Femtosecond Laser Patterned Templates and Imprinted Polymer Structures

Femtosecond laser machining is a direct-write lithography technique by which user-defined patterns are efficiently and rapidly generated at the surface or within the bulk of transparent materials. When femtosecond laser machining is performed with tightly focused amplified pulses in single-pulse mode, transparent substrates like fused silica can be surface patterned with high aspect ratio (\u3e10:1) and deep (\u3e10 μm) nanoholes. The main objective behind this dissertation is to develop single-pulse amplified femtosecond laser machining into a novel technique for the production of fused silica templates with user-defined patterns made of high aspect ratio nanoholes. The size of the nanoholes, both lateral and vertical, is controlled to a certain degree by controlling laser machining parameters or by chemical etching in a post-machining treatment. Fused silica templates produced by this new technique, both as-machined and chemically etched, are shown to be useful for imprinting polymer structures by a simple replication procedure using polymer thin films or solutions. In particular, a solution-based replication procedure, termed solution casting, is developed to imprint polymer structures from fused silica templates. Polymer structures in the form of nanowires, nanocones, and micropillars are successfully imprinted from various polymer types. Imprinted polymer structures are easily functionalized by subsequent surface treatment processes like cryogenic sputter coating and vapor deposition. A novel low-temperature chemical vapor deposition process is developed to coat polymer nanowires with silica to produce silica nanoneedles. Silica nanoneedles thus produced are shown to be useful as synthetic cell culture substrates to study the behavior of NIH 3T3 fibroblasts. In the final part of this dissertation, a report is given on more in-depth collaborative experiments to study the role of optical aberrations as part of the mechanism for producing high aspect ratio nanoholes by single-pulse amplified femtosecond laser machining. The results indicate that (i) precise optical alignment of the focusing lens is needed to avoid coma, which significantly deteriorates the ability to produce nanoholes, and (ii) 10-micron deep nanoholes can be produced by focusing a beam without spherical aberration but even deeper nanoholes are formed when the beam is focused with undercorrected spherical aberration

Laser Processing of Refractory Metal - Refractory Carbide Alloys

The objective of the present study was to laser process a refractory metal – refractory carbide alloy based on W-Ti-C ternary system for severe service applications. The key concept was to cast a eutectic alloy of tungsten and titanium carbide/carbonitride straight from the melt through laser materials processing route. In the present study, a WTi- C ternary alloy has been laser processed into three-dimensional objects and surface protective coatings. Two novel fabrication systems were designed to build threedimensional objects, namely tower nozzle solid freeform fabrication system and axissymmetric laser powder deposition system. W-Ti-C alloy based protective coatings were deposited on graphite substrates, through laser melting of pre-placed powder mixture, to widen the use of carbon structural elements for high temperature applications. A method for depositing W-Ti-C alloy on steel using multi-intermediate layers strategy is discussed and the preliminary results are presented in this study

Effects of advanced maternal age on pregnancy outcome

Background: Advanced maternal age, generally signify age after 35 years at the time of delivery. It is associated with decreased fertility and increased risk.Methods: This was a prospective study conducted in Kamla Raja Hospital, G.R. Medical College, Gwalior (M.P.) during the period of one year from July 2015 to June 2016.  Pregnant women aged 35 years and older at the time of delivery were selected and analyzed for maternal and perinatal outcome.Results: A total no. of 288 elderly pregnant patients were selected for the study. Most of the cases were in the age group 35 to 39 years (89.93%). Multi gravida (71.8%) and grand multi para (22.22%) constituted the largest group. Most of the cases belong to lower socio-economic status (90%). Percentage of unbooked cases was 82.98%. The causes of delay in pregnancy were preference for male child (23.95%) and unwareness of contraception (21.52%). The incidence of diabetes mellitus and chronic hypertension were increased. Overall cesarean rate was increased (35%). Incidence of abortions 28(9.72%), preterm delivery 18(6.25%), oligohydramnios 18(6.25%), APH 18(6.25%) and PROM 17(5.90%), low birth weight baby 30(13.19%), NICU admission 20 (6.94%), IUGR 11(3.81%) all were high. The preference for male child 69(23.95%) and lack of awareness 62(21.52%) were two major reason for continuing pregnancies and deliveries till late age.Conclusions: The present study showed that pregnancy at advanced age is a higher risk pregnancy in term of increased maternal and perinatal morbidity and mortality

ANN based peak power tracking for PV supplied DC motors.

The report presents an application of an Artificial Neural Network(ANN) for the identification of the optimal operating point of a PV supplied separately excited dc motor driving two different load torques. A gradient descent algorithm is used to train the ANN controller for the identification of the maximum power point of the Solar Cell Array (SCA) a gross mechanical energy operation of the combined system. The algorithm is developed based on matching of the SCA to the motor load through a buck-boost power converter so that the combined system can operate at the optimum point. The input parameter to the neural network is solar insulation and the output parameter is the converter chopping ratio corresponding to the maximum power output of the SCA or gross mechanical energy output of the combined PV system. The converter chopping ratios at different solar insulations are obtained from the ANN controller for two different load torques and are compared with computed values

Annular pancreas in adults: single unit experience from a tertiary care centre of Northern India

Annular pancreas is a rare congenital anomaly which usually presents with gastrointestinal symptoms early in life. In adults mostly it remains asymptomatic or may present with abdominal or features of duodenal obstruction the increased diagnosis of which is attributed to the improved imaging modalities. We hereby report our experience of adult annular pancreas in whom clinical presentation initially mimicked gastric or duodenal outlet obstruction. Adult annular pancreas was diagnosed with the aid of computed tomography of the abdomen and treated successfully with Roux-en-Y isoperistaltic gastrojejunostomy

Fallopian tube as a cause of intestinal obstruction: a rare case report with review of literature

Adhesive Intestinal obstruction is the most common cause of intestinal obstruction in post-operative period. Diagnosis is based on history, clinical examination, plain X-ray abdomen. Authors here report an interesting case of intestinal obstruction after surgery for chronic calcific pancreatitis with pancreatic duct stone with intractable pain. In post-operative period patient developed features of intestinal obstruction, patient was planned for re- exploration and it was found that band was formed by left fallopian tube with transition point at terminal ileum and treated successfully with left Salpingectomy. Very few cases of fallopian tube as cause of intestinal obstruction have been reported in literature and it should be considered as one of the cause of intestinal obstruction in females presenting with acute abdomen

DESIGN AND CHARACTERIZATION OF SUSTAINED RELEASE MATRIX TABLETS OF METFORMIN HYDROCHLORIDE USING COMBINATION OF HYDROPHILIC POLYMERS

Sustained release system is types of modified drug delivery system that can be used as an alternative to conventional system. Among different dosage forms, matrix tablets are widely accepted for oral sustained release Metformin hydrochloride has relatively short plasma half-life, low absolute bioavailability. The need for the administration two to three times a day when larger doses are required can decrease patient compliance. Sustained release formulation that would maintain plasma level for 8-12 h might be sufficient for daily dosing of metformin. Sustained release products are needed for metformin to prolong its duration of action and to improve patient compliances. They are capable of reducing the dose intake, minimize the blood level oscillation dose related adverse effect and cost thus improves the patient compliance in the therapeutic management of diabetes. The Metformin hydrochloride matrix Sustained release tablets were prepared using different hydrophilic polymers in various proportions as release retarding agent to prolong the drug release and to improve the patience compliance. The tablets were evaluated for various tests like hardness, friability, disintegration and in-vitro dissolution studies. Keywords: Matrix Tablets, Metformin hydrochloride, Hardness, Friability, Disintegration and in-vitro dissolution studie

Toward the use of CVD-grown MoS2 nanosheets as field-emission source

Densely populated edge-terminated vertically aligned two-dimensional MoS2 nanosheets (NSs) with thicknesses ranging from 5 to 20 nm were directly synthesized on Mo films deposited on SiO2 by sulfurization. The quality of the obtained NSs was analyzed by scanning electron and transmission electron microscopy, and Raman and X-ray photoelectron spectroscopy. The as-grown NSs were then successfully transferred to the substrates using a wet chemical etching method. The transferred NSs sample showed excellent field-emission properties. A low turn-on field of 3.1 V/μm at a current density of 10 µA/cm2 was measured. The low turn-on field is attributed to the morphology of the NSs exhibiting vertically aligned sheets of MoS2 with sharp and exposed edges. Our findings show that the fabricated MoS2 NSs could have a great potential as robust high-performance electron-emitter material for various applications such as microelectronics and nanoelectronics, flat-panel displays and electron-microscopy emitter tips

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Prevalence and predictors of depression and anxiety in patients of diabetes mellitus in a tertiary care center

Background: Diabetes is one of the most common chronic diseases and affects virtually every organ of the human system. Depression and anxiety is common among patients with diabetes and associated with worse diabetes outcomes. Aims and Objective: To study the prevalence and predictors of depression and anxiety in patients of Type 2 diabetes mellitus (T2DM) in Pt. B.D. Sharma, PGIMS, Rohtak, Haryana, India, a tertiary care center in Northern India. Materials and Methods: Four hundred ten consecutive patients having T2DM and 410 healthy controls matched for age and sex attending the endocrine out-patient department of a tertiary care center of Northern India were included in the study. Sociodemographic and relevant clinical variables were collected. They were evaluated for depression and anxiety using Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale respectively. Results: It was found that a significantly larger proportion of diabetic patients had depression (26.3% vs. 11.2%, P = 0.001), anxiety (27.6% vs. 12.7%, P = 0.001) and comorbid depression and anxiety (21.0% vs. 7.3%, P = 0.001) as compared to healthy controls. Diabetic women had higher depression (17.1% vs. 9.3%) and anxiety (17.6% vs. 10.0%) than men. The major predictors for a severe form of depression and anxiety among T2DM cases were age, female sex, insulin therapy, retinopathy, nephropathy, and ischemic heart disease. Conclusion: The present findings reveal that diabetic cases had significantly higher depression and anxiety as compared to healthy controls. The risk factors for depression and anxiety were age, female sex, insulin therapy, and diabetic complications