Compresión Digital en Imágenes Médicas

Imaging technology has long played a principal role in the medical domain, and as such, its use is widespread in the diagnosis and treatment of numerous health conditions. Concurrently, new developments in imaging techniques and sensor technology make possible the acquisition of increasingly detailed images of several organs of the human body. This improvement is indeed advantageous for medical practitioners. However, it comes to a cost in the form of storage and telecommunication infrastructures needed to handle high-resolution images reliably. Ordinarily, digital compression is a mainstay in the efficient management of digital media, including still images and video. From a technical point of view, medical imaging could take full advantage of digital compression technology. However, nuances unique to medical data impose constraints to the application of digital compression in medical images. This paper presents an overview of digital compression in the context of still medical images, along with a brief discussion on related regulatory and legal implications.La Imagenología desempeña un papel protagónico en el campo médico, siendo su uso ampliamente generalizado en el diagnóstico y tratamiento de numerosos trastornos de la salud.Nuevos desarrollos en la adquisición de imágenes y en la tecnología de sensores hacen posible obtener imágenes más detalladas de varios órganos del cuerpo humano. Tal mejora es ciertamente ventajosa para la práctica médica, pero supone un encarecimiento de los recursos tecnológicos necesarios para manejar imágenes de alta resolución de manera confiable. Comúnmente, el manejo eficiente de medios digitales se apoya principalmente en la compresión digital. Desde un punto de vista técnico, las imágenes médicas podrían aprovechar las ventajas de la compresión digital. Sin embargo, peculiaridades de los datos médicos imponen restricciones a su uso. Este artículo presenta un vistazo a la compresión digital en el contexto de las imágenes médicas, y una breve discusión de los aspectos regulatorios y legales asociados a su uso

The Internet of Things in Healthcare. An Overview

La prestación de servicios de salud está experimentando enormes cambios alrededor del mundo. El envejecimiento de la población, la creciente incidencia de enfermedades crónicas, y la escasez de recursos se están convirtiendo en una carga pesada para los actuales sistemas de salud y podrían comprometer la prestación de servicios de salud en las próximas décadas. Por otro lado, la creciente popularidad de dispositivos para el cuidado de la salud y el bienestar, junto con avances en comunicaciones inalámbricas y en sensores abren la puerta a nuevos modelos para la prestación de servicios de salud respaldados por el Internet de las cosas (IoT). Este artículo presenta una revisión general de las tendencias que están impulsando el desarrollo de aplicaciones para el cuidado de la salud basadas en IoT, y las describe brevemente a nivel de sistema.The provision of healthcare is experimenting enormous changes worldwide. Population ageing, rising incidence of chronic diseases, and shortages of resources are placing a heavy burden in current healthcare systems and have the potential to risk the delivery of healthcare in the next few decades. On the other hand, the growing popularity of smart devices for healthcare and wellness, along with advances in wireless communications and sensors are opening the door to novel models of health care delivery supported by the Internet of things (IoT). This paper presents a review of the trends that are driving the development of IoT-based applications for healthcare and briefly describe them at a system level

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Red “Universidad, género, docencia e igualdad”

La Red de investigación en docencia universitaria “Universidad, docencia, genero e igualdad” persigue avanzar en la calidad e innovación de las enseñanzas universitarias a partir de la inclusión de la perspectiva de género. Se busca dar cumplimiento a las directrices generales de los nuevos planes de estudio respecto del principio de igualdad de oportunidades entre hombres y mujeres en la formación universitaria (Real Decreto 1393/2007. BOE nº 260, 30 de octubre de 2007). En la quinta edición de la Red, y dada su composición multidisciplinar, se ha trabajado en tres líneas de investigación: 1) mantenimiento del “Portal web con recursos docentes con perspectiva de género”, proyecto financiado por el Instituto de la Mujer (PACUI, 2012) e iniciado en el curso 2012-2013; 2) desarrollo de la primera versión de “iLengUA”, una herramienta informática para un discurso inclusivo e igualitario; y 3) diseño de una Guía de recomendaciones para la inclusión de la perspectiva de género en la docencia universitaria

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

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

El impacto de la automatización en el mejoramiento de procesos

Esta investigación tiene la intención de evaluar el efecto de la automatización en el desempeño de los procesos de una empresa de servicios. Para tal efecto, se analiza los resultados de la automatización de un proceso clave de negocio en un proveedor de servicios de telecomunicaciones. La automatización implementada toma como referencia el ciclo de vida descrito por la metodología BPM (Business Process Management), el cual se compone de cuatro fases: Modelamiento, implementación, ejecución, y análisis. Para la modelación del proceso se utilizó la notación definida en el estándar Business Process Model and Notation (BPMN). La automatización se implementó usando un paquete de herramientas informáticas comercial del tipo BPMS (Business Process Management System)

Ensemble Learning Approach to Retinal Thickness Assessment in Optical Coherence Tomography

Manual assessment of the retinal thickness in optical coherence tomography images is a timeconsuming task, prone to error and inter-observer variability. The wide variability of the retinal appearance makes the automation of retinal image processing a challenging problem to tackle. The dif culty is even more accentuated in practice when the retinal tissue exhibits large structural changes due to disruptive pathology. In this work, we propose an ensemble-learning-based method for the automated segmentation of retinal boundaries in optical coherence tomography images that is robust to retinal abnormalities. The segmentation accuracy of the proposed algorithm was evaluated on two publicly available datasets that included cases of severe retinal edema. Moreover, the performance of the proposed method was compared to two existing methods, widely referenced in the relevant literature. The proposed algorithm outperformed reference methods at segmenting the retinal boundaries in both normal and pathological images. Furthermore, a thorough reliability analysis showed a strong agreement between the retinal thickness measurements derived from the segmentation obtained with the proposed method and corresponding manual measurements computed with the manual annotations