Permutation entropy and irreversibility in gait kinematic time series from patients with mild cognitive decline and early alzheimer’s dementia

Gait is a basic cognitive purposeful action that has been shown to be altered in late stages of neurodegenerative dementias. Nevertheless, alterations are less clear in mild forms of dementia, and the potential use of gait analysis as a biomarker of initial cognitive decline has hitherto mostly been neglected. Herein, we report the results of a study of gait kinematic time series for two groups of patients (mild cognitive impairment and mild Alzheimer’s disease) and a group of matched control subjects. Two metrics based on permutation patterns are considered, respectively measuring the complexity and irreversibility of the time series. Results indicate that kinematic disorganisation is present in early phases of cognitive impairment; in addition, they depict a rich scenario, in which some joint movements display an increased complexity and irreversibility, while others a marked decrease. Beyond their potential use as biomarkers, complexity and irreversibility metrics can open a new door to the understanding of the role of the nervous system in gait, as well as its adaptation and compensatory mechanismsThis research was funded through the Premio del Ilustre Colegio Profesional de Fisioterapeutas de la Comunidad De Madrid, prize number ICPFM-IX-201

HE-LHC: The High-Energy Large Hadron Collider – Future Circular Collider Conceptual Design Report Volume 4

In response to the 2013 Update of the European Strategy for Particle Physics (EPPSU), the Future Circular Collider (FCC) study was launched as a world-wide international collaboration hosted by CERN. The FCC study covered an energy-frontier hadron collider (FCC-hh), a highest-luminosity high-energy lepton collider (FCC-ee), the corresponding 100 km tunnel infrastructure, as well as the physics opportunities of these two colliders, and a high-energy LHC, based on FCC-hh technology. This document constitutes the third volume of the FCC Conceptual Design Report, devoted to the hadron collider FCC-hh. It summarizes the FCC-hh physics discovery opportunities, presents the FCC-hh accelerator design, performance reach, and staged operation plan, discusses the underlying technologies, the civil engineering and technical infrastructure, and also sketches a possible implementation. Combining ingredients from the Large Hadron Collider (LHC), the high-luminosity LHC upgrade and adding novel technologies and approaches, the FCC-hh design aims at significantly extending the energy frontier to 100 TeV. Its unprecedented centre-of-mass collision energy will make the FCC-hh a unique instrument to explore physics beyond the Standard Model, offering great direct sensitivity to new physics and discoveries

Neurología ambulatoria extrahospitalaria: análisis del área V de atención especializada de la Comunidad de Madrid

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid. Facultad de Medicina. Departamento de Medicina. Fecha de lectura: 28 de Noviembre de 200

Estudio del Síndrome de Piernas Inquietas y su influencia en Salud Laboral

Restless Legs Syndrome is a frequent pathology although insufficiently diagnosed, whose prevalence in Europe and USA ranges from 5-10%. Every time it is more habitual, than it is in the occupational health , where the suffering of this syndrome by some worker is clear, due to the special preventive attention that is dedicated to the adaptation of the jobs; because in times of an impact on the quality of life of the patient and even in his performance at work. We have made an Study Epidemiologist in video display terminal (VDT) of Repsol users, having used collected in the medical examinations of Monitoring of the Health. Our objectives are to know the prevalence this syndrome in this group and its possible physiopathological association with levels descended from iron, vitamin B 12, magnesium, sedentary style of life, smoking, and treatments with psycodrugs. Our main conclusion is that association statistically significant exists to suffer SPI from the sedentary style of life.El síndrome de Piernas Inquietas es una patología frecuente e insuficientemente diagnosticada cuya prevalencia en Europa y EEUU se sitúa entre un 5- 10% de media. Cada vez resulta más habitual, que sea en la actividad del médico del trabajo, donde se reconozca el padecimiento de este síndrome por algún trabajador, debido a la especial atención preventiva que se dedica a la adaptación de los puestos de trabajo; ya que en ocasiones supone un impacto en la calidad de vida del paciente e incluso en su rendimiento laboral. Hemos realizado un Estudio Epidemiológico en trabajadores usuarios de PVD (Pantallas de Visualización de Datos) de Repsol, utilizando la información recogida en los reconocimientos médicos de Vigilancia de la Salud. Nuestros objetivos son conocer la prevalencia de este síndrome en dicho colectivo y su posible asociación fisiopatológica con estados de ferropenia, hipoferritinemia, niveles descendidos de vitamina B 12 y magnesio, sedentarismo, tabaquismo, y tratamientos con psicofármacos. Nuestra conclusión principal es que existe asociación estadísticamente significativa de padecer SPI con el estilo de vida sedentario

Cerebral hemodynamics and vasoconstriction in preeclampsia: From diagnosis to resolution

Objectives: To evaluate maternal cerebral hemodynamics in patients with preeclampsia (PE) from diagnosis to clinical resolution using transcranial Doppler (TCD) and compare these findings with those of healthy pregnant women. Furthermore, we sought to describe the prevalence of vasoconstriction (VC) and related clinical parameters in PE. Study design: Case-control study including consecutive patients with PE at diagnosis and healthy pregnant women at week 36 of pregnancy. We prospectively collected clinical and neuroimaging data. TCD was repeated at inclusion and on days 1, 7, and 30 postpartum. Main outcome measures: Evolution of intracranial arteries hemodynamics (mean velocities (MV), resistance index). VC diagnosis and related features are described. Results: A total of 165 patients (80 with PE) underwent 467 TCD procedures. Patients with PE presented higher MAP. Intracranial arteries MV were significantly higher in patients with PE (at diagnosis and days 1 and 7 postpartum) but were normalized by day 30, without correlation with MAP evolution or treatment. VC was present in 32.5% of patients with PE (p < 0.001) and was mainly mild according to the Lindegaard index. Severe PE was associated with VC (50.0% vs. 22.6%; odds ratio 3.484; 95% confidence interval 1.425-8.520; p = 0.014). No other independent risk factors for reversible VC were identified. Conclusions: Patients with PE presented significantly higher MV in the anterior circulation compared to healthy controls, which worsened by day 7 and reverted by day 30 after delivery. VC was present in one-third of PE but was mainly mild and asymptomatic. Severe PE was associated with VC development.Sin financiación2.899 JCR (2020) Q2, 37/83 Obstetrics & Gynecology0.95 SJR (2021) Q1, 33/192 Obstetrics and GynecologyNo data IDR 2020UE

Presentation_1_Practical tool to identify Spasticity-Plus Syndrome amongst patients with multiple sclerosis. Algorithm development based on a conjoint analysis.PDF

IntroductionThe Spasticity-Plus Syndrome (SPS) in multiple sclerosis (MS) refers to a combination of spasticity and other signs/symptoms such as spasms, cramps, bladder dysfunction, tremor, sleep disorder, pain, and fatigue. The main purpose is to develop a user-friendly tool that could help neurologists to detect SPS in MS patients as soon as possible.MethodsA survey research based on a conjoint analysis approach was used. An orthogonal factorial design was employed to form 12 patient profiles combining, at random, the eight principal SPS signs/symptoms. Expert neurologists evaluated in a survey and a logistic regression model determined the weight of each SPS sign/symptom, classifying profiles as SPS or not.Results72 neurologists participated in the survey answering the conjoint exercise. Logistic regression results of the survey showed the relative contribution of each sign/symptom to the classification as SPS. Spasticity was the most influential sign, followed by spasms, tremor, cramps, and bladder dysfunction. The goodness of fit of the model was appropriate (AUC = 0.816). Concordance between the experts’ evaluation vs. model estimation showed strong Pearson’s (r = 0.936) and Spearman’s (r = 0.893) correlation coefficients. The application of the algorithm provides with a probability of showing SPS and the following ranges are proposed to interpret the results: high (> 60%), moderate (30–60%), or low (DiscussionThis study offers an algorithmic tool to help healthcare professionals to identify SPS in MS patients. The use of this tool could simplify the management of SPS, reducing side effects related with polypharmacotherapy.</p

Conditions associated with REM sleep behaviour disorder: description of a hospital series

Introducción: El trastorno de conducta de sueño REM (TCSR) se caracteriza por conductas violentas (gritos, patadas, sueños vívidos) durante la fase REM del sueño. Tiene una prevalencia del 1-2% de la población general, especialmente en varones y en mayores de 60 años. En la última década se ha asociado como pródromo a una enfermedad neurodegenerativa. Nos proponemos analizar las patologías asociadas a los 33 pacientes con TCSR atendidos en la Unidad Multidisciplinar de Trastornos del Sueño del Hospital Infanta Sofía, y su respuesta al tratamiento farmacológico. Pacientes y métodos: Análisis descriptivo, retrospectivo, observacional, de los pacientes con diagnóstico de TCSR, atendidos en la consulta monográfica de Neurología, desde octubre de 2012 hasta diciembre de 2015. Se valoran la edad, el sexo, las enfermedades asociadas, y los tratamientos empleados. Resultados: De los 365 pacientes valorados en la consulta, 33 presentan TCSR: 13 mujeres (40%) y 20 hombres (60%), con una edad media de 62,72 años. En el 48% se identifica una patología asociada: la más frecuente es el deterioro cognitivo leve (69%). El porcentaje de TCSR con patología asociada en mayores de 60 años se eleva al 68%. El 82% de los casos han requerido tratamiento. El fármaco más utilizado ha sido el clonazepam (76%), seguido de melatonina (9%), gabapentina (6%) y trazodona (3%). Discusión: En nuestra serie el 48% de los pacientes presentan una patología asociada. La mayor edad influye directamente en la posibilidad de encontrar una patología asociada. La gran mayoría han precisado tratamiento farmacológico por la severidad de los síntomas, siendo el clonazepam (76%) el fármaco más utilizado.IIntroduction: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. Patients and methods: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. Results: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). Discussion: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients’ age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%).Sin financiación1.938 JCR (2017) Q3, 136/197 Clinical Neurology0.534 SJR (2017) Q2, 1260/2878 Medicine (miscellaneous)No data IDR 2017UE

FCC Physics Opportunities: Future Circular Collider Conceptual Design Report Volume 1

We review the physics opportunities of the Future Circular Collider, covering its e+e-, pp, ep and heavy ion programmes. We describe the measurement capabilities of each FCC component, addressing the study of electroweak, Higgs and strong interactions, the top quark and flavour, as well as phenomena beyond the Standard Model. We highlight the synergy and complementarity of the different colliders, which will contribute to a uniquely coherent and ambitious research programme, providing an unmatchable combination of precision and sensitivity to new physics

HE-LHC: The High-Energy Large Hadron Collider: Future Circular Collider Conceptual Design Report Volume 4

In response to the 2013 Update of the European Strategy for Particle Physics (EPPSU), the Future Circular Collider (FCC) study was launched as a world-wide international collaboration hosted by CERN. The FCC study covered an energy-frontier hadron collider (FCC-hh), a highest-luminosity high-energy lepton collider (FCC-ee), the corresponding 100 km tunnel infrastructure, as well as the physics opportunities of these two colliders, and a high-energy LHC, based on FCC-hh technology. This document constitutes the third volume of the FCC Conceptual Design Report, devoted to the hadron collider FCC-hh. It summarizes the FCC-hh physics discovery opportunities, presents the FCC-hh accelerator design, performance reach, and staged operation plan, discusses the underlying technologies, the civil engineering and technical infrastructure, and also sketches a possible implementation. Combining ingredients from the Large Hadron Collider (LHC), the high-luminosity LHC upgrade and adding novel technologies and approaches, the FCC-hh design aims at significantly extending the energy frontier to 100 TeV. Its unprecedented centre-of-mass collision energy will make the FCC-hh a unique instrument to explore physics beyond the Standard Model, offering great direct sensitivity to new physics and discoveries