Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair.

BACKGROUND: Association of tendon degeneration, pre-existing posterior heel pain, Haglund's bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA). PURPOSE: The study compares the various predisposing factors that determine the distinct type of TA tear and the outcome following a repair. METHODS: This is a retrospective study of the patients who underwent tendoachilles repair during January 2012-June 2018. Patients above 18 years with a minimum follow-up of two years were included. Patients with calcaneal tuberosity avulsions, prior surgeries, and open injuries were excluded. Patients were divided into groups 1 (insertional tears (IT)) and 2 (non-insertional tears (NIT)), and further subdivided based on the tendon degeneration (as D-degenerative and N-normal sub types) from ultrasound findings. AOFAS score and predisposing factors like degeneration, posterior heel pain, Haglund's bump, spur, and mechanism of injury were compared between the groups. RESULTS: The study included N = 146 with a mean age of 51.6 years and mean follow-up of 38.6 (range 24 to 96) months. IT associated with degeneration (IT-D) had a trivial fall as the predominant mechanism (P < 0.001). All patients had significant postoperative improvement of scores with no significant difference between the groups (P = 0.59) and subgroups (P = 0.27).75.34% had degenerative tendon, of which 64.5% were in the IT group and the rest in the NIT group (P = 0.02). 51.4% patients had a Haglund bump in the IT group and n.s. (P = 0.9). Forty-seven percent of patients had pre-existing posterior heel pain, 68% in IT and 32% in NIT (P = 0.04). Subgroup analysis revealed 65% of patients were in the IT-D subgroup (P < 0.001). CONCLUSION: Predisposing factors like posterior heel pain, tendon degeneration, and trivial trauma have a strong propensity for insertional TA tear. In contrast, the prominence of Haglund's bump does not predispose to a distinct type of TA tears. The outcome following a surgical repair-yields good results with no difference between the two groups.

Can Mobile Health Improve Depression Treatment Access and Adherence Among Rural Indian Women? A Qualitative Study.

Major Depressive Disorder (MDD) is associated with low rates of treatment and medication non-adherence, more so in low- and middle-income countries (LMICs). Mobile mental health (mHealth) interventions offer promise as a tool to address these problems. However, the feasibility and acceptability of mHealth interventions among rural women in LMICs is unknown. We examined barriers to accessing mental health treatment, reasons for non-adherence, and attitudes towards mHealth solutions among women with MDD in rural south India. Six focus groups were conducted among women with MDD (n = 69) who had been in treatment at a rural community health center. The discussion was transcribed and analyzed using a modified grounded-theory approach. Women perceived limited autonomy within their family structure, and experienced financial and systemic barriers as contributing to poor treatment access and non-adherence. Illiteracy, limited personal access to mobile phones, and preference for in-person clinical consultation were identified as barriers to use of mHealth. This is the first qualitative study, to our knowledge, that examines attitude towards mHealth among women with MDD in a rural setting in India. The study identified contextual barriers that will be important to address before implementing mHealth interventions.

Application of Sanitation Safety Planning in the Usage of Wastewater for Agriculture in Bangalore Urban District, India.

Context: Due to water scarcity, wastewater is used in agriculture in peri-urban areas. Aims and Settings: We aimed to assess the hazards associated with wastewater farming and develop an incremental improvement plan for the sanitation system of wastewater use for agriculture using Sanitation Safety Planning (SSP) in Bangalore urban district, India. Methods: Interviews and observations were conducted among 100 farmers in the Mugalur Gram Panchayat area. Results: Direct ingestion and ingestion after contact with wastewater due to inadequate hand hygiene are the routes of contact with wastewater. The control measures followed in the community are the cultivation of crops, which do not have direct contact with wastewater, furrow and drip irrigation, and restricted irrigation. Methods to mitigate the hazards are the provision of interval between final irrigation and consumption,washing of produce with freshwater before transportation to market, and hygienic cooking. Conclusion: Occupational hazards and risks associated with wastewater farming can be mitigated through the adoption of locally acceptable preventive measures.

