Haptic interface based on tactile sensors for assistive devices

Tesis leída el 14 de febrero de 2018.Los países desarrollados deben hacer frente al creciente envejecimiento de su población. Un proceso de envejecimiento adecuado requiere capacidad funcional en las actividades del día a día. Así, las tecnologías de asistencia deben lidiar con uno de los principales problemas asociados con la edad: el deterioro de la movilidad. Los bastones y los andadores son prescritos para personas con movilidad reducida, pero aún con capacidad de andar. Sin embargo, hay un considerable número de personas en la tercera edad que necesitan otro tipo de ayuda. En este sentido, las sillas de ruedas eléctricas suponen un medio para el aumento de la participación y de la actividad de sus usuarios. Normalmente, estas sillas se conducen mediante un joystick alojado al final de uno de los reposabrazos. No obstante, este dispositivo no es adecuado para todo tipo de usuarios. Algunos de ellos lo encuentran difícil de usar y, para otros, su manejo no es posible y necesitan de la asistencia de otra persona (aquellos que padecen ciertas enfermedades del sistema nervioso, lesiones en la médula espinal, discapacidad mental, etc.). De esta manera, hay casos en que se requiere la ayuda de un cuidador que desplace la silla. Empujar una silla de ruedas de forma habitual produce distintos tipos de lesiones, por lo que es interesante que los asistentes o cuidadores también se beneficien de las ventajas de las sillas de ruedas eléctricas. En este caso, la solución más común consiste en otro joystick situado en la parte trasera de la silla. Como se ha apuntado anteriormente, este no es un dispositivo cómodo e intuitivo para muchos usuarios. Con respecto a la investigación, con frecuencia los dispositivos de asistencia propuestos basan su interfaz con el asistente en sensores de fuerza. Estos componentes son caros y suponen por tanto una barrera de cara a que el dispositivo llegue al mercado

Diseño de una pistola de aire comprimido para dardos anestésicos

The objective of the present project is to find a reliable solution to the current problem of the Veterinary Medicine department. Specifically, the wild animal’s team currently works with a blowgun to shot darts. Using this device jeopardizes the life of the user due to its small scope. For this reason, three solutions are proposed to solve this problem. These solutions use different engineering criteria for designing a useful and safe device...Este trabajo tiene como objetivo presentar una solución para el departamento de Medicina Veterinaria de la Universidad San Francisco de Quito que trabaja con animales silvestres, quienes al momento utilizan una cerbatana para disparar dardos anestésicos. Utilizar este equipo pone en riesgo al usuario debido a que el alcance del proyectil es corto, por lo que este debe disminuir la distancia entre el animal y él..

Wearable Urban Mobility Assistive Device for Visually Impaired Pedestrians Using a Smartphone and a Tactile-Foot Interface

This paper reports on the progress of a wearable assistive technology (AT) device designed to enhance the independent, safe, and efficient mobility of blind and visually impaired pedestrians in outdoor environments. Such device exploits the smartphone’s positioning and computing capabilities to locate and guide users along urban settings. The necessary navigation instructions to reach a destination are encoded as vibrating patterns which are conveyed to the user via a foot-placed tactile interface. To determine the performance of the proposed AT device, two user experiments were conducted. The first one requested a group of 20 voluntary normally sighted subjects to recognize the feedback provided by the tactile-foot interface. The results showed recognition rates over 93%. The second experiment involved two blind voluntary subjects which were assisted to find target destinations along public urban pathways. Results show that the subjects successfully accomplished the task and suggest that blind and visually impaired pedes-trians might find the AT device and its concept approach useful, friendly, fast to master, and easy to use

Evaluación del desempeño mecánico del mármol sintético basado en materiales compuestos poliéster – carbonato de calcio

RESUMEN: Los materiales compuestos basados en resinas de poliéster y carbonato de calcio son promisorios para la sustitución del mármol natural en varias aplicaciones tales como instalaciones sanitarias y decorativas. En el presente trabajo se evaluó las propiedades mecánicas de materiales compuestos de resina poliéster con diferentes contenidos de carbonato de calcio (5, 10, 15, 20, 25 y 30%). Se encontró que existe una estrecha dependencia entre la composición de las muestras y sus propiedades de resistencia a la tracción. Se determinó que a contenidos de carbonato de calcio superiores al 15% el material es completamente rígido. Alrededor de esta concentración se encuentra el límite de percolación mecánica del relleno en este tipo de materiales compuestos. La resistencia al impacto incrementó con la adición de relleno aun a concentraciones superiores a su límite de percolación, lo cual puede deberse a que la ruptura de la red de relleno absorbe parte de la energía que suministra el impacto.ABSTRACT: Composite materials based on polyester resin and calcium carbonate are promissory for the substitution of natural marble in several applications such as sanitary and decorative usage. In this work, the mechanical performance of composite materials of polyester with different calcium carbonate loads (5, 10, 15, 20, 25 and 30 wt%) were evaluated. A close relationship between the composition of the samples and their traction resistance properties was found. It was determined that at calcium carbonate contents higher than 15 wt% the material is completely stiff. Around this composition the mechanical percolation threshold is reached for this of composite materials. The impact resistance increased with the addition of filler even at concentrations lower than the percolation threshold, which could be due to fact that breaking down the filler network absorbs part of the energy applied to induce the rupture

Nuevos avances farmacologicos y no farmacologicos en diabetes tipo 1, revision de las nuevas fronteras y retos en una enfermedad endocrina compleja

Type 1 diabetes (DT1) is caused by autoimmune destruction of insulin-producing β cells located in the endocrine pancreas in areas known as islets of Langerhans. The current standard-of-care for DT1 is exogenous insulin replacement therapy. Recent developments in this field include the hybrid closed-loop system for regulated insulin delivery and long-acting insulins. Clinical studies on prediction and prevention of diabetes-associated complications have demonstrated the importance of early treatment and glucose control for reducing the risk of developing diabetic complications. Transplantation of primary islets offers an effective approach for treating patients with DT1. However, this strategy is hampered by challenges such as the limited availability of islets, extensive death of islet cells, and poor vascular engraftment of islets post-transplantation. Accordingly, there are considerable efforts currently underway for enhancing islet transplantation efficiency by harnessing the beneficial actions of stem cells. This review will provide an overview of currently available therapeutic options for DT1, and discuss the growing evidence that supports the use of stem cell approaches to enhance therapeutic outcomes La diabetes tipo 1 (DT1) es causada por la destrucción autoinmune de las células β productoras de insulina ubicadas en el páncreas endocrino en áreas conocidas como islotes de Langerhans. El estándar de atención actual para la DT1 es la terapia de reemplazo de insulina exógena. Los desarrollos recientes en este campo incluyen el sistema híbrido de circuito cerrado para la administración de insulina regulada e insulinas de acción prolongada. Los estudios clínicos sobre predicción y prevención de complicaciones asociadas a la diabetes han demostrado la importancia del tratamiento temprano y el control de la glucosa para reducir el riesgo de desarrollar complicaciones diabéticas. El trasplante de islotes primarios ofrece un enfoque eficaz para el tratamiento de pacientes con DT1. Sin embargo, esta estrategia se ve obstaculizada por desafíos como la disponibilidad limitada de islotes, la muerte extensa de las células de los islotes, y mal injerto vascular de los islotes después del trasplante. En consecuencia, actualmente se están realizando esfuerzos considerables para mejorar la eficiencia del trasplante de islotes mediante el aprovechamiento de las acciones beneficiosas de las células madre. Esta revisión brindará una descripción general de las opciones terapéuticas actualmente disponibles para la DT1 y analizará la creciente evidencia que respalda el uso de enfoques con células madre para mejorar los resultados terapeutico

Prevalence and Determinants of Mental Health among COPD Patients in a Population-Based Sample in Spain

(1) Background: To assess the prevalence of mental disorders (depression and anxiety), psychological distress, and psychiatric medications consumption among persons suffering from COPD; to compare this prevalence with non-COPD controls and to identify which variables are associated with worse mental health. (2) Methods: This is an epidemiological case-control study. The data were obtained from the Spanish National Health Survey 2017. Subjects were classified as COPD if they reported suffering from COPD and the diagnosis of this condition had been confirmed by a physician. For each case, we selected a non-COPD control matched by sex, age, and province of residence. Conditional logistic regression was used for multivariable analysis. (3) Results: The prevalence of mental disorders (33.9% vs. 17.1%; p < 0.001), psychological distress (35.4% vs. 18.2%; p < 0.001), and psychiatric medications consumption (34.1% vs. 21.9%; p < 0.001) was higher among COPD cases compared with non-COPD controls. After controlling for possible confounding variables, such as comorbid conditions and lifestyles, using multivariable regression, the probability of reporting mental disorders (OR 1.41; 95% CI 1.10–1.82).), psychological distress (OR 1.48; 95% CI 1.12–1.91), and psychiatric medications consumption (OR 1.38 95% CI 1.11–1.71) remained associated with COPD. Among COPD cases, being a woman, poor self-perceived health, more use of health services, and active smoking increased the probability of suffering from mental disorders, psychological distress, and psychiatric medication use. Stroke and chronic pain were the comorbidities more strongly associated with these mental health variables. (4) Conclusions: COPD patients have worse mental health and higher psychological distress and consume more psychiatric medications than non-COPD matched controls. Variables associated with poorer mental health included being a woman, poor self-perceived health, use of health services, and active smoking

Riesgo de accidente cerebrovascular en pacientes con aterosclerosis carotídea asintomática: ¿se debe tratar médicamente o quirúrgicamente?

Cerebrovascular disorders remain the leading cause of neurological morbidity and mortality in the world, representing one of the pathological entities responsible for the greatest burden of disease worldwide. Carotid atherosclerosis or stenosis is a potential risk factor for ischemic stroke. The identification and strict follow-up of this condition are essential in the secondary prevention of complications through primary care and the specialized treatment of cardiometabolicrisk. However, depending on this risk and/or presence of symptoms, definitive treatment is necessary. Currently, there is controversy as to whether asymptomatic carotid stenosis is better to be treated medically or surgically. Consideringthe significance of such entity, this review aims to analyze recent evidence on the risk of ischemic stroke in the case of asymptomatic carotid atherosclerosis among adults, as well as the potential benefit of the surgical vs. pharmacologicaltreatment for this condition. For this purpose, a literature search for publications up to 2023 was carried out in PubMed, ScienceDirect, Web of Science and MEDLINE databases. It was shown that there is a significant risk of stroke associated with asymptomatic carotid stenosis (&gt; 10 % approximately), even in patients with active antiplatelet and lipid-lowering therapy. Out of all those who receive medical treatment, around 80 % had a five-year survival rate. However, stenosisprogression occurs on average in more than 60 % of the cases and is significant. On the other hand, carotid stenting and endarterectomy are curative interventions. Nevertheless, these procedures involve a higher risk compared to the medicaltherapy during the peri- and postoperative period, as well as 30 days afterwards, due to the occurrence or recurrence of stroke, acute myocardial infarction or death from any cause. Despite this, the use of endarterectomy has shown superiorlong-term benefits concerning these same outcomes. Thus, evidence regarding the superiority of surgical treatment compared to pharmacological treatment for asymptomatic carotid atherosclerosis or stenosis is heterogeneous. However, it seems that surgical treatment, specifically endarterectomy, could have a significant impact on the occurrence orrecurrence of ipsilateral stroke and death in the long term but with controversial peri- and postoperative outcomes.Los desórdenes cerebrovasculares siguen siendo la primera causa de morbilidad y mortalidad neurológica en el mundo, representando una de las entidades patológicas que genera mayor carga de enfermedad a nivel global. La aterosclerosis,o estenosis carotídea, es un potencial factor de riesgo para el ictus isquémico. La identificación y seguimiento estricto de esta condición son esenciales en la prevención secundaria de complicaciones a través de la atención primaria yel manejo especializado del riesgo cardiometabólico. No obstante, dependiendo de este riesgo y/o la presencia de sintomatología, es necesario realizar un manejo definitivo. Actualmente, existe controversia sobre si es mejor tratar la estenosis carotídea asintomática, ya sea médica o quirúrgicamente. Teniendo en cuenta la relevancia de esta entidad, elobjetivo de esta revisión consiste en analizar la evidencia reciente sobre el riesgo de ictus isquémico en la aterosclerosis carotídea asintomática en adultos, y el potencial beneficio del manejo quirúrgico vs. farmacológico de esta condición.Para esto, se llevó a cabo una búsqueda bibliográfica en las bases de datos PubMed, ScienceDirect, Web of Science y MEDLINE, hasta el año 2023. Se evidenció que el riesgo de ictus asociado a estenosis carotídea asintomática es significativo (&gt;10 %, aproximadamente), incluso en aquellos con terapia antiplaquetaria e hipolipemiante activa. En aquellos con manejo médico, la supervivencia a cinco años es alrededor del 80 %. Sin embargo, la progresión de la estenosis sucede en promedio en más del 60 % de los casos, y es significativa. Por el contrario, el stent carotídeo y la endarterectomía son intervenciones resolutivas. Pero existe un riesgo mayor comparado con la terapia médica, el cual se atribuye al periodoperi- y posoperatorio, así como a 30 días de aparición o recurrencia del ictus, infarto agudo de miocardio o muerte por cualquier causa; aunque el uso de la endarterectomía ha demostrado beneficios superiores a largo plazo en cuanto a estos mismos desenlaces. Entonces, la evidencia es heterogénea en cuanto a la superioridad del tratamiento quirúrgicocomparado con la terapia farmacológica en el manejo de la aterosclerosis o estenosis carotídea asintomática. Sin embargo, parece ser que el manejo quirúrgico, específicamente la endarterectomía, podría impactar significativamente sobre la aparición o recurrencia del ictus ipsilateral y muerte a largo plazo, pero con resultados controversiales peri- ypostoperatorios

Sex-Related Disparities in the Incidence and Outcomes of Ischemic Stroke among Type 2 Diabetes Patients. A Matched-Pair Analysis Using the Spanish National Hospital Discharge Database for Years 2016–2018

Background: To analyze the incidence, use of therapeutic procedures, and in-hospital outcomes among patients suffering an ischemic stroke (IS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the existence of sex differences. Methods: Matched-pair analysis using the Spanish National Hospital discharge. Results: IS was coded in 92,524 men and 79,731 women (29.53% with T2DM). The adjusted incidence of IS (IRR 2.02; 95% CI 1.99–2.04) was higher in T2DM than non-T2DM subjects, with higher IRRs in both sexes. Men with T2DM had a higher incidence of IS than T2DM women (IRR 1.54; 95% CI 1.51–1.57). After matching patients with T2DM, those with other comorbid conditions, however, significantly less frequently received endovascular thrombectomy and thrombolytic therapy. In-hospital mortality (IHM) was lower among T2DM men than matched non-T2DM men (8.23% vs. 8.71%; p < 0.001). Women with T2DM had a higher IHM rate than T2DM men (11.5% vs. 10.20%; p = 0.004). After adjusting for confounders, women with T2DM had a 12% higher mortality risk than T2DM men (OR 1.12; 95% CI 1.04–1.21). Conclusions: T2DM is associated with higher incidence of IS in both sexes. Men with T2DM have a higher incidence rates of IS than T2DM women. Women with T2DM have a higher risk of dying in the hospital

Neuroaxial anesthesia caused paraplegia: a case report

Patients who undergo; anesthesia, neuraxial analgesia, or some type of neuraxial blockage are exposed to multiple complications. 33-year-old male patient, suffers a femur fracture with a long oblique trace causing pain and functional limitation for movements. Surgical resolution is determined using neuraxial block at L2-L3 level, and intravenous sedation. During his postoperative follow-up, a decrease in strength was confirmed in the lower limbs with 0/5 on the Daniels scale, 100% sensitivity without sphincter control, steroids were prescribed along with magnetic resonance imaging and a neurosurgical evaluation was requested. The MRI shows bulging of the fibrous annulus that obliterates the epidural fat and makes contact with the thecal sac in the L5-S1 intervertebral disc level. The neurosurgery service prescribes rehabilitation sessions at home, electrostimulation and neuropathic medications. Patient was discharged with rehabilitation sessions at home and medical treatment. In his last consultation, an evaluation from the psychiatry department was requested for ideas of disability, hopelessness, fantasies of death without a suicide plan related to limitations and loss of functionality. Patient does not return to external follow-up, cannot be located

Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru.

Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture where expectations, roles and interactions among individuals and their teams are horizontal, the true nature of partnerships