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OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

Background and Objective: To estimate the prevalence of obesity and overweight in children aged 2 to 14 years in Catalonia, its trends between 2006 and 2010-2012, and to evaluate social determinants and lifestyle associated with obesity., Material and Methods: A cross-sectional study, using the data from 4,389 surveys from Catalonia Health Surveys of the years 2006 and 2010-2012, was conducted. Obesity and overweight were determined by World Health Organization criteria. Socioeconomic position, parent's education, usual diet and activity, and hours of sleep were assessed., Results: The prevalence of obesity and overweight were: 15.4 and 20.2% in 2010-2012. The prevalence of obesity was higher in boys (15.5%) compared to girls (12.8%) (P<.05), and higher in children ranging from 2 to 9 years old (17.5%) than children aged 10 to 14 years (7.7%) (P<.05). In 2006, the prevalence of obesity and overweight were similar to the prevalence in 2010-2012. Obesity was more frequent in children with parents with a low socioeconomic position and/or a primary or elementary parent's education., Conclusions: During the last 5 years (2006-2012), child obesity and overweight have remained stable in Catalonia, yet they are relatively high in Europe. Public health programmes against obesity must consider conducting an intersectional action taking social determinants and family life styles into account., (Copyright © 2013 Elsevier España, S.L.U. All rights reserved.)

The aims of this work were characterized by the physicochemical and microbiological features of dried-cured hams classified by the manufacturer as altered (deep spoilage and swollen) and unaltered, as well as, correlated these results with the electronic measurements of impedance spectroscopy, in order to lay the groundwork to design a suitable electrode to be used for checking in line all dry-cured ham elaborated. Double electrode and coaxial needle electrode were used in a frequency range of 100Hz to 1MHz. The electronic measurements of the two electrodes were able undoubtedly to discriminate between altered and unaltered dry-cured hams; moreover a tendency to classify between deep spoilage and swollen hams was shown. The values into the range of frequencies between 100Hz-1000Hz, for both electrodes, showed the best clustering results. More studies are needed to select the best electrode which can be transformed in a robust and versatile electrode which could be used for checking in line all dry-cured ham elaborated., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The goal of the software proposed in this paper is to assist ophthalmologists in diagnosis and disease prevention, helping them to determine cardiovascular risk or other diseases where the vessels can be altered, as well as to monitor the pathology progression and response to different treatments. The performance of the tool has been evaluated by means of a double-blind study where its sensitivity, specificity, and reproducibility to discriminate between health fundus (without cardiovascular risk) and hypertensive patients has been calculated in contrast to an expert ophthalmologist opinion obtained through a visual inspection of the fundus image. An improvement of almost 20% has been achieved comparing the system results with the clinical visual classification.

Background: To date, still images or videos of real animals have been used in functional magnetic resonance imaging protocols to evaluate the brain activations associated with small animals' phobia., Objective: The objective of our study was to evaluate the brain activations associated with small animals' phobia through the use of virtual environments. This context will have the added benefit of allowing the subject to move and interact with the environment, giving the subject the illusion of being there., Methods: We have analyzed the brain activation in a group of phobic people while they navigated in a virtual environment that included the small animals that were the object of their phobia., Results: We have found brain activation mainly in the left occipital inferior lobe (P<.05 corrected, cluster size=36), related to the enhanced visual attention to the phobic stimuli; and in the superior frontal gyrus (P<.005 uncorrected, cluster size=13), which is an area that has been previously related to the feeling of self-awareness., Conclusions: In our opinion, these results demonstrate that virtual stimulus can enhance brain activations consistent with previous studies with still images, but in an environment closer to the real situation the subject would face in their daily lives.

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity, as indicated by disease, has appeared in Europe and other developed regions. It is likely that better treatment, preventive measures, and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity and links these with survival to provide estimates of life expectancy with and without diseases and mobility limitations. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity, and information from the Spanish National Statistics Institute for mortality. Our findings show that at age 65 the percentage of life with disease increased from 52 to 70 % for men, and from 56 to 72 % for women; the expectation of life with mobility limitations increased from 24 to 30 % for men and from 40 to 47 % for women between 1994 and 2011. These changes were attributable to increases in the prevalence of diseases and moderate mobility limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.

Sobriety checkpoints are not usually randomly located by traffic authorities. As such, information provided by non-random alcohol tests cannot be used to infer the characteristics of the general driving population. In this paper a case study is presented in which the prevalence of alcohol-impaired driving is estimated for the general population of drivers. A stratified probabilistic sample was designed to represent vehicles circulating in non-urban areas of Catalonia (Spain), a region characterized by its complex transportation network and dense traffic around the metropolis of Barcelona. Random breath alcohol concentration tests were performed during spring 2012 on 7596 drivers. The estimated prevalence of alcohol-impaired drivers was 1.29%, which is roughly a third of the rate obtained in non-random tests. Higher rates were found on weekends (1.90% on Saturdays and 4.29% on Sundays) and especially at night. The rate is higher for men (1.45%) than for women (0.64%) and it shows an increasing pattern with age. In vehicles with two occupants, the proportion of alcohol-impaired drivers is estimated at 2.62%, but when the driver was alone the rate drops to 0.84%, which might reflect the socialization of drinking habits. The results are compared with outcomes in previous surveys, showing a decreasing trend in the prevalence of alcohol-impaired drivers over time., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Impedance spectroscopy (IS), low-field proton nuclear magnetic resonance (LF (1)H NMR), chloride titration, ion chromatography, and an ion selective electrode were used to investigate the physicochemical parameters and measure sodium and potassium contents in low-salt brines and fish. Salt solutions (0-3 w/w, %) and model products of minced hake with added NaCl (0.5-3.0 w/w, %), or a mixture of NaCl and KCl (50/50 w/w, %), were analyzed. Good correlation was observed between the sodium content determined by using the ion selective electrode method and ion chromatography (R(2) = 0.97). In both salt solutions and fish minces, the impedance spectroscopy measurements could detect the difference in salt contents in mince with salt contents down to 0.5%. The NMR transversal relaxation time T2 measurements clearly distinguished samples with 0, 0.5, and 1.0-3.0% salt, based on principal component analysis (PCA). Therefore, LF (1)H NMR seems to be a suitable technique for studies of low-salt products.

Acquired brain injury (ABI) is one of the main problems of disability and death in the world. Its incidence and survival rate are increasing annually. Thus, the number of chronic ABI patients is gradually growing. Traditionally, rehabilitation programs are applied to postacute and acute patients, but recent publications determine that chronic patients may benefit from rehabilitation. Also, in the last few years, the potential of virtual rehabilitation (VR) systems has been demonstrated. However, until now, no previous studies have been carried out to compare the evolution of chronic patients with acute patients in a VR program. To perform this study, we developed a VR system for ABI patients. The system, vestibular virtual rehabilitation (V2R), was designed with clinical specialists. V2R has been tested with 21 people ranging in age from 18 to 80 years old that were classified in two groups: chronic patients and acute patients. The results demonstrate a similar recovery for chronic and acute patients during the intervention period. Also, the results showed that chronic patients stop their improvement when they finish their training. This conclusion encourages us to direct our developments toward VR systems that can be easily integrated at home, allowing chronic patients to have a permanent VR training program.

Background: New technologies have slowly become a part of psychologists' therapeutic office. However, many therapists still have doubts about the possibility of creating a good therapeutic relationship with patients in the presence of technology., Aims: This study evaluates the development of the therapeutic alliance in individuals with small animal phobia disorder who were treated with Augmented Reality Exposure Therapy or In Vivo Exposure Therapy., Method: Twenty-two participants received an intensive session of cognitive behavioural therapy in either a technology-mediated therapeutic context or in a traditional therapeutic context., Results: The results show no significant difference for the therapeutic alliance between two conditions., Conclusions: The results seem to show that technologies such as Augmented Reality do not represent a danger to negatively influence the therapeutic alliance.

New electroencephalography (EEG) devices, more portable and cheaper, are appearing on the market. Studying the reliability of these EEG devices for emotional studies would be interesting, as these devices could be more economical and compatible with Virtual Reality (VR) settings. Therefore, the aim in this work was to validate a low-cost EEG device (Emotiv Epoc) to monitor brain activity during a positive emotional induction procedure. Emotional pictures (IAPS) were used to induce a positive mood in sixteen participants. Changes in the brain activity of subjects were compared between positive induction and neutral conditions. Obtained results were in accordance with previous scientific literature regarding frontal EEG asymmetry, which supports the possibility of using this low-cost EEG device in future mood induction studies combined with VR.

In the Virtual Reality field, presence refers to the sense of "being there" in the virtual world. Our aim in this work is to evaluate the usefulness of the Emotiv EPOC EEG device to measure the brain activations due to the sense of presence during the navigation in a Virtual Environment (VE), using for the analysis the sLORETA tool. We compare between two experimental conditions: free and automatic navigation through a VE. In this preliminary step, we monitored 9 healthy subjects, obtaining significant differences between the free and automatic navigation conditions in the activity of the right insula for the Theta and Alpha bands. The insula activation is related to stimulus attention and selfawareness processes, directly related with the sense of presence.

We all have an irrational fear or two. Some of us get scared by an unexpected visit from a spider in our house; others get nervous when they look down from a high building. Fear is an evolutionary and adaptive function that can promote self-preservation and help us deal with the feared object or situation. However, when this state becomes excessive, it might develop into psychological disorders such as phobias, producing high anxiety and affecting everyday life. The Therapeutic Lamp is an interactive projection-based augmented-reality system for treating small-animal phobias. It aims to increase patient-therapist communication, promote more natural interaction, and improve the patient's engagement in the therapy.

Unilateral spatial neglect is a common consequence of stroke that directly affects the performance of activities of daily living. This impairment is traditionally assessed with paper-and-pencil tests that can lack correspondence to real life and are easily compensated. Virtual reality can immerse patients in more ecological scenarios, thus providing therapists with new tools to assess and train the effects of this impairment in simulated real tasks. This paper presents the clinical validation and convergent validity of a low-cost virtual reality system for training street-crossing in stroke patients with and without neglect. The performance of neglect patients was significantly worse than the performance of non-neglect and healthy participants. In addition, several correlations between the scores in the system and in the traditional scales were detected.

Virtual Environments (VEs) have been used as mood induction procedures. In this context, it is necessary to have instruments to analyze the emotional state during VE exposure. Objective techniques such as EEG should be evaluated for this purpose. The aim in this work was to study the changes in the brain activity with a portable EEG device during a negative mood induction based on a VE. A virtual park was used to induce a negative mood (sadness) in ten participants. Changes in the brain activity of subjects were compared between two moments (before and after emotional induction). Obtained results were in accordance with previous scientific literature regarding frontal EEG asymmetry, which supports the possibility of using the portable EEG as a reliable instrument to measure emotions in VE.

A new electronic tongue to monitor the presence of glyphosate (a non-selective systemic herbicide) has been developed. It is based on pulse voltammetry and consists in an array of three working electrodes (Pt, Co and Cu) encapsulated on a methacrylate cylinder. The electrochemical response of the sensing array was characteristic of the presence of glyphosate in buffered water (phosphate buffer 0.1 mol · dm-3, pH 6.7). Rotating disc electrode (RDE) studies were carried out with Pt, Co and Cu electrodes in water at room temperature and at pH 6.7 using 0.1 mol · dm-3 of phosphate as a buffer. In the presence of glyphosate, the corrosion current of the Cu and Co electrodes increased significantly, probably due to the formation of Cu2+ or Co2+ complexes. The pulse array waveform for the voltammetric tongue was designed by taking into account some of the redox processes observed in the electrochemical studies. The PCA statistical analysis required four dimensions to explain 95% of variance. Moreover, a two-dimensional representation of the two principal components differentiated the water mixtures containing glyphosate. Furthermore, the PLS statistical analyses allowed the creation of a model to correlate the electrochemical response of the electrodes with glyphosate concentrations, even in the presence of potential interferents such as humic acids and Ca2+. The system offers a PLS prediction model for glyphosate detection with values of 098, -2.3 × 10-5 and 0.94 for the slope, the intercept and the regression coefficient, respectively, which is in agreement with the good fit between the predicted and measured concentrations. The results suggest the feasibility of this system to help develop electronic tongues for glyphosate detection.

The success of oral surgery is subject to accurate advanced planning. In order to properly plan for dental surgery or a suitable implant placement, it is necessary an accurate segmentation of the jaw tissues: the teeth, the cortical bone, the trabecular core and over all, the inferior alveolar nerve. This manuscript presents a new automatic method that is based on fuzzy connectedness object extraction and mathematical morphology processing. The method uses computed tomography data to extract different views of the jaw: a pseudo-orthopantomographic view to estimate the path of the nerve and cross-sectional views to segment the jaw tissues. The method has been tested in a groundtruth set consisting of more than 9000 cross-sections from 20 different patients and has been evaluated using four similarity indicators (the Jaccard index, Dice's coefficient, point-to-point and point-to-curve distances), achieving promising results in all of them (0.726±0.031, 0.840±0.019, 0.144±0.023 mm and 0.163±0.025 mm, respectively). The method has proven to be significantly automated and accurate, with errors around 5% (of the diameter of the nerve), and is easily integrable in current dental planning systems., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Hospital expenses are a major cost driver of healthcare systems in Europe, with motor injuries being the leading mechanism of hospitalizations. This paper investigates the injury characteristics which explain the hospitalization of victims of traffic accidents that took place in Spain. Using a motor insurance database with 16,081 observations a generalized Tobit regression model is applied to analyse the factors that influence both the likelihood of being admitted to hospital after a motor collision and the length of hospital stay in the event of admission. The consistency of Tobit estimates relies on the normality of perturbation terms. Here a semi-parametric regression model was fitted to test the consistency of estimates, concluding that a normal distribution of errors cannot be rejected. Among other results, it was found that older men with fractures and injuries located in the head and lower torso are more likely to be hospitalized after the collision, and that they also have a longer expected length of hospital recovery stay., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The use of a voltammetric electronic tongue as tool for the prediction of concentration levels of certain water quality parameters from influent and effluent wastewater from a Submerged Anaerobic Membrane Bioreactor pilot plant applied to domestic wastewater treatment is proposed here. The electronic tongue consists of a set of noble (Au, Pt, Rh, Ir, and Ag) and non-noble (Ni, Co and Cu) electrodes that were housed inside a stainless steel cylinder which was used as the body of the electronic tongue system. As a previous step an electrochemical study of the response of the ions sulphate, orthophosphate, acetate, bicarbonate and ammonium was carried out in water using the electrodes contained in the electronic tongue. The second part of the work was devoted to the application of the electronic tongue to the characterization of the influent and effluent waters from the wastewater treatment plant. Partial Least Squares analysis was used to obtain a correlation between the data from the tongue and the pollution parameters measured in the laboratory such as soluble chemical oxygen demand (CODs), soluble biological oxygen demand (BODs), ammonia (NH(4)-N), orthophosphate (PO(4)-P), Sulphate (SO(4)-S), acetic acid (HAC) and alkalinity (Alk). A total of 28 and 11 samples were used in the training and the validation steps, respectively, for both influent and effluent water samples. The electronic tongue showed relatively good predictive power for the determination of BOD, COD, NH(4)-N, PO(4)-P, SO(4)-S, and Alk., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

As Virtual Reality (VR) is starting to be used to train emotional regulation strategies, it would be interesting to propose objective techniques to monitor the emotional reactions of participants during the virtual experience. In this work, the main goal is to analyze if portable EEG systems are adequate to monitor brain activity changes caused by the emotional regulation strategies applied by the participants. The EEG signals captured from subjects that navigate through a virtual environment designed to induce a negative mood will be compared between three experimental groups that will receive different instructions about the emotional regulation strategies to apply. The study will allow us to validate the possibilities of portable EEG devices to monitor emotional regulation strategies during VR exposure.

Self-awareness deficits can manifest as a consequence of acquired brain injury decreasing the motivation and the adherence to the treatment. We present a multitouch system that promotes the role-playing and the self-assessment strategies and challenges the participants in a competitive context. This paper presents an initial clinical trial to study the effectiveness of the virtual system in the rehabilitation of the self-awareness skills.According the evolution of the participants in the Self-Awareness Deficits Interview and in the Spanish Social Skills Scale, the participants improve the perception of their deficits and disabilities.

Stroke patients often suffer from hemiparesis, which affects their balance condition and consequently their self-dependency and quality of life. Balance rehabilitation can be a long and tedious process. Virtual rehabilitation systems have been reported to provide therapeutic benefits to the balance recovery of stroke patients while increasing their motivation. This paper presents a follow-up study involving chronic stroke patients to evaluate the clinical effectiveness of a virtual stepping exercise using skeleton tracking through a low-cost Kinect depth sensor.

The aim of this paper is to present digital representations of humans (i.e., avatars) that look like the self, applied to the Mental Health (MH) field. Virtual Representations of the Self (VRS) are in our opinion a tool with a great potential for engaging teenagers in emotional regulation strategies learning and an excellent example of new technology application to the basic concept in psychology field such as Bandura's modeling [1]. VRSs have already demonstrated their potential on human behavior modification (e.g. modification of physical activity; eating habits) in general population [2]. Thus, the same technology can bring in our opinion a lot to the Mental Health field, especially in emotional regulation learning. This paper presents a theoretical background and describes the methodology that we plan to apply in order to validate the efficacy of VRSs in clinical settings. Also, the implications of such technology and future research lines are discussed.

The aims of the present study are to examine the reliability and validity of the Heart Rate signal registered using two self-made wireless ECG systems, R-Tips and TipsShirt, and to compare them with another commercial ECG device typically used in psychophysiology studies. An ECG simulator was used to artificially generate signals corresponding to different cardiac frequencies. Results of the reliability study showed that the signal acquisition, signal processing and signal transmission were reliable and valid for R-Tips and TipsShirt. Consequently, these wireless ECG prototypes could be used for studies where the freedom of movements of the participants is fundamental without any loss of quality in the registered signals.

In this paper, a set of coefficients commonly used in Medical Image to estimate the committed error comparing two images is presented, which, combined together, allow to determine the similarity between volumes. Furthermore, an analysis of the behavior of these coefficients is performed to determine those coefficients that better discriminate the fit error, proving that these are Jaccard coefficient and a modification of Hausdorff coefficient. In addition, the combination of both coefficients is applied to compare two given biomechanical models of the lamb liver.

Life-review therapy has been recognized as an effective therapeutic approach for depression in older adults. Additionally, the use of new media is becoming increasingly common in psychological interventions. The aim of this study was to investigate a life-review therapy in a face-to-face setting with additional computer use. This study explored whether a six-week life-review therapy with computer supplements from the e-mental health Butler system constitutes an effective approach to treat depression in older adults aged 65 and over. A total of 36 participants with elevated levels of depressive symptoms were randomized to a treatment group or a waiting-list control group and completed the post-assessment. Fourteen individuals in the intervention group completed the follow-up assessment. Analyses revealed significant changes from pre- to post-treatment or follow-up for depression, well-being, self-esteem, and obsessive reminiscence, but not for integrative reminiscence and life satisfaction. Depressive symptoms decreased significantly over time until the three-month follow-up in the intervention group compared to the control group (pre to post: d = 1.13; pre to follow-up: d = 1.27; and group × time effect pre to post: d = 0.72). Furthermore, the therapy led to an increase in well-being and a decrease in obsessive reminiscence among the participants in the intervention group from pre-treatment to follow-up (well-being: d = 0.70; obsessive reminiscence: d = 0.93). Analyses further revealed a significant but small group × time effect regarding self-esteem (d = 0.19). By and large, the results indicate that the life-review therapy in this combined setting could be recommended for depressive older adults.

Emotional disorders (Anxiety disorders and Mood disorders) are one of the most common health problems worldwide, and their economic costs are very high. People suffering from emotional disorders often use maladaptive emotion regulation strategies and have low coping behaviour that contributes to the presence of clinical symptoms. For this reason, it is important to develop strategies to monitor coping and promote emotion regulation in people exposed to high levels of stress. Information and Communication Technologies (ICT) can help us in this task. Recent systematic reviews of literature on evidence-based CBT treatments delivered via the Internet show that these approaches are effective. We have developed an intervention program ICT based: Coping with Stress and Emotion Regulation Program (Smiling is Fun), a self-applied program via the Internet. Smiling is Fun follows a transdiagnostic perspective, and it is based on CBT techniques. However, it also includes other psychological strategies to improve positive mood. The aim of the present work is to describe Smiling is Fun and the study designed to test its efficacy.

The aim of this paper is to describe GameTeen, a novel instrument for the assessment and training of Emotional Regulation (ER) strategies in adolescent population. These new tools are based on the use of 3D serious games that can be played under different settings. The evolution of ER strategies will be monitored in two ways depending on the setting where the tool is presented. Firstly, in the laboratory, physiological signals and facial expressions of participants will be recorded. Secondly, in real life settings, ecological momentary assessment tools will be used to obtain answers from the subjects using their mobile phone. The goal is to obtain more attractive and reliable tools to evaluate and train ER strategies.

Background: Acquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo® Wii Balance Board® (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance., Methods: In this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n = 9) versus standard rehabilitation (n = 8). Effectiveness was evaluated by means of traditional static and dynamic balance scales., Results: The final sample consisted of 11 men and 6 women. Mean ± SD age was 47.3 ± 17.8 and mean ± SD chronicity was 570.9 ± 313.2 days. Patients using eBaViR had a significant improvement in static balance (p = 0.011 in Berg Balance Scale and p = 0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group., Conclusions: The results suggest that eBaViR represents a safe and effective alternative to traditional treatment to improve static balance in the ABI population. These results have encouraged us to reinforce the virtual treatment with new exercises, so an evolution of the system is currently being developed.

Introduction: Primary prevention by prophylactic vaccination against the major cause of cervical cancer, the carcinogenic human papillomavirus (HPV) types 16 and 18, is now available worldwide. Postlicensure adverse neurological effects have been described. The studies realized after the license are descriptive and limited by the difficulty to obtain the information, despite most of the statistical indexes show that the adverse effects by the vaccine of the HPV are not upper compared with other vaccines, the substimation must be considered., Case Reports: We describe the cases of four young women that developed demyelinating disease after the vaccination of the HPV, with a rank of time between the administration of the dose and the development of the clinical of seven days to a month, with similar symptoms with the successive doses. We have described six episodes coinciding after the vaccination., Conclusions: Have been described seizures, autoimmune disorders such as Guillain-Barre syndrome, transverse myelitis, or motor neuron disease, probably adverse effects following immunization by HPV vaccine. So we suggest that vaccine may trigger an immunological mechanism leading to demyelinating events, perhaps in predisposed young.

Most dental implant planning systems use a 3D representation of the CT scan of the patient under study as it provides a more intuitive view of the human jaw. The presence of metallic objects in human jaws, such as amalgam or gold fillings, provokes several artifacts like streaking and beam hardening which makes the reconstruction process difficult. In order to reduce these artifacts, several methods have been proposed using the raw data, directly obtained from the tomographs, in different ways. However, in DICOM-based applications this information is not available, and thus the need of a new method that handles this task in the DICOM domain. The presented method performs a morphological filtering in the polar domain yielding output images less affected by artifacts (even in cases of multiple metallic objects) without causing significant smoothing of the anatomic structures, which allows a great improvement in the 3D reconstruction. The algorithm has been automated and compared to other image denoising methods with successful results., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Introduction: Movement disorders induced by central nervous system trauma are well recognized. The relation between peripheral injury and the subsequent development of movement disorders has been documented in many reports, specially dystonia and tremor. Pathophysiological mechanisms underlying these movement disorders are not well understood., Case Reports: We report a group of seven patients with movement disorders induced by peripheral trauma. The inclusion criteria used for the patients were: the trauma was well documented for the patient and the medical history, and the onset of the movement disorder was anatomically and temporally related to the injury. We describe seven patients presenting respectively oromandibular dystonia, radicular myoclonus, tremor, segmental dystonia, lower limbs dystonia, segmental myoclonus and tremor, of the body parts previously exposed to traumatic injuries., Conclusions: Individual predisposition and central changes with pathological reorganization in response to peripheral injury have been considered in the pathogenesis of peripherally induced movements disorders.

This work aims to identify the arousal and presence level during an emotional engineering study. During the experimental sessions, a high-immersion Virtual Reality (VR) system, a CAVE-like configuration, will be used. Thirty-six volunteers will navigate through virtual houses that can be customized and that have been designed for emotional induction. Emotional induction will be obtained by stimulating the senses of sight, hearing and smell. For this purpose, the ambient lighting, music and smell will be controlled by the researcher, who will create a comfortable environment for the subject. Several physiological variables - Electrocardiogram (ECG), Respiratory signal and Galvanic Skin Response (GSR) - will be recorded during the sessions. The obtained results will help furniture companies identify the senses that have more influence on emotions and will be the basis for new studies about user needs in the sector of furniture and interior decoration.

EMMA project has been focused on how the sense of presence in virtual environments mediates or generates emotional responses, and how to use presence and emotional responses in virtual environments effectively in clinical and non clinical settings. EMMA project has developed two different virtual environments. The first one acts as a 'mood device' and is aimed to induce and enhance several moods on clinical and non clinical subjects. The second one is a virtual environment that acts as an adaptive display to treat emotional disorders (Post-traumatic Stress Disorder, Adjustment Disorder and Pathological Grief). This virtual world varies the contents that are presented depending on the emotions of the patient at each moment. The goal of this paper is to outline the main goals achieved by this project.

Augmented reality (AR) is a new technology in which various virtual elements are incorporated into the user's perception of the real world. The most significant aspect of AR is that the virtual elements add relevant and helpful information to the real scene. AR shares some important characteristics with virtual reality as applied in clinical psychology. However, AR offers additional features that might be crucial for treating certain problems. An AR system designed to treat insect phobia has been used for treating phobia of small animals, and positive preliminary data about the global efficacy of the system have been obtained. However, it is necessary to determine the capacity of similar AR systems and their elements that are designed to evoke anxiety in participants; this is achieved by testing the correspondence between the inclusion of feared stimuli and the induction of anxiety. The objective of the present work is to validate whether the stimuli included in the AR-Insect Phobia system are capable of inducing anxiety in six participants diagnosed with cockroach phobia. Results support the adequacy of each element of the system in inducing anxiety in all participants.

Transcranial Doppler (TCD) has been widely used to monitor cerebral blood flow velocity (BFV) during the performance of cognitive tasks compared with repose periods. Although one of its main advantages is its high temporal resolution, only some of the previous functional TCD studies have focused on the analysis of the temporal evolution of the BFV signal and none of them has performed a spectral analysis of the signal. In this study, maximum BFV data in both posterior cerebral arteries was monitored during a visual perception task (10 cycles of alternating darkness and illumination) for 23 subjects. A peak was located in the low-frequency band of the spectrum of the maximum BFV of each subject both during visual stimulation and repose periods. The frequency of this peak was in the range between 0.037 and 0.098Hz, depending on the subject, the vessel and the experimental condition. The component of the signal at this frequency, which is associated with the slow variations caused by the visual stimuli, was estimated. That way, the variations in BFV caused by the experimental stimuli were isolated from the variations caused by other factors. This low-frequency estimation signal was used to obtain parameters about the temporal evolution and the magnitude variations of the BFV in a reliable way, thus, characterizing the neurovascular coupling of the participants., (Copyright 2010 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We analyse accidents with victims and calculate the influence of traffic violations on the probability of having a serious or fatal accident, compared to a slight accident. Traffic violations related to speed limitations, administrative infringements or faults related to the driver are considered. Data were obtained from all available reports on accidents with victims that occurred in Spain from 2003 to 2005. A multinomial logistic regression model is specified to find the probability that an accident with victims is slight, serious or fatal, given the presence/absence of thirty different types of traffic violations. The average cost per victim and the average number of victims per accident are then used to find the estimated cost of an accident with victims, given the information on the traffic violations incurred. This demonstrates which combinations of traffic violations lead to higher estimated average costs, compared to cases in which no traffic violation occurred. We conclude with some recommendations on the severity of penalties, and suggest that regulators penalize the occurrences of some specific combinations of traffic violations more rigorously., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Introduction: Freezing of gait unresponsive to dopaminergic stimulation in patients with severe Parkinsonism. The freezing of gait episodes (FOG) normally appear during the off period and generally improve with dopaminergic stimulus, at the same time as improving other Parkinsonian symptoms., Patients and Methods: We report a group of 10 patients with severe Parkinson's disease. All patients suffered motor fluctuations, dyskinesias and episodes of FOG during the on and off state. The patients received a subcutaneous apomorphine bolus, without other dopaminergic medication; an effective dose of apomorphine was considered as one that induced a reduction of at least a 60% in the UPDRS motor scale., Results: The baseline motor UPDRS was 61.3 +/- 4.7, which dropped to 21 +/- 4.3 after the apomorphine injection. The mean dose of apomorphine was 5.5 mg (3-7 mg). The bolus of apomorphine improved the parameters of the gait related to bradykinesia and the tapping tests of the limbs, but the episodes of FOG did not vary significantly between the off and on state., Conclusions: We present a group of 10 patients with freezing of gait episodes that did not improve with treatment and persisted during the on period induced by dopaminergic stimulus with apomorphine.

eBaViR is a virtual rehabilitation system, which has been developed for balance rehabilitation for patients suffering from acquired brain injury. It is a game-based system that uses a low-cost interface, the Nintendo Wii Balance Board. The games have been specifically designed with the help of experts in the rehabilitation of balance disorders and can be adapted to patients according to their needs. We present an experimental study that has been carried out using the system. The aim of the study is to determine whether this setup could be applied as a Virtual Rehabilitation System for balance rehabilitation in Acquired Brain Injury. We randomly divided patients into two groups: a trial group and a control group. The trial group used eBaViR system during the rehabilitation sessions, and the control group followed traditional rehabilitation sessions. We obtained encouraging results.

In this experimental study, we present the results of user motor responses with and without the use of Tracking Feedback to complete correct movements in Virtual Rehabilitation Therapy. To carry out this study, we used a VRT system for standing balance rehabilitation. We applied it under two different conditions to twenty patients (with and without tracking feedback). We then analyzed their motor responses. By means of this analysis, we have confirmed the importance of Tracking Feedback in the achievement of rehabilitation goals. We also tested the possibility of eliminating the tracking components from the system to lower cost to make the integration of Virtual Rehabilitation systems available to more patients. Our results indicate that is currently not feasible.

Self-monitoring techniques, such as the use of dietary registers, are considered to be central to cognitive-behavioral treatment of Eating Disorders (ED). This information allows the clinician to identify the triggers of the behaviors associated to ED as purges and/or binges, and the associated thoughts and emotions, helping to carry out a more accurate assessment. Traditionally these registers are made with paper and pencil mode, where the patient has to register every eating and the emotions/thoughts associated; but this system has some problems, as low portability, low adherence or methodological difficulties. The use of PDA for self-registers can help to solve these problems. The aim of this study is to study the levels of acceptability and satisfaction with PDAs self-register system specifically designed for assessment and treatment of ED. Samples of 30 subjects diagnosed with ED are receiving a PDA with software specifically designed for recording type and amount of food, emotions before and after eating and other behaviors. The participants are completing self-register daily during a week, and afterwards answer an acceptance and satisfaction questionnaire. This work is in progress at the moment. It is expected that the PDA system will show high levels of acceptance and satisfaction.

Many studies have been developed using brain imaging methods to investigate psychological disorders. On the other hand, there are many studies that make use of virtual reality (VR) to simulate a real condition during psychological treatments. In this research, we plan to analyze brain activity during the exposure to a virtual environment related to phobias. Our first goal is to study the possibility of activating brain areas related to phobias, specifically phobias to small animals (spiders and cockroaches), using virtual reality as stimulus, while the patient is inside a functional magnetic resonance imaging (fMRI) machine. The second goal of the research is to analyze if there are differences in the activated areas after patients have followed a psychological treatment for this specific phobia. That is why two different sessions with fMRI will be performed, before and after an intensive treatment for the phobia. In the fMRI room, participants will wear special glasses to visualize the VR environments in which they have to navigate (using also a joystick adapted to fMRI). They will have to perform some tasks while being exposed to the phobic stimuli. The VR environment used in the fMRI sessions has three different conditions: first, a clean room without spiders or cockroaches; second, the same room, but dirty and disordered (giving the sensation of having small animals, although actually there are none); third, the same dirty room but having spiders and cockroaches. It is our hypothesis that the patients will get anxious in the situation in which it is possible that the animal appears and the patterns of brain activation will be different in this condition.

Transcranial Doppler is a tool to measure blood flow velocity (BFV) in the main arteries of the brain that has been used in previous studies to analyze brain activity during virtual reality (VR) experiences. Increments in BFV were found during the exposure to virtual environments in comparison with baseline periods. However, due to the complexity of VR experiences, there are several factors that can be having an influence in these variations, so it is necessary to separately analyze those different aspects. In this work, we summarize our results related to visual perception. A method based on spectral analysis was used to analyze the magnitude and temporal evolution of the maximum BFV signal. Results showed that, in the presence of visual stimuli, BFV quickly rises to a maximum that is achieved after a few seconds. The contribution of the visual stimuli factor to the observed BFV variations during a VR experience can be estimated from the results of the developed work.

Introduction: Current neuro-radiological techniques have led to a more frequent diagnosis of cerebral vein thrombosis (CVT), and revealed its greater clinical heterogeneity., Aim: To analize the characteristics of the cases with the diagnosis of CVT in our unit between 1996 and 2008., Patients and Methods: We describe 20 cases of CVT (14 women and 6 men), with ages of 22 to 75 years., Results: Headache was the most frequent symptom, followed by intracranial hypertension, disorders of consciousness and focal deficits. Unusual presentations included transitory ischemia and progressive optical neuropathy. Subacute and chronic courses were more frequent than acute. The etiology was diverse including puerperium, contraception, hyperthyroidism, meningitis, Leiden V factor mutation, multiple myeloma, Crohn, ulcerative colitis, meningioma and epidural anesthesia. No cause was found in 8 cases. Magnetic resonance imaging was always diagnostic. Patients were anticoagulated during the acute phase. In subacute or chronic presentations, a more conservative treatment was considered on individual basis. Only 6 patients had mild sequelae., Conclusions: We report a great variety of etiologies and patterns of presentation of CVT. CVT should be suspected in patients with subacute headache, even in outpatients. Nonacute presentation with isolated headache or intracranial hypertension could have better prognosis, requiring a less aggressive therapy.

The Butler Project is a technological e-health platform that uses the Internet to connect various users; it was designed to deliver health care to the elderly. The Butler platform has three levels of implementation: diagnosis (mood monitoring, alert system, management reports), therapy (training in inducing positive moods, memory work), and entertainment (e-mail, chat, video, photo albums, music, friend forums, accessibility to the Internet). The objective of this work is to describe the psychological aspects of the platform and to present data obtained from four users. Results show that after using the system, the participants increased their positive emotions and decreased their negative ones; in addition, they obtained high levels of satisfaction and experienced little difficulty in using the system.

In this work, we propose the use of Transcranial Doppler Monitoring (TCD) as a tool to measure brain activity during the exposure to Virtual Environments (VE) used in clinical therapy sessions. The technique is non-invasive, and can be easily integrated with Virtual Reality (VR) settings. Moreover, it provides a high temporal resolution, which grants the possibility to analyze changes in brain activity during the evolution of a clinical session and to correlate them with specific events that may occur in the VE. We have performed two studies combining TCD with VR. Results of these studies show that it is feasible to use this technique in combination with VR settings designed for virtual therapy. It was observed that immersion and navigation modifications in the VE generated changes in brain activity that can be detected using TCD.

In the last few years the use of medical and biomedical ontologies has increased considerably. It is very common to find applications and semantic webs using this kind of ontologies and a large number of papers have been written explaining why ontologies are useful in these fields. In this paper the use of ontologies for psychology and its benefits is discussed and a first ontology for obesity treatment is presented.

A new protocol is presented to validate TIPS (portable physiological monitoring device designed by I3BH that can get respiration, ecg and activity of the patient) for physical habits detection. Physiological and activity parameters and data from questionnaires have been acquired from a group of obese & non-obese children (n=20). Children completed activities from sedentary level to vigorous level. Preliminary results show variability on the response of children's effort and feasibility of TIPS platform as an ambulatory tool.