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Deploying 5G in new and diverse use cases, such as Industry 4.0 and factory automation, requires 5G systems to harmonize with the communication technologies used in these industries. To this end, 3GPP Release 16 and Release 17 have made significant progress in integrating 5G systems with the IEEE 802.1 working group specifications on Time-Sensitive Networking (TSN). This paper explains a method and architecture for supporting TSN over a wireless channel in a 5G network that adds the TSN synchronization function in a Small Cell gNB implementing the TSN Translator function (SC-TT). This TSN-capable small cell provides TSN over the wireless network to synchronize UEs with the Grand Master (GM) using the physical layer signal of the 5G radio frame and the transmission of the GM reference time to provide high-precision synchronization. This paper explores the pivotal role of a Slot Indicator Signal in enhancing synchronization precision, ensuring that the UE-GM synchronization occurs within an exceptionally narrow timeframe as small as 10 ns.

A system for analysis of histopathology data within a pharmaceutical R&D environment has been developed with the intention of enabling interdisciplinary collaboration. State-of-the-art AI tools have been deployed as easy-to-use self-service modules within an open-source whole slide image viewing platform, so that non-data scientist users (e.g., clinicians) can utilize and evaluate pre-trained algorithms and retrieve quantitative results. The outputs of analysis are automatically cataloged in the database to track data provenance and can be viewed interactively on the slide as annotations or heatmaps. Commonly used models for analysis of whole slide images including segmentation, extraction of hand-engineered features for segmented regions, and slide-level classification using multi-instance learning are included and new models can be added as needed. The source code that supports running inference with these models internally is backed up by a robust CI/CD pipeline to ensure model versioning, robust testing, and seamless deployment of the latest models. Examples of the use of this system in a pharmaceutical development workflow include glomeruli segmentation, enumeration of podocyte count from WT-1 immuno-histochemistry, measurement of beta-1 integrin target engagement from immunofluorescence, digital glomerular phenotyping from periodic acid-Schiff histology, PD-L1 score prediction using multi-instance learning, and the deployment of the open-source Segment Anything model to speed up annotation.

Recycling and revalorization of waste are currently essential for sustainable growth. Mill scale, a waste product from steel production industries, which contains high levels of iron and minimal impurities, is proposed in this study as the source to synthesize magnetite nanoparticles (Fe3O4) for an enhancement of a lactate biosensor range. The synthesized Fe3O4 nanoparticles were coated with polydopamine (PDA) to prevent aggregation and degradation, creating a stable platform for immobilizing lactate oxidase enzyme (LOx) on their surfaces. The characterization of the Fe3O4@PDA material was carried out using transmission electron microscopy (TEM), dynamic light scattering (DLS), and measurement of the polydispersity index (PdI). The Fe3O4@PDA-LOx material was then deposited on a screen-printed carbon electrode modified with Prussian blue (SPCE-PB) for lactate detection. The biosensor exhibited a broad, dual linear concentration-response range, one from 0.1 to 4.62 mM with a limit of detection of 0.32 mM and sensitivity of 1.54 μAmM−1cm−2, and another one from 4.62 to 149.21 mM with a limit of detection of 6.31 mM and sensitivity of 0.08 μAmM−1cm−2. The dual-range concentration response of the biosensor makes it an ideal tool for lactate determination in various applications, including sports medicine, clinical diagnosis, and industrial bioprocessing.

Abstract Grid background and dead‐time harmonic perturbations pose challenges in maintaining power quality and stability in the grid integration of renewable energy conversion systems. Therefore, a super‐twisting algorithm with the ability to reject harmonic perturbations on three‐phase grid‐tied inverters is proposed. The algorithm design is related to dead‐time and grid background harmonics so that robust performance is achieved under these perturbations. To highlight the advantages of the proposed algorithm, it is compared against proportional‐integral (PI) control in several dead‐time and grid background harmonic sweeps. The maximum inverter current distortion obtained with PI control in simulation is 15.53%. However, by using the proposed algorithm instead, the maximum current distortion is reduced to 1.8%. Dead‐time is experimentally swept by using a permanent magnet motor as a harmonic‐free grid. Experimental results of grid background harmonics are obtained by injecting reactive energy into a grid with 2.19% voltage distortion. When PI control is used in the experimental setup, the maximum inverter current distortion obtained is 11.4%. However, with the proposed algorithm, the maximum current distortion is reduced to 1.5%, which complies with the standard IEEE 1547‐2018.

