Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial

BACKGROUND Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis posterior muscle and its tendon can lead to a flattening of the longitudinal arch of the foot. Those affected can experience functional impairment and pain. Less severe cases at an early stage are eligible for non-surgical treatment and foot orthoses are considered to be the first line approach. Furthermore, strengthening of arch and ankle stabilising muscles are thought to contribute to active compensation of the deformity leading to stress relief of soft tissue structures. There is only limited evidence concerning the numerous therapy approaches, and so far, no data are available showing functional benefits that accompany these interventions. METHODS After clinical diagnosis and clarification of inclusion criteria (e.g., age 40-70, current complaint of foot and ankle pain more than three months, posterior tibial tendon dysfunction stage I & II, longitudinal arch flattening verified by radiography), sixty participants with posterior tibial tendon dysfunction associated complaints will be included in the study and will be randomly assigned to one of three different intervention groups: (i) foot orthoses only (FOO), (ii) foot orthoses and eccentric exercise (FOE), or (iii) sham foot orthoses only (FOS). Participants in the FOO and FOE groups will be allocated individualised foot orthoses, the latter combined with eccentric exercise for ankle stabilisation and strengthening of the tibialis posterior muscle. Participants in the FOS group will be allocated sham foot orthoses only. During the intervention period of 12 weeks, all participants will be encouraged to follow an educational program for dosed foot load management (e.g., to stop activity if they experience increasing pain). Functional impairment will be evaluated pre- and post-intervention by the Foot Function Index. Further outcome measures include the Pain Disability Index, Visual Analogue Scale for pain, SF-12, kinematic data from 3D-movement analysis and neuromuscular activity during level and downstairs walking. Measuring outcomes pre- and post-intervention will allow the calculation of intervention effects by 3×3 Analysis of Variance (ANOVA) with repeated measures. DISCUSSION The purpose of this randomised trial is to evaluate the therapeutic benefit of three different non-surgical treatment regimens in participants with posterior tibial tendon dysfunction and accompanying pes planovalgus. Furthermore, the analysis of changes in gait mechanics and neuromuscular control will contribute to an enhanced understanding of functional changes and eventually optimise conservative management strategies for these patients. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: ClinicalTrials.gov ID NCT01839669.

Management of Home Parenteral Nutrition: A Prospective Multicenter Observational Study

BACKGROUND There are no specific Swiss home parenteral nutrition (HPN) data showing patient characteristics, quality of life (QoL) and complications. The goal of this study was to collect representative nationwide data on current adult HPN patients in Switzerland for international comparability and benchmarking. METHODS This was a multicenter, nationwide, observational study. We conducted interviews for demographics, PN characteristics, QoL and complications. The data were assessed at baseline and after a follow-up of 3 months using a questionnaire. RESULTS Thirty-three adult patients were included. The most common underlying diseases were cancer, radiation enteritis and state after bariatric surgery, and the most prevalent indication was short bowel syndrome. During the 3-month observation period, significant increase or stabilization of body weight occurred in the patients, physical activity scores improved from 34.0 to 39.4 and mental scores improved from 41.9 to 46.4. HPN dependency and traveling restrictions were of the greatest concern. Diarrhea, xerostomia and/or thirst were frequent complaints. CONCLUSION Anthropometric parameters and QoL improved during the observational period in this HPN cohort. These Swiss HPN data are prerequisite for evaluation and comparison of HPN recommendations and best clinical practice, status of professional care instructions related to HPN effectiveness, quality of treatment and patient safety.

A feasibility study for assessing building occupants' indoor air quality expectations compared to nationally recognized standards

Indoor Air Quality (IAQ) can have significant implications for health, productivity, job performance, and operating cost. Professional experience in the field of indoor air quality suggests that high expectations (better than nationally established standards) (American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE)) of workplace indoor air quality lead to increase air quality complaints. To determine whether there is a positive association between expectations and indoor air quality complaints, a one-time descriptive and analytical cross-sectional pilot study was conducted. Area Safety Liaisons (n = 330) at University of Texas Health Science Center – Houston were asked to answer a questionnaire regarding their expectations of four workplace indoor air quality indicators i.e., (temperature, relative humidity, carbon dioxide, and carbon monoxide) and if they experienced and reported indoor air quality problems. A chi-square test for independence was used to evaluate associations among the variables of interest. The response rate was 54% (n = 177). Results did not show significant associations between expectation and indoor air quality. However, a greater proportion of Area Safety Liaisons who expected indoor air quality indicators to be better than the established standard experienced greater indoor air quality problems. Similarly, a slightly higher proportion of Area Liaisons who expected indoor air quality indicators to be better than the standard reported greater indoor air quality complaints. ^ The findings indicated that a greater proportion of Area Safety Liaisons with high expectations (conditions that are beyond what is considered normal and acceptable by ASHRAE) experienced greater indoor air quality discomfort. This result suggests a positive association between high expectations and experienced and reported indoor air quality complaints. Future studies may be able to address whether the frequency of complaints and resulting investigations can be reduced through information and education about what are acceptable conditions.^

