The medical treatment of chronic wounds, pressure ulcers in particular, burdens healthcare systems nowadays with high expenses that result mainly from their monitoring and assessment stages. Decision support systems applied within the ‘remote medicine’ framework may be of help, not only to the process of monitoring the evolution of chronic wounds under treatment, but also to facilitate the prevention and early detection of potential risk conditions in the affected patients. In this paper, the design and definition of a new decision-support methodology to be applied to the monitoring and assessment stages of the medical treatment process for pressure ulcers is proposed. Built upon the use and development of expert systems, the methodology makes it possible to generate alerts derived from the evolution of a patient’s chronic wound, by means of the interpretation and combination of data coming from both an image of the wound, and the considerations of a healthcare professional with expertise in the subject matter. Some positive results are already shown regarding the determination of the ulcer’s status in the tests that have been carried out so far. Therefore, it is considered that the proposed methodology might lead to substantial improvements regarding both the treatment’s efficiency and cost savings.

Breast cancer is currently one of the main causes of death and tumoral diseases in women. Even if early diagnosis processes have evolved in the last years thanks to the popularization of mammogram tests, nowadays, it is still a challenge to have available reliable diagnosis systems that are exempt of variability in their interpretation. To this end, in this work, the design and development of an intelligent clinical decision support system to be used in the preventive diagnosis of breast cancer is presented, aiming both to improve the accuracy in the evaluation and to reduce its uncertainty. Through the integration of expert systems (based on Mamdani-type fuzzy-logic inference engines) deployed in cascade, exploratory factorial analysis, data augmentation approaches, and classification algorithms such as k-neighbors and bagged trees, the system is able to learn and to interpret the patient’s medical-healthcare data, generating an alert level associated to the danger she has of suffering from cancer. For the system’s initial performance tests, a software implementation of it has been built that was used in the diagnosis of a series of patients contained into a 130-cases database provided by the School of Medicine and Public Health of the University of Wisconsin-Madison, which has been also used to create the knowledge base. The obtained results, characterized as areas under the ROC curves of 0.95–0.97 and high success rates, highlight the huge diagnosis and preventive potential of the developed system, and they allow forecasting, even when a detailed and contrasted validation is still pending, its relevance and applicability within the clinical field.

Respiratory diseases are currently considered to be amongst the most frequent causes of death and disability worldwide, and even more so during the year 2020 because of the COVID-19 global pandemic. Aiming to reduce the impact of these diseases, in this work a methodology is developed that allows the early detection and prevention of potential hypoxemic clinical cases in patients vulnerable to respiratory diseases. Starting from the methodology proposed by the authors in a previous work and grounded in the definition of a set of expert systems, the methodology can generate alerts about the patient’s hypoxemic status by means of the interpretation and combination of data coming both from physical measurements and from the considerations of health professionals. A concurrent set of Mamdani-type fuzzy-logic inference systems allows the collecting and processing of information, thus determining a final alert associated with the measurement of the global hypoxemic risk. This new methodology has been tested experimentally, producing positive results so far from the viewpoint of time reduction in the detection of a blood oxygen saturation deficit condition, thus implicitly improving the consequent treatment options and reducing the potential adverse effects on the patient’s health.

Exposure to high concentration levels of radon gas constitutes a major health hazard, being nowadays the second-leading cause of lung cancer after smoking. Facing this situation, the last years have seen a clear trend towards the search for methodologies that allow an efficient prevention of the potential risks derived from the presence of harmful radon gas concentration levels in buildings. With that, it is intended to establish preventive and corrective actions that might help to reduce the impact of radon exposure on people, especially in places where workers and external users must stay for long periods of time, as it may be the case of healthcare buildings. In this paper, a new methodology is developed and applied to the prevention of the risks derived from the exposure to radon gas in indoor spaces. Such methodology is grounded in the concurrent use of expert systems and regression trees that allows producing a diagram with recommendations associated to the exposure risk. The presented methodology has been implemented by means of a software application that supports the definition of the expert systems and the regression algorithm. Finally, after proving its applicability with a case study and discussing its contributions, it may be claimed that the benefits of the new methodology might lead on to an innovation in this field of study.

Forest fires have become a major problem that every year has devastating consequences at the environmental level, negatively impacting the social and economic spheres of the affected regions. Aiming to mitigate these terrible effects, intelligent prediction models focused on early fire detection are becoming common practice. Considering mainly a preventive approach, these models often use tools that indifferently apply statistical or symbolic inference techniques. However, exploring the potential for the hybrid use of both, as is already being done in other research areas, is a significant novelty with direct application to early fire detection. In this line, this work proposes the design, development, and proof of concept of a new intelligent hybrid system that aims to provide support to the decisions of the teams responsible for defining strategies for the prevention, detection, and extinction of forest fires. The system determines three risk levels: a general one called Objective Technical Fire Risk, based on machine learning algorithms, which determines the global danger of a fire in some area of the region under study, and two more specific others which indicate the risk over a limited area of the region. These last two risk levels, expressed in matrix form and called Technical Risk Matrix and Expert Risk Matrix, are calculated through a convolutional neural network and an expert system, respectively. After that, they are combined by means of another expert system to determine the Global Risk Matrix that quantifies the risk of fire in each of the study regions and generates a visual representation of these results through a color map of the region itself. The proof of concept of the system has been carried out on a set of historical data from fires that occurred in the Montesinho Natural Park (Portugal), demonstrating its potential utility as a tool for the prevention and early detection of forest fires. The intelligent hybrid system designed has demonstrated excellent predictive capabilities in such a complex environment as forest fires, which are conditioned by multiple factors. Future improvements associated with data integration and the formalization of knowledge bases will make it possible to obtain a standard tool that could be used and validated in real time in different forest areas.

Obstructive Sleep Apnea (OSA) is a chronic sleep-related pathology characterized by recurrent episodes of total or partial obstruction of the upper airways during sleep. It entails a high impact on the health and quality of life of patients, affecting more than one thousand million people worldwide, which has resulted in an important public health concern in recent years. The usual diagnosis involves performing a sleep test, cardiorespiratory polygraphy, or polysomnography, which allows characterizing the pathology and assessing its severity. However, this procedure cannot be used on a massive scale in general screening studies of the population because of its execution and implementation costs; therefore, causing an increase in waiting lists which would negatively affect the health of the affected patients. Additionally, the symptoms shown by these patients are often unspecific, as well as appealing to the general population (excessive somnolence, snoring, etc.), causing many potential cases to be referred for a sleep study when in reality are not suffering from OSA. This paper proposes a novel intelligent clinical decision support system to be applied to the diagnosis of OSA that can be used in early outpatient stages, quickly, easily, and safely, when a suspicious OSA patient attends the consultation. Starting from information related to the patient’s health profile (anthropometric data, habits, comorbidities, or medications taken), the system is capable of determining different alert levels of suffering from sleep apnea associated with different apnea-hypopnea index (AHI) levels to be studied. To that end, a series of automatic learning algorithms are deployed that, working concurrently, together with a corrective approach based on the use of an Adaptive Neuro-Based Fuzzy Inference System (ANFIS) and a specific heuristic algorithm, allow the calculation of a series of labels associated with the different levels of AHI previously indicated. For the initial software implementation, a data set with 4600 patients from the Álvaro Cunqueiro Hospital in Vigo was used. The results obtained after performing the proof tests determined ROC curves with AUC values in the range 0.8–0.9, and Matthews correlation coefficient values close to 0.6, with high success rates. This points to its potential use as a support tool for the diagnostic process, not only from the point of view of improving the quality of the services provided, but also from the best use of hospital resources and the consequent savings in terms of costs and time.

The workers operating and supervising machining tools are often in charge of monitoring a high number of parameters of the machining process, and they usually make use of, among others, cutting sound signals, for following-up and assessing that process. The interpretation of those signals is closely related to the operational conditions of the machine and to the work environment itself, because such signals are sensitive to changes in the process’ input parameters. Additionally, they could be considered as a valid indicator for detecting working conditions that either negatively affect the tools’ lifespan, or might even put the machine operators themselves at risk. In light of those circumstances, this work deals with the proposal and conceptual development of a new methodology for monitoring the work conditions of machining tools, based on expert systems that incorporate a reinforcement strategy into their knowledge base. By means of the combination of sound-processing techniques, together with the use of fuzzy-logic inference engines and hierarchization methods based on vague fuzzy numbers, it will be possible to determine existing undesirable behaviors in the machining tools, thus reducing errors, accidents and harmful failures, with consequent savings in time and costs. Aiming to show the potential for the use of this methodology, a concept test has been developed, implemented in the form of a short case study. The results obtained, even if they require more extensive validation, suggest that the methodology would allow for improving the performance and operation of machining tools, as well as the ergonomic conditions of the workplace.

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