Predictores del estado post-ictus en el alta hospitalaria. Importancia en enfermería / Predictors of the post-stroke status in the discharge from the hospital. Importance in nursing

A menudo, por parte del paciente y de la familia, se solicita a los profesionales de enfermería que predigan los factores que influyen en el estado post-ictus. Se han realizado numerosos estudios para determinar los factores que influyen en el estado neurológico post-ictus en el momento del alta hospitalaria. Sin embargo, las técnicas de aprendizaje automático no se han utilizado para este propósito. Con el objetivo de obtener reglas de asociación del pronóstico neurológico, se ha llevado a cabo un doble análisis, tanto clínico como con técnicas de aprendizaje automático, de las posibles asociaciones de factores que influyen en el estado neurológico de los pacientes post-ictus. El algoritmo Apriori detectó varias reglas de asociación con alta confianza (≥ 95%), con el siguiente patrón: En pacientes en el rango de edad de 50-80 años, la asociación de un NIHSS entre 11 y 15 puntos (NIHSS intermedio/bajo), junto con la trombectomía, conduce a la recuperación ad integrum al alta. Con la técnica de remuestreo SMOTE, se alcanzó el 100% de confianza para la asociación de NIHSS elevado (>20) y afectación de las arterias carótida y basilar, con pronóstico nefasto (exitus). Estas reglas confirman, por primera vez con aprendizaje automático, la importancia de la asociación de algunos predictores, en el pronóstico post-ictus. El conocimiento por parte de las enfermeras de estas reglas puede mejorar los resultados del ictus. Adicionalmente, el papel de la enfermería en los programas de educación sobre los factores de riesgo, y pronóstico de un ictus se torna imprescindible. (AU)

Nurses are often asked to predict factors that influence post-stroke outcome by the patient and family. Many studies have been carried out in order to determine the factors that influence the neurological status of the post-stroke patient at the moment of the discharge from the hospital. However, machine learning techniques have not been used for this purpose. Therefore, with the objective of obtaining association rules of neurological prognosis, a double analysis, both clinical and with machine learning techniques of the possible associations of factors that influence the neurological status of the post-stroke patients has been carried out. The Apriori algorithm detected several association rules with high confidence (≥ 95%), from which the following pattern: In patients in the age range of 50-80 years, the association of a NIHSS between 11 and 15 points (intermediate/low NIHSS), along with thrombectomy, leads to recovery ad integrum at discharge. With the SMOTE resampling technique, the 100% confidence was reached for the association of high NIHSS (>20) and involvement of the carotid and basilar arteries, with a dire prognosis (exitus). These rules confirm, for the first time with machine learning, the importance of the association of some predictors, in the post-stroke prognosis. The knowledge by the nurses of these association rules can successfully improve stroke outcome. In addition, the role of nurses in education programs that teach knowledge of risk factors and stroke prognosis becomes essential. (AU)

An Approach to Integrating Sentiment Analysis into Recommender Systems.

Recommender systems have been applied in a wide range of domains such as e-commerce, media, banking, and utilities. This kind of system provides personalized suggestions based on large amounts of data to increase user satisfaction. These suggestions help client select products, while organizations can increase the consumption of a product. In the case of social data, sentiment analysis can help gain better understanding of a user's attitudes, opinions and emotions, which is beneficial to integrate in recommender systems for achieving higher recommendation reliability. On the one hand, this information can be used to complement explicit ratings given to products by users. On the other hand, sentiment analysis of items that can be derived from online news services, blogs, social media or even from the recommender systems themselves is seen as capable of providing better recommendations to users. In this study, we present and evaluate a recommendation approach that integrates sentiment analysis into collaborative filtering methods. The recommender system proposal is based on an adaptive architecture, which includes improved techniques for feature extraction and deep learning models based on sentiment analysis. The results of the empirical study performed with two popular datasets show that sentiment-based deep learning models and collaborative filtering methods can significantly improve the recommender system's performance.

Environment Monitoring of Rose Crops Greenhouse Based on Autonomous Vehicles with a WSN and Data Analysis.

This work presents a monitoring system for the environmental conditions of rose flower-cultivation in greenhouses. Its main objective is to improve the quality of the crops while regulating the production time. To this end, a system consisting of autonomous quadruped vehicles connected with a wireless sensor network (WSN) is developed, which supports the decision-making on type of action to be carried out in a greenhouse to maintain the appropriate environmental conditions for rose cultivation. A data analysis process was carried out, aimed at designing an in-situ intelligent system able to make proper decisions regarding the cultivation process. This process involves stages for balancing data, prototype selection, and supervised classification. The proposed system produces a significant reduction of data in the training set obtained by the WSN while reaching a high classification performance in real conditions-amounting to 90 % and 97.5%, respectively. As a remarkable outcome, it is also provided an approach to ensure correct planning and selection of routes for the autonomous vehicle through the global positioning system.

Multiclassifier Systems for Predicting Neurological Outcome of Patients with Severe Trauma and Polytrauma in Intensive Care Units.

This paper presents an ensemble based classification proposal for predicting neurological outcome of severely traumatized patients. The study comprises both the whole group of patients and a subgroup containing those patients suffering traumatic brain injury (TBI). Data was gathered from patients hospitalized in the Intensive Care Unit (ICU) of the University Hospital in Salamanca. Predictive models were induced from both epidemiologic and clinical variables taken at the emergency room and along the stay in the ICU. The large number of variables leads to a low accuracy in the classifiers even when feature selection methods are used. In addition, the presence of a much larger number of instances of one of the classes in the subgroup of TBI patients produces a significantly lesser precision for the minority class. Usual ways of dealing with the last problem is to use undersampling and oversampling strategies, which can lead to the loss of valuable data and overfitting problems respectively. Our proposal for dealing with these problems is based in the use of ensemble multiclassifiers as well as in the use of an ensemble playing the role of base classifier in multiclassifiers. The proposed strategy gave the best values of the selected quality measures (accuracy, precision, sensitivity, specificity, F-measure and area under the Receiver Operator Characteristic curve) as well as the closest values of precision for the two classes under study in the case of the classification from imbalanced data.

Success/Failure Prediction of Noninvasive Mechanical Ventilation in Intensive Care Units. Using Multiclassifiers and Feature Selection Methods.

OBJECTIVES: This paper addresses the problem of decision-making in relation to the administration of noninvasive mechanical ventilation (NIMV) in intensive care units. METHODS: Data mining methods were employed to find out the factors influencing the success/failure of NIMV and to predict its results in future patients. These artificial intelligence-based methods have not been applied in this field in spite of the good results obtained in other medical areas. RESULTS: Feature selection methods provided the most influential variables in the success/failure of NIMV, such as NIMV hours, PaCO2 at the start, PaO2 / FiO2 ratio at the start, hematocrit at the start or PaO2 / FiO2 ratio after two hours. These methods were also used in the preprocessing step with the aim of improving the results of the classifiers. The algorithms provided the best results when the dataset used as input was the one containing the attributes selected with the CFS method. CONCLUSIONS: Data mining methods can be successfully applied to determine the most influential factors in the success/failure of NIMV and also to predict NIMV results in future patients. The results provided by classifiers can be improved by preprocessing the data with feature selection techniques.