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Rotator cuff tears are a common cause of pain and disability among adults. Partial tears are usually treated conservatively. Complete tears might be treated conservatively in some cases; however, surgical repair is often performed in selected cases and situations where conservative treatment fails to restore function and pain relief. In addition, some patients with acute tears might be good candidates for acute surgical repair, as will be studied in this chapter. A plethora of techniques is available to repair rotator cuff tears. Among these, the surgeon faces the dilemma to choose the best treatment for the patient. Open techniques were the gold standard in the 1990s. However, the advent of arthroscopy has led the shoulder and sports surgeon community towards these. Arthroscopic rotator cuff repair has become the gold standard nowadays despite the lack of proper evidence to support this change. Furthermore, simple single-row repairs had been discarded favouring double-row techniques, yet new evidence supports the use of the former due to similar results, simplicity and cost-effectiveness. This chapter examines current evidence to help the surgeon decide between open and minimally invasive techniques and select suitable repair configurations.

Elements composing complex systems usually interact in several different ways and as such the interaction architecture is well modelled by a multiplex network. However often this architecture is hidden, as one usually only has experimental access to an aggregated projection. A fundamental challenge is thus to determine whether the hidden underlying architecture of complex systems is better modelled as a single interaction layer or results from the aggregation and interplay of multiple layers. Here we show that using local information provided by a random walker navigating the aggregated network one can decide in a robust way if the underlying structure is a multiplex or not and, in the former case, to determine the most probable number of hidden layers. As a byproduct, we show that the mathematical formalism also provides a principled solution for the optimal decomposition and projection of complex, non-Markovian dynamics into a Markov switching combination of diffusive modes. We validate the proposed methodology with numerical simulations of both (i) random walks navigating hidden multiplex networks (thereby reconstructing the true hidden architecture) and (ii) Markovian and non-Markovian continuous stochastic processes (thereby reconstructing an effective multiplex decomposition where each layer accounts for a different diffusive mode). We also state and prove two existence theorems guaranteeing that an exact reconstruction of the dynamics in terms of these hidden jump-Markov models is always possible for arbitrary finite-order Markovian and fully non-Markovian processes. Finally, we showcase the applicability of the method to experimental recordings from (i) the mobility dynamics of human players in an online multiplayer game and (ii) the dynamics of RNA polymerases at the single-molecule level., 40 pages, 24 figures

Publication in the conference proceedings of EUSIPCO, Tampere, Finland, 2000

Energy, especially Electricity has become a critical concern of society. The generation and distribution are, to a large extent, not matched with each other. There are many initiatives to balance the load on the Grid vis-à-vis production and consumption. Recently, technology has made it possible to generate small amounts of energy in each household with solar, thermal, wind and other sources. With storage devices, it is possible to use the generated energy at the sources i.e., localized generation and consumption of energy. The system can be made efficient and possibly design a zero or positive-energy home with the use ICT infrastructure, wireless sensor networks, in particular. This paper proposes a three-layered architecture for this system and also lists several associated issues and challenges.

El shock meningocóccico es una entidad relativamente frecuente y de pronóstico muy grave, que provoca fallo multiorgánico con una alta mortalidad y que precisa ingreso en Unidad de Cuidados Intensivos. En los casos grandes puede provocar necrosis de tejidos mediante una fisiopatología poco clara. En los últimos años la supervivencia de estos pacientes ha aumentado debido al diagnóstico precoz y a medidas de reanimación más agresivas. Como consecuencia encontramos un aumento del número de pacientes con necrosis extensas de tejidos que precisan tratamiento. Lo fundamental ante el diagnóstico de un shock meningocóccico es establecer el tratamiento médico precoz con medidas de reanimación agresivas y antibioterapia. Sugerimos que la necrosis extensa de tejidos que sufren estos pacientes debe tratarse como si se tratase de un paciente quemado, realizando curas diarias con sulfadiacina argéntica y cirugías seriadas (desbridamiento - amputación - cobertura) tan pronto como la situación clínica del paciente lo permita. Es necesario un seguimiento muy cercano de estos pacientes, dada la necesidad de cirugías secundarias que van a precisar a lo largo de su vida, así como la realización de pruebas de imagen para descartar la presencia de osteomielitis secundarias. Meningococcal shock is a relatively frequent disease with a serious prognosis, that causes a multiorganic failure with high mortality and Intensive Care Unit admission. Serious meningococcal shock causes tissue necrosis by uncertain physiopathology. In the last years, there is an increase of the survival, as a result of early diagnosis and aggressive resuscitation. So, there is an increase of patient's tissue necrosis that needs surgery. The most important aspect in front of meningococcal shock is to establish early medical treatment with aggressive resuscitation and antibiotics. Tissue necrosis should be treated like burn patient: argentic sulfadiazine daily cure and serial surgeries (debridement - amputation - coverage) as soon as clinic situation allows it. It's necessary a follow-up, because the patient will need secondary surgeries, and image test to rule out secondary osteomielities.

Los lipomas son los tumores de tejidos blandos más frecuentes del organismo, pudiéndose presentar en cualquier localización. Habitualmente son asintomáticos, pero en ocasiones pueden producir clínica de compresión nerviosa. El objetivo de nuestro trabajo es revisar nuestra experiencia en el tratamiento de lipomas que producen compresión nerviosa. Ante la presencia de clínica de compresión nerviosa junto con tumoración de crecimiento lento debemos sospechar el diagnóstico de lipoma. Es muy importante la planificación quirúrgica adecuada, ayudada por las pruebas de imagen tipo Resonancia Nuclear Magnética (RNM), puesto que las estructuras nerviosas pueden estar incluidas en el lipoma. Lipomas are the most frequent soft tissues tumours of the body, and they can be located everywhere. They are usually asymptomatic, but uncommonly they can produce nerve compression. Our objective is to review our experience in the treatment of nerve compression syndromes caused by lipomas. Lipomas must be suspected when an slow growth tumour is present with nerve compression syndrome. It's very important an appropriate surgical planning, supported by image (NMR), because nerves can be included in the lipoma.

We propose a Monte Carlo methodology for the joint estimation of unobserved dynamic variables and unknown static parameters in chaotic systems. The technique is sequential, i.e., it updates the variable and parameter estimates recursively as new observations become available, and, hence, suitable for online implementation. We demonstrate the validity of the method by way of two examples. In the first one, we tackle the estimation of all the dynamic variables and one unknown parameter of a five-dimensional nonlinear model using a time series of scalar observations experimentally collected from a chaotic CO2 laser. In the second example, we address the estimation of the two dynamic variables and the phase parameter of a numerical model commonly employed to represent the dynamics of optoelectronic feedback loops designed for chaotic communications over fiber-optic links.