ANTERIOR KNEE PAIN (PATELLAR TENDONITIS) MANAGEMENT AND MODIFICATION IN BIKE FITTING FOR A TRACK CYCLIST

An elite track cyclist experienced anterior knee pain in both knees over a 6 month period while training on his new bike and was diagnosed with patellar tendonitis. A bike fitting session was conducted followed by sprint performance on a trainer. When sprinting the cyclist slipped (7 cm ±1.7) forward from the initial position on the saddle leading to his knee joint shifting ahead of the pedal at 11 o’clock position and resulted in irritation and pain on the patellar tendon. An intervention was done to increase the handlebar height and to change the stem bar. It was then observed that the tendency to slip forward at sprints immensely decreased. The cyclist was then asked to familiarize themselves with the new bike setting for a period of 3 weeks and provide feedback where he reported that the pain had considerably reduced and he could regain his previous performance

A FUNCTIONAL BIOMECHANICAL ANALYSIS OF AN ELITE CYCLIST

We are investigating possible causes of chronic back pain of an otherwise healthy elite cyclist while cycling. Asymmetry in the lower limbs and patterns of pelvic, hip, knee and ankle joint motion in gait and sports specific cycling movements were assessed

"Keep it simple - a lesson from COVID-19" : highlighting the utility of chest X-rays in ARDS-associated illnesses through the Zonal Scoring System

Purpose: The post-pandemic era calls for appropriate literature on chest X-ray score cut-offs, enabling swift categorization and faster radiological reporting of patients with acute respiratory distress syndrome (ARDS)-like illnesses, hence prompting healthcare equity in low-resource centres where extortionate modalities of imaging such as computed tomography (CT) are unavailable. In this study, we aim to bridge the literature gap using the versatile zonal scoring system. Material and methods: This retrospective cohort study uses data from 751 COVID-19 RT-PCR+ patients. Concordantchest radiograph (CXR) scores were reported, and inter-rater reliability was measured using kappa indices. receiver operating characteristic curves were used to establish cut-off scores for the outcomes of interest: mild or severe disease, admission to an intensive care unit (ICU), and intubation. Categorical data were expressed using means and percentages, and c2 or t-tests were used for comparison at an a level of 0.05. Unadjusted odds ratios for each outcome of interest vs. CXR score and comorbidity were then calculated using binary logistic regression. Results: CXR findings included infiltrates (46.07%), pleural effusions (7.05%), consolidation and fibrosis (4.43%), pneumothoraces (2.71%), and cardiomegaly (2.26%). Most patients had an index CXR score of 0 (54.19%). The index cut-off score of ≤ 1 (82.95, 81.68) was established for mild disease, ≥ 4 for severe disease (85.71, 83.99), ≥ 3 for ICU admission (86.90, 71.91), and ≥ 4 for intubation (87.61, 72.90). Hypertension, type 2 diabetes mellitus, hypothyroidism, history of ischaemic heart disease, and history of tuberculosis were independent risk factors for a high CXR index score, intubation, and ICU admission. Conclusions: CXR scores can be effectively used in low-resource settings for triaging patients, maintaining records, and disease prognostication

Performance Analysis in Strength Training: An Innovative Instrumentation

In strength training, the performance of the athletes varies according to different objectives of the training. In this study, the performance of the athlete in strength training is defined as the torque and power generated to lift given loads. Electromyography (EMG) is utilized during the performance assessment to prevent muscle injuries. Over the past few years, athletic and clinical testing on performance analysis and enhancement have traditionally taken place in the laboratory due to the low portability of the equipment. With the rapid development in electronics miniaturization, instrumentation for such data acquisition can be constructed in mini and micro scale. Miniaturized instrumentations are designed to be unobtrusive to athletes’ movement during performance analysis and enhancement. On the other hand, the correlation between muscle activity and real-time data for performance assessment is critical for coaches and physiologists. With the aid of a miniaturized system that can correlate the muscle activity with performance, fatigue, impulse and total energy expenditure, coaches and physiologists can plan the most suitable training for athletes to achieve higher performance. In conclusion, this study focuses on the miniaturized instrumentation for the analysis of athletes’ performance in strength training

Probing Vibrationally Mediated Ultrafast Excited-state Reaction Dynamics With Multireference (caspt2) Trajectories

Excited-state trajectories computed at the complete active space second-order perturbation theory (CASPT2) reveal how vibrational excitation controls the molecular approach to the intersection space that drives the photodissociation of a prototypical halogenated methyl radical, namely CF2I. Translating the Franck-Condon structure along the ground-state CASPT2 vibrational modes in this system followed by propagating the displaced structures in the first excited doublet state simulates specific vibrational excitations and vibrationally mediated dynamics, respectively. Three distinct situations are encountered: the trajectories (i) converge to an energetically flat segment of the intersection space, (ii) locate a segment of the intersection space, and (iii) access a region where the intersection space degeneracy is lifted to form a ridge of avoided crossings. The computational protocol documented herein can be used as a tool to design control strategies based on selective excitation of vibrational modes, including adaptive feedback schemes using coherent light sources

Privacy in VANET using Shared Key Management

Abstract: Vehicular Ad-Hoc Networks (VANET) are very likely to be emerged in the coming years. The main objective of this paper is to provide privacy in VANET using shared distributed key management. In shared key management, a short group signature scheme is used to facilitate the revocation of malicious vehicles and heterogeneous security policies. In this framework, road side unit (RSU) acts as the key distributor. A new problem encountered is that a RSU may misbehave. A secure key distribution protocol is used to detect such misbehaved RSUs. The protocol guarantees the traceability of compromised RSUs and malicious vehicles. Moreover, the issue of large computation overhead is also addressed in this paper. A group authentication protocol is proposed to mitigate the communication and computation overhead that occur while using the group signature scheme. Here only a small number of vehicles participate in verification process. Keywords: VANET, privacy, shared key management, Road side units, ad-hoc networks I INTRODUCTION VANET is a form of ad-hoc network that enables communications between nearby vehicles (V2V communications) and the road-side infrastructure (V2I communications).In other words , VANET is a special kind of mobile ad-hoc networks where wireless equipped vehicles form a network. VANET research came into existence with the Fleet-Net project in mid 2001. The main aim of that was to develop a communication platform for inter-vehicle communication. Privacy is an important issue in VANETS II BACKGROUND KNOWLEDGE A VANET is a form of MANET which provides communication between vehicles and between vehicles and road-side base stations. A vehicle in VANET is considered to be an intelligent mobile node capable of communicating with its neighbors and other vehicles in the network. VANET is mainly designed to provide safety related information, traffic management, and infotainment services. Privacy and security are the two important issues in VANET. Without security, a Vehicular Ad Hoc Network (VANET) system is wide open to a number of attacks such as propagation of false warning messages as well as suppression of actual warning messages, thereby causing accidents. Another form of attack in VANET is tracking. This makes security and privacy a factor of major concern in building such networks. There have been several proposals for privacy preservation of VANETs. Some of them are using pseudonyms, silent period [4], mix-zones [3] etc. Each vehicle in a mix zone will keep silent in transmission, and randomly update its pseudonyms when it travels out of the mix zone and becomes reactivated. Given a reasonable large mix zone, the location privacy can be well protected due to the untraceability of location and pseudonym updating in the silent period. In the AMOEBA [5], vehicles form groups. The messages of all group members are forwarded by the group leader, which implies that the privacy of group members is protected by sacrificing the privacy of group leader. Moreover, if a malicious vehicle is selected as a group leader, all group members' privacy may be leaked by the malicious leader. While the pure pseudonym schemes do not support the secure functionality of authentication, integrity, and nonrepudiation, an anonymous signing protocol [1] is proposed to provide such functions as well as privacy. In the protocol, each vehicle preloads a large number of certificated anonymou

Assessment of myofascial pain syndrome among married female healthcare workers: a cross sectional comparative study in a tertiary care centre

Background: Myofascial pain syndrome (MPS) is common among females between ages 20-40 years. Psychosomatic and mechanical reasons are attributed as causative factors. Female health care workers (FHW) in hospitals with rapid patient turn over are vulnerable to develop MPS. Our aim was to ascertain the prevalence of MPS in married FHW working in various departments of the hospital and its association with poor sleep and work stress. Methods: We selected married FHWs in 20-50 years age group and divided them into two groups, medical and paramedical (those involved directly and indirectly with patient care respectively). MPS was diagnosed after detailed personal interview and clinical examination. Sleep duration was divided into less than 5 hours and more than 5hours. Presence of work-related stress and other medical parameters were also recorded. Results: A total of 150 medical and 150 paramedical FHWs were included in the study. Overall prevalence of MPS among FHWs was 42%, of which, medical group was 32% and paramedical was 52%. The paramedical group showed significantly higher prevalence of MPS (p: 0.02). Sleep was less than 5 hours in 29.3% of medical FHW and 13.3% of paramedical. This difference didn’t show any association to MPS (p=0.8). 38% FHW perceived excessive work stress, 40% were paramedical and 36% were medical. This didn’t correlate with prevalence of MPS (p=0.2) among them. Conclusions: Paramedical FHW experienced more MPS than medical and it was more of mechanical type and not due to work stress or sleep deprivation

Community awareness, use and preference for pandemic influenza vaccines in Pune, India

Vaccination is a cornerstone of influenza prevention, but limited vaccine uptake was a problem worldwide during the 2009–2010 pandemic. Community acceptance of a vaccine is a critical determinant of its effectiveness, but studies have been confined to high-income countries. We conducted a cross-sectional, mixed-method study in urban and rural Pune, India in 2012–2013. Semi-structured explanatory model interviews were administered to community residents (n=436) to study awareness, experience and preference between available vaccines for pandemic influenza. Focus group discussions and in-depth interviews complemented the survey. Awareness of pandemic influenza vaccines was low (25%). Some respondents did not consider vaccines relevant for adults, but nearly all (94.7%), when asked, believed that a vaccine would prevent swine flu. Reported vaccine uptake however was 8.3%. Main themes identified as reasons for uptake were having heard of a death from swine flu, health care provider recommendation or affiliation with the health system, influence of peers and information from media. Reasons for non-use were low perceived personal risk, problems with access and cost, inadequate information and a perceived lack of a government mandate endorsing influenza vaccines. A majority indicated a preference for injectable over nasal vaccines, especially in remote rural areas. Hesitancy from a lack of confidence in pandemic influenza vaccines appears to have been less of an issue than access, complacency and other sociocultural considerations. Recent influenza outbreaks in 2015 highlight a need to reconsider policy for routine influenza vaccination while paying attention to sociocultural factors and community preferences for effective vaccine action

Public Health Policy and Experience of the 2009 H1N1 Influenza Pandemic in Pune, India.

BACKGROUND: Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness. METHODS: Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune. RESULTS: In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune. CONCLUSION: The World Health Organization's (WHO's) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies

Public Health Policy and Experience of the 2009 H1N1 Influenza Pandemic in Pune, India

Abstract Background: Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness. Methods: Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune. Results: In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune. Conclusion: The World Health Organization’s (WHO’s) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies