Evaluation of the stability of prosthetic screws of three craniofacial prostheses retention systems

Orientador: Jose Ricardo de Albergaria BarbosaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O uso de implantes osseointegrados em próteses craniofaciais ajuda na estabilidade outorgando maior conforto para o paciente, minimizando a perda facial existente, melhorando a aparência, estética e convivo social. Existem diferentes sistemas para retenção de próteses sobre implantes osseointegráveis como Barra-Clipe, Ball/O'ring e Magneto, com diferentes vantagens e limitações. O presente trabalho teve como objetivo avaliar a estabilidade de parafusos protéticos em três tipos de sistemas de retenção de próteses craniofaciais (Barra-Clipe, Ball/O'ring e Magneto), quando submetidos a ciclagem mecânica. Foram utilizados doze modelos de resina acrílica com dois implantes craniofaciais 4 mm x 6 mm (HABE implants ¿ Facie line, INP® System - São Paulo ¿ Brazil) instalados a 20 mm de distância entre si e separados em três grupos: I - Barra-clipe (Sistema INP® - São Paulo - Brasil); II- Ball/O-ring (Sistema INP®) e III Magneto (Metalmag®, São Paulo ¿ Brasil) com quatro amostras para cada grupo e foram submetidas ao teste de ciclagem mecânica de remoção e inserção (f = 0,5 Hz) para determinar o afrouxamento dos parafusos. A máquina servo-hidráulica MTS 810-Flex Test 40 (Eden Prairie, MN- USA) foi utilizada para realizar a ciclagem, com deslocamento de 2,5mm e velocidade de 10 mm/s. Os parafusos dos sistemas de retenção receberam 30 Ncm de torque inicial e os valores de afrouxamento foram obtidos em três ciclos (1080, 2160 e 3240), re-aplicando 30 Ncm nos parafusos antes do novo ciclo. Ouve diferencia estadistica significativa no grupo de Ball/O'ring no primeiro e segundo ciclo com maior afrouxamento no primeiro ciclo. Quando comparado entre os grupos, o grupo Ball/O'ring apresentou diferencia estatística no primeiro ciclo e Barra-Clipe no segundo ciclo. O resultado deste trabalho indica que todos os parafusos protéticos apresentam afrouxamento após torque inicial e o sistema de retenção Barra-Clipe apresenta maior afrouxamento quando comparados com os sistemas Ball/O'ring e MagnetoAbstract: The use of bone-integrated implants in craniofacial prostheses helps in the stability of the prosthesis granting a greater comfort for the patient and minimize the existing facial defects, improving appearance, aesthetic and social live. There are different types of prosthesis retention systems in bone-integrated implants as Bar-Clip, Ball/O'ring and Magnet and each retain system will have its advantages and limitations. This study aimed to evaluate the stability of prosthetic screws of three types of craniofacial prostheses retention system (Bar-Clip, Ball/O'ring and Magnet) when submitted to mechanical cycling. Twelve models of acrylic resin with two craniofacial implants of 4 mm x 6mm (HABE Implants - facie line, INP® System - São Paulo - Brazil) placed 20 mm from each other were separated into three groups: I - Bar-clip (Sistema INP® - São Paulo - Brasil); II- Ball/O'ring (Sistema INP®) and III Magnet (Metalmag®, São Paulo ¿ Brasil) with four samples for each group and underwent to a mechanical cycling removal and insertion test (f = 0,5 Hz) to determine the loosening of the retation screws. The servo-hydraulic MTS machine 810-Flextest 40 (Eden Prairie, MN-USA) was used to perform the cycling with 2.5mm and a displacement of 10 mm/s. The screws of the retation systems receive initial torque of 30 Ncm and the lossening of the screw values were obtained in three cycles (1080, 2160 and 3240) reapplying 30 Ncm on the screws before the new cycle. There were significant differences in the Ball/O'ring group between the first cycle and second cycle, with greater loosening values in the first cycle. When compared the torque values between the three groups, was observed difference with greater loosening in the Ball/O'ring group for the first cycle and the Bar-Clip group for the second cycle. The results of this study indicate that all prosthetic screws have a loosening after initial tightening torque and the Bar/Clip retention system have more influence causing loosening of the screws when compared with Ball/O'ring and Magnet retention systemMestradoCirurgia e Traumatologia Buco-Maxilo-FaciaisMestre em Clínica OdontológicaCAPE

Automatic Detection of Epileptic Seizures in Neonatal Intensive Care Units through EEG, ECG and Video Recordings: A Survey

