Optimal Endoscopic Treatment and Surveillance of Serrated Polyps

Vipin Gupta,James E. East 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.4

Serrated polyps are considered precursor lesions that account for 15% to 30% of colorectal cancers, and they are overrepresented as a cause of interval cancers. They are difficult to detect and resect comprehensively; however, recent data suggest that high definition endoscopy, chromoendoscopy (via spray catheter, pump or orally), narrow band imaging, split-dose bowel preparation and a slower withdrawal (>6 minutes) can all improve detection. Cold snare resection is effective and safe for these lesions, including cold snare piecemeal endoscopic mucosal resection, which is likely to become the standard of care for lesions >10 mm in size. Sessile serrated lesions ≥10 mm in size, those exhbiting dysplasia, or traditional serrated adenomas increase the chance of future advanced neoplasia. Thus, a consensus is emerging: a surveillance examination at 3 years should be recommended if these lesions are detected. Serrated lesions likely carry equivalent risk to adenomas, so future guidelines may consider serrated class lesions and adenomas together for risk stratification. Patients with serrated polyposis syndrome should undergo surveillance every 1 to 2 years once the colon is cleared of larger lesions, and their first degree relatives should undergo screening every 5 years starting at age 40.

Anisotropy and deformation heterogeneity in additive manufactured carbon-reinforced PEEK

Vipin Gupta,N. I. Thiruselvam,D. M. Kulkarni,V. V. Chaudhari,S. Suraj 대한기계학회 2023 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.37 No.6

Carbon-reinforced polyether ether ketone (C-PEEK) is one of the highperformance thermoplastic polymers used in engineering applications. To manufacture C-PEEK parts, a material extrusion process called fused deposition modeling (FDM) is more preferred than other 3D printing technologies such as material jetting, sheet lamination, VAT photopolymerization, binder jetting, directed energy deposition (DED) and powder bed fusion (PBF) due to its low cost and high efficiency. In FDM, the angle between printing and loading directions, called raster angle, is a known cause of material anisotropy. However, less attention has been paid to bring out the effect of raster angle on local state of strain. We fill this gap using digital image correlation (DIC) and scanning electron microscopy (SEM). Standard specimens made using three different raster angles, namely, 0°, 45°, and 90°, were tested upto failure by fracture. 0° raster angle offers the highest strength, whereas 90° raster angle yields the least strength. All specimens fail by brittle fracture. Strain localization that evolves near interfaces between two beads or layers play the most vital role in the failure mechanism.

An Estimate on the Rate of Convergence of Bezier Type Summation-integral Operators

Vijay Gupta,Vipin Vasishtha,Mridul KumarGupta 경북대학교 자연과학대학 수학과 2003 Kyungpook mathematical journal Vol.43 No.3

In the present paper, we introduce a new sequence of linear positive operators Bn (f; x), which is the modified form of recently introduced sequence of linear positive operators [J. Math. Anal. Appl. 225(1998), 660-672]. Here we obtain an estimate on the rate of convergence of Bn; (f; x) for functions of bounded variation. In the end we also propose an open problem for the readers.

Predictive Breast Cancer Statistical Modelling for Early Diagnosis

Amit Kumar Gupta,Ankit Verma,Vipin Kumar,Nikhil Kumar,Dowon Kim,Young-Jin Jung,Mangal Sain 한국자기학회 2023 Journal of Magnetics Vol.28 No.4

Breast cancer is a significant global health concern, stressing the urgent need for early detection. Early diagnosis improves access to varied treatments and significantly enhances patient outcomes. This study explores breast cancer detection over two days, aiming to create a precise and efficient machine learning model. The research uses a diverse dataset, combining clinical, genetic, and imaging data, including magnetic resonance imaging (MRI), X-ray, and electromagnetic data. Rigorous data preprocessing, including variable normalization and feature identification, enhances dataset quality. Predictive models use statistical techniques like logistic regression, decision trees, and random forest. Key metrics, such as accuracy, precision, recall, and area under the curve (AUC), assess model efficacy. Results reveal high accuracy and AUC scores, indicating potential for precise breast cancer detection. The study enhances our understanding of breast cancer dynamics, showcasing the effectiveness of machine learning for accurate and efficient early diagnosis. The research underscores diverse datasets and careful statistical modeling as crucial for predictive breast cancer capabilities.

Prevalence of hepatitis B, hepatitis C and human immunodeficiency viral infections in patients with inflammatory bowel disease in north India

( Parnita Harsh ),( Vipin Gupta ),( Saurabh Kedia ),( Sawan Bopanna ),( Sucharita Pilli ),( Surendernath ),( Govind Kumar Makharia ),( Vineet Ahuja ) 대한장연구학회 2017 Intestinal Research Vol.15 No.1

Background/Aims: Patients with inflammatory bowel disease (IBD) often require immunosuppressive therapy and blood transfusions and therefore are at a high risk of contracting infections due to hepatitis B (HBV) and hepatitis C (HCV) and human immunodeficiency virus (HIV). In the present study, we assessed the prevalence of these infections in patients with IBD. Methods: This retrospective study included 908 consecutive patients with IBD (ulcerative colitis [UC], n=581; Crohn`s disease [CD], n=327) who were receiving care at a tertiary care center. Ninety-five patients with intestinal tuberculosis (ITB) were recruited as disease controls. Prospectively maintained patient databases were reviewed for the prevalence of HBV surface antigen, anti-HCV antibodies, and HIV (enzyme-linked immunosorbent assay method). HCV RNA was examined in patients who tested positive for anti-HCV antibodies. Prevalence data of the study were compared with that of the general Indian population (HBV, 3.7%; HCV, 1%; HIV, 0.3%). Results: The prevalence of HBV, HCV, and HIV was 2.4%, 1.4%, and 0.1%, respectively, in the 908 patients with IBD. Among the 581 patients with UC, 2.2% (12/541) had HBV, 1.7% (9/517) had HCV, and 0.2% (1/499) had HIV. Among the 327 patients with CD, 2.8% (8/288) had HBV, 0.7% (2/273) had HCV, and 0% (0/277) had HIV. One patient with CD had HBV and HCV coinfection. The prevalence of HBV, HCV, and HIV in patients with ITB was 5.9% (4/67), 1.8% (1/57), and 1.2% (1/84), respectively. Conclusions: The prevalence of HBV, HCV, and HIV in north Indian patients with IBD is similar to the prevalence of these viruses in the general community. Nonetheless, the high risk of flare after immunosuppressive therapy mandates routine screening of patients with IBD for viral markers. (Intest Res 2017;15:97-102)

Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease

( Sanchit Sharma ),( Arti Gupta ),( Saurabh Kedia ),( Samagra Agarwal ),( Namrata Singh ),( Sandeep Goyal ),( Saransh Jain ),( Vipin Gupta ),( Pabitra Sahu ),( Sudheer Kumar Vuyyuru ),( Bhaskar Kante 대한장연구학회 2021 Intestinal Research Vol.19 No.3

Background/Aims: Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods: This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI >70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results: Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2-6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260-320] vs. 240 [180-280], P=0.001) and 8 weeks (baseline 290 [260-320] vs. 186 [160-240], P=0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n=4), B2 (n=18), and B3 (n=9) phenotypes were 50%, 78.8%, and 100% respectively (log-rank test, P=0.093). The response rates at 8 weeks with polymeric (n=8) and semi-elemental diet (n=23) were 75% and 82.6% respectively (log-rank test, P=0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002-1.017; P=0.046) predicted response to EEN. Conclusions: EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN. (Intest Res 2021;19:291-300)

Synthesis, characterization and adsorptive application of ferrocene based mesoporous material for hazardous dye Congo red

Sumanjit Kaur,Seema Rani,Vipin Kumar,R.K. Mahajan,Mohammad Asif,Inderjeet Tyagi,Vinod Kumar Gupta 한국공업화학회 2015 Journal of Industrial and Engineering Chemistry Vol.26 No.-

Mesoporous adsorbent is prepared first time using ferrocene based surfactant as a template and adsorption of azo dye Congo red is investigated. Adsorbent is characterized by Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, transmission electron microscopy, dynamic light scattering and N2 adsorption–desorption and deduced a lofty surface area of 342 m2/g. Effect of contact time, adsorbent dose, initial dye concentration and temperature were speculated to optimize adsorption conditions. Experimental data were contemplated for various kinetics and thermodynamic models at different temperatures and insinuated that adsorption process is film diffusion controlled and followed second order kinetics. Langmuir model imparted high value of monolayer capacity as 312.5 mg/g. The values of thermodynamic parameters like enthalpy (DH) and entropy (DS) were found to be 49.94 kJ/mol and 265.5 J/K/mol, respectively, and negative values of DG corroborated that the present adsorption system is feasible, spontaneous and endothermic.

Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver

( Ashish Agarwal ),( Alka Singh ),( Wajiha Mehtab ),( Vipin Gupta ),( Ashish Chauhan ),( Mahendra Singh Rajput ),( Namrata Singh ),( Vineet Ahuja ),( Govind K. Makharia ) 대한장연구학회 2021 Intestinal Research Vol.19 No.1

Background/Aims: Gluten-free diet has an excess of fats and simple sugars and puts patients with celiac disease at risk of metabolic complications including metabolic syndrome and fatty liver. We assessed prevalence of metabolic syndrome and fatty liver in two cohorts of celiac disease. Methods: Study was done in 2 groups. In group 1, 54 treatment naïve patients with celiac disease were recruited. Of them, 44 returned after 1-year of gluten-free diet and were reassessed. In group 2, 130 celiac disease patients on gluten-free diet for ≥1 year were recruited. All patients were assessed for anthropometric and metabolic parameters and fatty liver. Metabolic syndrome was defined as per consensus definition for Asian Indians. Fatty liver was defined as controlled attenuation parameter value >263 decibels by FibroScan. Results: In group 1, of 44 treatment naïve patients with celiac disease, metabolic syndrome was present in 5 patients (11.4%) at baseline and 9 (18.2%) after 1 year of gluten-free diet. Patients having fatty liver increased from 6 patients (14.3%) at baseline to 13 (29.5%) after 1year of gluten-free diet (P=0.002). In group 2, of 130 patients with celiac disease on gluten-free diet for a median duration of 4 years, 30 out of 114 (26.3%) and 30 out of 130 patients (23%) had metabolic syndrome and fatty liver, respectively. Conclusions: Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver, which increases further with gluten-free diet. These patients should be assessed for nutritional and metabolic features and counseled about balanced diet and physical activity regularly. (Intest Res 2021;19:106-114)

