Publications by authors named "Rashmi Bhardwaj"

17 Publications

  • Page 1 of 1

Application of the Bethesda system of reporting for cervical cytology to evaluate human papilloma virus induced changes in oral leukoplakia, oral squamous cell carcinoma, and oropharyngeal squamous cell carcinoma: A cytomorphological and genetic study.

Diagn Cytopathol 2021 Jun 24. Epub 2021 Jun 24.

Centre for Medical Biotechnology, MDU, Rohtak, India.

Background: Human papilloma virus (HPV) has a well-established carcinogenic role in certain head and neck cancers. These HPV associated cancers possess unique clinicopathological behavior and exhibits better prognosis than their negative counterparts. Detection through polymerase chain reaction (PCR) has been considered as the "gold standard" but imposes burden in low resource settings. Therefore, in the present study, we assessed the validity of cytomorphological features for the detection of HPV in oral leukoplakia (OL), oral squamous cell carcinoma (OSCC), and oropharyngeal squamous cell carcinoma (OPSCC).

Methodology: This study included 63 subjects comprising of 25 OL, 26 OSCC, and 12 OPSCC cases. Exfoliated cells were collected and processed for PCR followed by Papanicolaou staining and subsequent grading. Additionally the non-classical signs were evaluated and statistical analysis included Chi-square and Spearman's test.

Result: 23/63 (36.5%) cases showed PCR positivity for HPV16. Most of the cytomorphological features showed significant correlation for the presence of HPV. A greater sensitivity and specificity was observed in the Bethesda system for reporting cervical cytology (TBS) than the Papanicolaou grading system.

Conclusion: We conclude that the non-classic cytological features could be employed in the detection of HPV in low resource settings with improved sensitivity. Liquid based cytology graded using TBS could be suitable for oral cytology in the detection of early atypical changes.
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http://dx.doi.org/10.1002/dc.24813DOI Listing
June 2021

Bioactive compounds and their libraries: An insight into prospective phytotherapeutics approach for oral mucocutaneous cancers.

Biomed Pharmacother 2021 Jun 15;141:111809. Epub 2021 Jun 15.

Centre for Medical Biotechnology, Maharshi Dayanand University, Rohtak, Haryana, India. Electronic address:

Oral mucocutaneous cancers (OMCs) are cancers that affect both the oral mucosa and perioral cutaneous structures. Common OMCs are squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and malignant melanoma (MM). Anatomical similarities and conventions which categorizes these lesions blur the magnitude of OMCs in diverse populations. The burden of OMC is high in the sub-Saharan Africa and Indian subcontinents, and the cost of management is prohibitive in the resource-limited, developing world. Hence, there is a pressing demand for the use of cost-effective in silico approaches to identify diagnostic tools and treatment targets for diseases with high burdens in these regions. Due to their ubiquitousness and accessibility, the use of therapeutic efficacy of plant bioactive compounds in the management of OMC is both appropriate and plausible. Furthermore, screening known mechanistic disease targets with well annotated plant bioactive compound libraries is poised to improve the routine management of OMCs provided that the requisite access to database resources are available and accessible. Using natural products minimizes the side effects and morbidities associated with conventional therapies. The development of innovative treatments approaches would tremendously benefit the African and Indian populace and reduce the mortalities associated with OMCs in the developing world. Hence, we discuss herein, the potential benefits, opportunities and challenges of using bioactive compound libraries in the management of OMCs.
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http://dx.doi.org/10.1016/j.biopha.2021.111809DOI Listing
June 2021

Nonlinear dynamics for the spread of pathogenesis of COVID-19 pandemic.

J Infect Public Health 2021 Jul 20;14(7):817-831. Epub 2021 Apr 20.

University School of Basic & Applied Sciences (USBAS), Head, Non-Linear Dynamics-Research-Lab, GGS Indraprastha University, New Delhi, India. Electronic address:

Coronaviruses did not invite attention at a global level and responsiveness until the series of 2003-SARS contagion followed by year-2012 MERS plus, most recently, 2019-nCoV eruptions. SARS-CoV &MERS-CoV are painstaking, extremely pathogenic. Also, very evidently, both have been communicated from bats to palm-civets & dromedary camels and further transferred ultimately to humans. No country has been deprived of this viral genomic contamination wherever populaces reside and are interconnected. This study aimed to develop a mathematical model for calculating the transmissibility of this viral genome. The analysis aids the study of the outbreak of this Virus towards the other parts of the continent and the world. The parameters such as population mobility, natural history, epidemiological characteristics, and the transmission mechanism towards viral spread when considered into crowd dynamism result in improved estimation. This article studies the impact of time on the amount of susceptible, exposed, the infected person taking into account asymptomatic and symptomatic ones; recovered i.e., removed from this model and the virus particles existing in the open surfaces. The transition from stable phase to attractor phase happens after 13 days i.e.; it takes nearly a fortnight for the spread to randomize among people. Further, the pandemic transmission remains in the attractor phase for a very long time if no control measures are taken up. The attractor-source phase continues up to 385 days i.e., more than a year, and perhaps stabilizes on 386th day as per the Lyapunov exponent's analysis. The time series helps to know the period of the Virus's survival in the open sources i.e. markets, open spaces and various other carriers of the Virus if not quarantined or sanitized. The Virus cease to exist in around 60 days if it does not find any carrier or infect more places, people etc. The changes in LCEs of all variables as time progresses for around 400 days have been forecasted. It can be observed that phase trajectories indicate how the two variables interact with each other and affect the overall system's dynamics. It has been observed that for exposed and asymptomatically infected (y-z), as exposed ones (y) change from 0 to 100 the value of asymptomatically infected (z) increased upto around 58, at exposed ones (y)=100, asymptomatically infected (z) has two values as 58 and 10 i.e. follows bifurcation and as exposed ones (y) changes values upto 180, the value of asymptomatically infected (z) decreases to 25 so for exposed ones (y) from 100 to 180, asymptomatically infected (z) varies from 58 to 25 to 10 follows bifurcation. Also, phase structures of exposed-symptomatically infected (y-u), exposed-removed (y-v), exposed-virus in the reservoir (y-w), asymptomatically infected-removed (z-v), symptomatically infected-removed (u-v) specifically depict bifurcations in various forms at different points. In case of asymptomatically infected-virus in the reservoir (z-w), at asymptomatically infected (z)=10, the value of viruses in the reservoir (w)=50, then as asymptomatically infected (z) increases to upto around 60. At this point, removed ones (v) increase from 50 to 70 and asymptomatically infected (z) decrease to 20 i.e., crosses the same value twice, which shows its limiting is known as limit cycle behavior and both the values tend to decrease towards zero. It shows a closed-loop limit cycle. Today, there has been no scientific revolution in the development of vaccination, nor has any antiviral treatment been successful, resulting in lack of its medication. Based on the phases, time series, and complexity analysis of the model's various parameters, it is studied to understand the variation in this pandemic's scenario.
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http://dx.doi.org/10.1016/j.jiph.2021.04.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056826PMC
July 2021

In vitro expansion of fetal liver hematopoietic stem cells.

Sci Rep 2021 Jun 4;11(1):11879. Epub 2021 Jun 4.

Sri Sri Institute For Advanced Research (SSIAR), Ved Vignan Maha Vidhya Peeth (VVMVP), F003 Soudhamini Apartment, 21st Kanakpura Road, Art of Living International Center, Udaipura, Bengaluru, 560082, India.

Fetal liver hematopoietic stem and progenitor cells (HSPCs) have been considered appropriate for the management of aplastic anemia owing to their proliferative potential. Bone marrow recovery was possible in some cases; the engraftment potential of these cells, however was unsatisfactory, possibly due to the availability of a smaller number of these cells from a single fetus. The present study explores how we can expand fetal liver hematopoietic stem cells under in vitro conditions. We isolated mononuclear cells from fetal liver and hematopoietic stem cells were identified and analyzed by cell surface marker CD34. CD34 fetal liver HSPCs cells were separated by magnetic cell sorting positive selection method. HSPCs (CD34) were cultured by using 5 cytokines, stem cell factor (SCF), granulocyte macrophages-colony stimulating factor (GM-CSF), interleukin-6 (IL-6), Fms-related tyrosine kinase 3 (FLT-3) and erythropoietin (EPO), in 4 different combinations along with supplements, in serum-free culture media for 21 days. Cell viability continued to be greater than 90% throughout 21 days of culture. The cells expanded best in a combination of media, supplements and 5 cytokines, namely SCF, FLT-3, IL6, EPO and GM-CSF to yield a large number of total (CD34 & CD34) cells. Even though the total number of nucleated cells increased in culture significantly, levels of CD34 antigen expression declined steadily over this period.
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http://dx.doi.org/10.1038/s41598-021-91272-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178329PMC
June 2021

L. and Its Secondary Metabolites in the Management of Different Fungal Pathogens.

Molecules 2021 May 14;26(10). Epub 2021 May 14.

Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak 124001, India.

L. (Family-Asteraceae) is an annual aromatic invasive herb, mainly distributed over the tropical and subtropical regions of the world. It owns a reputed history of indigenous remedial uses, including as a wound dressing, an antimicrobial, and mouthwash as well as in treatment of dysentery, diarrhea, skin diseases, etc. In this review, the core idea is to present the antifungal potential of the selected medicinal plant and its secondary metabolites against different fungal pathogens. Additionally, toxicological studies (safety profile) conducted on the amazing plant L. are discussed for the possible clinical development of this medicinal herb. Articles available from 2000 to 2020 were reviewed in detail to exhibit recent appraisals of the antifungal properties of . Efforts were aimed at delivering evidences for the medicinal application of by using globally recognized scientific search engines and databases so that an efficient approach for filling the lacunae in the research and development of antifungal drugs can be adopted. After analyzing the literature, it can be reported that the selected medicinal plant effectively suppressed the growth of numerous fungal species, such as , , , , , and , owing to the presence of various secondary metabolites, particularly chromenes, terpenoids, flavonoids and coumarins. The possible mechanism of action of different secondary metabolites of the plant against fungal pathogens is also discussed briefly. However, it was found that only a few studies have been performed to demonstrate the plant's dosage and safety profile in humans. Considered all together, extract and its constituents may act as a promising biosource for the development of effective antifungal formulations for clinical use. However, in order to establish safety and efficacy, additional scientific research is required to explore chronic toxicological effects of , to determine the probability of interactions when used with different herbs, and to identify safe dosage. The particulars presented here not only bridge this gap but also furnish future research strategies for the investigators in microbiology, ethno-pharmacology, and drug discovery.
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http://dx.doi.org/10.3390/molecules26102933DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156077PMC
May 2021

Molecular and Immunohistochemical Cognizance of HPV16 in Oral Leukoplakia, Oral Squamous Cell Carcinoma and Oropharyngeal Squamous Cell Carcinoma.

Head Neck Pathol 2021 Feb 28. Epub 2021 Feb 28.

Centre for Medical Biotechnology, MDU, Rohtak, Haryana, 124001, India.

Prior studies have established the carcinogenic role of HPV16 and also demonstrated its unique biological behavior in cervical and oropharyngeal squamous cell carcinoma (OPSCC) but its role in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) is not well explored. Therefore, in the present study, we assessed HPV16 prevalence using PCR and Anti-HPV16 antibodies for the first time and correlated its biological behavior using p16 and Ki67 proliferation index (PI) in OL, OSCC, and OPSCC. This study included 63 subjects comprising of 25 OL, 26 OSCC, and 12 OPSCC cases. Exfoliated cells were collected and processed for PCR followed by immunohistochemistry with primary antibodies p16, Anti-HPV16, and Ki67. The expressions were evaluated and statistical analysis included Chi-square and Spearman's test. Cumulatively 37% (OL-7%, OSCC-14% & OPSCC-16%) of cases showed positive PCR expression. PCR positivity was observed to be significantly higher (p 0.00) in OPSCC (9/12) than OSCC (9/26) and OL (5/25) cases. Overall immunohistochemical expression of p16, Anti-HPV16, and Ki67 were significantly (p 0.02) higher in HPV16 (PCR) positive cases. HPV16 + OSCC cases showed higher grades of p16 and Ki67 expression. We have demonstrated a prevalence of HPV16 in OL, OSCC, and OPSCC through PCR, which may be concluded as a gold standard for the detection of HPV16 DNA.
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http://dx.doi.org/10.1007/s12105-021-01309-5DOI Listing
February 2021

Mesenchymal stem cell immunomodulation and regeneration therapeutics as an ameliorative approach for COVID-19 pandemics.

Life Sci 2020 Dec 10;263:118588. Epub 2020 Oct 10.

Centre for Medical Biotechnology, Maharshi Dayanand University Rohtak, 124001, India. Electronic address:

The severe acute respiratory syndrome-novel coronavirus mediated COVID-19 has been recently declared a pandemic by the World Health Organization. The primary target of the SARS-CoV-2 virus is the human lungs governed by the ACE-2 receptor of epithelial type II cells/endothelial cells, which promote modulation of the immune response of host cells through generating cytokine storm, inflammation, severe pneumonia symptoms, and secondary complications such as acute respiratory distress syndrome. Although numerous antiviral and anti-parasitic drugs are under clinical trials to combat this pandemic, to date, neither a specific treatment nor any successful vaccine has been established, urging researchers to identify any potential candidate for combating the disease. Mesenchymal stem cells own self-renewal, differentiation, homing, immunomodulation and remains unaffected by the coronavirus on the virtue of the absence of ACE-2 receptors, indicating that MSC's could be used an ameliorative approach for COVID-19. MSCs have shown to combat the disease via various pathways such as repairing the lung epithelial and endothelial cells, reducing hyperimmune response, maintaining the renin-angiotensin system. Although MSCs-based treatment approaches for COVID-19 is still under consideration with limited data, many human clinical trials of MSC's has been initiated to explore their potential for COVID 19 treatment. The current review summarizes and emphasizes on how MSC's modulate the immune response, can repair the lungs from the impact of the virus, and various aspects of MSC's as a remedial source for COVID-19, to provide better insight for biomedical researchers and for those who are fascinated by stem cells as a therapeutic approach.
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http://dx.doi.org/10.1016/j.lfs.2020.118588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547615PMC
December 2020

Correction to: Statistical, time series and fractal analysis of full stretch of river Yamuna (India) for water quality management.

Environ Sci Pollut Res Int 2020 Nov;27(33):42189-42191

USBAS, GGS Indraprastha University, Delhi, India.

As corresponding author, while going through higher research in this area, it is found that the formula for Hurst exponent given in equation (13) on page no. 401 is wrongly written.
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http://dx.doi.org/10.1007/s11356-020-10639-wDOI Listing
November 2020

Hematopoietic Stem Cells Culture, Expansion and Differentiation: An Insight into Variable and Available Media.

Int J Stem Cells 2020 Nov;13(3):326-334

Centre for Medical Biotechnology, Maharshi Dayanand University, Rohtak, India.

Owing to differentiation and self-renewal capacity, hematopoietic stem cells clasp potentiality to engender all blood cell types, leading to their immense competence to play a diverse role in therapeutic applications. Although these stem cells are the most investigated and exploited until now, further research is still essential to comprehend their nature, fate, and potential. Enhanced usage of hematopoietic stem cells in research and therapeutics intensified the requirement of expansion and differentiation of hematopoietic stem cells under conditions. Since these cells remain in senescence for a prolonged period before isolation, selection of appropriate growth medium along with supplements and culture conditions are crucial to initiate their cell division and to designate their destiny. The precise equilibrium between self-renewal and differentiation of stem cells sustained by exclusive medium along with special growth or differentiation factors is accountable for generating diverse cell lineages. Maintenance of hematopoietic stem and progenitor cell lines along with the advancement of research work generate an inexorable demand for production and commercialization of specialized stem cell culture media, with or without serum along with specific growth factors and supplements. Media commercialization for precise stem cell types, culturing and differentiation is a cost-effective developing field. Here in this review, we are assembling various types of hematopoietic stem cell self-renewal, expansion and differentiation media along with supplements and culture conditions, either developed and used by various scientists or are available commercially.
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http://dx.doi.org/10.15283/ijsc19157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691860PMC
November 2020

Data driven estimation of novel COVID-19 transmission risks through hybrid soft-computing techniques.

Chaos Solitons Fractals 2020 Nov 25;140:110152. Epub 2020 Jul 25.

Research Scholar, USBAS, GGS Indraprastha University, Delhi, India.

Coronavirus genomic infection-2019 (COVID-19) has been announced as a serious health emergency arising international awareness due to its spread to 201 countries at present. In the month of April of the year 2020, it has certainly taken the pandemic outbreak of approximately 11,16,643 infections confirmed leading to around 59,170 deaths have been recorded world-over. This article studies multiple countries-based pandemic spread for the development of the COVID-19 originated in the China. This paper focuses on forecasting via real-time responses data to inherit an idea about the increase and maximum number of virus-infected cases for the various regions. In addition, it will help to understand the panic that surrounds this nCoV-19 for some intensely affecting states possessing different important demographic characteristics that would be affecting the disease characteristics. This study aims at developing soft-computing hybrid models for calculating the transmissibility of this genome viral. The analysis aids the study of the outbreak of this virus towards the other parts of the continent and the world. A hybrid of wavelet decomposed data into approximations and details then trained & tested through neuronal-fuzzification approach. Wavelet-based forecasting model predicts for shorter time span such as five to ten days advanced number of confirmed, death and recovered cases of China, India and USA. While data-based prediction through interpolation applied through moving average predicts for longer time spans such as 50-60 days ahead with lesser accuracy as compared to that of wavelet-based hybrids. Based on the simulations, the significance level (alpha) ranges from 0.10 to 0.67, MASE varying from 0.06 to 5.76, sMAPE ranges from 0.15 to 1.97, MAE varies from 22.59 to 6024.76, RMSE shows a variation from 3.18 to 8360.29 & R varying through 0.0018 to 0.7149. MASE and sMAPE are relatively lesser applied and novel measures that aimed to achieve increase in accuracy. They eliminated skewness and made the model outlier-free. Estimates of the awaited outburst for regions in this study are India, China and the USA that will help in the improvement of apportionment of healthcare facilities as it can act as an early-warning system for government policy-makers. Thus, data-driven analysis will provide deep insights into the study of transmission of this viral genome estimation towards immensely affected countries. Also, the study with the help of transmission concern aims to eradicate the panic and stigma that has spread like wildfire and has become a significant part of this pandemic in these times.
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http://dx.doi.org/10.1016/j.chaos.2020.110152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381942PMC
November 2020

Recurrence quantification analysis of a three level trophic chain model.

Heliyon 2019 Aug 30;5(8):e02182. Epub 2019 Aug 30.

University School of Basic Sciences, Guru Gobind Singh Indraprastha University, Dwarka, Delhi, India.

Recurrence plots and recurrence quantification analysis based measures - recurrence rate, determinism, divergence, entropy, laminarity and trapping time, are used to detect transitions between periodic and chaotic states and also the laminar states of the complex three species food web model with improved growth rate function and predatory ability. The study of dynamical equation of such a complex biological system with transients in terms of these measures results in localization of bifurcation behavior of the system.
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http://dx.doi.org/10.1016/j.heliyon.2019.e02182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726590PMC
August 2019

Variability analysis in PM2.5 monitoring.

Data Brief 2019 Jun 14;24:103774. Epub 2019 Mar 14.

Guru Gobind Singh Indraprastha University, India.

United States Environmental Protection Agency (US EPA) and Central Pollution Control Board (CPCB) are two major air quality monitoring agencies in India that measure the concentration of particulate matter of size up to 2.5 μm (PM2.5). PM2.5 study over southern Asia has significance from the environment and ecosystem viewpoint (Abdullah et al.,2007; Dockery and Stone, 2007). In order to raise alert and controlling of pollutants, not only forecasting but the accuracy of forecasting has attracted attentions from various departments of research and air quality monitoring agencies. Quest for reducing error in forecasting has never come to pause. The precursor in forecasting is data monitoring. Keeping in focus the initial phase of data analysis, PM2.5 concentration was collected from both agencies within an area of radius 3.1 miles for the year 2016. Using the data, variability analysis is carried out for the efficiency of vital environment protection agencies.
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http://dx.doi.org/10.1016/j.dib.2019.103774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468191PMC
June 2019

Anti-CD117 antibody depletes normal and myelodysplastic syndrome human hematopoietic stem cells in xenografted mice.

Blood 2019 05 11;133(19):2069-2078. Epub 2019 Feb 11.

Division of Blood and Marrow Transplantation, Department of Medicine.

The myelodysplastic syndromes (MDS) represent a group of clonal disorders that result in ineffective hematopoiesis and are associated with an increased risk of transformation into acute leukemia. MDS arises from hematopoietic stem cells (HSCs); therefore, successful elimination of MDS HSCs is an important part of any curative therapy. However, current treatment options, including allogeneic hematopoietic cell transplantation (HCT), often fail to ablate disease-initiating MDS HSCs, and thus have low curative potential and high relapse rates. Here, we demonstrate that human HSCs can be targeted and eliminated by monoclonal antibodies (mAbs) that bind cell-surface CD117 (c-Kit). We show that an anti-human CD117 mAb, SR-1, inhibits normal cord blood and bone marrow HSCs in vitro. Furthermore, SR-1 and clinical-grade humanized anti-human CD117 mAb, AMG 191, deplete normal and MDS HSCs in vivo in xenograft mouse models. Anti-CD117 mAbs also facilitate the engraftment of normal donor human HSCs in MDS xenograft mouse models, restoring normal human hematopoiesis and eradicating aggressive pathologic MDS cells. This study is the first to demonstrate that anti-human CD117 mAbs have potential as novel therapeutics to eradicate MDS HSCs and augment the curative effect of allogeneic HCT for this disease. Moreover, we establish the foundation for use of these antibody agents not only in the treatment of MDS but also for the multitude of other HSC-driven blood and immune disorders for which transplant can be disease-altering.
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http://dx.doi.org/10.1182/blood-2018-06-858159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509544PMC
May 2019

Statistical, time series, and fractal analysis of full stretch of river Yamuna (India) for water quality management.

Environ Sci Pollut Res Int 2015 Jan 1;22(1):397-414. Epub 2014 Aug 1.

Non-Linear Dynamics Research Laboratory, Department of Mathematics, University School of Basic and Applied Sciences, Guru Gobind Singh Indraprastha University, Dwarka, Delhi, 110078, India,

River water is a major resource of drinking water on earth. Management of river water is highly needed for surviving. Yamuna is the main river of India, and monthly variation of water quality of river Yamuna, using statistical methods have been compared at different sites for each water parameters. Regression, correlation coefficient, autoregressive integrated moving average (ARIMA), box-Jenkins, residual autocorrelation function (ACF), residual partial autocorrelation function (PACF), lag, fractal, Hurst exponent, and predictability index have been estimated to analyze trend and prediction of water quality. Predictive model is useful at 95% confidence limits and all water parameters reveal platykurtic curve. Brownian motion (true random walk) behavior exists at different sites for BOD, AMM, and total Kjeldahl nitrogen (TKN). Quality of Yamuna River water at Hathnikund is good, declines at Nizamuddin, Mazawali, Agra D/S, and regains good quality again at Juhikha. For all sites, almost all parameters except potential of hydrogen (pH), water temperature (WT) crosses the prescribed limits of World Health Organization (WHO)/United States Environmental Protection Agency (EPA).
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http://dx.doi.org/10.1007/s11356-014-3346-1DOI Listing
January 2015

Patients' perspectives on timing of urinary catheter removal after surgery.

