R. Bhattacharya

<h3>Importance</h3> Following surgery to treat major trauma–related fractures, deep wound infection rates are high. It is not known if negative pressure wound therapy can reduce infection rates in this setting. <h3>Objective</h3> To assess outcomes in patients who have incisions resulting from surgery for lower limb fractures related to major trauma and were treated with either incisional negative pressure wound therapy or standard wound dressing. <h3>Design, Setting, and Participants</h3> A randomized clinical trial conducted at 24 trauma hospitals representing the UK Major Trauma Network that included 1548 patients aged 16 years or older who underwent surgery for a lower limb fracture caused by major trauma from July 7, 2016, through April 17, 2018, with follow-up to December 11, 2018. <h3>Interventions</h3> Incisional negative pressure wound therapy (n = 785), which involved a specialized dressing used to create negative pressure over the wound, vs standard wound dressing not involving negative pressure (n = 763). <h3>Main Outcomes and Measures</h3> The primary outcome measure was deep surgical site infection at 30 days diagnosed according to the criteria from the US Centers for Disease Control and Prevention. A preplanned secondary analysis of the primary outcome was performed at 90 days. The secondary outcomes were patient-reported disability (Disability Rating Index), health-related quality of life (EuroQol 5-level EQ-5D), surgical scar assessment (Patient and Observer Scar Assessment Scale), and chronic pain (Douleur Neuropathique Questionnaire) at 3 and 6 months, as well as other local wound healing complications at 30 days. <h3>Results</h3> Among 1548 participants who were randomized (mean [SD] age, 49.8 [20.3] years; 561 [36%] were aged ≤40 years; 583 [38%] women; and 881 [57%] had multiple injuries), 1519 (98%) had data available for the primary outcome. At 30 days, deep surgical site infection occurred in 5.84% (45 of 770 patients) of the incisional negative pressure wound therapy group and in 6.68% (50 of 749 patients) of the standard wound dressing group (odds ratio, 0.87 [95% CI, 0.57 to 1.33]; absolute risk difference, −0.77% [95% CI, −3.19% to 1.66%];<i>P</i> = .52). There was no significant difference in the deep surgical site infection rate at 90 days (11.4% [72 of 629 patients] in the incisional negative pressure wound therapy group vs 13.2% [78 of 590 patients] in the standard wound dressing group; odds ratio, 0.84 [95% CI, 0.59 to 1.19]; absolute risk difference, −1.76% [95% CI, −5.41% to 1.90%];<i>P</i> = .32). For the 5 prespecified secondary outcomes reported, there were no significant differences at any time point. <h3>Conclusions and Relevance</h3> Among patients who underwent surgery for major trauma–related lower limb fractures, use of incisional negative pressure wound therapy, compared with standard wound dressing, resulted in no significant difference in the rate of deep surgical site infection. The findings do not support the use of incisional negative pressure wound therapy in this setting, although the event rate at 30 days was lower than expected. <h3>Trial Registration</h3> isrctn.org Identifier:ISRCTN12702354

The synthetic chemists always look for developing new catalysts, sustainable catalysis, and their applications in various organic transformations. Herein, we report a new class of water-soluble complexes, (Ar-tpy)RuII(ACN)3, utilizing designed terpyridines possessing electron-donating and -withdrawing aromatic residues for tuning the catalytic activity of the Ru(II) complex. These complexes displayed excellent catalytic activity for several oxidative organic transformations including late-stage C–H functionalization of aldehydes with NH2OR to valuable primary amides in nonconventional aqueous media with excellent yield. Its diverse catalytic power was established for direct oxo-scissoring of a wide range of alkenes to furnish aldehydes and/or ketones in high yield using a low catalyst loading in the water. Its smart catalytic activity under mild conditions was validated for dioxygenation of alkynes to highly demanding labile synthons, 1,2-diketones, and/or acids. This general and sustainable catalysis was successfully employed on sugar-based substrates to obtain the chiral amides, aldehydes, and labile 1,2-diketones. The catalyst is recovered and reused with a moderate turnover. The proposed mechanistic pathway is supported by isolation of the intermediates and their characterization. This multifaceted sustainable catalysis is a unique tool, especially for late-stage functionalization, to furnish the targeted compounds through frequently used amidation and oxygenation processes in the academia and industry.

A systematic study is undertaken to investigate the less explored endo-trig radical cyclization in activated olefin-appended epoxides using Cp2TiCl. The radical generated by the Ti(III)-promoted reductive opening of the epoxy ring promptly underwent endo-trig cyclization, giving access to differently 1,3-disubstituted six- and seven-membered carbocycles in good yields and diastereoselectivity. This protocol was successfully employed in the construction of 5,7- and 6,7-fused bicyclic frameworks entailing a de novo synthesis of (±)-isoclavukerin A belonging to tri-nor-guaiane class of sesquiterpene natural products in eight simple steps from commercially available starting materials. Besides the Ti(III)-mediated reaction serving as a key step in the synthesis, a sequential [2,3]-sigmatropic rearrangement/syn-elimination of an allyl sulfenate intermediate successfully rendered the highly constrained diene moiety in the hydroazulene core of the target molecule.

