Dynamic Thresholds for a Reliable Diagnosis of Switched Systems

Safety, availability and reliability are the main concern of many industries. Thus, fault detection and isolation of industrial machines, which are in most cases switched systems, is a primary task in many companies. The presented paper proposes a new diagnostic approach for switched systems using two powerful tools: bond graph and observer. A diagnostic layer detects model errors using bond graph, and a smart algorithm identifies and locates faults using observer. Although observers serve as fault detectors, they also have their own errors caused by convergence delay of calculations; even in the case of no sensor defect, the residue does not converge to zero. In this paper, we propose a new method to solve this problem by integrating dynamic thresholds in the detection procedure, which helped to avoid false alarms and ensure a highly reliable diagnosis.

Dynamics of clinical manifestations and cytokine concentrations in rheumatoid arthritis patients on tofacitinib therapy

Objective - to study the dynamics of clinical and laboratory parameters of inflammatory activity of the disease and cytokines in rheumatoid arthritis (RA) patients on a background of tofacitinib (TOFA) treatment.Material and methods. Ten patients with a reliable diagnosis of RA have been examined: patients' age was 51.0 (48.0; 62.0) years, duration of disease was 7.0 (3.0; 20.0) years. All patients had high disease activity: DAS28 -5.88 (5.53; 5.94), CDAI - 33.0 (29.0; 36.0), SDAI - 33.72 (30.75; 36.85). All patients were treated with TOFA at a dose of 5 mg 2 times a day on a background of methotrexate therapy, non-steroidal anti-inflammatory drugs, and glucocorticoids. Observations were performed before treatment and after 3 and 6 months of therapy. Serum levels of 15 cytokines (IL-1β, IL-4, IL-6, TNF-α, INF-γ, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, sCD40L) were examined using multiplex xMAP technology.After 3 and 6 months of TOFA therapy, there was a significant decrease in DAS28 of 4.55 (3.47; 5.16) and 3.92 (3.80; 4.60); CDAI - 16.5 (11.0; 23.0) and 18.0 (15.0; 19.0); SDAI - 16.6 (11.23; 23.06) and 18.07 (15.06; 19.10); ESR - 19.0 (11.0; 26.0) and 7.0 (4.0; 18.0); CRP - 0.56 (0.50; 1.99) and 0.71 (0.51; 1.1) respectively. IL-6 levels decreased after 3 and 6 months of therapy (p<0.05). The concentration of INF-γ significantly decreased after 3 months (p<0.05), but remained unchanged thereafter. Concentrations of IL-25 and IL-31 decreased after 3 months (p<0.05), and by the 6th month of treatment there was an increase, however, not reaching the initial values.Conclusion. The results of the study show the efficacy of TOFA in RA and create prerequisites for further study of the cytokine-dependent mechanisms of inflammation in this disease.

Opportunities to improve the diagnosis chronic tndometritis

Goal of the research: optimization of the diagnosis of chronic endometritis. Methodology: perspective research. Institution: Department of obstetrics and gynecology of the Kursk medical University. Material of the research: 67 patients suffering benign diseases of endometrium and myometrium connected with it. 59 patients with the diseases of the uterus of the same пaтe without chronic endometritis. Methods of the research: clinico-laboratory, ultrasonography, hysteroscopic, histologic, cytologic, microbiologic examination of the endometrium, PSR, radioimmunological method to determine progesterone rate in the blood plasma. Results of the research: the endoscopice variants of chronic endometritis are extreted: hyperplastic and hypoplastic (and also its forms - focal and diffusive). They are necessary stages achieving reliable diagnosis of the inflammatory process of endometrium a differential method of probing of endometrium depending on a variant and damage rate of chronic endometritis is worked out. Conclusion: the complex method of the diagnosis chronic endometritis including hysteroscopy with visual biopsy and cytologic-histologic examination of endometrium increases the quality of diagnosis by 64,4% in comparison with the traditional curettement of the endometrium and considerably decreases the number of posttraumatic and inflammatory complications.

