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Recent literature on managing traumatic duodenal injuries suggests the superiority of primary repair. We hypothesized that duodenal trauma repair by primary closure might not be a safe strategy in an environment dealing predominantly blunt injuries with limited resources.Data analysis was done from the prospectively maintained trauma registry. The study period chosen was from January 1, 2014 to December 31, 2018. Data of 63 patients were analyzed for demographics, injuries, management, and outcome. Logistic regression was used to identify mortality predictors.The most common mechanism of injury was blunt (56/63, 88.9%). Forty (63.5%) patients had associated intraabdominal injuries. The most common American Association for the Surgery of Trauma grade of injury to the duodenum was three in 21 patients. Univariate analysis showed that mortality was associated with hypotension on presentation, higher duodenal grade, associated abdominal vascular injuries, primary closure, and duodenal leak. Logistic regression showed associated associated abdominal vascular injuries, primary closure, and leak remained significant predictors of mortality.Primary repair was found to be an independent predictor of mortality. A patient's physiology is a critical determinant of the outcome. Liberal use of tube duodenostomy over primary repair seems reasonable for blunt duodenal injury management.

We report on the design of slippery liquid-infused porous surfaces (SLIPS) fabricated entirely from building blocks that are biodegradable, edible, or generally regarded to be biocompatible. Our approach involves infusion of lubricating oils, including food oils, into nanofiber-based mats fabricated by electrospinning or blow spinning of poly(ε-caprolactone), a hydrophobic biodegradable polymer used widely in medical implants and drug delivery devices. This approach leads to durable and biodegradable SLIPS that prevent fouling by liquids and other materials, including microbial pathogens, on objects of arbitrary shape, size, and topography. This degradable polymer approach also provides practical means to design ‘controlled release’ SLIPS that release molecular cargo at rates that can be manipulated by the properties of the infused oils (e.g., viscosity or chemical structure). Together, our results provide new designs and introduce useful properties and behaviors to anti-fouling SLIPS, address important issues related to biocompatibility and environmental persistence, and thus advance new potential applications, including the use of slippery materials for food packaging, industrial and marine coatings, and biomedical implants.

Introduction: Three-dimensional (3D), high-definition (HD), and ultra-high-definition (4K HD) are recent additions over regular HD technology for laparoscopic surgery. The aim of this study was to ...

Objective: Complications during trauma management are the main factor responsible for the overall increase in treatment cost. There are very few grading systems to measure the burden of complications in trauma patients. A prospective study was conducted using the Adapted Clavien Dindo in Trauma (ACDiT) scale, with the primary aim of validating it at our center. As a secondary aim, it was also wanted to measure the mortality burden among our admitted patients. Material and Methods: The study was conducted at a dedicated trauma center. All patients with acute injuries, who were admitted, were included. An initial treatment plan was made within 24 hours of admission. Any deviation from this was recorded and graded according to the ACDiT. The grading was correlated with hospital-free days and ICU-free days within 30 days. Results: A total of 505 patients were included in this study, with a mean age of 31 years. The most common mechanism of injury was road traffic injury, with a median ISS and NISS of 13 and 14, respectively. Two hundred and forty-eight out of 505 patients had some grade of complication as determined by the ACDiT scale. Hospital-free days (13.5 vs. 25; p< 0.001) were significantly lower in patients with complications than those without complications, and so were ICU-free days (29 vs. 30; p< 0.001). Significant differences were also observed when comparing mean hospital free and ICU free days across various ACDiT grades. Overall mortality of the population was 8.3 %, the majority of whom were hypotensive on arrival and required ICU care. Conclusion: We successfully validated the ACDiT scale at our center. We recommend using this scale to objectively measure in-hospital complications and improve trauma management quality. ACDiT scale should be one of the data points in any trauma database/registry.

Attendance system is very important in schools and colleges' The student attendance program has many problems such as it may not be accurate and critical to maintain. Therefore, an existing system that uses a face recognition system increases accuracy and also requires less time than other methods. There are many systems available such as face recognition using IoT, PIR sensors and so on. With face recognition, hardware devices are helpful. But the challenge is to keep all the nerves properly without getting hurt. After learning all the techniques and techniques we try to use the system with Haar Cascade Algorithm with the highest accuracy among them all. It can take pictures from 50- 70cm. We create a graphical interface that takes pictures, builds a database and trains the database with a single click. After seeing the face it will show the student's name and roll number. That information is stored on an automatic attendance sheet by time and date.

The effect of improved dielectric properties in the presence of an applied magnetic field is discussed in Pr doped polycrystalline Gd$_{0.55}$Pr$_{0.45}$MnO$_3$ complemented by the structural properties down to 50 K and magnetic properties. Enhanced dielectric permittivity and low dielectric loss represent the strongly field-dependent dielectric behaviour of the sample. The structural characterizations using synchrotron angle dispersive X-ray diffraction confirm the orthorhombic symmetry of the polycrystalline sample with the Pnma space group from 300 K to 50 K. There is no structural transition at lower temperatures up to 50 K; however the Mn O octahedral distortion is reduced. The investigation of dielectric properties for frequencies range 500 Hz to 1 MHz was conducted in the temperature range 8 K to 300 K with and without a magnetic field of 7 Tesla, which shows the high dielectric constant in the 500 Hz frequency region. This confirms the relaxation phenomena in polycrystalline Gd$_{0.55}$Pr$_{0.45}$MnO$_3$. ac conductivity data shows the increasing trend for frequencies along with the activation energy which increases from low frequencies to higher frequencies. Temperature-dependent dc magnetization study shows the negative magnetization in polycrystalline Gd$_{0.55}$Pr$_{0.45}$MnO$_3$ at low temperature at 100 Oe applied field, due to spin canting of Mn-Mn magnetic lattice. High coercivity due to competition in between spin ordering of Mn and Gd,Pr magnetic lattice at 5 K are also observed in the field-dependent magnetization study., Comment: 33 pages, 9 figures, 3 tables

In the present communication, we report molecular interaction studies in binary systems of N,N-dimethylacetamide (DMA) with 1-propanol and methanol. The density (ρm) and ultrasonic velocity (um) have been measured experimentally for binary solutions of DMA with 1-propanol and methanol at varying concentrations and temperatures. The intermolecular interactions present in the mixtures have been investigated through deviation in ultrasonic velocity (Δu), excess acoustic impedance (ZE), and excess intermolecular free length (LfE). Various semi-empirical mixing rules and theories were proposed by Nomoto, Vandeal, Junjie, collision factor theory (CFT), and Flory’s statistical theory (FST) to estimate the ultrasonic velocity of liquid mixtures. Hankinson-Brobst-Thomson (HBT) and Rackett density models have been used to compare the experimental and theoretically calculated density values. The experimental data are in good agreement with the calculated data as obtained by the DFT (B3LYP and CAM-B3LYP) method.

Abdominal trauma management has seen a paradigm shift over the last few decades. There is wide variation in the treatment depending on the level of healthcare facilities available. With an aim to standardise the treatment of solid organ injuries in blunt abdominal trauma, Indian Society for Trauma and Acute Care (ISTAC®) formulated consensus guidelines to benefit doctors engaged in trauma care in the country.

A ferroelectric based electrostatic doping (Fe-ED) technique is proposed, as the alternative to chemical doping, providing non-volatile and programmable free electrons and holes for nanoscale devices. We show that Fe-ED achieves non-volatility and reconfigurability via the ferroelectric film inserted into the polarity gate, producing the reconfigurable nanosheet FETs (NSFETs) without the requirement of a constant bias. Thanks to the naturally formed lightly doped drain structures and the extremely high doping concentration over $1\times 10^{21}$ cm−3 in source/drain (S/D) regions, Fe-ED NSFETs exhibit the promising potential benefits for device scaling including the improved subthreshold swing, the suppressed drain-induced barrier lowering, and the ultralow S/D region resistance. Our study suggests a promising doping strategy of Fe-ED for versatile reconfigurable nanoscale transistors and highly integrated circuits.

The project depends on distinguishing the character of a singular utilizing AI calculations and large 5 models. The character of a human assumes a significant part in his own and proficient life. These days, numerous associations have likewise begun shortlisting the competitors in view of their character as this builds the proficiency of the work in light of the fact that the individual is working in what he is great at as opposed to what he is compelled to do. The Big Five model is otherwise called the Five-Factor Model (FFM) and OCEAN model was created in the mid 1980s as per numerous mental hypotheses. Whenever measurable examination is applied to character study information, a few words used to depict the individual and these words give a rundown of the general person or character of the individual precisely. Character as seen as a brand name of mindfulness, conduct and energetic models from natural and ecological parts. It shows individuals as they quarrel about contemplations, ways of behaving and sentiments. Character attributes don't change in that frame of mind as they give the sensation of being out of control the conspicuous characteristics of an individual with a predictable quality as opposed to mirroring a specific character. Character contrasts ought not out of the ordinary to forestall the justification behind the bar or struggle in the subject of work or schooling. Along these lines, in enrolling an everyday schedule of work, one must be isolated.

Background Despite the acceptance of non-operative management (NOM), there is no consensus on the optimal length of hospital stay in patients with blunt liver and splenic injury (BLSI). Recent studies on pediatric patients have demonstrated the safety of early discharge following NOM for BLSI. We aimed at evaluating the feasibility and safety of early discharge in adult patients with BLSI following NOM in a randomized controlled trial. Materials and methods After initial assessment and management, patients aged 18–60 years with BLSI planned for NOM were randomized into 2 groups: Group A (test group; discharge day 3), and Group B (control group; discharge day 5). Standard NOM protocol was followed. These patients were discharged on the proposed day if they met the pre-defined discharge criteria. All patients were followed at days 7, 15, and 30 of discharge. Results Sixty patients were recruited, 30 randomized to each arm. Most patients were males and aged less than 30 years. Road traffic injury was the most common mode of injury. Both groups were comparable in demography and injury-related parameters. 27 patients (90%) from group A and 28 patients (93%) from group B were discharged on the proposed day. Three patients had unplanned hospital visits for reasons unrelated to BLSI. All patients were asymptomatic and had a normal examination during their scheduled follow-up visits. Conclusion Adult patients undergoing NOM for BLSI can be safely discharged after 48 h of in-hospital observation, provided other injuries precluding discharge do not exist.

We report the design of 'slippery' nanoemulsion-infused porous surfaces (SNIPS). These materials are strongly anti-fouling to a broad range of substances, including microorganisms. Infusion with water-in-oil nanoemulsions also endows these slippery coatings with the ability to host and control or sustain the release of water-soluble agents, including polymers, peptides, and nucleic acids, opening the door to new applications of liquid-infused materials.

Pancreatic injuries pose a significant challenge to trauma surgeons. The mortality and morbidity associated with pancreatic injuries remain high. Furthermore, due to variability in the presentations, the management remains complex and involves a multidisciplinary approach. At our center, we follow the Eastern Association of Surgery for Trauma (EAST) guidelines in traumatic pancreatic injury. We present our experience of management and outcomes of blunt pancreatic injuries. A case-series analysis of 31 patients of blunt pancreatic trauma admitted from August 2017 to October 2019 was performed. The demographic profile, clinical profile, and outcomes were analysed. Grading of pancreatic injury was done by the Organ Injury Score given by the American Association for the Surgery of Trauma. There was a male preponderance with a male: female ratio of 28:3. The majority of patients were of 15–40 years of age. Road traffic injury (22/31) was the most common mechanism of injury. Four patients were hemodynamically unstable at the time of the presentation. Twelve patients underwent operative intervention. Two patients succumbed to their injuries. Higher-grade pancreatic injuries more likely require operative intervention. A protocol-based approach helps to improve the outcomes of traumatic pancreatic injuries.

Nanosheet gate-all-around transistors are analyzed for RF applications using calibrated TCAD simulations. The effects of stack spacing and number of stacks on device performance are studied and a substack design for improved RF performance is proposed. The novel substack design can improve cut-off frequency ( ${F}_{{t}}$ ) by ~10% and minimum number of substacks and minimum substack spacing should be used.

Pancreatic trauma remains a challenge to a trauma surgeon even with extensive advancement in medicine. The mortality and morbidity associated with this injury remain high. A high index of suspicion, mechanism of injury, and early identification hold key in the final outcome. The management of pancreatic injury should involve a multidisciplinary team comprising of trauma surgeons, radiologists, and gastroenterologists. This review highlights the burden of the pancreatic injury and its management.

Radiology plays a very important role in the management of acutely injured patients. As per the Advanced Trauma Life Support (ATLS) program, it has been made an integral part of primary and secondary surveys. The primary objective of the imaging during the primary survey is to identify immediately life-threatening injuries and to assist in resuscitation of the patient. While during the secondary survey, imaging modality is aimed to assist in definitive management of the trauma patient. However, imaging modality should never hamper the resuscitation process of the patient and should be used judiciously. This review is aimed to study the indications, advantages and disadvantages of these modalities and to guide the treating trauma surgeons about the utilization of imaging modalities in different aspects of the trauma care.

Background: Renal artery–inferior vena cava (IVC) fistula is usually caused by penetrating injury to the back. However, it is a very rarely reported entity with only 20 cases reported in the literature. They may present acutely with hemodynamic instability or chronically as congestive heart failure. A thorough examination and adequate imaging are required to avoid missing such injuries. Case Presentation: A 28-year-old gentleman presented after sustaining stab injury to the back. The stab had penetrated the renal artery and IVC, leading to arteriovenous fistula. He was managed surgically, as he went into hemorrhagic shock, with a successful outcome. The case is also unique as an accessory renal artery was also involved in the fistula. Conclusion: Early identification and management of renal artery–IVC fistula is important to ensure a successful outcome. Such fistulas can be managed by either endovascular approach or surgical approach. The decision of approach depends on the level of expertise available and hemodynamic status of the patient.

We propose an updated compact model for mobility in Nanosheet FETs. This is necessary since Nanosheet FETs exhibit significant mobility degradation with thickness and width scaling caused by centroid shift, changing effective mass due to quantum confinement as well as various crystal orientations of the various conduction planes. The model takes all of these effects into account. It has been implemented in Verilog-A and validated with experimental data. To the best of our knowledge, this is the first compact model capturing the effect of nanosheet scaling on mobility.

We propose a compact model for nanosheet FETs that take the effects of quantum confinement into account. The model captures the nanosheet width and thickness dependence of the electrostatic dimension, density of states, effective mass, subband energies, and threshold voltages and includes them in the charge calculation, resulting in an accurate terminal charge and current characteristics. The model has been implemented using Verilog-A in the BSIM-CMG framework for all simulations. It has been validated with band-structure calculation-based TCAD simulations as well as measured data. We have also highlighted the significance of quantum mechanical effects on analog and RF performance of the device.