Evidence-based focused approach for fulfillment of aims: Experiences of an asthma clinic

Background: A new health system for the 21st century should be based on the best scientific knowledge, according to the Institute of Medicine, US. Objective: We have evaluated the effectiveness of asthma clinic providing comprehensive care based on the best available scientific evidence. Materials and Methods: This intervention study was conducted in a tertiary care hospital having a devoted asthma clinic for the  comprehensive management. All children diagnosed as having asthma were included, and data of cases managed from July 2014 to June 2016 were analyzed. Intervention - comprehensive management of asthma including assessment, monitoring, health education, avoidance of triggers, management of comorbid conditions, appropriate medications, written asthma action plan, and counseling for follow-up. Outcome measures were treatment direction, asthma control, emergency visits, and hospitalizations. Results: 260 children were treated over a 2-year period. The effects of focused approach with progressive expertise lead to statistically significant benefits over the two successive years from July 2014 to June 2015 and July 2015 to June2016. These were in: (i) Treatment direction: Cases requiring stepping up of treatment decreased from 36.49% to 17.24% (relative risk [RR]: 0.473 [95% confidence interval {CI}: 0.249-0.895]); p=0.01229, (ii) asthma control: Cases with not well-controlled asthma decreased from 16.44% to 7.02% (RR 0.427: [95% CI: 0.199-0.914]); p=0.045, (iii) emergency department visits decreased from 35.62% to 21.05% (RR 0.591: [95% CI: 0.39-0.897]), p=0.00766, (iv) hospitalizations decreased from 16.44% to 5.26% (RR 0.32: [95% CI: 0.135-0.757]), p=0.00462. Conclusion: Establishing an asthma clinic and progressive expertise leads to significant beneficial results

Polymorphisms of TNF-enhancer and gene for FcγRIIa correlate with the severity of falciparum malaria in the ethnically diverse Indian population

<p>Abstract</p> <p>Background</p> <p>Susceptibility/resistance to <it>Plasmodium falciparum </it>malaria has been correlated with polymorphisms in more than 30 human genes with most association analyses having been carried out on patients from Africa and south-east Asia. The aim of this study was to examine the possible contribution of genetic variants in the <it>TNF </it>and <it>FCGR2A </it>genes in determining severity/resistance to <it>P. falciparum </it>malaria in Indian subjects.</p> <p>Methods</p> <p>Allelic frequency distribution in populations across India was first determined by typing genetic variants of the <it>TNF </it>enhancer and the <it>FCGR2A </it>G/A SNP in 1871 individuals from 55 populations. Genotyping was carried out by DNA sequencing, single base extension (SNaPshot), and DNA mass array (Sequenom). Plasma TNF was determined by ELISA. Comparison of datasets was carried out by Kruskal-Wallis and Mann-Whitney tests. Haplotypes and LD plots were generated by PHASE and Haploview, respectively. Odds ratio (OR) for risk assessment was calculated using EpiInfo™ version 3.4.</p> <p>Results</p> <p>A novel single nucleotide polymorphism (SNP) at position -76 was identified in the <it>TNF </it>enhancer along with other reported variants. Five <it>TNF </it>enhancer SNPs and the <it>FCGR2A </it>R131H (G/A) SNP were analyzed for association with severity of <it>P. falciparum </it>malaria in a malaria-endemic and a non-endemic region of India in a case-control study with ethnically-matched controls enrolled from both regions. <it>TNF </it>-1031C and -863A alleles as well as homozygotes for the TNF enhancer haplotype CACGG (-1031T>C, -863C>A, -857C>T, -308G>A, -238G>A) correlated with enhanced plasma TNF levels in both patients and controls. Significantly higher TNF levels were observed in patients with severe malaria. Minor alleles of -1031 and -863 SNPs were associated with increased susceptibility to severe malaria. The high-affinity IgG2 binding FcγRIIa AA (131H) genotype was significantly associated with protection from disease manifestation, with stronger association observed in the malaria non-endemic region. These results represent the first genetic analysis of the two immune regulatory molecules in the context of <it>P. falciparum </it>severity/resistance in the Indian population.</p> <p>Conclusion</p> <p>Association of specific <it>TNF </it>and <it>FCGR2A </it>SNPs with cytokine levels and disease severity/resistance was indicated in patients from areas with differential disease endemicity. The data emphasizes the need for addressing the contribution of human genetic factors in malaria in the context of disease epidemiology and population genetic substructure within India.</p

Phase transformations in processing of bismuth titanate

Doping bismuth titanate with sodium resulted in a reduction in the electrical conductivity. This is in apparent contradiction to the established conduction mechanism by holes. The lower conductivity enabled the application of a higher electric field across the sample while poling while keeping the leakage current low. This resulted in a higher piezoelectric constant d 33 and a higher relative permittivity. Sodium doping also results in a phase transformation from Bi4Ti3O12 to the Na0.5Bi4.5Ti4O15 phase. This transformation proceeds through the intermediate Na0.5Bi8.5 Ti7O27 phase which has a structure resembling half each of Bi4Ti3O12 and Na0.5Bi 4.5Ti4O15 unit cells. High resolution TEM was done to study the structure of bismuth titanate. The mechanism of the transformation was studied by observing the transformation front and the crystallographic index of the transformation front was calculated from the Moiré fringes that were observed in the high-resolution TEM image. From this, a mechanism has been proposed for the phase transformation. A model has also been developed to relate the phase fractions with the conductivity of the multi-phase samples. A model has been developed to explain the reduction in the conductivity with sodium doping. It is also been shown that the interface between the phases can offer a significantly large resistance and possibly plays an important role in reducing the conductivity of the multiphase, sodium doped bismuth titanate

Mechanism of Formation of Faceted Titania Nanoparticles from Anodized Titania Nanotubes

Though researchers worldwide have attempted to fabricate faceted titania nanoparticles with a higher fraction of {001} facets, which have high surface energy, the approaches have focused on use of either a very aggressive heating schedule or highly corrosive chemicals like HF. The current article reports a simple method for the transformation of the titania nanotubes to faceted nanoparticles (size varying from 15–120 nm) at relatively low temperatures and heating rates, without the use of any other corrosive chemicals, utilizing only the electrolyte inside the titania nanotubes remnant from the anodization of the titanium substrate. The formation of faceted nanoparticles was found to be strongly dependent on fluorine concentration and on initial state of titania nanotubes (amorphous/crystalline) and annealing temperature. The formation of the unique “nanorod in nanoporous” structures has been reported for the first time. The current article deals with a detailed study of the formation of these unique nanostructures and proposes a mechanism for the same

Electrochemical Method To Prepare Graphene Quantum Dots and Graphene Oxide Quantum Dots

In this study, we present the preparation of graphene quantum dots (GQDs) and graphene oxide quantum dots (GOQDs). GQDs/GOQDs are prepared by an easy electrochemical exfoliation method, in which two graphite rods are used as electrodes. The electrolyte used is a combination of citric acid and alkali hydroxide in water. Four types of quantum dots, GQD1–GQD4, are prepared by varying alkali hydroxide concentration in the electrolyte, while keeping the citric acid concentration fixed. Variation of alkali hydroxide concentration in the electrolyte results in the production of GOQDs. Balanced reaction of citric acid and alkali hydroxide results in the production of GQDs (GQD3). However, three variations in alkali hydroxide concentration result in GOQDs (GQD1, GQD2, and GQD4). GOQDs show tunable oxygen functional groups, which are confirmed by X-ray photoelectron spectroscopy. GQDs/GOQDs show absorption in the UV region and show excitation-dependent photoluminescence behavior. The obtained average size is 2–3 nm, as revealed by transmission electron microscopy. X-ray diffraction peak at around 10° and broad D band peak at 1350 cm^–1 in Raman spectra confirm the presence of oxygen-rich functional groups on the surface of GOQDs. These GQDs and GOQDs show blue to green luminescence under 365 nm UV irradiation

Comparison of Crosslinking Kinetics of UV-Transparent Ethylene-Vinyl Acetate Copolymer and Polyolefin Elastomer Encapsulants

Encapsulants based on ethylene-vinyl acetate copolymers (EVA) or polyolefin elastomers (POE) are essential for glass or photovoltaic module laminates. To improve their multi-functional property profile and their durability, the encapsulants are frequently peroxide crosslinked. The crosslinking kinetics are affected by the macromolecular structure and the formulation with stabilizers such as phenolic antioxidants, hindered amine light stabilizers or aromatic ultraviolet (UV) absorbers. The main objective of this study was to implement temperature-rise and isothermal dynamic mechanical analysis (DMA) approaches in torsional mode and to assess and compare the crosslinking kinetics of novel UV-transparent encapsulants based on EVA and POE. The gelation time was evaluated from the crossover of the storage and loss shear modulus. While the investigated EVA and POE encapsulants revealed quite similar activation energy values of 155 kJ/moles, the storage modulus and complex viscosity in the rubbery state were significantly higher for EVA. Moreover, the gelation of the polar EVA grade was about four times faster than for the less polar POE encapsulant. Accordingly, the curing reaction of POE was retarded up to a factor of 1.6 to achieve a progress of crosslinking of 95%. Hence, distinct differences in the crosslinking kinetics of the UV-transparent EVA and POE grades were ascertained, which is highly relevant for the lamination of modules

Conventional or Microwave Sintering: A Comprehensive Investigation to Achieve Efficient Clean Energy Harvesting

Layers of titania are the critical components in sensitized photovoltaics. The transfer of electrons occurs from the dye molecule to the external circuit through a transparent conducting oxide, namely fluorine-doped tin oxide (FTO). Porosity, interparticle connectivity, and the titania films&rsquo; defects play a vital role in assessing the dye-sensitized solar cells&rsquo; (DSSCs) performance. The conventional methods typically take several hours to fabricate these layers. This is a significant impediment for the large-scale manufacture of DSSCs. This step can be reduced to a few hours by a microwave sintering process and may facilitate the rapid fabrication of the critical layers for sensitized photovoltaics, thus, boosting the prospects for the commercialization of these devices. In the present study, we aimed to perform different heat treatments (conventional and microwave) on the titania films with different temperatures to understand the phase formation, transmittance, and porosity without losing the titania&rsquo;s interparticle connectivity. The solar cell performance of microwave-sintered titania films is comparatively higher than that of conventionally sintered titania films

Combinatorial Chemical Bath Deposition of CdS Contacts for Chalcogenide Photovoltaics

Contact layers play an important role in thin film solar cells, but new material development and optimization of its thickness is usually a long and tedious process. A high-throughput experimental approach has been used to accelerate the rate of research in photovoltaic (PV) light absorbers and transparent conductive electrodes, however the combinatorial research on contact layers is less common. Here, we report on the chemical bath deposition (CBD) of CdS thin films by combinatorial dip coating technique and apply these contact layers to Cu­(In,Ga)­Se₂ (CIGSe) and Cu₂ZnSnSe₄ (CZTSe) light absorbers in PV devices. Combinatorial thickness steps of CdS thin films were achieved by removal of the substrate from the chemical bath, at regular intervals of time, and in equal distance increments. The trends in the photoconversion efficiency and in the spectral response of the PV devices as a function of thickness of CdS contacts were explained with the help of optical and morphological characterization of the CdS thin films. The maximum PV efficiency achieved for the combinatorial dip-coating CBD was similar to that for the PV devices processed using conventional CBD. The results of this study lead to the conclusion that combinatorial dip-coating can be used to accelerate the optimization of PV device performance of CdS and other candidate contact layers for a wide range of emerging absorbers