Laparoscopic imaging has advanced significantly,with higher resolutions like 4K,and innovative light modes such as narrow band imaging and near-infrared imaging.Recently,yellow enhancement(YE)mode has emerged as a nov...Laparoscopic imaging has advanced significantly,with higher resolutions like 4K,and innovative light modes such as narrow band imaging and near-infrared imaging.Recently,yellow enhancement(YE)mode has emerged as a novel tool that enhances the pale-yellow colour of fat into a fluorescent yellow-green,improving contrast without the need for injected dyes.It can be toggled on and off easily during surgery.YE is still under evaluation,but early experience suggests it helps surgeons differentiate anatomical planes and key intraabdominal structures from surrounding adipose tissue.This is particularly useful in:(1)Dissecting structures surrounded or covered by fat;and(2)operating on patients with obesity,where excess intra-abdominal fat limits visualisation and retraction.By enhancing the visibility of vascular pedicles,ureters,and nerves,YE enables more precise dissections and may reduce the risk of accidental injury.It can also assist less experienced surgeons in identifying important structures,potentially improving efficiency and surgical outcomes.As a training tool,YE may shorten the learning curve,though further study is needed.Overall,YE offers potential benefits in fat-dense surgical fields by improving visualisation,reducing complications,and enhancing patient safety.展开更多
Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Du...Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Due to the varied initial presentation, treatment may be delayed, leading to poorer outcomes. Here, we present a unique case of a 27-year-old schizophrenic patient who initially presented with acute respiratory failure and septic shock and was ultimately diagnosed with cavitary pneumonia secondary to esophageal perforation.展开更多
Received 16 July 2016;revised 24 January 2017;accepted 7 February 2017 Available online 22 February 2017 Abstract Microstructural evolution of die-cast and homogenized AZ91 Mg-alloys was investigated during dry slidin...Received 16 July 2016;revised 24 January 2017;accepted 7 February 2017 Available online 22 February 2017 Abstract Microstructural evolution of die-cast and homogenized AZ91 Mg-alloys was investigated during dry sliding wear condition.Tribological tests were performed using a pin-on-disc(EN8 steel)configuration with a normal load of 50 N at a constant sliding speed of 2.5 ms^(−1) under ambient environment.Delamination was recognized as a predominant wear mechanism in both of these materials.The die-cast AZ91 Mg-alloy exhibits lower coefficient of friction and higher wear rate.This can be ascribed to increase in the intensity of load bearing capacity of hardβ-Mg_(17)Al_(12) phase,and crack formation/de-cohesion at the interface between primaryα-Mg and discontinuousβ-Mg_(17)Al_(12) phases.On the contrary,the homogenized AZ91 Mg-alloy experiences higher coefficient of friction and lower wear rate.The friction-induced microstructural evolution(supersaturatedα-Mg to eutectic(α+β-Mg_(17)Al_(12)))tending to minimize the wear rate by providing barrier to material removal in the near surface region of homogenized AZ91 Mg-alloy.Therefore,experimental observation revealed that an inverse relationship exists between wear rate and coefficient of friction for the investigated materials.The analysis of worn surfaces and subsurfaces by electron microscopy provided evidence to delamination wear and microstructural evolution.展开更多
We have introduced a polymer precursor into molten magnesium and then in-situ pyrolyzed to produce castings of metal matrix composites(P-MMCs)containing silicon-carbonitride(SiCNO)ceramic particles.Stress-rupture meas...We have introduced a polymer precursor into molten magnesium and then in-situ pyrolyzed to produce castings of metal matrix composites(P-MMCs)containing silicon-carbonitride(SiCNO)ceramic particles.Stress-rupture measurements of as-cast P-MMCs was performed at 350 ℃(0.69TM)to 450 ℃(0.78TM)under dead load condition corresponding to tensile stress of 2.5 MPa to 20 MPa.The time-to-fracture data were analyzed using the classical Monkman–Grant equation.The time-to-fracture is thermally activated and follows a power-law stress exponent exhibiting dislocation creep.Fractography analysis revealed that while pure magnesium appears to fracture by dislocation slip,the P-MMCs fail from the nucleation and growth of voids at the grain boundaries.展开更多
The present work concerns with correlation between microstructure and wear behavior of AZX915 Mg-alloy reinforced with 12 wt%of TiC particles by stir-casting process.Dry sliding tests were performed under ambient envi...The present work concerns with correlation between microstructure and wear behavior of AZX915 Mg-alloy reinforced with 12 wt%of TiC particles by stir-casting process.Dry sliding tests were performed under ambient environment by using a pin-on-disc(EN8 steel)configuration with a normal load of 50 N at a constant sliding speed of 2.50 ms^(−1).While as-cast composite experienced delamination wear,heat treated composite suffered from delamination and oxidation wear during dry sliding contact.Moreover,the heat treated composite exhibited lower friction and higher wear rate as compared to the as-cast composite.Friction and wear behavior were correlated with microstructures based on the concept of oxidation tendency and crack nucleation/propagation.Further,a schematic model has been proposed illustrating wear mechanisms from the point of view of subsurface microstructural evolution of the AZX915-TiCp composite.展开更多
Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female pres...Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.展开更多
One of the potential risks associated with subsurface storage of CO_2 is the seepage of CO_2 through existing faults and fractures. There have been a number of studies devoted to this topic. Some of these studies show...One of the potential risks associated with subsurface storage of CO_2 is the seepage of CO_2 through existing faults and fractures. There have been a number of studies devoted to this topic. Some of these studies show that geochemistry, especially mineralization, plays an important role in rendering the faults as conduits for CO_2 movement while others show that mineralization due to CO_2 injection can result in seep migration and flow diversion. Therefore, understanding the changes in reservoir properties due to pore alterations is important to ensure safe long term CO_2 storage in the subsurface. We study the changes in the Representative Elementary Volume（REV） of a rock due to reactive kinetics over a time, using a statistical approach and pore-scale CO_2-rock interactiondata.The goal of this study is to obtain the REV of a rock property that accounts for pore-scale changes over time due to reactive kinetics, and we call this as spatiotemporal REV. Scale-up results suggest that the REV changes with time when CO_2-rock interaction is considered. It is hypothesized that the alteration in pore structure introduces more heterogeneity in the rock, and because of this the magnitude of REV increases. It is possible that these noticeable changes in REV at pore-scale may have an impact when analyzed at the reservoir scale.展开更多
The physical limitations of complementary metal-oxide semiconductor?(CMOS) technology have led many researchers to consider other alternative technologies. Quantum-dot cellular automate (QCA), single electron tunnelin...The physical limitations of complementary metal-oxide semiconductor?(CMOS) technology have led many researchers to consider other alternative technologies. Quantum-dot cellular automate (QCA), single electron tunneling (SET), tunneling phase logic (TPL), spintronic devices, etc., are some of the nanotechnologies that are being considered as possible replacements for CMOS. In these nanotechnologies, the basic logic units used to implement circuits are majority and/or minority gates. Several majority/minority logic circuit synthesis methods have been proposed. In this paper, we give a comparative study of the existing majority/minority logic circuit synthesis methods that are capable of synthesizing multi-input multi-output Boolean functions. Each of these methods is discussed in detail. The optimization priorities given to different factors such as gates, levels, inverters, etc., vary with technologies. Based on these optimization factors, the results obtained from different synthesis methods are compared. The paper also analyzes the optimization capabilities of different methods and discusses directions for future research in the synthesis of majority/minority logic networks.展开更多
BACKGROUND A diverse country like India may have variable intensive care units(ICUs)practices at state and city levels.AIM To gain insight into clinical services and processes of care in ICUs in India,this would help ...BACKGROUND A diverse country like India may have variable intensive care units(ICUs)practices at state and city levels.AIM To gain insight into clinical services and processes of care in ICUs in India,this would help plan for potential educational and quality improvement interventions.METHODS The Indian ICU needs assessment research group of diverse-skilled individuals was formed.A pan-India survey"Indian National ICU Needs"assessment(ININ 2018-I)was designed on google forms and deployed from July 23rd-August 25th,2018.The survey was sent to select distribution lists of ICU providers from all 29 states and 7 union territories(UTs).In addition to emails and phone calls,social medial applications-WhatsApp™,Facebook™and LinkedIn™were used to remind and motivate providers.By completing and submitting the survey,providers gave their consent for research purposes.This study was deemed eligible for category-2 Institutional Review Board exempt status.RESULTS There were total 134 adult/adult-pediatrics ICU responses from 24(83%out of 29)states,and two(28%out of 7)UTs in 61 cities.They had median(IQR)16(10-25)beds and most,were mixed medical-surgical,111(83%),with 108(81%)being adult-only ICUs.Representative responders were young,median(IQR),38(32-44)years age and majority,n=108(81%)were males.The consultants were,n=101(75%).A total of 77(57%)reported to have 24 h in-house intensivist.A total of 68(51%)ICUs reported to have either 2:1 or 2≥:1 patient:nurse ratio.More than 80%of the ICUs were open,and mixed type.Protocols followed regularly by the ICUs included sepsis care,ventilator-associated pneumonia(83%each);nutrition(82%),deep vein thrombosis prophylaxis(87%),stress ulcer prophylaxis(88%)and glycemic control(92%).Digital infrastructure was found to be poor,with only 46%of the ICUs reporting high-speed internet availability.CONCLUSION In this large,national,semi-structured,need-assessment survey,the need for improved manpower including;in-house intensivists,and decreasing patient-tonurse ratios was evident.Sepsis was the most common diagnosis and quality and research initiatives to decrease sepsis mortality and ICU length of stay could be prioritized.Additionally,subsequent surveys can focus on digital infrastructure for standardized care and efficient resource utilization and enhancing compliance with existing protocols.展开更多
This review is done essentially to study results in the field of synthesis and characterization of Carbon Nanotubes (CNT’s) reinforced nanocomposite coatings using thermal sprayed coatings. CNT reinforced nanocomposi...This review is done essentially to study results in the field of synthesis and characterization of Carbon Nanotubes (CNT’s) reinforced nanocomposite coatings using thermal sprayed coatings. CNT reinforced nanocomposite coatings produced by thermal spray process are being developed for a wide variety of applications, e.g. aerospace, automotive and sports equipment industries. It is anticipated that, if properly deposited, nanocomposite ceramic coatings could also provide improved properties like wear resistance and thermal barrier coatings. These results clearly demonstrate that the significant improvement in coating performance can be achieved by utilizing proper thermal sprayed nanocomposite coatings. Thermal sprayed nanocomposite coatings shows improvement of resistance to wear, erosion, corrosion and mechanical properties. The purpose of this paper is to review CNT reinforced nanocomposite coatings using thermal spray by various researchers.展开更多
A sinus of Valsalva aneurysm (SOVA) is abnormal dilatation of the either aortic sinuses, area of the aortic root between the aortic valve annulus and the sinotubular junction. Their clinical presentation may range fro...A sinus of Valsalva aneurysm (SOVA) is abnormal dilatation of the either aortic sinuses, area of the aortic root between the aortic valve annulus and the sinotubular junction. Their clinical presentation may range from being asymptomatic as an incidental finding on cardiac imaging to symptomatic presentations related to the compression of adjoining structures or intracardiac shunting caused by rupture of the SOVA mostly into the right side of the heart. The compression leads to findings of tricuspid valve regurgitation, right ventricular outflow tract (RVOT) obstruction and rarely complete heart block (CHB). Dissection or erosion into interventricular septum is one of the rarest complications of SOVA. The symptomatic presentation is almost always a surgical emergency. Here we present a case report of a patient with unruptured sinus of valsalva originating from right sinus dissecting into interventricular septum causing complete heart bock. In this case after surgical correction the complete heart block reverted to sinus rhythm.展开更多
Right coronary artery (RCA) communicating to coronary sinus (CS) resulting in aneurysmal dilatation of RCA is a rare congenital anomaly, usually presenting late with complication of left to right shunt and volume over...Right coronary artery (RCA) communicating to coronary sinus (CS) resulting in aneurysmal dilatation of RCA is a rare congenital anomaly, usually presenting late with complication of left to right shunt and volume overload. We report a case of a 53 years old female presenting with dyspnea on exertion, orthopnea and angina. Echocardiography and computed tomography are suggestive of a fistulous communication of RCA to CS with aneurysm of RCA. Patient was treated surgically and is asymptomatic after three years of follow up.展开更多
Rapid prototyping (RP) or layered manufacturing (LM) technologies have been extensively used to manufacture prototypes composed mainly of plastics, polymers, paper, and wax due to the short product development time an...Rapid prototyping (RP) or layered manufacturing (LM) technologies have been extensively used to manufacture prototypes composed mainly of plastics, polymers, paper, and wax due to the short product development time and low costs of these technologies. However, such technologies, with the exception of selective laser melting and sintering, are not used to fabricate metallic products because of the resulting poor life, short cycle, poor surface finish, and low structural integrity of the fabricated parts. The properties endowed by these parts do not match those of functional parts. Therefore, extensive research has been conducted to develop new additive manufacturing (AM) technologies by extending existing RP technologies. Several AM technologies have been developed for the fabrication of metallic objects. These technologies utilize materials, such as Ni-, A1-, and Ti-based alloys and stainless steel powders, to fabricate high-quality functional components. The present work reviews the type of materials used in laserbased AM processes for the manufacture of metallic products. The advantages and disadvantages of processes and different materials are summarized, and future research directions are discussed in the final section. This review can help experts select the ideal type of process or technology for the manufacturing of elements composed of a given alloy or material (Ni, Ti, Al, Pb, and stainless steel).展开更多
We have calculated the in-medium magnetic moments of octet baryons in the presence of hot and dense symmetric nuclear matter. Effective magnetic moments of baryons have been derived from medium modified quark masses w...We have calculated the in-medium magnetic moments of octet baryons in the presence of hot and dense symmetric nuclear matter. Effective magnetic moments of baryons have been derived from medium modified quark masses within the chiral SU（3） quark mean field model. Further, for better insight into the medium modification of baryonic magnetic moments, we have considered the explicit contributions from the valence quarks, sea quarks and the sea orbital angular momentum of sea quarks. These effects have been successful in giving the description of baryonic magnetic moments in vacuum. The magnetic moments of baryons are found to vary significantly as a function of density of nuclear medium.展开更多
Acquired isolated palatal palsy is a rare disease.It is commonly seen in children.It usually presents with acute onset nasal regurgitation of fluids,rhinolalia,and palatal asymmetry.Many causes of this disease,such as...Acquired isolated palatal palsy is a rare disease.It is commonly seen in children.It usually presents with acute onset nasal regurgitation of fluids,rhinolalia,and palatal asymmetry.Many causes of this disease,such as infections,trauma,tumor,and brainstem lesions,etc.,have been reported.However,the most plausible explanation is immunological/ischemic damage to the affected nerve.After ruling out major potential causes of this disease,the damage is often considered to be idiopathic in nature.This disease has a benign self-limiting course with excellent recovery.In accordance with a hypothesized immunological basis for this condition,treatment with steroids results in significant improvement in its clinical features.展开更多
文摘Laparoscopic imaging has advanced significantly,with higher resolutions like 4K,and innovative light modes such as narrow band imaging and near-infrared imaging.Recently,yellow enhancement(YE)mode has emerged as a novel tool that enhances the pale-yellow colour of fat into a fluorescent yellow-green,improving contrast without the need for injected dyes.It can be toggled on and off easily during surgery.YE is still under evaluation,but early experience suggests it helps surgeons differentiate anatomical planes and key intraabdominal structures from surrounding adipose tissue.This is particularly useful in:(1)Dissecting structures surrounded or covered by fat;and(2)operating on patients with obesity,where excess intra-abdominal fat limits visualisation and retraction.By enhancing the visibility of vascular pedicles,ureters,and nerves,YE enables more precise dissections and may reduce the risk of accidental injury.It can also assist less experienced surgeons in identifying important structures,potentially improving efficiency and surgical outcomes.As a training tool,YE may shorten the learning curve,though further study is needed.Overall,YE offers potential benefits in fat-dense surgical fields by improving visualisation,reducing complications,and enhancing patient safety.
