Long-term follow-up after stroke in childhood

Over the last few years, the importance of paediatric stroke has become more and more evident; however, there is still little known about long-term neurological and especially neuropsychological outcome of these children. By retrospective chart review, questionnaire and clinical examination with structured interview, we analysed initial presentation, aetiology and long-term outcome of children suffering ischaemic childhood stroke between 1985 and 1999. A total of 20 children (13 boys) suffered acute arterial ischaemic events. Aetiology was detected in 14, and suspected in another five. Follow-up after 1-15 years (mean 7 years) was possible for 16 children; two had died and two were lost to follow-up. Only two were completely healthy, five suffered mild, six moderate, and three severe handicap. Eleven children presented with combined neurological and neuropsychological problems. Neurological problems were mild to moderate hemisyndrome in 11, dysphasia, epilepsy and other in six each. Mild to severe neuropsychological problems were detected in 13 children, school problems in eight, attention deficits in nine and behaviour problems in seven, increased fatigability and headache in six each. Recurrence was observed in three children, all due to progressive underlying disease. Outcome was most affected by the presence of combined cortical/subcortical and least affected by subcortical infarction. Epilepsy affected neuropsychological outcome. CONCLUSION: although prognosis of paediatric stroke is better than for adult stroke, neurological and especially neuropsychological long-term problems significantly influence the lives of these children. Careful long-term follow-up to support these children in their school career and integration into professional life is necessary. Future studies should evaluate whether specific treatments during the acute episode could improve outcome for these children.

Surgical capping of superior semicircular canal dehiscence

Surgical plugging and resurfacing are well established treatments of superior semicircular canal dehiscence, while capping with hydroxyapatite cement has been little discussed in literature. The aim of this study was to prove the efficacy of the capping technique. Charts of patients diagnosed with superior semicircular canal dehiscence were reviewed retrospectively. All patients answered the dizziness handicap inventory, a survey analyzing the impact of their symptoms on their quality of life. Capping of the dehiscent canal was performed via the middle fossa approach in all cases. Ten out of 22 patients diagnosed with superior semicircular canal dehiscence were treated with surgical capping, nine of which were included in this study. No major perioperative complications occurred. In 8 out of 9 (89 %) patients, capping led to a satisfying reduction of the main symptoms. One patient underwent revision surgery 1 year after the initial intervention. Scores in the dizziness handicap inventory were lower in the surgically treated group than in the non-surgically treated group, but results were not statistically significant (P = 0.45). Overall, capping is a safe and efficient alternative to plugging and resurfacing of superior semicircular canal dehiscence.

The influence of body mass index on injury pattern in polytrauma: thorax as the main source of complications

Background: Obesity is a growing problem in industrial nations. The aim of this study was to determine the relationship between the body mass index (BMI) and the pattern of injury after polytrauma. Methods: This retrospective study included 651 patients with an injury severity score (ISS) ≥16 and aged ≥16 years who were subdivided into three groups: BMI < 25 kg/m2, BMI 25–30 kg/m2, and BMI > 30 kg/m2. The Abbreviated Injury Scale (AIS) was used to quantify the injuries in the different anatomical regions. The Murray score was assessed at admission and at its maximum during hospitalization to evaluate pulmonary problems. Data are presented as means ± standard errors of the means. One way analysis of variance, χ2 test and Kruskal-Wallis test were used for the analyses and the significance level was set at p < 0.05. Results: The AIS of the thorax was 3.2 ± 0.1 in the BMI < 25 kg/m2 group, 3.3 ± 0.1 in the BMI 25–30 kg/m2 group, and 2.8 ± 0.2 in the BMI > 30 kg/m2 group; p < 0.05. The Murray score at admission increased significantly with increasing BMI (0.8 ± 0.8 for BMI < 25 kg/m2, 0.9 ± 0.9 for BMI 25–30 kg/m2, and 1.0 ± 0.8 for BMI > 30 kg/m2; p < 0.05) as was the maximum Murray score during hospitalization (1.2 ± 0.9 for BMI < 25 kg/m2, 1.6 ± 1.0 for BMI 25–30 kg/m2, and 1.5 ± 0.9 for BMI > 30 kg/m2; p < 0.001). The number of ventilator days was also elevated significantly with increasing BMI (5.9 ± 0.4 for BMI < 25 kg/m2, 7.7 ± 0.8 for BMI 25–30 kg/m2, and 7.9 ± 1.6 for BMI > 30 kg/m2; p < 0.05). Conclusion: Overweight and obesity lead to a higher incidence of thoracic trauma in a polytrauma situation and may additionally handicap ventilation in an obstructive manner.

Isothermal loop-mediated amplification (LAMP) for diagnosis of contagious bovine pleuro-pneumonia.

BACKGROUND Contagious Bovine Pleuropneumonia (CBPP) is the most important chronic pulmonary disease of cattle on the African continent causing severe economic losses. The disease, caused by infection with Mycoplasma mycoides subsp. mycoides is transmitted by animal contact and develops slowly into a chronic form preventing an early clinical diagnosis. Because available vaccines confer a low protection rate and short-lived immunity, the rapid diagnosis of infected animals combined with traditional curbing measures is seen as the best way to control the disease. While traditional labour-intensive bacteriological methods for the detection of M. mycoides subsp. mycoides have been replaced by molecular genetic techniques in the last two decades, these latter approaches require well-equipped laboratories and specialized personnel for the diagnosis. This is a handicap in areas where CBPP is endemic and early diagnosis is essential. RESULTS We present a rapid, sensitive and specific diagnostic tool for M. mycoides subsp. mycoides detection based on isothermal loop-mediated amplification (LAMP) that is applicable to field conditions. The primer set developed is highly specific and sensitive enough to diagnose clinical cases without prior cultivation of the organism. The LAMP assay detects M. mycoides subsp. mycoides DNA directly from crude samples of pulmonary/pleural fluids and serum/plasma within an hour using a simple dilution protocol. A photometric detection of LAMP products allows the real-time visualisation of the amplification curve and the application of a melting curve/re-association analysis presents a means of quality assurance based on the predetermined strand-inherent temperature profile supporting the diagnosis. CONCLUSION The CBPP LAMP developed in a robust kit format can be run on a battery-driven mobile device to rapidly detect M. mycoides subsp. mycoides infections from clinical or post mortem samples. The stringent innate quality control allows a conclusive on-site diagnosis of CBPP such as during farm or slaughter house inspections.

The quiet eye and tasks demands: Do tougher shots need a quieter eye?

The Quiet Eye (QE; Vickers 1996) has been shown to underpin successful performance, differentiating both expertise (inter-individual) and proficiency (intra-individual), with experts and successful attempts characterised by longer QE durations. The QE is proposed to reflect the time needed to organise and fine tune the parameters of movement (e.g. force and direction). In order to examine this prediction and build upon previous research we experimentally manipulated the difficulty of a golf putting task; we hypothesised that if the QE is related to motor programming then a more difficult task should be associated with longer QE durations. 33 golfers (M age= 21.16, SD= 3.98) with an average handicap of 6.5 (SD= 6.02) performed putts in 4 conditions of increasing difficulty. We manipulated the length of the golf putt (short-4ft, long-8ft) and the contact point of the putter head (large-1.7cm, small-0.5cm,) giving increasingly difficult putting conditions of short-large [1], short-small [2], long-large [3] and long-small [4]. We measured performance (radial error from hole in cm) and QE (in ms) for 10 putts in each condition. A repeated measures ANOVA was performed on the performance and QE data. The performance data suggest that we were successful in increasing the difficulty of the task (F (3,93) = 26.46. p = .000), with the best performance in condition [1] (8.57cm), followed by [2] (9.10cm) followed by [3] (16.11cm) and finally the worst performance was in condition [4] (23.40cm). The QE data suggest that, in keeping with our hypothesis, the QE was lengthened as task difficulty increased (F (3,87) = 11.91, p = .043). The QE was shortest in condition [1] (1787.85ms) and increased to condition [2] (1939.78ms) and condition [3] (2076.51ms), with the longest QE in condition [4] (2164.08ms). More detailed analysis of the QE reveal that it was the proportion of the QE that occurred before movement initiation (pre-QE) which increased with shot difficulty, rather than the proportion that occurred during the swing (Online-QE; see Vine et al., 2013). Results support the notion that more complex tasks are associated with a longer QE duration, specifically participants appear to spend longer fixating the target prior to movement. This likely reflects the time needed to process visual information gathered in a pre-performance routine, to inhibit external distraction, and to pre-programme the increasingly difficult parameters of the movement. Vickers, J.N. (1996). Visual control when aiming at a far target. Journal of Experimental Psychology: Human Perception and Performance, 22, 342-354. Vine, S.J. et al. (2013). Quiet eye and choking: Online control breaks down at the point of performance failure. Medicine and Science in Sports and Exercise, 45, 1988-1994.

Le genre comme ressource politique en Suisse. La perception de l'élite politique

Traditionnellement un monde d’homme, la politique fonctionne encore aujourd’hui selon des règles faites par et pour les hommes. Malgré cet univers hostile à la gente féminine, les femmes sont entrées en politique dès que les pays leurs ont accordés les droits politiques. Toujours minoritaire, les femmes se sont aujourd’hui faites une place dans les parlements et gouvernements du monde. L’augmentation de la proportion de femmes dans les instances politiques laisse supposer qu’être une femme ne constitue pas obligatoirement un handicap en politique. Ce livre s’intéresse à ce changement de signification du genre féminin en politique et montre, à l’exemple de la Suisse, comment les membres de l’élite politique perçoivent le rôle du genre dans les affaires publiques. Cette étude s’adresse à toute personne intéressée par les rapports de genre dans le monde du pouvoir.

