The house museum environment: A methodology for evaluation of hygrothermal conditions

In recent decades, the obvious deterioration suffered by the collections exhibited in museum rooms has become alarming. The lack of environmental control is currently one of the most vulnerable points in the exhibition of objects and works of art in museums.In historic cities, museums are usually housed in old buildings or museum-houses that were not created specifically for the preservation of heritage objects. In this case, preventive conservation includes both the collections and the building itself. The possibilities of creating stable microclimates for the conservation of objects on display are reduced when it is not possible to change its architectural characteristics either due to lack of resources or because it is a priority to conserve the building envelope.The literature indicates that within the criteria of preventive conservation, the monitoring and control of environmental conditions are essential practices to minimize damage to the heritage during the exhibition.The purpose of this work is to present a methodology to evaluate the degree of adequacy of environmental conditions to the exposed heritage in museum-houses through the measurement and analysis of the microclimatic parameters (temperature and relative humidity). The procedure consisted in measuring the temperature and relative humidity conditions of a given space and correlating them with the appropriate conditions according to the material composition of the object, both in average levels and fluctuations. For them, two experimental studies were carried out in three representative rooms belonging to the Historic House of Independence Museum in Tucuman (Phot. 1), Argentina, which is built with two types of materials (brick and adobe). The first, analyzes the evolution of the parameters of temperature and relative humidity in recent years inside a museum-house (2010-2014) and the second, evaluates the degree of adaptation of the heritage exposed to the temperature and relative humidity conditions in specifics works of art (February to May of 2013). The approach is based on a short, medium and long-term field monitoring of the environmental parameters and the measured data are elaborated in terms of average monthly and daily values and mean daily fluctuation. The analysis of the microclimatic data has been carried out according to the Standard ASHRAE for historical buildings and a Performance Index PI for temperature and relative humidity parameters has calculated and related to the potential damage of the works of art exhibited. The results of the analysis of study 1 show that this house is affected significantly by the influence of the climatic conditions, especially during the hottest months of the year. The statistical analysis did not show significant changes in the behavior of the parameters in relation to the characteristics of both types of materials that were used in the building of the museum, which may be related to the location of each room and the opening or not of windows to the exterior. The results of study 2 indicate that the heritage exhibited in the selected rooms is exhibited in inadequate thermo hygrometric conditions, effects that could become visible over time if the conditions are not reversed. During the period analyzed in 2013, only 10% of the time the average levels remained within the levels established by ASHRAE B (Fig. 1). Some daily fluctuations of short periods of RH above the limit allowed of 10% were detected through more quickly by means of an extension of the performance index PI that defines the percentage of time during which the daily fluctuations of temperature and relative humidity were kept inside safe limits.The analysis of the indoor environment through the proposed methodology permits the assessment of the environmental quality in contact with the exposed heritage and the planning of actions aimed at improving the conservation of heritage according to the potentialities of the building. The evaluation of actual levels of variation of the thermo hygrometric variables also determines the most critical variable, which requires constant vigilance of the staff in charge of the collections and the evaluation of success of the applied actions. In the case analyzed, for example, is necessary to implement improvements to control the temperature and humidity levels to bring the PI = 10% index to a percentage of at least 30 or 40%.The application of this methodology together with the collaboration of museum curators will allow the detection of the causes of damage without having to implement the high cost of energetic systems as an alternative solution. The thermo hygrometric behavior observed in this house-museum is typical of the museums in the region and, therefore, the procedure explained could extend to other cases with the purpose of implementing real solutions for a sustainable preventive conservation of heritage.Fil: Zamora, María Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Investigación en Luz, Ambiente y Visión. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Instituto de Investigación en Luz, Ambiente y Visión; ArgentinaFil: O´donell, Beatriz Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Investigación en Luz, Ambiente y Visión. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Instituto de Investigación en Luz, Ambiente y Visión; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Departamento de Luminotecnia, Luz y Visión; Argentin

Functional vision barriers: a new concept analyzed in terms of human visual performance

