Expectancy Theory is a well known theory in work motivation literature. It was first proposed by ... more Expectancy Theory is a well known theory in work motivation literature. It was first proposed by Victor Vroom in 1964 after studying the motivations behind individuals’ decision making. Expectancy Theory holds that a person’s choice to behave in a certain way reflects the belief that chosen actions will result in desired outcomes. Expectancy Theory is parsed of three components: Expectancy (E), Instrumentality (I) and Valence (V). Expectancy (E) is the belief that performance goals will be met if appropriate efforts are applied. Instrumentality (I) denotes an expectation that rewards will follow if defined performance outcomes are met. Valence (V) refers to the value an individual places on the reward being given. Expectancy Theory involves an interaction between these components, summing in a Motivational Force (MF). Namely, E x I x V = MF. Thus, as viewed by Expectancy Theory, MF will be affected by changes in performance expectations, recognition of goal achievements, and valuations of declared rewards. Interestingly, the traditional work-place organizational structure is in many ways analogous to contemporary surgical residency training in theUnited States. Examples include varied work assignments in the workplace being similar to varied clinical rotation assignments during residency; promotions offered in the workplace likened to training year advancement in residency; and the work-place hierarchy (e.g. employee to manager) akin to the hospital hierarchy (e.g. intern to department head). Many other similarities exist as well. These analogies between work-place organizational structure and surgical residency are significant as we propose the application of Expectancy Theory to surgical residency training. What follows are opportunities for greater insight into surgical resident MF, as well as the potential to enhance surgical residency training and performance. Learning Objectives: 1. To understand Expectancy Theory and its relevance to adult learning 2. To understand the application of Expectancy Theory to surgical residency education 3. To understand factors affecting motivation in adult learners 4. To understand Expectancy Theory, and Motivational Force in enhancing surgical resident trainin
Journal of Dr. NTR University of Health Sciences, 2014
Incidence of coronary artery disease is on rise amongst the population, which is the major underl... more Incidence of coronary artery disease is on rise amongst the population, which is the major underlying pathology for acute coronary syndrome (ACS). So every anesthetist may encounter the patients with ACS and should know how to recognize and manage them. Its earliest detection and proper management can prevent further myocardial damage, thus preventing further morbidity and mortality. The patient described here had an increased risk for perioperative ischemia because of old age associated with history of hypertension, diabetes mellitus, chronic renal failure, and underwent a major surgical procedure (laprotomy). Beta-blockers were not administered and aspirin was discontinued during his preoperative preparation. All these factors might have contributed for the genesis of the myocardial ischemia in this patient.
The objective of this study was to review the development of a multidisciplinary asthma disease m... more The objective of this study was to review the development of a multidisciplinary asthma disease management program in a large medical group practice in an urban area, and evaluate the impact of the program on processes of care and health care utilization for adults and children with asthma. The disease management intervention included the development of a patient registry, a systematic approach to assessment of asthma control using the Asthma Therapy Assessment Questionnaire (ATAQ), case management, and physician education. An administrative database was used to examine hospital admissions and emergency department (ED) visits. A medical record audit was conducted to examine recorded compliance with asthma guidelines and documentation practices. The baseline study population included 3486 adults and children with asthma. The ATAQ suggested that, at baseline, control problems were frequent, with 34% of adult respondents missing work because of asthma. ATAQ also revealed several areas ...