In Neonatal Intensive Care Units (NICUs), the early detection of neonatal seizures is of utmost importance for a timely, effective and efficient clinical intervention. The continuous video electroencephalogram (v-EEG) is the gold standard for monitoring neonatal seizures, but it requires specialized equipment and expert staff available 24/24h. The purpose of this study is to present an overview of the main Neonatal Seizure Detection (NSD) systems developed during the last ten years that implement Artificial Intelligence techniques to detect and report the temporal occurrence of neonatal seizures. Expert systems based on the analysis of EEG, ECG and video recordings are investigated, and their usefulness as support tools for the medical staff in detecting and diagnosing neonatal seizures in NICUs is evaluated. EEG-based NSD systems show better performance than systems based on other signals. Recently ECG analysis, particularly the related HRV analysis, seems to be a promising marker of brain damage. Moreover, video analysis could be helpful to identify inconspicuous but pathological movements. This study highlights possible future developments of the NSD systems: a multimodal approach that exploits and combines the results of the EEG, ECG and video approaches and a system able to automatically characterize etiologies might provide additional support to clinicians in seizures diagnosis

Robust Head Mounted Wearable Eye Tracking System for Dynamical Calibration

In this work, a new head mounted eye tracking system is presented. Based on computer vision techniques, the system integrates eye images and head movement, in real time, performing a robust gaze point tracking. Nystagmus movements due to vestibulo-ocular reflex are monitored and integrated. The system proposed here is a strongly improved version of a previous platform called HATCAM, which was robust against changes of illumination conditions. The new version, called HAT-Move, is equipped with accurate inertial motion unit to detect the head movement enabling eye gaze even in dynamical conditions. HAT-Move performance is investigated in a group of healthy subjects in both static and dynamic conditions, i.e. when head is kept still or free to move. Evaluation was performed in terms of amplitude of the angular error between the real coordinates of the fixed points and those computed by the system in two experimental setups, specifically, in laboratory settings and in a 3D virtual reality (VR) scenario. The achieved results showed that HAT-Move is able to achieve eye gaze angular error of about 1 degree along both horizontal and vertical direction

Propuesta de un programa de gestión de costos, Area de Salud No.13 Baquerizo Moreno 2011

Nunca se debe olvidar que la salud, y con ello la asistencia sanitaria, es un derecho de la ciudadanía, sin embargo también debemos considerar que la cobertura a otorgar debe ser adecuadamente seleccionada para poder obtener de ella el mayor de los réditos, intentando en ese proceso hacerla eficiente, o sea a un costo accesible para ser solventado por el Estado, o por el usuario que accede a ella. A fin de ser prácticos, se planteará la aplicación del enfoque económico que permita al sistema de servicios de salud brindar a cada uno de sus demandantes la mejor calidad de atención de acuerdo a su necesidad; lo que no significa obviamente la más cara, sino la mejor. El objetivo de este trabajo es determinar los costos por servicios ofertados a la población del Centro de Salud Nº 13 Baquerizo Moreno (Juján). Esta investigación, por el periodo y secuencia en la que se lleva a cabo, emplea un estudio descriptivo y por el diseño no experimental- Transversal. La obtención de datos se realizó mediante la recopilación de la información de estadística, administración, contabilidad, proveeduría del Centro de Salud Nº 13. Primeramente, se identificarán los centros de costos: productivos y administrativos; luego, se asignaron los costos indirectos a centros de costos productivos y finalmente, la asignación de costos por actividades productivas. El período de investigación es de enero a diciembre del 2011.It must never be forgotten that one’s health, and therefore their health care too, is a citizen’s right. However, it is equally as important to consider that the health coverage provided must be appropriately selected, in order to obtain the greatest revenues from it. Through this process, the health coverage should aim to be efficient; in other words, at an affordable cost to be paid for by the State, or the user that accesses it. In terms of practicality, this study poses to implement an economic approach that allows the health care system to provide each of their applicants with the best quality of care in accordance to their needs; this does not necessarily mean the most expensive care, but the best. The aim of this study is to determine the cost of the services offered to the patients of Health Centre No. 13 Baquerizo Moreno (Juján). This research, given the time and sequence in which it is performed, employs a descriptive study and a non-experimental cross-sectional design. Data collection was conducted through the compilation of statistical, managerial, accounting, and procurement information provided by Health Centre No.13 Baquerizo Moreno (Juján). Firstly, cost centres will be identified: productive and administrative; then, indirect costs were allocated to production cost centres; and finally, the allocation of costs for productive activities. The research period is from January to December 2011. It must never be forgotten that one’s health, and therefore their health care too, is a citizen’s right. However, it is equally as important to consider that the health coverage provided must be appropriately selected, in order to obtain the greatest revenues from it. Through this process, the health coverage should aim to be efficient; in other words, at an affordable cost to be paid for by the State, or the user that accesses it. In terms of practicality, this study poses to implement an economic approach that allows the health care system to provide each of their applicants with the best quality of care in accordance to their needs; this does not necessarily mean the most expensive care, but the best. The aim of this study is to determine the cost of the services offered to the patients of Health Centre No. 13 Baquerizo Moreno (Juján). This research, given the time and sequence in which it is performed, employs a descriptive study and a non-experimental cross-sectional design. Data collection was conducted through the compilation of statistical, managerial, accounting, and procurement information provided by Health Centre No.13 Baquerizo Moreno (Juján). Firstly, cost centres will be identified: productive and administrative; then, indirect costs were allocated to production cost centres; and finally, the allocation of costs for productive activities. The research period is from January to December 2011.Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduado

Ultrasound Poroelastic Tissue Typing

Employing the poroelastic theory of acoustic waves in gels, the ultrasound (US) propagation in a gel medium filled by poroelastic spherical cells is studied. The equation of fast compressional wave, the phase velocity and the attenuation as a function of the elasticity, porosity and concentration of the cells into the gel matrix are investigated. The outcomes of the theory agree with the preliminary measurements done on PVA gel scaffolds inseminated by porcine liver cells at various concentrations. The feasibility of a non-invasive tech-nique for the health assessment of soft biological tissues steaming by the model is analyzed

cvxEDA: a Convex Optimization Approach to Electrodermal Activity Processing

This paper reports on a novel algorithm for the analysis of electrodermal activity (EDA) using methods of convex optimization. EDA can be considered one of the most common observation channels of sympathetic nervous system activity, and manifests itself as a change in electrical properties of the skin, such as skin conductance (SC). The proposed model describes SC as the sum of three terms: the phasic component, the tonic component, and an additive white Gaussian noise term incorporating model prediction errors as well as measurement errors and artifacts. This model is physiologically inspired and fully explains EDA through a rigorous methodology based on Bayesian statistics, mathematical convex optimization and sparsity. The algorithm was evaluated in three different experimental sessions to test its robustness to noise, its ability to separate and identify stimulus inputs, and its capability of properly describing the activity of the autonomic nervous system in response to strong affective stimulation. Results are very encouraging, showing good performance of the proposed method and suggesting promising future applicability, e.g. in the field of affective computing

Complexity index from a personalized wearable monitoring system for assessing remission in mental health

This study discusses a personalized wearable monitoring system, which provides information and communication technologies to patients with mental disorders and physicians managing such diseases. The system, hereinafter called the PSYCHE system, is mainly comprised of a comfortable t-shirt with embedded sensors, such as textile electrodes, to monitor electrocardiogram-heart rate variability (HRV) series, piezoresistive sensors for respiration activity, and triaxial accelerometers for activity recognition. Moreover, on the patient-side, the PSYCHE system uses a smartphone-based interactive platform for electronic mood agenda and clinical scale administration, whereas on the physician-side provides data visualization and support to clinical decision. The smartphone collects the physiological and behavioral data and sends the information out to a centralized server for further processing. In this study, we present experimental results gathered from ten bipolar patients, wearing the PSYCHE system, with severe symptoms who exhibited mood states among depression (DP), hypomania(HM), mixed state (MX), and euthymia (EU), i.e., the good affective balance. In analyzing more than 400 h of cardiovascular dynamics, we found that patients experiencing mood transitions from a pathological mood state (HM, DP, or MX - where depressive and hypomanic symptoms are simultaneously present) to EU can be characterized through a commonly used measure of entropy. In particular, the SampEn estimated on long-term HRV series increases according to the patients' clinical improvement. These results are in agreement with the current literature reporting on the complexity dynamics of physiological systems and provides a promising and viable support to clinical decision in order to improve the diagnosis and management of psychiatric disorders

Recognizing emotions induced by affective sounds through heart rate variability

This paper reports on how emotional states elicited by affective sounds can be effectively recognized by means of estimates of Autonomic Nervous System (ANS) dynamics. Specifically, emotional states are modeled as a combination of arousal and valence dimensions according to the well-known circumplex model of affect, whereas the ANS dynamics is estimated through standard and nonlinear analysis of Heart rate variability (HRV) exclusively, which is derived from the electrocardiogram (ECG). In addition, Lagged Poincaré Plots of the HRV series were also taken into account. The affective sounds were gathered from the International Affective Digitized Sound System and grouped into four different levels of arousal (intensity) and two levels of valence (unpleasant and pleasant). A group of 27 healthy volunteers were administered with these standardized stimuli while ECG signals were continuously recorded. Then, those HRV features showing significant changes (p < 0.05 from statistical tests) between the arousal and valence dimensions were used as input of an automatic classification system for the recognition of the four classes of arousal and two classes of valence. Experimental results demonstrated that a quadratic discriminant classifier, tested through Leave-One-Subject-Out procedure, was able to achieve a recognition accuracy of 84.72 percent on the valence dimension, and 84.26 percent on the arousal dimension