Errors in preparation and medication management in nursing professionals

The preparation and administration of medications is one of the most common and relevant functions of nurses, demanding great responsibility. Incorrect administration of medication, currently constitutes a serious problem in health services, and is considered one of the main adverse effects suffered by hospitalized patients. Objectives: Identify the major errors in the preparation and administration of medication by nurses in hospitals and know what factors lead to the error occurred in the preparation and administration of medication. Methods: A systematic review of the literature. Deined as inclusion criteria: original scientiic papers, complete, published in the period 2011 to May 2016, the SciELO and LILACS databases, performed in a hospital environment, addressing errors in preparation and administration of medication by nurses and in Portuguese language. After application of the inclusion criteria obtained a sample of 7 articles. Results: The main errors identiied in the pr eparation and administration of medication were wrong dose 71.4%, wrong time 71.4%, 57.2% dilution inadequate, incorrect selection of the patient 42.8% and 42.8% via inadequate. The factors that were most commonly reported by the nursing staff, as the cause of the error was the lack of human appeal 57.2%, inappropriate locations for the preparation of medication 57.2%, the presence of noise and low brightness in preparation location 57, 2%, professionals untrained 42.8%, fatigue and stress 42.8% and inattention 42.8%. Conclusions: The literature shows a high error rate in the preparation and administration of medication for various reasons, making it important that preventive measures of this occurrence are implemented.

Time-Reversal Massive Multipath Effect and Bandwidth Heterogeneity

The proliferation of new mobile communication devices, such as smartphones and tablets, has led to an exponential growth in network traffic. The demand for supporting the fast-growing consumer data rates urges the wireless service providers and researchers to seek a new efficient radio access technology, which is the so-called 5G technology, beyond what current 4G LTE can provide. On the other hand, ubiquitous RFID tags, sensors, actuators, mobile phones and etc. cut across many areas of modern-day living, which offers the ability to measure, infer and understand the environmental indicators. The proliferation of these devices creates the term of the Internet of Things (IoT). For the researchers and engineers in the field of wireless communication, the exploration of new effective techniques to support 5G communication and the IoT becomes an urgent task, which not only leads to fruitful research but also enhance the quality of our everyday life. Massive MIMO, which has shown the great potential in improving the achievable rate with a very large number of antennas, has become a popular candidate. However, the requirement of deploying a large number of antennas at the base station may not be feasible in indoor scenarios. Does there exist a good alternative that can achieve similar system performance to massive MIMO for indoor environment? In this dissertation, we address this question by proposing the time-reversal technique as a counterpart of massive MIMO in indoor scenario with the massive multipath effect. It is well known that radio signals will experience many multipaths due to the reflection from various scatters, especially in indoor environments. The traditional TR waveform is able to create a focusing effect at the intended receiver with very low transmitter complexity in a severe multipath channel. TR's focusing effect is in essence a spatial-temporal resonance effect that brings all the multipaths to arrive at a particular location at a specific moment. We show that by using time-reversal signal processing, with a sufficiently large bandwidth, one can harvest the massive multipaths naturally existing in a rich-scattering environment to form a large number of virtual antennas and achieve the desired massive multipath effect with a single antenna. Further, we explore the optimal bandwidth for TR system to achieve maximal spectral efficiency. Through evaluating the spectral efficiency, the optimal bandwidth for TR system is found determined by the system parameters, e.g., the number of users and backoff factor, instead of the waveform types. Moreover, we investigate the tradeoff between complexity and performance through establishing a generalized relationship between the system performance and waveform quantization in a practical communication system. It is shown that a 4-bit quantized waveforms can be used to achieve the similar bit-error-rate compared to the TR system with perfect precision waveforms. Besides 5G technology, Internet of Things (IoT) is another terminology that recently attracts more and more attention from both academia and industry. In the second part of this dissertation, the heterogeneity issue within the IoT is explored. One of the significant heterogeneity considering the massive amount of devices in the IoT is the device heterogeneity, i.e., the heterogeneous bandwidths and associated radio-frequency (RF) components. The traditional middleware techniques result in the fragmentation of the whole network, hampering the objects interoperability and slowing down the development of a unified reference model for the IoT. We propose a novel TR-based heterogeneous system, which can address the bandwidth heterogeneity and maintain the benefit of TR at the same time. The increase of complexity in the proposed system lies in the digital processing at the access point (AP), instead of at the devices' ends, which can be easily handled with more powerful digital signal processor (DSP). Meanwhile, the complexity of the terminal devices stays low and therefore satisfies the low-complexity and scalability requirement of the IoT. Since there is no middleware in the proposed scheme and the additional physical layer complexity concentrates on the AP side, the proposed heterogeneous TR system better satisfies the low-complexity and energy-efficiency requirement for the terminal devices (TDs) compared with the middleware approach.

A medida e as escalas de avaliação da saúde das populações neonatais e pediátricas : estudo de simulação de Monte Carlo com variáveis ordinais

A investigação na área da saúde e a utilização dos seus resultados tem funcionado como base para a melhoria da qualidade de cuidados, exigindo dos profissionais de saúde conhecimentos na área específica onde desempenham funções, conhecimentos em metodologia de investigação que incluam as técnicas de observação, técnicas de recolha e análise de dados, para mais facilmente serem leitores capacitados dos resultados da investigação. Os profissionais de saúde são observadores privilegiados das respostas humanas à saúde e à doença, podendo contribuir para o desenvolvimento e bem-estar dos indivíduos muitas vezes em situações de grande vulnerabilidade. Em saúde infantil e pediatria o enfoque está nos cuidados centrados na família privilegiando-se o desenvolvimento harmonioso da criança e jovem, valorizando os resultados mensuráveis em saúde que permitam determinar a eficácia das intervenções e a qualidade de saúde e de vida. No contexto pediátrico realçamos as práticas baseadas na evidência, a importância atribuída à pesquisa e à aplicação dos resultados da investigação nas práticas clínicas, assim como o desenvolvimento de instrumentos de mensuração padronizados, nomeadamente as escalas de avaliação, de ampla utilização clínica, que facilitam a apreciação e avaliação do desenvolvimento e da saúde das crianças e jovens e resultem em ganhos em saúde. A observação de forma sistematizada das populações neonatais e pediátricas com escalas de avaliação tem vindo a aumentar, o que tem permitido um maior equilíbrio na avaliação das crianças e também uma observação baseada na teoria e nos resultados da investigação. Alguns destes aspetos serviram de base ao desenvolvimento deste trabalho que pretende dar resposta a 3 objetivos fundamentais. Para dar resposta ao primeiro objetivo, “Identificar na literatura científica, os testes estatísticos mais frequentemente utilizados pelos investigadores da área da saúde infantil e pediatria quando usam escalas de avaliação” foi feita uma revisão sistemática da literatura, que tinha como objetivo analisar artigos científicos cujos instrumentos de recolha de dados fossem escalas de avaliação, na área da saúde da criança e jovem, desenvolvidas com variáveis ordinais, e identificar os testes estatísticos aplicados com estas variáveis. A análise exploratória dos artigos permitiu-nos verificar que os investigadores utilizam diferentes instrumentos com diferentes formatos de medida ordinal (com 3, 4, 5, 7, 10 pontos) e tanto aplicam testes paramétricos como não paramétricos, ou os dois em simultâneo, com este tipo de variáveis, seja qual for a dimensão da amostra. A descrição da metodologia nem sempre explicita se são cumpridas as assunções dos testes. Os artigos consultados nem sempre fazem referência à distribuição de frequência das variáveis (simetria/assimetria) nem à magnitude das correlações entre os itens. A leitura desta bibliografia serviu de suporte à elaboração de dois artigos, um de revisão sistemática da literatura e outro de reflexão teórica. Apesar de terem sido encontradas algumas respostas às dúvidas com que os investigadores e os profissionais, que trabalham com estes instrumentos, se deparam, verifica-se a necessidade de desenvolver estudos de simulação que confirmem algumas situações reais e alguma teoria já existente, e trabalhem outros aspetos nos quais se possam enquadrar os cenários reais de forma a facilitar a tomada de decisão dos investigadores e clínicos que utilizam escalas de avaliação. Para dar resposta ao segundo objetivo “Comparar a performance, em termos de potência e probabilidade de erro de tipo I, das 4 estatísticas da MANOVA paramétrica com 2 estatísticas da MANOVA não paramétrica quando se utilizam variáveis ordinais correlacionadas, geradas aleatoriamente”, desenvolvemos um estudo de simulação, através do Método de Monte Carlo, efetuado no Software R. O delineamento do estudo de simulação incluiu um vetor com 3 variáveis dependentes, uma variável independente (fator com três grupos), escalas de avaliação com um formato de medida com 3, 4, 5, e 7 pontos, diferentes probabilidades marginais (p1 para