Eleven patients with a chronic acromio-clavicular joint disruption underwent acromio-clavicular joint stabilisation using the Nottingham Surgilig and were followed up clinically and radiologically for an average of 24 months post operation. The mean post-operative Constant score was 83.1, the Imatani score was 81.2 and the Walsh score was 14.1. Eighty-two per cent of patients were satisfied with the operation. There was one case of rupture through the central portion of the Surgilig, and following laboratory analysis, the ligament has been modified since. In 4 patients there was evidence of loosening of the screw but only one complained of this being a problem. This short-term outcome analysis of the Nottingham Surgilig is the first such report outside the Nottingham unit where the prosthesis was originally developed. Our results are encouraging and justify further use and evaluation of this relatively new technique.

We have systematically studied the effect of swift heavy ion bombardment on surface morphologies of nanocrystalline ferrite thin films using atomic force microscopy (AFM) technique. From TRIM calculation, 150 MeV Ni11+ ions and 100 MeV Ag7+ ions have been selected to suffice the two irradiation conditions namely Se < Seth and Se ∼ Seth, respectively. Nanocrystalline films of Li0.5Mn0.1Fe2.4O4 have been grown on Si(1 0 0) substrate by using rf magnetron sputtering technique. Implementation of the first condition (150 MeV Ni11+ ions) resulted in irradiation induced growth in the grain volumes at the fluence of 2.5 × 1012 ions/cm2. The results of the second experimental condition (100 MeV Ag7+ ions) are entirely different showing deep ditches (holes) and channels on the surfaces. Online elastic recoil detection analysis (ERDA) has been performed to observe the effects on preferential loss of the elements in the films.

Respiration rate is monitored in most diseases, especially ones like sleep apnea and respiratory arrest. However, most devices available for monitoring are expensive, fragile and often need trained staff for operation. For obvious reasons, constantly monitoring the patient's breathing rate is also not feasible and our proposed module tends to modify this scenario. The hardware module uses a thermistor to monitor the patient's breathing rate. This is less costly, and also involves low power consumption as well as robust performance. The device also uses cloud computing to transmit the data to the doctor's smartphone app as well as to the patient's relatives' correspondence. A buzzer attached to the system notifies nearby medics in case of abnormal breathing rates. The device is specially adapted to suit rural Indian conditions. The prototype has been substantiated for accurate monitoring of breathing rates through the standard tests.

Nanocrystalline Li0.25Mg0.5Mn0.1Fe2.15O4 ferrite thin films, prepared by R.F. magnetron sputtering technique, are irradiated with 190 MeV Au14+ ions. The significant behavioural changes in magnetic and electrical properties of thin films after swift heavy ion irradiation confirm the formation of stable defects. A transformation from ferrimagnetic to superparamagnetic behaviour is observed from CEMS (conversion electron Mössbauer spectroscopy) with increase in fluence from 2.5 × 1012 to 1 × 1013 ions/cm2. The resistivity initially increases after irradiation till the fluence reaches 1 × 1012 ions/cm2 and then reduces with further increase in fluence. We have also studied the X-ray diffraction pattern with fluence variation. A possible explanation of the above results on the basis of thermal spike model is presented. These effects are mainly due to amorphized latent tracks and variation in the cation distribution due to heavy ion irradiation.

Abstract. Solar diffuse radiation data including global radiation, shortwave and longwave balances, net radiation and sunshine hours have been extensively analyzed to study the variation of diffuse radiation with turbidity and cloud discharges appearing in the form of atmospherics over the tropics. Results of surface radiation measurements at Calcutta, Poona, Delhi and Madras are presented together with some meteorological parameters. The monthly values of diffuse radiation and the monthly ratios of diffuse to global solar radiation have been examined, with a special emphasis in relation to the noise level of atmospherics at Calcutta in the very low frequency band. The results exhibit some definite seasonal changes which appear to be in close agreement with one another.

The effects of re-infusion drains on the rate of allogeneic blood transfusion and post-op haemoglobin levels in Total Knee Arthroplasty were examined. A group of 22 patients undergoing primary Total Knee Arthroplasty using a CBCII Constavac Stryker re-infusion drainage system were compared with a group of 30 patients, matched for age, sex and type of prosthesis but without any drain usage. The re-infusion drain.group had a significantly lower day 1 and day 3 post-operative haemoglobin compared to the non-drainage group. The re-infusion drain group had a higher allogenic transfusion rate compared to the non-drainage group. There were no significant differences between the two groups regarding the rate of wound and transfusion related complications and mean length of post-operative stay. We found that reinfusion drains were ineffective in reducing allogeneic transfusion requirements as compared with non-drainage in total knee arthroplasty.

