Rehabilitation of tendon injuries in sport

Clinicians are faced with a growing number of athletes with injured tendons. Treatment of both acute and chronic injuries has proven to be quite complex. It is difficult to maintain the balance between resting the injured tendon and preventing atrophy of the surrounding muscles and joints. Questions also arise as to when the tendon should be strengthened and when the athlete is ready to return to full activity in sport. Through an awareness of the structural and mechanical properties of the tendon, an exercise programme for the rehabilitation of tendon injuries has been developed. It is recommended that this programme be used in combination with ice and other physical modalities. This approach will resolve most tendon injuries within 6 weeks of its implementation. The use of anti-inflammatory medications and surgery can only be recommended in select situations where more conservative measures are inadequate.     

Evaluation of sport injuries in children and adolescents

Dengue type 2 virus (DV)-induced cytotoxic factor (CF) is capable of reproducing various pathological lesions in mice that are seen in human dengue. The present study was undertaken to investigate the protective effect of active immunization of mice with CF. Mice were immunized with 5 microgram of CF and prevention of CF-induced increase in capillary permeability and damage to the blood-brain barrier were studied at weekly intervals, up to 48 weeks, by challenging with 3 microgram of CF. Maximum protection against increase in capillary permeability and damage to the blood-brain barrier was observed in week 4 after immunization. A breakthrough in the protection occurred with higher doses of CF in a dose-dependent manner. Challenge with a lethal intracerebral (i.c.) dose of DV showed significantly prolonged mean survival time and delayed onset of symptoms of sickness in the immunized mice compared with the normal mice, but the titre of the virus in the brain was similar in the two groups. On i.p. challenge with the virus the protection against damage to the blood-brain barrier was 86 +/- 7% at week 4 and 17 +/- 4% at week 26 after immunization. Sera obtained from the immunized mice showed the presence of CF-specific antibodies by ELISA, Western blot, and by neutralization of the cytotoxic activity of CF in vitro. The present study describes successful prevention of a cytokine-induced pathology by specific active immunization.     

基于贝叶斯决策模型的热轧卷筒电机故障诊断

卷筒电机是卷筒的动力来源,对钢卷卷形质量和卷取稳定性有着重要影响.针对热连轧机组卷取工序中卷筒电机的鼠笼条断裂问题,通过从现场采集卷筒电机电流信号,并经过信号截取、滤波、拟合等操作提取出信号特征,利用多元高斯模型进行建模,并基于最小风险的贝叶斯分类算法对其进行故障诊断.试验结果表明,采用最小风险贝叶斯决策模型可以较好地...     

Bayesian analysis of mixtures applied to post-synaptic potential fluctuations

Bayesian inference techniques have been applied to the analysis of fluctuation of post-synaptic potentials in the hippocampus. The underlying statistical model assumes that the varying synaptic signals are characterized by mixtures of (unknown) numbers of individual gaussian, or normal, component distributions. Each solution consists of a group of individual components with unique mean values and relative probabilities of occurrence and a predictive probability density. The advantages of bayesian inference techniques over the alternative method of maximum likelihood estimation (MLE) of the parameters of an unknown mixture distribution include the following: (1) prior information may be incorporated in the estimation of model parameters; (2) conditional probability estimates of the number of individual components in the mixture are calculated; (3) flexibility exists in the extent to which the estimated noise standard deviation indicates the width of each component; (4) posterior distributions for component means are calculated, including measures of uncertainty about the means; and (5) probability density functions of the component distributions and the overall mixture distribution are estimated in relation to the raw grouped data, together with measures of uncertainty about these estimates. This expository report describes this novel approach to the unconstrained identification of components within a mixture, and provides demonstration of the usefulness of the technique in the context of both simulations and the analysis of distributions of synaptic potential signals.     

Bayesian inference for hierarchical mixtures-of-experts with applications to regression and classification

This paper studies the problems of inference and prediction in a class of models known as hierarchical mixtures-of-experts (HME). The statistical model underlying an HME is a mixture model in which both the mixture coefficients and the mixture components are generalized linear models. Bayesian inference regarding an HME's parameters is presented in the contexts of regression and classification using Markov chain Monte Carlo methods. A benefit of this Bayesian approach is the ability to obtain a sample from the posterior distribution of any functional of the parameters of the given model. In this way, more information is obtained than provided by a point estimate. The methods are illustrated on a nonlinear regression problem and on a breast cancer classification problem. The results indicate that the HME showed good prediction performance, and also gave the additional benefit of providing for the opportunity to assess the degree of certainty of the model in its predictions.     

