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Silicon (Si) nano-electronics is advancing towards the end of the Moore’s Law, as gate lengths of just a few nanometers have been already reported in state-of-the-art transistors. In the nanostructures that act as channels in transistors or depletion layers in pn diodes, the role of dopants becomes critical, since the transport properties depend on a small number of dopants and/or on their random distribution. Here, we present the possibility of single-charge tunneling in codoped Si nanodevices formed in silicon-on-insulator films, in which both phosphorus (P) donors and boron (B) acceptors are introduced intentionally. For highly doped pn diodes, we report band-to-band tunneling (BTBT) via energy states in the depletion layer. These energy states can be ascribed to quantum dots (QDs) formed by the random distribution of donors and acceptors in such a depletion layer. For nanoscale silicon-on-insulator field-effect transistors (SOI-FETs) doped heavily with P-donors and also counter-doped with B-acceptors, we report current peaks and Coulomb diamonds. These features are ascribed to single-electron tunneling (SET) via QDs in the codoped nanoscale channels. These reports provide new insights for utilizing codoped silicon nanostructures for fundamental applications, in which the interplay between donors and acceptors can enhance the functionalities of the devices.

In the past decades, AI was not playing a pivotal role in technology. But now, artificial intelligence is a key part of the revolution of technology. AI has become a powerful tool in recent years, enabling machines to think and act like humans. AI helps in developing a better approach to teaching students (i.e., adaptive learning where a computer algorithm identifies the rate of learning of a student and adapts itself so that the student learns efficiently). The aim of implementing AI in education is not to replace tutors, but to assist them in understanding the potential and limitations of each student individually. This chapter will cover the introduction, existing applications, and new applications of artificial intelligence in higher education. The prime focus of the chapter will be on the approaches to different product developments and their implementation using artificial intelligence in the education sector. It provides a brief idea of how the existing applications solve the problems in higher education and new approaches to make higher education more efficient.

Persistent sciatic artery is a direct continuation of the internal iliac artery. It is a rare anatomic variant where the sciatic artery does not regress during fetal development. We present a case of a 43-year-old male with a right leg ulcer who has an incidental finding of persistent sciatic artery on Computed Tomography (CT) of the thigh with Intravenous (IV) contrast to evaluate for abscess formation. A major complication seen in some patients with persistent sciatic artery is aneurysm formation which predispose patients to limb-threatening thromboembolism. Asymptomatic cases such as this case require no intervention apart from follow up.

創造科学技術大学院, 甲第1226号

Patient: Female, 52 Final Diagnosis: Spontaneous fungal peritonitis Symptoms: Abdominal pain • shortness of breath Medication: — Clinical Procedure: — Specialty: General and Internal Medicine Objective: Rare disease Background: Spontaneous fungal peritonitis (SFP) is a life-threatening infection which occurs more commonly in patients with liver failure. SFP is not as common as spontaneous bacterial peritonitis (SBP) and has higher mortality rates due to late recognition and difficulty in differentiation between SFP and SBP. Spontaneous fungal peritonitis is extremely uncommon in patients with cardiac ascites due to a high protein content, which predisposes to a low risk of infections. Case Report: This report presents a rare case of spontaneous fungal peritonitis in a patient with cardiogenic ascites. To the best of our knowledge, this is the second known case of SFP occurring in a patient with cardiac cirrhosis. The patient did not respond to initiation of SBP treatment and after ascitic fluid grew Candida glabrata, the diagnosis of SFP was made. The patient’s clinical status improved after initiation of intravenous caspofungin. Conclusions: SFP should be a differential diagnosis in patients who have cardiac or liver cirrhosis, who are not improving with empirical antibiotic therapy for spontaneous bacterial peritonitis.

BACKGROUND Bronchial asthma is a very common illness causing considerable mortality and morbidity. Long acting beta 2 agonists in combination with inhalation steroid is useful for reducing the severity of asthma. We have attempted to compare the efficacy of formoterol/budesonide and salmeterol/fluticasone combinations among patients of bronchial asthma. We wanted to compare the efficacy of Formoterol/Budesonide combination and Salmeterol/Fluticasone combination as Dry Powder Inhaler and Metered Dose Inhaler in patients with Bronchial Asthma in terms of asthma control and improvement in pulmonary function as assessed by FVC (%), FEV1 (%), FEV1/FVC (%), PEFR and Asthma Control Test (ACT) Score. METHODS This is a prospective, observational, non-interventional study conducted in Bronchial Asthma patients attending out-patient Respiratory Medicine Department of NRI General Hospital, Guntur. A total of 100 patients were included in the study. All the patients who were diagnosed with Asthma and who met the inclusion criteria and are prescribed with either Formoterol/Budesonide as DPI or MDI or Salmeterol/Fluticasone as DPI or MDI were reviewed for the efficacy of treatment. These different groups were created based on block randomization method. Initially base line PFT was performed and asthma control scores were obtained before treatment using GINA Guidelines. Reversibility of bronchoconstriction is assessed within 15 minutes of nebulization with 0.05% Salbutamol. After 15 days of PFT values and Asthma Control Scores were again obtained and compared with the base line values. Data analysis was conducted using paired ANOVA and t-test. RESULTS Of these 100 patients, 25 (25%) patients belong to Group-IA, 26 (26%) belong to Group-IB, 24 (24%) patients belong to Group-IIA and 25 (25%) patients belong to Group-IIB. After 2 weeks of treatment, PFT was repeated and asthma control scores were obtained. These obtained values were compared to baseline values. The improvement in lung function and the level of asthma control was assessed by performing PFTs and using Asthma Control Test Questionnaire. The corresponding Mean of FVC, FEV1, FEV1/FVC, PEFR and Asthma Control Score in the sample population using Formoterol/Budesonide DPI is more when compared to those using Formoterol/Budesonide MDI after 15 days of treatment with significant p-value of

From the viewpoint of high- (room-) temperature operation of donor-based single-electron transistors, we make a comparative study of nano-scale silicon-on-insulator transistors with phosphorus-doped channels for two dopant-concentration regimes: N D ≈ 1 × 1018 and 2 × 1020 cm−3. We experimentally show that the high-N D devices can provide room-temperature single-electron tunneling operation owing to a large tunnel-barrier height, while operation temperature is limited to about 100 K for the low-N D devices. Numerical simulations of random donor-atom distributions indicate that donor clustering plays a dominant role in the formation of quantum dots, and suggests that clusters comprising of more-than-three donors are responsible for room-temperature operation.

Background In response to the COVID-19 pandemic, medical schools suspended clinical rotations. This displacement of medical students from wards has limited experiential learning. Concurrently, outpatient practices are experiencing reduced volumes of in-person visits and are shifting towards virtual healthcare, a transition that comes with its own logistical challenges. This article describes a workflow that enabled medical students to engage in meaningful clinical education while helping an institution’s outpatient practices implement remote telemedicine visits. Methods A 4-week virtual elective was designed to allow clinical learners to participate in virtual telemedicine patient encounters. Students were prepared with EMR training and introduced to a novel workflow that supported healthcare providers in the outpatient setting. Patients were consented to telehealth services before encounters with medical students. All collected clinical information was documented in the EMR, after which students transitioned patients to a virtual Doxy.me video appointment. Surveys were used to evaluate clinical and educational outcomes of students’ participation. Elective evaluations and student reflections were also collected. Results Survey results showed students felt well-prepared to initiate patient encounters. They expressed comfort while engaging with patients virtually during telemedicine appointments. Students identified clinical educational value, citing opportunities to develop patient management plans consistent with in-person experiences. A significant healthcare burden was also alleviated by student involvement. Over 1000 total scheduled appointments were serviced by students who transitioned more than 80 % of patients into virtual attending provider waiting rooms. Conclusions After piloting this elective with fourth-year students, pre-clerkship students were also recruited to act in a role normally associated with clinical learners (e.g., elicit patient histories, conduct a review of systems, etc.). Furthermore, additional telemedicine electives are being designed so medical students can contribute to patient care without risk of exposure to COVID-19. These efforts will allow students to continue with their clinical education during the pandemic. Medical educators can adopt a similar workflow to suit evolving remote learning needs.

IntroductionIn response to the Coronavirus pandemic, medical schools suspended clinical rotations. This displacement of students from the wards has limited experiential learning opportunities. Concurrently, outpatient practices are experiencing reduced volumes of in-person visits and shifting towards virtual healthcare. This transition comes with its own logistical challenges. Here, we discuss a workflow that enabled students to engage in meaningful clinical education while helping the RWJMS outpatient practices implement remote telehealth visits.MethodsA four-week virtual elective was designed to offer clerkship students the opportunity to participate in virtual telehealth patient encounters. Students were prepared with EMR training and introduced to an outpatient workflow that supports healthcare providers in the ambulatory setting. Patients were consented to telehealth services before encounters with students. All collected clinical information was documented in the EMR, after which students transitioned patients to a virtual Doxy.me video call appointment. Clinical and educational outcomes of students’ participation were evaluated.ResultsSurvey results showed students felt well-prepared to initiate patient encounters. They also expressed comfort while engaging with patients virtually during telehealth appointments. Students further identified educational value, citing opportunities to develop patient management plans consistent with in-person clinical experiences. A significant healthcare burden was also alleviated by student involvement. Over 1000 total scheduled appointments were serviced by students who transitioned over 80% of patients into virtual provider waiting rooms.DiscussionAfter piloting this elective with rising fourth-year students, pre-clerkship students were also recruited to act in a role normally associated with clinical learners (e.g., elicit patient histories, conduct a review of systems, etc.). An additional telehealth elective is being designed so medical students can contribute to inpatient care without risk of exposure to SARS-CoV-2. These efforts are designed to allow students to continue with their clinical education during the pandemic.

As an extension of the continuous miniaturization trend for Si transistors, single-electron effects related to dopants in the nanoscale transistor channels have been recently considered for low-power and fundamental applications. Research on dopant-based single-electron tunneling (SET) functionality extends from single-donor quantum dots (QDs) to multiple-donor QDs. Different from using complex techniques for doping, we show that a simpler, uniform doping technique at high-concentration of nanoscale silicon-on-insulator (SOI) transistors can offer the statistical conditions for the formation of isolated multiple-donor clusters that allow SET functionality, even at room temperature.

In conventional downscaled Si transistors, the role of discrete dopants in nano-channels becomes critical; uniform high doping is desirable. Even in such highly-doped transistors, however, quantum dots formed by clusters of donors may work for single-electron tunneling (SET), and can be further assisted by co-doping. Here, we first analyze transport characteristics of co-doped Si nanowires by simulations, extending then the analysis to experiments on co-doped SOI-FETs with nanoscale channels. SET behavior is reported, and B-acceptors may contribute to the formation of tunnel barriers in such channels, suggesting a simple technique for Si SET devices.

Synthesis of lithium stuffed cubic Li7La3Zr2O12 (c-LLZO) garnet at low-processing temperatures is hampered by the lack of deep understanding on powder processing technology. The present article proposes a hybrid solid-state approach to accomplish controllable synthesis of Al doped LLZO cubic garnet oxide nanoparticles at low-processing temperatures. In this procedure, powders of ZrO2 and La(OH)3 in ethanol based suspension were mechanochemically (MC) treated along with 1 wt.% of AlOOH in a planetary ball mill with increasing milling time to increase the homogeneity of the precursor. Lithium acetate in the form of an ethanolic solution was subsequently added for the solid-state synthesis of single phase LLZO. Cubic LLZO phases were obtained at temperatures i.e. 700 °C within 3 h. The ease of lithium diffusion in these MC activated La-Zr precursor materials is attributed to the formation of single phase LLZO with the lowest Al3+ doping content. The sintered pellets (94% relative density at 1100 °C for 3 h in air) of the newly obtained Li6.61La3Zr2Al0.13O11.98 deliver high bulk Li-ion conductivity of 1.35 × 10−4 Scm-1. The new low-temperature processing of typical garnet and the use of c-Li6.61La3Zr2Al0.13O11.98 nanoparticles could open pathways toward future solid electrolyte–electrode assembly options for all-solid state Li-ion batteries.

Cardiac myxoma is an uncommon diagnosis but presents with common manifestations. There is a wide range of symptomatology from non-specific fever and weight loss to stroke-like symptoms. It is also one of the rare causes of cardiac syncope and thromboembolic events. We present a case of a 67-year-old female who presented with seemingly benign vertigo symptoms which she ignored for years before seeking medical attention. An echocardiogram revealed a 3.5 x 3.0 x 1.0 cm atrial myxoma which was surgically excised. Her symptoms have resolved entirely with no recurrence since surgery.

Anion gap metabolic acidosis (AGMA) occurs when an anion gap exists along with metabolic acidosis, most commonly due to diabetic ketoacidosis (DKA) and lactic acidosis (LA). Isolated starvation ketoacidosis (ISK) is one of the rare causes of AGMA; however, it usually presents with a mild disturbance in pH. We report a rare case of a 45-year-old female with previously diagnosed squamous cell cancer (SCC) of the larynx. She presented to the emergency department complaining of difficulty in breathing following laryngectomy and tracheostomy for SCC. Her laboratory results on admission were consistent for isolated starvation ketoacidosis and the patient responded quickly to the appropriate treatment.

Anion gap metabolic acidosis (AGMA) occurs when an anion gap exists along with metabolic acidosis, most commonly due to diabetic ketoacidosis (DKA) and lactic acidosis (LA). Isolated starvation ketoacidosis (ISK) is one of the rare causes of AGMA; however, it usually presents with a mild disturbance in pH. We report a rare case of a 45-year-old female with previously diagnosed squamous cell cancer (SCC) of the larynx. She presented to the emergency department complaining of difficulty in breathing following laryngectomy and tracheostomy for SCC. Her laboratory results on admission were consistent for isolated starvation ketoacidosis and the patient responded quickly to the appropriate treatment.