Patient-oriented computerized clinical guidelines for mobile decision support in gestational diabetes

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients’ self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient’s access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients’ personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients’ acceptance of the whole system.

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons

Background The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons’ psychomotor skills. Methods Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand–eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach’s α test. Results Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels. Conclusions EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons.

Signals and Systems Students trainer.

Higher education students demand fast feedback about their assignments and the opportunity to repeat them in case they do in a wrong way. Here a computer based trainer for Signals and Systems students is presented. An application, that automatically generates and assesses thousands of numerically different versions of several Signals and Systems problems have been developed. This applet guides the students to find the solution and automatically assesses and grades the students proposed solution. The students can use the application to practice in solving several types of Signals and Systems basic problems. After selecting the problem type, the student introduces a seed and the application generates a numerical version of the selected problem. Then the application presents a sequence of questions that the students must solve and the application automatically assess their answers. After solving a given problem, the students can repeat the same numerical variation of the problem by introducing the same seed to the application. In this way, they can review their solution with the help of the hints given by the application for wrong solutions. This application can also be used as an automatic assessment tool by the instructor. When the assessment is made in a controlled environment (examination classroom or laboratory) the instructor can use the same seed for all students. Otherwise, different seeds can be assigned to different students and in this way they solve different numerical variation of the proposed problem, so cheating becomes an arduous task. Given a problem type, the mathematical or conceptual difficulty of the problem can vary depending on the numerical values of the parameters of the problem. The application permits to easily select groups of seeds that yield to numerical variations with similar mathematical or conceptual difficulty. This represents an advantage over a randomised task assignment where students are asked to solve tasks with different difficulty.

Valoración de Indicadores de calidad para el diseño e implementación de tecnologías de manejo en Luvisoles de la zona norte de la provincia de Las Tunas, Cuba

La calidad del suelo es una herramienta de evaluación que puede facilitar la adaptación de prácticas de manejo que promuevan sistemas agropecuarios sostenibles. La investigación de este trabajo se inició con un diagnóstico participativo en 12 comunidades rurales de la provincia de Las Tunas en el año 2009 en el cual los productores identificaron los puntos críticos de calidad de los suelos de la región y sirvieron de punta de partida para seleccionar las variables físicas, químicas y biológicas a determinar en cinco sistemas de uso agropecuario (arboleda, pasto natural, pasto cultivado y dos sistemas silvopastoriles) en la zona La Veguita, municipio Las Tunas. El sistema arboleda se utilizó como referencia de las propiedades naturales del suelo. El pasto natural se distingue por el desarrollo de especies de baja productividad, sin embargo el pasto cultivado está representado por Pennisetum purpureum vc CUBA CT-115, y constituye una contribución a la tecnología de bancos de biomasa, para utilizarse en el pastoreo durante la seca. Los sistemas silvopastoriles están representados por Leucaena leucocephala Lam. en franjas y Panicum maximun vc. Likoni, los que se diferencian en su diseño, manejo y propiedades mineralógicas. El objetivo fundamental fue valorar indicadores de calidad de los suelos Luvisoles háplicos sobre granitoides, para diseñar e implementar tecnologías de manejo que permitan incrementar la capacidad agroproductiva de los suelos. Mediante el análisis de componentes principales se obtuvo un conjunto mínimo de indicadores físicos, químicos y biológicos que proporcionaron información útil referente a los procesos edáficos y se integraron para determinar un índice de calidad. En el sistema de uso, caracterizado por el pasto cultivado (Pennisetum purpureum) se estableció, en parcelas experimentales, un ensayo de corta duración, en el que se comparó el laboreo tradicional y el laboreo sin inversión del prisma, con y sin aplicación de compost. En ambos sistemas de labranza se evaluó el desarrollo del cultivo e indicadores de calidad del suelo. Los resultados mostraron que del conjunto de indicadores edáficos estudiados se seleccionaron 6 en los que la capacidad de intercambio catiónico, materia orgánica, potasio intercambiable, contenido de arena, densidad aparente y biomasa de lombrices explicaron la mayor variabilidad y sirvieron de base para evaluar la calidad de estos suelos. Se establecieron valores umbrales de referencia de indicadores de calidad, que permitirán evaluar y monitorear los sistemas de uso y manejo de la región. El sistema Silvopastoril 2 resultó el de mayor índice de calidad de los suelos tomando como referencia la arboleda por su condición natural. El manejo silvopastoril influyó predominantemente en mejores resultados productivos pero las características edáficas principalmente físicas, deben definir su diseño y manejo. El sistema de pastos cultivados con Pennisetum purpureum vc CUBA CT 115, alcanzó la mayor acumulación de carbono orgánico, sin embargo, el manejo limitó su calidad física y el funcionamiento productivo del sistema. De manera general los sistemas de uso no garantizan un índice de la calidad del suelo, puesto que se ve afectado por las propiedades edáficas y las prácticas de manejo. En el ámbito biológico, las lombrices constituyeron los organismos más numerosos con predominio en los sistemas silvopastoriles y arboleda. Los valores superiores de densidad y biomasa de oligoquetos y mayor diversidad de otros individuos de la macrofauna, indican que la presencia de árboles en los pastizales de gramínea potencia y diversifican las comunidades de macroinvertebrados del suelo. El sistema de labranza sin inversión del prisma propicia una mejor calidad física del suelo, manteniendo el carbono e incrementando los rendimientos del Penisetum purpureum cv CUBA CT 115. La labranza tradicional, a base de aradura y grada, afecta a los contenidos de materia orgánica en el corto plazo y mantiene capas compactas en el horizonte subyacente, además influye desfavorablemente al flujo del aire, agua y al desarrollo radical de los pastos. La aplicación de compost favoreció mejores resultados productivos en ambas tecnologías de manejo. Los resultados alcanzados recomiendan la implantación de tecnologías de manejo conservacionistas y la aplicación de materiales orgánicos que restituyan los elementos nutricionales requeridos por los pastos, por lo que no se justifica la continuidad del uso de prácticas tradicionales de laboreo con inversión del prisma que se realizan actualmente. ABSTRACT The soil quality is an assessment tool, which could facilitate the adaptation of management practices that promote sustainable agricultural systems. The present investigation was carried out with a participatory diagnostic in twelve rural communities from Las Tunas province in 2009, in which producers identified the critical soil quality points of region and served as a starting point to select the physical, chemical and biological variables, in order to determine on five agricultural used systems (grove, natural grass, cultivated grass and two silvopastoral systems) in La Veguita zone from municipality Las Tunas. The system grove was used as reference of natural soil properties. The natural grass is distinguished by the development of low-productivity species, however the cultivated grass is represented by Pennisetum purpureum vc CUBA CT-115, and is a contribution to the biomass banks technology, in order to use in grazing during the dry season. The silvopastoral systems are represented by Leucaena leucocephala Lam. in stripes and Panicum maximum cv. Likoni, which differ in their design, handling and mineralogical properties. The main aim of this study was to assess the quality indicators for haplic Luvisols on granitoids for designing and implementing management technologies in order to increase the agroproductive capacity of soils. A minimal set of physical, chemical and biological indicators by Principal Component Analysis was obtained, which provided some useful information regarding soil processes and their integration for determining an index of quality. In the use system, characterized for the cultivated grass (Pennisetum purpureum) a short term assay in experimental plots was established, where the traditional and prism without inversion tillage were compared with and without compost application. In both tillage systems were evaluated the crop development and soil quality indicators. The results showed that the studied soil indicators set, six were selected, specifically the ones with exchangeable cationic capacity, organic matter, interchangeable potassium, sand content, bulk density and earthworm biomass, which explained the higher variability and served as the basis for evaluating the soil quality. The Reference threshold values of quality indicators for evaluating and monitoring the use and management systems from the region were established. The silvopastoral system 2 had the highest quality soil index, taking of reference the grove system for its natural condition. The silvopastoral management influenced on better productive results, but the soil characteristics, particularly the physical properties to be defined its design and management. However, the cultivated grass system with Pennisetum purpureum vc CUBA CT 115, reached the greatest accumulation of organic carbon. However, the management limited its physical quality and productive performance of the system. In addition, the use systems do not guarantee an index of soil quality, since it is affected by soil properties and management practices. From the biological aspect, the earthworms are the most numerous organisms on the silvopastoral systems and grove. The higher values of oligochaetes biomass and density and the greater diversity of other organisms from macrofauna indicate that the tree presence on the pasture grasses allows enhancing and diversifying soil macro invertebrate communities. The non-inversion prism tillage system provides a better physical quality of soil, maintaining the carbon content and increasing the yields of Penisetum purpureum vc CUBA CT 115. The traditional tillage, using the plowing and harrowing affects the organic matter content in a short term and keeps on compact layers of underlying horizon, and adversely affects the air and water flow, and pasture radical development. The compost application favored the best production results in both management technologies. The results obtained recommend the implementation of conservation management technologies and the application of organic materials that restore the nutritional elements required by the pasture, so it does not justify the continued use of traditional tillage practices with prism investment that are currently being made.

Numerical and experimental study of the parametric rolling of a fisihing vessel in regular head waves

The dynamic behaviour of a fishing vessel in waves is studied in order to reveal its parametric rolling characteristics. This paper presents experimental and numerical results in longitudinal regular waves. The experimental results are compared against the results of a time-domain non-linear strip theory model of ship motions in six degrees-of-freedom. These results contribute to the validation of the parametric rolling prediction method, so that it can be used as an assessment tool to evaluate both the susceptibility and severity of occurrence of parametric rolling at the early design stage of these types of vessels.

Termografía como nueva herramienta de evaluación en baloncesto. Estudio piloto realizado a un jugador profesional de la ACB

Thermography as a new assessment tool in basketball. Pilot study carried out with a professional player in the ACB

Especificaciones eMathTeacher, creación del Modelo Granular Lingüístico de la evaluación del aprendizaje humano, y diseño de sistemas que implementan estos conceptos

El concepto de algoritmo es básico en informática, por lo que es crucial que los alumnos profundicen en él desde el inicio de su formación. Por tanto, contar con una herramienta que guíe a los estudiantes en su aprendizaje puede suponer una gran ayuda en su formación. La mayoría de los autores coinciden en que, para determinar la eficacia de una herramienta de visualización de algoritmos, es esencial cómo se utiliza. Así, los estudiantes que participan activamente en la visualización superan claramente a los que la contemplan de forma pasiva. Por ello, pensamos que uno de los mejores ejercicios para un alumno consiste en simular la ejecución del algoritmo que desea aprender mediante el uso de una herramienta de visualización, i. e. consiste en realizar una simulación visual de dicho algoritmo. La primera parte de esta tesis presenta los resultados de una profunda investigación sobre las características que debe reunir una herramienta de ayuda al aprendizaje de algoritmos y conceptos matemáticos para optimizar su efectividad: el conjunto de especificaciones eMathTeacher, además de un entorno de aprendizaje que integra herramientas que las cumplen: GRAPHs. Hemos estudiado cuáles son las cualidades esenciales para potenciar la eficacia de un sistema e-learning de este tipo. Esto nos ha llevado a la definición del concepto eMathTeacher, que se ha materializado en el conjunto de especificaciones eMathTeacher. Una herramienta e-learning cumple las especificaciones eMathTeacher si actúa como un profesor virtual de matemáticas, i. e. si es una herramienta de autoevaluación que ayuda a los alumnos a aprender de forma activa y autónoma conceptos o algoritmos matemáticos, corrigiendo sus errores y proporcionando pistas para encontrar la respuesta correcta, pero sin dársela explícitamente. En estas herramientas, la simulación del algoritmo no continúa hasta que el usuario introduce la respuesta correcta. Para poder reunir en un único entorno una colección de herramientas que cumplan las especificaciones eMathTeacher hemos creado GRAPHs, un entorno ampliable, basado en simulación visual, diseñado para el aprendizaje activo e independiente de los algoritmos de grafos y creado para que en él se integren simuladores de diferentes algoritmos. Además de las opciones de creación y edición del grafo y la visualización de los cambios producidos en él durante la simulación, el entorno incluye corrección paso a paso, animación del pseudocódigo del algoritmo, preguntas emergentes, manejo de las estructuras de datos del algoritmo y creación de un log de interacción en XML. Otro problema que nos planteamos en este trabajo, por su importancia en el proceso de aprendizaje, es el de la evaluación formativa. El uso de ciertos entornos e-learning genera gran cantidad de datos que deben ser interpretados para llegar a una evaluación que no se limite a un recuento de errores. Esto incluye el establecimiento de relaciones entre los datos disponibles y la generación de descripciones lingüísticas que informen al alumno sobre la evolución de su aprendizaje. Hasta ahora sólo un experto humano era capaz de hacer este tipo de evaluación. Nuestro objetivo ha sido crear un modelo computacional que simule el razonamiento del profesor y genere un informe sobre la evolución del aprendizaje que especifique el nivel de logro de cada uno de los objetivos definidos por el profesor. Como resultado del trabajo realizado, la segunda parte de esta tesis presenta el modelo granular lingüístico de la evaluación del aprendizaje, capaz de modelizar la evaluación y generar automáticamente informes de evaluación formativa. Este modelo es una particularización del modelo granular lingüístico de un fenómeno (GLMP), en cuyo desarrollo y formalización colaboramos, basado en la lógica borrosa y en la teoría computacional de las percepciones. Esta técnica, que utiliza sistemas de inferencia basados en reglas lingüísticas y es capaz de implementar criterios de evaluación complejos, se ha aplicado a dos casos: la evaluación, basada en criterios, de logs de interacción generados por GRAPHs y de cuestionarios de Moodle. Como consecuencia, se han implementado, probado y utilizado en el aula sistemas expertos que evalúan ambos tipos de ejercicios. Además de la calificación numérica, los sistemas generan informes de evaluación, en lenguaje natural, sobre los niveles de competencia alcanzados, usando sólo datos objetivos de respuestas correctas e incorrectas. Además, se han desarrollado dos aplicaciones capaces de ser configuradas para implementar los sistemas expertos mencionados. Una procesa los archivos producidos por GRAPHs y la otra, integrable en Moodle, evalúa basándose en los resultados de los cuestionarios. ABSTRACT The concept of algorithm is one of the core subjects in computer science. It is extremely important, then, for students to get a good grasp of this concept from the very start of their training. In this respect, having a tool that helps and shepherds students through the process of learning this concept can make a huge difference to their instruction. Much has been written about how helpful algorithm visualization tools can be. Most authors agree that the most important part of the learning process is how students use the visualization tool. Learners who are actively involved in visualization consistently outperform other learners who view the algorithms passively. Therefore we think that one of the best exercises to learn an algorithm is for the user to simulate the algorithm execution while using a visualization tool, thus performing a visual algorithm simulation. The first part of this thesis presents the eMathTeacher set of requirements together with an eMathTeacher-compliant tool called GRAPHs. For some years, we have been developing a theory about what the key features of an effective e-learning system for teaching mathematical concepts and algorithms are. This led to the definition of eMathTeacher concept, which has materialized in the eMathTeacher set of requirements. An e-learning tool is eMathTeacher compliant if it works as a virtual math trainer. In other words, it has to be an on-line self-assessment tool that helps students to actively and autonomously learn math concepts or algorithms, correcting their mistakes and providing them with clues to find the right answer. In an eMathTeacher-compliant tool, algorithm simulation does not continue until the user enters the correct answer. GRAPHs is an extendible environment designed for active and independent visual simulation-based learning of graph algorithms, set up to integrate tools to help the user simulate the execution of different algorithms. Apart from the options of creating and editing the graph, and visualizing the changes made to the graph during simulation, the environment also includes step-by-step correction, algorithm pseudo-code animation, pop-up questions, data structure handling and XML-based interaction log creation features. On the other hand, assessment is a key part of any learning process. Through the use of e-learning environments huge amounts of data can be output about this process. Nevertheless, this information has to be interpreted and represented in a practical way to arrive at a sound assessment that is not confined to merely counting mistakes. This includes establishing relationships between the available data and also providing instructive linguistic descriptions about learning evolution. Additionally, formative assessment should specify the level of attainment of the learning goals defined by the instructor. Till now, only human experts were capable of making such assessments. While facing this problem, our goal has been to create a computational model that simulates the instructor’s reasoning and generates an enlightening learning evolution report in natural language. The second part of this thesis presents the granular linguistic model of learning assessment to model the assessment of the learning process and implement the automated generation of a formative assessment report. The model is a particularization of the granular linguistic model of a phenomenon (GLMP) paradigm, based on fuzzy logic and the computational theory of perceptions, to the assessment phenomenon. This technique, useful for implementing complex assessment criteria using inference systems based on linguistic rules, has been applied to two particular cases: the assessment of the interaction logs generated by GRAPHs and the criterion-based assessment of Moodle quizzes. As a consequence, several expert systems to assess different algorithm simulations and Moodle quizzes have been implemented, tested and used in the classroom. Apart from the grade, the designed expert systems also generate natural language progress reports on the achieved proficiency level, based exclusively on the objective data gathered from correct and incorrect responses. In addition, two applications, capable of being configured to implement the expert systems, have been developed. One is geared up to process the files output by GRAPHs and the other one is a Moodle plug-in set up to perform the assessment based on the quizzes results.