Efectividad clínica de la intervención terapéutica sobre la mano con realidad virtual en sujetos hemipléjicos: revisión sistemática

Objetivo Revisar de forma sistemática y realizar una evaluación critica de las diferentes publicaciones existentes sobre el uso de la realidad virtual como elemento rehabilitador en la mano. Estrategias de búsqueda Se ha realizado una búsqueda en la base de datos Medline completada con búsquedas en Google Schoolar. Se ha limitado la búsqueda a 10 años de extensión, idiomas: inglés y español. Selección de estudios: se ha centrado sobre aquellos artículos relacionados con la realidad virtual y la rehabilitación funcional de la mano en el accidente cerebrovascular. Síntesis de resultados Debido a la falta de homogeneidad, no ha sido posible evaluar metodológicamente mediante instrumento Caspe. Se detectaron 200 artículos de los cuales 12 cumplen los criterios de selección de los mismos. Dichos artículos han sido agrupados en relación con diferentes criterios como son: tipo de estudio, sistema de evaluación utilizado, periféricos usados o resultados obtenidos entre otros. Conclusiones No se ha obtenido una homogeneidad conjunta sobre los artículos, por ello se debe continuar realizando avances en este ámbito. A pesar de ello, los entornos de realidad virtual pueden ser un instrumento válido para la recuperación funcional de la mano en los accidentes cerebrovasculares, no siendo aptos como elemento único rehabilitador. Abstract in English Objective To make a systematic review and critical assessment of the different existing publications on the use of virtual reality as an element in rehabilitation of the hand. Search Method A search was made in the Medline database completed with searches in Google Schoolar. The search was limited to a period of ten years, and English and Spanish languages. Study selection The study was focused on those articles related to virtual reality and the functional rehabilitation of the hand in stroke. Synthesis of results It was not possible to perform a methodological evaluation using the Caspe instrument due to lack of homogeneity. Two hundred 200 articles were found. Of these, 12 met the criteria for their selection. These articles were grouped in relation to different criteria such as: type of study, assessment system used, hardware used or outcomes results obtained, among others. Conclusions Joint homogeneity was not obtained for the articles. Therefore, progress must still be made in this area. In spite of this, virtual reality environments can be a valid tool for functional recovery of the hand in strokes but they are not adequate for use as a single rehabilitative treatment element.

Contribución de la fuerza y el dolor en la función del paciente con artrosis trapecio metacarpiana. Estudio transversal

Objetivo Establecer una posible relación entre la fuerza (Jamar), el dolor (EVA) y la capacidad funcional referida por el paciente (DASH) determinando en qué grado influyen unas en otras. Estudio observacional transversal analítico. Participantes Muestra de 72 pacientes que presentaban una artrosis trapecio metacarpiana grado 2-3 de Eaton. Los pacientes fueron reclutados cuando acudían a la Unidad de Cirugía de mano. Método Se realizaron mediciones de fuerza de agarre, pinza, valoración del dolor y funcionalidad, y se establecieron las correlaciones entre cada una de ellas. Resultados El modelo más significativo para la función (R2 =0.83) incluye la variable dolor y la fuerza. Pero es la fuerza punta contra punta la que presenta una mayor correlación con el cuestionario DASH (B-estandarizado: –57). Respecto al dolor, influye en todas las mediciones de fuerza realizadas con el dinamómetro, siendo también la fuerza de la pinza punta contra punta la que presenta una mayor correlación. Conclusiones Los hallazgos corroboran que existe una correlación significativa entre la función referida por el paciente y variables que podemos medir en consulta, como la fuerza del puño y la pinza. Pero también esta correlación es significativa entre las variables función y dolor entre sí, pero es la pinza punta contra punta la que presenta una mayor asociación con el cuestionario DASH. Abstract in English Objective To assess the relationship between muscle strength (Jama), and pain (VAS) levels with hand function (DASH) in patients with trapeziometarcapal osteoarthritis. Cross-sectional study. Participants Sample of 72 patients with osteoarthritis stage 2-3 (Eaton) and trapeziometacarpal osteoarthritis. Patients were recruited when they came to the Hand Surgery Unit. Method Grip strength, pinch, pain and hand function were measured, and correlation and regression coefficients between them were obtained. Results For function, the most significant model (R2 = 0.83) included pain and strength. But it is tip to tip pinch force which has a stronger relationship with DASH (Standardized B: –57) questionnaire. Pain also influenced strength measured with the dynamometer but it was tip to tip pinch force that was the most affected. Conclusions Findings confirm that there is a significant correlation between function referred by the patient and variables that can be measured in the clinic such as grip strength and pinch. The correlation between pain intensity and function was also significant, but tip to tip pinch strength had the greatest impact on the function.