RETRACTED: Goud et al. Numerical Case Study of Chemical Reaction Impact on MHD Micropolar Fluid Flow Past over a Vertical Riga Plate. Materials 2022, 15, 4060.

The Materials Editorial Office retracts the article "Numerical Case Study of Chemical Reaction Impact on MHD Micropolar Fluid Flow Past over a Vertical Riga Plate" [...].

Correction: Hybrid optimal-FOPID based UPQC for reducing harmonics and compensate load power in renewable energy sources grid connected system.

[This corrects the article DOI: 10.1371/journal.pone.0300145.].

Hybrid optimal-FOPID based UPQC for reducing harmonics and compensate load power in renewable energy sources grid connected system.

Integration of renewable energy sources (RES) to the grid in today's electrical system is being encouraged to meet the increase in demand of electrical power and also overcome the environmental related problems by reducing the usage of fossil fuels. Power Quality (PQ) is a critical problem that could have an effect on utilities and consumers. PQ issues in the modern electric power system were turned on by a linkage of RES, smart grid technologies and widespread usage of power electronics equipment. Unified Power Quality Conditioner (UPQC) is widely employed for solving issues with the distribution grid caused by anomalous voltage, current, or frequency. To enhance UPQC performance, Fractional Order Proportional Integral Derivative (FOPID) is developed; nevertheless, a number of tuning parameters restricts its performance. The best solution for the FOPID controller problem is found by using a Coati Optimization Algorithm (COA) and Osprey Optimization Algorithm (OOA) are combined to make a hybrid optimization CO-OA algorithm approach to mitigate these problems. This paper proposes an improved FOPID controller to reduce PQ problems while taking load power into account. In the suggested model, a RES is connected to the grid system to supply the necessary load demand during the PQ problems period. Through the use of an enhanced FOPID controller, both current and voltage PQ concerns are separately modified. The pulse signal of UPQC was done using the optimal controller, which analyzes the error value of reference value and actual value to generate pulses. The integrated design mitigates PQ issues in a system at non-linear load and linear load conditions. The proposed model provides THD of 12.15% and 0.82% at the sag period, 10.18% and 0.48% at the swell period, and 10.07% and 1.01% at the interruption period of non-linear load condition. A comparison between the FOPID controller and the traditional PI controller was additionally taken. The results showed that the recommended improved FOPID controller for UPQC has been successful in reducing the PQ challenges in the grid-connected RESs system.

Factors influencing burnout in millennial medical students during the COVID-19 pandemic!

BACKGROUND: Burnout among millennial medical students is an important health issue with a possibility of potential professional dissatisfaction. The reason for burnout is multifactorial. The gender of the medical student may play a significant role when choosing a residency specialty and making a career choice. Gender may also influence while establishing the burnout seen in students. Here we tested the association between burnout in medical students based on gender and residency specialty choice during COVID-19. METHODS: A multicentric cross-sectional study, using a questionnaire-based survey on the items related to gender, educational interest, status, residency aspiration, changes to career aspiration based on gender, and COVID-19 and an indigenous burnout assessment tool that was administered to all the medical students in the study. Reliability and validity of the tool were assessed, and the burnout was calculated for emotional exhaustion, personal achievement, and depersonalization domain. RESULTS: A total of 487 medical students (42.5% males, 57.2% females) completed the survey. A higher number of female participants felt that COVID-19 affected their energy levels (68.9%), interest in education (53.2%), and developed reservations about residency specialty of choice (46%); emotional and physical exhaustion (2.88 ± 0.69 & 2.34 ± 0.76) was higher than the male participants (3.16 ± 0.67 & 2.75 ± 0.85). CONCLUSION: More female participants experienced emotional distress, depersonalization or professional disengagement, and psychological and physical stress and exhaustion due to the COVID-19 pandemic. An important association observed in the study was between residency choice and burnout.

