Detection of Anomalies in Daily Activities Using Data from Smart Meters.

The massive deployment of smart meters in most Western countries in recent decades has allowed the creation and development of a significant variety of applications, mainly related to efficient energy management. The information provided about energy consumption has also been dedicated to the areas of social work and health. In this context, smart meters are considered single-point non-intrusive sensors that might be used to monitor the behaviour and activity patterns of people living in a household. This work describes the design of a short-term behavioural alarm generator based on the processing of energy consumption data coming from a commercial smart meter. The device captured data from a household for a period of six months, thus providing the consumption disaggregated per appliance at an interval of one hour. These data were used to train different intelligent systems, capable of estimating the predicted consumption for the next one-hour interval. Four different approaches have been considered and compared when designing the prediction system: a recurrent neural network, a convolutional neural network, a random forest, and a decision tree. By statistically analysing these predictions and the actual final energy consumption measurements, anomalies can be detected in the undertaking of three different daily activities: sleeping, breakfast, and lunch. The recurrent neural network achieves an F1-score of 0.8 in the detection of these anomalies for the household under analysis, outperforming other approaches. The proposal might be applied to the generation of a short-term alarm, which can be involved in future deployments and developments in the field of ambient assisted living.

Light and shadow of watch-and-wait strategy in rectal cancer: oncological result, clinical outcomes, and cost-effectiveness analysis.

BACKGROUND: The watch-and-wait (WW) strategy is a potential option for patients with rectal cancer who obtain a complete clinic response after neoadjuvant therapy. The aim of this study is to analyze the long-term oncological outcomes and perform a cost-effectiveness analysis in patients undergoing this strategy for rectal cancer. MATERIAL AND METHODS: The data of patients treated with the WW strategy were prospectively collected from January 2015 to January 2020. A control group was created, matched 1:1 from a pool of 480 patients undergoing total mesorectal excision. An independent company carried out the financial analysis. Clinical and oncological outcomes were analyzed in both groups. Outcome parameters included surgical and follow-up costs, quality-adjusted life years (QALYs), and the incremental cost per QALY gained or the incremental cost-effectiveness ratio (ICER). RESULTS: Forty patients were included in the WW group, with 40 patients in the surgical group. During a median follow-up period of 36 months, metastasis-free survival (MFS) and overall survival (OS) were similar in the two groups. In the WW group, nine (22%) local regrowths were detected in the first 2 years. The permanent stoma rate was slightly higher after salvage surgery in the WW group compared to the surgical group (48.5% vs 20%, p < 0.01). The cost-effectiveness analysis was slightly better for the WW group, especially for low rectal cancer compared to medium-high rectal cancer (ICER = - 108,642.1 vs ICER = - 42,423). CONCLUSIONS: The WW strategy in locally advanced rectal cancer offers similar oncological outcomes with respect to the surgical group and excellent results in quality of life and cost outcomes, especially for low rectal cancer. Nonetheless, the complex surgical field during salvage surgery can lead to a high permanent stoma rate; therefore, the careful selection of patients is mandatory.

Heme catabolism mediated by heme oxygenase in uninfected interstitial cells enables efficient symbiotic nitrogen fixation in Lotus japonicus nodules.

Legume nodules produce large quantities of heme required for the synthesis of leghemoglobin (Lb) and other hemoproteins. Despite the crucial function of Lb in nitrogen fixation and the toxicity of free heme, the mechanisms of heme homeostasis remain elusive. Biochemical, cellular, and genetic approaches were used to study the role of heme oxygenases (HOs) in heme degradation in the model legume Lotus japonicus. Heme and biliverdin were quantified and localized, HOs were characterized, and knockout LORE1 and CRISPR/Cas9 mutants for LjHO1 were generated and phenotyped. We show that LjHO1, but not the LjHO2 isoform, is responsible for heme catabolism in nodules and identify biliverdin as the in vivo product of the enzyme in senescing green nodules. Spatiotemporal expression analysis revealed that LjHO1 expression and biliverdin production are restricted to the plastids of uninfected interstitial cells. The nodules of ho1 mutants showed decreased nitrogen fixation, and the development of brown, rather than green, nodules during senescence. Increased superoxide production was observed in ho1 nodules, underscoring the importance of LjHO1 in antioxidant defense. We conclude that LjHO1 plays an essential role in degradation of Lb heme, uncovering a novel function of nodule plastids and uninfected interstitial cells in nitrogen fixation.

Simulation Tool and Online Demonstrator for CDMA-Based Ultrasonic Indoor Localization Systems.

This work presents the CODEUS platform, which includes a simulation tool together with an online experimental demonstrator to offer analysis and testing flexibility for researchers and developers in Ultrasonic Indoor Positioning Systems (UIPSs). The simulation platform allows most common encoding techniques and sequences to be tested in a configurable UIPS. It models the signal modulation and processing, the ultrasonic transducers' response, the beacon distribution, the channel propagation effects, the synchronism, and the application of different positioning algorithms. CODEUS provides results and performance analysis for different metrics and at different stages of the signal processing. The UIPS simulation tool is specified by means of the MATLAB© App-Designer environment, which enables the definition of a user-friendly interface. It has also been linked to an online demonstrator that can be managed remotely by means of a website, thus avoiding any hardware requirement or equipment on behalf of researchers. This demonstrator allows the selected transmission schemes, modulation or encoding techniques to be validated in a real UIPS, therefore enabling a fast and easy way of carrying out experimental tests in a laboratory environment, while avoiding the time-consuming tasks related to electronic design and prototyping in the UIPS field. Both simulator and online demonstrator are freely available for researchers and students through the corresponding website.

LOCATE-US: Indoor Positioning for Mobile Devices Using Encoded Ultrasonic Signals, Inertial Sensors and Graph-Matching.

Indoor positioning remains a challenge and, despite much research and development carried out in the last decade, there is still no standard as with the Global Navigation Satellite Systems (GNSS) outdoors. This paper presents an indoor positioning system called LOCATE-US with adjustable granularity for use with commercial mobile devices, such as smartphones or tablets. LOCATE-US is privacy-oriented and allows every device to compute its own position by fusing ultrasonic, inertial sensor measurements and map information. Ultrasonic Local Positioning Systems (U-LPS) based on encoded signals are placed in critical zones that require an accuracy below a few decimeters to correct the accumulated drift errors of the inertial measurements. These systems are well suited to work at room level as walls confine acoustic waves inside. To avoid audible artifacts, the U-LPS emission is set at 41.67 kHz, and an ultrasonic acquisition module with reduced dimensions is attached to the mobile device through the USB port to capture signals. Processing in the mobile device involves an improved Time Differences of Arrival (TDOA) estimation that is fused with the measurements from an external inertial sensor to obtain real-time location and trajectory display at a 10 Hz rate. Graph-matching has also been included, considering available prior knowledge about the navigation scenario. This kind of device is an adequate platform for Location-Based Services (LBS), enabling applications such as augmented reality, guiding applications, or people monitoring and assistance. The system architecture can easily incorporate new sensors in the future, such as UWB, RFiD or others.

Hemoglobins in the legume-Rhizobium symbiosis.

Legume nodules have two types of hemoglobins: symbiotic or leghemoglobins (Lbs) and nonsymbiotic or phytoglobins (Glbs). The latter are categorized into three phylogenetic classes differing in heme coordination and O2 affinity. This review is focused on the roles of Lbs and Glbs in the symbiosis of rhizobia with crop legumes and the model legumes for indeterminate (Medicago truncatula) and determinate (Lotus japonicus) nodulation. Only two hemoglobin functions are well established in nodules: Lbs deliver O2 to the bacteroids and act as O2 buffers, preventing nitrogenase inactivation; and Glb1-1 modulates nitric oxide concentration during symbiosis, from the early stage, avoiding the plant's defense response, to nodule senescence. Here, we critically examine early and recent results, update and correct the information on Lbs and Glbs with the latest genome versions, provide novel expression data and identify targets for future research. Crucial unresolved questions include the expression of multiple Lbs in nodules, their presence in the nuclei and in uninfected nodule cells, and, intriguingly, their expression in nonsymbiotic tissues. RNA-sequencing data analysis shows that Lbs are expressed as early as a few hours after inoculation and that their mRNAs are also detectable in roots and pods, which clearly suggests that these heme proteins play additional roles unrelated to nitrogen fixation. Likewise, issues awaiting investigation are the functions of other Glbs in nodules, the spatiotemporal expression profiles of Lbs and Glbs at the mRNA and protein levels, and the molecular mechanisms underlying their regulation during nodule development and in response to stress and hormones.

