Mechanical response of nets of graphical objects

This research produces networks of graphical objects that respond to human manipulation in a fashion that would be deemed physically reasonable. That is, a graphical network is given a mechanics-like behavior in the presence of the human interaction. In this approach, nonlinear models replace commonly used linear models to mimic physical reality better. Software solutions are provided via a class library useful for such interactive visual modeling --Abstract, page iii

On Solution of Interval Valued Intuitionistic Fuzzy Assignment Problem Using Similarity Measure and Score Function

The primary objective of the paper is to propose a new method for solving assignment problem under uncertain situation. In the classical assignment problem ( ), denotes the cost for assigning the job to the person which is deterministic in nature. Here in some uncertain situation, we have assigned a cost in the form of composite relative degree instead of and this replaced cost is in the maximization form. In this paper, it has been solved and validated by the two proposed algorithms, a new mathematical formulation of assignment problem has been presented where the cost has been considered to be an IVIFN and the membership of elements in the set can be explained by positive and negative evidences. To determine the composite relative degree of similarity of the concept of similarity measure and the score function is used for validating the solution which is obtained by Composite relative similarity degree method. Further, hypothetical numeric illusion is conducted to clarify the method's effectiveness and feasibility developed in the study. Finally, conclusion and suggestion for future work are also proposed

On Solution of Interval Valued Intuitionistic Fuzzy Assignment Problem Using Similarity Measure and Score Function

The primary objective of the paper is to propose a new method for solving assignment problem under uncertain situation. In the classical assignment problem ( ), denotes the cost for assigning the job to the person which is deterministic in nature. Here in some uncertain situation, we have assigned a cost in the form of composite relative degree instead of and this replaced cost is in the maximization form. In this paper, it has been solved and validated by the two proposed algorithms, a new mathematical formulation of assignment problem has been presented where the cost has been considered to be an IVIFN and the membership of elements in the set can be explained by positive and negative evidences. To determine the composite relative degree of similarity of the concept of similarity measure and the score function is used for validating the solution which is obtained by Composite relative similarity degree method. Further, hypothetical numeric illusion is conducted to clarify the method's effectiveness and feasibility developed in the study. Finally, conclusion and suggestion for future work are also proposed

On Solution of Interval Valued Intuitionistic Fuzzy Assignment Problem Using Similarity Measure and Score Function

The primary objective of the paper is to propose a new method for solving assignment problem under uncertain situation. In the classical assignment problem ( ), denotes the cost for assigning the job to the person which is deterministic in nature. Here in some uncertain situation, we have assigned a cost in the form of composite relative degree instead of and this replaced cost is in the maximization form. In this paper, it has been solved and validated by the two proposed algorithms, a new mathematical formulation of assignment problem has been presented where the cost has been considered to be an IVIFN and the membership of elements in the set can be explained by positive and negative evidences. To determine the composite relative degree of similarity of the concept of similarity measure and the score function is used for validating the solution which is obtained by Composite relative similarity degree method. Further, hypothetical numeric illusion is conducted to clarify the method's effectiveness and feasibility developed in the study. Finally, conclusion and suggestion for future work are also proposed

The post-coital pills as over the counter drugs

Post-coital pill or emergency contraceptives are birth control measures that, if taken after sexual intercourse, may prevent pregnancy. High dose of postcoital contraceptives like diethylstilbestrol & other estrogens were being used for some time without any approval by FDA. Task force on postovulatory methods of fertility regulations 1998, conducted clinical trials leading to approval of two preparations for postcoital contraception by FDA namely levonorgestrel 0.75mg & combination of 0.25 levonorgestrel & 0.05 mg of ethinyl estradiol. Levonorgestrel is more popular in India because it is more effective & has fewer side effects. The first dose of levonorgestrel 0.75mg should be taken within 72 hours of unprotected intercourse followed by a second dose after 12 hours. This treatment reduces the risk of pregnancy by approximately 75%. Oral levonorgestrel acts as an emergency contraceptive principally by preventing ovulation or fertilization by altering tubal transport of sperm and/or ova. In addition, it may inhibit implantation by altering the endometrium. It is not effective once the process of implantation has begun

