P<0.05) the weight gain and feed intake but improved (P<0.05) feed efficiency. Supplementation with N-GT increased the AMEn on d 7 and 21, and with Se-GT on d 7 (P<0.05). AMEn increased with age for all treatments. Fat digestibility increased (P<0.05) in birds fed N-GT on d 21 and Se-GT on d 7 and 21. Starch digestibility increased (P<0.05) on d 21 with N-GT supplementation and on d 7 with Se-GT supplementation. Carcass and breast meat yields were unaffected (P<0.05) by the dietary treatments. The abdominal fat pad decreased (P<0.05) in the N-GT diet and numerically in the Se- GT diet. Drip loss was less in meat from birds (P<0.05) fed both green tea treatments. Cooking loss was reduced in the Se-GT treatment (P<0.05). Dietary inclusion of green tea powder positively influenced microbiota profile, with increased (P<0.05) numbers of beneficial bacteria (Lactobacillus spp. and Bifidobacterium spp.) and reduced (P<0.05) numbers of pathogenic bacteria (Clostridium spp. and Bacteroides spp.). Differences were observed between the two green tea types, with Se-GT being more beneficial than N-GT in the positive modulation of intestinal microbiota.
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Affiliation(s)
- D.V. Thomas
- Monogastric Research Centre, School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
| | - A.L. Molan
- Monogastric Research Centre, School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
- Present address: Department of Biotechnology, College of Science, University of Diyala, Diyala, Iraq
| | - Y. Singh
- Monogastric Research Centre, School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
- Present address: Department of Livestock Production and Management, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Science University (GADVASU), Ludhiana, Punjab 141004, India
| | - V. Ravindran
- Monogastric Research Centre, School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
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Singh Y, Chitranshi J. Relevance of work-from-home culture in post Covid-19 era: regarding productivity of employees in IT sector. CM 2022. [DOI: 10.18137/cardiometry.2022.22.290296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
COVID-19 has not just affected the health of citizens. However, the world’s economic wheel stopped. All the import-export activities were sieged, schools, colleges, malls, and any other similar place, where there is a chance of gathering, has been locked down. A major section of the global economy was closed down for a period of two to three months. Still, they are operating with minimum permitted capacity. The service sector is opening up stage-wise, and people have started to work in their respective offices. Before this, most people, right from teachers to CEOs of top companies, worked from home. 100% of IT and ITES based organizations were working from their homes in the recent past; rather, these people were working from home before the COVID-19 situation. This present study will evaluate the interest areas of people working from home and try to evaluate the scenario of working from home even after the pandemic of COVID-19 is over.
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Gogtay M, Singh Y, Bullappa A, Scott J. Retrospective analysis of aspirin's role in the severity of COVID-19 pneumonia. World J Crit Care Med 2022; 11:92-101. [PMID: 35433312 PMCID: PMC8968479 DOI: 10.5492/wjccm.v11.i2.92] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/03/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Since December 2019, an outbreak of pneumonia caused by severe acute respiratory syndrome - coronavirus-2 (SARS-CoV-2) has led to a life-threatening ongoing pandemic worldwide. A retrospective study by Chow et al showed aspirin use was associated with decreased intensive care unit (ICU) admissions in hospitalized coronavirus disease 2019 (COVID-19) patients. Recently, the RECOVERY TRIAL showed no associated reductions in the 28-d mortality or the progression to mechanical ventilation of such patients. With these conflicting findings, our study was aimed at evaluating the impact of daily aspirin intake on the outcome of COVID-19 patients.
AIM To study was aimed at evaluating the impact of daily aspirin intake on the outcome of COVID-19 patients.
METHODS This retrospective cohort study was conducted on 125 COVID-19 positive patients. Subgroup analysis to evaluate the association of demographics and comorbidities was undertaken. The impact of chronic aspirin use was assessed on the survival outcomes, need for mechanical ventilation, and progression to ICU. Variables were evaluated using the chi-square test and multinomial logistic regression analysis.
RESULTS 125 patients were studied, 30.40% were on daily aspirin, and 69.60% were not. Cross-tabulation of the clinical parameters showed that hypertension (P = 0.004), hyperlipidemia (0.016), and diabetes mellitus (P = 0.022) were significantly associated with aspirin intake. Regression analysis for progression to the ICU, need for mechanical ventilation and survival outcomes against daily aspirin intake showed no statistical significance.
CONCLUSION Our study suggests that daily aspirin intake has no protective impact on COVID-19 illness-associated survival outcomes, mechanical ventilation, or progression to ICU level of care.
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Affiliation(s)
- Maya Gogtay
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
| | - Yuvaraj Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
| | - Asha Bullappa
- Community Medicine and Biostatistics, SS Institute of Medical Sciences, Davangere 577003, Karnataka, India
| | - Jeffrey Scott
- Department of Critical Care Medicine and Pulmonology, Reliant medical group- Saint Vincent Hospital, Worcester, MA 01604, United States
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21
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Singh Y, Gurung S, Gogtay M. Glycogen hepatopathy in type-1 diabetes mellitus: A case report. World J Hepatol 2022; 14:471-478. [PMID: 35317186 PMCID: PMC8891674 DOI: 10.4254/wjh.v14.i2.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/19/2021] [Accepted: 01/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been studied that fluctuating glucose levels may superimpose glycated hemoglobin in determining the risk for diabetes mellitus (DM) complications. While non-alcoholic steatohepatitis (NASH) remains a predominant cause of elevated transaminases in Type 2 DM due to a strong underplay of metabolic syndrome, Type 1 DM can contrastingly affect the liver in a direct, benign, and reversible manner, causing Glycogen hepatopathy (GH) - with a good prognosis.
CASE SUMMARY A 50-year-old female with history of poorly controlled type 1 DM, status post cholecystectomy several years ago, and obesity presented with nausea, vomiting, and abdominal pain. Her vitals at the time of admission were stable. On physical examination, she had diffuse abdominal tenderness. Her finger-stick glucose was 612 mg/dL with elevated ketones and low bicarbonate. Her labs revealed abnormal liver studies: AST 1460 U/L, ALP: 682 U/L, ALP: 569 U/L, total bilirubin: 0.3mg/dL, normal total protein, albumin, and prothrombin time/ international normalized ratio (PT/INR). A magnetic resonance cholangiopancreatography (MRCP) demonstrated mild intra and extra-hepatic biliary ductal dilation without evidence of choledocholithiasis. She subsequently underwent a diagnostic ERCP which showed a moderately dilated CBD, for which a stent was placed. Studies for viral hepatitis, Wilson’s Disease, alpha-1-antitrypsin, and iron panel came back normal. Due to waxing and waning transaminases during the hospital course, a liver biopsy was eventually done, revealing slightly enlarged hepatocytes that were PAS-positive, suggestive of glycogenic hepatopathy. With treatment of hyperglycemia and ensuing strict glycemic control, her transaminases improved, and she was discharged.
CONCLUSION With a negative hepatocellular and cholestatic work-up, our patient likely had GH, a close differential for NASH but a poorly recognized entity. GH, first described in 1930 as a component of Mauriac syndrome, is believed to be due to glucose and insulin levels fluctuation. Dual echo magnetic resonance imaging sequencing and computed tomography scans of the liver are helpful to differentiate GH from NASH. Still, liver biopsy remains the gold standard for diagnosis. Biopsy predominantly shows intra-cellular glycogen deposition, with minimal or no steatosis or inflammation. As GH is reversible with good glycemic control, it should be one of the differentials in patients with brittle diabetes and elevated transaminases. GH, however, can cause a dramatic elevation in transaminases (50-1600 IU/L) alongside hepatomegaly and abdominal pain that would raise concern for acute liver injury leading to exhaustive work-up, as was in our patient above. Fluctuation in transaminases is predominantly seen during hyperglycemic episodes, and proper glycemic control is the mainstay of the treatment.
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Affiliation(s)
- Yuvaraj Singh
- Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
| | - Susant Gurung
- Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
| | - Maya Gogtay
- Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
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Harte S, Singh Y, Malone S, Heussler H, Wallace G. Cannabidiol and refractory epilepsy: parental and caregiver perspectives of participation in a compassionate access scheme. BMC Health Serv Res 2022; 22:173. [PMID: 35144615 PMCID: PMC8832815 DOI: 10.1186/s12913-022-07592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
Background The Compassionate Access Scheme (CAS) being delivered through the Queensland Children’s Hospital is designed to allow access to an investigational purified Cannabidiol oral solution to paediatric patients with severe refractory epilepsy. The objectives of this study were to conduct semi-structured interviews to: 1. Understand families’ expectations and attitudes about the use of an investigational cannabinoid product for their child’s seizures; 2. Understand families’ perceptions of Cannabidiol’s efficacy for their child’s seizures; and other aspects of their child’s behaviour, quality of life and/or cognition. Methods Children aged 2-18 years had been enrolled in, or were enrolled in a compassionate access scheme for Cannabidiol at the time of the study. Semi-structured interviews (n = 19) with parents or caregivers (n = 23) of children diagnosed with refractory epilepsy were voice-recorded, transcribed and analysed to generate common themes. Results Key themes emerged relating to seizure activity, family and school engagement, drug safety and legal access, efficacy, clinical support, social acceptance of the medication and program delivery. The use of Cannabidiol was perceived to have benefits in relation to reducing the severity and frequency of seizure activity for almost a third of patients experiencing refractory epilepsy. Participants described other benefits including improved social engagement, wakefulness and a reduction of side effects related to a reduction of conventional medication dosage. Conclusion This study provided unique perspectives of families’ experiences managing untreatable epilepsy, their experiences with conventional and experimental pharmacological treatments and health services. Whilst families’ perceptions showed the use of Cannabidiol did not provide a therapeutic reduction in the seizure activity for all patients diagnosed with refractory epilepsy, it’s use as an additional pharmacological agent was perceived to provide other benefits by some patient families.
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Affiliation(s)
- S Harte
- The University of Queensland, School of Medicine, Brisbane, Australia.
| | - Y Singh
- Queensland Children's Hospital, South Brisbane, Australia
| | - S Malone
- Queensland Children's Hospital, South Brisbane, Australia
| | - H Heussler
- Queensland Children's Hospital, South Brisbane, Australia.
| | - G Wallace
- Queensland Children's Hospital, South Brisbane, Australia
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Tripathi K, Godoy Brewer G, Thu Nguyen M, Singh Y, Saleh Ismail M, Sauk JS, Parian AM, Limketkai BN. COVID-19 and Outcomes in Patients With Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Inflamm Bowel Dis 2021; 28:1265-1279. [PMID: 34718595 PMCID: PMC8574492 DOI: 10.1093/ibd/izab236] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Our understanding of coronavirus disease 2019 (COVID-19) and its implications for patients with inflammatory bowel diseases (IBD) is rapidly evolving. We performed a systematic review and meta-analysis to investigate the epidemiology, clinical characteristics, and outcomes in IBD patients with COVID-19. METHODS We searched PubMed, EMBASE, Cochrane Central, Clinicaltrials.gov, Web of Science, MedRxiv, and Google Scholar from inception through October 2020. We included studies with IBD patients and confirmed COVID-19. Data were collected on the prevalence, patient characteristics, pre-infection treatments for IBD, comorbidities, hospitalization, intensive care unit (ICU), admission, and death. RESULTS Twenty-three studies with 51,643 IBD patients and 1449 with COVID-19 met our inclusion criteria. In 14 studies (n = 50,706) that included IBD patients with and without COVID-19, the prevalence of infection was 1.01% (95% confidence interval [CI], 0.92-1.10). Of IBD patients with COVID-19, 52.7% had Crohn's disease, 42.2% had ulcerative colitis, and 5.1% had indeterminate colitis. Nine studies (n = 687) reported outcomes according to IBD therapy received. Compared with patients on corticosteroids, those on antitumor necrosis factor (anti-TNF) therapy had a lower risk of hospitalization (risk ratio [RR], 0.24; 95% CI, 0.16-0.35; P < .01; I2 = 0%) and ICU admission (RR, 0.10; 95% CI, 0.03-0.37; P < .01) but not death (RR, 0.16; 95% CI, 0.02-1.71; P = .13; I2 = 39%). Compared with patients on mesalamine, those on antitumor necrosis factor therapy had a lower risk of hospitalizations (RR, 0.37; 95% CI, 0.25-0.54), ICU admissions (RR, 0.20; 95% CI, 0.07-0.58), and death (0.21; 95% CI, 0.04-1.00). Comparing patients on immunomodulators vs mesalamine or anti-TNF therapy, there was no difference in these outcomes. CONCLUSIONS The prevalence of COVID-19 in IBD patients was low. Use of corticosteroids or mesalamine was significantly associated with worse outcomes, whereas use of anti-TNFs was associated with more favorable outcomes. Further investigation clarifying the mechanisms of these disparate observations could help identify risk and adverse outcome-mitigating strategies for patients with IBD.
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Affiliation(s)
- Kartikeya Tripathi
- University of Massachusetts Medical School, Baystate Campus, Springfield, MA, USA,Address correspondence to: Kartikeya Tripathi, MD, 759 Chestnut St., Springfield, MA, 01199, USA ()
| | - Gala Godoy Brewer
- Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Minh Thu Nguyen
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA
| | | | - Mohamed Saleh Ismail
- Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jenny S Sauk
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA
| | - Alyssa M Parian
- Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Berkeley N Limketkai
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA
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Ramani D, Singh Y, White R, Haddow T, Wegener M, Orfino F, Ghassemzadeh L, Dutta M, Kjeang E. Four-dimensional in situ imaging of chemical membrane degradation in fuel cells. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.138194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Singh Y, Patel RN, Patel SK, Jadeja R, Patel AK, Patel N, Roy H, Kumar P, Butcher R, Jasinski JP, Cortijo M, Herrero S. Non-covalent interactions governing the supramolecular assembly of copper(II) complexes with hydrazone-type ligand: Experimental and quantum chemical study. Polyhedron 2021. [DOI: 10.1016/j.poly.2021.115142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Singh Y, Gupta G, Anand K, Kumar Jha N, Thangavelu L, Kumar Chellappan D, Dua K. Molecular exploration of combinational therapy of orlistat with metformin prevents the COVID-19 consequences in obese diabetic patients. Eur Rev Med Pharmacol Sci 2021; 25:580-582. [PMID: 33577009 DOI: 10.26355/eurrev_202101_24614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y Singh
- Mahatma Gandhi College of Pharmaceutical Sciences, Sitapura, Jaipur, India.
