Towards the automated analysis of simple polyphonic music : a knowledge-based approach

PhDMusic understanding is a process closely related to the knowledge and experience of the listener. The amount of knowledge required is relative to the complexity of the task in hand. This dissertation is concerned with the problem of automatically decomposing musical signals into a score-like representation. It proposes that, as with humans, an automatic system requires knowledge about the signal and its expected behaviour to correctly analyse music. The proposed system uses the blackboard architecture to combine the use of knowledge with data provided by the bottom-up processing of the signal's information. Methods are proposed for the estimation of pitches, onset times and durations of notes in simple polyphonic music. A method for onset detection is presented. It provides an alternative to conventional energy-based algorithms by using phase information. Statistical analysis is used to create a detection function that evaluates the expected behaviour of the signal regarding onsets. Two methods for multi-pitch estimation are introduced. The first concentrates on the grouping of harmonic information in the frequency-domain. Its performance and limitations emphasise the case for the use of high-level knowledge. This knowledge, in the form of the individual waveforms of a single instrument, is used in the second proposed approach. The method is based on a time-domain linear additive model and it presents an alternative to common frequency-domain approaches. Results are presented and discussed for all methods, showing that, if reliably generated, the use of knowledge can significantly improve the quality of the analysis.Joint Information Systems Committee (JISC) in the UK National Science Foundation (N.S.F.) in the United states. Fundacion Gran Mariscal Ayacucho in Venezuela

Consenso colombiano para el manejo de pacientes con Hipofosfatasia

La hipofosfatasia (HPP) es una enfermedad metabólica, de tipo hereditario, causada por mutaciones en el gen ALPL. Teniendo en cuenta los retos del manejo adecuado de los pacientes con HPP, se realizó un consenso interdisciplinario de expertos (endocrocrinólogos pediatras, nefrólogos pediatras, ortopedistas infantiles y genetistas clínicos) con el fin de proponer recomendaciones de utilidad clínica para el diagnóstico, tratamiento y seguimiento de los pacientes colombianos con HPP. Estas sugerencias se realizan en el contexto de los diferentes tipos de presentaciones y las edades de los pacientes.Q41-7Hypophosphatasia (HPP) is a hereditary metabolic disease caused by mutations in the ALPL gene. Taking into account the challenges found in the adequate management of patients with HPP, an interdisciplinary consensus of experts (pediatric endocrinologists, pediatric nephrologists, pediatric orthopedists and clinical geneticists) was carried out, in order to propose recommendations of clinical utility for the diagnosis, treatment and follow-up of Colombian patients with HPP. These suggestions are made in the context of the different types of presentations and the ages of the patients

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

Prevalence of vaginal and rectal colonization by Streptococcus agalactiae in pregnant women with preterm labor in Clinica Maternidad Rafael Calvo for the period August 2011 to January 2012

Introduction: to be premature is the main cause of perinatal morbimortality, identifyingto the infections during the pregnancy as cause of preterm labor. It has been describedthat colonization of pregnant women by the bacteria Streptococcus agalactiae entailsunfavorable effects about the maternal and neonatal health.Objective: to determine the frequency of vaginal and rectal colonization by Streptococcusagalactiae and its susceptibility to antibiotics in pregnant women with preterm labor.Methods: with prior informed consent, vaginal and rectal specimens were taken to pregnantwomen with preterm labor who admitted to the Clínica Maternidad Rafael Calvo, Cartagena,Colombia, between August 1st, 2011 and January 31st, 2012. The isolations of S.agalactiae were gotten by means of culture in selective medium CHROMagar™ StrepB. Theconfirmation of the specie was carried out by means of CRP with specific primers. Proofsof antibiotic susceptibility were done with Kirby-Bauer methods. Additionally, a form wasapplied to register socio-demographic data and medical record. As an independent variablewas used the colonization, which was correlated with socio-demographic and obstetric dataand with prenatal results. Telephonic follow-up was done for one month.Results: 93 patients were included in the study. A prevalence of 37.6% for vaginal andrectal colonization by Streptococcus agalactiae was found. 15 (16.1%) newborns presentedneonatal sepsis. There were not found statistically significant differences in the perinatalresults between the colonized and not colonized groups. There were found statistically significantdifferences in the gestational age between early preterm and late preterm births.Conclusions: Although the occurrence of neonatal sepsis was associated with being earlypremature, there was not association with the colonization status by Streptococcus agalactiaein the mother. It is required the realization of studies that orientate to establishif antibiotic prophylaxis against this bacteria in the population of pregnant women withearly preterm labor contributes to reduce the rate of early-onset neonatal sepsis. Additionalstudies are needed which allow us to establish if the colonization by Streptococcusagalactiae is a risk factor for neonatal sepsis in late preterm birth. Rev.cienc.biomed.2013;4(1):20-30RESUMENIntroducción: la prematurez es causa principal de morbimortalidad perinatal, señalándosea las infecciones durante el embarazo como causa de parto pretérmino. Se ha descritoque la colonización de gestantes por la bacteria Streptococcus agalactiae conlleva efectosdesfavorables sobre la salud materno-neonatal.Objetivo: determinar la frecuencia de colonización a nivel vaginal y rectal por la especieStreptococcus agalactiae y su susceptibilidad a antibióticos, en gestantes con trabajo departo pretérmino.Metodología: previo consentimiento informado, se tomaron muestras vaginales y rectalesa gestantes con trabajo de parto pretérmino que ingresaron a la Clínica Maternidad RafaelCalvo, Cartagena, Colombia, entre 1 de agosto 2011 y 31 de enero de 2012. Los aislamientosde S. agalactiae se obtuvieron mediante cultivo en medio selectivo CHROMagar™Strep B. La confirmación de la especie se realizó mediante PCR con cebadores específicos.Se realizaron pruebas de susceptibilidad a antibióticos mediante el método Kirby-Bauer.Adicionalmente, se aplicó un formulario para registrar datos sociodemográficos e historialmédico. Se utilizó como variable independiente la colonización, la cual se correlacionó condatos sociodemográficos, obstétricos y resultados perinatales. Se hizo seguimiento telefónicopor un mes.Resultados: se incluyeron en el estudio 93 pacientes, determinándose una prevalenciade colonización vaginal y rectal por Streptococcus agalactiae del 37.6%. Entre los reciénnacidos, 15 (16.1%) presentaron sepsis neonatal. No se encontraron diferencias estadísticamentesignificativas entre los grupos de colonizadas y no colonizadas en lo concerniente a los resultados perinatales. Al tomar en cuenta la edad gestacional se identificaron diferenciasestadísticamente significativas entre pretérminos tempranos y pretérminos tardíos.Conclusión: aunque la ocurrencia de sepsis neonatal estuvo asociada a prematuridadtemprana, no se encontró asociación con el estado de colonización por Streptococcus agalactiaeen la madre. Se requiere la realización de estudios dirigidos a establecer si la profilaxisantibiótica contra esta bacteria en la población de embarazadas con trabajo de partopretérmino temprano contribuye a reducir la tasa de sepsis neonatal temprana. Se necesitanestudios adicionales que permitan establecer si la colonización por S. agalactiae esun factor de riesgo para sepsis neonatal en pre-términos tardíos. Rev.cienc.biomed.2013;4(1):20-3

Prevalencia de colonización vaginal y rectal por Streptococcus agalactiae en gestantes con trabajo de parto pretérmino en Clínica Maternidad Rafael Calvo entre agosto 2011 y enero 2012

Revista Ciencias Biomédicas Vol.4 Num.1 (2013) Pág. 20 – 29El presente estudio tiene por objeto determinar la frecuencia de colonización a nivel vaginal y rectal por la especie Streptococcus agalactiae y su susceptibilidad a antibióticos, en gestantes con trabajo de parto pretérmino

Lo público. Un espacio en disputa

Rastrear los diferentes sentidos de lo público en la historia de la humanidad, es entrar en un terreno marcado por la polémica. Sus raíces y huellas son posibles de encontrar en la polis griega como en la res pública romana. Su fisonomía moderna está marcada, sin duda, por el pensamiento de Inmanuel Kant, quien de alguna manera delimitará el debate, que continuará en las reflexiones seminales de Jurgen Habermas sobre la esfera pública o en la crítica de Hannah Arendt a la distinción entre lo social y lo político. Trabajos que han dado la pauta a un conjunto amplio de reflexiones y que a su vez han generado una serie de respuestas, derivados, revisiones, comentarios y críticas al concepto de lo público, al punto que el debate ha desbordado los márgenes de la teoría política para desplegarse en variadas disciplinas, desde la sociología, el urbanismo, la geografía, la antropología, los estudios culturales y comunicacionales

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially