Single and multi-user capacity of communication by silence in terahertz band

Nanotechnology utilizes the operation of nano-sensors also called nano-machines. Nano-machines are very small in size, about a few hundreds of nanometers. At the nanoscale, single nano-machine has very limited functionalities so it is able to perform only a simple task. However, the group of nano-machine can perform complex tasks when they communicate among themselves. The tasks performed by those machines have applications in the field of biomedical, environmental, and military. There are various models of communication among nano machines, like electromagnetic wireless communication, molecular communication, acoustic communication, nano-mechanical communication model. In this studies, electromagnetic wireless communication model is used with the latest advancement in graphene based electronic. Graphene and its derivatives points that the frequency range of operation of future electronic nano-machines is terahertz band (0.1 – 10.0 THz). This band of frequency is still unlicensed and it can theoretically support a very large transmission speed. Nano-machines, due to its small size have resource constrain. Nano-machines with nano-batteries are typically characterized by a limited energy supply. Hence, to overcome the power limitation, there is a need of an energy-efficient communication paradigm. Such an energy-efficient communication paradigm is communication through silence (CtS) strategy. This strategy enables energy-efficient information transfer within the nano-machines. In CtS, information is transmitted using silence period which makes this strategy energy-efficient. This thesis is focused in this new communication paradigm, CtS. The performance from this strategy is evaluated in terms of channel capacity for both single and multiple user cases in terahertz band. A propagation model for terahertz band based on radiative transfer theory is used to calculate the total path loss and the molecular absorption noise that a travelling wave suffers. Chanel capacity was formulated in this studies using those parameters. Analytical result in this studies shows that the performance is very high for both lower distance like, 1 meter and lower number of water vapour (H2O) molecules

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Single and multi-user capacity of communication by silence in terahertz band

Nanotechnology utilizes the operation of nano-sensors also called nano-machines. Nano-machines are very small in size, about a few hundreds of nanometers. At the nanoscale, single nano-machine has very limited functionalities so it is able to perform only a simple task. However, the group of nano-machine can perform complex tasks when they communicate among themselves. The tasks performed by those machines have applications in the field of biomedical, environmental, and military. There are various models of communication among nano machines, like electromagnetic wireless communication, molecular communication, acoustic communication, nano-mechanical communication model. In this studies, electromagnetic wireless communication model is used with the latest advancement in graphene based electronic. Graphene and its derivatives points that the frequency range of operation of future electronic nano-machines is terahertz band (0.1 – 10.0 THz). This band of frequency is still unlicensed and it can theoretically support a very large transmission speed. Nano-machines, due to its small size have resource constrain. Nano-machines with nano-batteries are typically characterized by a limited energy supply. Hence, to overcome the power limitation, there is a need of an energy-efficient communication paradigm. Such an energy-efficient communication paradigm is communication through silence (CtS) strategy. This strategy enables energy-efficient information transfer within the nano-machines. In CtS, information is transmitted using silence period which makes this strategy energy-efficient. This thesis is focused in this new communication paradigm, CtS. The performance from this strategy is evaluated in terms of channel capacity for both single and multiple user cases in terahertz band. A propagation model for terahertz band based on radiative transfer theory is used to calculate the total path loss and the molecular absorption noise that a travelling wave suffers. Chanel capacity was formulated in this studies using those parameters. Analytical result in this studies shows that the performance is very high for both lower distance like, 1 meter and lower number of water vapour (H2O) molecules

The double edged sword : the role of nuclear weapons in South Asia

This thesis exammes the consequences of nuclear proliferation on South Asia, specifically whether India and Pakistan are moving towards a stable nuclear balance. The thesis uses comparative case study methods to examine the role of nuclear weapons in crises and the lessons learnt from those crises. The thesis argues that nuclear weapons have played the dual role of crisis instigator and crisis manager in South Asia. That is, nuclear weapons have contributed to the outbreak of crises predominantly by empowering Pakistan to provoke India. However, once these crises were underway, the fear of escalation to nuclear war prompted considerable restraint and hence nuclear weapons can be understood to have also played a role of crisis manager. Furthermore, although India and Pakistan's growing nuclear arsenals, nuclear doctrines and command and control systems have exhibited complexity of deterrence, the evolving nuclear learning in India and Pakistan limits the likelihood of nuclear weapons use during a crisis. The thesis demonstrates that the role of nuclear weapons in South Asia can be best understood through this dual characterisation and that we may exercise sober optimism for the stability of nuclear deterrence in South Asia

Demographic Profile of Liver Injury Managed at a Tertiary Care Hospital in Central Nepal -A Retrospective Study

Background &amp; Objectives:The liver is one of the commonly injured solid organ following abdominal trauma. The aim of this study was to determine the outcome of liver injuries managed operatively or non-operatively and predict factors affecting morbidity and mortality.Materials &amp; Methods:This was a retrospective study of 40 liver injuries managed in the department of Surgical Gastroenterology at College of Medical Sciences over a period of 2 years. The liver injury was classified in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups those managed operatively or non-operatively and were compared in terms of demographic profile and outcome.Results:Forty patients were analyzed. The mean age of the patients was 29.95years. Male predominance was seen with 72.5% of the cases. Road traffic accidents were the commonest mode of injury seen in 72.5% cases. The mean Revised Trauma Score (RTS) and Injury severity score (ISS)  were 7.11and 22.58. The mean systolic BP, hospital stay and ICU stay were 93.80 mm of mercury, 11.55 days and 3.55 days respectively. Twenty six patients (65%) were initially managed non-operatively and 14 patients were managed operatively. Five patients had to be converted to operative management for hemodynamic instability. Mortality was 7.6% in patient undergoing non-operative management and 21.43% in patients managed operatively. Low systolic BP at presentation, low RTS score, high ISS score, high AST, ALT and prothrombin time were significantly associated with operative management and mortality.Conclusion:Patients with hemodynamic instability, low RTS score, high ISS score, high liver enzymes have high likelihood of operative management.</p

Children and revolution: mental health and psychosocial well-being of child soldiers in Nepal

Children and revolution: mental health and psychosocial well-being of child soldiers in Nepa

Social Ecology of Child Soldiers: ChilD, Family, and Community Determinants of Mental Health, Psychosocial Well-being, and Reintegration in Nepal

This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted lack of reintegration supports. Ultimately, social ecology is well suited to identify intervention foci across ecological levels based on community differences in vulnerability and protective factors. © 2010, SAGE Publications. All rights reserved

Social ecology of child soldiers:child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal

This study employs social ecology to evaluate psychosocial wellbeing in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Scale (CPSS), and locally developed measures of function impairment and reintegration. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted fewer reintegration supports. Ultimately, social ecology is well-suited to identify intervention foci across ecological levels, based on community differences in vulnerability and protective factors

Pulmonary atresia with intact ventricular septum: Midterm outcomes from a multicenter cohort

Contemporary multicenter data regarding midterm outcomes for neonates with pulmonary atresia with intact ventricular septum are lacking. We sought to describe outcomes in a contemporary multicenter cohort, determine factors associated with end-states, and evaluate the effect of right ventricular coronary dependency and coronary atresia on transplant-free survival. Neonates treated during 2009-2019 in 19 United States centers were reviewed. Competing risks analysis was performed to determine cumulative risk of each end-state, and multivariable regression analyses were performed to identify factors associated with each end-state and transplant-free survival. We reviewed 295 patients. Median tricuspid valve Z-score was - 3.06 (25%, 75%: - 4.00, - 1.52). Final end-state was biventricular repair for 45 patients (15.2%), one-and-a half ventricle for 16 (5.4%), Fontan for 75 (25.4%), cardiac transplantation for 29 (9.8%), and death for 54 (18.3%). Seventy-six patients (25.7%) remained in mixed circulation. Cumulative risk estimate of death was 10.9%, 16.1%, 16.9%, and 18.8% at 1, 6 months, 1 year, and 5 years, respectively. Tricuspid valve Z-score was inversely, and coronary atresia positively associated with death or transplantation [odds ratio (OR) = 0.46, (95% confidence interval (CI) = 0.29-0.75, p \u3c 0.001) and OR = 3.75 (95% CI 1.46-9.61, p = 0.011), respectively]. Right ventricular coronary dependency and left coronary atresia had a significant effect on transplant-free survival (log-rank p \u3c 0.001). In a contemporary multicenter cohort of patients with PAIVS, consisting predominantly of patients with moderate-to-severe right ventricular hypoplasia, we observed favorable survival outcomes. Right ventricular coronary dependency and left, but not right, coronary atresia significantly worsens transplant-free survival