ABSTRACT
Currently available drugs for complex diseases have such limitations as unsatisfactory efficacy, drug resistance, and toxic side effects. Complexity of biological systems is a determinant of drug efficacy. It is not an effective approach to find disturbance strategies for the complicated biological network for complex diseases based on the static topological structures, as biological systems undergo dynamic changes all the time. Supported by profound theoretical basis and rich clinical experience, traditional Chinese medicine(TCM) emphasizes systematic and dynamic treatment depending on changes. Guided by TCM theory in practical treatment, Chinese medicine dynamically and comprehensively regulates the overall state. Therefore, if the dynamic factors are taken into consideration in design, the resultant drugs will be more effective. This study proposes state-regulating(SR) medicine from the perspective of system dynamics, elaborating the concept in terms of the connotations and principle and verifying the feasibility of SR medicine design with the attractor method. Thus, SR medicine is a new concept for drug discovery and design from the aspect of system dynamics, which integrates the TCM focusing on holistic dynamic regulation with biomedicine that features local microscopic research such as molecular mechanisms. The attractor method is a feasible techinical way for SR medicine design.
Subject(s)
Drug Discovery , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Research DesignABSTRACT
Lorenz plot (LP) method which gives a global view of long-time electrocardiogram signals, is an efficient simple visualization tool to analyze cardiac arrhythmias, and the morphologies and positions of the extracted attractors may reveal the underlying mechanisms of the onset and termination of arrhythmias. But automatic diagnosis is still impossible because it is lack of the method of extracting attractors by now. We presented here a methodology of attractor extraction and recognition based upon homogeneously statistical properties of the location parameters of scatter points in three dimensional LP (3DLP), which was constructed by three successive RR intervals as , and axis in Cartesian coordinate system. Validation experiments were tested in a group of RR-interval time series and tags data with frequent unifocal premature complexes exported from a 24-hour Holter system. The results showed that this method had excellent effective not only on extraction of attractors, but also on automatic recognition of attractors by the location parameters such as the azimuth of the points peak frequency ( ) of eccentric attractors once stereographic projection of 3DLP along the space diagonal. Besides, was still a powerful index of differential diagnosis of atrial and ventricular extrasystole. Additional experiments proved that this method was also available on several other arrhythmias. Moreover, there were extremely relevant relationships between 3DLP and two dimensional LPs which indicate any conventional achievement of LPs could be implanted into 3DLP. It would have a broad application prospect to integrate this method into conventional long-time electrocardiogram monitoring and analysis system.
ABSTRACT
Antecedentes: la teoría de los sistemas dinámicos estudia la evolución de los sistemas. Mediante esta teoría y la geometría fractal se desarrolló una ley matemática de ayuda diagnóstica a los sistemas dinámicos cardiacos, que permite diferenciar entre normalidad y enfermedad, y la evolución entre los dos estados. Objetivo: confirmar la capacidad diagnóstica de la ley matemática exponencial desarrollada inicialmente para dinámicas cardiacas en 21 horas, para dinámicas evaluadas en 18 horas. Método: se tomaron 400 registros electrocardiográficos, 80 de dinámicas normales y 320 de dinámicas anormales. Se generó una sucesión pseudoaleatoria con el número de latidos/hora y las frecuencias máximas y mínimas cada hora; luego, se construyó el atractor de cada dinámica, para así calcular los espacios de ocupación y la dimensión fractal. Finalmente, se estableció el diagnóstico físico-matemático en 18 y 21 horas y se comparó con el diagnóstico clínico tomado como Gold Standard, obteniendo valores de sensibilidad, especificidad y coeficiente Kappa. Resultados: se encontraron valores de ocupación espacial en la rejilla Kp para normalidad entre 236 y 368 y para estados patológicos entre 22 y 189, lo que permitió diferenciar entre normalidad, enfermedad, y estados de evolución hacia la enfermedad en 18 horas. Se obtuvieron valores de sensibilidad y especificidad del 100 por ciento y coeficiente Kappa igual a 1. Conclusión: la ley matemática permitió dictaminar diagnósticos reduciendo el tiempo de evaluación a 18 horas confirmando así su aplicabilidad clínica(AU)
Dynamical systems theory aims to study the evolution of systems. With this theory and fractal geometry, it was developed a mathematical law of diagnostic utility in cardiac dynamical systems that may differentiate normality from disease and evolution between these two states. Objective: To confirm the diagnostic capacity of the exponential mathematical law initially developed for cardiac dynamics in 21 hours, for dynamics evaluated in 18 hours. Method: There were taken 400 electrocardiographic records, 80 from normal dynamics and 320 from abnormal dynamics. A pseudorandom sequence was generated with the number of beats per hour and the maximum and minimum frequencies each hour; then, the attractors were built for each dynamic, in order to calculate the space occupation and the fractal dimension. Finally the physical and mathematical diagnosis in 18 and 21 hours was established, and compared to clinical diagnosis taken as Gold Standard, obtaining values of sensitivity, specificity and Kappa coefficient. Results: There were found values for spatial occupation in the Kp grid between 236 and 368 for normal cases, and between 22 and 189 for pathological states, which allowed distinguish normality from disease and states of progression to disease in 18 hours. There were obtained values for sensitivity and specificity of 100 percent and a Kappa coefficient equal to 1. Conclusion: The mathematical law allowed to stablish diagnostics by reducing the evaluation time to 18 hours confirming its clinical applicability(AU)
Subject(s)
Humans , Jurisprudence , Mathematics/methodsABSTRACT
El objetivo del presente escrito consiste en investigar la constitución subjetiva desde una nueva perspectiva a fin de abordar las estructuras psicopatológicas, con miras a una terapéutica que incluya una noción de salud acorde a la ética psicoanalítica. Desarrollaremos el concepto de agujero en la estructura: proponemos que en un primer momento de la enseñanza de Lacan el agujero originario es leído en términos de falta y luego se concibe como un vacío. En este sentido, realizaremos un recorrido que nos permita argumentar qué se concibe por agujero desde el psicoanálisis y diferenciar distintos tipos de agujeros. Postulamos que el agujero, que llamaremos inicial, requerirá ser redoblado por otras operaciones tanto como para vaciarse, como para transformarse en un agujero con bordes. Para ello señalaremos la importancia de diferenciar el concepto de vacío y de agujero, y luego los tratamientos posibles de éste. Por último consideramos que la concepción que se tenga de la estructuración subjetiva tiene consecuencias en la praxis. En este recorrido nos serviremos de algunas nociones de la física para articular el concepto de estructura disipativa y desde allí pensar la orientación analítica.
The aim of this paper is to investigate the subjective constitution from a new perspective in order to approach psychopathological structures looking forward to a kind of practice that includes a notion of health consistent with psychoanalytic ethics. We will develop the concept of hole in the structure: we propose that in Lacan' s first teachings the originary hole is read in terms of lack, while in his last teachings it is conceived as a void. In this sense, we will follow a path that will allow us to argue what is the concept of hole in psychoanalysis and identify the different types of holes. We postulate that the hole, which we call originary, will need to be reinforced by other operations in order to be emptied or to become a hole with edges. And to do that, we will stress the importance of differentiating the concepts of void and hole, and then lay out the possible treatments for the latter. Finally, we consider that the concept that one may have of subjective structuring has consequences for the practice. On the course of this investigation we will use some notions of physics to articulate the concept of dissipative structure and think the analytical orientation from there.
Subject(s)
Humans , Research Subjects , Psychoanalysis , Therapeutics/psychologyABSTRACT
ResumenIntroducción:La dinámica cardíaca ha sido caracterizada a partir de la teoría de los sistemas dinámicos y la geometría fractal, permitiendo generar metodologías de aplicación clínica.Objetivo:desde los sistemas dinámicos, se desarrollará una metodología de evaluación de los pH y presiones de dióxido de carbono arteriales y venosos para pacientes de la Unidad de Cuidados Intensivos.Materiales y Métodos:se escogieron 10 pacientes con diversas patologías de la Unidad de Cuidados Intensivos Postqui rúrgicos del Hospital Militar Central, registrando pH y presiones de dióxido de carbono arteriales y venosas durante su tiempo de estancia; posteriormente se construyeron atractores, determinando su tipo de trayectoria y estableciendo los valores máximos y mínimos de estas variables en el mapa de retardo.Resultados:se encontró un comportamiento caótico de las variables evaluadas, hallando valores mínimos y máximos de 7,01 y 7,59 para pH arterial, 6,97 y 7,53 para pH venoso, 14,40 y 73,70 para presión arterial de dióxido de carbono, y 19,20 y 97,90 para presión venosa de dióxido de carbono.Conclusiones:La evaluación de los valores máximos y mínimos del atractor en el mapa de retardo constituye un nuevo método, objetivo y reproducible, para la evaluación matemática de cada una de las variables estudiadas, de utilidad para el seguimiento de pacientes en UCI.
SummaryIntroduction:Cardiac dynamics has been characterized from the theory of dynamical systems and fractal geometry, allowing to generate methodologies with clinical application. Objective: from dynamic systems, a methodology for evaluating the arterial and venous pH and dioxide of carbon pressures for patient in Intensive Care Unit will be developed.Materials and Methods:10 patients with various pathologies were selected from Post-surgical Intensive Care Unit of the Central Military Hospital, recording arterial and venous pH and dioxide of carbon pressures of during its stay; attractors were built subsequently, determining the type of path and setting the maximum and minimum values of these variables on the delay map.Results:chaotic behavior of the variables evaluated was found, finding maximum and minimum values of 7,01 and 7,59 for arterial pH values, 6,97 and 7,53 for venous pH, 14,40 and 73,70 for arterial dioxide of carbon pressure, and 19,20 and 97,90 for venous dioxide of carbon pressure.Conclusions:The evaluation of the maximum and minimum values of the attractor on the delay map is a new method, objective and reproducible for the mathematical evaluation of each of the variables studied, useful for monitoring patients in Intensive Care Unit.
Subject(s)
Humans , Venous Pressure , Blood Gas Analysis , Carbon Dioxide , Hypocapnia , Critical Care , Arterial Pressure , Hypercapnia , Intensive Care UnitsABSTRACT
Strange attractor can be constructed from time series data such as heart sound. In the areas of the recognition and diagnosis of abnormal heart sounds, signal presentation method is very useful because good features can be detected from good presentation. This paper examines efficiency in diagnosing abnormal heart sounds of the two different methods for constructing attractor. Nine different heart sounds from typical clinical conditions were used for this study. The first method was constructing attractors using original heart sounds, and the second was modifying the original sounds by autocorrelation and they were then applied to the orignal sounds as to cross correlation checks. Attractors could be constructed using signals generated by these methods, and values of fractal dimensions would then be calculated which has been a well known method to measure characteristics of attractors. The results showed that the second method appeared to provide more efficient way to correctly classify abnormal heart sounds.
Subject(s)
Diagnosis , Fractals , Heart Sounds , HeartABSTRACT
Strange attractor can be constructed from time series data such as heart sound. In the area of the recognition and diagnosis problem, signal presentation method is very important because good features can be detected from good presentation. This paper discusses a way to extract a cycle from strange attractor and introduce new attractor construction method using autocorrelation value of the heart rate. The result shows well-formed attractor and good ability for extraction features. Largest Lyapunov Exponent is used to check whether the attractors provide distinguish abilities among different types of heart rate. The result shows good points that can be applied to some areas of human signal processing.