The diagnostic accuracy of truncal ataxia and HINTS as cardinal signs for acute vestibular syndrome

Copyright: © 2016 Carmona, Martínez, Zalazar, Moro, Batuecas-Caletrio, Luis and Gordon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.info:eu-repo/semantics/publishedVersio

The axial skeleton of Bagualia alba (Dinosauria: Eusauropoda) from the Early Jurassic of Patagonia

Sauropod dinosaurs were the dominant large-bodied herbivores in many Mesozoic terrestrial ecosystems. Such predominance took place after a faunal replacement event linked to a global environmental change during the Early Jurassic (Pliensbachian-Toarcian), when the smaller basal sauropodomorphs were replaced by giant forms in the subclade Eusauropoda. Two main characteristics of this latter group are large body size (exceeding 10 tons) and a remarkably long neck. New data is presented on the axial anatomy of one of the earliest known eusauropods, Bagualia alba from the Toarcian levels of the Cañadón Asfalto Formation (Chubut Province, Argentina), which bear on the origins of these characteristics. Optimizing relevant axial characters on sauropodomorph phylogeny highlights important changes in cervical anatomy in the evolution of Sauropoda: a greater elongation of the neck due to both an increase in the vertebral count and the elongation of each cervical vertebra, and the appearance of pneumatic structures, first on the external surface (e.g., pleurocoels, laminae within the pleurocoels, accessory laminae of the neural arch) and subsequently invading the internal body of the vertebrae. These two changes have been considered essentials for body mass increase in Eusauropoda. The Toarcian age of Bagualia indicates that several important modifications in the axial skeleton and especially the neck occurred early in eusauropod evolution. These modifications are of ecomorphological importance and likely influenced the success of the eusauropods during the climatic changes surrounding the Pliensbachian-Toarcian crisis.Fil: Gomez, Kevin Leonel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; ArgentinaFil: Carballido, José Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; ArgentinaFil: Pol, Diego. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Paleontológico Egidio Feruglio; Argentin

Portuguese local E-government

The Internet, the World Wide Web and electronic commerce are transforming the way of doing business. These changes are impacting every industry in our country, including local government. The Internet offers a wide variety of opportunities to improve services to citizens and to divulge information's about the communities. In Portugal, the adherence to the Internet by local government is increasing visibly, but much more has to be done. In 1999 a first study was done in order to evaluate the situation of e-government in our country, and two years passed a new study was undertaken, this time in order to evaluate the evolution registered in this area. In this paper we describe some conclusions achieved in these studies comparing their evolution in these two years.- (undefined

Biological basis for cerebral dysfunction in schizophrenia in contrast with Alzheimer’s disease

Schizophrenia and Alzheimer’s disease are two disorders that, while conceptualized as pathophysiologically and clinically distinct, cause substantial cognitive and behavioral impairment worldwide, and target apparently similar – or nearby – circuitry in regions such as the temporal and frontal lobes.We review the salient differences and similarities from selected historical, nosological, and putative mechanistic viewpoints, as a means to help both clinicians and researchers gain a better insight into these intriguing disorders, for which over a century of research and decades of translational development was needed to begin yielding treatments that are objectively effective, but still very far from entirely satisfactory. Ongoing comparison and “cross-pollination” among these approaches to disorders that produce similar deficits is likely to continue improving both our insight into the mechanisms at play, and the development of biotechnological approaches to tackle both conditions – and related disorders – more rapidly and efficaciously

Análisis comparativo de las técnicas de Deep Learning perceptrón multicapa y redes neuronales convolucionales aplicadas a la clasificación musical

Construir un sistema clasificador que permita a un usuario cargar un archivo digital de audio, procesar el archivo utilizando cualquiera de las dos redes neuronales antes descrita y mostrar los resultados de la clasificación por género musical del mismo, así comparar la precisión y velocidad de predicción de los dos métodos de clasificación antes descritos, en general y por género musical

Validación del instrumento para medir la calidad de atención y satisfacción en usuarios de consulta externa del Hospital General Martín Icaza 2021

Introduction: Patient satisfaction is a critical component in the evaluation of the quality of service received. Patient satisfaction provides information about the success of service delivery and the fulfillment of patient expectations. Objective: To determine the factors that influence the quality of care of outpatient users of the Hospital General Martin Icaza. Methodology: A cross-sectional cohort, descriptive and correlational type was conducted applying the qualitative-quantitative research modality. The instrument used in the quantitative section was the modified SERVQUAL questionnaire which was applied in a pilot plan to twenty users of the outpatient service, obtaining a Crombach's Alpha of 0.821, while the interview was the instrument used for the qualitative section and this was applied to a focus group of ten participants. Results: It was evidenced that the average satisfaction of the group was 3.2/5 points being this a regular service, whose worst evaluated indicator was the one referring to empathy towards the patient (2.50) and the best evaluated was the continuous education through talks to the community (3.85). Conclusions: The instruments implemented in this research maintain a strong relationship and have been statistically significant in terms of their relevance and reliability, so they are considered suitable for replication in the final research.Introducción: La satisfacción del paciente es un componente importante en la evaluación de la calidad del servicio recibido. La satisfacción del paciente provee información acerca del éxito en la prestación de los servicios y el cumplimiento de sus expectativas acerca de este. Objetivo: Determinar los factores que influyen la calidad de atención de los usuarios de consulta externa del Hospital General Martin Icaza. Metodología: Se realizó una investigación tipo descriptiva y correlacional aplicando la modalidad de investigación cuali-cuantitativa. El instrumento utilizado en la sección cuantitativa fue el cuestionario SERVQUAL modificado el cual se aplicó en un plan piloto a 20 usuarios del servicio de consulta externa, obteniéndose un Alfa de Crombach de 0,821 mientras que la entrevista fue el instrumento utilizado para la sección cualitativa y esta se aplicó a un grupo focal de 3 participantes. Resultados: Se evidencio que el promedio de satisfacción del grupo fue de 3,2/5 puntos siendo este un servicio regular, cuyo indicador peor evaluado fue el referente a la empatía hacia el paciente (2,50) y el mejor evaluado fue la educación continua mediante charlas a la comunidad (3,85). Conclusiones: Los instrumentos implementados en esta investigación mantienen fuerte relación y han sido estadísticamente significativos en cuanto a su pertinencia y fiabilidad, por lo cual se los considera aptos para su replicación en la investigación final.   &nbsp

Detailed Study of Amplitude Nonlinearity in Piezoresistive Force Sensors

This article upgrades the RC linear model presented for piezoresistive force sensors. Amplitude nonlinearity is found in sensor conductance, and a characteristic equation is formulated for modeling its response under DC-driving voltages below 1 V. The feasibility of such equation is tested on four FlexiForce model A201-100 piezoresistive sensors by varying the sourcing voltage and the applied forces. Since the characteristic equation proves to be valid, a method is presented for obtaining a specific sensitivity in sensor response by calculating the appropriate sourcing voltage and feedback resistor in the driving circuit; this provides plug-and-play capabilities to the device and reduces the start-up time of new applications where piezoresistive devices are to be used. Finally, a method for bypassing the amplitude nonlinearity is presented with the aim of reading sensor capacitance