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This article presents an ingestion procedure towards an interoperable repository called ALPACS (Anonymized Local Picture Archiving and Communication System). ALPACS provides services to clinical and hospital users, who can access the repository data through an Artificial Intelligence (AI) application called PROXIMITY. This article shows the automated procedure for data ingestion from the medical imaging provider to the ALPACS repository. The data ingestion procedure was successfully applied by the data provider (Hospital Clínico de la Universidad de Chile, HCUCH) using a pseudo-anonymization algorithm at the source, thereby ensuring that the privacy of patients' sensitive data is respected. Data transfer was carried out using international communication standards for health systems, which allows for replication of the procedure by other institutions that provide medical images. OBJECTIVES: This article aims to create a repository of 33,000 medical CT images and 33,000 diagnostic reports with international standards (HL7 HAPI FHIR, DICOM, SNOMED). This goal requires devising a data ingestion procedure that can be replicated by other provider institutions, guaranteeing data privacy by implementing a pseudo-anonymization algorithm at the source, and generating labels from annotations via NLP. METHODOLOGY: Our approach involves hybrid on-premise/cloud deployment of PACS and FHIR services, including transfer services for anonymized data to populate the repository through a structured ingestion procedure. We used NLP over the diagnostic reports to generate annotations, which were then used to train ML algorithms for content-based similar exam recovery. OUTCOMES: We successfully implemented ALPACS and PROXIMITY 2.0, ingesting almost 19,000 thorax CT exams to date along with their corresponding reports.

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Introducción: la enseñanza de cursos de ciencias básicas en carreras de la salud es un desafío por no estar directa e inmediatamente rela-cionada con el ámbito profesional. Por otra parte, las condiciones de estrés que ha impuesto el trabajo a distancia requiere de metodologías motivantes, y, que a su vez permitan una evaluación significativa. Objetivos: reportar las adaptaciones metodológicas y los resultados de una adaptación local de la metodología de especificaciones de las calificaciones y retroalimentación del trabajo. Métodos: se aplica una metodología de formación basada en la retroalimentación en el curso de Física para estudiantes de Tecnología Médica (N=106) durante un semestre. Las calificaciones promedio de los estudiantes fueron comparadas con las obtenidas en años anteriores. Para evaluar el desempeño docente se realizaron 2 encuestas a los estudiantes. El cumplimiento de los logros de aprendizaje se midió mediante auto-evaluación (escala likert 1 a 5) al inicio y término de cada uno de los cuatro capítulos. Resultados: las reprobaciones y eliminaciones de estudiantes en el curso fueron menores a años anteriores, siendo las notas significativamente mayores subiendo desde 4,89 a 6,29 (escala de 1 a 7, p<0,001). Los estudiantes se mostraron en un 95% satisfechos con el desempeño docente y finalmente, la auto-evaluación de logros de aprendizaje mostró un aumento promedio de 1 punto. Conclusiones: la metodología de evaluación basada en especificaciones adaptada a dos entregas y con evaluaciones en una escala no-binaria mejoró el rendimiento, los logros de los aprendizajes esperados y la motivación de los estudiantes.

Background: Teaching basic science courses in health careers is a challenge because these courses are not directly linked to professional practice. On the other hand, the stressful conditions imposed by distance work require motivating methodologies and a meaningful evaluation. Objectives: To report the methodological adaptations and the results of a local adaptation of the specifications grading and feedback methodology. Methods: A training methodology based on feedback is applied in the Physics course for Medical Technology students (N = 106) during one semester. We compared the students' average grades to those obtained in previous years with the same topics. To evaluate the teaching performance, we conducted two student surveys. We measure compliance with learning achievements by self-assessment (Likert scale 1 to 5) at the beginning and end of each of the four chapters. Results: Failures and eliminations of students in the course were lower than previous years, with significantly higher grades from 4.89 to 6.29 (p <0.001). The students were 95% satisfied with the teaching performance, and finally, the self-evaluation of learning achievements showed an average increase of 1 point. Conclusion: The evaluation methodology based on specifications adapted to two deliveries and evaluations on a non-binary scale improved the performance, expected learning achievements, and students' motivation.

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Medical imaging is essential nowadays throughout medical education, research, and care. Accordingly, international efforts have been made to set large-scale image repositories for these purposes. Yet, to date, browsing of large-scale medical image repositories has been troublesome, time-consuming, and generally limited by text search engines. A paradigm shift, by means of a query-by-example search engine, would alleviate these constraints and beneficially impact several practical demands throughout the medical field. The current project aims to address this gap in medical imaging consumption by developing a content-based image retrieval (CBIR) system, which combines two image processing architectures based on deep learning. Furthermore, a first-of-its-kind intelligent visual browser was designed that interactively displays a set of imaging examinations with similar visual content on a similarity map, making it possible to search for and efficiently navigate through a large-scale medical imaging repository, even if it has been set with incomplete and curated metadata. Users may, likewise, provide text keywords, in which case the system performs a content- and metadata-based search. The system was fashioned with an anonymizer service and designed to be fully interoperable according to international standards, to stimulate its integration within electronic healthcare systems and its adoption for medical education, research and care. Professionals of the healthcare sector, by means of a self-administered questionnaire, underscored that this CBIR system and intelligent interactive visual browser would be highly useful for these purposes. Further studies are warranted to complete a comprehensive assessment of the performance of the system through case description and protocolized evaluations by medical imaging specialists.

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Dengue, a mosquito-borne zoonotic disease, is the most common vector-borne disease in tropical and subtropical areas. In this study, we aim to demonstrate biological evidence of dengue virus infection in bats. A cross-sectional study was carried out in the departments of Cordoba and Sucre, Colombia. A total of 286 bats were captured following the ethical protocols of animal experimentation. The specimens were identified and euthanized using a pharmacological treatment with atropine, acepromazine and sodium pentobarbital. Duplicate samples of brain, heart, lung, spleen, liver, and kidney were collected with one set stored in Trizol and the other stored in 10% buffered formalin for histopathological and immunohistochemical analysis using polyclonal antibodies. Brain samples from lactating mice with an intracranial inoculation of DENV-2 were used as a positive control. As a negative control, lactating mouse brains without inoculation and bats brains negative for RT-PCR were included. Tissue sections from each specimen of bat without conjugate were used as staining control. In a specimen of Carollia perspicillata captured in Ayapel (Cordoba) and Phylostomus discolor captured in San Carlos (Cordoba), dengue virus was detected, and sequences were matched to DENV serotype 2. In bats RT-PCR positive for dengue, lesions compatible with viral infections, and the presence of antigens in tissues were observed. Molecular findings, pathological lesions, and detection of antigens in tissues could demonstrate viral DENV-2 replication and may correspond to natural infection in bats. Additional studies are needed to elucidate the exact role of these species in dengue epidemics.

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Stroke is currently the world's second cause of disability. It can cause deficits such as postural control, and telerehabilitation could improve the therapeutic dose as well as functional results. The aim of this work is to determine the effectiveness and usability of a low-cost telerehabilitation system in patients with stroke. We developed a telerehabilitation system based on exergames on smartphones, inertial sensors, and a cloud database. We trained the balance of six participants (three men and three women) in early subacute stroke (seven weeks of progress). In addition to their conventional treatment, these participants trained for a total of nine sessions of 30 min per week, for four weeks. The telerehabilitation group was compared with a control group of four clinically similar participants (three men and one woman). Clinical and usability measurements were made before and after the training. The results show a significant improvement of 11.3 ± 3.5 points in the Berg Balance Scale, 8.3 ± 3.01 points in the Mini-BESTest, and 17.5 ± 9.87 points in the Barthel scale for the telerehabilitation group. However, only the improvements of Berg and Barthel scales were statistically higher for the telerehabilitation group compared to the control group. The proposed system achieved excellent usability on the System Usability Scale (87.5 ± 11.61). Our results demonstrate that a complementary low-cost telemedicine approach is feasible, and that it can significantly improve the balance of stroke patients; therefore, the proposed clinical strategy could potentially improve dosage and overall treatment effectiveness.

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The spreading of mesenchymal-like cell layers is critical for embryo morphogenesis and tissue repair, yet we know little of this process in vivo. Here we take advantage of unique developmental features of the non-conventional annual killifish embryo to study the principles underlying tissue spreading in a simple cellular environment, devoid of patterning signals and major morphogenetic cell movements. Using in vivo experimentation and physical modelling we reveal that the extra-embryonic epithelial enveloping cell layer, thought mainly to provide protection to the embryo, directs cell migration and the spreading of embryonic tissue during early development. This function relies on the ability of embryonic cells to couple their autonomous random motility to non-autonomous signals arising from the expansion of the extra-embryonic epithelium, mediated by cell membrane adhesion and tension. Thus, we present a mechanism of extra-embryonic control of embryo morphogenesis that couples the mechanical properties of adjacent tissues in the early killifish embryo.

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Semen analysis is the first step in the evaluation of an infertile couple. Within this process, an accurate and objective morphological analysis becomes more critical as it is based on the correct detection and segmentation of human sperm components. In this paper, we present an improved two-stage framework for detection and segmentation of human sperm head characteristics (including acrosome and nucleus) that uses three different color spaces. The first stage detects regions of interest that define sperm heads, using k-means, then candidate heads are refined using mathematical morphology. In the second stage, we work on each region of interest to segment accurately the sperm head as well as nucleus and acrosome, using clustering and histogram statistical analysis techniques. Our proposal is also characterized by being fully automatic, where a user intervention is not required. Our experimental evaluation shows that our proposed method outperforms the state-of-the-art. This is supported by the results of different evaluation metrics. In addition, we propose a gold-standard built with the cooperation of a referent expert in the field, aiming to compare methods for detecting and segmenting sperm cells. Our results achieve notable improvement getting above 98% in the sperm head detection process at the expense of having significantly fewer false positives obtained by the state-of-the-art method. Our results also show an accurate head, acrosome and nucleus segmentation achieving over 80% overlapping against hand-segmented gold-standard. Our method achieves higher Dice coefficient, lower Hausdorff distance and less dispersion with respect to the results achieved by the state-of-the-art method.

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Se presenta el análisis de 370 productos que fallecieron en la etapa neonatal en el Hospital de Ginecoobstetricia del Centro Médico "La Raza". Hubo antecedentes maternos patológicos en el 90%, entre los que se incluyen edad no óptima para procreación en 23%; baja escolaridad en 54% la primera gesta en 20% y gran multiparidad en 11%. Durante la gestación hubo toxemia en 15%, problemas placentarios en 23%, trabajo de parto prematuro en 12%, y ruptura prematura de membranas en 26%. Se consideró como causa primaria de la defunción la inmadurez en 38%, prematurez en 36%, con la mitad de los casos con síndrome de insuficiencia respiratoria idiopática; hemorragia intraventricular en 20%, hemorragia pulmonar 11%; infección en 17% y malformaciones mayores en 10.7%. Se subraya la conveniencia del conocimiento de estas características para una mejor planificación de la asistencia a la gestante y finalmente se hacen recomendaciones de manejo

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