distribuição simétrica, p2 para distribuição assimétrica positiva, p3 para distribuição assimétrica negativa e p4 para distribuição uniforme) em cada um dos três grupos, correlações de baixa, média e elevada magnitude (r=0.10, r=0.40, r=0.70, respetivamente), e seis dimensões de amostras (n=30, 60, 90, 120, 240, 300). A análise dos resultados permitiu dizer que a maior raiz de Roy foi a estatística que apresentou estimativas de probabilidade de erro de tipo I e de potência de teste mais elevadas. A potência dos testes apresenta comportamentos diferentes, dependendo da distribuição de frequência da resposta aos itens, da magnitude das correlações entre itens, da dimensão da amostra e do formato de medida da escala. Tendo por base a distribuição de frequência, considerámos três situações distintas: a primeira (com probabilidades marginais p1,p1,p4 e p4,p4,p1) em que as estimativas da potência eram muito baixas, nos diferentes cenários; a segunda situação (com probabilidades marginais p2,p3,p4; p1,p2,p3 e p2,p2,p3) em que a magnitude das potências é elevada, nas amostras com dimensão superior ou igual a 60 observações e nas escalas com 3, 4,5 pontos e potências de magnitude menos elevada nas escalas com 7 pontos, mas com a mesma ma magnitude nas amostras com dimensão igual a 120 observações, seja qual for o cenário; a terceira situação (com probabilidades marginais p1,p1,p2; p1,p2,p4; p2,p2,p1; p4,p4,p2 e p2,p2,p4) em que quanto maiores, a intensidade das correlações entre itens e o número de pontos da escala, e menor a dimensão das amostras, menor a potência dos testes, sendo o lambda de Wilks aplicado às ordens mais potente do que todas as outra s estatísticas da MANOVA, com valores imediatamente a seguir à maior raiz de Roy. No entanto, a magnitude das potências dos testes paramétricos e não paramétricos assemelha-se nas amostras com dimensão superior a 90 observações (com correlações de baixa e média magnitude), entre as variáveis dependentes nas escalas com 3, 4 e 5 pontos; e superiores a 240 observações, para correlações de baixa intensidade, nas escalas com 7 pontos. No estudo de simulação e tendo por base a distribuição de frequência, concluímos que na primeira situação de simulação e para os diferentes cenários, as potências são de baixa magnitude devido ao facto de a MANOVA não detetar diferenças entre grupos pela sua similaridade. Na segunda situação de simulação e para os diferentes cenários, a magnitude das potências é elevada em todos os cenários cuja dimensão da amostra seja superior a 60 observações, pelo que é possível aplicar testes paramétricos. Na terceira situação de simulação, e para os diferentes cenários quanto menor a dimensão da amostra e mais elevada a intensidade das correlações e o número de pontos da escala, menor a potência dos testes, sendo a magnitude das potências mais elevadas no teste de Wilks aplicado às ordens, seguido do traço de Pillai aplicado às ordens. No entanto, a magnitude das potências dos testes paramétricos e não paramétricos assemelha-se nas amostras com maior dimensão e correlações de baixa e média magnitude. Para dar resposta ao terceiro objetivo “Enquadrar os resultados da aplicação da MANOVA paramétrica e da MANOVA não paramétrica a dados reais provenientes de escalas de avaliação com um formato de medida com 3, 4, 5 e 7 pontos, nos resultados do estudo de simulação estatística” utilizaram-se dados reais que emergiram da observação de recém-nascidos com a escala de avaliação das competências para a alimentação oral, Early Feeding Skills (EFS), o risco de lesões da pele, com a Neonatal Skin Risk Assessment Scale (NSRAS), e a avaliação da independência funcional em crianças e jovens com espinha bífida, com a Functional Independence Measure (FIM). Para fazer a análise destas escalas foram realizadas 4 aplicações práticas que se enquadrassem nos cenários do estudo de simulação. A idade, o peso, e o nível de lesão medular foram as variáveis independentes escolhidas para selecionar os grupos, sendo os recém-nascidos agrupados por “classes de idade gestacional” e por “classes de peso” as crianças e jovens com espinha bífida por “classes etárias” e “níveis de lesão medular”. Verificou-se um bom enquadramento dos resultados com dados reais no estudo de simulação.

Development of a novel platform for high-throughput gene design and artificial gene synthesis to produce large libraries of recombinant venom peptides for drug discovery

Tese de Doutoramento em Ciências Veterinárias na Especialidade de Ciências Biológicas e Biomédicas

Using dysphonic voice to characterize speaker's biometry

Phonation distortion leaves relevant marks in a speaker's biometric profile. Dysphonic voice production may be used for biometrical speaker characterization. In the present paper phonation features derived from the glottal source (GS) parameterization, after vocal tract inversion, is proposed for dysphonic voice characterization in Speaker Verification tasks. The glottal source derived parameters are matched in a forensic evaluation framework defining a distance-based metric specification. The phonation segments used in the study are derived from fillers, long vowels, and other phonation segments produced in spontaneous telephone conversations. Phonated segments from a telephonic database of 100 male Spanish native speakers are combined in a 10-fold cross-validation task to produce the set of quality measurements outlined in the paper. Shimmer, mucosal wave correlate, vocal fold cover biomechanical parameter unbalance and a subset of the GS cepstral profile produce accuracy rates as high as 99.57 for a wide threshold interval (62.08-75.04%). An Equal Error Rate of 0.64 % can be granted. The proposed metric framework is shown to behave more fairly than classical likelihood ratios in supporting the hypothesis of the defense vs that of the prosecution, thus ofering a more reliable evaluation scoring. Possible applications are Speaker Verification and Dysphonic Voice Grading.

Comparison of Computer-Based and Optical Face Recognition Paradigms

The main objectives of this thesis are to validate an improved principal components analysis (IPCA) algorithm on images; designing and simulating a digital model for image compression, face recognition and image detection by using a principal components analysis (PCA) algorithm and the IPCA algorithm; designing and simulating an optical model for face recognition and object detection by using the joint transform correlator (JTC); establishing detection and recognition thresholds for each model; comparing between the performance of the PCA algorithm and the performance of the IPCA algorithm in compression, recognition and, detection; and comparing between the performance of the digital model and the performance of the optical model in recognition and detection. The MATLAB © software was used for simulating the models. PCA is a technique used for identifying patterns in data and representing the data in order to highlight any similarities or differences. The identification of patterns in data of high dimensions (more than three dimensions) is too difficult because the graphical representation of data is impossible. Therefore, PCA is a powerful method for analyzing data. IPCA is another statistical tool for identifying patterns in data. It uses information theory for improving PCA. The joint transform correlator (JTC) is an optical correlator used for synthesizing a frequency plane filter for coherent optical systems. The IPCA algorithm, in general, behaves better than the PCA algorithm in the most of the applications. It is better than the PCA algorithm in image compression because it obtains higher compression, more accurate reconstruction, and faster processing speed with acceptable errors; in addition, it is better than the PCA algorithm in real-time image detection due to the fact that it achieves the smallest error rate as well as remarkable speed. On the other hand, the PCA algorithm performs better than the IPCA algorithm in face recognition because it offers an acceptable error rate, easy calculation, and a reasonable speed. Finally, in detection and recognition, the performance of the digital model is better than the performance of the optical model.

Conversação homem-máquina. Caracterização e avaliação do estado actual das soluções de speech recognition, speech synthesis e sistemas de conversação homem-máquina

A comunicação verbal humana é realizada em dois sentidos, existindo uma compreensão de ambas as partes que resulta em determinadas considerações. Este tipo de comunicação, também chamada de diálogo, para além de agentes humanos pode ser constituído por agentes humanos e máquinas. A interação entre o Homem e máquinas, através de linguagem natural, desempenha um papel importante na melhoria da comunicação entre ambos. Com o objetivo de perceber melhor a comunicação entre Homem e máquina este documento apresenta vários conhecimentos sobre sistemas de conversação Homemmáquina, entre os quais, os seus módulos e funcionamento, estratégias de diálogo e desafios a ter em conta na sua implementação. Para além disso, são ainda apresentados vários sistemas de Speech Recognition, Speech Synthesis e sistemas que usam conversação Homem-máquina. Por último são feitos testes de performance sobre alguns sistemas de Speech Recognition e de forma a colocar em prática alguns conceitos apresentados neste trabalho, é apresentado a implementação de um sistema de conversação Homem-máquina. Sobre este trabalho várias ilações foram obtidas, entre as quais, a alta complexidade dos sistemas de conversação Homem-máquina, a baixa performance no reconhecimento de voz em ambientes com ruído e as barreiras que se podem encontrar na implementação destes sistemas.

Improving Bangla ocr output through correction algorithms

Bangla OCR (Optical Character Recognition) is a long deserving software for Bengali community all over the world. Numerous e efforts suggest that due to the inherent complex nature of Bangla alphabet and its word formation process development of high fidelity OCR producing a reasonably acceptable output still remains a challenge. One possible way of improvement is by using post processing of OCR’s output; algorithms such as Edit Distance and the use of n-grams statistical information have been used to rectify misspelled words in language processing. This work presents the first known approach to use these algorithms to replace misrecognized words produced by Bangla OCR. The assessment is made on a set of fifty documents written in Bangla script and uses a dictionary of 541,167 words. The proposed correction model can correct several words lowering the recognition error rate by 2.87% and 3.18% for the character based n- gram and edit distance algorithms respectively. The developed system suggests a list of 5 (five) alternatives for a misspelled word. It is found that in 33.82% cases, the correct word is the topmost suggestion of 5 words list for n-gram algorithm while using Edit distance algorithm the first word in the suggestion properly matches 36.31% of the cases. This work will ignite rooms of thoughts for possible improvements in character recognition endeavour.

Performance of LTE-V2V for Cooperative Awareness

The large scale development of an Intelligent Transportation System is very close. The main component of such a smart environment is the network that provides connectivity for all vehicles. Public safety is the most demanding application because requires a fast, reliable and secure communication. Although IEEE 802.11p is presently the only full wireless standard for vehicular communications, recent advancements in 3GPP LTE provide support to direct communications and the ongoing activities are also addressing the vehicle to vehicle case. This thesis focuses on the resource allocation procedures and performance of LTE-V2V. To this aim, a MATLAB simulator has been implemented and results have been obtained adopting different mobility models for both in-coverage and out-of-coverage scenarios.

