Coding mode decision algorithm for binary descriptor coding

In visual sensor networks, local feature descriptors can be computed at the sensing nodes, which work collaboratively on the data obtained to make an efficient visual analysis. In fact, with a minimal amount of computational effort, the detection and extraction of local features, such as binary descriptors, can provide a reliable and compact image representation. In this paper, it is proposed to extract and code binary descriptors to meet the energy and bandwidth constraints at each sensing node. The major contribution is a binary descriptor coding technique that exploits the correlation using two different coding modes: Intra, which exploits the correlation between the elements that compose a descriptor; and Inter, which exploits the correlation between descriptors of the same image. The experimental results show bitrate savings up to 35% without any impact in the performance efficiency of the image retrieval task. © 2014 EURASIP.

An energy efficient vertical handover decision algorithm

As wireless communications evolve towards heterogeneousnetworks, mobile terminals have been enabled tohandover seamlessly from one network to another. At the sametime, the continuous increase in the terminal power consumptionhas resulted in an ever-decreasing battery lifetime. To that end,the network selection is expected to play a key role on howto minimize the energy consumption, and thus to extend theterminal lifetime. Hitherto, terminals select the network thatprovides the highest received power. However, it has been provedthat this solution does not provide the highest energy efficiency.Thus, this paper proposes an energy efficient vertical handoveralgorithm that selects the most energy efficient network thatminimizes the uplink power consumption. The performance of theproposed algorithm is evaluated through extensive simulationsand it is shown to achieve high energy efficiency gains comparedto the conventional approach.

CHEOPS Performance for Exomoons: The Detectability of Exomoons by Using Optimal Decision Algorithm

Many attempts have already been made to detect exomoons around transiting exoplanets, but the first confirmed discovery is still pending. The experiences that have been gathered so far allow us to better optimize future space telescopes for this challenge already during the development phase. In this paper we focus on the forthcoming CHaraterising ExOPlanet Satellite (CHEOPS), describing an optimized decision algorithm with step-by-step evaluation, and calculating the number of required transits for an exomoon detection for various planet moon configurations that can be observable by CHEOPS. We explore the most efficient way for such an observation to minimize the cost in observing time. Our study is based on PTV observations (photocentric transit timing variation) in simulated CHEOPS data, but the recipe does not depend on the actual detection method, and it can be substituted with, e.g., the photodynamical method for later applications. Using the current state-of-the-art level simulation of CHEOPS data we analyzed transit observation sets for different star planet moon configurations and performed a bootstrap analysis to determine their detection statistics. We have found that the detection limit is around an Earth-sized moon. In the case of favorable spatial configurations, systems with at least a large moon and a Neptune-sized planet, an 80% detection chance requires at least 5-6 transit observations on average. There is also a nonzero chance in the case of smaller moons, but the detection statistics deteriorate rapidly, while the necessary transit measurements increase quickly. After the CoRoT and Kepler spacecrafts, CHEOPS will be the next dedicated space telescope that will observe exoplanetary transits and characterize systems with known Doppler-planets. Although it has a smaller aperture than Kepler (the ratio of the mirror diameters is about 1/3) and is mounted with a CCD that is similar to Kepler's, it will observe brighter stars and operate with larger sampling rate; therefore, the detection limit for an exomoon can be the same as or better, which will make CHEOPS a competitive instruments in the quest for exomoons.

A New Fast Motion Estimation and Mode Decision algorithm for H.264 Depth Maps encoding in Free Viewpoint TV

In this paper, we consider a scenario where 3D scenes are modeled through a View+Depth representation. This representation is to be used at the rendering side to generate synthetic views for free viewpoint video. The encoding of both type of data (view and depth) is carried out using two H.264/AVC encoders. In this scenario we address the reduction of the encoding complexity of depth data. Firstly, an analysis of the Mode Decision and Motion Estimation processes has been conducted for both view and depth sequences, in order to capture the correlation between them. Taking advantage of this correlation, we propose a fast mode decision and motion estimation algorithm for the depth encoding. Results show that the proposed algorithm reduces the computational burden with a negligible loss in terms of quality of the rendered synthetic views. Quality measurements have been conducted using the Video Quality Metric.

MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

An entropy-based financial decision support system (e-FDSS) for project analysis in construction SMEs

Uncertainty contributes a major part in the accuracy of a decision-making process while its inconsistency is always difficult to be solved by existing decision-making tools. Entropy has been proved to be useful to evaluate the inconsistency of uncertainty among different respondents. The study demonstrates an entropy-based financial decision support system called e-FDSS. This integrated system provides decision support to evaluate attributes (funding options and multiple risks) available in projects. Fuzzy logic theory is included in the system to deal with the qualitative aspect of these options and risks. An adaptive genetic algorithm (AGA) is also employed to solve the decision algorithm in the system in order to provide optimal and consistent rates to these attributes. Seven simplified and parallel projects from a Hong Kong construction small and medium enterprise (SME) were assessed to evaluate the system. The result shows that the system calculates risk adjusted discount rates (RADR) of projects in an objective way. These rates discount project cash flow impartially. Inconsistency of uncertainty is also successfully evaluated by the use of the entropy method. Finally, the system identifies the favourable funding options that are managed by a scheme called SME Loan Guarantee Scheme (SGS). Based on these results, resource allocation could then be optimized and the best time to start a new project could also be identified throughout the overall project life cycle.

Healthcare Information System Selection Model for Medical Clinics

The issue of selecting an appropriate healthcare information system is a very essential one. If implemented healthcare information system doesn’t fit particular healthcare institution, for example there are unnecessary functions; healthcare institution wastes its resources and its efficiency decreases. The purpose of this research is to develop a healthcare information system selection model to assist the decision-making process of choosing healthcare information system. Appropriate healthcare information system helps healthcare institutions to become more effective and efficient and keep up with the times. The research is based on comparison analysis of 50 healthcare information systems and 6 interviews with experts from St-Petersburg healthcare institutions that already have experience in healthcare information system utilization. 13 characteristics of healthcare information systems: 5 key and 7 additional features are identified and considered in the selection model development. Variables are used in the selection model in order to narrow the decision algorithm and to avoid duplication of brunches. The questions in the healthcare information systems selection model are designed to be easy-to-understand for common a decision-maker in healthcare institution without permanent establishment.

Towards automated derivation in the theory of allegories

We provide an algorithm that automatically derives many provable theorems in the equational theory of allegories. This was accomplished by noticing properties of an existing decision algorithm that could be extended to provide a derivation in addition to a decision certificate. We also suggest improvements and corrections to previous research in order to motivate further work on a complete derivation mechanism. The results presented here are significant for those interested in relational theories, since we essentially have a subtheory where automatic proof-generation is possible. This is also relevant to program verification since relations are well-suited to describe the behaviour of computer programs. It is likely that extensions of the theory of allegories are also decidable and possibly suitable for further expansions of the algorithm presented here.

Le diagnostic des tuméfactions latérales solides cervicales chez l'enfant

Introduction : Faute de tests diagnostiques précis, une étude histologique est souvent nécessaire pour diagnostiquer les tuméfactions latérales solides cervicales (TLSC) chez l’enfant. Nous étudierons les modalités diagnostiques pour les TLSC afin de créer une approche diagnostique standardisée intégrant de nouveaux outils diagnostics à ceux actuellement offerts. Méthodologie : Après révision des étiologies et des modalités diagnostiques, une revue de la littérature a été effectuée. Une étude rétrospective entre 2002 à 2012 est présentée suivie d’une étude de faisabilité de la cytoponction. Puis, un arbre décisionnel est créé basé sur nos résultats et sur l’avis d’un groupe d’experts de différentes disciplines médicales. Résultats : Le diagnostic différentiel des TLSC est varié, la littérature scientifique est désuète et la comparaison reste difficile. Pour nos 42 enfants avec un âge médian de sept ans, les tuméfactions inflammatoires représentent 59% (26/44 biopsies) des TLSC, surtout des lymphadénites à mycobactérie atypique (13/26) qui ont un dépistage ardu et multimodal. La biopsie fut peu contributive à la prise en charge dans 39% (17/44) des cas. La cytoponction sous échoguidance est une technique diagnostique faisable et moins invasive que la biopsie. L’arbre décisionnel offre aux cliniciens une approche diagnostique standardisée des TLSC appuyée sur des faits scientifiques que nous souhaitons valider par une étude prospective. Conclusion : Les TLSC chez l’enfant représentent un défi diagnostic et notre arbre décisionnel répond au manque de standardisation dans l’approche diagnostique. Une étude prospective sur notre arbre décisionnel est en voie d’acceptation au CHU Sainte-Justine.