Br J Nurs 2012 Oct 11-24;21(18):S4, S6-9

Newcastle University.

Unlabelled: A prolonged catheter duration is a major risk factor for catheter-associated urinary tract infection, with bacteriuria increasing by 5% per day (Gokula et al, 2004).

Aim: In this study, the authors explored patients' perceptions of the care process relating to peri-operative catheterisation to identify patient factors that encourage early removal.

Method: Semi-structured interviews, incorporating a grounded theory approach, were performed on three men and seven women during 2010. Interviews were transcribed and analysed using constant comparative method and thematic framework analysis.

Results: Catheter duration ranged 1-10 days. Main themes elicited included: lack of understanding of the purpose and catheterisation process; loss of patient autonomy and dignity; and impact of environmental factors.

Conclusion: Lack of knowledge of the catheterisation process among participants led to fears and concerns that may have contributed to delayed catheter removal. Changes to patient care that are likely to reduce catheter duration include ensuring the provision of pre-operative information, greater patient involvement in catheter removal decisions, and provision of easily accessible toilet facilities.
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http://dx.doi.org/10.12968/bjon.2012.21.Sup18.S4DOI Listing
December 2012

Reduced ribosomal protein gene dosage and p53 activation in low-risk myelodysplastic syndrome.

Blood 2011 Sep 25;118(13):3622-33. Epub 2011 Jul 25.

Departments of Genetics, Stanford University, Stanford, CA, USA.

Reduced gene dosage of ribosomal protein subunits has been implicated in 5q- myelodysplastic syndrome and Diamond Blackfan anemia, but the cellular and pathophysiologic defects associated with these conditions are enigmatic. Using conditional inactivation of the ribosomal protein S6 gene in laboratory mice, we found that reduced ribosomal protein gene dosage recapitulates cardinal features of the 5q- syndrome, including macrocytic anemia, erythroid hypoplasia, and megakaryocytic dysplasia with thrombocytosis, and that p53 plays a critical role in manifestation of these phenotypes. The blood cell abnormalities are accompanied by a reduction in the number of HSCs, a specific defect in late erythrocyte development, and suggest a disease-specific ontogenetic pathway for megakaryocyte development. Further studies of highly purified HSCs from healthy patients and from those with myelodysplastic syndrome link reduced expression of ribosomal protein genes to decreased RBC maturation and suggest an underlying and common pathophysiologic pathway for additional subtypes of myelodysplastic syndrome.
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http://dx.doi.org/10.1182/blood-2010-11-318584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3186336PMC
September 2011

Documented adherence to standards and guidelines: an audit.

Br J Nurs 2010 Oct 14-27;19(18):S26-30

(Catheter Study), Newcastle‑upon-Tyne Hospitals NHS Foundation Trust.

The authors conducted a cross-sectional audit within Newcastle-upon-Tyne Hospitals NHS Foundation Trust to determine the prevalence of urethral catheterisation and documented adherence to relevant NHS standards. An on-line audit questionnaire was completed for all 80 inpatient wards within the Trust on a single day during the third week in June 2009. The tool collected data on prevalence and care requirements detailed in the Department of Health's (DH) Saving Lives High Impact Intervention 6 (2007). Data were analysed using Snap survey software. Overall, 172 of 1187 (14.5%) inpatients were catheterized and all were using a closed drainage system or catheter valve. Evidence of correct continuing catheter care was documented for 168 (98%) patients, while details of catheter insertion were identified in 153 (89%) patient records. Eight (4.5%) patients were being treated for a urinary tract infection. The authors found satisfactory adherence to basic documentation standards with regard to catheter care. This was associated with a low prevalence rate of catheterization and catheter-associated urinary infection within the Trust relative to previously published figures. Details of catheter insertion were missing from 10% of patient records, requiring further development of accessible and transferable documentation tools. Provision of relevant information to patients is also a target for development.
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http://dx.doi.org/10.12968/bjon.2010.19.Sup8.79066DOI Listing
December 2010
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