A study on clinico etiological spectrum of intestinal obstruction in paediatric age group

Background: Acute intestinal obstruction is very common surgical emergencies in paediatric age. There are many surgical causes for morbidity and mortality in paediatric age group of which intestinal obstruction giving large contribution. In most of studies child survival after surgical procedures for intestinal obstruction was good while the death rates were more when there was delay in presentation, and management. Morbidity, complications and mortalities are more severe when presented late. There is a delay in the initial presentation of intestinal obstruction cases due to various reasons.Methods: Present study enrolled all the patients presenting with signs and symptoms of intestinal obstruction in Paediatric surgery unit of Dept. of surgery of Dr. BRAM Hospital, Raipur (C.G.), India during January 2014 to August 2015. Patients with intestinal obstruction were admitted in paediatric surgery ward with provisional diagnosis of acute intestinal obstruction. Immediately after admission, conservative management started till the hydration and urine output becomes normal. Routine and specific investigations were done.  As the study includes most of cases of acute dynamic intestinal obstruction most of cases after initial resuscitation were managed by appropriate procedures.   Postoperative care was done and outcome of the study was noted.Results: Maximum cases of intestinal obstruction were in neonatal period and least in 5-14 years. Sex ratio is 2.5:1 (male to female). ARM was the major cause of obstruction in neonatal (<1 month) age group. IHPS and Hirschsprung’s disease were most common cause of GI obstruction in 1 month to 1 year age group in our study. 4 of our cases did not have accurate diagnosis and were responded well to conservative management. Most of the patients presented with complain of not passing stool followed by distension of abdomen. 85.94% of cases are congenital in our study. Large gut portion was involved in majority of cases. Overall survival rate was 91.40%.Conclusions: Present study concludes that congenital causes are more common in paediatric intestinal obstruction cases. Early diagnosis and intervention are crucial factors to improve the outcome.

Anatomy of ultrafast quantitative magneto-acoustics in freestanding nickel thin films

We revisit the quantitative analysis of the ultrafast magneto-acoustic experiment in a freestanding nickel thin film by Kim and Bigot [1] by applying our recently proposed approach of magnetic and acoustic eigenmodes decomposition by Vernik et al. [2]. We show that the application of our modeling to the analysis of time-resolved reflectivity measurements allows for the determination of amplitudes and lifetimes of standing perpendicular acoustic phonon resonances with unprecedented accuracy. The acoustic damping is found to scale as $\propto\omega^2$ for frequencies up to 80~GHz and the peak amplitudes reach $10^{-3}$. The experimentally measured magnetization dynamics for different orientations of an external magnetic field agrees well with numerical solutions of magneto-elastically driven magnon harmonic oscillators. Symmetry-based selection rules for magnon-phonon interactions predicted by our modeling approach allow for the unambiguous discrimination between spatially uniform and non-uniform modes, as confirmed by comparing the resonantly enhanced magneto-elastic dynamics simultaneously measured on opposite sides of the film. Moreover, the separation of time scales for (early) rising and (late) decreasing precession amplitudes provide access to magnetic (Gilbert) and acoustic damping parameters in a single measurement.Comment: 9 pages, 7 figure

Neuromuscular Electrical Stimulation Effects on Skeletal Muscle Fatigue in Older Adults