The rainrate distributions obtained from rapid response rain gauge measurements over five different locations in India are presented. On the basis of simultaneous observations of rainrate measured by rain gauges having integration times of 10 seconds and 15 minutes, a power law has been established. Rain attenuation characteristics at 11GHz were analysed and some interesting results are presented, which are also compared with International Radio Consultative Committee and other models. Attenuations due to water vapour are deduced for a frequency range of 1-350GHz at elevation angles 3 and 10 . The attenuation due to water vapour at a lower elevation angle is found to increase as the tropospheric effects become dominant. It can also be seen that the antenna temperature attains a peak value of about 160K in the monsoon months and a minimum of about 80 K during the winter. The monthly variation of antenna temperature reveals a similar variation for the attenuation and water vapour content.

This paper reviews the literature on attenuation of mm-wave due to rain and rain rate prediction methods to analyze the performance of the various systems proposed by different workers at different parts of the globe under varying meteorological and topographical conditions with an emphasis on the observational reports made in the tropics, particularly in the Indian subcontinent. In this comprehensive review, besides considering the various features related to rain rate, the various methods proposed for prediction of rain attenuation have been examined and thereby a comparison of those prediction methods is made. Finally, scopes for future investigation have been critically focused.

Musculoskeletal symptoms, visual fatigue and stress are the common health hazards among the computer users. The objective of this study is to compute the level of risk among the computer users using Rapid Upper Limb Assessment (RULA) method. Working postures are recorded with 10 participants having age range from 25 to 33. It is observed that more than 70% postures are harmful for prolonged use of computer and for not maintains any work-rest schedule. However ergonomics improvement may help to reduce the problems.

We establish a sample of 370 Mira variables that are likely near the Galactic center (GC). The sources have been selected from the OGLE and BAaDE surveys based on their sky coordinates, OGLE classifications, and BAaDE maser-derived line-of-sight velocities. As the distance to the GC is known to a high accuracy, this sample is a test bed for reddening and extinction studies toward the GC and in Mira envelopes. We calculated separate interstellar- and circumstellar-extinction values for individual sources, showing that there is a wide range of circumstellar extinction values (up to four magnitudes in the K s band) in the sample, and that circumstellar reddening is statistically different from interstellar reddening laws. Further, the reddening laws in the circumstellar environments of our sample and the circumstellar environments of Large Magellanic Cloud (LMC) Miras are strikingly similar despite the different metallicities of the samples. Period-magnitude relations for the mid-infrared (MIR) WISE and MSX bands are also explored, and in the WISE bands we compare these to period-magnitude relationships derived from Miras in the LMC as it is important to compare these LMC relations to those in a higher metallicity environment. Emission from the envelope itself may contaminate MIR magnitudes altering the relations, especially for sources with thick envelopes.

We establish a sample of 370 Mira variables that are likely near the Galactic center (GC). The sources have been selected from the OGLE and BAaDE surveys based on their sky coordinates, OGLE classifications, and BAaDE maser-derived line-of-sight velocities. As the distance to the GC is known to a high accuracy, this sample is a test bed for reddening and extinction studies toward the GC and in Mira envelopes. We calculated separate interstellar- and circumstellar-extinction values for individual sources, showing that there is a wide range of circumstellar extinction values (up to four magnitudes in the K$_s$ band) in the sample, and that circumstellar reddening is statistically different from interstellar reddening laws. Further, the reddening laws in the circumstellar environments of our sample and the circumstellar environments of Large Magellanic Cloud (LMC) Miras are strikingly similar despite the different metallicities of the samples. Period-magnitude relations for the mid-infrared (MIR) WISE and MSX bands are also explored, and in the WISE bands we compare these to period-magnitude relationships derived from Miras in the LMC as it is important to compare these LMC relations to those in a higher metallicity environment. Emission from the envelope itself may contaminate MIR magnitudes altering the relations, especially for sources with thick envelopes.

The lyoluminescence yield in γ-irradiated glucose, lactose and mannose has been studied, to look for the effect of mass at different doses and solvent pHs on the yield. It is seen that the light yield per mg (Y/m) is different for different solute masses and its nature of variation with mass is independent of irradiation dose and solvent pH. Further, Y/m is independent of pH in the range 4–9. No significant dependence of Y/m on solute mass is found above a certain mass, the level-off point. Estimation of a dose, when it is necessary to be carried out by using a solute mass below the level-off point, therefore, has to be made with reference to the particular Y/m vs dose curve drawn for that solute mass.

Abstract. The records of VLF atmospherics over Calcutta and then over Kalyani (West Bengal) during the torrential rainfall, caused by violent monsoon and post-monsoon depressions, exhibit distinct long-period fadings both at day and night. Interesting results obtained from an analysis of round-the-clock atmospherics data and associated meteorological parameters are reported in this paper. A possible correlation between the severe meteorological activity with the solar geophysical phenomena was studied. The results are indicative of an interesting sequence of solar-terrestrial events. A tentative conclusion is reached, suggesting an origin of the fading from atmospheric gravity waves generated in the centre of activity of the depressions concerned.Key words. Meteorology and atmospheric dynamics · Lightning · Precipitation

In this paper, some exact solutions of Einstein–Dirac–Maxwell zero mass scalar field equations are given.

<h2>Abstract</h2> <i>Aims</i> The aim of this study was to assess functional outcome, at medium-term follow up, in patients undergoing intra-medullary nailing of tibial shaft fractures, using the supra-patellar approach. <i>Materials and methods</i> The study included patients with intra-medullary nailing, for diaphysial tibia fractures, between March 2013 to August 2015. An initial audit compared short-term functional outcomes at 15 months, between the supra and infra-patellar approaches, using a cohort of 20 patients (10 in each group). Subsequently, a larger cohort of 22 patients with supra-patellar nailing, were reviewed for medium term assessment of their functional outcomes at average 60 months (50 – 78 months) and the results between all 3 groups were compared. All patients were assessed using the Kujala and Oxford Knee Scores. <i>Results</i> The mean age of the cohorts was 38 years (18-87years). The mean follow-up was 15 months for the initial audit and 60 months for the medium-term results. The initial audit showed that the supra-patellar group had statistically significantly better Oxford and Kujala scores when compared to infra-patellar group (p < 0.05). At 5 years following supra-patellar nailing, the medium-term cohort showed improved outcome scores compared to the infra-patellar group at 1 year (p < 0.01) but showed no difference with the supra-patellar group at 1 year (p value >0.1). <i>Conclusion</i> Our study suggests that patients undergoing supra-patellar tibial nailing have better outcomes at 15 months compared to traditional infra-patellar nailing and more importantly, they continue to do well even at 5 years, despite perceived risks associated with this technique.

The bone quality of patients undergoing hip replacement surgery is poorly predicted by radiographs alone. With better bone quality information available to a surgeon, the operation can be performed more safely. The aim of this study was to investigate whether ultrasound signals of cortical bone at peripheral sites such as the tibia and radius can be used to predict the compressive mechanical properties of cortical bone at the femoral neck. We recruited 19 patients undergoing elective hip arthroplasty and assessed the radius and tibia of these patients with the Azalée guided wave ultrasound to estimate the porosity and thickness of the cortex. Excess bone tissues were collected from the femoral neck and the compressive mechanical properties of the cortex were characterised under a mechanical loading rig to determine stiffness, ultimate strength, and density. The correlations between the ultrasound measurements and mechanical properties were analysed using linear regression, Pearson correlation statistics, and multiple regression analysis. Cortical mechanical properties were weakly to moderately correlated with the ultrasound measurements at various sites (R2 = 0.00–0.36). The significant correlations found were not consistent across all 4 peripheral measurement sites. Additionally, weak to moderate ability of the ultrasound to predict mechanical properties at the neck of femur with multiple regression analysis was found (R2 = 0.00–0.48). Again, this was inconsistent across the different anatomical sites. Overall, the results demonstrate the need for ultrasound scans to be collected directly from clinically relevant sites such as the femoral neck due to the inconsistency of mechanical properties across various sites.

The decay times of lyoluminescent NaCl, KCl and KBr have been measured using the photon counting technique. It is seen that there are two decay components for all these halides. The conventional light emission mechanism does not seem to explain more than one decay. A possible explanation of the origin of the two decay components is presented.

Nitrous oxide (N O) emissions from winter wheat field were measured using closed chamber technique during 2012-2013 and 2 o o 2013-2014 at Bidhan Chandra Krishi Viswavidyalaya farm (22 572 N latitude, 88 202 E longitude). Experiment was conducted th th taking two winter wheat varieties (K0307 and KRL-288) with two dates of sowing (15 November and 30 November) and two nutritional traits (100% inorganic and 50% organic + 50% Inorganic). The aim of the experiment was to evaluate the effect of crop eco- climate and sunshine hours on nitrous oxide emission rate from wheat field. Experimental results showed that canopy temperature and sunshine hours directly affect N O efflux at different phenophases of wheat under different treatment 2 combinations. Whereas during active vegetative stage variety-K0307 responded positive relation for N O emission with canopy 2 temperature and sunshine hours. But for both nutritional approaches similar response was observed during active vegetative st stage as well as advance reproductive stage. Results imply that 1 sowing with K0307 and 100% inorganic and 50% organic + 50% inorganic fertilization had some effective responses towards microclimatic variation as well as ambient sunshine hours. Moreover, wheat productivity had some association with N O emission rate. 2

The intensification of tornado depends mainly on the synoptic conditions of the troposphere. The main objective of this paper is to differentiate the prevalent atmosphere from thermodynamically point of view. Atmospheric stability parameters such as Lifted Index (LI), Total Total Index (TT), Deep Convective Index (DCI), Wind Index (WI), Severe Weather Threat Index (SWEAT), Convective Available Potential Energy (CAPE), Convective Inhibition (CIN) and Bulk Richardson Number (BRN) are computed on the tornado events over NE India and Bangladesh from 1993 to 2010. It is observed that TT may be used as a best predictor of differentiating prevalent atmosphere from fair one.

The lyoluminescence decay times of γ-irradiated saccharides (mannose, glucose, lactose and trehalose dihydrate) have been measured by employing photon counting technique. It is observed that all the saccharides show three decay components for all the doses studied. It is also seen that the decay times and their corresponding intensities do not depend on the irradiation dose. Attempts have been made to correlate the results with the findings from ESR measurements.

In view of the contradictory reports of various investigators, the mass effect in radiation-induced lyoluminescence has been reinvestigated using a photon-counting technique. It is seen that the mass effect is present in both the disaccharide materials investigated, viz. sucrose and trehalose dihydrate. A likely cause of the effect may lie in the free radicals getting quenched in solution due to molecular aggregation at larger masses when the recombined nonradical product (due to radical-radical interaction) increases. This results in a decrease in LL yield with an increase of solute mass.

physica status solidi (a)Volume 144, Issue 1 p. K27-K30 Short Note Mössbauer studies on the precipitates of Fe(OH)3 and KFeIII[FeII(CN)6] S. Kumar, S. Kumar Department of Physics, Calcutta University Search for more papers by this authorK. Maiti, K. Maiti Department of Physics, Calcutta University Search for more papers by this authorS. Bhattacharya, S. Bhattacharya Department of Chemistry, Calcutta University Search for more papers by this authorD. Banerjee, D. Banerjee Department of Physics, Calcutta University Search for more papers by this authorK. C. Das, K. C. Das Department of Physics, Calcutta University Search for more papers by this authorR. Bhattacharya, R. Bhattacharya Department of Physics, Calcutta University Search for more papers by this author S. Kumar, S. Kumar Department of Physics, Calcutta University Search for more papers by this authorK. Maiti, K. Maiti Department of Physics, Calcutta University Search for more papers by this authorS. Bhattacharya, S. Bhattacharya Department of Chemistry, Calcutta University Search for more papers by this authorD. Banerjee, D. Banerjee Department of Physics, Calcutta University Search for more papers by this authorK. C. Das, K. C. Das Department of Physics, Calcutta University Search for more papers by this authorR. Bhattacharya, R. Bhattacharya Department of Physics, Calcutta University Search for more papers by this author First published: 16 July 1994 https://doi.org/10.1002/pssa.2211440132Citations: 3 92, Acharya Prafulla Chandra Road, Calcutta 700009, India. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 J. Th. G. Overbeek, in: Colloid Science, Vol 1, Ed. H. R. Kruyt, Elsevier Publ. Co., Amsterdam 1952 (p. 336). 2 J. Th. G. Overbeek, Cryst. Res. Technol. (p. 63) and references therein. 3 R. J. Hunter, Foundations of Colloid Science, Vol. 1, Clarendon Press, Oxford 1989 (p. 89). 4 S. Voitskii, Colloid Chemistry, Izd. Mir, Moscow 1978 (p. 344) (in Russian). 5 G. K. Wertheim, Mössbauer Effect Principles and Applications. Academic Press, New York/London 1971 (p. 10). 6 D. Nicholls, in: Comprehensive Inorganic Chemistry, Ed. A. F. Trotman-Dickenson, Pergamon Press, Oxford/New York/Toronto 1975 (p. 1040). 7 A. Pron et al., J. chem. Phys. 83, 5926 (1985). 8 S. Voitskii, see [4] ( p. 271). 9 S. Voitskii, see [4] ( p. 331). 10 K. Maer, Jr., M. L. Beaslay, R. L. Collins, and W. O. Milligan, J. Amer. Chem. Soc. 90, 3201 (1968). Citing Literature Volume144, Issue116 July 1994Pages K27-K30 ReferencesRelatedInformation

The shift of millimeter wave window frequencies owing to changes of water vapour concentration for four Indian stations having different climatic behaviours have estimated for horizontal mode of propagation. Difference in specific attenuation at minimum and maximum humidity for 94 GHz and corresponding window frequencies are also analysed.

The temperature dependence of lyoluminescent decay times in saccharides has been studied employing photon counting technique over a solvent (water) temperature range 10–90 °C. It is observed that the decay times of all the three components decrease with increase in temperature. An attempt has been made to explain the results on the basis of free radical recombination, rate of dissolution and molecular structure.

The effect of solvent temperature on the lyoluminescence yield in saccharides has been studied employing photon counting technique over a solvent temperature range 10–90°C. It is observed that yield per mg decreases with temperature in all the five saccharides. A qualitative explanation of the findings, on the basis of molecular structure, formation of collisional pairs and molecular aggregation, has been offered.