MixInYeast: A Multicenter Study on Mixed Yeast Infections.

Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.

CRISPR/Cas9 knockout of leghemoglobin genes in Lotus japonicus uncovers their synergistic roles in symbiotic nitrogen fixation.

Legume nodules contain high concentrations of leghemoglobins (Lbs) encoded by several genes. The reason for this multiplicity is unknown. CRISPR/Cas9 technology was used to generate stable mutants of the three Lbs of Lotus japonicus. The phenotypes were characterized at the physiological, biochemical and molecular levels. Nodules of the triple mutants were examined by electron microscopy and subjected to RNA-sequencing (RNA-seq) analysis. Complementation studies revealed that Lbs function synergistically to maintain optimal N2 fixation. The nodules of the triple mutants overproduced superoxide radicals and hydrogen peroxide, which was probably linked to activation of NADPH oxidases and changes in superoxide dismutase isoforms expression. The mutant nodules showed major ultrastructural alterations, including vacuolization, accumulation of poly-ß-hydroxybutyrate and disruption of mitochondria. RNA-seq of c. 20 000 genes revealed significant changes in expression of carbon and nitrogen metabolism genes, transcription factors, and proteinases. Lb-deficient nodules had c. 30-50-fold less heme but similar transcript levels of heme biosynthetic genes, suggesting a post-translational regulatory mechanism of heme synthesis. We conclude that Lbs act additively in nodules and that the lack of Lbs results in early nodule senescence. Our observations also provide insight into the reprogramming of the gene expression network associated with Lb deficiency, probably as a result of uncontrolled intracellular free O2 concentration.

Unsolicited consultation by infectious diseases specialist improves outcomes in patients with bloodstream infection: A prospective cohort study.

INTRODUCTION: The objective of this study was to evaluate the impact of an intervention based on unsolicited consultations by an infectious diseases specialist (IDS) on the adequacy of antimicrobial treatment and mortality in patients with BSI. METHODS: A prospective cohort study was performed in a 410-bed hospital. An intervention based on unsolicited consultation by an IDS for patients with BSI was performed only on days when an IDS was available. Outcomes were the percentage of days on optimal antimicrobial treatment (PDOAT) and mortality. Analyses were performed by linear regression and multivariate logistic regression. RESULTS: Of 400 episodes of BSI included, 292 received the intervention. The median (interquartile range) PDOAT among those with and without the intervention was 93 (6-100) and 0 (0-53), respectively. The intervention was independently associated with a higher PDOAT (r = 0.5; p < 0.001) but not with mortality. The IDS recommendations were followed in full in 183 episodes, and not in 109. Mortality was 10.4% and 27.6%, respectively. Adherence to recommendations was associated with lower mortality (adjusted OR = 0.3; 95% CI: 0.1-0.5). CONCLUSIONS: An intervention based on unsolicited IDS consultation for BSI episodes was associated with improved use of antibiotics and, when the recommendations were fully followed, with lower mortality.

Hemoglobin LjGlb1-1 is involved in nodulation and regulates the level of nitric oxide in the Lotus japonicus-Mesorhizobium loti symbiosis.

Leghemoglobins transport and deliver O2 to the symbiosomes inside legume nodules and are essential for nitrogen fixation. However, the roles of other hemoglobins (Hbs) in the rhizobia-legume symbiosis are unclear. Several Lotus japonicus mutants affecting LjGlb1-1, a non-symbiotic class 1 Hb, have been used to study the function of this protein in symbiosis. Two TILLING alleles with single amino acid substitutions (A102V and E127K) and a LORE1 null allele with a retrotransposon insertion in the 5'-untranslated region (96642) were selected for phenotyping nodulation. Plants of all three mutant lines showed a decrease in long infection threads and nodules, and an increase in incipient infection threads. About 4h after inoculation, the roots of mutant plants exhibited a greater transient accumulation of nitric oxide (NO) than did the wild-type roots; nevertheless, in vitro NO dioxygenase activities of the wild-type, A102V, and E127K proteins were similar, suggesting that the mutated proteins are not fully functional in vivo The expression of LjGlb1-1, but not of the other class 1 Hb of L. japonicus (LjGlb1-2), was affected during infection of wild-type roots, further supporting a specific role for LjGlb1-1. In conclusion, the LjGlb1-1 mutants reveal that this protein is required during rhizobial infection and regulates NO levels.

Cholesterol dependent and Amphotericin B resistant isolates of a Candida glabrata strain from an Intensive Care Unit patient.

Here we report on two isolates of Candida glabrata recovered from urine samples collected from of an Intensive Care Unit patient. D1/D2 and ITS 1+2 rDNA sequence analysis confirmed its identification. The isolates were cholesterol dependent and resistant to Amphotericin B.

Inter-single-sequence-repeat-PCR typing as a new tool for identification of Microsporum canis strains.

BACKGROUND: Microsporum canis is a ubiquitous dermatophyte that commonly causes human infections. Since contact with infected animals is the usual way of infection, tracing its source is an essential preventive measure. OBJECTIVE: To type isolates of M. canis from human patients whose skin was affected, and from some animals (dogs and cats) that were closely associated to the patients. METHODS: The inter-single-sequence-repeat-PCR (ISSR-PCR) technique has been used for typing 24 isolates of M. canis. Seventeen isolates tested were from human patients, 5 from cats and 1 from a dog RESULTS: A total of 21 genotypes were identified. The same genotype was found infecting a patient and a cat that was living closely with him, but another member of the same family proved to be infected with two genotypes different from that. Clinical specimens from two patients had been contaminated with the same genotype, probably in the laboratory where the samples were handled. CONCLUSION: These results demonstrate that ISSR-PCR polymorphism is a reliable method for the identification of the M. canis strains.

Association between AIDS disease progression rates and the Fok-I polymorphism of the VDR gene in a cohort of HIV-1 seropositive patients.

In addition to its role in mineral metabolism, 1,25-dihydroxivitamin D3 (1,25(OH)2D3) also has immunomodulatory effects. Vitamin D receptor (VDR) mediates genomic actions of 1,25(OH)2D3, by acting as a transcription factor that modulates the expression of several 1,25(OH)2D3 response genes. Variations at the VDR locus have been associated with susceptibility and progression to several immune diseases. We investigated the association between rates of progression to acquired immunodeficiency syndrome (AIDS) and the Fok-I polymorphism, which is located at the initiation codon of the VDR gene. The study was performed with a cohort of 185 patients infected with human immunodeficiency virus type 1 (HIV-1): all belonged to the intravenous drug abuse risk group. Progression to AIDS was according to the Centers for Disease Control 1993 criterion (CDC-1993). In addition, a first drop in CD4 cell count to below 200 microL(-1) was considered as outcome. Patients who reached outcomes during follow-up were considered progressors. Non-progressors were those patients remaining outcome-free after a minimum follow-up of 8 years. Heterozygous at the Fok-I polymorphism were over-represented in the group of patients that progressed to AIDS CDC-1993 (50% of progressors versus 36% of non-progressors, P=0.061; risk ratio (RR)=1.38 (95% confidence interval (CI): 0.98-1.96)) and in the group of patients that showed a drop in CD4 cell count to below 200 microL(-1) (52% of progressors versus 36% of non-progressors, P=0.037; RR=1.44 (95% CI: 1.02-2.03)). Mean time to AIDS CDC-1993 was shorter for those with Ff genotype than for those with FF and ff genotypes (non-Ff genotype patients), (log rank test P=0.035; Cox hazard ratio (HR) for Ff versus non-Ff=1.53 (95% CI: 1.0-2.33), P=0.047). In addition the drop in CD4 cell count to below 200 microL(-1) was reached faster in Ff carriers than in non-Ff patients (log rank test P=0.015; HR for Ff versus non-Ff=1.77 (95% CI: 1.12-2.8), P=0.014). According to these results, HIV-1 seropositive patients carrying the Ff genotype could be considered prone to a faster progression to AIDS.