2,090 research outputs found
Mission Planner Algorithm for Urban Air Mobility Initial Performance Characterization
In this paper, an initial characterization was performed of the Mission Planner algorithm developed by NASA for Urban Air Mobility (UAM) operations research. The algorithm plans conflict-free trajectories for flights to support a given set of UAM passenger trips. The UAM trips are planned in an on-demand, first-come, first-served manner, such that any given trip is subject to the constraints imposed by previously planned trips. For this analysis, the mission planning algorithm considered only the trajectory constraints from previously-planned trips in one test condition and added vertiport constraints for the second test condition. The conflict and constraint resolution strategies used by the Mission Planner were characterized by their percentage contribution to planning iterations, their percentage effectiveness in those iterations, and their contributions to the departure delay applied to each UAM trips flight. With the exception of the climb and descent vertical speed strategies, most strategies showed reasonable or good performance in all test scenarios. In the test condition with vertipad constraints enabled, both the total number of iterations executed, and the number of flights that required planning iterations, was reduced for all scenarios. This was the result of the natural conditioning of the traffic achieved with scheduling and the additional information available to the Mission Planner from the vertiport scheduler. The next steps for this work will include improvements to the mission planning strategies and analyses with additional constraints and under other demand scenarios
First, Do No Harm: The Risks Of Overtreating Children With Epilepsy
Background: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. Objective: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. Method: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. Results: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). Conclusion: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.65114Camfield, C.S., Camfield, P., Gordon, K., Smith, B., Dooley, J., Outcome of childhood epilepsy: A population-based study with a simple scoring system for those treated with medication (1993) J Pediatr, 122, pp. 861-868Silva, M., MacArdle, B., MaGowan, M., Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy (1996) Lancet, 347, pp. 709-713Baulac, M., Rational conversion from antiepileptic polytherapy to monotherapy (2003) Epileptic Disord, 5, pp. 125-132Holmes, G.L., Overtreatment in children with epilepsy (2002) Epilepsy Res, 52, pp. 35-42Fischbacher, E., Effect of reduction of anticonvulsants on wellbeing (1982) Br Med J (Clin Res Ed), 285, pp. 423-424Schmidt, D., Reduction of two-drug therapy in intractable epilepsy (1983) Epilepsia, 24, pp. 368-376Alvarez, N., Discontinuance of antiepileptic medications in patients with developmental disability and diagnosis of epilepsy (1989) Am J Ment Retard, 93, pp. 593-595Guerrini, R., Belmonte, A., Genton, P., Antiepileptic drug-induced worsening of seizures in children (1998) Epilepsia, 39 (SUPPL. 3), pp. S2-S10TS, K., Holmes, G.L., EEG and clinical predictors of medically intractable childhood epilepsy (1999) Clin Neurophysiol, 110, pp. 1245-1251Huttenlocker, P.R., Hapke, R.J., A follow-up study of intractable seizures in childhood (1990) Ann Neurol, 28, pp. 699-705Ferngren, H., Akerstrom, I., Rane, A., Mono or polypharmacotherapy in institutionalized epileptic children with severe mental retardation? A team approach for optimizing antiepileptic therapy (1991) Acta Paediatr Scand, 80, pp. 458-465Dooley, J., Gordon, K., Camfield, C., Smith, E., Discontinuation of anticonvulsant therapy in children free of seizures for 1 year: A prospective study (1996) Neurology, 46, pp. 969-974Shinnar, S., Berg, A.T., Moshé, S.L., Discontinuing antiepileptic drugs in children with epilepsy:a prospective study (1994) Ann Neurol, 35, pp. 534-545Shorvon, S.D., Reynolds, E.H., Unnecessary polypharmacy for epilepsy (1977) Br Med J, 1, pp. 1635-1637Vickery, B.G., Hay, R., Engel, J., Outcome assessment for epilepsy surgery: The impact of measuring health-related quality of life (1995) Ann Neurol, 37, pp. 158-16
Predisposition To Metabolic Acidosis Induced By Topiramate.
Metabolic acidosis induced by topiramate is a well documented but infrequent adverse event. The objective was to demonstrate the lowering of carbon dioxide serum levels, which is usually asymptomatic but may facilitate the occurrence of metabolic acidosis in patients using topiramate. We evaluated, prospectively, the carbon dioxide serum levels of 18 patients seen at the epilepsy clinic of our university hospital, before and 3 months after introducing topiramate. Five patients were female and 13 were male, age ranging from 2 to 16 years old (mean=9. 3). Carbon dioxide mean serum levels were 25 and 21.2 mmol/L (normal = 22 to 30), before and 3 months after introducing topiramate, respectively. Dose ranged from 2.08 to 11.76 mg/kg/day (mean=6. 7mg/kg/day). Adverse events were anorexia, nausea and somnolence. We conclude that the lowering of carbon dioxide serum levels induced by topiramate is mostly asymptomatic, but may facilitate the occurrence of metabolic acidosis. Since patients in use of topiramate have refractory epilepsy, they may need epilepsy surgery, and must be carefully monitored for the risk of metabolic acidosis during surgery.581021-
Port of JMF to JME-CDC
Estágio realizado na Sun Microsystems Ireland IncTese de mestrado integrado. Engenharia Informática e Computação. Faculdade de Engenharia. Universidade do Porto. 200
Alveolar extraction socket behaviour to alloplastic regenerative procedures: a comparative study
Aim: To compare clinical, and volumetric alterations of post extraction sockets with and without bone regeneration with Adbone®BCP on a socket preservation type of
regeneration.
Materials and Methods: Participants were assigned to one of two groups, at surgery day, having 16 anterior teeth divided equally into two groups. Bone regeneration was tested
by application of a biphasic calcium phosphate synthetic bone graft (Adbone®BCP) while natural healing was the control group. Clinical evaluation included intra-oral photographs and
an alginate impression. 3D examination consisted in extra-oral scanning of the obtained gypsum casts to generate 3D STL files. A comparison between initial and final buccolingual
dimensions was formed using CloudCompareV2 (version 2.6.1 [GPL software], 2019),measuring initial and final dimensions of both groups in 5 different sites (loss at 2, 3, 4, 5, 6
mm measured from coronal to apical of the extraction socket). Follow-up appointments were performed at days 7, 14 and 3 months postoperative.
Results: For the t-test, there was a significantly higher ridge dimensions loss on the control group, p=0.029, 0.045 and 0.041 for the first three measurements, respectively.
Given these p-values being < 0.05, there are significant differences regarding the loss between
the 2 groups, hence confirming the H1.
Discussion: There were differences between the test and control groups on the first three measurements (H2, H3, H4) given that tissue modelling is a rather rapid process. However, the
measurements situated apically on the alveolus, had p-values > 0.05, indicating that, given the short follow-up, the subsequent woven bone remodelling may take years to be completed and
thus had not happened yet.
Conclusion: Sockets grafted with Adbone®BCP suffered a reduced loss of volume on the alveolar socket contour, thus being effective on preserving the alveolar ridge.As extrações dentárias são um dos procedimentos mais comuns no ramo da medicina dentária, levando a mudanças significativas no rebordo edêntulo, dificultando o correto e satisfatório posicionamento de implantes, podendo assim comprometer o resultado das reabilitações protéticas.
A extração dentária envolve um trauma mecânico nos tecidos moles, no ligamento periodontal e no osso do processo alveolar, levando a uma resposta inflamatória que recruta células hematopoiéticas e mesenquimais no local.
ApĂłs uma extração, o processo de cicatrização inicia-se com hemorragia e seguinte formação de um coágulo, sendo substituĂdo por tecido de granulação. Em seguida, forma-se uma matriz provisĂłria de tecido conjuntivo, dando inĂcio Ă fase proliferativa onde há uma incorporação de vasos e cĂ©lulas formadoras de osso dentro da matriz provisĂłria. Ao fim do primeiro mĂŞs apĂłs extração, verifica-se o preenchimento do alvĂ©olo com osso imaturo que será progressivamente substituĂdo por osso lamelar e medular. O tĂ©rmino do processo de cicatrização Ă© clinicamente observado pelo encerramento, primário ou secundário, do alvĂ©olo com tecido mole epitelizado e radiográfico pelo preenchimento Ăłsseo do alvĂ©olo.
Consequentemente, este processo levará a alterações dimensionais no rebordo edêntulo.
Embora se verifique alterações dimensionais atĂ© ao primeiro ano apĂłs extração, sĂŁo durante os primeiros 3 meses que a perda Ăłssea e tecidular Ă© mais acentuada. Esta perda Ă© influenciada por diversos fatores como as variações biolĂłgicas dos indivĂduos, o tamanho do alvĂ©olo pĂłs-extracional e a extensĂŁo do trauma provocado durante a extração.
Esta bem descrito na literatura que, apĂłs uma extração dentária, o rebordo edĂŞntulo move-se em direção ao longo eixo do osso basal. A forma do maxilar parece retornar Ă forma em que estava antes do desenvolvimento do processo alveolar durante a erupção dentária. A falta de um estĂmulo funcional nas paredes Ăłsseas e a necessidade de ajuste dos tecidos para se adaptar Ă geometria da crista na ausĂŞncia de dentes podem explicar esta modificação.
Dadas estas alterações dimensionais, a reabilitação destes espaços edĂŞntulo fica comprometida, influenciando tanto o resultado estĂ©tico como funcional. De forma a tentar prevenir estas complicações, muitos estudos mostraram os efeitos do uso de enxerto de diferentes biomateriais e diferentes tĂ©cnicas e respetivos benefĂcios na regeneração Ăłssea.
As primeiras investigações concentraram-se no uso apenas de membranas regenerativas. Entretanto, pesquisas com enxertos ósseos em defeitos periodontais levaram os pesquisadores a explorar a utilidade das membranas em combinação com enxertos ósseos.
Hoje em dia, a regeneração Ăłssea guiada Ă© geralmente realizada como um procedimento de combinação envolvendo membranas e um substituto Ăłsseo de suporte. Alguns investigadores empregaram aloenxertos desmineralizados, maleáveis, rapidamente reabsorvidos e supostamente osteoindutores, enquanto outros utilizaram enxertos mineralizados, mais rĂgidos e osteocondutores. No entanto, nĂŁo está claro qual material Ă© mais eficaz para esta indicação clĂnica, já que estas tĂ©cnicas incluem a colocação de diferentes materiais de enxerto, como autoenxertos Ăłsseos, xenoenxertos, aloenxertos, combinados com membranas reabsorvĂveis ou nĂŁo reabsorvĂveis e, mais recentemente, materiais bioativos, como L-PRF (leucĂłcitos e fibrinas ricas em plaquetas).
Um autoenxerto envolve a utilização de osso obtido do mesmo indivĂduo que recebe o enxerto, enquanto que um aloenxerto Ă© derivado de seres humanos que Ă© colhido de outro indivĂduo que recebe o enxerto, como por exemplo de cadáveres. Os xenoenxertos sĂŁo enxertos Ăłsseos de uma espĂ©cie diferente da humana, como os bovinos, sĂŁo usados como uma matriz calcificada. Os aloplásticos podem ser feitos de hidroxiapatite, um mineral Ăłsseo natural, fosfato tricálcico ou uma combinação de ambos. Os enxertos Ă base de fatores de crescimento sĂŁo produzidos utilizando tecnologia de ADN recombinante, consistindo em fatores de crescimento humanos ou morfogĂ©nicos. Os substitutos de enxerto Ăłsseo a base de cerâmica envolvem cerâmicas, isoladamente ou em combinação com outro material, como sulfato de cálcio, vidro bioativo e Fosfato de Cálcio. Contudo, a literatura nĂŁo Ă© clara relativamente ao material mais eficaz para as tĂ©cnicas de regeneração alveolar. Um dos materiais mais estudados, o xenoenxerto, apresenta resultados benĂ©ficos com a sua utilização. Contudo, este material tem uma taxa de reabsorção lenta, levando a presença de partĂculas residuais que poderĂŁo interferir com a normal cicatrização alveolar bem como influenciar a qualidade do osso regenerado.
Por outro lado, o uso de materiais aloplásticos de osteocondução tambĂ©m visa minimizar as alterações dimensionais que advĂ©m apĂłs extração. Adbone®BCP Ă© um material de enxerto Ăłsseo totalmente bifásico feito de 75% de hidroxiapatite (HAp) e 25% de fosfato tricálcico betafosfato (β-TCP). Deste modo, parece ter todas as propriedades necessárias para minimizar as mudanças que ocorrem em alvĂ©olos pĂłs-extracionais, tanto a nĂvel Ăłsseo como dos tecidos moles, conduzindo a uma menor reabsorção da tabua Ăłssea vestibular e menor colapso tecidual.
O objetivo deste estudo Ă© comparar as alterações clĂnicas e volumĂ©tricas de alvĂ©olos pĂłs-extracionais com e sem regeneração Ăłssea com Adbone®BCP.
Materiais e MĂ©todos: 11 participantes foram inseridos de acordo com os critĂ©rios de inclusĂŁo e exclusĂŁo, sendo designados para um dos dois grupos, no dia da cirurgia, com 16 dentes anteriores divididos igualmente em ambos os grupos. A regeneração Ăłssea foi testada pela aplicação de enxerto Ăłsseo sintĂ©tico de Fosfato de Cálcio bifásico (Adbone®BCP) comparando-a com o grupo de controlo, a cicatrização natural. A avaliação clĂnica incluiu fotografias intra-orais e uma impressĂŁo em alginato. O exame 3D consistiu em leitura extra-oral dos modelos em gesso obtidos para gerar arquivos 3D STL e usando o CloudCompare v2 (versĂŁo 2.6.1 [GPL software], 2019), formando uma comparação entre as dimensões bucolinguais inicial e final dos tecidos duros e moles. Para tal, os ficheiros STL foram sobrepostos, escolhendo sete pontos em comum entre ambos para uma maior correspondĂŞncia. Em seguida, traçou-se uma reta do ponto mais vestibular ao ponto mais palatino da raiz. Por fim, traçaram-se 5 retas, de 2 mm em 2 mm, a unir os dois ficheiros podendo avaliar as alterações dimensionais bucolinguais, em 5 regiões diferentes desde um ponto coronal e um mais apical. As consultas de acompanhamento foram realizadas nos dias 7, 14 e 3 meses de pĂłs-operatĂłrio.
Resultados: Foram medidas as dimensões iniciais e finais de ambos os grupos em 5 locais diferentes (perda de 2, 3, 4, 5, 6 mm, medidos de mais coronal para mais apical no alvéolo). Para o teste t, houve uma perda significativamente maior no grupo controle, com valores de p=0,029, 0,045 e 0,041 para as três primeiras medições, respetivamente. A nossa hipótese nula corresponde a que não há diferenças significativas na perda dimensional entre os dois grupos. Considerando-se que esses p-valores são < 0,05, existem diferenças significativas em relação a perda entre os dois grupos, confirmando, assim, a nossa hipótese testada.
DiscussĂŁo: Dados os resultados apresentados, existem diferenças estatisticamente significativas entre os grupos teste e controle nas trĂŞs primeiras medições (H2, H3, H4), dado que a modelação tecidual e um processo bastante rápido. No entanto, as duas Ăşltimas medições, sendo estas mais apicais no alvĂ©olo, apresentaram p-valores > 0,05. Deste modo, especula-se que, dado o curto perĂodo de acompanhamento, o remodelamento Ăłsseo subsequente, sendo um processo um pouco mais lento, pode levar anos para ser concluĂdo, logo ainda nĂŁo serem visĂveis tais alterações.
Conclusao: Podemos concluir que existem diferenças estatisticamente significantes entre os alvĂ©olos do grupo teste, regenerados com Adbone®BCP em comparação com a cicatrização de alvĂ©olos do grupo de controlo. No entanto, há um nĂşmero limitado de estudos sobre este enxerto Ăłsseo, expondo assim a necessidade de mais ensaios clĂnicos randomizados avaliando o efeito do enxerto Ăłsseo sintĂ©tico Fosfato de Cálcio bifásico na regeneração Ăłssea. Devido ao tamanho da amostra e curto perĂodo de acompanhamento, nĂŁo Ă© possĂvel aplicar Ă população em geral
Late Onset Temporal Lobe Epilepsy With Mri Evidence Of Mesial Temporal Sclerosis Following Acute Neurocysticercosis: Case Report.
The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with albendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T2 signal in this patient has not, to date, been associated with a poor seizure control. This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE.59255-
Characterization of fish scale regeneration: environmental and endocrine control
Fish scales are calcified structures present in skin which have a protective function but which are also implicated in calcium homeostasis. Information about the molecular and cellular organisation of scales and the endocrine factors which regulate their turnover is scarce. In the present study as a first step to studying the influence of hormones on scale metabolism we aimed to characterize elasmoid scales from the sea bream (Sparus auratus), the dynamics of scale regeneration and the possible regulation of this process by calcium availability. Regenerating scales were evident 7 days after their removal in fish maintained in seawater (SW) and brackish water (BW). In BW, the activity of enzymes involved in scale turnover, tartrate resistant acid phosphatase (TRAP) and alkaline phosphatase (ALP), increased indicating active remodelling. The higher activity of TRAP compared to ALP suggests that the reduced calcium availability in BW led to calcium mobilization from the scales. The results suggest that the scales can be used as a regulated reservoir of calcium in this fish.info:eu-repo/semantics/publishedVersio
Reading-together as a transformational practice : the potential role of literary fiction in the work with non-neurotic analysands
Dans ce mĂ©moire, j’explore la construction du sujet en relationnalitĂ© en m’appuyant sur un cadre thĂ©orique composĂ© de concepts issus Ă la fois des Ă©tudes littĂ©raires et d’approches psychanalytiques contemporaines. Dans la première partie de mon travail, j'explore la manière dont le travail littĂ©raire peut faciliter l'actualisation de l'altĂ©ritĂ© Ă la fois dans le texte et chez le lecteur. Dans la deuxième partie de ce travail, j'illustre cette actualisation possible en en explorant les affects Ă©voquĂ©s et produits dans l’histoire « I Only Came to Use the Phone » de Gabriel GarcĂa Márquez. Dans la troisième partie, j’explore thĂ©oriquement l’impact potentiel de la fiction littĂ©raire comme moyen thĂ©rapeutique auprès des lectrices/lecteurs « nonnevrotiques ». J’explore la façon dont la lecture d’histoires peut contribuer Ă l’activation de certaines traces mnĂ©siques qui pourrait renforcer la capacitĂ© de symboliser expĂ©riences Ă©motionnelles jusque-lĂ non mĂ©tabolisĂ©es ou non reprĂ©sentĂ©es. Je soutiens que la lecture et la discussion d’histoires dans des suivis thĂ©rapeutiques pourront aider des patientes Ă co-construire (Ă l’aide de leur thĂ©rapeute) de nouveaux rĂ©cits qui pourront mener Ă une certaine transformation de la structure psychique non-nĂ©vrotique des patients. Dans la dernière partie, j’avance comme hypothèse que le tiers intersubjectif issu de la rencontre d’un couple analytique avec l’histoire « I Only Came to Use the Phone » pourrait nourrir de nouvelles façons de penser, de sentir et d'exprimer des affects en sĂ©ance, tout en activant des « rĂŞves » dont l’émergence tĂ©moigne de la manière dont la lecture d’histoires pourrait potentiellement animer la vie inconsciente des personnes prises avec des Ă©tats mentaux non reprĂ©sentĂ©es. Enfin, je soutiens que la lecture de fiction littĂ©raire pourrait initier chez des personnes avec des Ă©tats mentaux non reprĂ©sentĂ©s un mouvement de transformation, et ce, d’une part, en les aidant Ă passer d’un « bain mycĂ©lien de non-figurabilitĂ© » interne au renforcement de leur capacitĂ© Ă (se) reprĂ©senter ; de l’autre, en leur sortant d’un Ă©tat d’apathie vers le dĂ©veloppement de nouvelles cartographies affectives.In this thesis, I explore the subject’s construction in relationality, first by presenting a theoretical framework built from concepts drawn both from literary studies and contemporary psychoanalytic approaches. In the first part of the thesis, I explore how the literary work has the potential to facilitate the actualization of otherness both in the text and within the reader. To illustrate this contention, in Part II, I explore the affective tone of the short story, “I Only Came to Use the Phone” by Gabriel GarcĂa Márquez. In Part III, I elaborate theoretically on the potential benefits of using literature as a therapeutic medium with non-neurotic readers. I explore how the reading of short stories may contribute to the stimulation of the non-neurotic reader’s capacity to memorize and to remember while promoting and strengthening her/his capacity for symbolizing previously unmetabolized or unrepresented emotional experiences. I argue that reading and discussing stories in the context of analytically oriented sessions may lead to the co-construction of subsequent narratives that may be transformational for the reader’s non-neurotic psychic structure. In the fourth and last part, I argue that the intersubjective inbetween space that might emerge from the encounter of an analytic dyad with the story by GarcĂa Márquez could potentially facilitate the important task of supplying new ways of thinking, feeling and expressing, while simultaneously potentially producing “dream” material that may contribute to the enlivening of the analysand’s non-neurotic conscious and unconscious life. Finally, I contend that the reading of literary fiction may initiate in non-neurotic analysands a transformational movement: first, from an internal “mycelial bath of non-figurability” to the strengthening of their representational capacity; and second, from an emotional apathy to the
extension of the analysand’s affective cartographies
Fragile X Syndrome. Clinical, Electroencephalographic And Neuroimaging Characteristics.
We studied 11 patients (9 males) with cytogenetic diagnosis of fragile X syndrome (FXS) with the purpose of investigating the neural circuitry involved in this condition. The ages ranged from 8 to 19. All the individuals presented large ears, elongated faces and autistic features. Ten patients had severe mental retardation. Attention disorder was found in 10 individuals. Electroencephalographic recordings were abnormal in 6 of 10 patients examined, showing focal epileptiform discharges predominantly in frontal and parietal areas. All patients underwent magnetic resonance imaging studies which were abnormal in 8 of them. The most important abnormalities were reduction of the cerebellar vermis and enlargement of the IV ventricle. Single photon emission computerized tomography (SPECT) was performed in 7 patients and was abnormal in all of them, the most frequent finding being a hypoperfusion of the inferior of the frontal lobes. Based on the clinical picture, neuropsychological findings and functional and structural imaging studies we suggest that FXS presents with a dysfunction involving a large area of the central nervous system: cerebellum-basal frontal regions-parietal lobes. The literature points to a disturbance involving the same neural circuitry in patients with autism.5618-2
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