In this work we introduce a new category of barriers that we call "functional vision barriers." This expression refers to lighting and visual elements that may complicate or hinder functional vision and may make life even more difficult for people with visual defects. These barriers appear as a consequence of certain negative effects caused by the poor design of the visual stimulus or visual environment that surrounds it in which lighting is one of the main factors. We use the term "functional vision" because this expression refers to the ability of the visual system to perform everyday tasks. We analyzed some of our previous results with regard to situations that can be considered "functional vision barriers": (1) stimuli with low luminance contrast information in which the addition of chromatic contrast improves visual performance and (2) tasks that are performed in the presence of a glare source in the visual field, diminishing visual performance and reducing brightness perception.Fil: Colombo, Elisa Margarita. Universidad Nacional de Tucuman. Facultad de Cs.exactas y Tecnologia. Departamento de Luminotecnia, Luz y Vision; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucuman. Instituto de Investigacion En Luz, Ambiente y Vision; ArgentinaFil: O´Donell, Beatriz M.. Universidad Nacional de Tucuman. Facultad de Cs.exactas y Tecnologia. Departamento de Luminotecnia, Luz y Vision; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucuman. Instituto de Investigacion En Luz, Ambiente y Vision; ArgentinaFil: Santillán, Javier Enrique. Universidad Nacional de Tucuman. Facultad de Cs.exactas y Tecnologia. Departamento de Luminotecnia, Luz y Vision; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucuman. Instituto de Investigacion En Luz, Ambiente y Vision; ArgentinaFil: Issolio, Luis Alberto. Universidad Nacional de Tucuman. Facultad de Cs.exactas y Tecnologia. Departamento de Luminotecnia, Luz y Vision; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucuman. Instituto de Investigacion En Luz, Ambiente y Vision; Argentin

Rehabilitation following first-time patellar dislocation: a randomised controlled trial of purported vastus medialis obliquus muscle versus general quadriceps strengthening exercises.

Purpose: Define whether distal vastus medialis (VM) muscle strengthening improves functional outcomes compared to general quadriceps muscles strengthening following first-time patellar dislocation (FTPD). Methods: Fifty patients post-FTPD were randomised to either a general quadriceps exercise or rehabilitation programme (n=25) or to a specific-VM exercise and rehabilitation regime (n=25). Primary outcome was the Lysholm Knee Score, secondary outcomes included the Tegner Level of Activity Scale, the Norwich Patellar Instability (NPI) Score, and isometric knee extensions strength at various knee flexion ranges of motion. Outcomes were assessed at baseline, six weeks, six months and 12 months. Results: There were statistically significant differences in functional outcome and activity levels through the Lysholm Knee Score and Tegner Level of Activity Scale at 12 months in the general quadriceps exercise group compared to the VM group (p=0.05; 95% CI: -14.0 to 0.0/p=0.04; 95% CI: -3.0 to 0.0). This did not reach a clinically important difference. There was no statistically significant difference between the groups for the NPI Score and isometric strength at any follow-up interval. The trial experienced substantial participant attrition (52% at 12 months). Conclusions: Whilst there was a statistical difference in Lysholm Knee Score and Tegner Level of Activity Score between general quadriceps and VM exercise groups at 12 months, this may not have necessarily been clinically important. This trial highlights that the recruitment and retention of participants from this population is a challenge and should be considered during the design of future trials in this populatio

Color discrimination is affected by modulation of luminance noise in pseudoisochromatic stimuli