The limitations of decision trees and automatic learning in real world medical decision making

The decision tree approach is one of the most common approaches in automatic learning and decision making. The automatic learning of decision trees and their use usually show very good results in various "theoretical" environments. But in real life it is often impossible to find the desired number of representative training objects for various reasons. The lack of possibilities to measure attribute values, high cost and complexity of such measurements, and unavailability of all attributes at the same time are the typical representatives. For this reason we decided to use the decision trees not for their primary task--the decision making--but for outlining the most important attributes. This was possible by using a well-known property of the decision trees--their knowledge representation, which can be easily understood by humans. In a delicate field of medical decision making, we cannot allow ourselves to make any inaccurate decisions and the "tips," provided by the decision trees, can be of a great assistance. Our main interest was to discover a predisposition to two forms of acidosis: the metabolic acidosis and respiratory acidosis, which can both have serious effects on child's health. We decided to construct different decision trees from a set of training objects. Instead of using a test set for evaluation of a decision tree, we asked medical experts to take a closer look at the generated trees. They examined and evaluated the decision trees branch by branch. Their comments show that trees generated from the available training set mainly have surprisingly good branches, but on the other hand, for some, no medical explanation could be found.     

Comparison of classification approaches applied to NIR-spectra of clinical study lots

NIR-spectroscopy combined with pattern recognition approaches is applied to classify samples of clinical study lots in the pharmaceutical industry. The performance of linear discriminant analysis (LDA), quadratic discriminant analysis (QDA) and K-nearest neighbour (KNN) method is evaluated on a tablet data set and a capsule data set. To establish a classification model a strategy is followed, which is described in this work. Frequently, in the pharmaceutical industry, several batches of the same clinical study lot are produced. We tested whether it is possible to merge several batches in one class for modelling or, instead, whether it is necessary to model each batch individually.     

Evaluation and diagnosis of ankle injuries

The evaluation of ankle injuries is a common challenge for family physicians. Diagnosis is made by using knowledge of the anatomy and function of the ankle joint to aid in taking an adequate history and performing an appropriate physical examination. The patient should be questioned about the mechanism of injury, previous injury, disability, treatment and pain. The ankle should be evaluated for ecchymosis, swelling, areas of tenderness and laxity. These measures help to determine what, if any, additional diagnostic procedures may be needed. Most ankle sprains are lateral, affecting the anterior talofibular, calcaneofibular and posterior talofibular ligaments. Other injuries include medial ankle sprains affecting the deltoid ligament, trauma to the Achilles and peroneal tendons, tarsal tunnel syndrome, fractures, syndesmotic sprains, synovial impingement and chronic instability. Criteria for radiographic evaluation include inability to bear weight initially or when examined, and tenderness over the medial or lateral malleolus. Accurate diagnosis is critical for appropriate treatment and minimizing functional disability.     

Study of major volatiles in wines and discriminant analysis applied to classification according to region

The major volatiles of eighty eight wines (white, rosè and red) from Madrid were studied. The samples came from the three districts forming the "Vinos de Madrid" DO (Denominación de Origen) region: Arganda, Navalcarnero and San Martín, and were analyzed by gas chromatography. The resulting data were treated by Stepwise Discriminant Analysis (SDA) in order to ascertain the efficacity of these compounds in classifying the wines according to their geographical origin. The results confirm that the above components were of little use in classifying the red and white wines and, although a correct classification percentage of 90.91% was obtained for the rosés when all the variables were used, this too was considered unsatisfactory.     

Dynamic and consequential consistency of choices between paths of decision trees.

The generally prescribed procedure for choosing a decision strategy from a decision tree employs a backward induction analysis that entails 3 fundamental consistency principles: dynamic, consequential, and strategic. The first requires the decision maker to follow through on plans to the end, the second requires the decision maker to focus solely on future events and final consequences given the current state of events, and the third is the conjunction of the first 2. Five experiments were reported to test these principles using different subject populations, different procedures for estimating consistency, and different factors for manipulating the attractiveness of the gamble at the final stage of the tree. The main findings were that strategic and dynamic consistency principles were violated at rates that exceeded choice inconsistency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Migraines and other headaches: an approach to diagnosis and classification

Headache is a symptom that accounts for over 18 million visits to physicians each year. In an effort to resolve inconsistencies and problems with the differentiation of specific types of headache, the International Headache Society (IHS) has established a classification system. For each major type of headache, the IHS classification specifies diagnostic criteria and recognized subtypes where appropriate. Migraine headaches are commonly encountered in clinical practice. Recognition and accurate diagnosis of migraine headache depend on a thorough history, appropriate physical examination and diagnostic testing.     

Current and unresolved problems in the classification of cranio-cerebral injuries

A careful study of the literature of the recent years and a special questionary presented in 1974 to 146 leading scientists and specialists of the country revealed important problems for discussion, such as contradictory approaches to the differentiation of the prevailing forms of lesions--commotion and contusion of the brain--by the degree of their severity, to distinguishing between brain contusion and compression. A prognosis of the tendencies and pathways to the creation of a common up-to-date classification of craniocerebral injuries is made.     

Feedback and response mode in performing a Bayesian decision task.

In a complex decision-making situation 64 male undergraduates received data generated by 1 of 3 hypotheses according to specified conditional probabilities. Ss inferred which hypothesis had generated the data or estimated the probability of each hypothesis given the data. Feedback was given after each trial either as the hypothesis which generated the data or the probability that each hypothesis generated the data calculated by Bayes' theorem. The percentage of trials when Ss chose the most probable hypothesis was significantly higher for the groups responding with a single hypothesis than for the probability response groups, and higher for the Bayesian probability feedback groups than for the groups receiving no feedback. The Bayesian probability feedback group also gave probability responses which were much closer to the optimal probabilities than did the no-feedback group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Bayesian approach to subvoxel tissue classification in NMR microscopic images of trabecular bone

NMR microscopy is currently being used as an investigational tool for the evaluation of micromorphometric parameters of trabecular bone as a possible means to assess its strength. Since, typically, the image voxel size is not significantly smaller than individual trabecular elements, partial volume blurring can be a major complication for accurate tissue classification. In this paper, a Bayesian segmentation technique is reported that achieves improved subvoxel tissue classification. Each voxel is subdivided either into eight subvoxels twice the original resolution, or up to four subvoxels along the transaxial direction and the subvoxels optimally classified as volume blurring, the likelihood for the number of marrow subvoxels in each voxel can be computed on the basis of its measured signal. To resolve the ambiguity of the location of the marrow subvoxels, a Gibbs distribution is introduced to model the interaction between the subvoxels. Neighboring subvoxel pairs with the same tissue label are encouraged, and pairs with distinct labels are penalized. The segmentation is achieved by maximizing the a posteriori probability of the label image using the block ICM (iterative conditional mode) algorithm. The potential of the proposed technique is demonstrated in real and synthetic NMR microscopic images.     

Modern diagnosis and classification of diabetes mellitus

In July 1997, the American Diabetes Association (ADA) has published new recommendations for the diagnosis and classification of diabetes mellitus. Except for gestational diabetes they should be identical to the new WHO recommendations (not yet published). From now on, only the fasting glucose should be used for clinical routine. The oral glucose tolerance test is no longer recommended for this purpose. The diagnostic cut-off level for fasting glucose was decreased from 140 mg/100 ml (venous plasma) to 126 mg/dl, and the range between 110 and 125 mg/100 ml was defined as impaired fasting glucose (IFG), a new diagnostic category introduced in analogy to impaired glucose tolerance (IGT). The lower diagnostic cut-off level for fasting glucose has been proposed because the risk of developing diabetic late complications (predominantly at the vascular system) is already increased in blood glucose ranges thought to be normal. The diagnostic criteria for gestational diabetes are unchanged and still discrepant between ADA and WHO. The two major forms of diabetes should be designated only as type 1- and type 2-diabetes with respect to etiology and pathogenesis. Type 1-diabetes was subdivided into an immune-mediated and into an idiopathic form. MODY (maturity-onset type diabetes in young people) was listed separately from type 2-diabetes under the category of genetic defects of beta-cell function, also mitochondrial diabetes (maternally inherited diabetes and deafness). Malnutrition-related diabetes has been omitted as a major form of diabetes.     

Native CSF spectrophotometry--contribution to the differential diagnosis of closed cranial injuries

The development of postoperative peritoneal adhesions was studied in rats and rabbits, the frequency of adhesions in the experimental model used being very high. In the development of an adhesion, fibrin seems to be an important contributor to the bridge between different tissues. Dextran, which modifies the fibrin network and makes it more susceptible to lysis, was used as a possible prophylactic agent, but we found no difference between treated and control groups. It is concluded that the stimulus for fibrin formation in the peritoneal adhesions using this atraumatic model was too strong to be overcome by the normal fibrinolytic system. The anti-inflammatory reaction of hyaluronic acid did not diminish the frequency or degree of adhesions.