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Flexible electronics have attracted wide attention for a variety of applications in the last few years; some based on components such as diodes and transistors have been reported earlier. This paper reports an optimized design of a flexible film bulk acoustic resonator suitable as a sensor for toluene gas detection with polyethylene terephthalate as flexible substrate. Aluminium nitride, lead zirconate titanate, and zinc oxide were chosen as the piezoelectric materials, and a polydimethylsiloxane (PDMS) coated electrode was placed on top to perform as a functional layer for sensing. Finite element modeling was used for the optimization of PDMS flexible film. The paper also reports the effect of different piezoelectric materials used, Bragg reflector stages and effect of PDMS layer thickness on the performance of the sensor. The optimal sensor configuration was obtained using Taguchi DoE and ANOVA techniques. For the optimized structure, simulated values of coupling coefficient, quality factor and figure of merit are 0.237574 (or 23.7574%), 991 and ~ 235, respectively. The sensor exposure to toluene in the concentrations from 0 to 500 ppm resulted in down shifting of its resonant frequency. Sensitivity of 12 kHz/ppm has been observed and reported.

Introduction: Organophosphorus poisoning is associated with high rate of mortality if not diagnosed and treated in time. Therefore aim of present study is to evaluate the significance of cholinesterase activity in assessing severity and to predict the outcome of Organophosphorus poisoning. Material and Methods: Present study was conducted in the department of Forensic Medicine, S.N. Medical College & Hospital, Agra during the period of 18 months (February 2011 to July 2012). Total 160 patients were enrolled after applying inclusion and exclusion criteria. Peradeniya Organophosphorus Poisoning Scale was applied to all study subjects. Result and Observation: Majority of patients were married (70%) and male (64%). About 42% of cases belong to the age group 21–30 years. About 1/3rd of the cases had low socioeconomic status and about 1/3rd cases were farmers by occupation. On applying Peradeniya Organophosphorus Poisoning (POP) Scale, about one third of patients had tachypnoea, followed by impaired consciousness (29%). Serum/ plasma cholinesterase level showed higher mortality in patients having suppressed cholinesterase activity (< 4000 IU/L). Conclusion: Organophosphorus poisoning diagnosed at early stages of poisoning determining pseudocholinesterase activity form a reliable diagnostic test for management and can serve as lives saving tool.

This work reports the finite element modeling, fabrication and structural characterization a film bulk acoustic resonator (FBAR) devices using shadow mask technique. For the performance analysis of the FBAR device, simulations were performed on COMSOL Multiphysics platform. RF sputtering technique is used to deposit c-axis oriented zinc oxide (ZnO) thin film on Aluminum electrodes. The Aluminum electrodes were deposited using e-beam evaporation technique. The X-ray diffraction (XRD), atomic force microscopy (AFM), and scanning electron microscopy (SEM) techniques were used to examine the surface morphologies of the deposited piezoelectric film (ZnO). The quality of the deposited piezoelectric material film was measured with the help of XRD spectra and AFM is used to measure surface roughness of the deposited ZnO film and its measured value is 6.94 nm. The resonant characteristics of fabricated FBAR device are evaluated with the help of COMSOL Multiphysics simulations and the obtained values of effective electromechanical coupling constant (k2eff), quality factors (Qs and Qp) and Figure of merit are 3.0025%, 1811.3, 1711.4 and 54 (approximately), respectively.

Introduction: In our world, many human lives are lost to crime and violence in which asphyxial deaths are one of the major contributors. Materials and Methods: In present study analysis of 391 deaths caused by asphyxia out of 3224 autopsies conducted in mortuary of S. N. Medical College, Agra during period of 1½ years from March 2015 to August 2016 is conducted. Data obtained is reviewed and analyzed according to different types of asphyxial deaths, their age wise distribution, sex wise distribution, manner of death and contributing factors. Results: Proportion of asphyxial deaths was 12.1% (391 cases). Hanging (64.9%) is most commonly encountered followed by drowning (24.8%) and strangulation (4.6%). Most common victims are male with male: female ratio of 1.37: 1. Most cases falls in 21-30 years age group with 27.4% of total. Majority of hanging cases were suicidal while all strangulation cases were homicidal. Majority of drowning cases were accidental. It was elicited from history that personal reasons like failure in examinations, psychiatric problems, long time illness etc. were the most common reasons for suicide by hanging. Conclusion: In present study, suicidal hanging and accidental drowning seems to be major proportions of violent asphyxial deaths. Both these manners of deaths indicate frustration and carelessness on part of population which are preventable and needs to be rectified on urgent basis. Keywords: Asphyxia, Hanging, Strangulation, Drowning.

In this work, a microhollow cathode variant consisting of cylindrical cathode structure and a coaxial anode, with a layer of dielectric barrier on the inner wall of the cathode cavity, has been investigated. This arrangement allows the device to be operated at atmospheric pressure reaching electron densities up to 1018 m−3 in the microhollow cathode cavity. The discharge initiates from the narrow gap region between the cathode and the anode, followed by hollow cathode discharge. The presence of the anode in the discharge cavity causes the discharge electrons to be absorbed by the anode. A theoretical approach has been followed and it establishes a criterion for sustenance of this discharge in the microhollow cathode cavity. This criterion resulted from the fact that for discharge to be sustained in the hollow cathode cavity, the generation of electrons should be balanced by the absorption of electrons. Both these phenomena have been quantitatively explained by electron multiplication quotient and a multipass parameter for hollow cathode discharge has been evaluated.

Single-walled carbon nanotubes (SWNTs) are incorporated in different device configurations such as chemiresistors and field-effect transistors (FETs) as a sensing element for the fabrication of highly sensitive and specific biochemical sensors. For this purpose, sorting and aligning of semiconducting SWNTs between the electrodes is advantageous. In this work, a silicon shadow mask fabricated using conventional semiconductor processes and silicon bulk micromachining was used to make metal contacts over SWNTs with a minimum feature of 1 μm gap between the electrodes. The developed silicon shadow mask-based metal contact patterning process is cost-effective and free from photoresist (PR) chemical coatings and thermal processing. After a detailed investigation, sodium dodecyl sulfate (SDS), an anionic surfactant, along with ultrasonication process, was found to be effective for the removal of unclamped and metallic SWNTs, resulting in aligned and clamped semiconducting SWNTs between the electrodes. The presence of aligned semiconducting SWNTs was confirmed using atomic force microscopy (AFM), field emission scanning electron microscopy (FESEM), and Raman spectroscopy techniques. The fabricated devices were tested for nitrogen dioxide (NO2) gas sensing as a test case. The sensitivity enhancement of ∼21 to 76% in the 20-80 ppm NO2 concentration range has been observed in the case of aligned semiconducting SWNT devices compared to the random network SWNT-based sensors.

Penile strangulation is not commonly encountered in orthopedic practice. Quick decision and immediate removal of the metallic ring with readily available instruments is the key to a successful outcome. Jumbo cutter is a commonly available instrument. It can be used with ease without causing any thermal or soft tissue damage, giving satisfactory results.

In this paper, we report a cost effective and facile approach to produce uniform nanostructural black silicon over large-area by metal assist chemical etching followed by its transfer over pressure sensitive flexible substrate. Structural and optical properties of black silicon over flexible substrate were investigated. Field emission scanning electronic microscope (FESEM) reveals textured surface and dense morphology of silicon nanostructures; that appeared to be black. An intense and broadband UV and Visible photoluminescence spectra from these nanostructures was observed and suggested the optically active nature of black silicon. Broadening and asymmetric shifting of Raman line shape, corresponding to black silicon, confirmed quantum confinement of phonon. The crystal sizes of silicon (Si) nanostructures calculated using frequency shift in Raman spectra analytical model were 3.4 nm to 4.7 nm. Significant reduction of reflection below (1%) over the wide UV–Vis spectrum was recorded due to presence of textured surface as observed by FESEM. The present work aids our understanding of tuning the optical properties of black silicon and its’ realization on flexible substrate could be beneficial for flexible electronics including bio-sensing and optoelectronics devices. More interestingly low reflectance of black silicon could pave the way for realization of highly efficient flexible solar cells.

In this paper, technology for a gas sensor platform with borofloat as the substrate material is presented. Comprehensive characterization of the platform, its comparison with silicon and alumina, fabrication yield improvement and a study of reliability of the micro-heater platform have been carried out. Usually, the chips are suspended in air to reduce power consumption. However, the presented technology is a non-MEMS technique and doesn’t require any complex packaging. Borofloat has much lower thermal conductivity in comparison to silicon and alumina, thereby reducing the thermal losses, making it possible to operate the device with low power consumption. The process adapted for the fabrication of the gas sensor platform has lesser complexities and the process cost is reduced compared to conventional gas sensor fabrication, as it does not require thermal oxidation and bulk micromachining. Different substrates (silicon, alumina and glass) have been simulated using COMSOL to depict the benefit of lower thermal conductivity. Micro-heater has also been fabricted on all the three above mentioned substrates and the power consumption is compared. Various reliability analysis have been carried out on the glass based platform such as maximum temperature test, long term ON test and ON–OFF pulse test.

Background: India has been amongst the most affected nations during the SARS CoV2 pandemic, with sparse data on country wide spread of asymptomatic infections and antibody persistence. This longitudinal cohort study was aimed to evaluate SARS CoV2 seropositivity rate as a marker of infection and evaluate temporal persistence of antibodies with neutralization capability and to infer possible risk factors for infection. Methods: Council of Scientific and Industrial Research, India (CSIR) with its more than 40 laboratories and centers in urban and semi urban settings spread across the country piloted the pan country surveillance. 10427 adult individuals working in CSIR laboratories and their family members based on voluntary participation were assessed for antibody presence and stability was analyzed over 6 months utilizing qualitative Elecysys SARS CoV2 specific antibody kit and GENScript cPass SARS CoV2 Neutralization Antibody Detection Kit. Along with demographic information, possible risk factors were evaluated through self to be filled online forms with data acquired on blood group type, occupation type, addiction and habits including smoking and alcohol, diet preferences, medical history and transport type utilized. Symptom history and information on possible contact and compliance with COVID 19 universal precautions was also obtained. Findings:1058 individuals (10.14%) had antibodies against SARS CoV2. A follow up on 346 seropositive individuals after three months revealed stable to higher antibody levels against SARS CoV2 but declining plasma activity for neutralizing SARS CoV2 receptor binding domain and ACE2 interaction. A repeat sampling of 35 individuals, at six months, revealed declining antibody levels while the neutralizing activity remained stable compared to three months. Majority of seropositive individuals (75%) did not recall even one of nine symptoms since March 2020. Fever was the most common symptom with one fourth reporting loss of taste or smell. Significantly associated risks for seropositivity (Odds Ratio, 95% CI, p value) were observed with usage of public transport (1.79, 1.43 to 2∙24, 2.81561x10-6), occupational responsibilities such as security, housekeeping personnel etc. (2.23, 1.92 to 2.59, 6.43969x10-26), non smokers (1.52, 1.16 to 1.99, 0.02) and non vegetarianism (1.67, 1.41 to 1.99, 3.03821x10-8). An iterative regression analysis was confirmatory and led to only modest changes to estimates. Predilections for seropositivity was noted with specific ABO blood groups; O was associated with a lower risk. Interpretation: In a first of its kind study from India, we report the seropositivity in a country wide cohort and identify variable susceptible associations for contacting infection. Serology and Neutralizing Antibody response provides much sought for general insights on the immune response to the virus among Indians and will be an important resource for designing vaccination strategies. Funding: Council of Scientific and Industrial Research, India (CSIR)

Regadenoson myocardial perfusion imaging (MPI) is a widely used screening study for patients with an intermediate pretest probability of coronary artery disease (CAD). Via selective agonism of the adenosine A2A receptor, regadenoson can induce coronary steal, revealing stenotic vessel territory through transient ischemia. Common side effects of this medication include chest pain, shortness of breath, nausea, vomiting, atrioventricular block, seizure, and allergic reactions. Here we present a case of severe shivering and chest tightness after the administration of regadenoson, along with a physiologic explanation and treatment.

The human body is a highly sophisticated machine that is not fully understood to date. The body function is highly dependent on the versatile functions performed by different organs, which have their diverse arrangement of cells. Every organ (perhaps every body part) is prone to damage and malfunction because of the topological conditions, lifestyle, habitats, and food chemicals. Helping humans to lead an easy, luxurious, and healthy life are the primary goal of any technology, especially extending human life is the ultimate target of medical instrumentation. The importance of developing innovative techniques for disease diagnosis and treatment are burning topics since the start of the medical and pharmaceutical industry. Kidney failure is one of the common health issues worldwide, which is a slow poison affecting 10% of the world population. The importance of replacing the kidney is essential to extend a patient life. This review focuses on Organ-on-Chip technology with a major focus on Kidney-on-Chip (KOC). The evolution of techniques to diagnose and treat organ failure is elaborately presented. Major emphasis solely on the development of kidney failure causes, diagnostic techniques, replacement techniques are reported with a timeline of developments. The major functions of the kidney that have been achieved artificially so far are reviewed to the deepest level. The future directions in this field are predicted and presented. MEMS and microfluidics allow the design and manufacturing of devices at microscale without compromising the actual functionalities, especially in terms of disease diagnosis and treatment. Microfluidics technology revolutionized the development of artificial organ industry, the chances of realizing an organ substantially improved.

Background: Large epidemiologic studies have established diabetes mellitus as an independent risk factor for all-cause mortality. There is also evidence to suggest a linear relationship between hemoglobin A1c (HbA1c) and mortality. We find that poorly controlled diabetes in high-risk US Veterans carries an independent mortality risk mediated through reduced ejection fraction (rEF) and obstructive coronary artery disease (ObCAD). Methods: 1535 consecutive US Veterans presenting for left heart catheterization were retrospectively analyzed for presence of risk factors with long-term follow-up. Results: 248 patients had HbA1c ≥8 with 76.2% mortality compared to 198 patients with HbA1c in the prediabetic range of 5.70-6.49 with 67.2% mortality (p = 0.03) with univariate hazard ratio (HR) 1.25 [1.002-1.56, p=0.048]. Multivariate adjustment for age, BMI, hypertension, hyperlipidemia, chronic kidney disease yielded HR 1.28 [1.02-1.60, p=0.034]. Multivariate adjustment for aforementioned variables with addition of rEF, ObCAD and prior revascularization yielded HR 1.17 [0.93-1.48, p=0.19]. Conclusion: We conclude that poorly controlled diabetes with HbA1c 8 or greater carries independent mortality risk when controlled for traditional risk factors however loses significance after controlling for rEF, ObCAD and prior revascularization.

India is agriculture dominant country and organophosphorus commonly used by former in agriculture field. Therefore, Organophosphorus poisoning is common India. Study done at emergency department to know the pattern of sign and symptoms presentation at the time of admission. Total number of cases was 160, out of them 102 (64%) were males and only 58 (36%) were females. Male to female ratio was 1.75:1. farmers 61 (38%) were commonly affected, followed by 35(22%) of patients were housewives and 26 (16%) of patients were students. symptoms presented were vomiting 150 (93.75%) and salivation 150 (93.75%), followed by sweating 147 (91.88%), lacrimation 102 (63.75%) and blurring of vision 80 (50%), breathlessness (40%), faecal incontinence (31.88%), urinary incontinence (18.13%), headache (18.13%) and convulsion (10%). commonest signs were smell of poison 150 (93.75%), followed by tachypnoea 134 (83.75%), altered consciousness 115 (71.88%), miosis 86 (53.75%), fasciculation 70 (43.75%), tachycardia (36.25%), bradycardia (28.13) and pulmonary oedema (06.25%). Increased body secretions were the commonest presentation then other symptoms followed were blurring vision, tachypnoea altered consciousness, and respiratory symptoms. It can be helpful to make diagnosis and take awareness, preventive measures about organophosphorus poisoning.

Background: The prognostic importance of right bundle branch block (RBBB) has been debated. It has been described as a benign variant, especially when compared to left bundle branch block (LBBB). We studied the presence of bundle branch blocks in a high-risk U.S. Veteran cohort. Methods: Retrospective electrocardiogram (ECG) analysis for presence of RBBB or LBBB was conducted in 1,535 consecutive patients presenting for left heart catheterization. Evaluated risk factors were gender, age, BMI, hypertension, hyperlipidemia, diabetes, smoking history, chronic kidney disease, reduced ejection fraction and history of previous revascularization. Mean follow up time was 112 ± 66 months. Results: Analysis of 1,535 ECGs revealed 113 patients with RBBB and 65 patients with LBBB. Risk factor burden between the two groups appeared similar with exception of higher incidence of reduced ejection fraction and previous revascularization in the LBBB group. Mortality of RBBB group was 92.0% compared to 96.9% of LBBB group. Mean time to death for RBBB group was 74.1 months compared to 61.0 months for LBBB group. Hazard ratio (HR) for RBBB with Cox regression controlling for aforementioned risk factors was 1.41, 95% CI = 1.14-1.74; p =.002. HR for LBBB controlling for the same risk factors was 1.84, 95% CI = 1.42-2.40; p = Conclusion: In a high-risk cohort of US Veterans, both LBBB and RBBB are independent risk factors for mortality. While LBBB is a known adverse risk factor, presence of RBBB portends a poor prognosis and warrants further research.

Background: The association between psychiatric illness, coronary artery disease (CAD) and mortality is poorly understood. It has been theorized that psychiatric diseases may result in increased mortality and poor cardiovascular outcomes, but prior studies have been limited by short follow-up time and non-angiographic methods to document CAD. In a long-term follow-up study we report the relationship between psychiatric disease, mortality, and angiographically proven CAD. Methods: We retrospectively reviewed 1532 consecutive patients presenting to the Dayton VA Medical Center between 2001-2005 for left heart catheterization. “Psychiatric illness” was defined as the prior diagnosis of a psychiatric disorder or the current prescription of antidepressant/antipsychotic medication. We evaluated the association between psychiatric illness, mortality and CAD with mean follow-up time of 9.3 ± 5.4 years. Results: Of 1532 patients, 503 (32.8%) had a psychiatric illness. Mortality did not differ in patients with and without psychiatric disease (psychiatric disease = 65.4% vs no psychiatric disease = 69.8%, p =0.084). Psychiatric illness had a Cox hazard ratio of 0.92 (CI 0.81-1.05, p =0.20) and 0.97 (CI 0.85-1.11, p =0.63) after controlling for reduced ejection fraction, obstructive coronary artery disease, chronic kidney disease, hypertension, hyperlipidemia, and diabetes mellitus. Patients with psychiatric illness had a lower prevalence of obstructive coronary artery disease compared to those without psychiatric illness (66.6% vs 75.1% respectively, p Conclusion: In a high-risk US Veteran population followed for a mean of 9.3 years, psychiatric disease was associated with a lower incidence of obstructive coronary artery disease but was not associated with a significant difference in mortality. These finding challenge the existing assumption that all psychiatric illnesses are associated with CAD and mortality. The Veteran population (regardless of psychiatric disease) has a high baseline risk factor burden compared to the general population, which may obscure the negative effects of psychiatric disease. Our population had 32.8% mental disease (vs 18.9% in general population per NIMH/NIH), 72.3% obstructive CAD (vs 4.8% per AHA) and mean lifespan of 71.8 years (vs 78.6 years per CDC). Psychiatric illness was associated with lower rates of obstructive CAD and no significant difference in mortality in our population, suggesting that further research is required on individual psychiatric disorders and that Veterans require aggressive management of coronary risk factors.

Background: The mortality rate of US Veterans is greater than that of civilians, and US Veterans experience disproportionately higher burden of medical comorbidities. Disparities in coronary artery disease (CAD) incidence and its risk factors between US veterans and civilians has not previously been reported. This study seeks to identify disparities in the incidence of CAD and CAD risk factors in US veterans and the general population. Methods: A total of 1535 consecutive US Veterans presenting for left heart catheterization (LHC) were reviewed. We present risk factor burden, LHC outcome, and mortality with mean follow-up time of 112 ± 65.2 months. Results: At mean follow-up of 112 months (9.3 years), all-cause mortality was 68.3%. 12.7% had normal coronaries (NC), 14.9% had non-obstructive coronary artery disease and 72.3% had obstructive coronary artery disease (ObCAD). Mean BMI was 30.0; 87.8% had hypertension (HTN), 78.1% had hyperlipidemia (HLD), 52.2% has reduced ejection fraction (rEF), 45.5% had diabetes (DM), and 17.5% had chronic kidney disease (CKD). In order of decreasing Cox hazard, six risk factors (CKD, rEF, PVD, HTN, obesity and DM) were independent predictors of mortality. Conclusion: Mortality and incidence of ObCAD in US veterans are notably greater than in the American general population (per the CDC National Health Report) and other developed countries (per the WHO NCD Report). Compared to the general population, there is greater burden of HTN, HLD, DM and CKD in US Veterans. Among US Veterans, CKD carried a greater HR compared to HTN and DM, with no significant HR for HLD. This differs markedly from the general population studied in the REACH registry which established HTN, HLD and DM as the greatest predictors of cardiovascular mortality. The low hazard of HLD was likely secondary to its ubiquity in most patients in the cohort, regardless of CAD status. US Veterans have unique healthcare needs and our study guides which risk factors need to be managed to improve disparities in US Veteran health.

Breath analysis has gained interest of many researchers lately. Acetone has been proven to be the biomarker for diabetes mellitus. The research depicts a thin film MEMS based gas sensor for acetone gas detection. MEMS techniques have been followed to develop the gas sensor involving the processes like oxidation, lithography, sputtering for deposition of thin films and electrodes, etc. Tin oxide thin film has been incorporated for detecting different concentration levels of acetone gas, viz, 20, 10, 7, 5, 3, 1.5 ppm. Various characterization like X-ray diffraction (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM), gas sensing characterization for recording resistance changes have been performed. XRD patterns reveal the formation of SnO2. AFM and SEM depict clear images of grain boundaries on the film. SnO2 thin films have been annealed at 300 °C to achieve an optimum grain size of 86.3 nm as depicted by AFM. Optimum operating temperature for sensing acetone gas has been computed to be 360 °C. Tin oxide can detect even a very low concentration of 1.5 ppm acetone gas with a good resistance response change of 30%. Apart from acetone gas, other interfering gases present in breath have also been tested. The sensor does not respond to them. The response time of the sensor for detection of acetone gas is approximately 3 min and the recovery time is approximately 4 min. A suitable instrumentation circuitry has also been designed for the sensor which displays the resistance value of the thin film before and after it comes in contact with acetone gas.

Particle filtration and concentration have great significance in a multitude of applications. Physical filters are nearly indispensable in conventional separation processes. Similarly, microfabrication-based physical filters are gaining popularity as size-based particle sorters, separators, and prefiltration structures for microfluidics platforms. The work presented here introduces a linear combination of obstructions to provide size contrast-based particle separation. Polystyrene particles that are captured along the crossflow filters are packed in the direction of the dead-end filters. Separation of polydisperse suspension of 5 μm and 10 μm diameter polystyrene microspheres is attained with capture efficiency for larger particles as 95%. Blood suspension is used for biocharacterization of the device. A flow induced method is used to improve particle capture uniformity in a single microchannel and reduce microgap clogging to about 30%. This concept is extended to obtain semiquantification obtained by comparison of the initial particle concentration to captured-particle occupancy in a microfiltration channel.

In this work, process development for the realization of Microchannels is carried out using standard micro fabrication techniques with polysilicon as sacrificial material. Polysilicon (PolySi) material is deposited using LPCVD process. Thermal silicon oxide layer work as a capping layer after the polysilicon layer is released using wet chemical etching using Tetra Methyl Ammonium Hydroxide (TMAH). Fabricated microchannels are characterized using 3D optical imaging and scanning electron microscopy. Fabrication of the Microchannel with an open cross-section of 4 µm X 0.85 µm and 50 µm length is demonstrated.

A microfluidic device capable of sensing even fraction of pico Farad capacitive change is proposed. Purpose of the developed device is fluid concentration identification and characterization on the basis of the dielectric permittivity. A microchannel, realized on Silicon layer, below a sensing capacitor formed by electrodes sputter printed on a glass substrate. Fluids inside the microchannel affects the capacitance that is measured by a standard electronic interface system. Experimental results obtained for different fluids injected in the microchannel demonstrate the ability of the system to differentiate the fluids and estimate their dielectric permittivity both as pure samples and as mixtures at varying concentration of solute fractions. This makes the device a promising building block for fluid mixing monitoring in microfluidic systems.

We report a case of a 72 year old hypertensive male who developed severe hypertension followed by neurological deterioration in the immediate postoperative period after transurethral resection of prostate. While arterial blood gas and laboratory tests excluded transurethral resection of prostate syndrome or any other metabolic cause, reduction of blood pressure failed to ameliorate the symptoms. A cranial CT done 4 hours after the onset of neurological symptoms revealed bilateral gangliocapsular and right thalamic infarcts. Oral aspirin was advised to prevent early recurrent stroke. Supportive treatment and mechanical ventilation ensured physiological stability and the patient recovered completely over the next few days without any residual neurological deficit. Resumo: Relatamos o caso de um paciente hipertenso, 72 anos, que desenvolveu hipertensão grave seguida de deterioração neurológica no pós-operatório imediato após ressecção transuretral de próstata. Embora os testes laboratoriais e a gasometria tenham excluído a síndrome de ressecção transuretral de próstata ou qualquer outra causa metabólica, a diminuição da pressão sanguínea não conseguiu melhorar os sintomas. Uma tomografia computadorizada craniana, realizada 4 horas após o aparecimento de sintomas neurológicos, revelou infartos gangliocapsular bilateral e talâmico à direita. AAS oral foi aconselhado para prevenir um acidente vascular cerebral recorrente precoce. O tratamento de apoio e a ventilação mecânica garantiram a estabilidade fisiológica e o paciente obteve recuperação completa durante os próximos dias, sem qualquer déficit neurológico residual. Keywords: Transurethral resection of prostate, Perioperative period, Stroke, Hypertension, Neurologic manifestations, Unconsciousness, Palavras-chave: Ressecção transuretral de próstata, Perioperatório, Acidente vascular cerebral, Hipertensão, Manifestações neurológicas, Inconsciência

Background and purpose In patients with squamous cell carcinoma of the head and neck (HNSCC), extracapsular spread (ECS) of metastases in cervical lymph nodes affects prognosis and therapy. We assessed the accuracy of intravenous contrast-enhanced computed tomography (CT) and the utility of imaging criteria for preoperative detection of ECS in metastatic cervical lymph nodes in patients with HNSCC. Materials and methods Preoperative intravenous contrast-enhanced neck CT images of 93 patients with histopathological HNSCC metastatic nodes were retrospectively assessed by two neuroradiologists for ECS status and ECS imaging criteria. Radiological assessments were compared with histopathological assessments of neck dissection specimens, and interobserver agreement of ECS status and ECS imaging criteria were measured. Results Sensitivity, specificity, positive predictive value, and accuracy for overall ECS assessment were 57%, 81%, 82% and 67% for observer 1, and 66%, 76%, 80% and 70% for observer 2, respectively. Correlating three or more ECS imaging criteria with histopathological ECS increased specificity and positive predictive value, but decreased sensitivity and accuracy. Interobserver agreement for overall ECS assessment demonstrated a kappa of 0.59. Central necrosis had the highest kappa of 0.74. Conclusion CT has moderate specificity for ECS assessment in HNSCC metastatic cervical nodes. Identifying three or more ECS imaging criteria raises specificity and positive predictive value, therefore preoperative identification of multiple criteria may be clinically useful. Interobserver agreement is moderate for overall ECS assessment, substantial for central necrosis. Other ECS CT criteria had moderate agreement at best and therefore should not be used individually as criteria for detecting ECS by CT.

In this work, expressivity two operators fuzzy and skyline is primarily focused upon. Stated two known operators have been used here for augmenting selection operator of SQL. Since SQL is unable to understand linguistic concepts of natural language there is essence of a preference based solution so as to return answers according to user preferences. Both these operators can return a different answer to the same query. Additionally in this paper, performance of fuzzy and skyline processing time and the number of returned answers by means of an experimental study is analyzed.

Infective endocarditis (IE) is a life-threatening complication in patients with prosthetic heart valves. Early diagnosis and prompt management are necessary to prevent significant morbidity and mortality. We present an interesting case of IE involving a bioprosthetic aortic valve, aortic root

In developing countries like India, adulteration in the milk consumed by the population presents stern implications as tarnishing of the same poses serious issues, such as health deterioration, corruption, and so on. There are many adulterants that are added to milk, including water, flour, starch, and even urea, in quantitative measures making it undetectable. There are many devices in the market to measure adulteration in milk but most of them are bulky, require large sample volume, and need a technical operator for working. In the recent decade, microfluidics has emerged as a huge market for biomedical research. It has paved the pathway for a quick, robust, and plug-and-play device for various applications. This paper describes a low-cost, durable, and simple optofluidic microviscometer fabricated by the stereolithography technique. The device operation is based on the linear relationship between dynamic viscosity and channel width derived from the flow of two immiscible fluids inside a channel. The principle of operation is based on the modified Hagen–Poiseuille flow equation. The working principle is the viscosity-dependent capture of the microchannel width by the fluids flowing inside the microchannel under the laminar flow based on the pressure gradient between the inlets and the outlet. In this paper, around 60 milk samples with various adulteration ratios of various adulterants ranging from 1% to 10% have been tested. A best fit curve for every adulterant was defined, and the device was found to be accurate enough to measure the entire range of adulteration ratios with a high accuracy of 0.95.

The proposed article presents optimized Indium doped ZnO thin film for acetylene gas sensor. Thin films of ZnO and Indium doped ZnO of thickness 100 nm were successfully deposited on glass substrate using resistive thermal evaporation method. Structural properties have been performed by using XRD which reveals polycrystalline nature of the thin films. Morphological studies have been performed by using FESEM which reveals the information that thin film is homogeneous and uniform. AFM showed that with the increasing of indium doping concentration in ZnO resulting increment in vertical roughness of thin films. Further sample were tested for acetylene gas sensing using Keithley source meter and multimeter. The fabricated sensor (IZO-3) showed high sensitivity magnitude of 29.06 (100 ppm), short response and recovery time of 49.28 s and 58.45 s respectively at 150 °C operating temperature. IZO-3 sensor showed good linearity with good selectivity and excellent reproducibility.

The independent mortality risk of left bundle branch block (LBBB) has been established in the literature. While the pathophysiology remains controversial, obstructive coronary artery disease (ObCAD) and reduced ejection fraction (rEF) have been cited as mediating factors. We analyzed the mortality

Radiation-associated cardiac disease (RACD) comprises a spectrum of complications of wide-field mediastinal radiation. We describe a case of a young man who, after exposure to mediastinal radiation therapy (RT) several years ago, developed accelerated coronary artery disease, multivalvular disease

Stress myocardial perfusion imaging (MPI) is the gold standard test for stratification of suspected obstructive coronary artery disease (ObCAD) and has a reported false positive rate of 5-15% in small, non-angiographic studies. Approximately 600,000 angioplasties are completed annually in the US

Atrial functional mitral regurgitation (MR) secondary to long-standing atrial fibrillation is often misdiagnosed. 59 year old male with a 15 year history of persistent long-standing atrial fibrillation (AF) experienced recurrent hospitalizations for respiratory failure. Transesophageal

— This paper reports a novel shadow mask aligner, which is capable of aligning planar with ~ 1 µm alignment error as well as provision to compensate the wedge error by using movements of three precision linear actuators, spotted under optical microscope. The use of three points leveling also overcomes the common error of the upper assembly bending, which could occur with time after its continuous use. The reported wafer/ mask holding mechanism is able to accommodate substrates of 3"to 6" diameter. The unique magnetic clamping mechanism after alignment has been successfully demonstrated. The fabricated system is useful for alignment of mask and wafer, as well as for other applications like nano-imprint and micro-contact printing lithography. In these cases, moulds/ stamp is aligned with the patterned/ un-patterned target substrate; to create complex 3D structures micro-assembly of independently fabricated 2D components by proper aligning and clamping.

This paper presents design and fabrication of MEMS 1-D micro mirror using thermally actuated bimorph actuator, for out of plane actuation application. Bimorph actuator was made of aluminum and silicon dioxide materials. Micro mirror performance was simulated using COMSOL multiphysics tool. Maximum displacement and temperature profile with voltage along micro mirror were presented. Aluminum was used as heater element as well as top layer of bimorph layer. Micro mirror was successfully released using surface micromachining with copper as sacrificial layer.

This paper presents fabrication of thermally actuated multi-layered micro actuator for out of plane actuation application. Multi-layered actuators are fabricated using ammonium per sulphate based TMAH etching with metal passivation. Multi-layered $[\text{Au}/\text{Si}_{3}\mathrm{N}_{4}/\text{SiO}_{2}]$ micro actuators with straight and cross-heaters are characterized using I-V and LDV measurements. Gold as upper layer of micro actuator is fully protected during the release process. Fundamental mode or resonant frequency of fabricated multi-layered micro actuator is measured by Laser Doppler Vibrometer which is observed around 20 KHz.

Silicon nanowire (SiNW) arrays are fabricated using complementary metal-oxide semiconductor (CMOS) compatible technology, for the detection of proteins, pH levels, cardiac biomarker troponin-T (cTnT) etc. The sensor output is fed to a ‘current to frequency converter circuit’. Neuromorphic approach based low input referred noise frequency converter circuit is developed. The circuit generates a sequence of spikes with the help of Leaky integrate and fire neuron model (LIF) where firing delay maps to the strength of the stimulation across the array. The proposed read-out circuit is implemented using Tower Jazz Semiconductor's 0.18μm CMOS technology. The SiNW arrays are producing current change from 200pA to 1.6nA for a corresponding change of 50m V/0.5ng/ml protein concentration at the gate. The circuit is able to detect a change in current as low as 50pA and consuming IlμW power and 93×17μm2silicon area.

In this paper, we present a gas sensor platform technology which is non-MEMS and doesn't require any complex packaging for example hanging the chips in air while packing to reduce the power consumption. Our work is based on changing the substrate material to borofloat glass, which has much lower thermal conductivity in comparison to silicon and alumina, hence reducing the thermal losses making it possible to operate the device even with lower power consumption. The presented process has lesser complexities and the process cost is certainly reduced, as it does not require thermal oxidation and bulk micromachining. Different substrates (silicon, alumina and glass) have been simulated using COMSOL to depict the benefit of lower thermal conductivity. Fabricated gas sensor platform is rugged and reliable; the same has been verified by maximum temperature test, long term ON test and ON-OFF pulse test.

In this paper a new approach based on silicon shadow mask has been reported to realize metal-carbon nanotubes (CNTs) contacts in end-contact configuration, which provides low-ohmic and stable contacts than that of side-contacted configuration. The source and drain contacts were fabricated by placing the fabricated silicon shadow mask over the single walled CNTs (SWNTs) coated wafer followed by deposition of Cr/Au∼100nm/500 nm using e-beam evaporation. The SEM image clearly shows the end-contacts of individual SWNTs with the gold electrodes. Further, Keithley SCS 4200 parameter analyzer was used to perform electrical characterization of the fabricated devices. The calculated ION/IOFF ratio and threshold voltage of the typically shown device are ∼120 and∼290 mV respectively.