Primary Care Provider Knowledge and Practice in Risk Assessment for Early Age Onset Colorectal Cancer: Opportunities for Improvement

Anjali Parekh,Camille J. Hochheimer,Jeannine M. Espinoza,Jordan J. Karlitz,Carmen L. Lewis,Sachin Wani,Swati G. Patel 대한암예방학회 2021 Journal of cancer prevention Vol.26 No.4

Colorectal cancer (CRC) incidence and mortality are rising in individuals under age 50, termed early age onset (EAO) CRC. Lower endoscopy is recommended for all patients with unexplained iron deficiency anemia (IDA) or hematochezia to assess the EAOCRC. For those without symptoms, professional societies recommend decreasing the age to start screening from 50 to 45. Primary care provider (PCP) knowledge and practices around EAO-CRC risk assessment and screening are unknown. We conducted a survey study in May, 2020 of multi-specialty PCPs from three large medical systems to assess PCP knowledge, risk stratification practices and barriers/facilitators they face to offer CRC screening in patients < 50. We conducted univariate analysis to assess factors associated with knowledge and diagnostic practices. Response rate was 27.7% (196/708). Although 77.6% of respondents were aware that EAO-CRC incidence is increasing, only 42.9% knew that EAO-CRC mortality is also increasing. Of note, 91.8% recommend starting average risk screening at age 50. For 40- to 49-year-old patients present with unexplained IDA or hematochezia, 71.9% and 50.5% of respondents, respectively, recommend a diagnostic colonoscopy. Trainees were less likely to be aware of rising EAO-CRC mortality (odds ratio, 0.42; 95% CI, 0.21 to 0.82) and non-internal medicine providers were less likely to recommend CRC screening in those with a first-degree relative with CRC (odds ratio, 0.82; 95% CI, 0.72 to 0.93). Ongoing education efforts will be required to improve recognition and management of high-risk symptoms, particularly among non-internists and trainees. Key Words Colorectal neoplasms, Early detection of cancer, Gastrointestinal hemorrhage, Iron deficiencies, Primary health care

Identification and Assigning Weight of Indicator Influencing Performance of Municipal Solid Waste Management using AHP

Harshul Parekh,Kunwar Yadav,Sanjay Yadav,Navinchandra Shah 대한토목학회 2015 KSCE JOURNAL OF CIVIL ENGINEERING Vol.19 No.1

The management of municipal solid waste has become an acute problem due to enhanced economic activities and rapidurbanization. This paper aims to demonstrate the application of Analytical Hierarchy Process (AHP) to assign weightage of eachPerformance Indicator for Solid Waste Management (SWM). The AHP is a theory of measurement through pair-wise comparisonsand relies on the judgments of experts to derive priority scales. The degrading state of urban civic services requires immediatesolution to the problems related to mismanagement of urban waste. To evaluate performance of municipal waste management system44 indicators are identified by brainstorming sessions and structured interview, group discussions with experts. A questionnaire wasprepared for pairwise comparison of indicators. Judgment of experts through questionnaire is evaluated using AHP model to find outweights of indicators and sub-indicators. For application of prepared model, SWM System of two big cities of Gujarat; Ghaziabadand Surat have been studied and results are discussed. Our research findings will eventually lead to the identification of loop holes inSWM system.

Patterns of Impaired Neurocognitive Performance on the Global Neuropsychological Assessment, and Their Brain Structural Correlates in Recent-onset and Chronic Schizophrenia

Vineeth Mohan(Vineeth Mohan ),Pravesh Parekh(Pravesh Parekh ),Ammu Lukose(Ammu Lukose ),Sydney Moirangthem(Sydney Moirangthem ),Jitender Saini(Jitender Saini ),David J. Schretlen(David J. Schretlen ) 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.2

Objective: Schizophrenia is associated with impairment in multiple cognitive domains. There is a paucity of research on the effect of prolonged illness duration (≥ 15 years) on cognitive performance along multiple domains. In this pilot study, we used the Global Neuropsychological Assessment (GNA), a brief cognitive battery, to explore the patterns of cognitive impairment in recent-onset (≤ 2 years) compared to chronic schizophrenia (≥ 15 years), and correlate cognitive performance with brain morphometry in patients and healthy adults. Methods: We assessed cognitive performance in patients with recent-onset (n = 17, illness duration ≤ 2 years) and chronic schizophrenia (n = 14, duration ≥ 15 years), and healthy adults (n = 16) using the GNA and examined correlations between cognitive scores and gray matter volumes computed from T1-weighted magnetic resonance imaging images. Results: We observed cognitive deficits affecting multiple domains in the schizophrenia samples. Selectively greater impairment of perceptual comparison speed was found in adults with chronic schizophrenia (p = 0.009, η2 partial = 0.25). In the full sample (n = 47), perceptual comparison speed correlated significantly with gray matter volumes in the anterior and medial temporal lobes (TFCE, FWE p < 0.01). Conclusion: Along with generalized deficit across multiple cognitive domains, selectively greater impairment of perceptual comparison speed appears to characterize chronic schizophrenia. This pattern might indicate an accelerated or premature cognitive aging. Anterior-medial temporal gray matter volumes especially of the left hemisphere might underlie the impairment noted in this domain in schizophrenia.

A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men

Douglas Christopher,Parekh Neel,Kahn Linda G.,Henkel Ralf,Agarwal Ashok 대한남성과학회 2021 The World Journal of Men's Health Vol.39 No.2

Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP’s potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.

Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Ashok Agarwal,Neel Parekh,Manesh Kumar Panner Selvam,Ralf Henkel,Rupin Shah,Sheryl T. Homa,Ranjith Ramasamy,Edmund Ko,Kelton Tremellen,Sandro Esteves,Ahmad Majzoub,Juan G. Alvarez,David K. Gardner,Cha 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.3

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm’s potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.

ROOM TEMPERATURE DEPOSITION OF SINGLE-WALLED CARBON NANOTUBE THIN FILMS

SEUNG YOL JEONG,BHARVIN PAREKH,VARUN GUPTA,GIOVANNI FANCHINI,MANISH CHHOWALLA 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2010 NANO Vol.5 No.5

A simple method for direct deposition of single-walled carbon nanotube (SWNT) networks on flexible substrates at room temperature is reported. Deposition of thin films was carried out using a two-zone tube furnace where the nucleation and growth of SWNTs occur in vapor phase in the hot zone and condense onto substrates in the cold zone. Raman spectroscopy and scanning electron microscopy reveal individual, uniformly distributed SWNTs over large areas (several cm2). The coverage density of the SWNTs on flexible substrates can be controlled by the location of the substrates within the cold zone. The opto-electronic properties of the thin films indicated that they can be transparent and conducting with sheet resistances ranging from 4 to 21 kΩ/sq at corresponding transparencies of 51 to 87%, respectively.

Room Temperature Deposition of Single-Walled Carbon Nanotube Thin Films

Jeong, S.Y.,Parekh, B.,Gupta, V.,Fanchini, G.,Chhowalla, M. WORLD SCIENTIFIC PUBLISHING CO PTE LTD 2010 NANO Vol.5 No.5

CONTROLLED LYSIS OF ESCHERICHIA COLI DOUBLE - LYSOGEN OF BACTERIOPHAGES λHL1 AND φ434

Koo, Yoon Mo,Parekh, Bhavin S,Hatfield, G Wesley,Lim, Henry C 한국화학공학회 1996 Korean Journal of Chemical Engineering Vol.13 No.2

A novel phage double-lysogen was developed to produce an intracellular protein and disrupt the host cell in the same reactor. Using this double-lysogen, we could simplify the recovering processes without cell harvest and disruption. Construction of the double-lysogen is based on the fact that a lysogen of a phage can be superinfected by another phage with different immunity. The single-lysogen of Escherichia coli, P90c/λHL1, was superinfected with bacteriophage Φ434 to produce a double-lysogen, in which phage genomes from each phage coexisted in the host chromosome. Two different inducers were used to induice the double-lysogen to produce a protein and to lyse the host cell. The first phage genome, λHL1, the prophage of the original lysogen, containing the temperature sensitive cI_(857), lacZ and defective Q genes was induced by increasing temperature to produce β-galactosidase, an intracellular reporter protein. The overproduction of β-galactosidase was carried out without experiencing the cell lysis due to the defective Q gene. After the temperature shift, the second prophage from the lysogen MS21/Φ434 was induced by mitomycin C or ultra-violet light to lyse the cell. The lysis of the cell releases the intracellular protein to the outer space. The cell lysis was confirmed by the decrease of cell density and the increase of the extracellular activity of β-galactosidase at the same time.

Unaddressed Factors and Their Role in Descemet Membrane Endothelial Keratoplasty Outcomes: Comments on “Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty Using a Preloaded Imported Graft”

Alexander Wallace,Mohit Parekh,Vito Romano 대한안과학회 2024 Korean Journal of Ophthalmology Vol.38 No.3

STATISTICAL EVALUATION OF HYPERBARIC FILTRATION FOR FINE COAL DEWATERING

Sung, Dong Jin,Parekh, Bhupendra K 한국화학공학회 1996 Korean Journal of Chemical Engineering Vol.13 No.3

A statistical design of parametric study of pressure filtration for fine coal dewatering is presented. The effects of five major parameters of the dewatering, i.e. applied pressure, filtration time, cake thickness, solids concentration and slurry pH, on cake moisture reduction and air consumption were investigated. The study was conducted starting with two level factorial experiments to identify the most significant parameters, and concluding with response surface methodologies to establish an optimum operating condition for the dewatering of fine coal. It was observed that applied pressure, cake thickness and filtration time were identified to be the key operating variables for reduction of filter cake moisture as well as air consumption. With the key parameters, an optimum condition for the dewatering was determined to be an applied pressure of 93 psi with a cake thickness of 2.5 ㎝ and a filtration time of 4.8 minutes for the laboratory filtration system. At these optimum conditions the filter cake containing about 22 percent moisture by weight and consuming air by 4.1 ㎥/(㎡·min·㎏) on dry solid basis was obtained.