Hasil untuk "Miscellaneous systems and treatments"

Renuka Kulkarni-Munshi, Deepti Talmohite, Anand More et al.

Background: The study was planned when, the hydroxychloroquine (HCQ) was the only prophylactic agent approved by health authorities in several countries and no prophylactic COVID-19 vaccine was available. Objective: The present study aimed to evaluate efficacy of Withania Somnifera (L.) Dunal (WS) as a chemoprophylactic and immunomodulatory agent against SARS-CoV-2 infection. Methods: In a 12 week, randomized, open label, parallel group, two arm, comparative, multicentric, controlled trial compared WS with hydroxychloroquine (HCQ) in health care workers (HCWs). Total 400 HCWs were randomized in 1:1 ratio to receive either oral WS (500 mg for 12 weeks) or HCQ 400 mg (for 7 weeks). The primary outcome was to establish equivalence between WS and HCQ for the proportion of participants contracting SARS-CoV-2 infection. Results: Seven participants contracted SARS-CoV-2 infection: 5 in WS arm and 2 in HCQ arm. The equivalence between WS and HCQ was established for the proportion difference of participants contracting SARS-CoV-2 infection for per-protocol (PP) (1.6%, 95% CI: −1.08%–4.33%) and in subgroup analysis (ITT, mIIT, non-vaccinated and seronegative).Notably, the immunomodulatory effect of WS stood scientifically validated by the statistically significant difference in cytokine levels (p < 0.0001) at 12 weeks compared to baseline for Tumor Necrosis Factor (TNF)-alpha, Interleukin (IL)-2, IL-10, IL-17 and Monocyte chemoattractant protein-1 (MCP-1).Gastrointestinal-related AEs were most frequent (53 in WS and 58 in HCQ). Headache and sneezing were observed only with HCQ. Participant global assessment showed excellent tolerability with both treatment arms. Conclusion: WS was found equivalent to HCQ as a prophylactic against SARS-CoV-2 infection with no safety concern. WS is thus inferred to be an effective and safe Ayurvedic intervention for prophylaxis against SARS-CoV-2 infection, and also as an immunobooster.

Kuldeep Kavathiya, Jitesh Verma, Umakant Tiwari et al.

Epidermolysis bullosa (EB) is a group of inherited rare skin disorders that causes the skin to become fragile and blister easily due to minor trauma or friction. Blisters can appear anywhere on the body. There are limitations in treating this disease in the conventional system of medicine. This paper elaborates on the case of two siblings who presented with blisters all over the body with itching, discharge, difficulty in walking, and disfigurement of fingers, toes, and feet. Based on Ayurvedic clinical assessment, the condition was diagnosed as Kapha-pitta dominant Tridoshaja Visphota. They were treated through Ayurveda on the line of Visphota (a type of Kushtha/skin disorder) with the use of Dipana (digestion and metabolism-enhancing), Pachana (enhancing digestion), and Mridu Shodhana (mild bio-cleansing) medicines. Both patients have shown improvement with a reduction in EBDASI (Epidermolysis bullosa disease activity and scaring index) from 174 to 45 and 176 to 39, respectively, in the first and second sibling with 4 months of ayurvedic medication. No relapse was seen in both patients during the next one year. The case study is unique as EB is a genetic disorder with limitations in its management in the conventional system of medicine. Moreover, the authors could not find any published case of EB managed through Ayurveda treatment. Thus, it opens new areas of research in the management of EB through traditional systems of medicine like Ayurveda.

Jee Hoon Baek, Minjoo Lee, Taegyeong Kwon et al.

Tarsal tunnel syndrome (TTS) is a compressive neuropathy caused by pressure within the tarsal tunnel. It manifests as ankle pain and sensory abnormalities that considerably impact daily life. The present study aimed to synthesize the data obtained from clinical research on Korean medicine treatments for TTS to evaluate their efficacy. A comprehensive search of five databases identified 14 studies that met the study’s predefined inclusion and exclusion criteria. The treatments utilized in these studies included acupuncture, acupotomy, electroacupuncture, herbal medicine, pharmacopuncture, fumigation, chuna, warm acupuncture, and cupping. Acupotomy was the most frequently used treatment method. The Ashi points were the most frequently used acupoints, followed by KI3 and KI6. Although all the studies reported favorable outcomes, limitations such as small sample sizes and insufficient documentation of adverse effects were noted. These findings suggest that Korean medicine treatment may offer effective therapeutic options for TTS.

Desmond Nguetsa Sakou, Borris Rosnay Galani Tietcheu

Background: Gardenia ternifolia (GT) is a plant of the Rubiaceae family, with a wide range of ethnopharmacological properties. However, its hepatoprotective effects were poorly investigated. This work aimed at assessing the hepatoprotective activity of GT leaf aqueous extracts against chronic ethanol-induced damage in vivo. Materials and methods: Male Wistar albino rats were given orally 10 % ethanol (10 mL/kg) and different doses of GT extracts (50, 100, and 200 mg/kg) or distilled water (negative control) simultaneously and daily for 28 days. Normal controls were fed with a normal diet while positive controls received, in addition to ethanol, silymarin (50 mg/kg). After treatment, animals were sacrificed, blood and liver samples were collected, various biochemical parameters were quantified and the histological sections were performed. Moreover, a qualitative phytochemical analysis of this extract was carried out. Results: GT administration significantly reduced alanine aminotransferase (10.35 ± 2.13 U/L and 9.07 ± 2.13 U/L vs 24.43 ± 4.28 UI/L) and aspartate aminotransferase (14.25 ± 3.02 and 18.32 ± 2.13 UI/L vs 34.61 ± 3.23 UI/L) activities at doses of 50 and 100 mg/kg respectively in comparison with the negative control. Likewise, serum triglyceride and total cholesterol levels were significantly reduced by GT extract, especially at the dose of 200 mg/kg compared to the ethanol-treated group. Histological examination showed that the extract protected the liver by reducing hepatic cytolysis, and leukocyte infiltration. Different secondary metabolites including condensed tannins, phenolic acids, and saponins were found in the GT extract but none of these compounds corresponded to epicatechin, coumarin and naringenin. Conclusion: These results show that GT extract may be a potential therapeutic agent against alcoholic liver disease.

Yijun Chen, Kanghong Shi, Ian R. Petersen et al.

In the transition to achieving net zero emissions, it has been suggested that a substantial expansion of electric power grids will be necessary to support emerging renewable energy zones. In this paper, we propose employing battery-based feedback control and nonlinear negative imaginary (NI) systems theory to reduce the need for such expansion. By formulating a novel Luré-Postnikov-like Lyapunov function, stability results are presented for the feedback interconnection of two single nonlinear NI systems, while output feedback consensus results are established for the feedback interconnection of two networked nonlinear NI systems based on a network topology. This theoretical framework underpins our design of battery-based control in power transmission systems. We demonstrate that the power grid can be gradually transitioned into the proposed NI systems, one transmission line at a time.

Frederik Baymler Mathiesen, Sofie Haesaert, Luca Laurenti

This paper introduces a novel abstraction-based framework for controller synthesis of nonlinear discrete-time stochastic systems. The focus is on probabilistic reach-avoid specifications. The framework is based on abstracting a stochastic system into a new class of robust Markov models, called orthogonally decoupled Interval Markov Decision Processes (odIMDPs). Specifically, an odIMDPs is a class of robust Markov processes, where the transition probabilities between each pair of states are uncertain and have the product form. We show that such a specific form in the transition probabilities allows one to build compositional abstractions of stochastic systems that, for each state, are only required to store the marginal probability bounds of the original system. This leads to improved memory complexity for our approach compared to commonly employed abstraction-based approaches. Furthermore, we show that an optimal control strategy for a odIMDPs can be computed by solving a set of linear problems. When the resulting strategy is mapped back to the original system, it is guaranteed to lead to reduced conservatism compared to existing approaches. To test our theoretical framework, we perform an extensive empirical comparison of our methods against Interval Markov Decision Process- and Markov Decision Process-based approaches on various benchmarks including 7D systems. Our empirical analysis shows that our approach substantially outperforms state-of-the-art approaches in terms of both memory requirements and the conservatism of the results.

Thomas G. Kelly, Mohammad D. Soorati, Klaus-Peter Zauner et al.

Swarm robotics is a study of simple robots that exhibit complex behaviour only by interacting locally with other robots and their environment. The control in swarm robotics is mainly distributed whereas centralised control is widely used in other fields of robotics. Centralised and decentralised control strategies both pose a unique set of benefits and drawbacks for the control of multi-robot systems. While decentralised systems are more scalable and resilient, they are less efficient compared to the centralised systems and they lead to excessive data transmissions to the human operators causing cognitive overload. We examine the trade-offs of each of these approaches in a human-swarm system to perform an environmental monitoring task and propose a flexible hybrid approach, which combines elements of hierarchical and decentralised systems. We find that a flexible hybrid system can outperform a centralised system (in our environmental monitoring task by 19.2%) while reducing the number of messages sent to a human operator (here by 23.1%). We conclude that establishing centralisation for a system is not always optimal for performance and that utilising aspects of centralised and decentralised systems can keep the swarm from hindering its performance.

Gautam Kumar, Ashwini Ratnoo

This article considers the problem of conflict-free distribution of point-sized agents on a circular periphery encompassing all agents. The two key elements of the proposed policy include the construction of a set of convex layers (nested convex polygons) using the initial positions of the agents, and a novel search space region for each of the agents. The search space for an agent on a convex layer is defined as the region enclosed between the lines passing through the agent's position and normal to its supporting edges. Guaranteeing collision-free paths, a goal assignment policy designates a unique goal position within the search space of an agent at the initial time itself, requiring no further computation thereafter. In contrast to the existing literature, this work presents a one-shot, collision-free solution to the circular distribution problem by utilizing only the initial positions of the agents. Illustrative examples and extensive Monte-Carlo studies considering various practical attributes demonstrate the effectiveness of the proposed method.

Andrea Martin, Luca Furieri

The increasing reliance on numerical methods for controlling dynamical systems and training machine learning models underscores the need to devise algorithms that dependably and efficiently navigate complex optimization landscapes. Classical gradient descent methods offer strong theoretical guarantees for convex problems; however, they demand meticulous hyperparameter tuning for non-convex ones. The emerging paradigm of learning to optimize (L2O) automates the discovery of algorithms with optimized performance leveraging learning models and data - yet, it lacks a theoretical framework to analyze convergence of the learned algorithms. In this paper, we fill this gap by harnessing nonlinear system theory. Specifically, we propose an unconstrained parametrization of all convergent algorithms for smooth non-convex objective functions. Notably, our framework is directly compatible with automatic differentiation tools, ensuring convergence by design while learning to optimize.

Janilce Dorneles de Quadros, Roger dos Santos Rosa, Cristianne Maria Famer Rocha et al.

Este artigo tem por objetivo conhecer os desafios e as potencialidades da atenção primária à saúde (APS) em relação ao cuidado da tuberculose, buscando traçar estratégias de educação permanente em saúde que qualifiquem o atendimento à tuberculose prestado pelas equipes neste âmbito de atenção. Trata-se de uma pesquisa de caráter exploratório descritivo com análise qualitativa, desenvolvida com as 19 coordenações regionais de atenção básica do Estado do Rio Grande do Sul. Foi utilizado um questionário autoaplicado, individual, utilizando a ferramenta Google Forms. O questionário foi composto por 11 perguntas, das quais duas relativas ao objetivo deste artigo. Dos 19 participantes, foram obtidas 15 respostas, três abstenções e uma negativa. A necessidade de formação e conscientização dos profissionais da APS em relação à tuberculose e às questões de vulnerabilidade social, foram os principais desafios apontados. Dentre as potencialidades identificadas, destacou-se a proximidade com o usuário, a presença de equipe multidisciplinar e do agente comunitário de saúde e a possibilidade de realização do tratamento diretamente observado. Deste modo, assim como existem múltiplas potencialidades na APS, também há, ainda, muitos desafios a serem enfrentados para qualificar o cuidado de usuários acometidos pela tuberculose, sendo essencial promover por meio de espaços de educação permanente processos de desacomodação e ressignificação do  modo de produzir cuidado.

Adrien Banse, Zheming Wang, Raphaël M. Jungers

We present a data-driven framework based on Lyapunov theory to provide stability guarantees for a family of hybrid systems. In particular, we are interested in the asymptotic stability of switching linear systems whose switching sequence is constrained by labeled graphs, namely constrained switching linear systems. In order to do so, we provide chance-constrained bounds on stability guarantees, that can be obtained from a finite number of noisy observations. We first present a method providing stability guarantees from sampled trajectories in the hybrid state-space of the system. We then study the harder situation where one only observes the continuous part of the hybrid states. We show that in this case, one may still obtain formal chance-constrained stability guarantees. For this latter result we provide a new upper bound of general interest, also for model-based stability analysis

Zahra Ramezani, Kenan Šehić, Luigi Nardi et al.

Cyber-physical systems (CPSs) are often complex and safety-critical, making it both challenging and crucial to ensure that the system's specifications are met. Simulation-based falsification is a practical testing technique for increasing confidence in a CPS's correctness, as it only requires that the system be simulated. Reducing the number of computationally intensive simulations needed for falsification is a key concern. In this study, we investigate Bayesian optimization (BO), a sample-efficient approach that learns a surrogate model to capture the relationship between input signal parameterization and specification evaluation. We propose two enhancements to the basic BO for improving falsification: (1) leveraging local surrogate models, and (2) utilizing the user's prior knowledge. Additionally, we address the formulation of acquisition functions for falsification by proposing and evaluating various alternatives. Our benchmark evaluation demonstrates significant improvements when using local surrogate models in BO for falsifying challenging benchmark examples. Incorporating prior knowledge is found to be especially beneficial when the simulation budget is constrained. For some benchmark problems, the choice of acquisition function noticeably impacts the number of simulations required for successful falsification.

E. Florek, W. Piekoszewski, A. Czarnywojtek et al.

INTRODUCTION Tobacco smoke constitutes, among others, polycyclic aromatic hydrocarbons (PAHs) and heterocyclic analogs, aromatic amines, N-nitrosamines, volatile hydrocarbons, aldehydes, phenols, miscellaneous organic compounds, metals, and inorganic compounds Tobacco smoking can harm a women's reproductive system and may reduce fertility. The objective of the study was to explore the effect caused by tobacco smoke on the menstrual cycle caused by smoking and second-hand smoke exposure. MATERIAL AND METHODS The study was performed on 153 women of reproductive age who received care at the Gynecological-Obstetric Clinical Hospital of the Poznan University of Medical Sciences. They were divided into three treatment groups: non-smokers, second-hand smokers, and smokers. Comprehensive assessment of all hormone levels: follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (E2), and progesterone (P) in the various phases of the menstrual cycle and with concomitant determinations of serum cotinine concentrations was performed. The menstrual cycle was observed with ultrasonography. RESULTS Cigarette smoking may be an important factor in disrupting reproduction: 1. The increase in estradiol E2 level was accompanied by significantly lowered serum cotinine concentrations in tobacco smokers, 2. In smoking patients, the serum level of LH significantly increased on the first days of the menstrual cycle, 3. The higher levels of P (in the 14th and 21st days) were assumed to be the result of a longer menstrual cycle. CONCLUSIONS Active and passive smoking may be an important contributor to reproductive health issues and deserves a greater focus in health education programs directed towards women of reproductive age.

