235 results on '"Aggarwal, R"'
Search Results
2. Performance evaluation of a novel dustable powder formulation of Trichoderma viridefor seed treatment against Fusariumwilt in chickpea
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Pradhan, P. C., Mukhopadhyay, A., Kumar, R., Patanjali, N., Kundu, A., Kamil, D., Bag, T. K., Aggarwal, R., Bharadwaj, C., and Singh, A.
- Abstract
Fusarium wilt is a devastating fungal disease of chickpea responsible for severe yield losses. Products for biological control present a preferred option to combat with this disease but suffer due to quality issue. In the present work, composition of a novel dustable powder for seed treatment containing Trichoderma viridespores (DS2) was optimized assessed w.r.t. physicochemical properties and bio-efficacy in vivo against Fusarium oxysporumf. sp. ciceris. Dual culture assay based screening of five strains of T. viridenamely, ITCC 6889, ITCC 7204, ITCC 7764, ITCC 7847, ITCC 8276 revealed the highest potency (91.16% inhibition) of ITCC 7764 strain, which was used as the active ingredient biomass for development of the dustable powder formulation for dry seed treatment (DS) (1% w/w). Physico-chemical characteristics using standard (CIPAC) methods registered the free flowing character of the optimized formulation (DS2) with slightly acidic character (6.50) and apparent density of 0.732 g cm−3. In-vivo bio-efficacy assessment of the DS formulation as chickpea seed coat revealed significant inhibitory influence of DS2 on the growth and development of the pathogen. The germination of DS2 treated seeds was superior at all the test doses relative to the commercial fungicide and the talc based T. virideformulation. The highest germination percentage was recorded in case of DS applied at RD with nominal value of 93.33%, as compared to 80.33% and 83.33% in case of carbendazim and talc based formulations respectively. The percent wilting incidence of chickpea plants in DS treatment was 3.33%, 6.67% and 13.33% at recommended, double of recommended and 1/2 of recommended dosages of DS2, respectively, the damage being significantly lesser than that in the commercial fungicide carbendazim (50%WP) as well as the talc formulation (2% Dust) treatments.
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- 2022
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3. Unveiling the intricacies of attracting zones in magnetic binary systems: Investigating the impact of Yukawa correction.
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Kumar, V., Aggarwal, R., and Marig, S.K.
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THREE-body problem ,MAGNETIC moments ,GRAVITATION ,EQUILIBRIUM - Abstract
This study delves into the restricted three-body problem with a Yukawa correction to Newtonian gravitational forces, focusing on magnetic binary systems. We scrutinize the influence of Yukawa correction parameters (α , β) and the ratio of magnitude of magnetic moments (λ) on the system's equilibrium points and their stability, zero-velocity curves. In our case, there exist of five and seven equilibrium points and all are found to be unstable for given range of parameters. Our examination extends to the basins of convergence and the existence of fractal under the influence of α and λ. Graphs drawn with the help of Wolfram Mathematica software vividly portray the parameter-driven evolution of equilibrium points, zero-velocity curves and basins of convergence. Furthermore, we explore the fractal characteristics within the basins of convergence, offering valuable insights into the complex dynamics of magnetic binary systems with Yukawa correction. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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4. Empirical model for the estimation of global solar radiation for Indian locations
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Kumar, Rajesh, Verma, Ritesh, and Aggarwal, R. K.
- Abstract
ABSTRACTA new empirical model is developed to estimate the monthly average global solar radiation. The estimated values of solar radiation for eighteen Indian locations in different climatic zones of India are compared with measured values. The performance of the empirical model was evaluated on the basis of the statistical error tests: the mean percentage error, root mean square error and mean bias error. The values of mean percentage error, root mean square error and mean bias error are found to be in the range of −13.99 to 14.76, 0.00 to 15.26 and −4.73 to 6.73 respectively. Small variations in the errors have made this empirical model an easy asset to determine the solar radiation data with better accuracy and with less error at places where meteorological observatories are not established.
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- 2021
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5. Update on Conservative Management of Vestibular Schwannoma—The Manchester Experience
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Suryanarayanan, R., Aggarwal, R., Ramsden, R. T, Saeed, S. R, King, A. T, and Rutherford, S.
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- 2024
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6. Unveiling the intricacies of attracting zones in magnetic binary systems: Investigating the impact of Yukawa correction
- Author
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Kumar, V., Aggarwal, R., and Marig, S.K.
- Abstract
This study delves into the restricted three-body problem with a Yukawa correction to Newtonian gravitational forces, focusing on magnetic binary systems. We scrutinize the influence of Yukawa correction parameters (α, β) and the ratio of magnitude of magnetic moments (λ) on the system’s equilibrium points and their stability, zero-velocity curves. In our case, there exist of five and seven equilibrium points and all are found to be unstable for given range of parameters. Our examination extends to the basins of convergence and the existence of fractal under the influence of αand λ. Graphs drawn with the help of Wolfram Mathematica software vividly portray the parameter-driven evolution of equilibrium points, zero-velocity curves and basins of convergence. Furthermore, we explore the fractal characteristics within the basins of convergence, offering valuable insights into the complex dynamics of magnetic binary systems with Yukawa correction.
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- 2024
- Full Text
- View/download PDF
7. Textile-integrated MoS2-PDMS single electrode triboelectric nanogenerator for vibrational energy harvesting and biomechanical motion sensing.
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Mahapatra, Abhinav, Ajimsha, R.S., Deepak, Deepak, Sumit, Aggarwal, R., Kumar, Sushil, Venkatesh, R., Roy, Susanta Sinha, and Misra, Pankaj
- Abstract
With the increasing demand for portable electronics, durable and flexible textile-based single electrode triboelectric nanogenerators (TENGs) have received a significant amount of attention. In this work, we have proposed a flexible textile based single electrode TENG (STENG) composed of MoS 2 -PDMS composite film. The effect of the concentration (0–10 wt%) of MoS 2 in PDMS on the output performance of the as-fabricated devices was systematically studied. The STENG with a 6 wt% concentration of MoS 2 exhibits the best output performance with an open-circuit output voltage, short-circuit output current density, and maximum instantaneous output power density of ∼ 320 V, ∼ 15.4 µA/cm
2 , and ∼ 3.2 mW/cm2 , respectively. The enhancement in the output characteristics of the STENG can be explained by the formation of network of nanocapacitors, where the layers of MoS 2 behave as electrodes and the insulating PDMS behaves as a nanodielectric. The powering capability of the as-fabricated STENG was tested by charging commercial capacitors and directly flashing 100 commercially available LEDs without any external charge storage component. The textile-based MoS 2 -PDMS composite is not only used as STENG, but also as a human motion sensor capable of detecting diverse human actions, including wrist bending, arm bending, and leg bending. As a result of its flexible structure, scalable manufacturing process, and ability to sense human motions, the developed MoS 2 -PDMS composite STENG has promising applications in self-powered wearable electronics and human-machine interaction. [Display omitted] • Fabricated textile based MoS 2 -PDMS STENG with excellent performance of ∼ 320 V, ∼ 15.4 μA/cm2 and ∼ 3.2 mW/cm2 . • Flower like MoS 2 nanofillers are incorporated into PDMS matrix leads to the formation of network of nanocapacitors. • The STENG with best performance illuminated 100 LEDs via hand tapping, without any external storage element. • The fabricated STENG also used as a biomechanical motion sensor, to capture signals like wrist, arm, and leg bending. [ABSTRACT FROM AUTHOR]- Published
- 2023
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8. Textile-integrated MoS2-PDMS single electrode triboelectric nanogenerator for vibrational energy harvesting and biomechanical motion sensing
- Author
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Mahapatra, Abhinav, Ajimsha, R.S., Deepak, Deepak, Sumit, Aggarwal, R., Kumar, Sushil, Venkatesh, R., Roy, Susanta Sinha, and Misra, Pankaj
- Abstract
With the increasing demand for portable electronics, durable and flexible textile-based single electrode triboelectric nanogenerators (TENGs) have received a significant amount of attention. In this work, we have proposed a flexible textile based single electrode TENG (STENG) composed of MoS2-PDMS composite film. The effect of the concentration (0–10 wt%) of MoS2in PDMS on the output performance of the as-fabricated devices was systematically studied. The STENG with a 6 wt% concentration of MoS2exhibits the best output performance with an open-circuit output voltage, short-circuit output current density, and maximum instantaneous output power density of ∼ 320 V, ∼ 15.4 µA/cm2, and ∼ 3.2 mW/cm2, respectively. The enhancement in the output characteristics of the STENG can be explained by the formation of network of nanocapacitors, where the layers of MoS2behave as electrodes and the insulating PDMS behaves as a nanodielectric. The powering capability of the as-fabricated STENG was tested by charging commercial capacitors and directly flashing 100 commercially available LEDs without any external charge storage component. The textile-based MoS2-PDMS composite is not only used as STENG, but also as a human motion sensor capable of detecting diverse human actions, including wrist bending, arm bending, and leg bending. As a result of its flexible structure, scalable manufacturing process, and ability to sense human motions, the developed MoS2-PDMS composite STENG has promising applications in self-powered wearable electronics and human-machine interaction.
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- 2023
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9. Colorectal surgery and enhanced recovery: Impact of a simulation-based care pathway training curriculum.
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Beyer-Berjot, L., Pucher, P., Patel, V., Hashimoto, D.A., Ziprin, P., Berdah, S., Darzi, A., and Aggarwal, R.
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Summary Background The aim was to determine whether a simulation-based care pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents’ participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients’ outcomes in colorectal surgery (CS). Methods All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum. Twenty consecutive patients undergoing CS were prospectively included before ( n = 10) and after ( n = 10) the training. All demographic and perioperative data were prospectively collected, including compliance for ERP. Residents’ participation as primary operator in LCS was measured. Results Five residents (PGY 4–7) were enrolled. None had performed LCS as primary operator. Overall satisfaction and usefulness were both rated 4.5/5, usefulness of pre-, post- and intraoperative training was rated 5/5, 4.5/5 and 4/5, respectively. Residents’ participation in LCS significantly improved after the training (0% (0–100) vs. 82.5% (10–100); P = 0.006). Pre- and intraoperative data were comparable between groups. Postoperative morbidity was also comparable. Compliance for ERP improved at Day 2 in post-training patients (3 (30%) vs. 8 (80%); P = 0.035). Length of stay was not modified. Conclusions A simulated CPA curriculum to training in LCS and ERP was correctly implemented. It seemed to improve compliance for ERP, and promoted residents participation as primary operator without adversely altering patients’ outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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10. A Proficiency Based Stepwise Endovascular Curricular Training (PROSPECT) Program Enhances Operative Performance in Real Life: A Randomised Controlled Trial.
- Author
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Maertens, H., Aggarwal, R., Moreels, N., Vermassen, F., and Van Herzeele, I.
- Abstract
Objectives Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. Design A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions. Materials All subjects performed two endovascular interventions treating patients with symptomatic iliac and/or superficial femoral artery stenosis under supervision. Primary outcomes were technical performances (Global Rating Scale [GRS]; Examiner Checklist), operative metrics, and patient outcomes, adjusted for case difficulty and trainee experience. Secondary outcomes included knowledge and technical performance after 6 weeks and 3 months. Methods Thirty-two general surgical trainees were randomised into three groups. Besides traditional training, the first group ( n = 11) received e-learning and simulation training (PROSPECT), the second group ( n = 10) only had access to e-learning, while controls ( n = 11) did not receive supplementary training. Results Twenty-nine trainees (3 dropouts) performed 58 procedures. Trainees who completed PROSPECT showed superior technical performance (GRS 39.36 ± 2.05; Checklist 63.51 ± 3.18) in real life with significantly fewer supervisor takeovers compared with trainees receiving e-learning alone (GRS 28.42 ± 2.15; p = .001; Checklist 53.63 ± 3.34; p = .027) or traditional education (GRS 23.09 ± 2.18; p = .001; Checklist 38.72 ± 3.38; p = .001). Supervisors felt more confident in allowing PROSPECT trained physicians to perform basic ( p = .006) and complex ( p = .003) procedures. No differences were detected in procedural parameters (such as fluoroscopy time, DAP, procedure time, etc.) or complications. Proficiency levels were maintained up to 3 months. Conclusions A structured, stepwise, proficiency based endovascular curriculum including e-learning and simulation based training should be integrated early into training programs to enhance trainee performance. [ABSTRACT FROM AUTHOR]
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- 2017
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11. Estimation of genetic diversity and relationship among goats of Maharashtra state.
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MISHRA, PRIYANKA, DIXIT, S. P., AGGARWAL, R. A. K., BEHL, JYOTSNA, DANGI, P. S., and VERMA, N. K.
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GOATS ,PHYSIOLOGY ,GOAT genetics ,GENETIC markers ,MICROSATELLITE repeats ,CATTLE - Abstract
Sangamneri, Osmanabadi, Berari and Konkan Kanyal are the known breeds of Maharashtra state of India. DNA from 50 unrelated goats of each breed was analysed to know the genetic diversity using 25 microsatellite markers. A total of 479 alleles (192 in Sangamneri, 153 in Osmanabadi, 294 in Berari and 255 in Konkan Kanyal) were observed. Mean number of alleles per locus and observed heterozygosity were 7.68, 6.12, 11.76, 10.20 and 0.53, 0.42, 0.67 and 0.58 for Sangamneri, Osmanabadi, Berari and Kanyal goat populations respectively. The fixation coefficients of sub-populations within the total population (F
ST ), varied from 0.04 (OarHH64) to 0.68 (OarJMP29) with a mean of 0.17. The L-shaped mode-shift curve indicated the absence of reduction in effective population size. The genetic distances between four breeds indicated the distinctness of Berari and Konkan Kanyal from Sangamneri and Osmanabadi. Berari and Konkan Kanyal although exists at different geographic locations but show some genetic overlapping. The Nei's genetic distance observed between breeds were 0.472 (Sangamneri and Osmanabadi), 0.667 (Sangamneri and Berari), 0.819 (Sangamneri and Konkan Kanyal), 0.797 (Osmanabadi and Berari), 0.994 (Osmanabadi and Konkan Kanyal) and 0.092 (Berari and Konkan Kanyal). Konkan Kanyal is genetically more distant from Osmanabadi and Sangamneri than Berari. Sangamneri and Osmanabadi goat breeds were assigned to cluster-3 where the proportion of membership for each breed was 0.975 (Sangamneri) and 0.992 (Osmanabadi). Kanyal and Berari goat populations were assigned to another cluster (Cluster 4). The proportion for their membership was 0.923 (Konkan Kanyal) and 0.869 (Berari). [ABSTRACT FROM AUTHOR]- Published
- 2017
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12. Evaluation of Different Light-Curing Units—Light-Emitting Diodes and Quartz–Tungsten–Halogen-Based Light-Curing Units in Polymerization of Posterior Composite: An In Vitro Study
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Bansal, R., Bansal, M., Walia, S., Gupta, C., Bansal, L., and Aggarwal, R.
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- 2018
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13. Refinement of HMM Model Parameters for Punjabi Automatic Speech Recognition (PASR) System
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Kadyan, Virender, Mantri, Archana, and Aggarwal, R. K.
- Abstract
ABSTRACTAn automatic speech recognition system follows an approach of pattern matching, which consists of a training phase and testing phase. Despite advancement in training phase, the performance of the acoustic model is adverse while adopting the statistical technique like hidden Markov model (HMM). However, HMM-based speech system faces high computational complexity and becomes challenging to provide accuracy during isolated Punjabi lexicon. As the corpus of the system increases, the complexity of training phase will also increase drastically. The redundancy and confusion occurred between feature distributions in training phase of the system. This paper proposes an approach for the generation of HMM parameters using two hybrid classifiers such as GA+HMM and DE+HMM. The proposed technique focuses on refinement of processed feature vectors after calculating its mean and variance. The refined parameters are further employed in the generation of HMM parameters that help in reduction of training complexity of the system. The proposed techniques are compared with an existing technique such as HMM on benchmark database and self-developed corpus in clean, noisy, and real-time environments. The results show the performance improvement in pattern matching of spoken utterance when demonstrated on large vocabulary isolated Punjabi lexicons.
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- 2018
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14. Practical consensus recommendations regarding the management of sentinel lymph node issues in early breast cancer
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Kabra, Vedant, Aggarwal, R., Vardhan, S., Singh, M., Khandelwal, R., Jain, S., Sahani, S., Saini, S., Deo, N., Kaul, R., Parikh, P. M., and Aggarwal, S.
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- 2018
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15. Response of Putative Pathogenicity-related Genes in Tilletia indicaInciting Karnal Bunt of Wheat
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Gurjar, M. S., Jogawat, A., Saharan, M. S., and Aggarwal, R.
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Karnal bunt of wheat (Tilletia indica) is an important internationally quarantined disease from food security point of view. For understanding host specificity and host-pathogen interaction, putative pathogenicity-related genes were analysed in Tilletia indicain response to host factor at different time points. Highest radial mycelia growth (3.4 cm) was recorded in media amended with susceptible host factor followed by resistant host (2.6 cm) and control (2.0 cm) at 30 days after incubation significantly. Fourteen homologous sequences of putative pathogenicity-related genes, viz. TiPmk1, TiKss1, TiHog1, TiHsp70, TiKpp2, TiCts1, TiHos2, TiChs1, TiPrf1, TiSid1, TiSsp1, TiSte20, TiUbc4and TiUkc1, were identified in T. indicaby in silicoanalysis. Some of the pathogenicity-related genes were highly expressed significantly in T. indicain response to susceptible host factor as compared to resistant host factor. TiPmk1, TiHog1, TiKss1were found highly upregulated up to 26-fold (3 days), 20-fold (3 days) and 18-fold (4 days), respectively, significantly in presence of susceptible host factor. The TiCts1and TiChs1showed transcripts up to 26-fold (4 days) and 20-fold (3 days) in the presence of susceptible host factor. Further, the TiUbc4and TiUkc1were found upregulated up to 20-fold and 7-fold at 8 days and 3 days post incubation. This study provided the insight on expression of putative pathogenicity-related genes in T. indicawhich will help in understanding the infection mechanism and basis for further functional genomics approach.
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- 2018
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16. Transatlantic Multispecialty Consensus on Fundamental Endovascular Skills: Results of a Delphi Consensus Study.
- Author
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Maertens, H., Aggarwal, R., Macdonald, S., Vermassen, F., and Van Herzeele, I.
- Abstract
Objectives The aim of this study was to establish a consensus on Fundamental Endovascular Skills (FES) for educational purposes and development of training curricula for endovascular procedures. The term “Fundamental Endovascular Skills” is widely used; however, the current literature does not explicitly describe what skills are included in this concept. Endovascular interventions are performed by several specialties that may have opposing perspectives on these skills. Methods A two round Delphi questionnaire approach was used. Experts from interventional cardiology, interventional radiology, and vascular surgery from the United States and Europe were invited to participate. An electronic questionnaire was generated by endovascular therapists with an appropriate educational background but who would not participate in subsequent rounds. The questionnaire consisted of 50 statements describing knowledge, technical, and behavioral skills during endovascular procedures. Experts received the questionnaires by email. They were asked to rate the importance of each skill on a Likert scale from 1 to 5. A statement was considered fundamental when more than 90% of the experts rated it 4 or 5 out of 5. Results Twenty-three of 53 experts invited agreed to participate: six interventional radiologists (2 USA, 4 Europe), 10 vascular surgeons (4 USA, 6 Europe), and seven interventional cardiologists (4 USA, 3 Europe). There was a 100% response rate in the first round and 87% in the second round. Results showed excellent consensus among responders (Cronbach's alpha = .95 first round; .93 second round). Ninety percent of all proposed skills were considered fundamental. The most critical skills were determined. Conclusions A transatlantic multispecialty consensus was achieved about the content of “FES” among interventional radiologists, interventional cardiologists, and vascular surgeons from Europe and the United States. These results can serve as directive principles for developing endovascular training curricula. [ABSTRACT FROM AUTHOR]
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- 2016
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17. Chirurgie colorectale et réhabilitation améliorée : impact d’une formation en parcours de soin simulé
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Beyer-Berjot, L., Pucher, P., Patel, V., Hashimoto, D.A., Ziprin, P., Berdah, S., Darzi, A., and Aggarwal, R.
- Abstract
Déterminer si une formation en parcours de soin simulé (FPSS) améliore le respect des objectifs réhabilitation améliorée (ORA) et la participation des internes au bloc opératoire en chirurgie colorectale laparoscopique (CCL).
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- 2017
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18. MRI features in dengue encephalitis: A case series in South Indian tertiary care hospital
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Soni, Brijesh K, Das, Debasheesh S R, George, R A, Aggarwal, R, and Sivasankar, R
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- 2017
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19. Phenotypic characterization and microsatellite markers based genetic evaluation of Kalahandi goats.
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MISHRA, PRIYANKA, ALI, AYESHA S., AGGARWAL, R. A. K., DIXIT, S. P., DASH, S. K., DANGI, P. S., TYAGI, NEHA, and VERMA, N. K.
- Abstract
This article discusses research which examined the genetic diversity of Kalahandi goats of India. Topics discussed include the use of genomic DNA isolated from blood samples in the study, the average number of observed allele, and substantial genetic variation and polymorphism across the studied loci in Kalahandi goats. The low inbreeding found in Kalahandi flocks is also noted.
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- 2015
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20. Characterization, performance and genetic diversity among goats of Odisha.
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VERMA, N. K., MISHRA, PRIYANKA, AGGARWAL, R. A. K., DIXIT, S. P., DANGI, P. S., and DASH, S. K.