Patient-reported outcomes of maxillary implant-supported overdentures compared with conventional dentures

OBJECTIVE The aim of the present prospective clinical study was to compare patient-reported outcomes for maxillary conventional dentures and maxillary implant-supported dentures. MATERIAL AND METHODS Twenty-one patients (6 women and 15 men) being edentulous in the maxilla and encountering problems with their existing dentures were included. Twelve patients (4 women and 8 men) received a new set of conventional dentures, due to insufficient dentures. In nine patients (2 women and 7 men), the existing dentures were adjusted by means of relining or rebasing. All patients received implant-supported dentures on two retentive anchors. In total, 42 implants were inserted in the anterior maxilla. The participants rated their satisfaction on their existing conventional dentures, 2 months after insertion of new conventional dentures and 2 months after insertion of implant-supported dentures. Thereby, patients responded to questionnaires capturing the oral health impact profile (OHIP) using visual analog scales. Seven domains (functional limitation, physical pain, psychological discomfort, physical, psychological and social disability and handicap) were assessed. Higher scores implied poorer patient satisfaction. In addition, the questionnaire involved the evaluation of cleaning ability, general satisfaction, speech, comfort, esthetics, stability, and chewing ability. Higher scores implied higher patient satisfaction. RESULTS Patient satisfaction significantly increased for implant-supported dentures compared with old dentures in all seven OHIP subgroups, as well as for cleaning ability, general satisfaction, ability to speak, comfort, esthetics, and stability (P < 0.05). The comparison of new conventional dentures and implant-supported dentures revealed a statistically significantly increased satisfaction for functional limitation (difference of 33.2 mm), psychological discomfort (difference of 36.7 mm), physical disability (difference of 36.3 mm), and social disability (difference of 23.5 mm), (P < 0.05). Additionally, general satisfaction, chewing ability, speech, and stability significantly improved in implant-supported dentures (P < 0.05). CONCLUSIONS Within the limits of this study, maxillary dentures retained by two implants provided some significant short-term improvements over conventional dentures in oral- and health-related quality of life.

Stuck in Mobility? Fragmented Journeys of Migrants without Chances of Admission in Europe

This paper is about young migrants without chance of being granted legal residence status in the Schengen zone. Previous observations suggest that some migrants, whose country of origin leaves them with low chances of receiving asylum or in fact any type of residence permit, exhibit a highly complex migration pattern that is characterised by 1) durable “transit” across Europe, which is a multi-linear movement according to opportunities that open up along the journey; 2) a high degree of flexibility, as they have to respond to suddenly changing conditions, such as work opportunities, rejection of asylum claims, detention or deportation, and 3) switching between different legal statuses, such as asylum seeker, sans papiers or detainee. The experiences of these young adults thus show a deep ambivalence between a sense of autonomy, on the one hand, and of profound hope and powerlessness, on the other. The Dublin Convention intends to limit such a hypermobility of migrants but seems to fail in many cases. Simultaneously it provokes some of the movements by sending asylum seekers and irregular migrants back to their first country of arrivals. Given the fact that little is known about these fragmented journeys inside of the Schengen area, this ethnographic study produces novel data on a highly pertinent migration pattern, the impact of the European migration management on individual migrants as well as the inter-relatedness of the asylum regime and irregular migration in Europe. At the same time these fragmented journeys are an excellent example to discuss mobility as a resource on the one hand (since it enables this specific migrant group to extend their presence in Europe) and as a handicap on the other (since it impedes the building of stable social networks, the planning of the future, etc.).

Take me to a Place Outside

The film is the result of a participatory media project with female offenders at HM Styal prison. Eight women present and represent an imagined outside through dimensions of the visual and aural offering alternative ways for understanding their realities. Focusing on the imagination shaped by the experience of absences and presences this film is a sensory journey into these women's worlds of desire, longing and relief.

Identification of maltreatment type in children with disabilities using the National Child Abuse and Neglect Data System (NCANDS)

This study was a retrospective design and used secondary data from the National Child Abuse and Neglect Data System (NCANDS), provided by the National Data Archive on Child Abuse and Neglect Family Life Development Center administered by Cornell University. The dataset contained information for the year 2005 on children from birth to 18 years of age. Child abuse and neglect for disabled children, was evaluated in-depth in the present study. Descriptive and statistical analysis was performed using the children with and without disabilities. It was found that children with disabilities have a lower rate of substantiation that likely indicates the interference of reporting due to their handicap. The results of this research demonstrate the important need to teach professionals and laypersons alike on how to recognize and substantiate abuse among disabled children.^

Cary's Illustrated and Priced Catalogue: Surgical Instruments, Physicians, Hospital Supplies, and Furnishings, Druggist Sundries, Etc.

Second Edition. Pp.5-61 General Surgical Necessities, Gauze, Antiseptic Sundries, Surgical Sundries, Rubber Bandages, Catheters, Bougies, Splints, Tents, Emergency Bags, Surgeon's Needles, Operating Instruments, Amputating, Forceps, Aspiration, Cases, Catheters and Directors, Pocket Case Instruments, Dissecting and Post-Mortem Pp.62-118 General Operating - Osteotomy, Mastoid, Trephining, Eye Instruments, Aural, Nasal, Mouth and Throat, Tooth Forceps, Laryngoscopic Sets, Hydraulic Air Compressor, Variocele, Genito Urinary Pp. 119-167 Genito Urinary-Lithotrity, Alimentary, Anal and Rectal, Gynaecological, Pessaries, Microscopes, Syringes Pp.168-205 Chemical Apparatus and Glassware, Physician's Cabinets, Office Furniture, Operating Chairs and Tables, Hospital Beds, Cautery, Electrolytic, Batteries Pp.206-246 Cases, Varicose, Braces, Abdominal Supporters, Trusses, Invalid Chairs and Supplies, Sterilizers, Saddle-Bags, Deformity Apparatus Advertisements: Bandages, Abdominal Supporters, Rubber Supplies, Bags, Batteries, Cotton, Microscopes, Hypodermic Tablets, Atomizers, Furniture, Sterilizers, Syringes

De la ciudad en vibración al ser resonante: Una investigación a propósito de los conciertos de campanas de Llorenç Barber

Este trabajo tiene la vocación de dibujar el mapa de los dominios de oportunidad que hay a disposición de un arquitecto, al imaginar el aspecto sonoro de la ciudad en relación con la campana. Muchas de las dimensiones señaladas, tanto conocidas como desconocidas, son sencillamente despertadas al estudio de lo que un diseñador del espacio sonoro, como Llorenç Barber, viene a decirnos, desde una disciplina aparentemente contactada, pero muchas veces paralela a la arquitectónica. Tomando los conciertos de campanas celebrados hasta la fecha como puestas en práctica real de la condición instrumental de más de doscientas ciudades de todo el mundo, el estudio analiza los hallazgos, éxitos y fracasos, obtenidos a lo largo de estos últimos veinticinco años de experiencia, como resultados explícitos de un trabajo sonoro en la ciudad, probado, contrastado y afinado, del que extraer indicaciones concretas susceptibles de ser aplicadas en el diseño del espacio urbano. Mediante un análisis triangular de vértices definidos: emisor-campana, medio-ciudad, receptor-ciudadano; la investigación aborda los aspectos relativos a la producción y recepción del fenómeno sonoro generado por la campana en la ciudad. En relación con la producción, una parte del trabajo se dedica al estudio de los efectos acústicos observados, ordenado por escalas graduales en las que se produce una distribución del sonido susceptible de diseño: el vaso de la campana, la sala de campanas, el campanario, el cuerpo del edificio, la ciudad y el territorio. A modo de cajas de resonancia y leídas como muñecas rusas, unas dentro de otras, los espacios identificados muestran cualidades sonoras específicas, definidas tanto por sus condiciones geométricas, formales, constructivas o de uso; como por las correspondientes a las subsiguientes cajas que alojan. A fin de esclarecer la influencia de tales cuestiones en el aspecto sonoro de la ciudad, se propone un modelo ordenado de conexión y desconexión de escalas, utilizando una paramétrica puramente técnica creada ex profeso, junto con variables metodológicas más tradicionales. Al mismo tiempo, y tratando de esclarecer cómo, al ser puesta en vibración, la ciudad es aprehendida, disfrutada y rememorada por el ciudadano-oyente, otra parte del trabajo se dedica al estudio de los aspectos relativos a su recepción aural en deambulación compartida. En este caso la investigación se propone reclamar otras dimensiones más subversivas que, si bien escapan a los modos habituales de trabajar del arquitecto, se revelan intensamente en la experiencia plurifocal, multiplicando los efectos a considerar: efectos funcionales y significativos, de reconocimiento, integración y pertenencia a un cuerpo territorial y social de coordenadas históricas y geográficas de nuevo significadas; efectos perceptuales de inmersión, ubicuidad, temporalidad o inestabilidad; efectos estéticos, de rememoración, interpretación simbólica y recreación poética; e incluso efectos políticos, descubriendo un espacio urbano en continua regeneración, lugar para la exposición en su doble acepción, para la exhibición y el peligro, o como contenedor situacional del más profundo sentido ciudadano. Para afinar la relevancia de lo obtenido en cada una de las dimensiones señaladas, el trabajo se articula en tres aproximaciones graduales: el corpus general de los conciertos celebrados hasta la fecha; los conciertos celebrados en España; los tres conciertos para Madrid: Magna Mater (1991), Festi Clamores (2000) y Aurea Catena (2007). Si bien el modelo propuesto nace a la luz de los conciertos de campanas de Llorenç Barber, a escala de una ciudad entera y con una intención compositiva individual, se entiende que sería útil para el uso ordenado de cualquier profesional interesado en el aspecto sonoro de la ciudad, faceta escasamente atendida, dicho sea de paso, desde la disciplina arquitectónica. ABSTRACT This work has the vocation of drawing out the numerous opportunities an architect has at his disposal, upon imagining the sonorous aspect of the city in relation to the bell. Many of the dimensions indicated, both known and unknown, are just awakened to the study of what a sound space designer, as Llorenç Barber, comes to tell us, from a discipline apparently contacted, but often parallel to the architecture. Taking the bell concerts held so far as actual implementation of the instrumental condition of over two hundred cities around the world, the study analyzes the findings, successes and failures, obtained over the last twenty years of experience, as explicit results of a sound work in the city, tested, verified and refined, from which to extract specific indications that can be applied in the design of urban space. By triangular analyzing of defined vertices: sender-bell, half-city, receptor-citizen; the research addresses issues relating to the production and reception of sound phenomenon generated by the bell in the city. In relation to production, part of the work is devoted to the study of observed acoustic effects, ordered gradual scale which produces a distribution of sound capable of design: the glass of the bell, the bell room, the bell tower and the body of the building, the city and territory. By way of sounding boards and read as if they were Russian dolls, one inside the other, the show spaces identified specific sound qualities, defined both for their geometric, formal, constructive use, such as those for hosting the subsequent boxes. In order to clarify the influence of such issues in the sound aspect of the city, we propose an ordered pattern of connection and disconnection of scales, using a purely parametric technique created on purpose, along with more traditional methodological variables. At the same time, and trying to clarify how, when set in vibration, the city is apprehended, enjoyed and remembered for the citizen-listener, another part of the work is devoted to the study of aspects of aural reception in shared ambulation. In this case the research aims to claim more subversive than other dimensions, but beyond the usual ways in which an architect works, the experience reveals intensely plurifocal multiplying effects to consider: functional effects and significant recognition and integration belonging to a body of territorial and social historical and geographical coordinates of new meaning and perceptual effects of immersion, ubiquity, timeliness or instability; aesthetic effects of recall, interpretation and recreation of symbolic poetic; and even political effects, revealing a continuous urban space regeneration site for the exhibition in its double meaning, for display and danger, or as a citizen sense container. To sharpen the relevance of what was obtained in each of the dimensions mentioned, the work is divided into three incremental approaches: the general corpus of the concerts held so far, the concerts in Spain, the three concerts for Madrid: Magna Mater (1991), Festi Clamores (2000) and Aurea Catena (2007). While the proposed model comes in the light of the bells concert Llorenç Barber, the scale of a whole city and individual compositional intent, it is understood that it would be useful for the orderly use of any professional interested in the sound aspect of the city, an aspect sparsely attended, incidentally, from the architectural discipline.

Metodologías de modelado, monitorización y asistencia robótica en neurorrehabilitación funcional de extremidad superior

La Organización Mundial de la Salud (OMS) prevé que para el año 2020, el Daño Cerebral Adquirido (DCA) estará entre las 10 causas más comunes de discapacidad. Estas lesiones, dadas sus consecuencias físicas, sensoriales, cognitivas, emocionales y socioeconómicas, cambian dramáticamente la vida de los pacientes y sus familias. Las nuevas técnicas de intervención precoz y el desarrollo de la medicina intensiva en la atención al DCA han mejorado notablemente la probabilidad de supervivencia. Sin embargo, hoy por hoy, las lesiones cerebrales no tienen ningún tratamiento quirúrgico que tenga por objetivo restablecer la funcionalidad perdida, sino que las terapias rehabilitadoras se dirigen hacia la compensación de los déficits producidos. Uno de los objetivos principales de la neurorrehabilitación es, por tanto, dotar al paciente de la capacidad necesaria para ejecutar las Actividades de Vida Diaria (AVDs) necesarias para desarrollar una vida independiente, siendo fundamentales aquellas en las que la Extremidad Superior (ES) está directamente implicada, dada su gran importancia a la hora de la manipulación de objetos. Con la incorporación de nuevas soluciones tecnológicas al proceso de neurorrehabilitación se pretende alcanzar un nuevo paradigma centrado en ofrecer una práctica personalizada, monitorizada y ubicua con una valoración continua de la eficacia y de la eficiencia de los procedimientos y con capacidad de generar conocimientos que impulsen la ruptura del paradigma de actual. Los nuevos objetivos consistirán en minimizar el impacto de las enfermedades que afectan a la capacidad funcional de las personas, disminuir el tiempo de incapacidad y permitir una gestión más eficiente de los recursos. Estos objetivos clínicos, de gran impacto socio-económico, sólo pueden alcanzarse desde una apuesta decidida en nuevas tecnologías, metodologías y algoritmos capaces de ocasionar la ruptura tecnológica necesaria que permita superar las barreras que hasta el momento han impedido la penetración tecnológica en el campo de la rehabilitación de manera universal. De esta forma, los trabajos y resultados alcanzados en la Tesis son los siguientes: 1. Modelado de AVDs: como paso previo a la incorporación de ayudas tecnológicas al proceso rehabilitador, se hace necesaria una primera fase de modelado y formalización del conocimiento asociado a la ejecución de las actividades que se realizan como parte de la terapia. En particular, las tareas más complejas y a su vez con mayor repercusión terapéutica son las AVDs, cuya formalización permitirá disponer de modelos de movimiento sanos que actuarán de referencia para futuros desarrollos tecnológicos dirigidos a personas con DCA. Siguiendo una metodología basada en diagramas de estados UML se han modelado las AVDs 'servir agua de una jarra' y 'coger un botella' 2. Monitorización ubícua del movimiento de la ES: se ha diseñado, desarrollado y validado un sistema de adquisición de movimiento basado en tecnología inercial que mejora las limitaciones de los dispositivos comerciales actuales (coste muy elevado e incapacidad para trabajar en entornos no controlados); los altos coeficientes de correlación y los bajos niveles de error obtenidos en los corregistros llevados a cabo con el sistema comercial BTS SMART-D demuestran la alta precisión del sistema. También se ha realizado un trabajo de investigación exploratorio de un sistema de captura de movimiento de coste muy reducido basado en visión estereoscópica, habiéndose detectado los puntos clave donde se hace necesario incidir desde un punto de vista tecnológico para su incorporación en un entorno real 3. Resolución del Problema Cinemático Inverso (PCI): se ha diseñado, desarrollado y validado una solución al PCI cuando el manipulador se corresponde con una ES humana estudiándose 2 posibles alternativas, una basada en la utilización de un Perceptrón Multicapa (PMC) y otra basada en sistemas Artificial Neuro-Fuzzy Inference Systems (ANFIS). La validación, llevada a cabo utilizando información relativa a los modelos disponibles de AVDs, indica que una solución basada en un PMC con 3 neuronas en la capa de entrada, una capa oculta también de 3 neuronas y una capa de salida con tantas neuronas como Grados de Libertad (GdLs) tenga el modelo de la ES, proporciona resultados, tanto de precisión como de tiempo de cálculo, que la hacen idónea para trabajar en sistemas con requisitos de tiempo real 4. Control inteligente assisted-as-needed: se ha diseñado, desarrollado y validado un algoritmo de control assisted-as-needed para una ortesis robótica con capacidades de actuación anticipatoria de la que existe un prototipo implementado en la actualidad. Los resultados obtenidos demuestran cómo el sistema es capaz de adaptarse al perfil disfuncional del paciente activando la ayuda en instantes anteriores a la ocurrencia de movimientos incorrectos. Esta estrategia implica un aumento en la participación del paciente y, por tanto, en su actividad muscular, fomentándose los procesos la plasticidad cerebral responsables del reaprendizaje o readaptación motora 5. Simuladores robóticos para planificación: se propone la utilización de un simulador robótico assisted-as-needed como herramienta de planificación de sesiones de rehabilitación personalizadas y con un objetivo clínico marcado en las que interviene una ortesis robotizada. Los resultados obtenidos evidencian como, tras la ejecución de ciertos algoritmos sencillos, es posible seleccionar automáticamente una configuración para el algoritmo de control assisted-as-needed que consigue que la ortesis se adapte a los criterios establecidos desde un punto de vista clínico en función del paciente estudiado. Estos resultados invitan a profundizar en el desarrollo de algoritmos más avanzados de selección de parámetros a partir de baterías de simulaciones Estos trabajos han servido para corroborar las hipótesis de investigación planteadas al inicio de la misma, permitiendo, asimismo, la apertura de nuevas líneas de investigación. Summary The World Health Organization (WHO) predicts that by the year 2020, Acquired Brain Injury (ABI) will be among the ten most common ailments. These injuries dramatically change the life of the patients and their families due to their physical, sensory, cognitive, emotional and socio-economic consequences. New techniques of early intervention and the development of intensive ABI care have noticeably improved the survival rate. However, in spite of these advances, brain injuries still have no surgical or pharmacological treatment to re-establish the lost functions. Neurorehabilitation therapies address this problem by restoring, minimizing or compensating the functional alterations in a person disabled because of a nervous system injury. One of the main objectives of Neurorehabilitation is to provide patients with the capacity to perform specific Activities of the Daily Life (ADL) required for an independent life, especially those in which the Upper Limb (UL) is directly involved due to its great importance in manipulating objects within the patients' environment. The incorporation of new technological aids to the neurorehabilitation process tries to reach a new paradigm focused on offering a personalized, monitored and ubiquitous practise with continuous assessment of both the efficacy and the efficiency of the procedures and with the capacity of generating new knowledge. New targets will be to minimize the impact of the sicknesses affecting the functional capabilitiies of the subjects, to decrease the time of the physical handicap and to allow a more efficient resources handling. These targets, of a great socio-economic impact, can only be achieved by means of new technologies and algorithms able to provoke the technological break needed to beat the barriers that are stopping the universal penetration of the technology in the field of rehabilitation. In this way, this PhD Thesis has achieved the following results: 1. ADL Modeling: as a previous step to the incorporation of technological aids to the neurorehabilitation process, it is necessary a first modelling and formalization phase of the knowledge associated to the execution of the activities that are performed as a part of the therapy. In particular, the most complex and therapeutically relevant tasks are the ADLs, whose formalization will produce healthy motion models to be used as a reference for future technological developments. Following a methodology based on UML state-chart diagrams, the ADLs 'serving water from a jar' and 'picking up a bottle' have been modelled 2. Ubiquitous monitoring of the UL movement: it has been designed, developed and validated a motion acquisition system based on inertial technology that improves the limitations of the current devices (high monetary cost and inability of working within uncontrolled environments); the high correlation coefficients and the low error levels obtained throughout several co-registration sessions with the commercial sys- tem BTS SMART-D show the high precision of the system. Besides an exploration of a very low cost stereoscopic vision-based motion capture system has been carried out and the key points where it is necessary to insist from a technological point of view have been detected 3. Inverse Kinematics (IK) problem solving: a solution to the IK problem has been proposed for a manipulator that corresponds to a human UL. This solution has been faced by means of two different alternatives, one based on a Mulilayer Perceptron (MLP) and another based on Artificial Neuro-Fuzzy Inference Systems (ANFIS). The validation of these solutions, carried out using the information regarding the previously generated motion models, indicate that a MLP-based solution, with an architecture consisting in 3 neurons in the input layer, one hidden layer of 3 neurons and an output layer with as many neurons as the number of Degrees of Freedom (DoFs) that the UL model has, is the one that provides the best results both in terms of precission and in terms of processing time, making in idoneous to be integrated within a system with real time restrictions 4. Assisted-as-needed intelligent control: an assisted-as-needed control algorithm with anticipatory actuation capabilities has been designed, developed and validated for a robotic orthosis of which there is an already implemented prototype. Obtained results demonstrate that the control system is able to adapt to the dysfunctional profile of the patient by triggering the assistance right before an incorrect movement is going to take place. This strategy implies an increase in the participation of the patients and in his or her muscle activity, encouraging the neural plasticity processes in charge of the motor learning 5. Planification with a robotic simulator: in this work a robotic simulator is proposed as a planification tool for personalized rehabilitation sessions under a certain clinical criterium. Obtained results indicate that, after the execution of simple parameter selection algorithms, it is possible to automatically choose a specific configuration that makes the assisted-as-needed control algorithm to adapt both to the clinical criteria and to the patient. These results invite researchers to work in the development of more complex parameter selection algorithms departing from simulation batteries Obtained results have been useful to corroborate the hypotheses set out at the beginning of this PhD Thesis. Besides, they have allowed the creation of new research lines in all the studied application fields.

Effects of binaural stimulation in attention and EEG

When two pure tones of slightly different frequency are presented separately to each ear, the listener perceives a third single tone with amplitude variations at a frequency that equals the difference between the two tones, this perceptual illusion is known as binaural auditory beat. There are anecdotal reports that suggest that the binaural beat can entrain EEG activity and may affect the arousal levels, although few studies have been published. There is a need for double-blind, well-designed studies in order to establish a solid foundation for these sounds, as most of the documented benefits come from self-reported cases that could be affected by placebo effect. As BB’s are a cheap technology (it even exists a free open source programmable bin aural-beat generator on the internet named Gnaural), any achievement in this area could be of public interest. The aim in our research was to explore the potential of BB’s in a particular field: tasks that require focus and concentration. In order to detect changes in the brain waves that could relate to any particular improvement, EEG recordings of a small sample of individuals were also obtained. In this study we compare the effect of different binaural stimulation in 7 EEG frequency ranges, 78 participants were exposed to 20 min binaural beat stimulation. The effects were obtained both qualitative with cognitive test and quantitative with EEG analysis. Results suggest no significant statistical improvement in 20 min stimulation.

Modelización de reacciones químicas en presencia de un campo electromagnético variable

En esta tesis se aborda el estudio del proceso de isomerización del sistema molecular LiNC/LiCN tanto aislado como en presencia de un pulso láser aplicando la teoría del estado de transición (TST). Esta teoría tiene como pilar fundamental el hecho de que el conocimiento de la dinámica en las proximidades de un punto de silla de la superficie de energía potencial permite determinar los parámetros cinéticos de la reacción objeto de estudio. Históricamente, existen dos formulaciones de la teoría del estado de transición, la versión termodinámica de Eyring (Eyr38) y la visión dinámica de Wigner (Wig38). Ésta última ha sufrido recientemente un amplio desarrollo, paralelo a los avances en sistemas dinámicos que ha dado lugar a una formulación geométrica en el espacio de fases que sirve como base al trabajo desarrollado en esta tesis. Nos hemos centrado en abordar el problema desde una visión fundamentalmente práctica, ya que la teoría del estado de transición presenta una desventaja: su elevado coste computacional y de tiempo de cálculo. Dos han sido los principales objetivos de este trabajo. El primero de ellos ha sido sentar las bases teóricas y computacionales de un algoritmo eficiente que permita obtener las magnitudes fundamentales de la TST. Así, hemos adaptado con éxito un algoritmo computacional desarrollado en el ámbito de la mecánica celeste (Jor99), obteniendo un método rápido y eficiente para la obtención de los objetos geométricos que rigen la dinámica en el espacio de fases y que ha permitido calcular magnitudes cinéticas tales como el flujo reactivo, la densidad de estados de reactivos y productos y en última instancia la constante de velocidad. Dichos cálculos han sido comparados con resultados estadísticos (presentados en (Mül07)) lo cual nos ha permitido demostrar la eficacia del método empleado. El segundo objetivo de esta tesis, ha sido la evaluación de la influencia de los parámetros de un pulso electromagnético sobre la dinámica de reacción. Para ello se ha generalizado la metodología de obtención de la forma normal del hamiltoniano cuando el sistema químico es alterado mediante una perturbación temporal periódica. En este caso el punto fijo inestable en cuya vecindad se calculan los objetos geométricos de interés para la aplicación de la TST, se transforma en una órbita periódica del mismo periodo que la perturbación. Esto ha permitido la simulación de la reactividad en presencia de un pulso láser. Conocer el efecto de esta perturbación posibilita el control de la reactividad química. Además de obtener los objetos geométricos que rigen la dinámica en una cierta vecindad de la órbita periódica y que son la clave de la TST, se ha estudiado el efecto de los parámetros del pulso sobre la reactividad en el espacio de fases global así como sobre el flujo reactivo que atraviesa la superficie divisoria que separa reactivos de productos. Así, se ha puesto de manifiesto, que la amplitud del pulso es el parámetro más influyente sobre la reactividad química, pudiendo producir la aparición de flujos reactivos a energías inferiores a las de aparición del sistema aislado y el aumento del flujo reactivo a valores constantes de energía inicial. ABSTRACT We have studied the isomerization reaction LiNC/LiCN isolated and perturbed by a laser pulse. Transition State theory (TST) is the main tool we have used. The basis of this theory is knowing the dynamics close to a fixed point of the potential energy surface. It is possible to calculate kinetic magnitudes by knowing the dynamics in a neighbourhood of the fixed point. TST was first formulated in the 30's and there were 2 points of view, one thermodynamical by Eyring (Eyr38) and another dynamical one by Wigner (Wig38). The latter one has grown lately due to the growth of the dynamical systems leading to a geometrical view of the TST. This is the basis of the work shown in this thesis. As the TST has one main handicap: the high computational cost, one of the main goals of this work is to find an efficient method. We have adapted a methodology developed in the field of celestial mechanics (Jor99). The result: an efficient, fast and accurate algorithm that allows us to obtain the geometric objects that lead the dynamics close to the fixed point. Flux across the dividing surface, density of states and reaction rate coefficient have been calculated and compared with previous statistical results, (Mül07), leading to the conclusion that the method is accurate and good enough. We have widen the methodology to include a time dependent perturbation. If the perturbation is periodic in time, the fixed point becomes a periodic orbit whose period is the same as the period of the perturbation. This way we have been able to simulate the isomerization reaction when the system has been perturbed by a laser pulse. By knowing the effect of that perturbation we will be able to control the chemical reactivity. We have also studied the effect of the parameters on the global phase space dynamics and on the flux across the dividing surface. It has been prove that amplitude is the most influent parameter on the reaction dynamics. Increasing amplitude leads to greater fluxes and to some flux at energies it would not if the systems would not have been perturbed.