816 resultados para Composite Physical Function Scale
Resumo:
El trastorno de hiperactividad y déficit de atención (THDA), es definido clínicamente como una alteración en el comportamiento, caracterizada por inatención, hiperactividad e impulsividad. Estos aspectos son clasificados en tres subtipos, que son: Inatento, hiperactivo impulsivo y mixto. Clínicamente se describe un espectro amplio que incluye desordenes académicos, trastornos de aprendizaje, déficit cognitivo, trastornos de conducta, personalidad antisocial, pobres relaciones interpersonales y aumento de la ansiedad, que pueden continuar hasta la adultez. A nivel global se ha estimado una prevalencia entre el 1% y el 22%, con amplias variaciones, dadas por la edad, procedencia y características sociales. En Colombia, se han realizado estudios en Bogotá y Antioquia, que han permitido establecer una prevalencia del 5% y 15%, respectivamente. La causa específica no ha sido totalmente esclarecida, sin embargo se ha calculado una heredabilidad cercana al 80% en algunas poblaciones, demostrando el papel fundamental de la genética en la etiología de la enfermedad. Los factores genéticos involucrados se relacionan con cambios neuroquímicos de los sistemas dopaminérgicos, serotoninérgicos y noradrenérgicos, particularmente en los sistemas frontales subcorticales, corteza cerebral prefrontal, en las regiones ventral, medial, dorsolateral y la porción anterior del cíngulo. Basados en los datos de estudios previos que sugieren una herencia poligénica multifactorial, se han realizado esfuerzos continuos en la búsqueda de genes candidatos, a través de diferentes estrategias. Particularmente los receptores Alfa 2 adrenérgicos, se encuentran en la corteza cerebral, cumpliendo funciones de asociación, memoria y es el sitio de acción de fármacos utilizados comúnmente en el tratamiento de este trastorno, siendo esta la principal evidencia de la asociación de este receptor con el desarrollo del THDA. Hasta la fecha se han descrito más de 80 polimorfismos en el gen (ADRA2A), algunos de los cuales se han asociado con la entidad. Sin embargo, los resultados son controversiales y varían según la metodología diagnóstica empleada y la población estudiada, antecedentes y comorbilidades. Este trabajo pretende establecer si las variaciones en la secuencia codificante del gen ADRA2A, podrían relacionarse con el fenotipo del Trastorno de Hiperactividad y el Déficit de Atención.
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Introducción: la osteogénesis es una patología de origen genético caracterizada por fragilidad ósea, en su curso natural los pacientes que la padecen se enfrentan a múltiples fracturas y múltiples intervenciones quirúrgicas, este tipo de pacientes por ser de alto riesgo necesitan técnicas quirúrgicas que aumenten el tiempo entre cada intervención y que demuestren un mayor impacto en el estado funcional. Objetivo: Determinar el impacto en el estado funcional de los pacientes con osteogénesis imperfecta llevados a tratamiento quirúrgico con clavos telescopados tipo Fassier Duval. Diseño: Estudio descriptivo prospectivo en el que se incluyeron 8 pacientes con diagnóstico de osteogénesis imperfecta, llevados a tratamiento quirúrgico con clavos telescopados tipo Fassier Duval desde el 2009 al 2013 a los cuales se les realizó seguimiento menor de 1 año del post operatorio. Resultados: La respuesta encontrada fue satisfactoria en la mayoría de los pacientes analizados 6 de 8, con cercanía a un estado funcional normal; un riesgo de caída bajo, incorporación y deambulación adecuada y una valoración funcional motora gruesa con valores cercanos al 100% identificando un buen nivel de independencia funcional. Se pudo demostrar que existieron cambios en los valores de la escala y que estos fueron estadísticamente significativos con p=0,028 indicando que el aumento dichos valores en el posoperatorio están relacionados con el procedimiento quirúrgico al utilizado en este grupo de pacientes. Conclusión: El tratamiento quirúrgico con el clavo telescopado de Fassier Duval en nuestra experiencia demostró tener una mejoría en el estado funcional de los pacientes del presente estudio, por lo tanto se sugiere la posibilidad de implementar su uso según este indicado con el fin de obtener un mejor resultado quirúrgico y funcional. Palabras clave: Osteogénesis Imperfecta, Clavo de Fassier Duval, Valoración Funcional Motora
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Antecedentes. La enfermedad de Parkinson (EP) es la segunda enfermedad neurodegenerativa más común en el mundo, la cual afecta el componente físico, psicológico y social de los individuos que la padecen. Numerosos estudios han abordado los beneficios de diferentes programas de ejercicio, llegando a ser una estrategia no-farmacológica efectiva para aminorar el deterioro funcional de los pacientes con EP. Objetivo. Determinar los efectos de las diferentes modalidades de ejercicio físico en los principales desenlaces clínicos en pacientes con EP. Métodos. Se consultaron las bases de datos MEDLINE, EMBASE, Scopus, CENTRAL y PEDro desde febrero de 1990 hasta febrero de 2014 para identificar Ensayos Clínicos Aleatorizados (ECA) publicados. Además, se examinaron las listas de referencias de otras revisiones y de estudios identificados. La extracción de datos se realizó por dos autores independientes. Se empleó un modelo de efectos aleatorios en presencia de heterogeneidad estadística (I2>50%). El sesgo de publicación fue evaluado mediante el gráfico de embudo. Resultados: Un total de 18 estudios fueron incluidos. Se encontraron diferencias estadísticamente significativas en las intervenciones con ejercicio y las siguientes medidas de resultado, severidad de los síntomas motores (MDS-UPDRS) DME 1.44, IC 95% [-2.09 a -0.78] (p<0.001) I2= 87,9% y el equilibrio DME 0,52 IC 95% [0,30 a 0,74] (p<0.001) I2= 85,6%. En el análisis de subgrupos en la modalidad de ejercicio aeróbico, en MDS-UPDRS DME -1,28, IC 95% [-1,98 a -0,59] (p<0.001), 3 calidad de vida DME -1,91 IC 95% [-2,76 a -1,07] (p<0.001), equilibrio DME 0,54 IC 95% [0,31 a 0,77] (p<0.001), 10-m WT DME 0,15 IC 95% [0,06 a 0,25] (p<0.001) y Vo2 máximo DME -1,09 IC 95% [-1,31 a -0,88] (p=0.001), 6MWT DME 40,46 IC 95% [11,28 a 69,65] (p=0.007). Conclusiones: El ejercicio aeróbico produjo mejoras significativas en MDS UPDRS, equilibrio, calidad de vida, 10-m WT y y Vo2 máximo; mientras que el ejercicio combinado mejoró la fuerza.
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The total energy of molecule in terms of 'fuzzy atoms' presented as sum of one- and two-atomic energy components is described. The divisions of three-dimensional physical space into atomic regions exhibit continuous transition from one to another. The energy components are on chemical energy scale according to proper definitions. The Becke's integration scheme and weight function determines realization of method which permits effective numerical integrations
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Procesos hidrodinámicos determinan, en un alto grado la calidad del agua en embalse, sin embargo dichos procesos han sido tradicionalmente olvidados en la gestión de embalse. En esta tesis se presentan evidencias de los principales procesos hidrodinámicos que ocurren en un embalse Mediterráneo a escala de cuenca a través de campañas experimentales y modelización numérica; y su influencia en la dinámica de poblaciones de fitoplancton. Dichos procesos son principalmente la generación de ondas internas o secas y la intrusión del río. La presencia de viento periódico genera secas forzadas, amplificando los modos cercanos al periodo del viento, de manera que modos verticales altos, considerados como raros en la naturaleza, tienden a dominar en el sistema.
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La present tesi proposa una metodología per a la simulació probabilística de la fallada de la matriu en materials compòsits reforçats amb fibres de carboni, basant-se en l'anàlisi de la distribució aleatòria de les fibres. En els primers capítols es revisa l'estat de l'art sobre modelització matemàtica de materials aleatoris, càlcul de propietats efectives i criteris de fallada transversal en materials compòsits. El primer pas en la metodologia proposada és la definició de la determinació del tamany mínim d'un Element de Volum Representatiu Estadístic (SRVE) . Aquesta determinació es du a terme analitzant el volum de fibra, les propietats elàstiques efectives, la condició de Hill, els estadístics de les components de tensió i defromació, la funció de densitat de probabilitat i les funcions estadístiques de distància entre fibres de models d'elements de la microestructura, de diferent tamany. Un cop s'ha determinat aquest tamany mínim, es comparen un model periòdic i un model aleatori, per constatar la magnitud de les diferències que s'hi observen. Es defineix, també, una metodologia per a l'anàlisi estadístic de la distribució de la fibra en el compòsit, a partir d'imatges digitals de la secció transversal. Aquest anàlisi s'aplica a quatre materials diferents. Finalment, es proposa un mètode computacional de dues escales per a simular la fallada transversal de làmines unidireccionals, que permet obtenir funcions de densitat de probabilitat per a les variables mecàniques. Es descriuen algunes aplicacions i possibilitats d'aquest mètode i es comparen els resultats obtinguts de la simulació amb valors experimentals.