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The article discusses a study to characterize local goat populations of Odisha, India by conducting systematic surveys in identified areas and collecting data on phenotype, biometry and management practices. Topics discussed include the comparison between Ghumusar and Kalahandi goats with Ganjam and Black Bengal goats and findings that Ghumusar and Kalahandi have the highest genetic distance while the Ganjam and Black Bengal have minimum genetic distance.
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- 2015
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21. Effect of Ozone and Antioxidants on Wheat and its Pathogen — Bipolaris sorokininana
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Mina, U., Fuloria, A., and Aggarwal, R.
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Tropospheric ozone (O3) adversely affects growth and productivity of crops and also influences crop–pathogen interactions. Adverse effects of O3on crops can be mitigated by antioxidants application. In the present study through lab and field experiments impact of O3and antioxidants treatment to wheat was assessed on growth of Bipolaris sorokiniana(BS-75 strain) pathogen responsible for Spot blotch disease, pathogenesis related (PR) proteins and chitinase content. Results showed that growth of Bipolariswas significantly higher in elevated ozone (EO3) exposed plants as compared to control plants. Antioxidants – ascorbic acid (AA), tagetes extract (T) and quercetin (Q) application on culture media and wheat plants, respectively, retarded the growth of Bipolaris sorokiniana. Among the three antioxidants minimum growth of Bipolariswas observed in AA-treated plants as compared to control plants. Reduction in chitinase activity and PR proteins content due to EO3treatment in wheat plants was 18% and 78%, respectively, as compared to control plants. Increase in chitinase activity and PR proteins content due to antioxidants treatment in wheat plants was 45% and 60%, respectively, as compared to control plants.
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- 2016
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22. P48.05 Is Relapse-Free Survival at 2-Years an Appropriate Surrogate for Overall Survival at 5-Years in EGFR-mutated Resected NSCLC?
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Garcia, M., Schmid, S., Hueniken, K., Zhan, L., Balaratnam, K., Khan, K., Fares, A., Chan, S., Smith, E., Aggarwal, R., Brown, M.C., Patel, D., Sacher, A., Bradbury, P., Shepherd, F.A., Leighl, N., and Liu, G.
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- 2021
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23. Abstract No. 162 Medium and long-term outcomes of single session inferior vena cava filter removal, recanalization and endovenous reconstruction for filter-related chronic iliocaval thrombosis.
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Xiao, N., Aggarwal, R., Soliman, M., Lewandowski, R., Karp, J., Salem, R., Hohlastos, E., and Desai, K.
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- 2022
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24. Aspirin therapy is associated with less compact fibrin networks and enhanced fibrinolysis in patients with abdominal aortic aneurysm
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Bailey, M.A., Aggarwal, R., Bridge, K.I., Griffin, K.J., Iqbal, F., Phoenix, F., Purdell‐Lewis, J., Thomas, T., Johnson, A.B., Ariëns, R.A.S., Scott, D.J.A., and Ajjan, R.A.
- Abstract
Thrombotic changes in fibrin networks contribute to increased cardiovascular risk in patients with abdominal aortic aneurysm (AAA). Given that aspirin modulates the fibrin network, we aimed to determine if aspirin therapy is associated with changes in ex‐vivofibrin clot characteristics in AAA patients and also conducted an exploratory analysis of 5‐year mortality in these individuals.
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- 2015
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25. Patient-specific Rehearsal Prior to EVAR: A Pilot Study.
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Desender, L., Rancic, Z., Aggarwal, R., Duchateau, J., Glenck, M., Lachat, M., Vermassen, F., and Van Herzeele, I.
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Objectives: This study aims to evaluate feasibility, face validity, influence on technical factors and subjective sense of utility of patient-specific rehearsal (PsR) prior to endovascular aortic aneurysm repair (EVAR). Design: A prospective, multicentre pilot study. Methods: Patients suitable for EVAR were enrolled and a three-dimensional (3D) model of the patient's anatomy was generated. Less than 24 h prior to the real case, rehearsals were conducted in the laboratory or clinical angiosuite. Technical metrics were recorded during both procedures. A subjective questionnaire was used to evaluate realism, technical and human factor aspects (scale 1–5). Results: Ten patients were enrolled. In one case, the treatment plan was altered based on PsR. In 7/9 patients, the rehearsal significantly altered the optimal C-arm position for the proximal landing zone and an identical fluoroscopy angle was chosen in the real procedure. All team members found the rehearsal useful for selecting the optimal fluoroscopy angle (median 4). The realism of the EVAR procedure simulation was rated highly (median 4). All team members found the PsR useful to prepare the individual team members and the entire team (median 4). Conclusions: PsR for EVAR permits creation of realistic case studies. Subjective evaluation indicates that it may influence optimal C-arm angles and be valuable to prepare the entire team. A randomised controlled trial (RCT) is planned to evaluate how this technology may influence technical and team performance, ultimately leading to improved patient safety. [Copyright &y& Elsevier]
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- 2013
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26. Phenotypic characteristics, management, performance and genetic variability in Surti breed of goat.
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DIXIT, S. P., AGGARWAL, R. A. K., DANGI, P. S., VERMA, N. K., VYAS, M. K., RANA, JYOTI, SHARMA, ANURODH, KHARADI, V. B., SABAPARA, G. P., and DESHPANDE, S. B.
- Abstract
The article discusses the results of a study examining the genetic and phenotypic characteristics of Surti goat breeds. The authors used microsatellite markers to estimate breed's genetic variability, average body weights and biometrical characteristics. The results showed that 72 percent of breeds had positive deviation from Hardy Weinberg equilibrium through heterozygote deficiency analysis. Information on breeds' milk production, effective number of alleles, and polymorphism is provided.
- Published
- 2013
27. Efficient Implementation of Patient-specific Simulated Rehearsal for the Carotid Artery Stenting Procedure: Part-task Rehearsal.
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Willaert, W., Aggarwal, R., Harvey, K., Cochennec, F., Nestel, D., Darzi, A., Vermassen, F., and Cheshire, N.
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CAROTID artery surgery ,SURGICAL stents ,ENDOVASCULAR surgery ,OPERATIVE surgery ,EMBOLISMS ,TOMOGRAPHY ,PERFORMANCE evaluation - Abstract
Abstract: Objective(s): Patient-specific simulated rehearsal (PsR) is a technological advance within the domain of endovascular virtual reality (VR) simulation. It allows incorporation of patient-specific computed tomography Digital Imaging and Communications in Medicine (CT DICOM) data into the simulation and subsequent rehearsal of real patient cases. This study aimed to evaluate whether a part-task rehearsal (PTr) of a carotid artery stenting procedure (CAS) on a VR simulator is as effective as a full-task (FTr) preoperative run through. Methods: Medical trainees were trained in the CAS procedure and randomised to a PTr or FTr of a challenging CAS case (Type-II arch). PTr consisted of 30min of repeated catheterisations of the common carotid artery (CCA). Thereafter, both groups performed the CAS procedure in a fully functional simulated operating suite (SOS) with an interventional team. Technical performances were assessed using simulator-based metrics and expert ratings. Other aspects of performance were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring. Results: Twenty trainees were evenly randomised to either PTr or FTr. No differences in performance were seen except for the total time the embolic protection device (EPD) was deployed (9.4min for the PT vs. 8.1min for the FT, p =0.02). Total time (26.3 vs. 25.5min, p =0.94), fluoroscopy time (15.8 vs. 14.4min, p =0.68), number of roadmaps (10.5 vs. 11.0, p =0.54), amount of contrast (53.5 vs. 58.0ml, p =0.33), time to deploy the EPD (0.9 vs. 0.8min, p =0.31) and time to catheterise the CCA (9.2 vs. 8.9min, p=0.94) were similar. Qualitative performances as measured by expert ratings (score 24 vs. 24, p =0.49) and NOTSS (p >0.05 for all categories) were also comparable. Conclusions: Part- and full-task rehearsals are equally effective with respect to the operative performance of a simulated CAS intervention. This finding makes a patient-specific rehearsal more efficient and may increase the feasibility of implementation of this technology into medical practice. [Copyright &y& Elsevier]
- Published
- 2011
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28. Parents and young patients as partners in care.