High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India

( Ashish Agarwal ),( Saurabh Kedia ),( Saransh Jain ),( Vipin Gupta ),( Sawan Bopanna ),( Dawesh P Yadav ),( Sandeep Goyal ),( Venigalla Pratap Mouli ),( Rajan Dhingra ),( Govind Makharia ),( Vineet A 대한장연구학회 2018 Intestinal Research Vol.16 No.4

Background/Aims: The data on the risk of tuberculosis (TB) reactivation with infliximab (IFX) in patients with inflammatory bowel disease (IBD) from TB endemic countries, like India, is limited. The risk of TB reactivation on IFX and its predictors in patients with IBD was assessed. Methods: This retrospective review included consecutive patients with IBD who received IFX, and were on follow-up from January 2005 to November 2017. The data was recorded on age/disease duration, indications for IFX, screening for latent tuberculosis (LTB) before IFX, response to IFX, incidence and duration when TB developed after IFX, and type of TB (pulmonary [PTB]/extra-pulmonary [EPTB]/disseminated). Results: Of 69 patients (22 ulcerative colitis/47 Crohn’s disease; mean age, 35.6±14.5 years; 50.7% males; median follow-up duration after IFX, 19 months [interquartile range, 5.5-48.7 months]), primary non-response at 8 weeks and secondary loss of response at 26 and 52 weeks were seen in 14.5%, 6% and 15% patients respectively. Prior to IFX, all patients were screened for LTB, 8 (11.6%) developed active TB (disseminated, 62.5%; EPTB, 25%; PTB, 12.5%) after a median of 19 weeks (interquartile range, 14.0-84.5 weeks) of IFX. Of these 8 patients’ none had LTB, even when 7 of 8 were additionally screened with contrast-enhanced chest tomography. Though not statistically significant, more patients with Crohn’s disease than ulcerative colitis (14.9% vs. 4.5%, P=0.21), and those with past history of TB (25% vs. 9.8%, P=0.21), developed TB. Age, gender, disease duration, or extraintestinal manifestations could not predict TB reactivation. Conclusions: There is an extremely high rate of TB with IFX in Indian patients with IBD. Current screening techniques are ineffective and it is difficult to predict TB after IFX. (Intest Res 2018;16:588-598)

Hierarchical Macroporous Particles for Efficient Whole-Cell Immobilization: Application in Bioconversion of Greenhouse Gases to Methanol

Patel, Sanjay K. S.,Jeon, Min Soo,Gupta, Rahul K.,Jeon, Yale,Kalia, Vipin Chandra,Kim, Sun Chang,Cho, Byung Kwan,Kim, Dong Rip,Lee, Jung-Kul American Chemical Society 2019 ACS APPLIED MATERIALS & INTERFACES Vol.11 No.21

<P>A viable approach for methanol production under ambient physiological conditions is to use greenhouse gases, methane (CH<SUB>4</SUB>) and carbon dioxide (CO<SUB>2</SUB>), as feed for immobilized methanotrophs. In the present study, unique macroporous carbon particles with pore sizes in the range of ∼1-6 μm were synthesized and used as support for the immobilization of <I>Methylocella tundrae</I>. Immobilization was accomplished covalently on hierarchical macroporous carbon particles. Maximal cell loading of covalently immobilized <I>M. tundrae</I> was 205 mg<SUB>DCM</SUB> g<SUP>-1</SUP> of particles. Among these particles, the cells immobilized on 3.6 μm pore size particles showed the highest reusability with the least leaching and were chosen for further study. After immobilization, <I>M. tundrae</I> showed up to 2.4-fold higher methanol production stability at various pH and temperature values because of higher stability and metabolic activity than free cells. After eight cycles of reuse, the immobilized cells retained 18.1-fold higher relative production stability compared to free cells. Free and immobilized cells exhibited cumulative methanol production of 5.2 and 9.5 μmol mg<SUB>DCM</SUB><SUP>-1</SUP> under repeated batch conditions using simulated biogas [CH<SUB>4</SUB> and CO<SUB>2</SUB>, 4:1 (v/v)] as feed, respectively. The appropriate pore size of macroporous particles favors the efficient <I>M. tundrae</I> immobilization to retain better biocatalytic properties. This is the first report concerning the covalent immobilization of methanotrophs on the newly synthesized macroporous carbon particles and its subsequent application in repeated methanol production using simulated biogas as a feed.</P> [FIG OMISSION]</BR>