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Piccinelli E, Herberg J, Kang H, Fraisse A, Krupickova S, Altamar IB, Sabatino J, Singh Y, Bautista-Rodriguez C, Di Salvo G. Segmental and global longitudinal strain differences between children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 pandemic and Kawasaki disease. Eur Heart J Cardiovasc Imaging 2021. [PMCID: PMC7929042 DOI: 10.1093/ehjci/jeaa356.186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Introduction The paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and Kawasaki disease (KD) have overlapping features. This study aimed to describe the strain segmental analysis among both entities. Methods Retrospective review of strain segmental analysis within 4 weeks of presentation of symptoms among children diagnosed with PIMS-TS between April and June 2020 and a historic cohort of typical KD from the Royal Brompton Hospital, London. Results We included 33 PIMS-TS patients (23 males, 69.7%) at a mean age of 8 ± 4,9 years old and 45 KD patients (31 males, 68,9%) at a mean age of 5,8 ± 4,5 years old. PIMS-TS patients were older at presentation (p = 0.038). Left ventricle ejection fraction (LVEF) was normal in both groups (63,3% vs 63,5%; p= 0,89), 4/33 PIMS-TS children (12,1%) had coronary arteries abnormalities (CAA), whereas 100% of KD cohort had CAA. Both groups had a normal global longitudinal strain (GLS),but in PIMS-TS it was significantly reduced compared to the KD group (-20% vs -22%; p = 0,008). Basal segments were the most affected in PIMS-TS with significant difference in the basal anterior and anterolateral strain compared to KD (respectively -18,2% vs -23,4%; p < 0,001 and - 16,7% vs -22,7%; p < 0,001). PIMS-TS had a greater anterior, anterolateral and posterior segments involvement with a significant reduction in the anterolateral mid-wall longitudinal strain (-18,3% vs -22%; p = 0,002). Apical segments were less involved, with significant difference only in the septal and inferior apical strain (respectively p = 0.001 and p = 0,032). Conclusions These preliminary data showed that after 4 weeks from the onset of symptoms, all PIMS-TS patients had a normal LVEF but they had a significant reduction in GLS and different segmental involvement compared to KD cohort. We hypothesize that these findings may be related to direct myocardial damage in PIMS-TS rather than caused by coronaries perfusion abnormalities. Abstract Figure. Bull"s eye ![]()
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Affiliation(s)
- E Piccinelli
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Herberg
- St Mary"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - H Kang
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - A Fraisse
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - S Krupickova
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - IB Altamar
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Sabatino
- Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Y Singh
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom of Great Britain & Northern Ireland
| | - C Bautista-Rodriguez
- Royal Brompton and Harefield Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Dalle Zotte A, Singh Y, Squartini A, Stevanato P, Cappellozza S, Kovitvadhi A, Subaneg S, Bertelli D, Cullere M. Effect of a dietary inclusion of full-fat or defatted silkworm pupa meal on the nutrient digestibility and faecal microbiome of fattening quails. Animal 2021; 15:100112. [PMID: 33573975 DOI: 10.1016/j.animal.2020.100112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 01/08/2023] Open
Abstract
Silkworm (Bombyx mori L.) pupae are a by-product derived from silk production, which is often treated as waste and thus discarded: this can cause serious environmental problems and a loss of nutrients. Silkworm pupae are a rich source of protein and lipids, and the resulting protein meal can provide promising outcomes as livestock feed, notably for monogastric species. However, one possible issue that needs to be considered is the possible implication of the 1-Deoxynojirimycin (1-DNJ), a bio-compound of the silkworm that impairs glucose absorption, in poultry nutrition. Therefore, the present study evaluated the effect of the dietary inclusion of full-fat or defatted silkworm pupa meal (SWM) on the apparent digestibility of nutrients, feed choice and faecal microbiome in meat-producing quails. For the digestibility trial, a total of thirty-three 27-day-old Japanese quails (Coturnix coturnix japonica) were individually housed in digestibility cages and received three experimental diets: a control diet (control, commercial feed for fattening quails), and two other diets containing the 12.5% of either a full-fat SWM (SWM-FULL) or a defatted SWM (SWM-DEF). Subsequently, twenty-seven 33-day-old quails were simultaneously provided with Control, SWM-FULL and SWM-DEF diets for a 10-day feed choice trial. The results of the digestibility trial showed that the DM intake and excreta production were higher in both SWM groups than in the Control one (P < 0.001). The apparent digestibility of DM, organic matter, CP, ether extract, starch and energy was lower in both SWM groups than in the control group (P < 0.001), suggesting the possible implication of chitin and 1-DNJ. The feed choice test showed that quails preferred the Control diet (P < 0.001). From the microbiome analysis of the excreta, families such as Streptococcaceae (P < 0.05), Rikenellaceae and Eubacteriaceae (P < 0.01) and taxa at species level such as Lactobacillus delbrueckii (P < 0.05), Aneurinibacillus thermoaerophilus and Bacillus thermoamylovorans (P < 0.01) scored higher in SWM-FULL quails than in SWM-DEF and Control treatments. The present study demonstrated that a successful dietary inclusion of SWM for fattening quails needs to overcome the digestive criticalities caused by the of presence specific bio-compounds, namely chitin and 1-DNJ.
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Affiliation(s)
- A Dalle Zotte
- Department of Animal Medicine, Production and Health, MAPS, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy.
| | - Y Singh
- Department of Animal Medicine, Production and Health, MAPS, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy
| | - A Squartini
- Department of Agronomy, Food, Natural Resources, Animals and Environment, DAFNAE, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy
| | - P Stevanato
- Department of Agronomy, Food, Natural Resources, Animals and Environment, DAFNAE, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy
| | - S Cappellozza
- Council for Agricultural Research and Economics, Research Centre for Agriculture and Environment (CREA - AA), Sericulture Laboratory of Padua, Via Eulero 6a, 35143, Padova, Italy
| | - A Kovitvadhi
- Department of Physiology, Faculty of Veterinary Medicine, Kasetsart University, 10900 Bangkok, Thailand
| | - S Subaneg
- Department of Animal Medicine, Production and Health, MAPS, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy; Department of Physiology, Faculty of Veterinary Medicine, Kasetsart University, 10900 Bangkok, Thailand
| | - D Bertelli
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125 Modena, Italy
| | - M Cullere
- Department of Animal Medicine, Production and Health, MAPS, University of Padova, Agripolis, Viale dell'Università 16, 35020 Legnaro, Padova, Italy
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Chakrabarty B, Nagaraja N, Singh Y, Jayalakshmi M. Vitamin D status and its determinants among young unmarried adult females in Northeast India: A cross-sectional study. J Mar Med Soc 2021. [DOI: 10.4103/jmms.jmms_69_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Singh Y, Cullere M, Kovitvadhi A, Chundang P, Dalle Zotte A. Effect of different killing methods on physicochemical traits, nutritional characteristics, in vitro human digestibility and oxidative stability during storage of the house cricket (Acheta domesticus L.). INNOV FOOD SCI EMERG 2020. [DOI: 10.1016/j.ifset.2020.102444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Affes K, Slimani A, Singh Y, Maalej A, Boukheddaden K. Magneto-elastic properties of a spin crossover membrane deposited on a deformable substrate. J Phys Condens Matter 2020; 32:255402. [PMID: 32101800 DOI: 10.1088/1361-648x/ab7a4a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Spin-crossover (SCO) solids have been studied for several years due to their fascinating physical properties and their potential applications as optical switches and reversible high-density memories for information storage. Through this article, we will examine in details the effects of substrate's lattice parameters, on a deformable spin crossover membrane, simulated using an electro-elastic model taking into account the volume change at the transition. The molecules of the membrane can be either in the low spin state (LS) or the high spin state (HS), while those of the substrate are electronically neutral. Magnetic properties of the SCO membrane and the pressure distribution as a function of the lattice parameter of the substrate have been investigated. We demonstrated that the thermally induced first-order spin transition is significantly affected by the structural properties of the substrate, where a rise in the lattice parameter of the latter lowers the transition temperature and reduces the width of the thermal hysteresis loop. The investigations on the spatiotemporal aspects of the spin transition in the membrane demonstrates that the nucleation and growth processes are sensitive to the structural properties of the elastic misfit between the substrate and the SCO membrane.
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Affiliation(s)
- K Affes
- Laboratoire des Matériaux Multifonctionnels et Applications, Université de Sfax, Faculté des Sciences de Sfax, Route de la Soukra km 3.5, 3000, Sfax, Tunisia. GEMaC, CNRS-Université de Versailles Saint Quentin en Yvelines, 45 Avenue des Etats Unis, F-78035 Versailles Cedex, France
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Singh Y, Shakyawar D, Singh H. Functional annotation and identification of putative drug target in strain ankara. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chandrashekara S, Shobha V, Dharmanand BG, Jois R, Kumar S, Mahendranath KM, Haridas V, Prasad S, Singh Y, Daware MA, Swamy A, Subramanian R, Somashekar SA, Shanthappa AM, Anupama KR. Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study. Reumatismo 2017; 69:47-58. [PMID: 28776358 DOI: 10.4081/reumatismo.2017.898] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 01/17/2017] [Accepted: 04/27/2017] [Indexed: 11/23/2022] Open
Abstract
The aim was to study the prevalence of comorbidities in rheumatoid arthritis (RA) patients in everyday clinical practice and their association with disease-specific and demographic factors. The multi-center study recruited 3,247 (at 14 centers, and 265) were excluded due to incomplete data. The number of subjects considered for the analysis was 2982. The mean (±standard deviation) age was 48.98±12.64 years and the male-to-female ratio was 1:5. The data was collected based on a pre-structured pro forma by trained clinical research associates through interview and verification of charts and reports available in the patient records. The following comorbidities were studied: cardiovascular disease, hypertension, diabetes mellitus, hypercholesterolemia, thyroid disease, psychiatric diseases like depression, and pulmonary disease. Hypertension (20.7%), diabetes mellitus (14.4%) and thyroid disease (18.3%) were the most prevalent comorbidities. Hypercholesterolemia (5.3%), pulmonary diseases (2.1%), cardiovascular diseases (0.2%) and depression (0.03%) were prevalent in ≤5% of the study population. The overall presence of comorbidity increased with age and reduced with the duration of illness prior (DOIP). The age, gender, and DOIP differed significantly between groups with and without hypercholesterolemia. Females had a statistically increased prevalence of thyroid disease. The prevalence of comorbidities in RA patients from south India is around 40% and the incidence of comorbidity increased with age. As per the literature evidence, the prevalence in the current study subjects was higher when compared to prevalence of similar diseases occurring in the general south Indian population.
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Tomar P, Singh Y, Mahajan N, Jindal N, Singh M. Molecular Detection of Avian Mycoplasmas in Poultry Affected with Respiratory Infections in Haryana (India). ACTA ACUST UNITED AC 2017. [DOI: 10.20546/ijcmas.2017.606.254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Singh Y, Mirdha BR, Guleria R, Khalil S, Panda A, Chaudhry R, Mohan A, Kabra SK, Kumar L, Agarwal SK. Circulating genotypes of Pneumocystis jirovecii and its clinical correlation in patients from a single tertiary center in India. Eur J Clin Microbiol Infect Dis 2017; 36:1635-1641. [PMID: 28401321 DOI: 10.1007/s10096-017-2977-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
Abstract
The present study was carried out with the objectives of genotyping Pneumocystis jirovecii at three distinct loci, to identify the single nucleotide polymorphisms (SNPs), and to study its clinical implications in patients with Pneumocystis pneumonia (PCP). Analysis of genetic diversity in P. jirovecii from immunocompromised patients was carried out by genotyping at three distinct loci encoding mitochondrial large subunit rRNA (mtLSU rRNA), cytochrome b (CYB), and superoxide dismutase (SOD) using polymerase chain reaction (PCR) assays followed by direct DNA sequencing. Of the 300 patients enrolled in the present study, 31 (10.33%) were positive for PCP by a specific mtLSU rRNA nested PCR assay, whereas only 15 P. jirovecii could be amplified at the other two loci (SOD and CYB). These positives were further subjected to sequence typing. Important genotypic combinations between four SNPs (mt85, SOD110, SOD215, and CYB838) and clinical outcomes could be observed in the present study, and mt85A, mt85T, and SOD110C/SOD215T were frequently associated with "negative follow-up". These SNPs were also noted to be relatively more prevalent amongst circulating genotypes in our study population. The present study is the first of its kind from the Indian subcontinent and demonstrated that potential SNPs of P. jirovecii may possibly be attributed to the clinical outcome of PCP episodes in terms of severity or fatality in different susceptible populations likely to develop PCP during their course of illness.
