Role of bone marrow infiltration in management of delayed union of long bones fracture

Background: Usually delayed union of fracture long bones are managed by putting a bone graft at fracture site , but bone grafting have donor site complication like scar, infection ,hernia ,gait disturbance , cosmetic problem, as well as recipient site complication like soft tissue trauma , de-vascularisation of fracture fragment. Bone marrow infiltration is a minimally invasive method done percutaneously. It is easy, safe procedure with no associated complications that may occur in bone grafting.Methods: This prospective study was conducted in the Department of orthopedics, Government Medical College, Kota from June 2011 to November 2013 to evaluate the efficacy of percutaneous bone marrow infiltration in cases of delayed union of long bones. 27 patients included in study with 28 bones, as one patient has given bone marrow injection in two bones (tibia & femur), so the cases included in study counted as 28 cases. The mean age of this study was 38.28 years, ranging from 18 years to 75 years.  All cases were follow up after 4 to 6 weeks and thereafter one month interval. Final follow up was taken when fracture site shows clinical and radiological sign of union.Results: Out of 23 united cases 19 had excellent results and 04 cases had good results. The five cases which fail to unite were taken as poor results.Conclusions: Bone marrow infiltration is a minimally invasive, safe bone graft substitute for delayed union of long bones and have less complications

Acceptance of COVID-19 Vaccination Among Health Care Workers in India

Background: The coronavirus disease 2019 has been spread almost all over the world in the last two years, including in India. Vaccines are a critical tool in the battle against COVID-19, and India has flagged the largest vaccination drive on 16 January 2021. Although public acceptance was varying, which can lead to non-acceptance. Aim & Objective: To estimate an acceptance of the COVID-19 vaccine and its associated factors. Settings and Design: An analytical cross-sectional study among health care workers in India   Methods & Material: It was conducted using a validated, self-administrated online survey questionnaire, and data were analyzed using SPSS 23 version. The outcome variable was healthcare workers’ acceptance of a COVID-19 vaccine. Results: A total of 450 HCWs participated, including 205(45.6%) women and 245(54.4%) men. A total of 270 (60%) subjects will accept vaccines, while 33.3% were unwilling to accept and wait for vaccines. Male gender (OR=3.14), being married and experienced (OR=11.49), vaccine effectiveness (OR=6.4), vaccine safety (OR=3.4), and past history (OR=2.28) were significantly associated. On applying logistic regression for associated factors, gender (B= -1.145, S.E.= 0.200, Wald 32.748), being married (B= -1.482, S.E.= 0.216, Wald 46.937), for experienced (B= -0.865, S.E.= 0.200, effectiveness (B= -1.856, S.E.= 0.245, Wald 57.431), Safety (B= -1.224, S.E.= 0.202, Wald 36.633) and past history (B= -0.357, S.E.= 0.248, Wald 2.071) found significant. Recommendation: Proper information is crucial and healthcare workers’ attitudes about vaccines are an important factor for acceptance and recommendation of the vaccine to the public for population-wide coverage

Exploring the implications of modified advanced lung cancer inflammation index on outcomes in patients with advanced non-small cell lung cancer

Aim: Sarcopenia and skeletal muscle density (SMD) have been shown to be both predictive and prognostic marker in oncology. Advanced lung cancer inflammation index (ALI) has been shown to predict overall survival (OS) in small cell lung cancer (SCLC). Computed tomography (CT) enables skeletal muscle to be quantified, whereas body mass index (BMI) cannot accurately reflect body composition. The purpose was to evaluate the prognostic value of modified ALI (mALI) using CT-determined third lumbar vertebra (L3) muscle index beyond original ALI and see the interaction between sarcopenia, SMD, neutrophil-lymphocyte ratio (NLR), ALI and mALI at baseline and post 4 cycles of chemotherapy and their effects on OS and progress free survival (PFS) in patients with advanced non-SCLC (NSCLC). Methods: This retrospective study consisted of a total of 285 advanced NSCLC patients. The morphometric parameters such as SMD, skeletal muscle index (SMI) and fat-free mass (FFM) were measured by CT at the L3 vertebra. ALI was defined as BMI × serum albumin/NLR and mALI was defined as SMI × serum albumin/NLR. Results: Sarcopenia was observed in over 70% of patients across all BMI categories. Patients having sarcopenia suffered from a higher incidence of chemotherapeutic drug toxicities but this was not found to be statistically significant. Concordance was seen between ALI and mALI in the pre-treatment setting and this was statistically significant. A significant proportion of patients with poor ALI (90.9%), poor pre-chemotherapy mALI (91.3%) and poor post-chemotherapy mALI (89%) had poor NLR and each of them was statistically significant. Conclusions: In both univariate and multivariate analyses, this study demonstrated the statistical significance of sarcopenia, SMD, and mALI as predictive factors for OS. Additionally, sarcopenia and SMD were also found to be statistically significant factors in predicting PFS. These biomarkers could potentially help triage patients for active nutritional intervention for better outcomes

Five new systems heuristics to analyze small group teamwork

Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, School of Engineering, System Design and Management Program, Engineering and Management Program, 2016.Cataloged from PDF version of thesis.Includes bibliographical references (pages 69-72).Small groups are the most common of all organizations. In this thesis we apply a systems architecture approach to small group teamwork in order to study small groups. We propose five new systems heuristics and use these heuristics as lenses to view small groups. We make use of concepts from systems and complexity theories in order to come up with these heuristics. With each heuristic, we provide literature review both from systems and small group perspectives. We find that in many cases there is sufficient literature available to support application of each heuristic on small groups, but in some cases the literature is scant. We further apply these heuristics to small group work in a movie called "Twelve Angry Men" to provide an application example of these heuristics to analyze the work of a jury group presented in the movie. We find that each heuristic within its scope is able to provide significant insights into the working of the group. We finally provide guidelines for how these heuristics can be used for the practice of leadership in small groups. We report that each heuristic covers different aspects of group life and together can be used to analyze group work in details. Understanding group work in real time opens up opportunities for a member or members to influence the work and thus help practice leadership.by Devendra Goyal.S.M. in Engineering and Managemen

Improved DSVM-DTC based current sensorless permanent magnet synchronous motor drive

This paper presents the current sensorless control of a direct torque controlled (DTC) permanent magnet synchronous motor (PMSM) drive using an improved discrete space vector modulation (DSVM) technique. After considering the primary ideas of the DSVM-DTC technique, a new set of voltage vectors are synthesized in optimized sequence by applying three standard voltage space vectors for three equal time intervals at each sampling period for the realization of the DSVM-DTC methodology of PMSM drive which further reduces torque ripple. However, it addresses the problem by introducing a higher number of predefined voltage space vectors. The current estimation is based on discrete electrical motor model in rotor reference frame. Such sensor elimination results in reduction in drive cost, size, noise immunity, increases drive efficiency and reliability. The effectiveness of the proposed drive system is demonstrated and clarified by several drive tests in MATLAB/SIMULINK platform under loads perturbation and speed reversal dynamics incorporating constant power operation

Computer aided design of permanent magnet brushless DC motor for hybrid electric vehicle application

This paper deals with a method of design of permanent magnet brushless DC machine (BDCM), primarily aimed for hybrid electric vehicle applications. The design variables such as airgap flux density, slot electric loading, stacking factor, coil fill factor, end turn coil factor, magnet fraction, slot fraction, flux density in the stator back iron, etc., are used in design process. The simplified design equations for trapezoidal back emf motor of rating 16 hp (12 kW), 1100 rpm, 72 V radial flux surface mounted BDCM are obtained and used for CAD algorithm which gives the calculated performance of the motor. Since the motor is for high current and low voltage application so water cooling is used. Sequence quadratic programming technique is used as a constraint optimization tool to achieve feasible and acceptable design. Finite element analysis are then carried out to obtain the electromagnetic characteristics of the motor for modification and verification of the obtained computer aided design

Rheokinetic Analysis of Hydroxy Terminated Polybutadiene Based Solid Propellant Slurry

The cure kinetics of propellant slurry based on hydroxy-terminated polybutadiene (HTPB) and toluene diisocyanate (TDI) polyurethane reaction has been studied by viscosity build up method. The viscosity (ɳ)–time (t) plots conform to the exponential function ɳ = aebt, where a & b are empirical constants. The rate constants (k) for viscosity build up at various shear rate (rpm), evaluated from the slope of dɳ/dt versus ɳ plots at different temperatures, were found to vary from 0.0032 to 0.0052 min-1. It was observed that the increasing shear rate did not have significant effect on the reaction rate constants for viscosity build up of the propellant slurry. The activation energy (Eɳ), calculated from the Arrhenius plots, was found to be 13.17±1.78 kJ mole-1, whereas the activation enthalpy (∆Hɳ*) and entropy (∆Sɳ*) of the propellant slurry, calculated from Eyring relationship, were found to be 10.48±1.78 kJ mole-1 and –258.51± 5.38 J mole-1K-1, respectively. The reaction quenching temperature of the propellant slurry was found to be -9 ° C, based upon the experimental data. This opens up an avenue for a “freeze-and-store”, then “warm-up and cast”, mode of manufacturing of very large solid rocket propellant grains