Automatic control of physiological variables is one of the most active areas in biomedical engineering. This paper is centered in the prediction of the analgesic variables evolution in patients undergoing surgery. The proposal is based on the use of hybrid intelligent modelling methods. The study considers the Analgesia Nociception Index to assess the pain in the patient and remifentanil as intravenous analgesic. The model proposed is able to make a one-step-ahead prediction of the remifentanil dose corresponding to the current state (...) of the patient. The input information is the previous remifentanil dose, the ANI variable and the electromyogram signal. Modelling techniques used are Artificial Neural Networks and Support Vector machines for Regression combined with clustering methods. Both training and validation were done with a real dataset from different patients. Results obtained show the potential of this methodology to calculate the drug dose corresponding to a given analgesic state of the patient. (shrink)

RESUMEN Con un enfoque cualitativo y alcance descriptivo, el presente artículo tiene como objetivo sintetizar aspectos de materiales publicados en diversas fuentes relacionados con el estrés para lo cual se emplea el método de revisión bibliográfica. Durante el estudio se encontraron aspectos teóricos que permiten entender la evolución del concepto, acceder a modelos, evaluar la repercusión del fenónemo y constatar instrumentos para su evaluación, así como obtener sugerencias para controlarlo. Se concluye que el estrés puede ser percibido como positivo o (...) negativo según el manejo que hace cada individuo y su estilo de afrontarlo, es una manifestación relacionada con el proceso salud enfermedad en el que, para algunos, contribuye al crecimiento personal y en otros, a su malestar o enfermedad. ABSTRACT With a qualitative approach and descriptive scope, the present article takes as an objective to synthesize aspects of materials published in diverse sources related to the stress for which uses the method of bibliographical review. During the study there were theoretical aspects that allow understanding the evolution of the concept, gaining access to models, evaluating the aftereffect of the phenomenon and state instruments for their evaluation, as well as obtaining suggestions to control it. It was concluded that the stress can be perceived as positive or negative according to the handling that there does every individual and its style of confronting it, a declaration related to the process is a health illness in the one that, for some, contributes to the personal growth and in others, to its discomfort or illness. (shrink)

Extrapolation of causal claims from study populations to other populations of interest is a problematic issue. The standard approach in experimental research, which prioritises randomized controlled trials and statistical evidence, is not devoid of difficulties. Granted that, it has been defended that evidence of mechanisms is indispensable for causal extrapolation. We argue, contrarily, that this sort of evidence is not indispensable. Nonetheless, we also think that occasionally it may be helpful. In order to clarify its relevance, we introduce a distinction (...) between a positive and a negative role of evidence of mechanisms. Our conclusion is that the former is highly questionable, but the latter may be a trustworthy resource for causal extrapolation. (shrink)

ObjectiveLoss of control eating has been directly related to the core aspects of the psychopathology of eating disorders and to different dimensions of emotion and behavior regulation and self-criticism. This study investigates a model representing the interplay between these dimensions to understand LOC eating among a nonclinical sample.MethodsA total of 341 participants, recruited in a college campus, completed a set of self-report measures assessing LOC eating, weight suppression, psychopathology of eating disorders, depression, negative urgency, emotion regulation difficulties, and self-criticism. Path (...) analysis modeling tested a hypothesized model with 3 paths for LOC eating as follows: psychopathology of eating disorders; emotion and behavior regulation; and interplay between these paths.ResultsWe found goodness-of-fit indexes to our data: χ2 = 17.11, df = 10, Comparative Fit Index = 0.99, Tucker-Lewis index = 0.98, Root Mean Square Error Approximation = 0.045, Standardized Root Mean Square Residual = 0.041, suggesting that: participants with higher weight suppression showed higher degrees of the psychopathology of eating disorders, which was linked to higher levels of LOC eating; self-criticism was a mediator between emotion regulation and depression/negative urgency; self-criticism was a mediator between emotion regulation and disorder eating, which was significantly associated with LOC eating via increased negative urgency.ConclusionOur model shows that LOC eating occurs for individuals with the psychopathology of higher eating disorders who experience depressive symptoms and act rashly under distress for their inability to cope adequately with negative feelings of self-devaluation. These findings point to the importance of negative self-evaluations and feelings of inadequacy or worthlessness to understand LOC eating among college students. (shrink)

El texto aquí desarrollado aborda los principios más generales del realismo sociológico escandinavo, en particular de la teoría de la función jurisdiccional y del interés de Alf Ross, que sostiene a la objetividad y subjetividad como parte integrante de la actividad del juzgador, contrastán..

The unfinished imperfect procedural justice raised by John Rawls can be projected towards the theory of the jurisdictional function of Alf Ross, if we took in consideration the judge as an institution and citizen when he applies the law in the population that judges. The theory of the justice of the..

The article briefly approaches some questions on the main penal theories that they turn around the determination of the penalty in the sentenced ones of codified legal systems, being jurisdictional processes, among them, the theory of the danger of Cesar Lombroso. The tendency of these criminal po..

Lower extremity non-contact soft tissue injuries are prevalent in elite futsal. The purpose of this study was to develop robust screening models based on pre-season measures obtained from questionnaires and field-based tests to prospectively predict LE-ST injuries after having applied a range of supervised Machine Learning techniques. One hundred and thirty-nine elite futsal players underwent a pre-season screening evaluation that included individual characteristics; measures related to sleep quality, athlete burnout, psychological characteristics related to sport performance and self-reported perception of chronic (...) ankle instability. A number of neuromuscular performance measures obtained through three field-based tests [isometric hip strength, dynamic postural control and lower extremity joints range of motion ] were also recorded. Injury incidence was monitored over one competitive season. There were 25 LE-ST injuries. Only those groups of measures from two of the field-based tests, as independent data sets, were able to build robust models [area under the receiver operating characteristic curve score ≥0.7] to identify elite futsal players at risk of sustaining a LE-ST injury. Unlike the measures obtained from the five questionnaires selected, the neuromuscular performance measures did build robust prediction models. The inclusion in the same data set of the measures recorded from all the questionnaires and field-based tests did not result in models with significantly higher performance scores. The model generated by the UnderBagging technique with a cost-sensitive SMO as the base classifier and using only four ROM measures reported the best prediction performance scores. The models developed might help coaches, physical trainers and medical practitioners in the decision-making process for injury prevention in futsal. (shrink)

Este trabajo tiene como objetivo caracterizar el proceso de evaluación del aprendizaje del contenido estadístico en la carrera de Medicina. Los resultados obtenidos evidencian que el nivel de asimilación alcanzado por los estudiantes en muchas ocasiones es el reproductivo, lo que refleja la necesidad de seguir profundizando en los estudios de esta problemática. Issues related to the learning evaluation have been present throughout the teaching learning process history. The following research aims at characterizing the learning process of evaluation of the (...) statistical content in medicine. Results demonstrate that the assimilation level reached by students, on many occasions, is the reproductive one, as a need to deepen on methodology of the design of the system of evaluation of the statistical content learning in medicine. (shrink)

One of the main challenges in medicine is to guarantee an appropriate drug supply according to the real needs of patients. Closed-loop strategies have been widely used to develop automatic solutions based on feedback variables. However, when the variable of interest cannot be directly measured or there is a lack of knowledge behind the process, it turns into a difficult issue to solve. In this research, a novel algorithm to approach this problem is presented. The main objective of this study (...) is to provide a new general algorithm capable of determining the influence of a certain clinical variable in the decision making process for drug supply and then defining an automatic system able to guide the process considering this information. Thus, this new technique will provide a way to validate a given physiological signal as a feedback variable for drug titration. In addition, the result of the algorithm in terms of fuzzy rules and membership functions will define a fuzzy-based decision system for the drug delivery process. The method proposed is based on a Fuzzy Inference System whose structure is obtained through a decision tree algorithm. A four-step methodology is then developed: data collection, preprocessing, Fuzzy Inference System generation, and the validation of results. To test this methodology, the analgesia control scenario was analysed. Specifically, the viability of the Analgesia Nociception Index as a guiding variable for the analgesic process during surgical interventions was studied. Real data was obtained from fifteen patients undergoing cholecystectomy surgery. (shrink)

Organ shortage constitutes an unsolved problem for every country that offers transplantation as a therapeutic option. Besides the largely implemented donation model and the eventually implemented market model, a theorized automatic organ procurement model has raised a rich debate in the legal, medical and bioethical community, since it could show a higher potential to solve organ shortage. In this paper, we study the main arguments for and against this model. We show how, in the light of empirical data extracted from (...) countries with a universal health care system, its implementation could lead to a positive impact on organ procurement rates. Three factors are envisioned as fundamental in the comprehension and a possible regulation of the automatic organ procurement model: the lack of recognition of the conscientious objection, the preservation of the right to choose end of life conditions, and the need to avoid incentives for families or healthcare professionals. (shrink)

There are many real-world applications like healthcare systems, job monitoring, well-being and personal fitness tracking, monitoring of elderly and frail people, assessment of rehabilitation and follow-up treatments, affording Fall Detection (FD) and ADL (Activity of Daily Living) identification, separately or even at a time. However, the two main drawbacks of these solutions are that most of the times, the devices deployed are obtrusive (devices worn on not quite common parts of the body like neck, waist and ankle) and the poor (...) battery life. Thus, this work proposes a low-power classification algorithm based on an Ensemble of KNN and K-Means algorithms (EKMeans) to identify Falls and High-Intensity ADL events such as running, jogging and climbing up stairs. The input of EKMeans are triaxial accelerometer data gathered from wrist-wearable devices. The proposal will be validated on the Fall&ADL publicly available datasets UMAFall, UCIFall and FallAllD, considering two kinds of activity labelling: Two-Class and Multi-Class. An exhaustive comparative study between our proposal, and the baseline algorithms KNN and a feed-forward Neural Network (NN) is deployed, where EKMeans outperformed clearly the Specificity (ADL classification) of the KNN and NN for the three datasets. Finally, a comparative battery consumption study has been included deploying the analyzed algorithms in a WearOS smartwatch, where EKMeans drains the battery from 100% to 0% in 27.45 hours, saving 5% and 21% concerning KNN and NN, respectively. Keywords: Human Activity Recognition, ADL Identification, Fall Detection TS Clustering, TS Classification, Wearable Devices, Low-Power HAR. (shrink)

We report a scanning tunnelling microscopy investigation of the emission of dislocations around nanoindentations in the form of dislocation arrangements previously called hillocks , consisting of two pairs of Shockley partial dislocations, each encompassing a stacking fault. The spatial arrangement and size distribution of hillocks around the nanoindentation traces are studied. We show that standard dislocation theory for an isotropic continuum can be used to describe the stability of the hillocks, their size and spatial distribution and the broadening of the (...) corresponding extended dislocations near the surface. A model is proposed in which hillocks originate from the split into dislocations partials of primary perfect dislocation loops punched into the crystal by the scanning tunnelling microscope tip. This model implies the operation of a novel dislocation mechanism involving long-range transport of matter across the surface. (shrink)

The expressivist account of knowledge attributions, while claiming that these attributions are nonfactual, also typically holds that they retain a factual component. This factual component involves the attribution of a belief. The aim of this work is to show that considerations analogous to those motivating an expressivist account of knowledge attributions can be applied to belief attributions. As a consequence, we claim that expressivists should not treat the so-called factual component as such. The phenomenon we focus on to claim that (...) belief attributions are non-factual is that of normative doxastic disagreement. We show through several examples that this kind of disagreement is analogous to that of the epistemic kind. The result will be a doxastic expressivism. Finally, we answer some objections that our doxastic expressivism could seem to face. (shrink)

El presente texto se inscribe dentro de la temática dirigida a la investigación sobre la violencia intrafamiliar. Tiene como objetivo sistematizar aspectos históricos y teóricos inherentes al estudio del maltrato infantil y sus consecuencias en el ámbito social y familiar para su detección y tratamiento en el nivel de atención primaria de los servicios de salud en Cuba. Mediante una revisión bibliográfica se logró concretar un análisis documental de materiales y textos en soporte digital e impreso que condujo a los (...) acercamientos teórico e histórico del fenómeno en el ámbito internacional y nacional, para su conceptualización, la determinación de su tipología y el establecimiento de sus consecuencias; elementos imprescindibles del saber profesional del futuro egresado de las ciencias médicas, en función de su desempeño en los diferentes niveles de atención de salud, en especial, la atención primaria. The text falls within the research on intrafamiliar violence subject matter. Its objective is to systematize historical and theoretical aspects inherent to the study of child abuse and its consequences within the social and domestic scopes for its detection and treatment in the Cuban primary health care services. By means of a bibliographic review, a documentary analysis of electronic and printed form materials and texts was summarized. It led to theoretical and historical approaches to the phenomenon within the national and international scopes for its conceptualization, the establishment of its typology and consequences. They are essential elements of the professional knowledge of future medical sciences graduates towards their performance in different health care levels, especially in primary health care. (shrink)

This work focuses on the application of machine learning techniques to assist the clinicians in the administration of analgesic drug during general anaesthesia. Specifically, the main objective is to propose the basis of an intelligent system capable of making decisions to guide the opioid dose changes based on a new nociception monitor, the analgesia nociception index. Clinical data were obtained from 15 patients undergoing cholecystectomy surgery. By means of an off-line study, machine learning techniques were applied to analyse the possible (...) relationship between the analgesic dose changes performed by the physician due to the hemodynamic activity of the patients and the evolution of the ANI. After training different classifiers and testing the results under cross validation, a preliminary relationship between the evolution of ANI and the dosage of remifentanil was found. These results evidence the potential of the ANI as a promising index to guide the infusion of analgesia. (shrink)

En el presente artículo se evidencia la vinculación que establece Rama entre lengua/literatura y espacio/poder en La ciudad letrada. Este nuevo paradigma ha permitido pensar y repensar la literatura latinoamericana y los estudios culturales, sin embargo, entraña contradicciones dentro del mismo pensamiento del uruguayo. La tajante división que el autor establece entre ciudad real y ciudad letrada hace imposible pensar el rol de la literatura fuera de la esfera del poder institucional, al mismo tiempo que relega ontológicamente la realidad de (...) esta última a una meramente instrumental. Nuestra propuesta es leer a la luz del concepto de transculturación esta oposición, para establecer una dialéctica que permita considerar la politicidad propia de la ciudad real y su rol activo en la expresión de una literatura de resistencia política. (shrink)

Closed-loop administration of propofol for the control of hypnosis in anesthesia has evidenced an outperformance when comparing it with manual administration in terms of drug consumption and post-operative recovery of patients. Unlike other systems, the success of this strategy lies on the availability of a feedback variable capable of quantifying the current hypnotic state of the patient. However, the appearance of anomalies during the anesthetic process may result in inaccurate actions of the automatic controller. These anomalies may come from the (...) monitors, the syringe pumps, the actions of the surgeon or even from alterations in patients. This could produce adverse side effects that can affect the patient postoperative and reduce the safety of the patient in the operating room. Then, the use of anomaly detection techniques plays a significant role to avoid this undesirable situations. This work assesses different one-class intelligent techniques to detect anomalies in patients undergoing general anesthesia. Due to the difficulty of obtaining real data from anomaly situations, artificial outliers are generated to check the performance of each classifier. The final model presents successful performance. (shrink)

Las crisis económicas están generando desigualdades, producto de la violencia estructural; éstas están derivando en las maneras en que los jóvenes construyen y dibujan los sentidos sociales. Los jóvenes deberían ser sujetos que se mueven en toda una temporalidad sin embargo, sus condiciones materiales de vida, no les permiten pensar en un futuro con certezas. Más bien, éstas se desdibujan para ellos y hoy más que nunca aparecen sus sueños postergados y aplazados por la propia violencia de la que son (...) objeto. De ahí, nuestro interés en ver cómo los jóvenes egresados de la universidad, están construyendo dichos sentidos.Economic crises are generating inequalities resulting from structural violence; they are drifting in the ways in which young people build and draw social senses. Young people should be the subjects of movement along temporariness; nevertheless, their material living conditions do not allow them to think in their future with certainty. For our young generations these conditions are blurred, and now more than ever their dreams are deferred and delayed by the violence they are subjected to. Hence, our interest in finding out how young university graduates are building these senses. (shrink)