Viadya Amol S. Kadu, Rupali D. Asutkar, Anita Sharma
et al.
Introduction:
Alcohol consumption is a significant public health issue, contributing to substantial morbidity and mortality worldwide. In India, alcohol use prevalence ranges from 3.8% to 21%, predominantly affecting men. Despite estimates of alcohol use disorder (AUD) ranging from 7.1% to 14.2%, limited hospital-based studies exist in Rajasthan. This study examines alcohol consumption patterns, AUD prevalence, and their association with sociodemographic factors among male outpatients at NIA OPD.
Methods:
A hospital-based cross-sectional study was conducted on 1000 male outpatients aged 18 and above with a history of alcohol use. Data were collected from December 2018 to December 2020 using a pretested questionnaire, including the AUD identification test (AUDIT). Participants were selected through purposive sampling, and drinking patterns were categorized into hazardous, harmful, and dependent levels. Sociodemographic factors, drinking behaviors, and familial influences were analyzed using descriptive statistics.
Results:
The study found that 41.8% of participants consumed alcohol four or more times weekly, and 28.8% consumed six or more drinks daily. Stress relief and peer pressure were primary motivators, with 21% reporting a family history of substance abuse. Despite 76.7% awareness of alcohol’s adverse effects, risky drinking behaviors persisted. AUDIT analysis categorized 43.8% as hazardous drinkers, 29.2% as harmful drinkers, and 12.4% as alcohol-dependent. High-risk behaviors included memory blackouts, inability to meet responsibilities, and polysubstance use.
Conclusion:
The study underscores the need for targeted interventions, including routine screening, behavioral counseling, community awareness programs, and strengthened de-addiction services to mitigate AUD-related risks.
Mishael Adje, Sven Karstens, Chidozie Mbada
et al.
Abstract Background Traditional bone setting (TBS) remains a prevalent healthcare practice in Nigeria, offering complementary treatments for musculoskeletal conditions such as low back pain (LBP). This study explores the perspectives of both patients and physiotherapists regarding TBS and its implications for the management of LBP. Methods A qualitative research approach was employed, utilizing semi-structured interviews with 25 participants (13 patients who had utilized TBS services for LBP, and 12 physiotherapists). Theoretical sampling was employed in participant recruitment until saturation. Recordings were transcribed and thematic analysis was conducted as a secondary analysis. Reporting was informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results Eleven (11) participants were female and 14 were male; with a mean age of 35 years. Five themes were identified from this study: driving impetus for TBS, influencing perceptions with information, turning to TBS as a final recourse, exploring the primary alternative, and integrating TBS. The shift towards TBS for LBP stems from deficiencies in prevailing healthcare practices in Nigeria. Patients and physiotherapists hold varying perspectives regarding cultural significance, and effectiveness and safety of TBS compared to professional physiotherapy interventions. Accessibility, affordability, and perceived efficacy are common facilitators for the patronage of TBS among patients, while others were hesitant and viewed it as a last resort. Negative perception of physiotherapists about TBS for LBP were based on concerns regarding the lack of scientific evidence, standardized practices, and potential complications associated with the procedures. Conclusion Participants consider TBS viable when professional physiotherapy fails, citing expectations for therapist-guided techniques, affordability, and cultural factors. Physiotherapists remain cautious, stressing the need for evidence-based care and noting severe TBS complications. Some participants advocate for integrating TBS with professional healthcare through collaboration and better communication. This study, supported by literature, highlights the potential for TBS integration, with open communication and training fostering collaboration. Future studies could investigate the practicality of this integration, prioritizing culturally appropriate, safe, and effective approaches to LBP management.
Gonçalo Granjal Cruz, Balazs Renczes, Mark C Runacres
et al.
While accurate, black-box system identification models lack interpretability of the underlying system dynamics. This paper proposes State-Space Kolmogorov-Arnold Networks (SS-KAN) to address this challenge by integrating Kolmogorov-Arnold Networks within a state-space framework. The proposed model is validated on two benchmark systems: the Silverbox and the Wiener-Hammerstein benchmarks. Results show that SS-KAN provides enhanced interpretability due to sparsity-promoting regularization and the direct visualization of its learned univariate functions, which reveal system nonlinearities at the cost of accuracy when compared to state-of-the-art black-box models, highlighting SS-KAN as a promising approach for interpretable nonlinear system identification, balancing accuracy and interpretability of nonlinear system dynamics.
Group Decision-Making (GDM) plays a crucial role in various real-life scenarios where individuals express their opinions in natural language rather than structured numerical values. Traditional GDM approaches often overlook the subjectivity and ambiguity present in human discussions, making it challenging to achieve a fair and consensus-driven decision. This paper proposes a fuzzy consensus-based group decision-making system that integrates sentiment and emotion analysis to extract preference values from textual inputs. The proposed framework combines explicit voting preferences with sentiment scores derived from chat discussions, which are then processed using a Fuzzy Inference System (FIS) to compute a total preference score for each alternative and determine the top-ranked option. To ensure fairness in group decision-making, we introduce a fuzzy logic-based consensus measurement model that evaluates participants' agreement and confidence levels to assess overall feedback. To illustrate the effectiveness of our approach, we apply the methodology to a restaurant selection scenario, where a group of individuals must decide on a dining option based on brief chat discussions. The results demonstrate that the fuzzy consensus mechanism successfully aggregates individual preferences and ensures a balanced outcome that accurately reflects group sentiment.
Objective: To determine the main components of Astragalus membranaceus (Fisch.) Bge (A. membranaceus, Huang Qi), Astragaloside IV (AIV) and Astragalus polysaccharides (AP), to characterize their properties, evaluate their in vivo efficacy, and to analyze drug diffusion using dissolving microneedle (DMN) technology in vivo. Methods: Respectively, AIV- and AP-loaded DMNs comprising chitosan (CTS) and polyvinyl alcohol (PVA) were prepared via dual-mold forming. Their morphology, mechanical properties, in vivo solubility, and skin irritation characteristics were tested. In vivo efficacy was assessed in cyclophosphamide-induced immunosuppressed mice, in vivo diffusion of AIV and AP by DMNs and conventional methods was compared, and the rheological properties of AIV-CTS-PVA and AP-CTS-PVA mixtures were measured. Results: Subcutaneous dissolution and absorption of AIV-CTS-PVA and AP-CTS-PVA microneedles (MNs) at low doses (50%–17% of intraperitoneal AIV injection and 12%–4% of intravenous AP injection) reduced the spleen index and acid phosphatase activity in immunosuppressed mouse models, increased the thymus index, and achieved equivalent or better systemic therapeutic effects. Compared with injections, AIV and AP achieved controllable solid-liquid conversion through delivery with CTS-PVA MNs, resulting in highly localized aggregation within 48 h, reducing the initial explosive effect of the drug, and achieving stable and slow drug release. Conclusion: The present study enhances our understanding of the efficacy and remote effects of drug-loaded DMNs from a traditional Chinese medicine (TCM) perspective, thereby promoting the development of precise and efficient delivery of TCM and further expanding the drug-loading range and application scenarios for DMNs.
We associate parametric classes of $n$-component Lotka-Volterra systems which admit $k$ additional linear Darboux polynomials, with admissible loopless hypergraphs of order $n$ and size $k$. We study the equivalence relation on admissible hypergraphs induced by linear transformations of the associated LV-systems, for $n\leq 5$. We present a new 13-parameter 5-component superintegrable Lotka-Volterra system, i.e. one that is not equivalent to a so-called tree-system. We conjecture that tree-systems associated with nonisomorphic trees are not equivalent, which we verified for $n<9$.
Introduction: This article is part of the Focus Theme of METHODS of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". Background: The proliferation of archetypes as a means to represent information of Electronic Health Records has raised the need of binding terminological codes - such as SNOMED CT codes - to their elements, in order to identify them univocally. However, the large size of the terminologies makes it difficult to perform this task manually. Objectives: To establish a baseline of results for the aforementioned problem by using off-the-shelf string comparison-based techniques against which results from more complex techniques could be evaluated. Methods: Nine Typed Comparison METHODS were evaluated for binding using a set of 487 archetype elements. Their recall was calculated and Friedman and Nemenyi tests were applied in order to assess whether any of the methods outperformed the others. Results: Using the qGrams method along with the 'Text' information piece of archetype elements outperforms the other methods if a level of confidence of 90% is considered. A recall of 25.26% is obtained if just one SNOMED CT term is retrieved for each archetype element. This recall rises to 50.51% and 75.56% if 10 and 100 elements are retrieved respectively, that being a reduction of more than 99.99% on the SNOMED CT code set. Conclusions: The baseline has been established following the above-mentioned results. Moreover, it has been observed that although string comparison-based methods do not outperform more sophisticated techniques, they still can be an alternative for providing a reduced set of candidate terms for each archetype element from which the ultimate term can be chosen later in the more-than-likely manual supervision task.
This paper presents the development of a comprehensive dynamics and stabilizing control architecture for Tethered Unmanned Aerial Vehicle (TUAV) systems. The proposed architecture integrates both onboard and ground-based controllers, employing nonlinear backstepping control techniques to achieve asymptotic stability of the TUAV's equilibrium. The onboard controllers are responsible for the position and attitude control of the TUAV, while the ground controllers regulate the winder mechanism to maintain the desired tether length, ensuring it retains its catenary form. Simulation results demonstrate the ability of the TUAV system to accurately track linear and circular trajectories, ensuring robust performance under various operational scenarios. The code and movies demonstrating the performance of the system can be found at https://github.com/sof-danny/TUAV\_system\_control.
BackgroundTraumatic brain injury (TBI) outcomes are dependent on patients' biological sex (e.g., hormone levels) and sociocultural gender (e.g., norms, responsibilities). Informal caregivers additionally experience disruptions to identity and roles post-TBI. However, information on this topic remains largely unavailable to patients and caregivers.PurposeThis study aimed to determine the effectiveness of a one-time educational intervention on sex and gender influences in TBI for patients and informal caregivers.Materials and methodsWe conducted a pilot pre-test/post-test randomized control-group design study. Groups (i.e., passive, active and control) consisted a total of 16 persons with TBI and caregivers (75% persons with TBI, 63% women). Individual and group learning gains, and group-average normalized gain, were computed for three learning domains: knowledge, attitude, and skill. An intervention with an average normalized gain of ≥30% was considered effective. Educational intervention evaluation and qualitative comments post-participation were summarized.ResultsThe passive group demonstrated the highest average normalized gain across the three learning domains, including 100% for knowledge, 40% and 61% for attitude, and 37% for skill. The remaining groups did not reach an average normalized gain of ≥30%, except for the attitude domain of the control group (33% and 32%). Two key categories were identified qualitatively: (1) gendered self-expectations post-injury and (2) implications of gender stereotypes in rehabilitation, including the need for rehabilitation treatment to look beyond sex and gender. The post-participation educational session evaluation conveyed high appraisal of content, organization, and usability of the intervention.ConclusionA one-time passive educational intervention on sex and gender in TBI may improve knowledge, attitude, and skill on the topic of sex and gender among adults with TBI and caregivers. Obtaining knowledge and skill on sex and gender effects in TBI can potentially help persons with TBI and caregivers adapt to changes in roles and behaviours post-injury.
Yogesh Chand Yadav, Kamla Pathak, Ramakant Yadav
et al.
Objective: Hesperetin is a natural flavonoid with antioxidant potential and can be used to treat disorders of the brain. Therefore, present study is designed to investigate effect of hesperetin on dimethylsulphoxide induced cognitive dysfunction mediated through oxidative stress marker and neuroinflammation in hippocampus Methodology: The experiment was conducted using five treatment groups, each group consisting six rats. Group 1 (control) received 1 ml/kg normal saline interperitoneally for 14 days. Group 2 received 1 ml/kg DMSO per oral for14 days. Group 3 received donepezil 3 mg/kg per day for 14 days and DMSO (1 ml/kg p.o.) for 14th day. Group 4 and 5 received a dose of 25 mg /kg of hesperetin (H1) and 50 mg/kg hesperetin (H2) per oral, per day for 14 days, respectively. Hesperetin was dissolved in DMSO to get 25 mg/ml solution. On 14th day, the memory of rats was assessed by Cook's pole climbing apparatus and Morris water maze test. On 15th day, six rats of each group were sacrificed and the isolated brain tissues were subjected for the estimation of biochemical parameters, beta actin blot analysis and histopathological examination. Results: The DMSO treated rats showed significantly enhanced escape latency time (P < 0.0001) acetylcholinesterase (AchE) activity (P < 0.0001), lipid peroxidation (P < 0.0001), TNF-α level and decreased reduced glutathione levels (p < 0.001), attenuated beta actin blot density, degradation and inflammation in the hippocampus region as compared to the control group. These parameters were significantly recovered in the rats pretreated with donepezil and hesperetin. Conclusion: The findings of this study demonstrated that DMSO induced cognitive dysfunction in rats and hesperetin has potential to improve the cognitive performance against DMSO via reduced oxidative stress and neuroinflammation in hippocampus.
Other systems of medicine, Therapeutics. Pharmacology
Endometrial calcification is an uncommon clinical entity. They can be detected during pelvic ultrasonography or as incidental pathologic findings. Most of the cases are asymptomatic or present with secondary infertility and menstrual anomalies. Its definite etiology is still not known and the pathogenesis is uncertain; its clinical importance is not yet fully validated. Since there is no exact simulating disease to compare this condition in Ayurveda; according to the features involved in its pathophysiology; involvement of Tridosha has been contemplated. Therefore, the management of endometrial calcifications is conducted by considering the specific Dosha involved. Uttara Basti is a minimally invasive procedure that can be easily performed as an outpatient procedure, offering a more convenient and cost-effective approach to enhance the treatment of endometrial calcifications. Here in this case study, the patient had been diagnosed with endometrial calcifications and was subsequently scheduled for an Ayurvedic management protocol. The procedure of Uttara Basti with Kshara Oil and Phala ghrita, was undertaken for a duration of 3 consecutive months, following the cessation of menstrual flow. The patient experienced improvment in scanty menses, her USG showed a reduction in endometrial calcification. Furthermore, she was conceived.
Topology diagrams are widely seen in power system applications, but their automatic generation is often easier said than done. When facing power transmission systems with strongly-meshed structures, existing approaches can hardly produce topology diagrams catering to the aesthetics of readers. This paper proposes an integrated framework for generating aesthetically-pleasing topology diagrams for power transmission systems. Input with a rough layout, the framework first conducts visibility region analysis to reduce line crossings and then solves a mixed-integer linear programming problem to optimize the arrangement of nodes. Given that the complexity of both modules is pretty high, simplification heuristics are also proposed to enhance the efficiency of the framework. Case studies on several power transmission systems containing up to 2,046 nodes demonstrate the capability of the proposed framework in generating topology diagrams conforming to aesthetic criteria in the power system community. Compared with the widespread force-directed algorithm, the proposed framework can preserve the relative positions of nodes in the original layout to a great extent, which significantly contributes to the identification of electrical elements on the diagrams. Meanwhile, the time consumption is acceptable for practical applications.
Kailynn Mannella, Alan C. Cudlip, Michael W. R. Holmes
Muscular weakness and loss of motor function are common symptoms of multiple sclerosis. Robotic rehabilitation can improve sensorimotor function and motor control in this population. However, many studies using robotics for rehabilitation have overlooked changes in muscular strength, despite research demonstrating its utility in combating functional impairments. The purpose of this scoping review was to critically examine changes in muscular strength following robotic rehabilitation interventions for individuals with multiple sclerosis. A literature search of five databases was conducted and search terms included a combination of three primary terms: robotic rehabilitation/training, muscular strength, and multiple sclerosis. Thirty one articles were found, and following inclusion criteria, 5 remained for further investigation. Although muscular strength was not the primary targeted outcome of the training for any of the included articles, increases in muscular strength were present in most of the studies suggesting that robotic therapy with a resistive load can be an effective alternative to resistance training for increasing muscular strength. Outcome measures of isometric knee-extensor force (kg) (right: p < 0.05, left: p < 0.05), isometric knee flexion and extension torque (Nm) (p < 0.05), ankle dorsiflexion and plantarflexion torque (Nm) (all p < 0.05) and handgrip force (kg) (p < 0.05) all improved following a robotic training intervention. These adaptations occurred with sustained low resistive loads of hand grip or during gait training. This scoping review concludes that, despite a lack of studies focusing on strength, there is evidence robotics is a useful modality to improve muscular strength in combination with motor control and neuromotor improvements. A call for more studies to document changes in strength during robotic rehabilitation protocols is warranted.
Jennifer Phillips, Annemarie Lee, Rodney Pope
et al.
Abstract Background Airway clearance techniques are recommended for individuals with bronchiectasis both in stable state and during an acute exacerbation, however the current use of airway clearance techniques in the management of individuals during an acute exacerbation is unclear. The aims of this study were to establish what current physiotherapy clinical practice comprises for adults and paediatrics during an acute exacerbation of bronchiectasis; identify physiotherapist’s perceptions of the effectiveness of airway clearance techniques and identify what factors influence their treatment decisions in this population. Methods An anonymous online survey was distributed to the members of the Australian Physiotherapy Association and Physiotherapy New Zealand between August 2016 and April 2017. Results The survey was accessed by 130 physiotherapists and 121 of those deemed themselves eligible and consented to participate. Most participants (89%) reported prescribing airway clearance techniques for 81–100% of individuals during an acute exacerbation of bronchiectasis. The most commonly used airway clearance techniques with adults were huffing (92%), exercise (89%) and the active cycle of breathing technique (89%). The techniques perceived most effective for adults were physical exercise (100%), oscillating positive expiratory pressure devices (97%), directed huffing (95%) the active cycle of breathing technique (90%) and positive expiratory pressure (90%). The most commonly used airway clearance techniques for paediatric patients were: newborn-3 years - percussion (85%) and modified postural drainage (85%); 4–10 years - huffing (100%) and exercise (85%); 11–18 years - huffing (92%) and exercise (77%), active cycle of breathing technique (77%) and positive expiratory pressure therapy (77%). The techniques perceived most effective for paediatric patients were directed huffing (100%), percussion (100%) and positive expiratory pressure via a mask or mouthpiece (93%). The most commonly reported factors influencing choice of technique were patient clinical presentation (72%) and the presence/absence of contra-indications (72%). Conclusion This survey demonstrates that airway clearance techniques are routinely used as part of physiotherapy management of individuals experiencing an acute exacerbation of bronchiectasis, and that choice of technique and perceived effectiveness varies depending on the age of the patient.
Learning a stable Linear Dynamical System (LDS) from data involves creating models that both minimize reconstruction error and enforce stability of the learned representation. We propose a novel algorithm for learning stable LDSs. Using a recent characterization of stable matrices, we present an optimization method that ensures stability at every step and iteratively improves the reconstruction error using gradient directions derived in this paper. When applied to LDSs with inputs, our approach---in contrast to current methods for learning stable LDSs---updates both the state and control matrices, expanding the solution space and allowing for models with lower reconstruction error. We apply our algorithm in simulations and experiments to a variety of problems, including learning dynamic textures from image sequences and controlling a robotic manipulator. Compared to existing approaches, our proposed method achieves an orders-of-magnitude improvement in reconstruction error and superior results in terms of control performance. In addition, it is provably more memory-efficient, with an O(n^2) space complexity compared to O(n^4) of competing alternatives, thus scaling to higher-dimensional systems when the other methods fail.
In Part I of this paper we have introduced the closed-form conditions for guaranteeing regional frequency stability in a power system. Here we propose a methodology to represent these conditions in the form of linear constraints and demonstrate their applicability by implementing them in a generation-scheduling model. This model simultaneously optimises energy production and ancillary services for maintaining frequency stability in the event of a generation outage, by solving a frequency-secured Stochastic Unit Commitment (SUC). We consider the Great Britain system, characterised by two regions that create a non-uniform distribution of inertia: England in the South, where most of the load is located, and Scotland in the North, containing significant wind resources. Through several case studies, it is shown that inertia and frequency response cannot be considered as system-wide magnitudes in power systems that exhibit inter-area oscillations in frequency, as their location in a particular region is key to guarantee stability. In addition, securing against a medium-sized loss in the low-inertia region proves to cause significant wind curtailment, which could be alleviated through reinforced transmission corridors. In this context, the proposed constraints allow to find the optimal volume of ancillary services to be procured in each region.
Positron emission tomography (PET) is a medical imaging method based on the measurement of concentrations of positron-emitting radionuclides in a living body. In the PET imaging system, glucose is labeled with a positron-emitting radionuclide and injected intravenously. Then, the positrons move through the tissue and collide with the electrons of the cells in which they interact. As a result of this interaction, two gamma rays are emitted in the opposite direction. Gama rays emitted from cancerous tissue that has retained radioactive glucose are detected through ring-shaped detectors. And the detected signals are converted into an electrical response. Subsequently, these responses are sampled with electronic circuits and recorded as histogram matrix to generate the image set. The gamma rays may not reach the detectors located in the opposite position in equal time. In PETs having TOF characteristics, it is aimed to obtain better positioning information by a method based on the principle of measuring the difference between the reach time of the two photons to detectors. The measurement of the flight time is carried out with TDC structures. The measurement of this time difference at the ps level is directly related to the spatial resolution of the PET system. In this study, 45 nm CMOS VLSI simulations of TDC structures that have various architectural approaches were performed for use in PET systems. With the designed TDC architectures, two gamma photons time reach to detectors have been simulated and the time difference has been successfully digitized. In addition, various performance metrics such as input and output voltages, time resolutions, measurement ranges, and power analysis of TDC architectures have been determined. Proposed Vernier oscillator-based TDC architecture has been reached 25 ps time resolution with a low power consumption of 1.62681 mW at 1V supply voltage.