BackgroundPost-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health.Materials and methodsOne hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans.ResultsThe effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample.DiscussionThe MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients’ cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes.Clinical trial registrationwww.ClinicalTrials.gov, identifier NCT04759950.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. The molecular pathogenesis of HCC varies due to the different etiologies and genotoxic insults. The development of HCC is characterized by complex interactions between several etiological factors that result in genetic and epigenetic changes in proto-onco and/or tumor suppressor genes. MicroRNAs (miRNAs) are short non-coding RNAs that also can act as oncomiRs or tumor suppressors regulating the expression of cancer-associated genes post-transcriptionally. Studies revealed that several microRNAs are directly or indirectly involved in cellular signaling, and dysregulation of those miRNAs in the body fluids or tissues potentially affects key signaling pathways resulting in carcinogenesis. Therefore, in this mini-review, we discussed recent progress in microRNA-mediated regulation of crucial signaling networks during HCC development, concentrating on the most relevant ones such as PI3K/Akt/mTOR, Hippo-YAP/TAZ, and Wnt/β-catenin, which might open new avenues in HCC management.

Instant controlled pressure drop (DIC) is one of the emerging technologies in food processing; it can be used for drying, freezing and the extraction of bioactive molecules without damaging their properties. Legumes, such as lentils, are one of the most consumed foods in the world; however, they are mainly cooked by boiling, which causes the loss of antioxidant compounds. This work evaluated the effect of 13 different DIC treatments (with pressure ranges of 0.1–0.7 MPa and times of 30–240 s) on the content of polyphenols (Folin–Ciocalteu and High Performance Liquid Chromatography HPLC) and flavonoids (2-aminoethyl diphenylborinate) as well as the antioxidant activity (DPPH and TEAC) of green lentils. The DIC 11 treatment (0.1 MPa, 135 s) obtained the best release of polyphenols, which in turn are related to antioxidant capacity. The abiotic stress generated by DIC could lead to the breakdown of the cell wall structure, which favors the availability of antioxidant compounds. Finally, the most efficient conditions for DIC to promote the release of phenolic compounds and maintain antioxidant capacity were found under low pressures (

This paper presents a review of the power and torque coefficients of various wind generation systems, which involve the real characteristics of the wind turbine as a function of the generated power. The coefficients are described by mathematical functions that depend on the trip speed ratio and blade pitch angle of the wind turbines. These mathematical functions are based on polynomial, sinusoidal, and exponential equations. Once the mathematical functions have been described, an analysis of the grouped coefficients according to their function is performed with the purpose of considering the variations in the trip speed ratio for all the coefficients based on sinusoidal and exponential functions, and with the variations in the blade pitch angle. This analysis allows us to determine the different coefficients of power and torque used in wind generation systems, with the objective of developing algorithms for searching for the point of maximum power generated and for the active control of wind turbines with variations in the blade pitch angle.

