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Article ; Online: Anaerobic Antibiotic Coverage in Aspiration Pneumonia and the Associated Benefits and Harms: A Retrospective Cohort Study.

Bai, Anthony D / Srivastava, Siddhartha / Digby, Geneviève C / Girard, Vincent / Razak, Fahad / Verma, Amol A

2024

Abstract: Background: Antibiotics with extended anaerobic coverage are used commonly to treat aspiration pneumonia, which is not recommended by current guidelines.: Research question: In patients admitted to hospital for community-acquired aspiration pneumonia, ...

Abstract	Background: Antibiotics with extended anaerobic coverage are used commonly to treat aspiration pneumonia, which is not recommended by current guidelines. Research question: In patients admitted to hospital for community-acquired aspiration pneumonia, does a difference exist between antibiotic therapy with limited anaerobic coverage (LAC) vs antibiotic therapy with extended anaerobic coverage (EAC) in terms of in-hospital mortality and risk of Clostridioides difficile colitis? Study design and methods: We conducted a multicenter retrospective cohort study across 18 hospitals in Ontario, Canada, from January 1, 2015, to January 1, 2022. Patients were included if the physician diagnosed aspiration pneumonia and prescribed guideline-concordant first-line community-acquired pneumonia parenteral antibiotic therapy to the patient within 48 h of admission. Patients then were categorized into the LAC group if they received ceftriaxone, cefotaxime, or levofloxacin. Patients were categorized into the EAC group if they received amoxicillin-clavulanate, moxifloxacin, or any of ceftriaxone, cefotaxime, or levofloxacin in combination with clindamycin or metronidazole. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included incident C difficile colitis occurring after admission. Overlap weighting of propensity scores was used to balance baseline prognostic factors. Results: The LAC and EAC groups included 2,683 and 1,316 patients, respectively. In hospital, 814 patients (30.3%) and 422 patients (32.1%) in the LAC and EAC groups died, respectively. C difficile colitis occurred in 5 or fewer patients (≤ 0.2%) and 11 to 15 patients (0.8%-1.1%) in the LAC and EAC groups, respectively. After overlap weighting of propensity scores, the adjusted risk difference of EAC minus LAC was 1.6% (95% CI, -1.7% to 4.9%) for in-hospital mortality and 1.0% (95% CI, 0.3%-1.7%) for C difficile colitis. Interpretation: Extended anaerobic coverage likely is unnecessary in aspiration pneumonia because it is associated with no additional mortality benefit, only an increased risk of C difficile colitis.
Language	English
Publishing date	2024-02-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2024.02.025
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Article ; Online: Hotspot driven air pollution during crop residue burning season in the Indo-Gangetic Plain, India.

Saharan, Ummed Singh / Kumar, Rajesh / Singh, Siddhartha / Mandal, Tuhin Kumar / Sateesh, M / Verma, Shubha / Srivastava, Akhil

Environmental pollution (Barking, Essex : 1987)

2024 Volume 350, Page(s) 124013

Abstract: Intensive crop residue burning (CRB) in northern India triggers severe air pollution episodes over the Indo-Gangetic Plain (IGP) each year during October and November. We have quantified the contribution of hotspot districts (HSDs) and total CRB to poor ... ...

Abstract	Intensive crop residue burning (CRB) in northern India triggers severe air pollution episodes over the Indo-Gangetic Plain (IGP) each year during October and November. We have quantified the contribution of hotspot districts (HSDs) and total CRB to poor air quality over the IGP. Initially, we investigated the spatiotemporal distribution of CRB fire within the domain and pinpointed five HSD in each Punjab and Haryana. Furthermore, we have simulated air quality and quantified the impact of CRB using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem), incorporating recent anthropogenic emissions (EDGAR v5) and biomass burning emissions (FINN v2.4) inventories, along with MOZART-MOSAIC chemistry. The key finding is that HSDs contributed ∼80% and ∼50% of the total fire counts in Haryana and Punjab, respectively. The model effectively captured observed PM₂.₅ concentrations, with a normalized mean bias (NMB) below 0.2 and R-squared (R
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	280652-6
ISSN	1873-6424 ; 0013-9327 ; 0269-7491
ISSN (online)	1873-6424
ISSN	0013-9327 ; 0269-7491
DOI	10.1016/j.envpol.2024.124013
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Article ; Online: Restoring chaos using deep reinforcement learning.

Vashishtha, Sumit / Verma, Siddhartha

Chaos (Woodbury, N.Y.)

2020 Volume 30, Issue 3, Page(s) 31102

Abstract: A catastrophic bifurcation in non-linear dynamical systems, called crisis, often leads to their convergence to an undesirable non-chaotic state after some initial chaotic transients. Preventing such behavior has been quite challenging. We demonstrate ... ...

Abstract	A catastrophic bifurcation in non-linear dynamical systems, called crisis, often leads to their convergence to an undesirable non-chaotic state after some initial chaotic transients. Preventing such behavior has been quite challenging. We demonstrate that deep Reinforcement Learning (RL) is able to restore chaos in a transiently chaotic regime of the Lorenz system of equations. Without requiring any a priori knowledge of the underlying dynamics of the governing equations, the RL agent discovers an effective strategy for perturbing the parameters of the Lorenz system such that the chaotic trajectory is sustained. We analyze the agent's autonomous control-decisions and identify and implement a simple control-law that successfully restores chaos in the Lorenz system. Our results demonstrate the utility of using deep RL for controlling the occurrence of catastrophes in non-linear dynamical systems.
MeSH term(s)	Computer Simulation ; Deep Learning
Language	English
Publishing date	2020-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1472677-4
ISSN	1089-7682 ; 1054-1500
ISSN (online)	1089-7682
ISSN	1054-1500
DOI	10.1063/5.0002047
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Book ; Online: Answering open questions in biology using spatial genomics and structured methods

Jena, Siddhartha G / Verma, Archit / Engelhardt, Barbara E

2023

Abstract: Genomics methods have uncovered patterns in a range of biological systems, but obscure important aspects of cell behavior: the shape, relative locations of, movement of, and interactions between cells in space. Spatial technologies that collect genomic ... ...

Abstract	Genomics methods have uncovered patterns in a range of biological systems, but obscure important aspects of cell behavior: the shape, relative locations of, movement of, and interactions between cells in space. Spatial technologies that collect genomic or epigenomic data while preserving spatial information have begun to overcome these limitations. These new data promise a deeper understanding of the factors that affect cellular behavior, and in particular the ability to directly test existing theories about cell state and variation in the context of morphology, location, motility, and signaling that could not be tested before. Rapid advancements in resolution, ease-of-use, and scale of spatial genomics technologies to address these questions also require an updated toolkit of statistical methods with which to interrogate these data. We present four open biological questions that can now be answered using spatial genomics data paired with methods for analysis. We outline spatial data modalities for each that may yield specific insight, discuss how conflicting theories may be tested by comparing the data to conceptual models of biological behavior, and highlight statistical and machine learning-based tools that may prove particularly helpful to recover biological insight.
Keywords	Statistics - Applications ; Quantitative Biology - Cell Behavior ; Quantitative Biology - Tissues and Organs
Subject code	004 ; 612
Publishing date	2023-10-14
Publishing country	us
Document type	Book ; Online
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Article: Thoracic follicular dendritic cell sarcoma - an outlandish presentation of a rare tumour with review of literature.

V, Vinay / Bansal, Saraansh / Purwar, Pallavi / Dewan, Ravindra Kumar / Verma, Paras / Mullick, Shalini / Dixit, Mallika / Phanindra, B Rama / Siddhartha, Kanishk

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2022 Volume 93, Issue 2

Abstract: Follicular dendritic cell sarcoma is a rare low grade malignant neoplasm that arises from follicular dendritic cells in lymphoid tissue germinal centres and accounts for 0.4% of all soft tissue sarcomas. It is extremely rare to have pulmonary follicular ... ...

Abstract	Follicular dendritic cell sarcoma is a rare low grade malignant neoplasm that arises from follicular dendritic cells in lymphoid tissue germinal centres and accounts for 0.4% of all soft tissue sarcomas. It is extremely rare to have pulmonary follicular dendritic cell sarcoma with endobronchial extension and as an anterior mediastinal mass with mediastinal lymph node involvement. We present the case of a 34-year-old male non-smoker who had been experiencing chest pain for three months. A lobulated left peri-hilar mass with endobronchial spread into the left main bronchus and mediastinal lymphadenopathy was identified on a chest CT. The bronchoscope-guided cryobiopsy of the endobronchial mass was inconclusive. After a thorough multidisciplinary discussion, the patient underwent left sided pneumonectomy, mediastinal mass resection, and systematic lymph node dissection. Histologic examination using immunohistochemistry revealed follicular dendritic cell sarcoma.
MeSH term(s)	Male ; Humans ; Adult ; Dendritic Cell Sarcoma, Follicular/diagnosis ; Dendritic Cell Sarcoma, Follicular/surgery ; Dendritic Cell Sarcoma, Follicular/pathology ; Mediastinum/pathology ; Lymph Nodes/pathology ; Lymph Node Excision ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-09-20
Publishing country	Italy
Document type	Case Reports ; Review ; Journal Article
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2022.2360
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Article: Analysis of gut bacteriome of

Shukla, Shagun / Srivastava, Ankita / Verma, Digvijay / Gangopadhyay, Siddhartha / Chauhan, Anchal / Srivastava, Vikas / Budhwar, Savita / Tyagi, Dushyant / Sharma, Deepak Chand

Frontiers in microbiology

2023 Volume 14, Page(s) 1147505

Abstract: Introduction: Approximately 200 million people worldwide are affected by arsenic toxicity emanating from the consumption of drinking water containing inorganic arsenic above the prescribed maximum contaminant level. The current investigation deals with ... ...

Abstract	Introduction: Approximately 200 million people worldwide are affected by arsenic toxicity emanating from the consumption of drinking water containing inorganic arsenic above the prescribed maximum contaminant level. The current investigation deals with the role of prenatal arsenic exposure in modulating the gut microbial community and functional pathways of the host. Method: 16S rRNA-based next-generation sequencing was carried out to understand the effects of Results: The study focused on gestational exposure to arsenic and the altered gut microbial community at phyla and genus levels, along with diversity indices. A significant decrease in firmicutes was observed in the gut microbiome of mice treated with arsenic. Functional analysis revealed that a shift in genes involved in crucial pathways such as insulin signaling and non-alcoholic fatty liver disease pathways may lead to metabolic diseases in the host. Discussion: The present investigation may hypothesize that
Language	English
Publishing date	2023-09-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2023.1147505
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Article: Aorto-esophageal fistula: successful open surgical management of two cases.

Pahwa, Siddharth / Bhattacharya, Susmit / Mukhopadhyay, Siddhartha / Verma, Ashok

Journal of surgical case reports

2020 Volume 2020, Issue 6, Page(s) rjaa114

Abstract: An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis ... ...

Abstract	An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis and hemodynamic instability. The aorta in the first patient was normal; the defect was small and was repaired with a Dacron patch. The second patient had an aneurysmal aorta, which was replaced with a Dacron graft. Both cases were performed under partial bypass. The esophageal rent in both patients was debrided, primarily closed and buttressed with a vascularized intercostal pedicle. Nonavailability of endovascular personnel and equipment along with hemodynamic instability of the patient influenced our surgical strategy. Long-term follow-up of these patients is necessary to analyze the outcomes of our surgical repair.
Language	English
Publishing date	2020-06-17
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjaa114
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Article ; Online: Burst-and-coast swimming is not always energetically beneficial in fish (Hemigrammus bleheri).

Ashraf, Intesaaf / Van Wassenbergh, Sam / Verma, Siddhartha

Bioinspiration & biomimetics

2020 Volume 16, Issue 1, Page(s) 16002

Abstract: Burst-and-coast swimming is an intermittent mode of locomotion used by various fish species. The intermittent gait has been associated with certain advantages such as stabilizing the visual field, improved sensing ability, and reduced energy expenditure. ...

Abstract	Burst-and-coast swimming is an intermittent mode of locomotion used by various fish species. The intermittent gait has been associated with certain advantages such as stabilizing the visual field, improved sensing ability, and reduced energy expenditure. We investigate burst-coast swimming in rummy nose tetra fish (Hemigrammus bleheri) using a combination of experimental data and numerical simulations. The experiments were performed in a shallow water channel where the tetra fish swam against an imposed inflow. High speed video recordings of the fish were digitized to extract the undulatory kinematics at various swimming speeds. The kinematics data were then used in Navier-Stokes simulations to prescribe the undulatory motion for three-dimensional geometrical models of the fish. The resulting steady-state speeds of the simulated self-propelled swimmers agree well with the speeds observed experimentally. We examine the power requirements for various realistic swimming modes, which indicate that it is possible to use continuous swimming gaits that require considerably less mechanical energy than intermittent burst-coast modes at comparable speeds. The higher energetic cost of burst-coast swimming suggests that the primary purpose of intermittent swimming may not be to conserve energy, but it may instead be related to a combination of other functional aspects such as improved sensing and the likely existence of a minimum tail-beat frequency. Importantly, using sinusoidal traveling waves to generate intermittent and continuous kinematics, instead of using experiment-based kinematics, results in comparable power requirements for the two swimming modes.
MeSH term(s)	Animals ; Biomechanical Phenomena ; Fishes ; Locomotion ; Models, Biological ; Swimming
Language	English
Publishing date	2020-11-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2235670-8
ISSN	1748-3190 ; 1748-3182
ISSN (online)	1748-3190
ISSN	1748-3182
DOI	10.1088/1748-3190/abb521
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Article: Visualizing droplet dispersal for face shields and masks with exhalation valves.

Verma, Siddhartha / Dhanak, Manhar / Frankenfield, John

Physics of fluids (Woodbury, N.Y. : 1994)

2020 Volume 32, Issue 9, Page(s) 91701

Abstract: Several places across the world are experiencing a steep surge in COVID-19 infections. Face masks have become increasingly accepted as one of the most effective means for combating the spread of the disease when used in combination with social-distancing ...

Abstract	Several places across the world are experiencing a steep surge in COVID-19 infections. Face masks have become increasingly accepted as one of the most effective means for combating the spread of the disease when used in combination with social-distancing and frequent hand-washing. However, there is an increasing trend of people substituting regular cloth or surgical masks with clear plastic face shields and with masks equipped with exhalation valves. One of the factors driving this increased adoption is improved comfort compared to regular masks. However, there is a possibility that widespread public use of these alternatives to regular masks could have an adverse effect on mitigation efforts. To help increase public awareness regarding the effectiveness of these alternative options, we use qualitative visualizations to examine the performance of face shields and exhalation valves in impeding the spread of aerosol-sized droplets. The visualizations indicate that although face shields block the initial forward motion of the jet, the expelled droplets can move around the visor with relative ease and spread out over a large area depending on light ambient disturbances. Visualizations for a mask equipped with an exhalation port indicate that a large number of droplets pass through the exhale valve unfiltered, which significantly reduces its effectiveness as a means of source control. Our observations suggest that to minimize the community spread of COVID-19, it may be preferable to use high quality cloth or surgical masks that are of a plain design, instead of face shields and masks equipped with exhale valves.
Keywords	covid19
Language	English
Publishing date	2020-09-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1472743-2
ISSN	1089-7666 ; 1070-6631
ISSN (online)	1089-7666
ISSN	1070-6631
DOI	10.1063/5.0022968
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Article ; Online: Ceftriaxone and the Risk of Ventricular Arrhythmia, Cardiac Arrest, and Death Among Patients Receiving Lansoprazole.

Bai, Anthony D / Wilkinson, Amelia / Almufleh, Aws / Rai, Mandip / Razak, Fahad / Verma, Amol A / Srivastava, Siddhartha

JAMA network open

2023 Volume 6, Issue 10, Page(s) e2339893

Abstract: Importance: The combination of ceftriaxone and lansoprazole has been shown to prolong the corrected QT interval on electrocardiogram. However, it is unknown whether this translates to clinically important patient outcomes.: Objective: To compare ... ...

Abstract	Importance: The combination of ceftriaxone and lansoprazole has been shown to prolong the corrected QT interval on electrocardiogram. However, it is unknown whether this translates to clinically important patient outcomes. Objective: To compare lansoprazole with another proton pump inhibitor (PPI) during ceftriaxone treatment in terms of risk for ventricular arrhythmia, cardiac arrest, and in-hospital mortality. Design, setting, and participants: A retrospective cohort study including adult medical inpatients receiving ceftriaxone with lansoprazole or another PPI in 13 hospitals in Ontario, Canada, was conducted from January 1, 2015, to December 31, 2021. Exposure: Lansoprazole during ceftriaxone treatment vs other PPIs during ceftriaxone treatment. Main outcomes and measures: The primary outcome was a composite of ventricular arrhythmia or cardiac arrest that occurred after hospital admission. The secondary outcome was all-cause in-hospital mortality. Propensity-score weighting was used to adjust for covariates including hospital site, demographic characteristics, comorbidities, risk factors for ventricular arrhythmia, illness severity, admitting diagnoses, and concomitant medications. Results: Of the 31 152 patients hospitalized on internal medicine wards who were treated with ceftriaxone while receiving a PPI, 16 135 patients (51.8%) were male, and the mean (SD) age was 71.7 (16.0) years. The study included 3747 patients in the lansoprazole group and 27 405 patients in the other PPI group. Ventricular arrhythmia or cardiac arrest occurred in 126 patients (3.4%) within the lansoprazole group and 319 patients (1.2%) within the other PPI group. In-hospital mortality occurred in 746 patients (19.9%) within the lansoprazole group and 2762 patients (10.1%) in the other PPI group. After weighting using propensity scores, the adjusted risk difference for the lansoprazole group minus other PPI group was 1.7% (95% CI, 1.1%-2.3%) for ventricular arrhythmia or cardiac arrest and 7.4% (95% CI, 6.1%-8.8%) for in-hospital mortality. Conclusions and relevance: The findings of this cohort study suggest that combination therapy with lansoprazole and ceftriaxone should be avoided. More studies are needed to determine whether these findings could be replicated in other populations and settings.
MeSH term(s)	Adult ; Humans ; Male ; Aged ; Female ; Lansoprazole/therapeutic use ; Ceftriaxone/adverse effects ; Cohort Studies ; Retrospective Studies ; Arrhythmias, Cardiac/chemically induced ; Arrhythmias, Cardiac/epidemiology ; Heart Arrest/chemically induced ; Heart Arrest/epidemiology ; Proton Pump Inhibitors/adverse effects ; Inpatients ; Ontario/epidemiology
Chemical Substances	Lansoprazole (0K5C5T2QPG) ; Ceftriaxone (75J73V1629) ; Proton Pump Inhibitors
Language	English
Publishing date	2023-10-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.39893
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