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Krishnamurthy SL, Shah R, Krishnan R, Wasdev A, Kaushik YS, Nedumparampil MM, Amaravathi RS. Bailout Options for Intra-operative Implant and Instrumentation Related Incidents and Complications During Arthroscopic Knee Surgery-A Retrospective Study. Indian J Orthop 2024; 58:289-297. [PMID: 38425827 PMCID: PMC10899144 DOI: 10.1007/s43465-023-01086-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/11/2023] [Indexed: 03/02/2024]
Abstract
Background Arthroscopic knee procedures are one amongst the common surgical interventions for problems in the knee. It is technically more demanding than an open procedure and is associated with several potential complications. During arthroscopy procedures, several technical challenges may arise, and even experienced surgeons may encounter new issues. However, careful attention to the surgical technique can help prevent or resolve them. Methodology The study was conducted on all patients who underwent knee arthroscopy procedure during study period. We recorded details of the implants used and any unexpected situations related to them, as well as how they were managed. Instrumentation-related parameters such as screwdriver issues, radiofrequency ablator issues, scope damages, shaver complications, probe complications, and meniscus suture passing devices were also assessed. Results In total, there were 12 (3.73%) implant and instrument-related incidents and complications, of which 5 (1.55%) were implant-related and 7 (2.17%) were instrument related. Among the instrumentation-related incidents and complications, two (0.62%) were screwdriver breakage incidents, two (0.62%) were radiofrequency ablator-related incidents, one was arthroscopic probe (0.31%) related incident, one (0.31%) was meniscus suture passing device related complication and one (0.31%) was arthroscope related incident. Conclusion Surgeons must be ready to anticipate and effectively manage any technical difficulties that may arise during the procedure, maintaining composure in the face of unexpected challenges and guiding the team. In most cases, incidents can be addressed intra operatively and may not have long-term effects on patient outcomes. It is crucial to have multiple implant and instrument backup options available for successful surgery.
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Affiliation(s)
- Sunil Lakshmipura Krishnamurthy
- Department of Orthopaedics, Dr Chandramma Dayananda Sagar Institute of Medical Education and Research, CDSIMER, Unit of Dayananda Sagar University, Bangalore, India
| | - Rahul Shah
- Department of Orthopaedics, Aster Whitefield Hospital, Bangalore, India
| | - Rinju Krishnan
- Department of Orthopaedics, St Gregorios Medical Mission Hospital, Parumala, Pathanamthitta, Kerala India
| | - Abhey Wasdev
- Department of Orthopaedics, Apollo Clinic, Sarjapur Road, Bangalore, India
| | - Y. S. Kaushik
- Department of Orthopaedics, Deepak Hospital, Jayanagar, Bangalore, India
| | | | - Rajkumar S. Amaravathi
- Division of Sports Injury, Arthroscopy and Regenerative Medicine, Department of Orthopaedics, St Johns Medical College and Hospital, Bangalore, Karnataka India
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Malzbender K, Barbarino P, Barkman Ferrell P, Bradshaw A, Brookes AJ, Díaz C, van der Flier WM, Georges J, Hansson O, Hartmanis M, Jönsson L, Krishnan R, MacLeod T, Mangialasche F, Mecocci P, Minguillon C, Middleton L, Pla S, Sardi SP, Schöll M, Suárez-Calvet M, Weidner W, Visser PJ, Zetterberg H, Bose N, Solomon A, Kivipelto M. Validation, Deployment, and Real-World Implementation of a Modular Toolbox for Alzheimer's Disease Detection and Dementia Risk Reduction: The AD-RIDDLE Project. J Prev Alzheimers Dis 2024; 11:329-338. [PMID: 38374739 DOI: 10.14283/jpad.2024.32] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
The Real-World Implementation, Deployment, and Validation of Early Detection Tools and Lifestyle Enhancement (AD-RIDDLE) project, recently launched with the support of the EU Innovative Health Initiative (IHI) public-private partnership and UK Research and Innovation (UKRI), aims to develop, test, and deploy a modular toolbox platform that can reduce existing barriers to the timely detection, and therapeutic approaches in Alzheimer's disease (AD), thus accelerating AD innovation. By focusing on health system and health worker practices, AD-RIDDLE seeks to improve and smooth AD management at and between each key step of the clinical pathway and across the disease continuum, from at-risk asymptomatic stages to early symptomatic ones. This includes innovation and improvement in AD awareness, risk reduction and prevention, detection, diagnosis, and intervention. The 24 partners in the AD-RIDDLE interdisciplinary consortium will develop and test the AD-RIDDLE toolbox platform and its components individually and in combination in six European countries. Expected results from this cross-sectoral research collaboration include tools for earlier detection and accurate diagnosis; validated, novel digital cognitive and blood-based biomarkers; and improved access to individualized preventative interventions (including multimodal interventions and symptomatic/disease-modifying therapies) across diverse populations, within the framework of precision medicine. Overall, AD-RIDDLE toolbox platform will advance management of AD, improving outcomes for patients and their families, and reducing costs.
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Affiliation(s)
- K Malzbender
- Miia Kivipelto, MD, PhD, Center for Alzheimer's Research, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, 171 64 Solna, Sweden, , Phone: +46 73 99 409 22
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Weigert M, Li Y, Zhu L, Eckart H, Bajwa P, Krishnan R, Ackroyd S, Lastra RR, Bilecz A, Basu A, Lengyel E, Chen M. A Cellular atlas of the human fallopian tube reveals the metamorphosis of secretory epithelial cells during the menstrual cycle and menopause. medRxiv 2023:2023.11.22.23298470. [PMID: 38045369 PMCID: PMC10690352 DOI: 10.1101/2023.11.22.23298470] [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] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
The fallopian tube, connecting the uterus with the ovary, is a dynamic organ that undergoes cyclical changes and is the site of several diseases, including serous cancer. Here, we use single-cell technologies to construct a comprehensive cell map of healthy pre-menopausal fallopian tubes, capturing the impact of the menstrual cycle and menopause on different fallopian tube cells at the molecular level. The comparative analysis between pre- and post-menopausal fallopian tubes reveals substantial shifts in cellular abundance and gene expression patterns, highlighting the physiological changes associated with menopause. Further investigations into menstrual cycle phases illuminate distinct molecular states in secretory epithelial cells caused by hormonal fluctuations. The markers we identified characterizing secretory epithelial cells provide a valuable tool for classifying ovarian cancer subtypes. Graphical summary Graphical summary of results. During the proliferative phase (estrogen high ) of the menstrual cycle, SE2 cells (OVGP1 + ) dominate the fallopian tube (FT) epithelium, while SE1 cells (OVGP1 - ) dominate the epithelium during the secretory phase. Though estrogen levels decrease during menopause, SE post-cells (OVGP1 + , CXCL2 + ) make up most of the FT epithelium.
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Krishnan R, Shamsher S, Adzura S. Safeguarding against potential injury from an eye drops bottle. Med J Malaysia 2023; 78:849-851. [PMID: 38031231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
We describe a potential cause of eye injury, its concerns and ways to prevent it. The first author underwent a left cataract operation and was prescribed eye drops postoperatively. While applying one of the eye drops, he felt an object hitting the lower eyelid. A serrated plastic piece had fallen off the bottle. Had it fallen on the operated site, it might have caused serious untoward complications. Nurses, carers and patients need to be educated to remove the serrated piece from the bottle before applying eye drops. Manufacturers of eye drops should design safer bottles without such serrated pieces to prevent such eye injuries.
