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Iatrogenic opioid dependence is endemic and legal: Genetic addiction risk score (GARS) with electrotherapy a paradigm shift in pain treatment programs

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Health 2013年第11期5卷 16-34页

作者： Kenneth Blum David Han Marlene Oscar-Berman Gary Reinl Nicholas DiNubile Margaret A. Madigan anish bajaj Bernard William Downs John Giordano Wayne Westcott Leonard Smith Eric R. Braverman Kristina Dushaj Mary Hauser Thomas Simpatico Thomas McLaughlin Joan Borsten Debmayla Barh Center for Psychiatric Medicine North Andover USA Centre for Genomics and Applied Gene Technology Institute of Integrative Omics and Applied Biotechnology (IIOAB) Nonakuri Purba Medinipur India Department of Addiction Research & Therapy Malibu Beach Recovery Center Malibu Beach USA Department of Executive Health Path Research Foundation NY New York USA Department of Exercise Science Quincy College Quincy USA Department of Holistic Medicine and Pain Track National Institute for Holistic Addiction Studies North Miami Beach USA Department of Management Science and Statistics The University of Texas at San Antonio San Antonio USA Department of Molecular Nutrition Impact Genomics Inc. Austin USA Igene LLC Austin USA Department of Psychiatry Anatomy & Neurobiology Boston VA and Boston University School of Medicine Boston USA Department of Psychiatry College of Medicine & McKnight Brain Institute University of Florida Gainesville USA Department of Executive Health Path Research Foundation NY New York USA Department of Psychiatry College of Medicine & McKnight Brain Institute University of Florida Gainesville USA Electronic Waveform Lab Department of Pain Research Huntington Beach USA Department of Orthopedic Surgery Hospital of the University of Pennsylvania Philadelphia USA Department of Molecular Nutrition Impact Genomics Inc. Austin USA Department of Executive Health Path Research Foundation NY New York USA Department of Holistic Medicine and Pain Track National Institute for Holistic Addiction Studies North Miami Beach USA Dominion Diagnostics LLC North Kingstown USA Department of Psychiatry Human Integrated Services Unit of Vermont Center for Clinical & Translational Science University of Vermont College of Medicine Burlington USA Department of Addiction Research & Therapy Malibu Beach Recovery Center Malibu Beach USA Centre for Genomics and Applied Gene Technology Institute of Integrative Omics and Applied Biotechnology (IIOAB) Nonakuri Purba Me

The mounting endemic of prescription iatrogenic opioid dependence in pain patients provoked this treatise about an alternative method that can be used to treat pain, improve function and reduce the risk of opioid dependence. It is well known that as well as the side effects reported for chronic opioid therapy, genetically predisposed individuals are at risk for opioid dependence. We propose the use of the Genetic Addiction Risk Score (GARS) assessment to identify patients early in treatment who should avoid narcotic pain medications. Primarily, this review will be an exploration of the mechanisms of action of an electrotherapeutic alternative to narcotic treatment that can be used to augment tissue healing and reduce the pain associated with human injuries and neuropathies. This particular electrotherapeutic device was developed at the Electronic Waveform Laboratory in Huntington Beach, California and is called the H-Wave? device. The primary effect of the H-Wave?device is stimulation (HWDS) of small diameter fibers of “red-slow-twitch” skeletal muscle. Mechanisms of action of HWDS have been investigated in both animal and human studies. They include edema reduction, induction of nitric oxide dependent augmented microcirculation and angiogenesis, small muscle contraction that eliminates transcapillary fluid shifts, reducing the painful effects of tetanizing fatigue and gradual loading of healing injured muscle tissue that helps repair and remodeling. A recent metaanalysis found a moderate-to-strong-positive effect of the HWDS in providing pain relief, reducing the requirement for pain medication, with the most robust effect being increased functionality. We are proposing that GARS can be used to identify those at risk of developing opioid dependence and that the need for opioid analgesia can be reduced by use of this electro therapeutic alternative to opioid analgesia in the treatment of pain and injuries.

关键词： Microcirculation Angiogenesis Analgesic Therapy Electrical Device Stimulation Tissue Loading Remodeling Genetic Addiction Risk Score (GARS) Reward Deficiency Syndrome (RDS)

Solving Markov Decision Processes with Downside Risk Adjustment

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International Journal of Automation and computing 2016年第3期13卷 235-245页

作者： Abhijit Gosavi anish Parulekar 219 Engineering Management Building Department of Engineering Management and Systems Engineering Missouri University of Science and Technology Rolla MO 65409 USA Axis Bank Mumbai India

Markov decision processes （MDPs） and their variants are widely studied in the theory of controls for stochastic discrete- event systems driven by Markov chains. Much of the literature focusses on the risk-neutral criterion in which the expected rewards, either average or discounted, are maximized. There exists some literature on MDPs that takes risks into account. Much of this addresses the exponential utility （EU） function and mechanisms to penalize different forms of variance of the rewards. EU functions have some numerical deficiencies, while variance measures variability both above and below the mean rewards; the variability above mean rewards is usually beneficial and should not be penalized/avoided. As such, risk metrics that account for pre-specified targets （thresholds） for rewards have been considered in the literature, where the goal is to penalize the risks of revenues falling below those targets. Existing work on MDPs that takes targets into account seeks to minimize risks of this nature. Minimizing risks can lead to poor solutions where the risk is zero or near zero, but the average rewards are also rather low. In this paper, hence, we study a risk-averse criterion, in particular the so-called downside risk, which equals the probability of the revenues falling below a given target, where, in contrast to minimizing such risks, we only reduce this risk at the cost of slightly lowered average rewards. A solution where the risk is low and the average reward is quite high, although not at its maximum attainable value, is very attractive in practice. To be more specific, in our formulation, the objective function is the expected value of the rewards minus a scalar times the downside risk. In this setting, we analyze the infinite horizon MDP, the finite horizon MDP, and the infinite horizon semi-MDP （SMDP）. We develop dynamic programming and reinforcement learning algorithms for the finite and infinite horizon. The algorithms are tested in numerical studies an

关键词： Downside risk Markov decision processes reinforcement learning dynamic programming targets thresholds.

Ultrasonically Assisted Cutting of Histological Sections for Reducing the Environmental and Financial Impact of Microtomy

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Chinese Journal of Mechanical Engineering 2022年第3期35卷 200-206页

作者： Dong Wang Daniel De Becker anish Roy Wolfson School of Mechanical and Manufacturing Engineering Loughborough UniversityLoughborough LE113TUUK Department of Engineering College of EngineeringMathematics and Physical SciencesUniversity of ExeterExeter EX44QFUK

Modern-day microtomy requires high precision equipment to thinly section biological *** sectioned tissue must be of good quality not showing cutting tracks or so-called *** quality of these sections is dependent on the blade wear,which is related to the hardness of the tissue sample,cutting angle and cutting speed.A test rig has been designed and manufactured to allow these parameters to be *** has allowed for the blade wear to be analysed and quantified,and this has been completed for both ultrasonically assisted and conventional *** obtained results showed a 25.2%decrease in average blade roughness after 38 cuts when using the ultrasonically assisted cutting *** data also showed no adverse effect on the quality of the slides produced when using this cutting ***,the cutting force measured for both cutting regimes showed that ultrasonically assisted cutting required less force compared to conventional *** the reduction of surface roughness and force,it is possible to state that ultrasonically assisted cutting reduces the wear of the blade,thereby increasing the life of the *** increase of just 10%in blade life would yield a cost saving of approximately 25%thereby reducing the environmental and financial impact of microtomy.

关键词： Microtome Ultrasonically assisted cutting Blade wear

Simple,intuitive key performance indicators for flag state performance and its pilot application in Latin-America

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Journal of Safety Science and Resilience 2021年第3期2卷 101-110页

作者： anish Arvind Hebbar Santiago Juan Geymonat World Maritime University Fiskehamnsgatan 1Malmö21118Sweden

The presence of sub-standard ships has been a long-standing concern in the maritime domain and a slew of measures are implemented to tide over the *** is a key to verifying the success of measures adopted to enhance maritime safety and protect the marine *** there is an abundance of literature based on Port State Control inspections it is argued that in addition to the prevailing indicators of flag State performance deeper insights are to be gained by exploring indicators in other areas such as findings of IMO member State *** paper proposes simple and intuitive indicators in conjunction with existing indicators to identify trends in flag State performance and explores application of the indicators to a select set of member States in Latin-America *** paper concludes that the proposed indicators have the potential for global application.

关键词： Flag state performance Key performance indicators KPI Performance measurement Implementation Flag state implementation Implementation of IMO instruments

Optimum path planning of mobile robot in unknown static and dynamic environments using Fuzzy-Wind Driven Optimization algorithm

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Defence Technology（防务技术） 2017年第1期13卷 47-58页

作者： anish Pandey Dayal R.Parhi Mechanical Engineering Department N.I.T.RourkelaOrissaIndia

This article introduces a singleton type-1 fuzzy logic system(T1-SFLS) controller and Fuzzy-WDO hybrid for the autonomous mobile robot navigation and collision avoidance in an unknown static and dynamic environment. The WDO(Wind Driven Optimization) algorithm is used to optimize and tune the input/output membership function parameters of the fuzzy controller. The WDO algorithm is working based on the atmospheric motion of infinitesimal small air parcels navigates over an N-dimensional search domain. The performance of this proposed technique has compared through many computer simulations and real-time experiments by using Khepera-Ⅲ mobile robot. As compared to the T1-SFLS controller the Fuzzy-WDO algorithm is found good agreement for mobile robot navigation.

关键词： Singleton type-1 fuzzy Navigation Wind driven optimization Membership function Atmospheric motion

Comprehensive evaluation of key management hierarchies for outsourced data

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Cybersecurity 2019年第1期2卷 150-166页

作者： Naveen Kumar anish Mathuria Indian Institute of Information Technology VadodaraIndia Dhirubhai Ambani Institute of Information and Communication Technology GandhinagarIndia

Key management is an essential component of a cryptographic access control system with a large number of *** manages the secret keys assigned to the system entities in such a way that only authorized users can access a *** access control allows read access of a resource by the authorized users and disallows *** important objective of a key management is to reduce the secret key storage with each authorized *** this end,there exist two prominent types of key management hierarchy with single key storage per user used for read access control in data outsourcing scenario:user-based and *** this work,we analyze the two types of hierarchy with respect to static hierarchy characteristics and dynamic operations such as adding or revoking user *** analysis shows that the resource-based hierarchies can be a better candidate which is not given equal emphasis in the literature.A new heuristic for minimizing the key management hierarchy is introduced that makes it practical in use even for a large number of users and *** performance evaluation of dynamic operations such as adding or revoking a user’s read subscription is shown experimentally to support our analytical results.

关键词： Key management hierarchy Data outsourcing Access control

Climatic periodicities recorded in lake sediment magnetic susceptibility data:Further evidence for solar forcing on Indian summer monsoon

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Geoscience Frontiers 2017年第6期8卷 1349-1355页

作者： anish Kumar Warrier Kizhur Sandeep Rajasekharaiah Shankar Department of Marine Geology Mangalore UniversityMangalagangotri 574199KarnatakaIndia Department of Civil Engineering Manipal Institute of TechnologyManipal UniversityManipal 576104KarnatakaIndia Department of Geology School of Earth Science SystemsCentral University of KeralaTejaswini HillsPeriye(P.O.)KasaragodKerala 671 123India

The Indian summer monsoon exhibits considerable spatio-temporal *** is therefore important to understand its dynamics and the inherent *** this study,we have performed spectral and wavelet analyses of magnetic susceptibility data for sediments from Thimmannanayakanakere(TK)-a small lake in southern *** main objective of this investigation is to identify and explain the possible origin of the prominent periodicities present in the magnetic susceptibility *** periodicities in the TK χ_(lf)data are centered at 906,232,147,128,96,61,54 and 44 years,which might have a solar *** wavelet power spectrum of the raw and detrended χ_(lf)data confirms the findings of spectral analysis and also provides temporal variations of the significant cyclicities during the past3700 *** *** correlation is documented between sunspot activity and TK xif data;crossspectral analysis of the reconstructed sunspot data and TK xif data suggest that there is a strong coherence between the two datasets as significant periodicities are documented in *** is a good match between the TK xif and the reconstructed total solar irradiance data for the past 1200 ***,an out-of-phase relationship is documented at certain time-intervals,which may be attributed to uncertainties in the age-depth *** results obtained from this study show that solar variations are the main controlling factor of the southwest monsoon and,like other archives from different regions in India,the TK lake sediments have also recorded these solar signatures.

关键词： Spectral analysis Periodicity Paleorainfall Lake sediments Magnetic susceptibility Southern India

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

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Modern Plastic Surgery 2024年第1期14卷 9-14页

作者： Taif Alsafy Joe Jacob anish Thadathil Elias Ahmed Salah El Din Salim Mohammed Ghawas Majid Tariq Saud Albusaidi Ahmed Al Jabri Al Anood Al Hadhrami Mutazz Obeid Al Khaldi Moath Abdelhamid Shummo Karim Mohamed Haridi Aml Eid Saleh Said Al-Busaidi Department of Plastic and Reconstructive Surgery Sultan Qaboos Hospital Salalah Oman ENT Department Al Nahdha Hospital Muscat Oman Department of Plastic Reconstructive and Craniofacial Surgery Khoula Hospital Muscat Oman

Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.

关键词： Burns Burn Units Burn Management Delayed Grafting Major Burns Treatment Efficacy

Energy Efficient Modelling of a Network

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China Communications 2018年第1期15卷 107-117页

作者： anish Kumar Saha Koj Sambyo Chandan Tilak Bhunia Dept. of Computer Science and Engineering NIT Arunachal Pradesh India

Most of the networks are generally less energy efficient and most of the time resources are underutilized. Even resources of busy networks are also underutilized and thus networks show energy inefficient management system. This paper focuses on how to obtain minimum resources for the current situation of the network to maintain connectivity, power saving and quality of service. Four different models are proposed in this perspective with different purposes and functions. These models determine the minimum resources under certain constrains. Two types of services namely, "minimum bandwidth" and "trivial file transfer" are considered. For "minimum bandwidth" service, minimum edge, minimum delay and minimum change models are proposed. Here data rate switch and enable/disable of edges are placed in these models for power saving strategy. Another model, multi flow is proposed for "trivial file transfer" service. It is proposed for transferring files through multiple flows in multiple paths from source to destination. All models except multi flow model are mixed integer programming optimization problem.

关键词： energy efficient networking data rate switch power saving state multipleflows mixed integer linear programming op-timization problem