Monozygotic twins discordant for phacomatosis pigmentovascularis: evidence for the concept of twin spotting.

The term phacomatosis pigmentovascularis (PPV) refers to the occurrence of vascular nevi with melanocytic or epidermal nevi. We report on monozygotic twins (MZTs) discordant for phacomatosis cesioflammea (PPV type II) providing evidence for the mechanism of twin spotting in the development of PPV. The affected twin had a nevus flammeus on the right arm and the right maxilla, and a pigmented area on the trunk in keeping with a persistent, aberrant Mongolian spot. The affected twin had bilateral ocular melanocytosis with abnormal scleral pigmentation, iris mamillations, increased pigmentation of the trabecular meshwork, and increased fundal pigmentation and secondary glaucoma. DNA testing confirmed monozygosity. This case of MZTs discordant for PPV supports the hypothesis that PPV results from mosaicism due to a post-zygotic mutational event and the concept of twin spotting.

Molecular testing of respiratory swabs aids early recognition of meningococcal disease in children

Early meningococcal disease (MD) diagnosis is difficult. We assessed rapid molecular testing of respiratory specimens. We performed genotyping of respiratory swabs, blood, and cerebrospinal fluid from children with suspected disease and nasal swabs (NSs) from matched controls. Thirty-nine of 104 suspected cases had confirmed disease. Four controls were carriers. Throat swab ctrA and porA testing for detection of disease gave a sensitivity of 81% (17/21), specificity of 100% (44/44), positive predictive value (PPV) of 100% (17/17), negative predictive value (NPV) of 92% (44/48), and relative risk of 12. NS ctrA and porA testing gave a sensitivity of 51% (20/39), specificity of 95% (62/65), PPV of 87% (20/23), NPV of 77% (62/81), and relative risk of 4. Including only the 86 NSs taken within 48 h of presentation, the results were sensitivity of 60% (18/30), specificity of 96% (54/56), PPV of 90% (18/20), NPV of 82% (54/66), and relative risk of 5. Swab type agreement was excellent (kappa 0.80, P

Performance of a Novel Molecular Method in the Diagnosis of Late-Onset Sepsis in Very Low Birth Weight Infants

OBJECTIVE: To compare the use of a generic molecular assay to 'standard' investigations used to assist the diagnosis of late onset bacterial sepsis in very low birth weight infants (VLBW, <1500g).

METHODS: VLBW infants, greater than 48 hours of age, who were clinically suspected to have sepsis were investigated using standard tests (full blood count, C-reactive protein (at presentation) and blood culture), in addition, blood was taken for a universal molecular assay (16S rRNA reverse transcriptase PCR) for comparison. Clinical data were recorded during the suspected infection episode. A validated sepsis score (NEO-KISS) was used to retrospectively determine the presence of sepsis (independent of blood culture). The performance of each of the tests were compared by sensitivity, specificity, positive/negative likihood ratios (+/-LR) and postive/negative predictive values (PPV/NPV).

RESULTS: Sixty-five babies with suspected clinical sepsis were prospectively included. The performance indicators are presented with 95% confidence limits. For the detection of bacteria, blood culture had sensitivity of 0.57 (0.34-0.78), specificity of 0.45 (0.30-0.61); +LR of 1.05 (0.66-1.66) and-LR of 0.94 (0.52-1.7); PPV of 33.3 (18.56-50.97) and NPV of 68.97 (49.17-87.72). Serum CRP had sensitivity of 0.92 (0.64-1) and specificity of 0.36 (0.17-0.59); +LR of 1.45 (1-2.1) and-LR of 0.21 (0.03-1.5); PPV of 44.46 (26.6-66.6) and NPV of 88.9 (51.8-99.7). The universal molecular assay had sensitivity of 0.76 (0.53-0.92), specificity of 0.95 (0.85-0.99); +LR of 16.8 (4.2-66.3) and-LR of 0.25 (0.1-0.5); PPV of 88.9 (65.3-98.6) and NPV of 89.4 (76.9-96.5).

CONCLUSIONS: In VLBW infants this universal molecular assay performed better in the diagnosis of late onset sepsis (LOS) than blood culture and CRP. Further development is required to explore and improve the performance of the assay in real-time diagnosis.

