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In this work, the influence of Al (0, 2, 4, and 6 wt.%) on the optical properties of ZnO has been briefly investigated and described. The undoped and doped samples were characterized using a UV-visible spectrophotometer and Photoluminescence (PL). The X-ray diffraction (XRD) data in our preceding study is also indexed, and materials are said to have a wurtzite-structured hexagonal phase and exhibit no impurity phases. The average crystallite sizes of the pure ZnO were found to increase, i.e., from 14.19 nm to 34.17 nm with an increase in temperature, and in the case of Al-doped ZnO, at a constant temperature, from 35.05 nm to 18.89 nm, respectively. The average crystallite size of AZO (Al-doped ZnO) decreases with increasing Al content. With the increasing temperature, increases in crystallinity and size of the pure ZnO have been observed. In the case of Al doping, with an increase in the concentration of doping the crystallite size is seen to be decreased, without any change in the temperature. Al doping improves the formation of the well-ordered crystalline structure of ZnO up to a certain limit of doping. The absorbance spectra were used to determine the optical band gap of the samples. The optical photoluminescence (PL) spectra of both ZnO and AZO nanopowder are obviously influenced by the increasing temperature and Al doping content, respectively. Different optical properties of ZnO and AZO were observed for different contents of Al in ZnO. The band gap of AZO nanopowder with different concentrations has been seen to be lower than that of undoped ZnO (3.10 eV), suggesting broad application potential. Also, the optical properties of ZnO were tailored by Al doping in the near visible region, suggesting various potential uses.

We present numerical simulations of the cavity optomechanical detection of persistent currents and bright solitons in an atomic Bose-Einstein condensate confined in a ring trap. This paper describes a technique that measures condensate rotation in situ, in real time, and with minimal destruction, in contrast to currently used methods, all of which destroy the condensate completely. For weakly repulsive interatomic interactions, the analysis of persistent currents extends our previous few-mode treatment of the condensate [P. Kumar et al. Phys. Rev. Lett. 127, 113601 (2021)0031-900710.1103/PhysRevLett.127.113601] to a stochastic Gross-Pitaevskii simulation. For weakly attractive atomic interactions, we present the first analysis of optomechanical detection of matter-wave soliton motion. We provide optical cavity transmission spectra containing signatures of the condensate rotation, sensitivity as a function of the system response frequency, and atomic density profiles quantifying the effect of the measurement backaction on the condensate. We treat the atoms at a mean-field level and the optical field classically, account for damping and noise in both degrees of freedom, and investigate the linear as well as nonlinear response of the configuration. Our results are consequential for the characterization of rotating matter waves in studies of atomtronics, superfluid hydrodynamics, and matter-wave soliton interferometry.

Kidney bean (Phaseolus vulgaris) productivity and nutritional quality are declining due to less nutrient accessibility, poor soil health, and indigent agronomic practices in hilly regions, which collectively led to a fall in farmer’s income, and to malnutrition in consumers. Addressing such issues, the present investigation was designed to assess the impact of Pseudomonas jesenii MP1 and Pseudomonas palleroniana N26 treatment on soil health, microbial shift, yield, and nutrient status of the kidney bean in the Harsil and Chakrata locations of Indian Central Himalaya. P. jesenii MP1 and P. palleroniana N26 were characterized as cold adaptive PGPR as they possessed remarkable in vitro plant growth promoting traits. Further, field trial study with PGPR treatments demonstrated remarkable and prolific influence of both strains on yield, kidney bean nutrient status, and soil health at both geographical locations, which was indicated with improved grain yield (11.61%–23.78%), protein (6.13%–24.46%), and zinc content (21.86%–61.17%) over control. The metagenomic study revealed that use of bioinoculants also concentrated the nutrient mobilizing and plant beneficial microorganisms in the rhizosphere of the kidney bean. Moreover, correlation analysis also confirmed that the plant growth-promoting traits of P. jesenii MP1 and P. palleroniana N26 are the basis for improved yield and nutrient status of the kidney bean. Further, cluster and principal component analysis revealed that both P. jesenii MP1 and P. palleroniana N26 exhibited pronounced influence on yield attributes of the kidney bean at both the locations. At the Harsil location, the P. jesenii MP1-treated seed demonstrated highest grain yield over other treatments, whereas at Chakarata, P. jesenii MP1, and P. palleroniana N26 treatment showed almost equal enhancement (~23%) in grain yield over control. The above results revealed that these bioinoculants are efficient plant growth promoters and nutrient mobilizers; they could be used as green technology to improve human health and farmer’s income by enhancing soil health, yield, and nutrient status of the kidney bean at hilly regions.

Abstract Significant advances in deep learning techniques have made it possible to offer technologically advanced methods to detect cardiac abnormalities. In this study, we have proposed a new deep learning based Restricted Boltzmann machine (RBM) model for the classification of arrhythmias from Electrocardiogram (ECG) signal. The work is divided into three phases where, in the first phase, signal processing is performed, including the normalization of the heartbeats as well as the segmentation of the heartbeats. In the second phase, the stacked RBM model is implemented which extracts the essential features from the ECG signal. Finally, a SoftMax activation function is used that classifies the ECG signal into four types of heartbeat classes according to ANSI/AAMA standards. This stacked RBM model is offered as three types of experiments, patient independent data classification for multi-class, patient independent data for binary classification, and patient specific classification. The best result was obtained using patient independent binary classification with an overall accuracy of 99.61%. For Patient Independent Multi Class classification, accuracy obtained was 98.61% and for patient specific data, the accuracy was 95.13%. The experimental results shows that the developed RBM model has better performance in terms of accuracy, sensitivity and specificity as compared to work mentioned in the other research papers. Article highlights The proposed RBM model is skilled to automatically classify ECG heartbeat according to the ANSI- AAMI standards with accuracy, Recall, specificity. The performance of the RBM model to correctly classify heartbeat classes was found to be improved. The model is fully automatic, hence there is no requirement of additional system like feature extraction, feature selection, and classification.

While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.

Using a two-fluid shell model, we numerically investigate the energy spectrum and the scale by scale energy budget for superfluid turbulence in the temperature range of T = 0.9–2.175 K. Both the normal and superfluid components exhibit the Kolmogorov-like spectrum (Ek ∼ k−5/3) in the inertial range for all the temperatures. The scale to scale energy budget analysis in the wavenumber space indicates a strong coupling between the normal and superfluid components at low temperature (T = 0.9 K), which is quite evident from the observation of balancing between the viscous dissipation and the energy transfer due to the mutual friction between the components at low temperature for the normal component. We also compute the temporal probability distribution function of the energy induced by the mutual friction to a particular component, which indicates the positive energy supply at low temperature (T = 0.9 K) and negative energy supply at high temperature (T = 1.9 K) for the normal component. The results are consistent with the previous numerical and experimental studies.

Objective: To evaluate the functional and radiological outcome of balloon kyphoplasty and to endorse the unilateral single balloon extrapedicular kyphoplasty as practically more feasible and safer method in comparison to the conventional methods.Methods: Totally, 81 patients were presented to our center with osteoporotic vertebral compression fracture. Among these, 59 patients (61 vertebrae) were enrolled with stable wedge osteoporotic compression fracture. Pre-operatively percentage of vertebral height loss and kyphotic angle were calculated and single balloon extrapedicular kyphoplasty was performed in all cases.Results: Postoperatively, anterior vertebral height improved to 79.61% of normal subjects. In our study, the mean segmental kyphosis correction following balloon kyphoplasty was 14.27°. Overall incidence of cement leak in our study was 15.25%.Conclusion: Although we encountered the few difficulties, but this technique holds the safety and feasibility measures. Furthermore, it is effective in restoring anterior vertebral height, alignment and angle of kyphosis.

Background: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed. Materials and Methods: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included. They were propensity-matched 1:1 to patients without renal impairment (control). Data were prospectively collected, and health-related QOL questionnaire was sent to patients who were alive at least 1-year postoperatively at the time of the study. Results: There was no significant difference in the preoperative characteristics between the two groups (age, gender, left ventricular ejection fraction, procedure, urgency, logistic Euroscore), respectively. Median follow-up was 52 months. Survival data were available in all patients. Questionnaires were returned in 64% of eligible patients. Long-term survival was significantly lower, and QOL, in particular the physical aspect, was significantly worse for the AKI group as compared to non-AKI group (38.8 vs. 44.2, P = 0.002), especially so in patients who required RRT. In alive respondents, despite an 18% (66/359) incidence of ongoing renal follow-up, the need for late RRT was only in 1.1% (4/359). Conclusion: AKI and especially the need for RRT following cardiac surgery are associated with increased long-term mortality as well as worse quality of life in a propensity-matched control group.

In the horizon of knowledge, there is dearth of documentation depicting the incidence of Primary Bone Lymphoma (PBL) being delayed/misdiagnosed as chronic osteomyelitis, which entails that this case report is of more magnitude. It is a case report of young female, having complaints of pain and swelling in left arm initially which was misdiagnosed as chronic osteomyelitis. Later on, she was diagnosed as PBL. Here, we want to discuss the clinical presentation of PBL, and to make aware from such grave pathology and to consider it in the differential diagnosis of chronic osteomyelitis.

Introduction: Hereditary Multiple Exostoses (HME) is an inherited genetic skeletal disorder of enchondral bone. It is an autosomal dominant disorder affecting juxtaepiphyseal region of the long bones and includes multiple exostoses. The treatment of HME is mainly surgical, while the medical approach is still in evolving phase. Surgery is needed only in symptomatic cases to avoid eventual intricacy. Limb length equalization, deformity correction by osteotomy and epiphysiodesis are frequently entertained procedures. Aim: To carry out the descriptive study over HME patients with clinical profile and surgical execution. Materials and Methods: It was a prospective study involving 17 cases. The present institute provides tertiary care as well; caters to the major number of cases, even from long distance. So it is assumed that most of the HME patients would have been referred to or visited the hospital only after moderate to severe functional deficit in their lifestyle. All the patients were dealt with according to their complaint and the Short Assessment of Patient Satisfaction (SAPS) score was obtained. Results: Three patients (17.6%) were very satisfied, 11 patients were satisfied (64.7%), 3 (17.64%) patients were dissatisfied and one patient was very dissatisfied with the treatment executed. Conclusion: The orthopaedic surgeon is the first treating doctor who faces diagnosis and treats HME patients. Orthopaedists should be cognizant to clinical display of it, along with its differential and aftermath. Surgical mediation often needed to excise the clinically obliged exostoses only.

Introduction: Due to increased number of trauma cases, several injuries in the same limb are not an uncommon entity now. Literature describes the floating elbow as a forearm fracture and supracondylar fracture of humerus in same extremity. Aim: The purpose of the study was to evaluate our experience in dealing with such uncommon injury. Materials and Methods: This is a prospective interventional study of floating elbow in younger age group. All the cases were managed by K-wire fixation and followed up to the average of 20 months. All the patients were followed by clinical and radiological mean. Functional score were obtained by Mayo Elbow Performance Score (MEPS) and Khalfayan score. Results: Results are based on 17 cases with average age of 9.58 years. The fracture healing was noticed at average of 9 weeks with average range of movement of 95 degree. Conclusion: Floating elbow is a serious injury. Injury type is out of the way and treatment recommendations are polemical. In our experience, this injury can be best treated by aggressive surgical intervention.

The restriction on the battery life of sensors is a bottleneck for wireless sensor networks (WSNs). This paper proposes a new feed-forward multi-clustering protocol (FFMCP) to boost the network lifetime. The utilization of fuzzy logic helps to overcome the uncertainties in the value of input parameters. The proposed protocol selects the most suitable cluster heads (CHs) using the multi-clustering method. A multi-clustering technique is defined utilizing the node’s information of the previous round and a fuzzy inference system to decide the CHs. The sensor nodes spend energy due to non-uniform CH distribution and long-distance data transmission by member nodes. The main focus of the proposed protocol is to reduce the member node distance. Our proposal distributes CH nodes uniformly using unequal clustering. The simulation outcome reveals that the proposed algorithm(FFMCP) has better performance in terms of tenth node death (TND), half node death (HND), remaining energy after 800 rounds (E_800), and average energy spent per round (AVG_PR) as compared to standard clustering schemes in the past.

Chronic haematoma formation and its acute expansion are rare in clinical scenario. Its clinical presentation may simulate to malignant soft tissue lesion. Usually they remain inactive for long time but sometimes shows sudden spurt of growth. The accepted treatment is excision of the haematoma. Here we are presenting the chronic haematoma of thigh in young boy, which remained dormant for years. But until recently it became huge and rendered the surgeon in dilemma for diagnosis making, which was managed after clinico-radiological evaluation. Here we are sharing our experience of a young patient with acutely expanded huge haematoma swelling which emulated to neoplasm.

Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real-time monitoring of cerebral oxygenation with near-infrared spectroscopy (NIRS). The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery) in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8). In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends) was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO 2 , etc.,) were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our "work in progress," and we aim to conduct a larger study.

Objective: Objective platelet function assessment after cardiac surgery can predict postoperative blood loss, guide transfusion requirements and discriminate the need for surgical re-exploration. We conducted this study to assess the predictive value of point-of-care testing platelet function using the Multiplate® device. Methods: Patients undergoing isolated coronary artery bypass grafting were prospectively recruited ( n = 84). Group A ( n = 42) patients were on anti-platelet therapy until surgery; patients in Group B ( n = 42) stopped anti-platelet treatment at least 5 days preoperatively. Multiplate® and thromboelastography (TEG) tests were performed in the perioperative period. Primary end-point was excessive bleeding (>2.5 ml/kg/h) within first 3 h postoperative. Secondary end-points included transfusion requirements, re-exploration rates, intensive care unit and in-hospital stays. Results: Patients in Group A had excessive bleeding (59% vs. 33%, P = 0.02), higher re-exploration rates (14% vs. 0%, P < 0.01) and higher rate of blood (41% vs. 14%, P < 0.01) and platelet (14% vs. 2%, P = 0.05) transfusions. On multivariate analysis, preoperative platelet function testing was the most significant predictor of excessive bleeding (odds ratio [OR]: 2.3, P = 0.08), need for blood (OR: 5.5, P < 0.01) and platelet transfusion (OR: 15.1, P < 0.01). Postoperative "ASPI test" best predicted the need for transfusion (sensitivity - 0.86) and excessive blood loss (sensitivity - 0.81). TEG results did not correlate well with any of these outcome measures. Conclusions: Peri-operative platelet functional assessment with Multiplate® was the strongest predictor for bleeding and transfusion requirements in patients on anti-platelet therapy until the time of surgery. Study registration: ISRCTN43298975 (http://www.controlled-trials.com/ISRCTN43298975/).

Synovitis of knee due to an unaware incident of splinter piercing is rare in adults. This is a case report of 30-year-old female with a painful knee in a flexed attitude with a swelling. Her history did not reveal any positive findings, i.e., recent trauma, fever or any such previous episode. Arthrotomy revealed a turbid synovial fluid with inflamed friable synovial thickening. On further inspection, there was a presence of a foreign body in the suprapateller pouch. It was removed and washed. This was ultimately found to be a splinter. Normal inflammatory markers with minimal signs and symptoms of infection may provide weightage to this differential diagnosis. Arthrotomy and antibiotic coverage can give an excellent result.

Chaput tubercle fracture occurs at the antero-lateral position of the distal tibia in adult as a counterpart of adolescent Tillaux fracture. It is a case of adult male which presented to us with onset of acute pain, swelling and restricted movements of ankle after a road side accident. A clinical diagnosis of Chaput tubercle fracture was established after a CT-scan. The displaced fracture was managed by open reduction and internal fixation by screw. At the end of follow up, the foot and ankle ability score measured. Through this case report we convey that Chaput tubercle fracture in an adult is a rare entity.

Introduction: Clavicular injury is common in active and younger age group with male preponderance (male-female ratio is 2:1). Purpose of this study was to analyze the outcome of surgically treated displaced fracture midshaft clavicular fracture using Intramedullary fixation by titanium elastic nail. Materials and Methods: We present a series of cases of midshaft clavicular fracture who were subjected to Intra medullary fixation with the average nail diameter of 2.5 to 3 mm titanium elastic nail system by the closed/open reduction method under Image intensifier control. Results: Average time taken for full clinical and radiological union was nine weeks (with minimum six weeks to maximum eleven weeks). Time taken for fully functional recovery (time of functional disability) was 35±7 days in all patients except in two cases of floating shoulder and one case of poly-traumatic patient in which it was 50 days. Follow-up period ranged between 9 months and 24 months with an average of 18 months. Average ConstantMurley-Score after assessment of shoulder function was 96.8. Conclusion: Titanium elastic intra-medullary nailing is a promising surgery with excellent functional outcome, safer percutaneous method with less invasive nature and rapid healing tendency with fewer complications in contrast to plate osteosynthesis.

Introduction: Non-traumatic fracture of pedunculated osteochondroma is a known, but rare complication. Treatment protocols for such complication are debatable. However, surgical intervene have been advocated. Case Report: It is a case report of a 14 years old male patient of atraumatic fracture of solitary osteochondroma. On radiographic examination, it showed fracture through base of pedunculated osteochondroma. Conclusion: By pathology and clinico-radiological examination, it was a benign diagnosis. We recommend operative intervention for this rare complication. Keywords: Pedunculated osteochondroma; fracture; non-traumatic.

Plexiform neurofibroma (PNF) arises as a diffuse mass from nerve trunk and leads to overgrowth of cutis and subcutis structure. This is a case report of 20-year-old male, presented to our hospital with a giant ulcerated swelling over his left arm. Differential diagnosis of sarcoma, neurofibroma, hemangioma and angiolipoma was made but biopsy confirmed the diagnosis of plexiform neurofibroma. Isolated PNF with ulceration of overlying skin over arm is a rare presentation and here we are presenting it as a perusal of rare entity.

Abstract Complications related to permanent pacing wires insertion include ventricular perforation. It commonly perforates the right ventricle. We present images of an unusual case where the pacing wires perforated the anterior left ventricular wall between the left anterior descending artery and diagonal artery.