BACKGROUND Early diagnosis is key to prevent bowel damage in inflammatory bowel disease(IBD).Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients ex...BACKGROUND Early diagnosis is key to prevent bowel damage in inflammatory bowel disease(IBD).Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients exists.AIM To identify risk factors leading to prolonged diagnostic time in a German IBD cohort.METHODS Between 2012 and 2022,430 IBD patients from four Berlin hospitals were enrolled in a prospective study and asked to complete a 16-item questionnaire to determine features of the path leading to IBD diagnosis.Total diagnostic time was defined as the time from symptom onset to consulting a physician(patient waiting time)and from first consultation to IBD diagnosis(physician diagnostic time).Univariate and multivariate analyses were performed to identify risk factors for each time period.RESULTS The total diagnostic time was significantly longer in Crohn’s disease(CD)compared to ulcerative colitis(UC)patients(12.0 vs 4.0 mo;P<0.001),mainly due to increased physician diagnostic time(5.5 vs 1.0 mo;P<0.001).In a multivariate analysis,the predominant symptoms diarrhea(P=0.012)and skin lesions(P=0.028)as well as performed gastroscopy(P=0.042)were associated with longer physician diagnostic time in CD patients.In UC,fever was correlated(P=0.020)with shorter physician diagnostic time,while fatigue(P=0.011)and positive family history(P=0.046)were correlated with longer physician diagnostic time.CONCLUSION We demonstrated that CD patients compared to UC are at risk of long diagnostic delay.Future efforts should focus on shortening the diagnostic delay for a better outcome in these patients.展开更多
The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame fr...The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame from the onset of symptoms to the definitive diagnosis is often attributed to the heterogeneity of IBD and the non-specificity of clinical manifestations.Specific to patients with Crohn’s disease,the issue of delayed diagnosis appears to be more pronounced across different regions globally.The intricate interplay of real-world factors has led to debates regarding the primary contributors to these diagnostic delays.Drawing a comparison solely between patients and physicians and implicating the latter as the predominant influence factor may fall into a simplistic either-or logical trap that may obscure the truth.This letter,grounded in published evidence,explores areas for improvement in a forthcoming paper within the field,hoping to pinpoint the culprit behind the diagnosis delay issue for IBD patients rather than simply attributing it to so-called“physician-dependent factors”.Our objective is to motivate healthcare providers and policymakers in relevant fields to reflect on strategies for addressing this problem to reduce diagnostic delays and enhance patient outcomes.展开更多
In this article,we comment on the article by Blüthner et al published recently.Inflammatory bowel disease(IBD),including ulcerative colitis and Crohn’s disease,is a chronic relapsing and remitting condition prim...In this article,we comment on the article by Blüthner et al published recently.Inflammatory bowel disease(IBD),including ulcerative colitis and Crohn’s disease,is a chronic relapsing and remitting condition primarily as a consequence of intestinal inflammation.It is important about adopting early and effective treatment to control clinical symptoms of IBD patients.Diagnostic delay can lead to adverse clinical outcomes and increase disease burden.Diagnostic delay is multifactorial.There are some factors related to diagnostic delay,such as patient factors and healthcare factors.We focus on the diagnostic tools for IBD,the outcomes and factors of diagnostic delay of IBD.展开更多
A neural network Smith predictive control strategy is proposed to deal with inpu t and feedback time delays in telerobot systems. The delay time is assumed to b e invariant and unknown. The proposed control structure...A neural network Smith predictive control strategy is proposed to deal with inpu t and feedback time delays in telerobot systems. The delay time is assumed to b e invariant and unknown. The proposed control structure consists of a slave syst em and a master controller. In the slave system, a recurrent neural network (RNN ) with on-line weight tuning algorithm is employed to approximate the dynamics of the time-delay-free nonlinear plant, which is used to linearize the slave s ystem. The master controller is a Smith predictor for the linearized slave syste m, which provides prediction and maintains the desirable tracking performance. S tability propriety is guaranteed based on the Lyapunov method. A simulation of a two-link robotic manipulator is provided to illustrate the effectiveness of th e proposed control strategy.展开更多
AimTo study effects of PVP K30 on the aque ou s solubility and dissolution properties of daidzein. Methods To measure the aqueous solubility and dissolution rates of daidzein in three diffe rent states (within solid d...AimTo study effects of PVP K30 on the aque ou s solubility and dissolution properties of daidzein. Methods To measure the aqueous solubility and dissolution rates of daidzein in three diffe rent states (within solid dispersions, physical mixtures and as a pure drug) and investigate drug-polymer interactions in the solid state using X-ray powder d iffraction and fourier-transform infrared spectroscopy. Results The negative values of the Gibbs free energy and enthalpy of transfer explaine d the spontaneous transfer of daidzein from phosphate buffer solution (PBS) to a solution of PVP in PBS. X-ray powder diffraction patterns showed that the drug was in the amorphous state (ratio of the drug ∶ PVP<1∶5) when dispers ed i n PVP K30. The infrared spectra indicated there exist interactions between the O H of daidzein and the C=O of PVP K30. Conclusionthe dispersion of daidzein in PVP K30 considerably enhances the solubility and dissolution rat e.展开更多