Molecular classification of non-invasive breast lesions for personalised therapy and chemoprevention

Breast cancer screening has led to a dramatic increase in the detection of pre-invasive breast lesions. While mastectomy is almost guaranteed to treat the disease, more conservative approaches could be as effective if patients can be stratified based on risk of co-existing or recurrent invasive disease.Here we use a range of biomarkers to interrogate and classify purely non-invasive lesions (PNL) and those with co-existing invasive breast cancer (CEIN). Apart from Ductal Carcinoma In Situ (DCIS), relative homogeneity is observed. DCIS contained a greater spread of molecular subtypes. Interestingly, high expression of p-mTOR was observed in all PNL with lower expression in DCIS and invasive carcinoma while the opposite expression pattern was observed for TOP2A.Comparing PNL with CEIN, we have identified p53 and Ki67 as predictors of CEIN with a combined PPV and NPV of 90.48% and 43.3% respectively. Furthermore, HER2 expression showed the best concordance between DCIS and its invasive counterpart.We propose that these biomarkers can be used to improve the management of patients with pre-invasive breast lesions following further validation and clinical trials. p53 and Ki67 could be used to stratify patients into low and high-risk groups for co-existing disease. Knowledge of expression of more actionable targets such as HER2 or TOP2A can be used to design chemoprevention or neo-adjuvant strategies. Increased knowledge of the molecular profile of pre-invasive lesions can only serve to enhance our understanding of the disease and, in the era of personalised medicine, bring us closer to improving breast cancer care.

Detecting Adverse Events in Clinical Trial Free Text

Thesis (Master's)--University of Washington, 2013

PET/CT com 18-fluor-fluorodeoxiglucose no seguimento do melanoma maligno cutâneo

Introdução – O melanoma maligno cutâneo (MMC) é considerado uma das mais letais neoplasias e no seu seguimento recorre-se, para além dos exames clínicos e da análise de marcadores tumorais, a diversos métodos imagiológicos, como é o exame Tomografia por Emissão de Positrões/Tomografia Computorizada (PET/CT, do acrónimo inglês Positron Emission Tomography/Computed Tomography) com 18fluor-fluorodeoxiglucose (18F-FDG). O presente estudo tem como objetivo avaliar a utilidade da PET/CT relativamente à análise da extensão e à suspeita de recidiva do MMC, comparando os achados imagiológicos com os descritos em estudos CT. Metodologia – Estudo retrospetivo de 62 estudos PET/CT realizados em 50 pacientes diagnosticados com MMC. Excluiu-se um estudo cujo resultado era duvidoso (nódulo pulmonar). As informações relativas aos resultados dos estudos anatomopatológicos e dos exames imagiológicos foram obtidas através da história clínica e dos relatórios médicos dos estudos CT e PET/CT. Foi criada uma base de dados com os dados recolhidos através do software Excel e foi efetuada uma análise estatística descritiva. Resultados – Dos estudos PET/CT analisados, 31 foram considerados verdadeiros positivos (VP), 28 verdadeiros negativos (VN), um falso positivo (FP) e um falso negativo (FN). A sensibilidade, especificidade, o valor preditivo positivo (VPP), o valor preditivo negativo (VPN) e a exatidão da PET/CT para o estadiamento e avaliação de suspeita de recidiva no MMC são, respetivamente, 96,9%, 96,6%, 96,9%, 96,6% e 96,7%. Dos resultados da CT considerados na análise estatística, 14 corresponderam a VP, 12 a VN, três a FP e cinco a FN. A sensibilidade, especificidade, o VPP e o VPN e a exatidão da CT para o estadiamento e avaliação de suspeita de recidiva no MMC são, respetivamente, 73,7%, 80,0%, 82,4%, 70,6% e 76,5%. Comparativamente aos resultados CT, a PET/CT permitiu uma mudança na atitude terapêutica em 23% dos estudos. Conclusão – A PET/CT é um exame útil na avaliação do MMC, caracterizando-se por uma maior acuidade diagnóstica no estadiamento e na avaliação de suspeita de recidiva do MMC comparativamente à CT isoladamente.

Parent Prediction of Autism Spectrum Disorder in Infants At Risk: A Follow-up Study

Later-born siblings of children with autism spectrum disorder (ASD) are considered at biological risk for ASD and the broader autism phenotype. Early screening may detect early signs of ASD and facilitate intervention as soon as possible. This follow-up study revisits and re-examines a second-degree autism screener for children at biological risk of autism, the Parent Observation Early Markers Scale (POEMS, Feldman et al., 2012). Using available follow-up information, 110 children (the original 108 infants plus 2 infants recruited after the completion of the original study) were divided into three groups: diagnosed group (n = 13), lost diagnosis group (n = 5), and undiagnosed group (n = 92). The POEMS continued to show acceptable predictive validity. The POEMS total scores and mean number of elevated items were significantly higher in the diagnosed group than the undiagnosed group. The lost diagnosis group did not differ from the undiagnosed group on POEMS total scores and elevated items at any age, but the lost diagnosis group had significantly lower total scores and number of elevated items than the diagnosed group starting at 18 months. Both ASD core and subsidiary behaviours differentiated the diagnosed and undiagnosed groups from 9−36 months of age. Using 70 as a cut-off score, sensitivity, specificity, and positive predictive value (PPV) were .69, .84, and .38, respectively. The study provides further evidence that the POEMS may serve as a low-cost early screener for ASD in at risk children and pinpoint specific developmental and behavioural problems that may be amenable to very early intervention.

Évaluation d’un prototype de détecteur de glucose dans le tissu interstitiel sans aiguille, le PGS (Photonic Glucose Sensor)

Objectif : Déterminer la fiabilité et la précision d’un prototype d’appareil non invasif de mesure de glucose dans le tissu interstitiel, le PGS (Photonic Glucose Sensor), en utilisant des clamps glycémiques multi-étagés. Méthodes : Le PGS a été évalué chez 13 sujets avec diabète de type 1. Deux PGS étaient testés par sujet, un sur chacun des triceps, pour évaluer la sensibilité, la spécificité, la reproductibilité et la précision comparativement à la technique de référence (le Beckman®). Chaque sujet était soumis à un clamp de glucose multi-étagé de 8 heures aux concentrations de 3, 5, 8 et 12 mmol/L, de 2 heures chacun. Résultats : La corrélation entre le PGS et le Beckman® était de 0,70. Pour la détection des hypoglycémies, la sensibilité était de 63,4%, la spécificité de 91,6%, la valeur prédictive positive (VPP) 71,8% et la valeur prédictive négative (VPN) 88,2%. Pour la détection de l’hyperglycémie, la sensibilité était de 64,7% et la spécificité de 92%, la VPP 70,8% et la VPN : 89,7%. La courbe ROC (Receiver Operating Characteristics) démontrait une précision de 0,86 pour l’hypoglycémie et de 0,87 pour l’hyperglycémie. La reproductibilité selon la « Clark Error Grid » était de 88% (A+B). Conclusion : La performance du PGS était comparable, sinon meilleure que les autres appareils sur le marché(Freestyle® Navigator, Medtronic Guardian® RT, Dexcom® STS-7) avec l’avantage qu’il n’y a pas d’aiguille. Il s’agit donc d’un appareil avec beaucoup de potentiel comme outil pour faciliter le monitoring au cours du traitement intensif du diabète. Mot clés : Diabète, diabète de type 1, PGS (Photonic Glucose Sensor), mesure continue de glucose, courbe ROC, « Clark Error Grid».

Reconnaissance des actions humaines à partir d'une séquence vidéo

The work done in this master's thesis, presents a new system for the recognition of human actions from a video sequence. The system uses, as input, a video sequence taken by a static camera. A binary segmentation method of the the video sequence is first achieved, by a learning algorithm, in order to detect and extract the different people from the background. To recognize an action, the system then exploits a set of prototypes generated from an MDS-based dimensionality reduction technique, from two different points of view in the video sequence. This dimensionality reduction technique, according to two different viewpoints, allows us to model each human action of the training base with a set of prototypes (supposed to be similar for each class) represented in a low dimensional non-linear space. The prototypes, extracted according to the two viewpoints, are fed to a $K$-NN classifier which allows us to identify the human action that takes place in the video sequence. The experiments of our model conducted on the Weizmann dataset of human actions provide interesting results compared to the other state-of-the art (and often more complicated) methods. These experiments show first the sensitivity of our model for each viewpoint and its effectiveness to recognize the different actions, with a variable but satisfactory recognition rate and also the results obtained by the fusion of these two points of view, which allows us to achieve a high performance recognition rate.

Investigations on polyaniline based systems for technologically important applications and some novel polymers as prospective candidates for fabricating polymer light emitting diodes

Light emitting polymers (LEP) have drawn considerable attention because of their numerous potential applications in the field of optoelectronic devices. Till date, a large number of organic molecules and polymers have been designed and devices fabricated based on these materials. Optoelectronic devices like polymer light emitting diodes (PLED) have attracted wide-spread research attention owing to their superior properties like flexibility, lower operational power, colour tunability and possibility of obtaining large area coatings. PLEDs can be utilized for the fabrication of flat panel displays and as replacements for incandescent lamps. The internal efficiency of the LEDs mainly depends on the electroluminescent efficiency of the emissive polymer such as quantum efficiency, luminance-voltage profile of LED and the balanced injection of electrons and holes. Poly (p-phenylenevinylene) (PPV) and regio-regular polythiophenes are interesting electro-active polymers which exhibit good electrical conductivity, electroluminescent activity and high film-forming properties. A combination of Red, Green and Blue emitting polymers is necessary for the generation of white light which can replace the high energy consuming incandescent lamps. Most of these polymers show very low solubility, stability and poor mechanical properties. Many of these light emitting polymers are based on conjugated extended chains of alternating phenyl and vinyl units. The intra-chain or inter-chain interactions within these polymer chains can change the emitted colour. Therefore an effective way of synthesizing polymers with reduced π-stacking, high solubility, high thermal stability and high light-emitting efficiency is still a challenge for chemists. New copolymers have to be effectively designed so as to solve these issues. Hence, in the present work, the suitability of a few novel copolymers with very high thermal stability, excellent solubility, intense light emission (blue, cyan and green) and high glass transition temperatures have been investigated to be used as emissive layers for polymer light emitting diodes.

Blue, Green and Orange-Red Light Emitting Polymers: Synthesis, Characterization and Prospects of Applications in Optoelectronic Devices

Light emitting polymers (LEPs) are considered as the second generation of conducting polymers. A Prototype LEP device based on electroluminescence emission of poly(p-phenylenevinylene) (PPV) was first assembled in 1990. LEPs have progressed tremendously over the past 20 years. The development of new LEP derivatives are important because polymer light emitting diodes (PLEDs) can be used for the manufacture of next-generation displays and other optoelectronic applications such as lasers, photovoltaic cells and sensors. Under this circumstance, it is important to understand thermal, structural, morphological, electrochemical and photophysical characteristics of luminescent polymers. In this thesis the author synthesizes a series of light emitting polymers that can emit three primary colors (RGB) with high efficiency

Modified Block Adaptive Predictive Coder For Speech Processing

This thesis investigated the potential use of Linear Predictive Coding in speech communication applications. A Modified Block Adaptive Predictive Coder is developed, which reduces the computational burden and complexity without sacrificing the speech quality, as compared to the conventional adaptive predictive coding (APC) system. For this, changes in the evaluation methods have been evolved. This method is as different from the usual APC system in that the difference between the true and the predicted value is not transmitted. This allows the replacement of the high order predictor in the transmitter section of a predictive coding system, by a simple delay unit, which makes the transmitter quite simple. Also, the block length used in the processing of the speech signal is adjusted relative to the pitch period of the signal being processed rather than choosing a constant length as hitherto done by other researchers. The efficiency of the newly proposed coder has been supported with results of computer simulation using real speech data. Three methods for voiced/unvoiced/silent/transition classification have been presented. The first one is based on energy, zerocrossing rate and the periodicity of the waveform. The second method uses normalised correlation coefficient as the main parameter, while the third method utilizes a pitch-dependent correlation factor. The third algorithm which gives the minimum error probability has been chosen in a later chapter to design the modified coder The thesis also presents a comparazive study beh-cm the autocorrelation and the covariance methods used in the evaluaiicn of the predictor parameters. It has been proved that the azztocorrelation method is superior to the covariance method with respect to the filter stabf-it)‘ and also in an SNR sense, though the increase in gain is only small. The Modified Block Adaptive Coder applies a switching from pitch precitzion to spectrum prediction when the speech segment changes from a voiced or transition region to an unvoiced region. The experiments cont;-:ted in coding, transmission and simulation, used speech samples from .\£=_‘ajr2_1a:r1 and English phrases. Proposal for a speaker reecgnifion syste: and a phoneme identification system has also been outlized towards the end of the thesis.