Neuromuscular electrical stimulation (NMES) is often used as a rehabilitative modality and evidence has suggested that high frequencies of NMES may elicit increases in muscle strength. However, little is known regarding the effects of a high-frequency NMES intervention on voluntary skeletal muscle fatigue. PURPOSE: The aim of this study was to determine the effect of a 4-week high-frequency NMES intervention on voluntary muscular fatigue and changes in neuromuscular activation patterns of the quadriceps during voluntary fatiguing muscle contractions in older adults. METHODS: Seventeen healthy, older adults (68.8 ± 1.8 years old) participated in the study (NMES: n = 12; SHAM: n = 5). Each participant was seated on an isokinetic dynamometer, and a 40-min NMES treatment was applied to the quadriceps muscles of each leg 3x/week for 4 weeks with the stimulation frequency set at 60 Hz. Stimulation intensity was set to achieve 15% of knee extension maximal voluntary contraction (MVC). Those in the SHAM group underwent the same treatment procedures but did not receive the NMES treatment. All subjects performed maximal voluntary contractions (MVC) and an intermittent knee extension isometric submaximal voluntary fatigue task at 50% MVC until the fatigue criteria were met for pre-post testing. Surface electromyography (sEMG) of the vastus lateralis (VL) and vastus medialis (VM) muscles were recorded during the fatigue task to examine changes in muscle activation. EMG data were quantified for root mean square (RMS) EMG and reported as a percent rate of change over the duration of the fatigue task and median frequency (MF) is reported as the average MF during the fatigue task. Repeated measures ANOVAs were used to determine differences pre-post NMES for muscular endurance time, MVC and EMG measures. Statistical significance was set at p \u3c 0.05. RESULTS: MVC increased pre-post NMES in the NMES group (117.1 ± 8.7 Nm vs 127.6 ± 11.1 Nm, p = 0.049; pre- and post-training, respectively) with no change in SHAM (p = 0.96). Muscular endurance time did not change pre-post NMES (NMES: 159.3 ± 20.1s vs 141.9 ± 21.2s, p = 0.29; SHAM: 242.2 ± 43.3s vs 202.9 ± 23.3s, p = 0.13; pre- and post-training, respectively). RMS EMG rate of change did not change following NMES treatment (NMES: VL: 16.6 ± 3.6% vs 18.8 ± 10.4%, p = 0.84; VM: 11.4 ± 2.1% vs 19.6 ± 5.5%, p = 0.15; SHAM: VL: 7.8 ± 1.6% vs 7.1 ± 3.0%, p = 0.81; VM: 7.1 ± 3.3% vs 5.9 ± 2.2%, p = 0.55; pre- and post-training, respectively). Also, there was no difference in MF EMG with NMES training (NMES: VL: 77.6 ± 4.1 Hz vs 74.9 ± 3.6 Hz, p = 0.13; VM: 72.5 ± 2.4 Hz vs 72.6 ± 2.2 Hz, p = 0.97; SHAM: VL: 79.3 ± 3.4 Hz vs 80.2 ± 4.9 Hz, p = 0.85; VM: 76.9 ± 3.7 Hz vs 83.9 ± 5.1 Hz, p = 0.12; pre- and post-training, respectively). CONCLUSION: Treatment with high-frequency NMES did not improve muscle endurance or related EMG parameters. It is possible that NMES induced adaptations may be frequency-specific and that high-frequency NMES may not be efficacious when the goal is to improve skeletal muscle endurance

Morning versus Afternoon Body Mass in Free-Living or Controlled Euhydration

The standard protocol to assess hydration status is by measuring body mass in the early morning without controlling fluid intake. However, obtaining first-morning body mass is not necessarily feasible for many situations, for example, most physical activities take place in the afternoon. Thus, first-morning body mass might not be practical to assess hydration status. PURPOSE: To investigate first-morning body mass versus afternoon body mass in free- living and controlled euhydration. METHODS: 9 males (age: 21 ± 2; mass: 79.7 ± 17.8 kg) and 5 females (age: 22 ± 2; mass: 60.5 ± 13.6 kg) visited the laboratory in the morning (7:00-9:00am) and afternoon (2:00-4:00pm) for six days to measure their nude body mass and urine specific gravity (USG). Participants were in the free-living (FL) condition for the first three consecutive days, and then in a euhydrated (EUH) state (USGRESULTS: There were no interactions between FL and EUH with morning and afternoon in USG (Morning-FL, 1.017±0.005; Afternoon-FL, 1.012±0.006; Morning-EUH, 1.011±0.004; Afternoon-EUH, 1.007±0.004; p=0.390). No statistically significant differences were found between morning and afternoon in both FL and EUH controlled (Morning-FL, 72.7±18.3 kg; Afternoon-FL, 72.0±18.1 kg; Morning-EUH, 72.9±18.1 kg; Afternoon-EUH, 73.1±18.1 kg, p=0.661). CONCLUSION: There is no difference between morning and afternoon body mass, regardless of the hydration status. This means that first morning body mass is no more, or less, accurate than afternoon

Characterization of Physical and Cognitive Performance and Hydration in Older Adults

In younger adults, dehydration has been shown to impair physical and cognitive performance. Older adults are habitually hypohydrated alongside experiencing physical and cognitive performance deficits. Despite these deficits, the link between these factors remains unexplored. Purpose: To examine the effect of hydration status on physical and cognitive performance in older adults. Methods: Sixteen (5 men and 11 women) community-dwelling adults (74±7yr; 78.2±15.0kg; 161±11cm) completed measurements of hydration status (urine specific gravity [USG], urine color), bioelectrical impedance analysis (lean mass, fat mass, total body fluid, intracellular to extracellular fluid ratio [ICF: ECF]), blood pressure, physical performance (handgrip strength test, sit-to-stand test, and a timed-up-and-go test), and reaction time (Flanker task). Hierarchical cluster analysis was performed on the distance matrix of USG and urine color to group participants. One-way ANOVAs were performed to determine differences among groups. Results: Hierarchical cluster analysis assigned participants to 4 groups (group1, n=3; group2, n=4; group3, n=5; group4,n=4). Consistent with the cluster analysis, each group had significantly (p1: 1.0±0.0, group2: 2.3±0.3, group3: 4.2±0.4, group4, 6.0±0.0). In addition, the reaction time was significantly different among groups. For group1, compatible and incompatible tasks (compatible: 1116±71.7s, p=0.049; incompatible: 1205±13.4ms, p=0.042) had a longer response time compared to group2(compatible: 640±67.5ms; incompatible: 688±74.0ms), group3 (compatible: 725±67.4ms; incompatible: 796±174.2ms), and group4 (compatible: 731±139.8ms; incompatible: 782±122.7ms). No significant differences were observed for lean mass, fat mass, total body fluid, ICF:ECF, blood pressure, handgrip strength, sit-to-stand test, and time-up-and-go test. Conclusion: Despite grouping by USG and urine color, no relationship was observed between body composition and physical performance. Surprisingly, hydrated individuals performed poorly cognitively compared to less hydrated individuals. We suggest these differences may reflect varying individual cognitive functions, not hydration status, among free-living older adults

First Measurement of Timeline Compton Scattering

We present the first measurement of the timelike Compton scattering process, p →p′∗(∗→e+e−), obtained with the CLAS12 detector at Jefferson Lab. The photon beam polarization and the decay lepton angular asymmetries are reported in the range of timelike photon virtualities 2.25 \u3c Q2 \u3c 9  GeV2, squared momentum transferred 0.1 \u3c −t \u3c 0.8  GeV2, and average total center-of-mass energy squared s = 14.5  GeV2 . The photon beam polarization asymmetry, similar to the beam-spin asymmetry in deep virtual Compton scattering, is sensitive to the imaginary part of the Compton form factors and provides a way to test the universality of the generalized parton distributions. The angular asymmetry of the decay leptons accesses the real part of the Compton form factors and thus the D-term in the parametrization of the generalized parton distributions

Measurement of Deeply Virtual Compton Scattering Off \u3csup\u3e4\u3c/sup\u3eHe with the CEBAF Large Acceptance Spectrometer at Jefferson Lab

We report on the measurement of the beam spin asymmetry in the deeply virtual Compton scattering off 4He using the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab using a 6 GeV longitudinally polarized electron beam incident on a pressurized 4He gaseous target. We detail the method used to ensure the exclusivity of the measured reactions, in particular the upgrade of CLAS with a radial time projection chamber to detect the low-energy recoiling 4He nuclei and an inner calorimeter to extend the photon detection acceptance at forward angles. Our results confirm the theoretically predicted enhancement of the coherent (e4He→e′4Heγ′) beam spin asymmetries compared to those observed on the free proton, while the incoherent (e4He→ e′p′γ′X′) asymmetries exhibit a 30% suppression. From the coherent data, we were able to extract, in a model-independent way, the real and imaginary parts of the only 4He Compton form factor, HA, leading the way toward 3D imaging of the partonic structure of nuclei

Status of micro/mini-grid systems in a Himalayan nation: a comprehensive review

Nepal is a Himalayan country with its 83% of its geography being composed of hills and mountains. Around 22% of the Nepalese population is not receiving electricity through the national power utility and is forced to identify alternative approaches to electrification. The Micro/Mini-Grid (MG) system is one of the promising approaches in terms of cost, reliability and performance for rural electrification, where electrification through national power utility is not techno-economically feasible. However, various issues must be identified and considered during the implementation of MGs in a rural community. In this paper, numerous technical, social and management issues are identified and discussed relating to the implementation and operation of reliable and stable MGs in the Himalayas. To our knowledge, this is the first scientific work that presents a comprehensive review of Himalayan MGs and their associated elements. This article reviews the available research articles, project documents, and Government reports on MG development, from which a clear roadmap is constructed. From the comprehensive study, it is observed that the existing MGs are not adequately designed for the specific area, considering the local resources and local information. Based on the identified issues, some practical and efficient recommendations have been made, so that future MG projects will address the possible problems during the design and implementation phase

Status of micro/mini-grid systems in a Himalayan nation : a comprehensive review

Nepal is a Himalayan country with its 83% of its geography being composed of hills and mountains. Around 22% of the Nepalese population is not receiving electricity through the national power utility and is forced to identify alternative approaches to electrification. The Micro/Mini-Grid (MG) system is one of the promising approaches in terms of cost, reliability and performance for rural electrification, where electrification through national power utility is not techno-economically feasible. However, various issues must be identified and considered during the implementation of MGs in a rural community. In this paper, numerous technical, social and management issues are identified and discussed relating to the implementation and operation of reliable and stable MGs in the Himalayas. To our knowledge, this is the first scientific work that presents a comprehensive review of Himalayan MGs and their associated elements. This article reviews the available research articles, project documents, and Government reports on MG development, from which a clear roadmap is constructed. From the comprehensive study, it is observed that the existing MGs are not adequately designed for the specific area, considering the local resources and local information. Based on the identified issues, some practical and efficient recommendations have been made, so that future MG projects will address the possible problems during the design and implementation phase