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Aggarwal R, Brissett J, Aggarwal, Rahul, and Brissett, Jane
- Published
- 2011
29. Patient-specific Endovascular Simulation Influences Interventionalists Performing Carotid Artery Stenting Procedures.
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Willaert, W.I.M., Aggarwal, R., Van Herzeele, I., O’Donoghue, K., Gaines, P.A., Darzi, A.W., Vermassen, F.E., and Cheshire, N.J.
- Subjects
CAROTID artery surgery ,ENDOVASCULAR surgery ,HEALTH outcome assessment ,FLUOROSCOPY ,VIRTUAL reality - Abstract
Abstract: Objective: The ability to perform patient-specific simulated rehearsal of complex endovascular interventions is a technological advance with potential benefits to patient outcomes. This study aimed to evaluate whether patient-specific rehearsal of a carotid artery stenting (CAS) procedure has an influence on tool selection and the use of fluoroscopy. Methods: Following case note and computed tomography (CT) angiographic review of a real patient case, subjects performed the CAS procedure on a virtual reality simulator. Endovascular tool requirements and fluoroscopic angles were evaluated with a pre- and post-case questionnaire. Participants also rated the simulation from 1 (poor) to 5 (excellent). Results: Thirty-three endovascular physicians with varying degrees of CAS experience were recruited: inexperienced (5–20 CAS procedures) n = 11, moderately (21–50 CAS procedures) n = 7 or highly experienced (>50 CAS procedures) n = 15. For all participants, 96 of a possible 363 changes (26%) were observed from pre- to post-case questionnaires. This was most notable for optimal fluoroscopy C-arm position 15/33 (46%), choice of selective catheter 13/33 (39%), choice of sheath or guiding catheter 11/33 (33%) and balloon dilatation strategy 10/33 (30%). Experience with the CAS procedure did not influence the degree of change significantly (p > 0.05), and all groups exhibited a considerable modification in tool and fluoroscopy preference. The model was considered realistic and useful as a tool to practice a real case (median score 4/5). Conclusion: Patient-specific simulated rehearsal of a complex endovascular procedure strongly influences tool selection and fluoroscopy preferences for the real case. Further research has to evaluate how this technology may transfer from in vitro to in vivo and if it can reduce the radiation dose and the number of endovascular tools used and improve outcomes for patients in the clinical setting. [Copyright &y& Elsevier]
- Published
- 2011
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30. Genetic variability and bottleneck analyses of Kanniadu goat breed based on microsatellite markers.
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DIXIT, S. P., AGGARWAL, R. A. K., VERMA, N. K., VYAS, M. K., RANA, JYOTI, SHARMA, ANURODH, and CHANDER, R.
- Abstract
The article presents a study that investigated the genetic variation in Kanniadu's, goats that are prolific meat breeders thriving in the tropical drought conditions of Tamil Nadu, India. Molecular techniques to generate allelic data from a battery of 25 microsatellite markers were done by isolating genomic DNA from blood samples of 48 unrelated Kanniadus. The samples showed a high level of genetic variability which suggested the further genetic improvement of the goats for the purpose of uniform breeding.
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- 2011
31. Breed characteristics and genetic variability in Changthangi goats.
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MISHRA, PRIYANKA, VERMA, N. K., AGGARWAL, R. A. K., and DIXIT, S. P.
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The article discusses a research study on the genetic variability within the breed of Changthangi goats of India. Blood samples were collected from the breeding tract and a battery of 12 microsatellite was used for genetic characterization of Changthangi breed. It suggests that Changthangi goats exhibited a substantial amount of genetic variation as seen in the heterozygosity and number of alleles per locus and that heterozygosity can be increased and exploited to improve productivity by avoiding unplanned and indiscriminate mating among the breed.
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- 2010
32. Phenotypic and genetic characterization of Sangamneri goat breed.
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VERMA, N. K., DIXIT, S. P., AGGARWAL, R. A. K., DANGI, P. S., and JOSHI, B. K.
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The article analyzes the phenotypic and genetic variability in Sangamneri goats in India. The number of alleles observed in 25 micro-satellite markers was three to 21 with an overall mean of 9.0. Most of the loci observed had polymorphic information content (PIC) value higher than 0.5. Observed heterozygosity varied from 0.2769 to 0.8880.
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- 2010
33. Assessment and feedback in the skills laboratory and operating room.
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Sugden C and Aggarwal R
- Published
- 2010
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34. Infections due to Elizabethkingia meningoseptica in critically injured trauma patients: a seven-year study.
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Rastogi, N., Mathur, P., Bindra, A., Goyal, K., Sokhal, N., Kumar, S., Sagar, S., Aggarwal, R., Soni, K. D., and Tandon, V.
- Abstract
Elizabethkingia meningoseptica is an infrequent cause of hospital-acquired infections. The clinical and microbiological profiles of infections due to E. meningoseptica over a seven-year period at a Level-I trauma centre are reported in this study. Medical records of patients from whose clinical samples E. meningoseptica was isolated on more than one occasion were reviewed. A total of 21 cases were observed during the study, 16 (76.2%) of which exhibited multidrug resistance. The observed in-hospital mortality rate was 47.6%. A high index of clinical suspicion and effective detection of E. meningoseptica in clinical samples are requisite for improved clinical outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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35. Malabari goats: Characterization, management performance and genetic variability.
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VERMA, N. K., DIXIT, S. P., DANGI, P. S., AGGARWAL, R. A. K., KUMAR, SUBODH, and JOSHI, B. K.
- Abstract
The article discusses a study on the phenotype and genetic features from the breeding information on Malabari goats in Kerala, India. The goat keepers are interviewed for information on goat performance and herd management. The goats mature early, the female is able to conceive at 8-10 months while the male starts to breed at 9-12 months of age. There is a five percent probability of having quadruplets. The milk production of the goats range from 500 milliliters to 1.5 liters per day.
- Published
- 2009
36. Validation of Video-based Skill Assessment in Carotid Artery Stenting.
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Van Herzeele, I., Aggarwal, R., Malik, I., Gaines, P., Hamady, M., Darzi, A., Cheshire, N., and Vermassen, F.
