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  1. Article: Modeling Zero-inflated Count Data Using Generalized Poisson and Ordinal Logistic Regression Models in Medical Research.

    Yadav, Bijesh / Jeyaseelan, Lakshmanan / Sappani, Marimuthu / Mani, Thenmozhi / George, Sebastian / Bangdiwala, Shrikant I

    Oman medical journal

    2024  Volume 39, Issue 1, Page(s) e586

    Abstract: Objectives: In medical research, the study's design and statistical methods are pivotal, as they guide interpretation and conclusion. Selecting appropriate statistical models hinges on the distribution of the outcome measure. Count data, frequently used ...

    Abstract Objectives: In medical research, the study's design and statistical methods are pivotal, as they guide interpretation and conclusion. Selecting appropriate statistical models hinges on the distribution of the outcome measure. Count data, frequently used in medical research, often exhibit over-dispersion or zero inflation. Occasionally, count data are considered ordinal (with a maximum outcome value of 5), and this calls for the application of ordinal regression models. Various models exist for analyzing over-dispersed data such as negative binomial, generalized Poisson (GP), and ordinal regression model. This study aims to examine whether the GP model is a superior alternative to the ordinal logistic regression (OLR) model, specifically in the context of zero-inflated Poisson models using both simulated and real-time data.
    Methods: Simulated data were generated with varied estimates of regression coefficients, sample sizes, and various proportions of zeros. The GP and OLR models were compared using fit statistics. Additionally, comparisons were made using real-time datasets.
    Results: The simulated results consistently revealed lower bias and mean squared error values in the GP model compared to the OLR model. The same trend was observed in real-time datasets, with the GP model consistently demonstrating lower standard errors. Except when the sample size was 1000 and the proportions of zeros were 30% and 40%, the Bayesian information criterion consistently favored the GP model over the OLR model.
    Conclusions: This study establishes that the proposed GP model offers a more advantageous alternative to the OLR model. Moreover, the GP model facilitates easier modeling and interpretation when compared to the OLR model.
    Language English
    Publishing date 2024-01-31
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2571431-4
    ISSN 2070-5204 ; 1999-768X
    ISSN (online) 2070-5204
    ISSN 1999-768X
    DOI 10.5001/omj.2024.41
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association of antibiotic duration and all-cause mortality in a prospective study of patients with ventilator-associated pneumonia in a tertiary-level critical care unit in Southern India.

    Stanley, Nivin Daniel / Jeevan, Jonathan Arul / Yadav, Bijesh / Gunasekaran, Karthik / Pichamuthu, Kishore / Chandiraseharan, Vignesh Kumar / Sathyendra, Sowmya / Hansdak, Samuel George / Iyyadurai, Ramya

    BMJ open

    2024  Volume 14, Issue 4, Page(s) e077428

    Abstract: Objectives: To estimate all-cause mortality in ventilator-associated pneumonia (VAP) and determine whether antibiotic duration beyond 8 days is associated with reduction in all-cause mortality in patients admitted with VAP in the intensive care unit.: ...

    Abstract Objectives: To estimate all-cause mortality in ventilator-associated pneumonia (VAP) and determine whether antibiotic duration beyond 8 days is associated with reduction in all-cause mortality in patients admitted with VAP in the intensive care unit.
    Design: A prospective cohort study of patients diagnosed with VAP based on the National Healthcare Safety Network definition and clinical criteria.
    Setting: Single tertiary care hospital in Southern India.
    Participants: 100 consecutive adult patients diagnosed with VAP were followed up for 28 days postdiagnosis or until discharge.
    Outcome measures: The incidence of mortality at 28 days postdiagnosis was measured. Tests for association and predictors of mortality were determined using χ
    Results: The overall case fatality rate due to VAP was 46%. There was no statistically significant difference in mortality rates between those receiving shorter antibiotic duration (5-8 days) and those on longer therapy. Among those who survived until day 9, the observed risk difference was 15.1% between both groups, with an HR of 1.057 (95% CI 0.26 to 4.28). In 70.4% of isolates, non-fermenting Gram-negative bacilli were identified, of which the most common pathogen isolated was
    Conclusion: In this hospital-based cohort study, there is insufficient evidence to suggest that prolonging antibiotic duration beyond 8 days in patients with VAP improves survival.
    MeSH term(s) Adult ; Humans ; Pneumonia, Ventilator-Associated/drug therapy ; Pneumonia, Ventilator-Associated/epidemiology ; Prospective Studies ; Anti-Bacterial Agents/therapeutic use ; Cohort Studies ; Intensive Care Units ; India/epidemiology ; Critical Care
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2024-04-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-077428
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Hyperactivation of p21-Activated Kinases in Human Cancer and Therapeutic Sensitivity.

