Low cost gaze estimation: knowledge-based solutions

Eye tracking technology in low resolution scenarios is not a completely solved issue to date. The possibility of using eye tracking in a mobile gadget is a challenging objective that would permit to spread this technology to non-explored fields. In this paper, a knowledge based approach is presented to solve gaze estimation in low resolution settings. The understanding of the high resolution paradigm permits to propose alternative models to solve gaze estimation. In this manner, three models are presented: a geometrical model, an interpolation model and a compound model, as solutions for gaze estimation for remote low resolution systems. Since this work considers head position essential to improve gaze accuracy, a method for head pose estimation is also proposed. The methods are validated in an optimal framework, I2Head database, which combines head and gaze data. The experimental validation of the models demonstrates their sensitivity to image processing inaccuracies, critical in the case of the geometrical model. Static and extreme movement scenarios are analyzed showing the higher robustness of compound and geometrical models in the presence of user's displacement. Accuracy values of about 3° have been obtained, increasing to values close to 5° in extreme displacement settings, results fully comparable with the state-of-the-art

The effect of a multicomponent intervention on steatosis is partially mediated by the reduction of intermuscular abdominal adipose tissue in children with overweight or obesity: the EFIGRO Project

OBJECTIVE: In adults, there is evidence that improvement of metabolic-associated fatty liver disease (MAFLD) depends on the reduction of myosteatosis. In children, in whom the prevalence of MAFLD is alarming, this muscle-liver crosstalk has not been tested. Therefore, we aimed to explore whether the effects of a multicomponent intervention on hepatic fat is mediated by changes in intermuscular abdominal adipose tissue (IMAAT) in children with overweight/obesity. RESEARCH DESIGN AND METHODS: A total of 116 children with overweight/obesity were allocated to a 22-week family-based lifestyle and psychoeducational intervention (control group, n = 57) or the same intervention plus supervised exercise (exercise group, n = 59). Hepatic fat percentage and IMAAT were acquired by MRI at baseline and at the end of the intervention. RESULTS: Changes in IMAAT explained 20.7% of the improvements in hepatic steatosis (P < 0.05). Only children who meaningfully reduced their IMAAT (i.e., responders) had improved hepatic steatosis at the end of the intervention (within-group analysis: responders -20% [P = 0.005] vs. nonresponders -1.5% [P = 0.803]). Between-group analysis showed greater reductions in favor of IMAAT responders compared with nonresponders (18.3% vs. 0.6%, P = 0.018), regardless of overall abdominal fat loss. CONCLUSIONS: The reduction of IMAAT plays a relevant role in the improvement of hepatic steatosis after a multicomponent intervention in children with overweight/obesity. Indeed, only children who achieved a meaningful reduction in IMAAT at the end of the intervention had a reduced percentage of hepatic fat independent of abdominal fat loss. Our findings suggest that abdominal muscle fat infiltration could be a therapeutic target for the treatment of MAFLD in childhood.This project was funded by the Spanish Ministry of Health's Fondos de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01335), the Spanish Ministry of the Economy Industry and Competitiveness (DEP2016-78377-R), and by European Regional Development Funds (ERDF): Una Manera de Hacer Europa. Support was also provided by the Regional Government of Navarra's Department of Economic Development (0011-1365-2019-000152 & 0011-1365-2020-000243), co-funded by European Regional Development Funds (ERDF 2014-2020 for Navarra). CC-S is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). MM is supported by Junta de Andalucía and European Union (SNGJ Ref-8025). MO is supported by the Spanish Ministry of Economy and Competitiveness (BES-2017-080770). This study was supported by the University of Granada Plan Propio de Investigación 2021 -Excellence actions: Unit of Excellence on Exercise, Nutrition and Health (UCEENS)- and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, European Regional Development Funds (ref. SOMM17/6107/UGR)

Mathematical talent in Braille code pattern finding and invention

The recognition of patterns and creativity are two characteristics associated with mathematical talent. In this study, we analyzed these characteristics in a group of 37 mathematically talented students. The students were asked to find the pattern the Braille code had been built upon and reinvent it with the aim of making its mathematical language become more functional. Initially, the students were unable to identify the formation pattern of Braille, but after experiencing the difficulties that blind people face when reading it, they recognized the generating element and the regularity. The results were in contrast with those of a control group, and it is noted that the students with mathematical talent were more effective in using visualization to identify the regularity of the pattern and their invention proposals were more sophisticated and used less conventional mathematical content.This research is part of the R+D+I project EDU2015- 69,731-R (Spanish Government/MinEco and ERDF)

Hung Out to Dry: Choice of Priority Ecoregions for Conserving Threatened Neotropical Anurans Depends on Life-History Traits

Background: In the Neotropics, nearly 35 % of amphibian species are threatened by habitat loss, habitat fragmentation, and habitat split; anuran species with different developmental modes respond to habitat disturbance in different ways. This entails broad-scale strategies for conserving biodiversity and advocates for the identification of high conservation-value regions that are significant in a global or continental context and that could underpin more detailed conservation assessments towards such areas. Methodology/Principal Findings: We identified key ecoregion sets for anuran conservation using an algorithm that favors complementarity (beta-diversity) among ecoregions. Using the WWF’s Wildfinder database, which encompasses 700 threatened anuran species in 119 Neotropical ecoregions, we separated species into those with aquatic larvae (AL) or terrestrial development (TD), as this life-history trait affects their response to habitat disturbance. The conservation target of 100 % of species representation was attained with a set of 66 ecoregions. Among these, 30 were classified as priority both for species with AL and TD, 26 were priority exclusively for species with AL, and 10 for species with TD only. Priority ecoregions for both developmental modes are concentrated in the Andes and in Mesoamerica. Ecoregions important for conserving species with AL are widely distributed across the Neotropics. When anuran life histories were ignored, species with AL were always underrepresented in priority sets

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Caracterización ecológica del área marina del banco de Galicia

Se integra información hidrográfica, geomorfológica, sedimentológica, biológica, sobre hábitats marinos y pesquera, para establecer las bases ecológicas necesarias para la protección y conservación del banco de GaliciaEl banco de Galicia es un monte submarino profundo situado a 180 km de la costa gallega, con una cima situada entre los 650 y los 1.500 m de profundidad y rodeado de zonas abisales de más de 4.000 m de profundidad. El relieve de las montañas submarinas interactúa con la circulación oceánica modificando las condiciones de oligotrofismo imperantes en el mar profundo. El cambio de dirección de las corrientes marinas, al chocar con el banco, produce las llamadas columnas de Taylor que tienen como consecuencia giros sobre la cima y finalmente un enriquecimiento de las aguas que bañan el banco, lo que influye, a través de la cadena trófica, en las especies de cetáceos, aves y tortugas. Estas condiciones, junto al aislamiento de estos bancos, convierten a estos bancos en puntos calientes de biodiversidad. Esta teoría se ha visto corroborada por los estudios realizados en el proyecto INDEMARES, basados en dos campañas de investigación, dónde se ha encontrado una elevada biodiversidad y la presencia de hábitats vulnerables. El banco de Galicia está bañado por tres capas diferentes: la masa de agua central del Atlántico nordeste europeo (East North Atlantic Central Water: ENACW), por debajo de las aguas superficiales y hasta los 500-600 m; la masa de agua mediterránea (Mediterranean Outflow Water: MOW) y la masa de agua del Labrador (Labrador Sea Water: LSW), que es la capa más profunda. En cuanto al tipo de fondo, se encuentra roca en el área del flanco oriental y hacia el sureste y en los montes adyacentes como el Rucabado, distinguiendo claramente dos tipos en cuanto a la pendiente, correspondiendo con la roca plana de la cima y la roca en pendiente del borde del banco y paredes. En la cima se encuentran fondos de arenas medias, de reflectividad media y baja según el espesor de sedimento, y arenas finas en los fondos sedimentaruios de los flancos, a profundidades mayores de 1.500. En el banco se han identificado hasta el momento 793 especies, con taxones que superan las 100 especies como son moluscos, peces (con especial énfasis en los elasmobranquios), crustáceos y cnidarios. Este inventario incluye especies nuevas para la ciencia, primeras citas para aguas españolas y europeas y especies de gran interés científico y biogeográfico. Este último punto se explica por la situación del Banco entre regiones biogeográficas conectadas por corrientes y masas de agua. El estudio de las conexiones tróficas entre este elevado número de especies ha mostrado el reforzamiento de las rutas bentopelágicas (gambas y macrozooplancton) frente a las dietas epi- y endobentónicas más habituales en otros fondos equivalentes. Mediante técnicas de muestreo extractivas (arrastres, dragas) y de vídeo, y su proyección sobre la interpretación geomorfológica realizada a partir de la sonda multihaz, se ha obtenido una estimación de la distribución de los hábitats bentónicos del banco. Los hábitats identificados en fondos sedimentarios son 1) arenas medias con ofiuras Ophiacantidae y Flabellum chunii, 2) arenas medias con arrecife de corales profundos de Lophelia pertusa y/o Madrepora oculata, y 3) arenas finas con holoturias elasipódidas (Benthogone rosea). En fondos rocosos se han caracterizado los hábitats de 4) roca batial sin pendiente con gorgonias y corales negros, 5) roca batial de talud con comunidades de corales y esponjas, 6) roca batial de talud con corales blancos, bambú y negros, gorgonias y esponjas, 7) arrecife de corales profundos de Lophelia pertusa y/o Madrepora oculata y 8) roca con nódulos manganésicos. El único tipo de hábitat de la DH descrito en la zona es el 1.170 (arrecifes). Sólo se han incluido en la Directiva Hábitats como 1.170 aquellos que presentaban una densidad y diversidad suficientes para cumplir la definición de “arrecifes”. De los hábitats descritos en el banco (ver características ecológicas y biológicas más arriba) solo se han incluido en el 1.170 los arrecifes de corales blancos situados en las arenas medias de la cima del banco, los arrecifes de corales blancos de aguas frías de las especies Lophelia pertusa y Madrepora oculata sobre la roca de la cima del monte Rucabado, las comunidades de roca batial de talud de la ladera sur del banco constituidas por colonias de corales blancos de aguas frías de las especies Lophelia pertusa y Madrepora oculata, y una fauna acompañante muy diversa de escleractinias solitarias, corales bambú, corales negros, gorgonias y esponjas de gran porte, y el resto de zonas de roca batial de talud con comunidades de corales y esponjas. Muchos de los hábitats pueden ser incluidos en los listados de hábitat vulnerables de OSPAR, en los tipos jardines de coral, agregaciones de esponjas de profundidad, arrecifes de Lophelia y montículos carbonatados. En cuanto a las especies de interés para la protección, de las citadas en el banco, el delfín mular (Tursiops truncatus) y la tortuga boba (Caretta caretta) son las únicas especies que figuran en el Anexo II de la Directiva de Hábitats. Sin embargo, muchas epecies de elasmobranquis y algunos peces óseos son consideradas vulnerables, amenazadas o en declive según los criterios definidos por OSPAR y la lista roja de especies amenazadas de IUCN. Algunas de están protegidas por el reglamento europeo 1262/2012 que regula la pesca de especies profundas. La lejanía del banco respecto a los principales focos de presión y la ausencia casi total de presión pesquera hace que el grado de conservación sea muy alto, pudiéndose hablar de un ecosistema prácticamente prístino. Las recomendaciones para la gestión de esta zona van encaminadas a garantizar esta calidad ambiental actual.Instituto Español de Oceanografía, Comisión Europea Programa LIFE+, Fundación Biodiversida

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC &gt; 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries