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Chronic wound is one of a leading cause of amputation worldwide. Successful management of chronic wound has become a challenge to all existing medical systems across the world. Sri Lankan Traditional and Ayurvedic medicine reveals many promising herbal and alternative remedies for chronic wounds. We hereby report a successfully managed case of an 80-year-old female patient suffering from a chronic wound for two years, when presenting has advised for amputation of the leg. The treatment protocol included the application of hirudotherapy along with the bark paste of Pongamia pinnata followed by Flueggea leucopyrus with recommended other external and internal remedies. At the end of the treatment protocol, pain, exudates, odor, burning sensation, and itching were reduced completely while swelling and wound size was reduced remarkably and showed a significant healing in the wounded area.This paper deals with the parameter estimation of Hammerstein-Wiener (H-W) nonlinear systems which have unknown time delay. click here The linear variable weight particle swarm method is formulated for such time delay systems. This algorithm transforms the nonlinear system identification issue into a function optimization issue in the parameter space, then utilizes the parallel searching ability of the particle swarm optimization and the iterative identification technique to realize the simultaneous estimation of all parameters and the unknown time delay. Finally, parameters in the linear submodule, nonlinear submodule and the time delay are separated from the optimum parameter. Moreover, two illustrative examples are exhibited to evaluate the effectiveness of the proposed method. The simulation results demonstrate that the derived method has fast convergence speed and high estimation accuracy for estimating H-W systems with unknown time delay, and it is applied to the identification of the bed temperature systems.In this paper, a model-free incremental adaptive optimal fault-tolerant controller with prescribed performance is proposed for nonlinear systems subject to actuator faults. Considering the system actuator redundancy, an actuator grouping scheme is introduced according to the actuator functions. An incremental adaptive fault observer is designed to estimate the faults. The recursive least squares (RLS) identification is utilized to identify the incremental system parameters. Both dynamic process requirements and optimal performance index of the closed loop system are taken into consideration by combining prescribed performance bound (PPB) and incremental adaptive dynamic programming (IADP). Simulations are given to verify the effectiveness of the proposed IADP reconfigurable fault-tolerant control scheme.Error attenuation capacity of a target tracking system is the key indicator for the system's tracking precision. Without changing the system's feedback control structure, the traditional first order integral control, which is widely used in traditional tracking systems, cannot meet a higher precision for those fast targets with high mobility. The work described in this paper concerns about this problem, and proposes a cascade lag control scheme with one or more order to level up the system's active error suppression capacity in low-frequency range. By substituting the cascade lag controllers for additional integral operator, a higher amplitude ratio system, which implies higher tracking precision, is obtained without loss of stability. As a difficult task for massive parameters' designing, a concept of relative order and a configuration proportion law is proposed to simplify the analysis as well as parameters tuning. Relationship between the relative order and system performance is given. The multi-order cascade lag control scheme's efficiency is proved in both theoretical analysis and experiments in an electro-optical tracking system.This paper studies the energy-constraint output formation control for swarm systems with leaderless and leader-following topology structures. Most existing results on output formation with the dynamic output feedback protocols focus on the swarm systems without the energy constraint, but it is well known that the energy constraint is critically important for practical applications. In order to analyze the impacts of the energy constraint, a new energy-constraint output formation protocol is proposed. First, by the observable decomposition approach, a dynamic output formation protocol is presented, which contains an energy-constraint term to restrict the whole consumption. Then, sufficient conditions for leaderless energy-constraint output formation are presented via establishing the relationship of the energy constraint and the matrix variables, where it is found that the designed gain matrices of the output formation protocol can ensure that the actual energy consumption is lower than the total energy supply. Especially, a partition checking algorithm is proposed to check those conditions, which can ensure the scalability and solvability of a swarm system. Moreover, the output formation center function is derived to depict the whole macroscopic movement of a swarm system. A nonsingular transformation approach is presented to unify leaderless energy-constraint output formation and energy-constraint output formation tracking into the same framework, which are usually discussed in different theoretical frameworks. Finally, two simulation examples are illustrated to show that the theoretical results about leaderless energy-constraint output formation and energy-constraint output formation tracking are correct.The multimodal non-identical generators having close frequency modes may complicate the design of subsynchronous damping controller. In this paper, the Band-Pass Filter (BPF) based Subsynchronous Damping Controller (SSDC) is designed with SSSC to damp multimode SSR. The system is adapted from IEEE First Benchmark Model (FBM) with two non-identical generators in parallel. One of the generators has a six-mass mechanical system and other has a four-mass mechanical system. The SSDC using reduced number of BPFs is proposed to enhance the damping of multimodal SSR while maintaining the frequency selectivity of filters. The proposed BPF based SSDC is designed to modulate the SSSC injected voltage so as to suppress the multimode components in the line. The DQ model is developed in MATLAB-Simulink using the differential and algebraic equations of the combined system. The analysis of SSR are carried out through damping torque, eigenvalue and transient simulation. The participation factor analysis is performed to identify the torsional modes of the generators. The eigenvalue analysis is used to select the number of BPFs. The BPFs with appropriate frequency selectivity are chosen to improve the damping of all critical torsional modes in the entire range of practical compensation level. The results show that, the peak negative damping at both generators is considerably reduced with the proposed SSDC in the entire range of torsional mode frequencies through practical compensation levels.Stereotactic body radiotherapy (SBRT) has demonstrated promising outcomes for patients with early-stage, medically inoperable, primary renal cell carcinoma (RCC) in large multi-institutional studies and prospective clinical trials. The traditional approach used in these studies consisted of a CT-based planning approach for target and organ-at-risk (OAR) volume delineation, treatment planning, and daily treatment delivery. Alternatively, MRI-based approaches using daily online adaptive radiotherapy have multiple advantages to improve treatment outcomes (1) more accurate delineation of the target volume and OAR volumes with improved soft tissue visualization; (2) gated beam delivery with biofeedback from the patient; and (3) potential for daily plan adaptation due to changes in anatomy to improve target coverage, reduce dose to OARs, or both. The workflow, treatment planning principles, and aspects of treatment delivery specific to this technology are outlined using a case example of a patient with an early-stage RCC of the right kidney treated with MRI-guided SBRT using daily adaptive treatment to a dose of 42 Gy in 3 fractions.

The aim of this study was to compare the effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on pain and quality of life in patients with fibromyalgia.

Thirty participants were randomized into two groups of 15 patients, to receive 3 sessions of either high-frequency (10 Hz) rTMS or 2 mA, 20 min anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex (DLPFC) over 1 week. Pain was assessed using a Visual Analog Scale (VAS) before treatment, immediately after treatment, 6 and 12 weeks later. Quality of life was evaluated using the Revised Fibromyalgia Impact Questionnaire (FIQR) and psychiatric symptoms were measured using the Depression Anxiety Stress Scale-21 Item (DASS-21) before treatment, and 6 and 12 weeks after treatment.

For the VAS there was a significant time-group interaction, showing that the behavior of two groups differed regarding changes of VAS in favor of the RTMS group (df = 1.73, F = 4.80, p = <0.016). Time-group interaction effect on DASS-21 and FIQR was not significant. 66.6% of patients in rTMS group and 26.6% of patients in tDCS group experienced at least a 30% reduction of VAS from baseline to last follow-up (p = 0.028).

With the methodology used in this study, both rTMS and tDCS were safe modalities and three sessions of rTMS over DLPFC had greater and longer lasting analgesic effects compared to tDCS in patients with FM. However, considering the limitations of this study, further studies are needed to explore the most effective modality.

With the methodology used in this study, both rTMS and tDCS were safe modalities and three sessions of rTMS over DLPFC had greater and longer lasting analgesic effects compared to tDCS in patients with FM. However, considering the limitations of this study, further studies are needed to explore the most effective modality.

The aim of the study was to investigate sensory information processing induced by visual sexual stimuli and to assess its relationship with sexual behaviors and symptoms in patients with vaginismus.

Twenty-one patients with vaginismus and 20 controls were included in the study. The sociodemographic information and sexual life history of the patients with vaginismus and controls were examined and electrophysiological measurements related to auditory P50 sensory gating were obtained using a double click paradigm during by sexual/horror visual stimulation, which was thought to be related to the pathophysiology of the disease.

P50 suppression ratios during visual sexual stimuli were lower in vaginismus group compared to the control group. There was no difference in P50 suppression ratios during visual horror stimuli when the two groups were compared. The P50 suppression of the vaginismus group with visual sexual stimuli was found to be lower than P50 suppression with visual horror stimuli. A positive moderate correlation was found between the duration of foreplay and P50 suppression ratio during visual sexual stimuli in vaginismus group.

Our study revealed that patients with vaginismus had sensory gating impairment during visual sexual stimuli. Increase in the duration of foreplay in vaginismus patients may improve sensory gating impairment by affecting sensory gating functions.

Our study revealed that patients with vaginismus had sensory gating impairment during visual sexual stimuli. Increase in the duration of foreplay in vaginismus patients may improve sensory gating impairment by affecting sensory gating functions.