Iterative expert-in-the-loop classification of sleep PSG recordings using a hierarchical clustering.

BACKGROUND: The classification of sleep signals is a subjective and time consuming task. A large number of automatic classifiers have been published in the past decade but a sleep community has no strong confidence to use them in clinical practice and still remains using a standard manual scoring according standardized rules. NEW METHOD: We developed a semi-supervised data-driven approach for objective and efficient evaluation of polysomnographic (PSG) data. The proposed algorithm finds a representative set of signal segments that are subsequently scored by a sleep neurologist. The remaining part of the recording is then automatically classified using these templates. RESULTS: The method was evaluated on 36 PSG recordings (18 chronic insomniacs, 18 healthy controls). We show a faster and objective evaluation of PSG data compared to the manual scoring that is over-performing automated classifiers (accuracy increases ∼14%). The classification results are comparable on both datasets. COMPARISON WITH EXISTING METHOD(S): The methodology that we propose has not yet been published in the area of sleep PSG data processing. The performance of our method is comparable to various published automated approaches (a typical published classification accuracy is ∼75-95%). The method allows the evaluation of PSG recordings in more general terms and across different recording devices and standards. CONCLUSIONS: The proposed solution is not based on a single-purpose rules or heuristics and training model is not trained on other patient's sleep recordings. The method is applicable to wide range of similar tasks and various types of physiological signals.

[Personality traits and burnout in family doctors]. / Rasgos de personalidad y burnout en médicos de familia.

OBJECTIVE: With this research we try to study personality traits that could be associated with high punctuation at burnout scales (Maslach Burnout Inventory) in primary care physicians. DESIGN: Observational, descriptive, transversal. STUDY SETTING: 93 primary care centres in Barcelona-city and the northern province's region: Vallès Oriental, Vallès Occidental, Maresme, Osona, Bages and Berguedà (centre sanitary region). METHOD: Individual or collective direct interview to 528 primary care physicians. Three questionnaires were administrated: a sociodemographic item one, the Maslach Burnout Inventory (MBI), and the Cattell personality test 16-PF. RESULTS: The 40% of the interviewed physicians had some burnout symptoms without any difference between sexes. 12.4% of these showed very high burnout levels. Those subjects with burnout criteria punctuated different at stability, tension and vigilance traits and anxiety dimension. CONCLUSION: Some personality traits like low stability, the tension and the anxiety are associated with high punctuation of burnout.

Rasgos de personalidad y burnout en médicos de familia / Personality traits and "burnout" in family doctors

Objetivo. Investigar los rasgos de personalidad que podrían asociarse con puntuaciones altas en las escalas de burnout (Maslach Burnout Inventory) en médicos de atención primaria. Diseño. Estudio observacional, descriptivo, transversal. Emplazamiento. Noventa y tres centros de atención primaria de la ciudad de Barcelona y las comarcas del norte de la provincia: Vallès Oriental, Vallès Occidental, Maresme, Osona, Bages y Berguedà (región sanitaria centro). Método. Encuesta directa por entrevista personal o grupal a 528 médicos de atención primaria. Se administraron 3 cuestionarios: uno de datos sociodemográficos generales, el Maslasch Burnout Inventory (MBI) y el test de personalidad de Cattell 16 PF-5.Resultados. Un 40 por ciento de los encuestados presentaba algún síntoma de burnout sin diferencia entre sexos. De éstos, un 12,4 por ciento manifestaba niveles muy altos de 'quemazón' profesional. Los sujetos con criterios de burnout obtuvieron puntuaciones significativamente diferentes en los rasgos de estabilidad, tensión y vigilancia y en la dimensión ansiedad. Conclusiones. Algunos rasgos de personalidad, como la baja estabilidad emocional, la tensión y la ansiedad, se asocian de manera significativa a puntuaciones altas de burnout. Existen algunas diferencias entre estos factores internos por sexo (AU)

Plasma fibronectin depletion after cardiac surgery in children with or without cardiopulmonary bypass.

Plasma fibronectin depletion decreases resistance to sepsis. After cardiac surgery, septic complications occur more frequently when the surgical procedure is managed with a cardio-pulmonary bypass than when it is not. To determine whether cardio-pulmonary bypass produces a greater decrease in plasma fibronectin than surgery without cardio-pulmonary bypass, we studied plasma fibronectin concentrations in two groups of children operated for congenital heart diseases. Group I: 10 children undergoing surgery with cardio-pulmonary bypass. Group II: 11 children undergoing surgery without cardio-pulmonary bypass. Plasma fibronectin was monitored pre-operatively (t 1) and post-operatively at the 6th hour (t 2), 1st (t 3) and 7th (t 4) days. In both groups, plasma fibronectin concentration dropped at (t 2) and (t 3) and rose again at (t 4). There was no significant difference in plasma fibronectin levels between the two groups at any time. We conclude that the plasma fibronectin decline alone cannot explain why septic complications after surgery are more frequent with cardio-pulmonary bypass than without.