    Sankaran, Deivendran / Amjesh, Revikumar / Paul, Aswathy Mary / George, Bijesh / Kala, Rajat / Saini, Sunil / Kumar, Rakesh

    Biomedicines

    2023  Volume 11, Issue 2

    Abstract: Over the last three decades, p21-activated kinases (PAKs) have emerged as prominent intracellular nodular signaling molecules in cancer cells with a spectrum of cancer-promoting functions ranging from cell survival to anchorage-independent growth to ... ...

    Abstract Over the last three decades, p21-activated kinases (PAKs) have emerged as prominent intracellular nodular signaling molecules in cancer cells with a spectrum of cancer-promoting functions ranging from cell survival to anchorage-independent growth to cellular invasiveness. As PAK family members are widely overexpressed and/or hyperactivated in a variety of human tumors, over the years PAKs have also emerged as therapeutic targets, resulting in the development of clinically relevant PAK inhibitors. Over the last two decades, this has been a promising area of active investigation for several academic and pharmaceutical groups. Similar to other kinases, blocking the activity of one PAK family member leads to compensatory activity on the part of other family members. Because PAKs are also activated by stress-causing anticancer drugs, PAKs are components in the rewiring of survival pathways in the action of several therapeutic agents; in turn, they contribute to the development of therapeutic resistance. This, in turn, creates an opportunity to co-target the PAKs to achieve a superior anticancer cellular effect. Here we discuss the role of PAKs and their effector pathways in the modulation of cellular susceptibility to cancer therapeutic agents and therapeutic resistance.
    Language English
    Publishing date 2023-02-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11020462
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Speckle tracking echocardiography-derived left ventricular global longitudinal strain in ex-thalassaemics

    Amal Paul / Uday Kulkarni / Bijesh Yadav / Fouzia N. Aboobacker / Anup J. Devasia / Anu Korula / Aby Abraham / Biju George / Paul V. George / Alok Srivastava

    PLoS ONE, Vol 18, Iss

    2023  Volume 11

    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Effect of administration of tranexamic acid on blood loss and transfusion requirements in children undergoing posterior fossa tumor excision: a retrospective cohort study.

    Thakkar, Keta / Moorthy, Ranjith K / Yadav, Bijesh / George, Smitha Elizabeth / Singh, Georgene

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2022  Volume 39, Issue 4, Page(s) 877–886

    Abstract: Background: Surgical resection of posterior fossa tumors (PFT) in the pediatric age group often results in significant intraoperative blood loss. The primary objective was to assess the effect of tranexamic acid (TXA) on blood loss and transfusion ... ...

    Abstract Background: Surgical resection of posterior fossa tumors (PFT) in the pediatric age group often results in significant intraoperative blood loss. The primary objective was to assess the effect of tranexamic acid (TXA) on blood loss and transfusion requirement in pediatric patients undergoing excision of PFT.
    Methods: In this retrospective study, all pediatric patients ≤ 18 years, who underwent PFT resection over a period of 7 years, were included. The patient and surgical characteristics, estimated blood loss (EBL), the need for blood and blood product transfusion, use of crystalloids, vasopressors, and any adverse events like seizures and thromboembolic events were recorded and compared between Group A who received TXA and Group B who did not.
    Results: The study included 50 patients, out of which 36 belonged to Group A and 14 to Group B. The median age was 8 years (IQR, 2-17) and the mean BMI was 16.46 ± 4.11 kg/m
    Conclusion: The use of TXA in the pediatric population undergoing PFT resection aids in reducing blood loss during the surgery without increasing complications.
    MeSH term(s) Humans ; Child ; Child, Preschool ; Adolescent ; Tranexamic Acid/therapeutic use ; Retrospective Studies ; Antifibrinolytic Agents/therapeutic use ; Treatment Outcome ; Blood Loss, Surgical/prevention & control ; Blood Transfusion ; Infratentorial Neoplasms/surgery ; Brain Neoplasms
    Chemical Substances Tranexamic Acid (6T84R30KC1) ; Antifibrinolytic Agents
    Language English
    Publishing date 2022-12-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-022-05758-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: End-of-Treatment FDG PET-CT (EOT-PET) in Patients with Post-Chemotherapy Masses for Seminoma: Can We Avoid Further Intervention?

    Joel, Anjana / Singh, Ashish / Hepzibah, Julie / Devasia, Antony / Kumar, Santosh / Gnanamuthu, Birla Roy / Chandramohan, Anuradha / George, Arun Jacob Philip / John, Nirmal Thampi / Yadav, Bijesh / John, Ajoy Oommen / Georgy, Josh Thomas / John, Subhashini / Chacko, Raju Titus

    South Asian journal of cancer

    2022  Volume 11, Issue 4, Page(s) 315–321

    Abstract: ... Anjana ... ...

    Abstract Anjana Joel
    Language English
    Publishing date 2022-08-22
    Publishing country India
    Document type Journal Article
    ZDB-ID 2719571-5
    ISSN 2278-4306 ; 2278-330X
    ISSN (online) 2278-4306
    ISSN 2278-330X
    DOI 10.1055/s-0041-1735480
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Speckle tracking echocardiography-derived left ventricular global longitudinal strain in ex-thalassaemics.

    Paul, Amal / Kulkarni, Uday / Yadav, Bijesh / Aboobacker, Fouzia N / Devasia, Anup J / Korula, Anu / Abraham, Aby / George, Biju / George, Paul V / Srivastava, Alok

    PloS one

    2023  Volume 18, Issue 11, Page(s) e0293452

    Abstract: Aims: Long term survivors of haematopoietic stem cell transplantation (HSCT) for β-thalassemia major are designated "ex-thalassaemics". Whether ex-thalassaemics continue to harbour residual myocardial dysfunction and thereby stand the risk of heart ... ...

    Abstract Aims: Long term survivors of haematopoietic stem cell transplantation (HSCT) for β-thalassemia major are designated "ex-thalassaemics". Whether ex-thalassaemics continue to harbour residual myocardial dysfunction and thereby stand the risk of heart failure-related morbidity and mortality is unknown. The aim of this study was to assess the prevalence and predictors of subclinical left ventricular (LV) dysfunction in an apparently normal ex-thalassaemic population.
    Methods: We conducted a single centre cross-sectional study among 62 ex-thalassaemic patients, who had undergone HSCT for β-thalassaemia major at our centre. The primary outcome variable was LV systolic dysfunction, as assessed by 1) LV global longitudinal strain (GLS) derived by 2D speckle tracking echocardiography and 2) LV ejection fraction (EF) derived by 2D Simpsons Biplane method.
    Results: Among the 62 patients included in the study, 7 [11.3%] were found to have LV systolic dysfunction, all of which were subclinical. Of these, 4 [6.5%] had abnormal GLS and LVEF, 2 [3.2%] had abnormal GLS with normal LVEF, and 1 [1.6%] had abnormal LVEF with low normal mean GLS. There were no statistically significant predictors of LV dysfunction in this cohort.
    Conclusion: There was a high prevalence of subclinical myocardial dysfunction in the ex-thalassaemic population reiterating the need for close follow up of these patients. 2D Speckle tracking echocardiography-derived LV global longitudinal strain is an effective tool in detecting subclinical myocardial dysfunction in this cohort.
    MeSH term(s) Humans ; Global Longitudinal Strain ; Cross-Sectional Studies ; Echocardiography/methods ; Ventricular Function, Left ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/epidemiology ; Stroke Volume ; Cardiomyopathies
    Language English
    Publishing date 2023-11-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0293452
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  8. Article ; Online: Speckle tracking echocardiography-derived left ventricular global longitudinal strain in ex-thalassaemics.

    Amal Paul / Uday Kulkarni / Bijesh Yadav / Fouzia N Aboobacker / Anup J Devasia / Anu Korula / Aby Abraham / Biju George / Paul V George / Alok Srivastava

    PLoS ONE, Vol 18, Iss 11, p e

    2023  Volume 0293452

    Abstract: Aims Long term survivors of haematopoietic stem cell transplantation (HSCT) for β-thalassemia major are designated "ex-thalassaemics". Whether ex-thalassaemics continue to harbour residual myocardial dysfunction and thereby stand the risk of heart ... ...

    Abstract Aims Long term survivors of haematopoietic stem cell transplantation (HSCT) for β-thalassemia major are designated "ex-thalassaemics". Whether ex-thalassaemics continue to harbour residual myocardial dysfunction and thereby stand the risk of heart failure-related morbidity and mortality is unknown. The aim of this study was to assess the prevalence and predictors of subclinical left ventricular (LV) dysfunction in an apparently normal ex-thalassaemic population. Methods We conducted a single centre cross-sectional study among 62 ex-thalassaemic patients, who had undergone HSCT for β-thalassaemia major at our centre. The primary outcome variable was LV systolic dysfunction, as assessed by 1) LV global longitudinal strain (GLS) derived by 2D speckle tracking echocardiography and 2) LV ejection fraction (EF) derived by 2D Simpsons Biplane method. Results Among the 62 patients included in the study, 7 [11.3%] were found to have LV systolic dysfunction, all of which were subclinical. Of these, 4 [6.5%] had abnormal GLS and LVEF, 2 [3.2%] had abnormal GLS with normal LVEF, and 1 [1.6%] had abnormal LVEF with low normal mean GLS. There were no statistically significant predictors of LV dysfunction in this cohort. Conclusion There was a high prevalence of subclinical myocardial dysfunction in the ex-thalassaemic population reiterating the need for close follow up of these patients. 2D Speckle tracking echocardiography-derived LV global longitudinal strain is an effective tool in detecting subclinical myocardial dysfunction in this cohort.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: AKT1 Transcriptomic Landscape in Breast Cancer Cells

    Bijesh George / Bin Gui / Rajeswari Raguraman / Aswathy Mary Paul / Harikrishna Nakshatri / Madhavan Radhakrishna Pillai / Rakesh Kumar

    Cells, Vol 11, Iss 2290, p

    2022  Volume 2290

    Abstract: Overexpression and hyperactivation of the serine/threonine protein kinase B (AKT) pathway is one of the most common cellular events in breast cancer progression. However, the nature of AKT1-specific genome-wide transcriptomic alterations in breast cancer ...

    Abstract Overexpression and hyperactivation of the serine/threonine protein kinase B (AKT) pathway is one of the most common cellular events in breast cancer progression. However, the nature of AKT1-specific genome-wide transcriptomic alterations in breast cancer cells and breast cancer remains unknown to this point. Here, we delineate the impact of selective AKT1 knock down using gene-specific siRNAs or inhibiting the AKT activity with a pan-AKT inhibitor VIII on the nature of transcriptomic changes in breast cancer cells using the genome-wide RNA-sequencing analysis. We found that changes in the cellular levels of AKT1 lead to changes in the levels of a set of differentially expressed genes and, in turn, imply resulting AKT1 cellular functions. In addition to an expected positive relationship between the status of AKT1 and co-expressed cellular genes, our study unexpectedly discovered an inherent role of AKT1 in inhibiting the expression of a subset of genes in both unstimulated and growth factor stimulated breast cancer cells. We found that depletion of AKT1 leads to upregulation of a subset of genes—many of which are also found to be downregulated in breast tumors with elevated high AKT1 as well as upregulated in breast tumors with no detectable AKT expression. Representative experimental validation studies in two breast cancer cell lines showed a reasonable concurrence between the expression data from the RNA-sequencing and qRT-PCR or data from ex vivo inhibition of AKT1 activity in cancer patient-derived cells. In brief, findings presented here provide a resource for further understanding of AKT1-dependent modulation of gene expression in breast cancer cells and broaden the scope and significance of AKT1 targets and their functions.
    Keywords breast cancer ; AKT1 ; RNA-sequencing ; transcriptome ; emerging functions and targets ; cancer therapeutics ; Biology (General) ; QH301-705.5
    Subject code 616
    Language English
    Publishing date 2022-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Absence of posterior pituitary bright spot in adults with CNS tuberculosis: A case-control study.

    G, Smitesh G / Mannam, Pavithra / Kumar, Vignesh / George, Tina / K, Murugabharathy / Prakash, Turaka Vijay / Yadav, Bijesh / Sudarsanam, Thambu David

    PloS one

    2022  Volume 17, Issue 10, Page(s) e0275460

    Abstract: Introduction: Current diagnostic methods used in Central Nervous System Tuberculosis (CNS TB) are limited by the paucibacillary nature of this form of tuberculosis. Posterior pituitary bright spot (PPBS) refers to an area of T1 hyperintensity in the ... ...

    Abstract Introduction: Current diagnostic methods used in Central Nervous System Tuberculosis (CNS TB) are limited by the paucibacillary nature of this form of tuberculosis. Posterior pituitary bright spot (PPBS) refers to an area of T1 hyperintensity in the posterior pituitary in MR imaging of the brain. It is found in 80-90% of healthy children and adults. In children with CNS TB, nearly half have absence of PPBS. This finding has not been described in adults. Our study looked for absence of PPBS in MR imaging and its association with CNS tuberculosis.
    Objective: To study prevalence of the absence of PPBS in patients with CNS tuberculosis when compared to a control group of normal patients.
    Methods: This was a retrospective case-control study of 100 patients with CNS tuberculosis and 200 controls (matched in 1:2 ratio) of patients with normal MRI brain. The MRI images were presented to a blinded radiologist in a randomised sequence to report for absence of PPBS. The data was subsequently analysed to look for association of absence of PPBS with CNS tuberculosis.
    Results: Absence of PPBS (cases (47%), controls (8.5%)) was significantly associated with CNS tuberculosis in (Odds ratio-7.90, 95%CI 4.04-15.44, P-value<0.0001). The specificity, sensitivity, positive predictive value and positive likelihood ratio are 91.5%, 47%, 73.4% and 5.53 respectively. Adding of absence of PPBS as an additional radiological feature in diagnosis of CNS TB increased the sensitivity from 77% to 84%.
    Conclusion: Absence of PPBS is significantly associated with CNS tuberculosis and could be a relatively simple diagnostic aid in the diagnosis of CNS tuberculosis.
    MeSH term(s) Adult ; Case-Control Studies ; Child ; Humans ; Pituitary Gland, Posterior ; Retrospective Studies ; Sensitivity and Specificity ; Tuberculosis/diagnosis ; Tuberculosis, Central Nervous System/diagnostic imaging
    Language English
    Publishing date 2022-10-07
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0275460
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