RONAK SHAH - Academia.edu (original) (raw)
Papers by RONAK SHAH
Journal of Cardiothoracic and Vascular Anesthesia, 2022
ICTACT Journal on Communication Technology, 2017
IEEE 802.11 Wi-Fi networks are increasingly becoming popular for its use in industrial applicatio... more IEEE 802.11 Wi-Fi networks are increasingly becoming popular for its use in industrial applications. With the availability of recent amendments to IEEE 802.11 series of standards, particularly IEEE 802.11n, the adoption of Wi-Fi networks for process automation is gaining more focus and importance. The installation of Wireless networks naturally provides reduction in cable and its maintenance related costs, provides increased flexibility and mobility to enhance performance of industrial control system. The IEEE 802.11n supports parameterization that can be set for particular industrial applications and hence it has addressed to the aspects of timeliness and criticality to some extent. This paper proposes the use of IEEE 802.11n network to interconnect field instruments with Siemens PLC controller in harsh EMI/EMC environment. An application example is shown where the alternate control system architecture is developed in which non-critical and non-safety signals are communicated over Wi-Fi. While, for critical and safety signals, traditional hardwired signals methods can be implemented.
Journal of Cardiothoracic and Vascular Anesthesia, 2021
ABSTRACTBackgroundIt has been projected that there will be too few ventilators to meet demand dur... more ABSTRACTBackgroundIt has been projected that there will be too few ventilators to meet demand during the COVID-19 (SARS CoV-2) pandemic. Ventilator sharing has been suggested as a crisis standard of care strategy to increase availability of mechanical ventilation. The safety and practicality of shared ventilation in patients is unknown. We designed and evaluated a system whereby one mechanical ventilator can be used to simultaneously ventilate two patients who have different lung compliances using a custom manufactured flow control valve to allow for individual adjustment of tidal volume and airway pressure for each patient.MethodsThe system was first evaluated in a simulation lab using two human patient simulators under expected clinical conditions. It was then tested in an observational study of four patients with acute respiratory failure due to COVID-19. Two separately ventilated COVID-19 patients were connected to a single ventilator for one hour. This intervention was repeated...
I would like to thank my parents and my sister, for their encouragement and constant support. I w... more I would like to thank my parents and my sister, for their encouragement and constant support. I would also like to thank my friends to give me a valuable feedback on my project.
Journal of Cardiothoracic and Vascular Anesthesia, 2020
SEVERE VASOPLEGIA may complicate adult cardiac surgery, depending on the risk profile. 1,2 The ri... more SEVERE VASOPLEGIA may complicate adult cardiac surgery, depending on the risk profile. 1,2 The risk factors may be related not only to the patient but also to the procedure itself. 3-5 Over the past decade, vasopressin has become a common additive vasopressor for restoration of vascular tone and enhanced clinical outcomes. 5-12 Herein a case of severe vasoplegia after coronary artery bypass surgery with cardiopulmonary bypass that was refractory to catecholamines and vasopressin is presented. The expert commentaries explore the management considerations in this clinical setting. Case Presentation * The patient was a 53-year-old man from Pakistan who presented with a pattern of stable angina, recently complicated with several weeks of worsening shortness of breath, especially with physical exertion. His medical history was noteworthy for gout, hyperlipidemia, and systemic hypertension. He was not diabetic and recently had stopped smoking. His family history was strongly positive for coronary artery disease and ischemic cardiomyopathy. He was evaluated on an outpatient basis. His electrocardiogram revealed normal sinus rhythm and nonspecific ST-segment changes. His chest x-ray demonstrated hyperinflated lung fields and cardiomegaly. A transthoracic echocardiogram showed a dilated myopathic left ventricle with an estimated ejection fraction of 10% and global
BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, ... more BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of face-to-face training are expensive, time consuming, and difficult to scale, which necessitates improvements in ACLS training aimed at improving patient survival. Virtual Reality (VR) has been proposed as an alternative or adjunct to high fidelity simulation (HFS) in several environments. Although it has been studied in the realm of ACLS education, no evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills as well as demonstrate a cost comparison. Additionally, prior studies involving VR applications in ACLS education relied on additional peripheral devices and did not utilize a fully immersive VR environment. OBJECTIVE Evaluate the feasibility, human factor impact, and cost of a voice based VR ACLS refresher course as compared to hi...
International Journal of Ambient Energy, 2019
The hybrid solar system contains a photovoltaic cell (PV) module and compound parabolic concentra... more The hybrid solar system contains a photovoltaic cell (PV) module and compound parabolic concentrator (CPC). The present study aims to evaluate the potential for the introduction of the PV/T technology into Gujarat, India. The photovoltaic thermal (PV/T) system converts the solar radiation into thermal and electrical energy simultaneously. The solar radiation increases the temperature of PV modules, resulting in a drop in electrical efficiency. Through circulation of water with low temperature, heat can be extracted from the PV modules to improve the electrical efficiency. The extracted thermal energy can be used for heating purpose. The individual electrical efficiency of the PV module and thermal efficiency of CPC have been observed as 13.56% and 53.92% respectively.While the combined efficiency found as 79.18%, which is higher than the individual performance of the PV module and CPC. The combined PV/T system is a new era in solar-based power system.
Journal of Cardiothoracic and Vascular Anesthesia, 2019
Anesthesia & Analgesia, 2019
Journal of cardiothoracic and vascular anesthesia, Jan 31, 2018
ACUTE TYPE A aortic dissection is a life-threatening condition that commonly is associated with c... more ACUTE TYPE A aortic dissection is a life-threatening condition that commonly is associated with connective tissue disorders. 1 Although the perioperative management of this surgical emergency often is challenging, it can be complicated further in rare situations by an associated pregnancy. 2 In these circumstances, meticulous diagnosis and management in a multidisciplinary setting is paramount to secure the best outcomes for both the mother and the fetus. In this case conference, the management of a pregnant woman referred for surgical management of an acute type A dissection is presented and discussed from multiple perspectives. Case Presentation A 31-year-old female at 32 weeks' gestation presented with palpitations and acute nontraumatic chest pain. She had no significant past medical history. Her physical examination was remarkable for sinus tachycardia, normotension, and a singleton pregnancy at 32 weeks. There were no clinical signs of fetal distress. The full blood count and serum chemistries were within normal limits for a third-trimester pregnancy. The electrocardiogram was notable for sinus tachycardia and no Contents lists available at ScienceDirect
Fusion Engineering and Design, 2016
h i g h l i g h t s • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyr... more h i g h l i g h t s • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyrotron test facility. • National Instruments® make PXIe system for real time control & data acquisition and Siemens® PLC for sequence control function. • Hardwired FPGA based fast protection interlock system. • High speed analog fiber optical transmission link using V/F and F/V technique. • Software framework based on LabVIEW TM platform and ITER CODAC Core System.
Journal of Cardiothoracic and Vascular Anesthesia, 2015
ONG QT SYNDROME (LQTS) and short QT syndrome SODIUM CHANNEL PATHOPHYSIOLOGY AND LQTS/SQTS L(SQTS)... more ONG QT SYNDROME (LQTS) and short QT syndrome SODIUM CHANNEL PATHOPHYSIOLOGY AND LQTS/SQTS L(SQTS) are genetic cardiac ion channelopathies that occur in the general population and have a well-documented association with sudden cardiac death both in children and adults. Sudden cardiac death usually is caused by sustained ventricular tachycardia, including ventricular fibrillation. The published incidence averages about 5 to 10 deaths per 10,000 population. In the United States, sudden cardiac death is responsible for about 300,000 to 450,000 deaths per year. The ion channelopathies are a heterogenous group of inherited multisystem disorders that include Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and arrhythmogenic right ventricular cardiomyopathy. These conditions have 3 features in common: (1) a structurally normal heart, (2) genetic basis, and (3) predisposition to lethal arrhythmias. They are being recognized with increased frequency in the perioperative period, and guidelines for the management of patients with these complex arrhythmias are lacking. This review addresses the perioperative issues associated with LQTS and SQTS, with a focus on evidence-based management.
Heart, lung and vessels, 2015
There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia an... more There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia and intensive care. There has been a revolution in the clinical approach to acute and chronic adult aortic diseases. Contemporary management of adult aortic disease is based on etiology, clinical presentation, extent, and integrated intervention with medical, endovascular and/or surgical measures. Further European guidelines have explored in depth the cardiovascular management in non-cardiac surgery with a thematic focus to reduce perioperative mortality from the leading offender, namely myocardial ischemia. Integrated guidelines address the management of myocardial revascularization including the percutaneous and surgical options. Despite 50 years since the first coronary artery bypass grafting procedure and impressive advances in interventional cardiology, surgical revascularization remains a gold standard for many patients with coronary artery disease. These advances in 2014 will likely...
F1000 - Post-publication peer review of the biomedical literature, 2014
F1000 - Post-publication peer review of the biomedical literature, 2013
Journal of Cardiothoracic and Vascular Anesthesia, 2012
There have been rapid advances in oral anticoagulation. The oral factor Xa inhibitors rivaroxaban... more There have been rapid advances in oral anticoagulation. The oral factor Xa inhibitors rivaroxaban and apixaban and the oral direct thrombin inhibitor dabigatran recently have been rigorously evaluated. These novel anticoagulants will usher in a new paradigm for perioperative anticoagulation. Perioperative blood conservation in cardiac surgery recently has been highlighted in the updated guidelines by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons. These recommendations reflect a comprehensive evaluation of the recent evidence to optimize transfusion practice. Transcatheter mitral valve repair continues to mature. Transcatheter aortic valve implantation for aortic stenosis has entered the clinical mainstream, with randomized trials showing its superiority over medical management and its equivalency to surgical valve replacement in high-risk patients. This transformational technology represents a major leadership opportunity for the cardiac anesthesiologist. Minimally invasive valve surgery has shown effectiveness in high-risk patients. Radial access is equivalent to femoral access for percutaneous coronary intervention in acute coronary syndromes but significantly reduces the risk of local vascular complications. Recent trials have further clarified the roles of medical therapy, percutaneous coronary intervention, and coronary artery bypass surgery in patients with significant coronary artery disease and left ventricular dysfunction. The past year has witnessed major advances in cardiovascular practice with new drugs, new devices, and new guidelines. The coming year most likely will advance these achievements to enhance the care of patients.
IEEE Transactions on Plasma Science, 2013
High-power tests on chemical vapor deposited (CVD) diamond window are carried out using 82.6-GHz ... more High-power tests on chemical vapor deposited (CVD) diamond window are carried out using 82.6-GHz Gyrotron. To test CVD diamond window with calorimetric dummy load, a matching optic unit is designed and fabricated with special profiled mirrors. The mirrors are fabricated by Gycom Russia and a mirror box assembly is fabricated at Institute for Plasma Research. The mirrors and mirror box are cooled with water. The mirror box consists of four arc detectors for the protection of window. The CVD diamond window is connected to a dummy load with this mirror box. The alignment of mirror is done during the testing of CVD window in pulsed condition. After achieving the desired Gaussian pattern at the exit of mirror box, system is connected to a dummy load for continuous wave test. The CVD window is tested maximum power up to 60 kW in pulse duration of 600 s.
Journal of Cardiothoracic and Vascular Anesthesia, 2022
ICTACT Journal on Communication Technology, 2017
IEEE 802.11 Wi-Fi networks are increasingly becoming popular for its use in industrial applicatio... more IEEE 802.11 Wi-Fi networks are increasingly becoming popular for its use in industrial applications. With the availability of recent amendments to IEEE 802.11 series of standards, particularly IEEE 802.11n, the adoption of Wi-Fi networks for process automation is gaining more focus and importance. The installation of Wireless networks naturally provides reduction in cable and its maintenance related costs, provides increased flexibility and mobility to enhance performance of industrial control system. The IEEE 802.11n supports parameterization that can be set for particular industrial applications and hence it has addressed to the aspects of timeliness and criticality to some extent. This paper proposes the use of IEEE 802.11n network to interconnect field instruments with Siemens PLC controller in harsh EMI/EMC environment. An application example is shown where the alternate control system architecture is developed in which non-critical and non-safety signals are communicated over Wi-Fi. While, for critical and safety signals, traditional hardwired signals methods can be implemented.
Journal of Cardiothoracic and Vascular Anesthesia, 2021
ABSTRACTBackgroundIt has been projected that there will be too few ventilators to meet demand dur... more ABSTRACTBackgroundIt has been projected that there will be too few ventilators to meet demand during the COVID-19 (SARS CoV-2) pandemic. Ventilator sharing has been suggested as a crisis standard of care strategy to increase availability of mechanical ventilation. The safety and practicality of shared ventilation in patients is unknown. We designed and evaluated a system whereby one mechanical ventilator can be used to simultaneously ventilate two patients who have different lung compliances using a custom manufactured flow control valve to allow for individual adjustment of tidal volume and airway pressure for each patient.MethodsThe system was first evaluated in a simulation lab using two human patient simulators under expected clinical conditions. It was then tested in an observational study of four patients with acute respiratory failure due to COVID-19. Two separately ventilated COVID-19 patients were connected to a single ventilator for one hour. This intervention was repeated...
I would like to thank my parents and my sister, for their encouragement and constant support. I w... more I would like to thank my parents and my sister, for their encouragement and constant support. I would also like to thank my friends to give me a valuable feedback on my project.
Journal of Cardiothoracic and Vascular Anesthesia, 2020
SEVERE VASOPLEGIA may complicate adult cardiac surgery, depending on the risk profile. 1,2 The ri... more SEVERE VASOPLEGIA may complicate adult cardiac surgery, depending on the risk profile. 1,2 The risk factors may be related not only to the patient but also to the procedure itself. 3-5 Over the past decade, vasopressin has become a common additive vasopressor for restoration of vascular tone and enhanced clinical outcomes. 5-12 Herein a case of severe vasoplegia after coronary artery bypass surgery with cardiopulmonary bypass that was refractory to catecholamines and vasopressin is presented. The expert commentaries explore the management considerations in this clinical setting. Case Presentation * The patient was a 53-year-old man from Pakistan who presented with a pattern of stable angina, recently complicated with several weeks of worsening shortness of breath, especially with physical exertion. His medical history was noteworthy for gout, hyperlipidemia, and systemic hypertension. He was not diabetic and recently had stopped smoking. His family history was strongly positive for coronary artery disease and ischemic cardiomyopathy. He was evaluated on an outpatient basis. His electrocardiogram revealed normal sinus rhythm and nonspecific ST-segment changes. His chest x-ray demonstrated hyperinflated lung fields and cardiomegaly. A transthoracic echocardiogram showed a dilated myopathic left ventricle with an estimated ejection fraction of 10% and global
BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, ... more BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of face-to-face training are expensive, time consuming, and difficult to scale, which necessitates improvements in ACLS training aimed at improving patient survival. Virtual Reality (VR) has been proposed as an alternative or adjunct to high fidelity simulation (HFS) in several environments. Although it has been studied in the realm of ACLS education, no evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills as well as demonstrate a cost comparison. Additionally, prior studies involving VR applications in ACLS education relied on additional peripheral devices and did not utilize a fully immersive VR environment. OBJECTIVE Evaluate the feasibility, human factor impact, and cost of a voice based VR ACLS refresher course as compared to hi...
International Journal of Ambient Energy, 2019
The hybrid solar system contains a photovoltaic cell (PV) module and compound parabolic concentra... more The hybrid solar system contains a photovoltaic cell (PV) module and compound parabolic concentrator (CPC). The present study aims to evaluate the potential for the introduction of the PV/T technology into Gujarat, India. The photovoltaic thermal (PV/T) system converts the solar radiation into thermal and electrical energy simultaneously. The solar radiation increases the temperature of PV modules, resulting in a drop in electrical efficiency. Through circulation of water with low temperature, heat can be extracted from the PV modules to improve the electrical efficiency. The extracted thermal energy can be used for heating purpose. The individual electrical efficiency of the PV module and thermal efficiency of CPC have been observed as 13.56% and 53.92% respectively.While the combined efficiency found as 79.18%, which is higher than the individual performance of the PV module and CPC. The combined PV/T system is a new era in solar-based power system.
Journal of Cardiothoracic and Vascular Anesthesia, 2019
Anesthesia & Analgesia, 2019
Journal of cardiothoracic and vascular anesthesia, Jan 31, 2018
ACUTE TYPE A aortic dissection is a life-threatening condition that commonly is associated with c... more ACUTE TYPE A aortic dissection is a life-threatening condition that commonly is associated with connective tissue disorders. 1 Although the perioperative management of this surgical emergency often is challenging, it can be complicated further in rare situations by an associated pregnancy. 2 In these circumstances, meticulous diagnosis and management in a multidisciplinary setting is paramount to secure the best outcomes for both the mother and the fetus. In this case conference, the management of a pregnant woman referred for surgical management of an acute type A dissection is presented and discussed from multiple perspectives. Case Presentation A 31-year-old female at 32 weeks' gestation presented with palpitations and acute nontraumatic chest pain. She had no significant past medical history. Her physical examination was remarkable for sinus tachycardia, normotension, and a singleton pregnancy at 32 weeks. There were no clinical signs of fetal distress. The full blood count and serum chemistries were within normal limits for a third-trimester pregnancy. The electrocardiogram was notable for sinus tachycardia and no Contents lists available at ScienceDirect
Fusion Engineering and Design, 2016
h i g h l i g h t s • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyr... more h i g h l i g h t s • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyrotron test facility. • National Instruments® make PXIe system for real time control & data acquisition and Siemens® PLC for sequence control function. • Hardwired FPGA based fast protection interlock system. • High speed analog fiber optical transmission link using V/F and F/V technique. • Software framework based on LabVIEW TM platform and ITER CODAC Core System.
Journal of Cardiothoracic and Vascular Anesthesia, 2015
ONG QT SYNDROME (LQTS) and short QT syndrome SODIUM CHANNEL PATHOPHYSIOLOGY AND LQTS/SQTS L(SQTS)... more ONG QT SYNDROME (LQTS) and short QT syndrome SODIUM CHANNEL PATHOPHYSIOLOGY AND LQTS/SQTS L(SQTS) are genetic cardiac ion channelopathies that occur in the general population and have a well-documented association with sudden cardiac death both in children and adults. Sudden cardiac death usually is caused by sustained ventricular tachycardia, including ventricular fibrillation. The published incidence averages about 5 to 10 deaths per 10,000 population. In the United States, sudden cardiac death is responsible for about 300,000 to 450,000 deaths per year. The ion channelopathies are a heterogenous group of inherited multisystem disorders that include Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and arrhythmogenic right ventricular cardiomyopathy. These conditions have 3 features in common: (1) a structurally normal heart, (2) genetic basis, and (3) predisposition to lethal arrhythmias. They are being recognized with increased frequency in the perioperative period, and guidelines for the management of patients with these complex arrhythmias are lacking. This review addresses the perioperative issues associated with LQTS and SQTS, with a focus on evidence-based management.
Heart, lung and vessels, 2015
There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia an... more There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia and intensive care. There has been a revolution in the clinical approach to acute and chronic adult aortic diseases. Contemporary management of adult aortic disease is based on etiology, clinical presentation, extent, and integrated intervention with medical, endovascular and/or surgical measures. Further European guidelines have explored in depth the cardiovascular management in non-cardiac surgery with a thematic focus to reduce perioperative mortality from the leading offender, namely myocardial ischemia. Integrated guidelines address the management of myocardial revascularization including the percutaneous and surgical options. Despite 50 years since the first coronary artery bypass grafting procedure and impressive advances in interventional cardiology, surgical revascularization remains a gold standard for many patients with coronary artery disease. These advances in 2014 will likely...
F1000 - Post-publication peer review of the biomedical literature, 2014
F1000 - Post-publication peer review of the biomedical literature, 2013
Journal of Cardiothoracic and Vascular Anesthesia, 2012
There have been rapid advances in oral anticoagulation. The oral factor Xa inhibitors rivaroxaban... more There have been rapid advances in oral anticoagulation. The oral factor Xa inhibitors rivaroxaban and apixaban and the oral direct thrombin inhibitor dabigatran recently have been rigorously evaluated. These novel anticoagulants will usher in a new paradigm for perioperative anticoagulation. Perioperative blood conservation in cardiac surgery recently has been highlighted in the updated guidelines by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons. These recommendations reflect a comprehensive evaluation of the recent evidence to optimize transfusion practice. Transcatheter mitral valve repair continues to mature. Transcatheter aortic valve implantation for aortic stenosis has entered the clinical mainstream, with randomized trials showing its superiority over medical management and its equivalency to surgical valve replacement in high-risk patients. This transformational technology represents a major leadership opportunity for the cardiac anesthesiologist. Minimally invasive valve surgery has shown effectiveness in high-risk patients. Radial access is equivalent to femoral access for percutaneous coronary intervention in acute coronary syndromes but significantly reduces the risk of local vascular complications. Recent trials have further clarified the roles of medical therapy, percutaneous coronary intervention, and coronary artery bypass surgery in patients with significant coronary artery disease and left ventricular dysfunction. The past year has witnessed major advances in cardiovascular practice with new drugs, new devices, and new guidelines. The coming year most likely will advance these achievements to enhance the care of patients.
IEEE Transactions on Plasma Science, 2013
High-power tests on chemical vapor deposited (CVD) diamond window are carried out using 82.6-GHz ... more High-power tests on chemical vapor deposited (CVD) diamond window are carried out using 82.6-GHz Gyrotron. To test CVD diamond window with calorimetric dummy load, a matching optic unit is designed and fabricated with special profiled mirrors. The mirrors are fabricated by Gycom Russia and a mirror box assembly is fabricated at Institute for Plasma Research. The mirrors and mirror box are cooled with water. The mirror box consists of four arc detectors for the protection of window. The CVD diamond window is connected to a dummy load with this mirror box. The alignment of mirror is done during the testing of CVD window in pulsed condition. After achieving the desired Gaussian pattern at the exit of mirror box, system is connected to a dummy load for continuous wave test. The CVD window is tested maximum power up to 60 kW in pulse duration of 600 s.