Background The worldwide incidence of trauma is increasing and the World Health Organisation has identified it as a major cause of clinical burden globally. Intramedullary nailing is a common orthopaedic procedure and is one of the definitive surgical treatments for open fractures of the lower limb. We piloted the first intraoperative intramedullary nailing scenario and to create a global rating scale for its assessment. Methodology 9 participants from different stages of orthopaedic training were recruited and attended a lecture showing all the steps required to perform the procedure. The scenario consisted of an Orthopaedic trainee being called into theatre to complete a trochanteric intramedullary nail with the help of a scrub nurse, runner and anaesthetist. Metrics were assessed for each participant by two senior orthopaedic trainees using a novel 16-point global rating score (range 1–5) for which the Cronbach alpha for inter-rater validity was calculated. Each participant was also individually debriefed after the exercise with their assessor for reflection and constructive feedback. Results 66% of participants were male (n = 6). The median level of training was post-graduate year 4 (range PG yrs 2–7), with experience of observing 10 cases, assisting in 10 cases and none had performed cases independently. Pre-and post-questionnaire results were both significant within the cohort (p = 0.013 and p Conclusions This is the first pilot study to validate an entire simulated intramedullary trochanteric nail under pressure within a multi-disciplinary team environment using a mobile theatre set up. The simulation scenario was found to have significant acceptability and a realistic global rating scale. This simulation scenario can also be reproducible anywhere since it is an out-of-box mobile operating theatre unit. References Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004;79(10 Suppl):S70–81 Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005;27(1):10–28 McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011;86:706–11 Reznick RK, MacRae H. Teaching surgical skills-changes in the wind. N Engl J Med 2006;21;355:2664–9

A summary map concerning the formation of depression and cyclonic storms over the North Indian Ocean in the year 2013 is first presented pointing out their names, durations and peak intensities. The cyclone Phailin originating from North Indian Ocean rapidly developed an eye when it was converted to a very severe cyclonic storm on October 10, 2013. Maximum sustained winds are estimated at 195 km/h, gusting to 295 km/h while minimum central pressure is estimated at 936 hPa with Dvorak intensity of the storm as T6.0. The system subsequently intensified and became equivalent to a category 5 hurricane. The locations of the movement of the cyclone Phailin as well as its satellite images have examined indicating incessant and torrential rainfall in many parts of Andaman Islands, Odisha, Andhra Pradesh and West Bengal during its whole journey. In association with the cyclone, we have analyzed the effect on VLF atmospherics at 27 kHz to observe the characteristic variation in the atmospherics record at Kalyani (22.98°N, 88.46°E), West Bengal showing that even when the severe cyclone was approaching from a sufficiently remote location towards West Bengal the fading pattern in the atmospherics record formed continuously suggesting that the severe disturbances may be responsible to influence the lower ionospheric layers and thus may cause temporary problem in radio communication.

Modulation of Cosmic Ray Intensity (CRI) depends to some extent on solar activity parameters e.g. planetary index, sunspot number, solar radio flux. Variation of CRI during descending and ascending phases of solar cycles 21 to 24 are analyzed to observe the intercorrelation of different parameters with CRI. For long term modulation of CRI, It is observed that both SRF and SSN may be the good indices.

Emission of nitrous oxide (N 2 O) from wheat field under various management practices was measured over two years. The experimental design consisted of two winter wheat ( Triticum austivum L.) varieties with three nutritional treatments and two dates of sowing. The results revealed that soil moisture and soil temperature at different depths are the key parameters influencing N 2 O emission. A positive increase of N 2 O flux was noticed with increasing soil moisture along with decreasing soil temperature at specific wheat phenophases. Maximum N 2 O was emitted at the flowering stage. Individual factors, viz. nutrient, date of sowing and variety, and an interactive combination of these factors significantly influenced N 2 O emission rates. It was also found that there was no significant association between wheat grain yield and seasonal N 2 O flux.

I would like to start off by thanking the British Orthopaedic Association for selecting me as the 2012 Austria Swiss German (ASG) Fellow from UK.

Tropical cyclone is affected mainly by steering flow, Rossby drift and surface frictional effects. There are many models to predict the storm track. In this paper two thermodynamic parameters SWEAT and ACE are analyzed to observe the variation of these two parameters along the track of two cyclonic storms MALA and BIJLI over the Bay of Bengal. Peak ACE is found on the third day of the cyclonic system MALA at 850 hPa whereas for BIJLI it is at 200 hPa. However more analysis is needed considering the other Bay cyclones before coming to a definite conclusion regarding the variational pattern of these two thermodynamic parameters.

