Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age / Desarrollo y evaluación de un software diseñado por un equipo de enfermería y tecnología para la valoración del estado de salud de los adultos mayores de 65 año / Desenvolvimento e avaliação de um software desenvolvido por uma equipe de enfermagem e tecnologia para avaliação do estado de saúde de adultos com mais de 65 anos

Objective. This work sought to develop the Actuasalud platformas a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods. For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results. The software was developed in three large blocks that include all the dimensions of frailty: a) sociodemographic variables, b) comorbidities, and c) assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion.Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence,which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Objetivo. Desarrollar la plataforma Actuasalud como una herramienta útil para enfermería que permita evaluar la salud, en términos de fragilidad, en población mayor de 65 años. Métodos. Para el diseño y desarrollo de Actuasalud,se constituyeron dos grupos de trabajo: uno de enfermería con diferentes perfiles para identificar el contenido científico y uno informático que se responsabilizó de la programación y desarrollo del software. Ambos equipos adaptaron el contenido científico a la tecnología de manera que la herramienta permitiese hacer un cribado poblacional con detección de problemas de salud y estados de fragilidad. Resultados. Se desarrolló el software en tres grandes bloques que incluyen todas las dimensiones de fragilidad: a) variables sociodemográficas, b) comorbilidades y c) herramientas de evaluación de necesidades relacionadas con la autonomía que evalúan las dimensiones de fragilidad. Al finalizar la evaluación, se visualiza un informe detallado mediante diagrama de barras con el diagnóstico de cada una de las dimensiones evaluadas. La evaluación en los mayores participantes mostró que el 44.7% (n = 38) de la población se consideró como no frágil, y un 55.3%; (n = 47) como frágiles. En cuanto a las patologías asociadas, destacaron hipertensión arterial (67,1 %; n = 57), artrosis y/o artritis (55.3%; n = 47), diabetes (48.2 %; n = 41) y caídas en el último año (35,3 %; n = 30). Conclusión.Actuasalud es una aplicación que permite a los profesionales de enfermería evaluar fragilidad y emitir un diagnóstico de forma ágil con secuencia ordenada que ayuda a brindar cuidados individualizados a personas mayores de acuerdo los problemas detectados en la evaluación.

Objetivo. Desenvolver a plataforma Actuasalud como uma ferramenta útil para a enfermagem que permite avaliar a saúde, em termos de fragilidade, numa população com mais de 65 anos. Métodos. Para a concepção e desenvolvimento do Actuasalud foram formados dois grupos de trabalho: um grupo de enfermagem com perfis diferentes, para identificar o conteúdo científico, e um grupo de informática que foi responsável pela programação e desenvolvimento do software. Ambas as equipas adaptaram o conteúdo científico à tecnologia para que a ferramenta permitisse o rastreio da população para detectar problemas de saúde e estados de fragilidade. Resultados. O software foi desenvolvido em três grandes blocos que incluem todas as dimensões da fragilidade: a) variáveis sociodemográficas, b) comorbidades ec) instrumentos de avaliação de necessidades relacionadas à autonomia que avaliam as dimensões da fragilidade. Ao final da avaliação é apresentado um relatório detalhado através de um diagrama de barras com o diagnóstico de cada uma das dimensões avaliadas. A avaliação nos idosos mostrou que 44.7% (n=38) da população foi considerada não frágil e 55.3%; (n=47) como frágil. Quanto às patologias associadas, destacaram-se a hipertensão arterial (67.1%; n=57), a osteoartrite e/ou artrite (55.3%; n=47), a diabetes (48.2%; n=41) e as quedas no último ano (35.3%; n=30). Conclusão. Actuasalud é um aplicativo que permite ao profissional de enfermagem avaliar a fragilidade e emitir um diagnóstico de forma ágil e com sequência ordenada que auxilia no atendimento individualizado ao idoso de acordo com os problemas detectados na avaliação.

Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age.

Objective: This work sought to develop the Actuasalud platform as a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods: For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results: The software was developed in three large blocks that include all the dimensions of frailty: a: sociodemographic variables, b: comorbidities, and c: assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion: Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence, which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Structural analysis of the reducing-end xylose-releasing exo-oligoxylanase Rex8A from Paenibacillus barcinonensis BP-23 deciphers its molecular specificity.

Reducing-end xylose-releasing exo-oligoxylanases (Rex) are GH8 enzymes that depolymerize xylooligosaccharides complementing xylan degradation by endoxylanases in an exo manner. We have studied Paenibacillus barcinonensis Rex8A and showed the release of xylose from xylooligomers decorated with methylglucuronic acid (UXOS) or with arabinose (AXOS). This gives the enzyme a distinctive trait among known Rex, which show activity only on linear xylooligosaccharides. The structure of the enzyme has been solved by X-ray crystallography showing a (α/α)6 folding common to GH8 enzymes. Analysis of inactived Rex8A-E70A complexed with xylotetraose revealed the existence of at least four binding subsites in Rex8A, with the oligosaccharide occupying subsites -3 to +1. The enzyme shows an extended Leu320-His321-Pro322 loop, common to other Rex, which blocks the binding of longer substrates to positive subsites further than +1 and seems responsible for the lack or diminished activity of Rex enzymes on xylan. Mutants with smaller residues in this loop failed to increase Rex8A activity on the polymer. Analysis of the complexes with AXOS showed the accommodation of arabinose at subsite -2, which cannot be allocated at subsite -1. Arabinose substitutions at the xylose O2 or O3 are accommodated by hydrophobic interaction and seem tolerated rather than recognized by Rex8A. A strained binding of the branch is facilitated by the lack of direct polar interactions of the xylose occupying this subsite, its water-mediated links allowing some conformational flexibility of the sugar. The plasticity of Rex8A is a notable property of the enzyme for its application in xylan deconstruction and upgrading. DATABASE: Structural data are available in PDB database under the accession numbers 6SRD (native form), 6TPP (E70A mutant in complex with EDO), 6TOW (E70A in complex with Xyl4), 6SUD (L320A mutant in complex with xylose), 6SHY (L320A/H321S double mutant in complex with EDO), 6TO0 (E70A in complex with AX3), and 6TRH (E70A in complex with AX4).

Smart Management Consumption in Renewable Energy Fed Ecosystems.

Advances in embedded electronic systems, the development of new communication protocols, and the application of artificial intelligence paradigms have enabled the improvement of current automation systems of energy management. Embedded devices integrate different sensors with connectivity, computing resources, and reduced cost. Communication and cloud services increase their performance; however, there are limitations in the implementation of these technologies. If the cloud is used as the main source of services and resources, overload problems will occur. There are no models that facilitate the complete integration and interoperability in the facilities already created. This article proposes a model for the integration of smart energy management systems in new and already created facilities, using local embedded devices, Internet of Things communication protocols and services based on artificial intelligence paradigms. All services are distributed in the new smart grid network using edge and fog computing techniques. The model proposes an architecture both to be used as support for the development of smart services and for energy management control systems adapted to the installation: a group of buildings and/or houses that shares energy management and energy generation. Machine learning to predict consumption and energy generation, electric load classification, energy distribution control, and predictive maintenance are the main utilities integrated. As an experimental case, a facility that incorporates wind and solar generation is used for development and testing. Smart grid facilities, designed with artificial intelligence algorithms, implemented with Internet of Things protocols, and embedded control devices facilitate the development, cost reduction, and the integration of new services. In this work, a method to design, develop, and install smart services in self-consumption facilities is proposed. New smart services with reduced costs are installed and tested, confirming the advantages of the proposed model.

Precision Agriculture Design Method Using a Distributed Computing Architecture on Internet of Things Context.

The Internet of Things (IoT) has opened productive ways to cultivate soil with the use of low-cost hardware (sensors/actuators) and communication (Internet) technologies. Remote equipment and crop monitoring, predictive analytic, weather forecasting for crops or smart logistics and warehousing are some examples of these new opportunities. Nevertheless, farmers are agriculture experts but, usually, do not have experience in IoT applications. Users who use IoT applications must participate in its design, improving the integration and use. In this work, different industrial agricultural facilities are analysed with farmers and growers to design new functionalities based on IoT paradigms deployment. User-centred design model is used to obtain knowledge and experience in the process of introducing technology in agricultural applications. Internet of things paradigms are used as resources to facilitate the decision making. IoT architecture, operating rules and smart processes are implemented using a distributed model based on edge and fog computing paradigms. A communication architecture is proposed using these technologies. The aim is to help farmers to develop smart systems both, in current and new facilities. Different decision trees to automate the installation, designed by the farmer, can be easily deployed using the method proposed in this document.

Electromagnetic Differential Measuring Method: Application in Microstrip Sensors Developing.

Electromagnetic radiation is energy that interacts with matter. The interaction process is of great importance to the sensing applications that characterize material media. Parameters like constant dielectric represent matter characteristics and they are identified using emission, interaction and reception of electromagnetic radiation in adapted environmental conditions. How the electromagnetic wave responds when it interacts with the material media depends on the range of frequency used and the medium parameters. Different disciplines use this interaction and provides non-intrusive applications with clear benefits, remote sensing, earth sciences (geology, atmosphere, hydrosphere), biological or medical disciplines use this interaction and provides non-intrusive applications with clear benefits. Electromagnetic waves are transmitted and analyzed in the receiver to determine the interaction produced. In this work a method based in differential measurement technique is proposed as a novel way of detecting and characterizing electromagnetic matter characteristics using sensors based on a microstrip patch. The experimental results, based on simulations, show that it is possible to obtain benefits from the behavior of the wave-medium interaction using differential measurement on reception of electromagnetic waves at different frequencies or environmental conditions. Differential method introduce advantages in measure processes and promote new sensors development. A new microstrip sensor that uses differential time measures is proposed to show the possibilities of this method.

A vision based proposal for classification of normal and abnormal gait using RGB camera.

Human gait is mainly related to the foot and leg movements but, obviously, the entire motor system of the human body is involved. We hypothesise that movement parameters such as dynamic balance, movement harmony of each body element (arms, head, thorax…) could enable us to finely characterise gait singularities to pinpoint potential diseases or abnormalities in advance. Since this paper deals with the preliminary problem pertaining to the classification of normal and abnormal gait, our study will revolve around the lower part of the body. Our proposal presents a functional specification of gait in which only observational kinematic aspects are discussed. The resultant specification will confidently be open enough to be applied to a variety of gait analysis problems encountered in areas connected to rehabilitation, sports, children's motor skills, and so on. To carry out our functional specification, we develop an extraction system through which we analyse image sequences to identify gait features. Our prototype not only readily lets us determine the dynamic parameters (heel strike, toe off, stride length and time) and some skeleton joints but also satisfactorily supplies us with a proper distinction between normal and abnormal gait. We have performed experiments on a dataset of 30 samples.

Developing Ubiquitous Sensor Network Platform Using Internet of Things: Application in Precision Agriculture.

The application of Information Technologies into Precision Agriculture methods has clear benefits. Precision Agriculture optimises production efficiency, increases quality, minimises environmental impact and reduces the use of resources (energy, water); however, there are different barriers that have delayed its wide development. Some of these main barriers are expensive equipment, the difficulty to operate and maintain and the standard for sensor networks are still under development. Nowadays, new technological development in embedded devices (hardware and communication protocols), the evolution of Internet technologies (Internet of Things) and ubiquitous computing (Ubiquitous Sensor Networks) allow developing less expensive systems, easier to control, install and maintain, using standard protocols with low-power consumption. This work develops and test a low-cost sensor/actuator network platform, based in Internet of Things, integrating machine-to-machine and human-machine-interface protocols. Edge computing uses this multi-protocol approach to develop control processes on Precision Agriculture scenarios. A greenhouse with hydroponic crop production was developed and tested using Ubiquitous Sensor Network monitoring and edge control on Internet of Things paradigm. The experimental results showed that the Internet technologies and Smart Object Communication Patterns can be combined to encourage development of Precision Agriculture. They demonstrated added benefits (cost, energy, smart developing, acceptance by agricultural specialists) when a project is launched.

Therapies against murine Candida guilliermondii infection, relationship between in vitro antifungal pharmacodynamics and outcome.

BACKGROUND: Candida guilliermondii has been recognized as an emerging pathogen showing a decreased susceptibility to fluconazole and considerably high echinocandin MICs. AIMS: Evaluate the in vitro activity of anidulafungin in comparison to amphotericin B and fluconazole against different isolates of C. guilliermondii, and their efficacy in an immunosuppressed murine model of disseminated infection. METHODS: The in vitro susceptibility of four strains against amphotericin B, fluconazole and anidulafungin was performed by using a reference broth microdilution method and time-kill curves. The in vivo efficacy was evaluated by determination of fungal load reduction in kidneys of infected animals receiving deoxycholate AMB at 0,8 mg/kg i.v., liposomal amphotericin B at 10 mg/kg i.v., fluconazole at 50 mg/kg, or anidulafungin at 10 mg/kg. RESULTS: Amphotericin B and anidulafungin showed fungicidal activity, while fluconazole was fungistatic for all the strains. In the murine model, liposomal amphotericin B at 10 mg/kg/day was effective in reducing the tissue burden in kidneys of mice infected with any of the tested strains. However, amphotericin B, anidulafungin and fluconazole were only effective against those strains showing low MIC values. CONCLUSIONS: Liposomal amphotericin B showed the higher activity and efficacy against the two strains of C. guilliermondii, in contrast to the poor effect of fluconazole and anidulafungin. Further studies with more isolates of C. guilliermondii representing a wider range of MICs should be carried out to assess whether there is any relationship between MIC values and anidulafungin efficacy.

Experimental therapy with azoles against Candida guilliermondii.

We evaluated the in vitro killing activity of voriconazole (VRC) and posaconazole (PSC) against two clinical isolates of Candida guilliermondii. The two drugs showed fungistatic activity against both isolates and were effective in reducing kidney fungal burden in a neutropenic murine model of disseminated candidiasis in infected mice. PSC was significantly more effective than VRC against one of the strains. The serum levels of PSC and VRC were above the corresponding MICs for these isolates.

A vision-based system for intelligent monitoring: human behaviour analysis and privacy by context.

Due to progress and demographic change, society is facing a crucial challenge related to increased life expectancy and a higher number of people in situations of dependency. As a consequence, there exists a significant demand for support systems for personal autonomy. This article outlines the vision@home project, whose goal is to extend independent living at home for elderly and impaired people, providing care and safety services by means of vision-based monitoring. Different kinds of ambient-assisted living services are supported, from the detection of home accidents, to telecare services. In this contribution, the specification of the system is presented, and novel contributions are made regarding human behaviour analysis and privacy protection. By means of a multi-view setup of cameras, people's behaviour is recognised based on human action recognition. For this purpose, a weighted feature fusion scheme is proposed to learn from multiple views. In order to protect the right to privacy of the inhabitants when a remote connection occurs, a privacy-by-context method is proposed. The experimental results of the behaviour recognition method show an outstanding performance, as well as support for multi-view scenarios and real-time execution, which are required in order to provide the proposed services.

Evaluation of the Neo-Sensitabs diffusion method for determining the antifungal susceptibilities of Cryptococcus gattii isolates, using three different agar media.

The Neo-Sensitabs diffusion method was evaluated for determining the antifungal susceptibilities of 30 Cryptococcus gattii isolates to amphotericin B (AMB), fluconazole (FLC), itraconazole (ITC) and voriconazole (VRC). Three different culture media, Müeller-Hinton (MH), RPMI 1640 (RPMI) and Antibiotic medium 3 (AM3), all supplemented with 2% of glucose and 0.5 microg/ml of methylene blue, were tested. The tests were repeated three times on different days at three incubation times (48, 72 and 96 h). Results were compared with those obtained with the CLSI M27-A2 broth microdilution method. The degree of reproducibility of the diffusion test was 100% for VRC and ITC, 98.3-100% for AMB and 43.3-73.3% for FLC. The best reproducibility was observed at 48 h of incubation and no important differences among media were observed at any of the incubation times assayed. Between Neo-Sensitabs and the reference method, VRC showed the best agreement and ITC the worst in all conditions tested (100% and 56.7%, respectively). AMB showed a high agreement between the two methods (93.3% to 96.7%) but Neo-Sensitabs assay failed to detect resistant isolates (discrepancy classified as "very major error") in all times of incubation assayed. Only agreement between both methods for FLC was clearly affected by incubation time and media used, the best results being achieved at 48 h of incubation when MH and RPMI (80.0%, in both media) were used.

[Anidulafungin: experimental therapy of fungal infections in animal models]. / Anidulafungina en el tratamiento de la infección fúngica en modelos animales.

We have reviewed the existing data on the efficacy of anidulafungin, which is the most recent echinocandin in the experimental treatment of fungal infections. The scarce published data practically only refers to disseminated and pulmonary aspergillosis and to disseminated candidiasis. Anidulafungin shows fungistatic activity against Aspergillus fumigatus, and fungicidal activity against Candida albicans and Candida glabrata.

Effect of antifungal treatment in a murine model of blastoschizomycosis.

Blastoschizomyces capitatus is an emerging pathogenic fungus that can cause deep invasive diseases in neutropenic patients. We developed a model of disseminated blastoschizomycosis in immunosuppressed mice to evaluate the effectiveness of amphotericin B, flucytosine, fluconazole and voriconazole. High-dose fluconazole was the most effective drug at prolonging the survival of mice and at reducing fungal burden in the kidneys, spleen and liver.

[In vitro activity of the echinocandins. How should it be evaluated?]. / Actividad in vitro de las equinocandinas. Cómo debe evaluarse?

Echinocandins are a novel class of antifungal drugs. They have good activity against Candida spp and Aspergillus spp. Their low selective toxicity allows their administration at high doses with few secondary side effects. We have reviewed the available data on the endpoints for these drugs in their in vitro susceptibility testing on yeasts and moulds. The microdilution broth method is the most commonly used technique and MIC-1 (80% of growth inhibition) seems to be the most reliable endpoint when yeasts are tested. This endpoint also seems to be the most appropriate for the different drugs when they are combined with echinocandins using the checkerboard method for testing yeasts. By contrast, in the case of moulds, the minimum effective concentration (MEC) correlates better with the in vivo activity than the MIC when echinocandins are tested, and when these drugs are combined with other antifungals, MIC-2 (50% of growth inhibition) seems the most appropriate endpoint. Criteria based on drug pharmacodynamics is the most useful to define the echinocandin endpoints that best correlate with their in vivo efficacy.

In vitro antifungal susceptibilities of uncommon basidiomycetous yeasts.

The in vitro activities of eight antifungal drugs against 50 isolates of basidiomycetous yeasts were determined by a microdilution method. In general fluconazole and micafungin were inactive. Terbinafine was active only against Sporobolomyces salmonicolor. The activities of the other antifungals were variable and depended on the species tested. The new triazoles showed the lowest MICs, but amphotericin B and itraconazole were the only drugs active against Cryptococcus albidus.