Anup Bhat

Pulmonary Rehabilitation (PR) is an essential and comprehensive intervention recommended in the management of people with chronic respiratory diseases (CRD). Scientific evidence suggests significant health benefits with respect to repeated hospital admissions, exercise tolerance and Health Related Quality of Life (HRQoL). However, the uptake and completion of PR programs are globally low. In order to understand the factors contributing to underutilization of PR, it is important to review and recognize the barriers to PR program. A literature search was conducted on Medline (PubMed) database. After reviewing the title and abstracts, full text articles were scrutinized for their relevance. Twenty-two studies involving factors affecting the uptake, participation and completion of PR program were included in this review. Reported barriers to PR were healthcare system, healthcare professional and patient related factors. Primary factors related to healthcare system and healthcare professionals were fewer PR centers, accessibility inconvenience, lack of awareness of PR program, low knowledge of referral process and lack of interdisciplinary teamwork. Difficulties faced by patients to take up and/or to complete PR programs were lack of transportation, co-morbidities, lack of perceived benefits, socio-economic status and lack of funding facilities. Identified and reported barriers resulted into discontinuity between knowledge of health benefits and utilization of PR service for patients with CRDs. Addressing the barriers would accelerate the healthcare professionals' referral and patients to avail the health benefits of rehabilitation service.

OBJECTIVE: The aim of this study was to identify the publication speed (peer review time and publication time) of biomedical Indian journals and identify the journals having the facility of advance online publication (AOP). MATERIALS AND METHODS: Biomedical Indian journals were identified from the Journal Citation Report of 2013. Thirty original articles published between January 2012 and June 2014 were systematically selected from each journal. Information about the date of submission, revision, and acceptance were extracted from the full text of the articles. Median peer review time (submission to acceptance) and publication time (acceptance to AOP/electronic publication) were calculated for each journal. RESULTS: Of the 19 journals studied, 5 (26.3%), 15 (78.9%), and 6 (31.6%) journals did not mention details about date of submission, date of revision, and date of acceptance, respectively. The individual median peer review time of the journals ranged from 87 to 377.5 days and the combined median peer review time (interquartile range) was 143.5 days (105.5, 238). The individual median publication time ranged from 14 to 349 days. The publication time for journals with AOP was significantly lesser (29.5 [19.6, 50.6] vs. 146.5 [126.5, 202.5]; P = 0.02) compared to journals without AOP. Impact factor of the journal did not correlate with the publication speed. The facility of AOP was provided by 6 (31.6%) journals. CONCLUSIONS: Overall, the peer review time and publication time of biomedical Indian journals included in our study seems to be fairly long. Less than one-third of biomedical Indian journals provide the facility of AOP.

CONTEXT: Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs. AIM: The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India. SETTINGS AND DESIGN: A tertiary care hospital in Karnataka, India, and cross-sectional survey. SUBJECTS AND METHODS: A questionnaire was formulated and content validated to assess the current chest physiotherapy practices in neurological ICUs of India. The questionnaire was constructed online and a link was distributed via E-mail to 185 physiotherapists working in neurological ICUs across India. STATISTICAL ANALYSIS USED: Descriptive statistics. RESULTS: The response rate was 44.3% (n = 82); 31% of the physiotherapists were specialized in cardiorespiratory physiotherapy and 30% were specialized in neurological physiotherapy. Clapping, vibration, postural drainage, aerosol therapy, humidification, and suctioning were used commonly used airway clearance (AC) techniques by the majority of physiotherapists. However, devices for AC techniques such as Flutter, Acapella, and standard positive expiratory pressure devices were used less frequently for AC. Techniques such as autogenic drainage and active cycle of breathing technique are also frequently used when appropriate for the patients. Lung expansion therapy techniques such as breathing exercises, incentive spirometry exercises, and positioning, proprioceptive neuromuscular facilitation of breathing are used by majority of physiotherapists. CONCLUSIONS: Physiotherapists in this study were using conventional chest physiotherapy techniques more frequently in comparison to the devices available for AC.

Honorary authorship is the inclusion of an author on an article whose contribution does not warrant authorship. We conducted an Internet-based survey among first authors publishing in Indian biomedical journals from 2012 to 2013 to study the frequency and factors associated with honorary authorship. The response rate was 27% (245/908) with the prevalence of perceived, International Committee of Medical Journal Editors (ICMJE)-defined, and unperceived honorary authorship of 20.9% (50/239), 60% (147/245), and 46.9% (115/245), respectively. Those residing in India were found to list more honorary authors. We hope to increase awareness of the ICMJE authorship guidelines and the general issue of honorary authorship among researchers in India and elsewhere.

<div class="htmlview paragraph">Lower carbon to Hydrogen ratio of CNG makes it a cleaner fuel, due to this CNG is gaining popularity as an Internal Combustion (IC) engine fuel in transport sector. Hydrogen fuel for IC engines is also being considered as a future fuel due to its simple carbonless structure. But several obstacles have to overcome before commercialization of H<sub>2</sub> as an IC engine fuel for transport sector.</div> <div class="htmlview paragraph">Hydrogen & CNG blends may be considered as an automotive fuel without any major modification in the existing SI engines. The Present work is undertaken to demonstrate the viability of HCNG as an automotive fuel. A passenger car fitted with a 4 cylinder, 1.3 liter, SI engine has been used in the present investigation. A sequential gas injection system has been developed to avoid the risk of back firing. The effect of gas pressure and gas temperature on the duration gas injection has been considered in the control strategy. In the first phase the duration of injection, ignition timing were optimized using CNG, subsequently 18% Hydrogen by volume was mixed in CNG and used in the present investigation.</div> <div class="htmlview paragraph">Different parameters like injector pulse width and ignition timing were optimized under idling and different load conditions. Detailed testing has been conducted on idling operation to analyse the idle stability and emission. Subsequently vehicle mass emission tests were conducted on chassis dynamometer with CNG and HCNG fuel.</div> <div class="htmlview paragraph">Test results indicate that COV in engine idle speed has been reduced from 1.1% to 0.5% with HCNG fuel as compared to CNG. CO emission has been reduced from 198 ppm to 15 ppm with HCNG as compared to Gasoline operation. HC emission has been also reduced from 67 ppm to 25 ppm with HCNG fuel as compared to gasoline. With HCNG mode NOx has increased significantly as compared to CNG mode. However, NOx was reduced by retarding the ignition timing by 30 crank angle with HCNG as compared to CNG operation during idling. CO<sub>2</sub> is reduced by 19.47% with CNG as compared to gasoline and 31.74 % with HCNG as compared to gasoline during idling operation. During mass emission test CO, CO2 and HC were reduced with HCNG operation with respect to CNG operation The driveability with HCNG fuel was observed to be fairly good.</div>