文摘BACKGROUND Early diagnosis is key to prevent bowel damage in inflammatory bowel disease(IBD).Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients exists.AIM To identify risk factors leading to prolonged diagnostic time in a German IBD cohort.METHODS Between 2012 and 2022,430 IBD patients from four Berlin hospitals were enrolled in a prospective study and asked to complete a 16-item questionnaire to determine features of the path leading to IBD diagnosis.Total diagnostic time was defined as the time from symptom onset to consulting a physician(patient waiting time)and from first consultation to IBD diagnosis(physician diagnostic time).Univariate and multivariate analyses were performed to identify risk factors for each time period.RESULTS The total diagnostic time was significantly longer in Crohn’s disease(CD)compared to ulcerative colitis(UC)patients(12.0 vs 4.0 mo;P<0.001),mainly due to increased physician diagnostic time(5.5 vs 1.0 mo;P<0.001).In a multivariate analysis,the predominant symptoms diarrhea(P=0.012)and skin lesions(P=0.028)as well as performed gastroscopy(P=0.042)were associated with longer physician diagnostic time in CD patients.In UC,fever was correlated(P=0.020)with shorter physician diagnostic time,while fatigue(P=0.011)and positive family history(P=0.046)were correlated with longer physician diagnostic time.CONCLUSION We demonstrated that CD patients compared to UC are at risk of long diagnostic delay.Future efforts should focus on shortening the diagnostic delay for a better outcome in these patients.
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Tibet Autonomous Region,No.XZ2024ZR-ZY100(Z).
文摘The challenge of diagnosis delay in inflammatory bowel disease(IBD)has emerged as a significant concern for both patients and healthcare professionals.The widely accepted notion that there is an extended time frame from the onset of symptoms to the definitive diagnosis is often attributed to the heterogeneity of IBD and the non-specificity of clinical manifestations.Specific to patients with Crohn’s disease,the issue of delayed diagnosis appears to be more pronounced across different regions globally.The intricate interplay of real-world factors has led to debates regarding the primary contributors to these diagnostic delays.Drawing a comparison solely between patients and physicians and implicating the latter as the predominant influence factor may fall into a simplistic either-or logical trap that may obscure the truth.This letter,grounded in published evidence,explores areas for improvement in a forthcoming paper within the field,hoping to pinpoint the culprit behind the diagnosis delay issue for IBD patients rather than simply attributing it to so-called“physician-dependent factors”.Our objective is to motivate healthcare providers and policymakers in relevant fields to reflect on strategies for addressing this problem to reduce diagnostic delays and enhance patient outcomes.
文摘In this article,we comment on the article by Blüthner et al published recently.Inflammatory bowel disease(IBD),including ulcerative colitis and Crohn’s disease,is a chronic relapsing and remitting condition primarily as a consequence of intestinal inflammation.It is important about adopting early and effective treatment to control clinical symptoms of IBD patients.Diagnostic delay can lead to adverse clinical outcomes and increase disease burden.Diagnostic delay is multifactorial.There are some factors related to diagnostic delay,such as patient factors and healthcare factors.We focus on the diagnostic tools for IBD,the outcomes and factors of diagnostic delay of IBD.
文摘A neural network Smith predictive control strategy is proposed to deal with inpu t and feedback time delays in telerobot systems. The delay time is assumed to b e invariant and unknown. The proposed control structure consists of a slave syst em and a master controller. In the slave system, a recurrent neural network (RNN ) with on-line weight tuning algorithm is employed to approximate the dynamics of the time-delay-free nonlinear plant, which is used to linearize the slave s ystem. The master controller is a Smith predictor for the linearized slave syste m, which provides prediction and maintains the desirable tracking performance. S tability propriety is guaranteed based on the Lyapunov method. A simulation of a two-link robotic manipulator is provided to illustrate the effectiveness of th e proposed control strategy.
文摘AimTo study effects of PVP K30 on the aque ou s solubility and dissolution properties of daidzein. Methods To measure the aqueous solubility and dissolution rates of daidzein in three diffe rent states (within solid dispersions, physical mixtures and as a pure drug) and investigate drug-polymer interactions in the solid state using X-ray powder d iffraction and fourier-transform infrared spectroscopy. Results The negative values of the Gibbs free energy and enthalpy of transfer explaine d the spontaneous transfer of daidzein from phosphate buffer solution (PBS) to a solution of PVP in PBS. X-ray powder diffraction patterns showed that the drug was in the amorphous state (ratio of the drug ∶ PVP<1∶5) when dispers ed i n PVP K30. The infrared spectra indicated there exist interactions between the O H of daidzein and the C=O of PVP K30. Conclusionthe dispersion of daidzein in PVP K30 considerably enhances the solubility and dissolution rat e.
