Modelado de sistemas de inteligencia ambiental para el entrenamiento de las cualidades físicas

En un ejercicio no extenuante la frecuencia cardíaca (FC) guarda una relación lineal con el consumo máximo de oxígeno (V O2max) y se suele usar como uno de los parámetros de referencia para cuantificar la capacidad del sistema cardiovascular. Normalmente la frecuencia cardíaca puede remplazar el porcentaje de V O2max en las prescripciones básicas de ejercicio para la mejora de la resistencia aeróbica. Para obtener los mejores resultados en la mejora de la resistencia aeróbica, el entrenamiento de los individuos se debe hacer a una frecuencia cardíaca suficientemente alta, para que el trabajo sea de predominio dinámico con la fosforilación oxidativa como fuente energética primaria, pero no tan elevada que pueda suponer un riesgo de infarto de miocardio para el sujeto que se está entrenando. Los programas de entrenamiento de base mínima y de base óptima, con ejercicios de estiramientos para prevenir lesiones, son algunos de los programas más adecuados para el entrenamiento de la resistencia aeróbica porque maximizan los beneficios y minimizan los riesgos para el sistema cardiovascular durante las sesiones de entrenamiento. En esta tesis, se ha definido un modelo funcional para sistemas de inteligencia ambiental capaz de monitorizar, evaluar y entrenar las cualidades físicas que ha sido validado cuando la cualidad física es la resistencia aeróbica. El modelo se ha implementado en una aplicación Android utilizando la camiseta inteligente “GOW running” de la empresa Weartech. El sistema se ha comparado en el Laboratorio de Fisiología del Esfuerzo (LFE) de la Universidad Politécnica de Madrid (UPM) durante la realización de pruebas de esfuerzo. Además se ha evaluado un sistema de guiado con voz para los entrenamientos de base mínima y de base óptima. También el desarrollo del software ha sido validado. Con el uso de cuestionarios sobre las experiencias de los usuarios utilizando la aplicación se ha evaluado el atractivo de la misma. Por otro lado se ha definido una nueva metodología y nuevos tipos de cuestionarios diseñados para evaluar la utilidad que los usuarios asignan al uso de un sistema de guiado por voz. Los resultados obtenidos confirman la validez del modelo. Se ha obtenido una alta concordancia entre las medidas de FC hecha por la aplicación Android y el LFE. También ha resultado que los métodos de estimación del VO2max de los dos sistemas pueden ser intercambiables. Todos los usuarios que utilizaron el sistema de guiado por voz para entrenamientos de 10 base mínima y de base óptimas de la resistencia aeróbica consiguieron llevar a cabo las sesiones de entrenamientos con un 95% de éxito considerando unos márgenes de error de un 10% de la frecuencia cardíaca máxima teórica. La aplicación fue atractiva para los usuarios y hubo también una aceptación del sistema de guiado por voz. Se ha obtenido una evaluación psicológica positiva de la satisfacción de los usuarios que interactuaron con el sistema. En conclusión, se ha demostrado que es posible desarrollar sistemas de Inteligencia Ambiental en dispositivos móviles para la mejora de la salud. El modelo definido en la tesis es el primero modelo funcional teórico de referencia para el desarrollo de este tipo de aplicaciones. Posteriores estudios se realizarán con el objetivo de extender dicho modelo para las demás cualidades físicas que suponen modelos fisiológicos más complejos como por ejemplo la flexibilidad. Abstract In a non-strenuous exercise, the heart rate (HR) shows a linear relationship with the maximum volume of oxygen consumption (V O2max) and serves as an indicator of performance of the cardiovascular system. The heart rate replaces the %V O2max in exercise program prescription to improve aerobic endurance. In order to achieve an optimal effect during endurance training, the athlete needs to work out at a heart rate high enough to trigger the aerobic metabolism, while avoiding the high heart rates that bring along significant risks of myocardial infarction. The minimal and optimal base training programs, followed by stretching exercises to prevent injuries, are adequate programs to maximize benefits and minimize health risks for the cardiovascular system during single session training. In this thesis, we have defined an ambient intelligence system functional model that monitors, evaluates and trains physical qualities, and it has been validated for aerobic endurance. It is based on the Android System and the “GOW Running” smart shirt. The system has been evaluated during functional assessment stress testing of aerobic endurance in the Stress Physiology Laboratory (SPL) of the Technical University of Madrid (UPM). Furthermore, a voice system, designed to guide the user through minimal and optimal base training programs, has been evaluated. Also the software development has been evaluated. By means of user experience questionnaires, we have rated the attractiveness of the android application. Moreover, we have defined a methodology and a new kind of questionnaires in order to assess the user experience with the audio exercise guide system. The results obtained confirm the model. We have a high similarity between HR measurements made of our system and the one used by SPL. We have also a high correlation between the VO2max estimations of our system and the SPL system. All users, that tried the voice guidance system for minimal and optimal base training programs, were able to perform the 95% of the training session with an error lower than the 10% of theoretical maximum heart rate. The application appeared attractive to the users, and it has also been proven that the voice guidance system was useful. As result we obtained a positive evaluation of the users' satisfaction while they interacted with the system. In conclusion, it has been demonstrated that is possible to develop mobile Ambient Intelligence applications for the improvement of healthy lifestyle. AmIRTEM model is the first theoretical reference functional model for the design of this kind of applications. Further studies will be realized in order to extend the AmIRTEM model to other physical qualities whose physiological models are more complex than the aerobic endurance.

Contribución a la automatización de sistemas de respuesta frente a intrusiones mediante ontologías

La seguridad en redes informáticas es un área que ha sido ampliamente estudiada y objeto de una extensa investigación en los últimos años. Debido al continuo incremento en la complejidad y sofisticación de los ataques informáticos, el aumento de su velocidad de difusión, y la lentitud de reacción frente a las intrusiones existente en la actualidad, se hace patente la necesidad de mecanismos de detección y respuesta a intrusiones, que detecten y además sean capaces de bloquear el ataque, y mitiguen su impacto en la medida de lo posible. Los Sistemas de Detección de Intrusiones o IDSs son tecnologías bastante maduras cuyo objetivo es detectar cualquier comportamiento malicioso que ocurra en las redes. Estos sistemas han evolucionado rápidamente en los últimos años convirtiéndose en herramientas muy maduras basadas en diferentes paradigmas, que mejoran su capacidad de detección y le otorgan un alto nivel de fiabilidad. Por otra parte, un Sistema de Respuesta a Intrusiones (IRS) es un componente de seguridad que puede estar presente en la arquitectura de una red informática, capaz de reaccionar frente a los incidentes detectados por un Sistema de Detección de Intrusiones (IDS). Por desgracia, esta tecnología no ha evolucionado al mismo ritmo que los IDSs, y la reacción contra los ataques detectados es lenta y básica, y los sistemas presentan problemas para ejecutar respuestas de forma automática. Esta tesis doctoral trata de hacer frente al problema existente en la reacción automática frente a intrusiones, mediante el uso de ontologías, lenguajes formales de especificación de comportamiento y razonadores semánticos como base de la arquitectura del sistema de un sistema de respuesta automática frente a intrusiones o AIRS. El objetivo de la aproximación es aprovechar las ventajas de las ontologías en entornos heterogéneos, además de su capacidad para especificar comportamiento sobre los objetos que representan los elementos del dominio modelado. Esta capacidad para especificar comportamiento será de gran utilidad para que el AIRS infiera la respuesta óptima frente a una intrusión en el menor tiempo posible. Abstract Security in networks is an area that has been widely studied and has been the focus of extensive research over the past few years. The number of security events is increasing, and they are each time more sophisticated, and quickly spread, and slow reaction against intrusions, there is a need for intrusion detection and response systems to dynamically adapt so as to better detect and respond to attacks in order to mitigate them or reduce their impact. Intrusion Detection Systems (IDSs) are mature technologies whose aim is detecting malicious behavior in the networks. These systems have quickly evolved and there are now very mature tools based on different paradigms (statistic anomaly-based, signature-based and hybrids) with a high level of reliability. On the other hand, Intrusion Response System (IRS) is a security technology able to react against the intrusions detected by IDS. Unfortunately, the state of the art in IRSs is not as mature as with IDSs. The reaction against intrusions is slow and simple, and these systems have difficulty detecting intrusions in real time and triggering automated responses. This dissertation is to address the existing problem in automated reactions against intrusions using ontologies, formal behaviour languages and semantic reasoners as the basis of the architecture of an automated intrusion response systems or AIRS. The aim is to take advantage of ontologies in heterogeneous environments, in addition to its ability to specify behavior of objects representing the elements of the modeling domain. This ability to specify behavior will be useful for the AIRS in the inference process of the optimum response against an intrusion, as quickly as possible.

RECLAMO: virtual and collaborative honeynets based on trust management and autonomous systems applied to intrusion management

Security intrusions in large systems is a problem due to its lack of scalability with the current IDS-based approaches. This paper describes the RECLAMO project, where an architecture for an Automated Intrusion Response System (AIRS) is being proposed. This system will infer the most appropriate response for a given attack, taking into account the attack type, context information, and the trust and reputation of the reporting IDSs. RECLAMO is proposing a novel approach: diverting the attack to a specific honeynet that has been dynamically built based on the attack information. Among all components forming the RECLAMO's architecture, this paper is mainly focused on defining a trust and reputation management model, essential to recognize if IDSs are exposing an honest behavior in order to accept their alerts as true. Experimental results confirm that our model helps to encourage or discourage the launch of the automatic reaction process.

Functional antioxidant responsive elements

Exposure of human and rodent cells to a wide variety of chemoprotective compounds confers resistance against a broad set of carcinogens. For a subset of the chemoprotective compounds, protection is generated by an increase in the abundance of protective enzymes like glutathione S-transferases (GST). Antioxidant responsive elements (AREs) mediate the transcriptional induction of a battery of genes which comprise much of this chemoprotective response system. Past studies identified a necessary ARE “core” sequence of RTGACnnnGC, but this sequence alone is insufficient to mediate induction. In this study, the additional sequences necessary to define a sufficient, functional ARE are identified through systematic mutational analysis of the murine GST Ya ARE. Introduction of the newly identified necessary nucleotides into the regions flanking a nonresponsive, ARE-like, GST-Mu promoter sequence produced an inducible element. A screen of the GenBank database with the newly identified ARE consensus identified 16 genes which contained the functional ARE consensus sequence in their promoters. Included within this group was an ARE sequence from the murine ferritin-L promoter that mediated induction when tested. In an electrophoretic mobility-shift assay, the ferritin-L ARE was bound by ARE–binding protein 1, a protein previously identified as the likely mediator of the chemoprotective response. A three-level ARE classification system is presented to account for the distinct induction strengths observed in our mutagenesis studies. A model of the ARE as a composite regulatory site, where multiple transcription factors interact, is presented to account for the complex characteristics of ARE-mediated chemoprotective gene expression.

Estado actual de la investigación sobre la teoría tridimensional de la ansiedad de Lang

Este estudio ofrece una revisión de la teoría tridimensional propuesta por Lang (1968), quien mantiene que la ansiedad se manifiesta según un triple sistema de respuesta (cognitivo, fisiológico y motor o conductual) que pueden ser discordantes. Estos tres sistemas, regulados por normas diferentes, dan lugar a perfiles de respuesta diferenciales, los cuales será necesario evaluar por separado para, posteriormente, elegir el método de tratamiento más adecuado. En esta línea, el presente estudio ofrece una revisión de investigaciones que, hasta el día de hoy, han apoyado la teoría propuesta por Lang. Finalmente, este estudio revisa diferentes cuestionarios, inventarios y escalas construidos desde la teoría propuesta por Lang, revelando que, en la actualidad, la teoría tridimensional de la ansiedad continúa siendo aplicada en el ámbito clínico, de la salud y el escolar, lo que denota su actualidad, relevancia y practicidad.

Wireless telemedicine for the delivery of specialist paediatric services to the bedside

A mobile interactive online health system was used to conduct virtual ward rounds at a regional hospital which had no specialist paediatrician. The system was wireless, which allowed telepaediatric services to be delivered direct to the bedside. Between December 2004 and May 2005, 43 virtual ward rounds were coordinated between specialists based in Brisbane and local staff at the Gladstone Hospital. Eighty-six consultations were provided for 64 patients. The most common conditions included asthma (27%), chest infections (12%), gastroenteritis (10%) and urinary tract infections (10%). In the majority of cases, there were partial (67%) or complete changes (11%) in the clinical management of patients. Specialist services were offered by a team of 13 clinicians at the Royal Children's Hospital: 10 general paediatricians, two physiotherapists and one registered nurse. Feedback from all consultants involved in the service and local staff in Gladstone was extremely positive. In 43 videoconference calls there were three technical problems, probably due to an intermittent mains power supply at the regional hospital. There appears to be potential for other rural and regional hospitals to adopt this model of service delivery.

