ESTIMATION OF MEAN TIME TO RECRUITMENT FOR A TWO GRADED MANPOWER SYSTEM WITH TWO THRESHOLDS, DIFFERENT EPOCH FOR EXITS AND EXPONENTIAL INTER-DECISIONS UNDER CORRELATED WASTAGE.

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

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Clinical and Radiological Changes after use of Alpha-1 Blocker Therapy in Patients of Posterior Urethral Valve with Bladder Neck Hypertrophy

JMS SKIMS ◽

10.33883/jms.v12i1.7 ◽

2009 ◽

Vol 12 (1) ◽

pp. 3-7

Author(s):

Aejaz A Baba ◽

Bajpai Minu

Keyword(s):

Bladder Neck ◽

Posterior Urethral Valve ◽

Posterior Urethral Valves ◽

Blocker Therapy ◽

Urethral Valve ◽

Novel Method ◽

Radiological Changes ◽

Group 2 ◽

Mean Time ◽

Group 1

Background: We evaluated the effects of alpha-1 blocker therapy on clinical and radiological abnormalities in patients of posterior urethral valve with bladder neck hypertrophy. Materials and Methods: A total of 74 patients with posterior urethral valves were seen at our department between 2003 and 2007. Out of these 24 had radiological evidence of bladder neck hypertrophy. Those patients with bladder neck hypertrophy who were seen before June 2006 and did not receive alpha-1 blocker (prazocin) therapy after valve ablation were assigned to group 1 (n=10). Group 2 consisted of 14 age matched patients with bladder neck hypertrophy and comparable prognostic factors who received alpha-1 blocker therapy after valve ablation (n=14). Micturating cystourethrography (MCU) was done periodically and a novel method used to calculate bladder neck hypertrophy. Trends in symptoms and radiological changes were evaluated throughout follow-up. Results: Mean patient age at presentation was 3.02±2.68 years in group 1 and 3.12±3.4 years in group 2. Bladder neck hypertrophy decreased from 2.3±1.0 to 2.0±0.5 in a mean time of 52.0 (34-52) weeks in group 1 where as it decreased from 2.2±0.5 to 1.6±0.3 in a mean time of 32.0 (22-52) weeks. Symptomatically patients in group 2 who received alpha-1 blocker therapy after valve ablation were better and had quick resolution of bladder neck hypertrophy. Conclusions: Use of alpha-1 blocker therapy in patients of posterior urethral valve with bladder neck hypertrophy helps in quick resolution of bladder neck hypertrophy. J Med Sci 2009;12(1):3-7.

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Reliability Analysis of Cold Standby Parallel System Possessing Failure And Repair Rate Under Geometric Distribution

Recent Advances in Computer Science and Communications ◽

10.2174/2666255813666191219110504 ◽

2019 ◽

Vol 13 ◽

Author(s):

Jasdev Bhatti ◽

Mohit Kumar Kakkar

Keyword(s):

Failure Rate ◽

Geometric Distribution ◽

Discrete Distribution ◽

Maintenance Cost ◽

Discrete Problem ◽

New Techniques ◽

Testing Strategies ◽

Cold Standby ◽

Mean Time ◽

Iteration Technique

Background and Aim: With an increase in demands about reliability of industrial machines following continuous or discrete distribution, the important thing to be noticed is that in all previous researches where systems are having more than one failure no iteration technique has been studied to separate the failed unit on basis of its failure. Therefore, aim of our paper is to analyze the real industrial discrete problem following cold standby units arranged in parallel manner with newly concept of inspection procedure for failed units to inspect the exact failure and being communicator to the repairman for repairing exact failed part of unit for saving time and maintenance cost. Methods: The geometric distribution and regenerative techniques had been applied for calculating different reliability measures like mean time to system failure, availability of a system, inspection, repair and failed time of unit. Results: Graphical and analytical study had also been done to analyze the increasing/decreasing behavior of profit function w.r.t repair and failure rate. The system responded properly in fulﬁlling his basic needs. Conclusion: The calculated value of all reliability parameter is helpful for studying any other models following same concept under different environmental conditions. Thus, it concluded that, reliability increases/decreases with increase in repair/failure rate. Also, the evaluated results by this paper provides the better reliability testing strategies that helps to develop new techniques which leads to increase the effectiveness of system.

