Влияние насыщения на индуктивность пазового рассеяния обмотки статора ударного генератора

На основе расчета нелинейного магнитного поля в пазу статора ударного генератора методом конечных разностей получены значения коэффициентов проводимости пазового рассеяния и по коронкам зубцов при различных соотношениях ширины зубца к зубцовому делению

Правове регулювання внутрішнього ринку Європейського Союзу

Навчально-методичний посібник підготовлено відповідно до курсу "Правове регулювання внутрішнього ринку ЄС". Він містить програму курсу теми даного курсу, плани семінарських занять, завдання для самостійної роботи студентів, варіанти контрольних робіт, запитання до іспиту, термінологічний словник, а також список рекомендованої літератури та джерела законодавства для більш ретельного вивчення даної дисципліни. Посібник буде корисним як для студентів, так і для викладачів

Physical fitness training in Subacute Stroke (PHYS-STROKE) - study protocol for a randomised controlled trial

BACKGROUND: Given the rising number of strokes worldwide, and the large number of individuals left with disabilities after stroke, novel strategies to reduce disability, increase functions in the motor and the cognitive domains, and improve quality of life are of major importance. Physical activity is a promising intervention to address these challenges but, as yet, there is no study demonstrating definite outcomes. Our objective is to assess whether additional treatment in the form of physical fitness-based training for patients early after stroke will provide benefits in terms of functional outcomes, in particular gait speed and the Barthel Index (co-primary outcome measures) reflecting activities of daily living (ADL). We will gather secondary functional outcomes as well as mechanistic parameters in an exploratory approach. METHODS/DESIGN: Our phase III randomised controlled trial will recruit 215 adults with moderate to severe limitations of walking and ADL 5 to 45 days after stroke onset. Participants will be stratified for the prognostic variables of “centre”, “age”, and “stroke severity”, and randomly assigned to one of two groups. The interventional group receives physical fitness training delivered as supported or unsupported treadmill training (cardiovascular active aerobic training; five times per week, over 4 weeks; each session 50 minutes; total of 20 additional physical fitness training sessions) in addition to standard rehabilitation treatment. The control intervention consists of relaxation sessions (non-cardiovascular active; five times per week week, over 4 weeks; each session 50 minutes) in addition to standard rehabilitation treatment. Co-primary efficacy endpoints will be gait speed (in m/s, 10 m walk) and the Barthel Index (100 points total) at 3 months post-stroke, compared to baseline measurements. Secondary outcomes include standard measures of quality of life, sleep and mood, cognition, arm function, maximal oxygen uptake, and cardiovascular risk factors including blood pressure, pulse, waist-to-hip ratio, markers of inflammation, immunity and the insulin-glucose pathway, lipid profile, and others. DISCUSSION: The goal of this endpoint-blinded, phase III randomised controlled trial is to provide evidence to guide post-stroke physical fitness-based rehabilitation programmes, and to elucidate the mechanisms underlying this intervention. TRIAL REGISTRATION: Registered in ClinicalTrials.gov with the Identifier NCT01953549

Impact of the first COVID lockdown on accident- and injury-related pediatric intensive care admissions in Germany - a multicenter study

Children’s and adolescents’ lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017–2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85–1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93–1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57–1.02 and 0.26 (0.05–0.75)), whereas household and leisure accidents increased (1.33 (1.06–1.66) and 1.34 (1.06–1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38–1.16) and 2.09 (1.19–3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42–1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51–3.02)), but decreased in adolescent girls (0.56 (0.32–0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation

Cerebral mechanisms and clinical effects of the mirror illusion

Der Schlaganfall gehört zu den häufigsten Ursachen für eine Behinderung im Erwachsenalter. Dabei weisen vor allem schwere Armlähmungen eine schlechte Prognose auf. Die Rehabilitation beruht weiterhin meistens auf indirekter zerebraler Stimulation durch hochfrequente Übungsbehandlung der betroffenen Extremität. Durch Nutzung der visuellen Körperrepräsentation kann aber auch eine direkte Stimulation geschädigter Areale erreicht werden. Eine dieser Techniken ist die Spiegelillusion, bei der über einen Spiegel die nicht- betroffene Extremität so präsentiert wird, als wäre es die betroffene Extremität. Die vorliegende Arbeit beschreibt zunächst eine Serie von insgesamt vier Bildgebungsstudien an hirngesunden Probandinnen und Probanden, die die zerebralen Mechanismen der Spiegelillusion präzisierten. Es wurden zwei dissoziierte Aktivierungsmuster bei der Durchführung von Bewegungen unter visueller Kontrolle identifiziert, die unabhängig voneinander moduliert werden können: Das bilaterale Aktivierungsmuster in den primär motorischen Kortizes ist lateralisiert kontralateral zur aktuell bewegten Hand, das in den Precunei ist lateralisiert kontralateral zur visuell wahrgenommenen Hand. Somit führt die Bewegungsspiegelung zu einer quantifizierbaren Aktivitätsumkehr und damit lateralisierten Aktivierung im Bereich der Precunei. Dieses Muster findet sich nicht bei der reinen Bewegungsbeobachtung. Eine eventuelle zusätzliche Bewegungsspiegelung in der Sagittalebene stellt einen weiteren, davon unabhängigen Prozess dar. Weitere Studien beschrieben die therapeutischen Effekte der längerfristigen Anwendung der Spiegelillusion als Spiegeltherapie bei Patientinnen und Patienten nach Schlaganfall. In einer randomisierten klinischen Studie konnten positive Effekte auf die Motorik, die Sensibilität und einen eventuell vorliegenden Hemineglect gezeigt werden. In einer prospektiven Studie wurden beide Ansätze kombiniert: Hier zeigte die vor Therapiebeginn gemessene Aktivitätsänderung in den Precunei durch die Spiegelillusion einen prädiktiven Wert für den Erfolg eines Therapieregimes unter Einschluss der Spiegeltherapie. Durch diese Serie von neurophysiologischen und klinischen Befunden konnte ein optimiertes Therapieprotokoll definiert werden. Perspektivisch bieten die Arbeiten eine Grundlage zur Integration der funktionellen Bildgebung in die Therapieplanung für die neurologische Rehabilitation.Stroke is one of the leading causes for adult’s disability. Among the different symptoms after stroke, the prognosis of severe arm paresis is particularly poor. Currently, rehabilitation is still mainly based on indirect cerebral stimulation by highly repetitive training of the affected limb. However, visual body representation techniques could stimulate the affected areas directly. One of these techniques is mirror therapy, presenting the non- affected limb via a mirror in such a way that it appears to be the affected one. This thesis first describes a series of four imaging studies in healthy subjects, specifying the cerebral mechanisms of the mirror illusion. These studies identified two dissociated activation patterns during movement execution under visual control: The bilateral activation in the primary motor areas is lateralised contralateral to the actual moving limb, the bilateral activation in both precunei is lateralised contralateral to the visually perceived limb. Thus, movement mirroring leads to a quantifiable inversion and lateralised activation of the precunei. This pattern is different during pure movement observation. Movement mirroring in the sagittal plane is a further, independent process. Two further studies of this thesis describe the therapeutic effects of a long-term application of the mirror illusion as mirror therapy in patients after stroke. In a randomised controlled study, positive effects on motor function, sensory deficits and a possibly existing hemineglect could be shown. In a second, prospective clinical study, both approaches were combined: Now, the activation change in both precunei prior to therapy revealed a predictive value for the success of a therapy regime including mirror therapy. This series of neurophysiological and clinical studies led to the definition of an optimised therapy protocol. It provides a perspective for integration of functional imaging techniques in therapy planning in neurorehabilitation

The Efficacy of Movement Representation Techniques for Treatment of Limb Pain-A Systematic Review and Meta-Analysis

Relatively new evidence suggests that movement representation techniques (ie, therapies that use the observation and/or imagination of normal pain-free movements, such as mirror therapy, motor imagery, or movement and/or action observation) might be effective in reduction of some types of limb pain. To summarize the evidence regarding the efficacy of those techniques, a systematic review with meta-analysis was performed. We searched Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, Physiotherapy Evidence Database, and OT-seeker up to August 2014 and hand-searched further relevant resources for randomized controlled trials that studied the efficacy of movement representation techniques in reduction of limb pain. The outcomes of interest were pain, disability, and quality of life. Study selection and data extraction were performed by 2 reviewers independently. We included 15 trials on the effects of mirror therapy, (graded) motor imagery, and action observation in patients with complex regional pain syndrome, phantom limb pain, poststroke pain, and nonpathological (acute) pain. Overall, movement representation techniques were found to be effective in reduction of pain (standardized mean difference [SMD] = -.82, 95% confidence interval [CI], -1.32 to -.31, P = .001) and disability (SMD = .72, 95% CI,.22-1.22, P = .004) and showed a positive but nonsignificant effect on quality of life (SMD = 2.61, 85% CI, -3.32 to 8.54, P = .39). Especially mirror therapy and graded motor imagery should be considered for the treatment of patients with complex regional pain syndrome. Furthermore, the results indicate that motor imagery could be considered as a potential effective treatment in patients with acute pain after trauma and surgery. To date, there is no evidence for a pain reducing effect of movement representation techniques in patients with phantom limb pain and poststroke pain other than complex regional pain syndrome. (C) 2016 by the American Pain Societ