Background/Aims Many trusts struggle to meet the government-mandated referral-to-treatment target of 18 weeks. The mass knee clinic model is an innovative approach to elective service organisation, allowing large numbers of new patients to be seen in one day in a multidisciplinary setting. This study describes a cost–benefit analysis of the mass knee clinic in an NHS trust. Methods Data were taken from trust management regarding the number of patients seen in the clinic and the staff required to deliver it. Staff and non-staff costs were calculated using data from NHS England. The costs per appointment were calculated and the average number of patient visits required were compared to data from before the implementation of the clinic to find the associated cost savings. Results The average cost per appointment at the mass knee clinic was £98.52, with an average of 152.64 patients seen per clinic day. The mean number of patient visits required fell from 4.57 to 2.41 following the implementation of the clinic. Overall, the clinic can produce cost savings £29 335.43 per clinic day and £264 018.89 per year. Conclusions The mass knee clinic model can produce substantial cost savings and increase efficiency, allowing better management of waiting times and reducing reliance on outsourcing.

$$B^{0}_{s} \rightarrow \phi \phi \rightarrow $$ KKKK is an important physics process to study at the High LuminosityHigh luminosity Large Hadron Collider (LHC), also known as LHC Phase II, which is expected to start in 2024–25. The process involves a CP violating weak phase which arises due to CP violation in $$B^{0}_{s} \,-\, bar{B}^0_{s}$$ mixing through the rare gluonic penguin decay, b $$\rightarrow $$ s $$\bar{s}$$ s. The CMS experiment will install a new tracking system for the LHC Phase II and include tracker information at Level-1 trigger to keep the event rate manageable without sacrificing any physics potential. The aim of the present study is to understand whether the CMS detector will be able to trigger on the fully hadronic $$B^{0}_{s} \rightarrow \phi \phi \rightarrow $$ KKKK events and complement the LHCb experiment.

The Standard Model (SM) of Particle Physics precisely predicts the cross-sections for the extremely rare Flavour Changing Neutral Current (FCNC) processes $$B_{d/s}\rightarrow \mu \mu $$. Although, these processes are suppressed in the SM, beyond Standard Model (BSM) contributions can significantly enhance their decay rates. Therefore, a precise measurement of branching fractions and the $$B_s\rightarrow \mu \mu $$ lifetime is of prime concern for experiments like CMS in the quest for new physics. The SM also precisely predicts the CP violating phase $$\phi _s$$ in the $$B_s\rightarrow \phi \phi \rightarrow $$4 kaons decay process. Any significant deviation from the SM prediction for this rare FCNC process would provide a clear signature for BSM. During the High Luminosity (HL) period of the LHC, also known as LHC Phase-2, CMS will continue to look for $$B_{d/s}\rightarrow \mu \mu $$ and will also study $$B_s\rightarrow \phi \phi \rightarrow $$ 4 kaons. The latter will be possible for the first time in CMS due to inclusion of the tracking information in the Level-1 trigger. In this article, we shall discuss the CMS Phase-2 Tracker, Level 1 Tracking and present results obtained from Phase-2 simulations for $$B_{d/s}\rightarrow \mu \mu $$ and $$B_s\rightarrow \phi \phi \rightarrow $$ 4 kaons.

The radiograph is inadequate because it does not show the full pelvis and hips. Otherwise the radiograph shows a displaced subcapital intracapsular neck of femur fracture. I would obtain radiographs in orthogonal views to assess this fracture and consider requesting a CT scan to more fully understand the fracture pattern if necessary.

Purpose: To analyse preliminary outcomes of a new synthetic ligament used for reconstructing coraco-clavicular ligament in acromio-clavicular joint disruption.Methods: Patients who underwent acromi...

Abstract. A comparative study is made of the stepped structure of atmospherics during sunrise and sunset hours at three harmonically related frequencies in the VLF band, observed at the coast of the Bay of Bengal. The occurrences of the steps, their duration, time sequence and amplitudes are critically examined. Our analysis reveals that the start times of the third and second steps of the sunrise effect are always before ground sunrise, while the start of the main step is distributed on both sides of it. During sunset hours, the onset time of the main step is before the local ground sunset, but for the second and third steps, the onset times are after that. The results are interpreted by considering the multi-hop propagation as well as the distributed noise sources surrounding the observing site.

The paper deals with the effect of the rain drop size distribution on rain induced attenuation and a comparison is made between the theoretical prediction of attenuation and phase dispersion. The results show how the refractive indices change at different mm wavelengths at 20°C. The frequency spectrum indicates that in the range 0.05 cm—0.3 cm dropsize the scattering amplitude values follow a systematic relation while for larger drop diameter the variation is irregular. In the analysis emphasis is also laid to the differential attenuation values and the results' are compared on the basis of recently prediction method proposed by the International Radio Consultative Committee (CCIR) besides the existing models for the prediction of attenuation by rain.

Purpose: To analyse preliminary outcomes of a new synthetic ligament used for reconstructing coraco-clavicular ligament in acromio-clavicular joint disruption. Methods: Patients who underwent acromio-clavicular joint stabilisation using Nottingham Surgilig were followed up at average of 40 months (range 6–80 months) post operation. Apart from clinical and radiological assessment, the Constant-Murley scoring system and the Imatani scores were also used to measure outcome. Results: Twenty patients underwent this operation and data was available on 19 of them. These patients had their operation after an average of 18 months following injury, during which period they had conservative treatment, except in 2 cases where a Weaver Dunn operation was performed initially. The mean Constant score was 88 (s.d. 12). The mean Imatani score was 86 (s.d. 16). Most patients were satisfied with the operation (90%). There was one case of rupture through the central portion of the Surgilig, and following extensive laboratory analysis, the ligament has been modified since. One patient had a fracture of his coracoid while lifting heavy weights. In 4 patients there was clinical and radiological evidence of loosening of the screw but only 1 complained of this being a problem. Conclusion: This is an initial medium term outcome analysis of the Nottingham Surgilig. Our results are promising and justify further use and evaluation of this relatively new technique.

Abstract The effect of solute mass on lyoluminescence (LL) decay times of γ-irradiated saccharides has been studied employing photon counting technique over a solute mass range 1—20 mg at room temperature. It is observed that all the decay times increase linearly with solute mass. The decay time of the longest component in each of the saccharides studied increases markedly as the solute mass is increased. This finding suggests that the structure of the solute molecule persists longer as larger solute mass is dissolved.

To measure luminescen ce yield an integrator of pul ses by ph otomuttipli er tube-am pl ifier-disc rim inator system se rv ing as th e light detector is often used . In the present work the perform ance of an integrator is co mpared with th at of a photon co untin g (PC) system which is al so used for th e sam e purpose. A PC system is found to be more suitabl e in measuremen: of lu mi nesce nce yield and decay tim e. Furthermore, the values of yield and decay tim e is seen to be bes t obta in ed when PC is achieved by usin g a multichannel scaler (MCS). However, before adapting an MCS based PC system for th ese meas urements it is necessary to establish the singl e photon re sponse of that system. The perform ances of these systems have bee n evalu ated from experim ents done on Iyoluminescence of mannose irradi ated by y- ray to 55 0 Gy .

The GM tube compensator described stores background counts to cancel an equal number of pulses from the measuring channel providing time averaged compensation. The method suits portable instruments.

A description of the techniques and instruments developed for the study of atmospheric noise is given.

The effect of monsoon clouds in the level of VLF atmospherics at 10, 20 and 30 kHz have been analysed for a period from 1977 to 1979. Some of the interesting results obtained are reported in this paper and the results have been interpreted from a knowledge or source activity and the propagation involved.

Some characteristics in the atmospherics record at Calcutta during a violent cyclonic storm over the Indian Ocean and the Bay of Bengal have been noted. The results are presented here.

First Page

It is shown that the occurrence of different monsoon cloud amounts is closely associated with the integrated field intensity of atmospherics simultaneously recorded over Calcutta at 10, 20, and 30kHz. Some of the interesting results achieved from an analysis of the observations during the monsoons of 1977 to 1979 are reported here, and the results are critically discussed in light of the present knowledge of monsoon characteristics.

The detection and location of lightning by magnetic direction finding system (MDFS) and lightning position and tracking system (LPATS) are major meteorological techniques in recent years. The two systems have been critically discussed and the irrelative advantages and deficiencies are focused.Lightning is a major meteorological hazard. In addition to the protection of general public, access to real time lightning ground strike data could play a vital role in forest Are measurement, computer and communication network operation, explosives and toxic material handling, aircraft refueling and maintenance and repair of utility transmission and distribution systems. Even the nuclear plant operations may be considerably impacted by lightning [1]. Ruat et al [2] have shown the value of lightning data as a component of severe thunderstorm research. The needs for accurate location of lightning ground strikes are hence well documented.This note summarize the efforts to evaluate a new lightning location technology with an emphasis on the two recent techniques, viz (i) magnetic direction finding system (MDFS) and (ii) lightning position and tracking system (LPATS) developed in recent years.

The theory of the radar reflectivity factor and how to determine the radar parameters must be clearly known for an accurate measurement of rainfall with the help of a weather radar. Procedures for achieving these ends are presented first. Kinematics and microphysical influences on Z-R relationships and the effect on the rainfall estimates are pointed out. Consideration of radar areal estimates of rainfall utilizing gauges for calibration indicates a significant reduction in percent error when adjustments are made on a storm basis and thus suggesting an improved technique. Factors affecting such measurements are finally outlined.&#x0D;

The paper examines some characteristics of the field intensity level of atmospherics at three harmonically related frequencies due to local active monsoon clouds. Seasonal variations of the ratio of afternoon maximum to morning minimum as well as that of the afternoon minimum to morning minimum of atmospherics and the local rainfall have been critically analysed. The differences of the two ratios exhibit a pronounced seasonal variation, having minimum values during the monsoon months and also the significance ratio at such times decreases with the increase of rainfall. which. in turn. is related to local sferics. The results further indicate how the overhead cloud amount in okta contributes significantly over the intensity level of different frequencies and width of atmospherics.&#x0D;