Mobile Mental Health in Women's Community-Based Organizations: Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND: Of every 10 women in rural India, 1 suffers from a common mental disorder such as depression, and untreated depression is associated with significant morbidity and mortality. Several factors lead to a large treatment gap, specifically for women in rural India, including stigma, lack of provider mental health workforce, and travel times. There is an urgent need to improve the rates of detection and treatment of depression among women in rural India without overburdening the scarce mental health resources. OBJECTIVE: We propose to develop, test, and deploy a mental health app, MITHRA (Multiuser Interactive Health Response Application), for depression screening and brief intervention, designed for use in women's self-help groups (SHGs) in rural India. METHODS: We will use focus groups with SHG members and community health workers to guide the initial development of the app, followed by iterative modification based on input from a participatory design group consisting of proposed end users of the app (SHG members). The final version of the app will then be deployed for testing in a pilot cluster randomized trial, with 3 SHGs randomized to receive the app and 3 to receive enhanced care as usual. RESULTS: This study was funded in June 2021. As of September 2022, we have completed both focus groups, 1 participatory design group, and app development. CONCLUSIONS: Delivering app-based depression screening and treatment in community settings such as SHGs can address stigma and transportation-related barriers to access to depression care and overcome cultural and contextual barriers to mobile health use. It can also address the mental health workforce shortage. If we find that the MITHRA approach is feasible, we will test the implementation and effectiveness of MITHRA in multiple SHGs across India in a larger randomized controlled trial. This approach of leveraging community-based organizations to improve the reach of depression screening and treatment is applicable in rural and underserved areas across the globe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42919.

Performance Evaluation of Iodine Deficiency Disorder Control Program in Chikmagalur District: A Cross-Sectional Community-Based Survey.

Background: Routine evaluation of Iodine Deficiency Disorders (IDDs) is done through a national program called National Iodine Deficiency Disorder Control Program (NIDDCP). The aim of this study is to determine the goiter prevalence, to estimate salt Iodine and urinary Iodine levels. Materials and Methods: An institution-based cross-sectional study was conducted among 2700 school children across seven taluks of Chikmagalur. A total of 2700 children aged 6 to 12 years were selected from 30 clusters by multistage sampling method. The iodometric titration method and Sandell-Kolthoff method were used for the estimation of salt and urinary Iodine, respectively. Descriptive and Inferential statistics were used. Results: The prevalence of goiter was 13.0%. About 153 (28.3%) salt samples had inadequate iodine content (<15 ppm). Median Urinary Iodine Excretion was 126 µg/L. Conclusion: Chikmagalur district is still at risk of a significant public health problem which needs timely interventions and appropriate measures to prevent further consequences due to IDDs.

Rheology of electromagnetohydrodynamic tangent hyperbolic nanofluid over a stretching riga surface featuring dufour effect and activation energy.

The present model deals with the consequence of Dufour, activation energy, and generation of heat on electromagnetohydrodynamic flow of hyperbolic tangent nanofluid via a stretching sheet. This offers a broad significance in several engineering fields. With adequate similarity variables, the regulating governing equations of PDEs are renovated into nonlinear ODEs. The numerical output of the produced ordinary differential equations is conducted with MATLAB bvp4c. The influence of increasing features on temperature, velocity, concentration patterns, drag force coefficient, Sherwood number and Nusselt number is depicted graphically and numerically. Hence, the resultant conclusions are confirmed utilising contrast with earlier output. Interestingly, the activation energy retards the nanofluid's tangential hyperbolic concentration distribution and the rise in temperature of the hyperbolic tangential nanofluid flow is traceable to an increase in the Dufour effect, However, the electromagnetohydrodynamic variable increases the velocity distribution, which influences the Power law index. Conclusively, the rate of heat transfer is inhibited when the thermophoresis parameter, heat source and the Weissenberg number are enhanced.

Numerical Case Study of Chemical Reaction Impact on MHD Micropolar Fluid Flow Past over a Vertical Riga Plate.

