Re: Efficacy and Safety of Vildagliptin and Remogliflozin as Add-on Therapy to Metformin in Patients of Type 2 Diabetes Mellitus

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Indirect Estimation of Link Delays by Directly Observing a Triplet of Network Metrics

AbstractThis paper presents an improved indirect estimation link delays from a triplet of network metrics; path delays, packet loss rate (PLR), and jitter by using indirect inverse modeling techniques. conventionally a network metric is estimated by directly observing another network parameter. Based on the evidence in the literature that path delays, PLR, and jitter are interdependent, this work exploits this mutual interdependent of this triplet of metrics based on the notion that a better observation leads to better estimation. We applied NTF1 model, a variation of non negative tensor factorization (NTF) for this purpose and estimated link delay from a triplet of metrics. Evaluation process used data from an experimental test bed that consists of standard networking devices. The estimated link delays were correlated to actual link delays to benchmark the accuracy of estimation. Results showed a better correlation between the estimated and measured link delays when a triplet of metrics is used

Critical success factors in implementing an e-rostering system in a healthcare organisation

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts

Inkjet-printed UHF RFID tag based system for salinity and sugar detection

This article presents an RFID system to detect the salinity and sugar contents of water. The proposed system is based on low‐cost ink‐jet printed passive ultrahigh frequency (UHF) RFID tag. The tag is designed using slot match technique, which poses a good imaginary impedance match with RFID chip both in free space and after mounting on the water bottle. Moreover, the tag antenna is exploited as a sensor to detect salt and sugar contents of water by measuring the backscatter power from the tag in term of received signal strength indicator (RSSI). A Tagformance Pro setup form Voyantic is used for measuring RSSI. Furthermore, an approximate relationship is derived between backscatter power and no. of grams of salt and sugar dissolved in water. This study paves a way to check the contents of drinks using portable devices, which is pivotal for healthcare applications in smart cities and the future Internet of things (IoT)

n-Butyl 2-(2,4-dichloro­anilino)-4,4-dimethyl-6-oxocyclo­hex-1-enecarbo­dithio­ate

The cyclo­hexene ring in the title compound, C19H23Cl2NOS2, adopts an envelope conformation, with the C atom bearing the two methyl groups representing the flap. This atom deviates by 0.630 (2) Å from the plane passing through the other five atoms of the ring (r.m.s. deviation = 0.020 Å). The mol­ecular conformation is stabilized by an intra­molecular N—H⋯S hydrogen bond

Cystic Fibrosis - An Ever Evolving Challenge

Cystic fibrosis (CF) is a genetic disease that results from mutations in a large single gene located on chromosome 7. More than 2000 different mutations in the gene have been identified to have caused the disease. Most of these mutations are exceedingly rare and therefore not a part of CF screening or all testing panels. This case discusses an adult female with a history of asthma, bronchiectasis, pseudomonas colonization, and respiratory failure on chronic oxygen who presented to the ED with sudden onset shortness of breath, fever, chills, body aches, nonproductive cough, and headache. The patient\u27s condition clinically improved with treatment and was discharged on day three. The patient had previously undergone a laboratory evaluation of bronchiectasis. Due to the patient\u27s history of bronchiectasis and pseudomonas colonization, there was a decision to reconsider the possibility of CF. The patient underwent a routine cystic fibrosis genetic testing panel which subsequently confirmed a CFTR mutation. The discussion highlights the importance of remaining vigilant for signs of CF, to remain open to the possibility of CF or CFTR related disorders, when patients have had evaluations for such that predate current testing standards or capabilities

Cocaine as a Rare Cause of Cholecystitis

Cholecystitis, inflammation of the gallbladder, is diagnosed in approximately 200,000 people in the US each year. Cocaine is an illicit drug that is wildly abused in the US, GI complications such as acute pancreatitis, colitis, bowel perforation, mesenteric ischemia, and biliary tree obstruction have been reported in limited studies. To the best of our knowledge, there are no reported cases of cocaine-induced cholecystitis and no established treatment plans to date, however, we strongly believe that our patient’s cocaine use resulted in cholecystitis. Hence, we wanted to shed some light on the possible side effects of cocaine on the gall bladder

A comparison of software defined network (SDN) implementation strategies

Publisher's Version/PDF2nd International Workshop on Survivable and Robust Optical Networks (IWSRON)Software defined networking (SDN) is an emerging approach to handle data forwarding and control separately. The notion of programmability has central importance in SDN. Two implementation strategies; proprietary and open source, are shaping the trends of the adoptability of SDN by major hardware manufacturers. A group of leading vendors believes that loose coupling between the logical and physical layers of a network hinders the proper provision of physical resources and suggests a proprietary fix to this problem. The other group regards the notion of openness as s key feature of SDN. This paper compares and contrasts these two implementation strategies of SDN by identifying their respective operating principles, features of the product lines, and weakness and strengths

Early complications after biliary enteric anastomosis for benign diseases: A retrospective analysis

Background:Biliary-enteric anastomosis (BEA) is a common surgical procedure performed for the management of biliary obstruction or leakage that results from a variety of benign and malignant diseases. Complications following BEA are not rare. We aimed to determine the incidence and the factors associated with early complications occurring after BEA for benign diseases. Methods: We reviewed the medical records of all Patients who underwent BEA for benign diseases at our institution between January 1988 and December 2009. The primary outcome was early post operative complication. Logistic regression analysis was done to identify factors predicting the occurrence of complications. Results: Records of 79 Patients were reviewed. There were 34 (43%) males and 45 (57% females). Majority (53%) had choledocholithiasis with impacted stone or distal stricture, followed by traumatic injury to the biliary system (33%). Thirty-four Patients (43%) underwent a hepaticojejunostomy, 19 Patients (24%) underwent a choledochojejunostomy, and choledochoduodenostomy was performed in 26 Patients (33%). Early complications occurred in 39 (49%) Patients - 41% had local complications and 25% had systemic complications. Most frequent complications were wound infection (23%) and bile leak (10%). Four (5%) Patients died. On multivariate analysis, low serum albumin level (odds ratio = 16, 95% CI = 1.14-234.6) and higher ASA levels (odds ratio = 7, 95% CI: 1.22-33.34) were the independent factors predicting the early complications following BEA. Conclusions: Half of the Patients who underwent BEA for benign diseases had complications in our population. This high incidence may be explained by the high incidence of hypoalbuminemia and the high-risk group who underwent operation