Sanjay Sharma

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The number of patients who could benefit from liver transplantation markedly exceeds the number of available donors. This increasing gap has fuelled efforts to maximize existing donor pool and identify new avenues. To compare the outcome in deceased donor liver transplant (DDLT) based on extended donor selection criteria. Donor and recipients' data were analyzed following DDLT from Mar 2007 to Feb 2013. Donors were grouped into either ideal donor (ID) or extended criteria donor (ECD) based on donor and graft related characteristics. Primary nonfunction (PNF) and patient survival were the primary endpoints while early graft dysfunction (EGD) and incidence of major postoperative complications were the secondary endpoints of the study. We had a total of 6 mortalities (13%) at the end of 1 year. The Kaplan Meier survival analysis at 7 days, 3, 6 and 12 months were not statistically different (p > 0.05). PNF occurred in three (6.5%) patients and was not significantly different nor...

Prostate cancer is the commonest malignancy in men that causes significant morbidity and mortality worldwide. Screening by digital rectal examination (DRE) and serum prostate-specific antigen (PSA) is used despite its limitations. Gray-scale transrectal ultrasound (TRUS), used to guide multiple random prostatic biopsies, misses up to 20% cancers and frequently underestimates the grade of malignancy. Increasing the number of biopsy cores marginally increases the yield. Evolving techniques of real-time ultrasound elastography (RTE) and contrast-enhanced ultrasound (CEUS) are being investigated to better detect and improve the yield by allowing "targeted" biopsies. Last decade has witnessed rapid developments in magnetic resonance imaging (MRI) for improved management of prostate cancer. In addition to the anatomical information, it is capable of providing functional information through diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and dynamic contr...

During the last couple of decades, with standardization and progress in surgical techniques, immunosuppression and post liver transplantation patient care, the outcome of liver transplantation has been optimized. However, the principal limitation of transplantation remains access to an allograft. The number of patients who could derive benefit from liver transplantation markedly exceeds the number of available deceased donors. The large gap between the growing list of patients waiting for liver transplantation and the scarcity of donor organs has fueled efforts to maximize existing donor pool and identify new avenues. This article reviews the changing pattern of donor for liver transplantation using grafts from extended criteria donors (elderly donors, steatotic donors, donors with malignancies, donors with viral hepatitis), donation after cardiac death, use of partial grafts (split liver grafts) and other suboptimal donors (hypernatremia, infections, hypotension and inotropic suppo...

Abstract This study presents a characterization of (1) the global memory and interconnection network contention overhead,(2) the operating system overheads, and (3) the runtime system parallelization overheads for the Cedar shared-memory multiprocessor. The ...

Interindividual clinical response to leukotriene modifiers is highly variable, and less efficacious than inhaled corticosteroids in treating asthma. Genetic variability in 5-lipoxygenase biosynthetic and receptor pathway gene loci may influence cysteinyl-leukotriene production and subsequent response to leukotriene modifiers. Using data from two clinical trials of 12-week duration, post-hoc analyses were performed in 174 patients randomized to montelukast. Associations between polymorphisms in 10 candidate genes (ALOX5, ALOX5AP, LTC4S, CYSLTR1, CYSLTR2, PLA2G4A, CYP2C9, CYP3A4, ADRB2, and NR3C1) and response to montelukast were modeled using change in morning peak expiratory flow and forced expiratory volume in 1 s (FEV1) to define the response phenotype. In our sample, eight out of 25 markers in 10 candidate genes were statistically associated with response to montelukast, with an estimated proportion of false discoveries of 16%. The strongest statistical evidence of clinically relevant pharmacogenetic effects peak expiratory flow were identified in CYSLTR2 (rs91227 and rs912278; P=0.02 and P=0.02, respectively) and ALOX5 (rs4987105 and rs4986832; P=0.01 and P=0.01, respectively). Patients with these variant genotypes, found in roughly 10-13% of patients, had an 18-25% improvement in peak expiratory flow. In contrast, the majority of patients with the wild-type alleles had only a marginal (8-10%) improvement. The overall mean response to montelukast may be skewed towards a response phenotype by a small subset (<15%) of asthma patients. CYSLTR2 and ALOX5 polymorphisms may predispose a minority of individuals to excessive cysteinyl-leukotriene concentrations, yielding a distinct asthma phenotype most likely to respond to leukotriene modifier pharmacotherapy. These findings require replication to establish validity and clinical utility.

This paper describes the design of navigation, guidance and control systems for an uninhabited surface vehicle named Springer, based on conventional as well as interval Kalman filtering, line-of-sight, and model predictive control techniques. The heading of the vessel is estimated using an electronic compass model. Through the use of a weighted interval Kalman filter it is shown how it is possible to overcome biased estimates when an incorrect model of the compass is used, under which scenario the conventional Kalman filter fails to provide an accurate estimate. The autopilot is based on model predictive control which utilises a dynamic steering model of the vessel obtained from trials data. Applied in simulation to a way-point tracking mission, it is evidenced that the more accurate heading estimate based on the weighted interval Kalman filter endows the integrated navigation, guidance and control system with better accuracy and efficiency than that achieved with the traditional Ka...

The ability to understand the behavior of concurrent programs depends greatly on the facilities available to monitor execution and present the results to the user. Beyond the basic profiling tools that collect data for post-mortem viewing, explorative use of multiprocessor computer systems demands a dynamic monitoring environment capable of providing run-time access to program performance. A prototype of such an

ABSTRACT In real life situations, very often a sudden change in dynamics results in missions being aborted which results in it having to be rescued before damage to other marine craft in the vicinity is caused. This problem has been suitably dealt with by an innovative adaptive autopilot design that is described herein. A model predictive control (MPC) adopts an online adaptive nature by utilizing weighted least squares (WLS). Even with random initialization, significant improvements were achieved by WLS by maintaining the intermittent continuous values of system parameters and periodically reinitializing the covariance matrix. Also, a time frame of 25 seconds appears to be the optimum to reinitialize the parameters. This novel approach enables the autopilot to cope well with significant changes in the system dynamics and empowers USVs to accomplish their desired missions.

ABSTRACT An integrated navigation, guidance and control system is designed for an uninhabited surface vehicle named Springer built at Plymouth University. Interval Kalman filtering is used for navigation. Line of sight is used for guidance. Model predictive control is utilised to build the control system, or autopilot. The performance of this innovative navigation, guidance and control system is benchmarked against a conventional optimal method based on a linear quadratic Gaussian controller which uses traditional Kalman filtering. The performance of the systems are compared and analysed in this paper.

The bronchodilator response to short-acting β2-agonist and short-acting muscarinic antagonist monotherapies varies on a day-to-day basis within individual patients. The objective of this study was to compare daily variation in bronchodilator response to the combined use of albuterol and ipratropium with monotherapies in patients with chronic obstructive pulmonary disease (COPD). This was a 4-week, randomized, open-label, two-period crossover study in patients with COPD. Patients were randomized 1:1 to receive albuterol via metered dose inhaler followed by ipratropium or vice versa during treatment Period 1 (10-14 days). The order of treatments was then reversed during treatment Period 2 (10-14 days). Pre-defined efficacy endpoints were: forced expiratory volume in 1 s (FEV1), derived FEV1, inspiratory capacity (IC) and daily variability of FEV1 and IC as measured by coefficient of variation (CV). Albuterol and ipratropium improved FEV1 when administered as the first bronchodilator, ...

Detecting and quantifying human induced CO2 and other air pollutants are important in air quality as well as in carbon cycle related climate research, particularly for addressing the issue of the continued increase of atmospheric CO2. It is known that isotope compositions are widely used as tracers in source identifications and attributions for atmospheric CO2. Due to a long life

We have fabricated solution processed bulk heterojuction (BHJ) solar cell from small molecule (SM) as donor blended with PCBM as an acceptor. The BHJ showed power conversion efficiency (PCE) up to 2.80%. The PCE has been further improved up to 3.80 % after thermal annealing of the SM: PCBM layer. The higher PCE of the photovoltaic devices based on the

This study uses real system measurements to investigate the relationships between loop granularity, parallel loop distribution and barrier wait times, and their impact on the multiprogramming performance of loop parallel applications on the CEDAR shared-memory multiprocessor The overhead due to multiprogramming varies from 5% for applications with large loop granularity to 140% for applications with very fine-gram loops. This is

The construction of Automated Digital Libraries has grabbed widespread popularity over recent years, rendering the value added services that suit to the tailored user requirements. In this context, carrying out traditional searches over text material by querying upon a given metadata or a set of domain keywords is predominantly observe, not to retrieve the relevant documents, although these end up

Compared to adult medicine, drug use in children is not extensively researched. The objective of present study is to find out drug prescribing pattern in the Department of Pedodontics and Preventive Dentistry and Orthodontics in teaching hospitals in Rajasthan, India. A prospective study was conducted in June 2011. A total of 619 prescriptions were collected randomly. Prescribing pattern was analyzed using WHO basic drug indicator. The average number of drugs and antimicrobial agent prescribed per prescription were 2.24 and 0.81 respectively. Antimicrobial agent contained 81.74% of all prescriptions. Most common groups of drugs prescribed by pedodontist were NSAIDS & Antipyretics (37.7%), Antimicrobial (36.4%) and Vitamins (12.3%). Prophylactic use of antimicrobial agents was 5.5 ± 0.5 days. Fixed dose combination (45.6%) frequently used by brand name. twelve percent generic drugs were used. Most of the drugs were from Essential Drug List especially a only one drug was prescribed. T...

Quantifying human induced CO2 and other air pollutants in ambient air is important in air quality and climate change research. Elemental and organic carbon (EC and OC) components in fine carbonaceous particulate matter (PM) are key air pollutants, existing in urban, rural and remote environments. They are released from various emission sources (e.g., fossil fuel combustion, biomass burning, primary biological

Static Random Access Memory (SRAM) units are often directly integrated onto the same die with the microprocessors and influence the design metrics significantly. SRAM often consumes large percentages of the die size and their leakages significantly contribute to the static power dissipation of those chips. The main objective of this article is to characterize the leakage and acces time(speed) of

In the present work we have synthesized PANI by in-situ chemical oxidative polymerization method. The chemiresistor type gas sensors have been fabricated by deposited tantalum and polyaniline composite thin film on to interdigited electrodes (IDE) configuration using sputtering ad spin coating techniques respectively. The composite thin film was irradiated using 150 MeV Au+7 at the fluence of 1×1011 ions/cm2. The

... Authors: Huang, L.; Zhang, W.; Sharma, S.; Brook, J.; Chan, T.; Leaitch, R. ... Quartz filter samples were collected at the five sites over Canada, from Toronto (a typical urban site), Egbert (a rural site, ~ 80 km northwest of Toronto), to Fraserdale, and Berm-TT (both are continental ...

A middle-aged female with an atrial septal defect (secundum type) presented with a primary pulmonary amoebic abscess. She was successfully treated with antiamoebic therapy. One year later she presented with a similar lung abscess which again responded to antiamboebic treatment. Attention is drawn to the fact that a patient with a left to right shunt can present with a recurrent

Abstract This article analyzes the environmental responsiveness strategies of seven companies in the Canadian oil industry over a 15-year period, during which environmental issues gained increasing public and regulatory attention. These within-industry corporate ...

This article presents the results of a study conducted in two phases within a single industry context. The first phase involved comparative case studies to ground the applicability of the resource-based view of the firm within the domain of environmental responsiveness. The ...