VR BioViewer - A new interactive-visual model to represent medical information

Virtual reality (VR) techniques to understand and obtain conclusions of data in an easy way are being used by the scientific community. However, these techniques are not used frequently for analyzing large amounts of data in life sciences, particularly in genomics, due to the high complexity of data (curse of dimensionality). Nevertheless, new approaches that allow to bring out the real important data characteristics, arise the possibility of constructing VR spaces to visually understand the intrinsic nature of data. It is well known the benefits of representing high dimensional data in tridimensional spaces by means of dimensionality reduction and transformation techniques, complemented with a strong component of interaction methods. Thus, a novel framework, designed for helping to visualize and interact with data about diseases, is presented. In this paper, the framework is applied to the Van't Veer breast cancer dataset is used, while oncologists from La Paz Hospital (Madrid) are interacting with the obtained results. That is to say a first attempt to generate a visually tangible model of breast cancer disease in order to support the experience of oncologists is presented.

User Experience in Human-Technology Interaction. Communication, context and evaluation methodology

En esta Tesis se presentan dos líneas de investigación relacionadas y que contribuyen a las áreas de Interacción Hombre-Tecnología (o Máquina; siglas en inglés: HTI o HMI), lingüística computacional y evaluación de la experiencia del usuario. Las dos líneas en cuestión son el diseño y la evaluación centrada en el usuario de sistemas de Interacción Hombre-Máquina avanzados. En la primera parte de la Tesis (Capítulos 2 a 4) se abordan cuestiones fundamentales del diseño de sistemas HMI avanzados. El Capítulo 2 presenta una panorámica del estado del arte de la investigación en el ámbito de los sistemas conversacionales multimodales, con la que se enmarca el trabajo de investigación presentado en el resto de la Tesis. Los Capítulos 3 y 4 se centran en dos grandes aspectos del diseño de sistemas HMI: un gestor del diálogo generalizado para tratar la Interacción Hombre-Máquina multimodal y sensible al contexto, y el uso de agentes animados personificados (ECAs) para mejorar la robustez del diálogo, respectivamente. El Capítulo 3, sobre gestión del diálogo, aborda el tratamiento de la heterogeneidad de la información proveniente de las modalidades comunicativas y de los sensores externos. En este capítulo se propone, en un nivel de abstracción alto, una arquitectura para la gestión del diálogo con influjos heterogéneos de información, apoyándose en el uso de State Chart XML. En el Capítulo 4 se presenta una contribución a la representación interna de intenciones comunicativas, y su traducción a secuencias de gestos a ejecutar por parte de un ECA, diseñados específicamente para mejorar la robustez en situaciones de diálogo críticas que pueden surgir, por ejemplo, cuando se producen errores de entendimiento en la comunicación entre el usuario humano y la máquina. Se propone, en estas páginas, una extensión del Functional Mark-up Language definido en el marco conceptual SAIBA. Esta extensión permite representar actos comunicativos que realizan intenciones del emisor (la máquina) que no se pretende sean captadas conscientemente por el receptor (el usuario humano), pero con las que se pretende influirle a éste e influir el curso del diálogo. Esto se consigue mediante un objeto llamado Base de Intenciones Comunicativas (en inglés, Communication Intention Base, o CIB). La representación en el CIB de intenciones “no claradas” además de las explícitas permite la construcción de actos comunicativos que realizan simultáneamente varias intenciones comunicativas. En el Capítulo 4 también se describe un sistema experimental para el control remoto (simulado) de un asistente domótico, con autenticación de locutor para dar acceso, y con un ECA en el interfaz de cada una de estas tareas. Se incluye una descripción de las secuencias de comportamiento verbal y no verbal de los ECAs, que fueron diseñados específicamente para determinadas situaciones con objeto de mejorar la robustez del diálogo. Los Capítulos 5 a 7 conforman la parte de la Tesis dedicada a la evaluación. El Capítulo 5 repasa antecedentes relevantes en la literatura de tecnologías de la información en general, y de sistemas de interacción hablada en particular. Los principales antecedentes en el ámbito de la evaluación de la interacción sobre los cuales se ha desarrollado el trabajo presentado en esta Tesis son el Technology Acceptance Model (TAM), la herramienta Subjective Assessment of Speech System Interfaces (SASSI), y la Recomendación P.851 de la ITU-T. En el Capítulo 6 se describen un marco y una metodología de evaluación aplicados a la experiencia del usuario con sistemas HMI multimodales. Se desarrolló con este propósito un novedoso marco de evaluación subjetiva de la calidad de la experiencia del usuario y su relación con la aceptación por parte del mismo de la tecnología HMI (el nombre dado en inglés a este marco es Subjective Quality Evaluation Framework). En este marco se articula una estructura de clases de factores subjetivos relacionados con la satisfacción y aceptación por parte del usuario de la tecnología HMI propuesta. Esta estructura, tal y como se propone en la presente tesis, tiene dos dimensiones ortogonales. Primero se identifican tres grandes clases de parámetros relacionados con la aceptación por parte del usuario: “agradabilidad ” (likeability: aquellos que tienen que ver con la experiencia de uso, sin entrar en valoraciones de utilidad), rechazo (los cuales sólo pueden tener una valencia negativa) y percepción de utilidad. En segundo lugar, este conjunto clases se reproduce para distintos “niveles, o focos, percepción del usuario”. Éstos incluyen, como mínimo, un nivel de valoración global del sistema, niveles correspondientes a las tareas a realizar y objetivos a alcanzar, y un nivel de interfaz (en los casos propuestos en esta tesis, el interfaz es un sistema de diálogo con o sin un ECA). En el Capítulo 7 se presenta una evaluación empírica del sistema descrito en el Capítulo 4. El estudio se apoya en los mencionados antecedentes en la literatura, ampliados con parámetros para el estudio específico de los agentes animados (los ECAs), la auto-evaluación de las emociones de los usuarios, así como determinados factores de rechazo (concretamente, la preocupación por la privacidad y la seguridad). También se evalúa el marco de evaluación subjetiva de la calidad propuesto en el capítulo anterior. Los análisis de factores efectuados revelan una estructura de parámetros muy cercana conceptualmente a la división de clases en utilidad-agradabilidad-rechazo propuesta en dicho marco, resultado que da cierta validez empírica al marco. Análisis basados en regresiones lineales revelan estructuras de dependencias e interrelación entre los parámetros subjetivos y objetivos considerados. El efecto central de mediación, descrito en el Technology Acceptance Model, de la utilidad percibida sobre la relación de dependencia entre la intención de uso y la facilidad de uso percibida, se confirma en el estudio presentado en la presente Tesis. Además, se ha encontrado que esta estructura de relaciones se fortalece, en el estudio concreto presentado en estas páginas, si las variables consideradas se generalizan para cubrir más ampliamente las categorías de agradabilidad y utilidad contempladas en el marco de evaluación subjetiva de calidad. Se ha observado, asimismo, que los factores de rechazo aparecen como un componente propio en los análisis de factores, y además se distinguen por su comportamiento: moderan la relación entre la intención de uso (que es el principal indicador de la aceptación del usuario) y su predictor más fuerte, la utilidad percibida. Se presentan también resultados de menor importancia referentes a los efectos de los ECAs sobre los interfaces de los sistemas de diálogo y sobre los parámetros de percepción y las valoraciones de los usuarios que juegan un papel en conformar su aceptación de la tecnología. A pesar de que se observa un rendimiento de la interacción dialogada ligeramente mejor con ECAs, las opiniones subjetivas son muy similares entre los dos grupos experimentales (uno interactuando con un sistema de diálogo con ECA, y el otro sin ECA). Entre las pequeñas diferencias encontradas entre los dos grupos destacan las siguientes: en el grupo experimental sin ECA (es decir, con interfaz sólo de voz) se observó un efecto más directo de los problemas de diálogo (por ejemplo, errores de reconocimiento) sobre la percepción de robustez, mientras que el grupo con ECA tuvo una respuesta emocional más positiva cuando se producían problemas. Los ECAs parecen generar inicialmente expectativas más elevadas en cuanto a las capacidades del sistema, y los usuarios de este grupo se declaran más seguros de sí mismos en su interacción. Por último, se observan algunos indicios de efectos sociales de los ECAs: la “amigabilidad ” percibida los ECAs estaba correlada con un incremento la preocupación por la seguridad. Asimismo, los usuarios del sistema con ECAs tendían más a culparse a sí mismos, en lugar de culpar al sistema, de los problemas de diálogo que pudieran surgir, mientras que se observó una ligera tendencia opuesta en el caso de los usuarios del sistema con interacción sólo de voz. ABSTRACT This Thesis presents two related lines of research work contributing to the general fields of Human-Technology (or Machine) Interaction (HTI, or HMI), computational linguistics, and user experience evaluation. These two lines are the design and user-focused evaluation of advanced Human-Machine (or Technology) Interaction systems. The first part of the Thesis (Chapters 2 to 4) is centred on advanced HMI system design. Chapter 2 provides a background overview of the state of research in multimodal conversational systems. This sets the stage for the research work presented in the rest of the Thesis. Chapers 3 and 4 focus on two major aspects of HMI design in detail: a generalised dialogue manager for context-aware multimodal HMI, and embodied conversational agents (ECAs, or animated agents) to improve dialogue robustness, respectively. Chapter 3, on dialogue management, deals with how to handle information heterogeneity, both from the communication modalities or from external sensors. A highly abstracted architectural contribution based on State Chart XML is proposed. Chapter 4 presents a contribution for the internal representation of communication intentions and their translation into gestural sequences for an ECA, especially designed to improve robustness in critical dialogue situations such as when miscommunication occurs. We propose an extension of the functionality of Functional Mark-up Language, as envisaged in much of the work in the SAIBA framework. Our extension allows the representation of communication acts that carry intentions that are not for the interlocutor to know of, but which are made to influence him or her as well as the flow of the dialogue itself. This is achieved through a design element we have called the Communication Intention Base. Such r pr s ntation of “non- clar ” int ntions allows th construction of communication acts that carry several communication intentions simultaneously. Also in Chapter 4, an experimental system is described which allows (simulated) remote control to a home automation assistant, with biometric (speaker) authentication to grant access, featuring embodied conversation agents for each of the tasks. The discussion includes a description of the behavioural sequences for the ECAs, which were designed for specific dialogue situations with particular attention given to the objective of improving dialogue robustness. Chapters 5 to 7 form the evaluation part of the Thesis. Chapter 5 reviews evaluation approaches in the literature for information technologies, as well as in particular for speech-based interaction systems, that are useful precedents to the contributions of the present Thesis. The main evaluation precedents on which the work in this Thesis has built are the Technology Acceptance Model (TAM), the Subjective Assessment of Speech System Interfaces (SASSI) tool, and ITU-T Recommendation P.851. Chapter 6 presents the author’s work in establishing an valuation framework and methodology applied to the users’ experience with multimodal HMI systems. A novel user-acceptance Subjective Quality Evaluation Framework was developed by the author specifically for this purpose. A class structure arises from two orthogonal sets of dimensions. First we identify three broad classes of parameters related with user acceptance: likeability factors (those that have to do with the experience of using the system), rejection factors (which can only have a negative valence) and perception of usefulness. Secondly, the class structure is further broken down into several “user perception levels”; at the very least: an overall system-assessment level, task and goal-related levels, and an interface level (e.g., a dialogue system with or without an ECA). An empirical evaluation of the system described in Chapter 4 is presented in Chapter 7. The study was based on the abovementioned precedents in the literature, expanded with categories covering the inclusion of an ECA, the users’ s lf-assessed emotions, and particular rejection factors (privacy and security concerns). The Subjective Quality Evaluation Framework proposed in the previous chapter was also scrutinised. Factor analyses revealed an item structure very much related conceptually to the usefulness-likeability-rejection class division introduced above, thus giving it some empirical weight. Regression-based analysis revealed structures of dependencies, paths of interrelations, between the subjective and objective parameters considered. The central mediation effect, in the Technology Acceptance Model, of perceived usefulness on the dependency relationship of intention-to-use with perceived ease of use was confirmed in this study. Furthermore, the pattern of relationships was stronger for variables covering more broadly the likeability and usefulness categories in the Subjective Quality Evaluation Framework. Rejection factors were found to have a distinct presence as components in factor analyses, as well as distinct behaviour: they were found to moderate the relationship between intention-to-use (the main measure of user acceptance) and its strongest predictor, perceived usefulness. Insights of secondary importance are also given regarding the effect of ECAs on the interface of spoken dialogue systems and the dimensions of user perception and judgement attitude that may have a role in determining user acceptance of the technology. Despite observing slightly better performance values in the case of the system with the ECA, subjective opinions regarding both systems were, overall, very similar. Minor differences between two experimental groups (one interacting with an ECA, the other only through speech) include a more direct effect of dialogue problems (e.g., non-understandings) on perceived dialogue robustness for the voice-only interface test group, and a more positive emotional response for the ECA test group. Our findings further suggest that the ECA generates higher initial expectations, and users seem slightly more confident in their interaction with the ECA than do those without it. Finally, mild evidence of social effects of ECAs was also found: the perceived friendliness of the ECA increased security concerns, and ECA users may tend to blame themselves rather than the system when dialogue problems are encountered, while the opposite may be true for voice-only users.

Using Electronic Documents for Knowledge Acquisition and Model Maintenance

Knowledge acquisition and model maintenance are key problems in knowledge engineering to improve the productivity in the development of intelligent systems. Although historically a number of technical solutions have been proposed in this area, the recent experience shows that there is still an important gap between the way end-users describe their expertise and the way intelligent systems represent knowledge. In this paper we propose an original way to cope with this problem based on electronic documents. We propose the concept of intelligent document processor as a tool that allows the end-user to read/write a document explaining how an intelligent system operates in such a way that, if the user changes the content of the document, the intelligent system will react to these changes. The paper presents the structure of such a document based on knowledge categories derived from the modern knowledge modeling methodologies together with a number of requirements to be understandable by end-users and problem solvers.

Subjective quality assessment of an adaptive video streaming model

With the recent increased popularity and high usage of HTTP Adaptive Streaming (HAS) techniques, various studies have been carried out in this area which generally focused on the technical enhancement of HAS technology and applications. However, a lack of common HAS standard led to multiple proprietary approaches which have been developed by major Internet companies. In the emerging MPEG-DASH standard the packagings of the video content and HTTP syntax have been standardized; but all the details of the adaptation behavior are left to the client implementation. Nevertheless, to design an adaptation algorithm which optimizes the viewing experience of the enduser, the multimedia service providers need to know about the Quality of Experience (QoE) of different adaptation schemes. Taking this into account, the objective of this experiment was to study the QoE of a HAS-based video broadcast model. The experiment has been carried out through a subjective study of the end user response to various possible clients’ behavior for changing the video quality taking different QoE-influence factors into account. The experimental conclusions have made a good insight into the QoE of different adaptation schemes which can be exploited by HAS clients for designing the adaptation algorithms.

Implantación de un sistema de depósito, devolución y retorno en el mercado retail español

“Quien contamina, paga“, con esta premisa surgió la idea de este Trabajo Fin de Máster, en adelante TFM, cuyo objetivo era identificar medidas alternativas reales para una optimización del proceso actual de gestión de residuos sólidos urbanos ante una sociedad cada vez más superpoblada y con mayores ratios de consumo. Cada español genera anualmente un volumen de 485 Kg de residuos, de los cuales únicamente el 33 % son reciclados y pueden volver a un flujo normal de uso, especialmente preocupante durante los últimos años es el auge de los productos envasados, tanto de bebidas como de alimentos , cuya utilización se ha duplicado en la última década. La motivación de este trabajo Fin de Máster ha sido la de poner de manifiesto que la sostenibilidad con el medioambiente puede ir de la mano de la rentabilidad y del progreso. Durante este TFM se ha estudiado y analizado la viabilidad económica de implantación de un nuevo modelo de depósito, devolución y retorno en el mercado retail español y como con la adopción de este nuevo sistema se pueden lograr beneficios tanto para el propio minorista, como para el medio ambiente con ratios de reciclado superiores al 98%. La preocupación por el medio ambiente empieza a ser una constante entre los consumidores españoles y dicha preocupación comienza a ser influenciadora en las decisiones de compra (productos eco, sostenibilidad…). Nuestra propuesta consiste en dotar a los principales distribuidores del sector retail español de un sistema de depósito, devolución y retorno para envases de bebidas capaz de generar diferenciación, innovación y rentabilidad frente a la competencia. Dicho sistema consiste en pagar un depósito por cada envase de bebida que se adquiera y su correspondiente devolución en la siguiente compra, una vez que se devuelva vacío al establecimiento. Para ello se ha analizado el sector de la distribución en España, especialmente la distribución de bebidas. Se trata de un sector muy competitivo, que presenta varios formatos en función del tamaño del establecimiento (Hipermercados, Supermercados, tiendas tradicionales). Las principales empresas distribuidoras (Carrefour, Mercadona, Alcampo, Eroski, DIA) se encuentran en procesos de cambios estratégicos para lograr atraer a más consumidores hacia sus tiendas, por lo que nuestra propuesta podrá añadir valor a la hora de influenciar en la decisión del lugar de compra. En nuestro caso, nos dirigiremos principalmente a las grandes empresas distribuidoras, Hipermercados de más de 2.500 m2 ,que cuentan con más de 500 puntos de venta y distribución donde existe la posibilidad real de implantar un SDDR. Además se ha realizado un estudio de mercado sobre la influencia de dicho sistema en el consumidor final, donde se ha detectado dos segmentos principales cuya decisión de compra se vería muy influenciada por la implantación de un SDDR, un segmento Sénior, entre 45-54 años, preocupados por el medio ambiente y con poder adquisitivo suficiente como para que el pago del depósito no sea bloqueante, y un segmento Junior, entre 18-24 años, también muy concienciado el medio ambiente, de capacidad económica menor pero qué influye en la decisión de compra de sus progenitores. Para llevar a cabo este plan de negocio será necesario una inversión inicial de 57.000 €, con unas expectativas de recuperación de dicha inversión en el primer año y una TIR del 56%, presentando un VAN de 127.961 € para los 7 años de vida del proyecto. Para dar a conocer a los clientes del Hipermercado los beneficios de utilizar un sistema SDDR, se realizarán campañas de marketing a través de diferentes canales, promociones de apertura, acciones de marketing exteriores y planes de fidelización. La organización e implantación en el Hipermercado será muy sencilla con roles claramente diferenciados, únicamente involucraría a unos 9 recursos definidos y en aproximadamente 3 meses desde el inicio del proyecto ya se podría ofertar dicho servicio a los clientes del Hipermercado. Además se han analizado los principales riesgos a los que se enfrentaría el negocio, ponderándose en una matriz impacto-probabilidad. Se han establecido medidas correctoras en el caso que dicho riesgo aflore. Habrá que tener especialmente precaución con la pérdida de ventas durante el arranque del negocio en el caso que esto ocurra, por lo que se deberá controlar el gasto, fomentar la captación de clientes y mantener un fondo de maniobra lo suficientemente elevado como para absorber dicho riesgo.---ABSTRACT---“Polluters pay”, with this premise this TFM aimed at identifying real alternative measures for optimization of the current process of solid waste management in a crowded society and with greater consumption ratios. Spaniards generates an annual volume of 485 kg of waste; only 33 % are recycled and can return to a normal flow. Specially concern is the increased of packaged product in recent years, mainly drink and food, their use has been duplicated in the last decade. The motivation for this Thesis was to highlight that sustainability, profitability and progress can go together. During this TFM has been studied and analyzed the economic feasibility of implementing a new model of deposit , refund and return in the Spanish retail market and as with the adoption of this new system can achieve benefits for the retailer itself therefore to the environment with ratios above 98% recycled. Concern for the environment is becoming a constant among Spanish consumers , and this concern is becoming influencer in purchasing decisions ( eco, sustainability ... ) . Our proposal is to provide the main distributors of the Spanish retail sector a system of deposit, refund and return for beverage containers capable of generating differentiation, innovation and profitability over the competition. This system is to pay a deposit for each beverage container they purchase and their corresponding return in the next purchase, once they return empty to the establishment. For this we have analyzed the distribution sector in Spain, especially the distribution of beverages. This is a highly competitive industry, which features various formats depending on the size of establishments (hypermarkets, supermarkets, traditional shops). The main distribution companies (Carrefour, Mercadona, Alcampo, Eroski, DIA) are in the process of strategic changes in order to attract more consumers to their stores, so that our approach can add value in influencing the decision of place shopping. In our case, we will go mainly to large distributors, Hypermarkets of over 2,500 m2, which have more than 500 outlets and distribution where there is a real possibility of implementing a SDDR. It has also conducted a market study on the influence of that system on the final consumer, which has detected two main segments whose purchasing decisions would be greatly influenced by the introduction of a SDDR, a Senior segment, 45-54 years concerned about the environment and purchasing power enough that the deposit is not blocking, and a Junior Segment, aged 18-24, also concern with environment, lower economic capacity but what influences the decision purchase of their parents). To carry out this business plan will require an initial investment of 57,000 €, with expectations of recovery of such investment in the first year and an IRR of 56%, with an NPV of € 127,961 for the 7 years of the project . To publicize hypermarket customers the benefits of using a SDDR system, marketing campaigns conducted through different channels, opening promotions, marketing activities and external loyalty schemes. The organization and implementation in the Hypermarket is easy with distinct roles, involve only about 9 resourced and in about 3 months from the start of the project and could offer this service to customers in the hypermarket. We have also analyzed the main risks and established corrective measures to surface that risk . We should take caution with lost sales during startup of the business, such as control spending, customer retention and maintaining enough working capital.

An ICT-based closed-loop model to improve care for heart failure patients

Durante las últimas décadas se ha producido un fenómeno global de envejecimiento en la población. Esta tendencia se puede observar prácticamente en todos los países del mundo y se debe principalmente a los avances en la medicina, y a los descensos en las tasas de fertilidad y mortalidad. El envejecimiento de la población tiene un gran impacto en la salud de los ciudadanos, y a menudo es la causa de aparición de enfermedades crónicas. Este tipo de enfermedades supone una amenaza y una carga importantes para la sociedad, especialmente en aspectos como la mortalidad o los gastos en los sistemas sanitarios. Entre las enfermedades cardiovasculares, la insuficiencia cardíaca es probablemente la condición con mayor prevalencia y afecta a 23-26 millones de personas en todo el mundo. Normalmente, la insuficiencia cardíaca presenta un mal pronóstico y una tasa de supervivencia bajas, en algunos casos peores que algún tipo de cáncer. Además, suele ser la causa de hospitalizaciones frecuentes y es una de las enfermedades más costosas para los sistemas sanitarios. La tendencia al envejecimiento de la población y la creciente incidencia de las enfermedades crónicas están llevando a una situación en la que los sistemas de salud no son capaces de hacer frente a la demanda de la sociedad. Los servicios de salud existentes tendrán que adaptarse para ser efectivos y sostenibles en el futuro. Es necesario identificar nuevos paradigmas de cuidado de pacientes, así como mecanismos para la provisión de servicios que ayuden a transformar estos sistemas sanitarios. En este contexto, esta tesis se plantea la búsqueda de soluciones, basadas en las Tecnologías de la Información y la Comunicación (TIC), que contribuyan a realizar la transformación en los sistemas sanitarios. En concreto, la tesis se centra en abordar los problemas de una de las enfermedades con mayor impacto en estos sistemas: la insuficiencia cardíaca. Las siguientes hipótesis constituyen la base para la realización de este trabajo de investigación: 1. Es posible definir un modelo basado en el paradigma de lazo cerrado y herramientas TIC que formalice el diseño de mejores servicios para pacientes con insuficiencia cardíaca. 2. El modelo de lazo cerrado definido se puede utilizar para definir un servicio real que ayude a gestionar la insuficiencia cardíaca crónica. 3. La introducción, la adopción y el uso de un servicio basado en el modelo definido se traducirá en mejoras en el estado de salud de los pacientes que sufren insuficiencia cardíaca. a. La utilización de un sistema basado en el modelo de lazo cerrado definido mejorará la experiencia del usuario de los pacientes. La definición del modelo planteado se ha basado en el estándar ISO / EN 13940- Sistema de conceptos para dar soporte a la continuidad de la asistencia. Comprende un conjunto de conceptos, procesos, flujos de trabajo, y servicios como componentes principales, y representa una formalización de los servicios para los pacientes con insuficiencia cardíaca. Para evaluar el modelo definido se ha definido un servicio real basado en el mismo, además de la implementación de un sistema de apoyo a dicho servicio. El diseño e implementación de dicho sistema se realizó siguiendo la metodología de Diseño Orientado a Objetivos. El objetivo de la evaluación consistía en investigar el efecto que tiene un servicio basado en el modelo de lazo cerrado sobre el estado de salud de los pacientes con insuficiencia cardíaca. La evaluación se realizó en el marco de un estudio clínico observacional. El análisis de los resultados ha comprendido métodos de análisis cuantitativos y cualitativos. El análisis cuantitativo se ha centrado en determinar el estado de salud de los pacientes en base a datos objetivos (obtenidos en pruebas de laboratorio o exámenes médicos). Para realizar este análisis se definieron dos índices específicos: el índice de estabilidad y el índice de la evolución del estado de salud. El análisis cualitativo ha evaluado la autopercepción del estado de salud de los pacientes en términos de calidad de vida, auto-cuidado, el conocimiento, la ansiedad y la depresión, así como niveles de conocimiento. Se ha basado en los datos recogidos mediante varios cuestionarios o instrumentos estándar (i.e. EQ-5D, la Escala de Ansiedad y Depresión (HADS), el Cuestionario de Cardiomiopatía de Kansas City (KCCQ), la Escala Holandesa de Conocimiento de Insuficiencia Cardíaca (DHFKS), y la Escala Europea de Autocuidado en Insuficiencia Cardíaca (EHFScBS), así como cuestionarios dedicados no estandarizados de experiencia de usuario. Los resultados obtenidos en ambos análisis, cuantitativo y cualitativo, se compararon con el fin de evaluar la correlación entre el estado de salud objetivo y subjetivo de los pacientes. Los resultados de la validación demostraron que el modelo propuesto tiene efectos positivos en el cuidado de los pacientes con insuficiencia cardíaca y contribuye a mejorar su estado de salud. Asimismo, ratificaron al modelo como instrumento válido para la definición de servicios mejorados para la gestión de esta enfermedad. ABSTRACT During the last decades we have witnessed a global aging phenomenon in the population. This can be observed in practically every country in the world, and it is mainly caused by the advances in medicine, and the decrease of mortality and fertility rates. Population aging has an important impact on citizens’ health and it is often the cause for chronic diseases, which constitute global burden and threat to the society in terms of mortality and healthcare expenditure. Among chronic diseases, Chronic Heart Failure (CHF) or Heart Failure (HF) is probably the one with highest prevalence, affecting between 23 and 26 million people worldwide. Heart failure is a chronic, long-term and serious condition with very poor prognosis and worse survival rates than some type of cancers. Additionally, it is often the cause of frequent hospitalizations and one of the most expensive conditions for the healthcare systems. The aging trends in the population and the increasing incidence of chronic diseases are leading to a situation where healthcare systems are not able to cope with the society demand. Current healthcare services will have to be adapted and redefined in order to be effective and sustainable in the future. There is a need to find new paradigms for patients’ care, and to identify new mechanisms for services’ provision that help to transform the healthcare systems. In this context, this thesis aims to explore new solutions, based on ICT, that contribute to achieve the needed transformation within the healthcare systems. In particular, it focuses on addressing the problems of one of the diseases with higher impact within these systems: Heart Failure. The following hypotheses represent the basis to the elaboration of this research: 1. It is possible to define a model based on a closed-loop paradigm and ICT tools that formalises the design of enhanced healthcare services for chronic heart failure patients. 2. The described closed-loop model can be exemplified in a real service that supports the management of chronic heart failure disease. 3. The introduction, adoption and use of a service based on the outlined model will result in improvements in the health status of patients suffering heart failure. 4. The user experience of patients when utilizing a system based on the defined closed-loop model will be enhanced. The definition of the closed-loop model for health care support of heart failure patients have been based on the standard ISO/EN 13940 System of concepts to support continuity of care. It includes a set of concept, processes and workflows, and services as main components, and it represent a formalization of services for heart failure patients. In order to be validated, the proposed closed-loop model has been instantiated into a real service and a supporting IT system. The design and implementation of the system followed the user centred design methodology Goal Oriented Design. The validation, that included an observational clinical study, aimed to investigate the effect that a service based on the closed-loop model had on heart failure patients’ health status. The analysis of results comprised quantitative and qualitative analysis methods. The quantitative analysis was focused on determining the health status of patients based on objective data (obtained in lab tests or physical examinations). Two specific indexes where defined and considered in this analysis: the stability index and the health status evolution index. The qualitative analysis assessed the self-perception of patients’ health status in terms of quality of life, self-care, knowledge, anxiety and depression, as well as knowledge levels. It was based on the data gathered through several standard instruments (i.e. EQ-5D, the Hospital Anxiety and Depression Scale, the Kansas City Cardiomyopathy Questionnaire, the Dutch Heart Failure Knowledge Scale, and the European Heart Failure Self-care Behaviour Scale) as well as dedicated non-standardized user experience questionnaires. The results obtained in both analyses, quantitative and qualitative, were compared in order to assess the correlation between the objective and subjective health status of patients. The results of the validation showed that the proposed model contributed to improve the health status of the patients and had a positive effect on the patients’ care. It also proved that the model is a valid instrument for designing enhanced healthcare services for heart failure patients.

Design of a generalized tool for the performance assessment under sail based on analytical, numerical and empirical results : a global sailing yacht meta-model

La evaluación de las prestaciones de las embarcaciones a vela ha constituido un objetivo para ingenieros navales y marinos desde los principios de la historia de la navegación. El conocimiento acerca de estas prestaciones, ha crecido desde la identificación de los factores clave relacionados con ellas(eslora, estabilidad, desplazamiento y superficie vélica), a una comprensión más completa de las complejas fuerzas y acoplamientos involucrados en el equilibrio. Junto con este conocimiento, la aparición de los ordenadores ha hecho posible llevar a cabo estas tareas de una forma sistemática. Esto incluye el cálculo detallado de fuerzas, pero también, el uso de estas fuerzas junto con la descripción de una embarcación a vela para la predicción de su comportamiento y, finalmente, sus prestaciones. Esta investigación tiene como objetivo proporcionar una definición global y abierta de un conjunto de modelos y reglas para describir y analizar este comportamiento. Esto se lleva a cabo sin aplicar restricciones en cuanto al tipo de barco o cálculo, sino de una forma generalizada, de modo que sea posible resolver cualquier situación, tanto estacionaria como en el dominio del tiempo. Para ello se comienza con una definición básica de los factores que condicionan el comportamiento de una embarcación a vela. A continuación se proporciona una metodología para gestionar el uso de datos de diferentes orígenes para el cálculo de fuerzas, siempre con el la solución del problema como objetivo. Esta última parte se plasma en un programa de ordenador, PASim, cuyo propósito es evaluar las prestaciones de diferentes ti pos de embarcaciones a vela en un amplio rango de condiciones. Varios ejemplos presentan diferentes usos de PASim con el objetivo de ilustrar algunos de los aspectos discutidos a lo largo de la definición del problema y su solución . Finalmente, se presenta una estructura global de cara a proporcionar una representación virtual de la embarcación real, en la cual, no solo e l comportamiento sino también su manejo, son cercanos a la experiencia de los navegantes en el mundo real. Esta estructura global se propone como el núcleo (un motor de software) de un simulador físico para el que se proporciona una especificación básica. ABSTRACT The assessment of the performance of sailing yachts, and ships in general, has been an objective for naval architects and sailors since the beginning of the history of navigation. The knowledge has grown from identifying the key factors that influence performance(length, stability, displacement and sail area), to a much more complete understanding of the complex forces and couplings involved in the equilibrium. Along with this knowledge, the advent of computers has made it possible to perform the associated tasks in a systematic way. This includes the detailed calculation of forces, but also the use of those forces, along with the description of a sailing yacht, to predict its behavior, and ultimately, its performance. The aim of this investigation is to provide a global and open definition of a set of models and rules to describe and analyze the behavior of a sailing yacht. This is done without applying any restriction to the type of yacht or calculation, but rather in a generalized way, capable of solving any possible situation, whether it is in a steady state or in the time domain. First, the basic definition of the factors that condition the behavior of a sailing yacht is given. Then, a methodology is provided to assist with the use of data from different origins for the calculation of forces, always aiming towards the solution of the problem. This last part is implemented as a computational tool, PASim, intended to assess the performance of different types of sailing yachts in a wide range of conditions. Several examples then present different uses of PASim, as a way to illustrate some of the aspects discussed throughout the definition of the problem and its solution. Finally, a global structure is presented to provide a general virtual representation of the real yacht, in which not only the behavior, but also its handling is close to the experience of the sailors in the real world. This global structure is proposed as the core (a software engine) of a physical yacht simulator, for which a basic specification is provided.

Planning model for Peruvian university system

This paper arises from observing the effect that the education policy has had on the European Higher Education Area that promotes the primary objective of this research: the preparation of a planning model that contributes, based on the European experience, the basic elements for the quality of higher education in Peru. To appraise the timeliness and usefulness of the aforementioned model, the scope of the Spanish model is selected and specifically adapted to the Peruvian model, which can be considered a testing laboratory due to their historical, cultural and social similarities and in which the model offers a response to the society's need for quality education.

Experience and lessons learnt from the SMART 2013 Benchmark

The French CEA, together with EDF and the IAEA, recently organised an international benchmark to evaluate the ability to model the mechanical behaviour of a typical nuclear reinforced concrete structure subjected to seismic demands. The participants were provided with descriptions of the structure and the testing campaign; they had to propose the numerical model and the material laws for the concrete (stage #1). A mesh of beam and shell elements was generated; for modelling the concrete a damaged plasticity model was used, but a smeared crack model was also investigated. Some of the initial experimental results, with the mock-up remaining in the elastic range, were provided to the participants for calibrating their models (stage #2). Predictions had to be produced in terms of eigen-frequencies and motion time histories. The calculated frequencies reproduced reasonably the experimental ones; the time histories, calculated by modal response analysis, also reproduced adequately the observed amplifications. The participants were then expected to predict the structural response under strong ground motions (stage #3), which increased progressively up to a history recorded during the 1994 Northridge earthquake, followed by an aftershock. These results were produced using an explicit solver and a damaged plasticity model for the concrete, although an implicit solver with a smeared crack model was also investigated. The paper presents the conclusions of the pre-test exercise, as well as some observations from additional simulations conducted after the experimental results were made available.

Theory for normal and impaired experience-dependent plasticity in neocortex of adult rats

We model experience-dependent plasticity in the cortical representation of whiskers (the barrel cortex) in normal adult rats, and in adult rats that were prenatally exposed to alcohol. Prenatal exposure to alcohol (PAE) caused marked deficits in experience-dependent plasticity in a cortical barrel-column. Cortical plasticity was induced by trimming all whiskers on one side of the face except two. This manipulation produces high activity from the intact whiskers that contrasts with low activity from the cut whiskers while avoiding any nerve damage. By a computational model, we show that the evolution of neuronal responses in a single barrel-column after this sensory bias is consistent with the synaptic modifications that follow the rules of the Bienenstock, Cooper, and Munro (BCM) theory. The BCM theory postulates that a neuron possesses a moving synaptic modification threshold, θM, that dictates whether the neuron's activity at any given instant will lead to strengthening or weakening of its input synapses. The current value of θM changes proportionally to the square of the neuron's activity averaged over some recent past. In the model of alcohol impaired cortex, the effective θM has been set to a level unattainable by the depressed levels of cortical activity leading to “impaired” synaptic plasticity that is consistent with experimental findings. Based on experimental and computational results, we discuss how elevated θM may be related to (i) reduced levels of neurotransmitters modulating plasticity, (ii) abnormally low expression of N-methyl-d-aspartate receptors (NMDARs), and (iii) the membrane translocation of Ca2+/calmodulin-dependent protein kinase II (CaMKII) in adult rat cortex subjected to prenatal alcohol exposure.

A joint hazard and time scaling model to compare survival curves.

To provide a more general method for comparing survival experience, we propose a model that independently scales both hazard and time dimensions. To test the curve shape similarity of two time-dependent hazards, h1(t) and h2(t), we apply the proposed hazard relationship, h12(tKt)/ h1(t) = Kh, to h1. This relationship doubly scales h1 by the constant hazard and time scale factors, Kh and Kt, producing a transformed hazard, h12, with the same underlying curve shape as h1. We optimize the match of h12 to h2 by adjusting Kh and Kt. The corresponding survival relationship S12(tKt) = [S1(t)]KtKh transforms S1 into a new curve S12 of the same underlying shape that can be matched to the original S2. We apply this model to the curves for regional and local breast cancer contained in the National Cancer Institute's End Results Registry (1950-1973). Scaling the original regional curves, h1 and S1 with Kt = 1.769 and Kh = 0.263 produces transformed curves h12 and S12 that display congruence with the respective local curves, h2 and S2. This similarity of curve shapes suggests the application of the more complete curve shapes for regional disease as templates to predict the long-term survival pattern for local disease. By extension, this similarity raises the possibility of scaling early data for clinical trial curves according to templates of registry or previous trial curves, projecting long-term outcomes and reducing costs. The proposed model includes as special cases the widely used proportional hazards (Kt = 1) and accelerated life (KtKh = 1) models.

An anatomical substrate for experience-dependent plasticity of the rat barrel field cortex.

The objective of this study was to examine the influence of sensory experience on the synaptic circuitry of the cortex. For this purpose, the quantitative distribution of the overall and of the gamma-aminobutyric acid (GABA) population of synaptic contacts was investigated in each layer of the somatosensory barrel field cortex of rats which were sensory deprived from birth by continuously removing rows of whiskers. Whereas there were no statistically significant changes in the quantitative distribution of the overall synaptic population, the number and proportion of GABA-immunopositive synaptic contacts were profoundly altered in layer IV of the somatosensory cortex of sensory-deprived animals. These changes were attributable to a specific loss of as many as two-thirds of the GABA contacts targeting dendritic spines. Thus, synaptic contacts made by GABA terminals in cortical layer IV and, in particular, those targeting dendritic spines represent a structural substrate of experience-dependent plasticity. Furthermore, since in this model of cortical plasticity the neuronal receptive-field properties are known to be affected, we propose that the inhibitory control of dendritic spines is essential for the elaboration of these functional properties.

MDWEnet: a practical approach to achieving interoperability of model-driven web engineering methods

Current model-driven Web Engineering approaches (such as OO-H, UWE or WebML) provide a set of methods and supporting tools for a systematic design and development of Web applications. Each method addresses different concerns using separate models (content, navigation, presentation, business logic, etc.), and provide model compilers that produce most of the logic and Web pages of the application from these models. However, these proposals also have some limitations, especially for exchanging models or representing further modeling concerns, such as architectural styles, technology independence, or distribution. A possible solution to these issues is provided by making model-driven Web Engineering proposals interoperate, being able to complement each other, and to exchange models between the different tools. MDWEnet is a recent initiative started by a small group of researchers working on model-driven Web Engineering (MDWE). Its goal is to improve current practices and tools for the model-driven development of Web applications for better interoperability. The proposal is based on the strengths of current model-driven Web Engineering methods, and the existing experience and knowledge in the field. This paper presents the background, motivation, scope, and objectives of MDWEnet. Furthermore, it reports on the MDWEnet results and achievements so far, and its future plan of actions.

Assessment of University External Internships. Towards a Mixed Model for Measuring the Acquisition of Skills and the Satisfaction of Parties Involved

The continuous improvement of management and assessment processes for curricular external internships has led a group of university teachers specialised in this area to develop a mixed model of measurement that combines the verification of skill acquisition by those students choosing external internships with the satisfaction of the parties involved in that process. They included academics, educational tutors of companies and organisations and administration and services personnel in the latter category. The experience, developed within University of Alicante, has been carried out in the degrees of Business Administration and Management, Business Studies, Economics, Advertising and Public Relations, Sociology and Social Work, all part of the Faculty of Economics and Business. By designing and managing closed standardised interviews and other research tools, validated outside the centre, a system of continuous improvement and quality assurance has been created, clearly contributing to the gradual increase in the number of students with internships in this Faculty, as well as to the improvement in satisfaction, efficiency and efficacy indicators at a global level. As this experience of educational innovation has shown, the acquisition of curricular knowledge, skills, abilities and competences by the students is directly correlated with the satisfaction of those parties involved in a process that takes the student beyond the physical borders of a university campus. Ensuring the latter is a task made easier by the implementation of a mixed assessment method, combining continuous and final assessment, and characterised by its rigorousness and simple management. This report presents that model, subject in turn to a persistent and continuous control, a model all parties involved in the external internships are taking part of. Its short-term results imply an increase, estimated at 15% for the last course, in the number of students choosing curricular internships and, for the medium and long-term, a major interweaving between the academic world and its social and productive environment, both in the business and institutional areas. The potentiality of this assessment model does not lie only in the quality of its measurement tools, but also in the effects from its use in the various groups and in the actions that are carried out as a result of its implementation and which, without any doubt and as it is shown below, are the real guarantee of a continuous improvement.

A Belief System's Organization Based on a Computational Model of the Dynamic Context: First Approximation

In this article we present a model of organization of a belief system based on a set of binary recursive functions that characterize the dynamic context that modifies the beliefs. The initial beliefs are modeled by a set of two-bit words that grow, update, and generate other beliefs as the different experiences of the dynamic context appear. Reason is presented as an emergent effect of the experience on the beliefs. The system presents a layered structure that allows a functional organization of the belief system. Our approach seems suitable to model different ways of thinking and to apply to different realistic scenarios such as ideologies.