In this work, the modeling of a three-phase four wires inverter and the design of two control schemes for its grid-disconnected operation are presented. The advantages of the four-wire topology are that by means of a coordinate transformation (Park transformation) it is possible to obtain a decoupled linear model, as well as feeding single-phase and three-phase loads in this operating mode. In the model, two control loops are taken into account: a current loop (controller slave) and a voltage loop (controller master) with the aim that this inverter can regulate its output voltage and when it is supplied to a local load.. The contributions of this work is present in the inverter modeling, the method for obtaining the transfer functions and in the controllers design obtained by this method. The inverter model allows to easily obtain the transfer functions of both loops; this is very important for the control area, considering that using classical control techniques and the methodology proposed in this work, the gains can be obtained directly and not adjusted to trial and error. The main advantage of this proposal is that when the kp and ki gains are obtained through the Bode diagrams, we can obtain generalized integrators; applying the coordinate transformation method to the integral gain that was obtained by the design of the PI controller in direct current (dc); This method is described in detail in the presented work and allows obtaining a new controller called proportional controller plus generalized integrator (P+GI). This controller presents a good performance, since it can follow sinusoidal references, in addition to presenting a better disturbances rejection due to the high gains it presents at the grid frequency and harmonic frequencies of the load.

El objetivo de la investigación consistió en determinar la relación entre la perspectiva de eficiencia ciudadana y el comportamiento de uso del e-gobierno local por parte de la ciuda­danía, a través de un estudio empírico realizado al servicio de pago predial por Internet, bajo un estudio de caso en la localidad de Orizaba, Veracruz, México. En este se propone un modelo hipo­tético basado en el modelo de aceptación de tecnología (TAM) y la teoría unificada de aceptación y uso de tecnología (UTAUT). El instrumento empleado fue una encuesta aplicada a una muestra de 383 ciudadanos. La técnica estadística empleada para el análisis de los datos fue un análisis de regresión lineal. Los hallazgos sugieren que la perspectiva de eficiencia del ciudadano es un factor que influye en el comportamiento de uso del e-gobierno. Por lo tanto, la perspectiva de efi­ciencia ciudadana sobre los servicios públicos proporcionados vía Internet es un factor que influye en el comportamiento de uso del e-gobierno, determinando su inclusión a los medios digitales, perspectiva conformada por seis factores: confianza en la web, facilidad de uso, utilidad percibida, funcionalidad del portal, familiaridad con la tecnología y difusión del portal.

Natural or human-made disasters could do huge damage in urban areas and eventually could take lives. It is fundamental to get knowledge of the event’s characteristics to dispose of hasty information to help affected people or to prevent all the citizens from the danger zone, and then it will get time to respond to the crisis. Internet of Things (IoT) has a big impact on this kind of situation because a large amount of data through different devices could provide information about the situation, and about the people that are involved in the crisis. In a disaster, one of the big problems adding to the principal crisis is the disinformation, for that reason is necessary to have available and trusty data in case of disaster, also to know the data that provided the information system. To inform the affected people around the crisis event, there is exist some previous works that have used data from sensors, social networks text, or images, to finally be processed [1],[2],[3],[4],[5],[6],[7],[8]. This paper aims to review study-cases where cities implement crisis management platforms, focus on IoT environment where applications use hybrid data to be processed to help citizens in a crisis situation.

The city of Barrancabermeja has a deteriorated and disused railway corridor which is part of the national railway network to the corresponding section La Dorada - Chiriguaná. This corridor crosses the entire center of the urban area of ​​the municipality and is currently practically abandoned and is limited only to the transit of some wagons, called motor cars, belonging to the COOPSERCOL L.T.D.A. for transporting passengers and minor cargo. According to data from the Barrancabermeja Traffic and Transportation Inspection, between 2015 and 2019, the number of motorcycles in the city increased by 50%, reaching a ratio of one motorcycle for every 2 inhabitants. This phenomenon of excessive growth of motorcycles has caused congestion and safety problems in recent years and has triggered the accident and informality rates. Against this background this research makes an analysis through the use of macro simulation models in transport of what would be the benefits for vehicular mobility if the current railway corridor as it passes through the urban area of ​​the city were to become a vehicular route, creating a more direct connection to the city in the north-south direction.

Smart grids have their basis in distribution systems, and to take advantage of their full potential, the incorporation of distributed generation must be taken into account. This new strategy allows the decentralization of power generation and the microgrid represents a very important element in this generation scheme. With this perspective and considering the importance of power converters, this paper presents the development and operation of a reconfigurable photovoltaic inverter; which aims to operate in grid-connected mode and disconnected from this. To achieve this goal, a hierarchical control is proposed that serves as the basis to develop controllers at level one and level two. Particularly, in grid-disconnected operation, in level one of the hierarchical control a droop controller is implemented whose objective is to give the reference to be followed by the voltage loop controller; as well as allow that between inverters parallel connected, these can be distributed the active and reactive power demanded by the load. In level two of the hierarchical control, the controllers of the current and voltage loops are implemented for both modes of operation. Particularly, in grid-disconnected operation, the following contributions are made to this work: an integral sliding mode controller is implemented; which is a novelty for this application. The goal of this controller is to reduce the total harmonic distortion of the voltage signal that is delivered to the local load in this operation mode. Also, it presents a good performance at the moment of the transition of grid-disconnected operation to the connected operation to this. In addition, a synchronization algorithm was implemented for the inverter reconnection with the grid, as well as an algorithm for the detection of islanding.

The diagnosis of sleep disorders such as narcolepsy and insomnia currently requires experts to interpret sleep recordings (polysomnography). Here, the authors introduce a neural network analysis method for polysomnography that could reduce time spent in sleep clinics and automate narcolepsy diagnosis.

Abstract Introduction There is a high incidence of hand fractures, and a high percentage of them require surgical treatment. The functional result depends, to a large extent, on the technique used. The use of retrograde intramedullary screws allows for early mobilization and minimal dissection of soft tissues. The objective of the present study is to analyze the clinical results and complications with this type of osteosynthesis. Methods A total of 96 fractures in 81 patients were analyzed. There were 62 metacarpal fractures, 60% of which involved the 5th finger, 29% involved the 4th, 5% involved the 3rd, and 6% involved the 2nd finger. There were 34 fractures of the phalanxes, 27 of which (79.5%) involved the proximal phalanx, and 20.5% involved the middle phalanx. The range of active mobility, the time spent at work, and intraoperative complications were assessed. Results The average active mobility obtained was 260° (230–270°). Patients resumed their normal activity within an average time of 5 weeks (between 3 and 32 weeks). There was a 6% rate of intraoperative complications and a 13% rate of postoperative complications in the metacarpals, and an 8% rate of intraoperative complications and 11% of postoperative complications in the phalanxes. Conclusion The use of cannulated screws is a safe and effective option for the treatment of different types of fractures, obtaining a good range of mobility, early reintegration, and with an acceptable number of complications.

Este artículo presenta un estudio comparativo del desempeño de las turbinas eólicas en relación a su coeficiente de potencia y de par, esto es realizado en mediante su modelo matemático que define el comportamiento de cada turbina. El estudio establece que la potencia y el par de una turbina eólica depende del tipo de turbina y de las características de esta, reflejado en el coeficiente de potencia y en el coeficiente de par. El coeficiente de par es dependiente del coeficiente de potencia, por lo que este último se considera como básico en este estudio. De todos los coeficientes de potencia encontrados, se determina que existen tres modelos matemáticos básicos (función polinomial, sinusoidal o exponencial). Con esta información se realiza un estudio comparativo de la potencia de la turbina y del par en el eje de la turbina para cada uno de los casos. El estudio se realiza de forma analítica y se corrobora mediante simulación. El propósito de este análisis, es establecer todas las consideraciones necesarias, para evaluar los diferentes modelos de turbinas eólicas para la construcción de un emulador de una turbina eólica, de acuerdo al comportamiento de la potencia de la turbina y el par en el eje de la turbina eólica.

Resumen: En este trabajo se presenta la implementación digital del algoritmo de modulación de Sünter-Clare, para un convertidor matricial de tres hilos de 7.5 kVA. Este algoritmo es usado para calcular los ciclos de trabajo en un convertidor matricial 3x3, con lo que se generan tensiones de salida con amplitud y frecuencia constantes. El algoritmo de modulación de Sünter-Clare recalcula los tiempos y trayectorias de conmutación cada período de muestreo, con el objetivo de compensar las variaciones de amplitud y de frecuencia de las tensiones de entrada. Este algoritmo se ejecuta en cada muestreo y está en función de la tensión trifásica de entrada y de la tensión de referencia de salida, resultando adecuado para controles en lazo cerrado, cuando las señales de amplitud y de frecuencia de las tensiones de entrada son variables en el tiempo, como ocurre en los sistemas de generación de energía eléctrica a velocidad variable, que utilizan la energía del viento como fuente primaria de energía. El sistema de control para el trabajo experimental, además de la tarjeta del convertidor matricial, está compuesto por una tarjeta de arreglos de compuertas programable (FPGA) y por un procesador digital de señales (DSP) con una tarjeta de interfaz gráfica. Abstract: This paper presents the direct and easy way to implement digitally a Sünter-Clare modulation algorithm for a 7.5 KVA, three-wires, matrix converter. This modulation algorithm is used to calculate 3x3 matrix converter duty cycles to produce constant output voltage and frequency signals. The Sünter-Clare modulation algorithm recalculates switching patterns and switching times every sampling period in order to compensate the input voltage and frequency variations. This algorithm is defined in terms of the three-phase input and the output reference voltages at each sampling instant and is convenient for closed loop operations when the input voltage and frequency are variable in time as in the variable speed wind generation system. The experimental control setup is comprised of a field programmable gate array board, a digital signal processor and a graphics interface board. Palabras clave: Convertidor matricial, algoritmo de modulación Sünter-Clare, distorsión total armónica, Keywords: Matrix converter, Sünter-Clare modulation algorithm, Total Harmonic Distortion

In the advances of the research of the sedimentary basins from central Mexico, it is significant the discovery of the first records of equids of Clarendonian and early Hemphillian age that are mentioned. The specimens were collected in southwest deposits of the San Miguel de Allende basin, the ages are verified by radiometric dates. The largest collection of Dinohippus mexicanus skulls jaws and isolated teeth recovered, have shown the wide geographical distribution in faunas of central Mexico. The study of these records from localities of Coecillos, Rinconada, Arroyo Emilio, and Rancho el Ocote faunas of the San Miguel Allende, Guanajuato state, Tecolotlán, Jalisco state and Juchipila basin Zacatecas state, have shown the variability and transitional features they have in the structures of the skull and upper and lower molars. The skull from Tecolotlán and Rancho El Ocote, of the late Hemphillian age present a well-defined dorsal fossa, in contrast the oldest skull from early-late Hemphillian of Juchipila, the fossa is just a depression in the Maxillary and nasal bone, however, the skull from Coecillos has structures that differentiate it from others. The most relevant records are the lower and upper molars collected at the top of the biostratigraphic sequence of Rancho El Ocote, in the sites named GTO 2 site D and F. These specimens present features that differentiate them from Dinohippus and suggest a primitive Equus. Upper teeth from the Blancan age of Tecolotlán basin, have a high crown but a pronounced curvature like the Dinohippus mexicanus collected in the late Hemphillian strata of this basin.

La Hemeroteca Municipal de Madrid ha sido escogida como objeto de este trabajo de investigación sobre labores de documentación por una serie de razones que se han creído de importancia. La primera de éstas razones se centra en el interés, ya sea histórico o utilitario, que puede despertar el funcionamiento de una hemeroteca. Se ha considerado que sobre éste tipo de instituciones se mantiene una considerable demanda de consulta informativa por parte de un buen número de ciudadanos, ya sean estudiantes, investigadores, profesionales de la información, etc... También se ha tenido en cuenta el valor tanto histórico como cultural de los documentos que se manejan en una hemeroteca, así como el reto que supone para los encargados del centro el cuidado y el mantenimiento de determinados documentos que por su antigüedad y deterioro han de ser archivado con métodos especiales de almacenamiento. Interesaba especialmente atestiguar el grado de penetración que las nuevas tecnologías tienen en la práctica en este tipo de instituciones centradas en la labor documental. A su vez, comprobar si los nuevos soportes digitales, caso del cd-rom, el tradicional disquette o el más moderno videodisco - de mayor utilidad y capacidad -, son realmente utilizados o, por el contrario, son simples previsiones de futuro. Lo mismo se podría decir en lo referente al uso de la informática o de la conexión on line de los fondos.

Software test suites based on the concept of interaction testing are very useful for testing software components in an economical way. Test suites of this kind may be created using mathematical objects called covering arrays. A covering array, denoted by CA(N; t, k, v), is an N × k array over [Formula: see text] with the property that every N × t sub-array covers all t-tuples of [Formula: see text] at least once. Covering arrays can be used to test systems in which failures occur as a result of interactions among components or subsystems. They are often used in areas such as hardware Trojan detection, software testing, and network design. Because system testing is expensive, it is critical to reduce the amount of testing required. This paper addresses the Optimal Shortening of Covering ARrays (OSCAR) problem, an optimization problem whose objective is to construct, from an existing covering array matrix of uniform level, an array with dimensions of (N - δ) × (k - Δ) such that the number of missing t-tuples is minimized. Two applications of the OSCAR problem are (a) to produce smaller covering arrays from larger ones and (b) to obtain quasi-covering arrays (covering arrays in which the number of missing t-tuples is small) to be used as input to a meta-heuristic algorithm that produces covering arrays. In addition, it is proven that the OSCAR problem is NP-complete, and twelve different algorithms are proposed to solve it. An experiment was performed on 62 problem instances, and the results demonstrate the effectiveness of solving the OSCAR problem to facilitate the construction of new covering arrays.

The management of the power flow of a wind generation system is presented. This system is made up of a doubly fed induction generator and a Back to Back converter. The analysis focuses on the grid-side converter. The control loops of the current to the grid and the voltage of the DC-Link are designed based on proportional-integral controllers. These controls allow to manage the active and relative power that is injected into the grid. The Converter is simulated in Simulink of Matlab, where its operation as a rectifier and inverter is validated. This is able to be done due to the vector control technique used in the control structure of the wind generation system, in addition an adequate power exchange is obtained between the generator and the grid.

In this work, the analysis of a CD-CD converter type Boost is presented. This converter works in Discontinuous Conduction Mode; In addition, the design of its control loops is performed, using an Average Current Mode control. The Boost converter is part of a photovoltaic generation system using solar panels. The photovoltaic system is established in a microgrid, with which the inverter works in grid mode and island mode. The main objective of the Boost convertor is to raise and regulate the voting from the solar panels to feed a single-bridge full-bridge inverter. The controllers designed for the boost converter are validated by simulation. The results obtained prove that the designed controller has an acceptable transient response to disturbances in the system input and adequately analyzing overdrafts and establishment times when disturbances are generated.

[This corrects the article DOI: 10.1371/journal.pone.0114565.].

BackgroundSalivary proteins of Triatoma infestans elicit humoral immune responses in their vertebrate hosts. These immune responses indicate exposure to triatomines and thus can be a useful epidemiological tool to estimate triatomine infestation. In the present study, we analyzed antibody responses of guinea pigs to salivary antigens of different developmental stages of four T. infestans strains originating from domestic and/or peridomestic habitats in Argentina, Bolivia, Chile and Peru. We aimed to identify developmental stage- and strain-specific salivary antigens as potential markers of T. infestans exposure.Methodology and principal findingsIn SDS-PAGE analysis of salivary proteins of T. infestans the banding pattern differed between developmental stages and strains of triatomines. Phenograms constructed from the salivary profiles separated nymphal instars, especially the 5th instar, from adults. To analyze the influence of stage- and strain-specific differences in T. infestans saliva on the antibody response of guinea pigs, twenty-one guinea pigs were exposed to 5th instar nymphs and/or adults of different T. infestans strains. Western blot analyses using sera of exposed guinea pigs revealed stage- and strain-specific variations in the humoral response of animals. In total, 27 and 17 different salivary proteins reacted with guinea pig sera using IgG and IgM antibodies, respectively. Despite all variations of recognized salivary antigens, an antigen of 35 kDa reacted with sera of almost all challenged guinea pigs.ConclusionSalivary antigens are increasingly considered as an epidemiological tool to measure exposure to hematophagous arthropods, but developmental stage- and strain-specific variations in the saliva composition and the respective differences of immunogenicity are often neglected. Thus, the development of a triatomine exposure marker for surveillance studies after triatomine control campaigns requires detailed investigations. Our study resulted in the identification of a potential antigen as useful marker of T. infestans exposure.

Periodic Limb Movements (PLMs) are episodic, involuntary movements caused by fairly specific muscle contractions that occur during sleep and can be scored during nocturnal polysomnography (NPSG). Because leg movements (LM) may be accompanied by an arousal or sleep fragmentation, a high PLM index (i.e. average number of PLMs per hour) may have an effect on an individual's overall health and wellbeing. This study presents the design and validation of the Stanford PLM automatic detector (S-PLMAD), a robust, automated leg movement detector to score PLM. NPSG studies from adult participants of the Wisconsin Sleep Cohort (WSC, n = 1,073, 2000-2004) and successive Stanford Sleep Cohort (SSC) patients (n = 760, 1999-2007) undergoing baseline NPSG were used in the design and validation of this study. The scoring algorithm of the S-PLMAD was initially based on the 2007 American Association of Sleep Medicine clinical scoring rules. It was first tested against other published algorithms using manually scored LM in the WSC. Rules were then modified to accommodate baseline noise and electrocardiography interference and to better exclude LM adjacent to respiratory events. The S-PLMAD incorporates adaptive noise cancelling of cardiac interference and noise-floor adjustable detection thresholds, removes LM secondary to sleep disordered breathing within 5 sec of respiratory events, and is robust to transient artifacts. Furthermore, it provides PLM indices for sleep (PLMS) and wake plus periodicity index and other metrics. To validate the final S-PLMAD, experts visually scored 78 studies in normal sleepers and patients with restless legs syndrome, sleep disordered breathing, rapid eye movement sleep behavior disorder, narcolepsy-cataplexy, insomnia, and delayed sleep phase syndrome. PLM indices were highly correlated between expert, visually scored PLMS and automatic scorings (r² = 0.94 in WSC and r² = 0.94 in SSC). In conclusion, The S-PLMAD is a robust and high throughput PLM detector that functions well in controls and sleep disorder patients.

La implantación de las nuevas tecnologías han modificado de manera drástica las relaciones productivas y sociales de nuestro tiempo. La llamada economía informacional ha convertido el valor de lo producido en un elemento intangible e inaprensible, a diferencia del modelo industrial en que el producto final era material y tangible. Ese nuevo marco de interacción profesional ha originado el debate de la reorientación de los servicios públicos, de la implementación de sistemas de calidad en los mismos, cuestionando su capacidad a la hora de satisfacer las cada vez mayores necesidades de los ciudadanos.

Introducción y Objetivo. Los reimplantes y revascularizaciones del miembro superior en pacientes pediátricos son procesos infrecuentes. Presentan características diferenciales epidemiológicas, quirúrgicas y terapéuticas que deben ser conocidas por todos los especialistas que se dediquen a su tratamiento para obtener un resultado lo más satisfactorio posible. Presentamos un estudio descriptivo retrospectivo de los casos de reimplantes o revascularizaciones en pacientes en edad pediátrica atendidos en el Servicio de Cirugía Plástica en el Complejo Asistencial de Burgos (Burgos, España). Material y Método. Recogemos los datos de los pacientes con edad inferior o igual a 18 años atendidos durante los años 2001 a 2010. Para la evaluación del éxito vascular y sus diferentes variables añadimos un estudio analítico mediante la aplicación de la prueba exacta de Fisher. Describimos detalladamente las diferencias con los pacientes adultos, tanto en la técnica quirúrgica empleada como en los cuidados y tratamiento postoperatorios; haciendo hincapié en aquellas condiciones que, a nuestro entender, mejoran tanto la calidad asistencial de paciente como el éxito quirúrgico. Resultados. El total de procesos realizados fue de 48 en 40 pacientes diferentes. La tasa de incidencia de datos agregados de estos traumatismos durante el periodo de estudio hallada en nuestra área de referencia estable es de 0.42/100.000 niño-año. Conclusiones. En los reimplantes y revascularizaciones en pacientes pediátricos, dada la mayor frecuencia de traumatismos contusos y las especiales características de los mismos, los resultados vasculares suelen ser peores. Sin embargo, gracias a su enorme plasticidad cerebral y a su gran adaptabilidad, la recuperación funcional y sensitiva será mucho mejor, por lo que la indicación de reimplante/revascularización en estos pacientes es absoluta en todos los casos, y siempre debe ser llevado a cabo por especialistas experimentados y altamente cualificados. El único factor pronóstico del éxito quirúrgico con significación estadística en nuestro grupo de estudio fue el mecanismo lesional.

Introducción y Objetivo. El pulgar asume el 40-50% de la funcionalidad de la mano, por lo que es fundamental su reconstrucción estable y funcional. Además de las opciones que nos ofrece la microcirugía, debemos manejar de manera eficaz los colgajos locales para cobertura del pulgar, ya que nos pueden aportar soluciones adecuadas a difíciles problemas reconstructivos, si se emplean correctamente. El objetivo de este trabajo es presentar nuestra sistemática en la reconstrucción con colgajos locales de defectos de pequeño y moderado tamaño del pulgar. Para ello, utilizamos el concepto de unidades estético-funcionales del pulgar y describimos los colgajos que consideramos como primera línea reconstructiva en cada tipo de defecto. Material y Método. Realizamos una revisión retrospectiva, descriptiva, de una serie de 56 casos de pérdidas de sustancia del pulgar con exposición ósea, tendinosa o ambas, susceptibles de cobertura con colgajos locales. Recogemos la edad, mano lesionada, tipo de accidente y mecanismo lesional, subunidad digital afectada y geometría de la lesión. Describimos la técnica reconstructiva indicada en cada caso. Resultados. De los 56 pacientes, el 95% (53 casos) correspondieron a defectos en subunidad distal del pulgar (distal a articulación interfalángica (IF)) que comprometían pulpejo y placa ungueal; 2 de ellos asociados a lesión en subunidad proximal volar y 8 a subunidad proximal dorsal. El otro 5% (3 casos) correspondieron a subunidad dorsal proximal exclusivamente. Para su cobertura, contabilizamos 17 colgajos basados en arteria dorso-cubital tipo Brunelli modificado (30%), 3 Brunelli clásicos (5%), 12 colgajos basados en primera arteria intermetacarpiana dorsal tipo Foucher (22%), 9 Elliot (16%), 4 Elliot asociados a colgajo eponiquial (7%), 6 colgajos heterodigitales de Littler (12%), 3 basados en arteria dorso-radial tipo Moschella (5%) y 2 colgajos heterodigitales tipo Buchler (3%). Conclusiones. Aplicando el concepto reconstructivo de unidades estético funcionales del pulgar, para defectos volares, nuestra primera línea reconstructiva son los colgajos de avance volar o los heterodigitales, por sus características mecánicas y posibilidad de neurotización. En algunos casos, asociamos el colgajo eponiquial de Backach que aporta una mejoría estética considerable. En defectos de predominio dorsal, nuestra preferencia son los colgajos dorso-cubitales o dorso-radiales, o bien al colgajo de primera arteria intermetacarpiana dorsal en defectos mayores. Estos colgajos no aportan apenas senbilidad, pero presentan características similares a la piel dorsal en grosor y elasticidad.