Summaryobjectives To develop and validate clinical guidelines for diagnosis of smear-negative pulmonary tuberculosis (TB) in developing countries with low-HIV prevalence.methods We developed diagnostic guidelines for smear-negative TB. Clinical diagnoses based on these guidelines were compared with sputum culture, chest X-rays and reports of an expert panel.results The guidelines achieved a sensitivity of 0.59 [confidence interval (CI) 0.46-0.66] and a specificity of 0.86 (CI 0.84-0.88) in diagnosing smear-negative TB. A total of 6.8% of patients who initially improved after a course of antibiotics were later confirmed to have TB. Clinicians detected an abnormal chest X-ray in 92% (CI 88-96%) and radiological signs of pulmonary TB in 98% (CI 94-100%) of cases.conclusions Our experience highlights a number of dilemmas faced in developing, testing and implementing diagnostic guidelines in poorly resourced conditions. Using radiological criteria for TB and appropriate training can help in improving the diagnostic skills of primary care clinicians working in low-HIV settings with access to X-ray facilities. But a significant number of apparently smear-negative TB cases may in fact be smear positive and TB programmes should focus on improving the quality of direct acid-fast bacilli microscopy. The value of an antibiotic trial is questionable due to the relatively large number of false negatives generated by this approach.

This study provides an eight-component multiple-input multiple-output (MIMO) antenna architecture for fifth-generation (5G) mobile communication systems. The single antenna element is comprised of an L-shaped radiating component, an L-shaped parasitic element, and a ground plane with a rectangular slot. The main element with a slot-loaded ground plane helps to draw current from a coaxial feed from the other side of the board, while the parasitic element helps to elongate the current path and improve the impedance of the system. This enables the system to radiate at two different frequency ranges: 3.34–3.7 GHz and 4.67–5.08 GHz, with 360 MHz and 410 MHz bandwidths, respectively. For MIMO configuration, the radiating elements are designed on either side of a 0.8 mm thick FR-4 substrate, allowing space to accommodate a battery, radio frequency (RF) systems and subsystems, and camera and sensor modules. The corner and the middle elements are arranged in such a manner so that they can provide spatial and pattern diversity. Furthermore, at least 12 dB of isolation is established between any two radiating elements. Various MIMO performance parameters were evaluated, e.g., mean effective gain (MEG), channel capacity (CC), envelope correlation coefficient (ECC), realized gain, far-field characteristics, and efficiency. Single- and double-hand mode evaluations were performed to further demonstrate the capability of the proposed MIMO antenna. A prototype of the proposed MIMO antenna was manufactured and assessed to verify the simulated data. The measured and simulated results were found to be in good agreement. On the basis of its performance characteristics, the designed MIMO system could be used in 5G communication systems.

In this work, a new prototype of the eight-element MIMO antenna system for 5G communications, internet of things, and networks has been proposed. This system is based on an H-shaped monopole antenna system that offers 200 MHz bandwidth ranges between 3.4–3.6 GHz, and the isolation between any two elements is well below −12 dB without using any decoupling structure. The proposed system is designed on a commercially available 0.8 mm-thick FR4 substrate. One side of the chassis is used to place the radiating elements, while the copper from the other side is being removed to avoid short-circuiting with other components and devices. This also enables space for other systems, sub-systems, and components. A prototype is fabricated and excellent agreement is observed between the experimental and the computed results. It was found that ECC is 0.2 for any two radiating elements which is consistent with the desirable standards, and channel capacity is 38 bps/Hz which is 2.9 times higher than 4 × 4 MIMO configuration. In addition, single hand mode and dual hand mode analysis are conducted to understand the operation of the system under such operations and to identify losses and/or changes in the key performance parameters. Based on the results, the proposed antenna system will find its applications in modern 5G handheld devices and internet of things with healthcare and high rate delivery. Besides that, its design simplicity will make it applicable for mass production to be used in industrial demands.

This paper presents an S-shape four-port Multiple Input Multiple Output (MIMO) wideband mmWave antenna with bandwidth of 25 GHz to 39 GHz. The antenna is designed on 0.254 mm ultra-thin RO5880 with permittivity of 2.3. The dimensions of proposed S-shape antenna are 10 × 12 mm for single element and 24 × 24 mm for four-port MIMO configuration. A decoupling network is introduced to further compress mutual coupling among MIMO elements. The peak gain achieved is 7.1 dBi and MIMO assembly delivers diversity scheme. The proposed MIMO antenna is fabricated, and simulated results are found to be in excellent agreement with simulations. Through the results obtained, the proposed MIMO antenna system can be considered as a potential candidate for future mmWave devices.

Objective:To determine the frequency of hypocalcemia in term neonates with jaundice receiving phototherapy.Methods:This was a cross sectional study conducted at Neonatal intensive care unit, National Institute of Child Health, Karachi from 1st January 2014 to 30th December 2014. A total of 123 term neonates with jaundice of either gender managed by phototherapy were enrolled in the study. Gestational age was assessed through modified Ballard scoring. Duration of phototherapy was recorded. A sample of 3 ml of blood was sent to the laboratory for serum calcium level before initiating phototherapy and after 24 hours of continued phototherapy. All the data were recorded in the preformed proforma. Data was analyzed using SPSS version 19. P value <0.05 was taken as significant.Results:The mean age of the neonates was 8.35±6.74 days. Mean gestational age at the time of birth was 39.08±1.37 weeks. Mean duration of jaundice was 2.4±1.20 days. Mean duration of phototherapy was 1.74±0.98 days. Serum calcium level before and after 24 hours of initiating phototherapy was 8.73±0.68 mg/dl and 7.47±0.82mg/dl respectively Frequency of hypocalcemia in term jaundiced neonates receiving phototherapy were observed in 22.76% (28/123).Conclusions:The frequency of hypocalcemia is significant in the jaundiced neonates treated with phototherapy. One needs to be vigilant in dealing neonates in this context while serial monitoring for hypocalcemia and its complications should be considered in institutional policy and research priority.