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Affiliation(s)
- R Krishnan
- Asian Institute of Medicine, Science and Technology (AIMST) University, Faculty of Medicine, Family Medicine Unit, Bedong, Kedah, Malaysia
| | - S Shamsher
- Asian Institute of Medicine, Science and Technology (AIMST) University, Faculty of Medicine, Anaesthesia Unit, Bedong, Kedah, Malaysia
| | - S Adzura
- International Islamic University Malaysia, Kulliyyah of Medicine, Department of Ophthalmology, Kuantan, Pahang, Malaysia
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Krishnan R, Krishnamurthy SL, Shah R, Wasdev A, Theodore L, Amaravathi RS. Revision of Failed Medial Meniscus Posterior Root Repair: A Case Report. J Orthop Case Rep 2023; 13:42-46. [PMID: 37753135 PMCID: PMC10519303 DOI: 10.13107/jocr.2023.v13.i09.3870] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/28/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Meniscal root tear decreases the ability of the meniscus to convert the axial load to radially directed hoop stress. This leads to a decreased contact area and increased contact pressures, leading to early osteoarthrosis of the knee and eventually higher chances of undergoing total knee replacement. Meniscal root repair helps to restore normal knee kinematics; however, non-anatomical repair results in increased strain in the repair and causes early failure of the repair, leading to abnormal knee kinematics. Case Report A 45-year-old female with a body mass index of 40.6, hypothyroid, and type II diabetes mellitus presented to the outpatient department with the complaints of left knee pain and difficulty in walking. She had undergone an arthroscopic medial meniscus posterior root repair 1 year back. Clinical and radiological examinations helped to diagnose a re-tear of the medial meniscus root with a non-anatomic tibial tunnel. She then underwent arthroscopic revision root repair surgery. Currently, the patient is at a 1-year follow-up and has resumed her activities of daily living. Conclusion Anatomical repair of the posterior horn of the medial meniscus is important in restoring normal knee kinematics and for the ability of the meniscus to maintain the hoop stress. Non-anatomic repair leads to early failure and progression to rapid cartilage degeneration, resulting in early osteoarthritis and eventual knee replacement. Any revision surgery presents its own different set of challenges. The basic principles must be adhered to while addressing any failure of the primary surgery.
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Affiliation(s)
- Rinju Krishnan
- Department of Orthopaedics, Division of Sports Injury, Joint Preservation, and Regenerative Medicine, St. Johns Medical College, Bengaluru, Karnataka, India
| | - Sunil Lakshmipura Krishnamurthy
- Department of Orthopaedics, Division of Sports Injury, Joint Preservation, and Regenerative Medicine, St. Johns Medical College, Bengaluru, Karnataka, India
| | - Rahul Shah
- Department of Orthopaedics, Division of Sports Injury, Joint Preservation, and Regenerative Medicine, St. Johns Medical College, Bengaluru, Karnataka, India
| | - Abhey Wasdev
- Department of Orthopaedics, Division of Sports Injury, Joint Preservation, and Regenerative Medicine, St. Johns Medical College, Bengaluru, Karnataka, India
| | - Likhith Theodore
- Department of Orthopaedics, St. Johns Medical College, Bengaluru, Karnataka, India
| | - Rajkumar S Amaravathi
- Department of Orthopaedics, Division of Sports Injury, Joint Preservation, and Regenerative Medicine, St. Johns Medical College, Bengaluru, Karnataka, India
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Pinto AA, Krishnan R, Shekar KY, Amaravathi RS. A Novel Technique of Resecting Localized Pigmented Villonodular Synovitis of the Knee Joint. J Orthop Case Rep 2023; 13:18-21. [PMID: 37753128 PMCID: PMC10519308 DOI: 10.13107/jocr.2023.v13.i09.3860] [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] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/30/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Pigmented villonodular synovitis is an uncommon benign proliferation of the synovium. In the knee joint, it can present as a localized or a diffuse form and can mimic numerous conditions. Case Report We present a case report of a 54-year-old male with localized form of this condition. The diagnosis is not often made clinically but usually made with the help of magnetic resonance imaging and histopathology. We used a novel technique for resecting the tumor by arthroscopy. Conclusion A high index of suspicion is required for the diagnosis of the condition and arthroscopic excision results in lower morbidity and lesser recurrence rates.
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Affiliation(s)
- Aditi Ajoy Pinto
- Department of Orthopaedics, Division of Arthroscopy, Sports Injury, Joint Preservation and Regenerative Medicine, St Johns Medical College, Bengaluru, Karnataka, India
| | - Rinju Krishnan
- Department of Orthopaedics, Division of Arthroscopy, Sports Injury, Joint Preservation and Regenerative Medicine, St Johns Medical College, Bengaluru, Karnataka, India
| | - Kaushik Y Shekar
- Department of Orthopaedics, Division of Arthroscopy, Sports Injury, Joint Preservation and Regenerative Medicine, St Johns Medical College, Bengaluru, Karnataka, India
| | - Rajkumar S Amaravathi
- Department of Orthopaedics, Division of Arthroscopy, Sports Injury, Joint Preservation and Regenerative Medicine, St Johns Medical College, Bengaluru, Karnataka, India
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Wasdev A, P A, Krishnan R, Thomas A, G SM, Amaravathi RS. Anatomical Landmark Technique for Femoral Tunnel Placement of Lateral Extra-Articular Tenodesis. Arthrosc Tech 2023; 12:e779-e786. [PMID: 37323791 PMCID: PMC10265728 DOI: 10.1016/j.eats.2023.02.007] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/10/2023] [Indexed: 06/17/2023] Open
Abstract
The anterolateral ligament is a crucial part of the anterolateral complex of the knee, providing rotator stability to the knee and being a primary restraint to tibial internal rotation. Lateral extra-articular tenodesis added to anterior cruciate ligament reconstruction can reduce pivot shift without sacrificing the range of motion or increasing the risk of osteoarthritis. A 7- to 8-cm longitudinal skin incision is made and a 9.5- to 10-cm × 1- cm wide iliotibial band graft is dissected, leaving the distal attachment intact. The free end is whip stitched. One of the most important steps during the procedure is the identification of the site of attachment of the iliotibial band graft. The leash of vessels, fat pad, lateral supracondylar ridge, and fibular collateral ligament serve as important landmarks. The tunnel is drilled from the lateral femoral cortex with a guide pin and reamer pointing 20 to 30° anteriorly and proximally while the arthroscope visualizes the femoral anterior cruciate ligament tunnel. The graft is routed under the fibular collateral ligament. The graft is fixed with a bioscrew while the knee is kept in 30° flexion and the tibia is kept in neutral rotation. We believe that lateral extra-articular tenodesis gives the anterior cruciate ligament graft a good chance for faster healing along with addressing anterolateral rotatory instability. Choosing a correct fixation point is very important to restore normal knee biomechanics.
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Affiliation(s)
| | | | | | | | | | - Rajkumar S. Amaravathi
- Address correspondence to Rajkumar S. Amaravathi, D.N.B., F.R.C.S., Department of Orthopaedics, St. John’s National Academy of Health Sciences, Bengaluru, India.
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Shkolyar E, Bhambhvani H, Tiu E, Krishna V, Krishna V, Nimgaonkar V, Krishnan R, O’Donoghue O, Vrabac D, Kao CS, Joshi A, Shah J. Corrigendum to “1773P Prediction of chemotherapy response in muscle-invasive bladder cancer: A machine learning approach”. Ann Oncol 2023. [DOI: 10.1016/j.annonc.2023.02.014] [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: 03/09/2023] Open
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Shaikh A, Dixit T, Deshpande A, Krishnan R. GEANT4 based simulation study of converter and direct target design and optimization of target for 99Mo production using 30 MeV electron linear accelerator. Appl Radiat Isot 2022; 185:110239. [DOI: 10.1016/j.apradiso.2022.110239] [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] [Received: 12/21/2020] [Revised: 03/14/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022]
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10
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Krishnan R, Shamsher S, Prepageran N. Potential of smartphone enabled otoscopy for teleconsultation and teaching. Med J Malaysia 2022; 77:85-86. [PMID: 35086999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The smartphone enabled otoscope (SEO) provides an opportunity for telemedicine and enhancing teaching of otoscopy. We describe our preliminary experience with the use of one such inexpensive device bought from an online store. It is a simple and feasible procedure which patients can perform on themselves (or guardians on their wards) after minimal training. The resolution of the image is adequate for follow up through teleconsultation. It is also a good teaching tool as it enables the sharing of views.
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Affiliation(s)
- R Krishnan
- Asian Institute of Medicine, Science and Technology (AIMST) University, Faculty of Medicine, Family Medicine Unit, Bedong, Kedah, Malaysia
| | - S Shamsher
- Asian Institute of Medicine, Science and Technology (AIMST) University, Faculty of Medicine, Anaesthesia Unit, Bedong, Kedah, Malaysia.
| | - N Prepageran
- Universiti Malaya, Faculty of Medicine, Department of Otorhinolagyngology, Kuala Lumpur, Malaysia
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Kumar D, Mitra S, Sarkar M, Krishnan R, Kumar B, Bhatta A, Saraf P. Iodine(III)-promoted regioselective and efficient synthesis of β-triazolyl BODIPYs for the selective recognition of nickel ion and bovine serum albumin. Dalton Trans 2022; 51:8169-8176. [DOI: 10.1039/d2dt00946c] [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: 11/21/2022]
Abstract
Various ꞵ-triazolyl tethered BODIPYs were efficiently prepared in a sequential one-pot protocol involving the initial reaction of BODIPY with iodobenzene diacetate (IBD) and sodium azide to in situ generate BODIPY...
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Deshpande S, Krishnan R, Logan M, Mizzoni C, Kobylecky E, Dalle Fusine I, Lum R, Rhodes C, Pigeau G. Development and qualification of a standardized flow cytometry panel for the characterization of car-t cell products across sites. Cytotherapy 2021. [DOI: 10.1016/s1465324921006022] [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: 11/30/2022]
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Pogaku V, Krishnan R, Basavoju S. Synthesis and biological evaluation of new benzo[d][1,2,3]triazol-1-yl-pyrazole-based dihydro-[1,2,4]triazolo[4,3-a]pyrimidines as potent antidiabetic, anticancer and antioxidant agents. Res Chem Intermed 2020. [DOI: 10.1007/s11164-020-04285-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Singh M, Krishnan R, Goswami B, Choudhury AD, Swapna P, Vellore R, Prajeesh AG, Sandeep N, Venkataraman C, Donner RV, Marwan N, Kurths J. Fingerprint of volcanic forcing on the ENSO-Indian monsoon coupling. Sci Adv 2020; 6:6/38/eaba8164. [PMID: 32948581 PMCID: PMC7500933 DOI: 10.1126/sciadv.aba8164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
Coupling of the El Niño-Southern Oscillation (ENSO) and Indian monsoon (IM) is central to seasonal summer monsoon rainfall predictions over the Indian subcontinent, although a nonstationary relationship between the two nonlinear phenomena can limit seasonal predictability. Radiative effects of volcanic aerosols injected into the stratosphere during large volcanic eruptions (LVEs) tend to alter ENSO evolution; however, their impact on ENSO-IM coupling remains unclear. Here, we investigate how LVEs influence the nonlinear behavior of the ENSO and IM dynamical systems using historical data, 25 paleoclimate reconstructions, last-millennium climate simulations, large-ensemble targeted climate sensitivity experiments, and advanced analysis techniques. Our findings show that LVEs promote a significantly enhanced phase-synchronization of the ENSO and IM oscillations, due to an increase in the angular frequency of ENSO. The results also shed innovative insights into the physical mechanism underlying the LVE-induced enhancement of ENSO-IM coupling and strengthen the prospects for improved seasonal monsoon predictions.
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Affiliation(s)
- M Singh
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
- IDP in Climate Studies, Indian Institute of Technology, Bombay, India
| | - R Krishnan
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India.
| | - B Goswami
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Cluster of Excellence "Machine Learning in Science", University of Tübingen, Tübingen, Germany
| | - A D Choudhury
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - P Swapna
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - R Vellore
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - A G Prajeesh
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - N Sandeep
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - C Venkataraman
- IDP in Climate Studies, Indian Institute of Technology, Bombay, India
| | - R V Donner
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Magdeburg-Stendal University of Applied Sciences, Magdeburg, Germany
| | - N Marwan
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - J Kurths
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Lobachevsky State University Nizhny Novgorod, Nizhny Novgorod, Russia
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Payne SR, Fowler S, Mundy AR, Alhasso A, Almallah Y, Anderson P, Andrich D, Baird A, Biers S, Browning A, Chapple C, Cherian J, Clarke L, Conn I, Dickerson D, Doble A, Dorkin T, Duggan B, Eardley I, Garaffa G, Greenwell T, Hadway P, Harding C, Hilmy M, Inman R, Kayes O, Kirchin V, Krishnan R, Kumar V, Lemberger J, Malone P, Moore J, Moore K, Mundy A, Noble J, Nurse D, Palmer M, Payne S, Pickard R, Rai J, Rees R, Roux J, Seipp C, Shabbir M, Saxby M, Sharma D, Sinclair A, Summerton D, Tatarov O, Thiruchelvam N, Venn S, Watkin N, Zacherakis E. The logistical management of tertiary urethral disease in the United Kingdom: Implications from an online audit of male reconstructive urethral surgery. Journal of Clinical Urology 2020. [DOI: 10.1177/2051415819894182] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: To determine those patient groupings, based on volume and risk, whose optimal urethral reconstructive management might be provided by a reorganisation of UK reconstructive surgeons. Methods: Between 2010 and 2017, ~689 men/year were enrolled onto an online audit platform collecting data about urethral reconstruction in the UK; this accrual was compared against hospital episode statistics (HES). The available workforce, and where this was based, was collected. Individual and institutional incumbent patient volumes, pathology, surgical complexity and outcomes from treatment were collated to stratify volume/risk groups. Results: More than 90% of all HES-recorded data were accrued, being provided by 50 surgeons at 39 operative sites. Most reconstructive surgery was provided at 10 centres performing >20 procedures/year. More than 50% of all interventions were of a high-volume low-risk type. Of activity, 32.3% was intermediate volume or moderate risk, and 12.5% of men presented for lower-volume or higher-risk procedures. Conclusion: Correlation of detailed volume/outcome data allows the definition of patient populations presenting for urethral reconstruction. Stratification of each group’s management, to optimise the surgical outcome, may be applied to a hierarchical service delivery model based on the complexity of the patient’s presenting urethral pathology. Level of evidence: Level IV
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Affiliation(s)
| | - Sarah Fowler
- British Association of Urological Surgeons, London, UK
| | - Anthony R Mundy
- University College London Hospitals NHS Foundation Trust, London, UK
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Krishnan R, Jagannathan S, Samaranayake VA. Direct Error-Driven Learning for Deep Neural Networks With Applications to Big Data. IEEE Trans Neural Netw Learn Syst 2020; 31:1763-1770. [PMID: 31329564 DOI: 10.1109/tnnls.2019.2920964] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this brief, heterogeneity and noise in big data are shown to increase the generalization error for a traditional learning regime utilized for deep neural networks (deep NNs). To reduce this error, while overcoming the issue of vanishing gradients, a direct error-driven learning (EDL) scheme is proposed. First, to reduce the impact of heterogeneity and data noise, the concept of a neighborhood is introduced. Using this neighborhood, an approximation of generalization error is obtained and an overall error, comprised of learning and the approximate generalization errors, is defined. A novel NN weight-tuning law is obtained through a layer-wise performance measure enabling the direct use of overall error for learning. Additional constraints are introduced into the layer-wise performance measure to guide and improve the learning process in the presence of noisy dimensions. The proposed direct EDL scheme effectively addresses the issue of heterogeneity and noise while mitigating vanishing gradients and noisy dimensions. A comprehensive simulation study is presented where the proposed approach is shown to mitigate the vanishing gradient problem while improving generalization by 6%.
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Mohanty UC, Mohapatra M, Karumuri A, Krishnan R, Chowdary JS, Mukhopadhyay P. Indian Monsoons Variability and Extreme Weather Events: Recent Improvements in Observations and Modelling. PINSA 2020. [DOI: 10.16943/ptinsa/2020/49817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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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Phan M, Krishnan R, El Sayes N, Mathieu J, Selman M, Macklin A, Dornan M, Groom H, Patten D, Davis C, Lai F, Lichty B, Harper M, Arulanandam R, Bell J, Alain T, Josephy D, Smith J, Boddy C, Diallo J. Viral sensitizers potential infection of cancer cells via NF-kappaB. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.074] [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: 10/27/2022]
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Halim Mahphoth M, Koe WL, Krishnan R, Erfani Abd Ghani A, Ismail S. An Empirical Study of Service Quality and Customer Satisfaction of Malaysian Air Passenger. KSS 2018; 3:1106. [DOI: 10.18502/kss.v3i10.3196] [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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Gupta, Krishnan R. Urinary symptoms in patients with Parkinson's disease and progressive supranuclear palsy: Urodynamic findings and management of bladder dysfunction. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.889] [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: 12/01/2022]
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Krishnan R, Boddapati N, Sundarasamy M. PO-051 GNL1 regulates cell proliferation by associating with RPS20. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.95] [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: 11/03/2022] Open
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Senthil Kumar A, Kumar A, Krishnan R, Chakravarthi B, Deekshatalu BL. Soft Computing in Remote Sensing Applications. Proc Natl Acad Sci , India, Sect A Phys Sci 2017. [DOI: 10.1007/s40010-017-0431-0] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Saravanan K, Jayalakshmi G, Chandra S, Panigrahi BK, Krishnan R, Sundaravel B, Annapoorani S, Shukla DK, Rajput P, Kanjilal D. The influence of carbon concentration on the electronic structure and magnetic properties of carbon implanted ZnO thin films. Phys Chem Chem Phys 2017; 19:13316-13323. [PMID: 28492651 DOI: 10.1039/c7cp01939d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The influence of carbon concentration on the electronic and magnetic properties of C-implanted ZnO thin films has been studied using synchrotron radiation based X-ray absorption spectroscopic techniques and vibrating sample magnetometer measurements. 20 keV carbon ions were implanted in ZnO films with different fluences (2 × 1016, 4 × 1016 and 6 × 1016 ions per cm2). The pristine ZnO film shows diamagnetic behaviour while the C-implanted films exhibit room temperature ferromagnetism. Our first-principles calculations based on density functional theory show an appreciable magnetic moment only when the implanted C atom sits either in the O-site (2 μB) or in the interstitial position (1.88 μB), whereas the C atom in the Zn substitutional position does not possess any magnetic moment. X-ray absorption near edge structure analysis at the O K-edge reveals that the charge transfer from O-2p to the C-defect site causes the ferromagnetism in the C-implanted ZnO film at low fluence. However at high fluence, the implanted C replaces the lattice and produces more Zn vacancies, as evidenced by extended X-ray absorption fine structure studies at the Zn K-edge, which favors the ferromagnetism. The persistence of the implanted carbon and ferromagnetism of the C-implanted ZnO film has also been studied by isothermal annealing at 500 °C and discussed in detail.
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Affiliation(s)
- K Saravanan
- Material Science Group, Indira Gandhi Centre for Atomic Research, HBNI, Kalpakkam - 603102, India.
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Warwick AN, Brooks AP, Osmond C, Krishnan R. Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors. Eye (Lond) 2017; 31:333-341. [PMID: 28128798 DOI: 10.1038/eye.2016.294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/09/2016] [Indexed: 01/14/2023] Open
Abstract
PurposeThe purpose of the study was to provide contemporary estimates for diabetic retinopathy (DR) prevalence in a well-defined UK cohort of patients with type 1 diabetes (T1DM) and investigate potential risk factors for proliferative diabetic retinopathy (PDR) and diabetic maculopathy.Patients and MethodsFour hundred and sixty four T1DM patients in North Hampshire had T1DM duration, demographic and systemic risk factor data evaluated retrospectively alongside their DR status in 2010 using logistic regression analysis.ResultsOverall prevalence of any retinopathy, PDR, and maculopathy was 71.5%, 6.5%, and 10.8%, respectively. PDR and maculopathy prevalence were 0 and 0.7% for <10 years T1DM duration. PDR prevalence was 4%, 8%, and 16% for 10-19.9 years, 20-29.9, years and ≥30 years duration, respectively. Maculopathy prevalence was 15.6%, 18%, and 11% for 10-19.9 years, 20-29.9 years, and ≥30 years duration, respectively. In univariate analysis, PDR was associated with T1DM duration (odds ratio (OR) 1.07/year), age (OR 1.03/year), systolic blood pressure (OR 1.03/mmHg), and antihypertensive therapy (OR 10.63), while maculopathy was associated with duration (OR 1.03/year) and statin therapy (OR 2.83). In multivariate analysis, disease duration (OR 1.07/year) and antihypertensive therapy (OR 6.87) remained significantly associated with PDR, and maculopathy with statin therapy (OR 2.27).ConclusionThis study confirms T1DM duration is a strong risk factor for sight-threatening DR. Maculopathy and PDR prevalence within 10 years of T1DM diagnosis is very low. PDR prevalence at 10-20 years was 4% and then doubled for every 10-year interval thereafter up to 16% with ≥30 years duration. Antihypertensive therapy and statin therapy were strongly associated with PDR and maculopathy, respectively.
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Affiliation(s)
- A N Warwick
- Southampton Eye Unit, University Hospital Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire, UK
| | - A P Brooks
- Diabetes and Endocrinology, Royal Hampshire County Hospital (RHCH), Hampshire Hospitals NHS Foundation Trust, Winchester, Hampshire, UK
| | - C Osmond
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - R Krishnan
- Southampton Eye Unit, University Hospital Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire, UK
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Jenkins L, Krishnan R, Berookhim B, Coleman J, Eastham J, Ehdaie B, Laudone V, Nelson C, Mulhall J. 006 Safety of Testosterone Therapy in Patients on Active Surveillance for Prostate Cancer. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.010] [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: 10/20/2022]
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Krishnan R. Univariate Volatility Modeling: Theory and Practice. Decision Sciences 2016. [DOI: 10.1201/9781315183176-11] [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: 11/11/2022]
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Abstract
Steganography is primarily used for the covert transmission of information even though the purpose can be legitimate or malicious. The primary purpose of this work is to build a firewall which will thwart this transmission. This will be achieved by radiometric and geometric operations. These operations will degrade the quality of cover image. However these can be restored to some extent by a deconvolution operation. The finally deconvolved image is subjected to steganalysis to verify the absence of stego content. Experimental results showed that PSNR and SSIM values are between 35 dB - 45 dB and 0.96, respectively which are above the acceptable range. Our method can suppress the stego content to large extent irrespective of embedding algorithm in spatial and transform domain. We verified by using RS steganalysis, difference image histogram and chi-square attack, that 95 per cent of the stego content embedded in the spatial domain was removed by our showering techniques. We also verified that 100 per cent of the stego content was removed in the transform domain with PSNR 30 dB - 45 dB and SSIM between 0.67-0.99. Percentage of stego removed in both domains was measured by using bit error rate and first order Markov feature.
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Wang C, Ji F, Hong Z, Poh JS, Krishnan R, Lee J, Rekhi G, Keefe RSE, Adcock RA, Wood SJ, Fornito A, Pasternak O, Chee MWL, Zhou J. Disrupted salience network functional connectivity and white-matter microstructure in persons at risk for psychosis: findings from the LYRIKS study. Psychol Med 2016; 46:2771-2783. [PMID: 27396386 PMCID: PMC5358474 DOI: 10.1017/s0033291716001410] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Salience network (SN) dysconnectivity has been hypothesized to contribute to schizophrenia. Nevertheless, little is known about the functional and structural dysconnectivity of SN in subjects at risk for psychosis. We hypothesized that SN functional and structural connectivity would be disrupted in subjects with At-Risk Mental State (ARMS) and would be associated with symptom severity and disease progression. METHOD We examined 87 ARMS and 37 healthy participants using both resting-state functional magnetic resonance imaging and diffusion tensor imaging. Group differences in SN functional and structural connectivity were examined using a seed-based approach and tract-based spatial statistics. Subject-level functional connectivity measures and diffusion indices of disrupted regions were correlated with CAARMS scores and compared between ARMS with and without transition to psychosis. RESULTS ARMS subjects exhibited reduced functional connectivity between the left ventral anterior insula and other SN regions. Reduced fractional anisotropy (FA) and axial diffusivity were also found along white-matter tracts in close proximity to regions of disrupted functional connectivity, including frontal-striatal-thalamic circuits and the cingulum. FA measures extracted from these disrupted white-matter regions correlated with individual symptom severity in the ARMS group. Furthermore, functional connectivity between the bilateral insula and FA at the forceps minor were further reduced in subjects who transitioned to psychosis after 2 years. CONCLUSIONS Our findings support the insular dysconnectivity of the proximal SN hypothesis in the early stages of psychosis. Further developed, the combined structural and functional SN assays may inform the prognosis of persons at-risk for psychosis.
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Affiliation(s)
- C. Wang
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - F. Ji
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - Z. Hong
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. S. Poh
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - R. Krishnan
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Lee
- Research Division,
Institute of Mental Health, Singapore
- Office of Clinical Sciences,
Duke-NUS Medical School, Singapore
| | - G. Rekhi
- Research Division,
Institute of Mental Health, Singapore
| | - R. S. E. Keefe
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
| | - R. A. Adcock
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
- Center for Cognitive Neuroscience,
Duke University, Durham, NC,
USA
| | - S. J. Wood
- School of Psychology,
University of Birmingham, Edgbaston,
UK
- Department of Psychiatry,
Melbourne Neuropsychiatry Centre, University of
Melbourne and Melbourne Health, Victoria,
Australia
| | - A. Fornito
- Monash Clinical and Imaging
Neuroscience, School of Psychology and Psychiatry & Monash
Biomedical Imaging, Monash University,
Australia
| | - O. Pasternak
- Departments of Psychiatry and Radiology,
Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, USA
| | - M. W. L. Chee
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Zhou
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
- Clinical Imaging Research Centre, the Agency for
Science, Technology and Research and National University of
Singapore, Singapore
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31
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Faiz A, Donovan C, Nieuwenhuis MA, van den Berge M, Postma DS, Yao S, Park CY, Hirsch R, Fredberg JJ, Tjin G, Halayko AJ, Rempel KL, Ward JPT, Lee T, Bossé Y, Nickle DC, Obeidat M, Vonk JM, Black JL, Oliver BG, Krishnan R, McParland B, Bourke JE, Burgess JK. Latrophilin receptors: novel bronchodilator targets in asthma. Thorax 2016; 72:74-82. [PMID: 27325752 PMCID: PMC5329048 DOI: 10.1136/thoraxjnl-2015-207236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/16/2016] [Accepted: 05/19/2016] [Indexed: 01/30/2023]
Abstract
Background Asthma affects 300 million people worldwide. In asthma, the major cause of morbidity and mortality is acute airway narrowing, due to airway smooth muscle (ASM) hypercontraction, associated with airway remodelling. However, little is known about the transcriptional differences between healthy and asthmatic ASM cells. Objectives To investigate the transcriptional differences between asthmatic and healthy airway smooth muscle cells (ASMC) in culture and investigate the identified targets using in vitro and ex vivo techniques. Methods Human asthmatic and healthy ASMC grown in culture were run on Affymetrix_Hugene_1.0_ST microarrays. Identified candidates were confirmed by PCR, and immunohistochemistry. Functional analysis was conducted using in vitro ASMC proliferation, attachment and contraction assays and ex vivo contraction of mouse airways. Results We suggest a novel role for latrophilin (LPHN) receptors, finding increased expression on ASMC from asthmatics, compared with non-asthmatics in vivo and in vitro, suggesting a role in mediating airway function. A single nucleotide polymorphism in LPHN1 was associated with asthma and with increased LPHN1 expression in lung tissue. When activated, LPHNs regulated ASMC adhesion and proliferation in vitro, and promoted contraction of mouse airways and ASMC. Conclusions Given the need for novel inhibitors of airway remodelling and bronchodilators in asthma, the LPHN family may represent promising novel targets for future dual therapeutic intervention.
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Affiliation(s)
- A Faiz
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - C Donovan
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Pharmacology and Therapeutics, Lung Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - M Ae Nieuwenhuis
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - M van den Berge
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - D S Postma
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - S Yao
- Center for Vascular Biology Research, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - C Y Park
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - R Hirsch
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J J Fredberg
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - G Tjin
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia
| | - A J Halayko
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - K L Rempel
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - T Lee
- Kings College London, London, UK
| | - Y Bossé
- Department of Molecular Medicine, Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec, Quebec, Canada
| | - D C Nickle
- Merck Research Laboratories, Genetics and Pharmacogenomics, Boston, Massachusetts, USA
| | - M Obeidat
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - J L Black
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - B G Oliver
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,School of Medical and Molecular Biosciences, University of Technology, Sydney, New South Wales, Australia
| | - R Krishnan
- Center for Vascular Biology Research, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - B McParland
- Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - J E Bourke
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Pharmacology and Therapeutics, Lung Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - J K Burgess
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia.,University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
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Homenauth E, Ghiasi M, Feldman L, Arrouf N, Mallya S, Lacombe J, Pichika SC, Zhao K, Aibibula W, Krishnan R, Kajeguka D, Kaaya R, Protopopoff N, Mosha F, Desrochers R, Watts A, Kulkarni M, Saravu K, Nair S, Mukhopadhyay C, George LS, Pai M, Jiang H, Brown P, Blais L, Lefebvre G, Samoilenko M, Kulkarni M, Jolly A, Roy-Gagnon MH, Sander B, Gauvreau CL, Memon S, Popadiuk C, Flanagan WM, Nadeau C, Coldman AJ, Wolfson MC, Miller AB, Acar E, Cox J, Hamelin AM, McLinden T, Klein MB, Brassard P, Chong M, Martin J. The Canadian Society for Epidemiology and Biostatistics 2016 National Student Conference001INVESTIGATING ECOLOGICAL DETERMINANTS OF MALARIA VECTOR DISTRIBUTION IN RURAL TANZANIA “A MULTI-SCALAR INVESTIGATION”002PREVALENCE AND RISK FACTORS OF TUBERCULOSIS INFECTION AMONG HEALTHCARE TRAINEES IN SOUTH INDIA003SPATIAL MODELLING OF LUNG AND THYROID CANCERS IN UNITED STATES COUNTIES004A MEDIATION ANALYSIS TO ASSESS THE IMPACT OF INHALED CORTICOSTEROIDS (ICSS) DURING PREGNANCY ON BIRTHWEIGHT005MODELLING HUMAN RISK OF WEST NILE VIRUS IN ONTARIO, 2002-2013: INCORPORATING SURVEILLANCE AND ENVIRONMENTAL DATA006EXPLORING THE HEALTH OUTCOMES OF VARIOUS PAN-CANADIAN CERVICAL CANCER SCREENING PROGRAMS USING MICROSIMULATION MODELING007INTEGRATIVE ANALYSIS OF MICRORNA AND GENE EXPRESSION DATA USING SPARSE CANONICAL CORRELATION ANALYSIS008CONDITIONAL DEPENDENCE MODELS UNDER COVARIATE MEASUREMENT ERROR009ASSOCIATION BETWEEN FOOD INSECURITY AND HIV VIRAL SUPPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS010ANTIBIOTICS VERSUS APPENDECTOMY FOR UNCOMPLICATED APPENDICITIS: A GLOBAL HEALTH PERSPECTIVE. Am J Epidemiol 2016. [DOI: 10.1093/aje/kww058] [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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Ganesh CS, Krishnan R. A Review of Occupational Injury Research In Malaysia. Med J Malaysia 2016; 71:100-104. [PMID: 27801392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A literature review of 16 papers on occupational injury research in Malaysia published during a 13-year period from 2000-2013 was carried out. The objective of this review and article selection was based on relevance to the research theme and mention of areas for future research. Most of the publications have focused on descriptive epidemiology, management practices, worker's knowledge, attitude, training, and rehabilitation services. The transportation, agriculture and construction sectors were found to be the most hazardous sectors and would benefit the most from Occupational Safety & Health (OSH) research and interventions. There is a strong need to develop a national injury surveillance system and also a mechanism to ensure adherence to the Occupational Safety & Health Act(OSHA) 1994. Detailed description and identification of risk factors for occupational injury in the environment, including machinery and equipment used was generally lacking. Future research on occupational injury should focus on surveillance to determine the magnitude of occupational injuries, determination of risk factors, identifying costeffective interventions (such as enforcement of OSHA regulations), and assessment of rehabilitation services. Relevant government agencies, universities, corporate sector and occupational safety organizations need to play a proactive role in identifying priority areas and research capacity building. Funding for occupational injury should be commensurate with the magnitude of the problem.