文摘Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Due to the varied initial presentation, treatment may be delayed, leading to poorer outcomes. Here, we present a unique case of a 27-year-old schizophrenic patient who initially presented with acute respiratory failure and septic shock and was ultimately diagnosed with cavitary pneumonia secondary to esophageal perforation.
文摘Received 16 July 2016;revised 24 January 2017;accepted 7 February 2017 Available online 22 February 2017 Abstract Microstructural evolution of die-cast and homogenized AZ91 Mg-alloys was investigated during dry sliding wear condition.Tribological tests were performed using a pin-on-disc(EN8 steel)configuration with a normal load of 50 N at a constant sliding speed of 2.5 ms^(−1) under ambient environment.Delamination was recognized as a predominant wear mechanism in both of these materials.The die-cast AZ91 Mg-alloy exhibits lower coefficient of friction and higher wear rate.This can be ascribed to increase in the intensity of load bearing capacity of hardβ-Mg_(17)Al_(12) phase,and crack formation/de-cohesion at the interface between primaryα-Mg and discontinuousβ-Mg_(17)Al_(12) phases.On the contrary,the homogenized AZ91 Mg-alloy experiences higher coefficient of friction and lower wear rate.The friction-induced microstructural evolution(supersaturatedα-Mg to eutectic(α+β-Mg_(17)Al_(12)))tending to minimize the wear rate by providing barrier to material removal in the near surface region of homogenized AZ91 Mg-alloy.Therefore,experimental observation revealed that an inverse relationship exists between wear rate and coefficient of friction for the investigated materials.The analysis of worn surfaces and subsurfaces by electron microscopy provided evidence to delamination wear and microstructural evolution.
基金the Metals and Nanomaterials program in the Division of Materials Research at the National Science Foundation under Grant No.DMR1105347.
文摘We have introduced a polymer precursor into molten magnesium and then in-situ pyrolyzed to produce castings of metal matrix composites(P-MMCs)containing silicon-carbonitride(SiCNO)ceramic particles.Stress-rupture measurements of as-cast P-MMCs was performed at 350 ℃(0.69TM)to 450 ℃(0.78TM)under dead load condition corresponding to tensile stress of 2.5 MPa to 20 MPa.The time-to-fracture data were analyzed using the classical Monkman–Grant equation.The time-to-fracture is thermally activated and follows a power-law stress exponent exhibiting dislocation creep.Fractography analysis revealed that while pure magnesium appears to fracture by dislocation slip,the P-MMCs fail from the nucleation and growth of voids at the grain boundaries.
文摘The present work concerns with correlation between microstructure and wear behavior of AZX915 Mg-alloy reinforced with 12 wt%of TiC particles by stir-casting process.Dry sliding tests were performed under ambient environment by using a pin-on-disc(EN8 steel)configuration with a normal load of 50 N at a constant sliding speed of 2.50 ms^(−1).While as-cast composite experienced delamination wear,heat treated composite suffered from delamination and oxidation wear during dry sliding contact.Moreover,the heat treated composite exhibited lower friction and higher wear rate as compared to the as-cast composite.Friction and wear behavior were correlated with microstructures based on the concept of oxidation tendency and crack nucleation/propagation.Further,a schematic model has been proposed illustrating wear mechanisms from the point of view of subsurface microstructural evolution of the AZX915-TiCp composite.
文摘Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.
基金supported by the Center for Frontiers of Subsurface Energy Security (CFSES), UT Austinfunded by Basic Energy Sciences at the U.S.Department of Energy
文摘One of the potential risks associated with subsurface storage of CO_2 is the seepage of CO_2 through existing faults and fractures. There have been a number of studies devoted to this topic. Some of these studies show that geochemistry, especially mineralization, plays an important role in rendering the faults as conduits for CO_2 movement while others show that mineralization due to CO_2 injection can result in seep migration and flow diversion. Therefore, understanding the changes in reservoir properties due to pore alterations is important to ensure safe long term CO_2 storage in the subsurface. We study the changes in the Representative Elementary Volume（REV） of a rock due to reactive kinetics over a time, using a statistical approach and pore-scale CO_2-rock interactiondata.The goal of this study is to obtain the REV of a rock property that accounts for pore-scale changes over time due to reactive kinetics, and we call this as spatiotemporal REV. Scale-up results suggest that the REV changes with time when CO_2-rock interaction is considered. It is hypothesized that the alteration in pore structure introduces more heterogeneity in the rock, and because of this the magnitude of REV increases. It is possible that these noticeable changes in REV at pore-scale may have an impact when analyzed at the reservoir scale.
文摘The physical limitations of complementary metal-oxide semiconductor?(CMOS) technology have led many researchers to consider other alternative technologies. Quantum-dot cellular automate (QCA), single electron tunneling (SET), tunneling phase logic (TPL), spintronic devices, etc., are some of the nanotechnologies that are being considered as possible replacements for CMOS. In these nanotechnologies, the basic logic units used to implement circuits are majority and/or minority gates. Several majority/minority logic circuit synthesis methods have been proposed. In this paper, we give a comparative study of the existing majority/minority logic circuit synthesis methods that are capable of synthesizing multi-input multi-output Boolean functions. Each of these methods is discussed in detail. The optimization priorities given to different factors such as gates, levels, inverters, etc., vary with technologies. Based on these optimization factors, the results obtained from different synthesis methods are compared. The paper also analyzes the optimization capabilities of different methods and discusses directions for future research in the synthesis of majority/minority logic networks.
基金This study was deemed eligible for category-2 Institutional Review Board exempt status from Mayo Clinic IRB,Mayo Clinic,Rochester,MN,55905,United States.
文摘BACKGROUND A diverse country like India may have variable intensive care units(ICUs)practices at state and city levels.AIM To gain insight into clinical services and processes of care in ICUs in India,this would help plan for potential educational and quality improvement interventions.METHODS The Indian ICU needs assessment research group of diverse-skilled individuals was formed.A pan-India survey"Indian National ICU Needs"assessment(ININ 2018-I)was designed on google forms and deployed from July 23rd-August 25th,2018.The survey was sent to select distribution lists of ICU providers from all 29 states and 7 union territories(UTs).In addition to emails and phone calls,social medial applications-WhatsApp™,Facebook™and LinkedIn™were used to remind and motivate providers.By completing and submitting the survey,providers gave their consent for research purposes.This study was deemed eligible for category-2 Institutional Review Board exempt status.RESULTS There were total 134 adult/adult-pediatrics ICU responses from 24(83%out of 29)states,and two(28%out of 7)UTs in 61 cities.They had median(IQR)16(10-25)beds and most,were mixed medical-surgical,111(83%),with 108(81%)being adult-only ICUs.Representative responders were young,median(IQR),38(32-44)years age and majority,n=108(81%)were males.The consultants were,n=101(75%).A total of 77(57%)reported to have 24 h in-house intensivist.A total of 68(51%)ICUs reported to have either 2:1 or 2≥:1 patient:nurse ratio.More than 80%of the ICUs were open,and mixed type.Protocols followed regularly by the ICUs included sepsis care,ventilator-associated pneumonia(83%each);nutrition(82%),deep vein thrombosis prophylaxis(87%),stress ulcer prophylaxis(88%)and glycemic control(92%).Digital infrastructure was found to be poor,with only 46%of the ICUs reporting high-speed internet availability.CONCLUSION In this large,national,semi-structured,need-assessment survey,the need for improved manpower including;in-house intensivists,and decreasing patient-tonurse ratios was evident.Sepsis was the most common diagnosis and quality and research initiatives to decrease sepsis mortality and ICU length of stay could be prioritized.Additionally,subsequent surveys can focus on digital infrastructure for standardized care and efficient resource utilization and enhancing compliance with existing protocols.
文摘This review is done essentially to study results in the field of synthesis and characterization of Carbon Nanotubes (CNT’s) reinforced nanocomposite coatings using thermal sprayed coatings. CNT reinforced nanocomposite coatings produced by thermal spray process are being developed for a wide variety of applications, e.g. aerospace, automotive and sports equipment industries. It is anticipated that, if properly deposited, nanocomposite ceramic coatings could also provide improved properties like wear resistance and thermal barrier coatings. These results clearly demonstrate that the significant improvement in coating performance can be achieved by utilizing proper thermal sprayed nanocomposite coatings. Thermal sprayed nanocomposite coatings shows improvement of resistance to wear, erosion, corrosion and mechanical properties. The purpose of this paper is to review CNT reinforced nanocomposite coatings using thermal spray by various researchers.
文摘A sinus of Valsalva aneurysm (SOVA) is abnormal dilatation of the either aortic sinuses, area of the aortic root between the aortic valve annulus and the sinotubular junction. Their clinical presentation may range from being asymptomatic as an incidental finding on cardiac imaging to symptomatic presentations related to the compression of adjoining structures or intracardiac shunting caused by rupture of the SOVA mostly into the right side of the heart. The compression leads to findings of tricuspid valve regurgitation, right ventricular outflow tract (RVOT) obstruction and rarely complete heart block (CHB). Dissection or erosion into interventricular septum is one of the rarest complications of SOVA. The symptomatic presentation is almost always a surgical emergency. Here we present a case report of a patient with unruptured sinus of valsalva originating from right sinus dissecting into interventricular septum causing complete heart bock. In this case after surgical correction the complete heart block reverted to sinus rhythm.
文摘Right coronary artery (RCA) communicating to coronary sinus (CS) resulting in aneurysmal dilatation of RCA is a rare congenital anomaly, usually presenting late with complication of left to right shunt and volume overload. We report a case of a 53 years old female presenting with dyspnea on exertion, orthopnea and angina. Echocardiography and computed tomography are suggestive of a fistulous communication of RCA to CS with aneurysm of RCA. Patient was treated surgically and is asymptomatic after three years of follow up.
文摘Rapid prototyping (RP) or layered manufacturing (LM) technologies have been extensively used to manufacture prototypes composed mainly of plastics, polymers, paper, and wax due to the short product development time and low costs of these technologies. However, such technologies, with the exception of selective laser melting and sintering, are not used to fabricate metallic products because of the resulting poor life, short cycle, poor surface finish, and low structural integrity of the fabricated parts. The properties endowed by these parts do not match those of functional parts. Therefore, extensive research has been conducted to develop new additive manufacturing (AM) technologies by extending existing RP technologies. Several AM technologies have been developed for the fabrication of metallic objects. These technologies utilize materials, such as Ni-, A1-, and Ti-based alloys and stainless steel powders, to fabricate high-quality functional components. The present work reviews the type of materials used in laserbased AM processes for the manufacture of metallic products. The advantages and disadvantages of processes and different materials are summarized, and future research directions are discussed in the final section. This review can help experts select the ideal type of process or technology for the manufacturing of elements composed of a given alloy or material (Ni, Ti, Al, Pb, and stainless steel).
文摘We have calculated the in-medium magnetic moments of octet baryons in the presence of hot and dense symmetric nuclear matter. Effective magnetic moments of baryons have been derived from medium modified quark masses within the chiral SU（3） quark mean field model. Further, for better insight into the medium modification of baryonic magnetic moments, we have considered the explicit contributions from the valence quarks, sea quarks and the sea orbital angular momentum of sea quarks. These effects have been successful in giving the description of baryonic magnetic moments in vacuum. The magnetic moments of baryons are found to vary significantly as a function of density of nuclear medium.
文摘Acquired isolated palatal palsy is a rare disease.It is commonly seen in children.It usually presents with acute onset nasal regurgitation of fluids,rhinolalia,and palatal asymmetry.Many causes of this disease,such as infections,trauma,tumor,and brainstem lesions,etc.,have been reported.However,the most plausible explanation is immunological/ischemic damage to the affected nerve.After ruling out major potential causes of this disease,the damage is often considered to be idiopathic in nature.This disease has a benign self-limiting course with excellent recovery.In accordance with a hypothesized immunological basis for this condition,treatment with steroids results in significant improvement in its clinical features.
