Evaluation of Medical Officers' Certificate Programme (MOCP) Course Competency Based Learning

Medical Officers' Certificate Programme (MOCP) is a 6 months training programme in Pediatrics/Medicine at Medical colleges wherein doctors work like postgraduate students, learn various OPD, IPD, (Out Patients and In Patient Department) procedures, attain hands on skills, perform day and night duties, attend postgraduate training programmes and specialty clinics. This is a course unique to Maharashtra. It has been designed to overcome shortage of Pediatrians & Physicians in the state. Public Health Dept deputed 28 Medical Officers of Primary Health Centers to various Medical Colleges. At the end of 6 months training course they were evaluated during 2012-2013.It was done by questionnaire used before and after training. It was observed that OPD increased by 24% and IPD by 54%. There was a decrease in the number of cases referred to tertiary centers by 24%, post MOCP training. Infant immunization increased by 35% after training. Number of children with severe acute malnutrition/moderate acute malnutrition treated increased by 22%, neonatal emergencies, resuscitation, sepsis, jaundice patients treated, increased by 36%. No of adults with diarrhoea and snake bite treated increased by 40% & 63% respectively. No. of ECGs taken and myocardial infarctions managed also has shown rising trend. Thus, there was tremendous benefit to the patients after MOCP training. Skill of doctors was found to have enhanced. It is therefore recommended that such novel trainings should be imparted in other states of India too

Reforming electricity rates to enable economically competitive electric trucking

The imperative to decarbonize long-haul, heavy-duty trucking for mitigating both global climate change as well as air pollution is clear. Given recent developments in battery and ultra-fast charging technology, some of the prominent barriers to electrification of trucking are dissolving rapidly. Here we shed light on a significant yet less-understood barrier, which is the general approach to retail electricity pricing. We show that this is a near term pathway to 0.06/kWh charging costs that will make electric trucking substantially cheaper than diesel. This pathway includes (i) reforming demand charges to reflect true, time-varying system costs; (ii) avoiding charging during a few specific periods (<45 h in a year) when prices are high; and (iii) achieving charging infrastructure utilization of 33% or greater. However, without reforming demand charges and low utilization of charging infrastructure, charging costs more than quadruple (to 0.28/kWh). We also illustrate that a substantial share of current trucking miles within select large regions of the United States can be reliably electrified without constraining electricity generation capacity as it exists today. Using historical hourly electricity price and load data for last 10 years and future projections in Texas and California, we show that electricity demand is at least 10% lower than yearly peak demand for at least 15 h on any given day. In sum, with electricity rates that closely reflect actual power system costs of serving off-peak trucking load, we show that electric trucks can provide overwhelming cost savings over diesel trucks. For reference, at diesel prices of $3.16/gal and charging costs of$0.06/kWh (inclusive of amortized charging station infrastructure costs), an electric truck's fuel cost savings are $251 000 (NPV), providing net savings of$61 000 (18% of lifetime diesel fuel cost) over the truck's lifetime at battery price of $170/kWh, or up to$148 000 (44% of lifetime diesel fuel cost) at a battery price of $100/kWh (figure 1)

Cardan angle rotation sequence effects on first-metatarsophalangeal joint kinematics: implications for measuring hallux valgus deformity

BACKGROUND: There currently are no recommended standards for reporting kinematics of the first-metatarsophalangeal joint. This study compared 2 different rotation sequences of Cardan angles, with implications for understanding the measurement of hallux valgus deformity. METHODS: Thirty-one women (19 hallux valgus; 12 controls) participated. All were scanned in an open-upright magnetic resonance scanner, their foot posed to simulate the gait conditions of midstance, heel-off, and terminal stance. Using computer processes, selected tarsals were reconstructed into virtual bone models and embedded with principal-axes coordinate systems, from which the rotation matrix between the hallux and first metatarsal was decomposed into Cardan angles. Joint angles were then compared using a within factors (rotation sequence and gait condition) repeated-measures analysis of variance (ANOVA). RESULTS: Only the transverse plane-first sequence consistently output incremental increases of dorsiflexion and abduction across gait events in both groups. There was an interaction (F ≥ 25.1; p < 0.001). Follow-up comparisons revealed angles were different (p < 0.05) at terminal stance. CONCLUSIONS: Different rotation sequences yield different results. Extracting the first rotation in the transverse plane allows for the resting alignment of the hallux to deviate from the sagittal plane. Therefore, representing first-metatarsophalangeal joint kinematics with the transverse plane-first rotation sequence may be preferred, especially in cases of hallux valgus deformity

The Porcellini test: a novel test for accurate diagnosis of posterior labral tears of the shoulder: comparative analysis with the established tests

Questions/purposes: Although the posterior labral tears of the shoulder are known for their disabling clinical course, especially in overhead athletes, no clinical test used in isolation can diagnose it accurately in the preoperative period. We wanted to: (1) introduce “Porcellini test” with its radiological verification furnishing the anatomical basis of its mechanism; (2) determine its accuracy; and (3) compare its accuracy with that of the other established tests for diagnosing posterior labral tears of the shoulder. Methods: To determine the anatomical basis, we initially performed radiological verification of our test. Then, we evaluated its accuracy in a retrospective case-controlled study on 310 consecutive patients who underwent shoulder arthroscopic procedures at our hospital between January 2013 and December 2013. All patients were examined preoperatively for Porcellini test, and the presence of posterior labral tear was confirmed on arthroscopy. Later, in a cohort study on 91 consecutive patients who underwent shoulder arthroscopic procedures, we compared its accuracy with O’Brien’s test, the Kim test, the Jerk test, and the Load and Shift test. The accuracy was interpreted in terms of sensitivity, specificity, and predictive values. Results: The radiological verification conferred the anatomical basis for the mechanism of the Porcellini test. This new test showed high accuracy for posterior labral tears with sensitivity of 100 %, specificity of 99.3 %, the positive and negative predictive values of 92.6 and 100 %, respectively. Also, it had superior accuracy results than every other test. The interexaminer reliability for all test results was found to be >0.80. Conclusions: We propose “Porcellini test” as a simple, accurate, reproducible, and reliable test for the preoperative diagnosis of posterior labral tears of shoulder

Seasonal Variation of Calving in Murrah Buffalo in Bihar

The present study was carried out to estimate the seasonal variation of calving in Murrah buffaloes. The study was conducted in North West alluvial plain of Bihar (Chappra, Siwan and Samastipur), of India on 773 Murrah buffaloes, and these buffaloes were inseminated during June 2010 to December 2014 at BAIF's field Artificial Insemination centres which provide door-step artificial insemination service at village's level. The result indicated that the calving of Murrah buffaloes occurred throughout the year. In Chhapra maximum calving observed in August, i.e. 17% while 14% in October. September and November 13% each. Based on season majority of calving observed between July to January. In Samastipur maximum calving observed in August 16% while in September 14 % followed by November 13% and October month 11%. Based on season majority of calving observed between July to January months. In Samastipur maximum calving observed in August 16% while in September 14% followed by November 13% and October 11%. Based on season majority of calving found between July to January months. It could be concluded that Murrah buffaloes tend to calve more in the days with shorter photoperiod as compared to days with more extended photoperiod

Quality engineering of a traction alternator by robust design

Robust design is an engineering methodology for improving productivity during research and development so that high-quality products can be developed and produced quickly and at low cost. A large electrical company was developing traction alternators for a diesel electrical engine. Customer requirement was to obtain very high efficiency which, in turn, was influenced by several design parameters. The usual approach of the 'design-build-test' cycle was considered time-consuming and costly; it used to take anywhere from 4 months to 1 year before finalizing the product design parameters as it involved physical assembly and also testing. Instead, the authors used Taguchi's parameter design approach. This approach took about 8 weeks to arrive at optimum design parameter values; clearly demonstrating the cutting edge of this methodology over the traditional design-build-test approach. The prototype built and tested accordingly gave satisfactory overall performance, meeting and even exceeding customer requirements

Vulnerability analysis of satellite-based synchronized smart grids monitoring systems

The large-scale deployment of wide-area monitoring systems could play a strategic role in supporting the evolution of traditional power systems toward smarter and self-healing grids. The correct operation of these synchronized monitoring systems requires a common and accurate timing reference usually provided by a satellite-based global positioning system. Although these satellites signals provide timing accuracy that easily exceeds the needs of the power industry, they are extremely vulnerable to radio frequency interference. Consequently, a comprehensive analysis aimed at identifying their potential vulnerabilities is of paramount importance for correct and safe wide-area monitoring system operation. Armed with such a vision, this article presents and discusses the results of an experimental analysis aimed at characterizing the vulnerability of global positioning system based wide-area monitoring systems to external interferences. The article outlines the potential strategies that could be adopted to protect global positioning system receivers from external cyber-attacks and proposes decentralized defense strategies based on self-organizing sensor networks aimed at assuring correct time synchronization in the presence of external attacks

Evaluation of Medical Officer Certificate Programme Course Competency Based Learning

Background: Medical Officer Certificate Programme (MOCP) is a 6 months training programme in Pediatrics/Medicine at medical colleges wherein doctors work like postgraduate students, learn various Out Patients and In Patient Department (OPD and IPD) procedures, attain hands on skills, perform day and night duties, attend postgraduate training programmes and specialty clinics. This is a course unique to Maharashtra. It has been designed to overcome shortage of Pediatricians and Physicians in the state. Objective: To evaluate the efficacy of MOCP courses for medical officers by finding out if their clinical skills have improved and if they have achieved expected level of competence. Methods: Public Health Department deputed 28 medical officers of primary health centers. At the end of 6 months training course, they were evaluated during 2012-2013. Results: OPD increased by 24% and IPD by 54%. There was a decrease in the number of cases referred to tertiary centers by 24%, post-MOCP training. Infant immunization increased by 35% after training. Number of children with severe acute malnutrition/moderate acute malnutrition treated increased by 22%, treatment of neonatal emergencies, resuscitation, sepsis, jaundice increased by 36%. Number of adults with diarrhoea and snake bite treated increased by 40% and 63% respectively. Number of ECGs taken and myocardial infarctions managed also has shown rising trend. Conclusion: There was tremendous benefit to the patients after MOCP training. Skill of doctors was found to have enhanced. It is therefore recommended that such novel trainings should be imparted in other states of India too