A2LiGaI6 (A = Cs, Rb): New lead-free and direct bandgap halide double perovskites for IR application.

Recently, all inorganic double perovskites have drawn a lot of interest as promising solar materials. The optical, structural, thermoelectric, electronic, and mechanical properties of double halide perovskites A2LiGaI6 (A = Cs, Rb) are explored via first-principles calculations with the WIEN2k code, using GGA PBEsol and TB-mBJ potentials. The majority of perovskite materials utilized in the highest-performing solar cells have bandgaps ranging between 1.48 and 1.62 eV. The compounds A2LiGaI6 (A = Cs, Rb) have a direct bandgap of 1.51 eV and 1.55 eV, respectively, and are expected to be useful in solar cells. The optical study shows that there are large absorption bands in the visible region, as determined by the dielectric constant, absorption, and other dependent factors. Their potential for use in solar cells is increased by their absorption in the visible part. The BoltzTraP code has been used to perform thermoelectric studies to assess the electrical, thermal conductivities, and Seebeck coefficient. They are important for construction of thermoelectric generators that harvest heat energy because of their high figure of merit and incredibly low thermal conductivity of lattice at ambient temperature. Furthermore, by examining the spectroscopic limit maximum efficiency, up to 30 % efficiency is predicted for both compositions, which paves the way for the applicability of them in solar energy conversion.

Predictors of Mortality in Patients With Dengue Fever: Insights From a Comparative Analysis.

Objective To determine the clinical and biochemical predictors of mortality in patients with dengue fever. Methods This was an analytical, cross-sectional study conducted at Hayatabad Medical Complex, Peshawar, Pakistan. The study participants were patients admitted to the hospital for the management of dengue fever. Clinical parameters (age, gender, duration of hospital stay, and the presence of complications) and biochemical parameters [white blood cells count (WBC), platelet count, serum c-reactive protein (CRP) level, serum alanine aminotransferase (ALT) level, and serum creatinine] were recorded. These parameters were compared between the survivors and non-survivors of dengue fever. Results Out of 115 patients, the majority (n=82, 71.3%) were up to 45 years and the mean age was 38.40 ± 18.1 years. Most of the patients (n=105, 91.3%) survived. On univariate logistic regression analysis, age more than 45 years [odds ratio (OR) 0.141, 95% confidence interval (CI) 0.034 - 0.585, p = 0.007), leukocytosis (> 11,000/mcL) (OR 0.187, 95% CI 0.049 - 0.719, p = 0.015), and acute kidney injury (creatinine > 1.5 mg/dL) (OR 0.124, 95% CI 0.029 - 0.531, p = 0.005)] at the time of admission reduced the likelihood to survive. Leukocytosis and acute kidney injury remained significant independent predictors of mortality on multivariate logistic regression analysis. [(OR 0.201, 95% CI 0.042 - 0.960, p = 0.044) and (OR 0.148, 95% CI 0.026 - 0.857, p = 0.033) for survival, respectively]. Gender, duration of inpatient stay, thrombocytopenia (platelets < 30,000/mcL), and acute liver injury (ALT > 200 IU/L) were not associated with mortality from dengue fever. Conclusion Age over 45 years, leukocytosis, and acute kidney injury at presentation increased the likelihood of mortality from dengue fever in this study. Gender, duration of hospital stay, thrombocytopenia, and acute liver injury did not affect the odds of mortality.

Surface-enhanced Raman spectroscopy for monitoring antibacterial activity of imidazole derivative (1-benzyl-3-(sec­butyl)-1H-imidazole-3-ium bromide) against Bacillus subtilis and Escherichia coli.