To study prescription behavior of physician in regard to brand and generic name

Background: Drugs are the chemical substances used for diagnosis, prevention and treatment of a disease. They are prescribed either by using generic name or brand name. The objective of this study was study the preference of registered medical practitioners towards prescribing of drugs by generic name or brand name and to know the reasons for the same.Methods: The questionnaire based observational study was done on 300 registered medical practitioners after satisfying inclusion and exclusion criteria. The data collected was evaluated and the response recorded in percentage.Results: Out of 300 practitioners 92% admitted prescribing drug by brand name for fear of substitution by substandard product and did not allow pharmacist to substitute the same, rest 8% prescribe by generic names. 78% considered generic drugs to be less efficacious and 3% had the view that they have more side effects. 83% doctors consider patient affordability while prescribing however only 60% of them informed patients about the cost of prescribed drugs. Other factors influencing prescription behaviour were health care administration policy (10%) and company representative (7%).Conclusions: Majority of physicians prescribe drugs by brand names due to its assured efficacy and they are reluctant to prescribe generic names because of their view of substitution by less efficacious, substandard and counterfeit products. The regulating agencies have to assure the efficacy of generic products. The spurious and substandard drugs available in the market have to be checked and strict action should be taken in order to maintain the quality of these products. This will boost the confidence of the physicians in prescribing the generic drugs resulting in decreased health care cost

Post-traumatic acute bilateral facial nerve palsy: A management dilemma

Acute bilateral facial nerve paralysis is a rare clinical entity, and its management remains very controversial (operative or conservative). Here we are presenting a case of acute onset bilateral facial nerve palsy following head injury with bilateral temporal bone fracture with clinico-radiographic contrary. Patient was managed conservatively with complete recovery. By this article, authors want to stress on combining clinical examination and radiological findings for decision making of this rare entity and tried to evaluate the management

Reduced cortical thickness in patients with acute-on-chronic liver failure due to non-alcoholic etiology

Background: Acute-on-chronic liver failure (ACLF) is a form of liver disease with high short-term mortality. ACLF offers considerable potential to affect the cortical areas by significant tissue injury due to loss of neurons and other supporting cells. We measured changes in cortical thickness and metabolites profile in ACLF patients following treatment, and compared it with those of age matched healthy volunteers. Methods: For the cortical thickness analysis we performed whole brain high resolution T1-weighted magnetic resonance imaging (MRI) on 15 ACLF and 10 healthy volunteers at 3T clinical MR scanner. Proton MR Spectroscopy (1H MRS) was also performed to measure level of altered metabolites. Out of 15 ACLF patients 10 survived and underwent follow-up study after clinical recovery at 3 weeks. FreeSurfer program was used to quantify cortical thickness and LC- Model software was used to quantify absolute metabolites concentrations. Neuropsychological (NP) test was performed to assess the cognitive performance in follow-up ACLF patients compared to controls. Results: Significantly reduced cortical thicknesses in multiple brain sites, and significantly decreased N-acetyl aspartate (NAA), myo-inositol (mI) and significantly increased glutamate/glutamine (glx) metabolites were observed in ACLF compared to those of controls at baseline study. Follow-up patients showed significant recovery in cortical thickness and Glx level, while NAA and mI were partially recovered compared to baseline study. When compared to controls, follow-up patients still showed reduced cortical thickness and altered metabolites level. Follow-up patients had abnormal neuropsychological (NP) scores compared to controls. Conclusions: Neuronal loss as suggested by the reduced NAA, decreased cellular density due to increased cerebral hyperammonemia as supported by the increased glx level, and increased proinflammatory cytokines and free radicals may account for the reduced cortical thickness in ACLF patients. Presence of reduced cortical thickness, altered metabolites and abnormal NP test scores in post recovery subjects as compared to those of controls is associated with incomplete clinical recovery. The current imaging protocol can be easily implemented in clinical settings to evaluate and monitor brain tissue changes in patients with ACLF during the course of treatment

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years