Breast Cancer Detection by Means of Artificial Neural Networks

Breast cancer is a fatal disease causing high mortality in women. Constant efforts are being made for creating more efficient techniques for early and accurate diagnosis. Classical methods require oncologists to examine the breast lesions for detection and classification of various stages of cancer. Such manual attempts are time consuming and inefficient in many cases. Hence, there is a need for efficient methods that diagnoses the cancerous cells without human involvement with high accuracies. In this research, image processing techniques were used to develop imaging biomarkers through mammography analysis and based on artificial intelligence technology aiming to detect breast cancer in early stages to support diagnosis and prioritization of high-risk patients. For automatic classification of breast cancer on mammograms, a generalized regression artificial neural network was trained and tested to separate malignant and benign tumors reaching an accuracy of 95.83%. With the biomarker and trained neural net, a computer-aided diagnosis system is being designed. The results obtained show that generalized regression artificial neural network is a promising and robust system for breast cancer detection. The Laboratorio de Innovacion y Desarrollo Tecnologico en Inteligencia Artificial is seeking collaboration with research groups interested in validating the technology being developed

El modelo 1 a 1 en las Escuelas Secundarias. Un estudio a partir de la experiencia de las provincias de Entre Ríos, Formosa y Misiones. 16H362

En el Marco del Convenio de Cooperación, N° 375/12, suscripto entre la Universidad Nacional de Misiones, el Ministerio de Educación de la Nación y la Organización de Estados Iberoamericanos (OEI), el presente proyecto pretende conocer y analizar los cambios y/o continuidades que se estarían produciendo en las aulas, instituciones, sujetos y comunidades de las provincias de Entre Ríos, Formosa y Misiones, a partir de la implementación del Programa Conectar Igualdad. Programa que resulta ser uno de los principales pilares y referentes significativos de un nuevo perfil de política educativa, por parte de un estado nacional que asume su centralidad y responsabilidad como garante del derecho a la educación y la inclusión social, educativa y digital. Cuyo fin, en última instancia, es la revalorización de la escuela pública, a partir de la promoción de la inclusión digital y el mejoramiento de la calidad de la educación, garantizando el acceso y uso de las TIC’s en los procesos de enseñanza-aprendizaje

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Investigación en Matemáticas, Economía, Ciencias Sociales y Agronomía

Cada trabajo del libro incluye conclusiones para los interesados en las temáticas aludidas y en ellos nos enteramos de aspectos como los siguientes: - El mayor incremento del precio de los insumos como el maíz, sorgo y en menor medida desperdicio de pan, en relación con el menor crecimiento del precio del ganado en pie, dará como consecuencia un desabasto de carne bovina. - El agua es un recurso primordial en las zonas áridas y semiáridas de México, en tanto que su aporte limita la producción de la agricultura. En este estudio se observó que el precio real del agua es muy bajo en relación a otras zonas agrícolas del mundo. - Hoy en día en el país se consumen alrededor de 718 mil barriles diarios de gasolinas, un aproximado de 113.7 millones de litros, una cantidad tan grande que nuestro país se ve en la necesidad de importar cerca del 39 % de las gasolinas que consumimos. - Los jaliscienses radicados en Estados Unidos tienen una mayor capacidad de financiamiento del bienestar en la entidad, que el propio gobierno de ese estado. - México continuará basando sus finanzas públicas y su política de desarrollo económico en la extracción de combustibles fósiles (petróleo). Este modelo acelerará el deterioro y agotamiento de los recursos naturales. -La importancia de la agricultura orgánica radica en que retoma los tres ámbitos de la sustentabilidad; el ámbito ambiental, el económico y el social. - Es fundamental motivar la organización de los productores de haba para que ellos puedan captar una mayor proporción de los altos márgenes de precios que los consumidores están dispuestos a pagar. - Las condiciones del clima afectan a la producción agraria. Debido al fenómeno de cambio climático, es necesario contar con herramientas informáticas que proporcionen información climatológica para poder tomar medidas preventivas a favor de una mayor cantidad y calidad de producción. La herramienta de software permite la consulta del clima por localidades evitando la necesidad de contar con una estación meteorológica

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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

Avances del INTA en la silvicultura clonal de Eucalyptus grandis en la Mesopotamia Argentina

Se presentan los resultados de ensayos de manejo de plantaciones clonales en Corrientes y Entre Ríos, donde se evaluaron respuestas a espaciamientos iniciales, al raleo y a la fertilización inicial. En el sudeste de Corrientes y Entre Ríos los espaciamientos evaluados fueron 4 m entre líneas y 1,5, 2,25, 2,5, 3, 4, 5, 6, y 9 m entre plantas, y en el centro-sudoeste de Corrientes 7x2,3, 5x2,8 y 4x3 m (1667, 1111, 1000, 833, 714, 625, 613, 500, 417 y 278 plantas por hectárea). Se evaluaron clones de INTA, CIEF, Tapebicua y Pomera, diferentes en sus características fenotípicas, y en algunos ensayos se incluyó material de semilla para comparación con los clones. Los raleos se aplicaron a 40-50 % de las plantas, en plantaciones clonales a 4x2,5 m. Se evaluó también la respuesta en altura y daño por heladas de 5 clones comerciales a 27 tratamientos de fertilización NPK en un suelo arcilloso.EEA Bella VistaEEA ConcordiaFil: Caniza, Federico Javier. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bella Vista; ArgentinaFil: Garcia, Maria De Los Angeles. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concordia; ArgentinaFil: Aparicio, Jorge Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bella Vista; ArgentinaFil: De La Peña, Carlos Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concordia; ArgentinaFil: Mastrandrea, Ciro Andres. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concordia; ArgentinaFil: Flores Palenzona, Mario. Ministerio de Agricultura, Ganadería y Pesca de la Nación. Subsecretaría de Desarrollo Foresto Industrial; ArgentinaFil: Barrios, Maria Fernanda. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concordia; ArgentinaFil: Matinez, Matías S. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concordia; Argentin

Smart trees. Reusing UMA´s waste: un árbol biotecnológico para mejorar entornos docentes universitarios y ofrecer servicios conectivos

Resumen en inglés: At present, climate change will affect not only natural ecosystems, but also strongly threatens our urban environment, so mitigation work is necessary in our cities. Aware of this, the Smart Campus Vice-Rectorate of the University of Malaga (UMA) is working to make its Campus more environmentally friendly, sustainable, more technological, healthier and friendlier. Within this idea, the project presented here, framed within SDG 13 (Climate Action) is called “Smart-tree”. This is aimed at creating a relaxed and friendly co-working space, where nature (mainly plants) provides a microclimate of environmental and sensory comfort, and access technology to renewable energy and information is able. At the same time, the space is also intended to generate a friendly green atmosphere of leisure and recreation. It is widely known and proven that the benefits provided by green spaces to citizens are multiple: reduction of noise pollution, increase in evapotranspiration, decrease in wind when making a barrier effect, increase in the biodiversity of the area and increase in perceptual and sensory quality (landscape, environmental, aesthetic and aromatic qualities). The development of the project is being carried out by an interdisciplinary group of professors from the university knowledge areas of Architecture, Communications Engineering, Industrial Engineering Design and Botany, as well as students (through the elaboration of their final degrees works and final projects of Master) in the surroundings of the Teatinos Campus of the UMA (Malaga city, Spain). The structure of the Smart-Tree and its furniture have been designed to be built, based on the “re-using” of campus materials that have exhausted their first useful life (circular economy). For this, a catalogue of obsolete materials has been made, from both the different centres and the warehouses that the UMA has available and where there is material that can be used again. Therefore, it is possible to increase the life cycle of the products and decrease the use of new resources, achieving eco-efficiency in an nZEB (“Nearly Zero Energy Buildings”) prototype. In order to create the space and therefore provide it with plants that generate a new environmental and sensory microclimate, a proposal based on the use of primarily native flora has been developed and also considering the water requirement, maintenance needs, functionality, moments were flowering occurs and the ability to fix carbon. Taking all this into account, and through the use of Geographic Information Systems (GIS), the design of the most optimal nature tuning of the structure and surrounding area has been developed. The Smart-Tree also belongs to the IoT (Internet Of Things) and Smart-Campus paradigms, with the aim of apply the potential of Information and Communication Technologies (ICT) to monitor and guide its management in an efficient and ecological way. In this way, the necessary mechanisms for the monitoring of various environmental and energy variables through a near-range IoT system have been established in the Smart-Tree. This system has been designed based on the modification and appropriate hardware for the measurement of the desired variables and a system that allows the visualization of this information obtained in a web address. A small photovoltaic solar installation has also been defined in line with the nature of the project, which will provide infrastructure users with access to clean and sustainable electricity, in addition to meeting the energy needs of the aforementioned data collection system. As a result, the Smart-Tree space is being built in the environment of the Faculty of Sciences of the UMA, under the environmental and sustainability premises pursued. Specifically, the space has been located in the NW area of the Faculty, next to the Central Research Support Services (SCAI) and is in the assembly phase.En la actualidad, el cambio climático amenaza no sólo a los ecosistemas naturales, también a nuestro entorno urbano, por lo que se hace necesaria una labor de mitigación de éste en las ciudades. Conscientes de ello, desde la UMA se está trabajando por hacer un Campus más sostenible, más saludable y más tecnológico. Dentro de esa idea, surge el proyecto presentado, enmarcado dentro del ODS 13 denominado como “SMART-TREE”. Éste tiene por objetivo la creación de un espacio de “co-working”, que aporte un microclima de confort ambiental y sensorial, y la tecnología de acceso a las energías renovables y a la información. A la vez, también se pretende que el espacio contenga una atmósfera verde (fundamentalmente a base de plantas). El espacio se está ejecutando en el entorno de la Facultad de ciencias de la UMA y está siendo construido a través de materiales reutilizados (economía circular). El espacio está siendo naturado, dotándolo de plantas que generen un nuevo microclima ambiental y sensorial. Se ha elaborado una propuesta basada en la utilización de flora fundamentalmente autóctona y se atendió al requerimiento hídrico, las necesidades de mantenimiento, la funcionalidad, los momentos de floración. También se está dotando de toda la teconología TIC necesaria dentro de los despliegues de IoT (Internet Of Things) y Smart-Campus, con el objetivo de aprovechar las potencialidades TIC para monitorizar y guiar la gestión del mismo de un modo eficiente y ecológico. Este sistema ha sido diseñado partiendo de la determinación y hardware adecuado para la medición de las variables deseadas y un sistema que permite la visualización de esta información obtenida en una dirección web. También se ha dimensionado una pequeña instalación solar fotovoltaica, que proporcionará a los usuarios de la infraestructura el acceso a energía eléctrica limpia y sostenible, además de satisfacer las necesidades energéticas del sistema de toma de datos.Ayuda del Plan Propio de Investigación de la UMA: va a servir para justificar su solicitud, debe incluir en este campo: Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Usefulness of Early Treatment With Melatonin to Reduce Infarct Size in Patients With ST-Segment Elevation Myocardial Infarction Receiving Percutaneous Coronary Intervention (From the Melatonin Adjunct in the Acute Myocardial Infarction Treated With Angioplasty Trial)

Melatonin, an endogenously produced hormone, might potentially limit the ischemia reperfusion injury and improve the efficacy of mechanical reperfusion with primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI). This study was aimed to evaluate whether the treatment effect of melatonin therapy in patients with STEMI is influenced by the time to administration. We performed a post hoc analysis of the Melatonin Adjunct in the Acute Myocardial Infarction Treated With Angioplasty trial (NCT00640094), which randomized STEMI patients to melatonin (intravenous and intracoronary bolus) or placebo during pPCI. Randomized patients were divided into tertiles according to symptoms onset to balloon time: first tertile (136 ± 23 minutes), second tertile (196 ± 19 minutes), and third tertile (249 ± 41 minutes). Magnetic resonance imaging was performed within 1 week after pPCI. A total of 146 patients presenting with STEMI within 360 minutes of chest pain onset were randomly allocated to intravenous and intracoronary melatonin or placebo during pPCI. In the first tertile, the infarct size was significantly smaller in the melatonin-treated subjects compared with placebo (14.6 ± 14.2 vs 24.9 ± 9.0%; p = 0.003). Contrariwise, treatment with melatonin was associated with a larger infarct size in the group of patients included in the third tertile (20.5 ± 8.7% vs 11.2 ± 5.2%; p = 0.001), resulting in a significant interaction (p = 0.001). In conclusion, the administration of melatonin in patients with STEMI who presented early after symptom onset was associated with a significant reduction in the infarct size after pPCI