Mixed pain, defined by the concurrent involvement of nociceptive, neuropathic, and sometimes nociplastic mechanisms, poses a significant diagnostic and therapeutic challenge within modern pain medicine. This complex pain phenotype is increasingly recognized as a prevalent and burdensome clinical entity, yet it remains substantially underdiagnosed and sub-optimally managed across diverse healthcare settings. Epidemiological data indicate that mixed pain affects a substantial proportion of patients with chronic pain syndromes and is consistently associated with more severe symptomatology, prolonged pain duration, functional impairment, diminished quality of life, and escalated healthcare resource utilization compared to pain of a single mechanism. In response to this unmet clinical need, the present recommendations aim to provide a structured, evidence-informed framework for the diagnosis and management of mixed pain. Developed through a rigorous process involving systematic literature review and multidisciplinary expert consensus, this document emphasizes the importance of mechanism-based therapeutic strategies tailored to the individual patient’s pain profile. Central to the approach is the implementation of multimodal and interdisciplinary care models that address the biological, psychological, and functional dimensions of mixed pain. These recommendations are intended for a broad spectrum of healthcare professionals, including primary care physicians, pain specialists, neurologists, oncologists, physiatrists, nurses, pharmacists, physical and occupational therapists, and clinical psychologists. The target population encompasses patients affected by mixed pain conditions such as chronic low back pain with radiculopathy, cancer-related pain, persistent post-surgical pain, and osteoarthritis complicated by central sensitization. By facilitating accurate diagnosis and integrated treatment planning, these recommendations seek to advance clinical practice, reduce the burden of mixed pain, and enhance patient-centered outcomes. This guidance aims to transform mixed pain care by promoting mechanism-based, multidisciplinary strategies with direct clinical applicability.
Abstract
This paper discusses the essence of the developmental process in auditing firms and offices at the world today. This process is focused on how to adopt the audit concepts which is based on Information and Communication Technology (ICT), including the Continuous Auditing (CA) in particular. The purpose of this paper is to design a practical model for the adoption of CA and its requirements according to the Technology Acceptance Model (TAM). This model will serve as a road map for manage the change and development in the Iraqi auditing firms and offices. The paper uses the analytical approach in reaching to the target results. We design the logical and systematic relations between the nine variable
... Show MoreComplexes of Co(II),Ni(II),Cu(II) and Zn(II) with mixed ligands of phenylalanine (L) and tributylphosphine (TBPh) were prepared in aqueous ethanol with (2:1:1) (M:L:TBPh). The prepared complexes were characterized using flame atomic absorption,(C.H.N)Analysis, FT.IR and UV-Vis spectroscopic methods as well as magnetic susceptibility and conductivity measurements. In addition biological activity of the phenylalanine and complexes against two selected type of bacteria were also examined. Some of the complexes exhibit good bacterial activities. From the obtained data the octahedral structure was suggested for all prepared complexes.
In all applications and specially in real time applications, image processing and compression plays in modern life a very important part in both storage and transmission over internet for example, but finding orthogonal matrices as a filter or transform in different sizes is very complex and importance to using in different applications like image processing and communications systems, at present, new method to find orthogonal matrices as transform filter then used for Mixed Transforms Generated by using a technique so-called Tensor Product based for Data Processing, these techniques are developed and utilized. Our aims at this paper are to evaluate and analyze this new mixed technique in Image Compression using the Discrete Wavelet Transfo
... Show MoreThe researcher [1-10] proposed a method for computing the numerical solution to quasi-linear parabolic p.d.e.s using a Chebyshev method. The purpose of this paper is to extend the method to problems with mixed boundary conditions. An error analysis for the linear problem is given and a global element Chebyshev method is described. A comparison of various chebyshev methods is made by applying them to two-point eigenproblems. It is shown by analysis and numerical examples that the approach used to derive the generalized Chebyshev method is comparable, in terms of the accuracy obtained, with existing Chebyshev methods.
New complexes of Al(III) such as [Al (Ura) (Phen) (OH2) Cl ] Cl. 2H2O, [Al(Ura)2(OA)(OH2)Cl].H2O and [Al(Ura)3Cl3]H2O type, where (Ura)=Uracil, (Phen)= 1,10-Phenanthroline monohydrate and (OA)= Oxalic acid dihydrate, were prepared. The elemental microanalysis, FT.IR, electronic spectra, and magnetic susceptibility as well as the conductivity measurements are characterized. For isolated three complexes for six coordinated of Al(III) are proposed with molecular formulas that depend on the nature of (Ura), (Phen) and (OA) present. The suggested molecular structure into all complexes for aluminum ion is octahedral geometries .The antibacterial efficacy was examined from metal salt (AlCl3), ligands and metal complexes into the pathogenic bacteri
... Show MoreComplexes of Lanthanide ione Ln(III) =La(III) , Ce(III),Pr(III) and Nd(III) withligands of nicotinamide (na) and Benzimidazole (BIMD) have been prepared withgeneral formula [M(na)3(BIMD)3](NO3) where :M = Ln(III) = La(III) , Ce(III) , Gd(III) , Nd(III) .Na = nicotinamide = C7H6N2OBIMD = Benzimidazole = C7H6N2All compounds have been characterized by spectroscopic methods [FT-IR , UV-VIS ,AAS] , microanalysis (C.H.N) Along with conductivity measurements , solubility ,melting point , theroitical measurment by using chem office 3D prog .Model (2000) .Frome the above data the proposed moleculer structure for all complexes with its ionsis octahydral geometries
Theoretical and experimental investigations have been carried out on developing laminar
combined free and forced convection heat transfer in a vertical concentric annulus with uniformly
heated outer cylinder (constant heat flux) and adiabatic inner cylinder for both aiding and opposing
flows. The theoretical investigation involved a mathematical modeling and numerical solution for
two dimensional, symmetric, simultaneously developing laminar air flows was achieved. The
governing equations of motion (continuity, momentum and energy) are solved by using implicit
finite difference method and the Gauss elimination technique. The theoretical work covers heat flux
range from (200 to 1500) W/m2, Re range from 400 to 2000 an
This paper considers and proposes new estimators that depend on the sample and on prior information in the case that they either are equally or are not equally important in the model. The prior information is described as linear stochastic restrictions. We study the properties and the performances of these estimators compared to other common estimators using the mean squared error as a criterion for the goodness of fit. A numerical example and a simulation study are proposed to explain the performance of the estimators.
This study was conducted to assess the hydrocarbon degradation abilities of Sphingomonas paucimobilis, Pentoae species, Staphylococcus aureus, and Enterobacter cloacae, which isolated from diesel contaminated soil samples. Single strains and mixed bacterial consortia have been investigated their ability to degrade 1.0 % (v/v) of diesel oil in Bushnell- Haas medium as sole.carbon.and.energy.source. At temperature 30∘C, the individual.bacterial.isolates exhibited low growth and low degradation.than did the.mixed. bacterial.culture. After 28 days.of incubation the.combination.of four isolates degraded.an upper limit.of diesel 88.4%. This was. continued.by 85.1% by S. paucimobilis, 84 % by Pentoae sp., 79% by S.aureus, and
... Show MoreThe purpose of this research is to synthesize a new mixed ligand Schiff base complexes of Co(II),Ni(II),Cu(II), Zn(II), Cd(II), and Hg(II),which are formulated from the Schiff base (L) that resulted from orthophathalaldehyde (2-PA) with 4-chloroaniline(4-NA). Diagnosis of prepared Ligand and its complexes is done by spectral methods as 1H–NMR, mass spectrometer, FTIR, UV-Vis, molar conductance, elemental microanalyses, atomic absoption and magnetic susceptibility. The analytical studyofall new complexes has shown octahedral geometries. Organic performance study of ligand Schiff base and its complexes reveals different activities agansit four types of bactria; two gram (+) and two gram (-) .