Ayushi Mahajan, L. Kaur, Gurjeet Singh et al.

BACKGROUND Luliconazole is a broad-spectrum antifungal agent with impactful fungicidal and fungistatic activity. It has shown exceptional potency against miscellaneous fungal strains like Candida, Aspergillus, Malassezia, Fusarium species and various dermatophytes. OBJECTIVE Luliconazole belongs to class Ⅱ of the Biopharmaceutical Classification System with low aqueous solubility. Although it is available conventionally as 1% w/v topical cream, it has limitations of lower skin permeation and shorter skin retention. Therefore, nanoformulations based on various polymers and nanostructure carriers can be employed to overcome the impediments regarding topical delivery and efficacy of luliconazole. METHODS In this review, we have tried to provide insight into the literature gathered from authentic web resources and research articles regarding recent research conducted on the subject of formulation development, patents, and future research requisites of luliconazole. RESULTS Nanoformulations can play a fundamental role in improving topical delivery by escalating dermal localization and skin penetration. Fabricating luliconazole into nanoformulations can overcome the drawbacks and can efficiently enhance its antimycotic activity. CONCLUSION It has been concluded that luliconazole has exceptional potential in the treatment of various fungal infections, and therefore, it should be exploited to its maximum for its innovative application in the field of mycology.

You-Kyoung Cho, Erik W Anderson, Sara J Guevara et al.

Paraneoplastic rheumatic disorder (RD) is a disorder that may present before, concurrent with, or after the diagnosis of malignancy. Paraneoplastic RDs are a clinical expression of occult cancer that is not directly related to a tumor or metastasis and manifests as rheumatoid symptoms. The RD is determined by the organ system affected by articular, muscular, cutaneous, vascular, or miscellaneous symptoms. Each case is challenging to diagnose because cancer may present with similar symptoms as a common rheumatic disorder. Of note, the majority of cases have minimal responsiveness or no responsiveness to standard rheumatoid treatment. Therefore, it is imperative to recognize and treat the underlying cancer accordingly. Herein, we present four different diagnostic dilemma cases of RD: case #1 - leukocytoclastic vasculitis and C3 glomerulopathy, case #2 - scleroderma, case #3 - Raynaud’s syndrome and possible lupus-like syndrome, and case #4 - inflammatory myositis. Institutional IRB approval was obtained for this case series. We will discuss and review the literature on each topic. In addition, we will mention a review of paraneoplastic rheumatoid arthritis. As rheumatic disease is associated with the use of immune checkpoint inhibitors (ICIs) for cancer treatment, we will briefly discuss some of the most common rheumatic presentations in the setting of these drugs. This case review aims to inform clinicians about the atypical presentation of paraneoplastic RD and to highlight the need for interdisciplinary management between rheumatologists, oncologists, and primary care practitioners.

Sai Tejasvini Chebrolu, L. Kumar, R. Verma

Lacidipine (LAC) is a calcium antagonist used in the treatment of hypertension. It is a lipophilic drug containing dihydropyridine ring that is responsible for the activity. This review article gives an overview of various analytical techniques proposed for the determination of LAC in pharmaceutical dosage forms, in pure form, in biological fluids and to determine characteristics of LAC in modified release dosage forms. Ultra violet/visible spectrophotometric, spectroflourimetric, high performance liquid chromatography, high performance thin layer chromatography, electro-analytical, bioanalytical and miscellaneous methods such as microbiological assay, X-ray diffraction, differential scanning calorimetry, were discussed. Various parameters such as system suitability, selectivity, linearity, precision, accuracy, limit of detection, limit of quantification and robustness have been discussed for the employed methods.

Kaveri M. Adki, Yogesh A. Kulkarni

BACKGROUND Diabetic retinopathy is one of the important complication of diabetes. In major cases diabetic retinopathy is unnoticed until the irreversible damage to eye occurs and leads to blurred vision and eventually blindness. OBJECTIVE The pathogenesis and diagnosis of diabetic retinopathy is very complex and not fully understood. Currently, well-established laser techniques and medications are available but these treatment options have their own shortcomings on biological systems. Biomarkers can help to overcome this problem due to easy, fast and economic option for diagnosis of diabetic retinopathy. METHOD Literature was explored using search terms like "Diabetic retinopathy", "Biomarkers in diabetic retinopathy", "Novel biomarkers in diabetic retinopathy" and "Potential biomarkers of diabetic retinopathy" by using different scientific resources and database like EBSCO, ProQuest, PubMed and Scopus. Eligibility criteria included biomarkers involved in diabetic retinopathy in detectable range. Exclusion criteria included the repetition and duplication of biomarker in diabetic retinopathy. RESULTS Current review and literature study revealed that biomarkers of diabetic retinopathy can be categorized as inflammatory: tumor necrosis factor-α, monocyte chemoattractant protein-1, transforming growth factor- β; antioxidant: nicotinamide adenine dinucleotide phosphate oxidase; nucleic acid: poly ADP ribose polymerase- α, Apelin, Oncofetal; enzyme: ceruloplasmin, protein kinase C; and miscellaneous: erythropoietin. These biomarkers has a great potential in progression of diabetic retinopathy hence can be used in the diagnosis and management of this debilitating disease. CONCLUSION Above mentioned biomarkers play a key role in the pathogenesis of diabetic retinopathy hence they can also be considered as potential targets for new drug development.

Marianne Thornton, Jennifer Harris, Krista Breithaupt et al.

Abstract Background This paper describes the initial development process of an eLearning continuing professional education program primarily for post-licensure physiotherapists –“Electronic Aerobic Exercise Recommendations to Optimize Best Practices in Care after Stroke” (eAEROBICS). Our objective was to develop an evidence-based, clinically relevant, user-friendly eLearning program for online delivery tailored to facilitate prescription of aerobic exercise post-stroke by physiotherapists. The Demand Driven Learning Model guided curriculum design, delivery, and evaluation. Based on previously identified gaps in physiotherapists’ knowledge of aerobic exercise, four learning modules were developed and delivered using an eLearning platform to maximize cost-effectiveness and flexibility. Five physiotherapists volunteered to pilot eAEROBICS, providing preliminary feedback on strengths and suggestions for improvement. Results Theoretical information and clinical applications addressed the learning objectives of each module in a logical manner. All technical or administrative issues encountered during program delivery were addressed. The feedback from the pilot end-users informed modifications to the eAEROBICS program. Conclusions Processes used in developing eAEROBICS have the potential to serve as a model of electronic continuing professional education for other areas of physiotherapy practice. Further investigation of end-user perspectives and clinical impact of the program is warranted to determine the overall effectiveness of the program.

Chao Duan, Pratyush Chakraborty, Takashi Nishikawa et al.

Large-scale integration of renewables in power systems gives rise to new challenges for keeping synchronization and frequency stability in volatile and uncertain power flow states. To ensure the safety of operation, the system must maintain adequate disturbance rejection capability at the time scales of both rotor angle and system frequency dynamics. This calls for flexibility to be exploited on both the generation and demand sides, compensating volatility and ensuring stability at the two separate time scales. This article proposes a hierarchical power flow control architecture that involves both transmission and distribution networks as well as individual buildings to enhance both small-signal rotor angle stability and frequency stability of the transmission network. The proposed architecture consists of a transmission-level optimizer enhancing system damping ratios, a distribution-level controller following transmission commands and providing frequency support, and a building-level scheduler accounting for quality of service and following the distribution-level targets. We validate the feasibility and performance of the whole control architecture through real-time hardware-in-loop tests involving real-world transmission and distribution network models along with real devices at the Stone Edge Farm Microgrid.

E. Faist, A. Baue, H. Dittmer et al.