946 resultados para Mean square analysis


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We examined the impact of physical activity (PA) on surrogate markers of cardiovascular health in adolescents. 52 healthy students (28 females, mean age 14.5 ± 0.7 years) were investigated. Microvascular endothelial function was assessed by peripheral arterial tonometry to determine reactive hyperemic index (RHI). Vagal activity was measured using 24 h analysis of heart rate variability [root mean square of successive normal-to-normal intervals (rMSSD)]. Exercise testing was performed to determine peak oxygen uptake ([Formula: see text]) and maximum power output. PA was assessed by accelerometry. Linear regression models were performed and adjusted for age, sex, skinfolds, and pubertal status. The cohort was dichotomized into two equally sized activity groups (low vs. high) based on the daily time spent in moderate-to-vigorous PA (MVPA, 3,000-5,200 counts(.)min(-1), model 1) and vigorous PA (VPA, >5,200 counts(.)min(-1), model 2). MVPA was an independent predictor for rMSSD (β = 0.448, P = 0.010), and VPA was associated with maximum power output (β = 0.248, P = 0.016). In model 1, the high MVPA group exhibited a higher vagal tone (rMSSD 49.2 ± 13.6 vs. 38.1 ± 11.7 ms, P = 0.006) and a lower systolic blood pressure (107.3 ± 9.9 vs. 112.9 ± 8.1 mmHg, P = 0.046). In model 2, the high VPA group had higher maximum power output values (3.9 ± 0.5 vs. 3.4 ± 0.5 W kg(-1), P = 0.012). In both models, no significant differences were observed for RHI and [Formula: see text]. In conclusion, in healthy adolescents, PA was associated with beneficial intensity-dependent effects on vagal tone, systolic blood pressure, and exercise capacity, but not on microvascular endothelial function.

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In a retrospective multicentre study, the success rate and efficiency of activator treatment were analysed. All patients from two University clinics (Giessen, Germany and Berne, Switzerland) that fulfilled the selection criteria (Class II division 1 malocclusion, activator treatment, no aplasia, no extraction of permanent teeth, no syndromes, no previous orthodontic treatment except transverse maxillary expansion, full available records) were included in the study. The subject material amounted to 222 patients with a mean age of 10.6 years. Patient records, lateral head films, and dental casts were evaluated. Treatment was classified as successful if the molar relationship improved by at least half to three-fourths cusp width depending on whether or not the leeway space was used during treatment. Group comparisons were carried out using Wilcoxon two-sample and Kruskal-Wallis tests. For discrete data, chi-square analysis was used and Fisher's exact test when the sample size was small. Stepwise logistic regression was also employed. The success rate was 64 per cent in Giessen and 66 per cent in Berne. The only factor that significantly (P < 0.001) influenced treatment success was the level of co-operation. In approximately 27 per cent of the patients at both centres, the post-treatment occlusion was an 'ideal' Class I. In an additional 38 per cent of the patients, marked improvements in occlusal relationships were found. In subjects with Class II division 1 malocclusions, in which orthodontic treatment is performed by means of activators, a marked improvement of the Class II dental arch relationships can be expected in approximately 65 per cent of subjects. Activator treatment is more efficient in the late than in the early mixed dentition.

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PURPOSE: Understanding the learning styles of individuals may assist in the tailoring of an educational program to optimize learning. General surgery faculty and residents have been characterized previously as having a tendency toward particular learning styles. We seek to understand better the learning styles of general surgery residents and differences that may exist within the population. METHODS: The Kolb Learning Style Inventory was administered yearly to general surgery residents at the University of Cincinnati from 1994 to 2006. This tool allows characterization of learning styles into 4 groups: converging, accommodating, assimilating, and diverging. The converging learning style involves education by actively solving problems. The accommodating learning style uses emotion and interpersonal relationships. The assimilating learning style learns by abstract logic. The diverging learning style learns best by observation. Chi-square analysis and analysis of variance were performed to determine significance. RESULTS: Surveys from 1994 to 2006 (91 residents, 325 responses) were analyzed. The prevalent learning style was converging (185, 57%), followed by assimilating (58, 18%), accommodating (44, 14%), and diverging (38, 12%). At the PGY 1 and 2 levels, male and female residents differed in learning style, with the accommodating learning style being relatively more frequent in women and assimilating learning style more frequent in men (Table 1, p < or = 0.001, chi-square test). Interestingly, learning style did not seem to change with advancing PGY level within the program, which suggests that individual learning styles may be constant throughout residency training. If a resident's learning style changed, it tended to be to converging. In addition, no relation exists between learning style and participation in dedicated basic science training or performance on the ABSIT/SBSE. CONCLUSIONS: Our data suggests that learning style differs between male and female general surgery residents but not with PGY level or ABSIT/SBSE performance. A greater understanding of individual learning styles may allow more refinement and tailoring of surgical programs.

