A prospective observational study of fetomaternal outcome in second stage caesarean section

Background: Incidence of caesarean section is rapidly rising over last two decades and one fourth is contributed by caesarean section in second stage. The objective of this study was to study of fetomaternal outcome in second stage caesarean section.Methods: Prospective observational study was done in 80 women undergoing second stage caesarean section from December 2015 to March 2017 at Lady Hardinge Medical Collage Delhi. These women observed from labour to caesarean section in second stage of labour till post-operative period for any complication. Intraoperative and postoperative complications were observed in these women.Results: Caesarean section rate was 22% in which 3.9% were done in second stage of labour. Most common gestational age being 39-40 weeks (47%). Most common indication being deep transverse arrest (41.25%). Intraoperative complication as bladder injury (5%), extension of uterine incision (23%), PPH (33%) and need for blood transfusion (31%) and post-operative complication as wound sepsis in 58% and 20% requiring resuturing, post-operative fever, prolong hospital stay, prolonged catheterization etc. neonatal complications as severe birth asphyxia (2.5%), respiratory distress (55%), need for mechanical ventilation.Conclusions: Thus, caesarean section done in second stage of labour is associated with increased maternal and neonatal morbidity

Demographic profile in women undergoing second stage caesarean section

Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well

The Repetition of Video Game Music, its Impact on Video Game Enjoyment, and How Best to Manage it.

Video game music (VGM) has a functional role in video games which can cause it to be looped and repeated as it accompanies the player around the game world. This has an impact on players’ video game enjoyment and engagement when players become overfamiliar with repeating VGM. There have been numerous approaches and techniques implemented in video games to attempt to conceal, reduce, and remove repetition of VGM. However, familiarity through repeated exposure to VGM has a positive functional role for players with regards to player feedback. This constructivist study focuses on the phenomenon of VGM repetition and its impact on the complex concept of video game enjoyment, and gauges how best to manage the phenomenon using various approaches, and techniques, used to conceal, reduce, and remove repetition of VGM. The current study conducted qualitative interviews with actual players who believed that VGM was important to their enjoyment of video games. A codebook was developed from these interviews and used to interpret the data using heuristic inquiry. Findings show that players understand the reasons for VGM repetition and believe that their video game enjoyment is contextually dependent on whether repetition improves their engagement. Players are generally tolerant of VGM repetition but can become overfamiliar with VGM when it repeats, which has an impact on their video game enjoyment. However, players are more appreciative of the functional role that repeating VGM has with regards to feedback as they become more familiar with the repeating VGM. Ultimately a pragmatic worldview is held by the author who believes that this study could be beneficial to other VGM research and the video game industry because it focuses on the perspectives of the players themselves

A broadband X-ray study of the dwarf nova SS Cyg during quiescence and outburst

We present a broadband X-ray study ($\sim$\,0.3-50 keV) of the dwarf nova SS Cyg highlighting the changes in the accretion during two phases, the quiescence and the outburst states. The investigation was based on simultaneous observations carried out with the XMM-Newton and NuSTAR telescopes in two epochs, involving medium and high-resolution spectroscopy. Spectra were harder during quiescence ($kT_{\rm high}\sim22.8$ keV) than outburst ($kT_{\rm high}\sim8.4$ keV), while the mass accretion rate increased by $\sim35$ times in outburst ($1.7\times10^{16} \rm g\;s^{-1}$) than quiescence. The bolometric luminosity (0.01-100.0 keV) during the outburst was dominated by a blackbody emission ($kT_{\rm BB}\sim28$ eV) from the optically thick boundary layer, and the inner edge of the accretion disk resides very close to the WD surface. X-rays from the accretion disk boundary layer are consistent with the white dwarf having mass $1.18_{-0.01}^{+0.02} \rm M_{\odot}$. Our study conclusively confirms the presence of the reflection hump in the 10-30 keV range for both phases, which arises when X-ray photons hit colder material and undergo Compton scattering. We estimated a similarly strong reflection amplitude during quiescence ($\sim1.25$) and outburst ($\sim1.31$), indicating both the WD surface and disk are contributing to reflection. The neutral Fe K$_{\alpha}$ line, which is correlated with Compton reflection, also showed similar strength ($\sim80$ eV) in both phases. Finally, X-rays also revealed the presence of a partial intrinsic absorber during the outburst, possibly due to an outflowing accretion disk wind.Comment: 14 pages, 5 figures, 4 tables, Accepted for publication in The Astrophysical Journal (ApJ

