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The development and implementation of the classification module may be based either on supervised or unsupervised training methods cialis sublingual 20 mg on line. In supervised training generic cialis sublingual 20 mg, a set of characteristic vectors is considered generic 20mg cialis sublingual fast delivery, known as training set buy generic cialis sublingual 20mg on line. For each vector in the training set the class to which it belongs 20mg cialis sublingual visa, is known a priori. The vectors in the training set are used to train the classifier, which can subsequently classify any vector appearing to its input into one of the available classes (Duda, Hart & Stork, 2000). In unsupervised training a set of characteristic vectors is examined and the class each vector belongs to is unknown. Classification of vectors in the available categories is done automatically during the formation of the classifier. Subsequently, as before, each characteristic vector is classified in one of the categories (Duda, et al. Supervised Classification The most common supervised classifiers include Bayes classifiers, nearest neighbour classifiers, decision trees, and artificial neural networks (Jain et al. In Bayes classifiers, each feature belongs to the class with the highest a posteriori estimated probability. In nearest neighbour classifiers, features are classified based on their relative similarity. One of the most popular supervised classification methods is based on the use of ANNs, which are computational modelling tools that have recently emerged and found extensive acceptance in many disciplines for modelling complex real-world problems. ANNs may be defined as structures comprised of densely interconnected adaptive simple process- ing elements (called artificial neurons or nodes) that are capable of performing massively parallel computations for data processing and knowledge representation (Schalkoff, 1997). ANNs are applied to problems that cannot be described with rules or mathematical formulas. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Clinical Decision Support Systems 257 The inputs can be external signals or the outputs of other neurons. Subsequently, the sum of the inputs with the corresponding weights is transformed with a linear or a non- linear transform function to produce the neuron output. The outputs of the neurons of the input layer are conveyed to neurons of intermediate layers. The ability to train an ANN consists in the adaption of weighs during the training process. The most commonly used procedure for training ANNs is the feedforward error- backpropagation learning algorithm (Haykin, 1999). According to this method, each vector in the training set appears at the ANN input and is propagated through the intermediate layers toward the output layer. The response of the neurons at the output layer is compared with the desired response of each vector and the error is calculated. Subsequently, the error is backpropagated and used to re-estimate the weight of each neuron. At the end of each successful epoch the total error, for all vectors of the training set, is reduced. The procedure continues until a criterion for the termination of the training is satisfied. Unsupervised Classification The most common unsupervised classification method is C-means. Subsequently, each vector is assigned to the class for which the euclidean distance from the class centre is minimal. After all characteristic vectors are classified, the class centre is re-estimated. However, the method is sensitive to the initial estimation of the class centres and, as a result, convergence may appear at a local minimum of the euclidean distance of the vectors from the class centres. The difference in the two methods lies in the fact that in C-means method each vector is strictly assigned only to one class, whereas in fuzzy C-means method each vector belongs to all classes. The percentage with which each vector belongs to a class is the member function (Zadeh, 1965). Although ANNs are mainly supervised classifiers, unsupervised ANNs can be used to cluster characteristic vectors. The most representative network of this category is the Self-Organising Map (SOM) ANN (Kohonen, 1989).

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However buy cialis sublingual 20mg free shipping, several of these studies specifically compare chiropractic treatment to that by other practitioners cheap cialis sublingual 20 mg online. Positive responses for manipulation have been found in patients with subacute low 43 back pain (within 4–12 weeks) cialis sublingual 20 mg visa. In a prospective proven 20mg cialis sublingual, randomized trial generic 20 mg cialis sublingual free shipping, Hsieh and associates compared SMT with transcutaneous muscle stimulation, massage therapy or corset use in patients with subacute low back pain. At 3 weeks, the manipulation group showed the greatest improvement in lumbar flexion and in pain scores. There are a limited number of studies that have Complementary therapies in neurology 44 examined the effect of chiropractic treatment in patients with chronic low back pain. Each of the three therapeutic regimens was associated with similar and clinically important improvement, and there appeared to be a sustained reduction in medication use at the 1- year follow-up period in the SMT and therapeutic strengthening exercise group. After a median intervention period of 30 days, spinal manipulation was the only treatment that achieved statistically significant improvement, with a reduction on the Oswestry scale of 30. The authors concluded that, in spite of several shortcomings of this study, there was evidence that spinal manipulation resulted in greater improvement than acupuncture and commonly utilized medication in patients with chronic spinal pain. They found significantly greater benefits for the group treated by the chiropractors at several followup intervals: 6 weeks, 6 months, 1 year, 2 years and 3 years. One weakness of the study was the relatively high percentage of patients lost to follow-up, especially at the later time points. Nonetheless, the large size of this study (enrolling over 700 patients) and the long-term follow-up period with consistent findings over all time points provide some confidence in their findings. The group treated by chiropractors performed significantly better than the minimal intervention group at 4 weeks, but not at 12 weeks, 1 year or 2 years. There was no difference between the group undergoing spinal manipulation and the patients treated with physical therapy. Although disability scores were better for both the group treated with manipulation and those patients treated with physical therapy than the minimal intervention, this did not quite reach significance at any time point. It is noteworthy that the groups receiving active treatment were much more satisfied with the treatment, reporting that their care was good or excellent about 75% of the time (compared to 30% of the time for the patients who had been given the Chiropractic 45 booklet). This effect has the potential to limit the ability of a study to detect differences between treatment groups. These pragmatic studies, combined with the results of other studies of manipulative therapy, argue for some benefit of chiropractic in the treatment of low back pain of various durations versus several other forms of therapy. There is some question as to whether intensive physical therapy may be as effective, at similar overall cost. Additionally, the studies that have been carried out up to the present time cannot determine whether there are particular chiropractic procedures that are more effective than others or whether these treatments are cost-effective. Furthermore, studies have not been designed to address the important question of whether there are particular groups of back pain patients who are more likely to benefit. Disc herniation and sciatica Currently, there are no randomized clinical trials of chiropractic treatment of patients with sciatica and disc herniation. However, there have been a number of case studies and reports that suggest that SMT may be useful for such patients. In a review of data from the back pain clinic at the Royal University Hospital in Saskatoon, the use of side-lying chiropractic SMT (i. In another case series, 71 patients presenting to a chiropractic clinic with low back pain plus sciatica 51 52 were studied. Ninety per cent of the patients who received a course of treatment reported subjective improvement in both range of motion and nerve root tension signs. These authors concluded that SMT might be a safe, non-surgical treatment for low back 53 and radiating leg pain. Ben-Eliyahu, in a prospective study, described good clinical outcomes in 22 (81%) of 27 patients with symptomatic cervical or lumbar disc herniations verified by MRI. Reduction or complete resorption of the disc was seen in 17 patients (63%) in post-treatment MRI scans. However, the lack of a control group makes it impossible to determine whether the improvement could be directly attributed to the manipulation. Despite these promising descriptive case series, it appears that patients with demonstrated disc herniation and sciatica do less well following manipulation than 52 patients with uncomplicated back pain. Neck pain 6,12,42 Neck pain is the second most common reason that patients seek chiropractic care. However, substantially fewer clinical trials have been performed on neck pain than on low back pain. Fewer still of these have specifically investigated usual chiropractic care in comparison to other interventions.

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After several days, the nasal tissues be- • walnut ( or ) leaf tea, which stops come less inflamed and the watery discharge is replaced nasal discharge by a thick, sticky mucus. This change in the appearance of the nasal discharge helps to distinguish rhinitis caused by a viral infection from allergic rhinitis. Other natural remedies for rhinitis include those Allergies are another frequent cause of rhinitis from. Airborne allergens can be just about any- rhinitis remedy is Bi Yan Pian (Bi is for nose. A decoction of Yu Xing Cao ( Symptoms that last longer than a week may require fur- ) may be taken internally. Causes & symptoms Diagnosis Treatment GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1765 cians, and business executives. Ilana Rubenfeld reserves Swedish physician who employed vigorous massage to the right to interview all applicants for training, and certi- stimulate circulation of the blood and lymph, is usually fication requires both her approval and that of her faculty. Training takes place over four years, and consists of three Massage was not studied or used scientifically in Russia seven-day sessions a year, combined with three one-day until 1860. The center believes that its after World War II when pharmaceuticals were in short trainees must themselves experience the Rubenfeld supply. The Soviet Union employed physiatrists—med- method, so they are required to participate in 20 private ical doctors with Ph. The Rubenfeld They developed a form of petrissage to reverse atrophy in Synergy Center also offers post-graduate training. Russian physiol- ogists found all movements of massage function on the basis of neurohormone and neuroendocrine reflexes. Ailments said to benefit from massage therapy include,, arthritis,,, hip sprains and strains, rotator cuff injuries, myofascial, temporo- mandibular joint (TMJ) problems,, spastic colon,,, and immune function disorders. Be- cause of its gentle, non-invasive nature, Russian massage is considered especially suitable for seniors. Russian massage is considered less invasive and more relaxing than many other forms of massage thera- Russian massage is a system of therapeutic and py. One early advocate was Hip- other day, but may also be interrupted after a dozen or so pocrates, the Greek physician widely considered to be the treatments to ensure that patient does not become depen- father of medicine. BLACHFORD, EDITOR The GALE ENCYCLOPEDIA of GENETIC DISORDERS STAFF Since this page cannot legibly accommodate all copyright notices, the acknowledgments constitute an extension of the copyright notice. Blachford, Associate Editor While every effort has been made to ensure the reliability of the infor- mation presented in this publication, the Gale Group neither guarantees Christine B. Jeryan, Managing Editor the accuracy of the data contained herein nor assumes any responsibil- Melissa C. The Gale Group accepts no Ellen Thackery, Associate Editor payment for listing, and inclusion in the publication of any organiza- tion, agency, institution, publication, service, or individual does not Mark Springer, Technical Training Specialist imply endorsement of the editors or publisher. Errors brought to the Andrea Lopeman, Programmer/Analyst attention of the publisher and verified to the satisfaction of the publisher will be corrected in future editions. Barbara Yarrow, Manager, Imaging and Multimedia This book is printed on recycled paper that meets Environmental Content Protection Agency standards. Robyn Young, Project Manager, Imaging and The paper used in this publication meets the minimum requirements of Multimedia Content American National Standard for Information Sciences-Permanence Randy Bassett, Imaging Supervisor Paper for Printed Library Materials, ANSI Z39. Robert Duncan, Senior Imaging Specialist This publication is a creative work fully protected by all applicable Pamela A. Reed, Coordinator, Imaging and Multimedia copyright laws, as well as by misappropriation, trade secret, unfair com- petition, and other applicable laws. The authors and editors of this work Content have added value to the underlying factual material herein through one or more of the following: unique and original selection, coordination, Maria Franklin, Permissions Manager expression, arrangement, and classification of the information. Ryan Thomason, Permissions Associate Gale Group and design is a trademark used herein under license. Lori Hines, Permissions Assistant All rights to this publication will be vigorously defended.

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