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OBJECTIVE: The objective of this study was to evaluate the feasibility and reproducibility of high-resolution magnetic resonance imaging (MRI) and quantitative T2 mapping of the talocrural cartilage within a clinically applicable scan time using a new dedicated ankle coil and high-field MRI. MATERIALS AND METHODS: Ten healthy volunteers (mean age 32.4 years) underwent MRI of the ankle. As morphological sequences, proton density fat-suppressed turbo spin echo (PD-FS-TSE), as a reference, was compared with 3D true fast imaging with steady-state precession (TrueFISP). Furthermore, biochemical quantitative T2 imaging was prepared using a multi-echo spin-echo T2 approach. Data analysis was performed three times each by three different observers on sagittal slices, planned on the isotropic 3D-TrueFISP; as a morphological parameter, cartilage thickness was assessed and for T2 relaxation times, region-of-interest (ROI) evaluation was done. Reproducibility was determined as a coefficient of variation (CV) for each volunteer; averaged as root mean square (RMSA) given as a percentage; statistical evaluation was done using analysis of variance. RESULTS: Cartilage thickness of the talocrural joint showed significantly higher values for the 3D-TrueFISP (ranging from 1.07 to 1.14 mm) compared with the PD-FS-TSE (ranging from 0.74 to 0.99 mm); however, both morphological sequences showed comparable good results with RMSA of 7.1 to 8.5%. Regarding quantitative T2 mapping, measurements showed T2 relaxation times of about 54 ms with an excellent reproducibility (RMSA) ranging from 3.2 to 4.7%. CONCLUSION: In our study the assessment of cartilage thickness and T2 relaxation times could be performed with high reproducibility in a clinically realizable scan time, demonstrating new possibilities for further investigations into patient groups.

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This study develops an automated analysis tool by combining total internal reflection fluorescence microscopy (TIRFM), an evanescent wave microscopic imaging technique to capture time-sequential images and the corresponding image processing Matlab code to identify movements of single individual particles. The developed code will enable us to examine two dimensional hindered tangential Brownian motion of nanoparticles with a sub-pixel resolution (nanoscale). The measured mean square displacements of nanoparticles are compared with theoretical predictions to estimate particle diameters and fluid viscosity using a nonlinear regression technique. These estimated values will be confirmed by the diameters and viscosities given by manufacturers to validate this analysis tool. Nano-particles used in these experiments are yellow-green polystyrene fluorescent nanospheres (200 nm, 500 nm and 1000 nm in diameter (nominal); 505 nm excitation and 515 nm emission wavelengths). Solutions used in this experiment are de-ionized (DI) water, 10% d-glucose and 10% glycerol. Mean square displacements obtained near the surface shows significant deviation from theoretical predictions which are attributed to DLVO forces in the region but it conforms to theoretical predictions after ~125 nm onwards. The proposed automation analysis tool will be powerfully employed in the bio-application fields needed for examination of single protein (DNA and/or vesicle) tracking, drug delivery, and cyto-toxicity unlike the traditional measurement techniques that require fixing the cells. Furthermore, this tool can be also usefully applied for the microfluidic areas of non-invasive thermometry, particle tracking velocimetry (PTV), and non-invasive viscometry.

