Learning Individual Policies in Large Multi-agent Systems through Local Variance Minimization

In multi-agent systems with large number of agents, typically the contribution of each agent to the value of other agents is minimal (e.g., aggregation systems such as Uber, Deliveroo). In this paper, we consider such multi-agent systems where each agent is self-interested and takes a sequence of decisions and represent them as a Stochastic Non-atomic Congestion Game (SNCG). We derive key properties for equilibrium solutions in SNCG model with non-atomic and also nearly non-atomic agents. With those key equilibrium properties, we provide a novel Multi-Agent Reinforcement Learning (MARL) mechanism that minimizes variance across values of agents in the same state. To demonstrate the utility of this new mechanism, we provide detailed results on a real-world taxi dataset and also a generic simulator for aggregation systems. We show that our approach reduces the variance in revenues earned by taxi drivers, while still providing higher joint revenues than leading approaches.Comment: arXiv admin note: substantial text overlap with arXiv:2003.0708

Evaluation of severe acute maternal morbidity and mortality at a tertiary referral center of Uttarakhand, India

Background: Maternal mortality is an area of concern for the Governments across the globe. India is signatory to millennium declaration and is committed to achieving the target of millennium development goals by reducing MMR to 100. Known obstacles to reducing the MMR in developing countries, include lack of material and human resources, as well as difficulties in accessing services due to financial, geographical, and cultural limitations.Methods: It was a descriptive cross-sectional study conducted at a tertiary care centre in Uttarakhand for a period of one year. WHO’s near-miss approach was implemented for evaluation of severe maternal outcomes and to assess the quality of maternal health care.Results: During the period of this study there were 2243 total antenatal admissions, 1675 deliveries, 1591 live births and 59 near miss cases. Prevalence of SAMM in the present study is 3.52%. Out of every 9-10 women who survived a life-threatening condition 1 died. Mortality Index is 10.17%. Maternal mortality ratio is 377.12 per 1 lakh live births. A total of 43 patients with potentially life-threatening conditions were admitted in ICU out of which 26 were near miss cases. The leading cause of near miss in this tertiary health facility is obstetric haemorrhage (45.8%).Conclusions: Prompt identification of complications and timed intervention remains the key determinant in making mothers survive a life-threatening complication

Entropy based independent learning in anonymous multi-agent settings

Efficient sequential matching of supply and demand is a problem of interest in many online to offline services. For instance, Uber, Lyft, Grab for matching taxis to customers; Ubereats, Deliveroo, FoodPanda etc for matching restaurants to customers. In these online to offline service problems, individuals who are responsible for supply (e.g., taxi drivers, delivery bikes or delivery van drivers) earn more by being at the "right" place at the "right" time. We are interested in developing approaches that learn to guide individuals to be in the "right" place at the "right" time (to maximize revenue) in the presence of other similar "learning" individuals and only local aggregated observation of other agents states (e.g., only number of other taxis in same zone as current agent). A key characteristic of the domains of interest is that the interactions between individuals are anonymous, i.e., the outcome of an interaction (competing for demand) is dependent only on the number and not on the identity of the agents. We model these problems using the Anonymous MARL (AyMARL) model. The key contribution of this paper is in employing principle of maximum entropy to provide a general framework of independent learning that is both empirically effective (even with only local aggregated information of agent population distribution) and theoretically justified. Finally, our approaches provide a significant improvement with respect to joint and individual revenue on a generic simulator for online to offline services and a real world taxi problem over existing approaches. More importantly, this is achieved while having the least variance in revenues earned by the learning individuals, an indicator of fairness

Cast immobilization in fracture distal radius with wrist in dorsiflexion

Background: The purpose of this study was to evaluate the anatomical and functional outcome of cast immobilization in fracture distal radius with wrist in dorsiflexion. Study design selected was prospective cohort study.Methods: The study group comprised 60 patients, with a mean follow-up of 3 month. Patients were evaluated for radial height, radial inclination and volar tilt according to Lindstrom criteria. Functional outcome were assessed with PRWE score.Results: Mean loss of radial height was 4.11 mm. Mean loss of radial inclination was 6.85 degree and mean loss of volar tilt was 7.06 degree at the end of 3 month follow up. As per Lindstrom criteria 88% were excellent to fair and 93% were excellent to fair functional outcome as per PRWE score.Conclusions: Cast immobilization in fracture distal radius with wrist in dorsiflexion produces better anatomical and functional outcome.

Drug utilization study in Cardiology outpatient department at a tertiary care hospital

Background: Cardiovascular diseases are the most frequent cause of morbidity and mortality throughout the world particularly in South Asian population. With advent of newer, highly efficacious heterogeneous drugs and changing treatment guidelines, there’s a need to identify the cardiologist preference and prescribing patterns for rational utilization.Methods: It was an open label, prospective, cross-sectional, descriptive type of study conducted in Cardiology Outpatients at a Tertiary care hospital, Navi Mumbai. The study included 100 patients suffering from cardiovascular diseases attending cardiology outpatient department from October 2016 to March 2017. Informed consent was obtained and the currently prescribed drug details were recorded from prescription. The data was analysed for WHO core prescribing indicators and different types of drugs prescribed.Results: The average number of drug products prescribed was 3.4. Most commonly prescribed drugs were Antiplatelets (23%) followed by Statins (19.71%), β blockers (16%), Nitrates (11.70%), Angiotensin converting enzyme inhibitors (8.03%), Calcium channel blockers (5.50%), Angiotensin receptor blockers (4.70%), Diuretics (2.55%), Anticoagulant (1.83%), α+β blocker (1.46%), Cardiac glycosides ((1.09%), Potassium sparing diuretic and central sympatholytics. Majority of drugs were prescribed as single drugs (79.88%) while 20.11% as fixed dose combination (FDC). The combination of Telmisartan + Hydrochlorthiazide was the commonest prescribed FDC. Majority drugs were prescribed from NEDL 2015, but documented low generic prescribing.Conclusions: Antiplatelet and Statins dominated the prescribing pattern with high prescribing trend from national essential drug list, but showed scope for improvement in encouraging the cardiologist to prescribe by generic name

Modelling and Simulation of Noise Effects in Power Line Communications

Power line communications refers to the concept of transmitting information using the mains power line as a communications channel. Power line communication systems can be simply described as the distribution of data and other signals via electric power distribution wires. There are some challenges for communications over power lines, such as impedance variation, attenuation, channel transfer function varying widely over time, different kind of interference and noise in the system. This Paper deals with the noise scenario modelling approach and modulation schemes for the PLC system

Inter arm systolic blood pressure difference is associated with a high prevalence of cardio vascular diseases

Background: Blood pressure (BP) recordings often differ between arms. This study is aimed to observe the presence of inter-arm blood pressure difference and association with hypertension or diabetes. The objective of the study was to establish the prevalence of an inter-arm blood pressure difference and explore its association with obesity and cardiovascular disorder.Methods: A cross-sectional study conducted at King George’s Medical College, Lucknow, India among 100 first year MBBS students. After taking verbal consent the age, height, weight, waist circumference, hip circumference and family history of hypertension or diabetes were recorded.Results: The systolic blood pressure on right arm was 118.8±11.5 mmHg and 11.7±7.72 mmHg left arm. Result significantly showed higher mean systolic blood pressure on right arm. There were 54, 17 and 29 participants with inter-arm systolic blood pressure difference of 30). Out of 100 subjects, 11 subject having inter-arm systolic blood pressure difference ≥10 mmHg was associated with a family history of diabetes or hypertension.Conclusions: Presence of inter-arm blood pressure difference with having family history of hypertension or diabetes is more susceptible to develop cardiovascular disorder in future

A REVIEW OF THE COMBINATION OF XANTHINE AND BRONCHODILATOR DRUG IN MOUTH‑DISSOLVING FILM FOR ASTHMA TREATMENT”

There has been an increase in demand for caregiver dosage forms over the past two decades. In the oral cavity, mouth dissolving film dissolves swiftly. Oral films that dissolve in your mouth function best when combined with medications that act quickly, such as Xanthine category drugs (Salbutamol Sulphate) and Xanthene Derivative Theophylline. According to the World Health Organization (WHO), asthma affects one in six adults and a quarter of all children, according to the WHO. A child’s admission to the hospital is often due to asthma, which is one of the most prevalent reasons for admission. During an asthma attack, quick-relief or rescue drugs are used to relax and open the airways, as well as ease symptoms. If prescribed, these medications can also be administered prior to exercise. To treat asthma, a combination of Salbutamol Sulfate and Theophylline is available in tablet form under the brand name “Theo-Asthalin.” Oral films seem to be the most efficacious formulation. As a consequence, children with asthma should receive support from drugs given in the form of mouth-dissolving films, since they provide better patient compliance and an appropriate treatment method