Browsing by Author "Patel, Harsh"

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    Audemes: Exploring the Market Potential of a Sound Based Educational Tool
    (Office of the Vice Chancellor for Research, 2014-04-11) Meyer, Christopher; Ahsan, Sheheryar; Gupta, Vinayak; Parham, Abigail; Patel, Harsh; Qureshi, Mariam
    An Audeme is a 3-5 second non-speech sound that is used to transmit information aurally. Originally created and tested at the Indiana School for the Blind and Visually Impaired by Dr. Steve Manheimmer, Audemes were used as an educational tool that was proven to increase memory retention. The goal for this project is to expand the scope of the project from a BVI market to the larger market of sighted individuals. Specifically, we aim to further our understanding of Audemes by applying it to one specific application, including gaming and productivity. The project has consisted of a literature review of Audemes and its possible market applications; interviews with industry experts, including start-up specialists and lastly, a survey of sound app markets on both Android and Apple to determine profitable market segments. Finally, students at IUPUI will be surveyed to determine the entertainment value and usability of AUDEMES with a sighted audience. Through this proof of concept, we will determine the most profitable area for Audemes development. After establishing this, the future medical prospects could include rehabilitation of individuals with brain damage, use in speech therapy, and use in Alzheimer’s patients to slow deterioration of neural tissue. Additionally, this could be used in the emerging e-book market as well as an educational tool for better memory retention.
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    Prolonged Gastrointestinal Manifestations After Recovery From COVID-19
    (Elsevier, 2023) Elmunzer, B. Joseph; Palsson, Olafur S.; Forbes , Nauzer; Zakaria , Ali; Davis, Christian; Canakis, Andrew; Qayed, Emad; Bick, Benjamin; Pawa, Swati; Tierney, William M.; McLeod, Caroline G.; Taylor, Jason; Patel, Harsh; Mendelsohn, Robin B.; Bala, Gokul; Sloan, Ian; Merchant, Ambreen A.; Smith, Zachary L.; Sendzischew Shane, Morgan A.; Aroniadis, Olga C.; Ordiah, Collins O.; Ruddy, Johannah M.; Simren, Magnus; Tack, Jan; Drossman, Douglas; Medicine, School of Medicine
    Background & Aims Acute enteric infections are well known to result in long-term gastrointestinal (GI) disorders. Although COVID-19 is principally a respiratory illness, it demonstrates significant GI tropism, possibly predisposing to prolonged gut manifestations. We aimed to examine the long-term GI impact of hospitalization with COVID-19. Methods Nested within a large-scale observational cohort study of patients hospitalized with COVID-19 across North America, we performed a follow-up survey of 530 survivors 12–18 months later to assess for persistent GI symptoms and their severity, and for the development of disorders of gut-brain interaction (DGBIs). Eligible patients were identified at the study site level and surveyed electronically. The survey instrument included the Rome IV Diagnostic Questionnaire for DGBI, a rating scale of 24 COVID-related symptoms, the Gastrointestinal Symptoms Rating Scale, and the Impact of Events–Revised trauma symptom questionnaire (a measure of posttraumatic stress associated with the illness experience). A regression analysis was performed to explore the factors associated with GI symptom severity at follow-up. Results Of the 530 invited patients, 116 responded (52.6% females; mean age, 55.2 years), and 73 of those (60.3%) met criteria for 1 or more Rome IV DGBI at follow-up, higher than the prevalence in the US general population (P < .0001). Among patients who experienced COVID-related GI symptoms during the index hospitalization (abdominal pain, nausea, vomiting, or diarrhea), 42.1% retained at least 1 of these symptoms at follow-up; in comparison, 89.8% of respondents retained any (GI or non-GI) COVID-related symptom. The number of moderate or severe GI symptoms experienced during the initial COVID-19 illness by self-report correlated with the development of DGBI and severity of GI symptoms at follow-up. Posttraumatic stress disorder (Impact of Events–Revised score ≥33) related to the COVID-19 illness experience was identified in 41.4% of respondents and those individuals had higher DGBI prevalence and GI symptom severity. Regression analysis revealed that higher psychological trauma score (Impact of Events–Revised) was the strongest predictor of GI symptom severity at follow-up. Conclusions In this follow-up survey of patients 12–18 months after hospitalization with COVID-19, there was a high prevalence of DGBIs and persistent GI symptoms. Prolonged GI manifestations were associated with the severity of GI symptoms during hospitalization and with the degree of psychological trauma related to the illness experience.
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    Serial EUS-Guided FNA for the Surveillance of Pancreatic Cysts: A Study of Long-Term Performance of Tumor Markers
    (Springer, 2022) Rahal, Mahmoud A.; DeWitt, John M.; Patel, Harsh; Schmidt, C. Max; Ceppa, Eugene P.; Simpson, Rachel E.; Sherman, Stuart; Al-Haddad, Mohammad; Medicine, School of Medicine
    Background and aim: The natural history of KRAS mutations in mucinous pancreatic cysts (MPCs) over time remains to be fully understood. The aim of this study was to examine the performance of DNA markers and assess changes of KRAS mutations over time. Methods: Patients who underwent EUS-FNA of pancreatic cysts with at least two separate molecular analysis results were included in the study. We assessed the baseline patient and cyst characteristics, and DNA fluid analysis. The presence of either a KRAS mutation, or a CEA > 192 ng/ml was used as the diagnostic standard for mucinous cysts when surgical pathology was not available. Results: A total of 933 pancreatic cyst fluid samples were collected, including 117 with ≥ 2 FNAs. Examinations were performed over a median of 30 months (range 1-115 months). Forty-three (36%) had a mutant KRAS on the index analysis out of which 26 had a change in their KRAS status to the wild-type. Eighty-one (64%) had a wild-type KRAS on the index analysis out of which 18 had change in their KRAS status to mutant type. There was no significant difference in the index cyst characteristics, presence of symptoms, or main duct involvement based on KRAS status change. Increasing age was associated with a changing KRAS mutation status (p = 0.023). Conclusion: KRAS mutations gain and loss in pancreatic cyst fluid appears to occur frequently during long-term surveillance of MPCs. Age appears to be the only predictor for KRAS change over time.
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    The Environmental Impact of Gastrointestinal Procedures: A Prospective study of Waste Generation, Energy Consumption and Auditing in an Endoscopy Unit
    (Elsevier, 2023) Desai, Madhav; Campbell, Carlissa; Perisetti, Abhilash; Srinivasan, Sachin; Radadiya, Dhruvil; Patel, Harsh; Melquist, Stephanie; Rex, Douglas K.; Sharma, Prateek; Medicine, School of Medicine
    Background & Aims Gastrointestinal (GI) endoscopy procedures are critical for screening, diagnosis, and treatment of a variety of GI disorders. However, like the procedures in other medical disciplines, they are a source of environmental waste generation and energy consumption. Methods We prospectively collected data on total waste generation, energy consumption, and the role of intraprocedural inventory audit of a single tertiary care academic endoscopy unit over a 2-month period (May–June 2022). Detailed data on items used were collected, including procedure type (esophagogastroduodenoscopy or colonoscopy), accessories, intravenous tubing, biopsy jars, linen, and personal protective equipment use. Data on endoscope reprocessing-related waste generation and energy use in the endoscopy unit (equipment, lights, and computers) were also collected. We used an endoscopy staff-guided auditing and review of the items used during procedures to determine potentially recyclable items going to landfill waste. The waste generated was stratified into biohazardous, nonbiohazardous, or potentially recyclable items. Results A total of 450 consecutive procedures were analyzed for total waste management (generation and reprocessing) and energy consumption. The total waste generated during the study period was 1398.6 kg (61.6% directly going to landfill, 33.3% biohazard waste, and 5.1% sharps), averaging 3.03 kg/procedure. The average waste directly going to landfill was 219 kg per 100 procedures. The estimated total annual waste generation approximated the size of 2 football fields (1-foot-high layered waste). Endoscope reprocessing generated 194 gallons of liquid waste per day, averaging 13.85 gallons per procedure. Total energy consumption in the endoscopy unit was 277.1 kW·h energy per day; for every 100 procedures, amounting to 1200 miles of distance traveled by an average fuel efficiency car. The estimated carbon footprint for every 100 GI procedures was 1501 kg carbon dioxide (CO2) equivalent (= 1680 lbs of coal burned), which would require 1.8 acres of forests to sequester. The recyclable waste audit and review demonstrated that 20% of total waste consisted of potentially recyclable items (8.6 kg/d) that could be avoided by appropriate waste segregation of these items. Conclusions On average, every 100 GI endoscopy procedures (esophagogastroduodenoscopy/colonoscopy) are associated with 303 kg of solid waste and 1385 gallons of liquid waste generation, and 1980 kW·h energy consumption. Potentially recyclable materials account for 20% of the total waste. These data could serve as an actionable model for health systems to reduce total waste generation and decrease landfill waste and water waste toward environmentally sustainable endoscopy units.