New signal processing algorithms for automated external defibrillators

[ES]La fibrilación ventricular (VF) es el primer ritmo registrado en el 40\,\% de las muertes súbitas por paro cardiorrespiratorio extrahospitalario (PCRE). El único tratamiento eficaz para la FV es la desfibrilación mediante una descarga eléctrica. Fuera del hospital, la descarga se administra mediante un desfibrilador externo automático (DEA), que previamente analiza el electrocardiograma (ECG) del paciente y comprueba si presenta un ritmo desfibrilable. La supervivencia en un caso de PCRE depende fundamentalmente de dos factores: la desfibrilación temprana y la resucitación cardiopulmonar (RCP) temprana, que prolonga la FV y por lo tanto la oportunidad de desfibrilación. Para un correcto análisis del ritmo cardiaco es necesario interrumpir la RCP, ya que, debido a las compresiones torácicas, la RCP introduce artefactos en el ECG. Desafortunadamente, la interrupción de la RCP afecta negativamente al éxito en la desfibrilación. En 2003 se aprobó el uso del DEA en pacientes entre 1 y 8 años. Los DEA, que originalmente se diseñaron para pacientes adultos, deben discriminar de forma precisa las arritmias pediátricas para que su uso en niños sea seguro. Varios DEAs se han adaptado para uso pediátrico, bien demostrando la precisión de los algoritmos para adultos con arritmias pediátricas, o bien mediante algoritmos específicos para arritmias pediátricas. Esta tesis presenta un nuevo algoritmo DEA diseñado conjuntamente para pacientes adultos y pediátricos. El algoritmo se ha probado exhaustivamente en bases de datos acordes a los requisitos de la American Heart Association (AHA), y en registros de resucitación con y sin artefacto RCP. El trabajo comenzó con una larga fase experimental en la que se recopilaron y clasificaron retrospectivamente un total de 1090 ritmos pediátricos. Además, se revisó una base de arritmias de adultos y se añadieron 928 nuevos ritmos de adultos. La base de datos final contiene 2782 registros, 1270 se usaron para diseñar el algoritmo y 1512 para validarlo. A continuación, se diseñó un nuevo algoritmo DEA compuesto de cuatro subalgoritmos. Estos subalgoritmos están basados en un conjunto de nuevos parámetros para la detección de arritmias, calculados en diversos dominios de la señal, como el tiempo, la frecuencia, la pendiente o la función de autocorrelación. El algoritmo cumple las exigencias de la AHA para la detección de ritmos desfibrilables y no-desfibrilables tanto en pacientes adultos como en pediátricos. El trabajo concluyó con el análisis del comportamiento del algoritmo con episodios reales de resucitación. En los ritmos que no contenían artefacto RCP se cumplieron las exigencias de la AHA. Posteriormente, se estudió la precisión del algoritmo durante las compresiones torácicas, antes y después de filtrar el artefacto RCP. Para suprimir el artefacto se utilizó un nuevo método desarrollado a lo largo de la tesis. Los ritmos desfibrilables se detectaron de forma precisa tras el filtrado, los no-desfibrilables sin embargo no.

ATP Antagonizes Thrombin-Induced Signal Transduction through 12(S)-HETE and cAMP

15 p.

The Uniform World Model: A Methodology for Predicting the Health Impacts of Air Pollution

47 p.

Novel Evidence hat Attributing Affectively Salient Signal to Random Noise Is Associated with Psychosis

We wished to replicate evidence that an experimental paradigm of speech illusions is associated with psychotic experiences. Fifty-four patients with a first episode of psychosis (FEP) and 150 healthy subjects were examined in an experimental paradigm assessing the presence of speech illusion in neutral white noise. Socio-demographic, cognitive function and family history data were collected. The Positive and Negative Syndrome Scale (PANSS) was administered in the patient group and the Structured Interview for Schizotypy-Revised (SIS-R), and the Community Assessment of Psychic Experiences (CAPE) in the control group. Patients had a much higher rate of speech illusions (33.3% versus 8.7%, ORadjusted: 5.1, 95% CI: 2.3-11.5), which was only partly explained by differences in IQ (ORadjusted: 3.4, 95% CI: 1.4-8.3). Differences were particularly marked for signals in random noise that were perceived as affectively salient (ORadjusted: 9.7, 95% CI: 1.8-53.9). Speech illusion tended to be associated with positive symptoms in patients (ORadjusted: 3.3, 95% CI: 0.9-11.6), particularly affectively salient illusions (ORadjusted: 8.3, 95% CI: 0.7-100.3). In controls, speech illusions were not associated with positive schizotypy (ORadjusted: 1.1, 95% CI: 0.3-3.4) or self-reported psychotic experiences (ORadjusted: 1.4, 95% CI: 0.4-4.6). Experimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis.

Current Approaches for Predicting a Lack of Response to Anti-EGFR Therapy in KRAS Wild-Type Patients

Targeting epidermal growth factor receptor (EGFR) has been one of the most effective colorectal cancer strategies. Anti-EGFR antibodies function by binding to the extracellular domain of EGFR, preventing its activation, and ultimately providing clinical benefit. KRAS mutations in codons 12 and 13 are recognized prognostic and predictive biomarkers that should be analyzed at the clinic prior to the administration of anti-EGFR therapy. However, still an important fraction of KRAS wild-type patients do not respond to the treatment. The identification of additional genetic determinants of primary or secondary resistance to EGFR targeted therapy for further improving the selection of patients is urgent. Herein, we review the latest published literature highlighting the most important genes that may predict resistance to anti-EGFR monoclonal antibodies in colorectal cancer patients. According to the available findings, the evaluation of BRAF, NRAS, PIK3CA, and PTEN status could be the right strategy to select patients who are likely to respond to anti-EGFR therapies. In the future, the combination of those biomarkers will help establish consensus that can be introduced into clinical practice.

Analysis of multivariate stochastic signals sampled by on-line particle analyzers: Application to the quantitative assessment of occupational exposure to NOAA in multisource industrial scenarios (MSIS)

In multisource industrial scenarios (MSIS) coexist NOAA generating activities with other productive sources of airborne particles, such as parallel processes of manufacturing or electrical and diesel machinery. A distinctive characteristic of MSIS is the spatially complex distribution of aerosol sources, as well as their potential differences in dynamics, due to the feasibility of multi-task configuration at a given time. Thus, the background signal is expected to challenge the aerosol analyzers at a probably wide range of concentrations and size distributions, depending of the multisource configuration at a given time. Monitoring and prediction by using statistical analysis of time series captured by on-line particle analyzers in industrial scenarios, have been proven to be feasible in predicting PNC evolution provided a given quality of net signals (difference between signal at source and background). However the analysis and modelling of non-consistent time series, influenced by low levels of SNR (Signal-Noise Ratio) could build a misleading basis for decision making. In this context, this work explores the use of stochastic models based on ARIMA methodology to monitor and predict exposure values (PNC). The study was carried out in a MSIS where an case study focused on the manufacture of perforated tablets of nano-TiO2 by cold pressing was performed