Spray pyrolysed In2S3 thin films: A potential electron selective layer for large area inverted bulk-heterojunction polymer solar cells

In this paper, we report the results of investigations on the potential of spray pyrolysis technique in depositing electron selective layer over larger area for the fabrication of inverted bulk-heterojunction polymer solar cells. The electron selective layer (In2S3) was deposited using spray pyrolysis technique and the linear heterojunction device thus fabricated exhibited good uniformity in photovoltaic properties throughout the area of the device. An MEH-PPV:PCBM inverted bulk-heterojunction device with In2S3 electron selective layer (active area of 3.25 3.25 cm2) was also fabricated and tested under indoor and outdoor conditions. Fromthe indoor measurements employing a tungsten halogen lamp (50mW/cm2 illumination), an opencircuit voltage of 0.41V and a short-circuit current of 5.6mA were obtained. On the other hand, the outdoor measurements under direct sunlight (74mW/cm2) yielded an open-circuit voltage of 0.46V and a short-circuit current of 9.37mA

Synthesis, Characterization and Applications of Modified TiO2 Systems

This thesis is divided in to 9 chapters and deals with the modification of TiO2 for various applications include photocatalysis, thermal reaction, photovoltaics and non-linear optics. Chapter 1 involves a brief introduction of the topic of study. An introduction to the applications of modified titania systems in various fields are discussed concisely. Scope and objectives of the present work are also discussed in this chapter. Chapter 2 explains the strategy adopted for the synthesis of metal, nonmetal co-doped TiO2 systems. Hydrothermal technique was employed for the preparation of the co-doped TiO2 system, where Ti[OCH(CH3)2]4, urea and metal nitrates were used as the sources for TiO2, N and metals respectively. In all the co-doped systems, urea to Ti[OCH(CH3)2]4 was taken in a 1:1 molar ratio and varied the concentration of metals. Five different co-doped catalytic systems and for each catalysts, three versions were prepared by varying the concentration of metals. A brief explanation of physico-chemical techniques used for the characterization of the material was also presented in this chapter. This includes X-ray Diffraction (XRD), Raman Spectroscopy, FTIR analysis, Thermo Gravimetric Analysis, Energy Dispersive X-ray Analysis (EDX), Scanning Electron Microscopy(SEM), UV-Visible Diffuse Reflectance Spectroscopy (UV-Vis DRS), Transmission Electron Microscopy (TEM), BET Surface Area Measurements and X-ray Photoelectron Spectroscopy (XPS). Chapter 3 contains the results and discussion of characterization techniques used for analyzing the prepared systems. Characterization is an inevitable part of materials research. Determination of physico-chemical properties of the prepared materials using suitable characterization techniques is very crucial to find its exact field of application. It is clear from the XRD pattern that photocatalytically active anatase phase dominates in the calcined samples with peaks at 2θ values around 25.4°, 38°, 48.1°, 55.2° and 62.7° corresponding to (101), (004), (200), (211) and (204) crystal planes (JCPDS 21-1272) respectively. But in the case of Pr-N-Ti sample, a new peak was observed at 2θ = 30.8° corresponding to the (121) plane of the polymorph brookite. There are no visible peaks corresponding to dopants, which may be due to their low concentration or it is an indication of the better dispersion of impurities in the TiO2. Crystallite size of the sample was calculated from Scherrer equation byusing full width at half maximum (FWHM) of the (101) peak of the anatase phase. Crystallite size of all the co-doped TiO2 was found to be lower than that of bare TiO2 which indicates that the doping of metal ions having higher ionic radius into the lattice of TiO2 causes some lattice distortion which suppress the growth of TiO2 nanoparticles. The structural identity of the prepared system obtained from XRD pattern is further confirmed by Raman spectra measurements. Anatase has six Raman active modes. Band gap of the co-doped system was calculated using Kubelka-Munk equation and that was found to be lower than pure TiO2. Stability of the prepared systems was understood from thermo gravimetric analysis. FT-IR was performed to understand the functional groups as well as to study the surface changes occurred during modification. EDX was used to determine the impurities present in the system. The EDX spectra of all the co-doped samples show signals directly related to the dopants. Spectra of all the co-doped systems contain O and Ti as the main components with low concentrations of doped elements. Morphologies of the prepared systems were obtained from SEM and TEM analysis. Average particle size of the systems was drawn from histogram data. Electronic structures of the samples were identified perfectly from XPS measurements. Chapter 4 describes the photocatalytic degradation of herbicides Atrazine and Metolachlor using metal, non-metal co-doped titania systems. The percentage of degradation was analyzed by HPLC technique. Parameters such as effect of different catalysts, effect of time, effect of catalysts amount and reusability studies were discussed. Chapter 5 deals with the photo-oxidation of some anthracene derivatives by co-doped catalytic systems. These anthracene derivatives come underthe category of polycyclic aromatic hydrocarbons (PAH). Due to the presence of stable benzene rings, most of the PAH show strong inhibition towards biological degradation and the common methods employed for their removal. According to environmental protection agency, most of the PAH are highly toxic in nature. TiO2 photochemistry has been extensively investigated as a method for the catalytic conversion of such organic compounds, highlighting the potential of thereof in the green chemistry. There are actually two methods for the removal of pollutants from the ecosystem. Complete mineralization is the one way to remove pollutants. Conversion of toxic compounds to another compound having toxicity less than the initial starting compound is the second way. Here in this chapter, we are concentrating on the second aspect. The catalysts used were Gd(1wt%)-N-Ti, Pd(1wt%)-N-Ti and Ag(1wt%)-N-Ti. Here we were very successfully converted all the PAH to anthraquinone, a compound having diverse applications in industrial as well as medical fields. Substitution of 10th position of desired PAH by phenyl ring reduces the feasibility of photo reaction and produced 9-hydroxy 9-phenyl anthrone (9H9PA) as an intermediate species. The products were separated and purified by column chromatography using 70:30 hexane/DCM mixtures as the mobile phase and the resultant products were characterized thoroughly by 1H NMR, IR spectroscopy and GCMS analysis. Chapter 6 elucidates the heterogeneous Suzuki coupling reaction by Cu/Pd bimetallic supported on TiO2. Sol-Gel followed by impregnation method was adopted for the synthesis of Cu/Pd-TiO2. The prepared system was characterized by XRD, TG-DTG, SEM, EDX, BET Surface area and XPS. The product was separated and purified by column chromatography using hexane as the mobile phase. Maximum isolated yield of biphenyl of around72% was obtained in DMF using Cu(2wt%)-Pd(4wt%)-Ti as the catalyst. In this reaction, effective solvent, base and catalyst were found to be DMF, K2CO3 and Cu(2wt%)-Pd(4wt%)-Ti respectively. Chapter 7 gives an idea about the photovoltaic (PV) applications of TiO2 based thin films. Due to energy crisis, the whole world is looking for a new sustainable energy source. Harnessing solar energy is one of the most promising ways to tackle this issue. The present dominant photovoltaic (PV) technologies are based on inorganic materials. But the high material, low power conversion efficiency and manufacturing cost limits its popularization. A lot of research has been conducted towards the development of low-cost PV technologies, of which organic photovoltaic (OPV) devices are one of the promising. Here two TiO2 thin films having different thickness were prepared by spin coating technique. The prepared films were characterized by XRD, AFM and conductivity measurements. The thickness of the films was measured by Stylus Profiler. This chapter mainly concentrated on the fabrication of an inverted hetero junction solar cell using conducting polymer MEH-PPV as photo active layer. Here TiO2 was used as the electron transport layer. Thin films of MEH-PPV were also prepared using spin coating technique. Two fullerene derivatives such as PCBM and ICBA were introduced into the device in order to improve the power conversion efficiency. Effective charge transfer between the conducting polymer and ICBA were understood from fluorescence quenching studies. The fabricated Inverted hetero junction exhibited maximum power conversion efficiency of 0.22% with ICBA as the acceptor molecule. Chapter 8 narrates the third order order nonlinear optical properties of bare and noble metal modified TiO2 thin films. Thin films were fabricatedby spray pyrolysis technique. Sol-Gel derived Ti[OCH(CH3)2]4 in CH3CH2OH/CH3COOH was used as the precursor for TiO2. The precursors used for Au, Ag and Pd were the aqueous solutions of HAuCl4, AgNO3 and Pd(NO3)2 respectively. The prepared films were characterized by XRD, SEM and EDX. The nonlinear optical properties of the prepared materials were investigated by Z-Scan technique comprising of Nd-YAG laser (532 nm,7 ns and10 Hz). The non-linear coefficients were obtained by fitting the experimental Z-Scan plot with the theoretical plots. Nonlinear absorption is a phenomenon defined as a nonlinear change (increase or decrease) in absorption with increasing of intensity. This can be mainly divided into two types: saturable absorption (SA) and reverse saturable absorption (RSA). Depending on the pump intensity and on the absorption cross- section at the excitation wavelength, most molecules show non- linear absorption. With increasing intensity, if the excited states show saturation owing to their long lifetimes, the transmission will show SA characteristics. Here absorption decreases with increase of intensity. If, however, the excited state has strong absorption compared with that of the ground state, the transmission will show RSA characteristics. Here in our work most of the materials show SA behavior and some materials exhibited RSA behavior. Both these properties purely depend on the nature of the materials and alignment of energy states within them. Both these SA and RSA have got immense applications in electronic devices. The important results obtained from various studies are presented in chapter 9.