ABSTRACT Purpose: The addition of protease inhibitors, boceprevir or telaprevir, to pegylated int... more ABSTRACT Purpose: The addition of protease inhibitors, boceprevir or telaprevir, to pegylated interferon alpha and ribavirin (usual care) results in an improved sustained virologic response (SVR) in newly diagnosed Genotype 1 Chronic Hepatitis C (HCV) patients. The objective of this study was to evaluate the cost-effectiveness of all currently recommended pharmacotherapies from a payer’s perspective in this population. Methods: A Markov model was developed to simulate treatment effectiveness, costs and disease progression in a hypothetical cohort of newly diagnosed HCV patients . In addition to the usual care, triple therapies with usual care and boceprevir or telaprevir were considered. The model included the following outcomes: SVR, eventual disease progression to long-term adverse outcomes in those who did not achieve SVR or relapsed, and side effects. Probabilities, costs and utility values were determined from a review of the published literature. All costs were inflated to 2012 costs. Costs and quality adjusted life years were also discounted at standard rate of 5%. Sensitivity analyses were performed to assess model sensitivity and address uncertainty. Results: Boceprevir therapy resulted in lifetime costs and utilities of $106,376 and 12.68 QALYs compared to $92,440 and 12.66 QALYs for Telaprevir therapy and $83,036 and 12.19 QALYs for usual care. The ICER was found to be $47,173/QALY for boceprevir and $19,878/QALY for telaprevir relative to usual care. The ICER was found to be $642,485/QALY for boceprevir relative to telaprevir. The model was found to be most sensitive to variations in costs of initial drug therapy. Conclusion: Results indicate that when possible, telaprevir should be the preferred therapy for the Genotype 1 HCV patients. In patients where telaprevir is not tolerated or cannot be given, boceprevir should be the next preferred therapy. Effective management of side-effects is important to reduce the impact on rate of achieving sustained virological response.
Cyclosporine A-nanosuspensions were prepared using zirconium oxide beads as a milling media, Polo... more Cyclosporine A-nanosuspensions were prepared using zirconium oxide beads as a milling media, Poloxamer 407 as a stabilizer and distilled water as an aqueous medium using the Pearl Milling technique. The optimized formulation was characterized in terms of particle size distribution, surface morphology, drug-surfactant interaction, drug content, saturation solubility, osmolarity, and stability. The nanoparticles consisting of Poloxamer-bound cyclosporin A with a mean diameter of 213 nm revealed a spherical shape and 5.69 fold increased saturation solubility as compared to the parent drug. The formulation was found to be iso-osmolar with blood and stable up to 3 months at 2â8ÂC. In-vivo studies were carried out in albino rats and the pharmacokinetic parameters were compared with a marketed formulation, which indicated better results of the prepared formulation than the marketed one.
Performance of a Gas Turbine is largely dependent on inlet air temperature. Gas Turbines are cons... more Performance of a Gas Turbine is largely dependent on inlet air temperature. Gas Turbines are constant volume machines. At a given shaft speed they always move the same volume of air. But the power output of a turbine depends on the flow of mass through it. This is precisely the reason why on hot days, when air is less dense, power output falls off. A rise of one degree Centigrade temperature of Inlet air decreases the power output by 1% and at the same time heat rate of the turbine also goes up. This is a matter of great concern to power producers. Many techniques have been developed to cool Inlet air to Gas Turbine. Traditionally, Gas Turbine inlet air has been cooled by either mechanical chillers or media type evaporative coolers. It is also important to note that power consumption to cool inlet air is also of concern since it decreases the net power output of a Gas Turbine. In mechanical Chiller auxiliary power consumption is very high compared to media type evaporative coolers. ...
Extensive investigation has been carried out to elucidate the mechanisms involved in pseudoligand... more Extensive investigation has been carried out to elucidate the mechanisms involved in pseudoligand affinity chromatography using textile dyes, and, empirically, it has been attributed to the chemical and steric structures of dye and protein. Possibly, a variety of interactions especially ionic and/or hydrophobic influence with a varying share in the binding and differ from protein to protein and from dye to dye. In this study, we have attempted to understand the effect of various biophysical parameters like the nature of the eluant, pH, and ionic strength on the binding of crude luteinizing hormone (LH) with various triazine-based dyes and thus predict their nature. Based on the elution patterns, cibacron and reactive brown suggested a dual electrostatic and hydrophobic nature. Reactive blue and reactive yellow reflected a major electrostatic/ionic nature with yellow offering 50-fold purification in a single step, while reactive red and reactive green had a predominant hydrophobic na...
