Evolutionary learning using a sensitivity-accuracy approach for classification

Accuracy alone is insufficient to evaluate the performance of a classifier especially when the number of classes increases. This paper proposes an approach to deal with multi-class problems based on Accuracy (C) and Sensitivity (S). We use the differential evolution algorithm and the ELM-algorithm (Extreme Learning Machine) to obtain multi-classifiers with a high classification rate level in the global dataset with an acceptable level of accuracy for each class. This methodology is applied to solve four benchmark classification problems and obtains promising results

Neurofibroma mediastínico

Varón de 3 añios y 9 meses de edad, remitido por su Pediatra, por hallazgo casual de masa torácica tras práctica de radiografía de tórax, con motivo de una infección respiratoria intercurrente...

The effect of a “PBL” physical activity program based methodology on the development of values in Spanish Primary Education

The purpose of this research is to assess a Project-Based Learning (PBL) intervention program within the context of Physical Education. Research approaches PBL methodology in order to evaluate its importance regarding students’ ability to develop certain personal values and attitudes. The sample involved 38 girls and 37 boys among sixth year students in Spanish Primary Education (11-12 year olds) and the intervention program was carried and developed throughout the academic year in 2014/15 This study approaches an Action Research methodology assessing key items such as teachers’ journals, students’ questionnaires and also an interview reflecting the different opinions of the students. This research validates the suitability of the intervention program as results show increased students’ awareness respecting critical values and attitudes such as responsibility and respect

Management of progressive pulmonary fibrosis associated with connective tissue disease

Introduction: Fibrotic interstitial lung disease (ILD) is a frequent and severe complication of connective tissue disease (CTD). Areas covered: In this narrative review, we update the most relevant differential characteristics of fibrotic ILD associated with CTD (CTD-ILD) and propose a diagnostic and therapeutic approach based on a review of the articles published between 2002 and 2022 through PubMed. Expert opinion: The subset of ILD, mainly the radiological/histological pattern and the degree of fibrotic component, usually determines the prognosis and therapeutic strategy for these patients. Some patients with CTD-ILD can develop progressive pulmonary fibrosis (PPF) with severe deterioration of lung function, rapid progression to chronic respiratory failure, and high mortality. PPF has been described in many CTDs, mainly in systemic sclerosis and rheumatoid arthritis, and requires a multidisciplinary diagnostic and therapeutic approach to improve patient outcomes

Actualización de las recomendaciones para la determinación de biomarcadores en el carcinoma de pulmón avanzado de célula no pequeña. Consenso Nacional de la Sociedad Española de Anatomía Patológica y de la Sociedad Española de Oncología Médica

En el año 2011 se inició un proyecto conjunto entre la Sociedad Española de Oncología Médica (SEOM) y la Sociedad Española de Anatomía Patológica (SEAP) para establecer unas recomendaciones basadas en la evidencia actual con respecto a la determinación de biomarcadores en pacientes con carcinoma de pulmón de célula no pequeña (CPCNP) avanzado. La mayoría de estas recomendaciones siguen siendo válidas; sin embargo, existen nuevas evidencias que hacen necesaria la actualización de algunos aspectos. En concreto, se modifica la recomendación de qué biomarcadores hay que analizar y en qué pacientes, y se define el manejo óptimo de la muestra tumoral así como las características del material mínimo necesario para la determinación de biomarcadores. Además, se revisan las técnicas adecuadas para la determinación de las mutaciones de EGFR y el reordenamiento de ALK, y se consensúa en qué situaciones se debe llevar a cabo una re-biopsi

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Arauca, Norte de Santander y Santander

“En un escenario de violencia, el abordaje psicosocial se concentra en comprender y atender las dimensiones psicológicas y sociales de las víctimas, en el conflicto interno armado en Colombia que data del año 1960, se han visto afectadas poblaciones enteras que mediante las narraciones de sus experiencias sanas el dolor” En el primer paso sobre en caso de Shimaia vemos como los sujetos fueron expuestos a eventos enmarcados con desplazamiento forzado, reclutamiento indebido, amenazas, homicidios selectivos, torturas y estigmatización, origen de brechas de desigualdad económica, exclusión social, orientación política, lucha por los cultivos ilícitos y violencia que se ha prolongado, desencadenando problemáticas psicológicas y psicopatológicas en las familias y las comunidades. El segundo caso que fue sobre El Salado el informe se enfoca en la identificación de procesos de afrontamiento y eventos psicosociales traumáticos lo cual direcciona a la construcción de estrategias de acción psicosocial que logren contrarrestar daños causados, donde se resalta emergentes psicosociales como la pérdida de identidad, cambios en las costumbres, daño psicológico y moral. Se presentan estrategias como terapias en grupo, arteterapia y técnicas implementadas de forma individual y colectiva para la construcción de la identidad. Concluyendo la importancia en la praxis del psicólogo en escenarios como los vistos para ayudar a sanar, rehabilitar y reconstruir propósitos de vida con direcciones valiosas.“In a scenario of violence, the psychosocial approach focuses on understanding and addressing the psychological and social dimensions of the victims. In the internal armed conflict in Colombia that dates back to 1960, entire populations have been affected and through the narratives of their "healthy experiences, pain" In the first step in the case of Shimaia we see how the subjects were exposed to events framed with forced displacement, improper recruitment, threats, selective homicides, torture and stigmatization, origin of gaps of economic inequality, social exclusion, orientation politics, fight over illicit crops and violence that has been prolonged, triggering psychological and psychopathological problems in families and communities. The second case, which was about El Salado, the report focuses on the identification of coping processes and traumatic psychosocial events, which leads to the construction of psychosocial action strategies that manage to counteract the damage caused, where psychosocial emergencies such as the loss of identity are highlighted. Changes in customs, psychological and moral damage. Strategies such as group therapies, art therapy and techniques implemented individually and collectively for the construction of identity are presented. Concluding the importance in the psychologist's praxis in scenarios such as those seen to help heal, rehabilitate and reconstruct life purposes with valuable directions

Characterization, localization and comparison of c-Kit+ lung cells in never smokers and smokers with and without COPD

Background: c-Kit + lung stem cells have been described in the human healthy lung. Their potential relation with smoking and/or chronic obstructive pulmonary disease (COPD) is unknown. Methods: We characterized and compared c-Kit+ cells in lung tissue of 12 never smokers (NS), 15 smokers with normal spirometry (S) and 44 COPD patients who required lung resectional surgery. Flow cytometry (FACS) was used to characterize c-Kit+ cells in fresh lung tissue disaggregates, and immunofluorescence (IF) for further characterization and to determine their location in OCT- embedded lung tissue. Results: We identified 4 c-Kit+ cell populations, with similar proportions in NS, S and COPD: (1) By FACS, c-Kithigh/CD45 + cells (4.03 ± 2.97% (NS), 3.96 ± 5.30% (S), and 5.20 ± 3.44% (COPD)). By IF, these cells were tryptase+ (hence, mast cells) and located around the airways; (2) By IF, c-Kitlow/CD45+/triptase- (0.07 ± 0.06 (NS), 0.03 ± 0.02 (S), and 0.06 ± 0.07 (COPD) cells/field), which likely correspond to innate lymphoid cells; (3) By FACS, c-Kitlow/CD45-/CD34+ (0.95 ± 0.84% (NS), 1.14 ± 0.94% (S) and 0.95 ± 1.38% (COPD)). By IF these cells were c-Kitlow/CD45-/CD31+, suggesting an endothelial lineage, and were predominantly located in the alveolar wall; and, (4) by FACS, an infrequent c-Kitlow/CD45-/ CD34- population (0.09 ± 0.14% (NS), 0.08 ± 0.09% (S) and 0.08 ± 0.11% (COPD)) compatible with a putative lung stem cell population. Yet, IF failed to detect them and we could not isolate or grow them, thus questioning the existence of c-Kit+ lung stem-cells. Conclusions: The adult human lung contains a mixture of c-Kit+ cells, unlikely to be lung stem cells, which are independent of smoking status and/or presence of COPD

YKT6 expression, exosome release, and survival in non-small cell lung cancer

BACKGROUND: Cancer-derived exosomes are involved in metastasis. YKT6 is a SNARE protein that participates in the regulation of exosome production and release, but its role in non-small cell lung cancer (NSCLC) has not been examined. MATERIALS AND METHODS: Ultracentrifugation-purified exosomes from the A549 cell line were studied by CRYO-TEM, nanoparticle tracking analysis and western blot (TSG101 marker). YKT6 was inhibited using a DsiRNA and selected pre-microRNAs. MicroRNAs targeting YKT6 were validated by Renilla/Luciferase assay and western blot. YKT6 expression and its prognostic impact were analyzed in 98 tissue specimens from resected NSCLC patients. RESULTS: Membranous nanosized vesicles (mode size: 128nm) with TSG101 protein were purified from A549 cells. YKT6 inhibition reduced exosome release by 80.9%. We validated miR-134 and miR-135b as miRNAs targeting YKT6, and transfection with the pre-miRNAs also produced a significant reduction in exosome release. The analysis of YKT6 in tumor samples showed that patients with high levels had shorter disease-free and overall survival. CONCLUSIONS: YKT6 is a key molecule in the regulation of exosome release in lung cancer cells and is in turn precisely regulated by miR-134 and miR-135b. Moreover, YKT6 levels impact prognosis of resected NSCLC patients

Acute exacerbations of idiopathic pulmonary fibrosis: Does clinical stratification or steroid treatment matter?

Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) is defined as a sudden acceleration of the disease with the appearance of pulmonary infiltrates superimposed on the characteristic pattern of IPF that leads to a significant decline in lung function. It has high in-hospital mortality rates, despite medical treatment with systematic steroids. We sought to investigate whether there were in-hospital mortality differences according to clinical stratification (AE, suspected AE, or AE of known cause) and/or treatment with systemic steroids. We reviewed the clinical characteristics and outcomes of patients with IPF admitted to our hospital during the years 2003-2014 due to a worsening of their clinical status. We identified 50 IPF patients, 9 with AE (18%), 12 with suspected exacerbation (24%), and 29 with AE of known cause (58%), mostly respiratory infections. In-hospital mortality was similar in the three groups (33% vs. 17% vs. 34%, respectively). Likewise, we did not find differences between them with respect to the use of systemic steroids (length of treatment duration or total dose). Nevertheless, there was an independent association between in-hospital mortality and high average daily steroid dose. We did not observe significant differences in prognosis or use of systemic steroids according to current diagnostic stratification groups in patients hospitalized because of an exacerbation of IPF

Auscultation of velcro crackles is associated with usual interstitial pneumonia

Auscultation of Velcro crackles has been proposed as a key finding in physical lung examination in patients with interstitial lung diseases (ILDs), especially in idiopathic pulmonary fibrosis (IPF). However, no studies have been carried out to assess the association of Velcro crackles with other clinical variables. We evaluated a cohort of 132 patients, prospectively and consecutively included in our ILD diagnostic program at a tertiary referral center. All patients were auscultated during the physical examination. The patients were divided into 2 groups: "presence" or "nonpresence" of bilateral Velcro crackles. Of all patients assessed, 83 (63%) presented Velcro crackles in the respiratory auscultation. Patients with Velcro crackles usually had more frequently cough and dyspnea at the moment of diagnosis. Forced vital capacity (P = 0.002) and lung diffusion capacity for carbon monoxide (P = 0.04) was lower in these patients. The ILD-GAP index was higher in the group with Velcro crackles (P = 0.01). All patients with usual interstitial pneumonia (UIP) in high-resolution computed tomography and all patients with final IPF diagnosis presented Velcro crackles. In multivariate analysis, the presence of Velcro crackles was independently associated with an UIP pattern. In patients suspected of having ILD, the auscultation of Velcro crackles was associated with UIP, a possibility which must be taken into consideration in early ILD detection in primary care