Etapas del cambio en personas inactivas tras un programa de promoción de la actividad física en Atención Primaria

Objetivo El objetivo del estudio fue evaluar las Etapas del cambio en relación con la actividad física y el estado de salud general entre personas que participaron en un Programa de promoción de la actividad física (PPAF) de 12 semanas frente a un grupo control. Diseño Ensayo clínico aleatorizado. Participantes Noventa y ocho personas inactivas de ambos sexos con una edad media de 62,82 años procedentes de 2 centros de Atención Primaria del Distrito Sanitario Costa del Sol. Intervención Un PPAF organizado en grupos y siguiendo los criterios del Colegio Americano de Medicina del Deporte, 2 sesiones semanales de 60 min durante 12 semanas. Mediciones principales La variable principal de resultado fue resistencia al cambio en relación con la actividad física. La variable secundaria fue el estado de salud general (componentes físicos y mentales), determinado con el cuestionario de salud general SF12. Resultados Se encontraron diferencias significativas en las etapas del cambio a favor del grupo experimental (p < 0,05). No se encontraron diferencias estadísticamente significativas entre grupos después de la intervención en el estado general de salud. Conclusión Las etapas del cambio se modificaron en las personas inactivas que realizaron el PPAF en Atención Primaria. Futuros estudios son necesarios para identificar qué factores del entorno de los participantes influyen en la resistencia al cambio de la actividad física. Abstract Objective This study has aimed to evaluate the stages of change in relation to physical activity and overall health status among persons who participated in a 12-week Physical activity promotion program (PAPP) compared to a control group. Design Randomized clinical trial. Participants The study included 98 inactive persons of both sexes with a mean age of 62.82 years from 2 of Primary Care Centers of the Malaga Health Care District. Interventions A PAPP organized in groups according to the American College of Sports Medicine criteria including two weekly sessions of 60 minutes each for 3 months. Main measures The primary outcome was to assess resistance to change in relation to physical activity. The secondary variable was overall health (physical and mental components) determined with the SF12 general health questionnaire. Results Significant differences were found in the stages of change (P<.05). There were no significant differences found in general health status improvement in regards to the initial assessment. Conclusion The stages of change were modified in the inactive persons who carried out the PAPP in Primary Care. Future studies are needed to identify which environmental factors influence the resistance to change in physical activity of the participants.

Cambios hematológicos tras un programa de promoción de actividad física en sujetos inactivos. Ensayo aleatorizado controlado

Objetivo Comparar los cambios antropométricos y bioquímicos en personas inactivas, que realizan un programa de actividad física frente a los que no lo realizan desde los Centros de Atención Primaria. Métodos Cien personas inactivas de ambos sexos, mayores de 55 años fueron aleatorizadas a un grupo experimental (n = 50) y a un grupo control (n = 50). Se realizó un programa de promoción de actividad física siguiendo los criterios del Colegio Americano de Medicina del Deporte, de 60 min cada sesión, 2 sesiones por semana, durante 3 meses. Las medidas antropométricas incluyeron el índice de masa corporal y el porcentaje graso, y como variables bioquímicas el perfil lipídico, hematíes y la creatina kinasa. Resultados Completaron el estudio 75 personas. Esta investigación no presentó cambios significativos a nivel antropométrico, ni en las variables bioquímicas del perfil lipídico. Sí se observaron efectos clínicamente relevantes en la concentración de los hematíes de las mujeres que realizaron dicho programa. Conclusiones El efecto clínico global fue pequeño en las personas que realizaron el programa, pero relevante para la salud de la población. Esta intervención produce efectos a corto plazo en la bioquímica de las personas inactivas. Abstract in English Objective Compare anthropometry and biochemical changes in inactive people who participate in a physical activity program versus those who do not from the Primary Health Care Centers. Methods One hundred inactive subjects of both genders, 55 years and older, from Torremolinos, Spain were randomized into an experimental group (n = 50) and a control group (n = 50). A program promoting physical activity was carried out following the American Medical Society for Sport's Medicine criteria. The program included sessions a week for 3 months. Antropometric measurements included body mass index and fat percentage, and such as biochemical measures: the lipid profile, erythrocytes, and creatine kinase. Results Seventy-five persons completed the study. This research did not show significant changes to anthropometric or biochemical outcomes of the lipid profile. However, there were clinically relevant effects regarding red blood cells concentration in the women who participated in this program. Conclusions Overall clinical effect was small in those participating in the program, but relevant for the health of the population. This program has short-term effects on biochemistry results of inactive subjects.

