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京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18876号 / 医博第3987号 / 新制||医||1008(附属図書館) / 31827 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙橋 良輔, 教授 小泉 昭夫, 教授 宮本 享 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13061号 / 論医博第2119号 / 新制||医||1018(附属図書館) / (主査)教授 羽賀 博典, 教授 妹尾 浩, 教授 戸井 雅和 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

From the years of 1956 through 1977, Archaeologist Robert H. Dyson, Jr., directed the excavations of the archaeological site of Tepe Hasanlu, located in the West Azerbaijan region of Iran. Several archaeological reports of the finds include the overview of over 400 skeletons discovered in Hasanlu’s Lower Mound cemetery, though only 97 were ever retained for osteological analysis. Totaling 113 burials examined, 88-individuals were derived from the Low Mound and 25 individuals were from the High Mound. The excavated artifacts and skeletons are now split between The Pennsylvania Museum and The National Museum of Iran in Tehran. The Upper and Lower Mound burials of Tepe Hasanlu were examined through bioarchaeological, osteological, and archaeological (burial connotations) methodologies in an attempt to reveal the lifestyle, burial practices, and economy of the famous ancient city. It was hypothesized that there is a correlation between pathological conditions, sex, and the perceived economic/social status of the Bronze through Seluco-Parthian burials based on the associated grave goods and sociocultural characteristics viewed and examined within the burial space. This hypothesis was tested through skeletal and archaeological analysis, and it was found that individual pathological conditions correlate with the burial goods classified in Levels 1 and 2, however, Level 0 is more variable. The variations found among the level classifications and the frequencies of their individual pathological conditions reveal a high rate among Level 1 and a low rate among Level 2 burials. Additionally, it is possible that the different associated economic classes at Hasanlu exhibited dissimilar biological susceptibilities, nutrition, health, and lifestyles relating to their pathological conditions. However, this could also be a result of differential sampling, or the burials were excavated from a class-based cemetery. Age was found to be a major factor in the presentation of age-related degenerative pathological conditions, which was especially evident in the dentition of the sampled Hasanlu population. Furthermore, the High and Low Mounds appear to be drastically different in the associated economic class of their burials, as the LM appeared to contain individuals of higher classes (Level 2), and the HM exhibited a preference for burials with little (Level 1) to no grave goods (Level 0). As a result of such, it is theorized that the LM and HM were exhibiting different social structures and values, possibly representing separate societal class structures (egalitarian/non-egalitarian) influenced by economic opportunities or Hasanlu’s influence on the region. From the data examined, it appears that the social preferences exhibited by the Hasanlu peoples was evident in nearly every aspect of the burial space dictated by age, sex, and perceived economic class (Levels 0-2) through the burial characteristics of side, position, goods location, grave construction, interments, and possibly orientation. It is with this data that there are proven differences in the various subjects of archaeology and osteological features within the sampled burial population likely influenced by wealth, lifestyles, and/or various burial preferences.

No description available.

Activities of daily living (ADL) such as writing, eating, and object manipulation are challenging for patients suffering from pathological tremors. Pathological tremors are involuntary, rhythmic, and oscillatory movements that manifest in limbs, the head, and other body parts. Among the existing treatments, mechanical loading through wearable rehabilitation devices is popular for being non-invasive and innocuous to the human body. In particular, a few exoskeletons are developed to actively mitigate pathological tremors in the forearm. While these forearm exoskeletons can effectively suppress tremors, they still require significant improvements in ergonomics to be implemented for ADL applications. The ergonomics of the exoskeleton can be improved via design and motion control pertaining to human biomechanics, which leads to better efficiency, comfort, and safety for the user. The wrist is a complicated biomechanical joint with two coupled degrees of freedom (DOF) pivotal to human manipulation capabilities. Existing exoskeletons either do not provide tremor suppression in all wrist DOFs, or can be restrictive to the natural wrist movement. This motivates us to explore a better exoskeleton solution for wrist tremor suppression. We propose TAWE - a wearable exoskeleton that provides alleviation of pathological tremors in all wrist DOFs. The design adopts a 6-DOF rigid linkage mechanism to ensure unconstrained natural wrist movements, and wearability features without extreme tight-binding or precise positioning for convenient ADL applications. When TAWE is equipped by the user, a closed-kinematic chain is formed between the exoskeleton and the forearm. We analyze the coupled multibody dynamics of the human-exoskeleton system, which reveals a few robotic control problems - (i) The first problem is the identification of the unknown wrist kinematics within the closed kinematic chain. We realize the real-time wrist kinematic identification (WKI) based on a novel ellipsoidal joint model that describes the coupled wrist kinematics, and a sparsity-promoting Extended Kalman Filter for the efficient real-time regression; (ii) The second problem is the exoskeleton motion control for tremor suppression. We design a robust adaptive controller (IO-RAC) based on model reference adaptive control and inverse optimal robust control theories, which can identify the unknown model inertia and load, and provide stable tracking control under disturbance; (iii) The third problem is the estimation of voluntary movement from tremorous motion data for the motion planning of exoskeleton. We develop a lightweight and data-driven voluntary movement estimator (SVR-VME) based on least square support vector regression, which can estimate voluntary movements with real-time signal adaptability and significantly reduced time delay. Simulations and experiments are carried out to test the individual performance of robotic control algorithms proposed in this study, and their combined real-time performance when integrated into the full exoskeleton control system. We also manufacture the prototype of TAWE, which helps us validate the proposed solutions in tremor alleviation exoskeletons. Overall, the design of TAWE meets the expectations in its compliance with natural wrist movement and simple wearability. The exoskeleton control system can execute stably in real-time, identify unknown system kinematics and dynamics, estimate voluntary movements, and suppress tremors in the wrist. The results also indicate a few limitations in the current approaches, which require further investigations and improvements. Finally, the proposed exoskeleton control solutions are developed based on generic formulations, which can be applied to not only TAWE, but also other rehabilitation exoskeletons. / Doctor of Philosophy / Activities of daily living (ADL) such as writing, eating, and object manipulation are challenging for patients suffering from pathological tremors, which affect millions of people worldwide. Tremors are involuntary, rhythmic, and oscillatory movements. In recent years, rehabilitation exoskeletons are developed as non-invasive solutions to pathological tremor alleviation. The wrist is pivotal to human manipulation capabilities. Existing exoskeletons either do not provide tremor suppression in all wrist movements, or can be restrictive to natural wrist movements. To explore a better solution with improved performance and ergonomics, we propose TAWE - a wearable exoskeleton that provides tremor alleviation in full wrist motions. TAWE adopts a high-degree-of-freedom mechanism to ensure unconstrained natural wrist movements, and wearability features for convenient ADL applications. The coupled dynamics between the forearm and TAWE leads to a few robotic control problems. We propose novel real-time robotic control solutions in the identification of unknown wrist kinematics, robust adaptive exoskeleton control for tremor suppression, and voluntary movement estimation for motion planning. Later, simulations and experiments validate the TAWE prototype and its exoskeleton control framework for tremor alleviation, and reveal limitations in the current approaches that require further investigations and improvements. Finally, the proposed exoskeleton control solutions are developed based on generic formulations, which can be applied to not only TAWE, but also other rehabilitation exoskeletons.

No / BACKGROUND: Androgenetic alopecia, or male pattern baldness, is a common, progressive disorder where large, terminal scalp hairs are gradually replaced by smaller hairs in precise patterns until only tiny vellus hairs remain. This balding can cause a marked reduction in the quality of life. Although these changes are driven by androgens, most molecular mechanisms are unknown, limiting available treatments. The mesenchyme-derived dermal papilla at the base of the mainly epithelial hair follicle controls the type of hair produced and is probably the site through which androgens act on follicle cells by altering the regulatory paracrine factors produced by dermal papilla cells. During changes in hair size the relationship between the hair and dermal papilla size remains constant, with alterations in both dermal papilla volume and cell number. This suggests that alterations within the dermal papilla itself play a key role in altering hair size in response to androgens. Cultured dermal papilla cells offer a useful model system to investigate this as they promote new hair growth in vivo, retain characteristics in vitro which reflect their parent follicle's response to androgens in vivo and secrete mitogenic factors for dermal papilla cells and keratinocytes. OBJECTIVES: To investigate whether cultured dermal papilla cells from balding follicles secrete altered amounts/types of mitogenic factors for dermal papilla cells than those from larger, normal follicles. We also aimed to determine whether rodent cells would recognize mitogenic signals from human cells in vitro and whether factors produced by balding dermal papilla cells could alter the start of a new mouse hair cycle in vivo. METHODS: Dermal papilla cells were cultured from normal, balding and almost clinically normal areas of balding scalps and their ability to produce mitogenic factors compared using both human and rat whisker dermal papilla cells as in vitro targets and mouse hair growth in vivo. RESULTS: Normal scalp cells produced soluble factors which stimulated the growth of both human scalp and rat whisker dermal papilla cells in vitro, demonstrating dose-responsive mitogenic capability across species. Although balding cells stimulated some growth, this was much reduced and they also secreted inhibitory factor(s). Balding cell media also delayed new hair growth when injected into mice. CONCLUSIONS: Human balding dermal papilla cells secrete inhibitory factors which affect the growth of both human and rodent dermal papilla cells and factors which delay the onset of anagen in mice in vivo. These inhibitory factor(s) probably cause the formation of smaller dermal papillae and smaller hairs in male pattern baldness. Identification of such factor(s) could lead to novel therapeutic approaches.

O presente estudo teve como objetivo caracterizar o comportamento de jogadores que frequentam casas de bingo, videopoker e Jockey Club. Foram pesquisados 171 sujeitos, sendo 63 no Jockey Club, 65 em casas de bingo e 43 em casas de videopoker. Em cada categoria de jogo obtiveram-se 25 questionários classificados como jogadores patológicos pela escala SOGS. A maioria dos entrevistados eram de sexo masculino, casados, de religião católica, tinham 2o. grau ou superior completo e trabalhava em período integral. A média de idade foi de 40 anos e a mediana da renda foi R$ 4.000,00. Em ordem decrescente, os jogos mais praticados pelo menos uma vez na vida pelos jogadores pesquisados foram: loteria, bingo, cartas e corridas de cavalo. Jogadores patológicos e jogadores não patológicos não se diferenciaram quanto a nenhuma das características socio-demográficas pesquisadas, mas se diferenciaram quanto à prática de alguns jogos. Na vida, mais jogadores patológicos jogaram carta, em corridas de cavalo, videopoker e dados do que os não patológicos. Nos últimos 12 meses e nos últimos 30 dias, jogadores patológicos se diferenciaram por jogar mais videopoker. Esses jogadores também utilizaram mais dinheiro para apostar em um só dia, além declararem ter ganho quantias maiores de dinheiro no jogo. Quanto ao estado emocional relativo ao jogo, jogadores patológicos tendem a ficar mais ficam tensos antes de jogar e relatam sentimentos negativos durante e depois do jogo. Não patológicos sentem-se bem e tranquilos antes, relatam sentimentos neutros durante e positivos depois de jogar. Quando pararam de jogar por um tempo, jogadores patológicos relataram sentimentos negativos enquanto que os não patológicos relataram sentimentos neutros. Jogadores patológicos sentem mais falta do jogo quando param de jogar, mas poucos procuraram ajuda devido a problemas associados ao jogo. Pais de jogadores patológicos não se diferenciaram quanto ao fato de jogarem ou beberem demais de pais de jogadores não patológicos . Quando se analisa o uso de álcool e outras drogas, a única diferença significativa encontrada foi maior uso de tabaco na vida pelos jogadores patológicos. Os jogadores patológicos pesquisados no bingo, videopoker e Jockey Club foram também comparados entre si. As únicas diferenças significativas encontradas foram: presença de mais jogadores casados no bingo e jovens no videopoker; no Jockey Club, maior frequência de apostas em esportes, de discussão familiar por causa do dinheiro gasto no jogo e de empréstimo por agiotas. / In this study sociodemographic variables and gambling behavior of videopoker, bingo and horse-race gamblers were examined. One hundred seventy one subjects, 63 from the Jockey-Club of São Paulo, 65 from bingo clubs and 43 from videopoker clubs were administered a questionnaire adapted from the South Oacks Gambling Screen - SOGS, and 25 individuals of each group were classified as pathological gamblers. The majority of subjects were married catholic males, who had at least a high school degree and full-time jobs. Mean age was 40 years and median income was U$ 4000.00. In descending order, lottery, bingo, card games, and horse-race were the most frequent types of games played at least once by the subjects. Comparisons between pathological and non-pathological gamblers revealed no significant difference in any sociodemographic variables, but the two groups differed in their gambling activities. Pathological gamblers had played significantly more cards, bet on horses, played videopoker and dice games in their lives than the other group. Pathological gamblers also played significantly more videopoker in the previous month and previous year than non-pathological gamblers. They also bet more money in one day of gambling and also reported making more money from this activity than non-pathological gamblers. With respect to gambling-related emotions, pathological gamblers reported feeling tense before gambling and negative affects during and after gambling. The non-pathological group reported a sense of well being before gambling and neutral affects during and after it. Pathological-gamblers reported negative affects during periods when they stopped gambling, while neutral feelings were reported by the non-pathological group. The former also missed this activity more than the non-pathological group, but few sought help for problems associated with gambling. Gambling habits and alcohol use between parents of pathological and non-pathological gamblers were not significantly different. The two groups also did not differ in their use of alcohol and other drugs but tobacco, which was significantly more consumed in a lifetime by the pathological gambling subjects. Comparisons between bingo, videopoker and horse-race subgroups evidenced few significant differences. There were more married subjects in the bingo group and younger individuals in the videopoker group. The pathological gamblers interviewed at the Jockey Club reported higher frequency of bets in sports, of family arguments between family members because of the amount of money spent on gambling and more credit lines with bookies.

The current study addresses the fundamental role of expert evidence advanced in support of the defence of criminal incapacity. It was endeavoured to illustrate that the scientific entities of forensic psychiatry and psychology fulfil an essential and pivotal role in establishing and assessing the defence of criminal incapacity. The study proposed to illustrate the interaction between the professions of law and medicine on the backdrop of the defence of criminal incapacity. Recommendations were provided with the aim of enhancing the dialogue between the professions of law and medicine when the defence of criminal incapacity falls to be assessed. The study was approached from a dual dimensional perspective illustrating both the need for mental health experts as well as the need for adequately trained and experienced mental health experts to provide expert testimony as to an accused’s mental state when the defence of criminal incapacity is raised. The motivation for the current study is enumerated and the concepts of “criminal capacity”, “non-pathological criminal incapacity”, “pathological criminal incapacity” and “expert evidence” are, amongst others, conceptualized. It is indicated that expert evidence plays an essential role not only in cases where pathological criminal incapacity, or put differently, criminal incapacity attributable to mental illness or mental defect is raised, but also in instances where non-pathological criminal incapacity is raised as a defence. The role of the mental health expert is addressed with reference to battered woman syndrome evidence advanced in support of the defence of non-pathological criminal incapacity. It is illustrated that the defence of non-pathological criminal incapacity is in need of reform. It is in addition illustrated that legislative reform is essential to establish the defence of non-pathological criminal incapacity and to create legal certainty. The inconsistent approach in the application of expert evidence to the defence of criminal incapacity is emphasized with specific focus on the semantic distinction between the defences of non-pathological criminal incapacity and pathological criminal incapacity. The role and application of the DSM-IV in the definition and assessment of mental disorders is addressed in conjunction with the various obstacles associated with the application of the DSM-IV to the defence of criminal incapacity. The nature and scope of the basic rules of expert evidence as they would apply to mental health professionals acting as expert witnesses in support of the defence of criminal incapacity are addressed. The assessment of the probative value of expert evidence is addressed and the complexities associated therewith are espoused. The numerous ethical dilemmas faced by mental health experts are illustrated and recommendations are provided aimed at eliminating these dilemmas. A comparative study of selected principles pertaining to expert evidence in the United States of America is embarked upon to illustrate the need for a codification of the rules of expert evidence as well as effective guidelines aimed at enhancing the scientific reliability and validity of expert evidence advanced in support of the defence of criminal incapacity. Finally, conclusions are drawn and motivated recommendations are made. Law reform is proposed in the form of draft proposals for legislative reform in respect of the defence of criminal incapacity as well as a draft ethical code of conduct for mental health experts providing expert testimony in cases where the defence of criminal incapacity is raised. / Thesis (LLD)--University of Pretoria, 2011. / Public Law / unrestricted

The South Africa criminal law allows the battered woman to raise a battered woman syndrome defence in the context of non-pathological criminal incapacity. However, there is a need of expert evidence to support such defence for it to succeed in the court of law. Hence, this paper scrutinizes the task of expert evidence in support of the battered woman syndrome in order to reach the extent of its effectiveness. Nevertheless, such evidence is not indispensable but without it, the court hardly gets persuaded resulting into the failure of the defence. The meaning of battered woman syndrome is articulated in the paper as well as the fact that battered woman syndrome defence falls under the defence of non-pathological criminal incapacity. The origin and development of the non-pathological criminal incapacity has also been discussed by comparing it with pathological criminal incapacity which emanates from mental illness while the former does not originate from a mental illness. Psychiatrist are in a better position to understand the latter while psychologists are in a better position to understand the former, hence it is advisable if the court pays more attention or attach more weight to the evidence given by the psychologists if this defence is to succeed and have a brilliant future. Moreover, the possible defences available to the battered woman have been mentioned as well as the cases that used non-pathological criminal incapacity as a defence particularly with regard to the battered woman syndrome defence. Both cases that were successful and unsuccessful have been elaborated. However, the cases that failed with the defence are in large numbers than the successful ones. Although expert evidence is essential to support the battered woman syndrome defence, it is unjustly and unfairly applied on the battered woman who is an accused person in the court leading to the failure of the defence .In short the use of expert evidence has failed in its application as the two professions, law and medicine has failed to make this defence work as they have not reached an agreement concerning the battered woman syndrome defence. In addition, the paper looks at the obstacles linked with the battered woman syndrome defence as well as offering suggestions to be put in place in order to make the use of expert evidence achievable. This can only be done if both the lawyers and mental health professionals come to terms with each other where they are able to understand the battered woman syndrome and the actions which led to the situation where battered woman finds herself as an accused person. Finally, the paper concludes that expert evidence has failed tremendously in its application leading to the failure of the battered woman syndrome defence in the context of non-pathological criminal incapacity. Consequently a lot still needs to be done to protect the women who face numerous obstacles; both personal and legal as they do not face justice in court and everyone must take part to put an end to battering of women which is inhuman and morally wrong. / Dissertation (LLM)--University of Pretoria, 2012. / Public Law / unrestricted