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INTRODUCTION: The simple bedside method for sampling undiluted distal pulmonary edema fluid through a normal suction catheter (s-Cath) has been experimentally and clinically validated. However, there are no data comparing non-bronchoscopic bronchoalveolar lavage (mini-BAL) and s-Cath for assessing lung inflammation in acute hypoxaemic respiratory failure. We designed a prospective study in two groups of patients, those with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and those with acute cardiogenic lung edema (ACLE), designed to investigate the clinical feasibility of these techniques and to evaluate inflammation in both groups using undiluted sampling obtained by s-Cath. To test the interchangeability of the two methods in the same patient for studying the inflammation response, we further compared mini-BAL and s-Cath for agreement of protein concentration and percentage of polymorphonuclear cells (PMNs). METHODS: Mini-BAL and s-Cath sampling was assessed in 30 mechanically ventilated patients, 21 with ALI/ARDS and 9 with ACLE. To analyse agreement between the two sampling techniques, we considered only simultaneously collected mini-BAL and s-Cath paired samples. The protein concentration and polymorphonuclear cell (PMN) count comparisons were performed using undiluted sampling. Bland-Altman plots were used for assessing the mean bias and the limits of agreement between the two sampling techniques; comparison between groups was performed by using the non-parametric Mann-Whitney-U test; continuous variables were compared by using the Student t-test, Wilcoxon signed rank test, analysis of variance or Student-Newman-Keuls test; and categorical variables were compared by using chi-square analysis or Fisher exact test. RESULTS: Using protein content and PMN percentage as parameters, we identified substantial variations between the two sampling techniques. When the protein concentration in the lung was high, the s-Cath was a more sensitive method; by contrast, as inflammation increased, both methods provided similar estimates of neutrophil percentages in the lung. The patients with ACLE showed an increased PMN count, suggesting that hydrostatic lung edema can be associated with a concomitant inflammatory process. CONCLUSIONS: There are significant differences between the s-Cath and mini-BAL sampling techniques, indicating that these procedures cannot be used interchangeably for studying the lung inflammatory response in patients with acute hypoxaemic lung injury.

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Soil spectroscopy was applied for predicting soil organic carbon (SOC) in the highlands of Ethiopia. Soil samples were acquired from Ethiopia’s National Soil Testing Centre and direct field sampling. The reflectance of samples was measured using a FieldSpec 3 diffuse reflectance spectrometer. Outliers and sample relation were evaluated using principal component analysis (PCA) and models were developed through partial least square regression (PLSR). For nine watersheds sampled, 20% of the samples were set aside to test prediction and 80% were used to develop calibration models. Depending on the number of samples per watershed, cross validation or independent validation were used.The stability of models was evaluated using coefficient of determination (R2), root mean square error (RMSE), and the ratio performance deviation (RPD). The R2 (%), RMSE (%), and RPD, respectively, for validation were Anjeni (88, 0.44, 3.05), Bale (86, 0.52, 2.7), Basketo (89, 0.57, 3.0), Benishangul (91, 0.30, 3.4), Kersa (82, 0.44, 2.4), Kola tembien (75, 0.44, 1.9),Maybar (84. 0.57, 2.5),Megech (85, 0.15, 2.6), andWondoGenet (86, 0.52, 2.7) indicating that themodels were stable. Models performed better for areas with high SOC values than areas with lower SOC values. Overall, soil spectroscopy performance ranged from very good to good.

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We present an independent calibration model for the determination of biogenic silica (BSi) in sediments, developed from analysis of synthetic sediment mixtures and application of Fourier transform infrared spectroscopy (FTIRS) and partial least squares regression (PLSR) modeling. In contrast to current FTIRS applications for quantifying BSi, this new calibration is independent from conventional wet-chemical techniques and their associated measurement uncertainties. This approach also removes the need for developing internal calibrations between the two methods for individual sediments records. For the independent calibration, we produced six series of different synthetic sediment mixtures using two purified diatom extracts, with one extract mixed with quartz sand, calcite, 60/40 quartz/calcite and two different natural sediments, and a second extract mixed with one of the natural sediments. A total of 306 samples—51 samples per series—yielded BSi contents ranging from 0 to 100 %. The resulting PLSR calibration model between the FTIR spectral information and the defined BSi concentration of the synthetic sediment mixtures exhibits a strong cross-validated correlation ( R2cv = 0.97) and a low root-mean square error of cross-validation (RMSECV = 4.7 %). Application of the independent calibration to natural lacustrine and marine sediments yields robust BSi reconstructions. At present, the synthetic mixtures do not include the variation in organic matter that occurs in natural samples, which may explain the somewhat lower prediction accuracy of the calibration model for organic-rich samples.

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Background Tef [Eragrostis tef (Zucc.) Trotter] is the major cereal crop of Ethiopia where it is annually cultivated on more than three million hectares of land by over six million small-scale farmers. It is broadly grouped into white and brown-seeded type depending on grain color, although some intermediate color grains also exist. Earlier breeding experiments focused on white-seeded tef, and a number of improved varieties were released to the farming community. Thirty-six brown-seeded tef genotypes were evaluated using a 6 × 6 simple lattice design at three locations in the central highlands of Ethiopia to assess the productivity, heritability, and association among major pheno-morphic traits. Results The mean square due to genotypes, locations, and genotype by locations were significant (P < 0.01) for all traits studied. Genotypic and phenotypic coefficients of variations ranged from 2.5 to 20.3 % and from 4.3 to 21.7 %, respectively. Grain yield showed significant (P < 0.01) genotypic correlation with shoot biomass and harvest index, while it had highly significant (P < 0.01) phenotypic correlation with all the traits evaluated. Besides, association of lodging index with biomass and grain yield was negative and significant at phenotypic level while it was not significant at genotypic level. Cluster analysis grouped the 36 test genotypes into seven distinct classes. Furthermore, the first three principal components with eigenvalues greater than unity extracted 78.3 % of the total variation. Conclusion The current study, generally, revealed the identification of genotypes with superior grain yield and other desirable traits for further evaluation and eventual release to the farming community.

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We describe the recovery of three daily meteorological records for the southern Alps (Domodossola, Riva del Garda, and Rovereto), all starting in the second half of the nineteenth century. We use these new data, along with additional records, to study regional changes in the mean temperature and extreme indices of heat waves and cold spells frequency and duration over the period 1874–2015. The records are homogenized using subdaily cloud cover observations as a constraint for the statistical model, an approach that has never been applied before in the literature. A case study based on a record of parallel observations between a traditional meteorological window and a modern screen shows that the use of cloud cover can reduce the root-mean-square error of the homogenization by up to 30% in comparison to an unaided statistical correction. We find that mean temperature in the southern Alps has increased by 1.4°C per century over the analyzed period, with larger increases in daily minimum temperatures than maximum temperatures. The number of hot days in summer has more than tripled, and a similar increase is observed in duration of heat waves. Cold days in winter have dropped at a similar rate. These trends are mainly caused by climate change over the last few decades.

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This dissertation was written in the format of three journal articles. Paper 1 examined the influence of change and fluctuation in body mass index (BMI) over an eleven-year period, on changes in serum lipid levels (total, HDL, and LDL cholesterol, triglyceride) in a population of Mexican Americans with type 2 diabetes. Linear regression models containing initial lipid value, BMI and age, BMI change (slope of BMI), and BMI fluctuation (root mean square error) were used to investigate associations of these variables with change in lipids over time. Increasing BMI over time was associated with gains in total and LDL cholesterol and triglyceride levels in women. Fluctuation of BMI was not associated with detrimental lipid profiles. These effects were independent of age and were not statistically significant in men. In Mexican-American women with type 2 diabetes, weight reduction is likely to result in more favorable levels of total and LDL cholesterol and triglyceride, without concern for possible detrimental effects of weight fluctuation. Weight reduction may not be as effective in men, but does not appear to be harmful either. ^ Paper 2 examined the associations of upper and total body fat with total cholesterol, HDL and LDL cholesterol, and triglyceride levels in the same population. Multilevel analysis was used to predict serum lipid levels from total body fat (BMI and triceps skinfold) and upper body fat (subscapular skinfold), while controlling for the effects of sex, age and self-correlations across time. Body fat was not strikingly associated with trends in serum lipid levels. However, upper body fat was strongly associated with triglyceride levels. This suggests that loss of upper body fat may be more important than weight loss in management of the hypertriglyceridemia commonly seen in type 2 diabetes. ^ Paper 3 was a review of the literature reporting associations between weight fluctuation and lipid levels. Few studies have reported associations between weight fluctuation and total, LDL, and HDL cholesterol and triglyceride levels. The body of evidence to date suggests that weight fluctuation does not strongly influence levels of total, LDL and HDL cholesterol and triglyceride. ^

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The demand for an alternative and a high potency sweetener to substitute sugar increases year in year out, more so as a high percentage of the world population becomes increasingly diabetic. The alternative natural sweetener at hand has been Stevia rebaudiana Bertoni, a plant species, native to Paraguay and a member of the family compositae. Stevia is usually propagated by stem cuttings due to low percentage (10 %) seed germination, thus limiting large scales cultivation. To cultivate this crop en mass therefore, there is need to evolve efficient rooting techniques. Influences of irradiation from light, and hormones on rooting have been reported. The rooting efficacy in stem cuttings of this crop under varying light wavelengths, dark and hormone factors was investigated. Evaluated parameters include- (i) day of root emergent, (ii) percentage of rooted cuttings, (iii) average number, (iv) length and (v) width, of roots. Analysis of variance at p<.05 revealed that the number, length and width, of roots differed significantly in each case at p<0.000. Light irradiation was highly effective and a necessary factor for rooting in stems cuttings of this crop. The red light-IBA combined factors served best in stem micro-cutting practice and facilitation of effective mass cultivation in stevia crop.

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Abstract Air pollution is a big threat and a phenomenon that has a specific impact on human health, in addition, changes that occur in the chemical composition of the atmosphere can change the weather and cause acid rain or ozone destruction. Those are phenomena of global importance. The World Health Organization (WHO) considerates air pollution as one of the most important global priorities. Salamanca, Gto., Mexico has been ranked as one of the most polluted cities in this country. The industry of the area led to a major economic development and rapid population growth in the second half of the twentieth century. The impact in the air quality is important and significant efforts have been made to measure the concentrations of pollutants. The main pollution sources are locally based plants in the chemical and power generation sectors. The registered concerning pollutants are Sulphur Dioxide (SO2) and particles on the order of ∼10 micrometers or less (PM10). The prediction in the concentration of those pollutants can be a powerful tool in order to take preventive measures such as the reduction of emissions and alerting the affected population. In this PhD thesis we propose a model to predict concentrations of pollutants SO2 and PM10 for each monitoring booth in the Atmospheric Monitoring Network Salamanca (REDMAS - for its spanish acronym). The proposed models consider the use of meteorological variables as factors influencing the concentration of pollutants. The information used along this work is the current real data from REDMAS. In the proposed model, Artificial Neural Networks (ANN) combined with clustering algorithms are used. The type of ANN used is the Multilayer Perceptron with a hidden layer, using separate structures for the prediction of each pollutant. The meteorological variables used for prediction were: Wind Direction (WD), wind speed (WS), Temperature (T) and relative humidity (RH). Clustering algorithms, K-means and Fuzzy C-means, are used to find relationships between air pollutants and weather variables under consideration, which are added as input of the RNA. Those relationships provide information to the ANN in order to obtain the prediction of the pollutants. The results of the model proposed in this work are compared with the results of a multivariate linear regression and multilayer perceptron neural network. The evaluation of the prediction is calculated with the mean absolute error, the root mean square error, the correlation coefficient and the index of agreement. The results show the importance of meteorological variables in the prediction of the concentration of the pollutants SO2 and PM10 in the city of Salamanca, Gto., Mexico. The results show that the proposed model perform better than multivariate linear regression and multilayer perceptron neural network. The models implemented for each monitoring booth have the ability to make predictions of air quality that can be used in a system of real-time forecasting and human health impact analysis. Among the main results of the development of this thesis we can cite: A model based on artificial neural network combined with clustering algorithms for prediction with a hour ahead of the concentration of each pollutant (SO2 and PM10) is proposed. A different model was designed for each pollutant and for each of the three monitoring booths of the REDMAS. A model to predict the average of pollutant concentration in the next 24 hours of pollutants SO2 and PM10 is proposed, based on artificial neural network combined with clustering algorithms. Model was designed for each booth of the REDMAS and each pollutant separately. Resumen La contaminación atmosférica es una amenaza aguda, constituye un fenómeno que tiene particular incidencia sobre la salud del hombre. Los cambios que se producen en la composición química de la atmósfera pueden cambiar el clima, producir lluvia ácida o destruir el ozono, fenómenos todos ellos de una gran importancia global. La Organización Mundial de la Salud (OMS) considera la contaminación atmosférica como una de las más importantes prioridades mundiales. Salamanca, Gto., México; ha sido catalogada como una de las ciudades más contaminadas en este país. La industria de la zona propició un importante desarrollo económico y un crecimiento acelerado de la población en la segunda mitad del siglo XX. Las afectaciones en el aire son graves y se han hecho importantes esfuerzos por medir las concentraciones de los contaminantes. Las principales fuentes de contaminación son fuentes fijas como industrias químicas y de generación eléctrica. Los contaminantes que se han registrado como preocupantes son el Bióxido de Azufre (SO2) y las Partículas Menores a 10 micrómetros (PM10). La predicción de las concentraciones de estos contaminantes puede ser una potente herramienta que permita tomar medidas preventivas como reducción de emisiones a la atmósfera y alertar a la población afectada. En la presente tesis doctoral se propone un modelo de predicción de concentraci ón de los contaminantes más críticos SO2 y PM10 para cada caseta de monitorización de la Red de Monitorización Atmosférica de Salamanca (REDMAS). Los modelos propuestos plantean el uso de las variables meteorol ógicas como factores que influyen en la concentración de los contaminantes. La información utilizada durante el desarrollo de este trabajo corresponde a datos reales obtenidos de la REDMAS. En el Modelo Propuesto (MP) se aplican Redes Neuronales Artificiales (RNA) combinadas con algoritmos de agrupamiento. La RNA utilizada es el Perceptrón Multicapa con una capa oculta, utilizando estructuras independientes para la predicción de cada contaminante. Las variables meteorológicas disponibles para realizar la predicción fueron: Dirección de Viento (DV), Velocidad de Viento (VV), Temperatura (T) y Humedad Relativa (HR). Los algoritmos de agrupamiento K-means y Fuzzy C-means son utilizados para encontrar relaciones existentes entre los contaminantes atmosféricos en estudio y las variables meteorológicas. Dichas relaciones aportan información a las RNA para obtener la predicción de los contaminantes, la cual es agregada como entrada de las RNA. Los resultados del modelo propuesto en este trabajo son comparados con los resultados de una Regresión Lineal Multivariable (RLM) y un Perceptrón Multicapa (MLP). La evaluación de la predicción se realiza con el Error Medio Absoluto, la Raíz del Error Cuadrático Medio, el coeficiente de correlación y el índice de acuerdo. Los resultados obtenidos muestran la importancia de las variables meteorológicas en la predicción de la concentración de los contaminantes SO2 y PM10 en la ciudad de Salamanca, Gto., México. Los resultados muestran que el MP predice mejor la concentración de los contaminantes SO2 y PM10 que los modelos RLM y MLP. Los modelos implementados para cada caseta de monitorizaci ón tienen la capacidad para realizar predicciones de calidad del aire, estos modelos pueden ser implementados en un sistema que permita realizar la predicción en tiempo real y analizar el impacto en la salud de la población. Entre los principales resultados obtenidos del desarrollo de esta tesis podemos citar: Se propone un modelo basado en una red neuronal artificial combinado con algoritmos de agrupamiento para la predicción con una hora de anticipaci ón de la concentración de cada contaminante (SO2 y PM10). Se diseñó un modelo diferente para cada contaminante y para cada una de las tres casetas de monitorización de la REDMAS. Se propone un modelo de predicción del promedio de la concentración de las próximas 24 horas de los contaminantes SO2 y PM10, basado en una red neuronal artificial combinado con algoritmos de agrupamiento. Se diseñó un modelo para cada caseta de monitorización de la REDMAS y para cada contaminante por separado.

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INTRODUCTION: Objective assessment of motor skills has become an important challenge in minimally invasive surgery (MIS) training.Currently, there is no gold standard defining and determining the residents' surgical competence.To aid in the decision process, we analyze the validity of a supervised classifier to determine the degree of MIS competence based on assessment of psychomotor skills METHODOLOGY: The ANFIS is trained to classify performance in a box trainer peg transfer task performed by two groups (expert/non expert). There were 42 participants included in the study: the non-expert group consisted of 16 medical students and 8 residents (< 10 MIS procedures performed), whereas the expert group consisted of 14 residents (> 10 MIS procedures performed) and 4 experienced surgeons. Instrument movements were captured by means of the Endoscopic Video Analysis (EVA) tracking system. Nine motion analysis parameters (MAPs) were analyzed, including time, path length, depth, average speed, average acceleration, economy of area, economy of volume, idle time and motion smoothness. Data reduction was performed by means of principal component analysis, and then used to train the ANFIS net. Performance was measured by leave one out cross validation. RESULTS: The ANFIS presented an accuracy of 80.95%, where 13 experts and 21 non-experts were correctly classified. Total root mean square error was 0.88, while the area under the classifiers' ROC curve (AUC) was measured at 0.81. DISCUSSION: We have shown the usefulness of ANFIS for classification of MIS competence in a simple box trainer exercise. The main advantage of using ANFIS resides in its continuous output, which allows fine discrimination of surgical competence. There are, however, challenges that must be taken into account when considering use of ANFIS (e.g. training time, architecture modeling). Despite this, we have shown discriminative power of ANFIS for a low-difficulty box trainer task, regardless of the individual significances between MAPs. Future studies are required to confirm the findings, inclusion of new tasks, conditions and sample population.

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We apply diffusion strategies to propose a cooperative reinforcement learning algorithm, in which agents in a network communicate with their neighbors to improve predictions about their environment. The algorithm is suitable to learn off-policy even in large state spaces. We provide a mean-square-error performance analysis under constant step-sizes. The gain of cooperation in the form of more stability and less bias and variance in the prediction error, is illustrated in the context of a classical model. We show that the improvement in performance is especially significant when the behavior policy of the agents is different from the target policy under evaluation.