On the balance energy and nuclear dynamics in peripheral heavy-ion collisions

We present here the system size dependence of balance energy for semi-central and peripheral collisions using quantum molecular dynamics model. For this study, the reactions of $Ne^{20}+Ne^{20}$, $Ca^{40}+Ca^{40}$, $Ni^{58}+Ni^{58}$, $Nb^{93}+Nb^{93}$, $Xe^{131}+Xe^{131}$ and $Au^{197}+Au^{197}$ are simulated at different incident energies and impact parameters. A hard equation of state along with nucleon-nucleon cross-sections between 40 - 55 mb explains the data nicely. Interestingly, balance energy follows a power law $\propto{A^{\tau}}$ for the mass dependence at all colliding geometries. The power factor $\tau$ is close to -1/3 in central collisions whereas it is -2/3 for peripheral collisions suggesting stronger system size dependence at peripheral geometries. This also suggests that in the absence of momentum dependent interactions, Coulomb's interaction plays an exceedingly significant role. These results are further analyzed for nuclear dynamics at the balance point.Comment: 13 pages, 9 figures Accepted in IJMPE (in press

Antimicrobial sensitivity pattern of gram positive CSF isolates in children with septic meningitis in a Tertiary Care Hospital

The present study was conducted with the objective to determineantimicrobial susceptibility of Gram positive CSF isolates in septic meningitis in a tertiary care hospital. CSF (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and microbial sensitivity was assessed by the Kirby-Bauer’s disk diffusion method. Of the samples tested 102 (15.99%) were culture positive of which 45 (44.12%) culture positives were found inchildren aged 1-12 years. M: F ratio was 1.62:1. Maximum incidence (51 cases) was in summer-rainy season and in institutional delivery (58 cases). Primary immunization did not protect against septic meningitis. The isolates in 66 (64.71%) cases were Gram positive of which 36 (54.55%) were Streptococcus spp., 24 (36.36%) Staphylococcus aureus and 6 (9.09%) cases coagulase negative Staphylococcus (CONS). Both Streptococci and coagulase negative Staphylococci were highly sensitive (100%) to Linezolid, Vancomycin and Piperacillin-Tazobactam. However, Staphylococcus aureus were 100% sensitive to Linezolid and Vancomycin but were only 87.5% sensitive to Piperacillin-Tazobactam combination. The Streptococcus species showed a high degree of resistance to Tetracyclin91.67%, Co-trimoxazole 88.89% and Penicillin 63.89%. Staphylococcus aureus showed resistance to the tune of 83.33% each to Tetracycline and Co-trimoxazxole and 79.17% with Penicillin. In case of coagulase negative Staphylococcus, Co-trimoxazole showed resistance in 83.33%, Penicillin in 66.67% and Tetracycline in 50% cases. In septic meningitis Gram positive isolates predominate. Therapy should be based on trends of bacterial sensitivity

Prevalence of Gram-negative Pathogens and their antimicrobial susceptibility in bacterial meningitis in pediatric cases

The present study was conducted to find out the prevalence and spectrum of Gram negative pathogens causing bacterial meningitis and their antimicrobial susceptibility pattern in a tertiary care hospital. The cerebrospinal fluid (CSF) (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and antimicrobial susceptibility was assessed by the Kirby-Bauer disk diffusion method. Of the 638 samples tested 102 (15.99%) were culture positive. Male to female (M:F) ratio was 1.62:1. The maximum incidence of 45 (44.12%) cases was found in children (1-12 yrs); in institutional deliveries the incidence was 58 (56.86%) cases. Further, the incidence of 51 cases was found from May to August. Escherichia coli (E. coli) were commonest, seen in 9 (25%) cases followed by Acinetobacter spp., Citrobacter spp. and Klebsiella spp. with 6 (16.67%) cases each. Enterobacter spp., Neisseria spp. and Pseudomonas aeruginosa were isolated in 3 (8.33%) cases each. E. coli, Acinetobacter spp, Citrobacter spp and Klebsiella spp isolates were 100% susceptible to meropenem, piperacillin-tazobactam and cefoperazone-sulbactam and 100% resistant to cotrimoxazole and tetracycline. All strains of Neisseria spp, Enterobacter spp and Pseudomonas spp. were 100% susceptible to meropenem followed by gatifloxacin. These were 100% resistant to tetracycline and cotrimoxazole. Neisseria spp. were also 100% susceptible to pristinamycin. In septic meningitis Gram negative organisms are less common (35.29%). Of the isolates, more common Gram negative isolates included E. coli, Acinetobacter Spp., Citrobacter Spp., and Klebsiella spp. and these isolates were 100% susceptible to meropenem, piperacillin-tazobacatam and cefoperazone-sulbactam. Hence, empirical therapy should be formulated according to antimicrobial susceptibility patterns

Machine Learning Regression Approach to the Nanophotonic Waveguide Analyses

Machine learning is an application of artificial intelligence that focuses on the development of computer algorithms which learn automatically by extracting patterns from the data provided. Machine learning techniques can be efficiently used for a problem with a large number of parameters to be optimized and also where it is infeasible to develop an algorithm of specific instructions for performing the task. Here, we combine the finite element simulations and machine learning techniques for the prediction of mode effective indices, power confinement and coupling length of different integrated photonics devices. Initially, we prepare a dataset using COMSOL Multiphysics and then this data is used for training while optimizing various parameters of the machine learning model. Waveguide width, height, operating wavelength, and other device dimensions are varied to record different modal solution parameters. A detailed study has been carried out for a slot waveguide structure to evaluate different machine learning model parameters including number of layers, number of nodes, choice of activation functions, and others. After training, this model is used to predict the outputs for new input device specifications. This method predicts the output for different device parameters faster than direct numerical simulation techniques. Absolute percentage error of less than 5% in predicting an output has been obtained for slot, strip and directional waveguide coupler designs. This study pave the step towards using machine learning based optimization techniques for integrated silicon photonics devices

Multiple Myeloma as the Underlying Cause of Thrombotic Microangiopathy Leading to Acute Kidney Injury: Revisiting a Very Rare Entity

Thrombotic microangiopathy (TMA) describes a pathological process of microvascular thrombosis, consumptive thrombocytopenia, and microangiopathic hemolytic anemia, leading to end-organ ischemia and infarction, affecting particularly the kidney and brain. TMA is a pathological feature of a number of clinical disorders including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and atypical hemolytic uremic syndrome. Rare but important, TMA may also occur in malignancy, connective tissue disease, malignant hypertension, and renal transplantation (rejection or drug toxicity). We present a very rare case where the patient developed acute kidney injury from TMA but found to have multiple myeloma as the possible underlying etiology

Comparison of distal radial access versus standard transradial access in patients with smaller diameter radial Arteries(The distal radial versus transradial access in small transradial ArteriesStudy: D.A.T.A - S.T.A.R study).

AIMS: To evaluate safety and efficacy of distal right radial access (DRRA) compared to right radial access (RRA), for coronary procedures, in patients with smaller diameter radial arteries (SDRA) (radial artery diameter (RAD) < 2.1 mm). METHODS AND RESULTS: This is a retrospective analysis of safety and efficacy of DRRA Vs. RRA in patients undergoing coronary procedures at our cardiac catheterization laboratories over a 10- month period between September 2017 and June, 2018 (first 5 calendar months with RRA-first; next 5 calendar months with DRRA-first). All patients underwent pre-procedure ultrasound of arm arteries. All patients had RAD<2.1 mm (mean RAD 1.63 ± 0.27 mm; RAD≤1.6 mm in 73.5%). Baseline characteristics were similar between groups. Primary end-point of puncture success was significantly lower in DRRA vs RRA group [79.5% vs 98.5%, p < 0.0001]. Puncture success was also lower in the subgroup of patients with RAD <1.6 mm Vs. ≥ 1.6 mm in the DRRA group (p < 0.0001). The secondary end-point of puncture time was significantly higher (2.1 ± 1.4 min vs. 1.0 ± 0.45 min, p < 0.00001) in the DRRA Vs. RRA group. The occurrence of vascular access site complications (including access site hematomas), radial artery occlusion (RAO) and distal RAO at day 1 and day 30 were similar between RRA and DRRA groups.Non-vascular access-site complication was seen only in the DRRA group. CONCLUSION: DRRA is a safe and effective access for coronary procedures; though technically challenging in patients with SDRA (RAD<2.1 mm; mean RAD 1.63 ± 0.27 mm), with lower puncture success and higher puncture time compared to RRA

Thrombotic Microangiopathy Associated With Synthetic Cannabinoid Receptor agonists

Marijuana is one of the most commonly used recreational drugs in the United States. As marijuana is illegal in the majority of countries, the use of readily available and unregulated synthetic cannabinoids (SCBs) has increased. Little is known about the potential adverse effects of SCBs especially in regards to their nephrotoxicity. Case reports of acute kidney injury (AKI) from acute tubular injury secondary to their use have been reported. However, the exact pathology, mechanism, and extent of renal injury remain unknown. We report the first case of biopsy proven thrombotic microangiopathy (TMA) associated with SCBs resulting in AKI. The patient suffered significant morbidity with loss of renal function eventually requiring renal replacement therapy