Study of the acoustic conditioning of the Aula Magna of the Faculty of Law of the Universitat de València. Analysis of the current situation and a proposal for improvement

[EN] The objective of this thesis is to analyse the current state of the Aula Magna of the Faculty of Law of the Universitat de València. This room is used as a lecture hall and for chamber music performances. By measuring in situ the acoustic parameters of the hall the current situation can be analysed. The measurements are performed with an omnidirectional source and 22 receiving points. The measured acoustic parameters are compared to the recommended values, to analyse the current state of the hall. A 3D model is made using AutoCAD2013, the model only consists of 3D-faces. This model is imported in a room acoustics software, Odeon 10.1 Combined. After placing the source and receivers and assigning the materials, the model can be changed to match the reality. By changing the sound absorption coefficients of the materials, the model is adjusted to the measurements in situ. The model is a reliable presentation of the real hall if the results that are simulated by Odeon are the same as the measurements in situ. In the 3D model alterations can be made to improve the hall for a lecture or a chamber music performance. Changes are tested with the recommended values for the acoustical parameters for both usages of the hall. Double-sided tiles with a reflective and absorbent side, together with two movable panels are the proposal to improve the acoustic conditions. When there is a lecture the two movable panels are stored behind the screen and the tiles show the absorbent side. For a chamber music performance the tiles are turned to the reflective side and the two panels are placed on stage. This proposal leads to a significant improvement for both usages of the hall. It is easy to employ and will make a big difference for the experience of the audience.[ES] El objetivo de este Trabajo de fin de Máster es analizar el estado actual del Aula Magna de la Facultad de Derecho de la Universitat de València. Este sitio se emplea como sala de conferencias y para actuaciones de música de cámara. El estado actual se analiza mediante la medición “in situ” de los parámetros acústicos. La toma de datos se realiza con una fuente omnidireccional y 22 puntos de recepción. Después, los parámetros acústicos obtenidos se comparan con los valores recomendados para obtener el estado actual del Aula. También se realiza un modelo en 3D por medio de AutoCAD2013, el modelo se realiza únicamente en caras de sólidos 3D. Después, se importa el modelo a un software de mediciones acústicas, Odeon 10.1 Combined. Una vez colocados los receptores y la fuente, y seleccionados los materiales, el modelo puede ser modificado para ajustarse a la realidad. El ajuste del modelo se realiza modificando los coeficientes de absorción de los materiales, y será una simulación fidedigna de la sala real cuando los resultados ofrecidos por Odeon coincidan con los obtenidos “in situ”. En el modelo en 3D es posible realizar mejoras para optimizar la sala para la lectura de conferencias o para actuaciones de música de cámara. Se realizan pruebas introduciendo los valores recomendados para ambos usos de la sala. Para mejorar las condiciones acústicas se propone el uso de placas de doble cara, que reflejan el sonido por una de ellas y por la otra lo absorben, y también el uso de dos paneles móviles. En caso de que haya una conferencia los paneles se almacenarán tras la pantalla y las placas se usarán por su cara absorbente. Para una actuación de música de cámara las placas se usarán por la parte reflectiva, y los dos paneles se colocarán en la tarima. Esta propuesta conlleva una mejora significativa para ambos usos de la sala, es sencilla de emplear, y supondrá una gran diferencia en la experiencia de los usuarios.Van De Heyning, P. (2015). Study of the acoustic conditioning of the Aula Magna of the Faculty of Law of the Universitat de València. Analysis of the current situation and a proposal for improvement. http://hdl.handle.net/10251/57659.Archivo delegad

The Need to Increase Awareness and Access to Cochlear Implantation

Some degree of disabling hearing loss is present in 466 million people world-wide, representing 5% of the world’s population and the majority of these are adults over 65 years old. Hearing loss is associated with increased risks of social isolation, depression, dementia, stroke, vision loss, diabetes and mortality. It is in the top five causes of years lived with disability in 2015, 2016 and 2017 for males and top 10 for females. Hearing aids are a suitable treatment for mild to moderate loses but for some they do not provide enough benefit. Cochlear implantation is a proven and effective treatment for bilateral severe to profound hearing loss, yet despite good funding in high income countries, the utilisation of CI is poor (less than 10% of suitable patients), especially in the older adult population who arguably need it most. Prevalence data shows that hearing loss increases with age, but the provision of implants in the over 65 s is even lower, despite there being no clinical barriers to older adults receiving a CI. Survey data shows that awareness activities are needed for both professionals and the general population to improve knowledge of what a CI is and how it can help

Synthesis of Nanofiltration Membrane Developed from Triethanolamine (TEOA) and Trimesoyl Chloride (TMC) for Separation of Xylose from Glucose

Synthesis of thin film composite (TFC) nanofilt ration (NF) membrane has experienced tremendous development since the concept of interfacial polymerisation (IP) was first introduced. One of its new application is on the separation of xylose from glucos e in biomass hydrolysate. In this present study, NF TFC membrane has been produced through interfacial poly merisation by manipulation the concentration of triethanolamine (TEOA) at 35 min reaction time with 0. 15 % w/v of trimesoyl chloride (TMC). The membrane was then characterised in term of their chemical and physical properties, and separation performance between xylose and glucose. The growth of thin layer f ilm depends on concentration of TEOA as the monomer and reaction time. As concentration of TEOA and re action time increased, the layer of the TFC becomes thicker thus decreases the permeability of the membrane. Contradicted to this study, the lowest and the highest permeability were recorded at 4 % w/v of TEOA and 8 % w/v of TEOA at reaction time of 35-min in TMC. The TFC membrane prepared with 4 % w/v TEOA has high in permeate flux, resultant in high xylose separation of 1.3. Low permeate flux but moderate xylose separation factor of 0.93 was obtained for the TFC membrane prepared with 8 % w/v TEOA

Pilot study on patients with Mal de Debarquement syndrome during pregnancy

Aim: To evaluate if patients with Mal de Debarquement syndrome (MdDS) demonstrate different symptom levels or symptom type during pregnancy. Materials & methods: 18 MdDS patients that were or had been pregnant during their condition were recruited to complete a retrospective online questionnaire. Respondents answered questions regarding their basic clinical data, diagnosis, triggers and differences in symptom level and symptom type during pregnancy and before pregnancy. Results: A total of 81.3% reported that their symptoms were reduced during pregnancy compared with before pregnancy. Respondents also reported a different perception of motion and experienced less dizziness while being pregnant. Conclusion: The physiological changes that occur during pregnancy improve the symptoms of patients with MdDS, and this is potentially attributable to the rise in estrogen and progesterone. Lay abstract: Mal de Debarquement syndrome (MdDS) is a rare neurological disorder characterized by a constant sensation of self-motion. More women are affected than men, and subsequently a hormonal implication has been theorized. This study aimed to evaluate if symptoms change in patients with MdDS during their pregnancy. A total of 18 MdDS patients were recruited to complete a retrospective online questionnaire. Among these, 81.3% of respondents reported that their symptoms were lower during pregnancy compared with before pregnancy. Respondents also reported a different perception of motion and experienced less dizziness while being pregnant. Our results support the hypothesis that pregnancy positively influences MdDS symptoms

The effect of physical therapy treatment in patients with subjective tinnitus:A systematic review

Background: Tinnitus is a very common symptom that often causes distress and decreases the patient's quality of life. Apart from the well-known causes, tinnitus can in some cases be elicited by dysfunctions of the cervical spine or the temporomandibular joint (TMJ). To date however, it is unclear whether alleviation of these dysfunctions, by physical therapy treatment, also decreases the tinnitus complaints. Such physical therapy could be an interesting treatment option for patients that are now often left without treatment. Objectives: The aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus. Data sources: The online databases Pubmed, Web of Science, Cochrane, and Embase were searched up to March 2016. Two independent reviewers conducted the data extraction and methodological quality assessment. Study eligibility criteria: Only randomized controlled trials and quasi-experimental trials were included in the review. Studies had to be written in English, French, Dutch, or German. Participants and interventions: The included studies investigated the effect of physical therapy treatment modalities on tinnitus severity in patients suffering from subjective tinnitus. Results: Six studies were included in this review, four investigating cervical spine treatment and two investigating TMJ treatment. These studies show positive effects of cervical spine treatment (manipulations, exercises, triggerpoint treatment) on tinnitus severity. Additionally, decrease in tinnitus severity and intensity was demonstrated after TMJ treatment, following splints, occlusal adjustments as well as jaw exercises. Limitations: The risk of bias in the included studies was high, mainly due to lack of randomization, lack of blinding of subjects, therapists, and/or investigators. Additionally, risk of bias is present due to incomplete presentation of the data and selective reporting. A major issue of the reviewed papers is the heterogeneity of the included study populations, treatments and outcome measures, which inhibit data pooling and meta-analysis. Conclusions: Despite the methodological issues in the included studies and the consequent low quality evidence, it is noteworthy that all included studies show positive treatment effects. Before recommendations can be made, these results need to be confirmed in larger, high quality studies, using unambiguous inclusion criteria, state-of-the-art treatment, and high quality outcome measures

Comparison of the Long-Term Effect of Positioning the Cathode in tDCS in Tinnitus Patients

Objective: Transcranial direct current stimulation (tDCS) is one of the methods described in the literature to decrease the perceived loudness and distress caused by tinnitus. However, the main effect is not clear and the number of responders to the treatment is variable. The objective of the present study was to investigate the effect of the placement of the cathode on the outcome measurements. Methods: Patients considered for the trial were chronic non-pulsatile tinnitus patients with complaints for more than 3 months and a Tinnitus Functional Index (TFI) score that exceeded 25. The anode was placed on the right dorsolateral prefrontal cortex (DLPFC). In the first group—“bifrontal”—the cathode was placed on the left DLPFC, while in the second group—“shoulder”—the cathode was placed on the shoulder. Each patient received two sessions of tDCS weekly and eight sessions in total. Evaluations took place on the first visit for an ENT consultation, at the start of therapy, after eight sessions of tDCS and at the follow-up visit, which took place 84 days after the start of the therapy. Subjective outcome measures such as TFI, Visual Analog Scales (VAS) for loudness and percentage of consciousness of tinnitus were administered in every patient. Results: There was no difference in the results for tinnitus loudness and the distress experienced between the placement of the cathode on the left DLPFC or on the shoulder. In addition, no statistically significant overall effect was found between the four test points. However, up to 39.1% of the patients experienced a decrease in loudness, measured by the VAS for loudness. Moreover, 72% of those in the bifrontal group, but only 46.2% of those in the shoulder group reported some improvement in distress. Conclusion: While some improvement was noted, this was not statistically significant. Both electrode placements stimulated the right side of the hippocampus, which could be responsible for the effect found in both groups. Further research should rule out the placebo effect and investigate alternative electrode positions

Research Report 2008–2009

The NHMRC Clinical Trials Centre at the University of Sydney runs large multicentre investigator-initiated clinical trials, takes part in trials of national and international collaborative trial groups and contributes expertise to trials run by others. It also: • undertakes research into trial methods and is recognised through publications as a leader in trial methodology • reviews and synthesises evidence from completed trials, and is at the forefront of developments in methods, such as prospective meta-analysis • advises on trial design and operation, and randomises patients and analyses data for other groups conducting trials, particularly through its Outreach program • takes a lead in proposing new directions for trial research in Australia, particularly with regard to integrating clinical trials with national policy and clinical practice • offers placements for postgraduate students in all of these areas • runs short courses in the design and conduct of clinical trials as part of its undertaking to train people for Australian medical research. Core funding is provided by the NHMRC, and specific projects are funded by government, public and private institutions and the pharmaceutical industry. The CTC is at two sites in Camperdown in inner Sydney — the Medical Foundation Building on Parramatta Road and on Mallett Street. This report covers the CTC’s achievements for the biennium 2008–200

Comparison of the Long-Term Effect of Positioning the Cathode in tDCS in Tinnitus Patients

Objective: Transcranial direct current stimulation (tDCS) is one of the methods described in the literature to decrease the perceived loudness and distress caused by tinnitus. However, the main effect is not clear and the number of responders to the treatment is variable. The objective of the present study was to investigate the effect of the placement of the cathode on the outcome measurements.Methods: Patients considered for the trial were chronic non-pulsatile tinnitus patients with complaints for more than 3 months and a Tinnitus Functional Index (TFI) score that exceeded 25. The anode was placed on the right dorsolateral prefrontal cortex (DLPFC). In the first group—“bifrontal”—the cathode was placed on the left DLPFC, while in the second group—“shoulder”—the cathode was placed on the shoulder. Each patient received two sessions of tDCS weekly and eight sessions in total. Evaluations took place on the first visit for an ENT consultation, at the start of therapy, after eight sessions of tDCS and at the follow-up visit, which took place 84 days after the start of the therapy. Subjective outcome measures such as TFI, Visual Analog Scales (VAS) for loudness and percentage of consciousness of tinnitus were administered in every patient.Results: There was no difference in the results for tinnitus loudness and the distress experienced between the placement of the cathode on the left DLPFC or on the shoulder. In addition, no statistically significant overall effect was found between the four test points. However, up to 39.1% of the patients experienced a decrease in loudness, measured by the VAS for loudness. Moreover, 72% of those in the bifrontal group, but only 46.2% of those in the shoulder group reported some improvement in distress.Conclusion: While some improvement was noted, this was not statistically significant. Both electrode placements stimulated the right side of the hippocampus, which could be responsible for the effect found in both groups. Further research should rule out the placebo effect and investigate alternative electrode positions

Late gadolinium enhancement CMR in primary mitral regurgitation.

AIMS: The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) remains controversial. It has been shown that late gadolinium enhancement on cardiovascular magnetic resonance (LGE CMR), which may identify myocardial fibrosis, is associated with a worse outcome in various cardiomyopathies. We sought to investigate the prevalence and significance of delayed enhancement in primary MR. METHODS: We prospectively included 41 patients with at least moderate primary MR and without overt signs of left ventricular (LV) dysfunction. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for transthoracic echocardiography and LGE CMR. RESULTS: A total of 39 patients had interpretable LGE CMR images. Among them, 12 (31%) had late contrast uptake of the LV wall. LGE CMR showed an infarct pattern in three patients, a pattern of mid-wall fibrosis in seven patients and two patients had a combined pattern. Patients with delayed enhancement on CMR had significant higher LV diameters (LV end-systolic diameter 39 +/- 4 vs. 34 +/- 5 mm, P = 0.002; LV end-diastolic diameter 57 +/- 5 vs. 50 +/- 5 mm, P = 0.001). There was a trend towards a higher indexed left atrial volume (55 +/- 21 vs. 44 +/- 13 mL/m(2), P = 0.06). By contrast, there was no significant association between myocardial contrast uptake and age, LV ejection fraction and MR severity. CONCLUSION: Left ventricular remodelling seems to be associated with the presence of delayed enhancement on CMR in primary MR. Further data are needed to determine whether LGE CMR can predict a less favourable outcome or could improve risk stratification in asymptomatic primary MR