Multiband terahertz metamaterial perfect absorber for microorganisms detection.

We report a multi-resonant terahertz (THz) metamaterial perfect absorber (MPA)-based biosensor in the working frequency range of [Formula: see text] for sensing of microorganisms (such as fungi, yeast) and wheat pesticides. Nearly [Formula: see text] absorption is realized at [Formula: see text] and [Formula: see text]. We designed our THz MPA sensor making resonators' gap area compatible with the microorganisms' size. To obtain optimum performance of the MPA, a mapping of amplitudes and shifts in the absorption resonance peaks with different structural parameters of the resonators is carried out. A very high-frequency shift is obtained for microorganisms such as Penicillium chrysogenum (fungi), yeast, and pesticides (Imidacloprid, N, N-Diethyldithiocarbamate sodium salt trihydrate, Daminozide, N, N-Diethyldithiocarbamate sodium salt hydrate, and Dicofol). An equivalent circuit model using Advance Design System (ADS) software is developed. The calculated results through the model show similar trends as obtained in the simulations using CST. Investigations of the effect of incidence angle of THz wave on the absorption spectra of the MPA are also carried out. It is found that incidence angle does not impact the stability of the lower resonance absorption peak (1.79THz). Due to the wide working frequency range, the proposed sensor is extremely suitable for the detection of all range of pesticides because their specific absorption fingerprint lies in the frequency range of 0-3.8THz. We believe that our sensor could be a potential detection tool for detecting pesticide residues in agriculture and food products. The THz MPA-based biosensor is capable of detecting a very small change in the effective dielectric constant of the MPA environment. Therefore, it can also offer huge opportunities in label-free biosensing for future biomedical applications.

Visible-light driven reaction of CO2 with alcohols using a Ag/CeO2 nanocomposite: first photochemical synthesis of linear carbonates under mild conditions.

The first photochemical synthesis of linear carbonates from the reaction of CO2 with alcohols using a silver-doped ceria nanocomposite at room temperature under visible light irradiation is described. DFT calculations suggested the electron transfer from Ag 4d states to Ce 4f states in the composite for the photoreaction.

Visible Light-Active Ternary Heterojunction Photocatalyst for Efficient CO2 Reduction with Simultaneous Amine Oxidation and Sustainable H2O2 Production.

The present work described a unique approach for CO2 reduction to methanol along with the oxidation of various amines to the corresponding imines and photocatalytic H2O2 production from H2O and molecular O2 using a heterojunction photocatalyst made up of ZnIn2S4/Ni12P5/g-C3N4(NCZ) under visible light irradiation. The photocatalysts were synthesized via a high-temperature treatment of nickel and phosphorous precursors with g-C3N4 followed by decoration of ZnIn2S4. The synthesized photocatalysts were characterized using various spectroscopic and microscopic techniques. The density functional theory (DFT) studies suggested the participation of the valence band maximum (VBM) from Ni12P5 and the conduction band maximum (CBM) from ZnIn2S4 in the ternary NCZ heterojunction. The ternary composite exhibited superior photocatalytic activity compared to that of its individual components due to the formation of a heterojunction, thereby enhancing the transfer efficiency of electrons from the conduction band of g-C3N4 to that of ZnIn2S4 using Ni12P5 as an electron bridge. Moreover, the reduced band gap of the ternary heterojunction played a key role in its higher efficiency.

Spontaneous hemothorax and implication of diagnostic evaluation: A case report.

The most critical intervention for large hemothorax is draining the blood out of the pleural cavity by placing a thoracostomy tube but it can be disastrous if done without due consideration. We report a rare case of spontaneous hemothorax due to posterior intercostal artery aneurysm and implication of diagnostic evaluation on its management.

Plasma Fibrinogen: An Independent Predictor of Pediatric Appendicitis.

AIMS: Appendicitis, in spite of all the diagnostic advances, achieving an accurate and timely diagnosis of this common condition in children remains a challenge. Plasma fibrinogen (FB) is an acute inflammatory mediator and has been proposed and evaluated as an adjunct laboratory marker for improving diagnostic accuracy. The study evaluates the plasma values of Se FB along with other serum markers in pediatric appendicitis patients, to determine their diagnostic accuracy. METHODS: Prospective observational study on 120 patients between the age group of 5 and 12 years. All eligible enrolled cases underwent total leukocyte count (TLC), plasma FB, C reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), absolute neutrophil count (ANC), and erythrocyte sedimentation rate on admission along with pediatric appendicitis score. Final confirmation of diagnosis and allotment of cohort was made by intra operative findings and histopathological confirmation. Two groups were defined: (1) Histopathologically confirmed acute appendicitis-Cases (2) Nonspecific abdominal pain-Controls. Laboratory results were statistically analyzed between the case and the control groups for diagnostic accuracy. RESULTS: Study reflected strong statistical significance in terms of leukocyte count, ANC, NLR, CRP, and FB levels. However, plasma FB (value above 4.02 g/L) had the highest diagnostic accuracy rate of 82.50% compared to other laboratory values (TLC-70.83%, CRP-70.00%). CONCLUSION: Plasma FB has emerged as an accurate diagnostic tool and its diagnostic accuracy is superior to all other laboratory parameter studied (TLC, CRP, NLR, and ANC). Plasma FB values above 4.02 g/L is an independent predictor of appendicitis and can help in reducing negative laparotomy in pediatric age group.

A New ICU Delirium Prevention Bundle to Reduce the Incidence of Delirium: A Randomized Parallel Group Trial.

INTRODUCTION: Although various preventive strategies have been advocated, delirium is common in critically ill patients and is associated with increased morbidity, mortality, and long-term adverse effects. The efficacy of a novel delirium prevention bundle in mechanically ventilated critically ill patients was investigated in this study. METHODS: In this randomized controlled trial, 50 mechanically ventilated adult patients in a tertiary care medical-surgical intensive care unit (ICU) were randomized to receive either delirium prevention bundle protocol or standard of care protocol. Delirium was assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU) score by an independent investigator up to 28 days or death or discharge. The primary outcome was the incidence of new-onset delirium. Secondary outcomes were duration of mechanical ventilation, ICU length of stay (ICU-LOS), hospital LOS, and other adverse events. RESULTS: There was a 20% reduction in the incidence of delirium in the intervention group (36 vs 56%; p = 0.156). The 28-day mortality (28 vs 24%; p = 0.747), duration of mechanical ventilation (9 vs 12 days; p = 0.281), ICU-LOS (11 vs 12 days; p = 0.221), and hospital LOS (16 vs 20 days; p = 0.062) were similar between the groups. CONCLUSION: Implementation of delirium prevention bundle does not reduce the incidence of delirium compared to standard of care protocol in mechanically ventilated critically ill patients. HOW TO CITE THIS ARTICLE: Malik AK, Baidya DK, Anand RK, Subramaniam R. A New ICU Delirium Prevention Bundle to Reduce the Incidence of Delirium: A Randomized Parallel Group Trial. Indian J Crit Care Med 2021;25(7):754-760.

Efficacy of triple therapy in auricular keloids.

BACKGROUND: Keloids are characterised by their continued growth following trauma, extension into normal tissue and their high recurrence rate following excision. Auricular keloids are common following ear piercing or flame burns. These lesions are highly conspicuous and cosmetically unappealing. Multiple methods including surgery, radiotherapy, antimitotic agents, silicone sheet, pressure clips and cryotherapy have been advocated. The risk of recurrence and the need to prevent distortion of the three-dimensional structure of the ear following resection is a challenge to the cutaneous surgeon. OBJECTIVES: To devise a standard protocol for management of auricular keloids with minimal distortion and recurrence. SETTING AND DESIGN: The patients underwent day-care surgery and subsequent out-patient follow-up for a minimum period of 1 year. METHODS: Ten patients presenting with 22 ear keloids were enrolled into a keloid protocol: (a) surgical excision and keloid rind flap cover with (b) intra-operative and post-operative intra-lesional steroid and (c) silicone sheet application. Subjective assessment on follow-up was using Patient Observer Scar Assessment Scale and objective assessment was by Beausang scale. STATISTICAL ANALYSIS USED: Microsoft Excel and Statistical Package for the Social Sciences (SPSS). Kaplan-Meier survival analysis curve used to calculate Recurrence Free period. RESULTS: Two out of 22 (9.1%) keloids developed post-excision recurrence after a mean follow -up period of 16 months. The average keloid recurrence free interval was 21 months. CONCLUSION: Triple combination therapy for keloids on the ear is a simple technique for management with preservation of contour of the ear and a low recurrence rate.

Terahertz radiation generation by beating of two spatial-Gaussian lasers in the presence of a static magnetic field.

Resonant excitation of terahertz (THz) radiation based on beating of two spatial-Gaussian lasers having different frequencies and wave numbers but the same electric field amplitudes is proposed in a spatially periodic density plasma in the presence of a static magnetic field applied perpendicular to the direction of propagation of the lasers. In this process, the ponderomotive force is developed with its components parallel and perpendicular to the direction of propagation of the lasers. This leads to a nonlinear oscillatory current that resonantly excites the THz radiation with the frequency of the order of the upper hybrid frequency. The contribution of magnetic field, laser beamwidth, and amplitude and periodicity of the density ripples is discussed for the efficient THz radiation generation. With the optimization of these parameters, the efficiency on the order of 10(-3) or larger can be achieved in the present scheme.

Activator reloaded - Myofunctional appliance at its best.

Orthodontics from time immemorial has always been considered as the first speciality of dentistry. Diagnosis and treatment planning from Dr. Tweed's time always required extraction of four vital and functional premolar teeth. However, many patients, parents and general dentists have failed to understand that orthodontic treatment at an early age can help save the extraction teeth to achieve a full functional and esthetic harmonius dentition. Our case demonstrates a non-extraction orthodontic treatment plan of a developing skeletal Class II malocclusion. The results of this case show a successful correction of Class II molar malocclusion with excellent form and function, which resulted in improvement of the patient's frontal and facial profile, which, thereby boosted her personality and self-confidence.

Disseminated actinomycosis with multifocal muscular involvement.

We present a case of thoracic actinomycosis with hematogenous spread to the contralateral para-spinal muscles and ipsilateral lower extremity causing extensive myositis of the thigh. Aspiration secondary to chronic alcoholism and poor dentition were responsible for thoracic actinomycosis with subsequent hematogenous dissemination.

Successful treatment of head and neck cancer involving the prevertebral fascia.

Chemotherapy with radiation has become more popular than radiotherapy alone for patients with locally advanced head and neck cancer because of the successful results associated with it. We report the case of a 67-year-old man with hypopharyngeal cancer invading the prevertebral fascia who became free of disease after chemoradiation. This uncommon, positive observation supports the impression that combined therapy is efficacious in some patients with advanced stage carcinoma of the upper aerodigestive tract.

Obstructed ectopic kidney mimicking Chilaiditi syndrome on F-18 FDG imaging.

Fluorine-18 fluorodeoxyglucose positron emission tomography was obtained in a patient with a duodenal mass. Conventional imaging revealed multiple dilated intestinal loops. Initial impression of positron emission tomographic images was interposition of a loop of bowel between the liver and diaphragm (Chilaiditi syndrome) in an unusual location, with absent right kidney activity. Computed tomography and magnetic resonance imaging of the abdomen showed an obstructed ectopic kidney in this position with a markedly dilated collecting system. There is absence of fluorodeoxyglucose in the markedly dilated renal collecting system resulting from acute obstruction, giving the false appearance of gas-filled bowel loops with an unusual location of the interposition.