A dual approach for positive T–S fuzzy controller design and its application to cancer treatment under immunotherapy and chemotherapy

This study proposes an effective positive control design strategy for cancer treatment by resorting to the combination of immunotherapy and chemotherapy. The treatment objective is to transfer the initial number of tumor cells and immune–competent cells from the malignant region into the region of benign growth where the immune system can inhibit tumor growth. In order to achieve this goal, a new modeling strategy is used that is based on Takagi–Sugeno. A Takagi-Sugeno fuzzy model is derived based on the Stepanova nonlinear model that enables a systematic design of the controller. Then, a positive Parallel Distributed Compensation controller is proposed based on a linear co-positive Lyapunov Function so that the tumor volume and administration of the chemotherapeutic and immunotherapeutic drugs is reduced, while the density of the immune-competent cells is reached to an acceptable level. Thanks to the proposed strategy, the entire control design is formulated as a Linear Programming problem. Finally, the simulation results show the effectiveness of the proposed control approach for the cancer treatment

The Credibility of Cephalogram Parameters in Gender Identification From Medico-Legal Relevance Among the Iranian Populatio

Background: Normal cephalogram parameters seem to be gender discriminative and thus applicable in forensic medicine. We assessed validity of cephalogram parameters in gender identification among the Iranian population.Methods: This cross-sectional study was conducted on 75 Iranian men and 75 Iranian women aged 25 to 54 years. On their first admission, the physicians requested for simple lateral skull X-ray for all participants.Results: Using area under the ROC curve, gonion-gonion index (AUC=0.741) and vertex- mention index (AUC=0.697) had a moderate value to discriminate male from female gender, while other parameters lacked enough power to differentiate gender. The best cut-off point in gonion-gonion index for discriminating male from female gender was 103.75 with a sensitivity of 74.7% and a specificity of 65.3%. Also, the best cut-off value for vertex-mention index to differentiate two genders was 244.75 with a sensitivity of 74.7% and a specificity of 62.7%. By considering two parameters of gonion-gonion and vertex-mention, it is possible to differentiate males from females with a sensitivity of 82.6% and a specificity of 71.8%.Conclusion: The two gonion-gonion and vertex-mention indices on cephalogram are applicable for gender discrimination

A Novel Stochastic Predictive Stabilizer for DC Microgrids Feeding CPLs

In this work, a novel nonlinear approach is proposed for the stabilization of microgrids (MGs) with constant power loads (CPLs). The proposed method is constructed based on the incorporation of a pseudo-extended Kalman filter (EKF) into stochastic nonlinear model predictive control (MPC). In order to achieve high-performance and optimal control in dc MGs, estimating the instantaneous power flow of the uncertain CPLs and the available power units is essential. Thus, by utilizing the advantages of the stochastic MPC and the pseudo-EKF, an effective control solution for the stabilization of dc islanded MGs with CPLs is established. This technique develops a constrained controller for practical application to handle the states and control input constraints explicitly; furthermore, as it estimates the current by using the pseudo-EKF, it is a current-senseless approach. As noisy measurements are taken into account for the state estimation, it leads to a less conservative control action rather than the classical robust MPC, whereas it guarantees the global asymptotic stability in the presence of noisy measurements and parameter uncertainty. To validate the performance of the proposed controller, the attained results are compared with state-of-the-art controllers. Furthermore, the implementability of the proposed method is validated using real-time simulations on dSPACE hardware

Effect of levamisole on treatment of recurrent aphthous stomatitis: A systematic review and meta-analysis

BACKGROUND AND AIM: The aim of this study was to systematically analyze the effect of levamisole on treatment of recurrent aphthous stomatitis (RAS). METHODS: An electronic search was executed in PubMed, Cochrane, and Scopus after determining the research question using the appropriate Medical Subject Heading (MeSH) term covering the period from 1975 to 2015. Additional publications from hand searching and the reference section of each relevant article enriched the article list. Finally, 9 articles that have assessed the effect of levamisole on the treatment of RAS and had suitable qualifications for the accomplishment of systematic review and meta-analysis were included. RESULTS: The results showed that the chance of improvement in patients taking levamisole was 6 [odds ratio (OR) = 5.67, 95% confidence interval (CI)] times more than in patients not taking this drug. CONCLUSION: It appears that levamisole is an effective drug for the treatment of RAS, but further appropriate studies should carryout in this context. KEYWORDS: Levamisole; Treatment; Aphthous; Recurrent; Stomatiti

Adult emergency department performance in the largest teaching hospital in southern Iran: a 1.5-year cross-sectional study

Background: Emergency department (ED) is one of the most important hospital departments, with significant effects on public health. The aim of this study was to evaluate the adult ED's performance of the largest teaching hospital in southern Iran. Methods: In this retrospective cross-sectional study (March 2017-August 2018), the registered data in the Hospital Information System (HIS) were collected, and the ED’s performance was assessed based on the Iranian emergency performance index. The slopes of the trend lines were calculated for each indicator. Moreover, 2 six-month periods were compared. Results: The data of 104,081 patients were analyzed. The mean (±standard deviation) of visited patients per-month was 5,782.28 (±1258.55). The slope of the trend line was negative for all indicators, except for discharge from ED with personal responsibility. The mean duration of waiting time for the first visit by physician in each triage level slightly decreased. Comparison of the two six-month periods showed a significant difference between the visited patient (P<0.0001). The percentage of patients disposed within six hours (P<0.0001), leaving ED within 12 hours (P<0.0001), as well as the percentage of successful cardiopulmonary resuscitation (P=0.014) in the six-month period of 2018 was significantly lower. The percentage of discharge with personal responsibility significantly increased (P=0.005). Conclusion: Although the number of patients visited in this ED decreased, all indicators had dropped. However, the percentage of discharge with personal responsibility was increased. Moreover, the mean duration of waiting time for the first visit by physician slightly decreased in each triage level

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe