Autonomous Healthcare

Introduction. Multiple conceptual approaches exist for understanding facial aging, with a primary focus on either skin changes, volume fluctuations, gravitational changes in soft tissues, or facial skeletal atrophy. Many techniques following the concepts of aging are often used and promoted by the authors as universal. However, different individuals age differently, and therefore a differentiated approach to the choice of technique is logical. Each patient represents a unique combination of treatment objectives that are associated not only with the initial physical characteristics of the patient, but also with their subjective self-perception. The search for classifications or algorithms that could provide guidance for tactics remains relevant. Purpose of the study: to improve the planning of surgical correction of age-related changes in the face. Material and methods. The study was carried out by analyzing existing concepts of age-related changes in the face and approaches to the selection of surgical correction tactics. Results. The analysis of the literature showed that the classifications and assessment systems developed to date are not objective, given the diversity of facial structures, national characteristics, and subjective views on facial aesthetics. The main result of our work was the development of a surgical strategy based on identifying the individual needs of patients. It has been established that neither the presence nor the severity of certain signs of aging can determine the tactics. The correct approach is to determine the clinical significance of certain age-related changes in the face and, on this basis, to subordinate the options for surgical correction techniques (choice of incision line, detachment option, vectors of tissue movement and fixation, volumetric maneuvers) for each specific clinical situation individually. The algorithm for choosing a technique should be based on solving specific problems posed by a given patient. Each objective should correspond to its own technique, which may vary from person to person in the same area. Conclusions. Aging is fragmentary and can be described by individual signs. Each sign corresponds to a specific objective for the surgeon. Surgeons tend to objectify the severity of signs (visual manifestations), although this is unreliable. The relevance of the signs (the significance for the patient) does not necessarily correlate with the severity, i.e. cannot and does not require to be objectified. Essential is not the quantification of severity, but the presence of a symptom (indication for surgical intervention, i.e., the objective) and the improvement resulting from achieving the objective, i.e., patient satisfaction. The correction of the same facial area in patients with different types of age-related changes can be approached in different ways and depends on individual needs. The tactics for surgical facial rejuvenation should be based on solving specific tasks set by the patient. Введение. Существует много концептуальных подходов к пониманию старения лица, где главенствующая роль отдается либо изменениям кожи, либо колебаниям объема, либо гравитационным изменениям мягких тканей, а также атрофии лицевого скелета. Многие методики, следующие за концепциями старения, зачастую применяются и пропагандируются авторами как универсальные. Однако различные лица стареют по-разному, в связи с чем логичен дифференцированный подход к выбору методики. Каждый пациент представляет собой новую комбинацию лечебных задач, которые связаны не только с исходными физическими характеристиками пациента, но и с его субъективным самовосприятием Актуален поиск классификаций или алгоритмов, которые могли бы служить определителями тактики. Цель исследования: улучшение планирования хирургической коррекции возрастных изменений лица. Материал и методы. Исследование выполнено путем анализа существующих концепций возрастных изменений лица и подходов к выбору тактики хирургической коррекции. Результаты. Проведенный анализ литературы показал, что разработанные до настоящего времени классификации и системы оценок не являются объективными, учитывая многообразие вариантов строения лица, национальных особенностей, субъективных взглядов на эстетику лица. Основным результатом нашей работы явилась выработка хирургической стратегии, основанной на выявлении индивидуальных потребностей пациентов. Установлено, что ни факт наличия, ни степень выраженности тех или иных признаков старения не являются определителями тактики. Правильным подходом является определение клинической значимости тех или иных возрастных изменений лица и на этой основе субординирование вариантов хирургических техник коррекции (выбор линии разреза, вариант отслойки, векторы перемещения и фиксации тканей, волюметрические маневры) для каждой конкретной клинической ситуации индивидуально. Алгоритм выбора методики должен строиться на решении конкретных задач, поставленных данным пациентом. Каждой задаче должна соответствовать своя техника, на разных лицах в одной и той же зоне она бывает разной. Заключение. Старение фрагментарно и может быть описано отдельными признаками. Каждый признак соответствует отдельной задаче хирурга. Выраженность признаков (визуальных проявлений) хирурги в силу привычки стремятся объективизировать, хотя это ненадежно. Актуальность признаков (значение для пациента) не обязательно пропорциональна выраженности, т.е. объективизации не поддается, да и не требует ее. Важна не оцифровка степени выраженности, а, во-первых, факт наличия признака (показания к хирургическому маневру, т.е. задача) и, во-вторых, факт улучшения в результате решения задачи, т.е. удовлетворенность пациента. Задачи коррекции одной и той же зоны лица у пациентов с разным типом возрастных изменений могут решаться различным образом и зависят от индивидуальных потребностей. Тактика при хирургическом омоложении лица должна строиться на решении конкретных задач, поставленных пациентом.

Cystic fibrosis (CF) is a universal exocrine disorder that affects virtually all organs and systems containing exocrine glands. A genetic defect in the cystic fibrosis transmembrane conductance regulator gene leads to increased viscosity of exocrine gland secretions, primarily in the respiratory tract. CFTR modulators improve the synthesis, processing, and/or function of the defective CFTR protein, which is a chloride channel. Objective. To evaluate the efficacy of the generic drug ivacaftor + tezacaftor + elexacaftor/ivacaftor (trade name Trilexa®), in a group of patients not previously receiving triple targeted therapy after 3 months of treatment in patients who have not previously received the first threecomponent CFTR modulator. Methods. Data from the Russian CF Patient Registry, entered into the “Targeted Therapy” block, were analyzed for the period from January to August 2025 (main group) and for the period from January 2022 to August 2022 (comparison group). Two groups of patients were identified: Group 1 included 28 pediatric patients (12 boys/16 girls) with a confirmed diagnosis of cystic fibrosis, who started receiving triple targeted therapy generic drug ivacaftor + tezacaftor + elexacaftor/ivacaftor. Group 2, the comparison group, consisted of 34 pediatric patients (14 boys/20 girls) who started receiving the original triple targeted drug ivacaftor + tezacaftor + elexacaftor/ivacaftor (trade name Trikafta®). Results. When assessing the nutritional status, a significant increase in BMI was shown in both groups of patients at the start and after 3 months; p < 0.001. Sweat test parameters (conductivity in mmol/L) differed significantly both at the start of therapy and after a month in both groups. The difference between the average sweat test values (Δ mmol/L) in both groups were comparable and did not differ from each other. The groups did not differ in the number of adverse events, which were mild and did not lead to drug discontinuation. Both drugs, the original and the generic, demonstrated safety and good tolerability. Group 1 value was 43 (35.5; 55), and Group 2 value was 42 (32; 50.3); p = 0.86. FEV1 and FVC indicators showed a tendency to increase with both drugs, but it was not significant in both groups. Conclusion. The triple targeted therapy with the use of generic drug ivacaftor + tezacaftor + elexacaftor/ivacaftor is effective and safe in this sample of pediatric patients with cystic fibrosis. No significant differences were found between generic drug and the original drug in relation to the main efficacy criteria during 3 months of use. The frequency, spectrum, and severity of reported adverse events associated with the use of generic drug were comparable to those associated with the use of the original drug.

Abstract Model Predictive Control (MPC) has emerged as one of the most widely adopted and effective approaches in autonomous driving systems. Conventional design methodology of MPC systems, however, often rely on static rule-based architectures and predetermined control strategies, limiting their flexibility and responsiveness to complex and dynamic traffic environments. To enhance the system’s understanding of driver intentions and improve strategy adaptability, this paper proposes a novel autonomous driving framework, ChatMPC, that integrates Natural Language Processing (NLP) with MPC. The framework employs a Transformer-based sentence embedding model, Sentence-BERT (SBERT), to parse driving intents embedded in natural language commands (e.g., “overtake,” “follow”), and dynamically updates the MPC controller’s objective functions and constraints. This enables the generation of personalized driving behaviors aligned with user preferences. Simulation experiments conducted on the Matlab platform show that ChatMPC completes the full cycle from instruction parsing to control optimization in an average of 15 seconds, with MPC prediction requiring an average of 13.5 ms and a worst-case time of 22.2 ms, well within the 50 ms real-time budget. In typical traffic scenarios, the system achieves high tracking accuracy, with a following error of 0.827% and overtaking error of 1.67%, validating its real-time performance and effectiveness.

Context: Immunization is one of the most effective public health interventions to prevent infectious diseases and reduce childhood mortality. Urban slums in cities like Lucknow are characterized by overcrowded living conditions, limited access to healthcare, poor sanitation, and socioeconomic disadvantages. The aim was to determine the vaccination dropout rate among children aged 0-24 months in an urban slum of Lucknow and to assess the barriers to vaccination faced by families living in urban slums. Methods and Material: Community-based cross-sectional study among 320 children (0-24 months) residing in 16 randomly selected urban slums and 20 children were chosen randomly for participation within each selected slum in Lucknow, Uttar Pradesh. Multi-stage random sampling was applied pre structured, semi structured interview schedule was used to collected the data along with conformation of immunization status from MCP card and chi square test was used to association and p<0.05 considered significant. Results: Overall dropout rates ranged from 10.07% at birth to the cumulative dropout increased to 19.79 percent at 9 months. Significant associations were found between dropout and child sex, caste and delivery type. Children born at home 56.25% had higher dropout rate compared to institutional births 20%. Conclusions: Despite high institutional delivery rates and MCP card coverage, barriers such as parental literacy, healthcare access, and economic constraints persist.

This article presents the results of a study on the redistribution of nurse responsibilities in dentistry and the need to introduce a new position. The study was conducted in 2024. The job responsibilities of junior nurses and dental nurses were examined. A total of 315 respondents participated in the study: head nurses, senior nurses, and nurses from dental medical organizations.

[This corrects the article DOI: 10.7759/cureus.51360.].

The increasing demand for noncontact and continuous health monitoring during pandemic and emergency conditions has significantly accelerated the adoption of Internet of Things (IoT) technologies in healthcare. IoT health monitoring systems obviate the need for frequent doctor visits and patient-physician consultations. This paper presents an IoT-based real-time patient health supervision system using Raspberry Pi for track a person's temperature, pulse rate, humidity, and oxygen saturation. This approach is particularly beneficial in rural or village areas, where local clinics can share their patients’ medical information with larger city hospitals for better diagnosis and treatment. The proposed system integrates temperature, pulse rate, and humidity sensors to observe the patient’s health status with high accuracy. The suggested system consists of three parts: an inexpensive, lightweight IoT sensor, a mobile cloud server called Thing Speak, and a qr code scanning technique for data processing and diagnostics. ThingSpeak updates the data, and then the patient's health status is displayed. Although motivated by COVID-19 needs, the system is designed as a general-purpose telehealth solution suitable for elderly care, chronic disease monitoring, home quarantine, remote hospitals, and future pandemic preparedness. Experimental results demonstrate that the system is cost-effective, scalable, and reliable for modern healthcare environments.

Abstract We address the challenge of temporal change detection and estimation in nonlinear dynamical systems. Traditionally, model-based fault diagnosis methods rely on the parallel execution of multiple filters, each corresponding to different system models (nominal and faulty). Although effective, this approach becomes computationally expensive, especially when using numerical techniques such as the particle filter instead of closed form, Gaussian filters. In this work, we propose a novel fault diagnosis framework that integrates a Bernoulli state variable, in the form of a jump hidden Markov model, governed by a task-specific probabilistic mode switching mechanism, to represent the presence or absence of a fault (or change) within a dynamic system. By embedding this binary state within a Bayesian filtering framework, we develop a hybrid state filter that significantly reduces the computational complexity traditionally associated with particle filtering approaches for fault diagnosis. The proposed filter enables real-time evaluation of fault hypotheses based on the statistical moments of a single-posterior probability density function, thereby eliminating the requirement for maintaining multiple parallel filters. The proposed method is validated through a numerical benchmark example demonstrating its efficiency and effectiveness.

Background: Hypertension is a leading global public health issue, significantly contributing to cardiovascular disease, stroke, kidney failure, and premature death. In India, the burden of hypertension is increasing rapidly due to urbanization, sedentary lifestyles, unhealthy diets, and aging populations. Despite being preventable and manageable, hypertension often remains undiagnosed and poorly controlled, especially in rural and resource-limited settings. Aims and Objectives: To assess the prevalence of hypertension and identify associated risk factors among the adult population in Sitapur district, Uttar Pradesh. Materials and Methods: A cross-sectional study was conducted at the screening outpatient department of the Department of Community Medicine, HIMS, Sitapur. Adults aged 19 years and above were enrolled using systematic random sampling. A total of 500 participants were included. Data were collected through a pretested, semi-structured questionnaire covering sociodemographic, behavioral, psychosocial, and clinical factors. Statistical analysis was performed using Jamovi software, with Chi-square tests for bivariate analysis and multivariate logistic regression to identify independent predictors of hypertension. Results: A high prevalence of hypertension was seen in the age group of more than 60 years (37.8%), followed by 28.8% in the age group of 50–59 years. A high prevalence of hypertension was seen in male populations (63.5%) compared to 36.5% which was among the female population. Significant risk factors identified included older age, male sex, smoking, low physical activity, overweight/obesity (body mass index [BMI] ≥25), high waist-to-hip ratio in males, and poor mental health symptoms. Participants aged >60 years had the highest odds of hypertension (adjusted odds ratios: 4.20; 95% confidence intervals: 2.10–8.30). Smoking and higher BMI levels were strongly associated with increased hypertension risk. Physical inactivity and higher socioeconomic status also emerged as significant predictors. Conclusion: Targeted public health interventions focusing on lifestyle modification, early screening, and community awareness are essential to address the growing burden of hypertension in rural areas.