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This paper is focused on optical nonlinearity in CdS nanostructured thin films, which was reviewed comprehensively and discussed in detail along with future perspective. Due to third harmonic generation in CdS materials on exposed to highly intense light that is significant feature to develop modern photonics devices. CdS chalcogenide semiconductor binary compound is one of the most particularly promising candidate for nonlinear optical applications due to their enhanced nonlinear optical properties in thin films. CdS nanostructured thin films have been shown exceptional third order nonlinear optical (TONLO) behavior near the sub band gap energy region. This review will be based on TONLO properties of CdS nanostructured thin films, which will focus on the tailoring of TONLO properties as a function of particle size, dopant and CdS polymer nanocomposite. Doping and size effect in CdS system is the important opportunity to develop it with excellent TONLO properties. This review paper will give an open area of research possibilities to search the efficient nonlinear optical CdS nanostructured thin films for advanced modern photonics applications and also will provide an idea to develop efficient materials with exceptional TONLO properties.

Limited studies have examined arousal perception in obstructive sleep apnea (OSA) or other sleep disorders. The aim of this study is to evaluate the factors that affect patients’ arousal and total sleep time perception. This is a retrospective study of 210 subjects divided into 5 groups: Primary insomnia; upper airway resistance syndrome (UARS)/primary snoring; mild, moderate and severe OSA. Perceived arousals were compared to objectively defined arousals. The subjects’ age, body mass index (BMI), total sleep time (TST), perceived TST, sleep efficiency, stage shifts, rapid eye movement (REM) and delta time were compared. UARS/primary snoring group had significantly higher perceived arousal relative to arousal events and shorter total arousal duration than in primary insomnia and all OSA groups. There was a significant linear increase in total arousals and respiratory arousal as OSA severity increased. The number of perceived arousal events was negatively correlated with perception of TST. There was a trend for the insomnia group to have more perceived non-respiratory arousals compared with all OSA groups. Although subjects with UARS/primary snoring had the lowest total arousals, they perceived the highest arousals. The non-respiratory related arousals are probably perceived differently from respiratory arousal related perception. For the insomnia group to have more arousals not driven by respiratory events suggests that insomnia may be better defined as a disorder by being driven to arousals rather than apneas, who are aroused despite being driven towards sleep. Key words: Arousal perception, arousal misperception, insomnia, primary snoring, upper airway resistance syndrome, sleep

Mn:CdS nanostructured thin films with improved optoelectronic performance were grown on glass substrates via spray pyrolysis method with different Mn doping concentrations. The structural properties of the films were analyzed using X-ray diffraction (XRD) patterns which revealed that the grown films exhibit hexagonal wurtzite structure with a growth oriented along (002) plane. A systematic effect of Mn doping was observed on the structural and optical properties of the films. The grown films were found to be optically active and show high absorbance in the visible region. The optical band gap values of the films obtained from the absorbance spectra are in the range of 2.33-2.42 eV. A composition dependent analysis of Raman spectra of the thin films shows that the crystalline quality of as grown films is high. The near band, edge (NBE) and the defect related emission were recorded using photoluminescence spectroscopy with different excitation sources. Photodetector devices fabricated based on Mn:CdS thin films and their performance analysis show improved visible light photodetection with the incorporation of Mn in the CdS system. The film doped with 3.0 wt.% Mn concentrations demonstrates high photoresponse parameters such as photosensitivity (∼ 402), responsivity (8.37 A/W), detectivity (1.45 × 1012 Jones) and external quantum efficiency (EQE∼1954%) with 0.3 s and 0.6 s rise and decay times, respectively, in comparison with 1.0 and 5.0 wt.% Mn doped films. This study demonstrates that the 3.0 wt.% Mn doping concentration is the optimal for CdS based visible light photo-detector applications via cost effective method.

Visible-light photodetectors are in great demand in current scenario for advanced optoelectronic devices. Hence, in current work we have fabricated the photodetectors based on Cadmium Sulfide (CdS) thin films with different contents of Yttrium (Y) doping. Hexagonal phase confirmation of the fabricated films was confirmed by X-ray diffraction and FT-Raman spectroscopy analyses. The crystallite size of grown films was determined and found within the range of 33 nm. Scanning electron microscopy was carried out to analyse the surface morphology of the films and reveals nanograins formation on the surface. Optical absorption/transmission/reflectance spectra were recorded up to near-infrared region and optical energy gap was estimated including several other optical parameters. PL spectra were recorded and an intense emission was observed at 542 ± 12 nm when excited at 350 and 450 nm both. The electrical characteristics were explored under dark and light conditions. The highest photoelectrical resistivity and sensitivity were observed for 5.0 wt.% which are around ∼9.45 × 107 Ω−1 and 55.07 % at 0.5 mW/cm2. However, the highest responsivity, external quantum efficiency and detectivity was observed for 3.0 wt.% and noticed around 0.83 A/W, 193.82 % and 4.28 × 1011 Jones, respectively. Outcomes reveal that the Y doping enhances the CdS photodetection nature.

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: It is well known now that COVID-19 cause lymphopenia. In the retrospective study the number of total T cells, CD4+ and CD8+ T cells were dramatically reduced in COVID-19 patients, especially in patients requiring Intensive Care Unit (ICU) care. (1) Lymphopenia and drastic reduction of CD4+ T cell counts in COVID-19 patients have been linked with poor clinical outcome too. (2) We present a case of a patient with well controlled HIV infection with stable absolute CD4 count but significant drop during COVID infection CASE PRESENTATION: A 67 year-old-man with history of HIV on ARV therapy with undetectable viral load, panhypopituitarism with central hypothyroidism, adrenal insufficiency and hypogonadism, recurrent DVT/PE on AC therapy, BPH, overactive bladder, stable angina presented with 3 days of fever, chills, diarrhea and malaise to ER. He received first dose of Moderna vaccine 2 weeks before admission. VS -saturation 79% on RA, and 96% on NRB mask, HR 122 beats/min, BP 159/87 mmHg, RR 18/min, T 101. PE unremarkable. Labs: Covid PCR +, WBC 15.3 K/cmm, ferritin 585.8 ng/ml, LDH 489 U/LAST 122 U/l, ALT 100U/L, CRP quant 321 mg/L, D dimer 1287 D-DU ng/ml, HIV RNA quant undetectable, CD4 67 cell/Ul, previous CD4 568 cmm 2 weeks prior admission. CXR:b/l patchy infiltrates. He was treated with dexamethasone, therapeutic Lovenox and received 1 U of convalescent plasma. His oxygen saturation improved, overall course was uneventful and patient was discharged home. CD4 count improved to 523 cmm 2 months later. DISCUSSION: It is shown that HIV infection does not increase the occurrence of COVID-19 and there is no increase in morbidity and mortality (2). The exact influence of COVID-19 on absolute T4 cells subset in HIV and their significance is presently unknown. Our patient had stable absolute CD4 count for years. He was compliant with ART and HIV viral load was undetectable. However, there was a drastic decline in his CD4 count that occurred during an acute COVID infection although he was on the same medications. CD4 recovered to baseline after COVID infection resolved. CONCLUSIONS: This is a unique case with such a dramatic drop of absolute CD4 count in acute COVID infection and further investigation on CD4 cells and it effects on HIV infection will need to be studied. REFERENCE #1: Diao B, Wang C, Tan Y, et al. Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19). Front Immunol. 2020;11:827. Published 2020 May 1. doi:10.3389/fimmu.2020.00827 REFERENCE #2: Peng Xiaorong, Ouyang Jing, Isnard Stephane, Lin John, Fombuena Brandon, Zhu Biao, Routy Jean-Pierre, Sharing CD4+ T Cell Loss: When COVID-19 and HIV Collide on Immune System, JOURNAL=Frontiers in Immunology VOLUME=11, YEAR=2020, PAGES=3307, URL=https://www.frontiersin.org/article/10.3389/fimmu.2020.596631 DOI=10.3389/fimmu.2020.596631, ISSN=1664-3224 DISCLOSURES: no disclosure on file for Moses Bachan;no disclosure on file for Zinobia Khan;No relevant relationships by Mirjana Petrovic Elbaz, source=Web Response No relevant relationships by Robert Siegel, source=Web Response