BIOMEDICAL LANGUAGE UNDERSTANDING AND EXTRACTION (BLUE-TEXT): A MINIMAL SYNTACTIC, SEMANTIC METHOD

Clinical text understanding (CTU) is of interest to health informatics because critical clinical information frequently represented as unconstrained text in electronic health records are extensively used by human experts to guide clinical practice, decision making, and to document delivery of care, but are largely unusable by information systems for queries and computations. Recent initiatives advocating for translational research call for generation of technologies that can integrate structured clinical data with unstructured data, provide a unified interface to all data, and contextualize clinical information for reuse in multidisciplinary and collaborative environment envisioned by CTSA program. This implies that technologies for the processing and interpretation of clinical text should be evaluated not only in terms of their validity and reliability in their intended environment, but also in light of their interoperability, and ability to support information integration and contextualization in a distributed and dynamic environment. This vision adds a new layer of information representation requirements that needs to be accounted for when conceptualizing implementation or acquisition of clinical text processing tools and technologies for multidisciplinary research. On the other hand, electronic health records frequently contain unconstrained clinical text with high variability in use of terms and documentation practices, and without commitmentto grammatical or syntactic structure of the language (e.g. Triage notes, physician and nurse notes, chief complaints, etc). This hinders performance of natural language processing technologies which typically rely heavily on the syntax of language and grammatical structure of the text. This document introduces our method to transform unconstrained clinical text found in electronic health information systems to a formal (computationally understandable) representation that is suitable for querying, integration, contextualization and reuse, and is resilient to the grammatical and syntactic irregularities of the clinical text. We present our design rationale, method, and results of evaluation in processing chief complaints and triage notes from 8 different emergency departments in Houston Texas. At the end, we will discuss significance of our contribution in enabling use of clinical text in a practical bio-surveillance setting.