The purpose of this article is to investigate the mass and heat transport phenomena associated with micropolar fluid flow created by a vertically stretched Riga surface. This is constructed using an array of irregular electrodes and permanent magnets that are oriented spanwise. Additionally, we investigate the particles' micro rotational impacts. Furthermore, the flow behaviour of the modeled problem has been numerically calculated with bvp4c solver and the obtained results are presented graphically. Numerical data are used to illustrate physical parameters such as skin friction, Nusselt, and Sherwood numbers. For precise values of different flow parameters, the characteristics of fluid velocity, angular velocity, temperature, and concentration gradients are investigated graphically. The flowing parallel to the Riga plate in a positive x-path is aided by Lorentz forces introduced into the flowing simulation by the electro-magnetic poles of the Riga plate, which produces a rapidity greater than the inner speed. It is confirmed that the numerical calculations fit well with the results of earlier published investigations. Due to the participation of the Riga plate, the updated Hartmann number has a considerable effect on flow profiles.

Effectiveness of Nonuniform Heat Generation (Sink) and Thermal Characterization of a Carreau Fluid Flowing across a Nonlinear Elongating Cylinder: A Numerical Study.

During thermal radiation treatments, heat therapies, and examination procedures like scans and X-rays, the cylindrical blood vessels may get stretched; meanwhile, the blood flow through those blood vessels may get affected due to temperature variations around them. To overcome this issue, this work was framed to explore the impact of heat transmission in a Carreau fluid flow (CFF) through a stretching cylinder in terms of the nonlinear stretching rate and irregular heat source/sink. Temperature-dependent thermal conductivity and thermal radiation are taken into consideration in this study. To tranform complicated partial differential equations into ordinary differential equations, appropriate similarity variables are used. For a limited set of instances, the derived series solutions are compared to previously published results. For linear and nonlinear stretching rates, graphs and tables are used to examine the influence of an irregular heat source/sink on fluid movement and heat transfer. The research outcomes demonstrate that the heat source and nonlinear stretching rate cause a disruption in the temperature distribution in the fluid region, which can alter the blood flow through the vessels. In all conditions except for the heat in an internal heat sink, the nonlinear stretching situation improves the velocity and heat profile. Furthermore, with the increase in the values of the Weissenberg number, the temperature profile shows opposing features in a shear-thickening fluid and shear-thinning fluid. For the former n > 1, the blood fluidity gets affected, restricting the free movement of blood. For the latter, n < 1, the phenomenon is reversed. Other industrial applications of this work are wire coating, plastic coverings, paper fabrication, fiber whirling, etc. In all of those processes, the fluid flow is manipulated by thermal conditions.

Partial differential equations modeling of thermal transportation in Casson nanofluid flow with arrhenius activation energy and irreversibility processes.

The formation of entropy in a mixed convection Casson nanofluid model with Arhenius activation energy is examined in this paper using magnetohydrodynamics (MHD). The expanding sheet, whose function of sheet velocity is nonlinear, confines the Casson nanofluid. The final equations, which are obtained from the first mathematical formulations, are solved using the MATLAB built-in solver bvp4c. Utilizing similarity conversion, ODEs are converted in their ultimate form. A number of graphs and tabulations are also provided to show the effects of important flow parameters on the results distribution. Slip parameter was shown to increase fluid temperature and decrease entropy formation. On the production of entropy, the Brinkman number and concentration gradient have opposing effects. In the presence of nanoparticles, the Eckert number effect's augmentation of fluid temperature is more significant. Furthermore, a satisfactory agreement is reached when the findings of the current study are compared to those of studies that have been published in the past.

The role of ARF and Rab GTPases in membrane transport.

Two key events of intracellular transport and membrane trafficking in eukaryotic cells, the formation of transport vesicles and their specific delivery to target membranes, are controlled by small GTPases of the ADP-ribosylation factor (ARF) and Rab families, respectively. The past 18 months have seen the identification of proteins that regulate ARF and Rab GDP/GTP cycle, as well as the characterization of their effectors, shedding light on the molecular mechanisms of ARF and Rab function.

Evidence for a COP-I-independent transport route from the Golgi complex to the endoplasmic reticulum.

The cytosolic coat-protein complex COP-I interacts with cytoplasmic 'retrieval' signals present in membrane proteins that cycle between the endoplasmic reticulum (ER) and the Golgi complex, and is required for both anterograde and retrograde transport in the secretory pathway. Here we study the role of COP-I in Golgi-to-ER transport of several distinct marker molecules. Microinjection of anti-COP-I antibodies inhibits retrieval of the lectin-like molecule ERGIC-53 and of the KDEL receptor from the Golgi to the ER. Transport to the ER of protein toxins, which contain a sequence that is recognized by the KDEL receptor, is also inhibited. In contrast, microinjection of anti-COP-I antibodies or expression of a GTP-restricted Arf-1 mutant does not interfere with Golgi-to-ER transport of Shiga toxin/Shiga-like toxin-1 or with the apparent recycling to the ER of Golgi-resident glycosylation enzymes. Overexpression of a GDP-restricted mutant of Rab6 blocks transport to the ER of Shiga toxin/Shiga-like toxin-1 and glycosylation enzymes, but not of ERGIC-53, the KDEL receptor or KDEL-containing toxins. These data indicate the existence of at least two distinct pathways for Golgi-to-ER transport, one COP-I dependent and the other COP-I independent. The COP-I-independent pathway is specifically regulated by Rab6 and is used by Golgi glycosylation enzymes and Shiga toxin/Shiga-like toxin-1.

Dealers in Black Gold: Knowledge Attitude, and Practices Among Fecal Sludge Operators in Bengaluru, Southern Karnataka.

BACKGROUND AND OBJECTIVES: Fecal sludge management (FSM) is an unorganised sector, which is wrought with occupational health hazards for fecal sludge operators (FSOs). This study was conducted to identify the knowledge, attitude, and practices regarding FSM among FSOs. STUDY SETTING AND DESIGN: This cross-sectional study was conducted in a rural area of Anekal Taluk, Bengaluru Urban District, Karnataka and in Hosur, Krishnagiri District, Tamil Nadu. METHODS AND MATERIALS: Snowball method of sampling was employed and, 60 participants were interviewed using an interviewer administered semi-structured questionnaire. STATISTICAL ANALYSIS: The data has been described using measures of central tendency, frequencies, and percentages. RESULTS: All 60 participants were males with a mean age of 33.7 ± 7.9 years. Majority practised Hindu religion (98.3%) and 95.0% belonged to the scheduled castes; only 3.3% were illiterate. According to modified SLI, 45.0% belonged to high standard of living. The common occupational hazards reported were injuries, social stigma, and alcoholism. Although 91.7% felt that personal protective equipment (PPE) would protect against health hazards, 65.0% felt that it hampered work. Most (86.7%) felt that FSM was attached to social stigma. None reported the use of the full set of required PPE. All participants reported washing their hands and feet with only water at the end of each operation. CONCLUSION: The knowledge and practices followed by the FSOs were found to be inadequate in this study. Health awareness generation and provision of PPE must be employed to ensure sustained behaviour change.

Surfing on a retrograde wave: how does Shiga toxin reach the endoplasmic reticulum?

Bacterial Shiga toxin and related toxins are endocytosed by higher eukaryotic cells. The toxin protein is then transported via the Golgi apparatus to the endoplasmic reticulum (ER) and into the cytosol, where it exerts its toxic effect. This review discusses current understanding of this retrograde transport pathway and how newly developed modified toxins that allow detection and quantification of specific transport steps might prove useful tools in the future.

Emergence of a surface immunoglobulin recycling process during B lymphocyte differentiation.

