Aplicación de técnicas de inteligencia artificial para contribuir en la detección de microcalcificaciones en mamografía digitalizada

A nivel mundial, el cáncer de mama es el tipo de cáncer más frecuente además de una de las principales causas de muerte entre la población femenina. Actualmente, el método más eficaz para detectar lesiones mamarias en una etapa temprana es la mamografía. Ésta contribuye decisivamente al diagnóstico precoz de esta enfermedad que, si se detecta a tiempo, tiene una probabilidad de curación muy alta. Uno de los principales y más frecuentes hallazgos en una mamografía, son las microcalcificaciones, las cuales son consideradas como un indicador importante de cáncer de mama. En el momento de analizar las mamografías, factores como la capacidad de visualización, la fatiga o la experiencia profesional del especialista radiólogo hacen que el riesgo de omitir ciertas lesiones presentes se vea incrementado. Para disminuir dicho riesgo es importante contar con diferentes alternativas como por ejemplo, una segunda opinión por otro especialista o un doble análisis por el mismo. En la primera opción se eleva el coste y en ambas se prolonga el tiempo del diagnóstico. Esto supone una gran motivación para el desarrollo de sistemas de apoyo o asistencia en la toma de decisiones. En este trabajo de tesis se propone, se desarrolla y se justifica un sistema capaz de detectar microcalcificaciones en regiones de interés extraídas de mamografías digitalizadas, para contribuir a la detección temprana del cáncer demama. Dicho sistema estará basado en técnicas de procesamiento de imagen digital, de reconocimiento de patrones y de inteligencia artificial. Para su desarrollo, se tienen en cuenta las siguientes consideraciones: 1. Con el objetivo de entrenar y probar el sistema propuesto, se creará una base de datos de imágenes, las cuales pertenecen a regiones de interés extraídas de mamografías digitalizadas. 2. Se propone la aplicación de la transformada Top-Hat, una técnica de procesamiento digital de imagen basada en operaciones de morfología matemática. La finalidad de aplicar esta técnica es la de mejorar el contraste entre las microcalcificaciones y el tejido presente en la imagen. 3. Se propone un algoritmo novel llamado sub-segmentación, el cual está basado en técnicas de reconocimiento de patrones aplicando un algoritmo de agrupamiento no supervisado, el PFCM (Possibilistic Fuzzy c-Means). El objetivo es encontrar las regiones correspondientes a las microcalcificaciones y diferenciarlas del tejido sano. Además, con la finalidad de mostrar las ventajas y desventajas del algoritmo propuesto, éste es comparado con dos algoritmos del mismo tipo: el k-means y el FCM (Fuzzy c-Means). Por otro lado, es importante destacar que en este trabajo por primera vez la sub-segmentación es utilizada para detectar regiones pertenecientes a microcalcificaciones en imágenes de mamografía. 4. Finalmente, se propone el uso de un clasificador basado en una red neuronal artificial, específicamente un MLP (Multi-layer Perceptron). El propósito del clasificador es discriminar de manera binaria los patrones creados a partir de la intensidad de niveles de gris de la imagen original. Dicha clasificación distingue entre microcalcificación y tejido sano. ABSTRACT Breast cancer is one of the leading causes of women mortality in the world and its early detection continues being a key piece to improve the prognosis and survival. Currently, the most reliable and practical method for early detection of breast cancer is mammography.The presence of microcalcifications has been considered as a very important indicator ofmalignant types of breast cancer and its detection and classification are important to prevent and treat the disease. However, the detection and classification of microcalcifications continue being a hard work due to that, in mammograms there is a poor contrast between microcalcifications and the tissue around them. Factors such as visualization, tiredness or insufficient experience of the specialist increase the risk of omit some present lesions. To reduce this risk, is important to have alternatives such as a second opinion or a double analysis for the same specialist. In the first option, the cost increases and diagnosis time also increases for both of them. This is the reason why there is a great motivation for development of help systems or assistance in the decision making process. This work presents, develops and justifies a system for the detection of microcalcifications in regions of interest extracted fromdigitizedmammographies to contribute to the early detection of breast cancer. This systemis based on image processing techniques, pattern recognition and artificial intelligence. For system development the following features are considered: With the aim of training and testing the system, an images database is created, belonging to a region of interest extracted from digitized mammograms. The application of the top-hat transformis proposed. This image processing technique is based on mathematical morphology operations. The aim of this technique is to improve the contrast betweenmicrocalcifications and tissue present in the image. A novel algorithm called sub-segmentation is proposed. The sub-segmentation is based on pattern recognition techniques applying a non-supervised clustering algorithm known as Possibilistic Fuzzy c-Means (PFCM). The aim is to find regions corresponding to the microcalcifications and distinguish them from the healthy tissue. Furthermore,with the aim of showing themain advantages and disadvantages this is compared with two algorithms of same type: the k-means and the fuzzy c-means (FCM). On the other hand, it is important to highlight in this work for the first time the sub-segmentation is used for microcalcifications detection. Finally, a classifier based on an artificial neural network such as Multi-layer Perceptron is used. The purpose of this classifier is to discriminate froma binary perspective the patterns built from gray level intensity of the original image. This classification distinguishes between microcalcifications and healthy tissue.

Community Structure in Soil Porous System

Diffusion controls the gaseous transport process in soils when advective transport is almost null. Knowledge of the soil structure and pore connectivity are critical issues to understand and modelling soil aeration, sequestration or emission of greenhouse gasses, volatilization of volatile organic chemicals among other phenomena. In the last decades these issues increased our attention as scientist have realize that soil is one of the most complex materials on the earth, within which many biological, physical and chemical processes that support life and affect climate change take place. A quantitative and explicit characterization of soil structure is difficult because of the complexity of the pore space. This is the main reason why most theoretical approaches to soil porosity are idealizations to simplify this system. In this work, we proposed a more realistic attempt to capture the complexity of the system developing a model that considers the size and location of pores in order to relate them into a network. In the model we interpret porous soils as heterogeneous networks where pores are represented by nodes, characterized by their size and spatial location, and the links representing flows between them. In this work we perform an analysis of the community structure of porous media of soils represented as networks. For different real soils samples, modelled as heterogeneous complex networks, spatial communities of pores have been detected depending on the values of the parameters of the porous soil model used. These types of models are named as Heterogeneous Preferential Attachment (HPA). Developing an exhaustive analysis of the model, analytical solutions are obtained for the degree densities and degree distribution of the pore networks generated by the model in the thermodynamic limit and shown that the networks exhibit similar properties to those observed in other complex networks. With the aim to study in more detail topological properties of these networks, the presence of soil pore community structures is studied. The detection of communities of pores, as groups densely connected with only sparser connections between groups, could contribute to understand the mechanisms of the diffusion phenomena in soils.

A multinational SDI-based system to facilitate disaster risk management in the Andean Community

A useful strategy for improving disaster risk management is sharing spatial data across different technical organizations using shared information systems. However, the implementation of this type of system requires a large effort, so it is difficult to find fully implemented and sustainable information systems that facilitate sharing multinational spatial data about disasters, especially in developing countries. In this paper, we describe a pioneer system for sharing spatial information that we developed for the Andean Community. This system, called SIAPAD (Andean Information System for Disaster Prevention and Relief), integrates spatial information from 37 technical organizations in the Andean countries (Bolivia, Colombia, Ecuador, and Peru). SIAPAD was based on the concept of a thematic Spatial Data Infrastructure (SDI) and includes a web application, called GEORiesgo, which helps users to find relevant information with a knowledge-based system. In the paper, we describe the design and implementation of SIAPAD together with general conclusions and future directions which we learned as a result of this work.

Community Structurein Soil Porous System.

Soil is well recognized as a highly complex system. The interaction and coupled physical, chemical, and biological processes and phenomena occurring in the soil environment at different spatial and temporal scales are the main reasons for such complexity. There is a need for appropriate methodologies to characterize soil porous systems with an interdisciplinary character. Four different real soil samples, presenting different textures, have been modeled as heterogeneous complex networks, applying a model known as the heterogeneous preferential attachment. An analytical study of the degree distributions in the soil model shows a multiscaling behavior in the connectivity degrees, leaving an empirically testable signature of heterogeneity in the topology of soil pore networks. We also show that the power-law scaling in the degree distribution is a robust trait of the soil model. Last, the detection of spatial pore communities, as densely connected groups with only sparser connections between them, has been studied for the first time in these soil networks. Our results show that the presence of these communities depends on the parameter values used to construct the network. These findings could contribute to understanding the mechanisms of the diffusion phenomena in soils, such as gas and water diffusion, development and dynamics of microorganisms, among others.

TITIM GIS-tool: A GIS-based decision support system for measuring the territorial impact of transport infrastructures

To achieve sustainability in the area of transport we need to view the decision-making process as a whole and consider all the most important socio-economic and environmental aspects involved. Improvements in transport infrastructures have a positive impact on regional development and significant repercussions on the economy, as well as affecting a large number of ecological processes. This article presents a DSS to assess the territorial effects of new linear transport infrastructures based on the use of GIS. The TITIM ? Transport Infrastructure Territorial Impact Measurement ? GIS tool allows these effects to be calculated by evaluating the improvement in accessibility, loss of landscape connectivity, and the impact on other local territorial variables such as landscape quality, biodiversity and land-use quality. The TITIM GIS tool assesses these variables automatically, simply by entering the required inputs, and thus avoiding the manual reiteration and execution of these multiple processes. TITIM allows researchers to use their own GIS databases as inputs, in contrast with other tools that use official or predefined maps. The TITIM GIS-tool is tested by application to six HSR projects in the Spanish Strategic Transport and Infrastructure Plan 2005?2020 (PEIT). The tool creates all 65 possible combinations of these projects, which will be the real test scenarios. For each one, the tool calculates the accessibility improvement, the landscape connectivity loss, and the impact on the landscape, biodiversity and land-use quality. The results reveal which of the HSR projects causes the greatest benefit to the transport system, any potential synergies that exist, and help define a priority for implementing the infrastructures in the plan

A Multi-Agent System for the Solution of Fuzzy Incidents in Telecommunications

This article presents a multi-agent expert system (SMAF) , that allows the input of incidents which occur in different elements of the telecommunications area. SMAF interacts with experts and general users, and each agent with all the agents? community, recording the incidents and their solutions in a knowledge base, without the analysis of their causes. The incidents are expressed using keywords taken from natural language (originally Spanish) and their main concepts are recorded with their severities as the users express them. Then, there is a search of the best solution for each incident, being helped by a human operator using a distancenotions between them.

A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

The Road from Community Ideas to Organisational Innovation: A Life Cycle Survey of Idea Management Systems

This paper introduces a new emerging software component, the idea management system, which helps to gather, organise, select and manage the innovative ideas provided by the communities gathered around organisations or enterprises. We define the notion of the idea life cycle, which provides a framework for characterising tools and techniques that drive the evolution of community submitted data inside idea management systems. Furthermore, we show the dependencies between the community-created information and the enterprise processes that are a result of using idea management systems and point out the possible benefits.

Evaluation of a User-Adapted Spoken Language Dialogue System: Measuring the Relevance of the Contextual Information Sources

We present an evaluation of a spoken language dialogue system with a module for the management of userrelated information, stored as user preferences and privileges. The flexibility of our dialogue management approach, based on Bayesian Networks (BN), together with a contextual information module, which performs different strategies for handling such information, allows us to include user information as a new level into the Context Manager hierarchy. We propose a set of objective and subjective metrics to measure the relevance of the different contextual information sources. The analysis of our evaluation scenarios shows that the relevance of the short-term information (i.e. the system status) remains pretty stable throughout the dialogue, whereas the dialogue history and the user profile (i.e. the middle-term and the long-term information, respectively) play a complementary role, evolving their usefulness as the dialogue evolves.

Solving Incidents in Telecommunications Using a Multiagent System

This article presents the model and implementation of a multiagent fuzzy system (MAFS), to automate the search of solutions of incidents in telecommunications, expressed by the users in an imprecise way and, later, registered in a a knowledge base keeping their original vaguenesses and the relationships between the incidents considered as ancestors and descendants. The process of the fuzzy incidents, no matter their causes, is based on the application of a formula which transforms the intervals of the fuzzy incidents to a computational language and in the interaction between the different kinds of software agents and the humans. To search and suggest solutions of the incident originally stated, a search algorithm is used and illustrated with an example. The preliminary results obtained show the users' satisfaction, in a great percentage of the presented cases. The system is adaptive and allows to record new solutions for future users.

Hybrid Approach Combining Machine Learning and a Rule-Based Expert System for Text Categorization

This paper discusses a novel hybrid approach for text categorization that combines a machine learning algorithm, which provides a base model trained with a labeled corpus, with a rule-based expert system, which is used to improve the results provided by the previous classifier, by filtering false positives and dealing with false negatives. The main advantage is that the system can be easily fine-tuned by adding specific rules for those noisy or conflicting categories that have not been successfully trained. We also describe an implementation based on k-Nearest Neighbor and a simple rule language to express lists of positive, negative and relevant (multiword) terms appearing in the input text. The system is evaluated in several scenarios, including the popular Reuters-21578 news corpus for comparison to other approaches, and categorization using IPTC metadata, EUROVOC thesaurus and others. Results show that this approach achieves a precision that is comparable to top ranked methods, with the added value that it does not require a demanding human expert workload to train

Artificial cognitive control system based on the shared circuits model of sociocognitive capacities. A first approach

sharedcircuitmodels is presented in this work. The sharedcircuitsmodelapproach of sociocognitivecapacities recently proposed by Hurley in The sharedcircuitsmodel (SCM): how control, mirroring, and simulation can enable imitation, deliberation, and mindreading. Behavioral and Brain Sciences 31(1) (2008) 1–22 is enriched and improved in this work. A five-layer computational architecture for designing artificialcognitivecontrolsystems is proposed on the basis of a modified sharedcircuitsmodel for emulating sociocognitive experiences such as imitation, deliberation, and mindreading. In order to show the enormous potential of this approach, a simplified implementation is applied to a case study. An artificialcognitivecontrolsystem is applied for controlling force in a manufacturing process that demonstrates the suitability of the suggested approach

Bases territoriales y metodológicas de la planificación para el desarrollo del turismo sustentable en la región de Coquimbo

El proceso de planificación de una u otra forma ha estado implicado en el desarrollo del turismo, aunque su aplicación no ha sido del todo exitosa. Asimismo la revalorización que está teniendo la planificación en distintos ámbitos, público y privado, tampoco es ajena en el turismo, pero, aún requiere modificaciones en los métodos y técnicas para ser aplicada a un turismo sustentable. Las modificaciones en los métodos para la planificación del turismo sustentable en la Región de Coquimbo, constituyen el objeto de esta investigación. La investigación establece como hipótesis: “La integración de las metodologías de planificación con los principios del turismo sustentable permitiría generar un modelo de planificación turística sustentable, que incorpora los valores del territorio, las necesidades de los visitantes, la participación de la comunidad receptora y es aplicable a la Región de Coquimbo a través de un marco territorial-metodológico”. A partir de esta hipótesis, se define el objetivo general: Elaborar una propuesta de un marco territorial-metodológico para la planificación turística sustentable en la Región de Coquimbo. De este objetivo general se deducen los objetivos específicos relacionados con el análisis de los conceptos y enfoques teóricos de la planificación aplicada al turismo; el estudio de los instrumentos de planificación del desarrollo turístico de la Región de Coquimbo; la determinación de categorías y elementos estructurantes y la elaboración de un marco territorial-metodológico de la planificación para el desarrollo del turismo sustentable en la Región de Coquimbo. La metodología de la investigación es de carácter cualitativo, está relacionada principalmente con la teoría fundamentada o grounded theory y con las teorías procedimentales de la planificación. Ambas metodologías fueron utilizadas en la construcción del modelo genérico y en la elaboración del marco procedimental-territorial. La construcción del modelo genérico se asimiló con la de la teoría en la grounded theory y de esta forma, se generaron conceptos a partir del marco conceptual teórico (conceptualización o abstracción); se construyeron categorías de análisis procedimental, territorial y de turismo sustentable (codificación abierta), se elaboraron categorías síntesis procedimental-territoriales y de turismo sustentable (codificación axial); se analizó la dinámica relacional de las categorías procedimental-territoriales (codificación selectiva) y se estableció el modelo genérico de planificación del turismo sustentable (teoría), que cuenta con dos submodelos: el submodelo de Condiciones Generales y el submodelo de Etapas de la planificación. A partir del modelo genérico se jerarquizaron las categorías definidas y relacionadas en forma dinámica, de acuerdo a las características de la Región de Coquimbo. Conjuntamente se incluyeron los requisitos del turismo sustentable recomendados por el Servicio Nacional de Turismo (SERNATUR) a nivel nacional, regional y comunal y se incorporaron las etapas ausentes en los planes de desarrollo turístico formulados en la Región, para dar origen al marco procedimental-territorial aplicado en la Región de Coquimbo. La investigación entrega como resultado una metodología de planificación para el turismo sustentable (modelo genérico), que al aplicarse a un sistema territorial particular, como es la Región de Coquimbo, genera una nueva metodología específica de planificación para el turismo sustentable de esta región (marco procedimental-territorial). El modelo genérico podrá ser aplicable a cualquier territorio dentro o fuera de la Región de Coquimbo, relevando sus propios valores, las necesidades de los visitantes y la participación de la comunidad y generando sus propios marcos procedimentales—territoriales (considerando los rasgos propios de los territorios, los requisitos del turismo sustentable y corrigiendo las falencias de las planificaciones previas existentes en ese territorio particular). ABSTRACT One way or another the process of planning has been implied in the development of tourism, although its application has not been absolutely successful. Also the revaluation that the planning is having in different scopes, public and private, and tourism is not free from it either, but still it requires modifications in the methods and techniques to be applied to a sustainable tourism. The modifications in the methods for the planning of the sustainable tourism in the Region of Coquimbo constitute the object of this investigation. The research establishes as hypothesis: “The integration of planning methodologies with the principles of the sustainable tourism would allow to generate a model of sustainable tourist planning, that incorporates the values of the territory, the needs of the visitors, the participation of the receiving community and is applicable to the Region of Coquimbo through a territorial-methodologic frame”. From this hypothesis, the general objective is defined: To make a proposal of a territorial-methodologic frame for the sustainable tourist planning in the Region of Coquimbo. From this general objective the specific objectives related to the analysis of the concepts and theoretical approaches of the planning applied to the tourism are deduced; the study of the planning tools of the tourist development of the Region of Coquimbo; the determination of categories and structural elements and the elaboration of a territorial-methodologic frame of the planning for the development of the sustainable tourism in the Region of Coquimbo. The methodology of the investigation is of qualitative character, is related mainly to the based theory or grounded theory and to the procedural theories of the planning. Both methodologies were used in the construction of the generic model and in the elaboration of the procedural-territorial frame. The construction of the generic model assimilated with the one of the theory in grounded theory and thus, concepts from the theoretical conceptual frame were generated (conceptualization or abstraction); categories of procedural, territorial analysis were constructed and of sustainable tourism (open codification), procedural-territorial syntheses categories were elaborated and of sustainable tourism (axial codification); the relational dynamics of the procedural-territorial categories was analyzed (selective codification) and the generic model of sustainable tourism planning was established (theory), that counts with two submodels: the General Conditions submodel and the Stages of planning submodel. From the generic model the categories defined and related in dynamic way were hierarchized, according to the characteristics of the Region of Coquimbo. Together with the recommended requirements of sustainable tourism done by The National Service of Tourism (SERNATUR) were included at national, regional level and communal and the absent stages in the formulated plans of tourist development in the Region were included, to give rise to the applied procedural-territorial frame in the Region of Coquimbo. The research gives as a result a planning methodology for sustainable tourism (generic model), that when being applied to a given territorial system, as it is the Region of Coquimbo, it generates a new specific planning methodology for the sustainable tourism of this region (procedural-territorial frame). The generic model could be applicable to any territory inside or outside the Region of Coquimbo, standing out its own values, the needs of the visitors and the participation of the community generating its own procedural-territorial frames (considering the own features of the territories, the requirements of the sustainable tourism and correcting the mistakes of the previous existing planning in that particular territory).

Response threshold models, stochastic learning automata and ant colony optimization-based decentralized self-coordination algorithms for heterogeneous multi-tasks distribution in multi-robot systems

In recent decades, there has been an increasing interest in systems comprised of several autonomous mobile robots, and as a result, there has been a substantial amount of development in the eld of Articial Intelligence, especially in Robotics. There are several studies in the literature by some researchers from the scientic community that focus on the creation of intelligent machines and devices capable to imitate the functions and movements of living beings. Multi-Robot Systems (MRS) can often deal with tasks that are dicult, if not impossible, to be accomplished by a single robot. In the context of MRS, one of the main challenges is the need to control, coordinate and synchronize the operation of multiple robots to perform a specic task. This requires the development of new strategies and methods which allow us to obtain the desired system behavior in a formal and concise way. This PhD thesis aims to study the coordination of multi-robot systems, in particular, addresses the problem of the distribution of heterogeneous multi-tasks. The main interest in these systems is to understand how from simple rules inspired by the division of labor in social insects, a group of robots can perform tasks in an organized and coordinated way. We are mainly interested on truly distributed or decentralized solutions in which the robots themselves, autonomously and in an individual manner, select a particular task so that all tasks are optimally distributed. In general, to perform the multi-tasks distribution among a team of robots, they have to synchronize their actions and exchange information. Under this approach we can speak of multi-tasks selection instead of multi-tasks assignment, which means, that the agents or robots select the tasks instead of being assigned a task by a central controller. The key element in these algorithms is the estimation ix of the stimuli and the adaptive update of the thresholds. This means that each robot performs this estimate locally depending on the load or the number of pending tasks to be performed. In addition, it is very interesting the evaluation of the results in function in each approach, comparing the results obtained by the introducing noise in the number of pending loads, with the purpose of simulate the robot's error in estimating the real number of pending tasks. The main contribution of this thesis can be found in the approach based on self-organization and division of labor in social insects. An experimental scenario for the coordination problem among multiple robots, the robustness of the approaches and the generation of dynamic tasks have been presented and discussed. The particular issues studied are: Threshold models: It presents the experiments conducted to test the response threshold model with the objective to analyze the system performance index, for the problem of the distribution of heterogeneous multitasks in multi-robot systems; also has been introduced additive noise in the number of pending loads and has been generated dynamic tasks over time. Learning automata methods: It describes the experiments to test the learning automata-based probabilistic algorithms. The approach was tested to evaluate the system performance index with additive noise and with dynamic tasks generation for the same problem of the distribution of heterogeneous multi-tasks in multi-robot systems. Ant colony optimization: The goal of the experiments presented is to test the ant colony optimization-based deterministic algorithms, to achieve the distribution of heterogeneous multi-tasks in multi-robot systems. In the experiments performed, the system performance index is evaluated by introducing additive noise and dynamic tasks generation over time.

Distributed System for Cognitive Stimulation Over Interactive TV.

Descripción y evaluación de sistema de estimulación cognitiva a través de la TDT orientada a personas con enfermedad de Parkinson, con supervisión por parte de sus terapeutas de forma remota. Abstract: This paper details the full design, implementation, and validation of an e-health service in order to improve the community health care services for patients with cognitive disorders. Specifically, the new service allows Parkinson’s disease patients benefit from the possibility of doing cognitive stimulation therapy (CST) at home by using a familiar device such as a TV set. Its use instead of a PC could be a major advantage for some patients whose lack of familiarity with the use of a PC means that they can do therapy only in the presence of a therapist. For these patients this solution could bring about a great improvement in their autonomy. At the same time, this service provides therapists with the ability to conduct follow-up of therapy sessions via the web,benefiting from greater and easier control of the therapy exercises performed by patients and allowing them to customize new exercises in accordance with the particular needs of each patient. As a result, this kind of CST is considered to be a complement of other therapies oriented to the Parkinson patients. Furthermore, with small changes, the system could be useful for patients with a different cognitive disease such as Alzheimer’s or mild cognitive impairment.