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Background: The length of hospitalization is prolonged in patients with acute pancreatitis due to delay in feeding. The present study aimed at evaluating hunger-based early feeding for its efficacy in reducing length of hospitalisation. Aims and Methods: This was a parallel arm superiority randomized control trial. Patients with moderate and severe acute pancreatitis were randomised into hunger-based feeding and conventional feeding groups. Patients in hunger-based feeding group commenced feeding once they felt hungry and in conventional feeding group after normalization of biochemical parameters and resolution of symptoms. Patients were followed up till their discharge and were analyzed for length of hospitalisation, fasting duration, feed intolerance, incidence of infective morbidities and invasive procedures. Results: Hunger-based feeding and conventional feeding group included 56 and 54 patients, respectively. Hunger-based feeding led to a decrease in length of hospitalization (6.3 days in hunger-based feeding vs 7.3 days in conventional feeding group, P = 0.041) and fasting duration (1.6 days in hunger-based feeding vs 2.7 days in conventional feeding group, P = 0.001).The incidence of feed intolerance (P = 0.098), infective morbidities and invasive non-surgical procedures were similar in both the groups. Conclusion: Hunger-based feeding significantly reduces length of hospitalization and fasting duration in cases of moderate and severe acute pancreatitis without any significant rise in the incidence of complications. Registration number of Clinical Trails Registry India CTRI/2019/01/017,144. [ABSTRACT FROM AUTHOR]

A methodology that accurately simulates the brittle behavior of epoxy polymers initiating at the molecular level due to bond elongation and subsequent bond dissociation is presented in this paper. The system investigated in this study comprises a combination of crystalline carbon nanotubes (CNTs) dispersed in epoxy polymer molecules. Molecular dynamics (MD) simulations are performed with an appropriate bond order-based force field to capture deformation-induced bond dissociation between atoms within the simulation volume. During deformation, the thermal vibration of molecules causes the elongated bonds to re-equilibrate; thus, the effect of mechanical deformation on bond elongation and scission cannot be captured effectively. This issue is overcome by deforming the simulation volume at zero temperature-a technique adopted from the concept of quasi-continuum and demonstrated successfully in the authors' previous work. Results showed that a combination of MD deformation tests with ultra-high strain rates at near-zero temperatures provides a computationally efficient alternative for the study of bond dissociation phenomenon in amorphous epoxy polymer. In this paper, the ultra-high strain rate deformation approach is extended to the CNT-epoxy system at various CNT weight fractions and the corresponding bond disassociation energy extracted from the simulation volume is used as input to a low-fidelity continuum damage mechanics (CDM) model to demonstrate the bridging of length scales and to study matrix failure at the microscale. The material parameters for the classical CDM model are directly obtained from physics-based atomistic simulations, thus improving the accuracy of the multiscale approach. [ABSTRACT FROM AUTHOR]

Purpose: Ethmoidal foramina on the medial orbital wall show a higher incidence of variation. Surgeons performing endonasal, anterior cranial fossa and medial orbital wall surgeries must be aware of these variations as they are a source of hemorrhage and also serve as landmark in proximity to the orbital apex. Aim: The present study aims to describe the morphometric distances of various ethmoidal foramina between anterior lacrimal crest to optic canal in south Indian dry human skulls. Materials and method: The study was done on 44 adult dry human skulls. The occurrence of Ethmoidal foramina was noted by direct inspection. The distance of Ethmoidal foramina from anterior lacrimal crest to optic canal was measured with the help of ruler, probe and magnifying glass. Results: The Posterior ethmoidal foramina were found in all 44 skulls bilaterally. Middle ethmoidal foramen was present in 12 and 13 skulls on right and left, respectively. Anterior ethmoidal foramen was found in 38 and 37 skulls on right and left, respectively. The distance between anterior lacrimal crest (ALC) and posterior lacrimal crest (PLC) was in the range of 3-8 mm and that of ALC to anterior ethmoidal foramen was in the range of 24-30 mm. The range of distance between anterior ethmoidal foramen to posterior ethmoidal foramen was 9-17 mm and that between posterior ethmoidal foramen to optic canal was 5-13 mm. Conclusion: These observations would help to predict the anatomical variations in the position of ethmoidal foramina with respect to anterior and posterior lacrimal crest and ensure the safe and precise performance of medial orbital wall surgeries to avoid injuries to the important neurovascular bundles passing through various foramina and fissures. [ABSTRACT FROM AUTHOR]