Modelos de Aprendizaje Profundo. Aplicaciones con R y Python

La Inteligencia Artificial avanza desde hace unos años a pasos agigantados. El Aprendizaje Profundo (Deep Learning), una rama específica de ésta, no se queda atrás. Se ha desarrollado tanto que lo podemos aplicar en muchos los ámbitos de nuestra vida. Este aprendizaje es característico por estar basado en el funcionamiento de las redes neuronales que conforman el cerebro biológico. El análisis de estas redes y algunas aplicaciones concretas serán el objeto de estudio de este Trabajo de Fin de Grado. El trabajo comienza con una introducción a la Inteligencia Artificial hasta llegar a la explicación del Aprendizaje Profundo, donde se habla de sus ventajas y aplicaciones en el día a día. Tras comentar brevemente la similitud con el cerebro humano, se pasa a la clasificación de los modelos según el aprendizaje y la topología. Explicamos también algunos conceptos relacionados. Antes de empezar a trabajar con los ejemplos, se hace una breve introducción a las librerías de los programas que se van a utilizar y sus correspondientes funciones. Los ejemplos que se resuelven son tres: Detección de transacciones fraudulentas con tarjetas de crédito, Predicción del precio del vino español y Clasificación de diferentes prendas a través de imágenes.Artificial Intelligence has taken quantum leaps these last years. Deep Learning, an especific branch of A.I., isn’t too far behind. It has developed so much that it is useful in almost every aspect of our lives. This type of learning is special because it is based on how neural networks work inside biological brains. The analysis of these networks and its applications will be the subject of this Final Degree Project. This dissertation starts by introducing Artificial Intelligence until reaching Deep Learning, where all its advantages and applications are explained. After a brief comment on its similarity with the biological brain, different neural networks are classified by it topology and Machine Learning methods. Some necessary concepts are also explained. Before we start working on some Deep Learning examples, a brief introduction on libraries and its functions used in Rstudio and Python are explained. We are solving three examples: Credit card fraud detection, Spanish wine price prediction and image clasification of different types of clothing.Universidad de Sevilla. Doble Grado en Matemáticas y Estadístic

Gestión de la accesibilidad a los servicios de salud y percepción de las usuarias gestantes en una institución pública-San Ignacio

El estudio tuvo como objetivo general determinar la relación de la gestión de la accesibilidad a los servicios de salud con la percepción de las usuarias gestantes en una institución pública-San Ignacio. La metodología de la investigación es descriptiva, correlacional simple, de tipo cuantitativo con un diseño no experimental. Su población estuvo conformada por un total de 100 usuarias gestantes y la muestra se calculó por medio de una fórmula establecida, la cual fue 90 usuarias gestantes involucrados en la aplicación del instrumento. La recolección de datos se realizó a través de cuestionarios, que fueron validados por tres expertos, se utilizó para el análisis estadístico el software SPSS. Tuvo como resultado que existe la correlación entre la gestión de la accesibilidad a los servicios de salud con la percepción de las usuarias gestantes en una institución pública-San Ignacio, de manera que se rechaza la hipótesis nula y se acepta la hipótesis alterna. Se concluye que cada institución pública debe tener una gestión de la accesibilidad a los servicios de salud para la percepción de las usuarias gestantes, de manera que mejore las condiciones y necesidades de su atención, reduciendo los costos de atención por los diferentes servicios

Fortalecimiento de procesos psicosociales en la convivencia familiar, para prevenir la violencia intrafamiliar en la comunidad de la vereda la cañada, municipio de la Unión – Nariño.

La vida familiar es una realidad muy compleja que contiene multitud de aspectos y dimensiones. En este trabajo, además de abordar los cambios estructurales más relevantes en la vida familiar, se afianzan algunos de los aspectos más destacables de la convivencia y del proyecto educativo de los padres, así como de las satisfacciones y conflictos que se producen en la convivencia intergeneracional. La construcción de un escenario de reflexión en torno a uno de los problemas más acuciantes que enfrentamos actualmente: la violencia intrafamiliar su complejidad y magnitud, expresa no solamente la presentación de las estadísticas, los esfuerzos institucionales o las intenciones de políticas públicas; indica las confusas dinámicas y dispositivos que la encubren y hacen de ella una realidad que, no obstante su reconocimiento, aún se encuentra atrapada en entramados culturales que logran por una parte ocultarla, disfrazarla y justificarla y por otra, hacer de ella un indicador de la causalidad de la crisis y el deterioro de la sociedad colombiana. Se reconoce que en nuestra cultura existe una clara tendencia a confundir la autoridad con la violencia como única forma de corregir a los niños, niñas y adolescentes como procesos de justificación, en tanto se le reconoce como un medio para lograr unos fines. Es determinante construir en los espacios cotidianos de la familia nuevas alternativas de convivencia, que le permitan a cada uno de sus miembros reconocer al otro como su interlocutor y merecedor del reconocimiento a sus condiciones, habilidades y limitaciones. Por lo que el proyecto busca que los mensajes entregados a la familia como nuevos aprendizajes aluden a la importancia de su función formadora, a nuevas maneras de comunicación, a establecer el vínculo afectivo y de relacionarse entre sus miembros, al igual con sus comunidades.Family life is a very complex reality that contains many aspects and dimensions. In this paper, in addition to addressing the most important structural changes in family life, some of the most outstanding aspects of the coexistence and the educational project of the parents, as well as the satisfactions and conflicts that occur in intergenerational coexistence . The construction of a scenario of reflection around one of the most pressing problems that we face today: intrafamily violence its complexity and magnitude, expresses not only the presentation of statistics, institutional efforts or public policy intentions; Indicates the dynamic confusions and devices that conceal it and make it a reality that, despite its recognition, is still trapped in cultural frameworks that manage to conceal, disguise and justify it on the one hand and, on the other hand, make it an indicator of the Causality of the crisis and the deterioration of Colombian society. It is recognized that in our culture there is a clear tendency to confuse authority with violence as the only way to correct children and adolescents as processes of justification, as it is recognized as a means to achieve some ends. It is decisive to build in the daily spaces of the family new alternatives of coexistence, which allow each of its members to recognize the other as their interlocutor and deserving recognition of their conditions, skills and limitations. Therefore, the project seeks to ensure that the messages delivered to the family as new learnings allude to the importance of its formative role, to new ways of communication, to establishing an affective bond and to relating among its members, as well as with its communitie

Hip fracture in hospitalized medical patients

BACKGROUND: The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. METHODS: We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. RESULTS: A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). CONCLUSIONS: In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients

Efectos de la formación de directivos en las pymes españolas

A pesar de que la formación se considera imprescindible para que la empresa pueda desarrollar ventajas competitivas sostenibles y de que los directivos suelen ser el colectivo al que se dedica la mayor parte de las inversiones en esta área, poco se sabe sobre las repercusiones que esto tiene en los resultados globales de la empresa. Por ello, el presente trabajo, tras revisar la literatura teórica y empírica, estudia si la inversión en formación de directivos influye sobre los resultados organizativos, utilizando para ello una muestra de 214 pymes españolas. Los análisis efectuados identifican algunos efectos significativos

Consensus statement of the Spanish Society of Internal Medicine and the Spanish Society of Medical Oncology on secondary thromboprophylaxis in patients with cancer

Up to 20% of cancer patients will develop some manifestation of venous thromboembolic disease (VTD) during their clinical course. VTD greatly impacts morbidity, mortality, quality of life and pharmaceutical expenditure. In addition, both thrombotic relapse and major haemorrhages derived from VTD treatment are more likely in oncological patients. To make the decision to establish secondary thromboprophylaxis as an indefinite treatment in these patients, it is important to review all the risk factors involved, whether related to the disease, the patient or the prior thrombotic event. The objectives of this consensus of the Spanish Society of Internal Medicine (Sociedad Española de Medicina Interna -SEMI) and the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica -SEOM) are to establish recommendations that help assess the risk of recurrence of VTD and haemorrhagic risk in patients with cancer, as well as to analyse the evidence that exists on the currently available drugs, which will allow the establishment of a protocol for shared decision-making with the informed patient

Diffusion MRI signal cumulants and hepatocyte microstructure at fixed diffusion time: insights from simulations, 9.4T imaging, and histology

Histology; Liver; MicrostructureHistología; Hígado; MicroestructuraHistologia; Fetge; MicroestructuraPurpose Relationships between diffusion-weighted MRI signals and hepatocyte microstructure were investigated to inform liver diffusion MRI modeling, focusing on the following question: Can cell size and diffusivity be estimated at fixed diffusion time, realistic SNR, and negligible contribution from extracellular/extravascular water and exchange? Methods Monte Carlo simulations were performed within synthetic hepatocytes for varying cell size/diffusivity L / D0 , and clinical protocols (single diffusion encoding; maximum b-value: {1000, 1500, 2000} s/mm2; 5 unique gradient duration/separation pairs; SNR = { ∞ , 100, 80, 40, 20}), accounting for heterogeneity in (D0,L) and perfusion contamination. Diffusion ( D ) and kurtosis ( K ) coefficients were calculated, and relationships between (D0,L) and (D,K) were visualized. Functions mapping (D,K) to (D0,L) were computed to predict unseen (D0,L) values, tested for their ability to classify discrete cell-size contrasts, and deployed on 9.4T ex vivo MRI-histology data of fixed mouse livers Results Relationships between (D,K) and (D0,L) are complex and depend on the diffusion encoding. Functions mapping (D,K) to (D0,L) captures salient characteristics of D0(D,K) and L(D,K) dependencies. Mappings are not always accurate, but they enable just under 70% accuracy in a three-class cell-size classification task (for SNR = 20, bmax = 1500 s/mm2, δ = 20 ms, and Δ = 75 ms). MRI detects cell-size contrasts in the mouse livers that are confirmed by histology, but overestimates the largest cell sizes. Conclusion Salient information about liver cell size and diffusivity may be retrieved from minimal diffusion encodings at fixed diffusion time, in experimental conditions and pathological scenarios for which extracellular, extravascular water and exchange are negligible.This project was supported by Fundació La Caixa and by the investigator-initiated PREdICT study at the Vall d'Hebron Institute of Oncology (Barcelona), funded by AstraZeneca and supporting FG. FG has received funding from the postdoctoral fellowships programme Beatriu de Pinós (2020 BP 00117), funded by the Secretary of Universities and Research (Government of Catalonia). KB is funded by a Beatriu de Pinós post-doctoral grant (2019 BP 00182). RPL is supported by a CRIS Foundation Talent Award (TALENT19-05), the Instituto de Salud Carlos III-Investigación en Salud (PI18/01395), Spanish Ministry for Science, Innovation and Universities (RTI2018-095209-B-C21, FIS-G64384969), Prostate Cancer Foundation Young Investigator Award and Fero Foundation. ICS is supported by a fellowship from Fundació ”la Caixa” (ID 100010434) and the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 847648, fellowship code LCF/BQ/PI20/117600

Clinical screening for oropharyngeal dysphagia in a general hospital. Early outcomes

[ES] Introducción y objetivo: La disfagia orofaríngea es una patología de elevada prevalencia, infradiagnosticada e infratratada, que afecta al 15% de los pacientes en hospitalización de agudos, pudiendo llegar hasta el 80% en el caso de la enfermedad cerebrovascular. Los datos disponibles sugieren que prevención de la morbimortalidad asociada al control de las complicaciones de la disfagia (aspiraciones y malnutrición) es una actividad hospitalaria coste-efectiva. El objetivo del presente trabajo es realizar una primera valoración del volumen de actividad y de los resultados iniciales de un nuevo programa de disfagia en un hospital general. Material y método: Tras constituir la Unidad de Disfagia y realizar una campaña informativa en el hospital, se inicia la actividad con cribado por sospecha clínica. La demanda se tramita como interconsulta al servicio de ORL; la primera valoración la realiza la enfermera de disfagia. Se presentan los primeros resultados de actividad a través de la explotación del registro específico de disfagia. Resultados: En los primeros 3 meses (30/01/2014 a 30/04/2014) se ha realizado 135 valoraciones. La media de edad de los pacientes es de 80 años (DE= 12,9). El 50% de las solicitudes proceden de Medicina Interna y otro 30% de neurología. Los motivos más frecuentes de demanda fueron los procesos respiratorios con sospecha de origen aspirativo (33%) y la valoración en el contexto de un accidente cerebrovascular (26%). Dos tercios de los casos se han manejado sólo con valoración a pie de cama (incluido el test de volumen-viscosidad). En 47 casos se ha completado el estudio con una videoendoscopia de deglución, videofluroscopia o ambas. Las recomendaciones dietéticas iniciales han sido muy restrictivas, permitiéndose dieta oral libre sólo en el 15% de los casos. Discusión: El origen de la demanda intrahospitalaria de valoración de disfagia se corresponde con la epidemiología y la etiología reflejadas en la literatura. La protocolización de las valoraciones, adaptada a los recursos del centro, permite que el manejo de la disfagia sea operativo y sostenible. De acuerdo con los resultados iniciales, parece deseable escalar hacia el cribado por grupos de riesgo. Conclusiones: La sospecha y valoración clínicas de la disfagia tiene implicaciones en el cuidado de los pacientes. [EN] Introduction and objective: Oropharyngeal dysphagia is a highly prevalent disease, underdiagnosed and undertreated, which affects 15% of hospitalized patients, although it might rise to 80% in the case of stroke. Available data suggest that prevention of morbidity and mortality associated with the control of the complications of dysphagia (aspiration and malnutrition) is a cost-effective activity. The aim of this paper is to review the burden of activity and the initial results of a new program of dysphagia in a general hospital. Method: After establishing the Dysphagia Unit and conducting an information campaign in the hospital, we started the screening activity based on clinical suspicion. The demand is processed as a request of evaluation to the ENT department; the first assesment is performed by the dysphagia nurse. We present the early results of the program through the exploitation of a specific dysphagia database. Results: In the first 3 months (01/30/2014 to 30/04/2014) we performed 135 examinations. The mean age of patients was 80 years (SD = 12.9). 50% of the requests came from Internal Medicine department and 30% from Neurology. The most frequent reasons were respiratory processes with suspected aspiration origin (33%) and assessment in the context of stroke (26%). Two thirds of the cases were managed only with bedside assessment (including volume-viscosity test). In 47 cases the study was completed with a videoendoscopy of degluttition, videofluroscopy or both. The initial dietary recommendations have been very restrictive, allowing free oral diet only in 15% of cases. Discussion: The origin of the demand for the assesment of dysphagia in the hospital corresponds to the epidemiology and etiology reflected in the literature. The protocolization of the assesment, adapted to center resources, allows the management of dysphagia to be operational and sustainable. According to the initial results, it seems desirable to scale towards screening based on risk groups. Conclusions: Suspicion and clinical assessment of dysphagia has implications for patient care

Real-Time Dissemination of Aggregate Data on Presentation and Outcomes of Patients With Venous Thromboembolism : The RIETE Infographics Project

In the current era of patient empowerment and precision medicine, access to timely information is critical to decision-making. Unfortunately, we currently lack patient-specific, real-time data about clinical presentation, risk of thrombotic or hemorrhagic events, key risk factors, and adverse outcomes in patients with venous thromboembolism (VTE). Accordingly, the egistro nformatizado nfermedad rombombólica (RIETE) investigators developed a tool to provide an open-source, real-time graphic representation of VTE-related data derived from over 90 000 patients with confirmed VTE. This information is intended to facilitate discussion in the informed decision-making process. The current article describes the aims, rationale, methods, and ongoing and future efforts of the real-time VTE infographics developed by the RIETE registry collaborators

Identification of seasonal variation in the diagnosis of acute myeloid leukaemia:a population-based study

Until now, the role that seasonal factors play in the aetiology of acute myeloid leukaemia (AML) has been unclear. Demonstration of seasonality in AML diagnosis would provide supportive evidence of an underlying seasonal aetiology. To investigate the potential seasonal and long‐term trends in AML diagnosis in an overall population and in subgroups according to sex and age, we used population‐based data from a Spanish hospital discharge registry. We conducted a larger study than any to date of 26 472 cases of AML diagnosed in Spain between 2004 and 2015. Using multivariable Poisson generalized linear autoregressive moving average modelling, we found an upward long‐term trend, with monthly incidence rates of AML annually increasing by 0.4% [95% confidence interval (CI), 0.2%–0.6%; p = 0.0011]. January displayed the highest incidence rate of AML, with a minimum average difference of 7% when compared to February (95% CI, 2%–12%; p = 0.0143) and a maximum average difference of 16% compared to November (95% CI, 11%–21%; p < 0.0001) and August (95% CI, 10%–21%; p < 0.0001). Such seasonal effect was consistent among subgroups according to sex and age. Our finding that AML diagnosis is seasonal strongly implies that seasonal factors, such as infectious agents or environmental triggers, influence the development and/or proliferation of disease, pointing to prevention opportunities