Cumulative Prospect Theory Based Dynamic Pricing for Shared Mobility on Demand Services

Cumulative Prospect Theory (CPT) is a modeling tool widely used in behavioral economics and cognitive psychology that captures subjective decision making of individuals under risk or uncertainty. In this paper, we propose a dynamic pricing strategy for Shared Mobility on Demand Services (SMoDSs) using a passenger behavioral model based on CPT. This dynamic pricing strategy together with dynamic routing via a constrained optimization algorithm that we have developed earlier, provide a complete solution customized for SMoDS of multi-passenger transportation. The basic principles of CPT and the derivation of the passenger behavioral model in the SMoDS context are described in detail. The implications of CPT on dynamic pricing of the SMoDS are delineated using computational experiments involving passenger preferences. These implications include interpretation of the classic fourfold pattern of risk attitudes, strong risk aversion over mixed prospects, and behavioral preferences of self reference. Overall, it is argued that the use of the CPT framework corresponds to a crucial building block in designing socio-technical systems by allowing quantification of subjective decision making under risk or uncertainty that is perceived to be otherwise qualitative.Comment: 17 pages, 6 figures, and has been accepted for publication at the 58th Annual Conference on Decision and Control, 201

Evaluation of immediate reactions to β lactam antibiotics using a comprehensive diagnostic protocol

Background: β lactam antibiotics are commonly prescribed groups of antibacterial drugs for various infections however the prevalence of its allergic effects is not clear in our country, hence the need for an effective diagnostic protocol to determine immediate hypersensitivity reactions. The objective was to formulate a diagnostic protocol for evaluating immediate drug hypersensitivity to β lactam antibiotics.Methods: A prospective study was conducted at a tertiary care hospital. Adults who were prescribed any class of β lactam antibiotic were included. Non irritating concentrations of the antibiotic as per The European Network on drug Allergy were used. A strict three step diagnostic algorithm with skin prick test followed by intradermal test and drug provocation test, with 20 minutes observation period between each step, to determine cutaneous allergic reactions was followed.Results: The most commonly prescribed drug was cefazolin, followed by ceftriaxone, and cefoperazone + sulbactam combination. The culprit drugs were ceftriaxone in 4 (4.7%) patients, followed by piperacillin + tazobactam combination in 3 (3.5%), amoxicillin + clavulanic acid in 2 (2.3%) and 1 (1.1%) each for cefotaxime and cefepime + tazobactam combination. No patients were positive for skin prick test; 2.4% were positive for intradermal test and 10.6% were positive for drug provocation test.Conclusions: This diagnostic protocol is apt to adequately diagnose immediate reactions to β lactam antibiotics and henceforth can be used effectively in India. However, the skin prick test may be excluded but the intradermal test and drug provocation test is crucial to identify these immediate reactions

Comparison of self-medication practice for dysmenorrhoea in medical, nursing and dental students

Background: Dysmenorrhea is common in adolescent and young adult females and is responsible for impaired daily activities and significant absenteeism from college among female students. The self-treatment strategy varies among the students. Hence, the present study was done to analyse and compare the self-medication practice for dysmenorrhoea among medical, nursing and dental students.Methods: This was a cross-sectional study conducted among 188 female students with dysmenorrhoea in M. S. Ramaiah College Campus, Bangalore which included 62 medical, 63 nursing and 63 dental students. Data was collected with prevalidated questionnaire related to various aspects like demographic data, severity and duration of dysmenorrhoea and pattern of management in the three groups. Data collected was analysed using SPSS version 20.Results: The mean age of female students with dysmenorrhoea was 19.12±0.87 years. 28% students perceived hormonal changes as causative factor for dysmenorrhoea. About 92 (48.9%) were on self-medication and 46 (24.5%) of students used home remedies for dysmenorrhoea. Among 92 students drugscommonly used for self-medication were mefenemic acid+dicyclomine  (67.4%) followed by paracetamol (20.7%), ibuprofen (5.4%), dicyclomine (4.3%), and diclofenac (2.2%). NSAIDS such as mefenamic acid, paracetamol, ibuprofen, diclofenac were used commonly by students in the three groups.Conclusions: Dysmenorrhoea is a common cause for self-medication among young females. Self-medication practice for dysmenorrhoea was seen more in medical students where as non-pharmacological remedies in nursing and dental female students. NSAIDS like mefenamic acid and paracetamol are the mainstay of self-medication for dysmenorrhoea

Assessment of knowledge, attitude and practice of insulin injection among subjects with diabetes mellitus

Background: Diabetes mellitus (DM) is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycemic drugs and insulin along with the dietary and lifestyle modifications. Insulin is administered most subcutaneously. As the insulin injection sites are relatively painless, patients tend to inject in the same area repeatedly rather than moving to a newer site and increase risk for development of injection site reactions like lipodystrophy and impairment of glycemic control. Hence, it is utmost important for every diabetic patient and their relatives who would inject the insulin injection to be aware of appropriate manner of insulin injection. This helps in maintaining adequate glycemic control in diabetic patients. The main objective of this study was to assess the knowledge, attitude and practice of insulin injection technique among the diabetic patients.Methods: A cross-sectional study was conducted in the department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. A validated questionnaire was administered to patients to answer in order to assess their knowledge, attitude and practice about technique of insulin injection.Results: In this study, it was found that 90% of the patients were aware of rotating the injection site, whereas only 40% of the patients were aware of appropriate time duration (5-10 sec for syringes/counting 1-15 for releasing the pen) required for resting the syringe/pen needle inside the skin. Only 48% of the patients used to remove the air bubble prior to injection, 57% pinched the injection site before injecting, 20% rubbed the injection site after injection and 30% used to wash hands prior to injection. Hypoglycemia was the most common adverse effect noted in 54% of patients.Conclusions: It can be concluded from the present study that every patient and his/her attendant needs to be educated and trained appropriately regarding technique of injecting insulin injection for betterment of their health. 

Nanotechnology: a revolution in targeted drug delivery

Targeted drug delivery is a method of delivering medication in a unique way so that the concentration of the drug at the target site is optimized, burden of the drug to other tissues is reduced and toxicity minimized. There are various novel approaches to deliver drugs to the target sites in the form of nanocapsules, nanocrystals, nanoemulsions, dendrimers, polymeric micelles, nanotubes and monoclonal antibodies. They have the advantages of improved bioavailability, facilitated transport of drugs across difficult barriers to reach the target tissues for a specific action and providing protection to protect the drug against degradation. A number of anticancer drugs like Doxorubicin, Paclitaxel and 5-Fluorouracil have been formulated using nanoparticles. These innovative techniques have helped to overcome the limitations like resistance in the target cells and difficulty in movement across the barriers which are seen in the conventional drug delivery system. Apart from being a therapeutic tool, it also has brought revolution in early diagnosis of diseases and gene transfer. The surge of nanotechnology is now being translated into commercialized products. The future is exciting, and the promises are limitless as the application of nanotechnology in medicine will provide remarkable opportunities and newer perspectives for novel and effective treatment in various diseases.

Prevalence of insulin induced lipodystrophy in patients with diabetes mellitus in a tertiary care centre: a cross sectional study

Background: Diabetes Mellitus is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycaemic drugs and insulin along with the dietary and lifestyle modifications. Lipodystrophy is the most neglected adverse drug effect caused by injecting insulin. The main objective of this study was to assess the prevalence of lipodystrophy at the insulin injection sites in patients suffering from diabetes mellitus (Type 1 and Type 2).Methods: A cross-sectional study was conducted in the Department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. The demographic features and anthropometric measurements were noted. Insulin injection sites were examined clinically by inspection and palpation for presence of swelling like lipodystrophy, injection marks and signs of allergy like erythema etc. Lipodystrophy was graded from 0-3 and denoted as lipohypertrophy or lipoatrophy. The results were tabulated and presented accordingly.Results: In this study, out of 250 patients 17 (6.8%) patients presented with insulin induced lipodystrophy. Lipohypertrophy was the most common presentation and only one case presented with lipoatrophy.Conclusions: It can be concluded from the present study that lipodystrophy which is an important adverse effect due to insulin injection needs to be monitored regularly in every patient taking insulin for better control of glucose levels

Evaluation of efficacy of palonosetron versus ramosetron in patients receiving emetogenic chemotherapy

Background: Chemotherapy induced nausea and vomiting is the most distressing side effect of cancer chemotherapy. It can seriously impact patient’s quality of life, influence the adherence to chemotherapy and progression free survival causing a delay or refusal of potentially life-saving therapy. The objective of this study was to compare the efficacy of palonosetron with ramosetron in achieving complete response to the chemotherapy.Methods: This was a prospective randomized open-label study conducted on 130 patients admitted in Medical Oncology ward of a Tertiary Care Hospitals, Bangalore, India. Patients were randomized to receive either palonosetron 0.25 mg or ramosetron 0.3 mg I.V. along with aprepitant and dexamethasone 30 minutes prior to chemotherapy and were followed up for a period of 5 days post chemotherapy. The observations such as number and severity of vomiting and nausea, the outcome was assessed at the end of 5 days. Pearson’s Chi-square test was used to demonstrate the difference between both the study groups with respect to various categorical data.Results: The complete response rate in delayed phase was more significant in patients who received palonosetron than patients who received ramosetron (72.3% vs 50.8%). Total control was achieved in 38.5% patients with palonosetron as compared to 15.4% patients with ramosetron.Conclusions: Palonosetron is more efficacious than ramosetron in controlling chemotherapy induced nausea and vomiting especially in delayed phase of emesis