A multilevel model for movement rehabilitation in Traumatic Brain Injury (TBI) using virtual environments

This paper presents a conceptual model for movement rehabilitation of traumatic brain injury (TBI) using virtual environments. This hybrid model integrates principles from ecological systems theory with recent advances in cognitive neuroscience, and supports a multilevel approach to both assessment and treatment. Performance outcomes at any stage of recovery are determined by the interplay of task, individual, and environmental/contextual factors. We argue that any system of rehabilitation should provide enough flexibility for task and context factors to be varied systematically, based on the current neuromotor and biomechanical capabilities of the performer or patient. Thus, in order to understand how treatment modalities are to be designed and implemented, there is a need to understand the function of brain systems that support learning at a given stage of recovery, and the inherent plasticity of the system. We know that virtual reality (VR) systems allow training environments to be presented in a highly automated, reliable, and scalable way. Presentation of these virtual environments (VEs) should permit movement analysis at three fundamental levels of behaviour: (i) neurocognitive bases of performance (we focus in particular on the development and use of internal models for action which support adaptive, on-line control); (ii) movement forms and patterns that describe the patients' movement signature at a given stage of recovery (i.e, kinetic and kinematic markers of movement proficiency), (iii) functional outcomes of the movement. Each level of analysis can also map quite seamlessly to different modes of treatment. At the neurocognitive level, for example, semi-immersive VEs can help retrain internal modeling processes by reinforcing the patients' sense of multimodal space (via augmented feedback), their position within it, and the ability to predict and control actions flexibly (via movement simulation and imagery training). More specifically, we derive four - key therapeutic environment concepts (or Elements) presented using VR technologies: Embodiment (simulation and imagery), Spatial Sense (augmenting position sense), Procedural (automaticity and dual-task control), and Participatory (self-initiated action). The use of tangible media/objects, force transduction, and vision-based tracking systems for the augmentation of gestures and physical presence will be discussed in this context

Interactions entre metaux lourds et especes organiques presentes dans le milieu marin

SIGLEAvailable from Centre de Documentation Scientifique et Technique, CNRS, 26 rue Boyer, 75971 Paris Cedex 20 (France) / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Antibiotics AB-023 and process for preparing them.

The Antibiotic Complex AB-023 and its components: Antibiotic AB-023a and ibiotic AB-023b are disclosed, which are obtained by the controlled aerobic culture of Streptomyces sp. NCIMB 40212 in an aqueous nutrient culture substrate. Antibiotics AB-023 display a biological activity against pathogen fungi which attack agricultural crops and man

: Treatment of drug-resistant tuberculosis

International audienceThe incidence of drug-resistant tuberculosis is no longer increasing and significant progress have been made in the last decade regarding the prognosis of this severe disease. Its treatment is however still difficult and a multidisciplinary approach is of great importance to better treat these patients. Fluoroquinolones have to be used in case of isoniazid resistance, associated with rifampicin-ethamutol and pyrazinamid. Anti-tuberculosis drugs for multi or ultra-drug resistant tuberculosis are now classified into three groups according to their efficacy. Fluoroquinolones, bedaquiline and linezolid are the drugs of choice and have to be used as first line therapy. However, the choice of the initial treatment has to be based on the genotypic resistance research results and on the therapeutic history of the patient. Treatment duration is long and side effects are frequent but results of many recent studies pave the way to shorter and better tolerated treatments in a near future.Même si des progrès importants ont été réalisés cette dernière décennie, la prise en charge des personnes atteintes de tuberculose résistante reste difficile. Une prise en charge pluridisciplinaire permet de traiter au mieux ces patients complexes. En cas de résistance isolée à l'isoniazide, les fluoroquinolones seront associées à la rifampicine, l’éthambutol et le pyrazinamide. Les antituberculeux utilisables en cas de tuberculose multi (MDR) ou ultrarésistante (XDR) sont dorénavant classés en trois groupes selon leur niveau d'efficacité, les fluoroquinolones, la bédaquiline et le linézolide représentant le premier groupe, et donc les molécules à utiliser en première intention. Le choix du traitement initial en cas de tuberculose MDR ou XDR sera guidé par les résultats des tests génotypiques de résistance et l'histoire thérapeutique du patient. Les traitements restent prolongés et associés à des effets indésirables importants, mais de récents progrès permettent d'espérer prochainement des traitements plus courts et mieux supportés

Genitoperineal Injuries Associated With the Use of an Orthopedic Table With a Perineal Posttraction

Background: Surgical treatment of lower extremity fractures commonly involves the use of orthopedic table with perineal post for countertraction. However, prolonged application of the perineal post has been associated with significant complications. We describe our experience in the management of genitoperineal cutaneous injuries associated with the use of a traction table. Methods: Six patients with genitoperineal complications attributed to the use of a traction table were treated at our institution over a period of 2 years. The patient`s median age was 25 (range, 2028) years and all had fractures caused by motor vehicle collision. We evaluated the clinical presentation of these perineal injuries, operative time, therapeutic approach, clinical outcomes, and hospitalization time. Results. The mean operative time of the orthopedic surgery was 318 minutes 128 minutes (range, 185-540). All patients developed a partial-thickness necrotic area involving the perineum and scrotum in 2 days to 15 days (mean, 7 +/- 5.4) after the surgery. Three patients developed infection of the necrotic tissue. All patients underwent surgical debridement 16.5 days +/- 6.5 days (range, 13-29) after the orthopedic surgery and only one debridement procedure was nec-sure was possible in one case, and in the other cases the wound healed completely by second intention. The mean hospitalization time was 26.3 days +/- 9.7 days (range, 19-44). conclusion: Genitoperineal skin necrosis induced by perineal traction posttable is a morbid complication that demands surgical debridement and prolonged hospitalization for your treatment. There are many procedures available to reduce the risk of this complication that should be used more liberally by the orthopedic surgeons