Medical Imaging 1997: Physiology and Function from Multidimensional Images, 1997
Generators of spontaneous human brain activity such as alpha rhythm may be easier and more accura... more Generators of spontaneous human brain activity such as alpha rhythm may be easier and more accurate to localize in frequency-domain than in time-domain since these generators are characterized by a specific frequency range. We carried out a frequency-domain analysis of synchronous alpha sources by generating equivalent potential maps using the Fourier transform of each channel of electro-encephalographic (EEG) recordings. SInce the alpha rhythm recorded by EEG scalp measurements is probably produced by several independent generators, a distributed source imaging approach was considered more appropriate than a model based on a single equivalent current dipole. We used an imaging approach based on a Bayesian maximum entropy technique. Reconstructed sources were superposed on corresponding anatomy form magnetic resonance imaging. Results from human studies suggest that reconstructed sources responsible for alpha rhythm are mainly located in the occipital and parieto- occipital lobes.
Medical Imaging 1995: Physiology and Function from Multidimensional Images, 1995
A feasibility study was conducted to segment 1.5T fMRIs into gray matter and large veins using in... more A feasibility study was conducted to segment 1.5T fMRIs into gray matter and large veins using individual pixel intensity and temporal phase delay as two correlated parameters in gradient echo images. The time-course of each pixel in gradient echo images acquired during visual stimulation with a checkerboard flashing at 8Hz was correlated to the stimulation 'on'-'off' sequence to identify activated pixels. The temporal delay of each activated pixels was estimated by fitting its time-course to a reference sinusoidal function. The mean signal intensity difference of the activated pixels was computed by subtracting the average of the 'on' images from the average of the 'off' images. After replacing each activated pixel with 2D features (i.e., intensity and time-delay), a clustering method based on a K-means algorithm was employed to classify vein and tissue pixels. Good demarcation between large veins and activated gray matter was achieved with this method.
European Journal of Orthopaedic Surgery & Traumatology, 2009
Abstract Study design Prospective. Objective To assess the results of laminectomy in patients suf... more Abstract Study design Prospective. Objective To assess the results of laminectomy in patients suffering from multilevel multidirectional compressive cervical myelopathy with co-morbid conditions and to compare results of anterior and laminectomy clinically, ...
One-pot synthesis of 3,4-diaryl substituted 2(5H)-furanones was established and its commercial ap... more One-pot synthesis of 3,4-diaryl substituted 2(5H)-furanones was established and its commercial application has been demonstrated by accomplishing total synthesis of rofecoxib, under mild reaction conditions, with good yields and purity.
This paper reports the design and development of an indirect, natural convection batch-type solar... more This paper reports the design and development of an indirect, natural convection batch-type solar dryer fitted with NorthSouth reflectors. With the help of the reflectors the collector efficiency without load was enhanced from 40.0% to 58.5% under peak solar irradiation ...
ABSTRACT New ventures face numerous challenges stemming from environmental conditions. There are,... more ABSTRACT New ventures face numerous challenges stemming from environmental conditions. There are, however, specific strategies new ventures can take to mitigate potentially adverse external factors. This research draws upon stakeholder theory to offer rationale and evidence of the contingent role of primary stakeholder integration in moderating the influence of environmental conditions on new venture growth. Examination of 183 new ventures reveals that buyer integration mitigates negative effects of environmental dynamism and supplier integration mitigates negative effects of environmental complexity. The implications of these relationships for theory and practice are discussed.
International Journal of Water Resources Development, 2000
This paper examines how two of the Kyoto Protocol mechanismsthe clean development mechanism (CDM... more This paper examines how two of the Kyoto Protocol mechanismsthe clean development mechanism (CDM) and emissions tradinghave been applied to two water-related renewable power-generation projects. Traditional concerns related to hydropower ...
