30 results on '"Ramanan, T."'
Search Results
2. Do job competencies influence the satisfaction of customers? An investigation in the cooperative banking sector
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Shanujas, V. and Radha Ramanan, T.
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- 2023
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3. A risk comparison framework for evaluating the impact of telecom cloudification in organizational risk profile
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Jose, Binesh, Ramanan, T. Radha, and Kumar, S. D. Madhu
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- 2021
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4. An empirical introspection of the library website from user perspectives: resource gateways versus Web Content Management Systems (WCMS) in higher educational institutions.
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Silva, M. A. L., Ramanan, T., and Kuruppu, D. C.
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INTERNET content management systems , *LIBRARY websites , *ACADEMIC libraries , *UNIVERSITIES & colleges , *SELECTIVE dissemination of information , *CHATBOTS , *COVID-19 pandemic - Abstract
Library websites being the virtual or digital facet of any library it is paramount to constantly evaluate and enhance the interface with necessary resources and services. In this regard, this study was carried out to analyze a range of opinions and feedbacks from stakeholders of a university library, which has published the links to subscribed databases, training guides, reference services, and research support services on its website. Due to the restrictions on mobility by economic crisis and Corona pandemic, library users heavily relied on digital interfaces to share and retrieve information. In this regard, a survey was carried out to explore the demand and desire of the library users as whether the library website satisfies them or does it need redesigning. Convenient sampling technique was employed where hundred and fifteen (115) users had responded to semi-structured questionnaires. Data extracted were analyzed using the Pearson Chi-square test, one-way ANOVA, and one sample Wilcoxon sign rank test. Majority (33.3%) of the students of the Faculty of Science were using the library website more frequently than the students of other faculties. Responses showed that the Training Guides (Mean=4.00; SD = ±0.926) and past-paper portals (Mean=3.96; SD = ±0.989) accessed via the library website were useful. The chi-square test revealed a significant relationship of faculties with article requests (p=0.037) and adequacy of website information for academic work (p=0.036). Similarly, the level of students has a significant relationship with Selective Dissemination of Information (p=0.048); usefulness of the training guides (p=0.022); adequate research support (p=0.026); and effective organization of information (p=0.003). Overall responses revealed that the Library website is highly userfriendly (Mean=3.90; SD = ±0.909). One-way ANOVA revealed a significant relationship between the resourcefulness of the website and the respondents' overall satisfaction with the information received from the library website (p=0.021). These results evinced that the library website must comply with users' expectations and needs. Students' opinions and feedback emphasized on the need for updating the website through a benchmark of other library interfaces. FAQ section and Chat bot were a few suggestions made by the users. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Significance of School Libraries in Online Teaching-Learning Activities during the COVID-19 Pandemic in select National Schools of Batticaloa District, Sri Lanka.
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Ramanan, T. and Ravikumar, M. N.
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LIBRARY media specialists , *COVID-19 pandemic , *SCHOOL libraries , *SCHOOL librarians , *TEACHER evaluation , *ELECTRONIC information resources , *LIBRARY resources - Abstract
There is a tendency in reported documents pertaining to school education in Sri Lanka to have literally omitted school libraries and information resources. Teachers and students struggled to gain access to appropriate information resources. After performing a pilot survey to validate the reliability of the questionnaire, a sample of 209 subjects was randomly selected from 459 teachers in select National Schools in Batticaloa Education Zone. A semistructured questionnaire was administered across WhatsApp groups of those teachers and response rate was 77.5%. Data were analysed using One-Sample Wilcoxon Signed-Rank, Chi-Square, and thematic analysis since a mixed method was employed. In this survey, teachers have expressed that school libraries were essential in providing resources to support teaching-learning activities although they have not received sufficient support from school libraries. Study further found that the role of school librarians in educating teachers and students with respect to copyright was underrated. Therefore, as the study results revealed, there was a considerable gap between the need and the availability of resources, which needs to be bridged through school libraries. [ABSTRACT FROM AUTHOR]
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- 2023
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6. An Investigation of Order Review/Release Policies and Dispatching Rules for Assembly Job Shops with Multi Objective Criteria
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Paul, Midhun, Sridharan, R., and Radha Ramanan, T.
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- 2015
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7. A particle swarm optimization approach for permutation flow shop scheduling problem
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Radha Ramanan T., Iqbal Muhammed, and Umarali K.
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makespan ,flow shop scheduling ,particle swarm optimization ,variable neighbourhood search ,Industrial engineering. Management engineering ,T55.4-60.8 ,Industrial directories ,T11.95-12.5 - Abstract
Flow shop scheduling problem (FSSP) is a combinatorial optimization problem. This work, with the objective of optimizing the makespan of an FSSP uses a particle swarm optimization (PSO) approach. The problems are tested on Taillard’s benchmark problems. The results of Nawaz, Encore and Ham (NEH) heuristic are initialized to the PSO to direct the search into a quality space. Variable neighbourhood search (VNS) is employed to overcome the early convergence of the PSO and helps in global search. The results are compared with standalone PSO, traditional heuristics and the Taillard’s upper bounds. Five problem set are taken from Taillard’s benchmark problems and are solved for various problem sizes. Thus a total of 35 problems are solved. The experimental results show that the solution quality of FSSP can be improved if the search is directed in a quality space based on the proposed PSO approach (PSO-NEH-VNS).
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- 2014
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8. Factors affecting the Use of Information by Visually Impaired Students: With Special reference to the Library, University of Colombo.
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Lankathilake, M. A. and Ramanan, T.
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VISUALLY impaired students , *SPECIAL libraries , *ASSISTIVE technology , *LIBRARY personnel , *COMMUNITIES - Abstract
Visually-impaired (VI) students still face unusual difficulties in accessing library resources although there are several assistive technologies and devices being available to help them to get access to information resources. Equality in services mandates libraries to strive for their best to assist these special-need users by examining and mitigating the challenges faced by them. In this regard, a case study was carried out at the Main Library of the University of Colombo, where 42 visually-impaired students were interviewed using a set of semi-structured interview questions. The study population constituted totally blind and partially impaired students. Issues facing by the respondents were identified over institutional, personal and technological factors. Out of different challenges they mentioned, lack of appropriate resources was drawing primary concern. Problems relevant to use of the Internet were identified based on 5 aspects: social, institutional, financial, personal, and technical issues. Those challenges significantly affected VI users having access to their learning resources. It was found that VI users were largely left out in the mainstream student community since they make up a very miniscule faction of the entire student population. Hence, it is recommended to establish a special assistance mechanism for VI users of the library, meanwhile training both VI students and library staff on finding information resources specifically intended for VI users, and using the assistive technologies and equipment. [ABSTRACT FROM AUTHOR]
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- 2022
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9. An artificial neural network based heuristic for flow shop scheduling problems
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Ramanan, T. Radha, Sridharan, R., Shashikant, Kulkarni Sarang, and Haq, A. Noorul
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- 2011
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10. A bicriterian flow shop scheduling using artificial neural network
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Noorul Haq, A. and Radha Ramanan, T.
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- 2006
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11. Application of mixed metrics of bibliometric analysis on the journal of the University librarians' association of Sri Lanka (2005 to 2019): with special reference to VOS viewer visualization.
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Ravikumar, M. N. and Ramanan, T.
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LIBRARIAN associations , *ACADEMIC librarians , *LIBRARY science , *VISUALIZATION , *LIBRARY research - Abstract
This study, using mixed methods of bibliometric analysis, aims to cover the articles published in the Journal of the University Librarians' Association (JULA) of Sri Lanka from 2005 to 2019. Primary goal of the study is to holistically analyze the journal in terms of important bibliometric aspects in light of improving LIS research on open access platforms. Analyses were executed to illustrate authorship impact, citation patterns, subject coverage, and visualization of citations' connections, co-authorship, and co-occurrence network. Among 127 articles authored by 182 librarians/library professionals analyses were performed to find the influential contributors, degree of collaboration, currency of citation, core journals, most preferred topics of research, and outstanding institutions. Single authorship constitutes the majority of the total contribution (62.5%) nevertheless the degree of collaboration steadily increased over time (0.37). Study findings also conform to the application of Lotka's law of author productivity. University of Peradeniya ranks first among outstanding universities that contributed more to the JULA. Application of Bradford's law identified core journals used by the contributors. Authors of this article employed MS Excel and SPSS for carrying out the analyses. They also experimented using VOSviewer for finding the co-occurrence of LIS subjects. Finally, the study intends to find out the areas of improvements needed in library science research in Sri Lanka. And, the authors shed their opinions on improving the existing open access journals in light of installing altmetric tools. [ABSTRACT FROM AUTHOR]
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- 2020
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12. A hybrid neural network-genetic algorithm approach for permutation flow shop scheduling.
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Noorul Haq, A., Ramanan, T. Radha, Shashikant, Kulkarni Sarang, and Sridharan, R.
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GENETIC algorithms ,ARTIFICIAL neural networks ,PRODUCTION scheduling ,MACHINERY in the workplace ,RESOURCE allocation ,PROCESS control systems - Abstract
The objective of this paper is to find a sequence of jobs for the permutation flow shop to minimise the makespan. The shop consists of 10 machines. A feed-forward back-propagation artificial neural network (ANN) is used to solve the problem. The network is trained with the optimal sequences for five-, six- and seven-job problems. This trained network is then used to solve a problem with a greater number of jobs. The sequence obtained using the neural network is used to generate the initial population for the genetic algorithm (GA) using the random insertion perturbation scheme (RIPS). The makespan of the sequence obtained by this approach (ANN-GA-RIPS) is compared with that obtained using GA starting with a random population (ANN-GA). It was found that the ANN-GA-RIPS approach performs better than ANN-GA starting with a random population. The results obtained are compared with those obtained using the Nawaz, Enscore and Ham (NEH) heuristic and upper bounds of Taillard's benchmark problems. ANN-GA-RIPS performs better than the NEH heuristic and the results are found to be within 5% of the upper bounds. [ABSTRACT FROM AUTHOR]
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- 2010
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13. Perception of Academics Regarding the Credibility of Online Resources: Open Access versus Subscribed Journals with Special Reference to Eastern University, Sri Lanka.
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Ravikumar, M. Norman and Ramanan, T.
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SENSORY perception , *ELECTRONIC information resources , *EDUCATION - Abstract
Electronic information resources can be either credible or unreliable. Vast majority of information on the Internet is neither authenticated nor having any mechanism to validate its credibility. Thus, it has been a great challenge for any researcher who uses them for their problem-solving. Education and research institutions use and contribute to the development of academic journals that broadly fall under two categories, namely subscribed and open access. In this regard, this paper discusses about the views of academics of Eastern University, Sri Lanka depending on these resources for using and publishing their research work. Particularly, this study investigates about the perception of academics over subscription journals and open access resources in regard to their accessibility, visibility and credibility. Summary of results show that researchers hold high value for online subscribed journals in terms of their credibility, meanwhile accessibility to the same is quite a challenge. On the other hand, open access journals give rise to visibility and affordability. Therefore, authors shed light on the need of making open access resources more credible. [ABSTRACT FROM AUTHOR]
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- 2019
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14. Information Use and Mobile Devices: A Study Amongst Library Users of Selected Medical Faculties in Sri Lanka.
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Ramanan, T. and Santharooban, S.
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LIBRARY users , *MOBILE apps , *SOCIAL networks , *INFORMATION resources , *MEDICAL informatics - Abstract
A preliminary study was carried out as an initiative to probe into the possibilities of incorporating mobile apps and social networks in medical library services. Major objective was to find out the trend and preference of medical faculty students in using mobile devices for accessing information. The cross-sectional survey design was used with mixed method. Self-administered questionnaire was distributed among students of eight medical faculties in Sri Lanka and 120 filled questionnaires were received from six medical faculties. Data were analyzed using descriptive statistics and factor analysis. The use of a mobile device was analyzed through factor analysis. Cronbach's alpha of the particular statements is 0.864 which indicate the adequate internal consistency of the statements and Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) and Bartlett test value is 0.788 which indicate that the data is suitable for factor analysis. The factor analysis resulted in four-factor model, which explain 66.43% of variance in the data. The four factors are 'educational use', 'entertainment use', 'basic communicational use' and 'free call use'. Since the factor - educational use explain highest percentage (39%) of variance in the data, it indicates that there is a potential to use mobile device for educational purposes. The results also have revealed that majority of the students (85.2%) retrieved medical information through web resources using mobile devices. They also collect information using personal communication especially from friends and lecturers (41.5%). Among the information sources which they use through the mobile devices, Google is at the first place (82.3%) and Wikipedia (80%) is in second place. Only 67.2% of them use the mobile device to read e-books. In the purpose of using mobile devices for educational purpose, highest usage was observed for retrieval of images (81.8%), information on drugs (76.6%) and clinical guidelines (72.3%). Slow Internet connectivity (77.9%), poor network or signal coverage (76.6%), and lack of Wi-Fi facilities in faculty settings (55.9%) are the major barriers to using of mobile devices. Despite the students are positive about mobile devices, they consider more about the authenticity of online information and lack of knowledge and awareness on access to medical information. Moreover, they were mostly inclined to Google and Wikipedia but were unaware of other online resources to access medical information. Therefore, adopting mobile devices in health/medical information literacy programmes and curricula are recommended with further research. [ABSTRACT FROM AUTHOR]
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- 2019
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15. Improving Scholarship through Library Professionalism: an Inevitable Role of Librarianship in the World of Academia.
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Ramanan, T.
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PROFESSIONALISM , *LIBRARY science , *LIBRARY education , *SCHOOL librarians , *INTELLECTUALS - Published
- 2016
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16. Open Access, Peer Reviewing and Quality of Research Publications.
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Ramanan, T.
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OPEN access publishing , *SELECTIVE dissemination of information , *PUBLISHING , *ACADEMIC discourse , *SCHOLARLY peer review - Published
- 2015
17. Comparison of Greenstone Digital Library and DSpace: Experiences from Digital Library Initiatives at Eastern University, Sri Lanka.
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Ravikumar, M. N. and Ramanan, T.
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On the decline of budgetary allocation for libraries, information is being made available to wider audience through alternative means, such as digital libraries and online repositories. Increasing demand for certain print materials urge libraries to exploit open-source alternatives, which are highly advantageous for libraries with scarce financial resources and voracious demand from their users. An interview survey results justified the establishment of digital library service as both students and academics, amongst other issues, recorded their inability to spare time for accessing certain print collections. In this regard, like other libraries in the country, the Library of Eastern University, Sri Lanka has initiated digital library initiatives using freely available software. Amongst a number of open-source software (OSS) available to create and manage digital library collections, Greenstone and DSpace are being experimented for developing two different types of repositories. However, these two software have slight merits and demerits over one another. This paper scrutinizes those features corresponding to the needs of and challenges faced by the Library of Eastern University, Sri Lanka (EUSL), which is in its initial stage of launching digitized collections representing both its academic works and local publications. The demand for unpublished works of students and past examinations papers is always high, hence, the Library is has started digitizing materials in demand and rare to find. This comparative analysis is solely based on experiences gained by the Library of Eastern University, Sri Lanka. [ABSTRACT FROM AUTHOR]
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- 2014
18. A bicriterian flow shop scheduling using artificial neural network.
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Haq, A. Noorul and Ramanan, T. Radha
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ARTIFICIAL neural networks , *SCHEDULING , *PRODUCTION engineering , *INDUSTRIAL efficiency , *HEURISTIC - Abstract
This paper considers the sequencing of jobs that arrive in a flow shop in different combinations over time. Artificial neural network (ANN) uses its acquired sequencing knowledge in making the future sequencing decisions. The paper focuses on scheduling for a flow shop with ‘m’ machines and ‘n’ jobs. The authors have used the heuristics proposed by Campbell et al.(1970, A heuristic algorithm for n-jobs m-machines sequencing problem) to find a sequence and makespan (MS). Then a pair wise interchange of jobs is made to find the optimal MS and total flow time (TFT). The obtained sequence is used for giving training to the neural network and a matrix called neural network master matrix (NNMM) is constructed, which is the basic knowledge of the neurons obtained after training. From the matrix, interpretations are made to determine the optimum sequence for the jobs that arrive in the future over a period of time. The results obtained by the ANN are compared with a constructive heuristics and an improvement heuristics. The results show that the quality of the measure of performance is better when ANN approach is used than obtained by constructive or improvement heuristics. It is found that the system’s efficiency (i.e., obtaining the optimal MS and TFT) increases with increasing numbers of training exemplars. [ABSTRACT FROM AUTHOR]
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- 2006
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19. Electrical Resistivity of Hot-Pressed Compacts.
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RAMANAN, T. and CHAKLADER, A. C. D.
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- 1975
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20. Adoption of Open Source Integrated Library System: User’s Perception among the Selected Libraries in India
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Gireesh Kumar, T. K. and Ramanan, T
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LJ. Software. ,LQ. Library automation systems. - Abstract
Open Source Integrated Library Systems (OSILS) are gaining widespread adoption in Indian libraries during the last two decades. The study intended to assess the development and rate of adoption of OSILS and identify the major factors that influenced the adoption of OSILS in Indian libraries. The study also measures the activities performed by the OSILS users to sustain it and propose possible solutions to the problems if any they faced which contributed to the popularity of OSILS in Indian libraries. A survey with structured questionnaire was used to collect primary data from users of OSILS across the country through Google doc. Study was limited to libraries in India using OSILS. It was found that, in spite of a drastic enhancement in the rate of adoption of OSILS in Indian libraries, lack of technical support and shortage of skilled manpower to execute installation, maintenance and customization stands as hindrance to its extensive use.
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- 2016
21. CAR T-Cell Therapy: A Promising Modality for Autoimmune Diseases.
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Thakral D, Ramanan T, and Bagri NK
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Chimeric Antigen Receptor (CAR)-T cells have emerged as a promising immune effector cell-based therapy. With promising results and approval for the treatment of hematological malignancies, we discuss the scope of this novel therapeutic modality in systemic autoimmune diseases and immune-mediated inflammatory disorders refractory to conventional and biological disease-modifying agents.
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- 2024
22. Adverse clinical outcomes in patients undergoing both PCI and TAVR: Analysis from a pooled multi-center registry.
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Kumar A, Sammour Y, Reginauld S, Sato K, Agrawal N, Lee JM, Meenakshisundaram C, Ramanan T, Kamioka N, Sawant AC, Mohananey D, Gleason PT, Devireddy C, Krishnaswamy A, Mavromatis K, Grubb K, Svensson LG, Tuzcu EM, Block PC, Iyer V, Babaliaros V, Kapadia S, and Samady H
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- Humans, Registries, Risk Factors, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Coronary Artery Disease surgery, Coronary Artery Disease therapy, Percutaneous Coronary Intervention adverse effects, Transcatheter Aortic Valve Replacement adverse effects
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Background: There is a paucity of data regarding the optimum timing of PCI in relation to TAVR., Objective: We compared the major adverse cardiovascular and cerebrovascular events (MACCE) rates among patients who underwent percutaneous coronary intervention (PCI) before transcatheter aortic valve replacement (TAVR) with those who received PCI with/after TAVR., Methods: In this multicenter study, we pooled all consecutive patients who underwent TAVR at three high volume centers., Results: Among 3,982 patients who underwent TAVR, 327 (8%) patients underwent PCI within 1 year before TAVR, 38 (1%) had PCI the same day as TAVR and 15 (0.5%) had PCI within 2 months after TAVR. Overall, among patients who received both PCI and TAVR (n = 380), history of previous CABG (HR:0.501; p = .001), higher BMI at TAVR (HR:0.970; p = .038), and statin therapy after TAVR (HR:0.660, p = .037) were independently associated with lower MACCE while warfarin therapy after TAVR was associated with a higher risk of MACCE (HR:1.779, p = .017). Patients who received PCI within 1 year before TAVR had similar baseline demographics, STS scores, clinical risk factors when compared to patients receiving PCI with/after TAVR. Both groups were similar in PCI (Syntax Score, ACC/AHA lesion class) and TAVR (valve types, access) related variables. There were no significant differences in terms of MACCE (log rank p = .550), all-cause mortality (log rank p = .433), strokes (log rank p = .153), and repeat PCI (log rank p = .054) in patients who underwent PCI with/after TAVR when compared to patients who received PCI before TAVR., Conclusion: Among patients who underwent both PCI and TAVR, history of CABG, higher BMI, and statin therapy had lower, while those discharged on warfarin, had higher adverse event rates. Adverse events rates were similar regardless of timing of PCI., (© 2020 Wiley Periodicals LLC.)
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- 2021
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23. Aortic Paravalvular Leak Repair: Can TAVR Be the Answer?
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Abdel-Aal Ahmed M, Yatsynovich Y, Ramanan T, Colern G, Hansen R, Cimato T, Graham S, Page B, and Iyer V
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A 71-year-old male with endocarditis mediated severe paravalvular leak and nonischemic cardiomyopathy underwent percutaneous repair attempts with a closure device followed by valve-in-valve transcatheter aortic replacement procedure. The case was complicated by cardiac arrest requiring hemodynamic support with Impella placement and secondary iatrogenic central aortic insufficiency requiring further intervention. ( Level of Difficulty: Beginner. )., (© 2019 The Authors.)
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- 2019
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24. Inter- and Intraoperator Variability in Measurement of On-Site CT-derived Fractional Flow Reserve Based on Structural and Fluid Analysis: A Comprehensive Analysis.
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Kumamaru KK, Angel E, Sommer KN, Iyer V, Wilson MF, Agrawal N, Bhardwaj A, Kattel SB, Kondziela S, Malhotra S, Manion C, Pogorzelski K, Ramanan T, Sawant AC, Suplicki MM, Waheed S, Fujimoto S, Sharma UC, Rybicki FJ, and Ionita CN
- Abstract
Purpose: To measure the inter- and intraobserver variability among operators of varying expertise in conducting CT-derived fractional flow reserve (CT FFR) measurements on-site by using structural and fluid analysis and to evaluate differences in reproducibility between two different training methods for end users., Materials and Methods: This retrospective analysis of the prospectively enrolled cohort included 22 symptomatic patients who underwent both 320-detector row coronary CT angiography and catheter-derived fractional flow reserve (FFR) within 90 days. Thirteen operators of varying expertise were assigned to one of two training arms: arm 1, on-site training by a specialist in CT FFR technology; arm 2, self-training through use of written materials. After the training, all 13 operators reviewed the CT data and measured CT FFR in 24 vessels in 22 patients. Inter- and intraoperator variability and agreements between CT FFR and catheter-derived FFR measurements were evaluated., Results: The overall intraclass correlation coefficient (ICC) among operators was 0.71 (95% confidence interval: 0.58, 0.83) with a mean absolute difference (± standard deviation) of 0.027 ± 0.022. The operators in arm 2 showed greater interoperator differences than those in arm 1 (0.031 ± 0.024 vs 0.023 ± 0.018; P = .024). Among operators who recalculated CT FFR, the mean CT FFR value did not significantly differ between the first and second calculations (ICC, 0.66; 95% confidence interval: 0.46, 0.87), with the medical specialists producing the lowest intraoperator variability (0.053 ± 0.060). The overall correlation coefficient between CT FFR and catheter FFR was r = 0.61, with a mean absolute difference of 0.096 ± 0.089., Conclusion: Good reproducibility of CT FFR values calculated on-site on the basis of structural and fluid analysis was observed among operators of varying expertise. Face-to-face training sessions may cause less variability.© RSNA, 2019 Supplemental material is available for this article., Competing Interests: Disclosures of Conflicts of Interest: K.K.K. disclosed no relevant relationships. E.A. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: employed by Canon Medical Systems USA. Other relationships: disclosed no relevant relationships. K.N.S. disclosed no relevant relationships. V.I. disclosed no relevant relationships. M.F.W. Activities related to the present article: institution receives grant from Jacobs Institute. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. N.A. disclosed no relevant relationships. A.B. Activities related to the present article: institution receives grant from Jacobs Institute. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. S.B.K. disclosed no relevant relationships. S.K. Activities related to the present article: institution receives grant from Jacobs Institute. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. S.M. disclosed no relevant relationships. C.M. Activities related to the present article: author did not receive payment or services from a third party for any aspect of the submitted work; author is uncertain if his institution received payment or services from a third party for any aspect of the submitted work (defers to lead author). Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. K.P. disclosed no relevant relationships. T.R. Activities related to the present article: author received payment from the University of Buffalo for participation in review activities. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. A.C.S. disclosed no relevant relationships. M.M.S. Activities related to the present article: institution receives grant from Jacobs Institute. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. S.W. Activities related to the present article: author paid by Toshiba for participating in the data collection of this study. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. S.F. disclosed no relevant relationships. U.C.S. Activities related to the present article: author received consulting fee from Jacobs Neurological Research Institute for interpretation of CT FFT and was fully blinded and not influenced by any means regarding the outcome. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. F.J.R. Activities related to the present article: institution received grant from Canon Medical Systems. Activities not related to the present article: medical director of Imagia (there is no overlap between this work and any company activity). Other relationships: disclosed no relevant relationships. C.N.I. Activities related to the present article: University of Buffalo received grant from Canon Medical Systems; institution receives travel funds for graduate and undergraduates for international conferences. Activities not related to the present article: author paid consultant fee for studies on vascular device evaluation from Jacobs Institute; institution receives NIH grants, Cumming Foundation grant, Canon Medical Systems grant, author paid for lecture on 3D printing advances from Canon Medical Systems; paid for patent for x-ray system design (University of Buffalo); University of Buffalo gives travel grants to conferences. Other relationships: disclosed no relevant relationships., (2019 by the Radiological Society of North America, Inc.)
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- 2019
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25. Evaluation of YouTube as a reliable source for patient education on aortic valve stenosis.
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Khalil C, Megaly M, Ekladios C, Ibrahim A, Mosleh W, Tawadros M, Yatsynovich Y, Ramanan T, Youssef M, Hanna N, Khalil M, Al-Azizi KM, Shamoun F, Page B, and Corbelli J
- Abstract
Background: Aortic stenosis (AS) is a prevalent disease in the elderly population and has been a public health concern for decades. YouTube is currently being used for obtaining healthcare related information. We evaluated the quality of information about AS on YouTube for patient education., Methods: YouTube was queried for the search phrases "aortic valve stenosis", "aortic valve replacement", "transcatheter aortic valve replacement" and "TAVR". Videos were assessed for their reliability and content with two five-point scales. They were categorized into groups according to usefulness and uploader source. All videos were assessed for audience interaction. Videos were viewed and analyzed by 2 independent investigators. Conflicts were resolved by a third investigator., Results: Search phrases yielded 69,300 videos, among which, 120 videos were evaluated and 85 videos were included in the final analysis. Of the 85 videos, only 45 videos (53%) were found to be useful while 40 videos (47%) were found to be non-useful. The majority (98%) of the useful videos were uploaded by professional sources. Overall, videos uploaded by non-professional sources had higher number of views (23,553 vs. 11,110, P≤0.001) despite of being less useful (14% vs. 67%, P<0.001) when compared to videos uploaded by professional sources., Conclusions: There is a potential to increase public awareness about aortic valve stenosis and the available treatment options by utilizing YouTube. Professional societies are encouraged to provide more useful material that can deliver comprehensive and reliable information in an entertaining and intuitive manner to the public., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
- Published
- 2019
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26. Neutrophil-to-lymphocyte ratio predicts heart failure readmissions and outcomes in patients undergoing transcatheter aortic valve replacement.
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Khalil C, Pham M, Sawant AC, Sinibaldi E, Bhardwaj A, Ramanan T, Qureshi R, Khan S, Ibrahim A, Gowda SN, Pomakov A, Sadawarte P, Lahoti A, Hansen R, Baldo S, Colern G, Pershad A, and Iyer V
- Subjects
- Aged, 80 and over, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnosis, Female, Heart Failure epidemiology, Heart Failure etiology, Humans, Incidence, Male, Prognosis, Retrospective Studies, Risk Factors, Treatment Outcome, United States epidemiology, Aortic Valve Stenosis surgery, Heart Failure blood, Lymphocytes, Neutrophils, Patient Readmission trends, Risk Assessment, Transcatheter Aortic Valve Replacement methods
- Abstract
Objective: Neutrophil-to-lymphocyte ratio (NLR) has prognostic value in acute coronary syndromes. We investigated its utility for predicting heart failure (HF) admissions and major adverse cardiac outcomes in patients undergoing transcatheter aortic valve replacement (TAVR)., Methods: Data on clinical, laboratory, procedural, HF admissions, and major adverse cardiac events (MACEs) (all-cause mortality, recurrence of myocardial infarction requiring intervention, stroke) for 298 consecutive patients who underwent TAVR between 2012 and 2016 in our tertiary center were collected., Results: Analysis included 298 patients. The mean age was 83 ± 8 years, 51% were males, and 95% were Caucasians. The median Society of Thoracic Surgeons risk score was 9 (interquartile range: 6.3-11.8). Receiver-operating curve analysis identified a cutoff value of NLR of 4.0 for MACE after TAVR and sensitivity of 68% and specificity of 68% {area under the curve [AUC] = 0.65 [95% confidence interval (CI): 0.51-0.79], p = 0.03}. An NLR of 4.0 for HF hospitalizations after TAVR and sensitivity of 60% and specificity of 57% [AUC = 0.61 (95% CI: 0.53-0.69), p = 0.01]. NLR ≥4.0 before TAVR significantly predicted MACE after TAVR (68.4% vs. 31.6%, p = 0.02) and HF hospitalizations (58.3% vs. 41.7%, p = 0.03). NLR with TAVR risk score increased the predictive value for MACE after TAVR from AUC = 0.61 (95% CI: 0.50-0.72, p = 0.06) to AUC = 0.69 (95% CI: 0.57-0.80, p = 0.007)., Conclusion: NLR predicts all-cause mortality, MACE, and HF hospitalization 1 year after TAVR. NLR with TAVR risk score improved predictability for MACE. Further studies for prognostication using NLR are warranted., (Copyright © 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)
- Published
- 2018
- Full Text
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27. Quality of life outcomes in transcatheter aortic valve replacement patients requiring pacemaker implantation.
- Author
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Bhardwaj A, Ramanan T, Sawant AC, Sinibaldi E, Pham M, Khan S, Qureshi R, Agrawal N, Khalil C, Hansen R, Baldo S, Colern G, Corbelli J, Pershad A, Beck H, and Iyer V
- Abstract
Background: Permanent pacemaker implantation is the most common complication after Transcatheter aortic valve replacement (TAVR) and is associated with worse outcomes and mortality. However, its impact on quality-of-life (QoL) outcomes remains unknown., Methods: We included 383 consecutive patients undergoing TAVR from January 2012 to 2016 who completed a baseline Kansas City Cardiomyopathy Questionnaire (KCCQ-12) health survey. The clinical, laboratory, angiographic, QoL, mortality, and occurrence of poor outcomes (KCCQ-12 score < 45 or KCCQ decrease of ≥10 points) were obtained., Results: The mean age was 83 ± 8 years, 51% were men, and majority were Caucasians (n = 364, 95%). Permanent pacemaker (PPM) was implanted in 11.5% of patients post-TAVR. PPM patients were more likely to have prior conduction disease including RBBB (25% vs 12%, P = .02) and PQ interval >250 ms (11% vs 5%, P = .07). One-month median KCCQ-12 scores were significantly lower among PPM patients (84.7 vs 68.8, P = .04), but did not differ significantly at 1-year (86.5 vs 90.6, P = .5) post-TAVR. Occurrence of poor outcomes did not differ significantly among those with or without PPM at 1 month (11% vs 7%, P = .39) and 1 year (13% vs 9%, P = .45), respectively. However, patients with poor QoL outcomes at 1 month post-TAVR also had significantly worse mortality during follow-up in unadjusted (31.3% vs 4.5%, P < .001) and adjusted (HR = 5.30, 95% [CI: 1.85-15.22, P = .002])analyses, respectively., Conclusion: Permanent pacemaker implantation is associated with short-term reduction in QoL without long-term implications post-TAVR. Patients with poor QoL post-TAVR also have significantly higher mortality.
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- 2018
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28. Does manual T-wave window adjustment affect microvolt T-wave alternans results in patients with structural heart disease?
- Author
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Ramanan T, Balakumaran K, Ravichandran S, Ganocy SJ, Oshodi G, Costantini O, Dettmer M, Leo PJ, and Kaufman ES
- Subjects
- Comorbidity, Female, Humans, Male, Middle Aged, Ohio epidemiology, Prognosis, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Algorithms, Cardiomyopathies diagnosis, Cardiomyopathies epidemiology, Electrocardiography methods, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left epidemiology
- Abstract
Introduction: Microvolt T-wave alternans (MTWA) analysis can identify patients at low risk of sudden cardiac death who might not benefit from an implantable cardioverter-defibrillator (ICD). Current spectral methodology for performing MTWA analysis may "miss" part of the T-wave in patients with QT prolongation. The value of T-wave window adjustment in patients with structural heart disease has not been studied., Methods: We assembled MTWA data from 5 prior prospective studies including 170 patients with reduced left ventricular ejection fraction, adjusted the T-wave window to include the entire T-wave, and reanalyzed MTWA., Results: Of 170 patients, 43% required T-wave window adjustment. Only 3 of 170 patients (1.8%) had a clinically significant change in MTWA results., Conclusions: In 98.2% of patients, T-wave window adjustment did not improve the accuracy of MTWA analysis. Spectral MTWA as currently implemented remains effective for identifying patients with structural heart disease unlikely to benefit from ICD therapy., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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29. Send it: study of e-mail etiquette and notions from doctors in training.
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Resendes S, Ramanan T, Park A, Petrisor B, and Bhandari M
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- Adult, Attitude of Health Personnel, Competency-Based Education trends, Cross-Sectional Studies, Education, Medical, Graduate trends, Electronic Mail standards, Female, Humans, Male, Ontario, Quality Control, Surveys and Questionnaires, Education, Medical, Graduate standards, Electronic Mail ethics, Interprofessional Relations ethics, Orthopedics education
- Abstract
Objectives: Worldwide, more than 247 billion e-mails are sent each day. Little empiric evidence is available to guide how e-mail presentation style, tone, and content affect e-mail recipients and whether these factors impact opinions about the sender and the rapidity of response. In a study of physicians in training assessing a series of 100 e-mail examples, we examined the following: (1) formatting characteristics most and least endorsed, (2) impression of the sender based on the e-mail itself, and (3) factors associated with the decision to respond. We reasoned that our study would provide empiric data to support recommendations for e-mail etiquette, focusing specifically on doctors in training., Design: Cross-sectional survey study., Setting: Division of Orthopaedic Surgery at McMaster University, Hamilton, Ontario, Canada., Participants: After each e-mail, the participating surgical residents completed a series of questions focusing on their impression of the e-mail appearance, their perception of the sender, and their motivation to respond to the e-mail., Results: Thirty-two residents participated in this study. The responses indicate that the key negatively endorsed features of the e-mails included the use of colored backgrounds (84%), difficult-to-read font (83%), lack of a subject header (55%), opening salutations without recipient names (50%), or no salutation at all (42%). The senders of negatively endorsed e-mails were perceived by participants as inefficient (p = 0.03), unprofessional (p < 0.001), and irritating (p = 0.007). E-mails with overall positive endorsements were significantly more likely to have the participants perceive the e-mail senders as professional (p < 0.001), pleasant (p = 0.048), and kind (p = 0.059). The participants were 2.6-fold more likely to respond immediately when they perceived e-mails as favorable compared with disliking them (42% vs 16% of responses, respectively, p < 0.001)., Conclusion: The e-mails perceived as being disliked overall are likely to result in a negative perception of the sender and delays in response time., (Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
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- 2012
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30. An observational study of duplicate presentation rates between two national orthopedic meetings.
- Author
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Bhandari M, Patenall V, Devereaux PJ, Tornetta P 3rd, Dirschl D, Leece P, Ramanan T, and Schemitsch EH
- Subjects
- Canada, Duplicate Publications as Topic, United States, Congresses as Topic, Information Dissemination, Orthopedics, Societies, Medical
- Abstract
Background: National meetings such as those of the American Academy of Orthopaedic Surgeons (AAOS) and the Canadian Orthopaedic Association (COA) are invaluable in the dissemination of new research findings. Given the limits of meeting agendas, investigators who present the same paper at multiple meetings prevent other presentations on potentially important original research. To determine the incidence of duplicate presentation of research between recent COA and AAOS meetings and between national meetings (AAOS and subspecialty), we conducted an observational study., Methods: We hand-searched all podium papers and posters from the 2001 COA annual meeting for duplicate presentation at the 2001 and 2002 AAOS annual meetings and subspecialty meetings held in the USA. We evaluated summary data abstracted from the duplicate presentations for consistency., Results: Of 148 presentations at the 2001 COA meeting, 29 presentations (paper and poster) were duplicated at the 2001 or 2002 AAOS meeting: effectively 1 paper in 5 (19.5%). Canadian investigators were significantly more likely to present the same paper at both meetings than Americans (79% v. 13%, respectively; p < 0.01). Those who presented papers at COA altered their AAOS presentations in a variety of ways: by changing the wording in the title of their paper (24% of the time), adding or removing authors (38%), changing authorship order (34%) and changing the sample size (31%). Duplicate presentation rates between AAOS and other orthopedic subspecialty meetings averaged 11.4% (range 3.4%-26.4%)., Conclusions: We identified a 20% duplicate presentation rate between the COA and AAOS annual meetings, and an 11% rate between the AAOS and subspecialty meetings. Stricter enforcement of guidelines and improved dissemination of research findings at both national meetings may limit this practice.
- Published
- 2005
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