Objective analysis of gait coordination for total knee arthroplasty outcome

Introduction: Coordination is a strategy chosen by the central nervous system to control the movements and maintain stability during gait. Coordinated multi-joint movements require a complex interaction between nervous outputs, biomechanical constraints, and pro-prioception. Quantitatively understanding and modeling gait coordination still remain a challenge. Surgeons lack a way to model and appreciate the coordination of patients before and after surgery of the lower limbs. Patients alter their gait patterns and their kinematic synergies when they walk faster or slower than normal speed to maintain their stability and minimize the energy cost of locomotion. The goal of this study was to provide a dynamical system approach to quantitatively describe human gait coordination and apply it to patients before and after total knee arthroplasty. Methods: A new method of quantitative analysis of interjoint coordination during gait was designed, providing a general model to capture the whole dynamics and showing the kinematic synergies at various walking speeds. The proposed model imposed a relationship among lower limb joint angles (hips and knees) to parameterize the dynamics of locomotion of each individual. An integration of different analysis tools such as Harmonic analysis, Principal Component Analysis, and Artificial Neural Network helped overcome high-dimensionality, temporal dependence, and non-linear relationships of the gait patterns. Ten patients were studied using an ambulatory gait device (Physilog®). Each participant was asked to perform two walking trials of 30m long at 3 different speeds and to complete an EQ-5D questionnaire, a WOMAC and Knee Society Score. Lower limbs rotations were measured by four miniature angular rate sensors mounted respectively, on each shank and thigh. The outcomes of the eight patients undergoing total knee arthroplasty, recorded pre-operatively and post-operatively at 6 weeks, 3 months, 6 months and 1 year were compared to 2 age-matched healthy subjects. Results: The new method provided coordination scores at various walking speeds, ranged between 0 and 10. It determined the overall coordination of the lower limbs as well as the contribution of each joint to the total coordination. The difference between the pre-operative and post-operative coordination values were correlated with the improvements of the subjective outcome scores. Although the study group was small, the results showed a new way to objectively quantify gait coordination of patients undergoing total knee arthroplasty, using only portable body-fixed sensors. Conclusion: A new method for objective gait coordination analysis has been developed with very encouraging results regarding the objective outcome of lower limb surgery.

Effectiveness of three different walking prescription durations on total physical activity in normal- and overweight women.

OBJECTIVE: While there is a dose-response relationship between physical activity (PA) and health benefit, little is known about the effectiveness of different PA prescriptions on total daily PA. AIM: To test, under real-life conditions and using an objective, non-invasive measurement technique (accelerometry), the effect of prescribing additional physical activity (walking only) of different durations (30, 60 and 90 min/day) on compliance (to the activity prescribed) and compensation (to total daily PA). Participants in each group were prescribed 5 sessions of walking per week over 4 weeks. METHODS: 55 normal-weight and overweight women (mean BMI 25 ± 5 kg/m(2), height 165 ± 1 cm, weight 68 ± 2 kg and mean age 27 ± 1 years) were randomly assigned to 3 prescription groups: 30, 60 or 90 min/day PA. RESULTS: Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription. Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions. In parallel, degree of compensation subsequent to exercise increased progressively as length of prescription increased. CONCLUSION: A 30-min prescription of extra walking 5 times per week was well tolerated. However, in order to increase total PA further, much more than 60 min of walking may need to be prescribed in the majority of individuals. While total exercise 'volume' increased with prescriptions longer than 30 min, compliance to the prescription decreased and greater compensation was evident. © 2014 S. Karger GmbH, Freiburg.

Indicators for the total number of melanocytic naevi : an adjunct for screening campaigns. Observational study on 292 patients.

BACKGROUND: The presence of multiple melanocytic naevi is a strong risk factor for melanoma. Use of the whole body naevus count to identify at-risk patients is impractical. OBJECTIVES: To (i) identify a valid anatomical predictor of total naevus count; (ii) determine the number of naevi that most accurately predict total naevus count above 25, 50 and 100; and (iii) evaluate determinants of multiple melanocytic naevi and atypical naevi. METHODS: Clinical data from 292 consecutive Spanish patients consulting for skin lesions requiring debriding were collected throughout 2009 and 2010. Correlations between site-specific and whole body naevus counts were analysed. Cut-offs to predict total naevus counts were determined using the area under the receiver operating characteristic curve. RESULTS: The studied population was young (median age 31 years, interquartile range 28-43). The naevus count on the right arm correlated best with the total nevus count (R(2) 0·80 for men, 0·86 for women). Presence of at least five naevi on the right arm was the strongest determinant of a total naevus count above 50 [odds ratio (OR) 34·4, 95% confidence interval (CI) 13·9-85·0] and of having at least one atypical naevus (OR 5·7, 95% CI 2·4-13·5). Cut-off values of 6, 8 and 11 naevi on the right arm best predicted total naevus count above 25, 50 and 100, respectively. CONCLUSIONS: Our results support the arm as a practical and reliable site to estimate the total naevus count when screening or phenotyping large populations. Threshold values for the number of naevi on the arm are proposed to help identify patients for melanoma screening.