Decentralization in Nation State Building of Indonesia

Introduction：Today, many countries, regardless of developed or developing, are trying to promote decentralization. According to Manor, as his quoting of Nickson’s argument, decentralization stems from the necessity to strengthen local governments as proxy of civil society to fill the yawning gap between the state and civil society (Manor [1999]: 30). With the end to the Cold War following the collapse of the Soviet Union rendering the cause of the “leadership of the central government to counter communism” meaningless, Manor points out, it has become increasingly difficult to respond flexibly to changes in society under the centralized system. Then, what benefits can be expected from the effectuation of decentralization? Litvack-Ahmad-Bird cited the four points: attainment of allocative efficiency in the face of different local preferences for local public goods; improvement to government competitiveness; realization of good governance; and enhancement of the legitimacy and sustainability of heterogeneous national states (Litvack, Ahmad & Bird [1998]: 5). They all contribute to reducing the economic and social costs of a central government unable to respond to changes in society and enhancing the efficiency of state administration through the delegation of authority to local governments. Why did Indonesia have a go at decentralization? As Maryanov recognizes, reasons for the implementation of decentralization in Indonesia have never been explicitly presented (Maryanov [1958]: 17). But there was strong momentum toward building a democratic state in Indonesia at the time of independence, and as indicated by provisions of Article 18 of the 1945 Constitution, there was the tendency in Indonesia from the beginning to debate decentralization in association with democratization. That said debate about democratization was fairly abstract and the main points are to ease the tensions, quiet the complaints, satisfy the political forces and thus stabilize the process of government (Maryanov [1958]: 26-27). 　　　What triggered decentralization in Indonesia in earnest, of course, was the collapse of the Soeharto regime in May 1998. The Soeharto regime, regarded as the epitome of the centralization of power, became incapable of effectively dealing with problems in administration of the state and development administration. Besides, the post-Soeharto era of “reform (reformasi)” demanded the complete wipeout of the Soeharto image. In contraposition to the centralization of power was decentralization. The Soeharto regime that ruled Indonesia for 32 years was established in 1966 under the banner of “anti-communism.” The end of the Cold War structure in the late 1980s undermined the legitimate reason the centralization of power to counter communism claimed by the Soeharto regime. The factor for decentralization cited by Manor is applicable here. 　　　Decentralization can be interpreted to mean not only the reversal of the centralized system of government due to its inability to respond to changes in society, as Manor points out, but also the participation of local governments in the process of the nation state building through the more positive transfer of power (democratic decentralization) and in the coordinated pursuit with the central government for a new shape of the state. However, it is also true that a variety of problems are gushing out in the process of implementing decentralization in Indonesia. 　　　This paper discusses the relationship between decentralization and the formation of the nation state with the awareness of the problems and issues described above. Section 1 retraces the history of decentralization by examining laws and regulations for local administration and how they were actually implemented or not. Section 2 focuses on the relationships among the central government, local governments, foreign companies and other actors in the play over the distribution of profits from exploitation of natural resources, and examines the process of the ulterior motives of these actors and the amplification of mistrust spawning intense conflicts that, in extreme cases, grew into separation and independence movements. Section 3 considers the merits and demerits at this stage of decentralization implemented since 2001 and shed light on the significance of decentralization in terms of the nation state building. Finally, Section 4 attempts to review decentralization as the “opportunity to learn by doing” for the central and local governments in the process of the nation state building. 　　　In the context of decentralization in Indonesia, deconcentration (dekonsentrasi), decentralization (desentralisasi) and support assignments (tugas pembantuan; medebewind, a Dutch word, was used previously) are defined as follows. Dekonsentrasi means that when the central government puts a local office of its own, or an outpost agency, in charge of implementing its service without delegating the administrative authority over this particular service. The outpost agency carries out the services as instructed by the central government. A head of a local government, when acting for the central government, gets involved in the process of dekonsentrasi. Desentralisasi, meanwhile, occurs when the central government cedes the administrative authority over a particular service to local governments. Under desentralisasi, local governments can undertake the particular service at their own discretion, and the central government, after the delegation of authority, cannot interfere with how local governments handle that service. Tugas pembantuan occur when the central government makes local governments or villages, or local governments make villages, undertake a particular service. In this case, the central government, or local governments, provides funding, equipment and materials necessary, and officials of local governments and villages undertake the service under the supervision and guidance of the central or local governments. Tugas pembantuan are maintained until local governments and villages become capable of undertaking that particular service on their own.

Hogar digital para servicios FTTH : dispositivos, tecnologías y QoE

FTTH (fibra hasta el hogar) es actualmente, junto con la banda ancha móvil, la principal evolución tecnológica en Redes y Servicios de Telecomunicaciones. Se prevé que en los próximos años, el despliegue de las redes FTTH se vea incrementado de manera significativa, gracias al interés creciente tanto de Operadores de Telecomunicaciones como de Organismos Gubernamentales. Este despliegue (que en el año 2013 ya se está haciendo realidad) llevará servicios de muy alta velocidad (superiores a 100 Mbps, incluso 1 Gbps) de manera masiva a los hogares, exigiendo nuevos requisitos y prestaciones en la red del hogar de los clientes. Se abre aquí, por tanto, un campo de exploración novedoso, incipiente y de requerimientos cada vez más exigentes. De hecho, sin duda, la red del hogar es uno de los elementos fundamentales para el éxito de las redes y servicios en FTTH. Debido a todo lo anterior, se convierte en una necesidad para el sector de las Telecomunicaciones el encontrar soluciones a los problemas anteriormente mencionados. Con objeto de contribuir al análisis de soluciones, este proyecto se enfoca en dos temas, ambos relacionados con la problemática ya mencionada en la red del hogar:  Prospección e identificación de soluciones tecnológicas avanzadas para la red del hogar. Descrito en capítulos 2, 3 y 4. En ellos se realiza un estudio detallado de la situación actual y tendencias futuras de los dispositivos utilizados en la red del hogar. Este estudio está enfocado en la distribución de señales de muy alto ancho de banda (en torno a los 100 Mbps por segundo) en el hogar.  Diseño y desarrollo de una aplicación que permita determinar la calidad de experiencia de cliente (QoE) de un servicio de televisión IP (IPTV). Descrito en capítulos 5 y 6. Se ha seleccionado este tipo de servicios debido a que son los que requieren mayores prestaciones tanto de la red de transporte como de la red del hogar y, al mismo tiempo, son los más complicados de medir debido a la fuerte componente de subjetividad del usuario final. Una red del hogar correctamente diseñada debe cumplir de manera equilibrada los requisitos demandados tanto por el operador como por el cliente o usuario final del servicio. Los requisitos del operador se centran principalmente en el control de la inversión (CAPEX) y del gasto de mantenimiento de la red del hogar (OPEX). El usuario, por otra parte, requiere sencillez en la instalación y mínimo número de elementos a instalar (cero intrusismo, ausencia de cableado). Para adaptarse a estos requerimientos, existe una serie de dispositivos y tecnologías que buscan encontrar el punto de equilibrio entre necesidades de operadores y de clientes finales. Las soluciones actualmente utilizadas pueden dividirse en soluciones cableadas e inalámbricas. También existen soluciones híbridas. Todas ellas se describen en detalle en los capítulos 3 y 4. Al final del estudio se concluye que, con la tecnología actual, es preferible el uso de soluciones cableadas tipo Ethernet o POF. Es recomendable no usar soluciones PLC de manera extensiva (G.hn puede ser una alternativa a futuro) y, en caso de no requerir cableado, utilizar WiFi 11n con frecuencias de 5 GHz, así como sus evoluciones, WiFi 11ac y 11ad. La aplicación desarrollada, explicada en los capítulos 5 y 6, permite capturar y medir en tiempo real la señal de televisión IP que se entrega al usuario. Esta aplicación estimará, a partir de dichas medidas, la calidad de la señal entregada. Para ello tendrá en cuenta el tipo de descodificador utilizado por el usuario así como la red empleada (red FTTH de Telefónica). Esta aplicación podría ser utilizada en los centros de atención técnica de las operadoras de telecomunicaciones, determinando así la relación existente entre reclamaciones recibidas y calidad de servicio medida por la aplicación. Asimismo, aparte de realizar medidas en tiempo real, la aplicación vuelca las medidas realizadas y alarmas detectadas en ficheros log, facilitando el análisis técnico de los problemas e incidencias registrados por dichos centros técnicos. Igualmente, esta aplicación puede ser utilizada para el proceso de certificación de equipamiento de red del hogar o incluso como herramienta para profundizar en parámetros teóricos y criterios de medida de calidad de servicio en IPTV. ABSTRACT. FTTH (Fiber To The Home) and mobile broadband are currently the main technological trend in the Network and Telecommunications Services area. In the next few years, the deployment of FTTH networks will experiment a significant increase, due to the growing interest of both telecommunications operators and government agencies. This deployment (that is becoming a reality) which will massively carry high-speed services to households (speeds of more than 100 Mbps, even 1 Gbps) will demand new requirements and features in the customer’s home network. It can be found here a new and emerging field of exploration, with increasingly demanding requirements. In fact, the home network is one of the key elements for the success of FTTH network and services. Due to the aforementioned, it is a necessity for the telecommunications industry to find solutions to these problems. In order to contribute into the solution analysis, this project focuses on two subjects, both related to the problems of home networking:  Exploratory research and identification of advanced technology solutions for the home network. Described in chapters 2, 3 and 4. These chapters show a detailed study of the current situation and future trends of the devices used at the home network. It focuses on the distribution of very high bandwidth signals (around 100 Mbps per second) in the customer’s home.  Design and development of an application to evaluate customer’s quality of experience (QoE) of an IP television service (IPTV). Described in chapters 5 and 6. IPTV service has been selected because it requires higher performance both from the transport and the home networks and, at the same time, it is the most difficult to measure due to the strong component of subjectivity of the end user. A correct design of the home network must meet the requirements demanded both by the network operator and the customer (end user of the service). Network operator requirements mainly focus on reduced capital expenditures (CAPEX) and operational expenditures (OPEX). Additionally, the final user requires a simple and easy installation and also the minimum number of items to install (zero intrusion, lack of wiring, etc.). Different devices and technologies seek to find a balance between these two requirements (network operators and final users requirements). Solutions available in the market can be divided into wired and wireless. There are also hybrid solutions. All of them are described thoroughly in the first part of the project. The conclusion at the end of the study recommends the use of wired technologies like Ethernet or POF. Additionally, the use of PLC is not advised (G.hn can be an alternative in the future) and, in the case of not requiring wiring, the use of 11ac and 11ad WiFi is advised. The application developed in the second part of the project allows capturing and measuring the real-time IPTV signal delivered to the user. This application will estimate the delivered signal quality from the captured measurements. For this purpose, it will also consider the type of decoder installed on the customer’s premises and the transport network (Telefonica’s FTTH network). This application could be used at the operator’s technical service centres, determining in this way the relationship between user’s complaints and the quality of service measured. Additionally, this application can write all the measurements and alarms in log files, making easier the technical analysis of problems and impairments recorded by the technical centres. Finally, the application can also be used for the certification process of home networking equipment (i.e. decoders) or even as a tool to deepen theoretical parameters and measuring criteria of quality of service in IPTV.

¿Es este un proyecto de Mies? / Is this a Mies s project?

Is this a Mies?s project? Disappearances, or the art of being a Mies project Angel Borrego Several years ago I had to solve the structure of Mies House of the Werkbund exhibition of 1931 as an exercise for a course named Structures Projects in the School of Architecture of Madrid. We were offered this house as an exercise because there had been some complaints about having to calculate and deal with ?bad, real, anonymous? architecture widely recognized as such, in so far as it has been widely published, that furthermore had some ideal quality to it, a quality reinforced by the fact that it was not there anymore, one could not go and see it, old and deteriorated, all images we have of it are of a shiny new object: in fact its ideal quality was even present in that it had not even been designed to be a completely real house, as nobody ever lived there and wasn?t supposed to. It was a three dimensional representation of a house, what gave it a further flair of ideality. And it was as well the representation of an idea, and we all liked that. Last but not least, it had Mies to back it up, which promised us the remote possibility of analyzing one of his works in depth, with proper tools (this was a structures course, and we had already read, or heard, something about the importance of structures in Mies?s work.) We were lured by the possibility of reconstructing, if not the pavilion, some of the ideas leading to it. Ideas that were themselves structural, like the ?perfectly regular all columnar structure?, an ideal structure. We had a sensation that we could somehow reproduce the process and thoughts of Mies leading to the solution of a particular work, investigate him in a cuasi archaeological manner, reconstruct the project, as if being able to reconstruct one work we could reconstruct the entire Mies, and placing ourselves in his position replace him, which was to know for once where we were (1). All these thoughts, passed through our minds more or less abstractly, believe it or not, before we realized that we were supposed to imagine that the roof was also supported by the walls and that the plan was lacking two columns, which was short. We could not believe that only to make the exercise more difficult, as it was admitted, the professors would mutilate a Mies work in such a way. The exercise had lost all interest to us and there were some timid protests. The surprise came when, though admitting that the supporting walls had been their idea, the professors said they had not manipulated the plan of the house at all. Some confusion followed, since that seemed quite incredible to us, even more to professors I guess. Two of us went to the library and checkout two books, one being the ?History of Modern Architecture? (the Benevolo as it was known), from where they said to have copied the plan of the house for the exercise, and another book on Mies that included the same project. The Benevolo was actually lacking the two columns, but the other book included them, making clear our point. We were able to reorient the exercise and calculate the house just as Mies had designed it. We, the students I mean, were really happy, since we had a voice in the discipline of architecture: our own discipline since we were the ones being disciplined, and we had been allowed to freely talk our way through it. I had the nice sensation that what happened was curiously and rewardingly similar to, or a kind of metaphor for, the flowing space of the free plan, that was allowed to move through the perfectly regular structure, a most disciplined structure. As Mark Wigley has noted, discipline is intimately related to prothesis. The concept of prothesis (pro-thesis) would be already architectural as ?the act of placing before?, referring to a structure that has to be placed before anything else; it is already a structure, rather than being something added that could be removed..

Sistema de adquisición de datos para una aplicación de detección del ruido de reversa en tiempo real

Entre todas las fuentes de ruido, la activación de la propulsión en reversa de un avión después de aterrizar es conocida por las autoridades del aeropuerto como una causa importante de impacto acústico, molestias y quejas en las proximidades vecinas de los aeropuertos. Por ello, muchos de los aeropuertos de todo el mundo han establecido restricciones en el uso de la reversa, especialmente en las horas de la noche. Una forma de reducir el impacto acústico en las actividades aeroportuarias es implementar herramientas eficaces para la detección de ruido en reversa en los aeropuertos. Para este proyecto de fin de carrera, aplicando la metodología TREND (Thrust Reverser Noise Detection), se pretende desarrollar un sistema software capaz de determinar que una aeronave que aterrice en la pista active el frenado en reversa en tiempo real. Para el diseño de la aplicación se plantea un modelo software, que se compone de dos módulos:  El módulo de adquisición de señales acústicas, simula un sistema de captación por señales de audio. Éste módulo obtiene muestra de señales estéreo de ficheros de audio de formato “.WAV” o del sistema de captación, para acondicionar las muestras de audio y enviarlas al siguiente módulo. El sistema de captación (array de micrófonos), se encuentra situado en una localización cercana a la pista de aterrizaje.  El módulo de procesado busca los eventos de detección aplicando la metodología TREND con las muestras acústicas que recibe del módulo de adquisición. La metodología TREND describe la búsqueda de dos eventos sonoros llamados evento 1 (EV1) y evento 2 (EV2); el primero de ellos, es el evento que se activa cuando una aeronave aterriza discriminando otros eventos sonoros como despegues de aviones y otros sonidos de fondo, mientras que el segundo, se producirá después del evento 1, sólo cuando la aeronave utilice la reversa para frenar. Para determinar la detección del evento 1, es necesario discriminar las señales ajenas al aterrizaje aplicando un filtrado en la señal capturada, después, se aplicará un detector de umbral del nivel de presión sonora y por último, se determina la procedencia de la fuente de sonido con respecto al sistema de captación. En el caso de la detección del evento 2, está basada en la implementación de umbrales en la evolución temporal del nivel de potencia acústica aplicando el modelo de propagación inversa, con ayuda del cálculo de la estimación de la distancia en cada instante de tiempo mientras el avión recorre la pista de aterrizaje. Con cada aterrizaje detectado se realiza una grabación que se archiva en una carpeta específica y todos los datos adquiridos, son registrados por la aplicación software en un fichero de texto. ABSTRACT. Among all noise sources, the activation of reverse thrust to slow the aircraft after landing is considered as an important cause of noise pollution by the airport authorities, as well as complaints and annoyance in the airport´s nearby locations. Therefore, many airports around the globe have restricted the use of reverse thrust, especially during the evening hours. One way to reduce noise impact on airport activities is the implementation of effective tools that deal with reverse noise detection. This Final Project aims to the development of a software system capable of detecting if an aircraft landing on the runway activates reverse thrust on real time, using the TREND (Thrust Reverser Noise Detection) methodology. To design this application, a two modules model is proposed: • The acoustic signals obtainment module, which simulates an audio waves based catchment system. This module obtains stereo signal samples from “.WAV” audio files or the catchment system in order to prepare these audio samples and send them to the next module. The catchment system (a microphone array) is located on a place near the landing runway. • The processing module, which looks for detection events among the acoustic samples received from the other module, using the TREND methodology. The TREND methodology describes the search of two sounds events named event 1 (EV1) and event 2 (EV2). The first is the event activated by a landing plane, discriminating other sound events such as background noises or taking off planes; the second one will occur after event one only when the aircraft uses reverse to slow down. To determine event 1 detection, signals outside the landing must be discriminated using a filter on the catched signal. A pressure level´s threshold detector will be used on the signal afterwards. Finally, the origin of the sound source is determined regarding the catchment system. The detection of event 2 is based on threshold implementations in the temporal evolution of the acoustic power´s level by using the inverse propagation model and calculating the distance estimation at each time step while the plane goes on the landing runway. A recording is made every time a landing is detected, which is stored in a folder. All acquired data are registered by the software application on a text file.

Emotions in services: complaint in B2C e-commerce

This study proposes a service recovery (SR) model to describe how cumulative satisfaction, loyalty and word-of-mouth are affected by complaints. The model is based on the role of positive and negative emotions in satisfaction with service recovery (SSR) processes. While prior SSR studies usually investigated only negative emotions and satisfaction with a specific transaction, this research considered both positive and negative emotions.

A model of air transport passenger incidents and rights

This paper describes a representation of the legal framework in the air transport passenger's rights domain and the foremost incidents that trigger the top of consumer complaints ranking in the EU. It comprises the development of a small network of three ontologies, formalisation of scenarios, specification of properties and identification of relations. The approach is illustrated by means of a case study based in the context of a real life cancelled flight incident. This is part of an intended support-system that aims to provide both consumers and companies with relevant legal information to enhance the decision-making process.

Ontology-driven legal support-system in air transport passenger domain

This paper aims to present a preliminary version of asupport-system in the air transport passenger domain. This system relies upon an underlying on-tological structure representing a normative framework to facilitatethe provision of contextualized relevant legal information.This information includes the pas-senger's rights and itenhances self-litigation and the decision-making process of passengers.Our contribution is based in the attempt of rendering a user-centric-legal informationgroundedon case-scenarios of the most pronounced incidents related to the consumer complaints in the EU.A number ofadvantages with re-spect to the current state-of-the-art services are discussed and a case study illu-strates a possible technological application.

