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Process discovery helps companies automatically discover their existing business processes based on the vast, stored event log. The process discovery algorithms have been developed rapidly to discover several types of relations, i.e., choice relations, non-free choice relations with invisible tasks. Invisible tasks in non-free choice, introduced by $$\alpha ^{\$ }$$ α $ method, is a type of relationship that combines the non-free choice and the invisible task. $$\alpha ^{\$ }$$ α $ proposed rules of ordering relations of two activities for determining invisible tasks in non-free choice. The event log records sequences of activities, so the rules of $$\alpha ^{\$ }$$ α $ check the combination of invisible task within non-free choice. The checking processes are time-consuming and result in high computing times of $$\alpha ^{\$ }$$ α $ . This research proposes Graph-based Invisible Task (GIT) method to discover efficiently invisible tasks in non-free choice. GIT method develops sequences of business activities as graphs and determines rules to discover invisible tasks in non-free choice based on relationships of the graphs. The analysis of the graph relationships by rules of GIT is more efficient than the iterative process of checking combined activities by $$\alpha ^{\$ }$$ α $ . This research measures the time efficiency of storing the event log and discovering a process model to evaluate GIT algorithm. Graph database gains highest storing computing time of batch event logs; however, this database obtains low storing computing time of streaming event logs. Furthermore, based on an event log with 99 traces, GIT algorithm discovers a process model 42 times faster than α++ and 43 times faster than α$. GIT algorithm can also handle 981 traces, while α++ and α$ has maximum traces at 99 traces. Discovering a process model by GIT algorithm has less time complexity than that by $$\alpha ^{\$ }$$ α $ , wherein GIT obtains $$O(n^{3} )$$ O ( n 3 ) and $$\alpha ^{\$ }$$ α $ obtains $$O(n^{4} )$$ O ( n 4 ) . Those results of the evaluation show a significant improvement of GIT method in term of time efficiency.

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Background: Peripheral glucocorticoid receptors (GRs) are altered by peripheral nerve injury and may modulate the development of neuropathic pain. Two central pathogenic mechanisms underlying neuropathic pain are neuroinflammation and N-methyl-D-aspartate receptor (NMDAR)-dependent neural plasticity in the spinal cord. Objectives: This study examined the effect of the non-competitive NMDAR antagonist dextromethorphan on partial sciatic nerve ligation (PSL)-induced neuropathic pain and the spinal expression of the glucocorticoid receptor (GR). Methods: Male mice were randomly assigned into a sham group and two groups receiving PSL followed by intrathecal saline vehicle or dextromethorphan (iDMP). Vehicle or iDMP was administered 8 - 14 days after PSL. The hotplate paw-withdrawal latency was considered to measure thermal pain sensitivity. The spinal cord was then sectioned and immunostained for GR. Results: Thermal hyperalgesia developed similarly in the vehicle and iDMP groups prior to the injections (P = 0.828 and 0.643); however, it was completely mitigated during the iDMP treatment (P < 0.001). GR expression was significantly higher in the vehicle group (55.64 ± 4.50) than in the other groups (P < 0.001). The iDMP group (9.99 ± 0.66) showed significantly higher GR expression than the sham group (6.30 ± 1.96) (P = 0.043). Conclusions: The suppression of PLS-induced thermal hyperalgesia by iDMP is associated with the downregulation of GR in the spinal cord, suggesting that this analgesic effect is mediated by inhibiting GR-regulated neuroinflammation.

Since it was first introduced, a variety of modification techniques to block the impar ganglion appear such as transsacrococcygeal ligament technique, sacrococcygeal transdiscal approach, paramedian approach, and a two-needle technique using fluoroscopy or computed tomography scan. For therapeutic purposes, a combination of steroid and local anesthetic, neurolysis agents such as alcohol, phenol, cryolesioning, and heat lesioning using radiofrequency thermocoagulation could be used. Here, we reported a successful outcome in treating chronic perineal pain in a 65-year-old patient using combination of neurolysis agent which was alcohol 96% and radiofrequency thermocoagulation.

Background Spinal cord injury (SCI) is a significant cause of morbidity since it results in the inflammation process which leads to necrosis or apoptosis. Inflammatory response to the tissue damage increases IL-6 and IL-8 levels. ACTH4–10Pro8-Gly9-Pro10 is a peptide community that has been shown to have a beneficial effect on minimizing the morbidity and increasing the recovery time. Methods This study is a true experimental laboratory research with a totally randomized method. The subjects were animal models with light and extreme compression of spinal cord, respectively. Results The administration of ACTH 4–10 in mild SCI in the 3-hour observation group did not show a significant difference in IL-6 expression compared with the 6-hour observation group. The administration of ACTH 4–10 in severe SCI showed a significantly lower expression level of IL-6 in the 3-hour observation group compared with the 6-hour one. The administration of ACTH 4–10 in severe SCI led to a significantly lower IL-8 expression in the 3-hour observation group compared with the 6-hour one. However, there was no significant difference in IL-8 expression in the group receiving ACTH 4–10 in 3 hours observation compared with that in 6 hours observation. Conclusion The administration of ACTH4–10Pro8-Gly9-Pro10 can reduce the expression of IL-6 and IL-8 at 3-hour and 6-hour observation after mild and severe SCI in animal models. Future research works are recommended.

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Highlights Some of piriformis syndrome intractable with conservative treatment. Surgery was indicated for intractable piriformis syndrome. Piriformis resection can be a feasible option for intractable piriformis syndrome. Piriformis resection decrease visual analog scale in intractable piriformis syndrome.