The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles

DESIGN: A randomized controlled trial.OB JECTIVE: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND : Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P =.003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE : Therapy, level 1b. J Orthop Sports Phys Ther 2010;40(5):310-317. doi:10.2519/jospt.2010.3257. KEYWORDSDS: cervical manipulation, muscle trigger points, neck, TMJ, upper cervical.

Energy and ancillary services joint market simulation

In order to develop a flexible simulator, a variety of models for Ancillary Services (AS) negotiation has been implemented in MASCEM – a multi-agent system competitive electricity markets simulator. In some of these models, the energy and the AS are addressed simultaneously while in other models they are addressed separately. This paper presents an energy and ancillary services joint market simulation. This paper proposes a deterministic approach for solving the energy and ancillary services joint market. A case study based on the dispatch of Regulation Down, Regulation Up, Spinning Reserve, and Non-Spinning Reserve services is used to demonstrate that the use of the developed methodology is suitable for solving this kind of optimization problem. The presented case study is based on CAISO real AS market data considers fifteen bids.

Competitive dynamics for behavior coordination in a joint transportation task

We address the problem of coordinating two non-holonomic mobile robots that move in formation while transporting a long payload. A competitive dynamics is introduced that gradually controls the activation and deactivation of individual behaviors. This process introduces (asymmetrical) hysteresis during behavioral switching. As a result behavioral oscillations, due to noisy information, are eliminated. Results in indoor environments show that if parameter values are chosen within reasonable ranges then, in spite of noise in the robots communi- cation and sensors, the overall robotic system works quite well even in cluttered environments. The robots overt behavior is stable and smooth.

A sensor classification strategy for robotic manipulators

In practice the robotic manipulators present some degree of unwanted vibrations. The advent of lightweight arm manipulators, mainly in the aerospace industry, where weight is an important issue, leads to the problem of intense vibrations. On the other hand, robots interacting with the environment often generate impacts that propagate through the mechanical structure and produce also vibrations. In order to analyze these phenomena a robot signal acquisition system was developed. The manipulator motion produces vibrations, either from the structural modes or from endeffector impacts. The instrumentation system acquires signals from several sensors that capture the joint positions, mass accelerations, forces and moments, and electrical currents in the motors. Afterwards, an analysis package, running off-line, reads the data recorded by the acquisition system and extracts the signal characteristics. Due to the multiplicity of sensors, the data obtained can be redundant because the same type of information may be seen by two or more sensors. Because of the price of the sensors, this aspect can be considered in order to reduce the cost of the system. On the other hand, the placement of the sensors is an important issue in order to obtain the suitable signals of the vibration phenomenon. Moreover, the study of these issues can help in the design optimization of the acquisition system. In this line of thought a sensor classification scheme is presented. Several authors have addressed the subject of the sensor classification scheme. White (White, 1987) presents a flexible and comprehensive categorizing scheme that is useful for describing and comparing sensors. The author organizes the sensors according to several aspects: measurands, technological aspects, detection means, conversion phenomena, sensor materials and fields of application. Michahelles and Schiele (Michahelles & Schiele, 2003) systematize the use of sensor technology. They identified several dimensions of sensing that represent the sensing goals for physical interaction. A conceptual framework is introduced that allows categorizing existing sensors and evaluates their utility in various applications. This framework not only guides application designers for choosing meaningful sensor subsets, but also can inspire new systems and leads to the evaluation of existing applications. Today’s technology offers a wide variety of sensors. In order to use all the data from the diversity of sensors a framework of integration is needed. Sensor fusion, fuzzy logic, and neural networks are often mentioned when dealing with problem of combing information from several sensors to get a more general picture of a given situation. The study of data fusion has been receiving considerable attention (Esteban et al., 2005; Luo & Kay, 1990). A survey of the state of the art in sensor fusion for robotics can be found in (Hackett & Shah, 1990). Henderson and Shilcrat (Henderson & Shilcrat, 1984) introduced the concept of logic sensor that defines an abstract specification of the sensors to integrate in a multisensor system. The recent developments of micro electro mechanical sensors (MEMS) with unwired communication capabilities allow a sensor network with interesting capacity. This technology was applied in several applications (Arampatzis & Manesis, 2005), including robotics. Cheekiralla and Engels (Cheekiralla & Engels, 2005) propose a classification of the unwired sensor networks according to its functionalities and properties. This paper presents a development of a sensor classification scheme based on the frequency spectrum of the signals and on a statistical metrics. Bearing these ideas in mind, this paper is organized as follows. Section 2 describes briefly the robotic system enhanced with the instrumentation setup. Section 3 presents the experimental results. Finally, section 4 draws the main conclusions and points out future work.

