Restructuring Primary Health Care Network to Maximize Utilization and Reduce Patient Out-of-pocket Expenses

Kaushal Kumar,Amit Kumar Bardhan 아시아기술혁신학회 2019 Asian Journal of Innovation and Policy Vol.8 No.1

Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.

Fixed bed utilization for the isolation of xylene vapor: Kinetics and optimization using response surface methodology and artificial neural network

Kaushal Naresh Gupta,Rahul Kumar 대한환경공학회 2021 Environmental Engineering Research Vol.26 No.2

This paper discusses the isolation of xylene vapor through adsorption using granular activated carbon as an adsorbent. The operating parameters investigated were bed height, inlet xylene concentration and flow rate, their influence on the percentage utilization of the adsorbent bed up to the breakthrough was found out. Mathematical modeling of experimental data was then performed by employing a response surface methodology (RSM) technique to obtain a set of optimum operating conditions to achieve maximum percentage utilization of bed till breakthrough. A fairly high value of R² (0.993) asserted the proposed polynomial equation’s validity. ANOVA results indicated the model to be highly significant with respect to operating parameters studied. A maximum of 76.1% utilization of adsorbent bed was found out at a bed height of 0.025 m, inlet xylene concentration of 6,200 ppm and a gas flow rate of 25 mL.min<SUP>-1</SUP>. Furthermore, the artificial neural network (ANN) was also employed to compute the percentage utilization of the adsorbent bed. A comparison between RSM and ANN divulged the performance of the latter (R² = 0.99907) to be slightly better. Out of various kinetic models studied, the Yoon-Nelson model established its appropriateness in anticipating the breakthrough curves.

Low power SRAM design for 14nm GAA Si-nanowire technology

Kaushal, G.,Jeong, H.,Maheshwaram, S.,Manhas, S.K.,Dasgupta, S.,Jung, S.O. Mackintosh Publications] 2015 Microelectronics Journal Vol.46 No.12

This paper presents a low power and stable 6-T nanowire SRAM cell design by tuning the extension length of the access transistor. Our approach significantly reduces the power dissipation with a low active area and improves the SRAM cell read stability. We utilize device design parameters such as the nanowire diameter, the number of nanowires, and the device extension length to improve the stability of the SRAM cells. We find that the extension length tuning technique exhibits 15% and ~60% savings in active area and static power consumption, respectively, in comparison to a conventional multi-nanowire tuning technique. In addition, the proposed technique achieves 6% and 8% improvements in the read and hold noise margins, respectively, with a 6.5% decrease in write noise margin and a ~14% increase in the read/write access time. Our results show that the extension length-tuned access transistor is an excellent option for improving the satiability with low power for sub-14-nm technologies.

Non-traditional Straws: Alternate Feedstuffs for Ruminants

Kaushal, S.,Wadhwa, M.,Bakshi, M.P.S. Asian Australasian Association of Animal Productio 2006 Animal Bioscience Vol.19 No.12

The nutritive value of 4 straws, obtained after thrashing of seeds from fodder crops, was assessed as complete feed for ruminants. Sixteen male Murrah buffaloes (liveweight 365.8${\pm}$19.5 kg), were divided into 4 equal groups and offered ad lib. straw of either Trifolium resupinatum, Trifolium alexandrium, Medicago sativa or Lolium perenne, supplemented with minerals and vitamin A, for 40 days in a completely randomized design. Simultaneously, each straw was offered to 3 rumen fistulated male buffaloes in order to assess the biochemical changes in the rumen. Compared to other straws M. sativa straw had higher (p<0.05) organic matter (OM), crude protein (CP), acid-detergent fiber (ADF) and cellulose content. L .perenne had the highest (p<0.05) hemicellulose and lowest (p<0.05) CP and acid-detergent lignin (ADL) content. T. resupinatum had the lowest concentration of cell wall constituents (CWC). The digestibility of nutrients of T. resupinatum and L. perenne straw was similar, but higher (p<0.05) than that of other straws. M.sativa straw showed highest (p<0.05) digestibility of CP. The highest OM digestibility of T. resupinatum and CP digestibility of M. sativa were responsible for highest (p<0.05) total volatile fatty acids and trichloroacetic acid precipitable nitrogen in the strained rumen liquor. The digestible crude protein (DCP) was highest (p<0.05) in M. sativa followed by that in T. alexandrium. The total purine derivatives excreted in urine varied from 0.22-0.32 mmol/kg $W^{.75}/d$. The efficiency of microbial protein synthesis indicated that OM of straws of M. sativa and that of T. alexandrium was used more (p<0.05) efficiently. The microbial protein synthesized was highest in T. resupinatum, but statistically similar to other groups. The values for N-retention and apparent biological value were highest for L. perenne, though comparable with that of M. sativa and T. alexandrium. The available metabolizable energy (ME) was highest (p<0.05) in T. resupinatum followed by that in L. perenne and lowest in M. sativa. It was concluded that all the straws, supplemented with minerals and vitamin A, could be fed exclusively to adult ruminants with no adverse affect, as animals were able to maintain body weight (372${\pm}$20.1 kg).

Open injury, robotic repair—moving ahead! Total robotic Roux-en-Y hepaticojejunostomy for post-open cholecystectomy Bismuth type 2 biliary stricture using indocyanine green dye

Kaushal Singh Rathore,Peeyush Varshney,Subhash Chandra Soni,Vaibhav Kumar Varshney,Selvakumar B,Lokesh Agarwal,Chhagan Lal Birda 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.3

Hepaticojejunostomy is currently the best treatment for post-cholecystectomy biliary strictures. Laparoscopic repair has not gained popularity due to difficult reconstruction. We present case of 43-year-old-female with Bismuth type 2 stricture following laparoscopic converted open cholecystectomy with bile duct injury done elsewhere. Position was modified Llyod-Davis position and four 8-mm robotic ports (including camera) and 12-mm assistant port were placed. The procedure included noticeable steps such as adhesiolysis, identification of gallbladder fossa, identification of common hepatic duct, lowering of hilar plate etc. Operating and console time were 420 and 350 minutes and blood loss was 100 mL. Patient was discharged on postoperative day 4. Robotic repair (hepaticojejunostomy) of biliary tract stricture after cholecystectomy is safe and feasible with good outcomes.

Characterising the dynamic seals used in absorber rod drive mechanisms in Indian FBR

Kaushal, Nihal,Patri, Sudheer,Kumar, R. Suresh,Meikandamurthy, C.,Sreedhar, B.K.,Murugan, S.,Raghupathy, S. Korean Nuclear Society 2021 Nuclear Engineering and Technology Vol.53 No.10

Dynamic seals are one of the critical components of Absorber Rod Drive Mechanism of Fast Breeder Reactors, requiring separate experimental development. Their significance can't be overemphasized considering that the availability and re-usability of Control Rod Drive Mechanisms of Fast Breeder Test Reactor is governed by the failure rate of dynamic seals (bellows). For prototype and subsequent Fast Breeder Reactors in India, choice of the dynamic seal is changed to an in-house designed & developed labyrinth type V-ring seal. The present work is related to the numerical investigations carried out to gain insights into the sealing mechanism and the thermal behaviour of these seals. The results indicate that the seal geometry is very important for obtaining optimum performance. By changing the geometry of the present seal, performance enhancement by more than 50% in important indices is obtained. Further, the results point out that caution shall be exercised when the seal material & its operating temperature are changed. Also, the numerical model developed in this study will be useful for developing more robust dynamic seals in future.

Microstructure, Tensile and Fatigue Behaviour of Resistance Spot Welded Zinc Coated Dual Phase and Interstitial Free Steel

Kaushal Kishore,Pankaj Kumar,Goutam Mukhopadhyay 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.4

Galvannealed (hot dip galvanized and annealed) dual phase (DP600) steel and interstitial free (IF) steel are two of the widelyused materials in automotive industries owing to their high specific strength, toughness, formability and corrosion resistance. This inevitably requires their joining to form larger components. Resistance spot welding has emerged as the predominantwelding technique for joining of sheet metals in automotive industries. There are complexities regarding microstructuralvariation of the fusion zone and across heat affected zones during spot welding of fundamentally dissimilar steels. This isfurther aggravated by the prospect of zinc redistribution during the welding process. Current study presents the evolution ofmicrostructure in different zones of welding in IF and DP600 steel. Micro-hardness profiles and electron back scattered diffractionstudies were performed. Furthermore, redistribution of elements in different welding zones is studied using electronprobe micro analysis. The effect of welding current and time on the nugget size and the strength of the weld during tensile–shear is determined. It was observed that there was an increase in nugget diameter and maximum load bearing capacity ofthe joint with an increase in heat input, until the occurrence of expulsion. Furthermore, critical nugget diameter for pull-outfailure was determined and existing empirical models were verified for the applicability in this case. None of the existingempirical models could predict the critical nugget diameter correctly and thus a new empirical relationship between sheetthickness and critical nugget diameter for zinc coated dissimilar steels has been proposed. Failure behaviour of the spotweldedsheets were studied under tensile–shear configuration under quasi-static and fatigue mode of loading and it showedsubstantial difference in location of crack initiation and fractographic features. Tensile–shear specimen at optimum weldingparameter failed from the base metal of the IF steel side with dimples on the fracture surface, whereas fatigue specimenfailed from the heat affected zone of the IF steel side with transgranular striations on the fracture surface.

Deubiquitinating enzymes in cancer stem cells: functions and targeted inhibition for cancer therapy

Kaushal, Kamini,Antao, Ainsley Mike,Kim, Kye-Seong,Ramakrishna, Suresh Elsevier 2018 DRUG DISCOVERY TODAY Vol.23 No.12

<P>The ability of cancers to evade conventional treatments, such as chemotherapy and radiation therapy, has been attributed to a subpopulation of cancer stem cells (CSCs). CSCs are regulated by mechanisms similar to those that regulate normal stem cells (NSCs), including processes involving ubiquitination and deubiquitination enzymes (DUBs) that regulate the expression of various factors, such as Notch, Wnt, Sonic Hedgehog (Shh), and Hippo. In this review, we discuss the roles of various DUBs involved in the regulation of core stem cell transcription factors and CSC-related proteins that are implicated in the modulation of cellular processes and carcinogenesis. In addition, we discuss the various DUB inhibitors that have been designed to target processes relevant to cancer and CSC maintenance.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Ubiquitin proteasomal pathway and cancer stem cells (CSCs) mediate tumor obstinacy. </LI> <LI> Association of deubiquitinating enzymes (DUBs) with CSCs-mediated signaling pathways. </LI> <LI> Application of DUB inhibitors in CSCs and non-CSCs targeted therapy. </LI> </UL> </P>

Facile synthesis and electrochemical investigations of Tin‑doped MnO2/ carbon nanotube composites

Indu Kaushal,Ashok K. Sharma,Priya Saharan,Vinit Kumar,Surender Duhan 한국탄소학회 2019 Carbon Letters Vol.29 No.1

The composites of carbon nanotube (CNT) supported by Sn-doped MnO2 with enhanced capacitance have been fabricated with varying dopant concentrations. The composites have been subjected to physiochemical, configurational, and morphological analyses by FTIR, UV–Vis spectroscopy, X-ray diffraction and field emission scanning electron microscopy, high resolution transmission electron microscopy and selected area electron diffraction studies. The electrochemical performance of the composite has been evaluated by cyclic voltammetry and charge/discharge techniques. Highest specific capacitances of 940 F g−1 at a current density of 0.35 A g−1 and 927 F g−1 at 5 mV s−1 in 1 M Na2SO4 electrolyte solution was achieved in the case of 5% Sn doped composite. Moreover, the electrode demonstrated good cycling performance and retaining 79.7% of the initial capacitance over 3000 cycles. The superior electrochemical performance is accredited mainly to the porous sheath hierarchical architecture, which consist of inter connected MnO2 nanoneedles uniformly coated over the CNT surface. This peculiar architecture is responsible for fast ion/electron transfer and easy access of the active material.

Some Properties of Harmonic Functions Defined by Convolution

Dixit, Kaushal Kishor,Porwal, Saurabh Department of Mathematics 2009 Kyungpook mathematical journal Vol.49 No.4

In this paper, we introduce and study a comprehensive family of harmonic univalent functions which contains various well-known classes of harmonic univalent functions as well as many new ones. Also, we improve some results obtained by Frasin [3] and obtain coefficient bounds, distortion bounds and extreme points, convolution conditions and convex combination are also determined for functions in this family. It is worth mentioning that many of our results are either extensions or new approaches to those corresponding previously known results.