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A baby with an antenatal diagnosis of exomphalos was born at term. The abnormality had a highly unusual appearance, a right-sided paraumbilical defect, similar to gastroschisis, but with a sac typical of exomphalos containing both abdominal contents and over 1 L of serosanguinous fluid. The sac was drained and suspended from the top of the incubator in silo fashion. Definitive closure was achieved at day 3 of life, and the patient had a non-eventful recovery. Despite exomphalos and gastroschisis normally being discrete entities, ambiguity in the presentation this case necessitated a composite management approach., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

We demonstrate high-contrast electromagnetically induced absorption (EIA) bright resonances on the D 1 line of K39 with characteristics comparable to those of the electromagnetically induced transparency (EIT) dark resonances observed in the same conditions. EIA is produced by the interaction of a weak probe beam with the atomic ground state driven in a degenerate coherent superposition by either a co- or counter-propagating pump beam. We have obtained an order of magnitude increase of the EIA's contrast with respect to previous similar experiments, performed with other alkalis, without compromising its linewidth. Furthermore, we show that the magneto-optic resonances can be continuously tuned from EIT to EIA by changing the relative handedness of circular polarizations of pump and probe beams, or depending on whether they co- or counter-propagate. This opens new perspectives in the use of EIA in a broad range of physical domains and in a large wealth of potential applications in optics and photonics.

We describe an experiment of atomic spectroscopy devoted to ascertaining whether the orbital angular momentum (OAM) of photons has the same property of interacting with atoms or molecules as occurs for the spin angular momentum (SAM). In our experiment, rubidium vapors are excited by means of laser radiation with different combinations of OAM and SAM, particularly selected to inhibit or enhance the fluorescence according to the selection rules for the electric dipole transitions between the fundamental state and the first excited doublet. Our results clearly show that an electric-dipole-type transition is insensitive to the OAM value, and provide an original validation of a problem long debated in theoretical works.

Supermassive black holes with masses of millions to billions of solar masses are commonly found in the centers of galaxies. Astronomers seek to image jet formation using radio interferometry but still suffer from insufficient angular resolution. An alternative method to resolve small structures is to measure the time variability of their emission. Here we report on gamma-ray observations of the radio galaxy IC 310 obtained with the MAGIC (Major Atmospheric Gamma-ray Imaging Cherenkov) telescopes, revealing variability with doubling time scales faster than 4.8 min. Causality constrains the size of the emission region to be smaller than 20% of the gravitational radius of its central black hole. We suggest that the emission is associated with pulsar-like particle acceleration by the electric field across a magnetospheric gap at the base of the radio jet., (Copyright © 2014, American Association for the Advancement of Science.)

We report a measurement of the proton-air cross section for particle production at the center-of-mass energy per nucleon of 57 TeV. This is derived from the distribution of the depths of shower maxima observed with the Pierre Auger Observatory: systematic uncertainties are studied in detail. Analyzing the tail of the distribution of the shower maxima, a proton-air cross section of [505±22(stat)(-36)(+28)(syst)] mb is found.

Background and Aim: Short bowel syndrome poses a great challenge to pediatric teams. Several innovative techniques in the management of total parenteral nutrition (TPN) and bowel reconstructive surgery have improved the outcomes of these children. The authors present their experience during the last decade as a specialist unit using improved techniques and multidisciplinary approaches in the management of this condition., Methods: All of the children presenting with short bowel syndrome between 2000 and 2009 were identified. Diagnosis, length of residual gut, age at definitive surgery, length of gut prelengthening, length of gut postlengthening, TPN status, and survival were recorded. Median values were calculated., Results: Twenty-seven children were identified (14 boys, 13 girls). Overall survival was 92%. Two children died. Nineteen children required bowel lengthening and 8 children had simple bowel reconstruction while on our protocol. Overall median age at definitive surgery was 12 months. Overall median residual gut length for these was 35.5 cm, whereas the median residual gut length for patients undergoing bowel lengthening was 25 cm. Postbowel lengthening, the median gut length was 90 cm. TPN data were unavailable for 2 patients. Overall, excluding the 2 patients who died and the 2 we have no TPN data on, of 23 patients, 21 (91%) are now off TPN., Conclusions: Our series shows improved results not only with survival but also in the number of patients that are off TPN. Multidisciplinary approach consisting of both medical and surgical expertise is necessary in the management of these patients. The authors advocate centralisation of short gut services to experienced centers with multidisciplinary expertise.

Background and Aims: Short bowel syndrome (SBS) describes the malabsorptive state seen following extensive bowel resection. Management aims to optimise nutritional intake, promote intestinal adaptation, and prevent the development of complications. Surgical options such as autologous gastrointestinal reconstruction (AGIR) attempt to restore enteral autonomy to the patient. Although the literature focuses on the objective measurements of success following AGIR techniques, subjective assessment of its effect on the quality of life (QoL) should also be sought. Because children with SBS are reliant on caregivers, caregivers' satisfaction with surgery and their perception of the effect of AGIR on their daily lives should be assessed. This is the first report of caregiver satisfaction following AGIR in children., Methods: All children with SBS who had AGIR between January 1999 and June 2010 were identified. A questionnaire was developed. Caregivers were asked to complete the questionnaire to rate their satisfaction with surgery and the pre- and postoperative daily care, medical needs, and subjective interpretation of QoL for their child. Data were analysed using SPSS version 18, using the Friedman nonparametric test and 2-way analysis of variance by rank. Statistical significance was set at ≤0.05., Results: Thirty-two children were identified. Seven assessments were done outside our centre (5 outside the UK) and were not included in the study. One patient moved to another city and was not contacted. Two children died. Twenty patients were contactable and were included in the present study. Parents were satisfied with the AGIR and saw improvements in their child's physical condition, bowel habit, and subjective interpretation of QoL postoperatively. Parents perceived significant improvements in the ease of caring and in aspects of their relationship with their child, including the quality of time spent, their enjoyment, and the level of their frustration with them., Conclusions: The present study found that AGIR improved the physical well-being of the child and gave the impression of improvements on specific QoL aspects for both the child and the parents.

The treatment of short gut syndrome has evolved dramatically during the past decade. The combination of surgical techniques and medical management in the context of a multidisciplinary approach has improved the outcomes of these children. The authors describe in detail their technique of controlled tissue expansion of the bowel before lengthening procedures. Monitoring of the child and troubleshooting actions during the controlled tissue expansion program also are discussed.

A 10-yr-old child with impaired venous access (bilateral occlusion of internal jugular veins, subclavian veins, and inominate veins) underwent an isolated small bowel transplant. He presented with lethargy, shortness of breath 13 months into his follow-up and was diagnosed to have chylopericardium. MR venography and lymphangiography could not demonstrate the site of lymphatic leak. His chyloperciardium was treated with pericardiocentesis and MCT diet. The most likely cause for the chylopericardium was venous occlusion of the subclavian veins with backpressure resulting in a lymphatic leak. A brief review of literature along with treatment options is discussed., (© 2009 John Wiley & Sons A/S.)

Selected livers from controlled NHBD are accepted for OLT in adults. Recent evidence has shown good medium-term outcome. The purpose of this study was to report our experience of pediatric OLT with whole and partial grafts from NHBD, analyzing complications and outcome. Retrospective review of all the recipients who underwent primary OLT between December 2005 and December 2008, using livers from NHBD. Four children (one male child) mean age was 9.5 yr (0.2-17), mean weight was 26 kg (range 2.6-48), underwent OLT using NHBD. Mean donor age was 14.2 yr, and mean WIT (systolic BP<50 mmHg to cold perfusion) 12.2 min (range 10-15). Two children received reduced grafts and two full grafts. Mean cold ischemia time was 7.18 h (range 6-8). Liver function tests one wk and nine months post-OLT confirmed a good graft function. One child was treated for two episodes of acute rejection. Post-transplant complications included two cases of mild ischemic cholangiopathy treated conservatively. Graft and patient survival was 100% with a mean follow-up of 19 months (range 8.1-43.4). Short- to medium-term follow-up suggests that liver grafts from young NHBD with short warm and cold ischemia times can be safely utilized in pediatric transplantation., (Copyright (c) 2010 John Wiley & Sons A/S.)

We describe the measurement of the depth of maximum, X{max}, of the longitudinal development of air showers induced by cosmic rays. Almost 4000 events above 10;{18} eV observed by the fluorescence detector of the Pierre Auger Observatory in coincidence with at least one surface detector station are selected for the analysis. The average shower maximum was found to evolve with energy at a rate of (106{-21}{+35}) g/cm{2}/decade below 10{18.24+/-0.05} eV, and (24+/-3) g/cm{2}/decade above this energy. The measured shower-to-shower fluctuations decrease from about 55 to 26 g/cm{2}. The interpretation of these results in terms of the cosmic ray mass composition is briefly discussed.

We propose and experimentally implement a method, based on light-induced atomic desorption, for controlled generation of large sodium densities in siloxane-coated cells, kept at room temperature. An array of blue LEDs is used to desorb sodium atoms from the cell walls. The required atomic vapor density is achieved and stabilized by controlling the LED power through the feedback given by the sodium fluorescence. We show that sodium densities corresponding to about 400 K can be obtained and kept stable for a long time with less than 6 mW of LED light power. Moreover, this technique allows for precise vapor density modulation with a frequency of tenths of hertz, which is not possible using traditional heating methods.

Emergency liver transplantation is a life-saving procedure in selected subset of children with acute liver failure (ALF), when most recipients receive a segmental graft from a living or heart-beating deceased donor. The increased use of full-liver grafts from donors after cardiac death (DCD) has had a beneficial impact on elective liver transplantation in adults. These grafts however are more susceptible to poor initial function, and most centres are reluctant to consider their use as segmental grafts, let alone in the situation of ALF where good initial function is imperative. In this short article, we describe the use and successful outcome in two children aged 6 weeks and 6 years with acute liver failure who received reduced-size DCD liver grafts.

Some overtone absorption lines of ammonia and ethylene have been examined by using a tunable diode laser (TDL) spectrometer in the region around 12,650 and 11,800 cm(-1), respectively. The spectrometer sources are commercially available double heterostructure InGaAlAs and AlGaAs TDLs operating in the "free-running" mode. The high resolving power ( approximately 10(7) ) of the spectrometer permitted the detection and the study of the line positions of such molecules with a precision better than 0.01 cm(-1). In order to maximize the signal to noise ratio and to extract the necessary informations either on the line width and on the line position for the detected molecular resonances, the wavelength modulation spectroscopy (WMS) along with the second harmonic detection techniques have been applied. For this purpose, the fitting procedure took into account the instrumental effects and the amplitude modulation (AM) always associated with the frequency modulation (FM) of these type of sources. This technique permitted also the measurement of the collisional-broadening and -shifting coefficients by different buffer gases at room temperature.

We report the first observation of translationally cold ( approximately 90 &mgr;K) Rb2 molecules. They are produced in a magneto-optical trap in their triplet ground state. The detection is performed by selective mass spectroscopy after two-photon ionization into Rb+2, resonantly enhanced through the intermediate a (3)Sigma(+)(u)-->2 (3)Pi(g) molecular band. The two rubidium isotopes present very different types of behavior that are interpreted in terms of their respective collisional properties.

With the aid of commercial room-temperature AlGaAs diode lasers, frequency modulation absorption spectroscopy was performed on the 7900 A and 8600 A rovibrational combination overtone bands of methane. Three weak transitions are reported in the range around 8610 A that, to our knowledge, have not yet been observed and measured. Self-broadening and pressure-broadening coefficients of one ofthese new absorption features (at 8608.93 A) were derived from CH(4) and for CH(4) immersed in N(2) and He buffer gases. An evaluation of the methane detection sensitivity is given for favorable laboratory conditions as well as for an open-path situation.