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Weight reduction is a critical factor in the vehicles and numerous researchers worked on better materials and design optimization to achieve that goal. This paper is focused to design a natural fibre reinforced hybrid polymer composite mono leaf parabolic spring to replace the existing steel multi-leaf semi-elliptical spring in an attempt of reducing the unsprung mass and to investigate its characteristics. The spring so designed is analyzed for its deflection and stiffness, by Virtual work method, whose complex integral was solved numerically by Gauss Quadrature. Along with this, SolidWorks was used to construct a model and ANSYS tests were used to compute the deflection, analyze the stress pattern and verify that the fail proof condition is met. Subsequently, three prototypes of the springs were fabricated by hand lay-up method. These springs were subjected to a static load test which results in deflection values similar to that of laminated steel springs with an appreciable 83 percent weight reduction. Modal Analysis conducted ensures that the fundamental frequencies of different modes are conveniently away from values of human discomfort and also from the nominal driving engine speed of 2000 rpm. The responses to harmonic disturbances which were studied experimentally, analytically and by ANSYS which indicates that vibration amplitudes due to average road undulations are under control, limiting the amplitude within 12 mm. The newly designed spring shall be recommended as a potential replacement, which can further be augmented by future works to be carried out on pot holes and studying the force transmitted on to the vehicle.

Importance: Fear and distress during immunization may lead to long-term preprocedural anxiety and nonadherence to immunization schedules. Pictorial stories provide a way of educating the parent and child about the procedure. Objective: To determine the efficacy of pictorial stories in reducing pain perception among children and anxiety among mothers during immunization. Design: Three-arm randomized controlled trial Setting: Immunization clinic of a tertiary care hospital in South India. Participants: Fifty children ages 5 to 6 yr, who reported to the hospital for measles, mumps, and rubella and typhoid conjugate virus vaccines. Inclusion criteria were that the child was accompanied by the mother and maternal knowledge of either Tamil or English. Exclusion criteria were child hospitalization in the past year or neonatal intensive care unit admission in the neonatal period. Intervention: Pictorial story regarding immunization before the procedure that contained information related to immunization, coping strategies, and distraction techniques. Outcomes and Measures: Pain perception was evaluated using the Sound, Eye, Motor Scale; the Observation Scale of Behavioral Distress; and the Wong-Baker FACES Pain Rating Scale (FACES). Maternal anxiety was measured using the General Anxiety–Visual Analog Scale. Results: Of 50 children recruited, 17 were in the control group, 15 were in the placebo group, and 18 were in the intervention group. Children in the intervention group reported lower pain scores on the FACES (p =.04) compared with the placebo and control groups. Conclusions and Relevance: A pictorial story is a simple and cost-effective intervention to reduce pain perception among children. What This Article Adds: Pictorial stories may be a feasible, simple, and cost-effective intervention to reduce pain perception during immunization. Using a pictorial story that includes information related to immunization, coping strategies, and distraction techniques may be a feasible, simple, and cost-effective intervention to reduce pain perception among children during immunization and provide a way of educating the parent and child about the procedure. [ABSTRACT FROM AUTHOR]

[Display omitted] • Investigate HDH for freshwater from saltwater using heat pipes, employing waste heat from residential ACs. • Innovate with recovered AC waste heat to enhance efficiency in freshwater production. • Experimentally assess system performance across varied AC temperatures (19 °C, 20 °C, 21 °C). • Highlight superior freshwater production of R32 heat pipe compared to R134a and R600a. • Contribute to a holistic understanding of HDH system performance, emphasizing efficiency benefits. This study presents an experimental exploration of a desalination system that produces freshwater from saltwater using a novel heat pipe-assisted humidification-dehumidification (HDH) process. The system utilizes waste heat recovered from residential air conditioners that use vapour compression refrigeration systems. The study focuses on the mass and heat transfer within the system's components, with performance evaluations conducted at three different air conditioning temperatures (19 °C, 20 °C, and 21 °C). The experiments highlight the freshwater production of the R32 heat pipe over the R134a and R600a heat pipes. The study estimates the system's cost-effectiveness at $0.0085/L, emphasizing its economic viability. Preheating resulted in significant improvements in freshwater yield, ranging from 43.33 % to 51.5 %, at temperatures of 21 °C and 20 °C, respectively. The Gain Output Ratio (GOR) doubled from 0.75 to 1.52, indicating a more energy-efficient process with significant improvements in the effectiveness of humidification and dehumidification. The pH levels improved from 8.32 to 7.07, representing a 15 % reduction and falling within the WHO-recommended range of 6.5–8.5. Electrical Conductivity (EC) shows a notable reduction from 62,720 to 826.1 micromhos/cm, representing a 98.68 % reduction, and well below the permissible limit of 1500 micromhos/cm. Total Dissolved Solids (TDS) also experienced a drop from 31,777 to 413.1 ppm, representing a 98.7 % reduction, and falls under the WHO guideline of <600 ppm for drinking water. The experiments prove that the use of waste heat from household air conditioners for sustainable freshwater production through the HDH desalination method, with the added efficiency benefits of heat pipe. [ABSTRACT FROM AUTHOR]

Human beings are often driven to exhibit dietary preference according to their hedonic characteristics. Though previous studies proposed that the fat taste preference of an obese individual was associated with BMI, the perception of fat taste differs for every individual. The genetic variation among populations in taste receptor genes such as CD36 may be a contributing factor for this difference. Satiety peptides can also play a role in the regulation of fat taste perception. Generally, this hormone helps us to feel the sense of satiety. We have analysed the relationship among oro-gustatory perception of dietary lipids, salivary peptide-YY and genetic polymorphism in CD36. Oral fatty acid sensitivity analysis was performed by alternative forced choice method. Salivary peptide-YY concentration was analysed by ELISA and single nucleotide polymorphism (SNP) in CD36 gene was determined by Real-Time PCR experiments. We observed that the SNP at rs1761667 of CD36 and oral detection threshold for linoleic acid (LA) are associated with choice of food, lipid profiles, peptide-YY as well as adiposity parameters in obese population. Obese peoples had significantly low levels of peptide YY than people with BMI less than 25. These factors possibly play a role in preference for energy rich diets, development of obesity and associated complications. This study provides a solid foundation for understanding the alterations in the dietary fat intake and levels of peptide-YY, which are associated with polymorphism in fat taste receptor. This is the first report that shows a significant relationship between the satiety hormone level, SNP in CD36 gene and oral fat detection threshold in human subjects. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the effectiveness of caregiver education to prevent or reduce hemiplegic shoulder pain, a complication following stroke that adversely affects functional outcomes and prolongs rehabilitation. Method: The study was a randomised controlled trial involving acute stroke survivors in the hospital and their primary caregivers. The participants were conveniently selected and randomly allocated to the experimental (n = 20) and control groups (n = 20) using block randomisation. The stroke survivors of both the study groups received conventional therapy. In the experimental group, caregivers participated in three individual sessions of the education programme for shoulder care, which comprised provision of information, demonstration and training. The outcome measures at pre-assessment were the Visual Analogue Scale (VAS) for shoulder pain and the Fugyl-Meyer Assessment for Upper Extremity for Motor Recovery. Caregiver feedback scores were obtained following the intervention. The VAS scores were obtained at 30 days following intervention and 30 days following post-assessment (follow-up assessment) through the posted envelopes. Mann-Whitney U test and Chi- square test were used for statistical analysis. Results: There was no significant difference between the groups on VAS at follow-up assessment. The number of stroke survivors reporting "no pain" increased by 29% in the experimental group and decreased by 6% in the control group. Caregiver feedback scores were higher in the experimental group than in the control group (P < 0.001). Conclusion: This study indicates that educating caregivers on shoulder care during acute management at the hospital, improves their confidence in handling and positioning the stroke survivor after discharge and could reduce hemiplegic shoulder pain. [ABSTRACT FROM AUTHOR]

Obesity has been consistently associated with a higher incidence of ventral hernia. It is preferable to treat both obesity and hernia in such patients because, with weight loss, the risk of recurrence of hernia is reduced. Bariatric surgery offers the best treatment for obesity and its associated co-morbidities and in combination with intraperitoneal onlay mesh repair (IPOM) provides the best treatment in such patients. The bariatric surgical team often faces the dilemma of whether to offer concomitant bariatric surgery with IPOM or a staged procedure in such patients because the safety of a concomitant procedure still creates doubt. In this study we present our long-term results of the concomitant approach in such patients to analyze its long-term safety and efficacy. Tertiary care teaching hospital, India. We have performed a retrospective evaluation of all patients who underwent concomitant bariatric surgery with IPOM for primary or recurrent ventral hernia from January 2003 to July 2017 who completed a minimum follow-up of 12 months. A total of 156 patients of underwent concomitant bariatric surgery with IPOM, 120 patients (body mass index : 43.64 ± 6.8) underwent sleeve gastrectomy, and 36 patients (body mass index: 42.49 ± 8.57) underwent Roux-en-Y gastric bypass. One-hundred and seventeen patients were operated for primary hernia and 39 for recurrent hernia. There were no postoperative mesh infections and only 1 patient had recurrence. Bariatric surgery with IPOM provides the patient with a 1-stage treatment for both obesity and ventral hernia along with reduced risk of recurrence as a result of weight loss. It is safe to do a combined procedure in high volume centers with adequate expertise. • Bariatric surgery can be safely combined with ventral hernia mesh repair. • No mesh infections occurred after the concomitant procedure. • Recurrence rate after combined approach is very low (0.91%). • Surgeon should have the expertise to perform both the procedures expeditiously. [ABSTRACT FROM AUTHOR]

Bariatric surgery has proven benefits for morbid obesity and its associated comorbidities. Laparoscopic approach is well established for bariatric surgery. Single-incision laparoscopic surgery (SILS) offers even more minimally invasive approach for the same with the added advantage of better cosmesis. We have developed and standardised the SILS approach at our institute. We share our experience and technical 'tips' and modifications which we have learnt over the years. Technical details of performing sleeve gastrectomy and Roux-en-Y gastric bypass with special attention to liver retraction, techniques of dissection in difficult areas, creation of anastomoses and suturing have all been described. In our experience and in experience of others, single-incision bariatric surgery is feasible. Use of conventional laparoscopic instruments makes single-incision approach practical for day-to-day practice. Supervised training is essential to learn these techniques. [ABSTRACT FROM AUTHOR]