Interference mitigation techniques for cloud-RAN deployments in 5G and beyond systems

The deployment of ultra-dense networks is one of the most promising solutions to manage the phenomenon of co-channel interference that affects the latest wireless communication systems, especially in hotspots. To meet the requirements of the use-cases and the immense amount of traffic generated in these scenarios, 5G ultra-dense networks are being deployed using various technologies, such as distributed antenna system (DAS) and cloud-radio access network (C-RAN). Through these centralized densification schemes, virtualized baseband processing units coordinate the distributed access points and manage the available network resources. In particular, link adaptation techniques are shown to be fundamental to overall system operation and performance enhancement. The core of this dissertation is the result of an analysis and a comparison of dynamic and adaptive methods for modulation and coding scheme (MCS) selection applied to the latest mobile telecommunications standards. A novel algorithm based on the proportional-integral-derivative (PID) controller principles and block error rate (BLER) target has been proposed. Tests were conducted in a 4G and 5G system level laboratory and, by means of a channel emulator, the performance was evaluated for different channel models and target BLERs. Furthermore, due to the intrinsic sectorization of the end-users distribution in the investigated scenario, a preliminary analysis on the joint application of users grouping algorithms with multi-antenna and multi-user techniques has been performed. In conclusion, the importance and impact of other fundamental physical layer operations, such as channel estimation and power control, on the overall end-to-end system behavior and performance were highlighted.

NB-IoT via non terrestrial networks

Massive Internet of Things is expected to play a crucial role in Beyond 5G (B5G) wireless communication systems, offering seamless connectivity among heterogeneous devices without human intervention. However, the exponential proliferation of smart devices and IoT networks, relying solely on terrestrial networks, may not fully meet the demanding IoT requirements in terms of bandwidth and connectivity, especially in areas where terrestrial infrastructures are not economically viable. To unleash the full potential of 5G and B5G networks and enable seamless connectivity everywhere, the 3GPP envisions the integration of Non-Terrestrial Networks (NTNs) into the terrestrial ones starting from Release 17. However, this integration process requires modifications to the 5G standard to ensure reliable communications despite typical satellite channel impairments. In this framework, this thesis aims at proposing techniques at the Physical and Medium Access Control layers that require minimal adaptations in the current NB-IoT standard via NTN. Thus, firstly the satellite impairments are evaluated and, then, a detailed link budget analysis is provided. Following, analyses at the link and the system levels are conducted. In the former case, a novel algorithm leveraging time-frequency analysis is proposed to detect orthogonal preambles and estimate the signals’ arrival time. Besides, the effects of collisions on the detection probability and Bit Error Rate are investigated and Non-Orthogonal Multiple Access approaches are proposed in the random access and data phases. The system analysis evaluates the performance of random access in case of congestion. Various access parameters are tested in different satellite scenarios, and the performance is measured in terms of access probability and time required to complete the procedure. Finally, a heuristic algorithm is proposed to jointly design the access and data phases, determining the number of satellite passages, the Random Access Periodicity, and the number of uplink repetitions that maximize the system's spectral efficiency.

Satellite IoT: a Study and Performance Analysis of GEO and LEO Systems

The study is divided into two main part: one focused on the GEO Satellite IoT and the other on the LEO Satellite IoT. Concerning the GEO Satellite IoT, the activity has been developed in the context of EUMETSAT Data Collection Service (DCS) by investigating the performance at the receiver within challenging scenarios. DCS are provided by several GEO Satellite operators, giving almost total coverage around the world. In this study firstly an overview of the DCS end-to-end architecture is given followed by a detailed description of both the tools used for the simulations: the DCP-TST (message generator and transmitter) and the DCP-RX (receiver). After generating several test messages, the performances have been evaluated with the addition of impairments (CW and sweeping interferences) and considerations in terms of BER and Good Messages are produced. Furthermore, a study on the PLL System is also conducted together with evaluations on the effectiveness of tuning the PLL Bw on the overall performance. Concerning the LEO Satellite IoT, the activity was carried out in the framework of the ASI Bidirectional IoT Satellite Service (BISS) Project. The elaborate covers a survey about the possible services that the project can accomplish and a technical analysis on the uplink MA. In particular, the LR-FHSS is proved to be a valid alternative for the uplink through an extensive analysis on its Network capacity and through the study of an analytic model for Success Probability with its Matlab implementation.

Voice conversion with pre-trained representations for audio anonymization

The recording and processing of voice data raises increasing privacy concerns for users and service providers. One way to address these issues is to move processing on the edge device closer to the recording so that potentially identifiable information is not transmitted over the internet. However, this is often not possible due to hardware limitations. An interesting alternative is the development of voice anonymization techniques that remove individual speakers characteristics while preserving linguistic and acoustic information in the data. In this work, a state-of-the-art approach to sequence-to-sequence speech conversion, ini- tially based on x-vectors and bottleneck features for automatic speech recognition, is explored to disentangle the two acoustic information using different pre-trained speech and speakers representation. Furthermore, different strategies for selecting target speech representations are analyzed. Results on public datasets in terms of equal error rate and word error rate show that good privacy is achieved with limited impact on converted speech quality relative to the original method.

Kernel machines for epilepsy diagnosis via EEG signal classification: A comparative study

Objective: We carry out a systematic assessment on a suite of kernel-based learning machines while coping with the task of epilepsy diagnosis through automatic electroencephalogram (EEG) signal classification. Methods and materials: The kernel machines investigated include the standard support vector machine (SVM), the least squares SVM, the Lagrangian SVM, the smooth SVM, the proximal SVM, and the relevance vector machine. An extensive series of experiments was conducted on publicly available data, whose clinical EEG recordings were obtained from five normal subjects and five epileptic patients. The performance levels delivered by the different kernel machines are contrasted in terms of the criteria of predictive accuracy, sensitivity to the kernel function/parameter value, and sensitivity to the type of features extracted from the signal. For this purpose, 26 values for the kernel parameter (radius) of two well-known kernel functions (namely. Gaussian and exponential radial basis functions) were considered as well as 21 types of features extracted from the EEG signal, including statistical values derived from the discrete wavelet transform, Lyapunov exponents, and combinations thereof. Results: We first quantitatively assess the impact of the choice of the wavelet basis on the quality of the features extracted. Four wavelet basis functions were considered in this study. Then, we provide the average accuracy (i.e., cross-validation error) values delivered by 252 kernel machine configurations; in particular, 40%/35% of the best-calibrated models of the standard and least squares SVMs reached 100% accuracy rate for the two kernel functions considered. Moreover, we show the sensitivity profiles exhibited by a large sample of the configurations whereby one can visually inspect their levels of sensitiveness to the type of feature and to the kernel function/parameter value. Conclusions: Overall, the results evidence that all kernel machines are competitive in terms of accuracy, with the standard and least squares SVMs prevailing more consistently. Moreover, the choice of the kernel function and parameter value as well as the choice of the feature extractor are critical decisions to be taken, albeit the choice of the wavelet family seems not to be so relevant. Also, the statistical values calculated over the Lyapunov exponents were good sources of signal representation, but not as informative as their wavelet counterparts. Finally, a typical sensitivity profile has emerged among all types of machines, involving some regions of stability separated by zones of sharp variation, with some kernel parameter values clearly associated with better accuracy rates (zones of optimality). (C) 2011 Elsevier B.V. All rights reserved.

Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach

ABSTRACTObjective:to assess the impact of the shift inlet trauma patients, who underwent surgery, in-hospital mortality.Methods:a retrospective observational cohort study from November 2011 to March 2012, with data collected through electronic medical records. The following variables were statistically analyzed: age, gender, city of origin, marital status, admission to the risk classification (based on the Manchester Protocol), degree of contamination, time / admission round, admission day and hospital outcome.Results:during the study period, 563 patients injured victims underwent surgery, with a mean age of 35.5 years (± 20.7), 422 (75%) were male, with 276 (49.9%) received in the night shift and 205 (36.4%) on weekends. Patients admitted at night and on weekends had higher mortality [19 (6.9%) vs. 6 (2.2%), p=0.014, and 11 (5.4%) vs. 14 (3.9%), p=0.014, respectively]. In the multivariate analysis, independent predictors of mortality were the night admission (OR 3.15), the red risk classification (OR 4.87), and age (OR 1.17).Conclusion:the admission of night shift and weekend patients was associated with more severe and presented higher mortality rate. Admission to the night shift was an independent factor of surgical mortality in trauma patients, along with the red risk classification and age.