System Reliability Estimation in Multicomponent Exponential-Lindley Stress-Strength Models

A stress-strength model is formulated for a multi-component system consisting of k identical components. The k components of the system with random strengths ( ) 1 2 , ,..., k X X X are subjected to one of the r random stresses ( ) 1 2 , ,..., r Y Y Y . The estimation of system reliability based on maximum likelihood estimates (MLEs) and Bayes estimators in k component system are obtained when the system is either parallel or series with the assumption that strengths and stresses follow Lindley distribution and Exponential distribution respectively. A simulation study is conducted to compare MLE and Bayes estimator through the mean squared errors of the estimators

Benign papillary cystadenofibroma of fallopian tube presenting as posterior fornix cyst: case report

Benign papillary cystadenofibroma of fallopian tube is very rare tumor of female genital tract. Usually asymptomatic and incidental finding. Worldwide literature only 18 cases were found. On account of its rarity and best of our knowledge, is the first case of benign papillary cystadenofiboma presented as posterior fornix cyst, so we are presenting this case. We report a rare case of benign papillary cystadenofibroma of fallopian tube in a 30-years old female P3L3 presenting with abdominal pain. On examination abdomen was soft, per vaginally mobile non-tender cystic mass of 5×4 cm was noted. Laparotomy was planned. Intraoperatively 5x4 cm cyst arising from serosal surface of left fallopian tube near fimbrial end noted with bilateral ovaries normal. Left fimbrial cystectomy with salpingectomy was done with sparing both ovaries. Histopathology suggestive of benign papillary cystadenofibroma of fallopian tube. Patient had uneventful recovery in follow up period. Benign papillary cystadenofibroma of fallopian tube is rare tumor found incidentally. Tumor seems to have benign course only cystectomy is required for treatment

The value of kinetic glomerular filtration rate estimation on medication dosing in acute kidney injury.

BackgroundIn acute kidney injury (AKI), medication dosing based on Cockcroft-Gault creatinine clearance (CrCl) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rates (eGFR) are not valid when serum creatinine (SCr) is not in steady state. The aim of this study was to determine the impact of a kinetic estimating equation that incorporates fluctuations in SCrs on drug dosing in critically ill patients.MethodsWe used data from participants enrolled in the NIH Acute Respiratory Distress Syndrome Network Fluid and Catheters Treatment Trial to simulate drug dosing category changes with the application of the kinetic estimating equation developed by Chen. We evaluated whether kinetic estimation of renal function would change medication dosing categories (≥60, 30-59, 15-29, and <15mL/min) compared with the use of CrCl or CKD-EPI eGFR.ResultsThe use of kinetic CrCl and CKD-EPI eGFR resulted in a large enough change in estimated renal function to require medication dosing recategorization in 19.3% [95 CI 16.8%-21.9%] and 23.4% [95% CI 20.7%-26.1%] of participants, respectively. As expected, recategorization occurred more frequently in those with AKI. When we examined individual days for those with AKI, dosing discordance was observed in 8.5% of total days using the CG CrCl and 10.2% of total days using the CKD-EPI equation compared with the kinetic counterparts.ConclusionIn a critically ill population, use of kinetic estimates of renal function impacted medication dosing in a substantial proportion of AKI participants. Use of kinetic estimates in clinical practice should lower the incidence of medication toxicity as well as avoid subtherapeutic dosing during renal recovery

Navigating the clinical ambiguity of implant placement in two young pubescent patients: an insight from two case reports

The horizon of implant dentistry has been ever-expanding owing to its long-term success in rehabilitating partially or completely edentulous cases. This perennial success and efficiency have encouraged clinicians to use osseo-integrated implants to replace teeth lost in children either due to trauma or congenital absence. Although a myriad of studies and publications suggest the placement of implants only after the attainment of skeletal maturity, as the growth-related changes such as remodelling, displacement, and mesial drift can put the future of implant and restoration in jeopardy, the use of implants in young pubescent or adolescent looks promising due to its evident psychological and social advantages over other contemporary alternatives such as a removable prosthesis or resin-bonded bridge. The first case report highlights a 16-year follow-up of a young girl treated at the age of 10 with an implant-supported prosthesis for the replacement of a missing maxillary left central incisor. The second case report centers around a 19-year-old teenage girl who underwent rehabilitation with a permanent fixed prosthesis, replacing her previous implant-supported temporary prosthesis. The implant was initially placed when she was 10 years old

Interference mitigation in wireless mesh networks through radio co-location aware conflict graphs

Wireless Mesh Networks (WMNs) have evolved into a wireless communication technology of immense interest. But technological advancements in WMNs have inadvertently spawned a plethora of network performance bottlenecks, caused primarily by the rise in prevalent interference. Conflict Graphs are indispensable tools used to theoretically represent and estimate the interference in wireless networks. We propose a generic algorithm to generate conflict graphs which is independent of the underlying interference model. Further, we propose the notion of radio co-location interference, which is caused and experienced by spatially co-located radios in multi-radio multi-channel WMNs. We experimentally validate the concept, and propose a new all-encompassing algorithm to create a radio co-location aware conflict graph. Our novel conflict graph generation algorithm is demonstrated to be significantly superior and more efficient than the conventional approach, through theoretical interference estimates and comprehensive experiments. The results of an extensive set of ns-3 simulations run on the IEEE 802.11g platform strongly indicate that the radio co-location aware conflict graphs are a marked improvement over their conventional counterparts. We also question the use of total interference degree as a reliable metric to predict the performance of a Channel Assignment scheme in a given WMN deployment

Racial Differences in Serum Adipokine and Insulin Levels in a Matched Osteoarthritis Sample: A Pilot Study

Background. In an attempt to correlate biomarkers with disease, serum-based biomarkers often are compared between individuals with osteoarthritis (OA) and control subjects. However, variable results have been reported. Some studies have suggested an association between certain adipokines and insulin and OA. We know that there are racial differences in OA prevalence and incidence, and from general population-based studies, those of Asian race consistently demonstrate a unique adipokine/insulin serum concentration profile as compared to Caucasians. Whether similar racial differences exist within OA samples is unknown and may have implications for selecting appropriate controls in comparative studies. Methods. Serum levels of adipokines, leptin, and adiponectin, along with insulin, were determined by ELISA in patients scheduled for total hip or knee replacement surgery for OA. Fifteen Asian patients were matched 1 : 1 on age (±2 years), gender, body mass index (±1.5 kg/m2), and surgical joint with Caucasian patients. Differences in serum concentrations were tested using paired t-tests. Results. Serum leptin and insulin levels were significantly higher in Asians compared to Caucasians (p<0.05). While serum adiponectin levels were lower among Asians, the difference did not reach statistical significance (p=0.12). Conclusion. Findings from this work suggest that when studying serum biomarker concentrations in OA versus controls, race may be an important factor to consider. Our findings warrant confirmation in larger studies

Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death

Background: Misoprostol is a prostaglandin E1 analogue, a methyl-ester of prostaglandin E1 additionally methylated at C-16. Misoprostol is an effective myometrial stimulant of pregnant uterus, selectively binding to prostanoid receptors. The objective of the study was to compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD).Methods: A prospective randomised clinical trial, comparing 50µg oral and 50µg vaginal misoprostol, six hourlies for a maximum of four doses for the induction of labour in women with IUFD. All patients with IUFD after 28 weeks without previous uterine surgeries, without contraindications for prostaglandins are included in the study. The study was conducted in the Department of Obstetrics and Gynecology MVJ Medical College and Research Hospital, Hoskote. Bangalore from June 2012 to June 2015. It is a tertiary institution serving predominantly rural population. The primary outcome measure was the induction to delivery time, secondary all complications were noted.Results: Twenty-five women were randomised to the vaginal route and twenty-five to the oral route. The induction to delivery time was longer with vaginal misoprostol 10.5±4.03 compared to oral misoprostol (9.58±4.9). There was no significant difference in the amount of misoprostol needed to achieve successful induction in the two groups. 3 patients needed oxytocin augmentation to complete the induction of labour. There were no cases of failed induction. The systemic side effects (shivering, diarrhoea, vomiting and pyrexia) were more common with oral misoprostol (44.5%) compared to vaginal misoprostol (20%).Conclusions: Oral misoprostol achieved successful induction of labour in women with IUFD in a shorter time than vaginal misoprostol. Both routes are equally effective in termination of pregnancy. Sublingual route is easy to administer, patient compliant, no need for internal examination, less chance of labour dysfunction, less chance of post-partum sepsis

System reliability estimation in multicomponent exponential stress-strength models

A stress-strength model is formulated for a multi-component system consisting of k identical components. The k components of the system with random strengths (X1, X2, …, Xk) are subjected to one of the r random stresses (Xk+1, Xk+2, …, X k+r). The estimation of system reliability based on maximum likelihood estimates (MLEs) and Bayes estimators in k component system are obtained when the system is either parallel or series with the assumption that strengths and stresses follow exponential distribution. A simulation study is conducted to compare MLE and Bayes estimator through the mean squared errors of the estimator

System reliability estimation in multicomponent exponential stress-strength models

A stress-strength model is formulated for a multi-component system consisting of k identical components. The k components of the system with random strengths (X1, X2, …, Xk) are subjected to one of the r random stresses (Xk+1, Xk+2, …, X k+r). The estimation of system reliability based on maximum likelihood estimates (MLEs) and Bayes estimators in k component system are obtained when the system is either parallel or series with the assumption that strengths and stresses follow exponential distribution. A simulation study is conducted to compare MLE and Bayes estimator through the mean squared errors of the estimator