Statistical Machine Learning Methods for the Large Scale Analysis of Neural Data

Modern neurotechnologies enable the recording of neural activity at the scale of entire brains and with single-cell resolution. However, the lack of principled approaches to extract structure from these massive data streams prevent us from fully exploiting the potential of these technologies. This thesis, divided in three parts, introduces new statistical machine learning methods to enable the large-scale analysis of some of these complex neural datasets. In the first part, I present a method that leverages Gaussian quadrature to accelerate inference of neural encoding models from a certain type of observed neural point processes --- spike trains --- resulting in substantial improvements over existing methods. The second part focuses on the simultaneous electrical stimulation and recording of neurons using large electrode arrays. There, identification of neural activity is hindered by stimulation artifacts that are much larger than spikes, and overlap temporally with spikes. To surmount this challenge, I develop an algorithm to infer and cancel this artifact, enabling inference of the neural signal of interest. This algorithm is based on a a bayesian generative model for recordings, where a structured gaussian process is used to represent prior knowledge of the artifact. The algorithm achieves near perfect accuracy and enables the analysis of data hundreds of time faster than previous approaches. The third part is motivated by the problem of inference of neural dynamics in the worm C.elegans: when taking a data-driven approach to this question, e.g., when using whole-brain calcium imaging data, one is faced with the need to match neural recordings to canonical neural identities, in practice resolved by tedious human labor. Alternatively, on a bayesian setup this problem may be cast as posterior inference of a latent permutation. I introduce methods that enable gradient-based approximate posterior inference of permutations, overcoming the difficulties imposed by the combinatorial and discrete nature of this object. Results suggest the feasibility of automating neural identification, and demonstrate variational inference in permutations is a sensible alternative to MCMC

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Modelo estratégico integral para la implementación del Sistema de Gestión de la Seguridad y Salud en el Trabajo (SG-SST) en la Clínica Nuestra Señora de Fátima

Verificación de la situación actual referente al Sistema de Gestión en Seguridad y Salud en el Trabajo (SG-SST) de la Clínica Nuestra Señora de Fátima en la Ciudad de Pasto teniendo en cuenta normatividad vigente a través de la matriz de Evaluación Inicial de Estándares Mínimos, valorando los resultados y priorizando los ítems críticos para luego proceder al desarrollo de una propuesta de mejora junto con un diagrama de Gantt con el fin de que dichos Estándares Mínimos se cumplan al 100% y así desarrollar un modelo estratégico integral para su correcta y efectiva implementación.Verification of the current situation regarding the Occupational Health and Safety Management System (OHSMS) of the Fátima Clinic in Pasto, taking into account the current standard through the Initial Evaluation Matrix of Minimum Standards, valuing the results and prioritizing the elements for the development of an improvement proposal with a Gantt chart with the purpose of these Minimum Standards are fulfilled 100% and thus develop a comprehensive strategic model for its correct and effective implementation

Universidad y sociedad: comunicación, integración y colaboración con empresas e instituciones públicas y organizaciones no lucrativas. Nuevos avances

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Pneumonia treated in the internal medicine department: Focus on healthcare-associated pneumonia

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p<0.001), had poorer functional status (Barthel 100, 30 and 65; p<0.001) and had more risk factors for aspiration pneumonia (18, 50 and 34%; p<0.001). The frequency of testing to establish an aetiological diagnosis was lower among HCAP patients (87, 72 and 79; p<0.001), as was adherence to the therapeutic recommendations of guidelines (70, 23 and 56%; p<0.001). In-hospital mortality increased progressively between CAP, HCAP and HAP (8, 19 and 27%; p<0.001). Streptococcus pneumoniae was the main pathogen in CAP and HCAP. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) caused 17 and 12.3% of HCAP. In patients with a confirmed aetiological diagnosis, the independent risk factors for pneumonia due do difficult-to-treat microorganisms (Enterobacteriaceae, P. aeruginosa or MRSA) were HCAP, chronic obstructive pulmonary diseases and higher Port Severity Index. Our data confirm the importance of maintaining high awareness of HCAP among patients treated in IMDs, because of the different aetiologies, therapy requirements and prognosis of this population. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases