A panoramic view of a cohort of obstructive sleep apnea patients on positive airway pressure therapy using cloud based telemonitoring devices.

Background: Positive airway pressure therapy is mainstay of treatment of obstructive sleep apnea (OSA). But long-term compliance with is poor with such therapy. A proactive and vigilant management may improve the PAP therapy usage. Cloud-based telemonitoring PAP devices offer an opportunity for proactive monitoring and prompt interventions related to PAP troubleshooting. This technology is also used in India for adult OSA patients. But we lack our own data on behavior of Indian patients as a cohort on PAP therapy. The present study is an attempt to look at the behavior a cohort of PAP users in OSA. Methodology: This study was planned as a retrospective analysis of data of OSA patients who were using a cloud-based PAP devices. First 100 patients were chosen for data retrieval that who was on this therapy. The data was obtained for those patients who were on PAP for at least 7 days and maximum follow-up was available up to 390 days. Descriptive statistical analysis has been carried out in the present study. Results: The number of male and female patients was 75 and 25, respectively. Overall good compliance was present in 66% of patients. 34% of patients were not compliant with PAP during follow-up. The compliance was statistically same in both the sexes (P = 0.8088). Incomplete data recovery was present in 17 patients and 11 (64.70%) were non-compliant among them. In the initial, 60 days non-compliant patients were more than compliant patients. The difference was lost in 60 to 90 days of use. The air leak was present more in the compliant group than non-compliant group (P = 0.0239). 75.75% of compliant patients had achieved AHI control, whereas 35.29% of non-compliant patients also achieved AHI control. But overall, AHI control was poor in non-compliant patients and 61.76% of non-compliant patients had an AHI uncontrolled. Conclusions: We conclude that 3/4th of the compliant patients achieve AHI control while 1/4th didn't. This 1/4th population needs further exploration to determine the causes of poor AHI control. Cloud-based PAP devices give an easy opportunity to monitor patients of OSA. It gives an instant panoramic view of behavior of OSA patients on PAP therapy. The compliant patients can be tracked, and non-compliant patients can be segregated quickly.

Critical phase boundaries of static and periodically kicked long-range Kitaev chain.

We study the static and dynamical properties of a long-range Kitaev chain, i.e. a p -wave superconducting chain in which the superconducting pairing decays algebraically as [Formula: see text], where l is the distance between the two sites and [Formula: see text] is a positive constant. Considering very large system sizes, we show that when [Formula: see text], the system is topologically equivalent to the short-range Kitaev chain with massless Majorana modes at the ends of the system; on the contrary, for [Formula: see text], there exist symmetry protected massive Dirac end modes. We further study the dynamical phase boundary of the model when periodic [Formula: see text]-function kicks are applied to the chemical potential; we specially focus on the case [Formula: see text] and analyze the corresponding Floquet quasienergies. Interestingly, we find that new topologically protected massless end modes are generated at the quasienergy [Formula: see text] (where T is the time period of driving) in addition to the end modes at zero energies which exist in the static case. By varying the frequency of kicking, we can produce topological phase transitions between different dynamical phases. Finally, we propose some bulk topological invariants which correctly predict the number of massless end modes at quasienergies equal to 0 and [Formula: see text] for a periodically kicked system with [Formula: see text].

PI controller design for indirect vector controlled induction motor: A decoupling approach.

Decoupling of the stator currents is important for smoother torque response of indirect vector controlled induction motors. Typically, feedforward decoupling is used to take care of current coupling that requires exact knowledge of motor parameters, additional circuitry and signal processing. In this paper, a method is proposed to design the regulating proportional-integral gains that minimize coupling without any requirement of the additional decoupler. The variation of the coupling terms for change in load torque is considered as the performance measure. An iterative linear matrix inequality based H∞ control design approach is used to obtain the controller gains. A comparison between the feedforward and the proposed decoupling schemes is presented through simulation and experimental results. The results show that the proposed scheme is simple yet effective even without additional block or burden on signal processing.

Generic versus branded medicines: An observational study among patients with chronic diseases attending a public hospital outpatient department.

BACKGROUND: The concept of generic prescription is widely accepted in various parts of the world. Nevertheless, it has failed to gain popularity in India due to factors such as nonavailability and distrust on the product quality. However, since 2012, the Government of West Bengal, India, has initiated exclusive generic drug outlets called "fair price medicine shop" (FPMS) inside the government hospital premises in a "public-private-partnership" model. This study was undertaken to evaluate the experience and attitude of patients who were consuming generic drugs purchased from these FPMS. MATERIALS AND METHODS: It was a questionnaire-based cross-sectional study where we have interviewed 100 patients each consuming generic and branded drugs, respectively. The perceived effectiveness, reported safety, medication adherence, cost of therapy, and availability of drugs was compared between two mentioned groups. Medication adherence was estimated through Drug Attitude Inventory-10. RESULTS: 93% of generic and 87% branded drug users believed that their drugs were effective (P = 0.238) in controlling their ailments. No significant difference (9% generic, 10% branded drug users, P = 1.000) was observed in reported adverse effects between generic and branded drug users. 82% and 77% of patients were adherent generic and branded drugs, respectively (P = 0.289). As expected, a significantly lower cost of generic drugs was observed compared to its branded counterpart. CONCLUSION: The policy of FPMS implemented by the Government of West Bengal, India appeared to be promising in terms of perceived effectiveness, safety, and adherence of generic drugs from FPMS compared to drugs purchased from open market retailers. Therefore, this study might act as an impetus for the policy-makers to initiate similar models across the country.

Randomized controlled trial of effectiveness of lafutidine versus pantoprazole in uninvestigated dyspepsia.

OBJECTIVES: Lafutidine is a new H2-blocker in India claimed to be more potent and effective than existing H2-blockers. Proton pump inhibitors (PPIs), by virtue of their mechanism of action, have greater efficacy than H2-blockers in gastric acid suppression. However, clinical trials comparing H2-blockers directly with PPIs are limited. We carried out a head-to-head comparison of the effectiveness of lafutidine versus the PPI pantoprazole in uninvestigated dyspepsia [CTRI/2013/12/004261]. MATERIALS AND METHODS: A prospective, open label, randomized, controlled trial was conducted in a tertiary care hospital. Ambulatory adult patients with dyspepsia, not yet subjected to endoscopy, were recruited if they had at least moderately severe symptoms, defined as a score of ≥ 4 on a 7-point Global Overall Symptom (GOS) Scale. Those with alarm features or significant comorbidity were excluded. Subjects received either once daily lafutidine 10 mg or pantoprazole 40 mg, orally, for 8 weeks. Reflux, dysmotility and pain scores were assessed by Modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSGERD), and quality of life (QoL) by SF-8 scale. The latter had physical and mental components summarized by physical component summary score (PCS) and a mental component summary score (MCS). RESULTS: Of 122 patients enrolled, data of 57 on lafutidine and 60 on pantoprazole were analyzed. At 4 weeks, proportion of subjects responding (GOS score ≤ 2) in the two arms (lafutidine 45.61% vs. pantoprazole 48.33%, P = 0.854) or showing symptom resolution (GOS score ≤ 1) (lafutidine 12.28% vs. pantoprazole 5.00%; P = 0.197) were comparable. Similarly at 8 weeks, both responder (lafutidine 52.63% vs. pantoprazole 56.67%; P = 0.712) and symptom resolution proportions (lafutidine 33.33% vs. pantoprazole 30%; P = 0.843) were comparable. Total score on mFSSGERD scale, as well as all its three component scores, and PCS and MCS scores on QoL SF-8 scale showed improvement but no statistically significant difference between the two arms. Tolerability of both drugs was excellent. CONCLUSIONS: Lafutidine is well-tolerated and there is no clinically worthwhile difference between the two drugs in the empirical treatment of uninvestigated dyspepsia.

Border collision route to quasiperiodicity: Numerical investigation and experimental confirmation.

Numerical studies of higher-dimensional piecewise-smooth systems have recently shown how a torus can arise from a periodic cycle through a special type of border-collision bifurcation. The present article investigates this new route to quasiperiodicity in the two-dimensional piecewise-linear normal form map. We have obtained the chart of the dynamical modes for this map and showed that border-collision bifurcations can lead to the birth of a stable closed invariant curve associated with quasiperiodic or periodic dynamics. In the parameter regions leading to the existence of an invariant closed curve, there may be transitions between an ergodic torus and a resonance torus, but the mechanism of creation for the resonance tongues is distinctly different from that observed in smooth maps. The transition from a stable focus point to a resonance torus may lead directly to a new focus of higher periodicity, e.g., a period-5 focus. This article also contains a discussion of torus destruction via a homoclinic bifurcation in the piecewise-linear normal map. Using a dc-dc converter with two-level control as an example, we report the first experimental verification of the direct transition to quasiperiodicity through a border-collision bifurcation.