Influence of 36 years of integrated nutrient management on soil carbon sequestration, environmental footprint and agronomic productivity of wheat under rice-wheat cropping system

A long-term field experiment was conducted to study the effects of different combinations of integrated nutrient management (INM) on carbon sequestration and wheat yield in a rice-wheat cropping system. The experiment consisted of 11 treatments that were replicated three times. The organic manures used in the study included farmyard manure (FYM), wheat straw (WS), and green manure (GM) with Sesbania aculeata. The results of the experiment revealed that the application of 50% of the recommended dose of fertilizers (RDF) along with 50% nitrogen (N) through FYM during rice cultivation, and RDF during wheat cultivation, led to a significant increase in soil organic carbon (SOC). Specifically, the SOC content was enhanced by 46.4% (18.29 Mg ha-1) compared to RDF in rice and wheat, resulting in a C sequestration rate of 0.22 Mg ha-1 year-1. These increases were higher in treatments that combined organic and inorganic inputs. Additionally, the application of 50% RDF and substituting 50% of the nitrogen with FYM during wheat cultivation resulted in a 24.7% increase in grain yield compared to RDF in rice and wheat. The INM treatments, showed significantly (p ≤ 0.05) higher agronomic efficiency (AE) of nitrogen (N), phosphorus (P) and potassium (K), partial factor productivity (PFP) of N, P and K, and carbon pool index (CPI) compared to the application of inorganic fertilizers at the recommended dose. Moreover, the INM treatments also exhibited lower greenhouse gas (GHG) emission intensity. Application of neither chemical fertilizers nor organic manure (T1) resulted in maximum GHG emission intensity (328.1 kg CO2 eq Mg−1 yield). Based on these findings, it can be concluded that the combined use of inorganic fertilizers and organic manures significantly increased crop yield and soil organic carbon sequestration while reducing GHG emissions in a rice-wheat cropping system in the eastern Indo-Gangetic Plains (EIGP) of India

Science with the Daksha High Energy Transients Mission

We present the science case for the proposed Daksha high energy transients mission. Daksha will comprise of two satellites covering the entire sky from 1~keV to $>1$~MeV. The primary objectives of the mission are to discover and characterize electromagnetic counterparts to gravitational wave source; and to study Gamma Ray Bursts (GRBs). Daksha is a versatile all-sky monitor that can address a wide variety of science cases. With its broadband spectral response, high sensitivity, and continuous all-sky coverage, it will discover fainter and rarer sources than any other existing or proposed mission. Daksha can make key strides in GRB research with polarization studies, prompt soft spectroscopy, and fine time-resolved spectral studies. Daksha will provide continuous monitoring of X-ray pulsars. It will detect magnetar outbursts and high energy counterparts to Fast Radio Bursts. Using Earth occultation to measure source fluxes, the two satellites together will obtain daily flux measurements of bright hard X-ray sources including active galactic nuclei, X-ray binaries, and slow transients like Novae. Correlation studies between the two satellites can be used to probe primordial black holes through lensing. Daksha will have a set of detectors continuously pointing towards the Sun, providing excellent hard X-ray monitoring data. Closer to home, the high sensitivity and time resolution of Daksha can be leveraged for the characterization of Terrestrial Gamma-ray Flashes.Comment: 19 pages, 7 figures. Submitted to ApJ. More details about the mission at https://www.dakshasat.in

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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