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Affiliation(s)
- Y Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - B R Mirdha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - R Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - S Khalil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A Panda
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - R Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - S K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - L Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S K Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
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Kumar S, Gupta RK, Sharma A, Singh Y, Mehta N, Kashyap N. Performance and Carcass Characteristics of Broiler Chickens reared Under Light Emitting Diodes (LEDs) light vis-a-vis Incandescent light Supplemental Lighting Programme. ACTA ACUST UNITED AC 2017. [DOI: 10.5958/2277-940x.2017.00173.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kandel B, Singh Y. RM-060 Correlation of clinicopathological parameters with presence of human epidermal growth factor receptor in adenocarcinoma of stomach. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw201.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Origlia S, Schiller S, Pramod MS, Smith L, Singh Y, He W, Viswam S, Świerad D, Hughes J, Bongs K, Sterr U, Lisdat C, Vogt S, Bize S, Lodewyck J, Le Targat R, Holleville D, Venon B, Gill P, Barwood G, Hill IR, Ovchinnikov Y, Kulosa A, Ertmer W, Rasel EM, Stuhler J, Kaenders W. Development of a strontium optical lattice clock for the SOC mission on the ISS. ACTA ACUST UNITED AC 2016. [DOI: 10.1117/12.2229473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Affiliation(s)
- V Rana
- Department of Pathology, Command Hospital (SC), Pune, India
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Khattar J, Kaur S, Kaushal S, Singh Y, Singh D, Rana S, Gulati A. Hyperproduction of phycobiliproteins by the cyanobacterium Anabaena fertilissima PUPCCC 410.5 under optimized culture conditions. ALGAL RES 2015. [DOI: 10.1016/j.algal.2015.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Kandel B, Singh Y. P-144 Clinical Features and Outcome of Advanced Cholangiocarcinoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Magagula R, Rasool MN, Ramdial PK, Singh Y, Ramburan A. Osseous manifestations of non-Hodgkin's lymphoma in Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). SA orthop j 2015. [DOI: 10.17159/2309-8309/2015/v14n3a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Singh Y, Ravindran V. Influence of method of wheat inclusion and pellet diameter on performance, nutrient utilisation, digestive tract measurements and carcass characteristics of broilers. Anim Prod Sci 2015. [DOI: 10.1071/an13489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to determine the influence of method of wheat inclusion and pellet diameter on performance, nutrient utilisation, digestive tract development and carcass characteristics of broilers. The experimental design was a 3 × 2 factorial arrangement of treatments, which included three diet forms, namely ground wheat (GW) and 200 g/kg whole wheat (WW) replacing GW before or after pelleting, and two pellet diameters (3.0 and 4.76 mm). Experimental diets were offered ad libitum from Day 11 to Day 35 post-hatch. Pellet durability index was higher (P < 0.05) in GW diets and deteriorated (P < 0.05) with pre-pelleting inclusion of WW when the larger die was used. Larger pellet diameter increased (P < 0.05) the weight gain and lowered (P < 0.05) feed per gain of birds fed diets with GW and post-pellet inclusion of WW. However, in birds fed diets with pre-pelleting inclusion of WW, the larger pellet diameter lowered (P < 0.05) feed intake and weight gain, and increased (P < 0.05) feed per gain. Relative gizzard weight was increased (P < 0.05) by larger pellet diameter with pre-pelleting inclusion of WW, but was unaffected (P > 0.05) in diets containing GW or post-pellet inclusion of WW. Irrespective of the method of WW inclusion, larger pellet diameter increased (P < 0.05) the apparent metabolisable energy and ileal starch digestibility. Larger pellet diameter was associated with reductions (P < 0.05) in the relative length and weight of all components of the digestive tract in GW-fed birds, but had no effect (P > 0.05) on these parameters in birds fed WW diets. Larger pellet diameter increased (P < 0.05) carcass yield in the GW group, reduced (P < 0.05) in the pre-pelleting WW group and had no effect in the post-pelleting WW group. Overall, these results showed that the effect of pellet diameter on broiler performance varied depending on the form of wheat and method of WW inclusion. Adverse effects on weight gain in the pre-pelleting WW group were due primarily to reduced feed intake resulting from poor pellet quality.
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Singh Y, Ravindran V, Wester TJ, Molan AL, Ravindran G. Influence of prepelleting inclusion of whole corn on performance, nutrient utilization, digestive tract measurements, and cecal microbiota of young broilers. Poult Sci 2014; 93:3073-82. [PMID: 25306459 DOI: 10.3382/ps.2014-04110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of the present study was to examine the effects of prepelleting inclusion of graded levels of whole corn on performance, digestive tract measurements, nutrient utilization, and cecal microbiota in broiler starters. Five diets, containing 600 g/kg of ground corn or 150, 300, 450, and 600 g/kg of whole corn replacing (wt/wt) ground corn, were formulated and cold-pelleted at 65°C. Each diet was offered ad libitum to 6 replicates (8 birds per replicate cage) from d 1 to 21 posthatch. The proportion of coarse particles (>1 mm) increased with increasing prepelleting inclusion of whole corn. Pellet quality, measured as pellet durability index, increased (quadratic effect, P < 0.001) with the inclusion of whole corn to 450 g/kg and then plateaued. Weight gain and feed intake decreased (linear effect, P < 0.001) with increasing prepelleting inclusion of whole corn. Feed per gain (quadratic effect, P < 0.05) increased as the inclusion level of whole corn increased to 300 g/kg and then plateaued with further inclusions. Relative gizzard weight (quadratic effect, P < 0.05) increased with increasing inclusion of whole corn up to 300 g/kg and then levelled off. The AME (quadratic effect, P < 0.05) increased up to 300 g/kg of whole corn inclusion and then decreased with further inclusion. Apparent ileal digestibility of DM (P < 0.001), N (linear effect, P = 0.07), and starch (linear effect, P < 0.001) increased with increasing inclusion levels of whole corn. Based on the fluorescence in situ hybridization method, a linear (P < 0.05) effect was determined for cecal microbiota numbers. Lactobacillus spp. counts increased and counts of Clostridium spp., Campylobacterium spp., and Bacteroides spp. decreased with increasing inclusion levels of whole corn. The present data showed that, despite increased gizzard weight and nutrient utilization, weight gain of broilers was poorer with prepelleting inclusion of whole corn due to reductions in the feed intake.
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Affiliation(s)
- Y Singh
- Institute of Veterinary, Animal and Biomedical Sciences, Palmerston North 4442, New Zealand
| | - V Ravindran
- Institute of Veterinary, Animal and Biomedical Sciences, Palmerston North 4442, New Zealand
| | - T J Wester
- Institute of Veterinary, Animal and Biomedical Sciences, Palmerston North 4442, New Zealand
| | - A L Molan
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North 4442, New Zealand
| | - G Ravindran
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North 4442, New Zealand
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Dejaco C, Singh Y, Perel P, Hutchings A, Matteson E, Dasgupta B. FRI0458 Current Evidence on Prognostic Factors in Patients with Polymyalgia Rheumatica (PMR): A Systematic Literature Review Informing the Acr/Eular Recommendations for the Management of PMR. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dejaco C, Singh Y, Perel P, Hutchings A, Matteson E, Dasgupta B. FRI0457 Current Evidence for Therapeutic Interventions in Polymyalgia Rheumatica (PMR): A Systematic Literature Review Informing the Acr/Eular Recommendations for the Management of PMR. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Singh Y, Rao SVR, Ravindran V. Effect of feeding diets based on coarse maize on productive performance, gizzard development and energy utilisation of laying hens. Br Poult Sci 2014; 55:221-7. [PMID: 24735428 DOI: 10.1080/00071668.2014.883066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
1. A total of 2200 White Leghorn layers were used to study the effect of feeding coarse maize on productive performance, gizzard weight, apparent metabolisable energy (AME) and egg quality parameters. 2. The experiment was a completely randomised design with 5 treatments, each being replicated 5 times (88 birds per replicate). Dietary treatments included a control diet with 600 g/kg of ground maize (6 mm sieve) and experimental diets with 150, 300, 450 or 600 g/kg coarse maize (10 mm sieve) replacing (w/w) ground maize. Diets, in mash form, were offered from 39 to 62 weeks of age. 3. Over the entire experimental period, dietary treatments had no effect on any of the production parameters, except on feed intake. A quadratic effect was observed for feed intake, where intake increased at 150 g/kg coarse maize inclusion. At higher inclusion levels of coarse maize, feed intake was similar to that of the control diet. But the differences in daily intake between dietary treatments were only around 1 g/bird and may not be of any biological significance. 4. Dietary treatments had no effect on gizzard weight, AME or egg quality. 5. The results indicate that coarse maize could completely replace maize in layer diets with no adverse effect on egg production, egg quality and dietary energy utilisation. In the current work, although the proportion of coarse particles (over 1 mm) increased with increasing inclusion levels of coarse maize, the differences in the percentage of particles above 1 mm between the fine control (0 g/kg coarse maize) and coarsest (600 g/kg coarse maize) diets was only 15%, and this may limit the value of the findings reported herein.
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Affiliation(s)
- Y Singh
- a Institute of Veterinary and Animal and Biomedical Sciences , Massey University , Palmerston North 4442 , New Zealand
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Singh Y, Amerah A, Ravindran V. Whole grain feeding: Methodologies and effects on performance, digestive tract development and nutrient utilisation of poultry. Anim Feed Sci Technol 2014. [DOI: 10.1016/j.anifeedsci.2014.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Singh Y, Sidhu HS. Management of Cereal Crop Residues for Sustainable Rice-wheat Production System in the Indo-gangetic Plains of India. Proceedings of the Indian National Science Academy 2014. [DOI: 10.16943/ptinsa/2014/v80i1/55089] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Singh Y, Ravindran V, Wester T, Molan A, Ravindran G. Influence of feeding coarse corn on performance, nutrient utilization, digestive tract measurements, carcass characteristics, and cecal microflora counts of broilers. Poult Sci 2014; 93:607-16. [DOI: 10.3382/ps.2013-03542] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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