Hepatic Enzyme’s Reference Intervals and Their Modulating Factors in Western Indian Population     

Shalini N. Maksane  Sucheta P. Dandekar  Akash Shukla  Shobna Bhatia 《Indian journal of clinical biochemistry : IJCB》2016,31(1):108-116

The reference intervals (RIs) of serum aminotransferases and Gamma-glutamyl transferase (GGT) have been established many years ago. Recent RIs are not available. The prospective study was conducted to re-evaluate the RIs of liver enzymes and the effect of demographic and anthropometric variables on them in western Indian population. A total of 1059 blood donors comprised the study population. Anthropometry and serum liver enzymes levels were measured. Subjects were categorized into normal weight and overweight by using body mass index (BMI) and waist circumference (WC). For RI determination, non-parametric methodology recommended by IFCC/CLSI was adopted. Mann–Whitney test and Spearman’s rank correlation were used for statistical analysis. Upper limit of normal reference value of liver enzymes were lower in female compared to male. (ALT—23.55 F vs 36.00 M, GGT—34.58 F vs 36.20 M) When RI of liver enzymes were calculated according to body mass index, the upper limit of normal of ALT and GGT were higher in overweight group compared to normal weight group. (ALT—38.00 vs 27.00 IU/L and GGT—37.59 vs 35.26 IU/L). In both male and female, liver enzymes correlated significantly with age. WC and BMI were positively correlated with AST, ALT and GGT in both subgroups and the correlation was stronger in male. Demographic factors should be considered for making liver enzyme tests more clinically relevant. Gender based partitioning should be adopted for serum alanine aminotransferase (ALT) and GGT reference values for Western Indian population.  相似文献   

Revisiting the scrambling complexity hypothesis in sentence processing: a self-paced reading study on anomaly detection and scrambling in Hindi     

Ramesh K. Mishra  Aparna Pandey  Narayanan Srinivasan 《Reading and writing》2011,24(6):709-727

The scrambling complexity hypothesis based on working memory or locality accounts as well as syntactic accounts have proposed that processing a scrambled structure is difficult. However, the locus of this difficulty in sentence processing remains debatable. Several studies on multiple languages have explored the effect of scrambling on sentence processing and not all languages have shown an advantage for the canonical word order. Using a self-paced reading paradigm, we studied the effect of scrambling on semantic anomaly detection in Hindi sentence comprehension employing three word order types. Reading times on critical verbs, judgment latency, and error rates showed significant effect of word order type. The results further revealed significant interactions between word order and anomaly type. The patterns of results suggest that the canonical word order does not necessarily have a processing advantage in terms of speed and accuracy over non-canonical orders and do not provide support to sentence processing accounts that assume an advantage for canonical structures. The results indicate that processing speed depends on the distance between the subject and the verb, thus supporting a locality dependent working memory based model of sentence processing. The results provide evidence for the role of specific cognitive processes in Hindi sentence processing with further implications for language and literacy acquisition in Hindi.  相似文献   

Effect of l-Arginine on Nitric Oxide Levels in Intrauterine Growth Restriction and its Correlation with Fetal Outcome     

Shalini Singh  Archana Singh  Deepika Sharma  Abha Singh  M. K. Narula  Jayashree Bhattacharjee 《Indian journal of clinical biochemistry : IJCB》2015,30(3):298-304

The current management of intrauterine growth restriction (IUGR) being empirical and aimed at selecting a safe time for delivery. Acknowledging the beneficial effects of l-arginine on endothelial vasculature the present study was designed to evaluate efficacy of l-arginine on bioavailability of nitric oxide (NO) with respect to fetal outcome. With l-arginine supplementation, mean NO levels were significantly increased and a significant mild reduction in systolic/end-diastolic velocity ratio (S/D ratio) was observed on doppler blood flow study, also neonatal outcome improved and incidences of complications were lowered. A deficiency in NO may play an important role in the causation of asymmetric fetal growth restriction. l-Arginine can be used to increase maternal NO levels, enhancing birth weight and decreasing neonatal morbidity. The ideal candidate for arginine therapy according to our study would be IUGR cases with S/D ratio less than 4.96 ± 0.49 and NO levels below 33 μmol/L with minimum of 3 weeks duration of arginine supplementation.  相似文献   

Evaluation of Preanalytical Quality Indicators by Six Sigma and Pareto`s Principle     

Sweta Kulkarni  R. Ramesh  A. R. Srinivasan  C. R. Wilma Delphine Silvia 《Indian journal of clinical biochemistry : IJCB》2018,33(1):102-107

Preanalytical steps are the major sources of error in clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of laboratory and its quality measures. Hence in the present study six sigma and Pareto principle was applied to preanalytical quality indicators to evaluate the clinical biochemistry laboratory performance. This observational study was carried out for a period of 1 year from November 2015–2016. A total of 1,44,208 samples and 54,265 test requisition forms were screened for preanalytical errors like missing patient information, sample collection details in forms and hemolysed, lipemic, inappropriate, insufficient samples and total number of errors were calculated and converted into defects per million and sigma scale. Pareto`s chart was drawn using total number of errors and cumulative percentage. In 75% test requisition forms diagnosis was not mentioned and sigma value of 0.9 was obtained and for other errors like sample receiving time, stat and type of sample sigma values were 2.9, 2.6, and 2.8 respectively. For insufficient sample and improper ratio of blood to anticoagulant sigma value was 4.3. Pareto`s chart depicts out of 80% of errors in requisition forms, 20% is contributed by missing information like diagnosis. The development of quality indicators, application of six sigma and Pareto`s principle are quality measures by which not only preanalytical, the total testing process can be improved.  相似文献   

Return to Babel: Emergent Diversity, Digital Resources, and Local Knowledge     

Robin Boast  Michael Bravo  Ramesh Srinivasan 《The Information Society》2007,23(5):395-403

Information system research that recognizes, supports, and enables access of diverse knowledge communities online has become a major concern. Of particular concern is how these digital resources can support and preserve local identities and promote grass-roots involvement in creating the infrastructure of devolved governance. The aim of this article is to expose some of the conceptual obstacles to programs of devolved and local knowledge resources, and to provide an account of agency that recognizes that online communities, and community identity, are essential for eliciting, managing, and sharing local knowledges. Further, this article demonstrates how the implications of these issues impact institutions for managing knowledge that may be extended to all sorts of knowledge communities.  相似文献   

A randomized trial comparing cadaveric dissection and examination of prosections as applied surgical anatomy teaching pedagogies     

Zong Jie Koh  Marcus Yeow  Dinesh Kumar Srinivasan  Yee Kong Ng  Gominda G. Ponnamperuma  Choon Seng Chong 《Anatomical sciences education》2023,16(1):57-70

Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. A randomized controlled trial design was employed to compare both the immediate and long-term effectiveness of dissection and prosection. Eighty third-year medical students undergoing their surgical rotation from the Yong Loo Lin School of Medicine were randomized into two groups: dissection and prosection. Each participated in a one-day hands-on course following a similar outline that demonstrated surgical anatomy in the context of its clinical relevance. A pre-course test was conducted to establish baseline knowledge. A post-course test was conducted immediately after and at a one-year interval to evaluate learner outcome and knowledge retention. A post-course survey was conducted to assess participant perception. Thirty-nine and thirty-eight participants for the dissection and prosection groups, respectively, were included for analysis. There was no significant difference between mean pre-course test scores between the dissection and prosection groups [12.6 (3.47) vs. 12.7 (3.16), P > 0.05]. Both the mean immediate [27.9 (4.30) vs. 24.9 (4.25), P < 0.05] and 1 year [23.9 (4.15) vs. 19.9 (4.05), P < 0.05] post-course test scores were significantly higher in the dissection group. However, when adjusted for course duration [dissection group took longer than prosection group (mean 411 vs. 265 min)], these findings were negated. There is no conclusive evidence of either pedagogy being superior in teaching surgical anatomy. Based on learner surveys, dissection provides a greater learner experience.  相似文献   

Children's developing ability to adjust their beliefs reasonably in light of disagreement     

Antonia F. Langenhoff  Jan M. Engelmann  Mahesh Srinivasan 《Child development》2023,94(1):44-59

Two preregistered experiments (N = 218) investigated children's developing ability to respond reasonably to disagreement. U.S. children aged 4–9, and adults (50% female, mostly white) formed an initial belief, and were confronted with the belief of a disagreeing other, whose evidence was weaker, stronger than, or equal to participants' evidence. With age, participants were increasingly likely to maintain their initial belief when their own evidence was stronger, adopt the other's belief when their evidence was weaker, and suspend judgment when both had equally strong evidence. Interestingly, 4- to 6-year-olds only suspended judgment reliably when this was assessed via the search for additional information (Experiment 2). Together, our experiments suggest that the ability to respond reasonably to disagreement develops over the preschool years.  相似文献   

Counterfactual choices and moral judgments in children     

Shalini Gautam  Ruby Owen Hall  Thomas Suddendorf  Jonathan Redshaw 《Child development》2023,94(5):e296-e307

When making moral judgments of past actions, adults often think counterfactually about what could have been done differently. Considerable evidence suggests that counterfactual thinking emerges around age 6, but it remains unknown how this development influences children's moral judgments. Across two studies, Australian children aged 4–9 (N = 236, 142 Females) were told stories about two characters who had a choice that led to a good or bad outcome, and two characters who had no choice over a good or bad outcome. Results showed that 4- and 5-year-olds’ moral judgments were influenced only by the actual outcome. From age 6, children's moral judgments were also influenced by the counterfactual choices that had been available to the characters.  相似文献