Replacement of failed items in a two commodity retrial queueing-inventory system with multi-component demand and vacation interruption.

This study investigates a crucial aspect of inventory management, which is the process of replacing failed items. In dynamic commercial environments, it is essential to efficiently and strategically replace failed items to maintain operational efficiency and ensure profitability. We consider a two-commodity retrial queueing-inventory system with vacation interruption. Upon purchasing the first commodity, the second commodity is provided as a complimentary item. In contrast, no item is given as a complimentary for the purchase of the second item. Only the first commodity is stored in a dedicated pooled storage for replacement when it fails. The (s,Q) policy governs replenishing the first commodity while the second is replenished through instantaneous ordering. The model considers the multi-component demand rate for customer arrivals. Server vacations are initiated during customer absence in waiting hall or when the first commodity is unavailable. We formulate a level-dependent quasi-birth-and-death process, and its steady-state probability vector is computed using Neuts and Rao's truncation method. The stability condition for the system is derived, and various system performance measures, including expected total cost, number of replaceable items, and customers in the waiting hall and orbit, are established. The comparative analysis between the system with replacement is done with the regular model without replacement, which revealed the efficiency of replacement. The analysis of multi-component demand towards homogeneous arrival highlights the impact of multi-component demand on boosting customer arrival. Also, parametric sensitivity analysis has been conducted numerically over total cost, mean number of failed items for replacement, and mean number of customers in the waiting hall and orbit.

Analysis of the characteristics and risk factors affecting the judgment results of medical damage liability disputes in 3172 second-instance and retrial cases in China.

BACKGROUND: Medical disputes remain a global public health problem. However, an analysis of the characteristics and risk factors affecting the judgment results of medical damage liability disputes in second-instance and retrial cases in China has yet to be conducted. METHODS: We conducted a systematic search and evaluation of second-instance and retrial cases among all medical damage liability disputes in China Judgments Online; SPSS 22.0 was used for the statistical analysis. A χ2 test or likelihood ratio Chi-square test was used to compare differences between groups, and multivariate logistic regression analysis was performed to determine independent risk factors that could affect the judgment results of medical disputes. RESULTS: We included 3172 second-instance and retrial cases among all medical damage liability disputes in the analysis. The results showed that 48.04% of cases were unilateral appeals by the patient, and medical institutions were responsible for providing compensation in 80.64% of these cases. Cases involving compensation ranged from Chinese Yuan (CNY) 100 000 to 500 000 ranked first (40.95%); 21.66% were non-compensation cases. Cases involving mental damage compensation of less than CNY 20 000 accounted for 39.03%. Violations of medical treatment and nursing routines accounted for 64.25% of all cases. In addition, re-identification in 54.59% of cases changed the initial appraisal opinion. Independent risk factors for medical personnel to lose a lawsuit in a multivariate logistic regression model included appeal originator [patient side: OR = 18.809 (95% CI 11.854-29.845); both sides: OR = 22.168 (95% CI 12.249-40.117)], change of the original verdict (OR = 5.936, 95% CI 3.875-9.095), judicial identification (OR = 6.395, 95% CI 4.818-8.487), violations of medical treatment and nursing routines (OR = 8.783, 95% CI 6.658-11.588), and non-standard medical document writing (OR = 8.500, 95% CI 4.805-15.037). CONCLUSION: Our study clarifies the characteristics of second-instance and retrial cases among all medical damage liability disputes in China from multiple perspectives and identifies the independent risk factors for medical personnel losing a lawsuit. This study could help medical institutions prevent and reduce medical disputes, at the same time, it could be helpful for medical institutions to provide better medical treatment and nursing services for patients.

Transient analysis and reliability modeling of fault-tolerant system operating under admission control policy with double retrial features and working vacation.

Maintaining a high-level reliability and efficiency without interruption are the key concerns for many real-time machining systems. Using the redundancy and repair facility features, we develop a double retrial orbit queueing model for the fault-tolerant machining system (FTMS) operating under the restriction of admission of repair jobs based on threshold policy and working vacation. The provision of primary and secondary orbits is made so that the failed units can wait there based on the facility available in case the repairman is occupied. From the orbits, the failed units retry to get the repairman free so that the repair job can be accomplished. Chapman-Kolmogorov equations for the system states of FTMS have been constructed to evaluate the transient reliability and queueing indices using the spectral technique. The sensitivity along with the relative sensitivity analysis of crucial system parameters, have facilitated. The impacts of parameter variability on the system metrics and total expected cost are examined for illustrative examples.

Diffusion limit of a modified Erlang-B system with sensing time of secondary users.

We analyze a queueing model for cognitive wireless networks using the asymptotic-diffusion method (Moiseev et al. (2020); Nazarov et al. (2020)). Cognitive wireless is a technology that resolves radio spectrum shortages by allowing secondary users (SUs, unlicensed users) to occupy channels initially assigned to primary users (PUs, licensed users). SUs need to sense the channel availability upon arrival. After sensing, an SU can transmit if there is an idle channel; otherwise, the SU must continue sensing. We consider the situation where SUs may be interrupted by the arrivals of PUs when all channels are occupied. We derive a diffusion limit for the queueing model when the SUs' mean sensing time tends to infinity. The diffusion limit leads to an approximate probability distribution of the number of sensing SUs. Finally, we derive a necessary stability condition which turns out to be consistent with the sufficient condition obtained in previous research.

Reliability-based measure of a retrial machine repair problem with working breakdowns under the F-policy.

We study reliability and sensitivity analysis of a retrial machine repair problem with working breakdowns operating under the F-policy. The F-policy studies the most common issue of controlling arrival to a queueing problem and it requires startup time before allowing failed machines to enter the orbit. The server is subject to working breakdowns only when there is at least one failed machine in the system. When the server is busy it works at a fast rate, but when it is subject to working breakdowns, it works at a slow rate. Failure and repair times of the server are exponentially distributed. The Laplace transform technique is utilized to develop two system performance measures such as system reliability and mean time to system failure (MTTF). Extensive numerical results are carried out to reveal how performance measures are affected by changing various values of each system parameter.

Clozapine-induced myocarditis: Follow-up for 3.5 years after successful retrial.

Schizophrenia patients have significantly lower life expectancy than the general population. Clozapine is the most effective antipsychotic to reduce the mortality rate in these patients. Here, we report a schizophrenic patient with clozapine-induced myocarditis and successful retrial. In the first trial, clozapine was discontinued due to myocarditis. In the second trial, the titration rate was slower, and sodium valproate was not coadministered with clozapine. The patient has not developed myocarditis over 3.5 years of observation. It may be possible to take clozapine for a long time even after clozapine-induced myocarditis, and thus improve the life expectancy of schizophrenia patients.

Forensic Application of Analytical Mechanics in Fatal Fall From a Height.

Fatal fall from a height initiated with a swinging motion on the sagittal plane of the victim's body is examined. Method of analytical mechanics is adopted to establish the functional relations between the swinging angle of the body and the force needed to sustain the body until release, and the amount of the horizontal displacement that would occur after release. The analysis is applied to support an expert opinion presented in a criminal court in which two accused were convicted of murder for dropping a female victim from a bridge. The results indicate that it is unlikely for the body to locate as recorded by the police investigation report in the case. This study demonstrates that a straightforward mechanical analysis can be utilized to examine uncommon falling scenarios.

A successful re-trial after clozapine myopericarditis.

Clozapine-induced myopericarditis is a well-described adverse drug reaction. Clozapine is also the most efficacious agent in refractory schizophrenia. We report a case of a patient who was successfully re-trialled on clozapine two years after developing myopericarditis, after which multiple lines of alternative treatment failed. We propose a protocol for safely attempting a re-trial of clozapine in such cases.

Diet Redux: Outcomes from Reattempting Dietary Therapy for Epilepsy.

The outcome for patients attempting dietary therapy for epilepsy a second time is unknown. Twenty-six subjects treated with the ketogenic diet as children who then began either the ketogenic diet or a Modified Atkins Diet (MAD) at least 6 months later were evaluated. The mean age at the first diet trial was 5.6 years and at the second diet trial was 11.5 years. Most restarted dietary therapy because of persistent seizures (65%) or recurrence after seizure freedom (19%). Overall, 77% had a ≥50% seizure reduction with the first diet, and 50% with the second diet, P = .04. Individual subject responses were largely similar, with 14 (54%) having identical seizure reduction both times, 9 worse (35%) with the second attempt, and 3 (16%) improved. The second diet trial was more likely to lead to >50% seizure reduction if the first trial was started at a later age (7.4 vs 3.9 years, P = .04).

Homeopathic pathogenetic trial of Plumbum metallicum: the complete 2000 trial with a synthesis of the original 1828 trial / Homeopathic pathogenetic trial of Plumbum metallicum: the complete 2000 trial with a synthesis of the original 1828 trial

Background: in a previous paper we reported the statistical analysis and other distribution data of a homeopathic pathogenetic trial (HPT) of Plumbum metallicum 30cH carried out by our group. However, at that time we did not report the resulting pure materia medica, i.e., the totality of symptoms elicited by the tested medicine on healthy volunteers. Aim: to communicate to the homeopathic community the full record of symptoms collected in our HPT of Plb. Methods:methods to collect and select symptoms have been reported in the previous paper. In synthesis were excluded all previous common symptoms of volunteers, even with slight differences, and selected only those that were really unknown, never seen, unusual or very strange for the prover. In this paper special emphasis was given to new symptoms as well as unusual or repeated dreams, while in the previous paper special emphasis was given to repeated and crossed symptoms. Results: symptoms are reported in their chronological order of appearance in each volunteer. 37 new symptoms were found, useful to update Homeopathic Repertories. It is also included a synthesis of the original HPT of Plb carried out in 1828 in order to make available the full experimental materia medica currently existing. Conclusions: the new HPT, besides widening the pathogenetic picture of Plb (skin and mucosae symptoms), also allowed us to give new and deeper meanings to some of the symptoms reported in the original trial, such as Anxiety, Activity, Depression, Slowness, Gastro-oesophageal problems, Colitis. The dreams complete the remedy image, mainly in work, religion and sexual themes. Up to the present time there is no peer-reviewed publication devoted to HPTs. For this reason, researchers are compelled to publish HPTs as private editions. This results in poor control of the quality of publications and a lack of standards on how to present the results of HPTs.(AU)

Introdução: em artigo anterior, foi reportada a análise estatística e outras distribuições de dados de uma experimentação patogenética homeopática de Plumbum metallicum 30cH. Porém, nessa ocasião, não reportamos os resultados da materia médica pura, isto é, a totalidade dos sintomas induzidos pela substância testada, nos voluntários saudáveis. Objetivos: comunicar a comunidade homeopática a lista completa de sintomas coletados na experimentação de Plumbum metalicum. Métodos: os métodos de coleta e seleção de sintomas foram reportados em artigo anterior. Em síntese, excluí-se todos os sintomas comuns previamente apresentados pelos voluntários e selecionou-se aqueles que eram realmente desconhecidos, nunca vistos, incomuns para o experimentador. Ênfase especial foi dada a sintomas novos, assim como a sonhos incomuns e recorrentes. Resultados: os sintomas são reportados na ordem cronológicas em que foram aparecendo nos voluntários. 37 novos sintomas foram encontrados, e foram usados para atualizar o Repertório Homeopático. Também foi incluída uma síntese da experimentação originalmente realizada em 1828, a fim de disponibilizar uma matéria médica experimental completa. Conclusões: Esta nova experimentação, além de ampliar a imagem patogenética de Plb, também permitiu dar um novo e mais profundo significado para alguns dos sintomas relatados na experimentação original (ansiedade, atividade, depressão, lentidão, problemas gastroesofágicos, colite). Até onde sabemos, não existe uma publicação com revisão por pares dedicada à publicação de experimentações patogenéticas homeopáticas. Por esta razão, pesquisadores são compelidos a publicar seus resultados como edições privadas. Isto resulta num controle precário da qualidade dessas publicações e na falta de padronização sobre como apresentar tais resultados.(AU)

Introducción: Em um articulo anterior fue reportado el análisis estadistico y otras disteibuciones de datos de uma experimentacion patogenética homeopática de Plumbum metallicum 30cH. Pero em esta ocación no reportamos los resultados de la Materia médica pura, esto es, la totalidad de síntomas induzidos por la sustancia testada en voluntarios sanos. Objetivos: comunicar a la comunidad homeopática la lista completa de síntomas colectados em la experimentación de Plumbum metallicum. Métodos: los metodos de coleta y selección de sintomas foram reportados en artículo anterior. En síntese, foram excluidos todos los sintomas comunes previamente presentados por los voluntários y seleccionamos aquellos no conocidos, incomunes para el experimentador. Fue dado un énfasis especial a los sintomas nuevos y a los sueños incomunes y recurrentes. Resultados: los sintomas son reportados en el orden cronológico en que fueron apareciendo en los voluntarios. 37 nuevos sintomas fueron descritos y permitieron actualizar el Repertório Homeopático. También fue incluida uma síntesis de la experimentación originalmente realizada em 1828, com el fin de disponibilizar uma materia médica experimental completa. Conclusiones: Esta nueva experimentación, ademas de ampliar la imagen patogenetica Plumbum metallicum, también permitió dar un nuebo y mas profundo significado para algunos de los síntomas relatados em la experimentación original (ansiedad, actividade, depresión, problemas gastroesofágicos, colitis). Hasta donde sabemos, no existe uma publicación com revisión por pares, dedicada a la publicación de experimentaciones homeopáticas patogenéticas homeopáticas. Por esta razón investigadores son impelidos a publicar sus resultados como ediciones privadas. Estoresulta em um control precario de calidad de esas publicaciones y em la falta de padronización sobre como presentar tales resultados.(AU)

Homeopathic pathogenetic trial of Plumbum metallicum: the complete 2000 trial with a synthesis of the original 1828 trial / Homeopathic pathogenetic trial of Plumbum metallicum: the complete 2000 trial with a synthesis of the original 1828 trial

Background: in a previous paper we reported the statistical analysis and other distribution data of a homeopathic pathogenetic trial (HPT) of Plumbum metallicum 30cH carried out by our group. However, at that time we did not report the resulting pure materia medica, i.e., the totality of symptoms elicited by the tested medicine on healthy volunteers. Aim: to communicate to the homeopathic community the full record of symptoms collected in our HPT of Plb. Methods:methods to collect and select symptoms have been reported in the previous paper. In synthesis were excluded all previous common symptoms of volunteers, even with slight differences, and selected only those that were really unknown, never seen, unusual or very strange for the prover. In this paper special emphasis was given to new symptoms as well as unusual or repeated dreams, while in the previous paper special emphasis was given to repeated and crossed symptoms. Results: symptoms are reported in their chronological order of appearance in each volunteer. 37 new symptoms were found, useful to update Homeopathic Repertories. It is also included a synthesis of the original HPT of Plb carried out in 1828 in order to make available the full experimental materia medica currently existing. Conclusions: the new HPT, besides widening the pathogenetic picture of Plb (skin and mucosae symptoms), also allowed us to give new and deeper meanings to some of the symptoms reported in the original trial, such as Anxiety, Activity, Depression, Slowness, Gastro-oesophageal problems, Colitis. The dreams complete the remedy image, mainly in work, religion and sexual themes. Up to the present time there is no peer-reviewed publication devoted to HPTs. For this reason, researchers are compelled to publish HPTs as private editions. This results in poor control of the quality of publications and a lack of standards on how to present the results of HPTs.

Introdução: em artigo anterior, foi reportada a análise estatística e outras distribuições de dados de uma experimentação patogenética homeopática de Plumbum metallicum 30cH. Porém, nessa ocasião, não reportamos os resultados da materia médica pura, isto é, a totalidade dos sintomas induzidos pela substância testada, nos voluntários saudáveis. Objetivos: comunicar a comunidade homeopática a lista completa de sintomas coletados na experimentação de Plumbum metalicum. Métodos: os métodos de coleta e seleção de sintomas foram reportados em artigo anterior. Em síntese, excluí-se todos os sintomas comuns previamente apresentados pelos voluntários e selecionou-se aqueles que eram realmente desconhecidos, nunca vistos, incomuns para o experimentador. Ênfase especial foi dada a sintomas novos, assim como a sonhos incomuns e recorrentes. Resultados: os sintomas são reportados na ordem cronológicas em que foram aparecendo nos voluntários. 37 novos sintomas foram encontrados, e foram usados para atualizar o Repertório Homeopático. Também foi incluída uma síntese da experimentação originalmente realizada em 1828, a fim de disponibilizar uma matéria médica experimental completa. Conclusões: Esta nova experimentação, além de ampliar a imagem patogenética de Plb, também permitiu dar um novo e mais profundo significado para alguns dos sintomas relatados na experimentação original (ansiedade, atividade, depressão, lentidão, problemas gastroesofágicos, colite). Até onde sabemos, não existe uma publicação com revisão por pares dedicada à publicação de experimentações patogenéticas homeopáticas. Por esta razão, pesquisadores são compelidos a publicar seus resultados como edições privadas. Isto resulta num controle precário da qualidade dessas publicações e na falta de padronização sobre como apresentar tais resultados.

Introducción: Em um articulo anterior fue reportado el análisis estadistico y otras disteibuciones de datos de uma experimentacion patogenética homeopática de Plumbum metallicum 30cH. Pero em esta ocación no reportamos los resultados de la Materia médica pura, esto es, la totalidad de síntomas induzidos por la sustancia testada en voluntarios sanos. Objetivos: comunicar a la comunidad homeopática la lista completa de síntomas colectados em la experimentación de Plumbum metallicum. Métodos: los metodos de coleta y selección de sintomas foram reportados en artículo anterior. En síntese, foram excluidos todos los sintomas comunes previamente presentados por los voluntários y seleccionamos aquellos no conocidos, incomunes para el experimentador. Fue dado un énfasis especial a los sintomas nuevos y a los sueños incomunes y recurrentes. Resultados: los sintomas son reportados en el orden cronológico en que fueron apareciendo en los voluntarios. 37 nuevos sintomas fueron descritos y permitieron actualizar el Repertório Homeopático. También fue incluida uma síntesis de la experimentación originalmente realizada em 1828, com el fin de disponibilizar uma materia médica experimental completa. Conclusiones: Esta nueva experimentación, ademas de ampliar la imagen patogenetica Plumbum metallicum, también permitió dar un nuebo y mas profundo significado para algunos de los síntomas relatados em la experimentación original (ansiedad, actividade, depresión, problemas gastroesofágicos, colitis). Hasta donde sabemos, no existe uma publicación com revisión por pares, dedicada a la publicación de experimentaciones homeopáticas patogenéticas homeopáticas. Por esta razón investigadores son impelidos a publicar sus resultados como ediciones privadas. Estoresulta em um control precario de calidad de esas publicaciones y em la falta de padronización sobre como presentar tales resultados.