Surface immunoglobulin (Ig)-mediated endocytosis has been investigated in rat B lymphocytes and plasma cells, using horseradish peroxidase (HRP)-labeled sheep anti-rat Ig Fab' fragment of antibody and HRP as monomeric ligands, respectively. Quantitative estimates of HRP activity associated either with plasma membrane or with endomembrane compartments were made in several experimental conditions. Binding of HRP-conjugate on B lymphocytes was followed by its endocytosis in combination with surface Ig, as shown by the progressive disappearance of plasma membrane-associated HRP activity. Between 1 and 6 h at 37 degrees C in presence of conjugate the total amount of cell-associated activity was constant. These results indicate that during this time no reappearance of surface Ig occurred by neosynthesis, by the expression of an intracellular pool or by the recycling in a free form of the previously internalized molecules. On the contrary, at saturating doses, internalization of HRP by anti-HRP plasma cells increased linearly with time at 37 degrees C in presence of antigen, when, during the same time, the plasma membrane HRP-binding capacity remained constant. Cycloheximide did not affect continuous HRP uptake. The existence of a large intracellular pool of receptors has been ruled out by experiments of removal of binding sites with pronase. In addition, monensin caused a progressive decrease in the number of surface receptors on plasma cells but not on B lymphocytes. Our data then indicate that, unlike B lymphocytes, plasma cells were able to recycle their surface Ig.

Assembled and unassembled pools of clathrin: a quantitative study using an enzyme immunoassay.

Using polyclonal antibodies raised against clathrin, we have developed an enzyme-linked immunoassay that can specifically measure the quantity of clathrin in crude cell extracts. We found that the quantity (weight percent of total protein) of clathrin was similar in cell types that exhibit large differences in their levels of endocytosis and exocytosis (lymphoid cells, 0.11%; liver cells, 0.07%, fibroblasts, 0.18%; myeloma cells, 0.16%). However, the quantity of clathrin was found to be significantly higher in brain cortex (0.75%). Cellular clathrin was separated by high-speed centrifugation into two fractions: an unassembled form present in high-speed supernatants and an assembled form (clathrin coats) present in the pellets. We show that the fraction of clathrin in the unassembled state varies considerably depending on the cell type studied (14% in brain cortex to 70% in lymphocytes). Our data support the view that the amount of clathrin (relative to total cell protein) in eucaryotic cells is not related to the extent of receptor-mediated endocytosis and intracellular membrane traffic. However, the fraction of assembled clathrin seems to be higher in endocytically and/or exocytically active cells.

Inhibition of coated pit formation in Hep2 cells blocks the cytotoxicity of diphtheria toxin but not that of ricin toxin.

It has been recently shown (Larkin, J. M., M. S. Brown, J. L. Goldstein, and R. G. W. Anderson, 1983, Cell, 33:273-285) that after a hypotonic shock followed by incubation in a K+-free medium, human fibroblasts arrest their coated pit formation and therefore arrest receptor-mediated endocytosis of low density lipoprotein. We have used this technique to study the endocytosis of transferrin, diphtheria toxin, and ricin toxin by three cell lines (Vero, Wi38/SV40, and Hep2 cells). Only Hep2 cells totally arrested internalization of [125I]transferrin, a ligand transported by coated pits and coated vesicles, after intracellular K+ depletion. Immunofluorescence studies using anti-clathrin antibodies showed that clathrin associated with the plasma membrane disappeared in Hep2 cells when the level of intracellular K+ was low. In the absence of functional coated pits, diphtheria toxin was unable to intoxicate Hep2 cells but the activity of ricin toxin was unaffected by this treatment. By measuring the rate of internalization of [125I]ricin toxin by Hep2 cells, with and without functional coated pits, we have shown that this labeled ligand was transported in both cases inside the cells. Hep2 cells with active coated pits internalized twice as much [125I]ricin toxin as Hep2 cells without coated pits. Entry of ricin toxin inside the cells was a slow process (8% of the bound toxin per 10 min at 37 degrees C) when compared to transferrin internalization (50% of the bound transferrin per 10 min at 37 degrees C). Using the indirect immunofluorescence technique on permeabilized cells, we have shown that Hep2 cells depleted in intracellular K+ accumulated ricin toxin in compartments that were predominantly localized around the cell nucleus. Our study indicates that in addition to the pathway of coated pits and coated vesicles used by diphtheria toxin and transferrin, another system of endocytosis for receptor-bound molecules takes place at the level of the cell membrane and is used by ricin toxin to enter the cytosol.