Estudio de la fisuración en particiones verticales de yeso laminado, producidas por la deformación de forjados

Las exigencias de calidad, tanto en el ámbito de la rehabilitación como en el de las obras de nueva planta, obligan a evitar la fisuración de la tabiquería. Una de sus principales causas es la deformación excesiva de los forjados. Aunque en la mayoría de los casos no tiene efectos estructurales sino solamente estéticos, es necesario tomar precauciones para evitar la fisuración, pues es una de las patologías más frecuentes y en muchos casos motivo de reclamación de los usuarios. El aumento del consumo de los paneles de placa de yeso laminado y lana de roca para la realización de tabiquerías, justifica la necesidad de ahondar en el conocimiento del comportamiento y del mecanismo de fisuración de este material, pues hasta la fecha no se ha encontrado ningún trabajo especificamente dedicado al estudio del comportamiento en fractura de paneles sandwich de placa de yeso laminado y lana de roca en su plano. A la hora de abordar el estudio del comportamiento en fractura del material objeto de esta tesis, es preciso tener en cuenta que se trata de un material compuesto y, como tal, sus propiedades mecánicas y resistentes dependen en gran medida de las de sus componentes. Por tanto, para poder explicar el comportamiento en fractura del panel sandwich, habrá que estudiar también el de sus componentes. Por otro lado, se considera también muy útil disponer de una herramienta de calculo para la simulación de la fractura de paneles sandwich que sea predictiva. Este modelo hará posible facilitar el diseño de tabiquerías que no se fisure con este material, al poder relacionar las flechas que pueden tomar los forjados con su potencial fisuración. Para contrastar y validar un modelo de este tipo, es necesario disponer de suficientes datos experimentales del comportamiento en fractura del panel sandwich de placa de yeso laminado y lana de roca, que se puedan simular numericamente con el mismo. A partir de lo anteriormente expuesto se plantea, en primer lugar, una campaña experimental con el fin de obtener los parámetros necesarios para caracterizar el comportamiento en fractura de los paneles sandwich y sus componentes: placa de yeso laminado y lana de roca, estudiando también, su comportamiento en fractura en Modo Mixto, y el efecto del tamaño en los parámetros del panel. Por otro lado se propone un modelo de cálculo para la simulación de la fractura en Modo Mixto de paneles sandwich de placa de yeso laminado y lana de roca, comprobando la validez del modelo numérico a partir de los resultados experimentales obtenidos en la campaña de ensayos. Finalmente, se aplica el modelo para estudiar la fisuración de tabiquería realizada con el panel sandwich producida por la deformación de forjados unidireccionales realizados con viguetas de hormigón y bovedilla cerámica, por ser esta tipología la más usual en obras de edificación de viviendas. The quality requirements in terms of rehabilitation and new Works, force to prevent cracking on partitions and one of the main causes is the excessive deformation of the floor. In most of the cases, there are any structural damages, only aesthetic effects, but it is necessary to take precautions to avoid cracking because it is one of the most common diseases and in addition is the main reason of user’s complaints. The increased consumption of plasterboard panels and mineral wool used to build partitions, justifies the need to develop a deeper understanding of the cracking behaviour and mechanism, because by now, any specifically work dedicated to the study of fractures behaviour of sandwich plasterboard panels and rock wool has been found. When approaching the study of the fracture behaviour of the material it must bear in mind that we are referring to a composite material and as such, its mechanical and strength properties depend heavily on its components. Therefore, to explain the fracture behaviour of sandwich panels its components must be studied as well. On the other hand, it is also considered very useful to have a calculation tool to simulate the more likely fractures of the sandwich panel in order to predict it. This model used to perform simulations will enable the design of partitions built with these materials without cracks because it will relate the deflections in decks with its potential cracking. To contrast and validate this type of model, it is necessary and imperative to have enough experimental data of the sandwich plasterboard and rock wool fractures in order to enable its numerical simulation with it. On the basis of the above, the question arises firstly an experimental campaign in order to obtain the necessary parameters to characterize the cracking behaviour of sandwich panels and its components: plasterboard and rock wool, studying also its cracking behaviour in a mixed mode fracture and the effect of size parameters of the panel. Furthermore, a calculation model to simulate fractures in mixed mode of the sandwich panels made of plasterboard and rock wool is proposed in order to check the validity of the numerical model, based on experimental results obtained from the test campaign. Finally, this model is applied to study cracking on partitions built with sandwich panels resulting from the unidirectional floor’s deformations built with prestressed concrete beams and slab pottery pieces being this typology the most common one on residential buildings works.

Pré-condicionamento isquêmico remoto em portadores de claudicação intermitente de membros inferiores

INTRODUÇÃO: Pré-condicionamento isquêmico remoto (PCIR) é o fenômeno pelo qual curtos períodos de isquemia sub-letal sobre um órgão ou tecido, intercalados com reperfusão do mesmo, conferem a outros órgãos ou tecidos distantes deste, um aumento na capacidade da resistir a episódios subsequentes de isquemia, a qual os mesmos possam ser expostos. Com base nesse fato, testamos a hipótese de que o pré-condicionamento isquêmico remoto em pacientes portadores de claudicação intermitente de membros inferiores poderia aumentar a capacidade de deambulação desses pacientes, extrapolando o conceito do PCIR de aumento da capacidade de preservação da integridade celular frente à isquemia, para a manutenção da função celular, tornando a célula mais apta ao trabalho em situações de privação de oxigênio, geradas pela restrição do fluxo sanguíneo, como ocorre nos pacientes com claudicação intermitente de membros inferiores, durante o exercício. OBJETIVOS: Avaliar se o PCIR aumenta a distância de início de claudicação e/ou a distância total de claudicação em pacientes com doença arterial obstrutiva periférica. MÉTODOS: Foram estudados 52 pacientes ambulatoriais que apresentavam queixa de claudicação intermitente dos membros inferiores, associada a um pulso arterial ausente ou reduzido no membro sintomático e/ou um índice tornozelo-braço <0,90. Estes pacientes foram randomizados em três grupos (A, B e C). Todos os pacientes foram submetidos a dois testes de caminhada em esteira de acordo com o protocolo de Gardner. O grupo A fez o primeiro teste de esteira sem o pré-condicionamento isquêmico remoto e, após 7 dias, foi submetido a um novo teste de esteira, agora precedido pelo pré-condicionamento isquêmico remoto. O grupo B foi submetido ao pré-condicionamento isquêmico remoto antes do primeiro teste de esteira e, após 7 dias, realizou novo teste de esteira, agora sem o pré-condicionamento isquêmico remoto. Já no Grupo C (grupo controle), ambos os testes de esteira foram realizados sem pré-condicionamento isquêmico remoto, também com 7 dias de intervalo. RESULTADOS: Os grupos A e C mostraram um aumento na distância de início de claudicação, no segundo teste, em comparação com o primeiro teste. O grupo A teve um aumento estatisticamente significativo, em relação ao grupo C (grupo controle). Com relação à distância total de claudicação, todos os grupos (A, B e C), mostraram um aumento estatisticamente significativo a favor do segundo teste, porém não foi observada diferença entre os grupos (A, B e C). CONCLUSÕES: O pré-condicionamento isquêmico remoto aumentou a distância inicial de claudicação em pacientes com claudicação intermitente, no entanto, ele não afetou a distância total de claudicação dos pacientes portadores de claudicação intermitente de membros inferiores

A integralidade do cuidado na Estratégia Saúde da Família - um aporte para uma anamnese ampliada

A Estratégia Saúde da Família (ESF) nem sempre contempla a integralidade, apesar deste ser um princípio estruturante do Sistema Único de Saúde (SUS), nas definições da Organização Mundial de Saúde (OMS) e da legislação brasileira que ampliam o conceito de saúde, atribuindo ao processo saúde/doença as influências das determinações sociais. As profissões da saúde ainda funcionam com abordagem reducionista. Infelizmente, conceitos, definições e legislação não são suficientes para conscientizar e tão pouco transformar as práticas de saúde. Esse trabalho propõe a elaboração de um questionário anamnetico ampliado focada em pacientes poliqueixosos, baseada na teoria de Fernando González Rey o que significa trabalhar com o enfoque histórico-cultural e subjetividade, portanto mais humanizado, a fim de experimentar outros modos de intervir no processo saúde/doença e romper sua abordagem fragmentada positivista visando contribuir para uma melhora na relação profissional/usuário na ESF. Para testar a efetividade do questionário, foi realizado um piloto que indicou ser importante para se alcançar os objetivos esperados, a necessidade da capacitação da equipe e a alteração nos processos de trabalho encontrados atualmente na ESF.

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

PURPOSE: To compare disk halo size in response to a glare source in eyes with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL. SETTING: Rementeria Ophthalmological Clinic, Madrid, Spain. DESIGN: Prospective randomized masked study. METHOD: Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in eyes that had cataract surgery and bilateral implantion of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and low-contrast (10%) logMAR letter charts. RESULTS: The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. The mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P<.05). Greater halo effects were reported in the multifocal IOL group (P<.05). The mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas the mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 logMAR and 0.13 logMAR in the multifocal than in the monofocal IOL group, respectively (P <.01). A significant positive correlation was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group (r = 0.72, P<.001). CONCLUSIONS: The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA.