Oncoaudit: development and evaluation of an application for nurse auditors

Objective:To develop a web and mobile device application to search for chemotherapy drugs to support nursing audits of hospital bills and to evaluate user satisfaction and tool usability.Methods:Research of technological production for development of an application for web and mobile technology. The product was evaluated by nurse auditors using the System Usability Scale questionnaire. It was also evalutated by health informactics professionals using Nielsen's heuristics.Results: The application is available at http://telemedicina6.unifesp.br/projeto/oncoaudit. The mobile version can be is accessed at http://play.google.com/intl/pt-BR/about/index.html. Nurse evalaution indicated that the web and mobile versions addressed user needs. In the usability evaluation, 14 problems were identified in the mobile version and eight in the web system. Implementation of improvements according to the evaluation findings were made in both versions.Conclusion: The methods for development and evaluation were adequate to achieve the proposed objective.Objetivo: Desenvolver aplicativo de consulta de medicamentos quimioterápicos para sistema web e dispositivo móvel para auxiliar na auditoria em enfermagem de contas hospitalares e avaliar quanto a satisfação do usuário e usabilidade.Métodos: Pesquisa de produção tecnológica contendo desenvolvimento de aplicativo web e para tecnologia móvel. O produto foi avaliado quanto à satisfação por enfermeiros auditores utilizando o questionário System Usability Scale (SUS) e quanto à usabilidade pelas heurísticas de Nielsen, por profissionais de informática em saúde.Resultados: O aplicativo esta disponível no http://telemedicina6.unifesp.br/projeto/oncoaudit. O aplicativo móvel pode ser acessado em http://play.google.com/intl/pt-BR/about/index.html. A avaliação pelos enfermeiros indicou que o aplicativo web e móvel estão de acordo com as necessidades dos usuários. Na avaliação de usabilidade foram identificados 14 problemas no aplicativo móvel e oito no sistema web, gerando modificações am ambos.Conclusão: Os métodos escolhidos para desenvolvimento e avaliação mostraram-se satisfatórios para atingir os objetivos propostos.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP)UNIFESP, Escola Paulista de Enfermagem (EPE)SciEL

Análise computadorizada do ronco na síndrome da apneia do sono

The International Classification of Sleep Disorders lists 90 disorders. Manifestations, such as snoring, are important signs in the diagnosis of the Obstructive Sleep Apnea Syndrome; they are also socially undesirable. OBJECTIVE: The aim of this paper was to present and evaluate a computerized tool that automatically identifies snoring and highlights the importance of establishing the duration of each snoring event in OSA patients. MATERIAL AND METHODS: The low-sampling (200 Hz) electrical signal that indicates snoring was measured during polysomnography. The snoring sound of 31 patients was automatically classified by the software. The Kappa approach was applied to measure agreement between the automatic detection software and a trained observer. Student's T test was applied to evaluate differences in the duration of snoring episodes among simple snorers and OSA snorers. RESULTS: Of a total 43,976 snoring episodes, the software sensitivity was 99. 26%, the specificity was 97. 35%, and Kappa was 0. 96. We found a statistically significant difference (p <0. 0001) in the duration of snoring episodes (simple snoring x OSA snorers). CONCLUSIONS: This computer software makes it easier to generate quantitative reports of snoring, thereby reducing manual laborA classificação internacional de distúrbios do sono enumera aproximadamente 90 distúrbios. Manifestações, como o ronco, são um sinal no diagnóstico da Síndrome da Apneia Obstrutiva, além de ser um incômodo social. OBJETIVO: O objetivo deste artigo é apresentar e avaliar a ferramenta computacional que identifica o ronco automaticamente e destacar a importância da quantificação da duração de cada evento do ronco em pacientes com SAHOS. MATERIAL E MÉTODOS: O sinal elétrico que representa o ronco de baixa amostragem (200 hz) foi captado enquanto os pacientes eram submetidos à polissonografia. O sinal do ronco dos 31 pacientes foi classificado pelo programa computacional automaticamente. Utilizamos o valor de Kappa para avaliar a concordância entre o programa de detecção automática e o observador treinado (teste t-student). Avaliamos a diferença da duração dos episódios de ronco entre simples roncadores e roncadores com SAOS. RESULTADOS: De um total de 43,976 roncos, o programa computacional obteve uma sensibilidade de 99,26%, especificidade de 97,35% e Kappa de 0,96. Foi observada diferença estatística significante (p<0,0001) na duração de episódios de ronco (simples roncadores x roncadores com SAOS). CONCLUSÃO: Este programa computacional facilita a criação de relatórios quantitativos do ronco, oferecendo redução do trabalho manualInstituto Federal de Educação Tecnológica de São PauloUNIFESP Health Informatics Department graduate programUNIFESP, Health Informatics Department graduate programSciEL

Transfer learning in wastewater treatment plant control design : from conventional to long short-term memory-based controllers

In the last decade, industrial environments have been experiencing a change in their control processes. It is more frequent that control strategies adopt Artificial Neural Networks (ANNs) to support control operations, or even as the main control structure. Thus, control structures can be directly obtained from input and output measurements without requiring a huge knowledge of the processes under control. However, ANNs have to be designed, implemented, and trained, which can become complex and time-demanding processes. This can be alleviated by means of Transfer Learning (TL) methodologies, where the knowledge obtained from a unique ANN is transferred to the remaining nets reducing the ANN design time. From the control viewpoint, the first ANN can be easily obtained and then transferred to the remaining control loops. In this manuscript, the application of TL methodologies to design and implement the control loops of a Wastewater Treatment Plant (WWTP) is analysed. Results show that the adoption of this TL-based methodology allows the development of new control loops without requiring a huge knowledge of the processes under control. Besides, a wide improvement in terms of the control performance with respect to conventional control structures is also obtained. For instance, results have shown that less oscillations in the tracking of desired set-points are produced by achieving improvements in the Integrated Absolute Error and Integrated Square Error which go from 40.17% to 94.29% and from 34.27% to 99.71%, respectively

Denoising Autoencoders and LSTM-Based Artificial Neural Networks Data Processing for Its Application to Internal Model Control in Industrial Environments-The Wastewater Treatment Plant Control Case

Altres ajuts: Secretaria d'Universitats i Recerca del Departament d'Empresa i Coneixement de la Generalitat de Catalunya i del Fons Social Europeu (2020 FI_B2 000)The evolution of industry towards the Industry 4.0 paradigm has become a reality where different data-driven methods are adopted to support industrial processes. One of them corresponds to Artificial Neural Networks (ANNs), which are able to model highly complex and non-linear processes. This motivates their adoption as part of new data-driven based control strategies. The ANN-based Internal Model Controller (ANN-based IMC) is an example which takes advantage of the ANNs characteristics by modelling the direct and inverse relationships of the process under control with them. This approach has been implemented in Wastewater Treatment Plants (WWTP), where results show a significant improvement on control performance metrics with respect to (w.r.t.) the WWTP default control strategy. However, this structure is very sensible to non-desired effects in the measurements-when a real scenario showing noise-corrupted data is considered, the control performance drops. To solve this, a new ANN-based IMC approach is designed with a two-fold objective, improve the control performance and denoise the noise-corrupted measurements to reduce the performance degradation. Results show that the proposed structure improves the control metrics, (the Integrated Absolute Error (IAE) and the Integrated Squared Error (ISE)), around a 21.25% and a 54.64%, respectively

Evaluation of a ophthalmology learning support for handheld computer for medical students

OBJECTIVE: In the last decade the handheld computers have been popularized among health professionals, on the USA, for instance, among 60-70% of medical students already use them. Make clinical information available on these devices can aid teaching medical practices, however, the way they are structured may influence students' satisfaction and learning. The purpose of this paper is to present MDFluxo evaluation, a program developed in handheld computers to aid ophthalmology teaching. METHODS: The program was developed with structured flowcharts extracted from The Ophthalmology Guide book. The assessment was placed comparing 20 medical under-graduating students' performance solving clinical cases aided by the program, a book, or no material. RESULTS: The results shown that the performance of students in the evaluation with book was equivalent to MDFluxo in etiology (p <0.01) and conduct (p <0.05) on clinical cases solving and better performance than without the use any material. CONCLUSION: On MDFluxo user satisfaction evaluation 82.5% of students approved it's use on clinical case solving.OBJETIVO: Na última década os computadores de mão se popularizaram entre profissionais da saúde. Nos EUA, por exemplo, cerca de 60-70% dos estudantes de medicina já os utilizam. A disponibilização de informação clínica nestes dispositivos pode auxiliar no ensino de práticas médicas, no entanto, a maneira como são estruturadas pode influenciar na satisfação e no aprendizado dos alunos. Portanto, este artigo objetiva apresentar os resultados da avaliação do MDFluxo: um programa para auxílio ao ensino de oftalmologia em computadores de mão. MÉTODOS: O programa foi desenvolvido com fluxogramas estruturados, extraídos do Guia de Oftalmologia da Universidade Federal de São Paulo (UNIFESP). A avaliação foi realizada, comparando o desempenho de 20 estudantes de medicina na solução de casos clínicos, utilizando o programa, o livro ou nenhum material. RESULTADOS: Os resultados mostram que o desempenho dos estudantes na avaliação com o livro foi equivalente ao MDFluxo nas questões sobre etiologia (p<0,01) e conduta (p<0,05) na solução dos casos clínicos, desempenho melhor do que sem a utilização de nenhum material. CONCLUSÃO: Na avaliação de satisfação com o uso do programa 82,5% dos estudantes aprovou sua utilização na solução de casos clínicos.Universidade Federal de São Paulo (UNIFESP) Departamento de InformáticaUniversidade Federal de São Paulo (UNIFESP) , Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Informática em SaúdeUNIFESP, Depto. de InformáticaUNIFESP, , Depto. de OftalmologiaUNIFESP, Depto. de OftalmologiaUNIFESP, Depto. de Informática em SaúdeSciEL

LSTM-Based Wastewater Treatment Plants Operation Strategies for Effluent Quality Improvement

Wastewater Treatment Plants (WWTPs) are facilities devoted to managing and reducing the pollutant concentrations present in the urban residual waters. Some of them consist in nitrogen and phosphorus derived products which are harmful for the environment. Consequently, certain constraints are applied to pollutant concentrations in order to make sure that treated waters comply with the established regulations. In that sense, efforts have been applied to the development of control strategies that help in the pollutant reduction tasks. Furthermore, the appearance of Artificial Neural Networks (ANNs) has encouraged the adoption of predictive control strategies. In such a fashion, this work is mainly focused on the adoption and development of them to actuate over the pollutant concentrations only when predictions of effluents determine that violations will be produced. In that manner, the overall WWTP's operational costs can be reduced. Predictions are generated by means of an ANN-based Soft-Sensor which adopts Long-Short Term Memory cells to predict effluent pollutant levels. These are the ammonium (S-{NH,e}) and the total nitrogen (S-{Ntot,e}) which are predicted considering influent parameters such as the ammonium concentration at the entrance of the WWTP reactor tanks (S-{NH,po}), the reactors' input flow rate (Q-{po}), the WWTP recirculation rate (Q-{a}) and the environmental temperature (T-{as}). Moreover, this work presents a new multi-objective control scenario which consists in a unique control structure performing the reduction of S-{NH,e} and S-{Ntot,e} concentrations simultaneously. Performance of this new control approach is contrasted with other strategies to determine the improvement provided by the ANN-based Soft-Sensor as well as by the fact of being controlling two pollutants at the same time. Results show that some brief and small violations are still produced. Nevertheless, an improvement in the WWTPs performance w.r.t.The most common control strategies around 96.58% and 98.31% is achieved for S-{NH,e} and S-{Ntot,e}, respectively

Aplicació d'una xarxa neuronal artificial per donar suport a l'operació de plantes en la indústria de les aigües residuals

En els últims anys, l'aparició del paradigma Indústria 4.0, així com l'ús de la intel·ligència artificial i especialment de les xarxes neuronals, està impulsant un canvi en la forma d'entendre i d'actuar amb diferents processos industrials. En aquest aspecte, algunes línies d'investigació proposen l'ús de les xarxes neuronals en el desenvolupament d'elements de control atesa la seva capacitat per modelar sistemes no lineals i d'alta complexitat. D'aquesta manera, una xarxa neuronal és capaç de modelar el comportament de processos difícils d'abordar mitjançant processos de control convencional.En los últimos años, la aparición del paradigma Industria 4.0, así como el uso de la inteligencia artificial y especialmente de las redes neuronales, está impulsando un cambio en la forma de entender y de actuar con diferentes procesos industriales. En este aspecto, algunas líneas de investigación proponen el uso de las redes neuronales en el desarrollo de elementos de control dada su capacidad para modelar sistemas no lineales y de alta complejidad. De este modo, una red neuronal es capaz de modelar el comportamiento de procesos difíciles de abordar mediante procesos de control convencional.In the last decade, the incursion of the Industry 4.0 paradigm, as well as the adoption of artificial intelligence and specially the artificial neural network, has arisen a change in the the vision and management of the industrial processes. In that sense, some research lines have been proposed to adopt neural networks in the development of different control strategies due to their ability in modelling highly no-lineal and complex systems. Therefore, a neural network is able to model the behaviour of processes which are difficult to manage when conventional control strategies are considered

Aplicação de Redes Neurais Artificiais na Classificação de Padrões Posturais em Crianças Respiradoras Bucais e Nasais

A respiração é a primeira função vital desenvolvida por ocasião do nascimento, estabelecendo-se como principal função do organismo. A respiração bucal crônica pode provocar alterações posturais, além de incitar um menor esforço do músculo diafragma. Este artigo tem por objetivo apresentar resultados sobre a aplicação de um modelo de rede neural artificial não-supervisionado, especificamente o mapa auto-organizável (self-organizing map, SOM), para auxiliar no diagnóstico e na avaliação da evolução clínica da postura de crianças respiradoras bucais e nasais. Apresentamos como padrão de entrada ao SOM as variáveis de postura e distância da excursão do músculo diafragma de 30 crianças respiradoras bucais e 22 crianças respiradoras nasais. O SOM apresentou taxa de acerto de 95% no diagnóstico de crianças respiradoras bucais e nasais. Da topologia resultante foi possível definir categorizações da postura dos pacientes