Diagnozowanie logopedyczne uczniów w czasie pandemiiDiagnozowanie logopedyczne uczniów w czasie pandemii

Speech plays an extremely important role in interpersonal communication. Often times, speech does not develop according to the norm. The time of the pandemic is a very difficult time for specialists. Not an easy moment for a quick, reliable diagnosis. The article clarifies the issues of diagnosis and speech therapy. It talks about a reliable diagnosis, which is determined by many factors, opinions, and specialist research. The article focuses on specific conceptual terminology in the field of speech therapy diagnostics. It allows for the emergence of a consistent diagnostic procedure. He brings us closer to the difficult time of therapeutic work during remote learning. It shows us the difficult access to medical specialists such as a neurologist, ENT specialist, phoniatrist and others. Speech therapy care is designed to preventive and diagnostic measures. The work of a speech therapist is taking preventive measures to prevent speech defects and disorders. Supporting preventive activities, including in the field of teachers. Speech therapist Conducts screening tests to determine the speech of students. Organizing speech therapy assistance. These are activities in the field of living word culture. First of all, it shows us how many students use speech therapy in educational institutions. The aim of this article is to show the difficult work of a speech therapist in times of a pandemic. With what obstacles on the way to beautiful Polish pronunciation a modern specialist. Under what conditions do therapists work, wanting to further fulfill themselves as therapists who want to help.

Repeated Clinical Assessment Using Sensory Modality Assessment and Rehabilitation Technique for Diagnosis in Prolonged Disorders of Consciousness

Purpose: The recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient’s responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis.Materials and Methods: A retrospective analysis of all the adult patients (who received a SMART assessment) admitted to a specialist brain injury unit over the course of 4 years was conducted (n = 35). An independent rater analyzed the SMART levels for each modality and session and provided a suggestive diagnosis based on the highest SMART level per session.Results: For the vast majority of patients between 5 and 6 sessions was sufficient to reach the final clinical diagnosis. The visual, auditory, tactile, and motor function modalities were found to be more associated with the final diagnosis than the olfactory and gustatory modalities.Conclusion: These findings provide for the first time a rationale for optimizing the time spent on assessing patients using SMART.

Crimean Congo hemorrhagic fever in the COVID-19 pandemic: a case study

In the COVID-19 pandemic, the overlap of clinical features between the other viral infections, make a reliable diagnosis difficult in the initial stage of illness. We describe the first confirmed case of CCHF in Tehran province during this year, who first misdiagnosed as COVID-19 infection.

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

A smart multiantenna gene theranostic system based on the programmed assembly of hypoxia-related siRNAs

The systemic therapeutic utilisation of RNA interference (RNAi) is limited by the non-specific off-target effects, which can have severe adverse impacts in clinical applications. The accurate use of RNAi requires tumour-specific on-demand conditional activation to eliminate the off-target effects of RNAi, for which conventional RNAi systems cannot be used. Herein, a tumourous biomarker-activated RNAi platform is achieved through the careful design of RNAi prodrugs in extracellular vesicles (EVs) with cancer-specific recognition/activation features. These RNAi prodrugs are assembled by splitting and reconstituting the principal siRNAs into a hybridisation chain reaction (HCR) amplification machine. EVs facilitate the specific and efficient internalisation of RNAi prodrugs into target tumour cells, where endogenous microRNAs (miRNAs) promote immediate and autonomous HCR-amplified RNAi activation to simultaneously silence multiantenna hypoxia-related genes. With multiple guaranteed cancer recognition and synergistic therapy features, the miRNA-initiated HCR-promoted RNAi cascade holds great promise for personalised theranostics that enable reliable diagnosis and programmable on-demand therapy.

Some undesirable traps which can mislead the pathologist

In clinical laboratories, the diagnosis of parasite diseases can sometimes be challenging for non-expert microbiologists. Indeed, in spite of the advent of the molecular biology, macroscopic and microscopic examinations still remain essential. Nonetheless, it is usually not automated and requires great skills to complete the correct diagnosis. It is not infrequent that inert elements mislead to erroneous diagnoses. Through three different concrete examples, this article aims at underscoring the actual risk of parasite misidentification and at highlighting the systematic approach to be conducted in order to enable reliable diagnosis.