Background: Lumbar spondylosis affects approximately 80% of people over 40 years of age. There is currently no gold-standard treatment for lumbar spondylosis despite substantial research effort to identify both conservative and more invasive methods of managing symptoms and slowing progressive decline. Hence, we undertook this study to assess the effectiveness of homeopathic treatment of lumbar spondylosis. Methods: Between February and December 2013 patients with lumbar spondylosis attending the outpatient department of the Father Muller Homeopathic Medical College and Hospital in Mangalore, India were considered for the study. Patients younger than 30 and older than 70 years of age were excluded. Medical diagnosis was based on clinical symptomatology as well as radiographic studies. Homeopathic medicines were prescribed and the severity of symptoms was assessed before and after treatment using a Visual Analog Scale (VAS). The duration of improvement was noted. Results: A total of 15 cases were selected based on the inclusion and exclusion criteria. Out of these, 4 cases were excluded due to lack of follow-up and 11 cases completed the study. Symptom severity at entry to study was high (mean VAS score 81, out of a possible 100). Symptoms had been present for 1 -11 years (mean 3.4 years). Mean VAS score at end of study dropped to 19, representing a mean improvement of 78% over baseline. All cases improved substantially, most within one month. No case took longer than 2 months to experience benefit. Conclusion: Homeopathy appears to be effective in treating lumbar spondylosis. Larger, more rigorous trials are justified. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic pancreaticoduodenectomy (LPD), although an advanced surgical procedure, is being increasingly used for pancreatic head and periampullary tumors. We present our experience of 15 years with the largest series in total LPD for periampullary and pancreatic head tumors with data on oncological outcome and long-term survival. Materials and Methods: Prospective and retrospective data of patients undergoing LPD from March 1998 to April 2013 were reviewed. Of the 150 cases, 20 cases of LPD (7 cases done for chronic pancreatitis and 13 cases for benign cystic tumors of the pancreas) have been excluded, which leaves us with 130 cases of LPD performed for malignant indications. Results: In total, 130 patients were chosen for the study. The male:female ratio was 1:1.6, with a median age of 54 years. We had one conversion to open surgery in our series, the overall postoperative morbidity was 29.7%, and the mortality rate was 1.53%. The pancreatic fistula rate was 8.46%. The mean operating time was 310±34 minutes, and the mean blood loss was 110±22 mL. The mean hospital stay was 8±2.6 days. Resected margins were positive in 9.23% of cases. The mean tumor size was 3.13±1.21 cm, and the mean number of retrieved lymph nodes was 18.15±4.73. The overall 5-year actuarial survival was 29.42%, and the median survival was 33 months. Conclusions: LPD has evolved over a period of two decades and has the potential to become the standard of care for select periampullary and pancreatic head tumors with acceptable oncological outcomes, especially in high-volume centers. Randomized controlled trials are needed to establish the advantages of LPD. [ABSTRACT FROM AUTHOR]

Parastomal hernia is one of the most common but challenging complication after stoma formation. Modified Sugarbaker technique is the recommended procedure for repair parastomal hernia, however, keyhole repair technique had also been used in certain instances. In cases of parastomal hernia following ileal conduit procedure, the Sugarbaker technique is been described, although with associated theoretical risk of conduit failure. We are reporting a case of post-radical cystectomy with ileal conduit presented with symptomatic large parastomal hernia. Laparoscopic modified keyhole plus repair has been done successfully in this patient with no recurrence in 2 years of follow-up. The purpose of our case report is to describe our novel modification of the laparoscopic keyhole technique which can be a feasible and acceptable alternative surgical method in these types of patients. [ABSTRACT FROM AUTHOR]

The article discusses briefly the inventive step or non-obviousness of an invention. It also explores the concepts of skilled person, non-obviousness, judgment and some indicators of non-obviousness. The determination of inventive step or non-obviousness of an invention is one of the most complex aspects of patent law.

After the abolishment of Quota regime with effect from Jan. 2005, Garment industries in India had to face stiff competition from global players. In order to compete effectively, they focused on the most efficient way of capital utilization, investing in the right area for the right reason to boost the overall performance. A major investment of any industry lies in its stock. Garment industry too is very much dependent on its inventories. Control of inventory flow is vital for any manufacturing unit, since inventory control plays a significant role in its profitability. Inventory in Garment industry consists of the following items: * Garmenting items - are those which directly form a part of the garment. Eg.- fabrics and trims. * Non-garmenting items - are those which do not form a part of the garment, but, are very essential in the manufacturing process. Eg.- needles, trimmers, spare parts of sewing machinery, etc. Optimum inventory levels play a major role in the growth of an organization. On the other hand, excess inventories have resulted in the downfall of many industries. Industries are growing extensively aware of the benefits of having optimum inventories in stock so as to allow the usage of capital in a more effective way. [ABSTRACT FROM AUTHOR]