This study shows that the recurrence of varicose veins after surgery is not uncommon. However, the clinical condition of most affected limbs remains improved. Progression of the disease and neovascularisation are responsible for more than half of the recurrences. Rigorous evaluation of patients and assiduous surgical technique might reduce recurrence due to technical and tactical failures.
Abstract. Data on tsunami phenomena occurring in the East Hellenic Arc and Trench system (HA-T) from antiquity up to the present have been updated, critically evaluated and compiled in the standard GITEC format developed in the last decade for the New European Tsunami Catalogue. New field observations are presented for the tsunamis of 9 February 1948 and 24 March 2002. From the 18 tsunamis reported eight are rather well-documented while another nine remain doubtful. The mean recurrence of strong tsunamis is likely equal to about 142 years. Most of the tsunamis documented are caused by strong earthquakes occurring in the area offshore Rhodes to the east or northeast of the island. However, there are large earthquakes near Rhodes that do not cause tsunamis, like the 1926 and 1957 ones, which is of particular importance for the tsunami hazard assessment.
Although reinforcement learning (RL) is suitable for highly uncertain systems, the applicability of this class of algorithms to medical treatment may be limited by the patient variability which dictates individualised tuning for their usually multiple algorithmic parameters. This study explores the feasibility of RL in the framework of artificial pancreas development for type 1 diabetes (T1D). In this approach, an Actor-Critic (AC) learning algorithm is designed and developed for the optimisation of insulin infusion for personalised glucose regulation. AC optimises the daily basal insulin rate and insulin:carbohydrate ratio for each patient, on the basis of his/her measured glucose profile. Automatic, personalised tuning of AC is based on the estimation of information transfer (IT) from insulin to glucose signals. Insulin-to-glucose IT is linked to patient-specific characteristics related to total daily insulin needs and insulin sensitivity (SI). The AC algorithm is evaluated using an FDA-accepted T1D simulator on a large patient database under a complex meal protocol, meal uncertainty and diurnal SI variation. The results showed that 95.66% of time was spent in normoglycaemia in the presence of meal uncertainty and 93.02% when meal uncertainty and SI variation were simultaneously considered. The time spent in hypoglycaemia was 0.27% in both cases. The novel tuning method reduced the risk of severe hypoglycaemia, especially in patients with low SI.
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