Differences between theoretical predictions and operational performance in a stock control application

Over the past decade, several experienced Operational Researchers have advanced the view that the theoretical aspects of model building have raced ahead of the ability of people to use them. Consequently, the impact of Operational Research on commercial organisations and the public sector is limited, and many systems fail to achieve their anticipated benefits in full. The primary objective of this study is to examine a complex interactive Stock Control system, and identify the reasons for the differences between the theoretical expectations and the operational performance. The methodology used is to hypothesise all the possible factors which could cause a divergence between theory and practice, and to evaluate numerically the effect each of these factors has on two main control indices - Service Level and Average Stock Value. Both analytical and empirical methods are used, and simulation is employed extensively. The factors are divided into two main categories for analysis - theoretical imperfections in the model, and the usage of the system by Buyers. No evidence could be found in the literature of any previous attempts to place the differences between theory and practice in a system in quantitative perspective nor, more specifically, to study the effects of Buyer/computer interaction in a Stock Control system. The study reveals that, in general, the human factors influencing performance are of a much higher order of magnitude than the theoretical factors, thus providing objective evidence to support the original premise. The most important finding is that, by judicious intervention into an automatic stock control algorithm, it is possible for Buyers to produce results which not only attain but surpass the algorithmic predictions. However, the complexity and behavioural recalcitrance of these systems are such that an innately numerate, enquiring type of Buyer needs to be inducted to realise the performance potential of the overall man/computer system.

The integrated use of simulation and PRS voting systems

Peer reviewed

The integrated use of simulation and PRS voting systems

Peer reviewed

Building autonomous sensitive artificial listeners (Extended abstract)

This paper describes a substantial effort to build a real-time interactive multimodal dialogue system with a focus on emotional and non-verbal interaction capabilities. The work is motivated by the aim to provide technology with competences in perceiving and producing the emotional and non-verbal behaviours required to sustain a conversational dialogue. We present the Sensitive Artificial Listener (SAL) scenario as a setting which seems particularly suited for the study of emotional and non-verbal behaviour, since it requires only very limited verbal understanding on the part of the machine. This scenario allows us to concentrate on non-verbal capabilities without having to address at the same time the challenges of spoken language understanding, task modeling etc. We first summarise three prototype versions of the SAL scenario, in which the behaviour of the Sensitive Artificial Listener characters was determined by a human operator. These prototypes served the purpose of verifying the effectiveness of the SAL scenario and allowed us to collect data required for building system components for analysing and synthesising the respective behaviours. We then describe the fully autonomous integrated real-time system we created, which combines incremental analysis of user behaviour, dialogue management, and synthesis of speaker and listener behaviour of a SAL character displayed as a virtual agent. We discuss principles that should underlie the evaluation of SAL-type systems. Since the system is designed for modularity and reuse, and since it is publicly available, the SAL system has potential as a joint research tool in the affective computing research community.

Addressing the theory practice gap in nurse education: evaluating teaching through audit against NMC standards and final management placement

Introduction
This paper outlines an innovative approach to auditing and evaluating the content of a management and leadership module for undergraduate nursing students after their final management clinical placement. Normally evaluations of teaching in a module take place at the end of a teaching module and therefore do not properly reflect the value of the teaching in relation to practical clinical experience.
Aim
This audit and evaluation sought to explore both the practical value of the teaching and learning, and also the degree to which it the teaching reflected against the NMC Standards of Education and Learning (2010 domain 3).
Methods
Having piloted the evaluative tool with an earlier cohort of nursing students, this evaluation explored both a quantitative assessment employing a Personal Response System (n =172), together with a qualitative dimension (n=116), thus delivering paper-based comments and reflections from students on the value and practicality of the module teaching theory to their final clinical management experience. The quantitative audit data were analysed for frequencies and cross tabulation and the qualitative audit data were thematically analysed.
Results
Results suggest a significant proportion of the students, appreciated the quality of the standard of teaching, but more importantly, ‘valued or highly valued’ the teaching and learning in relation to how it helped to significantly inform their management placement experience. A smaller proportion of the students underlined limitations and areas in which further improvement can be made in teaching and learning to the module.
Conclusion
Significantly positive evaluation by the students of the practical value of teaching and learning, to the theoretical management module. This has proved a useful auditing approach in assessing the theoretical teaching to student’s Level 3 clinical experience, and facilitated significant recommendations as far as developing the teaching and learning to better reflect the practice needs of nursing students

The use of electronic voting systems to enhance deep learning.

The present paper introduces a technology-enhanced teaching method that promotes deep learning. Four stages that correspond to four different student cohorts were used for its development and to analyse its effectiveness. The effectiveness of the method has been assessed in terms of examination results as well as results obtained from class response system software statistics. The evidence gathered indicates that the method developed is very effective and its implementation is straightforward. Furthermore, its success in achieving results seems to be independent of the skills and/or experience of the lecturer.

Ansiedad escolar según género y edad en una muestra de adolescentes chilenos

La ansiedad constituye un factor de riesgo para el bienestar y el desarrollo personal, social y académico de niños y adolescentes. Altos niveles de ansiedad reducen la eficiencia en el aprendizaje, ya que disminuyen la atención, la concentración y la retención, con el consecuente deterioro en el rendimiento escolar. Las investigaciones muestran altas tasas de prevalencia de ansiedad en población adolescente, especialmente en las mujeres. El objetivo del estudio es analizar la ansiedad escolar en una muestra de adolescentes chilenos según género y edad. Participaron 673 adolescentes, estudiantes de 6 colegios de la provincia de Ñuble, cuyo rango de edad es de 13 a 17 años (M = 15, 26; DE = 1, 32). La Ansiedad Escolar se evaluó con el Inventario de Ansiedad Escolar (IAES) que evalúa tres sistemas de respuesta; ansiedad cognitiva, ansiedad conductual y ansiedad psicofisiológica, y tres factores situacionales: ansiedad ante la evaluación social, ansiedad ante el fracaso escolar, y ansiedad ante la agresión. Los hombres presentaron puntuaciones menores que las mujeres, siendo las diferencias estadísticamente significativas en todos los sistemas de respuesta y en todos los factores situacionales. En los grupos de edad, las diferencias significativas se presentaron en el sistema de respuesta cognitivo, en dos factores situacionales (ansiedad ante el fracaso escolar y ansiedad ante la agresión) y en la puntuación total. El grupo de varones de 17 años fue quien presentó menores niveles de ansiedad escolar.

Avaliação da resposta ao stress de gatas hospitalizadas no período pós-cirúrgico em distintas condições de macroambiente

Dissertação de Mestrado Integrado em Medicina Veterinária

Edoxaban versus enoxaparin–warfarin in patients undergoing cardioversion of atrial fibrillation (ENSURE-AF): a randomised, open-label, phase 3b trial

Background Edoxaban, an oral factor Xa inhibitor, is non-inferior for prevention of stroke and systemic embolism in patients with atrial fibrillation and is associated with less bleeding than well controlled warfarin therapy. Few safety data about edoxaban in patients undergoing electrical cardioversion are available. Methods We did a multicentre, prospective, randomised, open-label, blinded-endpoint evaluation trial in 19 countries with 239 sites comparing edoxaban 60 mg per day with enoxaparin–warfarin in patients undergoing electrical cardioversion of non-valvular atrial fibrillation. The dose of edoxaban was reduced to 30 mg per day if one or more factors (creatinine clearance 15–50 mL/min, low bodyweight [≤60 kg], or concomitant use of P-glycoprotein inhibitors) were present. Block randomisation (block size four)—stratified by cardioversion approach (transoesophageal echocardiography [TEE] or not), anticoagulant experience, selected edoxaban dose, and region—was done through a voice-web system. The primary efficacy endpoint was a composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular mortality, analysed by intention to treat. The primary safety endpoint was major and clinically relevant non-major (CRNM) bleeding in patients who received at least one dose of study drug. Follow-up was 28 days on study drug after cardioversion plus 30 days to assess safety. This trial is registered with ClinicalTrials.gov, number NCT02072434. Findings Between March 25, 2014, and Oct 28, 2015, 2199 patients were enrolled and randomly assigned to receive edoxaban (n=1095) or enoxaparin–warfarin (n=1104). The mean age was 64 years (SD 10·54) and mean CHA2DS2-VASc score was 2·6 (SD 1·4). Mean time in therapeutic range on warfarin was 70·8% (SD 27·4). The primary efficacy endpoint occurred in five (<1%) patients in the edoxaban group versus 11 (1%) in the enoxaparin–warfarin group (odds ratio [OR] 0·46, 95% CI 0·12–1·43). The primary safety endpoint occurred in 16 (1%) of 1067 patients given edoxaban versus 11 (1%) of 1082 patients given enoxaparin–warfarin (OR 1·48, 95% CI 0·64–3·55). The results were independent of the TEE-guided strategy and anticoagulation status. Interpretation ENSURE-AF is the largest prospective randomised clinical trial of anticoagulation for cardioversion of patients with non-valvular atrial fibrillation. Rates of major and CRNM bleeding and thromboembolism were low in the two treatment groups. Funding Daiichi Sankyo provided financial support for the study. © 2016 Elsevier Ltd