Pseudoisochromatic stimuli have been widely used to evaluate color discrimination and to identify color vision deficits. Luminance noise is one of the stimulus parameters used to ensure that subject´s response is due to their ability to discriminate target stimulus from the background based solely on the hue between the colors that compose such stimuli. We studied the influence of contrast modulation of the stimulus luminance noise on threshold and reaction time color discrimination. We evaluated color discrimination thresholds using the Cambridge Color Test (CCT) at six different stimulus mean luminances. Each mean luminance condition was tested using two protocols: constant absolute difference between maximum and minimum luminance of the luminance noise (constant delta protocol, CDP), and constant contrast modulation of the luminance noise (constant contrast protocol, CCP). MacAdam ellipses were fitted to the color discrimination thresholds in the CIE 1976 color space to quantify the color discrimination ellipses at threshold level. The same CDP and CCP protocols were applied in the experiment measuring RTs at three levels of stimulus mean luminance. The color threshold measurements show that for the CDP, ellipse areas decreased as a function of the mean luminance and they were significantly larger at the two lowest mean luminances, 10 cd/m2 and 13 cd/m2, compared to the highest one, 25 cd/m2. For the CCP, the ellipses areas also decreased as a function of the mean luminance, but there was no significant difference between ellipses areas estimated at six stimulus mean luminances. The exponent of the decrease of ellipse areas as a function of stimulus mean luminance was steeper in the CDP than CCP. Further, reaction time increased linearly with the reciprocal of the length of the chromatic vectors varying along the four chromatic half-axes. It decreased as a function of stimulus mean luminance in the CDP but not in the CCP. The findings indicated that visual performance using pseudoisochromatic stimuli was dependent on the Weber´s contrast of the luminance noise. Low Weber´s contrast in the luminance noise is suggested to have a reduced effect on chromatic information and, hence, facilitate desegregation of the hue-defined target from the background.Fil: Cormenzana Méndez, Iñaki. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Laboratorio de Luminotecnia; ArgentinaFil: Martín, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Investigación en Luz, Ambiente y Visión. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Instituto de Investigación en Luz, Ambiente y Visión; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Laboratorio de Luminotecnia; ArgentinaFil: Charmichael, Teaire L.. Christian Brothers University; Estados UnidosFil: Jacob, Mellina M.. Universidade Federal do Pará; BrasilFil: Lacerda, Eliza M. C. B.. Universidade Federal do Pará; BrasilFil: Gomes, Bruno D.. Universidade Federal do Pará; BrasilFil: Fitzgerald, Malinda E. C.. Christian Brothers University; Estados Unidos. University of Tennessee; Estados UnidosFil: Ventura, Dora F.. Universidade de Sao Paulo; BrasilFil: Silveira, Luiz C. L.. Universidade do Ceuma; Brasil. Universidade Federal do Pará; BrasilFil: O´donell, Beatriz Maria. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología. Laboratorio de Luminotecnia; ArgentinaFil: Souza, Givago S.. Universidade Federal do Pará; Brasi

Patient-directed self-management of pain (PaDSMaP) compared to treatment as usual following total knee replacement; a randomised controlled trial

Background Self-administration of medicines by patients whilst in hospital is being increasingly promoted despite little evidence to show the risks and benefits. Pain control after total knee replacement (TKR) is known to be poor. The aim of the study was to determine if patients operated on with a TKR who self-medicate their oral analgesics in the immediate post-operative period have better pain control than those who receive their pain control by nurse-led drug rounds (Treatment as Usual (TAU)). Methods A prospective, parallel design, open-label, randomised controlled trial comparing pain control in patient-directed self-management of pain (PaDSMaP) with nurse control of oral analgesia (TAU) after a TKR. Between July 2011 and March 2013, 144 self-medicating adults were recruited at a secondary care teaching hospital in the UK. TAU patients (n = 71) were given medications by a nurse after their TKR. PaDSMaP patients (n = 73) took oral medications for analgesia and co-morbidities after two 20 min training sessions reinforced with four booklets. Primary outcome was pain (100 mm visual analogue scale (VAS)) at 3 days following TKR surgery or at discharge (whichever came soonest). Seven patients did not undergo surgery for reasons unrelated to the study and were excluded from the intention-to-treat (ITT) analysis. Results ITT analysis did not detect any significant differences between the two groups’ pain scores. A per protocol (but underpowered) analysis of the 60% of patients able to self-medicate found reduced pain compared to the TAU group at day 3/discharge, (VAS -9.9 mm, 95% CI -18.7, − 1.1). One patient in the self-medicating group over-medicated but suffered no harm. Conclusion Self-medicating patients did not have better (lower) pain scores compared to the nurse-managed patients following TKR. This cohort of patients were elderly with multiple co-morbidities and may not be the ideal target group for self-medication

Proprioception deficiency in articular cartilage lesions of the knee

Purpose: The purpose of this study is to investigate the proprioceptive function of patients with isolated articular cartilage lesions of the knee as compared to normal controls. Methods: The Cartilage group consisted of eight subjects with radiologically and arthroscopically confirmed, isolated, unilateral, articular cartilage lesions of the knee (Outerbridge grade III or IV). They were compared to 50 normal controls. Knee proprioception was assessed by dynamic postural stabilometry using the Biodex Balance SD System. Patient-reported outcome measures (PROMs) were used to evaluate all subjects. Results: Proprioception of the injured knee of the Cartilage group was significantly poorer compared to that of the control group (p < 0.001). A significant proprioceptive deficit also was observed when the uninjured knees of the Cartilage group were compared to those in the Control group (p = 0.003). There was no significant proprioceptive difference between the injured and the contra-lateral uninjured knee of the Cartilage group (p = 0.116). A significant correlation was found between the proprioception measurements of the injured and uninjured knee of the Cartilage group (r = 0.76, p = 0.030). A significant difference was observed in all PROMs (p < 0.001) between the Cartilage and Control groups. Conclusions: Patients with isolated articular cartilage lesions of the knee had a significant proprioceptive deficit as compared to normal controls. The deficiency was profound and even affected the proprioceptive function of the contra-lateral uninjured knee. This study has shown that articular cartilage lesions have a major influence on knee proprioception. However, it remains uncertain as to whether a proprioceptive deficit leads to osteoarthritis or is a consequence of it

MRI texture analysis of subchondral bone at the tibial plateau

OBJECTIVES: To determine the feasibility of MRI texture analysis as a method of quantifying subchondral bone architecture in knee osteoarthritis (OA).   METHODS: Asymptomatic subjects aged 20-30 (group 1, n = 10), symptomatic patients aged 40-50 (group 2, n = 10) and patients scheduled for knee replacement aged 55-85 (group 3, n = 10) underwent high spatial resolution T1-weighted coronal 3T knee MRI. Regions of interest were created in the medial (MT) and lateral (LT) tibial subchondral bone from which 20 texture parameters were calculated. T2 mapping of the tibial cartilage was performed in groups 1 and 2. Mean parameter values were compared between groups using ANOVA. Linear discriminant analysis (LDA) was used to evaluate the ability of texture analysis to classify subjects correctly.   RESULTS: Significant differences in 18/20 and 12/20 subchondral bone texture parameters were demonstrated between groups at the MT and LT respectively. There was no significant difference in mean MT or LT cartilage T2 values between group 1 and group 2. LDA demonstrated subject classification accuracy of 97 % (95 % CI 91-100 %).   CONCLUSION: MRI texture analysis of tibial subchondral bone may allow detection of alteration in subchondral bone architecture in OA. This has potential applications in understanding OA pathogenesis and assessing response to treatment.   KEY POINTS: • Improved techniques to monitor OA disease progression and treatment response are desirable • Subchondral bone (SB) may play significant role in the development of OA • MRI texture analysis is a method of quantifying changes in SB architecture • Pilot study showed that this technique is feasible and reliable • Significant differences in SB texture were demonstrated between individuals with/without OA

PERFECTED enhanced recovery pathway (PERFECT-ER) versus standard acute hospital care for people after hip fracture surgery who have cognitive impairment: a feasibility cluster randomised controlled trial

Objectives: Assess feasibility of a cluster randomised controlled trial (RCT) to measure clinical and cost-effectiveness of an enhanced recovery pathway for people with hip fracture and cognitive impairment (CI). Design: Feasibility trial undertaken between 2016 and 2018. Setting: Eleven acute hospitals from three UK regions. Participants: 284 participants (208 female:69 male). Inclusion criteria: aged >60 years, confirmed proximal hip fracture requiring surgical fixation and CI; preoperative AMTS ≤8 in England or a 4AT score ≥1 in Scotland; minimum of 5 days on study ward; a ‘suitable informant’ able to provide proxy measures, recruited within 7 days of hip fracture surgery. Exclusion criteria: no hip surgery; not expected to survive beyond 4 weeks; already enrolled in a clinical trial. Intervention: PERFECT-ER, an enhanced recovery pathway with 15 quality targets supported by a checklist and manual, a service improvement lead a process lead and implemented using a plan–do–study–act model. Primary and secondary outcome measures: Feasibility outcomes: recruitment and attrition, intervention acceptability, completion of participant reported outcome measures, preliminary estimates of potential effectiveness using mortality, EQ-5D-5L, economic and clinical outcome scores. Results: 282 participants were consented and recruited (132, intervention) from a target of 400. Mean recruitment rates were the same in intervention and control sites, (range: 1.2 and 2.7 participants/month). Retention was 230 (86%) at 1 month and 54%(144) at 6 months. At 3 months a relatively small effect (one quarter of an SD) was observed on health-related quality of life of the patient measured with EQ-5D-5L proxy in the intervention group. Conclusion: This trial design was feasible with modifications to recruitment. Mechanisms for delivering consistency in the PERFECT-ER intervention and participant retention need to be addressed. However, an RCT may be a suboptimal research design to evaluate this intervention due to the complexity of caring for people with CI after hip fracture