Hasil untuk "Other systems of medicine"

Larisa Ryskalin, Federica Fulceri, Francesco Busoni et al.

BackgroundMedial epicondylitis is an overuse syndrome characterized by degeneration of the flexor-pronator tendons in the elbow, resulting from repetitive forced wrist flexion and forearm pronation. Due to its anatomical location, medial epicondylitis patients may also feature ulnar nerve instability, which can exacerbate symptoms and negatively impact treatment outcomes. Although conservative treatments remain the cornerstone of care for managing medial epicondylitis, the optimal treatment method remains an open question.ObjectiveTo evaluate the effects of a combined extracorporeal shockwave therapy (ESWT) protocol on pain, symptom severity, and functional outcomes in medial epicondylitis patients with concomitant ulnar nerve instability.DesignRetrospective case series study with two-year post-treatment follow-up.SettingCenter for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa.InterventionsPatients underwent a combined ESWT using the Duolith SD1 ultra device (Storz Medical AG., Switzerland), consisting of sequential focal (0.15–0.20 mJ/mm2, 5–6 Hz, 1,000 shocks) and radial (1.3–1.8 mJ/mm2, 14 Hz, 2,000 shocks) shockwave application per session. Each patient received three to five weekly sessions.ParticipantsMedial epicondylitis patients with concomitant ulnar nerve involvement who underwent a combined ESWT protocol between September 2019 and May 2023.Main outcome measuresPain severity and upper limb disability were assessed with the numerical rating scale, the shortened Disabilities of the Arm, Shoulder and Hand questionnaire, and the Ulnar Neuropathy at the Elbow Questionnaire. Patient treatment satisfaction was evaluated with the Roles and Maudsley score.ResultsOf the reviewed 15 consecutive medical charts, only three subjects fulfilled the inclusion criteria. Two patients showed a marked decrease in pain and improved functionality scores at all time points; one patient remained unchanged throughout the study; no adverse effects were observed.ConclusionsThis retrospective study suggests that ESWT may be efficacious and safe for treating medial epicondylitis patients with concurrent ulnar nerve instability. Prospective studies with a larger sample size are needed to warrant the present results.

Emma Gendre, Andrea Soubelet, Charlotte Henson et al.

Background: Posttraumatic growth (PTG) is associated with two important cognitive factors: challenge to core beliefs and event-related rumination. The objectives of this study were to 1) validate the French versions of the Core Beliefs Inventory (CBI, Cann et al., 2010) and the Event-Related Rumination Inventory (ERRI, Cann et al., 2011) and 2) explore direct and indirect effects of core beliefs and rumination on PTG in the long-term. Methods: A sample of adults (N = 433 at T1, N = 222 at T2, six months later) who had experienced at least one traumatic event in their lifetime completed online questionnaires measuring core beliefs, rumination, distress, and PTG. Confirmatory factor analyses, correlations, and structural equation modeling were performed. Results: Analyses supported a two-factor structure for the CBI: (1) beliefs about justice, control, and the causality of events and (2) beliefs about relationships, self, and the future; as well as for the ERRI: (1) intrusive rumination and (2) deliberate rumination. Both scales showed good psychometric qualities. Disruption of beliefs about relationships, self, and the future at T1 and deliberate rumination at T2 had a direct positive effect on PTG at T2, while intrusive rumination at T1 had no effect. Deliberate rumination mediated both the relationship between disruption of core beliefs and PTG and the relationship between intrusive rumination and PTG. Conclusions: The results demonstrate the validity of the CBI and ERRI and are consistent with the theoretical model emphasizing the importance of cognitive processing in the development of PTG.

PENG Yan, ZHANG Chi, GAO Li, LI Xiting, ZHAO Chuanjiang

Patients suffering from stage Ⅳ periodontitis manifest substantial alveolar bone destruction and pronounced tooth loss, frequently accompanied by masticatory dysfunction, occlusal disorder and tooth displacement or torsion. Standard periodontal interventions alone are insufficient to stabilize the condition, address masticatory dysfunction, and enhance patients’ quality of life. Hence, intricate reconstructive and interdisciplinary regimens, encompassing orthodontic treatment, are often indispensable. Orthodontic therapy can optimize the masticatory function and esthetic appearance of patients, and promote periodontal well-being. However, individuals with stage Ⅳ periodontitis present with inadequate periodontal support tissue and a heightened risk profile, rendering their orthodontic management a considerable clinical challenge. This article reviews the orthodontic considerations and optimal timing for intervention in patients with stage Ⅳ periodontitis and presents a representative case of combined periodontal-orthodontic-orthognathic treatment for periodontitis(stage Ⅳ, grade C), in order to provide reference for periodontists and orthodontists.

Emel TAŞVURAN HORATA, Fatma EKEN, Olgun TOPAL et al.

Purpose: Individuals with temporomandibular disorder (TMD), especially Group I, have a reduced quality of life (QoL). This study examines the relationship between the individual, physical, and psychosocial characteristics of individuals with Group I TMD and their QoL. Methods: The study was conducted with 73 participants aged 18-65 years and diagnosed with Group I TMD. Their individual (age, gender, education level, duration of TMD-related complaints), physical [joint sounds, pressure pain threshold (PPT), jaw muscle strength, temporomandibular joint range of motion (ROM), cervical ROM, pain intensity], and psychosocial characteristics (mental status) and QoL were evaluated. Pain intensity, mental status, and QoL were assessed using a numerical pain scale, the General Health Questionnaire-28 (GHQ-28), and Short Form-36, respectively. Results: Education level showed the greatest association with QoL among individual characteristics (r=0.243-0.336; p<0.05). PPT was weakly associated with some QoL parameters (r=0.238-0.278; p<0.05). The right excursion muscle strength was associated with many parameters of QoL (r=0.236-0.403; p<0.05). Only the maximum overbite ROM was related to general health (r=0.244; p<0.05). Pain intensity was the most associated with all parameters of QoL (r=-0.302 – -0.556; p<0.01). A correlation was revealed between the GHQ-28 and emotional well-being (r=-0.231; p<0.01) and energy/vitality (r=-0.364; p<0.05). Conclusion: To improve the QoL of individuals with TMD, biopsychosocial factors related to QoL should be taken into account during rehabilitation. Modifying pain-related beliefs and behaviors, along with pain and stress management interventions, would be beneficial in addition to physical modalities and exercise approaches.

Yuhan Tang

Type 2 diabetes prevention and treatment can benefit from personalized lifestyle prescriptions. However, the delivery of personalized lifestyle medicine prescriptions is limited by the shortage of trained professionals and the variability in physicians' expertise. We propose an offline contextual bandit approach that learns individualized lifestyle prescriptions from the aggregated NHANES profiles of 119,555 participants by minimizing the Magni glucose risk-reward function. The model encodes patient status and generates lifestyle medicine prescriptions, which are trained using a mixed-action Soft Actor-Critic algorithm. The task is treated as a single-step contextual bandit. The model is validated against lifestyle medicine prescriptions issued by three certified physicians from Xiangya Hospital. These results demonstrate that offline mixed-action SAC can generate risk-aware lifestyle medicine prescriptions from cross-sectional NHANES data, warranting prospective clinical validation.

John W. Sheppard

This chapter serves as an introduction to systems engineering focused on the broad issues surrounding realizing complex integrated systems. What is a system? We pose a number of possible definitions and perspectives, but leave open the opportunity to consider the system from the target context where it will be used. Once we have a system in mind, we acknowledge the fact that this system needs to integrate a variety of pieces, components, subsystems, in order for it to accomplish its task. Therefore, we concern ourselves at the boundaries and interfaces of different technologies and disciplines to determine how best to achieve that integration. Next we raise the specter that this integrated system is complex. Complexity can be defined in a number of ways. For one, the sheer number of subsystems or components can be a measure of complexity. We could also consider the functions being performed by the system and how those functions interact with one another. Further, we could consider computational aspects such as the time or memory that may be needed to accomplish one or more tasks. The extent to which new behaviors might emerge from the system can also be regarded as an element of complexity. In the end, complexity is that characteristic of a system that defines the associated challenges along the life of the system, so we are concerned with how to manage that complexity. Finally, realization refers to the process by which our complex integrated system moves from concept to deployment and subsequent support. It refers to the entire design, development, manufacture, deployment, operation, and support life cycle. Of particular note here, however, is that we focus on systems that, by their very nature, are complex. In other words, we are interested in large, complicated, interacting beasts that are intended to perform difficult tasks and meet a wide variety of end-user needs.

Guang An Ooi, Otavio Bertozzi, Mohd Asim Aftab et al.

Modern power systems with high penetration of inverter-based resources exhibit complex dynamic behaviors that challenge the scalability and generalizability of traditional stability assessment methods. This paper presents a dynamic recurrent adjacency memory network (DRAMN) that combines physics-informed analysis with deep learning for real-time power system stability forecasting. The framework employs sliding-window dynamic mode decomposition to construct time-varying, multi-layer adjacency matrices from phasor measurement unit and sensor data to capture system dynamics such as modal participation factors, coupling strengths, phase relationships, and spectral energy distributions. As opposed to processing spatial and temporal dependencies separately, DRAMN integrates graph convolution operations directly within recurrent gating mechanisms, enabling simultaneous modeling of evolving dynamics and temporal dependencies. Extensive validations on modified IEEE 9-bus, 39-bus, and a multi-terminal HVDC network demonstrate high performance, achieving 99.85%, 99.90%, and 99.69% average accuracies, respectively, surpassing all tested benchmarks, including classical machine learning algorithms and recent graph-based models. The framework identifies optimal combinations of measurements that reduce feature dimensionality by 82% without performance degradation. Correlation analysis between dominant measurements for small-signal and transient stability events validates generalizability across different stability phenomena. DRAMN achieves state-of-the-art accuracy while providing enhanced interpretability for power system operators, making it suitable for real-time deployment in modern control centers.

WANG Xirui, ZHU Huiyong

Head and neck cancer is the seventh most common cancer in the world, accounting for about 10% of all malignant tumors. Radiotherapy is an important treatment for head and neck cancer. Osteonecrosis of the jaws(ORNJ) is a refractory complication after radiotherapy for head and neck cancer, which often manifests as osteonecrosis of the jaw and soft tissue exposure. The current pathogenesis of ORNJ has not been fully clarified and its treatment remains challenging. The traditional treatment for this disease is partial resection of necrotic jaw bone and reconstruction with osteocutaneous flap. However, in recent years, some new techniques and ideas have been used to treat the disease. For mild osteoradionecrosis of the jaw, the treatment concept tends to be conservative. This article mainly summarizes the latest research progress at home and abroad, and reviews the pathogenesis, clinical manifestations and treatment strategies for osteoradionecrosis of the jaws.

Pedro Zuidberg Dos Martires, Vincent Derkinderen, Luc De Raedt et al.

Recent developments in AI have reinvigorated pursuits to advance the (life) sciences using AI techniques, thereby creating a renewed opportunity to bridge different fields and find synergies. Headlines for AI and the life sciences have been dominated by data-driven techniques, for instance, to solve protein folding with next to no expert knowledge. In contrast to this, we argue for the necessity of a formal representation of expert knowledge - either to develop explicit scientific theories or to compensate for the lack of data. Specifically, we argue that the fields of knowledge representation (KR) and systems biology (SysBio) exhibit important overlaps that have been largely ignored so far. This, in turn, means that relevant scientific questions are ready to be answered using the right domain knowledge (SysBio), encoded in the right way (SysBio/KR), and by combining it with modern automated reasoning tools (KR). Hence, the formal representation of domain knowledge is a natural meeting place for SysBio and KR. On the one hand, we argue that such an interdisciplinary approach will advance the field SysBio by exposing it to industrial-grade reasoning tools and thereby allowing novel scientific questions to be tackled. On the other hand, we see ample opportunities to move the state-of-the-art in KR by tailoring KR methods to the field of SysBio, which comes with challenging problem characteristics, e.g. scale, partial knowledge, noise, or sub-symbolic data. We stipulate that this proposed interdisciplinary research is necessary to attain a prominent long-term goal in the health sciences: precision medicine.

Anli du Preez, Peter A. Beling, Tyler Cody

The machine learning formulation of online learning is incomplete from a systems theoretic perspective. Typically, machine learning research emphasizes domains and tasks, and a problem solving worldview. It focuses on algorithm parameters, features, and samples, and neglects the perspective offered by considering system structure and system behavior or dynamics. Online learning is an active field of research and has been widely explored in terms of statistical theory and computational algorithms, however, in general, the literature still lacks formal system theoretical frameworks for modeling online learning systems and resolving systems-related concept drift issues. Furthermore, while the machine learning formulation serves to classify methods and literature, the systems theoretic formulation presented herein serves to provide a framework for the top-down design of online learning systems, including a novel definition of online learning and the identification of key design parameters. The framework is formulated in terms of input-output systems and is further divided into system structure and system behavior. Concept drift is a critical challenge faced in online learning, and this work formally approaches it as part of the system behavior characteristics. Healthcare provider fraud detection using machine learning is used as a case study throughout the paper to ground the discussion in a real-world online learning challenge.

Kehar Singh, Yogesh Murti, Mohit Sanduja et al.

Introduction: Livistona chinensis (L. chinensis) or Chinese fan palm is a tropical and subtropical plant that is commonly planted across the world. Its fruits are fleshy, green in appearance, and contain a firm seed. The biochar produced from Chinese fan palm fruit is an excellent source for the adsorption of colours from bodies of water for subsequent disposal. Biosorption is a great and environmentally beneficial method of removing contaminants from the environment. Traditional Chinese medicine (TCM) practitioners utilised it to treat cancer. Experiments have indicated that extracts of L. chinensis fruits and seeds have antiproliferative and antiangiogenic effects. Flavanoids, phenolic acids, terpenes, alkaloids, and other compounds are found in L. chinensis. Methodology: The online database including Google Scholar, Scopus, PubMed, and Web of Science were searched using different keywords: L. chinensis phytochemistry, pharmacology and toxicology. The purpose of this review was therefore to summarize the previously reported phytochemicals, pharmacological status of the chosen Chinese plant species. Results: Our findings show that Livistona chinensis includes a wide range of physiologically active chemicals, such as flavonoids and terpenoids. Furthermore, past research has shown that L. chinensis plant extracts and extracted principles have substantial pharmacological action, including anti-tumour, anti-inflammatory, antioxidant, anti-melanogenic, and other properties. Discussion: According to the research listed below, L. chinensis has a high potential for developing medicines and supplements for prophylactic as well as therapy of cancer, ulcer, diabetes, and other diseases. Furthermore, clinical research has demonstrated that jujube is a safe and effective plant for human consumption, and as such, it should be included in dietary intakes as well as active ingredients in pharmaceutical formulations. Conclusion: L. chinensis is a great source of bioactive compounds that may be put into human meals and show promise in the treatment of minor to life-threatening medical conditions. This review will inspire other scientists to conduct more research on the selected plant species, particularly in the areas of toxicity and bioactivity.

Wael Mostafa Hamza, Ahmed Fayed, Amr Mohamed Shaker et al.

Introduction: Medical renal diseases stand as one of the major health problems in pediatric age group considering its morbidity/mortality and the subsequent management plans. Objectives: In this manuscript, the spectrum of histopathological patterns of medical nephropathic lesions in Egyptian pediatric patients over duration of five years is reported with clinical indications. Patients and Methods: We conducted a retrospective study for analysis of our pathological reports of renal needle biopsies during the period from January 2014 until January 2019. One hundred and sixteen cases were included. Results: The most commonly encountered pediatric renal pathology was minimal change disease (27.59%), followed by congenital glomerular diseases (22.41%), focal segmental glomerulosclerosis (12.93%), and thrombotic microangiopathy (7.76%). The most common clinical indication for biopsy was nephrotic syndrome (37.07%) followed by impaired renal functions with elevated serum creatinine (21.55%). In addition, we report very rare histological findings in few cases including infantile nephropathic cystinosis, Barakat syndrome and C3 glomerulopathy. Conclusion: Minimal change disease and congenital glomerular diseases accounted for half of pediatric renal pathologies in the study population. The most common clinical indication for renal biopsy was nephrotic syndrome. Electron microscopic examination and genetic studies are mandatory for proper evaluation of pediatric nephropathies.

Xuechen Geng, Ziqiang Wang, Li Feng et al.

Abstract Introduction Colon cancer remains one of the most prevalent cancers worldwide. Unfortunately, there are no recognized and effective therapeutic strategies to prevent tumor recurrence after radical resection and chemotherapy, and the disease-free survival (DFS) in patients with stage IIIB or IIIC disease remains unsatisfactory. Xian-Lian-Jie-Du optimization decoction (XLJDOD) is a Chinese herbal medicine (CHM) empirical prescription, which has been validated experimentally and clinically that could inhibit the progression of colorectal cancer and ameliorate the symptoms. The purpose of this study is to evaluate the efficacy and safety of XLJDOD in prevention of recurrence of colon cancer. Methods This study is a multi-center, double-blind, randomized, placebo-controlled trial conducted at 13 hospitals of China. Following the completion of surgery and adjuvant 5- fluorouracil-based chemotherapy, a total of 730 subjects with stage IIIB or IIIC colon cancer will be randomized in a 1:1 ratio to an intervention group (n = 365; XLJDOD compound granule) and a control group (n = 365; Placebo). Patients will receive 6-month treatments and be followed up with 3 monthly assessments for 2 years. The primary outcome is 2-year DFS rate and the secondary outcomes are 1, 2-year relapse rate (RR), overall survival (OS) and quality of life (QoL). Safety outcomes such as adverse events will be also assessed. A small number of subgroup analysis will be carried out to explore the heterogeneity of effects of XLJDOD. Discussion The outcomes from this randomized controlled trial will provide objective evidences to evaluate XLJDOD’s role as an adjuvant treatment in colon cancer. Trial registration www.ClinicalTrials.gov , identifier: NCT05709249. Registered on 31 Jan 2023.

Peng MIAO

In the past few years, the medical knowledge transfer in a West-East direction has attracted increased scholarly attention from European and American historians, whereas studies on such “knowledge travels” conducted in the East Asian context focus mainly on political and socio-cultural concepts. To provide an alternative perspective on the travel of Western medicine to Chinese soil, a case study on “diabetes” is conducted, under the theoretical framework of “transcultural conceptual history.” This article systematically analyzes the standardization, popularization, politicization, and derivatization of “diabetes,” calling for further attention to transcultural histories of medical concepts in modern China.

Nan Zhang, Rami Bahsoon, Nikos Tziritas et al.

Engineering regulatory compliance in complex Cyber-Physical Systems (CPS), such as smart warehouse logistics, is challenging due to the open and dynamic nature of these systems, scales, and unpredictable modes of human-robot interactions that can be best learnt at runtime. Traditional offline approaches for engineering compliance often involve modelling at a higher, more abstract level (e.g. using languages like SysML). These abstract models only support analysis in offline-designed and simplified scenarios. However, open and complex systems may be unpredictable, and their behaviours are difficult to be fully captured by abstract models. These systems may also involve other business goals, possibly conflicting with regulatory compliance. To overcome these challenges, fine-grained simulation models are promising to complement abstract models and support accurate runtime predictions and performance evaluation with trade-off analysis. The novel contribution of this work is a Digital Twin-oriented architecture for adaptive compliance leveraging abstract goal modelling, fine-grained agent-based modelling and runtime simulation for managing compliance trade-offs. A case study from smart warehouse logistics is used to demonstrate the approach considering safety and productivity trade-offs.

Jesutofunmi A. Omiye, Haiwen Gui, Shawheen J. Rezaei et al.

Large language models (LLMs) have been applied to tasks in healthcare, ranging from medical exam questions to responding to patient questions. With increasing institutional partnerships between companies producing LLMs and healthcare systems, real world clinical application is coming closer to reality. As these models gain traction, it is essential for healthcare practitioners to understand what LLMs are, their development, their current and potential applications, and the associated pitfalls when utilized in medicine. This review and accompanying tutorial aim to give an overview of these topics to aid healthcare practitioners in understanding the rapidly changing landscape of LLMs as applied to medicine.

Silvana Tozzo Ritta

O trabalho é resultado de encontros inesperados. O primeiro encontro foi com o vírus SARS-CoV-2, a partir do qual desenvolvemos este trabalho. O objetivo é analisar as situações de conexão entre saúde e espiritualidade nos atendimentos dos pacientes acometidos por Covid-19, em áreas hospitalares do estado do Rio Grande do Sul durante a pandemia da Covid-19, identificando, comparando e relatando essa experiência. Na metodologia, optamos por um estudo de caso exploratório. Descrevemos toda complexidade de um caso concreto, já que o tema é ainda novo, inesperado, com poucos estudos, de modo a capturar um momento único para estudos futuros. Fontes de evidências utilizadas na pesquisa combinaram diferentes técnicas: observação participante pela pesquisadora e entrevistas semiestruturadas. Narrativas foram organizadas em eixos, são eles: formação, plano terapêutico, abordagem humanizada e protocolos. Isso possibilitou reflexões e observações entre relatos e observações da pesquisadora baseados na análise proposta por Minayo (2009), bem como através de diálogos com autores que transitam pelo tema. Resultados mostraram que a crise sanitária trouxe um medo que permeou todos os ambientes hospitalares. Ademais, a necessidade da construção de um novo fazer, incluindo o cuidado espiritual no plano terapêutico de forma clara e direta, baseada em estruturas éticas e humanizadas. Concluímos esta dissertação, não só relatando as principais experiências de superação de obstáculos e expressão de experiências com o sagrado no processo de cuidar dos indivíduos, como também propondo um objeto pedagógico (podcast), que tem por função complementar propostas de capacitação no e para o trabalho. Palavras-chave: Pandemia. Espiritualidade. Religiosidade. Crise sanitária. COVID-19. Educação.

Hamid Mohammadi Kojidi, Mohammad Habibullah Pulok, Banafshe Felezi-Nasiri et al.

The use of pesticides as one of the main agricultural poles has been increased in Iran in recent years. Organophosphate poisoning has harmful the consequences for human health. This study present clinical and laboratory evidences on the patients exposed to agricultural insecticides poisoning and the cause of these poisons. We collected clinical data from the patients referred to Razi Hospital, Rasht, Iran who were poisoned with organophosphorus toxins. For this purpose, a checklist was prepared, and data were collected for 414 patients between 2011 and 2016. The results showed that the most cases of poisoning were men (73%) and about 27.2% of the patients was in the age group of 45-60 years (highest frequency in age groups). The most frequent symptoms were vomiting (65%), nausea (61%), abdominal pain (39%), and perspiration (27%). There was also a decrease in consciousness (16%) and sialorrhea (16%). Totally, 186 (46.2%) patients were exposed to organophosphorus toxins by respiratory and 215 (53.4%) orally. Out of the 414 samples, 102 (33%) had abnormal creatine phosphokinase (CPK) enzymes and 114 (34.5%) abnormal lactate dehydrogenase (LDH). Mean hospital length of stay (LOS) was 3.3 days. We found significant relationship of LOS with heart failure, hypertension, and addiction. To better manage the process of treatment of agricultural poisoned patients and to reduce the waste of limited resources available, careful consideration should be given to the type of pesticide used by the patient to prevent overdose and unintentional use of antidote.

Mark Haring, Esten Ingar Grøtli, Signe Riemer-Sørensen et al.

Low complexity of a system model is essential for its use in real-time applications. However, sparse identification methods commonly have stringent requirements that exclude them from being applied in an industrial setting. In this paper, we introduce a flexible method for the sparse identification of dynamical systems described by ordinary differential equations. Our method relieves many of the requirements imposed by other methods that relate to the structure of the model and the data set, such as fixed sampling rates, full state measurements, and linearity of the model. The Levenberg-Marquardt algorithm is used to solve the identification problem. We show that the Levenberg-Marquardt algorithm can be written in a form that enables parallel computing, which greatly diminishes the time required to solve the identification problem. An efficient backward elimination strategy is presented to construct a lean system model.

Matthew Deakin, Phil C. Taylor, Janusz Bialek et al.

Distribution systems will require new cost-effective solutions to provide network capacity and increased flexibility to accommodate Low Carbon Technologies. To address this need, we propose the Hybrid Multi-Terminal Soft Open Point (Hybrid MT-SOP) to efficiently provide distribution system interconnection capacity. Each leg of the Hybrid MT-SOP has an AC/DC converter connected in series with a bank of AC switches (Feeder Selector Switches) to allow the converter to connect to any of the feeders at a node. Asymmetric converter sizing is shown to increase feasible power transfers by up to 50% in the three-terminal case, whilst a conic mixed-integer program is formulated to optimally select the device configuration and power transfers. A case study shows the Hybrid MT-SOP increasing utilization of the converters by more than one third, with a 13% increase in system loss reduction as compared to an equally-sized MT-SOP.