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.
Mixed-effects conditional logistic regression is evidently more effective in the study of qualitative differences in longitudinal pollution data as well as their implications on heterogeneous subgroups. This study seeks that conditional logistic regression is a robust evaluation method for environmental studies, thru the analysis of environment pollution as a function of oil production and environmental factors. Consequently, it has been established theoretically that the primary objective of model selection in this research is to identify the candidate model that is optimal for the conditional design. The candidate model should achieve generalizability, goodness-of-fit, parsimony and establish equilibrium between bias and variab
... Show MoreIn this research, the problem of multi- objective modal transport was formulated with mixed constraints to find the optimal solution. The foggy approach of the Multi-objective Transfer Model (MOTP) was applied. There are three objectives to reduce costs to the minimum cost of transportation, administrative cost and cost of the goods. The linear membership function, the Exponential membership function, and the Hyperbolic membership function. Where the proposed model was used in the General Company for the manufacture of grain to reduce the cost of transport to the minimum and to find the best plan to transfer the product according to the restrictions imposed on the model.
New polydentate ligand namely bis(N-carboxylatoethyl)-0,0`-dipyridinium) L was synthesised from the reaction of 0,0`-dipyridine with ethyl chloropropionate. Polymeric complexes of general formulae [Cr2(L)(N3)0]Cl2.H2O, Na2[Ag2(L)(N3)0].H2O and [M2(L)(N3)0].nH2O, where (M= Mn(II), Fe(II), Co(II), Ni(II), Cu(II), Zn(II) and Cd(II); (where n = 2;1;1;1;4;1 and 1, respectively)) are reported. The mode of bonding and overall geometry of the complexes were determined through physico-chemical and spectroscopic methods. These studies revealed octahedral geometry complexes. Molecular structure for the complexes has been optimised by CS Chem 3D Ultra Molecular Modelling and Analysis Program and supported a six coordinate geometry.
This paper presents the synthesis and study of some new mixed-ligand complexes containing anthranilic acid and amino acid phenylalanine (phe) with some metals . The resulting products were found to be solid crystalline complexes which have been characterized by using (FT-IR,UV-Vis) spectra , melting point, elemental analysis (C.H.N) , molar conductivity . The proposed structure of the complexes using program , chem office 3D(2000) . The general formula have been given for the prepared complexes : [M(A-H)(phe-H)] M(II): Hg(II) , Mn(II) ,Co(II) , Ni(II) , Cu(II) , Zn(II) , Cd(II) . A = Anthranilic acid = C7H7NO2 Phe = phenylalanine = C9H11NO2
The study aims at finding out:
1. The students' attitude towards the mixed learning at the university.
2. The statistically significant differences in attitude towards the mixed learning at the university according to the specialization variable.
3. The statistically significant differences in attitude towards the mixed learning at the university according to the gender variable.
The researcher has constructed a scale for measuring the students' attitude towards the mixed learning at the university.
After assuring its validity and reliability, the scale has been given to a sample of (100) students. The sample is selected randomly from (4) colleges of the university of Baghdad, (2) for scientific specialization and (2)for h
Background: Lateral sinus augmentation and simultaneous insertion of dental implants is a highlypredictable procedure and associated with high rate of implants success.Aims: To evaluate implant stability changes following maxillary sinus augmentation utilizing deproteinizedbovine bone alone or mixed with platelet-rich fibrin.Materials and Methods: A total of 34 lateral sinus augmentation procedures were performed and 50 dentalimplants simultaneously installed. The lateral sinus augmentation cases were allocated randomly into 3groups: Group A comprised 13 procedures and 21 dental implants utilizing solely deproteinized bovine bone.Group B involved 10 cases and 16 dental implants using deproteinized bovine bone mixed with leukocyteand
... Show MoreThe national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions.
This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The stud