Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth

Purpose To evaluate the efectiveness of apexifcation versus revascularization in the treatment of necrotic immature teeth and determine which strategy afords the greatest radiological success rate. Methods An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions. Results Signifcantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p<0.05). There were no signifcant diferences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p>0.05). Conclusion Apexifcation with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexifcation versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment

Knowledge-driven delivery of home care services

The version of record is available online at: http://dx.doi.org/10.1007/s10844-010-0145-0Home Care (HC) assistance is emerging as an effective and efficient alternative to institutionalized care, especially for the case of senior patients that present multiple co-morbidities and require life long treatments under continuous supervision. The care of such patients requires the definition of specially tailored treatments and their delivery involves the coordination of a team of professionals from different institutions, requiring the management of many kinds of knowledge (medical, organizational, social and procedural). The K4Care project aims to assist the HC of elderly patients by proposing a standard HC model and implementing it in a knowledge-driven e-health platform aimed to support the provision of HC services.Peer ReviewedPostprint (author's final draft

Machine learning for the development of diagnostic models of decompensated heart failure or exacerbation of chronic obstructive pulmonary disease

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are two chronic diseases with the greatest adverse impact on the general population, and early detection of their decompensation is an important objective. However, very few diagnostic models have achieved adequate diagnostic performance. The aim of this trial was to develop diagnostic models of decompensated heart failure or COPD exacerbation with machine learning techniques based on physiological parameters. A total of 135 patients hospitalized for decompensated heart failure and/or COPD exacerbation were recruited. Each patient underwent three evaluations: one in the decompensated phase (during hospital admission) and two more consecutively in the compensated phase (at home, 30 days after discharge). In each evaluation, heart rate (HR) and oxygen saturation (Ox) were recorded continuously (with a pulse oximeter) during a period of walking for 6 min, followed by a recovery period of 4 min. To develop the diagnostic models, predictive characteristics related to HR and Ox were initially selected through classification algorithms. Potential predictors included age, sex and baseline disease (heart failure or COPD). Next, diagnostic classification models (compensated vs. decompensated phase) were developed through different machine learning techniques. The diagnostic performance of the developed models was evaluated according to sensitivity (S), specificity (E) and accuracy (A). Data from 22 patients with decompensated heart failure, 25 with COPD exacerbation and 13 with both decompensated pathologies were included in the analyses. Of the 96 characteristics of HR and Ox initially evaluated, 19 were selected. Age, sex and baseline disease did not provide greater discriminative power to the models. The techniques with S and E values above 80% were the logistic regression (S: 80.83%; E: 86.25%; A: 83.61%) and support vector machine (S: 81.67%; E: 85%; A: 82.78%) techniques. The diagnostic models developed achieved good diagnostic performance for decompensated HF or COPD exacerbation. To our knowledge, this study is the first to report diagnostic models of decompensation potentially applicable to both COPD and HF patients. However, these results are preliminary and warrant further investigation to be confirmed

Effort Oxygen Saturation and Effort Heart Rate to Detect Exacerbations of Chronic Obstructive Pulmonary Disease or Congestive Heart Failure

Background: current algorithms for the detection of heart failure (HF) and chronic obstructive pulmonary disease (COPD) exacerbations have poor performance. Methods: this study was designed as a prospective longitudinal trial. Physiological parameters were evaluated at rest and effort (walking) in patients who were in the exacerbation or stable phases of HF or COPD. Parameters with relevant discriminatory power (sensitivity (Sn) or specificity (Sp) 80%, and Youden index 0.2) were integrated into diagnostic algorithms. Results: the study included 127 patients (COPD: 56, HF: 54, both: 17). The best algorithm for COPD included: oxygen saturation (SaO(2)) decrease 2% in minutes 1 to 3 of effort, end-of-effort heart rate (HR) increase 10 beats/min and walking distance decrease 35 m (presence of one criterion showed Sn: 0.90 (95%, CI(confidence interval): 0.75-0.97), Sp: 0.89 (95%, CI: 0.72-0.96), and area under the curve (AUC): 0.92 (95%, CI: 0.85-0.995)); and for HF: SaO(2) decrease 2% in the mean-of-effort, HR increase 10 beats/min in the mean-of-effort, and walking distance decrease 40 m (presence of one criterion showed Sn: 0.85 (95%, CI: 0.69-0.93), Sp: 0.75 (95%, CI: 0.57-0.87) and AUC 0.84 (95%, CI: 0.74-0.94)). Conclusions: effort situations improve the validity of physiological parameters for detection of HF and COPD exacerbation episodes

Oral Health Status of Syrian Children in the Refugee Center of Melilla, Spain

Introduction. Little is known about the state of oral health among immigrants from conflict zones, such as the refugee children from the Syrian Civil War. Aim. To determine the oral health status of Syrian immigrant children refugee at the Center for Temporary Stay of Immigrants in Melilla to plan prevention and care programs. Design. Using the criteria set by the World Health Organization, an exploration of the oral cavity of all Syrian children aged 5–13 living at that center was conducted in May 2015. All subjects were clinically evaluated by a calibrated and standardized examiner, accompanied by a dentist who registered the clinical variables, and translators. The sociodemographic and clinical variables were analyzed through a descriptive and analytical study, respectively. Results. The prevalence of caries in both the permanent and deciduous dentition was 75% and 50% in 6- and 12-year-olds, respectively. The dft was 3.2 ± 2.9 in 6-year-old children. At 12 years old, the DMFT was 1.6 ± 2.6 teeth, the DMFM was 1.1 ± 1.7 teeth, the SiC was 3.2, and the IR was 5%. Eighty-six percent of the examined sextants were periodontally healthy. Conclusions. The prevalence of caries was high in the sample population studied, confirming the need for a comprehensive primary oral health care program

A comparative study of STBC transmissions at 2.4 GHz over indoor channels using a 2 × 2 MIMO testbed

In this paper we employ a 2×2 Multiple-Input Multiple-Output (MIMO) hardware platform to evaluate, in realistic indoor scenarios, the performance of different space-time block coded (STBC) transmissions at 2.4GHz. In particular, we focus on the Alamouti orthogonal scheme considering two types of channel state information (CSI) estimation: a conventional pilot-aided supervised technique and a recently proposed blind method based on second-order statistics (SOS). For comparison purposes, we also evaluate the performance of a Differential (non-coherent) space-time block coding (DSTBC). DSTBC schemes have the advantage of not requiring CSI estimation but they incur in a 3dB loss in performance. The hardware MIMO platform is based on high-performance signal acquisition and generation boards, each one equipped with a 1GB memory module that allows the transmission of extremely large data frames. Upconversion to RF is performed by two RF vector signal generators whereas downconversion is carried out with two custom circuits designed from commercial components. All the baseband signal processing is implemented off-line in MATLAB®, making the MIMO testbed very flexible and easily reconfigurable. Using this platform we compare the performance of the described methods in line-of-sight (LOS) and non-line-of-sight (NLOS) indoor scenarios.This work has been supported by Ministerio de Educación y Ciencia of Spain, Xunta de Galicia and FEDER funds of the European Union under grant numbers TEC2004-06451-C05-02, TEC2004-06451-C05-01, PGIDT05PXIC10502PN, and FPU grants AP2004-5127 and AP2006-2965

Plataforma hardware para el desarrollo de sistemas MIMO

In this work we present a low-cost and flexible 2×2 MIMO testbed operating on the ISM band of 2.4 GHz with a total bandwith of 20 MHz. The transmitter and receiver baseband modules are PCs equipped with ADCs, DACs, memories, DSPs and FPGAs modules that allow a data transfer rate up to 200 MB/s per channel. Signals are generated at an IF of 15 MHz, upconverted to RF by two signal generators and downconverted to 15 MHz by means of two circuits specifically designed for this platform

¿En qué ocasiones el médico de familia solicita un tratamiento psicológico para sus pacientes? : análisis descriptivo y de concordancia entre diagnósticos

Los trastornos mentales son una de las causas más importantes de morbilidad en el mundo, y suponen elevados costes económicos y sociales. La atención primaria de salud juega un papel importante en su detección y tratamiento. Los tratamientos psicológicos, que han sido a menudo mal difundidos, son una opción de tratamiento eficaz para una gran parte de los trastornos mentales. El presente estudio pretende investigar en qué casos el médico de familia solicitó un tratamiento psicológico para sus pacientes. Se analizaron las solicitudes escritas que había realizado el médico de familia (n=322). Los principales resultados sugieren una discrepancia en cuanto a la necesidad de realizar un tratamiento psicológico, así como una ausencia de concordancia entre diagnósticos (médico de familia vs psicólogo). Los datos obtenidos podrían sugerir la necesidad de mejorar la difusión de los tratamientos psicológicos basados en la evidencia, especialmente en la atención primaria de saludThe mental health problems are one of the most important causes of morbidity in the World, and suppose a source of high economic and societal costs. The primary health care plays an important role in their detection and treatment. The psychological treatments have been often poorly disseminated; nevertheless, they are an efficacious treatment option for a great part of mental disorders. This study aims to analyze the indication of psychological treatments which were made by the general practitioners. The data presented in the written solicitude was analyzed (n=322). A discrepancy in the need to realize a psychological treatment, and the absence of concordance between diagnoses (family doctor vs. psychologist), were the major findings. These results could suggest a need of improve the dissemination of evidence based psychological treatments, especially in the primary health care setting

¿En qué ocasiones el médico de familia solicita un tratamiento psicológico para sus pacientes? : análisis descriptivo y de concordancia entre diagnósticos

Los trastornos mentales son una de las causas más importantes de morbilidad en el mundo, y suponen elevados costes económicos y sociales. La atención primaria de salud juega un papel importante en su detección y tratamiento. Los tratamientos psicológicos, que han sido a menudo mal difundidos, son una opción de tratamiento eficaz para una gran parte de los trastornos mentales. El presente estudio pretende investigar en qué casos el médico de familia solicitó un tratamiento psicológico para sus pacientes. Se analizaron las solicitudes escritas que había realizado el médico de familia (n=322). Los principales resultados sugieren una discrepancia en cuanto a la necesidad de realizar un tratamiento psicológico, así como una ausencia de concordancia entre diagnósticos (médico de familia vs psicólogo). Los datos obtenidos podrían sugerir la necesidad de mejorar la difusión de los tratamientos psicológicos basados en la evidencia, especialmente en la atención primaria de saludThe mental health problems are one of the most important causes of morbidity in the World, and suppose a source of high economic and societal costs. The primary health care plays an important role in their detection and treatment. The psychological treatments have been often poorly disseminated; nevertheless, they are an efficacious treatment option for a great part of mental disorders. This study aims to analyze the indication of psychological treatments which were made by the general practitioners. The data presented in the written solicitude was analyzed (n=322). A discrepancy in the need to realize a psychological treatment, and the absence of concordance between diagnoses (family doctor vs. psychologist), were the major findings. These results could suggest a need of improve the dissemination of evidence based psychological treatments, especially in the primary health care setting