High Loss Research Articles

High performance THz metasurface sensor based on modified-SWCNTs film for femtomolar protein detection

Terahertz (THz) metasurface sensor plays an important role in environmental monitoring, biomedical diagnostics, and materials science. However, most traditional THz metasurfaces for trace biological substance detection either suffer from high ohmic loss, or cannot achieve ultra-low concentration detection at the femtomolar level, which limits the application range of THz metasurfaces. Here, we propose a novel metasurface based on modified single-walled carbon nanotubes (SWCNTs) film for specific detection of SAA protein in femtomolar concentration. By modifying the SWCNTs film with concentrated sulfuric acid and introducing functionalized gold nanoparticles (Au-NPs), not only the non-resonant loss of the SWCNTs film was greatly reduced, but also the specific selection of trace SAA proteins was achieved. We experimentally demonstrated that the sensitivity of this THz metasurface sensor for SAA protein detection is 37.5 GHz/fM. In contrast to conventional metal or dielectric metasurfaces, because the unique mesh-like structure of the SWCNTs film can greatly increase the interaction between trace substances and the sensor, this new modifiable metasurface can achieve the lowest detection limit of 0.1 fM, which has increased by an order of magnitude. Our results provide a new and promising method for THz metasurfaces to realize high-performance biosensors.

Correlation the microstructure and magnetic properties of Fe-Ni-Mo soft magnetic composites fabricated via polymer-derived ceramics

The coatings play a crucial role in enhancing the performance of soft magnetic composites (SMCs). This study aims to create coatings for Fe-Ni-Mo SMCs using polysilazane (PSZ) as the precursor. The transformation mechanism of the PSZ/resin mixture is studied by analyzing functional groups and chemical bonds at various temperatures. During the self-polymerization process of PSZ at 350 °C, N–H, C = C–H, Si-H bonds, –CH3, and Si-CH3 groups undergo crosslinking reactions to form C–C and Si-N bonds. When the temperature reaches 600 °C, PSZ polymer cleavage, O-Si-C and Si-N-Si bond dominate in the coating. Additionally, PSZ can effectively enhance the heat resistance of silicone resin through its reaction with Si-OH groups, which has a significant effect on increasing the resistivity of SMCs and reducing high frequency core loss. Optimizing the PSZ content to 0.5 wt% enhances the magnetic properties of Fe-Ni-Mo SMCs, resulting in a μe of 74.0 at 100 kHz and a corresponding core loss (Pcv) of 547.7 mW/cm3 at 100 kHz/100 mT. The findings provide valuable insights for optimizing PSZ content to improve magnetic performance in SMCs.

Updating knowledge of vegetation belts on a complex oceanic island after 20 years under the effect of climate change

Climate change is causing major changes in terrestrial ecosystems and biomes around the world. This is particularly concerning in oceanic islands, considered reservoirs of biodiversity, even more in those with a significant altitudinal gradient and high complexity in the vegetation they potentially harbour. Here, in Tenerife (Canary Islands), we have evaluated the changes in potential vegetation belts during the last 20 years by comparing them with a previous study. Considering the intimate linkage between vegetation and climate, we used a methodology based on phytosociological knowledge, ordination techniques and geostatistics, using multivariate spatial interpolations of bioclimatic data. This has allowed us to spatially detect the variations experienced by eight vegetation units during the last 20 years and incorporating a set of vulnerability metrics. New bioclimatic and vegetation cartography are provided according to the current scenario studied (1990–2019). Our results indicate that summit vegetation, humid laurel forest and thermo-sclerophyllous woodland are the habitats that have experienced a very high area loss and mismatch index, strong changes, if we consider that we are only comparing a period of 20 years. Simultaneously, the more xeric vegetation belts, the dry laurel forest and the pine forest would have benefited from this new warmer and drier climate, by gaining area and experiencing strong upward movements. These changes have not been spatially uniform, indicating that the elevational gradient studied not explain completely our results, showing the influence of the complex island topography. Effective landscape management should consider current remnants, transition capacity and movement limitations to better understand current and future vegetation responses in a global change context.

Risk factors and prediction model of delirium in elderly patients after hip arthroplasty

Objective: To analyze the risk factors of delirium in elderly patients after hip arthroplasty and to construct a prediction model. Methods: Clinical data of 248 elderly patients who underwent hip arthroplasty in the Department of Traumatology and Orthopedics at Wuhan Fourth Hospital were retrospectively collected from November 2021 to February 2023. Logistic regression analysis was used to identify the risk factors of delirium after hip arthroplasty, and a nomogram prediction model was constructed using the RMS package of R4.1.2 software. The accuracy and stability of the model was evaluated based on the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic (ROC) curve. Results: Age, nighttime sleep, anesthesia method, intraoperative blood loss, hypoxemia, and C-reactive protein (CRP) level were all risk factors of delirium after the hip arthroplasty (P<0.05). These factors were used to construct a nomogram prediction model that was internally validated using the Bootstrap method. The prediction model had the area under ROC curve (AUC) of 0.980 (95% CI: 0.964-0.996), indicating that it has certain predictive value for postoperative delirium. When the optimal cut off value was selected, the sensitivity and specificity were 92.7% and 92.3%, respectively, indicating that the prediction model is effective. Conclusions: Age, short nighttime sleep, general anesthesia, high intraoperative blood loss, hypoxemia, and high CRP levels are independent risk factors for delirium after hip arthroplasty. The nomogram prediction model constructed based on these risk factors can effectively predict delirium in elderly patients after hip arthroplasty. doi: https://doi.org/10.12669/pjms.40.6.9306 How to cite this: Duan Y, Zhang R. Risk factors and prediction model of delirium in elderly patients after hip arthroplasty. Pak J Med Sci. 2024;40(6):1077-1082. doi: https://doi.org/10.12669/pjms.40.6.9306 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fabrication of FeSiBPCNbCu nanocrystalline soft magnetic powders with high saturation magnetization and low core loss

Fabrication of FeSiBPCNbCu nanocrystalline soft magnetic powders with high saturation magnetization and low core loss

Analysis of the Processes of Paraffin Deposition of Oil from the Kumkol Group of Fields in Kazakhstan

The oil pipeline transportation of highly waxy oils when it is cold is accompanied by the deposition of paraffins in the inner surface of the pipeline. This study of the initial properties of the oil; the composition, structure, and nature of the components of normal alkanes in oil; and their influence on the aggregative stability of the resulting system makes it possible to find the best solutions to optimize the conditions of oil transportation with the lowest energy costs. This study shows that, according to the content of solid paraffin (14.0–16.2%), the oils of the Kumkol group of fields in Kazakhstan are highly waxy. They are characterized by high yield loss temperature values (+9–+12 °C), which also correlate with the values of the rheological parameters (τ0 1.389 Pa, 3.564 Pa). The influence of the temperature and shear rate on the shear stress and effective viscosity of the initial oils was studied. At temperatures below 20 °C, depending on the shear rate, there is an increase in the effective viscosity values (0.020 Pa∙s, 0.351 Pa∙s). The influence of the nature of solid hydrocarbons on the parameters of the paraffinization process and of the intensity of the paraffinization of the metal surfaces was studied. Our study shows that the main share of n-alkanes in the Kumkol and Akshabulak oils falls on paraffins of the C15–C44 group. The greater the temperature difference between the oil and the cold steel surface (≤40 °C), the lesser the amount of asphalt–resin–paraffin deposits (ARPDs) that fall out on the surface of the rod, although the content of long-chain paraffins prevails in these ARPDs. At the same time, the consistency of the released asphalt–resin–paraffin deposits (ARPDs) becomes denser, which makes their mechanical removal more difficult. Furthermore, the results of this study of the cooling rate shows that the rapid cooling of oils leads to the formation of a large number of crystallization centers, which leads to an increase in the values of the yield loss temperature and kinematic viscosity of the oils.

Impact of Spodoptera frugiperda (Lepidoptera: Noctuidae), on maize yield in humid tropical zones of Central Africa.

Fall armyworm, Spodoptera frugiperda Smith, became the most important maize pest in Africa in 2016, with management based on chemical pesticides. High yield losses across the continent were predicted based on farmers' perceptions, but existing agroecological differences were not considered. In the Democratic Republic of Congo, experiments were conducted to assess fall armyworm damage and yield losses in maize farms with and without treatment. The study included 2 seasons in the Kipopo wetland in 2020 and 2021, one rainy season in Kanyameshi in 2021, 2 rainy seasons in Mulungu in 2020 and 2021, and one season in a wetland on the Bishibiru site in 2020. In addition, the research was also conducted at 4 sites in Cameroon from September to December 2020 and from March to July 2021. High levels of damage incidences were recorded, but the density of larvae per plant was low, with low to moderate levels of damage severities in different seasons and sites. Treatment significantly reduced the number of fall armyworm larvae and their damage severity. However, the high infestation levels did not significantly reduce yield. Cost-benefit ratios were either negative or, in most cases, less than 1. In the best case, the use of pesticides only allowed the recovery of the amount used for the intervention. We discussed the implications of these findings for fall armyworm management in humid tropical agroecology.

Global drivers of mangrove loss in protected areas.

Despite increasing efforts and investment in mangrove conservation, mangrove cover continues to decline globally. The extent to which protected area (PA) management effectively prevents mangrove loss globally across differing management objectives and governance types is not well understood. We combined remote sensing data with PA information to identify the extent and the drivers of mangrove loss across PAs with distinct governance types and protection levels based on categories developed by the International Union for Conservation of Nature (IUCN). Mangrove loss due to storms and erosion was prevalent across all governance types and most IUCN categories. However, the extent of human-driven loss differed across governance types and IUCN categories. Loss was highest in national government PAs. Private, local, shared arrangement, and subnational government agencies had low human-driven mangrove loss. Human-driven loss was highest in PAs with the highest level of restrictions on human activities (IUCN category I) due to mangrove conversion to areas for commodity production (e.g., aquaculture), whereas PAs that allowed sustainable resource use (e.g., category VI) experienced low levels of human-driven mangrove loss. Because category I PAs with high human-driven loss were primarily governed by national government agencies, conservation outcomes in highly PAs might depend not only on the level of restrictions, but also on the governance type. Mangrove loss across different governance types and IUCN categories varied regionally. Specific governance types and IUCN categories thus seemed more effective in preventing mangrove loss in certain regions. Overall, we found that natural drivers contributed to global mangrove loss across all PAs, whereas human-driven mangrove loss was lowest in PAs with subnational- to local-level governance and PAs with few restrictions on human activities.

The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single-Bundle Suspensory Loop Device.

The treatment of acromioclavicular joint (ACJ) dislocations offers numerous options, and ongoing debates persist regarding their comparative effectiveness. Among these options, the suspensory loop device (SLD) is one of the most favored treatment modalities. Despite the observed high reduction loss rate associated with SLD, the treatment yields favorable clinical outcomes. This study aimed to investigate the clinical outcomes of patients with acute type 3 and 5 ACJ dislocations who underwent open and arthroscopic procedures using a single-bundle SLD, and to evaluate the effect of clavicular tunnel position on reduction loss. Thirty-seven eligible patients diagnosed with acute type 3 and type 5 ACJ dislocation who underwent open and arthroscopic surgery with a single-bundle SLD between January 2015 and March 2022 were evaluated retrospectively. Demographic data and radiological measurements including coracoclavicular (CC) interval, clavicle length (CL), and implant distance (ID) were recorded. The ID/CL ratio was calculated and a value between 0.17 and 0.24 was considered as "acceptable implant position". Reduction loss and other complications were noted. Patients were divided into two groups: open (Group 1) and arthroscopic (Group 2). Constant Murray Score (CMS) and Visual Analog Scale (VAS) were used for clinical and functional outcomes. Non-parametric tests were used for statistical analysis of variables. The study included six females (16.2%) and 31 males (83.8%) with a mean age of 40.2 ± 14.7 years (range: 20-75). The mean follow-up period was 22.3 ± 16.7 months (range: 6-72). The average time from trauma to surgery was 6.3 ± 5.3 days (range: 1-18). At the last follow-up, the CMS was 89.3 ± 8.8 and the VAS score was 2.1 ± 0.9. The mean ID/CL ratio was 0.19 ± 0.1 and 19 patients (51.4%) were between 0.17 and 0.24. Reduction loss was observed in nine patients (24.3%). There were no significant differences between Group 1 and Group 2 regarding operation time (p = 0.998), ID/CL ratio (p = 0.442), reduction loss (p = 0.458), CMS (p = 0.325), and VAS score (p = 0.699). Of the 28 patients without reduction loss, 16 had an ID/CL ratio between 0.17 and 0.24 (p = 0.43). Furthermore, within the 0.17-0.24 interval, CMS was higher with an average of 91.8 ± 5.1 compared to the other intervals (p = 0.559). The clinical and functional outcomes of acute type 3 and type 5 ACJ dislocation operated open and arthroscopically with single-bundle SLD are similar and satisfactory. A clavicular tunnel position in the range of 0.17-0.24 (ID/CL ratio) is recommended to maintain postoperative reduction.

Multi‐level framework to assess social variation in response to ecological and social factors: modeled with coral gobies

Understanding variation in social organization that lacks a strong phylogenetic signal represents a key focus of research in behavioural ecology. Accordingly, we established a framework that identifies whether a range of ecological and social factors are affecting the social maintenance of taxa across multiple categories of social variation (ranging from large to fine‐scale): 1) forms of sociality, 2) degree of sociality, 3) social plasticity and 4) hierarchy maintenance. Each category of variation can then be assessed in combination to provide an outlook for social maintenance in light of predictor factors. We modelled this framework by quantifying each category over time, space and disturbance regime using multiple species of coral‐dwelling gobies, genus Gobiodon. Gobies are an interesting model system as they vary in social structure, have within‐group cooperation, and form mutualisms with coral hosts, which are vulnerable to climatic disturbances. We found that gobies varied in forms of sociality – from being more solitary or pair‐forming in high disturbance regimes, versus group‐forming in moderate disturbance regimes at some locations. Only low or moderate degrees of sociality were observed in gobies, with location or disturbance regime affecting some species. The size of coral hosts influenced the social plasticity of gobies, which was affected by climatic disturbances. Gobies did not exhibit direct changes to hierarchy maintenance, as location and disturbance regime did not affect their size‐based hierarchies. Lastly, by combining the four categories of variation, we found a high loss of sociality in coral‐dwelling gobies due to environmental disturbances, which likely affects overall goby survival as group‐forming can improve survival and fitness. By using our structured framework, we identified which categories of social variation were influenced by ecological factors like location and disturbance. This framework therefore provides an excellent tool for predicting future responses of animal societies to environmental stressors.

The hollow cubic octahedral structure of Fe3O4 with excellent electromagnetic wave absorption capacity

The unique nanostructure combined with high dielectric and magnetic losses is essential for electromagnetic wave (EMW) attenuation in microwave-absorbing materials (MAM). In this paper, using cubic octahedral Cu2O as a template, we synthesized hollow cubic octahedral Fe(OH)3 at first. After annealing at 450 °C, the hollow cubic octahedral structure Fe3O4 could be obtained. When the filling ratio was 40 %, the minimum reflection loss (RLmin) reached -66.08 dB, and the maximum effective absorption bandwidth (EAB) was 5.38 GHz at a thickness of 1.84 mm, exhibiting improved EMW properties compared with previous works. The hollow cubic octahedral structure of Fe3O4 enhances EMW absorption characteristics, which is attributed to abundant dipole polarization, interface polarization, and good conduction loss. These results indicate that Fe3O4 with the hollow cubic octahedral structure can be used as potential candidates for efficient and broadband EMW absorbers.

A Single Component, Single Layer Flexile Foam Evaporator with the Higher Efficiency for Water Generation.

One of the greenest and promising ways to solve the problem of freshwater crisis is surface solar steam generation from seawater. A great number of photothermal materials with multi-component and multi-layered delicate yet complex structures often suffer from either low evaporation rate or high energy loss. Here, this work presents a single component foam evaporator with steam generation rate of up to 4.32kg m-2 h-1 under 1 sun irradiation. The evaporator is constructed from an aniline oligomer as a single light-absorbing component, covalent linked with polyethylene glycol to form a monolithic polymer foam. Floating on the seawater, the foam has absorbance of 99.5% over the entire solar spectral range and low thermal conductivity (0.0077W K-1m-1) that effectively retains heat in the material and at the interface. After 3 months of continuous outdoor natural sunlight irradiation, the evaporator maintains a stable and durable evaporation rate. Moreover, the materials have good mechanical properties (7.48MPa young's modulus and 57.38% elongation at break) and excellent chemical resistance in 10 common organic solvents and aqueous solutions of pH = 1 to 14. This study provides a new system and strategy for desalination, steam power generation, treatment of polluted water and sewage, etc.

Strong microwave squeezing above 1 Tesla and 1 Kelvin.

Squeezed states of light have been used extensively to increase the precision of measurements, from the detection of gravitational waves to the search for dark matter. In the optical domain, high levels of vacuum noise squeezing are possible due to the availability of low loss optical components and high-performance squeezers. At microwave frequencies, however, limitations of the squeezing devices and the high insertion loss of microwave components make squeezing vacuum noise an exceptionally difficult task. Here we demonstrate direct measurements of high levels of microwave squeezing. We use an ultra-low loss setup and weakly-nonlinear kinetic inductance parametric amplifiers to squeeze microwave noise 7.8(2) dB below the vacuum level. The amplifiers exhibit a resilience to magnetic fields and permit the demonstration of large squeezing levels inside fields of up to 2 T. Finally, we exploit the high critical temperature of our amplifiers to squeeze a warm thermal environment, achieving vacuum level noise at a temperature of 1.8 K. These results enable experiments that combine squeezing with magnetic fields and permit quantum-limited microwave measurements at elevated temperatures, significantly reducing the complexity and cost of the cryogenic systems required for such experiments.

Design and Modeling of a Terahertz Transceiver for Intra- and Inter-Chip Communications in Wireless Network-on-Chip Architectures.

This paper addresses the increasing demand for computing power and the challenges associated with adding more core units to a computer processor. It explores the utilization of System-on-Chip (SoC) technology, which integrates Terahertz (THz) wave communication capabilities for intra- and inter-chip communication, using the concept of Wireless Network-on-Chips (WNoCs). Various types of network topologies are discussed, along with the disadvantages of wired networks. We explore the idea of applying wireless connections among cores and across the chip. Additionally, we describe the WNoC architecture, the flip-chip package, and the THz antenna. Electromagnetic fields are analyzed using a full-wave simulation software, Ansys High Frequency Structure Simulator (HFSS). The simulation is conducted with dipole and zigzag antennas communicating within the chip at resonant frequencies of 446 GHz and 462.5 GHz, with transmission coefficients of around -28 dB and -33 to -41 dB, respectively. Transmission coefficient characterization, path loss analysis, a study of electric field distribution, and a basic link budget for transmission are provided. Furthermore, the feasibility of calculated transmission power is validated in cases of high insertion loss, ensuring that the achieved energy expenditure is less than 1 pJ/bit. Finally, employing a similar setup, we study intra-chip communication using the same antennas. Simulation results indicate that the zigzag antenna exhibits a higher electric field magnitude compared with the dipole antenna across the simulated chip structure. We conclude that transmission occurs through reflection from the ground plane of a printed circuit board (PCB), as evidenced by the electric field distribution.

Complete gold extraction and recovery from double refractory gold ores by thiourea after bio-oxidation

Cyanidation, a conventional process to extract gold from gold ores, has been used for over 130 years in industrial mining because of the high efficiency and rate of formation of Au(CN)2− and the high recovery efficiency by adsorption of Au(CN)2− on activated carbon. However, carbonaceous refractory gold ores are not targeted because Au(CN)2− is easily adsorbed on carbonaceous matter in the ores, resulting in high recovery loss. In this study, the flotation concentrates of a carbonaceous refractory gold ores was subjected to biooxidation at 45 °C using a mixed culture containing iron-oxidizing and sulfur-oxidizing bacteria, followed by gold extraction using thiourea under strongly acidic conditions. The gold extraction efficiency reached ∼100% in 12 h without re-adsorption. Finally, the quantitative recovery of the Au(CS(NH2)2)2+ complex was confirmed by adsorption on strongly cationic exchange resin. Biooxidation reduced the amount of Fe-containing metal sulfides, which minimized the decomposition of thiourea, and the Au(CS(NH2)2)2+ complex had a low affinity toward carbonaceous matter, different to Au(CN)2−. Since the process described in this study does not require roasting to remove carbonaceous materials in pretreatment and does not use cyanide for gold extraction, it is environmentally friendly and should be considered for practical applications in carbonaceous gold ore-producing mines.

ANN-GA optimized composite color protectant combined with magnetic field assisted freezing: Effects on the quality of mushroom (Agaricus bisporus)

Due to their high water content, frozen mushrooms (Agaricus bisporus) were greatly affected by ice crystal formation, which can lead to the destruction of tissue structure, serious browning, high juice loss, and difficulty in maintaining good sensory characteristics. In order to improve the quality of frozen Agaricus bisporus, this study employed Artificial neural network and genetic algorithm (ANN-GA) to optimize the amount of composite color protectant, and identified the optimal freezing conditions for freezing Agaricus bisporus by determining the freezing curves under different magnetic field-assisted freezing conditions, the color variance, texture and structure, drip loss, and distribution of moisture. Furthering, using X-ray μCT three dimensional images were taken to characterize the microstructure of the samples. Among them, the 6 mT magnetic field-assisted freezing treatment group was significantly better than the control group, and the results showed that the magnetic field-assisted freezing combined with chemical color protectant as a composite processing technology improved the quality of frozen Agaricus bisporus. This provides a theoretical basis and technical support for enhanced processing of frozen Agaricus bisporus.

Flexible, superhydrophobic, and self-cleaning rGO/LDH/PPy-modified fabric for full X-band electromagnetic wave absorption

High-performance flexible microwave absorbing textiles are the subject of a research boom due to the growing need for flexible wearable electronic gadgets that can withstand electromagnetic wave pollution and operate in challenging situations. Herein, we combine the two techniques of thermal reduction and in-situ growth to produce a reduced graphene oxide/FeCo-layered double hydroxide/polypyrrole (rGO/LDH/PPy) coated fabric with good superhydrophobic qualities and high electromagnetic wave absorption (EWA) performance. rGO/LDH and PPy work together to generate a multidimensional heterostructure, which offers the coated fabric a high electromagnetic loss capacity. The coating design uses a fluffy and complicated aramid fabric as the skeleton. The impedance gradient may be created to modify the fabric's ability to absorb electromagnetic waves by varying the concentration of Py. Full coverage of the X-band can be achieved by the coated fabric, which has an RLmin of −45.0 dB and a thickness of 3.5 mm. The layered rough structure generated by PPy, FeCo-LDH, and rGO in conjunction with the low surface energy material SN-67 results in an exceptional superhydrophobic property with a WCA of 156.9° for the coated fabric. Furthermore, this rGO/LDH/PPy coated fabric is robust and does not lose its superhydrophobicity even after repeated tape stripping, extended chemical exposure, and high and low temperature conditions. This work indicates potential application value for flexible electromagnetic wave-absorbing materials that maintain high efficiency in challenging situations, and it offers a solid foundation for the design of multifunctional EWA materials based on textiles.

Cardamom Plant Disease Detection Approach Using EfficientNet

Cardamom is a queen of spices. It is indigenously grown in the evergreen forests of Karnataka, Kerala, Tamil Nadu, and the northeastern states of India. India is the third largest producer of cardamom. Plant diseases cause a catastrophic influence on food production safety; they reduce the eminence and quantum of agricultural products. Plant diseases may cause significantly high loss or no harvest in dreadful cases. Various diseases and pests affect the growth of cardamom plants at different stages and crop yields. This study concentrated on two diseases of cardamom plants, Colletotrichum Blight and Phyllosticta Leaf Spot of cardamom and three diseases of grape, Black Rot, ESCA, and Isariopsis Leaf Spot. Various methods have been proposed for plant disease detection, and deep learning has become the preferred method because of its spectacular accomplishment. In this study, U2 -Net was used to remove the unwanted background of an input image by selecting multiscale features. This work proposes a cardamom plant disease detection approach using the EfficientNetV2 model. A comprehensive set of experiments was carried out to ascertain the performance of the proposed approach and compare it with other models such as EfficientNet and Convolutional Neural Network (CNN). The experimental results showed that the proposed approach achieved a detection accuracy of 98.26%. Index Terms — Cardamom plant, deep learning, machine learning, neural networks, plant pathology

Ensuring universal access to quality care for persons with presumed tuberculosis reaching the private sector: lessons from Kerala.

More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with theprivate health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them. A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it. Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct 'problems' is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed. Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest.

High birefringence low loss nearly zero flat dispersion similar to slotted core photonic crystal fibers

Abstract Studying high-performance photonic crystal fibers (PCF) is of significant scientific importance for terahertz (THz) waveguide systems. This study introduces a novel PCF design with a core composed of the smallest sub-wavelength units resembling a slotted structure, aiming to achieve high birefringence and low loss. The optical properties of the proposed PCF are analyzed through simulations, yielding impressive results. The PCF exhibits an ultra-high birefringence of 0.07848, a minimum limiting loss of 10−17 dB/cm, and an effective material loss as low as 0.04251 cm−1. Moreover, it demonstrates near-zero flat dispersion of −0.012 ± 0.074 ps/THz/cm over a broad frequency range of 1.2–2.2 THz. This fiber stands out by not only providing high birefringence but also by striking an optimal balance among birefringence, transmission loss, and dispersion for THz waveguides. The implications of this work are profound for the development of THz communication systems, THz polarization-maintaining transmission, and sensing applications. Furthermore, it established an important benchmark for the design of THz-PCFs that prioritize high birefringence, low loss, and near-zero flat dispersion, offering an essential reference for future research and development in this field.