26 research outputs found

    Deep learning for food instance segmentation

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    Food object detection and instance segmentation are critical in many applications such as dietary management or food intake monitoring. Food image recognition poses different challenges, such as the existence of a large number of classes, a high inter-class similarity, and high intra-class variance. This, along with the traditional problems associated with object detection and instance segmentation make this a very complex computer vision task. Real-world food datasets generally suffer from long-tailed and fine-grained distributions. However, the recent literature fails to address food detection in this regard. In this research, we propose a novel two-stage object detector, which we call Strong LOng-tailed Food object Detection and instance Segmentation (SLOF-DS), to tackle the long-tailed nature of food images. In addition, a multi-task based framework, which exploits different sources of prior information, was proposed to improve the classification of fine-grained classes. Lastly, we also propose a new module based on Graph Neural Neworks, we call Graph Confidence Propagation (GCP) that additionally improves the performance of both object detection and instance segmentation modules by combining all the model outputs considering the global image context. Exhaustive quantitive and qualitative analysis performed on two open source food benchmarks, namely the UECFood-256 (object detection) and the AiCrowd Food Recognition Challenge 2022 dataset (instance segmentation) using different baseline algorithms prove the robust improvements introduced by the different components proposed in this thesis. More concretely, we outperformed the state-of-the-art performance on both public datasets

    Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

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    IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

    Natural History of MYH7-Related Dilated Cardiomyopathy

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    BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

    Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

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    Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

    Contextualizando la cerámica impressa : horizontes culturales en la Península Ibérica

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    Organizado por: GRAMPO: Grup de Recerques Arqueològiques al Mediterrani i Pròxim Orient. Universitat Autònoma de Barcelona PREMEDOC: Grup de Recerca de Prehistòria del Mediterràni Occidental. Universitat de València Servei d'Arqueologia. Ajuntament de Barcelona. Con la colaboración de: Museu d'Història de Barcelona. Ajuntament de BarcelonaDesde hace poco tiempo en el estudio sobre los orígenes de las primeras sociedades agrícolas en el Mediterráneo Occidental se ha generado un amplio debate en torno a la filiación y características culturales de los primeros grupos que practican una economía de subsistencia. En este contexto encuentra sentido la discusión sobre la presencia en la península Ibérica un momento relacionable con la denominada Impressa-Ligur presente en diferentes regiones del arco Ligur Provenzal. Este volumen, fruto de una reunión científica, reúne información actualizada sobre la posible presencia de estos contextos cerámicos en torno a la mitad del VI milenio cal en la península Ibérica dentro del marco más amplio del Mediterráneo occidental. Las primeras producciones cerámicas del Occidente son analizadas poniendo énfasis tanto en sus características como sobre todo en el contexto y la lectura histórica que aportan. Estructuradas por áreas geográficas, las 14 contribuciones realizadas por 38 investigadores nacionales e internacionales, ofrecen una visión inédita y original sobre una de las novedades más importantes de la investigación en Prehistoria reciente en el último decenio

    La expresión oral y escrita, objetivo fundamental de calidad de la enseñanza

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    Convocatoria de Proyectos de innovación de Extremadura 2017/2018Se describe un proyecto llevado a cabo en el IES Miguel Durán (Azuaga, Badajoz) desarrollado dentro del Sistema de Gestión de Calidad del centro, que tenía como objetivo principal que los alumnos adquirieran las competencias necesarias para una correcta expresión oral y escrita (mejora de la competencia informacional y las competencias comunicativa e idiomática). Para conseguir el objetivo se organizaron distintas actividades promovidas por el Grupo de Trabajo de la Biblioteca del centro: fomento de la lectura, feria del libro, Día de la poesía, diversas actividades de lectura en la biblioteca, club de lectura con libros digitales, etc., así como la realización de otras actividades y la elaboración de materiales por parte de los distintos departamentos del instituto como: exposiciones de los alumnos ante el aula, lectura en distintos soportes, realización de trabajos de investigación, actividades de enriquecimiento del vocabulario, etc.ExtremaduraES

    Guía de Terapéutica Antimicrobiana del Área Aljarafe, 3ª edición

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    Coordinadora: Rocío Fernández Urrusuno. Co-coordinadora: Carmen Serrano Martino.YesEstas guías son un recurso indispensable en los Programas de Optimización de Antibióticos (PROA). No sólo constituyen una herramienta de ayuda para la toma de decisiones en los principales síndromes infecciosos, proporcionando recomendaciones para el abordaje empírico de dichos procesos, sino que son el patrón/estándar de referencia que permitirá determinar la calidad o adecuación de los tratamientos realizados. Las guías pueden ser utilizadas, además, como herramienta de base para la formación y actualización en antibioterapia, ya que permiten mantener actualizados los conocimientos sobre las nuevas evidencias en el abordaje de las infecciones. Por último, deberían incorporar herramientas que faciliten el proceso de toma de decisiones compartidas con el paciente. El objetivo de esta guía es proporcionar recomendaciones para el abordaje de las enfermedades infecciosas más prevalentes en la comunidad, basadas en las últimas evidencias disponibles y los datos de resistencias de los principales patógenos que contribuyan a mejorar la calidad de la prescripción de antimicrobianos

    Evolution of the South-Iberian paleomargin: From hyperextension to continental subduction

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    Tiempos para pensar : investigación social y humanística hoy en Venezuela. Tomo II

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    En nuestros tiempos, hacer investigación en Ciencias Sociales y Humanidades e intentar aportar pensamiento crítico es un hacer personal y también una tarea colectiva que se gesta en el intercambio y en el encuentro, en el debate y en la puesta en común de visiones, análisis, puntos de partida y espacios que se recorren. Hay desafíos del nuevo tiempo que son desafíos de las sociedades, e interpelan a la producción de conocimiento social y humano, le proponen preguntas y encomiendas, exigen que responda a sus demandas éticas y epistémicas desde el Sur, piden que se construyan saberes alternativos, decoloniales, que expliquen, acompañen y prefiguren la emancipación. Este libro, que cuenta con dos tomos, encara este desafío con rigurosidad y espíritu crítico
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