Design and implementation of 4 bit binary weighted current steering DAC

A compact current-mode Digital-to-Analog converter (DAC) suitable for biomedical application is repesented in this paper .The designed DAC is binary weighted in 180nm CMOS technology with 1.8V supply voltage. In this implementation, authors have focused on calculaton of Non linearity error say INL and DNL for 4 bit DAC having various type of switches: NMOS, PMOS and Transmission Gate. The implemented DAC uses lower area and power compared to unary architecture due to absence of digital decoders. The desired value of Integrated non linearity (INL) and Differential non linearity (DNL) for DAC for are within a range of +0.5LSB. Result obtained in this works for INL and DNL for the case DAC using Transmission Gate is +0.34LSB and +0.38 LSB respectively with 22mW power dissipation

Management of Patients with Refractory Cardiogenic Shock and Cardiointestinal Syndrome with Impella 5.5 as Bridge to Decision: Case Series

Patients with advanced heart failure require multi-system management as a majority succumb to end-organ dysfunction, including gastrointestinal sequelae. Temporizing measures, such as early mechanical circulatory support, can assist in the recovery of patients with acute cardiogenic shock. The temporary support can improve patient characteristics to enable future definitive heart failure therapies such as durable left ventricular assist devices and orthotopic heart transplantation. We present two cases of cardiogenic shock that were successfully bridged with an Impella 5.5 (Abiomed). The management enabled the patients to recover from reversible cardiointestinal syndrome and undergo successful definitive therapies

Predictors of Cardiovascular and Gastrointestinal Disorders, Inappropriate Nonsteroidal Anti-inflammatory Drug Use, and Alzheimer’s Disease and Related Dementia in Older Adults with Osteoarthritis

Osteoarthritis (OA) is a degenerative arthritis affecting over 30 million Americans most of whom are over 65 years or older. Its clinical management is complicated by several disease- and treatment-specific factors. These include the co-occurrence of cardiovascular and gastrointestinal disorders (CV-GID), the inappropriate use of non-steroidal anti-inflammatory drugs (NSAID) to manage pain, and the risk of certain age-related chronic conditions like Alzheimer’s disease and related dementia (ADRD). Moreover, older adults with OA are at a higher risk of CV-GID, inappropriate NSAID use, and ADRD. Additionally, these factors can also affect one another in both a positive and a negative way. For example, the long-term use of NSAID has been shown to increase the risk for cardiovascular and gastrointestinal disorders. On the other hand, their use has been shown to decrease the risk of ADRD in some studies. NSAID use is disproportionately higher among older adults, so the benefits or risks associated with such use should be taken into account while making treatment decisions. However, there is a gap in our understanding of the clinical and demographic factors that increase the risk of co-occurring CV-GID, inappropriate NSAID use, and ADRD in older adults with OA. This dissertation pursued three related aims to fill this knowledge gap: 1) identify the leading predictors of CV-GID; 2) identify the leading predictors of inappropriate NSAID use; and 3) examine whether duration of NSAID use is a leading predictor of ADRD and how other factors affect this relationship using a combination of machine learning techniques. All three aims used a retrospective, longitudinal, cohort study design using de-identified commercial health insurance insurance claims data from Optum De-identified Clinformatics Data Mart for years 2015 through 2017. OA was identified from these data using a combination of International Classification of Disease – 9th Revision and 10th Revision (ICD-9 and ICD-10) codes. Using a random forest classifier, we identified age, cardiac arrhythmia, and the duration of opioid use to be the top three leading predictors of CV-GID in our study cohort. In the second aim, we found that around 13% of older adults with OA were prescribe NSAIDs not in accordance with their CV and GI risk profile (i.e. inappropriate NSAID use). Using an eXtreme Gradient Boosting classifier and Shapley Additive eXplanations, we found durations of non-selective and selective NSAID use to be the top two predictors of inappropriate NSAID use. Older adults with low CV and high GI or high CV and low GI risk were also identified to be more likely to be treated with inappropriate NSAIDs. Lastly, results from our third aim showed that duration of NSAID use was among the top five leading predictors of ADRD in our study cohort. With the help of interpretable machine learning techniques, we found that the effect of NSAID duration on ADRD varied by factors like age, gender, and OA-related pain. In summary, the results of these aims suggest a need to target certain patient-level factors for better management of older adults with OA to reduce their risk of CVGID, NSAID-related adverse events, and ADRD. The results from this dissertation also highlight the need for further research to identify the causal links between the leading factors and the outcomes. The clinical management of OA is complex, and the knowledge obtained from this dissertation could help ease its burden for clinicians and patients

Development of Pb and Cd chalcogenide nanomaterials, nanocomposites and thin films : synthesis, characterization and applications in solar cells and photocatalysis

Les Chalcogénures métalliques ont émergé comme une classe importante de matériaux en raison de leur grand potentiel dans de nombreuses applications technologiques. Dans cette thèse, des approches faciles et peu onéreuses ont été adoptées pour développer des nanomatériaux de chalcogénures métalliques et des films minces à partir de leurs précurseurs, les complexes organo-métalliques. L’utilisation des nanomatériaux synthétisés et des couches minces dans les cellules solaires et dans la purification photocatalytique de l’eau a été discutée. La première approche adoptée implique la synthèse de nanomatériaux de sulfure métallique à partir du complexe metal-thiourée (M-TU) comme précurseur. Des nanocristaux (NCs) de sulfure de plomb (PbS) ainsi que des nanostructures ont été synthétisés à partir des complexes méthanoliques plomb-thiourée (Pb-TU) via diverses techniques de précipitation basées sur la décomposition du complexe méthanolique Pb-TU. Nous avons aussi synthétisé des nanostructures de sulfure de cadmium (CdS) par décomposition hydrothermale et solvothermale du précurseur du complexe cadmium-thiourée mélangé à l’ACA. Les nanostructures de CdS telles que synthétisées ont montré des activités photocatalytiques très efficaces pour la dégradation du méthylorange et de la rhodamine B (RhB) en milieu aqueux. On a aussi développé des voies simples de synthèse pour préparer des nanomatériaux d’halogénure métallique à partir des complexes (M-O). La sulfurisation des précurseurs du complexe M-O à une température relativement basse produit des nanocristaux de sulfure métallique très stable vu que l'acide oléique (OA) est chimisorbé en tant que carboxylate à la surface des NCs. Le précurseur du complexe oléate de cadmium Cd-O a aussi été utilisé pour préparer des NCs de CdSe. Le traitement de surface des NCs de CdSe ainsi synthétisés avec de la pyridine et du tert-butylamine a été très efficace pour remplacer les ligands AO à longues chaines. Les cellules solaires à hétérojonction volumique fabriquées à partir des NCs de CdSe à surface traitée montrent une meilleure amélioration dans les performances photovoltaiques par rapport aux NCs de CdSe non traités. La décomposition solvothérmale du précurseur du complexe Cd-O mélangé à la thio-urée produit aussi des nanocristaux composés de microsphères de CdS en forme de chou-fleur ayant de bonnes propriétés physicochimiques et une capacité photocatalytique à dégrader le RhB en milieu aqueux. La technique de déposition de revêtement par centrifugation ‘spin coating’ a été utilisée pour fabriquer les films minces de CdS et de PbS à partir de leurs précurseurs, les complexes méthanoliques M-TU. Les films obtenus avaient une surface lisse et affichaient des bandes interdites à taille quantifiée. Les raisons possibles de la faible efficacité des dispositifs de cellules solaires à films minces de CdS/PbS ont été discutées.Metal chalcogenides have emerged as an important class of materials due to their potential significance in many technological applications. In this work, easy and low cost approaches have been developed to prepare metal chalcogenide nanomaterials and thin films from their metal-organic complex precursors. The use of synthesized nanomaterials and thin films in solar cells and photocatalytic water purification has been discussed. The first approach adopted involves the synthesis of metal sulphide nanomaterials using metal-thiourea (M-TU) complex precursors. Lead sulphide (PbS) nanocrystals (NCs) and nanostructures were synthesized from methanolic lead-thiourea (Pb-TU) complex via various precipitation techniques based on the decomposition of methanolic Pb-TU complex. We have also synthesized cadmium sulphide (CdS) nanostructures through hydrothermal and solvothermal treatment of aminocaproic acid (ACA)-mixed cadmium-thiourea complex precursor. The as-synthesized CdS nanostructures were found to exhibit highly efficient photocatalytic activities for the degradation of methyl orange and rhodamine B (RhB) in aqueous medium. We have also developed simple synthetic routes to prepare metal chalcogenide nanomaterials from metal-oleate (M-O) complexes. Sulphurizations of M-O complex precursors at relatively low temperatures produced highly stable metal sulphide NCs because oleic acid (OA) is chemisorbed as a carboxylate onto the surface of NCs. The cadmium-oleate (Cd-O) complex precursor was also used to prepare CdSe NCs. Surface treatments of the as-synthesized CdSe NCs with pyridine and tert-butylamine were very effective to replace long chain OA ligands. Bulk-heterojunction solar cells made from surface treated cadmium selenide (CdSe) NCs showed greater improvement in photovoltaic performances compared to those made from untreated CdSe NCs. Solvothermal decomposition of thiourea-mixed Cd-O complex precursor also produced nanocrystals composed of cauliflower-like CdS microspheres with good physicochemical properties and photocatalytic ability to degrade RhB in aqueous medium. The spin-coating deposition technique was used to develop PbS and CdS thin films from their methanolic M-TU complex precursors. The obtained films had smooth surface and showed size quantized band gaps. The possible reasons behind the low efficiency of CdS/PbS thin film solar cell device were also discussed

Assessment Of Natural Sand And Pond Ash In Indian Context

ABSTRACT-Energy generation is increasing day by day due to rapid industrialization. Energy generation through thermal power plants is very typical now days. Pond ash (PA) from these thermal plants is available in large quantities. Pond ash utilization helps to reduce the consumption of natural resources. In current time natural sand are using and a it is costly so it’s require to replace by Pond Ash. Use of alternative material in concrete such as industrial by-product coal Ash (Fly Ash and Pond Ash) is an important eco efficiency drive. It is also the social responsibility of researchers to encourage the “beneficial use of industrial by- products in order to preserve resources, conserve energy and reduce or eliminate the need for disposal of industrial waste in landfills. This research paper reports the basic properties of Pond ash. It also compares these properties with natural natural sand. Basic changes in both type of aggregate properties were determined by various test as per require IS code, thus, it is a suitable to use pond ash as fine aggregate or partial replacement with natural sand

Clinico-demographic study of Peptic Perforation

Objective: Peptic Ulcer perforation is commonest emergency faced by the surgeons. Objective of this study is to assess the surgical outcome and prognosis of peptic ulcer perforation. Materials & Methods : Data from 25 patients who underwent emergency exploratory laparotomy for peptic ulcer perforation were recorded retrospectively in general srgery department of  tertiary care hospital of Ahmedabad from November 2017 to November 2020. Demographic data with clinical presentation, intraoperative findings, surgical procedures and post-operative outcome were analysed. Result :The mortality rate was 16%. Of total patients, 44% had co-morbid illness. Co-morbid illness is also one of the reason for mortality in majority of elderly patients.  Most common complication was Wound Infection. Male outnumbered the Females.  Conclusion: Early patient presentation to the hospital with adequate resuscitation is must to reduce morbidity and mortality in peptic ulcer perforation patients