Using fractional derivatives for the joint ontrol of hexapod robots

This article studies several Fractional Order Control algorithms used for joint control of a hexapod robot. Both Padé and series approximations to the fractional derivative are considered for the control algorithm. The walking performance is evaluated through two indices: The mean absolute density of energy used per unit distance travelled, and the control effort. A set of simulation experiments reveals the influence of the different approximations upon the proposed indices. The results show that the fractional proportional and derivative algorithm, implemented using the Padé approximation with a small number of terms, gives the best results.

Implementação e integração do modelo de acreditação da Joint Commission International na unidade de imagiologia do Hospital Privado da Boavista

Este trabalho descreve a abordagem abrangente sobre a melhoria do sistema de gestão da qualidade na Unidade de Imagiologia do Hospital da Boavista através da implementação das normas de acreditação da Joint Commission International (JCI). Fundamental para a melhoria geral da qualidade é a redução contínua de riscos para os doentes e para os profissionais da Unidade. Tais riscos podem existir ao nível do ambiente físico assim como no circuito dos exames e dos doentes. A acreditação em Saúde é uma das prioridades estratégicas do Ministério da Saúde e tem como objetivo fortalecer a confiança dos cidadãos nos profissionais de saúde bem como nas instituições de saúde. É importante que Portugal cultive a melhoria da qualidade e segurança nas instituições de saúde mantendo uma relação adequada custo/benefício. A União Europeia tem feito um esforço para que a acreditação seja harmoniosa nos seus princípios, no entanto é respeitada sempre a prevalência da legislação de cada país, bem como as suas especificações culturais e religiosas (Shaw, 2006), responsabilizando-o pelo seu sistema de saúde O trabalho aqui apresentado tem como objetivo principal fundamentar a escolha do modelo de acreditação da JCI para o Hospital da Boavista, nomeadamente para a Unidade de Imagiologia, ver se os padrões estão de acordo com os procedimentos da Unidade, identificar falhas e apontar possiveis melhorias. Pretende-se ainda mostrar a importância da implementação dos sistemas de certificação e acreditação da gestão da qualidade, documentada pela experiência profissional, bem como o know-how do Hospital da Boavista, assim como a complementaridade dos programas da gestão da qualidade, certificação e acreditação. A escolha do modelo de acreditação da JCI, foi uma opção do Hospital da Boavista baseada na credibilidade e no grau de exigência que a entidade impõe. Foi imperativo que a Unidade de Imagiologia realizasse as suas funções de forma válida e fiável e que disponibilizasse produtos / serviços de qualidade. A monitorização e consequente controlo de qualidade do serviço prestado pela Unidade de Imagiologia, foi difícil mas simplificado, em parte, devido ao sistema de gestão da qualidade ISO 9001:2008 já implementado, tendo este sido consolidado com a implementação da acreditação da JCI, com padrões específicos bem definidos na gestão do controlo de qualidade na Unidade de Imagiologia do Hospital da Boavista.

Joint effects of salinity and the antidepressant sertraline on the estuarine decapod Carcinus maenas

Concurrent exposure of estuarine organisms to man-made and natural stressors has become a common occurrence. Numerous interactions of multiple stressors causing synergistic or antagonistic effects have been described. However, limited information is available on combined effects of emerging pharmaceuticals and natural stressors. This study investigated the joint effects of the antidepressant sertraline and salinity on Carcinus maenas. To improve knowledge about interactive effects and potential vulnerability,experiments were performed with organisms from two estuaries with differing histories of exposure to environmental contamination. Biomarkers related to mode of action of sertraline were employed to assess effects of environmentally realistic concentrations of sertraline at two salinity levels. Synergism and antagonism were identified for biomarkers of cholinergic neurotransmission, energy production,anti-oxidant defences and oxidative damage. Different interactions were found for the two study sites highlighting the need to account for differences in tolerance of local ecological receptors in risk evaluations.

Smart Grid Market Using Joint Energy and Ancillary Services Bids

The power systems operation in the smart grid context increases significantly the complexity of their management. New approaches for ancillary services procurement are essential to ensure the operation of electric power systems with appropriate levels of stability, safety, quality, equity and competitiveness. These approaches should include market mechanisms which allow the participation of small and medium distributed energy resources players in a competitive market environment. In this paper, an energy and ancillary services joint market model used by an aggregator is proposed, considering bids of several types of distributed energy resources. In order to improve economic efficiency in the market, ancillary services cascading market mechanism is also considered in the model. The proposed model is included in MASCEM – a multi-agent system electricity market simulator. A case study considering a distribution network with high penetration of distributed energy resources is presented.

Integration in MASCEM of the Joint Dispatch of Energy and Reserves Provided by Generation and Demand Resources

The provision of reserves in power systems is of great importance in what concerns keeping an adequate and acceptable level of security and reliability. This need for reserves and the way they are defined and dispatched gain increasing importance in the present and future context of smart grids and electricity markets due to their inherent competitive environment. This paper concerns a methodology proposed by the authors, which aims to jointly and optimally dispatch both generation and demand response resources to provide the amounts of reserve required for the system operation. Virtual Power Players are especially important for the aggregation of small size demand response and generation resources. The proposed methodology has been implemented in MASCEM, a multi agent system also developed at the authors’ research center for the simulation of electricity markets.

Ensaio para a implementação de procedimentos de um plano de manutenção das juntas de dilatação do estádio do Dragão

No Estádio do Dragão existem doze juntas de dilatação localizadas simetricamente, que separam o estádio em doze corpos independentes, com o objetivo de minimizar a fendilhação provocada pelas movimentações da estrutura resultantes da solicitação de ações diretas e, principalmente, indiretas nessa mesma estrutura. Neste relatório explicar-se-á a importância, causas e objetivos que levam à necessidade de utilização destas juntas de dilatação em geral nas edificações, e no caso particular do estádio referido. Este elemento estrutural é considerado pela empresa responsável pela manutenção do Estádio do Dragão como a causa de um dos principais problemas recorrentes no estádio que necessitam de uma exigente atenção. Esta consideração deve-se ao fato das intervenções nas juntas de dilatação terem um custo de manutenção bastante oneroso e também pelo frequente aparecimento de novas patologias associadas a este elemento, tais como infiltrações de água, que necessitam de uma reparação urgente. Portanto, no sentido de resolver estas patologias decorrentes do mau funcionamento dos sistemas de juntas existentes no Estádio do Dragão, foi proposto pela PortoEstádio a elaboração de procedimentos de um plano de manutenção das juntas de dilatação que permitisse planear as intervenções e mitigar o aparecimento dessas patologias, com o objetivo principal de minimizar os custos inerentes à manutenção das juntas de dilatação. Estes procedimentos solicitados e demais elementos complementares são apresentados no presente trabalho, com a classificação dos sistemas de juntas do Estádio do Dragão, identificação das principais patologias nos diversos sistemas de juntas, escolha de novos sistemas para substituição dos existentes no estádio e finalmente, a criação de uma calendarização de intervenções nas juntas para a implementação de um plano de manutenção preventiva neste elemento de grande importância estrutural.