Diagnóstico de apendicitis aguda en la edad pedíatrica en la Fundación Cardio Infantil : utilidad de la ultrasonografía

Los niños que presentan dolor abdominal agudo representan una de las principales demandas de atención en los servicios de Urgencias Pediátricas, convirtiéndose en un reto para quien realiza la valoración inicial la decisión de que paciente amerita realizar estudios adicionales, para descartar una patología quirúrgica. Considerando que la apendicitis es la primera emergencia quirúrgica en niños, y que sus complicaciones son un problema frecuente, es imprescindible que el clínico conozca cual es la utilidad y beneficio que le brindan las herramientas diagnósticas disponibles para realizar un diagnóstico más certero. Objetivo: Describir el manejo de los pacientes menores de 18 años con sospecha de apendicitis en la FCI y determinar la sensibilidad y especificidad de la ecografía en esta población. Métodos: Estudio de Prueba Diagnóstica. Revisión expedita de los niños valorados en la FCI con sospecha clínica de apendicitis aguda durante un periodo de 4 meses. Se tomaron datos de hallazgos ecográficos para apendicitis (positivos, negativos o indeterminados) y del desenlace de tener o no apendicitis. Posteriormente se realizó una inferencia mediante una tabla de contingencia, teniendo en cuenta intervalos de confianza para determinar la sensibilidad, especificidad, VPP, VPN y exactitud de la prueba basados en el diagnóstico final. Resultados: En 52% de pacientes que consultaron por dolor abdominal se sospecho patología quirúrgica, grupo en el que se utilizó la ecografía abdominal como herramienta diagnóstica para descartar apendicitis encontrando: sensibilidad: 63%(IC 95%, 48.6-75.5), especificidad: 82,7%(IC 95%, 76- 87.8) y exactitud: 78,2%(IC 95%, 72-83,4). La prevalencia de la enfermedad fue 22,8%, con probabilidad postprueba positiva de 88.3%(IC 95%, 82,1-92.6). Conclusiones: Los resultados de este estudio evidencian un menor rendimiento de la ecografía como prueba diagnóstica para apendicitis en pediatría en nuestro medio comparado al descrito en la literatura. Dicha discordancia probablemente se encuentra determinada por los sesgos propios de un estudio histórico como este, en el que básicamente la falta de uniformidad en el registro de datos en la historia clínica por los observadores (clínicos y radiólogos), así como las limitaciones para determinar el seguimiento de todos los pacientes que no fueron operados, pueden alterar la capacidad operativa real de la prueba. De ahí la importancia de realizar a futuro un estudio concurrente.