Correlation between the anatomical and functional human subthalamic nucleus.

International audienceThis work addresses the spatial correlation between the anatomical and functional human subthalamic nucleus (STN). The anatomical STN (A-STN), derived from the Schaltenbrand-Wahren brain atlas, is histology based. The functional STN (F-STN) is probabilistic, constructed from neuroelectrophysiological and neuroimaging data of 184 Parkinson's disease patients. The A-STN and F-STN are placed in the same space and compared in terms of mutual relative overlapping of anatomy with function. The F-STN and A-STN correlate well for medium and high probabilities of the F-STN. For probability p >or= 0.3, >95% of F-STN is inside the A-STN, and for p >or= 0.5, the complete F-STN is inside the A-STN for each left and right STN. Therefore, the F-STN for p = 0.5 can potentially be used for identification of the STN in neuroimages

A probabilistic functional atlas of the VIM nucleus constructed from pre-, intra- and postoperative electrophysiological and neuroimaging data acquired during the surgical treatment of Parkinson's disease patients.

International audienceWe have previously introduced a concept of a probabilistic functional atlas (PFA) to overcome limitations of the current electronic stereotactic brain atlases: anatomical nature, spatial sparseness, inconsistency and lack of population information. The PFA for the STN has already been developed. This work addresses construction of the PFA for the ventrointermediate nucleus (PFA-VIM). The PFA-VIM is constructed from pre-, intra- and postoperative electrophysiological and neuroimaging data acquired during the surgical treatment of Parkinson's disease patients. The data contain the positions of the chronically implanted electrodes and their best contacts. For each patient, the intercommissural distance, height of the thalamus and width of the third ventricle were measured. An algorithm was developed to convert these data into the PFA-VIM, and to present them on axial, coronal and sagittal planes and in 3-D. The PFA-VIM gives a spatial distribution of the best contacts, and its probability is proportional to best contact concentration in a given location. The region with the highest probability corresponds to the best target. The PFA-VIM is calculated with 0.25-mm3 resolution from 107 best contacts in two situations: with and without lateral compensation against the width of the third ventricle. For the PFA-VIM compensated laterally, the anterior, lateral and dorsal coordinates of the mean value are (in mm) 6.24, 13.83, 1.68 for the left VIM and 6.54, -13.84, 2.10 for the right VIM. The coordinates of the mean value of the highest probability region along with the highest number of the best contacts (P) are: 6.25, 14.25, 1.75, P = 16, for the left VIM, and 6.0, -14.0, 1.00, P = 18, for the right VIM. The coordinate system origin is at the posterior commissure. For the PFA-VIM not compensated laterally, the coordinates of the mean value are 6.24, 13.99, 1.68 for the left VIM and 6.53, -14.13, 2.10 for the right VIM. The coordinates of the mean value of the highest probability region along with the highest number of the best contacts are 5.58, 13.67, 1.33, P = 14, for the left VIM, and 6.36, -14.03, 1.11, P = 17, for the right VIM. The PFA-VIM atlas overcomes several limitations of the current anatomical atlases and can improve targeting of thalamotomies and thalamic stimulations. It is dynamic and can easily be extended with new cases

Lasten yleisimmät tapaturmat ja niiden ensiapu päiväkodissa

Tämän opinnäytetyön tarkoituksena oli tuottaa lapsien ensiapuohjeet postereiden muodossa päiväkoti Auringonkukkaan. Postereiden tarkoituksena oli tukea henkilökunnan toimintaa ensiaputilanteissa. Ennen postereiden tuottamista opinnäytetyössä selvitettiin lasten tyypillisiä tapaturmia ja niiden syitä, henkilökunnan ensiapuvalmiuksia sekä ensiapupostereiden ulkoasua ja sisältöä. Tämän opinnäytetyön teoreettisessa viitekehyksessä kuvataan lapsen fyysistä kehitystä, yleisimpiä tapaturmia ja niiden syytekijöitä. Lisäksi etsitään ratkaisuja yleisimpien tapaturmien ehkäisemiseksi. Posterit tuotettiin palvelumuotoilun avulla. Palvelumuotoiluprosessi aloitettiin asiakasymmärryksen hankkimisella. Sitä hankittiin päiväkodin henkilökunnan teemahaastattelulla. Haastateltavia oli kuusi kappaletta. Aineisto analysoitiin mind map- käsitekarttojen avulla. Tämän kiteytyksen jälkeen aloitettiin postereiden konseptointi. Konseptointivaiheessa ideoitiin itsenäisesti kuusi erilaista posteria, tekemällä niistä hahmotelmat perustuen teoriatietoon sekä teemahaastattelusta saatuihin tuloksiin. Posterit arvioitiin päiväkodin työntekijöiden toimesta niiden kehittelyvaiheessa palautelomakkeen avulla. Palautteen pohjalta tehtiin tarvittavia muutoksia lopullisiin postereihin, joita tuli kolme kappaletta. Aiheena niissä oli lapsen elvytys, silmätapaturmat sekä vierasesine hengitysteissä. Posterit tehtiin mahdollisimman helppolukuisiksi ja selkeiksi. Toimintaohjeet kuvattiin lyhyesti ja ytimekkäästi. Jalkautusvaihe toteutettiin tilaajan toiveiden mukaisesti pelkästään sähköpostin välityksellä. Henkilökunnan ensiapuvalmiutta voitaisiin lisätä esimerkiksi ottamalla työaikaan kuuluvat säännöllisesti tapahtuvat ensiaputaitojen päivitykset. Lasten kanssa työskentelevien ensiapuvalmiudet koetaan erittäin tärkeäksi ja riittävällä osaamisella voidaan ehkäistä vakavampia tapaturmia ja säästää terveydenhuollon kustannuksissa.The purpose of this thesis was to produce guidelines for children’s first aid in the form of posters for a day-care centre (Auringonkukka). The posters were aimed at supporting the personnel’s actions in first aid situations. Before producing the posters of the thesis, there was an investigation of typical accidents and causes by children, the first aid capability of the personnel, and the layout and content of the first-aid kit. In the theoretical framework of the thesis we describe a child’s physical development, most common accidents and their causes. Additionally, we searched for solutions to prevent the most common accidents. Posters were produced through service design. The service design process started in understanding customer acquisition which was acquired through a theme interview with day-care personnel. There were six interviewees. The material was analyzed using mind map concept maps. After this crystallization, the concept of the poster was started. In the conceptual phase, six different posters were independently created, sketching them based on theoretical knowledge and the result of the theme interview. The posters were evaluated by the day-care personnel during the development phase using a feedback form. Based in the feedback, the necessary changes were made to the final posters, which came in three copies. The subject was on the child’s recovery, eye injuries, as well a foreign matter in the respiratory track. The posters were made as easy to read and clear as possible and the procedure was briefly and concisely described. An implementation phase was carried out in accordance with the wishes of the subscribed unit only via e-mail. The personnel of day-care first aid capability could be enhanced, for example by incorporating regular first aid skills updates during working hours. With children working in the first aid skills are considered extremely important and competent expertise can prevent more serious injuries and in general save on healthcare costs