Interferometric complementarity is known to be one of the most nonclassical manifestations of the quantum formalism. It is commonly known as wave-particle duality and has been studied presently from the perspective of quantum information theory where wave and particle nature of a quantum system, called quanton, are characterised by coherence and path distinguishability respectively. We here consider the effect of noisy detectors on the complementarity relation. We report that by suitably choosing the initial quanton and the detector states along with the proper interactions between the quanton and the detectors, one can reduce the influence of noisy environment on complementarity, thereby pushing it towards saturation. To demonstrate this, three kinds of noise on detectors and their roles on the saturation of the complementarity relation are extensively studied. We also observe that for fixed values of parameters involved in the process, asymmetric quanton state posses low value of coherence while it can have a higher amount of distinguishability, and hence it has the potential to enhance the duality relation. (C) 2020 Elsevier B.V. All rights reserved.

BACKGROUND AND OBJECTIVES: Ischemic stroke (IS) and coronary artery disease (CAD) share common risk factors and one may be the harbinger of the other. We aimed to study prevalence of symptomatic and asymptomatic CAD in a cohort of consecutive patients with IS and assess its relationship with intracranial and extracranial large artery cerebrovascular disease (LAD).; METHODS: All consecutive eligible IS and Transient Ischemic Attack (TIA) patients were recruited into the study. Both clinically suspected and asymptomatic patients (N=E2=80=AF=3D=E2=80=AF259) underwent myocardial Stress-rest Gated Technetium-99m (Tc99m) MIBI Myocardial Perfusion SPECT scan performed on a dual head SPECT-CT to estimate evidence of myocardial ischemia.; RESULTS: Three hundred patients completed the study. Forty one patients were previously diagnosed cases of definitive CAD. Twelve patients were clinically suspected to have CAD and 247 patients were asymptomatic. Among these, 12 patients (4.81%) had a positive SPECT. The overall prevalence of CAD was 17.67% (n=E2=80=AF=3D=E2=80=AF53). Presence of diabetes was an independent predictor of CAD (OR 1.98, 95% CI 1.07-3.67. P .02). No significant association was found between the presence of LAD and CAD in all subgroup comparisons. However, there was a suggestion of higher LAD among patients with known CAD compared with others.; CONCLUSIONS: CAD is prevalent in patients with ischemic stroke. No definitive relationship was found between CAD and intracranial or extracranial LAD. Population based stratification tools are needed to further assess the need to detect subclinical CAD in patients with stroke. Copyright =C2=A9 2019 Elsevier Inc. All rights reserved.

BackgroundPerioperative pulmonary complications are frequent in patients with interstitial lung diseases (ILD). Limited literature exists regarding the safety of bariatric procedures in patients with ILD. This study aims to assess the safety, feasibility, and outcomes of patients with ILD who underwent bariatric surgery at our institution.MethodsAfter IRB approval, all patients with preoperative diagnosis of ILD who had bariatric surgery at an academic center between 2004 and 2014 were retrospectively reviewed.ResultsA total of 25 patients with ILD underwent bariatric surgery: Roux-en-Y gastric bypass (n=3D17, 68%), sleeve gastrectomy (n=3D7, 28%), and adjustable gastric banding (n=3D1, 4%). Twenty-one patients (84%) were females. The median age and preoperative body mass index (BMI) were 53 (IQR 42-58) years and 39 (IQR 37-44)kg/m(2), respectively. The median operative time and length of stay was 137 (IQR 110-187)min and 3 (IQR 2-5)days, respectively. The 30-day complications were reported in four patients (16%) but there was no pulmonary complication or unplanned admission to theintensive care unit. At 1-year follow-up (85%), the median BMI and excess weight loss were 30 (IQR 25-36)kg/m(2) and 67% (IQR 45-100), respectively. Compared to preoperative values, there was significant improvement in the pulmonary function test (PFT) variables at 1year with respect to forced vital capacity (62% vs 74%; n=3D13, p=3D0.003), and diffusing capacity of the lungs for carbon monoxide (53% vs 66%; n=3D10, p=3D0.003). Six out of the seven potential lung transplant candidates became eligible for transplantation after weight loss, and one of them had successful lung transplant at 88months after bariatric surgery.ConclusionIn our experience, bariatric patients with ILD achieved significant weight loss and improvement in PFT. Bariatric surgery in these higher risk ILD patients appears relatively safe with acceptable perioperative morbidity and improved candidacy for lung transplantation.

Home to a culturally heterogeneous population, India is also a melting pot of genetic diversity. The population architecture characterized by multiple endogamous groups with specific marriage patterns, including the widely prevalent practice of consanguinity, not only makes the Indian population distinct from rest of the world but also provides a unique advantage and niche to understand genetic diseases. Centuries of genetic isolation of population groups have amplified the founder effects, contributing to high prevalence of recessive alleles, which translates into genetic diseases, including rare genetic diseases in India. Rare genetic diseases are becoming a public health concern in India because a large population size of close to a billion people would essentially translate to a huge disease burden for even the rarest of the rare diseases. Genomics-based approaches have been demonstrated to accelerate the diagnosis of rare genetic diseases and reduce the socio-economic burden. The Genomics for Understanding Rare Diseases: India Alliance Network (GUaRDIAN) stands for providing genomic solutions for rare diseases in India. The consortium aims to establish a unique collaborative framework in health care planning, implementation, and delivery in the specific area of rare genetic diseases. It is a nation-wide collaborative research initiative catering to rare diseases across multiple cohorts, with over 240 clinician/scientist collaborators across 70 major medical/research centers. Within the GUaRDIAN framework, clinicians refer rare disease patients, generate whole genome or exome datasets followed by computational analysis of the data for identifying the causal pathogenic variations. The outcomes of GUaRDIAN are being translated as community services through a suitable platform providing low-cost diagnostic assays in India. In addition to GUaRDIAN, several genomic investigations for diseased and healthy population are being undertaken in the country to solve the rare disease dilemma. In summary, rare diseases contribute to a significant disease burden in India. Genomics-based solutions can enable accelerated diagnosis and management of rare diseases. We discuss how a collaborative research initiative such as GUaRDIAN can provide a nation-wide framework to cater to the rare disease community of India.

Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied. A total of 153 patients on CAT underwent surgery [Roux-en-Y gastric bypass (n =3D 79), sleeve gastrectomy (n =3D 63), and adjustable gastric banding (n =3D 11)] during the study period: 85 patients (55%) were females; median age was 56 years (interquartile range [IQR] 49-64), and median BMI was 49 kg/m(2) (IQR 43-56). The most common indications for CAT were venous thromboembolism (n =3D 87) and atrial fibrillation (n =3D 83). Median duration of procedure and estimated intraoperative blood loss was 150 min (IQR 118-177) and 50 ml (IQR 25-75), respectively. Thirty-day postoperative complications were reported in 33 patients (21.6%) including postoperative bleeding (n =3D 19), anastomotic leak (n =3D 3), and pulmonary embolism (n =3D 1). Nineteen patients (12%) with early postoperative bleeding were further categorized to intra-abdominal (n =3D 10), intraluminal (n =3D 6), and at the port site or abdominal wall (n =3D 3). All-cause readmissions within 30 days of surgery occurred in 19 patients (12%). There was no 30-day mortality. In our experience, patients who require chronic anticoagulation medication are higher than average risk for postoperative complications and all-cause readmission rates. Careful surgical technique and close attention to postoperative anticoagulation protocols are essential to decrease perioperative risk in this high-risk cohort.

Background Gastrojejunostomy revision after gastric bypass surgery is a challenging procedure that requires advanced skills. The air-leak test was performed to identify gastrojejunostomy leaks. Omental patch seal technique is a well-known treatment of perforated gastrojejunostomy ulcers (Surg Obes Relat Dis 4:423-8, 2012; Surg Endosc 2:384-9, 2013; Surg Endosc 11:2110, 2007). Methods We present a case of a 40-year-old female, who underwent laparoscopic gastric bypass 6 years prior and subsequently developed marginal ulcer, resulting in chronic gastrojejunostomy stricture. She underwent multiple endoscopic dilations until it became refractory. She was taken for a gastrojejunostomy revision. After dissection of dense adhesion, the gastric pouch was identified. The Roux limb was identified as retrocolic and retrogastric. The pouch was divided just below the left gastric pedicle. Endoscope air insufflation was showed no leak of the new pouch. The Roux limb was freed and gastrojejunal anastomosis was performed with a posterior lair, linear stapler, and two layers of running 2-0 absorbable sutures for common enterotomy. The leak test demonstrated air bubbles which were at the anastomosis lateral aspect. A 2-0 non-absorbable suture was placed repeatedly but the leak remained positive. Fibrin glue was placed over the gastrojejunostomy. A tongue of omentum was pulled posteriorly to the pouch and sewed to itself to encircle the gastrojejunostomy. The leak test was not repeated since it would not have changed our management at this point. A remnant gastrostomy tube was placed. Two suction drains were placed. Upper endoscopy, at the end of the case, demonstrated a patulous gastrojejunostomy. Results The patient's post-operative course was uneventful. Enteric feeding was initiated via the remnant gastrostomy. Upper GI fluoroscopy was performed on POD 5 and was negative for leak or stricture. She was discharged on POD 7. At 6-month follow-up, she was doing excellent, maintaining her weight without symptoms. Conclusions Gastrojejunostomy revision is a complex procedure that requires an advanced bariatric surgery skills and experience. Omental patch can be used in cases where friable tissue anastomosis leaks as a sealant along with a protective feeding gastrostomy.

Esophageal carcinoma is a highly lethal cancer associated with high morbidity and mortality. Esophageal squamous cell carcinoma and esophageal adenocarcinoma are the two distinct histological types. There has been significant progress in endoscopic diagnosis and treatment of early stages of cancer using resection and ablation techniques, as shown in several trials in the recent past. Earlier detection of esophageal cancer and advances in treatment modalities have lead to improvement in the 5-year survival from 5% to about 20% in the past decade. Endoscopic eradication therapy is the preferred modality of treatment in cancer limited to mucosal layer of the esophagus as there is very low risk of lymph node metastasis, leading to high cure rates, low risk of recurrence and with few adverse effects. The most common adverse events seen are strictures, bleeding and rarely perforation which can be endoscopically managed. In patients with recurrent advanced disease or invasive tumor, esophagectomy with lymph node dissection remains the mainstay of treatment. There is debate on post-endoscopic surveillance with some studies suggesting closer follow up with upper endoscopy every 6 mo for the first 1-2 years and then annually for the 3 years while others recommending the appropriate action only if symptoms or other abnormalities develop. Overall, the field of endoscopic therapy is still evolving and focus should be placed on careful patient selection using a multidisciplinary approach.=20

Understanding the technical constructs of bariatric surgery is important to the treating endoscopist to maximize effective endoluminal therapy. Post-opera-tive complication rates vary widely based on the complication of interest, and have been reported to be as high as 68% following adjustable gastric banding. Similarly, there is a wide range of presenting symptoms for post-operative bariatric complications, including abdominal pain, nausea and vomiting, dysphagia, gastrointestinal hemorrhage, and weight regain, all of which may provoke an endoscopic assessment. Bleeding and anastomotic leak are considered to be early (< 30 d) complications, whereas strictures, marginal ulcers, band erosions, and weight loss failure or weight recidivism are typically considered late (> 30 d) complications. Treatment of complications in the immediate post-operative period may require unique considerations. Endoluminal therapies serve as adjuncts to surgical and radiographic procedures. This review aims to summarize the spectrum and efficacy of endoscopic management of post-operative bariatric complications.

BACKGROUND: Studies on predictors of ischemic strokes caused by rheumatic heart disease (RHD) are sparse and extremely important for identifying high-risk cases to direct future therapeutic trials for prevention of ischemic stroke in this population.; OBJECTIVE: The aim of the present study was to study the predictors of ischemic stroke in patients with RHD and to observe outcome of patients with ischemic stroke at 3 months' follow-up using modified Rankin scale.; METHODS: We conducted a case-control study comparing the clinical profile of 40 adult patients with acute ischemic stroke caused by RHD with equal numbers of matched controls comprising patients with RHD without any prior history of stroke. We also observed the functional outcome of ischemic strokes in these patients.; RESULTS: The presence of left atrial spontaneous echo contrast (odds ratio =3D 39.9; 95% confidence interval, 3.16-501.9; P =3D.004) and atrial fibrillation (AF) (odds ratio =3D 3.2; 95% confidence interval, 1.6-6.7; P =3D.002) was significantly associated with stroke occurrence in RHD populations. The outcome of patients was good with low mortality and significant improvement of modified Rankin scale at 3 months' follow-up.; CONCLUSIONS: Presence of AF and left atrial spontaneous echo contrast are significant risk factors for ischemic stroke in patients with RHD. There is high percentage of subclinical AF in this population. Future large clinical trials for oral anticoagulation/antiplatelet agents are needed for stroke prevention in high-risk RHD patients identified by a detailed workup. Copyright =C2=A9 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

OBJECTIVE To characterize the status of cardiometabolic risk factors after late relapse of type 2 diabetes mellitus (T2DM) and to identify factors predicting relapse after initial diabetes remission following bariatric surgery to construct prediction models for clinical practice. RESEARCH DESIGN AND METHODS Outcomes of 736 patients with T2DM who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at an academic center (2004-2012) and had >=3D 5 years' glycemic follow-up were assessed. Of 736 patients, 425 (58%) experienced diabetes remission (HbA(1c) <6.5% [48 mmol/mol] with patients off medications) in the 1st year after surgery. These 425 patients were followed for a median of 8 years (range 5-14) to characterize late relapse of diabetes. RESULTS In 136 (32%) patients who experienced late relapse, a statistically significant improvement in glycemic control, number of diabetes medications including insulin use, blood pressure, and lipid profile was still observed at long-term. Independent baseline predictors of late relapse were preoperative number of diabetes medications, duration of T2DM before surgery, and SG versus RYGB. Furthermore, patients who relapsed lost less weight during the 1st year after surgery and regained more weight afterward. Prediction models were constructed and externally validated. CONCLUSIONS While late relapse of T2DM is a real phenomenon (one-third of our cohort), it should not be considered a failure, as the trajectory of the disease and its related cardiometabolic risk factors is changed favorably after bariatric surgery. Earlier surgical intervention, RYGB (compared with SG) and more weight loss (less late weight regain) are associated with less diabetes relapse in the long-term.

Purpose Innovation and entrepreneurship are regarded as the key drivers to steer the engine of economic development in any nation. As a result, to understand the context and process of innovation and entrepreneurship there has been a steady rise in scientific literature and empirical studies. The purpose of this paper is to study the trends and progress of academic research on innovation and entrepreneurship in India by identifying the key articles, journals, authors and institutions. Design/methodology/approach Scientometric methods especially bibliometrics is used, for measuring the maturity of this research field in the country. The paper studies the research landscape in innovation and entrepreneurship in India by doing a bibliometric analysis using data from publications indexed in the Scopus database from the year 2000 to 2018. The study takes a multidisciplinary review of the literature in innovation and entrepreneurship research in India and could be used as a reference for future studies in this theme. Findings The study finds an increase in the scholarly studies in innovation and entrepreneurship in India in the last decade. It was also found that a large number of publications were joint-authored and collaborations between Indian and foreign universities is happening. The paper also highlights the authorship patterns, top journals and the most cited papers. Research limitations/implications A major limitation of this study is that it has considered publications which are indexed in Scopus. This paper has contributed by highlighting the growth of studies in the field of innovation and entrepreneurship in the Indian context. The results can be used by future studies in this area as a starting point to highlight the nature of this research area. Originality/value The study attempts to present a trend analysis of published literature on innovation and entrepreneurship in India.