Error-Correcting Output Codes in the Framework of Deep Ordinal Classification

Automatic classification tasks on structured data have been revolutionized by Convolutional Neural Networks (CNNs), but the focus has been on binary and nominal classification tasks. Only recently, ordinal classification (where class labels present a natural ordering) has been tackled through the framework of CNNs. Also, ordinal classification datasets commonly present a high imbalance in the number of samples of each class, making it an even harder problem. Focus should be shifted from classic classification metrics towards per-class metrics (like AUC or Sensitivity) and rank agreement metrics (like Cohen’s Kappa or Spearman’s rank correlation coefficient). We present a new CNN architecture based on the Ordinal Binary Decomposition (OBD) technique using Error-Correcting Output Codes (ECOC). We aim to show experimentally, using four different CNN architectures and two ordinal classification datasets, that the OBD+ECOC methodology significantly improves the mean results on the relevant ordinal and class-balancing metrics. The proposed method is able to outperform a nominal approach as well as already existing ordinal approaches, achieving a mean performance of RMSE=1.0797 for the Retinopathy dataset and RMSE=1.1237 for the Adience dataset averaged over 4 different architectures

Perceived quality of basketball spectators : a measurement scale validation

The aim of the study was to obtain a valid, reliable and reduced measurement scale of basketball spectators. Trough application of structural equation modelling Eventqual scale was reduced to nine items and three dimensions with good indexes of reliability and validity. The resulting factor structure determined the tangibles, the personnel and the complementary services as quality dimensions for basketball spectators.El objetivo del presente estudio fue obtener una escala de calidad percibida por los espectadores de baloncesto válida, fiable y reducida. Mediante la aplicación de modelos de ecuaciones estructurales se redujo la escala Eventqual a nueve ítems y tres dimensiones con buenos indicadores de fiabilidad y validez. La estructura factorial resultante determinó como dimensiones de calidad para los espectadores de baloncesto a los tangibles, el personal y los servicios complementarios.O objetivo deste estudo foi obter uma escala de qualidade percebida pelos espectadores de basquetebol válida, fiável e reduzida. Através da aplicação de modelos de equações estruturais reduziu-se a escala Eventqual a nove itens e três dimensões, com bons indicadores de fidelidade e validade. A estrutura factorial resultante determinou como dimensões de qualidade para os telespectadores de basquetebol tangível, o pessoal e os serviços complementares

Impact of infectious mononucleosis in a second level hospital

Objetivo: Conocer la repercusión de la enfermedad en un hospital de segundo nivel asistencial, cuáles son los signos y síntomas que presentan los pacientes ingresados, cuáles son los tratamientos habitualmente administrados y a cargo de que servicios ingresan. Material y métodos: Estudio observacional realizado sobre la población que acudió al servicio de Urgencias del Hospital Rafael Méndez de Lorca entre el 1 de enero del 2011 y el 31 de diciembre del 2019 con diagnóstico de mononucleosis infecciosa. Obtenida la muestra se recogieron las variables tanto clínicas como analíticas necesarias de las historias clínicas. Resultados: 600 pacientes acudieron a urgencias con diagnóstico clínico de mononucleosis infecciosa, lo que supone una incidencia de 0,4 casos por 1000 habitantes/año. La tasa de ingreso fue de 0,026/1000 habitantes con una edad media de 16.8 ± 9.26 años, siendo el 57,1% mujeres. La serología fue positiva para Epstein-Bar en 29 pacientes, positiva para citomegalovirus en 1 paciente y negativa para ambos en 12 pacientes. Los síntomas más frecuentemente presentados fueron fiebre (66,7%), odinofagia (73,3%) y disfagia (62,7%). Se observo alteración de las enzimas hepáticas en un 81,6%. Los ingresos fueron realizados por medicina interna (44,4%), otorrinolaringología (33,3%) y pediatría (16,7%). El 55.5% (25) de los pacientes, estaba en tratamiento con antibióticos en el momento del ingreso. Conclusión: La mononucleosis suele cursar con cuadros leves con bajas tasas de ingreso hospitalario. La astenia ha mostrado ser, de forma significativa, un síntoma ligado a la mononucleosis por VEB en nuestra muestra. La neutropenia, la trombocitopenia y la elevación de las transaminasas son los rasgos analíticos más distintivos de la mononucleosis infecciosa por VEB en nuestra muestra. La formación de los médicos de atención primaria sería útil para evitar el uso de antibióticos innecesarios.Objective: To know the impact of the disease in a second level care hospital, which are the signs and symptoms shown by infected patients, which are the treatments usually administrated and which services are admitted. Material and methods: Retrospective descriptive analytical study among the population attending the Emergency service of Rafael Méndez Hospital of Lorca between January 1st 2011 and December 31st 2019 with an infectious mononucleosis diagnosis. Once the sample was obtained, the necessary clinical and analytical variables were collected from the clinical records. Results: 600 patients attended to the emergency service with a clinical diagnosis of infectious mononucleosis, which supposes an incidence of 0.4 cases each 1000 habitants per year. 42 patients with a middle age from 16.8 ± 9.26 years old were included, being 57.1% women. The serology for Epstein-Bar was positive on 29 patients, positive for cytomegalovirus on 1 patient and negative for both on 12 patients. The most frequent symptoms presented were fever (66.7%), odynophagia (73.3%) and dysphagia (62.7%). The alteration of the hepatic enzymes was observed on an 81.6%. Admission were made by internal medicine (44.4%), otorhinolaryngology (33.3%) and paediatrics (16.7%). The 55.5% (25) of patients was following a treatment with antibiotics at the moment of the admission. Conclusion: Mononucleosis usually presents mild symptoms and low rates of hospital admission. Asthenia has showed, in a significant way, a symptom linked to EBV mononucleosis. Neutropenia, thrombocytopenia, and elevated transaminases are the most distinctive laboratory features in EBV infectious mononucleosis. Training of primary care physicians would be useful in order to avoid the use of unnecessary antibiotic

Spontaneous tonsillar hemorrhage as initial presentation of acute promyelocytic myeloid leukemia

Actualmente, la hemorragia espontánea amigdalar es un signo faríngeo muy infrecuente. Su etiología habitual se relaciona con la amigdalitis crónica y su tratamiento suele ser local y sintomático. El caso clínico que presentamos refuerza la importancia del estudio integral del paciente con hemorragia espontánea amigdalar, ya que, puede ser la presentación inicial de enfermedades hematológicas graves.Currently, spontaneous tonsillar hemorrhage is a very uncommon pharyngeal sign. Its etiology is usually related to chronic tonsillitis and its treatment uses to be local and symptomatic. The case that we report reinforces the importance of the global study of the patient with spontaneous tonsillar hemorrhage because it can be the initial presentation of serious hematologic diseases

Health-related quality of life in men with localized prostate cancer treated with radiotherapy: validation of an abbreviated version of the Expanded Prostate Cancer Index Composite for Clinical Practice in Spain

Cáncer de próstata; Evaluación de la calidad de vida; RadioterapiaCàncer de pròstata; Avaluació de la qualitat de vida; RadioteràpiaProstate cancer; Quality-of-life assessment; RadiotherapyBackground Health-related quality of life (HRQoL) is greatly affected by prostate cancer (PCa) and associated treatments. This study aimed to measure the impact of radiotherapy on HRQoL and to further validate the Spanish version of the 16-item Expanded Prostate Cancer Index Composite (EPIC-16) in routine clinical practice. Methods An observational, non-interventional, multicenter study was conducted in Spain with localized PCa patients initiating treatment with external beam radiotherapy (EBRT) or brachytherapy (BQT). Changes from baseline in EPIC-16, University of California-Los Angeles Prostate Cancer Index (UCLA-PCI), and patient-perceived health status were longitudinally assessed at end of radiotherapy (V2) and 90 days thereafter (V3). Psychometric evaluations of the Spanish EPIC-16 were conducted. Results Of 516 patients enrolled, 495 were included in the analysis (EBRT, n = 361; BQT, n = 134). At baseline, mean (standard deviation [SD]) EPIC-16 global scores were 11.9 (7.5) and 10.3 (7.7) for EBRT and BQT patients, respectively; scores increased, i.e., HRQoL worsened, from baseline, by mean (SD) of 6.8 (7.6) at V2 and 2.4 (7.4) at V3 for EBRT and 4.2 (7.6) and 3.9 (8.2) for BQT patients. Changes in Spanish EPIC-16 domains correlated well with urinary, bowel, and sexual UCLA-PCI domains. EPIC-16 showed good internal consistency (Cronbach’s alpha = .84), reliability, and construct validity. Conclusion The Spanish EPIC-16 questionnaire demonstrated sensitivity, strong discriminative properties and reliability, and validity for use in clinical practice. EPIC-16 scores worsened after radiotherapy in different HRQoL domains; however, a strong tendency towards recovery was seen at the 3-month follow-up visit.This study was funded by Astellas Pharma Inc

An ordinal CNN approach for the assessment of neurological damage in Parkinson’s disease patients

3D image scans are an assessment tool for neurological damage in Parkinson’s disease (PD) patients. This diagnosis process can be automatized to help medical staff through Decision Support Systems (DSSs), and Convolutional Neural Networks (CNNs) are good candidates, because they are effective when applied to spatial data. This paper proposes a 3D CNN ordinal model for assessing the level or neurological damage in PD patients. Given that CNNs need large datasets to achieve acceptable performance, a data augmentation method is adapted to work with spatial data. We consider the Ordinal Graph-based Oversampling via Shortest Paths (OGO-SP) method, which applies a gamma probability distribution for inter-class data generation. A modification of OGO-SP is proposed, the OGO-SP- algorithm, which applies the beta distribution for generating synthetic samples in the inter-class region, a better suited distribution when compared to gamma. The evaluation of the different methods is based on a novel 3D image dataset provided by the Hospital Universitario ‘Reina Sofía’ (Córdoba, Spain). We show how the ordinal methodology improves the performance with respect to the nominal one, and how OGO-SP- yields better performance than OGO-SP

Atypical location of Schwannoma in Maxilla sinus

El schwannoma es tumor de que se localiza en cabeza y cuello en la mitad de los casos. La localización más frecuente es el VIII par craneal generando hipoacusia y vértigo. El tratamiento consiste en la exéresis quirúrgica. A continuación exponemos una localización rara de este tumor, el seno maxilar. La clínica consiste en cefalea e insuficiencia respiratoria nasal. No existe consenso sobre la vía de abordaje para la cirugía. En nuestro caso nos decantamos por una vía combinada: cirugía endoscópica nasosinusal (CENS) con cirugía abierta mediante antrostomia de Cadwel-Luc.Schwannoma is a tumor located in the head and neck in the middle of casos.The most frequent location is the eighth cranial nerve causing hearing loss and tinnitus. The treatment is surgical excision. Below are a rare location for this tumor, maxillary sinus. Causes of headache and nasal respiratory failure. There is no consensus on the approach to surgery. We opted for combined surgery: endoscopic sinus surgery (FESS) by external surgery of Cadwel-Luc antrostom

Economic impact of pharyngocutaneou fistulae in patients laryngectomy

Objetivo: Analizar el impacto económico derivado de la hospitalización de los pacientes con fístulas faringocutá- neas (FFC) como principal evento adverso tras laringectomía total entre los años 2006 y 2011 en un hospital de segundo nivel. Método: Cálculo estimado de los costes directos generados por la FFC mediante el Grupo de Diagnóstico Relacionado (GRD) y aplicación corporativa de contabilidad analítica del Servicio Andaluz de Salud (COAN h y d) para los años mencionados. Resultados: Entre 2006 y 2011 el coste de todos pacientes con FFC fue de 3.210.586,9€, a diferencia de 1.282.708,5€ para los que no cursaron esta complicación. El coste individual en el período de estudio fue 94.429,0.26€ en las FFC y 35.630,777€ en los que no la tuvieron. Los afectados registraron un incremento de 2,66 veces en el gasto sanitario. Conclusión: La aparición de FFC tras laringectomía supone un coste elevado para el hospital y la organización sanitaria. Se deben plantear estrategias preventivas que minimicen el impacto económico de este evento adverso.Objective: To analyze the economic impact of hospitalization of patients with fistulas pharyngocutaneous (FFC) as the main adverse event after total laryngectomy between 2006 and 2011 in a secondary hospital. Method: Calculate estimated direct costs generated by the FFC using Diagnosis Related Group (DRG) and cost accounting corporate application Andalusian Health Service (COAN hyd) for those years. Results: Between 2006 and 2011 the cost of all patients was € 3,210,586.9 FFC, unlike € 1,282,708.5 for those who missed out this complication. The individual cost in the study period was € 94.429,0.26 in FFC and € 35,630.777 in those without it. The patients had an increase of 2.66 times in health spending. Conclusion: The occurrence of FFC after laryngectomy involves a high cost for the hospital and healthcare organization. Preventive strategies must be implemented to minimize the economic impact of this adverse event

The nanomechanics of neurotoxina proteins reveals common features at the start of the neurodegeneration cascade.

1 pags. -- 56th Annual Meeting of the Biophysical-Society, FEB 25-29, 2012, San Diego, CAAmyloidogenic neurodegenerative diseases are incurable conditions caused by specific largely disordered proteins. However, the underlying molecular mechanism remains elusive. A favored hypothesis postulates that a critical conformational change in the monomer (an ideal therapeutic target) in these ‘‘neurotoxic proteins’’ triggers the pathogenic cascade. Using force spectroscopy with unequivocal singlemolecule identification we demonstrate a rich conformational polymorphism at their monomer level. This polymorphism strongly correlates with amyloidogenesis and neurotoxicity: it is absent in a fibrillization-incompetent mutant, favored by familial-disease mutations and diminished by a surprisingly promiscuous inhibitor of the monomeric b-conformational change and neurodegeneration. The demonstrated ability to inhibit the conformational heterogeneity of these proteins by a single pharmacological agent reveals common features in the monomer and suggests a common pathway to diagnose, prevent, halt or reverse multiple neurodegenerative disease