Inappropriate use of proton pump inhibitors in non-critical indoor patients in a tertiary care teaching hospital in Eastern India

Background: Proton pump inhibitors are one of the most commonly used drugs worldwide. Often they are used for inappropriate indications too, imposing economic burden to patients and governments. Many studies have showed equipotent efficacy of oral and intravenous proton pump inhibitor therapy. Despite that, most of the hospitalized patients receive intravenous proton pump inhibitor without appropriate indications. This study aimed to assess use of proton pump inhibitors in government hospital.Methods: It was an observational cross-sectional study done in the general medicine department of a tertiary care teaching hospital in Eastern India, including 800 noncritical patients. Objective was to assess the use of proton pump inhibitors (indications, route of administration, dosing frequency).Results: 100% patient received intravenous proton pump inhibitor irrespective of diagnosis. 80% of them received it twice daily and 18% received it once daily. Majority of the patients received intravenous proton pump inhibitor despite taking other drugs by oral route.Conclusions: Most of the PPI administration was done without appropriate indication. All patients received Intravenous proton pump inhibitors, which may impose economic burden on a government hospital. Majority of the patients received proton pump inhibitors twice daily. These approaches are not cost effective and need to be rectified

qq-enumeration of type B and D Eulerian polynomials based on parity of descents

Carlitz and Scoville in 1973 considered four-variable polynomials enumerating the permutations according to the parity of both descents and ascents. In a recent work, Pan and Zeng proved a $q$-analogue of Carlitz-Scoville's generating function by counting the inversion number. Moreover, they also proved a type B analogue by enumerating the signed permutations with respect to the parity of descent and ascent position. In this work we prove a $q$-analogue of the type B result of Pan and Zeng by counting the type B inversion number. We also obtain a $q$-analogue of the generating functions for the bivariate alternating descent polynomials. Similar results are also obtained for type D Coxeter groups. As a by-product of our proofs, we get $q$-analogues of Hyatt's recurrences for the type B and type D Eulerian polynomials.Comment: 23 pages. Comments are welcom

On Incremental Stability of Interconnected Switched Systems

In this letter, the incremental stability of interconnected systems is discussed. In particular, we consider an interconnection of switched nonlinear systems. The incremental stability of the switched interconnected system is a stronger property as compared to conventional stability. Guaranteeing such a notion of stability for an overall interconnected nonlinear system is challenging, even if individual subsystems are incrementally stable. Here, preserving incremental stability for the interconnection is ensured with a set of sufficient conditions. Contraction theory is used as a tool to achieve incremental convergence. For the feedback interconnection, the small gain characterisation is presented for the overall system's incremental stability. The results are derived for a special case of feedback, i.e., cascade interconnection. Matrix-measure-based conditions are presented, which are computationally tractable. Two numerical examples are demonstrated and supported with simulation results to verify the theoretical claims

Reconfiguration of supply chain network:an ISM-based roadmap to performance

Purpose: Short product life cycle and/or mass customization necessitate reconfiguration of operational enablers of supply chain (SC) from time to time in order to harness high levels of performance. The purpose of this paper is to identify the key operational enablers under stochastic environment on which practitioner should focus while reconfiguring a SC network. Design/methodology/approach: The paper used interpretive structural modeling (ISM) approach that presents a hierarchy-based model and the mutual relationships among the enablers. The contextual relationship needed for developing structural self-interaction matrix (SSIM) among various enablers is realized by conducting experiments through simulation of a hypothetical SC network. Findings: The research identifies various operational enablers having a high driving power towards assumed performance measures. In this regard, these enablers require maximum attention and of strategic importance while reconfiguring SC. Practical implications: ISM provides a useful tool to the SC managers to strategically adopt and focus on the key enablers which have comparatively greater potential in enhancing the SC performance under given operational settings. Originality/value: The present research realizes the importance of SC flexibility under the premise of reconfiguration of the operational units in order to harness high value of SC performance. Given the resulting digraph through ISM, the decision maker can focus the key enablers for effective reconfiguration. The study is one of the first efforts that develop contextual relations among operational enablers for SSIM matrix through integration of discrete event simulation to ISM. © Emerald Group Publishing Limited

Enhanced renewable energy adoption for sustainable development in India:interpretive structural modeling approach

Poverty alleviation and social upliftment of rural India is closely linked with the availability and use of energy for development. At the same time, sustainable supply of clean and affordable renewable energy sources is required if development is to be sustainable, so that it does not cause any environmental problems. The purpose of this paper is to determine the key variables of renewable energy implementation for sustainable development, on which the top management should focus. In this paper, an interpretive structural modeling (ISM) - based approach has been employed to model the implementation variables of renewable energy for sustainable development. These variables have been categorized under ‘enablers’ that help to increase the implementation of renewable energy for sustainable development. A major finding of this research is that public awareness regarding renewable energy for sustainable development is a very significant enabler. In this paper, an interpretation of variables of renewable energy for sustainable development in terms of their driving and dependence powers has been examined. For better results, top management should focus on improving the high-driving power enablers such as leadership, strategic planning, public awareness, top management support, availability of finance, government support, and support from interest groups

Parameter selection in non-traditional machining processes using a data mining approach

With ever-increasing demands for high surface finish and complex shape geometries on various difficult-to-machine materials, conventional metal removal methods are now being replaced by non-traditional machining (NTM) processes. These NTM processes use energy in its direct form to remove material from the workpiece surface. They are also cost effective for a wide range of micro- and nano-level applications. For effective utilization of different NTM processes, it is quite important to study their characteristics and material removal mechanisms in order to identify the most significant control parameters affecting the process responses. In this paper, a data mining approach using classification and regression tree algorithm is employed to identify the most important input parameters of three NTM processes, i.e. micro electro discharge milling process, wire electrical discharge machining process and laser beam machining process. The derived observations are also validated using the analysis of variance results

A study on the machinability of some metal alloys using grey TOPSIS method

The machinability of a material can be defined as the ease with which it can be machined. Materials with good machinability property require less power to cut, can be cut quickly, and easily obtain a good finish without wearing the tooling much. Therefore, to manufacture components economically, production engineers are challenged to discover ways to determine machinability of materials which mainly depends on their mechanical properties, as well as on other cutting conditions. In this paper, the machinability characteristics of alloys of three materials, i.e. aluminium, copper and steel are studied applying grey TOPSIS (technique for order preference by similarity to ideal solution) method. For each case, eight different alloys are considered whose machinability is evaluated based on different mechanical properties which are expressed in grey numbers. Using the adopted methodology, it now becomes easier for the manufacturers to select a particular alloy that can be easily machined. It is observed that A357RC, CuCr1Zr and AISI 5140 are the best machinable aluminium, copper and steel alloys respectively. It is also found that the ranking performance of grey TOPSIS method remains unaffected with the variation in greyness of the considered mechanical property values

Holonic supply chain:a study from family-based manufacturing perspective

In the contemporary business environment, to adhere to the need of the customers, caused the shift from mass production to mass-customization. This necessitates the supply chain (SC) to be effective flexible. The purpose of this paper is to seek flexibility through adoption of family-based dispatching rules under the influence of inventory system implemented at downstream echelons of an industrial supply chain network. We compared the family-based dispatching rules in existing literature under the purview of inventory system and information sharing within a supply chain network. The dispatching rules are compared for Average Flow Time performance, which is averaged over the three product families. The performance is measured using extensive discrete event simulation process. Given the various inventory related operational factors at downstream echelons, the present paper highlights the importance of strategically adopting appropriate family-based dispatching rule at the manufacturing end. In the environment of mass customization, it becomes imperative to adopt the family-based dispatching rule from the system wide SC perspective. This warrants the application of intra as well as inter-echelon information coordination. The holonic paradigm emerges in this research stream, amidst the holistic approach and the vital systemic approach. The present research shows its novelty in triplet. Firstly, it provides leverage to manager to strategically adopting a dispatching rule from the inventory system perspective. Secondly, the findings provide direction for the attenuation of adverse impact accruing from demand amplification (bullwhip effect) in the form of inventory levels by appropriately adopting family-based dispatching rule. Thirdly, the information environment is conceptualized under the paradigm of Koestler's holonic theory

Vision and Learning for Deliberative Monocular Cluttered Flight

Cameras provide a rich source of information while being passive, cheap and lightweight for small and medium Unmanned Aerial Vehicles (UAVs). In this work we present the first implementation of receding horizon control, which is widely used in ground vehicles, with monocular vision as the only sensing mode for autonomous UAV flight in dense clutter. We make it feasible on UAVs via a number of contributions: novel coupling of perception and control via relevant and diverse, multiple interpretations of the scene around the robot, leveraging recent advances in machine learning to showcase anytime budgeted cost-sensitive feature selection, and fast non-linear regression for monocular depth prediction. We empirically demonstrate the efficacy of our novel pipeline via real world experiments of more than 2 kms through dense trees with a quadrotor built from off-the-shelf parts. Moreover our pipeline is designed to combine information from other modalities like stereo and lidar as well if available