State Estimation in Partially Observable Power Systems via Graph Signal Processing Tools.

This paper considers the problem of estimating the states in an unobservable power system, where the number of measurements is not sufficiently large for conventional state estimation. Existing methods are either based on pseudo-data that is inaccurate or depends on a large amount of data that is unavailable in current systems. This study proposes novel graph signal processing (GSP) methods to overcome the lack of information. To this end, first, the graph smoothness property of the states (i.e., voltages) is validated through empirical and theoretical analysis. Then, the regularized GSP weighted least squares (GSP-WLS) state estimator is developed by utilizing the state smoothness. In addition, a sensor placement strategy that aims to optimize the estimation performance of the GSP-WLS estimator is proposed. Simulation results on the IEEE 118-bus system show that the GSP methods reduce the estimation error magnitude by up to two orders of magnitude compared to existing methods, using only 70 sampled buses, and increase of up to 30% in the probability of bad data detection for the same probability of false alarms in unobservable systems The results conclude that the proposed methods enable an accurate state estimation, even when the system is unobservable, and significantly reduce the required measurement sensors.

An Innovative Method for the Conservative Treatment of Idiopathic Scoliosis Using the GraviSpine Device According to the Concept of Spinal Reflex Balance.

Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal reflex balance using the GraviSpine device. This study is a retrospective analysis of prospectively collected data. Methods: A total of 199 patients aged 6-17 years, with a mean age of 11.26 ± 3.35 years, including 168 girls (84.4%) and 31 boys (15.6%), out of a total of 830 patients treated for IS at the Scoliosis Treatment Center in 2014-2019 were included in the assessment, which was conducted according to the inclusion and exclusion criteria. The study group was divided into three age groups. Group A subjects were 6-9 years old; group B, 10-12 years old; and group C, 13-17 years old. The mean follow-up time was 28.71 ± 10.98 months. Treatment outcomes were compared, based on changes in the Cobb angle and the angle of trunk rotation before and after treatment, both within the groups and with respect to sex and curvature location, using the Wilcoxon signed-rank test. Cobb angle changes in patients were classified as improvements, stabilizations, or deteriorations according to the SOSORT criteria. Results: A majority of patients improved or stabilized after treatment, with 67%, 71%, and 90% of subjects in groups A, B, and C, respectively, achieving these results. In group C (the oldest children), a statistically significant reduction of -1.84° ± 6.88° (6.31%) in the mean Cobb angle was achieved after treatment. With regard to sex, improvements and stabilizations accounted for 81% of cases in girls and 61% in boys, respectively. With respect to location, statistically significant reductions in the Cobb angle were noted for thoracic and thoracolumbar spines of -2.2° ± 7.54° (10.17%) p = 0.022 and -2.2° ± 6.58° (6.36%) p = 0.049, respectively. A significant reduction in the mean angle of trunk rotation was obtained in the group and in three curvature locations. Conclusions: Based on the presented research findings, the utilization of the GraviSpine device as an adjunct to specific PSSE (physiotherapeutic scoliosis-specific exercises) physiotherapy and bracing in the management of pediatric patients with mild to moderate scoliosis appears to enhance treatment efficacy.

Schroth Physiotherapeutic Scoliosis-Specific Exercise (PSSE) Trials-Systematic Review of Methods and Recommendations for Future Research.

The Schroth method is a non-operative treatment for scoliosis and kyphosis, used standalone or as an adjunct to bracing. While supporting evidence for its effectiveness is emerging, methodologic standardization and rigor are equivocal. Thus, we aimed to systematically review methods of published Schroth physiotherapeutic scoliosis-specific exercise (PSSE) trials and provide guidance for future research. We searched six databases for randomized controlled trials (RCT) and non-randomized studies of interventions (NRSIs) investigating the effect of Schroth in children and adults with scoliosis or kyphosis. General characteristics, methodological approaches, treatment protocols, and outcomes reporting were analyzed. Risk of bias (RoB) was assessed using an adapted Cochrane RoB2 tool for RCTs and ROBINS-I for NRSI. Eligible studies (n = 7) were conducted in six countries and included patients with Scheuermann's kyphosis (n = 1) and adolescent idiopathic scoliosis (n = 6). Though all seven studies used the term Schroth to describe their interventions, the Schroth method was used in four of seven studies, of which only one used Schroth classification, three used Schroth therapists, and none prospectively registered the study protocol. Overall, methodological rigor was suboptimal, potentially invalidating evidence synthesis. Authors should follow minimum standards for reporting, including prospectively registering detailed protocols; using appropriate exercise labeling, Schroth classification and certified therapists; naming and describing exercises per classification; and providing therapy dosages, prescription methods, and adherence.

Improving Home-Based Scoliosis Therapy: Findings From a Web-Based Survey.

BACKGROUND: Conservative scoliosis therapy in the form of assisted physiotherapeutic scoliosis exercises is supplemented by self-contained training at home, depending on the approach (eg, Schroth, the Scientific Exercises Approach to Scoliosis). Complex exercises, lack of awareness of the importance of training, and missing supervision by therapists often lead to uncertainty and reduced motivation, which in turn reduces the success of home-based therapy. Increasing digitalization in the health care sector offers opportunities to close this gap. However, research is needed to analyze the requirements and translate the potential of digital tools into concrete solution concepts. OBJECTIVE: The aim of this study is to evaluate the potential for optimizing home-based scoliosis therapy in terms of motivation, assistive devices, and digital tools. METHODS: In collaboration with the Institute of Physiotherapy at the Jena University Hospital, a survey was initiated to address patients with scoliosis and physical therapists. A digital questionnaire was created for each target group and distributed via physiotherapies, scoliosis forums, the Bundesverband für Skoliose Selbsthilfe e. V. newsletter via a link, and a quick response code. The survey collected data on demographics, therapy, exercise habits, motivation, assistive devices, and digital tools. Descriptive statistics were used for evaluation. RESULTS: Of 141 survey participants, 72 (51.1%; n=62, 86.1%, female; n=10, 13.9%, male) patients with scoliosis with an average age of 40 (SD 17.08) years and 30 scoliosis therapists completed the respective questionnaires. The analysis of home-based therapy showed that patients with scoliosis exercise less per week (2 times or less; 45/72, 62.5%) than they are recommended to do by therapists (at least 3 times; 53/72, 73.6%). Patients indicated that their motivation could be increased by practicing together with friends and acquaintances (54/72, 75%), a supporting therapy device (48/72, 66.7%), or a digital profile (46/72, 63.9%). The most important assistive devices, which are comparatively rarely used in home-based therapy, included balance boards (20/72, 27.8%), wall bars (23/72, 31.9%), mirrors (36/72, 50%), and long bars (40/72, 55.6%). Therapists saw the greatest benefit of digital tools for scoliosis therapy in increasing motivation (26/30, 87%), improving home therapy (25/30, 83%), monitoring therapy progress (25/30, 83%), and demonstrating exercise instructions (24/30, 80%). CONCLUSIONS: In this study, we investigated whether there is any potential for improvement in home-based scoliosis therapy. For this purpose, using online questionnaires, we asked patients with scoliosis and therapists questions about the following topics: exercise habits, outpatient and home-based therapy, motivation, supportive devices, and digital tools. The results showed that a lack of motivation, suitable training equipment, and tools for self-control leads to a low training workload. From the perspective of the patients surveyed, this problem can be addressed through community training with friends or acquaintances, a supportive therapy device, and digital elements, such as apps, with training instructions and user profiles.

Reliability, Quality, and Educational Suitability of TikTok Videos as a Source of Information about Scoliosis Exercises: A Cross-Sectional Study.

This study aimed to systematically assess the informational reliability, quality, and educational suitability of videos introducing scoliosis exercises on TikTok. We retrieved and screened 1904 TikTok videos with the hashtags: "#scoliosis", "#scoliosisexercise", and "#scoliosistips", before collecting a final sample of 171 scoliosis exercises in March 2022. Then, two independent raters assessed the reliability and quality of the videos using the DISCERN instrument and evaluated the educational suitability of the information using "Scoliosis Exercise Education Score" (SEES; exercise cycle, target, effect, precaution, and rationale). None of the videos were rated as excellent or good according to DISCERN. The mean SEES score was 2.02 out of 5. Videos uploaded by health organizations had significantly lower DISCERN and SEES scores than those by general users and healthcare professionals. Regarding the propriety of physiotherapeutic scoliosis-specific exercises (PSSE), DISCERN and SEES scores were significantly higher in the PSSE proper group than in the PSSE non-proper group. Although TikTok has become a popular source of scoliosis-related information, the overall information quality, reliability, and educational suitability of videos on scoliosis exercises in TikTok appear to be low, suggesting that TikTok is not suitable source for obtaining scoliosis exercise information.

Brace and Physiotherapeutic Scoliosis Specific Exercises (PSSE) for Adolescent Idiopathic Scoliosis (AIS) treatment: a prospective study following Scoliosis Research Society (SRS) criteria.

BACKGROUND: A growing scientific evidence for conservative treatment of AIS has recently proved that bracing is superior to natural history. Our aim was to investigate the effectiveness of a combined treatment with brace and PSSE for AIS. METHODS: Prospective study, following SRS research inclusion criteria (> 10 years, 25ο - 40ο, Risser 0-2, < 1-year post-menarche, no prior treatment). 102 consecutive patients (87 females-15 males, mean age 12.8 years, Risser 0.48, Cobb Thoracic 29.2ο, Lumbar 27.8ο) received treatment with Cheneau brace and PSSE. Average follow-up time was 26.4 months. A scale from A to C was used to evaluate compliance with brace and PSSE (A: full-compliant, B: partially compliant, C: non-compliant). 7 subjects dropped-out (6.8%), so finally 95 patients included for statistical analysis, using paired t-test. RESULTS: Sixty-two patients (65.3%) remained stable, 22 improved > 5ο (23.2%) and 11 progressed (11.5%). In-brace correction (IBC) was 49.7% for thoracic and 61.7% for lumbar curves. Analysis of progressed cases revealed that IBC (31.7% for thoracic and 34.4% for lumbar curves) and compliance (81.8% C for brace, 63.6% C for PSSE) was lower than average. Group A for treatment compliance (65.3%), showed significantly better results (70.9% stable, 29.1% improved, 0% progressed). CONCLUSION: A combination of bracing and PSSE can effectively treat AIS, according to SRS inclusion criteria. 88.5% of patients avoided progression > 5ο and only 6.4% overpassed 40ο. IBC and compliance are the most important prognostic factors for successful treatment result. Early detection of AIS is also necessary for increased possibilities of effective conservative treatment.

Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice.

Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients' quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.

Effect of PSSE on postural sway in AIS using center of pressure.

We haven't known whether the center of pressure (COP) could be considered as a better indicator in the evaluation of posture and balance change after the physiotherapeutic scoliosis specific exercise (PSSE) during level walking. The objective of this study was: 1) to determine changes in COP displacement in anterior-posterior (COP-AP) and medial-lateral (COP-ML) for AIS following the PSSE; 2) to find out COP oscillation(COP-OS) from the midline for the left and right foot; 3) to investigate max pressure at the forefoot, midfoot and hindfoot bilaterally. AIS patients with three reflective markers on their back walked on the pressure sensors embedded treadmill at 2 km/h and their trunks were also registered by DIERS Formetric 4D system. Each child received the PSSE for 12 weeks by the same physical therapist and had a dynamic pressure analysis before and after the PSSE. Six AIS children at a mean age of 13 years and with averaged major Cobb angle of 26° were enrolled. There was an increase in COP-AP (15%) and a decrease in the COP-ML (-25%) following the PSSE. COP-OS on the left foot shifted farther away from the midline (about 16%) as the right side moved closer (-1%), which becomes more symmetrical (Pre-PSSE: 0.86mm & Post-PSSE: 0.32mm). There were increased pressures on the left (35%) and right (26%) hallux after PSSE. Pressure metrics, especially including COP-ML, COP-AP, COP-OS, and peak pressures on the forefoot, may be opted as optimal predictors to posture improvements by the means of PSSE.

Adult patient perceptions on the effectiveness of scoliosis specific exercises.

There is a paucity of research focusing on adults with scoliosis, yet many of these individuals suffer from pain and disability. Recent literature has demonstrated that for this patient population general physical therapy is no better than other non-operative treatment options.[1-3] This study assessed the perceptions of the effectiveness of Physiotherapeutic Scoliosis Specific Exercises (PSSE) on adult scoliosis. The purpose of this study is to present the results of a retrospective analysis of how adults with scoliosis perceive that physical therapy utilizing PSSE has impacted their quality of life (QoL), function, and pain. A 10 question survey was sent via a secure server (Qualtrics) to all PSSE participating patients ≥ 18 years old from one PSSE specialty clinic from the beginning of the PSSE program, 7 years. Survey responses were anonymous, collected by someone other than the primary investigator, and statistics were calculated with SPSS 24 (IBM Corp., Armonk, NY). Results: Fifty-seven adults (88.9% female) responded to the survey (55% response rate) with 67.2% being over the age of 55 years. The majority (61.9%) felt that PT had moderately or significantly positively impacted their QoL. The most common number of PT visits ranged from 5-10, after which 71.9% of participants were either somewhat or very confident in their ability to perform their PSSE program unsupervised at home. The most common frequency of home exercise program (HEP) performance was 1-2 times per week (46.0%) for a duration of 5-40 minutes. Quantitative analysis of exercise adherence using a Spearman's rho (rs) revealed positive associations between confidence in correctly performing the HEP with the perceived positive impact of the exercises (rs = .45, p < .001), the greater frequency of performing the HEP (rs = .30, p = .024) and greater time performing the HEP (rs = .33, p = .004). This retrospective analysis showed that 61.9% of adults with scoliosis felt that PT utilizing PSSE had moderately or significantly positively impacted their QoL. Adherence to a HEP is critical to the success of the program. Greater confidence in correctly performing the HEP was positively correlated with perceived impact, frequency and time spent exercising. The sample was limited to adults from one clinic that specializes in scoliosis and may not be generalizable to other clinics.

Optimized Power System Management Scheme for LSS PV Grid Integration in Malaysia Using Reactive Power Compensation Technique.

A large-scale solar photovoltaic system (LSS PV) aims to reduce the gap as Malaysia plans to shift electricity generation from conventional sources like fossil fuels to renewable energy sources. The government plans to increase renewable energy to 20% of the generation mix by 2025. The first and second round of Malaysia's LSS programme has 958 MW of PV projects to be realized by 2020. The third round of the LSS program goes for an aggregate capacity of 500 MW. Being an intermittent source of energy, the major complication is with grid integration of the LSS PV system into the national power grid. This research aims to identify an optimum power system management scheme for LSS in Malaysia to stabilize voltage fluctuations by utilizing IEEE bus configuration. The simulation and planning of network type is based on PSS/E and PVSyst. The expected outcome of this research is to develop a solution for LSS grid integration with minimal loss in the system and in accordance with electricity standards as per Malaysian grid code. Additionally, the harmony of incorporating power electronic devices for reactive power compensation is tested. This work can be stated as a reference model for utility provider in other countries having similar network and grid configuration.

Management of Spinal Deformities and Evidence of Treatment Effectiveness.

INTRODUCTION: The review evaluates the up-to-date evidence for the treatment of spinal deformities, including scoliosis and hyperkyphosis in adolescents and adults. MATERIAL AND METHODS: The PubMed database was searched for review articles, prospective controlled trials and randomized controlled trials related to the treatment of spinal deformities. Articles on syndromic scoliosis were excluded and so were the articles on hyperkyphosis of the spine with causes other than Scheuermann's disease and osteoporosis. Articles on conservative and surgical treatments of idiopathic scoliosis, adult scoliosis and hyperkyphosis were also included. For retrospective papers, only studies with a follow up period exceeding 10 years were included. RESULTS: The review showed that early-onset idiopathic scoliosis has a worse outcome than late-onset idiopathic scoliosis, which is rather benign. Patients with AIS function well as adults; they have no more health problems when compared to patients without scoliosis, other than a slight increase in back pain and aesthetic concern. Conservative treatment of adolescent idiopathic scoliosis (AIS) using physiotherapeutic scoliosis-specific exercises (PSSE), specifically PSSR and rigid bracing was supported by level I evidence. Yet to date, there is no high quality evidence (RCT`s) demonstrating that surgical treatment is superior to conservative treatment for the management of AIS. For adult scoliosis, there are only a few studies on the effectiveness of PSSEs and a conclusion cannot as yet be drawn.For hyperkyphosis, there is no high-quality evidence for physiotherapy, bracing or surgery for the treatment of adolescents and adults. However, bracing has been found to reduce thoracic hyperkyphosis, ranging from 55 to 80° in adolescents. In patients over the age of 60, bracing improves the balance score, and reduces spinal deformity and pain. Surgery is indicated in adolescents and adults in the presence of progression of kyphosis, refractory pain and loss of balance. DISCUSSION: The available evidence reviewed has suggested that different approaches are needed towards the management of different spinal deformities. Specific exercises should be prescribed in children and adolescents with a Cobb angle in excess of 15°. In progressive curves, they should be used in conjunction with bracing. Clarity regarding differences and similarities is given as to what makes PSSE and PSSR specific exercises. As AIS is relatively benign in nature, conservative treatment should be tried when the curve is at a surgical threshold, before surgery is considered. Similarly, bracing and exercises should be prescribed for patients with hyperkyphosis, particularly when the lumbar spine is afflicted. Surgery should be considered only when the symptoms cannot be managed conservatively. CONCLUSION: There is at present high quality evidence in support of the conservative treatment of AIS. The current evidence supports the use of PSSE, especially those using PSSR, together with bracing in the treatment of AIS. In view of the lack of medical consequences in adults with AIS, conservative treatment should be considered for curves exceeding the formerly assumed range of conservative indications.There is, however a lack of evidence in support of any treatment of choice for hyperkyphosis in adolescents and spinal deformities in adults. Yet, conservative treatment should be considered first. Yet to date, there is no high quality evidence (RCT`s) demonstrating that surgical treatment is superior to conservative treatment for the management of AIS and hyperkyphosis. Additionally, surgery needs to be considered with caution, as it is associated with a number of long-term complications.