Taxation and Total Government Take from the UK Continental Shelf (UKCS) Following Phase 3 of the European Emissions Trading Scheme (EU ETS)

NORTH SEA STUDY OCCASIONAL PAPER No. 117

Validity of impedance-based equations for the prediction of total body water as measured by deuterium dilution in African women.

BACKGROUND: Little information is available on the validity of simple and indirect body-composition methods in non-Western populations. Equations for predicting body composition are population-specific, and body composition differs between blacks and whites. OBJECTIVE: We tested the hypothesis that the validity of equations for predicting total body water (TBW) from bioelectrical impedance analysis measurements is likely to depend on the racial background of the group from which the equations were derived. DESIGN: The hypothesis was tested by comparing, in 36 African women, TBW values measured by deuterium dilution with those predicted by 23 equations developed in white, African American, or African subjects. These cross-validations in our African sample were also compared, whenever possible, with results from other studies in black subjects. RESULTS: Errors in predicting TBW showed acceptable values (1.3-1.9 kg) in all cases, whereas a large range of bias (0.2-6.1 kg) was observed independently of the ethnic origin of the sample from which the equations were derived. Three equations (2 from whites and 1 from blacks) showed nonsignificant bias and could be used in Africans. In all other cases, we observed either an overestimation or underestimation of TBW with variable bias values, regardless of racial background, yielding no clear trend for validity as a function of ethnic origin. CONCLUSIONS: The findings of this cross-validation study emphasize the need for further fundamental research to explore the causes of the poor validity of TBW prediction equations across populations rather than the need to develop new prediction equations for use in Africa.

Stereoselective total synthesis of some insect pheromones: (±)-serricornine and (±)-invictolide

An efficient (12 steps, 12% overallyield) and stereoselective total synthesis of (±)-serricornine (1) the sex pheromone of the cigarette beetle (Lasioderma serricornine F) is described. The preparation of intermediate 5, which encompasses the proper relative configuration of three contiguous chiral centers of (±)-invictolide, (3), is discussed.

La qualitat informativa de les agències a Catalunya. Comparativa entre EFE, Europa Press y ACN

Anàlisi de la qualitat informativa de les tres agències amb implantació a Catalunya – EFE, Europa Press i ACN – a través d’un estudi de la seva història, dels seus llibres d’estil i d’un anàlisi ortogràfic, gramàtic i lèxic de les notícies que publiquen.

El Catàleg Col·lectiu de les Universitats de Catalunya: control de qualitat i detecció de duplicats en la creació d'una base de dades bibliogràfica

La ponència fa una introducció sobre la teoria, els objectius i els problemes de la detecció i l'eliminació de registres duplicats en bases de dades bibliogràfiques. A continuació, s'explica el procés de creació del Catàleg Col.lectiu de les Universitats de Catalunya (CCUC) amb una breu introducció històrica. Finalment s'analitza i es descriu el procés d'elaboració i el funcionament del programa de detecció de duplicats del CCUC.

Del Noguerola al Segre: els problemes de la qualitat ambiental de l'aigua

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. Els principals objectius del treball són intentar demostrar, cinc anys més tard, si el riu Noguerola és encara fruit d'abocaments residuals en el seu pas subterrani per la ciutat de Lleida, i observar i analitzar com el riu Segre sofreix múltiples impactes ambientals provinents, especialment, de les activitats agrícoles i ramaderes. Es van fer dos campanyes de mostrejos en les confluències de 10 afluents dels marges dret i esquerre del riu Segre, i en 5 punts al llarg d'aquest. Per a cada mostra es van analitzar: conductivitat, temperatura, ph, nitrats, nitrits, amoni, fosfats, duresa i microorganismes. A més a més, es van delimitar i determinar les superfícies de les conques i es van fer balanços hidrometeorològics per determinar les aportacions naturals de l’aigua de pluja, i es van estimar els excedents de reg de totes les conques, per així calcular les masses totals de cada paràmetre, aportades per cada afluent. Les principals conclusions a què s’ha arribat són: que el riu Noguerola continua sent fruit d'abocaments residuals en el seu pas subterrani per la ciutat de Lleida. I que, tant les activitats agrícoles i ramaderes, com les captacions d'aigua dels canals de Balaguer i de Seròs per a l’obtenció d’energia hidroelèctrica, provoquen greus impactes ambientals al riu Segre.

Síntesi i control de qualitat de biodièsel

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. Aquest treball té com a base donar les pautes necessàries per a l'obtenció de biodièsel i determinar-ne la seva acceptabilitat. Per tal de que això sigui possible, s'han sintetitzat biodièsels provinents d'oli de girasol refinat, d'oli d'oliva refinat, i d'aquests mateixos fregits al emprar-los al cuinar. Un cop sintetitzats se'ls hi ha realitzat una sèrie d'anàlisis fisicoquímics per tal de determinar-ne la seva acceptabilitat mitjançant una comparativa amb els resultats obtinguts amb un dièsel comercial, així com amb els límits que marca la unió europea en l'esborrany final de la norma prEN 14214.

Participació i qualitat democràtica: proposta de criteris de qualitat en l'anàlisi de processos de participació local a Catalunya

L’objectiu de la tesina és doble: 1. D’una banda, presentar una sèrie de criteris de qualitat democràtica pensats per avaluar processos participatius 2. D’altra banda, tot seguint el model presentat en el primer apartat de la tesina, he realitzat una temptativa d’avaluació de la qualitat democràtica dels processos participatius impulsats per l’administració local a Catalunya durant els darrers anys.

Implantació del distintiu de garantia de qualitat ambiental als establiments de turisme rural d'influència al Parc del Garraf

El present projecte té com a objecte d’estudi l’anàlisi de la situació ambiental en que es troben els ETR de l’àrea d’influència del Parc del Garraf (PG). En una primera fase, s’inventarien i analitzen els 12 ETR més propers als límits del sistema natural del PG, Parc d’Olèrdola i Foix a partir d’una ecofitxa de criteris ambientals d’àmbit general. Posteriorment, s’estudia la viabilitat d’implantació del Distintiu de Garantia de Qualitat Ambiental (DGQA) en els 6 ETR pilot escollits a partir d’una segona ecofitxa creada a partir dels criteris del distintiu. D’aquest detallat estudi s’extreuen relacions interessants com per exemple, que els ETR més aïllats del nucli urbà fan servir el doble de sistemes per obtenir energia que els establiments ubicats al recinte urbà i que actualment, el preu segueix estant més associat a confort que no pas a compromís ambiental. Finalment, s’elaboren unes propostes de millora i els pressupostos associats per que aquests ETR puguin complir les exigències del distintiu.

Outcomes and reoperations after total correction of complete atrio-ventricular septal defect

BACKGROUND: Surgical correction of complete atrio-ventricular septal defect (AVSD) achieves satisfactory results with low morbidity and mortality, but may require reoperation. Our recent operative results at mid-term were followed-up. METHODS: From June 2000 to December 2007, 81 patients (Down syndrome; n=60), median age 4.0 months (range 0.7-118.6) and weight 4.7kg (range 2.2-33), underwent complete AVSD correction. Patch closure for the ventricular septal defect (VSD; n=69) and atrial septal defect (ASD; n=42) was performed with left atrio-ventricular valve (LAVV) cleft closure (n=76) and right atrio-ventricular valve (RAVV) repair (n=57). Mortality, morbidity, and indications for reoperation were retrospectively studied; the end point 'time to reoperation' was analyzed using Kaplan-Meier curves. Follow-up was complete except in two patients and spanned a median of 28 months (range 0.4-6.1 years). RESULTS: In-hospital mortality was 3.7% (n=3) and one late death occurred. Reoperation was required in 7/79 patients (8.9%) for LAVV insufficiency (n=4), for a residual ASD (n=1), for right atrio-ventricular valve insufficiency (n=1), and for subaortic stenosis (n=1). At last follow-up, no or only mild LAVV and RAVV insufficiency was present in 81.3% and 92.1% of patients, respectively, and 2/3 of patients were medication-free. Risk factors for reoperation were younger age (<3 months; p=0.001) and lower weight (<4kg; p=0.003), and a trend towards less and later reoperations in Down syndrome (p<0.2). CONCLUSIONS: Surgical correction of AVSD can be achieved with low mortality and need for reoperation, regardless of Down syndrome or not. Immediate postoperative moderate or more residual atrio-ventricular valve insufficiency will eventually require a reoperation, and could be anticipated in patients younger than 3 months and weighing <4kg.