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Affiliation(s)
- C S Ganesh
- Clinical Research Centre & Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia.
| | - R Krishnan
- Penang Medical College, Department of Family Medicine, penang, Malaysia
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34
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Panda M, Mangamma G, Krishnan R, Madapu KK, Krishna DNG, Dash S, Tyagi AK. Nano scale investigation of particulate contribution to diamond like carbon film by pulsed laser deposition. RSC Adv 2016. [DOI: 10.1039/c5ra21361d] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Raman mapping and AFAM are useful tools to evaluate the relative stiffness of DLC films embedded with micro graphitic particulates.
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Affiliation(s)
- Madhusmita Panda
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
| | - G. Mangamma
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
| | - R. Krishnan
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
| | - Kishore K. Madapu
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
| | | | - S. Dash
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
| | - A. K. Tyagi
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- India
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35
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Alexander M, Krishnan R, Buder B, Lamb M, Laugenour K, Chapman D, Foster CE, Lakey JRT. Impact of hypothermic preservation on tissue yield and viability in pig pancreata. Transplant Proc 2015; 46:1975-7. [PMID: 25131086 DOI: 10.1016/j.transproceed.2014.05.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Chronic shortage of quality human cadaveric pancreata limits islet transplantation. Porcine islet xenotransplantation is being explored to increase the donor pool. For clinical-ready islets, centralized animal husbandry, Current Good Manufacturing Practice-regulated processing facilities, and organ transportation support are required. Amount of cold ischemia time (CIT) before isolation significantly affects transplantation. The goal of this study was to determine the maximum safe CIT of whole pancreata before islet isolation. MATERIALS AND METHODS Pancreata were rapidly removed from Yorkshire pigs (age, 14-22 days) and stored in modified University of Wisconsin solution or in EuroCollins solution at 4(°)C. Pancreata were processed with <1 hour CIT (control) or stored for 4 or 12 hours before isolation. Islet yield and percent purity and viability were determined after 7 days of in vitro tissue culture and maturation. Samples from nonprocessed pancreata were collected and snap-frozen in liquid nitrogen at 0, 3, 6, 9, 12, 15, and 24 hours of preservation, then analyzed for adenosine diphosphate/adenosine triphosphate ratio as a measure of tissue energetics. RESULTS Up to 12 hours in cold storage had no significant impact on overall islet yield after 7 days of in vitro culture compared with controls; islet yield at the end of the maturation process was 28,700 ± 500 islet equivalents per pancreas (mean ± SEM control yield, 30,300 ± 900 islet equivalents per pancreas); islet purity was 75 ± 5% compared with 74 ± 5% in controls. Islet viability was significantly reduced at 12 hours compared with controls (80 ± 6% vs 96 ± 5%; P < .05). The tissue adenosine diphosphate/adenosine triphosphate ratio was maintained within the first 6 hours (1.6 ± 0.1 to 1.8 ± 0.2; P = NS) but was markedly increased during the 24-hour study (3.3 ± 0.1 at 24 hours), indicating a progressive loss of adenosine triphosphate tissue stores. CONCLUSIONS Young pig pancreata can be hypothermically stored for up to 12 hours without affecting islet yield and purity; however, islet viability is reduced. These data highlight the need for uniform shipping parameters to standardize islet quality, ideally with CIT <6 hours.
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Affiliation(s)
- M Alexander
- Department of Surgery, University of California, Irvine, Orange, California
| | - R Krishnan
- Department of Surgery, University of California, Irvine, Orange, California
| | - B Buder
- Department of Surgery, University of California, Irvine, Orange, California
| | - M Lamb
- Department of Surgery, University of California, Irvine, Orange, California
| | - K Laugenour
- Department of Surgery, University of California, Irvine, Orange, California
| | - D Chapman
- Department of Surgery, University of California, Irvine, Orange, California
| | - C E Foster
- Department of Surgery, University of California, Irvine, Orange, California
| | - J R T Lakey
- Department of Surgery, University of California, Irvine, Orange, California; Department of Biomedical Engineering, University of California, Irvine, Orange, California.
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Krishnan R, Ramesh M, Chalakkal P. Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: an epidemiological study. Eur Arch Paediatr Dent 2015; 16:455-60. [PMID: 26349480 DOI: 10.1007/s40368-015-0194-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 03/09/2015] [Accepted: 06/19/2015] [Indexed: 12/01/2022]
Abstract
AIM This was to study the prevalence of molar incisor hypomineralisation (MIH) among school children residing in a fluorosis endemic area in Tamilnadu (Salem, India). METHODS A target sample of 5000 children of age ranging between 9 and 14 years, comprising 250 children from each of 20 blocks of Salem, participated in this study. The examination was completed in their respective schools by a calibrated examiner using EAPD criteria. RESULTS Of 4989 children examined, 384 children had MIH. A prevalence of 7.3 %. The MIH found in girls was 8.9 % compared with 6.1 % in boys. Single-tooth involvement of MIH was seen predominantly in incisors (2.24 %), whereas with molars usually three teeth were involved (1.1 %). MIH with caries involvement was found in 51 % of the teeth. CONCLUSION The prevalence of MIH in the endemic fluorosis district was found to be 7.3 %. A gradual increase in MIH was seen with age due to post enamel breakdown. Caries involvement was also seen in more than 50 % of the MIH-involved teeth. This prevalence study for molar incisor hypomineralisation (MIH) is rare in the literature, especially in a fluorosis endemic district in Tamilnadu.
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Affiliation(s)
- R Krishnan
- Department of Pedodontics & Preventive dentistry, Vinayaka Missons Sankarachariyar Dental College, Salem, 636308, Tamilnadu, India.
| | - M Ramesh
- Department of Oral pathology, Vinayaka Missons Sankarachariyar Dental College, Salem, Tamilnadu, India
| | - P Chalakkal
- Department of Pedodontics & Preventive Dentistry, Goa Dental College and Hospital, Bambolim, 403202, Goa, India
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Smith T, Gruber M, Simoes A, Krishnan R, Shrotri N. Should a 31/62-day target be applicable to urinary stone patients with indwelling stents? Journal of Clinical Urology 2015. [DOI: 10.1177/2051415814542866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Patients with urinary stone disease languish on waiting lists. They are often young and suffer morbidity and unemployment. Stone disease leads to sepsis, loss of renal units and even death. We aimed to assess the readmission rates and associated morbidity for patients with ureteric stents in situ secondary to stone disease. Patients and methods: Over 12 months 692 patients totalling 1114 admissions were admitted to our unit with a coded diagnosis of renal colic. Of the 692 individuals, 378 first presented as an emergency. The rest had elective first admissions. Results: Of the 378 emergency presentations, 78 were admitted between two and eight times. The total number of admissions for this group of 78 patients was 248. The average time interval was calculated from first emergency presentation to date of first elective treatment (52.3 days (range 2–281)) and from date of first emergency presentation to date of last treatment (63.6 days (range 2–281)). A total of 401 working days were lost. Conclusion: The management of patients with urinary stone disease needs serious reconsideration. We propose that patients with indwelling stents have a 31/62-day target similar to cancer patients due to the increased morbidity associated with loss of working days and the increased cost of readmissions to an overburdened health service.
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Affiliation(s)
- T Smith
- Kent and Canterbury Hospital, UK
| | - M Gruber
- Kent and Canterbury Hospital, UK
| | - A Simoes
- Kent and Canterbury Hospital, UK
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Saravanan K, Krishnan R, Hsieh SH, Wang HT, Wang YF, Pong WF, Asokan K, Avasthi DK, Kanjilal D. Effect of defects and film thickness on the optical properties of ZnO–Au hybrid films. RSC Adv 2015. [DOI: 10.1039/c5ra02144h] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Thickness and defects effects on the optical properties of ZnO–Au hybrid films were studied using optical and electronic structural studies.
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Affiliation(s)
- K. Saravanan
- Department of Physics
- Tamkang University
- Tamsui-251
- Taiwan
| | - R. Krishnan
- Materials Science Group
- Indira Gandhi Centre for Atomic Research
- Kalpakkam-603102
- India
| | - S. H. Hsieh
- Department of Physics
- Tamkang University
- Tamsui-251
- Taiwan
| | - H. T. Wang
- Department of Physics
- National Tsing Hua University
- Hsinchu-30013
- Taiwan
| | - Y. F. Wang
- Department of Physics
- Tamkang University
- Tamsui-251
- Taiwan
| | - W. F. Pong
- Department of Physics
- Tamkang University
- Tamsui-251
- Taiwan
| | - K. Asokan
- Materials Science Group
- Inter-University Accelerator Centre
- New Delhi-110067
- India
| | - D. K. Avasthi
- Materials Science Group
- Inter-University Accelerator Centre
- New Delhi-110067
- India
| | - D. Kanjilal
- Materials Science Group
- Inter-University Accelerator Centre
- New Delhi-110067
- India
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Krishnan R, Katz D, Nelson CJ, Mulhall JP. Erectile function recovery in patients after non-nerve sparing radical prostatectomy. Andrology 2014; 2:951-4. [PMID: 25270277 DOI: 10.1111/andr.282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 09/03/2014] [Indexed: 01/07/2023]
Abstract
Few studies have looked at erectile function recovery (EFR) rates in men undergoing non-nerve sparing resection during radical prostatectomy (RP). Existing studies show great variation in EFR rates owing to multiple factors that minimize their utility in counselling RP patients. We investigated the EFR rate and its predictors in unilateral cavernous nerve resection and bilateral cavernous nerve resection patients 24 months after RP. We conducted a population-based, prospective cohort study of 966 patients who underwent RP at a tertiary cancer centre from 2008 to 2012. Cavernous nerve condition was evaluated on a 4-point nerve sparing score and assigned to one of three groups: bilateral sparing, unilateral resection (UNR) and bilateral nerve resection (BNR). EF was assessed pre-RP and 24-30 months post-op using a validated 5-point patient-reported scale (1 = fully rigid; 5 = no tumescence). EFR was defined as a post-op EF grade of 1-2. Statistical analysis included descriptive statistics, anova, chi-square, Fisher's exact test and logistic regression. Mean baseline EF was 1.84 ± 1.3 and 2.74 ± 1.5 for UNR and BNR patients respectively. Thirty-three percent of UNR patients and 13% of BNR patients exhibited EFR. Age, baseline EF were predictors of EFR. Multivariable analysis showed baseline EF was a significant predictor of EFR at 24 months for UNR. For BNR patients, pre-RP EF was the only factor predictive of EFR. Patients undergoing nerve resection still have a significant chance of achieving true EFR, with UNR surgery patients showing more potential for improvement than patients undergoing BNR surgery. Age and baseline EFR characterize recovery prospects in these two groups. Physicians should thus measure and account for baseline EF in addition to age and the degree of nerve resection when advising patients about expectations for successful EF following RP.
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Affiliation(s)
- R Krishnan
- Division of Urology, Sexual and Reproductive Medicine Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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40
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Krishnan R, Shah P, Thomas D. Subacute idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) in a child and review of paediatric cases of IRVAN revealing preserved capillary perfusion as a more common feature. Eye (Lond) 2014; 29:145-7. [PMID: 25233821 DOI: 10.1038/eye.2014.213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- R Krishnan
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - P Shah
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - D Thomas
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Jee SL, Lim KF, Krishnan R. A rare case of fulminant hemobilia resulting from gallstone erosion of the right hepatic artery. Med J Malaysia 2014; 69:191-192. [PMID: 25500850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hemobilia is a rare but potentially lethal condition. The commonest cause of hemobilia is trauma, accounting up to 85% of all cases. Hemobilia caused by gallstones is very rare. Most of the cases of hemobilia are either managed conservatively or treated by embolization. Surgery is indicated only when there is an associated surgical condition or when embolization fails. We report a case of a 72-year-old patient with massive hemobilia caused by gallstone erosion to the adjacent artery, diagnosed intraoperatively. The complication was successfully managed by cholecystectomy and repair of the bleeding vessel. This case highlights the importance that hemobilia should be suspected in patients presenting with upper gastrointestinal bleeding. Although rare, massive hemobilia can be life threatening, leading to significant morbidity and mortality. Therefore, a high index of suspicion and timely intervention are important.
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Affiliation(s)
- S L Jee
- Hospital Selayang, General Surgery, Lebuhraya Selayang-Kepong, Batu Caves, Selangor 68100, Malaysia.
| | - K F Lim
- Hospital Selayang, Hepatobiliary Department, Lebuhraya Selayang-Kepong, Batu Caves, Selangor 68100, Malaysia
| | - R Krishnan
- Hospital Selayang, Hepatobiliary Department, Lebuhraya Selayang-Kepong, Batu Caves, Selangor 68100, Malaysia
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Prabu M, Banu IBS, Sundari ST, Krishnan R, Chen YC, Chavali M. Optical studies of pulsed laser deposited nanostructured Pb(Zr0.52Ti0.48)O3 thin film by spectroscopic ellipsometry. J Nanosci Nanotechnol 2014; 14:5335-5341. [PMID: 24758028 DOI: 10.1166/jnn.2014.8689] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pulsed laser deposition method was employed to grow nanostructured Pb(Zr0.52Ti0.48)O3 (PZT) thin film on Si(100) substrate. The structural and morphological properties of the thin film were investigated by X-ray diffraction (XRD) and scanning electron microscope (SEM) respectively. Optical properties of PZT thin film were studied using spectroscopic ellipsometry (SE) and a four layer model was applied. Spectra of ellipsometric parameters such as psi and delta were measured as a function of energy at room temperature. The refractive index (n), extinction coefficient (k), absorption coefficient (alpha) and the dielectric constants (epsilon(r) and epsilon(i)) of the thin film were obtained as a function of wavelength (200 to 900 nm range). The energy gap (E(g)) of the PZT thin film was estimated to be 3.65 eV. The thickness of the thin films was determined by the ellipsometric data (524 nm) and grain size is found to be in the range of 50-100 nm.
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Leow VM, Siam F, Saravanan K, Murbita SB, Krishnan R, Harjit S. Management of bleeding pseudoaneurysm of gastroduodenal artery secondary to chronic pancreatitis. Med J Malaysia 2013; 68:271-272. [PMID: 23749023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A bleeding pseudoaneurysm of the peripancreatic artery can present with massive upper gastrointestinal hemorrhage. History of pancreatitis and urgent imaging are crucial in the making of the diagnosis. Here, we report a patient with alcoholic chronic pancreatitis presented with ruptured pseudoaneurysm of gastroduodenal artery (GDA). He was treated with percutaneous angiographic embolisation.
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Affiliation(s)
- V M Leow
- Advanced Medical and Dental Institute, Oncology, No 1-8, Persiaran Seksyen 4/1, Bandar Putra Bertam, Kepala Batas, Kepala Batas, Penang 13200, Malaysia.
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Krishnan R, Rajeswari R, Venugopal J, Sundarrajan S, Sridhar R, Shayanti M, Ramakrishna S. Polysaccharide nanofibrous scaffolds as a model for in vitro skin tissue regeneration. J Mater Sci Mater Med 2012; 23:1511-1519. [PMID: 22491895 DOI: 10.1007/s10856-012-4630-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 03/21/2012] [Indexed: 05/31/2023]
Abstract
Tissue engineering and nanotechnology have advanced a general strategy combining the cellular elements of living tissue with sophisticated functional biocomposites to produce living structures of sufficient size and function at a low cost for clinical relevance. Xylan, a natural polysaccharide was electrospun along with polyvinyl alcohol (PVA) to produce Xylan/PVA nanofibers for skin tissue engineering. The Xylan/PVA glutaraldehyde (Glu) vapor cross-linked nanofibers were characterized by SEM, FT-IR, tensile testing and water contact angle measurements to analyze the morphology, functional groups, mechanical properties and wettability of the fibers for skin tissue regeneration. The cell-biomaterial interactions were studied by culturing human foreskin fibroblasts on Xylan/PVA Glu vapor cross-linked and Xylan/PVA/Glu blend nanofibrous scaffolds. The observed results showed that the mechanical properties (72 %) and fibroblast proliferation significantly increased up to 23 % (P < 0.05) in 48 h Glu vapor cross-linked nanofibers compared to 24 h Glu vapor cross-linked Xylan/PVA nanofibers. The present study may prove that the natural biodegradable Xylan/PVA nanofibrous scaffolds have good potential for fibroblast adhesion, proliferation and cell matrix interactions relevant for skin tissue regeneration.
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Affiliation(s)
- R Krishnan
- Centre for Nanofibers & Nanotechnology, NUSNNI, Faculty of Engineering, National University of Singapore, Singapore
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45
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Fisher R, Gannon K, Krishnan R, Tsubery H, Lulu M, Gartner M, Proschitsky M, Becker M, Wright J, Rockenstein E, Masliah E, Kirschner D, Myszka D, Solomon B. 22 NPT002: a novel approach for targeting β-amyloid and tau aggregates in Alzheimer's disease. Neurobiol Aging 2012. [DOI: 10.1016/j.neurobiolaging.2012.01.040] [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: 10/28/2022]
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Rojas-Canales D, Krishnan R, Jessup CF, Coates PT. Early exposure of interferon-γ inhibits signal transducer and activator of transcription-6 signalling and nuclear factor κB activation in a short-term monocyte-derived dendritic cell culture promoting 'FAST' regulatory dendritic cells. Clin Exp Immunol 2012; 167:447-58. [PMID: 22288588 DOI: 10.1111/j.1365-2249.2011.04537.x] [Citation(s) in RCA: 13] [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] [Indexed: 01/03/2023] Open
Abstract
Interferon (IFN)-γ is a cytokine with immunomodulatory properties, which has been shown previously to enhance the generation of tolerogenic dendritic cells (DC) when administered early ex vivo in 7-day monocyte-derived DC culture. To generate tolerogenic DC rapidly within 48 h, human monocytes were cultured for 24 h with interleukin (IL)-4 and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the presence (IFN-γ-DC) or absence of IFN-γ (500 U/ml) (UT-DC). DC were matured for 24 h with TNF-α and prostaglandin E(2) (PGE(2) ). DC phenotype, signal transducer and activator of transcription-6 (STAT-6) phosphorylation and promotion of CD4(+) CD25(+) CD127(neg/low) forkhead box P3 (FoxP3)(hi) T cells were analysed by flow cytometry. DC nuclear factor (NF)-κB transcription factor reticuloendotheliosis viral oncogene homologue B (RELB) and IL-12p70 protein expression were also determined. Phenotypically, IFN-γ-DC displayed reduced DC maturation marker CD83 by 62% and co-stimulation molecules CD80 (26%) and CD86 (8%). IFN-γ treatment of monocytes inhibited intracellular STAT6, RELB nuclear translocation and IL-12p70 production. IFN-γ-DC increased the proportion of CD4(+) CD25(+) CD127(neg/low) foxp3(hi) T cells compared to UT-DC from 12 to 23%. IFN-γ-DC primed T cells inhibited antigen-specific, autologous naive T cell proliferation by 70% at a 1:1 naive T cells to IFN-γ-DC primed T cell ratio in suppression assays. In addition, we examined the reported paradoxical proinflammatory effects of IFN-γ and confirmed in this system that late IFN-γ exposure does not inhibit DC maturation marker expression. Early IFN-γ exposure is critical in promoting the generation of regulatory DC. Early IFN-γ modulated DC generated in 48 h are maturation arrested and promote the generation of antigen-specific regulatory T cells, which may be clinically applicable as a novel cellular therapy for allograft rejection.
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Affiliation(s)
- D Rojas-Canales
- Renal and Transplantation Immunobiology Laboratory, Hanson Institute, Royal Adelaide Hospital, Adelaide, SA, Australia
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Zhou EH, Krishnan R, Stamer WD, Perkumas KM, Rajendran K, Nabhan JF, Lu Q, Fredberg JJ, Johnson M. Mechanical responsiveness of the endothelial cell of Schlemm's canal: scope, variability and its potential role in controlling aqueous humour outflow. J R Soc Interface 2011; 9:1144-55. [PMID: 22171066 DOI: 10.1098/rsif.2011.0733] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Primary open-angle glaucoma is associated with elevated intraocular pressure, which in turn is believed to result from impaired outflow of aqueous humour. Aqueous humour outflow passes mainly through the trabecular meshwork (TM) and then through pores formed in the endothelium of Schlemm's canal (SC), which experiences a basal-to-apical pressure gradient. This gradient dramatically deforms the SC endothelial cell and potentially contributes to the formation of those pores. However, mechanical properties of the SC cell are poorly defined. Using optical magnetic twisting cytometry and traction force microscopy, here we characterize the mechanical properties of primary cultures of the human SC cell, and for the first time, the scope of their changes in response to pharmacological agents that are known to modulate outflow resistance. Lysophosphatidic acid, sphingosine-1-phosphate (S1P) and thrombin caused an increase in cell stiffness by up to 200 per cent, whereas in most cell strains, exposure to latrunculin A, isoproterenol, dibutryl cyclic-AMP or Y-27632 caused a decrease in cell stiffness by up to 80 per cent, highlighting that SC cells possess a remarkably wide contractile scope. Drug responses were variable across donors. S1P, for example, caused 200 per cent stiffening in one donor strain but only 20 per cent stiffening in another. Isoproterenol caused dose-dependent softening in three donor strains but little or no response in two others, a finding mirrored by changes in traction forces and consistent with the level of expression of β(2)-adrenergic receptors. Despite donor variability, those drugs that typically increase outflow resistance systematically caused cell stiffness to increase, while in most cases, those drugs that typically decrease outflow resistance caused cell stiffness to decrease. These findings establish the endothelial cell of SC as a reactive but variable mechanical component of the aqueous humour outflow pathway. Although the mechanism and locus of increased outflow resistance remain unclear, these data suggest the SC endothelial cell to be a modulator of outflow resistance.
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Affiliation(s)
- E H Zhou
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
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Mehta P, Kalyanpur T, Narsinghpura K, Krishnan R, Raja D, Yadav M, Cherian M. Outcomes of Endovascular Coiling in Patients with Intracranial Aneurysms Presenting with Poor Clinical and SAH Grade. Neuroradiol J 2011; 24:669-76. [DOI: 10.1177/197140091102400502] [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] [Received: 10/06/2010] [Accepted: 01/23/2011] [Indexed: 11/16/2022] Open
Abstract
Although the treatment of intracranial aneurysms has made significant advances, prediction of outcomes in poor grades has always been difficult. We present our findings of patients in poor clinical and SAH grade treated with endovascular coiling. We aimed to evaluate the clinical outcomes in patients presenting with poorer neurological and SAH grades treated by endovascular techniques. Of 190 patients who presented with SAH over a period of nine years, 34 were of poorer clinical grade (Hunt & Hess Grades 4 and 5), of whom 30 presented with H&H grade 4 and four with grade 5. 44.1% of the 34 patients belonged to Fischer grade 4. We assessed the technical success and final outcomes based on the Glasgow outcome scale. Of the 30 patients with grade 4, 81.4% had a good outcome. Two out of four patients with grade 5 had a poor outcome. 82.5% of the patients with Fischer grade 4 had a good outcome. None of the poor outcomes were procedure-related. Endovascular treatment with its higher rates of technical success, lower complication rates and better outcomes should be recommended as the treatment of choice in patients with intracranial aneurysms even in patients with poorer clinical and SAH grades.
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Affiliation(s)
- P. Mehta
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - T. Kalyanpur
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - K.S. Narsinghpura
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - R. Krishnan
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - D. Raja
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - M. Yadav
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
| | - M. Cherian
- Department of Radiodiagnosis, Kovai Medical Center and Hospital; Coimbatore, Tamil Nadu, India
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Pradhan PK, Preethi B, Ashok K, Krishnan R, Sahai AK. Modoki, Indian Ocean Dipole, and western North Pacific typhoons: Possible implications for extreme events. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2011jd015666] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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