Expectancy Theory is a well known theory in work motivation literature. It was first proposed by ... more Expectancy Theory is a well known theory in work motivation literature. It was first proposed by Victor Vroom in 1964 after studying the motivations behind individuals’ decision making. Expectancy Theory holds that a person’s choice to behave in a certain way reflects the belief that chosen actions will result in desired outcomes. Expectancy Theory is parsed of three components: Expectancy (E), Instrumentality (I) and Valence (V). Expectancy (E) is the belief that performance goals will be met if appropriate efforts are applied. Instrumentality (I) denotes an expectation that rewards will follow if defined performance outcomes are met. Valence (V) refers to the value an individual places on the reward being given. Expectancy Theory involves an interaction between these components, summing in a Motivational Force (MF). Namely, E x I x V = MF. Thus, as viewed by Expectancy Theory, MF will be affected by changes in performance expectations, recognition of goal achievements, and valuations of declared rewards. Interestingly, the traditional work-place organizational structure is in many ways analogous to contemporary surgical residency training in theUnited States. Examples include varied work assignments in the workplace being similar to varied clinical rotation assignments during residency; promotions offered in the workplace likened to training year advancement in residency; and the work-place hierarchy (e.g. employee to manager) akin to the hospital hierarchy (e.g. intern to department head). Many other similarities exist as well. These analogies between work-place organizational structure and surgical residency are significant as we propose the application of Expectancy Theory to surgical residency training. What follows are opportunities for greater insight into surgical resident MF, as well as the potential to enhance surgical residency training and performance. Learning Objectives: 1. To understand Expectancy Theory and its relevance to adult learning 2. To understand the application of Expectancy Theory to surgical residency education 3. To understand factors affecting motivation in adult learners 4. To understand Expectancy Theory, and Motivational Force in enhancing surgical resident trainin
Journal of Dr. NTR University of Health Sciences, 2014
Incidence of coronary artery disease is on rise amongst the population, which is the major underl... more Incidence of coronary artery disease is on rise amongst the population, which is the major underlying pathology for acute coronary syndrome (ACS). So every anesthetist may encounter the patients with ACS and should know how to recognize and manage them. Its earliest detection and proper management can prevent further myocardial damage, thus preventing further morbidity and mortality. The patient described here had an increased risk for perioperative ischemia because of old age associated with history of hypertension, diabetes mellitus, chronic renal failure, and underwent a major surgical procedure (laprotomy). Beta-blockers were not administered and aspirin was discontinued during his preoperative preparation. All these factors might have contributed for the genesis of the myocardial ischemia in this patient.
The objective of this study was to review the development of a multidisciplinary asthma disease m... more The objective of this study was to review the development of a multidisciplinary asthma disease management program in a large medical group practice in an urban area, and evaluate the impact of the program on processes of care and health care utilization for adults and children with asthma. The disease management intervention included the development of a patient registry, a systematic approach to assessment of asthma control using the Asthma Therapy Assessment Questionnaire (ATAQ), case management, and physician education. An administrative database was used to examine hospital admissions and emergency department (ED) visits. A medical record audit was conducted to examine recorded compliance with asthma guidelines and documentation practices. The baseline study population included 3486 adults and children with asthma. The ATAQ suggested that, at baseline, control problems were frequent, with 34% of adult respondents missing work because of asthma. ATAQ also revealed several areas ...
ABSTRACT Purpose: The addition of protease inhibitors, boceprevir or telaprevir, to pegylated int... more ABSTRACT Purpose: The addition of protease inhibitors, boceprevir or telaprevir, to pegylated interferon alpha and ribavirin (usual care) results in an improved sustained virologic response (SVR) in newly diagnosed Genotype 1 Chronic Hepatitis C (HCV) patients. The objective of this study was to evaluate the cost-effectiveness of all currently recommended pharmacotherapies from a payer’s perspective in this population. Methods: A Markov model was developed to simulate treatment effectiveness, costs and disease progression in a hypothetical cohort of newly diagnosed HCV patients . In addition to the usual care, triple therapies with usual care and boceprevir or telaprevir were considered. The model included the following outcomes: SVR, eventual disease progression to long-term adverse outcomes in those who did not achieve SVR or relapsed, and side effects. Probabilities, costs and utility values were determined from a review of the published literature. All costs were inflated to 2012 costs. Costs and quality adjusted life years were also discounted at standard rate of 5%. Sensitivity analyses were performed to assess model sensitivity and address uncertainty. Results: Boceprevir therapy resulted in lifetime costs and utilities of $106,376 and 12.68 QALYs compared to $92,440 and 12.66 QALYs for Telaprevir therapy and $83,036 and 12.19 QALYs for usual care. The ICER was found to be $47,173/QALY for boceprevir and $19,878/QALY for telaprevir relative to usual care. The ICER was found to be $642,485/QALY for boceprevir relative to telaprevir. The model was found to be most sensitive to variations in costs of initial drug therapy. Conclusion: Results indicate that when possible, telaprevir should be the preferred therapy for the Genotype 1 HCV patients. In patients where telaprevir is not tolerated or cannot be given, boceprevir should be the next preferred therapy. Effective management of side-effects is important to reduce the impact on rate of achieving sustained virological response.
Cyclosporine A-nanosuspensions were prepared using zirconium oxide beads as a milling media, Polo... more Cyclosporine A-nanosuspensions were prepared using zirconium oxide beads as a milling media, Poloxamer 407 as a stabilizer and distilled water as an aqueous medium using the Pearl Milling technique. The optimized formulation was characterized in terms of particle size distribution, surface morphology, drug-surfactant interaction, drug content, saturation solubility, osmolarity, and stability. The nanoparticles consisting of Poloxamer-bound cyclosporin A with a mean diameter of 213 nm revealed a spherical shape and 5.69 fold increased saturation solubility as compared to the parent drug. The formulation was found to be iso-osmolar with blood and stable up to 3 months at 2â8ÂC. In-vivo studies were carried out in albino rats and the pharmacokinetic parameters were compared with a marketed formulation, which indicated better results of the prepared formulation than the marketed one.
Performance of a Gas Turbine is largely dependent on inlet air temperature. Gas Turbines are cons... more Performance of a Gas Turbine is largely dependent on inlet air temperature. Gas Turbines are constant volume machines. At a given shaft speed they always move the same volume of air. But the power output of a turbine depends on the flow of mass through it. This is precisely the reason why on hot days, when air is less dense, power output falls off. A rise of one degree Centigrade temperature of Inlet air decreases the power output by 1% and at the same time heat rate of the turbine also goes up. This is a matter of great concern to power producers. Many techniques have been developed to cool Inlet air to Gas Turbine. Traditionally, Gas Turbine inlet air has been cooled by either mechanical chillers or media type evaporative coolers. It is also important to note that power consumption to cool inlet air is also of concern since it decreases the net power output of a Gas Turbine. In mechanical Chiller auxiliary power consumption is very high compared to media type evaporative coolers. ...
Extensive investigation has been carried out to elucidate the mechanisms involved in pseudoligand... more Extensive investigation has been carried out to elucidate the mechanisms involved in pseudoligand affinity chromatography using textile dyes, and, empirically, it has been attributed to the chemical and steric structures of dye and protein. Possibly, a variety of interactions especially ionic and/or hydrophobic influence with a varying share in the binding and differ from protein to protein and from dye to dye. In this study, we have attempted to understand the effect of various biophysical parameters like the nature of the eluant, pH, and ionic strength on the binding of crude luteinizing hormone (LH) with various triazine-based dyes and thus predict their nature. Based on the elution patterns, cibacron and reactive brown suggested a dual electrostatic and hydrophobic nature. Reactive blue and reactive yellow reflected a major electrostatic/ionic nature with yellow offering 50-fold purification in a single step, while reactive red and reactive green had a predominant hydrophobic na...
Medical Imaging 1997: Physiology and Function from Multidimensional Images, 1997
Generators of spontaneous human brain activity such as alpha rhythm may be easier and more accura... more Generators of spontaneous human brain activity such as alpha rhythm may be easier and more accurate to localize in frequency-domain than in time-domain since these generators are characterized by a specific frequency range. We carried out a frequency-domain analysis of synchronous alpha sources by generating equivalent potential maps using the Fourier transform of each channel of electro-encephalographic (EEG) recordings. SInce the alpha rhythm recorded by EEG scalp measurements is probably produced by several independent generators, a distributed source imaging approach was considered more appropriate than a model based on a single equivalent current dipole. We used an imaging approach based on a Bayesian maximum entropy technique. Reconstructed sources were superposed on corresponding anatomy form magnetic resonance imaging. Results from human studies suggest that reconstructed sources responsible for alpha rhythm are mainly located in the occipital and parieto- occipital lobes.
Medical Imaging 1995: Physiology and Function from Multidimensional Images, 1995
A feasibility study was conducted to segment 1.5T fMRIs into gray matter and large veins using in... more A feasibility study was conducted to segment 1.5T fMRIs into gray matter and large veins using individual pixel intensity and temporal phase delay as two correlated parameters in gradient echo images. The time-course of each pixel in gradient echo images acquired during visual stimulation with a checkerboard flashing at 8Hz was correlated to the stimulation 'on'-'off' sequence to identify activated pixels. The temporal delay of each activated pixels was estimated by fitting its time-course to a reference sinusoidal function. The mean signal intensity difference of the activated pixels was computed by subtracting the average of the 'on' images from the average of the 'off' images. After replacing each activated pixel with 2D features (i.e., intensity and time-delay), a clustering method based on a K-means algorithm was employed to classify vein and tissue pixels. Good demarcation between large veins and activated gray matter was achieved with this method.
European Journal of Orthopaedic Surgery & Traumatology, 2009
Abstract Study design Prospective. Objective To assess the results of laminectomy in patients suf... more Abstract Study design Prospective. Objective To assess the results of laminectomy in patients suffering from multilevel multidirectional compressive cervical myelopathy with co-morbid conditions and to compare results of anterior and laminectomy clinically, ...
One-pot synthesis of 3,4-diaryl substituted 2(5H)-furanones was established and its commercial ap... more One-pot synthesis of 3,4-diaryl substituted 2(5H)-furanones was established and its commercial application has been demonstrated by accomplishing total synthesis of rofecoxib, under mild reaction conditions, with good yields and purity.
This paper reports the design and development of an indirect, natural convection batch-type solar... more This paper reports the design and development of an indirect, natural convection batch-type solar dryer fitted with NorthSouth reflectors. With the help of the reflectors the collector efficiency without load was enhanced from 40.0% to 58.5% under peak solar irradiation ...
ABSTRACT New ventures face numerous challenges stemming from environmental conditions. There are,... more ABSTRACT New ventures face numerous challenges stemming from environmental conditions. There are, however, specific strategies new ventures can take to mitigate potentially adverse external factors. This research draws upon stakeholder theory to offer rationale and evidence of the contingent role of primary stakeholder integration in moderating the influence of environmental conditions on new venture growth. Examination of 183 new ventures reveals that buyer integration mitigates negative effects of environmental dynamism and supplier integration mitigates negative effects of environmental complexity. The implications of these relationships for theory and practice are discussed.
International Journal of Water Resources Development, 2000
This paper examines how two of the Kyoto Protocol mechanismsthe clean development mechanism (CDM... more This paper examines how two of the Kyoto Protocol mechanismsthe clean development mechanism (CDM) and emissions tradinghave been applied to two water-related renewable power-generation projects. Traditional concerns related to hydropower ...
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Papers by Pankaj Patel