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Abstract Background Peripheral parenteral nutrition (PPN) represents an alternative option to central parenteral nutrition (CPN) for patients requiring short‐term parenteral nutrition (PN). We hypothesized that the use of PPN cou...
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Abstract Background Peripheral parenteral nutrition (PPN) represents an alternative option to central parenteral nutrition (CPN) for patients requiring short‐term parenteral nutrition (PN). We hypothesized that the use of PPN could be increased in certain patient cohorts referred for PN in our facility. Methods A retrospective observational study investigating the clinical characteristics of patients receiving PN under the nutrition support team over a 5‐year period was undertaken. Patients who received PPN were reviewed descriptively. Of the patients who received CPN, representative samples were grouped into those who received PN for ≤7 or >7–28 days (n = 100 each, randomly assigned). Clinical characteristics considered included indication, duration and referring team for PN, and nutrition status. Descriptive statistics and binary logistic regression model for predictors of PN duration of ≤7 or >7–28 days were derived. Results Only four patients received PPN for a median of 4 days, most of whom required this route because of loss of central venous access for CPN. A high proportion of patients with no enteral access received CPN for ≤7 days, whereas the majority of patients with malabsorption required >7–28 days of CPN. Being referred for PN following upper gastrointestinal surgery increased the likelihood of CPN use for >7 days (relative risk, 5.7; 95% CI, 1.7–18.9; P = 0.004). Conclusion Within our service, PN referrals for no enteral access may represent a group in whom PPN could be used in the first instance; those referred with an indication of malabsorption or following upper gastrointestinal surgery may benefit from early commencement of CPN.
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Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of the pancreas, regional tissues around the pancreas, or remote organ systems. Acute pancreatitis is one of the most common causes of e...
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Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of the pancreas, regional tissues around the pancreas, or remote organ systems. Acute pancreatitis is one of the most common causes of epigastric pain and numbers of studies have suggested that the disease may be increasing in incidence. The last two decades have seen the emergence of significant evidence that has altered certain aspects of the management of acute pancreatitis. While most cases of acute pancreatitis are mild, the challenge remains in managing the severe cases and the complications associated with acute pancreatitis. Gallstones are still the most common cause with epidemiological trends indicating a rising incidence. The surgical management of acute gallstone pancreatitis has evolved. The present study includes 60 cases of acute pancreatitis admitted in a tertiary care centre. The reason for this conduct was for the evaluation of the etiology, presenting symptoms, investigations, management and complications of acute pancreatitis in a rural set up. Once the diagnosis is made, clinical efforts should simultaneously concentrate on investigating for the underlying etiology and managing the condition by anticipating its complications. Management of acute pancreatitis is largely supportive.
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Miniaturized, low-cost wavelength detectors are gaining enormous interest as we step into the new age of photonics. Incompatibility with integrated circuits or complex fabrication requirement in most of the conventionally used fil...
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Miniaturized, low-cost wavelength detectors are gaining enormous interest as we step into the new age of photonics. Incompatibility with integrated circuits or complex fabrication requirement in most of the conventionally used filters necessitates the development of a simple, on-chip platform for easy-to-use wavelength detection system. Also, intensity fluctuations hinder precise, noise free detection of spectral information. Here we propose a novel approach of utilizing wavelength sensitive photocurrent across semiconductor heterojunctions to experimentally validate broadband wavelength detection on an on-chip platform with simple fabrication process. The proposed device utilizes linear frequency response of internal photoemission via 2-D electron gas in a ZnO based heterojunction along with a reference junction for coherent common mode rejection. We report sensitivity of 0.96?μA/nm for a broad wavelength-range of 280?nm from 660 to 940?nm. Simple fabrication process, efficient intensity noise cancelation along with heat resistance and radiation hardness of ZnO makes the proposed platform simple, low-cost and efficient alternative for several applications such as optical spectrometers, sensing, and Internet of Things (IOTs).
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An efficient photodetector based on the sub-bandgap transition in Silicon-Indium Tin Oxide (ITO) distributed heterojunctions in form of a grating is demonstrated. The barrier height of 0.45 eV across n: Si - n: ITO heterojunction ...
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An efficient photodetector based on the sub-bandgap transition in Silicon-Indium Tin Oxide (ITO) distributed heterojunctions in form of a grating is demonstrated. The barrier height of 0.45 eV across n: Si - n: ITO heterojunction is sufficient to knock out the electrons to be photoexcited from ITO to Si for a wide wavelength around 1550 nm without using any plasmonic interaction. The n: Si - n: ITO grating structure with high refractive index contrast provides enhanced light-matter interaction and improved absorption efficiency. A large amount of photoexcitation resulting from the distributed heterojunctions leads to an improved responsivity as compared to the single planar heterojunction. We report a responsivity of 0.28 A/W at 1550 nm wavelength in a sub-bandgap regime which is higher than that of photodetectors with metal/2D materials using plasmonic interactions. The responsivity remains acceptably high for a wide wavelength range of 1530 nm-1570 nm.
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A nanophotonic switch based on electrically tunable graphene-silicon ring resonator is realized by tuning the resonant wavelengths of ring resonator. The shift in resonant wavelengths of the ring is achieved through modulation of ...
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A nanophotonic switch based on electrically tunable graphene-silicon ring resonator is realized by tuning the resonant wavelengths of ring resonator. The shift in resonant wavelengths of the ring is achieved through modulation of fermi energy level of graphene by means of electrical gating. The hybrid plasmonic structure of the ring confines the light in nanoscale dimensions. The gap and length of the ring are optimized for better extinction ratio. The proposed optical switch exhibits an extinction ratio of 10.94 dB at a wavelength of 1550 nm. A minimum gap of 100 nm and a smaller ring radius of 3.1 μm offer minimal footprint area. The real and imaginary parts of the effective index of the ring w.r.t voltage across the graphene are observed. The reported results open the way for more optical switches, modulators based on electrically controllable characteristics of the graphene and the ring resonator. The proposed design finds applications in optical interconnects, optical static random-access memory (SRAM's) and other integrated photonic devices.
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An optically assisted electrically writable non-volatile nanophotonic resistive switch based on silicon is proposed with an optical readout capability. The proposed scheme also address the issue of undesired current overshoot in r...
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An optically assisted electrically writable non-volatile nanophotonic resistive switch based on silicon is proposed with an optical readout capability. The proposed scheme also address the issue of undesired current overshoot in resistive switches. Optical assistance is provided with the blue pump light which leads to the photogenrated charge carriers in the active $TiO_{2}$ layer to lower the set voltage and to improve the endurance of the device. A large hysteresis of the current loop in presence of a blue wavelength of light at lower voltages is observed with the proposed three-layered device of Ag/$TiO_{2}$/p-Si. The electrical resistive state of the device is readout at 1550-nm of wavelength with an optical extinction ratio of 16 dB for 1 mm long device. The optical guidance with the formation (low resistance state) and dissolution (high resistance state) of conductive path filament in the active layer of $TiO_{2}$ is also discussed. The proposed nanophotonic functionality can be useful in realizing ultra-compact on-chip devices for optical switching, modulation and neuromorphic computing.
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Background: Elevated serum bilirubin has been shown to be a reliable predictor of pancreatic and biliary malignancy but the relationship between serum bilirubin and inadequate (C1), benign (C2) and indeterminate (C3) cellular samp...
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Background: Elevated serum bilirubin has been shown to be a reliable predictor of pancreatic and biliary malignancy but the relationship between serum bilirubin and inadequate (C1), benign (C2) and indeterminate (C3) cellular samples has not been explored. The aim of this study is to determine the relationship between serum bilirubin and pancreatic, biliary or ampullary malignancy in the context of non-confirmatory cytology. Methods: This is a retrospective analysis of patients with obstructive jaundice undergoing investigation for possible pancreatic, peri-ampullary or biliary malignancy between 2009 and 2013. Results: 135 patients were included; 84 had a malignant diagnosis and 51 benign. All patients with C4 or C5 cytology (n=49) had confirmed malignancy. 35 out of 86 C1 – C3 samples were falsely negative. ROC curve analysis demonstrated a strong association (AUC 0.912) between elevated serum bilirubin and malignancy; serum bilirubin ≥ 100 μmol/L had a sensitivity of 86% and a specificity of 88%. In the C1-C3 subgroup, this association was maintained (AUC 0.905). Serum bilirubin ≥ 100 μmol/L had a sensitivity of 80% and specificity of 88%. Using this cut-off highlighted 28 out of 35 of the malignancies missed by cytology (p = 0.003). Conclusion: Our study demonstrates that a serum bilirubin ≥ 100 μmol/L is associated with malignancy and this relationship is maintained in C1-C3 cytology. When faced with non-confirmatory cytology in the absence of a benign aetiology and an elevated serum bilirubin ≥ 100 μmol/L, we advocate more aggressive investigation to avoid missing an occult malignancy.
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Here, a routine 15 day interval examination was done tofollow the structural development of endomycorrhizae in the hostplant. Results have shown that VAM fungi reproduce only inassociation with the host roots. Senescing roots show...
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Here, a routine 15 day interval examination was done tofollow the structural development of endomycorrhizae in the hostplant. Results have shown that VAM fungi reproduce only inassociation with the host roots. Senescing roots showed therelease of thick walled resting spores into soil by the decay ofdead host root cells. In Mentha spicta after inoculating the soilwith AM inoculums the initial rhizospere spore count was highwhile the root % colonization was low but as the plants grewolder the root % colonization increases and spore countdecreases. At the same time with the root colonization reaches itsmaximum the spore count was also found to increase.
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Mycorrhiza is a mutualistic relationship between the plant roots and fungal hyphae. Arbascular mycorrhizal fungal association in majority of terrestrial plants are universal. A survey of A.M. fungal colonization was done in roots ...
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Mycorrhiza is a mutualistic relationship between the plant roots and fungal hyphae. Arbascular mycorrhizal fungal association in majority of terrestrial plants are universal. A survey of A.M. fungal colonization was done in roots of M. arvensis. It was found that when there is more number of spores in the rhizophere soil, more is the degree of colonisation. In the present study Mentha arvensis showed the total maximum root length colonisation of 90%.
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Here, a routine 15 day interval examination was done to follow the structural development of endomycorrhizae in the host plant. Results have shown that VAM fungi reproduce only in association with the host roots. Senescing roots s...
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Here, a routine 15 day interval examination was done to follow the structural development of endomycorrhizae in the host plant. Results have shown that VAM fungi reproduce only in association with the host roots. Senescing roots showed the release of thick walled resting spores into soil by the decay of dead host root cells. In Mentha spicta after inoculating the soil with AM inoculums the initial rhizospere spore count was high while the root % colonization was low but as the plants grew older the root % colonization increases and spore count decreases. At the same time with the root colonization reaches its maximum the spore count was also found to increase.
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