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Virtual tools are commonly used nowadays to optimize product design and manufacturing process of fibre reinforced composite materials. The present work focuses on two areas of interest to forecast the part performance and the production process particularities. The first part proposes a multi-physical optimization tool to support the concept stage of a composite part. The strategy is based on the strategic handling of information and, through a single control parameter, is able to evaluate the effects of design variations throughout all these steps in parallel. The second part targets the resin infusion process and the impact of thermal effects. The numerical and experimental approach allowed the identificationof improvement opportunities regarding the implementation of algorithms in commercially available simulation software.
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The aim of this thesis is to narrow the gap between two different control techniques: the continuous control and the discrete event control techniques DES. This gap can be reduced by the study of Hybrid systems, and by interpreting as Hybrid systems the majority of large-scale systems. In particular, when looking deeply into a process, it is often possible to identify interaction between discrete and continuous signals. Hybrid systems are systems that have both continuous, and discrete signals. Continuous signals are generally supposed continuous and differentiable in time, since discrete signals are neither continuous nor differentiable in time due to their abrupt changes in time. Continuous signals often represent the measure of natural physical magnitudes such as temperature, pressure etc. The discrete signals are normally artificial signals, operated by human artefacts as current, voltage, light etc. Typical processes modelled as Hybrid systems are production systems, chemical process, or continuos production when time and continuous measures interacts with the transport, and stock inventory system. Complex systems as manufacturing lines are hybrid in a global sense. They can be decomposed into several subsystems, and their links. Another motivation for the study of Hybrid systems is the tools developed by other research domains. These tools benefit from the use of temporal logic for the analysis of several properties of Hybrid systems model, and use it to design systems and controllers, which satisfies physical or imposed restrictions. This thesis is focused in particular types of systems with discrete and continuous signals in interaction. That can be modelled hard non-linealities, such as hysteresis, jumps in the state, limit cycles, etc. and their possible non-deterministic future behaviour expressed by an interpretable model description. The Hybrid systems treated in this work are systems with several discrete states, always less than thirty states (it can arrive to NP hard problem), and continuous dynamics evolving with expression: with Ki ¡ Rn constant vectors or matrices for X components vector. In several states the continuous evolution can be several of them Ki = 0. In this formulation, the mathematics can express Time invariant linear system. By the use of this expression for a local part, the combination of several local linear models is possible to represent non-linear systems. And with the interaction with discrete events of the system the model can compose non-linear Hybrid systems. Especially multistage processes with high continuous dynamics are well represented by the proposed methodology. Sate vectors with more than two components, as third order models or higher is well approximated by the proposed approximation. Flexible belt transmission, chemical reactions with initial start-up and mobile robots with important friction are several physical systems, which profits from the benefits of proposed methodology (accuracy). The motivation of this thesis is to obtain a solution that can control and drive the Hybrid systems from the origin or starting point to the goal. How to obtain this solution, and which is the best solution in terms of one cost function subject to the physical restrictions and control actions is analysed. Hybrid systems that have several possible states, different ways to drive the system to the goal and different continuous control signals are problems that motivate this research. The requirements of the system on which we work is: a model that can represent the behaviour of the non-linear systems, and that possibilities the prediction of possible future behaviour for the model, in order to apply an supervisor which decides the optimal and secure action to drive the system toward the goal. Specific problems can be determined by the use of this kind of hybrid models are: - The unity of order. - Control the system along a reachable path. - Control the system in a safe path. - Optimise the cost function. - Modularity of control The proposed model solves the specified problems in the switching models problem, the initial condition calculus and the unity of the order models. Continuous and discrete phenomena are represented in Linear hybrid models, defined with defined eighth-tuple parameters to model different types of hybrid phenomena. Applying a transformation over the state vector : for LTI system we obtain from a two-dimensional SS a single parameter, alpha, which still maintains the dynamical information. Combining this parameter with the system output, a complete description of the system is obtained in a form of a graph in polar representation. Using Tagaki-Sugeno type III is a fuzzy model which include linear time invariant LTI models for each local model, the fuzzyfication of different LTI local model gives as a result a non-linear time invariant model. In our case the output and the alpha measure govern the membership function. Hybrid systems control is a huge task, the processes need to be guided from the Starting point to the desired End point, passing a through of different specific states and points in the trajectory. The system can be structured in different levels of abstraction and the control in three layers for the Hybrid systems from planning the process to produce the actions, these are the planning, the process and control layer. In this case the algorithms will be applied to robotics ¡V a domain where improvements are well accepted ¡V it is expected to find a simple repetitive processes for which the extra effort in complexity can be compensated by some cost reductions. It may be also interesting to implement some control optimisation to processes such as fuel injection, DC-DC converters etc. In order to apply the RW theory of discrete event systems on a Hybrid system, we must abstract the continuous signals and to project the events generated for these signals, to obtain new sets of observable and controllable events. Ramadge & Wonham¡¦s theory along with the TCT software give a Controllable Sublanguage of the legal language generated for a Discrete Event System (DES). Continuous abstraction transforms predicates over continuous variables into controllable or uncontrollable events, and modifies the set of uncontrollable, controllable observable and unobservable events. Continuous signals produce into the system virtual events, when this crosses the bound limits. If this event is deterministic, they can be projected. It is necessary to determine the controllability of this event, in order to assign this to the corresponding set, , controllable, uncontrollable, observable and unobservable set of events. Find optimal trajectories in order to minimise some cost function is the goal of the modelling procedure. Mathematical model for the system allows the user to apply mathematical techniques over this expression. These possibilities are, to minimise a specific cost function, to obtain optimal controllers and to approximate a specific trajectory. The combination of the Dynamic Programming with Bellman Principle of optimality, give us the procedure to solve the minimum time trajectory for Hybrid systems. The problem is greater when there exists interaction between adjacent states. In Hybrid systems the problem is to determine the partial set points to be applied at the local models. Optimal controller can be implemented in each local model in order to assure the minimisation of the local costs. The solution of this problem needs to give us the trajectory to follow the system. Trajectory marked by a set of set points to force the system to passing over them. Several ways are possible to drive the system from the Starting point Xi to the End point Xf. Different ways are interesting in: dynamic sense, minimum states, approximation at set points, etc. These ways need to be safe and viable and RchW. And only one of them must to be applied, normally the best, which minimises the proposed cost function. A Reachable Way, this means the controllable way and safe, will be evaluated in order to obtain which one minimises the cost function. Contribution of this work is a complete framework to work with the majority Hybrid systems, the procedures to model, control and supervise are defined and explained and its use is demonstrated. Also explained is the procedure to model the systems to be analysed for automatic verification. Great improvements were obtained by using this methodology in comparison to using other piecewise linear approximations. It is demonstrated in particular cases this methodology can provide best approximation. The most important contribution of this work, is the Alpha approximation for non-linear systems with high dynamics While this kind of process is not typical, but in this case the Alpha approximation is the best linear approximation to use, and give a compact representation.
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The behavior of the Asian summer monsoon is documented and compared using the European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis (ERA) and the National Centers for Environmental Prediction-National Center for Atmospheric Research (NCEP-NCAR) Reanalysis. In terms of seasonal mean climatologies the results suggest that, in several respects, the ERA is superior to the NCEP-NCAR Reanalysis. The overall better simulation of the precipitation and hence the diabatic heating field over the monsoon domain in ERA means that the analyzed circulation is probably nearer reality. In terms of interannual variability, inconsistencies in the definition of weak and strong monsoon years based on typical monsoon indices such as All-India Rainfall (AIR) anomalies and the large-scale wind shear based dynamical monsoon index (DMI) still exist. Two dominant modes of interannual variability have been identified that together explain nearly 50% of the variance. Individually, they have many features in common with the composite flow patterns associated with weak and strong monsoons, when defined in terms of regional AIR anomalies and the large-scale DMI. The reanalyses also show a common dominant mode of intraseasonal variability that describes the latitudinal displacement of the tropical convergence zone from its oceanic-to-continental regime and essentially captures the low-frequency active/break cycles of the monsoon. The relationship between interannual and intraseasonal variability has been investigated by considering the probability density function (PDF) of the principal component of the dominant intraseasonal mode. Based on the DMI, there is an indication that in years with a weaker monsoon circulation, the PDF is skewed toward negative values (i,e., break conditions). Similarly, the PDFs for El Nino and La Nina years suggest that El Nino predisposes the system to more break spells, although the sample size may limit the statistical significance of the results.
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The Met Office Unified Model is run for a case observed during Intensive Observation Period 18 (IOP18) of the Convective Storms Initiation Project (CSIP). The aims are to identify the physical processes that lead to perturbation growth at the convective scale in response to model-state perturbations and to determine their sensitivity to the character of the perturbations. The case is strongly upper-level forced but with detailed mesoscale/convective-scale evolution that is dependent on smaller-scale processes. Potential temperature is perturbed within the boundary layer. The effects on perturbation growth of both the amplitude and typical scalelength of the perturbations are investigated and perturbations are applied either sequentially (every 30 min throughout the simulation) or at specific times. The direct effects (within one timestep) of the perturbations are to generate propagating Lamb and acoustic waves and produce generally small changes in cloud parameters and convective instability. In exceptional cases a perturbation at a specific gridpoint leads to switching of the diagnosed boundary-layer type or discontinuous changes in convective instability, through the generation or removal of a lid. The indirect effects (during the entire simulation) are changes in the intensity and location of precipitation and in the cloud size distribution. Qualitatively different behaviour is found for strong (1K amplitude) and weak (0.01K amplitude) perturbations, with faster growth after sunrise found only for the weaker perturbations. However, the overall perturbation growth (as measured by the root-mean-square error of accumulated precipitation) reaches similar values at saturation, regardless of the perturbation characterisation.
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The Madden–Julian oscillation (MJO) interacts with and influences a wide range of weather and climate phenomena (e.g., monsoons, ENSO, tropical storms, midlatitude weather), and represents an important, and as yet unexploited, source of predictability at the subseasonal time scale. Despite the important role of the MJO in climate and weather systems, current global circulation models (GCMs) exhibit considerable shortcomings in representing this phenomenon. These shortcomings have been documented in a number of multimodel comparison studies over the last decade. However, diagnosis of model performance has been challenging, and model progress has been difficult to track, because of the lack of a coherent and standardized set of MJO diagnostics. One of the chief objectives of the U.S. Climate Variability and Predictability (CLIVAR) MJO Working Group is the development of observation-based diagnostics for objectively evaluating global model simulations of the MJO in a consistent framework. Motivation for this activity is reviewed, and the intent and justification for a set of diagnostics is provided, along with specification for their calculation, and illustrations of their application. The diagnostics range from relatively simple analyses of variance and correlation to more sophisticated space–time spectral and empirical orthogonal function analyses. These diagnostic techniques are used to detect MJO signals, to construct composite life cycles, to identify associations of MJO activity with the mean state, and to describe interannual variability of the MJO.
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Diffuse reflectance spectroscopy (DRS) is increasingly being used to predict numerous soil physical, chemical and biochemical properties. However, soil properties and processes vary at different scales and, as a result, relationships between soil properties often depend on scale. In this paper we report on how the relationship between one such property, cation exchange capacity (CEC), and the DRS of the soil depends on spatial scale. We show this by means of a nested analysis of covariance of soils sampled on a balanced nested design in a 16 km × 16 km area in eastern England. We used principal components analysis on the DRS to obtain a reduced number of variables while retaining key variation. The first principal component accounted for 99.8% of the total variance, the second for 0.14%. Nested analysis of the variation in the CEC and the two principal components showed that the substantial variance components are at the > 2000-m scale. This is probably the result of differences in soil composition due to parent material. We then developed a model to predict CEC from the DRS and used partial least squares (PLS) regression do to so. Leave-one-out cross-validation results suggested a reasonable predictive capability (R2 = 0.71 and RMSE = 0.048 molc kg− 1). However, the results from the independent validation were not as good, with R2 = 0.27, RMSE = 0.056 molc kg− 1 and an overall correlation of 0.52. This would indicate that DRS may not be useful for predictions of CEC. When we applied the analysis of covariance between predicted and observed we found significant scale-dependent correlations at scales of 50 and 500 m (0.82 and 0.73 respectively). DRS measurements can therefore be useful to predict CEC if predictions are required, for example, at the field scale (50 m). This study illustrates that the relationship between DRS and soil properties is scale-dependent and that this scale dependency has important consequences for prediction of soil properties from DRS data
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The research record on the quantification of sediment transport processes in periglacial mountain environments in Scandimvia dates back to the 1950s. A wide range of measurements is. available, especially from the Karkevagge region of northern Sweden. Within this paper satellite image analysis and tools provided by geographic information systems (GIS) are exploited in order to extend and improve this research and to complement geophysical methods. The processes of interest include mass movements such as solifluction, slope wash, dirty avalanches and rock-and boulder falls. Geomorphic process units have been derived in order to allow quantification via GIS techniques at a catchment scale. Mass movement rates based on existing Field measurements are employed in the budget calculation. In the Karkevagge catch ment. 80% of the area can be identified either as a source area for sediments or as a zone where sediments are deposited. The overall budget for the slopes beneath the rockwalls in the Karkevagge is approximately 680 t a(-1) whilst about 150 : a-1 are transported into the fluvial System.
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Relations between the apparent electrical conductivity of the soil (ECa) and top- and sub-soil physical properties were examined for two arable fields in southern England (Crowmarsh Battle Farms and the Yattendon Estate). The spatial variation of ECa and the soil properties was explored geostatistically. The variogram ranges showed that ECa varied on a similar spatial scale to many of the soil physical properties in both fields. Several features in the map of kriged predictions of ECa were also evident in maps of the soil properties. In addition, the correlation coefficients showed a strong relation between ECa and several soil properties. A moving correlation analysis enabled differences in the relations between ECa and the soil properties to be examined within the fields. The results indicated that relations were inconsistent; they were stronger in some areas than others. A regression of ECa on the principal component scores of the leading components for both fields showed that the first two components accounted for a large proportion of the variance in ECa, whereas the others accounted for little or none. For Crowmarsh topsoil sand and clay, loss on ignition and volumetric water measured in the autumn had large correlations on the first component, and for Yattendon they were large for topsoil sand and clay, and autumn and spring volumetric water. The cross-variograms suggested strong coregionalization between ECa and several soil physical properties; in particular subsoil sand and silt at Crowmarsh, and subsoil sand and clay at Yattendon. The structural correlations from the linear model of coregionalization confirmed the strength of the relations between ECa and the subsoil properties. Nevertheless, no one property was consistently important for both fields. Although a map of ECa can indicate the general patterns of spatial variation in the soil, it is not a substitute for information on soil properties obtained by sampling and analysing the soil. Nevertheless, it could be used to guide further sampling. (c) 2005 Elsevier B.V. All rights reserved.
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A combination of idealized numerical simulations and analytical theory is used to investigate the spacing between convective orographic rainbands over the Coastal Range of western Oregon. The simulations, which are idealized from an observed banded precipitation event over the Coastal Range, indicate that the atmospheric response to conditionally unstable flow over the mountain ridge depends strongly on the subridge-scale topographic forcing on the windward side of the ridge. When this small-scale terrain contains only a single scale (l) of terrain variability, the band spacing is identical to l, but when a spectrum of terrain scales are simultaneously present, the band spacing ranges between 5 and 10 km, a value that is consistent with observations. Based on the simulations, an inviscid linear model is developed to provide a physical basis for understanding the scale selection of the rainbands. This analytical model, which captures the transition from lee waves upstream of the orographic cloud to moist convection within it, reveals that the spacing of orographic rainbands depends on both the projection of lee-wave energy onto the unstable cap cloud and the growth rate of unstable perturbations within the cloud. The linear model is used in tandem with numerical simulations to determine the sensitivity of the band spacing to a number of environmental and terrain-related parameters.