Sodium and lithium storage properties of spray-dried molybdenum disulfide-graphene hierarchical microspheres

Developing nano/micro-structures which can effectively upgrade the intriguing properties of electrode materials for energy storage devices is always a key research topic. Ultrathin nanosheets were proved to be one of the potential nanostructures due to their high specific surface area, good active contact areas and porous channels. Herein, we report a unique hierarchical micro-spherical morphology of well-stacked and completely miscible molybdenum disulfide (MoS2) nanosheets and graphene sheets, were successfully synthesized via a simple and industrial scale spray-drying technique to take the advantages of both MoS2 and graphene in terms of their high practical capacity values and high electronic conductivity, respectively. Computational studies were performed to understand the interfacial behaviour of MoS2 and graphene, which proves high stability of the composite with high interfacial binding energy (−2.02 eV) among them. Further, the lithium and sodium storage properties have been tested and reveal excellent cyclic stability over 250 and 500 cycles, respectively, with the highest initial capacity values of 1300 mAh g−1 and 640 mAh g−1 at 0.1 A g−1.

Crystal structure of poly[[di-mu2-aqua-aquasodium] 4-amino-3,5,6-trichloropyridine-2-carboxylate trihydrate], the sodium salt of the herbicide picloram

In the structure of the title complex [[Na(H2O)3]+ (C6H2Cl3N2O2)-^ . 3(H2O)]n, the Na salt of the herbicide picloram, the cation is a polymeric chain structure, based on doubly water-bridged NaO5 trigonal bipyramidal complex units which have in addition, a singly-bonded monodentate water molecule. Each of the bridges within the chain which lies along the a cell direction is centrosymmetric with Na...Na separations of 3.4807(16) and 3.5109(16)Ang. In the crystal, there are three water molecules of solvation and these, as well as the coordinated water molecules and the amino group of the 4-amino-3,5,6-trichloropicolinate anion are involved in extensive inter-species hydrogen-bonding interactions with carboxyl and water O-atoms as well as the pyridine N-atom. Among these association is a centrosymmetric cyclic tetra-water R4/4(8) ring , resulting in an overall three-dimensional structure.

The three-dimensional hydrogen-bonded structures in the ammonium and sodium salt hydrates of 4-aminophenylarsonic acid

The structures of two hydrated salts of 4-aminophenylarsonic acid (p-arsanilic acid), namely ammonium 4-aminophenylarsonate monohydrate, NH4(+)·C6H7AsNO3(-)·H2O, (I), and the one-dimensional coordination polymer catena-poly[[(4-aminophenylarsonato-κO)diaquasodium]-μ-aqua], [Na(C6H7AsNO3)(H2O)3]n, (II), have been determined. In the structure of the ammonium salt, (I), the ammonium cations, arsonate anions and water molecules interact through inter-species N-H...O and arsonate and water O-H...O hydrogen bonds, giving the common two-dimensional layers lying parallel to (010). These layers are extended into three dimensions through bridging hydrogen-bonding interactions involving the para-amine group acting both as a donor and an acceptor. In the structure of the sodium salt, (II), the Na(+) cation is coordinated by five O-atom donors, one from a single monodentate arsonate ligand, two from monodentate water molecules and two from bridging water molecules, giving a very distorted square-pyramidal coordination environment. The water bridges generate one-dimensional chains extending along c and extensive interchain O-H...O and N-H...O hydrogen-bonding interactions link these chains, giving an overall three-dimensional structure. The two structures reported here are the first reported examples of salts of p-arsanilic acid.

Separate or simultaneous removal of radioactive cations and anions from water by layered sodium vanadate-based sorbents

Nanofibers of sodium vanadate, consisting of very thin negatively charged layers and exchangeable sodium ions between the layers, are efficient sorbents for the removal of radioactive 137Cs+ and 85Sr2+ cations from water. The exchange of 137Cs+ or 85Sr2+ ions with the interlayer Na+ ions eventually triggered structural deformation of the thin layers, trapping the 137Cs+ and 85Sr2+ ions in the nanofibers. Furthermore, when the nanofibers were dispersed in a AgNO3 solution at pH >7, well-dispersed Ag2O nanocrystals formed by firmly anchoring themselves on the fiber surfaces along planes of crystallographic similarity with those of Ag2O. These nanocrystals can efficiently capture I– anions by forming a AgI precipitate, which was firmly attached to the substrates. We also designed sorbents that can remove 137Cs+ and 125I– ions simultaneously for safe disposal by optimizing the Ag2O loading and sodium content of the vanadate. This study confirms that sorbent features such as fibril morphology, negatively charged thin layers and readily exchangeable Na+ ions between the layers, and the crystal planes for the formation of a coherent interface with Ag2O nanocrystals on the fiber surface are very important for the simultaneous uptake of cations and anions.

SnO2 decorated graphene nanocomposite anode materials prepared via an up-scalable wet-mechanochemical process for sodium ion batteries

A facile and up-scalable wet-mechanochemical process is designed for fabricating ultra-fine SnO2 nanoparticles anchored on graphene networks for use as anode materials for sodium ion batteries. A hierarchical structure of the SnO2@graphene composite is obtained from the process. The resultant rechargeable SIBs achieved high rate capability and good cycling stability.

Adolescent sexual behavioral intentions measurement: A gender approach in the Colombian Caribbean region [Medición de la Intención en la Actividad Sexual en Adolescentes: una Aproximación de Acuerdo al Género del Caribe Colombiano]

The study of 1777 male and female adolescent students of 11-19 years in the Colombian Caribbean had two objectives: development and validation of two reproductive health intention scales and analyze gender differences. The pilot of the scale consisted of 8 items and was reduced to 6, to check the reliability and validity using factor analysis and principal components with VARIMAX rotation yielded two factors: Intention and Intention Risk Protection, explained between 69.4% and 70% respectively. In the male Protection Intent (M = 3.87 and SD = 1.29) and risk (M = 2.56 and SD = 1.18) obtained an alpha between 0.74 and 0.86, and in Protection of Intent to female (M = 3.49 and SD = 1.35) and risk (M = 1.50 and SD = 0.89) ranged between 0.78 and 086. In conclusion, the reliability and structural stability are adequate and there are gender differences in the scales.

Elastic Properties Of Sodium Borovanadate Glasses

The elastic properties of sodium borovanadate glasses have been studied over a wide range of composition using ultrasonic measurements. It is found that variation of different elastic moduli is very similar in any given series of composition. The bulk and shear moduli show a monotonic variation with the covalent bond energy densities calculated from the proposed structural model for these glasses. The bulk moduli also vary as a negative power function of the mean atomic volume. The Debye temperature varies linearly with the glass transition temperature. The implications of the observed behavior have been discussed.

An asymmetric homodinuclear complex containing the mu-x-oxobis(mu-x-carboxylato)diruthenium(III) core: X-ray structure of [Ru20(o2ec6H4-p-OMe)3(en) (PPh3)2] (C104)" 3CHC13

Asymmetric tri-bridged diruthenium(III) complexes, [Ru2O(O(2)CR)(3)(en) (PPh(3))(2)](ClO4) (R = C6H4-p-X: X = OMe (1a), Me (1b); en=1,2-diaminoethane), were prepared and structurally characterized. Complex 1a 3CHCl(3), crystallizes in the triclinic space group P (1) over bar with a = 14.029(5), b = 14.205(5), c = 20.610(6) Angstrom, alpha= 107.26(3), beta = 101.84(3), gamma= 97.57(3)degrees, V= 3756(2) Angstrom(3) and Z = 2. The complex has an {Ru-2(mu-O)(mu-O(2)CR)(2)(2+)} core and exhibits [O4PRu(mu-O)RuPO2N2](+) coordination environments for the metal centers. The novel structural feature is the asymmetric arrangement of ligands at the terminal sites of the core which shows an Ru... Ru separation of 3.226(3) Angstrom and an Ru-O-Ru angle of 119.2(5)degrees. An intense visible band observed near 570 nm is assigned to a charge transfer transition involving the d pi-Ru(III) and p pi-mu-O Orbitals. Cyclic voltammetry of the complexes displays a reversible Ru-2(III,III) reversible arrow Ru-2(III,IV) couple near 0.8 V (versus SCE) in MeCN-0.1 M TBAP.

Silicon Tetrachloride/Sodium Iodide as a Convenient and Highly Regioselective Ether Cleaving Reagent

Abstract is not available.

Huellas de Eros y Thánatos en la narrativa de Diamela Eltit : La palabra en movimiento en el juego entre tropos, metáforas y deconstrucciones lingüísticas

Väitöskirja analysoi espanjan kielen dekonstruktioita ruumiin metaforista ja troopeista koostuvassa aineistossa chileläisen kirjailijan Diamela Eltitin (1949 -) neljässä romaanissa: Lumpérica (1983), Vaca sagrada (1991), El infarto del alma (1994) ja Los trabajadores de la muerte (1998). Näkökulma on kielen muutoksessa Eltitin proosassa 1980- ja 1990-luvuilla alkaen kokeellisesta huippuvaiheesta 1983, jolloin hän julkaisi esikoisromaaninsa Lumpérica. Tutkimus korostaa Eltitin romaanien historiallista arvoa, kirjallisuuden tapaa murtaa kielen rakenteita ja sitä miten tämä murros kytkeytyy taideteoreettiseen muutokseen kulttuuridiskursseissa. Tutkimus tarkastelee Eltitin kehityskaarta kenraali Augusto Pinochetin sotilasvallankaappauksesta 1973 halki sotilashallituksen kauden (1973-1990) aina kansalaisyhteiskunnan vahvistumiseen ja vuoteen 1998. Tutkimus analysoi ruumiin troopeista ja metaforista koostuvaa tutkimusaineistoa lingvistiikan, kirjallisuustieteen, historian ja sukupuolen tutkimuksen monitieteisessä viitekehyksessä. Sen vuoksi väitöskirja liittyy espanjalaisen filologian, yleisen kirjallisuustieteen, Latinalaisen Amerikan tutkimuksen ja naistutkimuksen oppiaineisiin. Kolme tärkeintä oppiteoreettista runkoa ovat lingvistinen strukturalismi, dekonstruktio ja feministiset kirjallisuusteoriat. Dekonstruktiivinen lähestymistapa tekstiin korostaa kielen merkityksen muodostumisen filosofista perustaa. Se pyrkii selvittämään, miten merkitys muodostuu kirjoittajan, tekstin ja lukijan välillä. Tekstikritiikki koostuu semanttisesta ja dekonstruktiivisesta tekstianalyysistä, jonka metodologisen mallin perusta on tanskalaisen kielitieteilijän Louis Hjelmslevin (1899-1965) kielitieteellinen malli. Väitös ei käytä mallia suoraan, vaan soveltaa sitä kaunokirjallisuuden tutkimukseen. Oppiteoreettisen viitekehyksen osalta tutkimus sijoittuu strukturalismin ja poststrukturalismin murrokseen. Tutkimus korostaa Eltitin radikaalia muotokieltä ja teatraalisuutta, hänen kielensä visuaalisuutta ja ruumiin metaforien eroottista jännitettä, mikä ilmenee mm. falloksen metaforaksi tulkitun hehkuvan valon kuvissa romaanissa Lumpérica. Vanhat kreikkalaiset myytit Éros ja Thánatos kasvavat esille länsimaisen taidehistorian perinteestä ja kontekstualisoituvat uusiksi kielikuviksi Chilen kirjallisessa maaperässä. Ne muodostavat Eltitin taiteellisen tuotannon pysyvän aihepiirin ja luovat teoksiin synkkää ja karua virettä sekä tummia ja eroottisia sävyjä. Tutkimus osoittaa, että Eltit dekonstruoi kieltä, mutta dekonstruktiot eivät ole jatkuvia eivätkä samanlaisia kaikissa romaaneissa. Kielellisten dekonstruktioiden variaatio on laaja eikä Eltit murra kielen syntaktisia ja morfologisia rakenteita kaikissa teksteissään. Tutkimuksen perusteella väitän, että Eltitin kirjoituksesta puhuttaessa useat tutkijat käyttävät epämääräisesti dekonstruktio-termiä. Useiden tutkijoiden toteamus dekonstruktiosta Diamela Eltitin kirjallisessa tuotannossa pysyvänä piirteenä on epätäsmällinen. Sen sijaan dekonstruktiivinen kirjoitus tarkoittaa Eltitillä laajasti vaihtelevaa lähestymistapaa kieleen, mikä ilmenee kehityslinjana hänen tuotannossaan ja eri tavoin jokaisessa teoksessa.

Fatigue crack growth rates and fracture toughness in electroslag refined En 52 steel

En 52 steel has been electroslag refined and the resultant effects of refining on its mechanical properties have been assessed. It was found that refining caused a decrease in fatigue crack growth rates and increases in fatigue strength, fracture toughness, Charpy fracture energy and tensile ductility. Fatigue crack growth rates in region I and in region III were found to be considerably lower in the electroslag refined steel: they were unaffected in region II. The fracture toughness values for the electroslag refined steel are nearly twice those estimated for the unrefined steel. Measurements on heat-treated samples have shown that the electroslag refined steel has a better response to heat-treatment. The improvement in the mechanical properties is explained in terms of the removal of nonmetallic inclusions and a reduction in the sulphur content of the steel.