BACKGROUND: Bacterial resistance against antibiotics remains a challenge and Raman Spectroscopy (SERS) may provide critical information concerning this. OBJECTIVES: In the current study, surface enhances Raman spectroscopy (SERS) has been used to determine the biochemical changes induced during the antibacterial activity of the in house synthesized imidazole derivative (1-benzyl-3-(sec­butyl)-1H-imidazole-3-ium bromide) in comparison to commercially available drugs (fasygien) against both gram-positive and gram-negative bacteria. METHODS: For this purpose, the antibacterial activity of this compound was assessed on Bacillus subtilis and Escherichia coli. The SERS spectral changes are detected which can be associated with the biochemical changes in the bacterial cells as a result of the application of both drugs, including fasygien and the imidazole derivative drug demonstrating the technique's potential for analyzing the antibacterial activities of drug candidates. RESULTS: The chemometric techniques such as Principal Component Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA) were performed for the differentiation of SERS spectral data sets of unexposed, exposed with imidazole derivative and commercially available antibacterial drugs for two different bacteria including E. coli and Bacillus. CONCLUSIONS: PCA was found helpful for the qualitative differentiation of all drug-treated E. coli and Bacillus in the form of separate clusters of spectral data sets and PLS-DA discriminated the unexposed and the exposed bacteria with imidazole derivative and commercially available drug with 93% sensitivity and 96% specificity for Bacillus and with 90% sensitivity and 89% specificity for E. coli.

Geographic accessibility to childhood tuberculosis care in Pakistan.

BACKGROUND: Tuberculosis (TB) in children is difficult to detect and often needs specialists to diagnose; the health system is supposed to refer to higher level of health care when diagnosis is not settled in a sick child. In Pakistan, the primary health care level can usually not diagnose childhood TB and will refer to a paediatricians working at a secondary or tertiary care hospital. We aimed to determine the health services access to child TB services in Pakistan. OBJECTIVE: We aimed to determine the geographical access to child TB services in Pakistan. METHOD: We used geospatial analysis to calculate the distance from the nearest public health facility to settlements, using qGIS, as well as population living within the World Health Organization's (WHO) recommended 5-km distance. RESULT: At primary health care level, 14.1% of facilities report child TB cases to national tuberculosis program and 74% of the population had geographical access to general primary health care within 5-km radius. To secondary- and tertiary-level health care, 33.5% of the population had geographical access within 5-km radius. The average distance from a facility for diagnosis of childhood TB was 26.3 km from all settlement to the nearest child TB sites. The population of one province (Balochistan) had longer distances to health care services. CONCLUSION: With fairly good coverage of primary health care but lower coverage of specialist care for childhood TB, the health system depends heavily on a good referral system from the communities.

Surface-enhanced Raman spectroscopy (SERS) for monitoring colistin-resistant and susceptible E. coli strains.

The emergence of drug-resistant bacteria is a precarious global health concern. In this study, surface-enhanced Raman spectroscopy (SERS) is used to characterize colistin-resistant and susceptible E. coli strains based on their distinguished SERS spectral features for the development of rapid and cost-effective detection and differentiation methods. For this purpose, three colistin-resistant and three colistin susceptible E. coli strains were analyzed by comparing their SERS spectral signatures. Moreover, multivariate data analysis techniques including Principal component analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA) were used to examine the SERS spectral data of colistin-resistant and susceptible strains. PCA technique was employed for differentiating colistin susceptible and resistant E.coli strains due to alteration in biochemical compositions of the bacterial cell. PLS-DA is employed on SERS spectral data sets for discrimination of these resistant and susceptible E. coli strains with 100% specificity, 100% accuracy, 99.8% sensitivity, and 86% area under receiver operating characteristics (AUROC) curve.

Quantitative analysis of solid dosage forms of Losartan potassium by Raman spectroscopy.

Raman spectroscopy is an outstanding analytical tool increasingly utilized in the pharmaceutical field for the solid-state pharmaceutical drug analysis. In current study, the potential of Raman spectroscopy has been investigated for qualitative and quantitative analysis of solid dosage form of Losartan potassium. For this purpose, different solid dosage forms/concentrations of losartan potassium were prepared to compensate the commercially available pharmaceutical drug formulations and their Raman spectral data showed a gradual change in the specific Raman spectral features associated with the active pharmaceutical ingredient (API) of Losartan potassium as a function of change in the concentration. The Raman spectral data was analyzed by using Principal Component Analysis (PCA) for the classification of different spectral data sets of different concentrations of drug. Moreover, partial least square regression (PLSR) analysis was performed for monitoring the quantitative relation among different concentrations of Losartan potassium API and spectral data by constructing a predictive model. From the model, the value of root mean square error of calibration (RMSEC) and root mean square error of prediction (RMSEP) were observed to be 0.38 and 2.98 respectively and the value of goodness of fit was found to be 0.99. Furthermore, the quantity of unknown/blind sample of Losartan potassium formulation was also estimated by using PLSR model. From these results, it is demonstrated that Raman spectroscopy can be considered to be used for quick and reliable quantitative analysis of pharmaceutical solids.

Surface-enhanced Raman spectroscopy for comparison of serum samples of typhoid and tuberculosis patients of different stages.

BACKGROUND: Surface-enhanced Raman spectroscopy (SERS) is a reliable tool for the identification and differentiation of two different human pathological conditions sharing the same symptomology, typhoid and tuberculosis (TB). OBJECTIVES: To explore the potential of surface-enhanced Raman spectroscopy for differentiation of two different diseases showing the same symptoms and analysis by principal component analysis (PCA) and partial least square discriminate analysis (PLS-DA). METHODS: Serum samples of clinically diagnosed typhoid and tuberculosis infected individuals were analyzed and differentiated by SERS using silver nanoparticles (Ag NPs) as a SERS substrate. For this purpose, the collected serum samples were analyzed under the SERS instrument and unique SERS spectra of typhoid and tuberculosis were compared showing notable spectral differences in protein, lipid and carbohydrates features. Different stages of the diseased class of typhoid (Early acute and late acute stage) and tuberculosis (Pulmonary and extra-pulmonary stage) were compared with each other and with healthy human serum samples, which were significantly separated. Moreover, SERS data was analyzed using multivariate data analysis techniques including principal component analysis (PCA) and partial least square discriminate analysis (PLS-DA) and differences were so prominent to observe. RESULTS: SERS Spectral data of typhoid and tuberculosis showed clear differences and were significantly separated using PCA. SERS spectral data of both stages of typhoid and tuberculosis were separated according to 1st principle component. Moreover, by analyzing data using partial least square discriminate analysis, differentiation of two disease classes were considered more valid with a 100% value of sensitivity, specificity and accuracy. CONCLUSION: SERS can be employed for identification and comparison of two different human pathological conditions sharing same symptomology.

Surface-enhanced Raman spectral analysis for comparison of PCR products of hepatitis B and hepatitis C.

BACKGROUND: Surface-enhanced Raman spectroscopy is a reliable tool for identification and differentiation of two diseases showing similar symptoms, hepatitis B (HBV) and hepatitis C (HCV). OBJECTIVES: To develop a polymerase chain reaction technique (PCR) based SERS technique for differentiation of two human pathological conditions sharing the same symptoms using multivariate data analysis techniques e.g. principle component analysis (PCA) and partial least square discriminate analysis (PLS-DA). METHODS: PCR products of HBV and HCV were differentiated by SERS using silver nanoparticles (AgNPs) as a SERS substrate. For this analysis, PCR products of both the diseases with predetermined viral loads were collected and analyzed under SERS instrument and unique SERS spectra of HBV and HCV was compared showing many differences at various points. Diseased classes of HBV and HCV and their negative control classes (viral load less than 1) were compared. PCR products of true healthy DNA and RNA were also compared, which were significantly separated. Moreover, SERS data was analyzed using multivariate data analysis techniques including principle component analysis (PCA) and partial least square discriminate analysis (PLS-DA) and differences were so prominent to observe. RESULTS: SERS spectral data of HBV and HCV showed clear differences and were significantly separated using PCA. Negative control samples of both disorders and their true healthy samples of DNA and RNA were separated according to 1st principle component. By analyzing data using partial least square discriminate analysis, differentiation of two disease classes was considered more valid with sensitivity, specificity and accuracy value of 96%, 94% and 98% respectively. Value of area under curve (AUROC) was 0.7527. CONCLUSION: SERS can be employed for identification and comparison of two human pathological conditions sharing the same symptomology.

Application of generated mask method based on Mask R-CNN in classification and detection of melanoma.

OBJECTIVE: Melanoma is a type of malignant skin cancer with high mortality, and its incidence is increasing rapidly in recent years. At present, the best treatment is surgical resection after early diagnosis. However, due to the high visual similarity between melanoma and benign melanocytic nevus, coupled with the scarcity and imbalance of data, traditional methods are difficult to achieve good recognition and detection results. Similarly, many machine learning methods have been applied to the task of skin disease detection and classification. However, the accuracy and sensitivity of the experiments are still not satisfactory. Therefore, this paper proposed a method to identify melanoma more efficiently and accurately. METHOD: We implemented a Mixed Skin Lesion Picture Generate method based on Mask R-CNN (MSLP-MR) to solve the problem of data imbalance. Besides, we designed a melanoma detection framework of Mask-DenseNet+ based on MSLP-MR. This method used Mask R-CNN to introduce the method of mask segmentation, and combined with the idea of ensemble learning to integrate multiple classifiers for weighted prediction. Compared with the ablation experiments, the accuracy, sensitivity and AUC of the proposed network classification are improved by 2.56%, 29.33% and 0.0345. RESULT: The experimental results on the ISIC dataset shown that the accuracy of the algorithm is 90.61%, the sensitivity reaches 78.00%, which is higher than the original methods; the specificity reaches 93.43%; and the AUC reaches 0.9502. CONCLUSION: The method is feasible and effective, and achieves the preliminary goal of melanoma detection. It is greatly improved the detection accuracy and reached the level of visual diagnosis of doctors.

Seizure outcome in moyamoya after indirect revascularization in pediatric patients: Retrospective study and literature review.

BACKGROUND: Moyamoya disease (MMD) is a unique cerebrovascular disorder characterized by progressive stenosis of anterior cerebral circulation. Moyamoya is not an uncommon disease in Saudi Arabia. Although a less common symptom of the disease, the incidence of seizure in MMD ranges from 6 to 30%. Indirect revascularization through Encephaloduroarteriosynangiosis technique is one of the surgical treatment options for MMD. In our cohort, we aim to evaluate seizure outcome in pediatric patients with moyamoya. METHODS: Eleven patients with seizure as primary presentation for MMD over a period of 10 years were included in the study. All patients underwent EDAS surgery. All patients underwent pre- and postoperative assessment of multiple factors contributing to seizure outcome. Patients were evaluated for surgery control clinically and radiologically. RESULTS: About 73% of MMD patients with seizures improved after EDAS surgery (P < 0.0005). Six patients out of 11 became seizure free. Patients with bilateral involvement of disease undergoing bilateral surgery had better seizure control than those undergoing unilateral surgery (P < 0.07). CONCLUSION: Patients with controlled seizure before surgery are more likely to be seizure free after intervention. Seizure outcome is favorable after indirect surgical revascularization in pediatric moyamoya patients.

Physicians and Family Caregivers: Two Perspectives of Physicians' Roles in Long-Term Care.

OBJECTIVES: We explored the roles of attending physicians of long-term care (LTC) residents in supporting their family caregivers (FCGs). DESIGN: In this mixed-methods study, we conducted surveys and focus group interviews with physicians and FCGs. SETTING AND PARTICIPANTS: There were 78 FCGs and 18 physicians in the survey, and 18 FCGs and 9 physicians in the focus groups. They were recruited from 5 urban LTC settings. RESULTS: Although 83.3% of physicians reported they had experience caring for FCGs, 71.8% of FCGs perceived they had not received support from the physicians. There was no statistically significant difference between the FCGs' and physicians' mean responses to the mirrored survey questions. Both groups gave similar ratings, means neutral and agree indicative of ambivalence, on physician's knowledge to identify FCGs who need assistance, ability to assess FCG stress, and aid those experiencing distress and needing advocacy. Analysis of the focus groups revealed the overarching theme: ambiguity about the LTC residents' physicians' role in supporting FCGs. Although physicians noted that residents and families come as a unit, there was ambivalence about the physician's role in supporting FCGs. FCG roles in LTC are also vague. There were 3 sub-themes: "accord on the surface"; "tension in the interface"; and "smoothing the relationship." Both groups thought FCG medical care was beyond the purview of the resident's physician. Physicians and FCGs provided different explanations for the tensions in the FCG/physician interface. Physicians attributed tension to FCG stress and inadequate knowledge, whereas FCGs thought physicians' communication could be improved. Suggestions to smooth the relationship were to align FCG expectations to reality of LTC and different staffing models. CONCLUSIONS AND IMPLICATIONS: Family physicians, policy makers, and FCGs will need to work on polices to ensure LTC physicians' roles in supporting FCGs and FCGs' roles in LTC are delineated and supported.

Incidental Findings Of Polypoid Cystitis In A 6-Year Old Child Without Any History Of Lower Urinary Tract Symptoms And Previous Urinary Catheterization.

A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.

REVIEW - Advancements in combination therapy of Hepatitis C virus.

Hepatitis C virus (HCV) is a primary cause of chronic liver disease along with various complications like liver cirrhosis and malignancy which leads to death. It has infected more than 185 million people worldwide. There is no congruence established for the treatment of various genotypes of HCV infection owing to diversity in prevalence globally. Assessment of affected individuals with HCV by polymerase chain reaction (PCR), viral load of HCV and liver enzyme levels (i.e., ALT and AST) are the foundation to evaluate the safety and efficacy of HCV therapies. The antiviral efficacy has been greatly improved and sustained viral response (SVR) rates increased from 6% with interferon monotherapy to 50-80% with PEG-interferon/ribavirin combination therapy to >95% after the approval of all interferon free oral direct acting antiviral agents. The main objective of this review article is to compile data from reference sources regarding the old and current therapeutic strategies used to manage HCV infection. It is accepted that chronic HCV infection increases patient's thrombocytopenia and neutropenia risk and complications increased in co-morbid disorders like in tuberculosis, HIV, diabetes etc. In past treatment associated side effects were the major consequences and many patients have to stop the treatment. But after the approval of direct acting antiviral drugs create a revolution in the treatment of HCV infection. So, it could be concluded that current combination therapies are a promising hope to eradicate and to control HCV but some safety concerns required more considerations Therefore, this review focus on the available latest combination therapies and their effectiveness to eradicate HCV infection.

Establishing Effective Resident and Family Councils: A Pilot Project to Increase Family and Resident Engagement in Alberta's Continuing Care Sites.

Resident and family councils aim to improve resident and family satisfaction, but guidelines for councils are scarce. This project developed a toolkit and tested its ability, along with networking meetings, to promote successful councils. Nine continuing care sites participated with residents, family and staff from each site who received the toolkit, completed surveys, attended meetings and participated in post-pilot interviews. Participants found that the toolkit helped improve council function and, with the networking meetings, increased participation. All sites found the toolkit and networking meetings to be valuable resources and had a strong desire to have them available in the future.

Impedance Model of Cylindrical Nanowires for Metamaterial Applications.

In metamaterials, metallic nanowires are used for creating artificial materials to functionalize them for various nanophotonics applications. Strong polarization-dependent response coupled with complex dielectric function at optical frequencies gives additional degrees of freedom to achieve scattering, absorption, and other benefits that go much beyond what is possible with conventional materials. In this paper, we propose an extended cylindrical wave impedance approach at optical frequencies to model the internal and external impedance of the metallic nanowire. Equivalent analytical expression for the scattering, extinction, and absorption cross-sectional area efficiencies are derived in terms of impedances. The motivation is to develop an all-mode solution ( TM n and TE n modes), by bringing the complex problem of plasmonic nanowire to linear system theory, where established methods can be applied to enable new applications. The equivalence of the impedance solution is compared with electromagnetic field solution and numerical full-wave field simulations. The proposed solution is accurate and may contribute to the rapid and efficient future designs for the metallic nanowire-based nanophotonic metamaterials.

Pronounced Impact of p-Type Carriers and Reduction of Bandgap in Semiconducting ZnTe Thin Films by Cu Doping for Intermediate Buffer Layer in Heterojunction Solar Cells.

Stabilized un-doped Zinc Telluride (ZnTe) thin films were grown on glass substrates under vacuum using a closed space sublimation (CSS) technique. A dilute copper nitrate solution (0.1/100 mL) was prepared for copper doping, known as an ion exchange process, in the matrix of the ZnTe thin film. The reproducible polycrystalline cubic structure of undoped and the Cu doped ZnTe thin films with preferred orientation (111) was confirmed by X-rays diffraction (XRD) technique. Lattice parameter analyses verified the expansion of unit cell volume after incorporation of Cu species into ZnTe thin films samples. The micrographs of scanning electron microscopy (SEM) were used to measure the variation in crystal sizes of samples. The energy dispersive X-rays were used to validate the elemental composition of undoped and Cu-doped ZnTe thin films. The bandgap energy 2.24 eV of the ZnTe thin film decreased after doping Cu to 2.20 eV and may be due to the introduction of acceptors states near to valance band. Optical studies showed that refractive index was measured from 2.18 to 3.24, whereas thicknesses varied between 220 nm to 320 nm for un-doped and Cu doped ZnTe thin film, respectively, using the Swanepoel model. The oxidation states of Zn+2, Te+2, and Cu+1 through high resolution X-ray photoelectron spectroscopy (XPS) analyses was observed. The resistivity of thin films changed from ~107 Ω·cm or undoped ZnTe to ~1 Ω·cm for Cu-doped ZnTe thin film, whereas p-type carrier concentration increased from 4 × 109 cm-2 to 1.4 × 1011 cm-2, respectively. These results predicted that Cu-doped ZnTe thin film can be used as an ideal, efficient, and stable intermediate layer between metallic and absorber back contact for the heterojunction thin film solar cell technology.

Incidence Of Paraphenylene-Diamine Poisoning In Three Districts Headquarter Hospitals Of Pakistan.

BACKGROUND: Paraphenylene-diamine (PPD) poisoning is an emerging problem of developing African and South Asian countries. This study was done with the objective to determine the clinical lab diagnostic accuracy of serum creatinine phosphokinase in cases initially reporting facial oedema followed by renal failure and rhabdomyolysis due to paraphenylene-diamine (PPD) poisoning. METHODS: It was a cross-sectional study in which data was retrospectively collected at District Head Quarter (DHQ) Hospitals. Data was collected over a period of one year from Jan- Dec 2018. Data was collected from the patient file records. Data was analysed on SPSS version 20. RESULTS: In the present study, 658 cases of Kala Pathar poisoning presented and treated. M: F ratio was 5:20. There were 518 (78.8%) females. Majority of the female patients were married 488 (94%). Most common clinical manifestations included marked facial oedema; dysphagia and stridor. Post complications include rhabdomyolysis and acute renal failure which developed after two to five days. Initial lab investigations within 6-8 hours after ingestion showed marked increase in TLC count, ALT and Na+ ions. There was marked elevation of serum CPK (1400±200 U/L) levels after 24 hours. CONCLUSIONS: PPD poisoning is more common in females of younger age group belonging to rural areas. Early diagnosis and prompt supportive treatment within 2-12 hours of ingestion can save many lives. There is no specific antidote available for this poison.

Lhermitte-Duclos Disease with Cervical Arteriovenous Fistula.

Lhermitte-Duclos disease is a rare condition with less than 250 cases reported in the literature. It was considered a neoplastic or hamartomatous growth in the cerebellum. It commonly presents with symptoms of high intracranial pressure or obstructive hydrocephalus. Surgical resection is often curative. The lesion is associated with PTEN gene mutation, and it is considered to be one of the diagnostic criteria of Cowden's syndrome. Vascular tumors are reported in this syndrome, including glioblastomas and meningiomas. Furthermore, central nervous system vascular lesions were also reported in Lhermitte-Duclos disease, such as deep venous anomalies and brain arteriovenous fistulas. A report of an asymptomatic spinal cervical AVF in a patient with Lhermitte-Duclos disease was published in 2006. We present the second case of Lhermitte-Duclos disease associated with an asymptomatic spinal cervical AVF in a 17-year-old young woman with literature review of central nervous system vascular lesions in Lhermitte-Duclos disease.