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Inspecting Briquette Machine with Different Faults

Recent Advances in Computer Science and Communications ◽

10.2174/2666255813999200909110603 ◽

2020 ◽

Vol 13 ◽

Author(s):

Divesh Garg ◽

Reena Garg ◽

Vanita Garg

Keyword(s):

Failure Rate ◽

Rate Increase ◽

Practical Importance ◽

System Failure ◽

Regenerative Point ◽

Semi Markov Process ◽

Major Fault ◽

Environment Study ◽

Burning Coal ◽

Mean Time

Background: A briquette machine can be considered very useful in modern times as the need of energy consumption is increasing rapidly. Considering the harm to environment, study of briquette machine is the need of present times. In this paper, the operative unit is considered as briquette machine also known as bio-coal which is used for agroforestry waste. Objective: A single operative unit has been analyzed stochastically. The inspection of breakdown of a unit reveals the feasibility of the unit under the supervision of either ordinary or expert repairmen. Two types of fault are revealed by the repairmen either minor or major fault. Minor faults are repaired immediately by the same repairmen but whenever major fault held, the machine’s fault will be handled by expert person. Method: It is assumed that the repair needs no modification once served. Availability, Mean-time for system failure, and profits are analyzed by utilizing the Regenerative point graphical technique and semi-Markov process. Result: Study reveals that the Mean-time for system failure of the system model go on decreasing as failure rate increase and availability goes on decreasing as failure-rate increase. Moreover, the study shows that the systems profit goes down on increase of Failure-rate. Conclusion: Findings of the study supports the hypothesis that the limits of failure/repair/inspection rate will surely have effective profitability. Moreover, it is found that the utility of scale of operation can easily be derived. The practical importance of biomass briquettes for burning coal or wood is very well appreciated.

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Simultaneous Casualty Admissions—Do they Affect Treatment in the Receiving Trauma Center?

World Journal of Surgery ◽

10.1007/s00268-021-06074-8 ◽

2021 ◽

Author(s):

Michel Paul Johan Teuben ◽

Carsten Mand ◽

Laura Moosdorf ◽

Kai Sprengel ◽

Alba Shehu ◽

...

Keyword(s):

Injury Severity ◽

Damage Control ◽

Ct Scanning ◽

Mortality Rates ◽

Trauma Centers ◽

Simultaneous Treatment ◽

Diagnostic Pathway ◽

Injured Patients ◽

The Impact ◽

Mean Time

Abstract Background Simultaneous trauma admissions expose medical professionals to increased workload. The impact of simultaneous trauma admissions on hospital allocation, therapy, and outcome is currently unclear. We hypothesized that multiple admission-scenarios impact the diagnostic pathway and outcome. Methods The TraumaRegister DGU® was utilized. Patients admitted between 2002–2015 with an ISS ≥ 9, treated with ATLS®- algorithms were included. Group ´IND´ included individual admissions, two individuals that were admitted within 60 min of each other were selected for group ´MULT´. Patients admitted within 10 min were considered as simultaneous (´SIM´) admissions. We compared patient and trauma characteristics, treatment, and outcomes between both groups. Results 132,382 admissions were included, and 4,462/3.4% MULTiple admissions were found. The SIM-group contained 1,686/1.3% patients. The overall median injury severity score was 17 and a mean age of 48 years was found. MULT patients were more frequently admitted to level-one trauma centers (68%) than individual trauma admissions were (58%, p < 0.001). Mean time to CT-scanning (24 vs. 26/28 min) was longer in MULT / SIM patients compared to individual admissions. No differences in utilization of damage control principles were seen. Moreover, mortality rates did not differ between the groups (13.1% in regular admissions and 11.4%/10,6% in MULT/SIM patients). Conclusion This study demonstrates that simultaneous treatment of injured patients is rare. Individuals treated in parallel with other patients were more often admitted to level-one trauma centers compared with individual patients. Although diagnostics take longer, treatment principles and mortality are equal in individual admissions and simultaneously admitted patients. More studies are required to optimize health care under these conditions.

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Retrospective analysis of mortality within 30 days of systemic anticancer therapy and comparison with a previous audit at an Australian Regional Cancer Centre

Journal of Oncology Pharmacy Practice ◽

10.1177/10781552211016086 ◽

2021 ◽

pp. 107815522110160

Author(s):

Bernadatte Zimbwa ◽

Peter J Gilbar ◽

Mark R Davis ◽

Srinivas Kondalsamy-Chennakesavan

Keyword(s):

Checkpoint Inhibitors ◽

Anticancer Therapy ◽

Mortality Rates ◽

Feedback Process ◽

Time To Death ◽

Cancer Centre ◽

Haematology Patients ◽

The Mean ◽

Regional Cancer Centre ◽

Mean Time

Purpose To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates. Method All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included. Results Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%). Conclusion The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.

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