911 resultados para Daily sedation interruption


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A case study of Brisbane, the capital city of Queensland, Australia, explored how explicit measures of transit quality of service (e.g., service frequency, service span, and travel time ratio) and implicit environmental predictors (e.g., topographic grade factor) influenced bus ridership. The primary hypothesis tested was that bus ridership was higher in suburbs with high transit quality of service than in suburbs with limited service quality. Multiple linear regression, used to identify a strong positive relationship between route intensity (bus-km/h-km2) and bus ridership, indicated that both increased service frequency and spatial route density corresponded to higher bus ridership. Additionally, the travel time ratio (i.e., the ratio of in-vehicle transit travel time to in-vehicle automobile travel time) had a significant negative association with suburban ridership: transit use declined as travel time ratio increased. In contrast, topographic grade and service span did not significantly affect suburban bus ridership. The study findings enhance the fundamental understanding of traveler behavior, which is informative to urban transportation policy, planning, and provision.

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The significance of treating rainfall as a chaotic system instead of a stochastic system for a better understanding of the underlying dynamics has been taken up by various studies recently. However, an important limitation of all these approaches is the dependence on a single method for identifying the chaotic nature and the parameters involved. Many of these approaches aim at only analyzing the chaotic nature and not its prediction. In the present study, an attempt is made to identify chaos using various techniques and prediction is also done by generating ensembles in order to quantify the uncertainty involved. Daily rainfall data of three regions with contrasting characteristics (mainly in the spatial area covered), Malaprabha, Mahanadi and All-India for the period 1955-2000 are used for the study. Auto-correlation and mutual information methods are used to determine the delay time for the phase space reconstruction. Optimum embedding dimension is determined using correlation dimension, false nearest neighbour algorithm and also nonlinear prediction methods. The low embedding dimensions obtained from these methods indicate the existence of low dimensional chaos in the three rainfall series. Correlation dimension method is done on th phase randomized and first derivative of the data series to check whether the saturation of the dimension is due to the inherent linear correlation structure or due to low dimensional dynamics. Positive Lyapunov exponents obtained prove the exponential divergence of the trajectories and hence the unpredictability. Surrogate data test is also done to further confirm the nonlinear structure of the rainfall series. A range of plausible parameters is used for generating an ensemble of predictions of rainfall for each year separately for the period 1996-2000 using the data till the preceding year. For analyzing the sensitiveness to initial conditions, predictions are done from two different months in a year viz., from the beginning of January and June. The reasonably good predictions obtained indicate the efficiency of the nonlinear prediction method for predicting the rainfall series. Also, the rank probability skill score and the rank histograms show that the ensembles generated are reliable with a good spread and skill. A comparison of results of the three regions indicates that although they are chaotic in nature, the spatial averaging over a large area can increase the dimension and improve the predictability, thus destroying the chaotic nature. (C) 2010 Elsevier Ltd. All rights reserved.

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The proportion of patients over 75 years of age, receiving all different types of healthcare, is constantly increasing. The elderly undergo surgery and anaesthetic procedures more often than middle-aged patients. Poor pain management in the elderly is still an issue. Although the elderly consumes the greatest proportion of prescribed medicines in Western Europe, most clinical pharmacological studies have been performed in healthy volunteers or middle-aged patients. The aim of this study was to investigate pain measurement and management in cognitively impaired patients in long term hospital care and in cognitively normal elderly patients after cardiac surgery. This thesis incorporated 366 patients, including 86 home-dwelling or hospitalized elderly with chronic pain and 280 patients undergoing cardiac surgery with acute pain. The mean age of patients was 77 (SD ± 8) years and approximately 8400 pain measurements were performed with four pain scales: Verbal Rating Scale (VRS), the Visual Analogue Scale (VAS), the Red Wedge Scale (RWS), and the Facial Pain Scale (FPS). Cognitive function, depression, functional ability in daily life, postoperative sedation and postoperative confusion were assessed with MMSE, GDS, Barthel Index, RASS, and CAM-ICU, respectively. The effects and plasma concentrations of fentanyl and oxycodone were measured in elderly (≥ 75 years) and middle-aged patients (≤ 60 years) and the opioid-sparing effect of pregabalin was studied after cardiac surgery. The VRS pain scores after movement correlated with the Barthel Index. The VRS was most successful in the groups of demented patients (MMSE 17-23, 11-16 and ≤ 10) and in elderly patients on the first day after cardiac surgery. The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients. The plasma concentrations of oxycodone were comparable between the groups. Pain intensity on the VRS was lower and the sedation scores were higher in the elderly. Total oxycodone consumption during five postoperative days was reduced by 48% and the CAM-ICU scores were higher on the first postoperative day in the pregabalin group. The incidence of postoperative pain during movement was lower in the pregabalin group three months after surgery. This investigation demonstrates that chronic pain did not seem to impair daily activities in home-dwelling Finnish elderly. The VRS appeared to be applicable for elderly patients with clear cognitive dysfunction (MMSE ≤17) and it was the most feasible pain scale for the early postoperative period after cardiac surgery. After cardiac surgery, plasma concentrations of fentanyl in elderly were elevated, although oxycodone concentrations were at similar level compared to middle-aged patients. The elderly had less pain and were more sedated after doses of oxycodone. Therefore, particular attention must be given to individual dosing of the opioids in elderly surgical patients, who often need a smaller amount for adequate analgesia than middle-aged patients. The administration of pregabalin reduced postoperative oxycodone consumption after cardiac surgery. Pregabalin-treated patients had less confusion, and additionally to less postoperative pain on the first postoperative day and during movement at three months post-surgery. Pregabalin might be a new alternative as analgesic for acute postoperative and chronic pain management in the elderly. Its clinical role and safety remains to be verified in large-scale randomized and controlled studies. In the future, many clinical trials in the older category of patients will be needed to facilitate improvements in health care methods.

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This study addresses the challenge of analyzing interruption in spoken interaction. It begins with my observation of eight hours of academic group work among speakers of English as a lingua franca (ELF) in a university course. Unlike the common findings of ELF research which underscore the cooperative orientation of ELF users, this particular group gave strong impressions of interruption and uncooperativeness as they prepared a scientific group presentation. In the effort to investigate these impressions, I found that no satisfactory method exists for systematically identifying and analyzing interruptions. A useful tool was found in Linear Unit Grammar or LUG (Sinclair & Mauranen 2006), which analyzes spoken interaction prospectively as linear text. In the course of transcribing one of the early group work meetings, I developed a model of LUG-based criteria for identifying individual instances of interruption. With this system in place, I was then able to evaluate the aggregate occurrences of interruption in the group work and identify co-occurring interactive features which further influenced the perception of uncooperativeness. Finally, these aggregate statistics directed a return to the data and a contextually sensitive, qualitative analysis. This research cycle illuminates the interactive features which contributed to my own impressions of uncooperativeness, as well as the group members orientations to their own interruptive practice.

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Perfect or even mediocre weather predictions over a long period are almost impossible because of the ultimate growth of a small initial error into a significant one. Even though the sensitivity of initial conditions limits the predictability in chaotic systems, an ensemble of prediction from different possible initial conditions and also a prediction algorithm capable of resolving the fine structure of the chaotic attractor can reduce the prediction uncertainty to some extent. All of the traditional chaotic prediction methods in hydrology are based on single optimum initial condition local models which can model the sudden divergence of the trajectories with different local functions. Conceptually, global models are ineffective in modeling the highly unstable structure of the chaotic attractor. This paper focuses on an ensemble prediction approach by reconstructing the phase space using different combinations of chaotic parameters, i.e., embedding dimension and delay time to quantify the uncertainty in initial conditions. The ensemble approach is implemented through a local learning wavelet network model with a global feed-forward neural network structure for the phase space prediction of chaotic streamflow series. Quantification of uncertainties in future predictions are done by creating an ensemble of predictions with wavelet network using a range of plausible embedding dimensions and delay times. The ensemble approach is proved to be 50% more efficient than the single prediction for both local approximation and wavelet network approaches. The wavelet network approach has proved to be 30%-50% more superior to the local approximation approach. Compared to the traditional local approximation approach with single initial condition, the total predictive uncertainty in the streamflow is reduced when modeled with ensemble wavelet networks for different lead times. Localization property of wavelets, utilizing different dilation and translation parameters, helps in capturing most of the statistical properties of the observed data. The need for taking into account all plausible initial conditions and also bringing together the characteristics of both local and global approaches to model the unstable yet ordered chaotic attractor of a hydrologic series is clearly demonstrated.

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The basic characteristic of a chaotic system is its sensitivity to the infinitesimal changes in its initial conditions. A limit to predictability in chaotic system arises mainly due to this sensitivity and also due to the ineffectiveness of the model to reveal the underlying dynamics of the system. In the present study, an attempt is made to quantify these uncertainties involved and thereby improve the predictability by adopting a multivariate nonlinear ensemble prediction. Daily rainfall data of Malaprabha basin, India for the period 1955-2000 is used for the study. It is found to exhibit a low dimensional chaotic nature with the dimension varying from 5 to 7. A multivariate phase space is generated, considering a climate data set of 16 variables. The chaotic nature of each of these variables is confirmed using false nearest neighbor method. The redundancy, if any, of this atmospheric data set is further removed by employing principal component analysis (PCA) method and thereby reducing it to eight principal components (PCs). This multivariate series (rainfall along with eight PCs) is found to exhibit a low dimensional chaotic nature with dimension 10. Nonlinear prediction employing local approximation method is done using univariate series (rainfall alone) and multivariate series for different combinations of embedding dimensions and delay times. The uncertainty in initial conditions is thus addressed by reconstructing the phase space using different combinations of parameters. The ensembles generated from multivariate predictions are found to be better than those from univariate predictions. The uncertainty in predictions is decreased or in other words predictability is increased by adopting multivariate nonlinear ensemble prediction. The restriction on predictability of a chaotic series can thus be altered by quantifying the uncertainty in the initial conditions and also by including other possible variables, which may influence the system. (C) 2011 Elsevier B.V. All rights reserved.

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Many downscaling techniques have been developed in the past few years for projection of station-scale hydrological variables from large-scale atmospheric variables simulated by general circulation models (GCMs) to assess the hydrological impacts of climate change. This article compares the performances of three downscaling methods, viz. conditional random field (CRF), K-nearest neighbour (KNN) and support vector machine (SVM) methods in downscaling precipitation in the Punjab region of India, belonging to the monsoon regime. The CRF model is a recently developed method for downscaling hydrological variables in a probabilistic framework, while the SVM model is a popular machine learning tool useful in terms of its ability to generalize and capture nonlinear relationships between predictors and predictand. The KNN model is an analogue-type method that queries days similar to a given feature vector from the training data and classifies future days by random sampling from a weighted set of K closest training examples. The models are applied for downscaling monsoon (June to September) daily precipitation at six locations in Punjab. Model performances with respect to reproduction of various statistics such as dry and wet spell length distributions, daily rainfall distribution, and intersite correlations are examined. It is found that the CRF and KNN models perform slightly better than the SVM model in reproducing most daily rainfall statistics. These models are then used to project future precipitation at the six locations. Output from the Canadian global climate model (CGCM3) GCM for three scenarios, viz. A1B, A2, and B1 is used for projection of future precipitation. The projections show a change in probability density functions of daily rainfall amount and changes in the wet and dry spell distributions of daily precipitation. Copyright (C) 2011 John Wiley & Sons, Ltd.

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A two-stage methodology is developed to obtain future projections of daily relative humidity in a river basin for climate change scenarios. In the first stage, Support Vector Machine (SVM) models are developed to downscale nine sets of predictor variables (large-scale atmospheric variables) for Intergovernmental Panel on Climate Change Special Report on Emissions Scenarios (SRES) (A1B, A2, B1, and COMMIT) to R (H) in a river basin at monthly scale. Uncertainty in the future projections of R (H) is studied for combinations of SRES scenarios, and predictors selected. Subsequently, in the second stage, the monthly sequences of R (H) are disaggregated to daily scale using k-nearest neighbor method. The effectiveness of the developed methodology is demonstrated through application to the catchment of Malaprabha reservoir in India. For downscaling, the probable predictor variables are extracted from the (1) National Centers for Environmental Prediction reanalysis data set for the period 1978-2000 and (2) simulations of the third-generation Canadian Coupled Global Climate Model for the period 1978-2100. The performance of the downscaling and disaggregation models is evaluated by split sample validation. Results show that among the SVM models, the model developed using predictors pertaining to only land location performed better. The R (H) is projected to increase in the future for A1B and A2 scenarios, while no trend is discerned for B1 and COMMIT.

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A hydrological modelling framework was assembled to simulate the daily discharge of the Mandovi River on the Indian west coast. Approximately 90% of the west-coast rainfall, and therefore discharge, occurs during the summer monsoon (June-September), with a peak during July-August. The modelling framework consisted of a digital elevation model (DEM) called GLOBE, a hydrological routing algorithm, the Terrestrial Hydrological Model with Biogeochemistry (THMB), an algorithm to map the rainfall recorded by sparse rain-gauges to the model grid, and a modified Soil Conservation Service Curve Number (SCS-CN) method. A series of discharge simulations (with and without the SCS method) was carried out. The best simulation was obtained after incorporating spatio-temporal variability in the SCS parameters, which was achieved by an objective division of the season into five regimes: the lean season, monsoon onset, peak monsoon, end-monsoon, and post-monsoon. A novel attempt was made to incorporate objectively the different regimes encountered before, during and after the Indian monsoon, into a hydrological modelling framework. The strength of our method lies in the low demand it makes on hydrological data. Apart from information on the average soil type in a region, the entire parameterization is built on the basis of the rainfall that is used to force the model. That the model does not need to be calibrated separately for each river is important, because most of the Indian west-coast basins are ungauged. Hence, even though the model has been validated only for the Mandovi basin, its potential region of application is considerable. In the context of the Prediction in Ungauged Basins (PUB) framework, the potential of the proposed approach is significant, because the discharge of these (ungauged) rivers into the eastern Arabian Sea is not small, making them an important element of the local climate system.

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The predictability of a chaotic series is limited to a few future time steps due to its sensitivity to initial conditions and the exponential divergence of the trajectories. Over the years, streamflow has been considered as a stochastic system in many approaches. In this study, the chaotic nature of daily streamflow is investigated using autocorrelation function, Fourier spectrum, correlation dimension method (Grassberger-Procaccia algorithm) and false nearest neighbor method. Embedding dimensions of 6-7 obtained indicates the possible presence of low-dimensional chaotic behavior. The predictability of the system is estimated by calculating the system’s Lyapunov exponent. A positive maximum Lyapunov exponent of 0.167 indicates that the system is chaotic and unstable with a maximum predictability of only 6 days. These results give a positive indication towards considering streamflow as a low dimensional chaotic system than as a stochastic system.

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The predictability of a chaotic series is limited to a few future time steps due to its sensitivity to initial conditions and the exponential divergence of the trajectories. Over the years, streamflow has been considered as a stochastic system in many approaches. In this study, the chaotic nature of daily streamflow is investigated using autocorrelation function, Fourier spectrum, correlation dimension method (Grassberger-Procaccia algorithm) and false nearest neighbor method. Embedding dimensions of 6-7 obtained indicates the possible presence of low-dimensional chaotic behavior. The predictability of the system is estimated by calculating the system's Lyapunov exponent. A positive maximum Lyapunov exponent of 0.167 indicates that the system is chaotic and unstable with a maximum predictability of only 6 days. These results give a positive indication towards considering streamflow as a low dimensional chaotic system than as a stochastic system.

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This paper presents the design and development of a novel optical vehicle classifier system, which is based on interruption of laser beams, that is suitable for use in places with poor transportation infrastructure. The system can estimate the speed, axle count, wheelbase, tire diameter, and the lane of motion of a vehicle. The design of the system eliminates the need for careful optical alignment, whereas the proposed estimation strategies render the estimates insensitive to angular mounting errors and to unevenness of the road. Strategies to estimate vehicular parameters are described along with the optimization of the geometry of the system to minimize estimation errors due to quantization. The system is subsequently fabricated, and the proposed features of the system are experimentally demonstrated. The relative errors in the estimation of velocity and tire diameter are shown to be within 0.5% and to change by less than 17% for angular mounting errors up to 30 degrees. In the field, the classifier demonstrates accuracy better than 97.5% and 94%, respectively, in the estimation of the wheelbase and lane of motion and can classify vehicles with an average accuracy of over 89.5%.