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: COVID infection can present with diverse manifestations. We present an interesting case of very high troponin elevation in patient with COVID infection without obvious reason for troponin elevation. CASE PRESENTATION: A 66-year-old man with history of HTN, DM2, CAD (CABG in 2009, percutaneous vascularization of RCA with multiple DES in 2018), NSTEMI- 1 year ago, PVD, status post left BKA, ESRD on HD presented with 1 week of watery diarrhea after being tested positive for COVID. He denied chest pain, had minimal SOB. He received first dose of COVID vaccine 2 weeks prior. Vital signs: afebrile, BP 145/68 mmhg, HR 75 beats/min, RR 20/min, oxygen saturation 90% on RA and 96% on 3L of O2 via NC. PE: R- IJ permanent catheter, L- BKA, lungs clear. Labs: COVID PCR assay (+), D dimer 359 D-DU ng/ml, LDH 330 U/l, ferritin 3207 ng/ml, CRP quant 87 ml/l, SARS-CoV-2 Ig G (RBD) 1.14 S/CO, SARS-COV-2 IgM (Beckman) 2.56. troponin (AccuTnI) 13.46 ng/ml, CPK normal, Cr 7.5 (at the baseline), EKG - sinus rhythm, left axis deviation, negative T waves in lateral leads and ST depression up to 1 m in anterior leads, no changes from old EKG, CXR - Increased b/l pulmonary opacities compatible with atypical/viral pneumonia. The most recent ECHO 1 year ago – mild LV dysfunction with thin and akinetic inferior and basal posterior walls, LVEF 50%. Patient was already on aspirin, plavix, statin and that treatment was continued during hospital course. COVID pneumonia was treated with dexamethasone and convalescent plasma versus placebo (VA Cures- 1 Trial). His hospital stay was uneventful, he remained hemodynamically stable and asymptomatic and was discharged home DISCUSSION: Our patient has known history of CAD and ESRD which are well known cause for elevated troponin. However his Cr level was at his baseline and his previous troponin levels were never this high even when he had NSTEMI, it was only 1.44 ng/ml. During this admission with Covid infection his troponin level was as high as 13.46 ng/ml and trended down to 4.15 ng/ml on discharge, his baseline level of troponin is 0.03-0.88 ng/ml. Reasons for such a high level of troponin can be due to Type II MI or myocarditis. In the settings of COVID infection it has been suggested that troponemia can be due to microvascular damage occurring in the heart with perfusion defects, vessel hyperpermeability, vasospasm and high cytokine levels may represent the key player of myocardial injury (1). Our patient did not have a very severe form of COVID pneumonia that required intubation in fact, he was saturating well on minimal oxygen requirements. He remained asymptomatic with no new interval EKG changes or any other signs of acute coronary syndrome (ACS). CONCLUSIONS: Serum Troponin can be significantly elevated in the setting of COVID infection and in the absence of ACS. REFERENCE #1: Reference #1: Tersalvi G, Vicenzi M, Calabretta D, Biasco L, Pedrazzini G, Winterton D. Elevated Troponin in Patients With Coronavirus Disease 2019: Possible Mechanisms. J Card Fail. 2020;26(6):470-475. doi:10.1016/j.cardfail.2020.04.009 DISCLOSURES: no disclosure on file for Moses Bachan;no disclosure on file for Zinobia Khan;No relevant relationships by Dileep Kumar, source=Web Response No relevant relationships by Mirjana Petrovic Elbaz, source=Web Response

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Hypertriglyceridemia (TGL) is the abnormal concentration of triglycerides in the blood associated with atherosclerosis. It is known to cause skin lesions when the blood levels are more than 3000 mg/dl. It is also associated with 1 to 10 percent cases of acute pancreatitis and 10 to 20 percent when levels are higher than 2000 mg/dl. CASE PRESENTATION: A 36-year old morbidly obese man with medication non-compliance was evaluated by a dermatologist via a video tele visit due to COVID19 Pandemic. He has a history of uncontrolled IDDM, hypertriglyceridemia status post plasmapheresis a year ago associated with pancreatitis. He has no family history of hypertriglyceridemia. He reported rashes on his forearms and thighs for 3 weeks and was advised to go to the Emergency Department to rule out cutaneous manifestation of his underlying conditions. He initially reported epigastric pain radiating to his back, but his lipase and CT abdomen were negative for pancreatitis. He was vitally stable, and his exam was significant for yellowish papules on his forearms, legs bilaterally with erythematous borders. Labs: TGL 1618, total cholesterol 647, Glucose 223, A1c 12.6%, no Anion Gap.Imaging: Splenomegaly with Hepatic Steatosis likely due to TGL deposition.Patient was placed on Insulin drip to prevent pancreatitis and was started on fenofibrate, fish oil and rosuvastatin. Kept NPO initially with dextrose infusion to increase insulin drip & metabolize the triglycerides. Triglycerides gradually improved, and insulin drip was d/c. Shave Biopsy confirmed Eruptive Xanthoma. DISCUSSION: Eruptive xanthomas are characterized by an eruption of yellowish skin papules, encircled by an erythematous halo, most commonly arising over the extensor surfaces of the extremities, buttocks and shoulders in the setting of high triglyceride levels secondary to diabetes, diet or familial causes. The lipid deposits in these xanthomas are derived from circulating plasma lipoproteins. CONCLUSIONS: This case was unique as our patient developed eruptive xanthomas even at TGL level under 2000 mg/dl which is rarely seen. Clinically diagnosing Xanthomas are extremely important in order to treat hypertriglyceridemia in order to prevent pancreatitis, which has a grim prognosis. It is also important for reducing CAD risk. Xanthomas should be evaluated to prevent pancreatitis and long-term cardiac events rather than the lipid deposit itself. They can also be the only signs of underlying metabolic diseases like diabetes. Management should include pharmacological agents, counseling for compliance, nutrition & lifestyle modifications. All these patients with high TGLs will benefit from E3/E4 genotype testing as it is associated with higher cardiac disease and low response to statins. REFERENCE #1: Severe hypertriglyceridemia presenting as eruptive xanthomatosisSameera S Vangara, Kyle D Klingbeil, Raymond M Fertig, Jason L RadickDepartment of Internal Medicine, University of Miami Miller School of Medicine, Florida, USA REFERENCE #2: Eruptive Xanthomas as a cutaneous Manifestation of HypertriglyceridemiaA Case ReportMichael Digby, Md, Robert Belli, MS, Timothy McGraw, and Abigail Lee, MD DISCLOSURES: no disclosure on file for Moses Bachan;no disclosure on file for Zinobia Khan;No relevant relationships by Robert Siegel, source=Web Response No relevant relationships by Goutham Talluri, source=Web Response

SESSION TITLE: Medical Student/Resident Lung Pathology SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: COVID-19 is caused by SARSCoV-2 virus which affects many organs, but mostly the respiratory system We report a case of COVID-19 disease associated with acute moderate pericardial effusion CASE PRESENTATION: 53 year old man with history of OSA, DM type 2, HTN, obesity and HLD had fever, chills and cough for which he was treated with Azithromicin for 5 days as an outpatient However, on day 6 he presented to the hospital with diarrhea, fever, chills and a productive cough He denied chest pain, palpitations, PND, orthopnea, previous cardiac issues In the ED, his vitals were: T 102 F, HR 87/min, BP 181/94 mmHg, O2 Sat 96% on RA On chest auscultation he had scattered bi-basilar rhonchi, and muffled heart sounds, no JVD Laboratory: WBC 3 4 K/cmm, Hgb 12 1 g/dl, Plt 166 K/cmm, Na 131, K 5 5, Cr 2 3, BUN:33, pro BNP 187;troponin negative COVID PCR assay (+), EKG: low voltage QRS, no ischemic changes Chest CT scan showed moderate size pericardial effusion, small scattered low attenuation patchy areas throughout both lungs He was started on Azithromycin/Hydroxychloroquine and given a dose of Tocilizumab Previous transthoracic ECHO 5 years ago was normal On hospital day 3 he developed worsening of hypoxic respiratory failure and was intubated He subsequently developed severe ARDS Repeated EKG with low voltage QRS, no cardiac ischemia, troponin level peaked up to 0 13, and trended down to 0 04, CPK 586 U/L The patient developed worsening renal failure, remained intermittently hypotensive requiring vasopressors, and hypoxemic to 70s despite maximal ventilator settings On day 8 he became bradycardic, developed PEA and passed away DISCUSSION: COVID-19 is caused by SARS COV 2 RNA beta coronavirus Fever, cough, dyspnea are most common symptoms Troponemia has been described as a cardiac manifestation of COVID-19 [1] Most common radiological findings are ground glass opacities (88 0%), bilateral involvement (87 5%), and multilobarity (78 8%)[2] Pericardial effusion can be acute or chronic Most common causes are viruses, bacteria, rheumatological diseases, malignancy, trauma and idiopathic Changes like pericardial effusion are very rarely described in COVID infected patients, mentioned with disease progression[2,3] Our case had a moderately sized pericardial effusion on initial presentation before he developed worsening of hypoxic respiratory failure Upon review of the old EKGs and CXR patient did not have any signs of pericardial effusion Radiological finding of pericardial effusion may also be a poor prognostic sign of COVID-19, which may be explained by escalation of the severe systemic inflammatory response Limitations of this case are no ECHO or pericardiocentesis were done due Infection control recommendations for COVID -19 at the time CONCLUSIONS: Pericardial effusion can be associated with COVID-19 infection, and may be an indicator of more severe disease Reference #1: Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19) Inciardi RM1, Lupi L1, Zaccone G1, Italia L1, Raffo M1, Tomasoni D1, Cani DS1, Cerini M1, Farina D2, Gavazzi E2, Maroldi R2, Adamo M1, Ammirati E3, Sinagra G4, Lombardi CM1, Metra M1 Reference #2: Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients Salehi S1, Abedi A1, Balakrishnan S1, Gholamrezanezhad A1 Reference #3: Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2Xi Xu,#1 Chengcheng Yu,#2 Jing Qu,2 Lieguang Zhang,2 Songfeng Jiang,2 Deyang Huang,2 Bihua Chen,2 Zhiping Zhang,2 Wanhua Guan,2 Zhoukun Ling,2 Rui Jiang,2 Tianli Hu,2 Yan Ding,2 Lin Lin,2 Qingxin Gan,2 Liangping Luo,corresponding author1 Xiaoping Tang,corresponding author2 and Jinxin Liucorresponding author2 DISCLOSURES: No relevant relationships by Moses Bachan, source=Web Response No relevant relationships by Nikola Djurdjevic, source=Web Response No relevant relationships by Zino ia Khan, source=Web Response No relevant relationships by Hana Rajevac, source=Web Response