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CAROTID artery surgery ,SURGICAL stents ,TELEVISION in medicine ,SURGICAL technology ,VIRTUAL reality in medicine ,PERFORMANCE evaluation - Abstract
Abstract: Objectives: To develop weighted error-based, generic and procedure-specific rating scales, to validate these scales for video-based assessment during virtual carotid artery stent (CAS) procedures and correlate them with simulator-derived metrics. Methods: A questionnaire was developed to assess the technique during live CAS procedures. Errors were rated from 1 (unimportant) to 5 (life-threatening) by 28 highly experienced CAS (>50 CAS) physicians. Virtual CAS procedure was performed by 21 interventionalists with varied CAS experience. Fluoroscopy screen and hand movements were video-taped, and simulator-derived metrics recorded. Experienced CAS practitioners then rated the video-taped performances using weighted error, generic and procedure-specific rating scales. Results: Of the 23 errors assessed, 12 were regarded as moderate (score 3), six serious (score 4) and four life-threatening (score 5). The generic rating scale was able to detect significant differences in performance between inexperienced and experienced CAS operators (score 25 vs. 32 respectively, P <0.01). All scoring systems demonstrated good inter-rater reliability (α =0.61–0.87). Significant correlations were observed between simulator-derived and video-based scores: weighted error-based score (r: 0.76, P <0.01), generic (r: 0.62, P <0.01) and procedure-specific (r: 0.76, P <0.01) rating scales. Conclusions: The generic endovascular rating scale differentiated between levels of CAS experience among skilled interventionalists and correlated to simulator-based error scoring. [Copyright &y& Elsevier]
- Published
- 2009
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37. New Density-based Thermal Conductivity Equation for Snow.
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Aggarwal, R. K., Negi, P. S., and Satyawali, P. K.
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THERMAL conductivity ,SNOW density ,RESEARCH stations ,TEMPERATURE measurements ,MICROSTRUCTURE - Abstract
More than two hundred thermal conductivity measurements for different snow densities and snow types were carried out in-situ at a field research station located in greater Himalayan range of India. These measurements were carried out using a commercially available portable thermal conductivity meter. Thermal conductivity measurements were carried out on the fresh snow, equi-temperature snow, and surface hoar and temperature-gradient snow. Average thermal conductivity of snow varied from 0.08 W/mK (Fresh snow of 120 kg/m³ density) to 0.32 W/m K (Equi-temperature snow of 420 kg/m³ density). Based on these measurements, a new density-based thermal conductivity equation is proposed. Using this proposed equation, modeled snowpack temperatures showed closer agreement with the observed data as compared to the predictions based on other well-known empirical and theoretical thermal conductivity equations for snow. This study highlights the advantages and limitations of empirical based thermal conductivity equations over the complex models based on snow microstructure. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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38. Poultry meat speciation by sequence analysis of mitochondrial 12S rRNA gene.
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GIRISH, P. S., ANJANEYULU, A. S. R., NAGALEEKAR, VISWAS K., HAUNSHI, SANTOSH, BHILEGAONKAR, K. N., AGGARWAL, R. K., and KONDAIAH, N.
- Abstract
The article presents information on a study which investigated poultry meat speciation through sequence analysis of mitochondrial 12S rRNA gene. A brief overview is provided on molecular approaches for poultry met species identification in India. It discusses some methods for species identification of different species of poultry meat, which include polymerase chain reaction (PCR) amplification, sequencing and analysis of mt 12S rRNA gene. It describes the mitochondrial 12S rRNA gene used in sequence analysis. It also details the nucleotide sequence similarities and divergence of mitochondrial 12S rRNA gene of different poultry species.
- Published
- 2009
39. Experienced Endovascular Interventionalists Objectively Improve their Skills by Attending Carotid Artery Stent Training Courses.
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Van Herzeele, I., Aggarwal, R., Neequaye, S., Hamady, M., Cleveland, T., Darzi, A., Cheshire, N., and Gaines, P.
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ENDOVASCULAR surgery ,CAROTID artery ,BLOOD vessels ,ARTERIES - Abstract
Objective: Carotid artery stenting (CAS) is an advanced endovascular intervention with a steep learning curve. Virtual reality (VR) simulation has been proposed as a means to train and objectively assess technical performance. Aim: To objectively assess psychomotor skills acquisition of experienced interventionalists attending a two-day CAS course, using a VR simulator. Methods: Both cognitive and technical skills of 11 interventionalists were trained in a two-day course using didactic sessions, case reviews, supervised VR simulation and live-cases. Pre- and post-course skills were assessed through performance on the same CAS procedure using metrics derived from the simulator. Results: Significant differences were noted between pre- and post-course performance for procedure (36 vs. 20min., p =0.005), X-ray (20 vs. 11min., p =0.016) and delivery-retrieval time of the embolic protection device (12 vs. 9min., p =0.007). Advancement of the guiding catheter without a leading wire occurred to a greater extent pre- versus post-course (199 vs. 152mm., p =0.050) as did spasm of the internal carotid artery (4 vs. 2, p =0.049). Conclusions: This study has objectively proven a benefit for experienced interventionalists to attend CAS courses for skills acquisition measured by a VR simulator. These data can be used to offer participants an insight into their skills and objectively audit course efficacy. [Copyright &y& Elsevier]
- Published
- 2008
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40. Emphysematous pyelonephritis: A report of three cases.
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Aggarwal, R., Kumar, S., Goyal, R., Prakash, V., Rai, N., Agrawal, N.K., and Singh, S.K.
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PYELONEPHRITIS ,DIABETES ,SEPSIS ,MULTIPLE organ failure ,KIDNEY surgery ,NEPHROSTOMY ,THERAPEUTICS - Abstract
Summary: Emphysematous pyelonephritis (EPN) is a rare necrotizing infection of renal parenchyma and/or urinary tract caused by gas producing organisms more commonly associated with diabetes mellitus. It has life threatening potential primarily due to septicemia and multiorgan failure and often requires nephrectomy. We report three patients with EPN who were managed with medical treatment and nephrostomy. [Copyright &y& Elsevier]
- Published
- 2007
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41. Identification of Skills Common to Renal and Iliac Endovascular Procedures Performed on a Virtual Reality Simulator.
- Author
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Neequaye, S.K., Aggarwal, R., Brightwell, R., Van Herzeele, I., Darzi, A., and Cheshire, N.J.W.
- Subjects
VASCULAR diseases ,VIRTUAL reality ,CURRICULUM ,COMPUTER simulation - Abstract
Introduction: There is a learning curve in the acquisition of endovascular skills for the treatment of vascular disease. Integration of Virtual reality (VR) simulator based training into the educational training curriculum offers a potential solution to overcome this learning curve. However evidence-based training curricula that define which tasks, how often and in which order they should be performed have yet to be developed. The aim of this study was to determine the nature of skills acquisition on the renal and iliac modules of a commercially-available VR simulator. Method: 20 surgical trainees without endovascular experience were randomised to complete eight sessions on a VR iliac (group A) or renal (group B) training module. To determine skills transferability across the two procedures, all subjects performed two further VR cases of the other procedure. Performance was recorded by the simulator for parameters such as time taken, contrast fluid usage and stent placement accuracy. Results: During training, both groups demonstrated statistically significant VR learning curves: group A for procedure time (p <0.001) and stent placement accuracy (p =0.013) group B for procedure time (p <0.001), fluoroscopy time (p =0.003) and volume of contrast fluid used (p <0.001). At crossover, subjects in group B (renal trained) performed to the same level of skill on the simulated iliac task as group A. However, those in group A (iliac trained) had a significantly higher fluoroscopy time (median 118 vs 72 secs, p =0.020) when performing their first simulated renal task than for group B. Conclusion: Novice endovascular surgeons can significantly improve their performance of simulated procedures through repeated practice on VR simulators. Skills transfer between tasks was demonstrated but complex task training, such as selective arterial cannulation in simulators and possibly in the real world appears to involve a separate skill. It is thus suggested that a stepwise and hierarchical training curriculum is developed for acquisition of endovascular skill using VR simulation to supplement training on patients. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
- View/download PDF
42. Virtual Reality Simulation Training can Improve Inexperienced Surgeons' Endovascular Skills.
- Author
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Aggarwal, R., Black, S.A., Hance, J.R., Darzi, A., and Cheshire, N.J.W.
- Subjects
ENDOVASCULAR surgery ,VIRTUAL reality ,OCCUPATIONAL training ,ANGIOPLASTY - Abstract
Abstract: Purpose: The aim of this study was to evaluate virtual reality (VR) simulation for endovascular training of surgeons inexperienced in this technique. Methods: Twenty consultant vascular surgeons were divided into those who had performed >50 endovascular procedures (e.g. aortic and carotid stent) as primary operator (n=8), and those having performed <10 procedures (n=12). To test for endovascular skill rather than procedural knowledge, all subjects performed a renal artery balloon angioplasty and stent procedure. The simulator uses real tools with active force feedback, and provides a realistic image of the virtual patient. Surgeons with endovascular skills performed two repetitions and those without completed six repetitions of the same task. The simulator recorded time taken for the procedure, the amount of contrast fluid used and total fluoroscopy time. Results: Initially, surgeons with endovascular skills were significantly faster (median 571.5 vs. 900.0s, p=0.039) and used less contrast fluid (19.1 vs. 42.9ml, p=0.047) than inexperienced operators, though differences for fluoroscopy time were not significant (273 vs. 441s, p=0.305). Over the six sessions, the inexperienced group made significant improvements in performance for time taken (p=0.007) and contrast fluid usage (p=0.021), achieving similar scores at the end of the training program to the experienced group. Conclusions: Surgeons with minimal endovascular experience can improve their time taken and contrast usage during short-phase training on a VR endovascular task. VR simulation may be useful for the early part of the learning curve for surgeons who wish to expand their endovascular interests. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
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43. Purification and Characterization of a Novel Toxin from Bipolaris sorokiniana, Causing Spot Blotch of Wheat and Analysis of Variability in the Pathogen
- Author
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Jahani, M., Aggarwal, R., Gupta, S., Sharma, S., and Dureja, P.
- Abstract
Bipolaris sorokiniana, causal agent of spot blotch of wheat is a hemibiotrophic pathogen. This fungus produced a toxin in culture that induced necrosis not only in wheat but also in barley, sorghum and some weeds. The toxic compound purified by prep TLC from culture filtrate of virulent strain BS-75, characterized using NMR and GC-MS techniques, was identified to be ‘Bipolaroxin’, which is a first report of its production by B. sorokinianainfecting wheat. It is a bicyclical sesquiterpene belonging to family Eremophilane. Besides producing necrotic lesions on wheat, toxin (30 ng/ml) caused necrotic lesions on barley, maize, sorghum, Phalaris minor, Avena sativaand Cynodon dactylonas studied using leaf infiltration bioassay. Qualitative and quantitative differences among the pathogenically variable isolates were observed with respect to toxin production by TLC and HPLC. Different isolates produced bipolaroxin in the range of 0.05 µg/ml (BS-41) to 1.4 µg/ml (BS-75).
- Published
- 2014
- Full Text
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44. Phenotypic characterization, biometry and management of Singharey goat of Sikkim.
- Author
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VERMA, N. K., AGGARWAL, R. A. K., SHARMA, REKHA, DANGI, P. S., and BHUTIA, N. T.
- Abstract
The article discusses research concerning the effect of climatic conditions on the phenotypic characterization, biometry and welfare of Singharey goat located at hilly terrain rocky mountaineous region of Sikkim, India.
- Published
- 2015
- Full Text
- View/download PDF
45. Toward technology-supported surgical training: the potential of virtual simulators in laparoscopic surgery
- Author
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Beyer-Berjot, L. and Aggarwal, R.
- Abstract
Background and Aims: The mastery of manual skills that are indispensable for the performance of surgical tasks is a competence specific to surgery. One way of facilitating this acquisition is to move the training out of the operating room and all of its restrictions. Surgical training out of the operating room, also called simulation, has spread widely in the past decade, especially in laparoscopic and endoscopic surgery.Material and Methods: This review assesses the role of virtual reality (VR) simulators in laparoscopic surgery and their actual impact on technical skills.Results and Conclusions: There is a wealth of simulators, ranging from low- to high-fidelity simulators incorporating haptic feedback. They comprise basic tasks, procedural modules, and full procedures. Virtual reality simulators have shown acceptable fidelity and validity evidence. Moreover, training out of the operating room on virtual reality simulators has demonstrated its positive impact on basic skills during real laparoscopic procedures in patients. The benefit of virtual reality over simple video trainers remains unclear for teaching basic skills. However, virtual reality simulators provide automatic feedback that permitted to design structured competency-based curricula and allow deliberate practice. Finally, advanced procedures and patient-specific models have been designed on virtual reality simulators, and further investigations are still awaited to appraise their educational value.
- Published
- 2013
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46. Interleukin-5, interleukin-6, interleukin-8 and tumour necrosis factor-alpha levels obtained within 24-h of admission do not predict high-risk infection in children with febrile neutropenia
- Author
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Aggarwal, R, Bansal, D, Bansal, F, Nanda, N, Ray, P, Trehan, A, and Marwaha, RK
- Abstract
Purpose:Biomarkers that can predict the severity of febrile neutropenia (FN) are potential tools for clinical practice. Objective:The objective of this study is to evaluate the reliability of plasma interleukin (IL) levels as indicators of high-risk FN. Materials and Methods:Children with haematological malignancies and FN were enrolled prospectively. A blood sample was obtained within 24-h of admission for estimation of IL-5, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-α) level by the enzyme-linked immunosorbent assay. Patients were stratified into three groups. Group I (low-risk): No focus of infection; Group II: Clinical/radiological focus of infection; Group III: Microbiologically proven infection or FN related mortality. Groups II and III were analysed as high-risk. The cytokines were assessed at three different cut-off levels. Results:A total of 52 episodes of FN in 48 patients were evaluated. The mean age was 6 years (range: 2-13). Primary diagnosis included acute lymphoblastic leukaemia (82%), non-Hodgkin’s lymphoma (13%) and acute myeloid leukaemia (5%). Absolute neutrophil count was < 200 cells/μl in half and 200-500 in 23%. Majority were categorised as Group I (69%), followed by Group II (16%) and III (15%). The range of IL-5 was too narrow and similar in the two risk-groups to be of any relevance. The best sensitivity of TNF-α and IL-6 for high-risk group was 78% and 70%, respectively. The highest specificity observed was 35%. The negative predictive value of IL-6, IL-8 and TNF-α exceeded 80%. Conclusion:IL-5, IL-6, IL-8 and TNF-α failed as predictors of clinically localised or microbiologically documented infection in children with chemotherapy induced FN. However, IL-6, IL-8 and TNF-α could be useful in excluding the possibility of high-risk infection.
- Published
- 2013
- Full Text
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47. Kruppel-Like Factor 2 (KLF2) Regulates Monocyte Differentiation and Functions in mBSA and IL-1-Induced Arthritis
- Author
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Das, M., Lu, J., Joseph, M., Aggarwal, R., Kanji, S., McMichael, B.K., Lee, B.S., Agarwal, S., Ray-Chaudhury, A., Iwenofu, O.H., Kuppusamy, P., Pompili, V.J., Jain, M.K., and Das, H.
- Abstract
Kruppel-like factor 2 (KLF2) plays an important role in the regulation of a variety of immune cells, including monocytes. We have previously shown that KLF2 inhibits proinflammatory activation of monocytes. However, the role of KLF2 in arthritis is yet to be investigated. In the current study, we show that recruitment of significantly greater numbers of inflammatory subset of CD11bF4/80Ly6C monocytes to the inflammatory sites in KLF2 hemizygous mice compared to the wild type littermate controls. In parallel, inflammatory mediators, MCP-1, Cox-2 and PAI-1 were significantly up-regulated in bone marrow-derived monocytes isolated from KLF2 hemizygous mice, in comparison to wild-type controls. Methylated-BSA and IL-1-induced arthritis was more severe in KLF2 hemizygous mice as compared to the littermate wild type controls. Consistent with this observation, monocytes isolated from KLF2 hemizygous mice showed an increased number of cells matured and differentiated towards osteoclastic lineage, potentially contributing to the severity of cartilage and bone damage in induced arthritic mice. The severity of arthritis was associated with the higher expression of proteins such as HSP60, HSP90 and MMP13 and attenuated levels of pPTEN, p21, p38 and HSP25/27 molecules in bone marrow cells of arthritic KLF2 hemizygous mice compared to littermate wild type controls. The data provide new insights and evidences of KLF2-mediated transcriptional regulation of arthritis via modulation of monocyte differentiation and function.
- Published
- 2012
48. Hematopoietic Stem Cells: Transcriptional Regulation, Ex Vivo Expansion and Clinical Application
- Author
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Aggarwal, R., Lu, J., J. Pompili, V., and Das, H.
- Abstract
Maintenance of ex vivo hematopoietic stem cells (HSC) pool and its differentiated progeny is regulated by complex network of transcriptional factors, cell cycle proteins, extracellular matrix, and their microenvironment through an orchestrated fashion. Strides have been made to understand the mechanisms regulating in vivo quiescence and proliferation of HSCs to develop strategies for ex vivo expansion. Ex vivo expansion of HSCs is important to procure sufficient number of stem cells and as easily available source for HSC transplants for patients suffering from hematological disorders and malignancies. Our lab has established a nanofiber-based ex vivo expansion strategy for HSCs, while preserving their stem cell characteristics. Ex vivo expanded cells were also found biologically functional in various disease models. However, the therapeutic potential of expanded stem cells at clinical level still needs to be verified. This review outlines transcriptional factors that regulate development of HSCs and their commitment, genes that regulate cell cycle status, studies that attempt to develop an effective and efficient protocol for ex vivo expansion of HSCs and application of HSC in various non-malignant and malignant disorders. Overall the goal of the current review is to deliver an understanding of factors that are critical in resolving the challenges that limit the expansion of HSCs in vivo and ex vivo.
- Published
- 2012
49. CONGENITAL CMV INFECTION; DIAGNOSIS IN SYMPTOMATIC INFANTS
- Author
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Gandhoke, I, Aggarwal, R, Hussain, SA, Pasha, ST, Sethi, P, Thakur, S, Lal, S, and Khare, S
- Abstract
Background:Samples from babies exhibiting clinical symptoms suggestive of congenital infection are referred regularly to NICD, New Delhi, from Government Hospitals located in Delhi and a home for abandoned children (Palna), for the diagnosis of etiological agents like toxoplasma, rubella, CMV and herpes. Blood samples of mothers of most of the affected babies are also received. Objective:Evaluation of rapid and accurate technique for the diagnosis of congenital CMV infection. Materials and Methods:One hundred and twenty five blood samples suggestive of symptomatic congenital CMV infection were selected from samples received at NICD during the period June 2005-March 2007. A request to collect and send the urine samples of the selected babies was sent to the respective hospitals. Serum samples of the babies were tested for CMV-IgM antibodies using µ-capture ELISA. Mothers’ serum samples were subjected to CMV-IgM and IgG class antibodies assay by commercial ELISA kits. DNA isolation and amplification was performed in urine samples and some of the serum samples using a commercial PCR kit for detection of HCMV. Blood and urine samples from 20 normal babies were included in the study. Results:Twenty Seven serum samples (21.6%) of infants, of the 125 tested, were positive for CMV-IgM antibodies. Twenty five samples (20%) showed amplification of CMV –DNA. All 25 samples positive for PCR were positive for CMV IgM antibodies. Sera of 73 mothers, out of 75 tested (97.3%), were positive for CMV IgG antibodies. However, none of them was positive for CMV IgM antibodies. Mothers of all 27 positive babies were positive for CMV-IgG antibodies. Serum and urine samples from 20 normal babies were negative for ELISA and PCR. Conclusion:µ-capture ELISA technique was found to be more sensitive than PCR (92.6%) for detection of congenital CMV infection. ELISA is also rapid, less cumbersome and cost effective for diagnosis of CMV infection.
- Published
- 2009
- Full Text
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50. Validation of orthopaedic bench models for trauma surgery
- Author
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Leong, J. J. H., Leff, D. R., Das, A., Aggarwal, R., Reilly, P., Atkinson, H. D. E., Emery, R. J., and Darzi, A. W.
- Abstract
The aim of this study was to validate the use of three models of fracture fixation in the assessment of technical skills. We recruited 21 subjects (six experts, seven intermediates, and eight novices) to perform three procedures: application of a dynamic compression plate on a cadaver porcine model, insertion of an unreamed tibial intramedullary nail, and application of a forearm external fixator, both on synthetic bone models. The primary outcome measures were the Objective Structural Assessment of technical skills global rating scale on video recordings of the procedures which were scored by two independent expert observers, and the hand movements of the surgeons which were analysed using the Imperial College Surgical Assessment Device.The video scores were significantly different for the three groups in all three procedures (p < 0.05), with excellent inter-rater reliability (a = 0.88). The novice and intermediate groups specifically were significantly different in their performance with dynamic compression plate and intramedullary nails (p < 0.05). Movement analysis distinguished between the three groups in the dynamic compression plate model, but a ceiling effect was demonstrated in the intramedullary nail and external fixator procedures, where intermediates and experts performed to comparable standards (p > 0.6). A total of 85% (18 of 21) of the subjects found the dynamic compression model and 57% (12 of 21) found all the models acceptable tools of assessment.This study has validated a low-cost, high-fidelity porcine dynamic compression plate model using video rating scores for skills assessment and movement analysis. It has also demonstrated that Synbone models for the application of and intramedullary nail and an external fixator are less sensitive and should be improved for further assessment of surgical skills in trauma. The availability of valid objective tools of assessment of surgical skills allows further studies into improving methods of training.
- Published
- 2008
- Full Text
- View/download PDF
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