A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States

Rupak Desai,Upenkumar Patel,Shreyans Doshi,Dipen Zalavadia,Wardah Siddiq,Hitanshu Dave,Mohammad Bilal,Vikas Khullar,Hemant Goyal,Madhav Desai,Nihar Shah 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5

Background/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (Julyto September) and later (October to June) academic months to assess the “July effect”. Methods: The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teachinghospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluatethe odds of post-ERCP sepsis and its predictors. Results: Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academicmonths. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higherincidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during theearly academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients withpost-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications suchas cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis inprocedures performed during the early academic months. Conclusions: The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into considerationthe predictors of post-ERCP sepsis to lower health-care burden.

Investigations on the thickness dependent structural, morphological, and optoelectronic properties of sprayed cadmium based transparent conducting oxide

Desai, S.P.,Suryawanshi, M.P.,Gaikwad, M.A.,Mane, A.A.,Kim, J.H.,Moholkar, A.V. Elsevier S.A. 2017 Thin Solid Films Vol.628 No.-

The influence of thickness on the properties of cadmium oxide thin films deposited using simple and cost-effective chemical spray pyrolysis technique is studied. The maximum film of thickness 2752nm is achieved by tuning spraying parameters. The thickness dependent structural, morphological, and optoelectronic properties of CdO thin films have been investigated in detail. The microstructure of CdO thin films significantly changed from rough to smooth and further to rougher surface with increase in film thickness. This behavior has been further confirmed from water contact angle measurement. The optical studies show that the direct band gap energy values ranging between 2.23 and 2.46eV. The Hall effect measurement indicates that all the films exhibit n-type semiconducting behavior with their electrical resistivity lies in the range of 12.8x10<SUP>-4</SUP> to 3.7x10<SUP>-4</SUP>Ω.cm. The CdO film with thickness of 1371nm exhibited the best optoelectronics properties (transmittance of 74%, figure of merit of 18.23x10<SUP>-3</SUP>(Ω)<SUP>-1</SUP>, carrier concentration of 7.30x10<SUP>20</SUP>/cm<SUP>3</SUP> and mobility of 23.11cm<SUP>2</SUP>/Vs) among all the films.

Retrospective Evaluation of Risk Factors and Immunohistochemical Findings for Pre-Neoplastic and Neoplastic lesions of Upper Urinary Tract in Patients with Chronic Nephrolithiasis

Desai, Fanny Sharadkumar,Nongthombam, Jitendra,Singh, Lisam Shanjukumar Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.18

Background: Urinary stones are known predisposing factors for upper urinary tract carcinoma (UUTC) which are commonly detected at advanced stage with poor outcome because of rarity and lack of specific criteria for early detection. Aims and objectives: The main aim was to evaluate the impact of age, gender andstone characteristics on risk of developing UUTC in patients with chronic nephrolithiasis. We also discuss the role of aberrant angiogenesis (AA) and immunohistochemical expression of p53, p16INK4a, CK20 and Ki-67 in diagnosis of pelvicalyceal neoplastic (NL) and pre-neoplastic lesions (PNL) in these patients. Materials and Methods: Retrospective analysis of pelvicalyceal urothelial lesions from 88 nephrectomy specimens were carried out in a tertiary care centre from June 2012 to December 2014. Immunohistochemistry (IHC) was performed on 37 selected cases. Computed image analysis was performed to analyse aberrant angiogenesis. Results: All UUTC (5.7%) and metaplastic lesions were found to be associated with stones. Some 60% were pure squamous cell carcinoma and 40% were transitional cell carcinoma. Odd ratios for developing NL and PNL lesions in presence of renal stone, impacted stones, multiple and large stag horn stones were 9.39 (95% CI 1.15-76.39, p value 0.05), 6.28 (95% CI 1.59-24.85, p value 0.000) and 7.4 (95% CI, 2.29-23.94, p value 0.001) respectively. When patient age was ${\geq}55$, the odds ratio for developing NL was 3.43 (95% CI 1.19-9.88, p value 0.019). IHC analysis showed that mean Ki-67 indices were $3.15{\pm}3.63%$ for non-neoplastic lesions, $10.0{\pm}9.45%$ for PNL and $28.0{\pm}18.4%$ for NL. Sensitivity and specificity of CK20, p53, p16INK4a, AA were 76% and 95.9%; 100% and 27.5%; 100% and 26.5%; 92.3 % and 78.8% respectively. Conclusions: Age ${\geq}55years$, large stag horn stones, multiple stones and impacted stones are found to be associated with increased risk of NL and PNL in UUT. For flat lesions, a panel of markers, Ki 67 index >10 and presence of aberrant angiogenesis were more useful than individual markers.

Elastin-Based Rubber-Like Hydrogels

Desai, Malav S.,Wang, Eddie,Joyner, Kyle,Chung, Tae Won,Jin, Hyo-Eon,Lee, Seung-Wuk American Chemical Society 2016 Biomacromolecules Vol.17 No.7

<P>We developed rubber-like elastomeric materials using a natural elastin derived sequence and genetic engineering to create precisely defined elastin-like polypeptides. The coiled elastin-like polypeptide chains, which behave like entropic springs, were cross-linked using an end-to-end tethering scheme to synthesize simple hydrogels with excellent extensibility and reversibility. Our hydrogels extend to strains as high as 1500% and remain highly resilient with elastic recovery as high as 94% even at 600% strain, significantly exceeding any other protein-based valuable as elastomeric hydrogels for designing extremely robust scaffolds useful for tissue engineering.</P>

Triticum aestivum (Wheatgrass) formulation: An alternate treatment for the patients with Thalassemia

Desai, TR,Solanki, JK,Buch, Pankaj,Goyal, RK Kyung Hee Oriental Medicine Research Center 2008 Oriental pharmacy and experimental medicine Vol.7 No.5

We have developed the tablet formulation of Triticum aestivum (wheatgrass) and investigated clinically, its effects in patients suffering from b-thalassemia (major) at K. T. Children Hospital, Civil Hospital, Rajkot. The tablets (wheatgrass powder 250 mg.) were given 3 times in a day for 9 months. Blood samples were collected at the start, after 6 months and 9 months and analyzed for various biochemical and hematological parameters. Treatment with wheatgrass formulation for 9 months produced significant decrease in hemoglobin, total RBC, eosinophil and reticulocyte counts. The mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were significantly increased was significantly increased. The serum ferritin was also significantly decreased. There was no influence on serum magnesium, serum iron and Thiobarbituric acid reacting substances (TBARS). Our data indicate that treatment with wheatgrass on patients with $\beta$-thalassemia (major) may have beneficial effects in the form of a decrease in ineffective erythropoiesis, stimulation of hemoglobin synthesis in RBC, decrease in iron load and decrease in eosinophil count.

Search for dark matter WIMPs using upward through-going muons in Super-Kamiokande

Desai, S.,Ashie, Y.,Fukuda, S.,Fukuda, Y.,Ishihara, K.,Itow, Y.,Koshio, Y.,Minamino, A.,Miura, M.,Moriyama, S.,Nakahata, M.,Namba, T.,Nambu, R.,Obayashi, Y.,Sakurai, N.,Shiozawa, M.,Suzuki, Y.,Takeuch American Physical Society 2004 PHYSICAL REVIEW D - Vol.70 No.8

Mixed finite element model for laminated composite beams

Desai, Y.M.,Ramtekkar, G.S. Techno-Press 2002 Structural Engineering and Mechanics, An Int'l Jou Vol.13 No.3

A novel, 6-node, two-dimensional mixed finite element (FE) model has been developed to analyze laminated composite beams by using the minimum potential energy principle. The model has been formulated by considering four degrees of freedom (two displacement components u, w and two transverse stress components ${\sigma}_z$, $\tau_{xz}$) per node. The transverse stress components have been invoked as nodal degrees of freedom by using the fundamental elasticity equations. Thus, the present mixed finite element model not only ensures the continuity of transverse stress and displacement fields through the thickness of the laminated beams but also maintains the fundamental elasticity relationship between the components of stress, strain and displacement fields throughout the elastic continuum. This is an important feature of the present formulation, which has not been observed in various mixed formulations available in the literature. Results obtained from the model have been shown to be in excellent agreement with the elasticity solutions for thin as well as thick laminated composite beams. A few results for a cross-ply beam under fixed support conditions are also presented.

Organizing Pastoral Women in the Process of Social Reform to Change the Social and Judiciary Structure in Wagad Region of Kutchh in India

DESAI Geeta Jivanbhai 이화여자대학교 아시아여성학센터 2014 이화여자대학교 아시아여성학센터 학술대회자료집 Vol.2014 No.1

Effect of manufacturing parameters on the characteristics of vitamin C encapsulated tripolyphosphate-chitosan microspheres prepared by spray-drying

Desai, K. G.,Park, H. J. Taylor & Francis 2006 Journal of microencapsulation Vol.23 No.1

<P>To prepare the sustained release vitamin C carriers, vitamin C was successfully encapsulated in tripolyphosphate (TPP) cross-linked chitosan (TPP-chitosan) microspheres by the spray-drying method at different manufacturing conditions. Manufacturing parameters (inlet temperature, liquid flow rate, chitosan concentration and volume of 1% w/v TPP solution) had a significant influence on the characteristics of thus prepared microspheres. The optimum spray-drying conditions such as inlet temperature, liquid flow rate and compressed air flow rate for the encapsulation of vitamin C in TPP-chitosan microspheres was found to be 170°C, 2 ml min −1 and 10 l min −1 , respectively. The size and yield of the TPP-chitosan microspheres ranged from 3.9–7.3 µm and 54.5–67.5%, respectively. The encapsulation efficiency of TPP-chitosan microspheres ranged from 45.72–68.7% and it decreased with the increasing volume of 1% w/v TPP solution. At the same cross-linking extent, the encapsulation efficiency of TPP-chitosan microspheres increased when the concentration of chitosan was increased from 0.5–1% w/v. Effect of volume of 1% w/v TPP solution on the surface morphology of chitosan microspheres was examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). These studies revealed that chitosan solution (250 ml) cross-linked with 15 ml 1% w/v TPP solution produced more porous microspheres than that cross-linked with 5 and 10 ml TPP solution. The release rate of vitamin C from TPP-chitosan microspheres decreased when the concentration of chitosan was increased from 0.5–1.0% w/v. Vitamin C release rate was also modulated by varying the volume of 1% w/v TPP solution. The release rate of vitamin C from TPP-chitosan microspheres decreased with increasing volume (5–15 ml) of 1% w/v TPP solution.</P>

Preparation, Characterization and Protein Loading of Hexanoyl-Modified Chitosan Nanoparticles

Desai, Kashappa Goud,Park, Hyun Jin Taylor Francis 2006 Drug delivery Vol.13 No.5

<P>Hexanoyl chitosan was synthesized through a coupling reaction between chitosan and hexanoic anhydride. Proton nuclear magnetic resonance (<SUP>1</SUP>HNMR) and fourier-transform infrared (FTIR) spectroscopy studies showed the formation of hexanoyl chitosan. The nanoparticles of hexanoyl chitosan were prepared through ionotropic gelation with tripolyphosphate (TPP) followed by sonication. The hexanoyl chitosan-TPP nanoparticles exhibited uniform spherical shape with smooth surface as observed by atomic force microscopy and transmission electron microscopy. The particle size of nanoparticles was between 54.1 to 724 nm with a mean diameter of 324 nm. At 0.2, 0.4, and 0.6 mg/mL bovine serum albumin initial concentration, the encapsulation efficiency and loading capacity of hexanoyl-chitosan-TPP nanoparticles were 58.2, 44.5, and 28.1%, and 14.1, 23.4, and 30.3%, respectively.</P>