Next-Generation Sequencing-Based Mutations Scanning Strategy of the BCR-ABL Kinase Domain in Patients with PhiladelPhia-Chromosome Positive Leukemias Treated with Tyrosine Kinase Inhibitors

In chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia patients resistant to tyrosine kinase inhibitors (TKIs), BCR-ABL kinase domain mutation status is an essential component of the therapeutic decision algorithm. The recent development of Ultra-Deep Sequencing approach (UDS) has opened the way to a more accurate characterization of the mutant clones surviving TKIs conjugating assay sensitivity and throughput. We decided to set-up and validated an UDS-based for BCR-ABL KD mutation screening in order to i) resolve qualitatively and quantitatively the complexity and the clonal structure of mutated populations surviving TKIs, ii) study the dynamic of expansion of mutated clones in relation to TKIs therapy, iii) assess whether UDS may allow more sensitive detection of emerging clones, harboring critical 2GTKIs-resistant mutations predicting for an impending relapse, earlier than SS. UDS was performed on a Roche GS Junior instrument, according to an amplicon sequencing design and protocol set up and validated in the framework of the IRON-II (Interlaboratory Robustness of Next-Generation Sequencing) International consortium.Samples from CML and Ph+ ALL patients who had developed resistance to one or multiple TKIs and collected at regular time-points during treatment were selected for this study. Our results indicate the technical feasibility, accuracy and robustness of our UDS-based BCR-ABL KD mutation screening approach. UDS was found to provide a more accurate picture of BCR-ABL KD mutation status, both in terms of presence/absence of mutations and in terms of clonal complexity and showed that BCR-ABL KD mutations detected by SS are only the “tip of iceberg”. In addition UDS may reliably pick 2GTKIs-resistant mutations earlier than SS in a significantly greater proportion of patients.The enhanced sensitivity as well as the possibility to identify low level mutations point the UDS-based approach as an ideal alternative to conventional sequencing for BCR-ABL KD mutation screening in TKIs-resistant Ph+ leukemia patients

Use of linezolid in neonatal and pediatric inpatient facilities-results of a retrospective multicenter survey

The purpose of this investigation was to describe the use of linezolid in pediatric inpatient facilities. A retrospective multicenter survey including data from nine participating tertiary care pediatric inpatient facilities in Germany and Austria was undertaken. Data on 126 off-label linezolid treatment courses administered to 108 patients were documented. The survey comprises linezolid treatment in a broad spectrum of clinical indications to children of all age groups; the median age was 6.8 years (interquartile range 0.6-15.5 years; range 0.1-21.2 years; ten patients were older than 18 years of age but were treated in pediatric inpatient units). Of the 126 treatment courses, 27 (21%) were administered to preterm infants, 64 (51%) to pediatric oncology patients, and 5% to patients soon after liver transplantation. In 25%, the infection was related to a medical device. Linezolid iv treatment was started after intensive pre-treatment (up to 11 other antibiotics for a median duration of 14 days) and changed to enteral administration in only 4% of all iv courses. In 39 (53%) of 74 courses administered to children older than 1 week and younger than 12 years of age, the dose was not adjusted to age-related pharmacokinetic parameters. In only 17 courses (13%) was a pediatric infectious disease consultant involved in the clinical decision algorithm. Linezolid seemed to have contributed to a favorable outcome in 70% of all treatment courses in this survey. Although retrospective, this survey generates interesting data on the off-label use of linezolid and highlights several important clinical aspects in which the use of this rescue antibiotic in children might be improved.

Hospitalized children with respiratory syncytial virus infection and neuromuscular impairment face an increased risk of a complicated course

BACKGROUND: Respiratory syncytial virus (RSV) infection is an important cause of viral respiratory tract infection in children. In contrast to other confirmed risk factors that predispose to a higher morbidity and mortality, the particular risk of a preexisting neuromuscular impairment (NMI) in hospitalized children with RSV infection has not been prospectively studied in a multicenter trial. METHODS: The DMS RSV Paed database was designed for the prospective multicenter documentation and analysis of all clinically relevant aspects of the management of inpatients with RSV infection. Patients with clinically relevant NMI were identified according to the specific comments of the attending physicians and compared with those without NMI. RESULTS: This study covers 6 consecutive seasons; the surveillance took place in 14 pediatric hospitals in Germany from 1999 to 2005. In total, 1568 RSV infections were prospectively documented in 1541 pediatric patients. Of these, 73 (4.7%) patients displayed a clinically relevant NMI; 41 (56%) NMI patients had at least 1 additional risk factor for a severe course of the infection (multiple risk factors in some patients; prematurity in 30, congenital heart disease in 19, chronic lung disease 6 and immunodeficiency in 8). Median age at diagnosis was higher in NMI patients (14 vs. 5 months); NMI patients had a greater risk of seizures (15.1% vs. 1.6%), and a higher proportion in the NMI group had to be mechanically ventilated (9.6% vs. 1.9%). Eventually, the attributable mortality was significantly higher in the NMI group (5.5% vs. 0.2%; P < 0.001 for all). Multivariate logistic regression confirmed that NMI was independently associated with pediatric intensive care unit (PICU) admission (OR, 4.94; 95% CI, 2.69-8.94; P < 0.001] and mechanical ventilation (OR, 3.85; 95% CI, 1.28-10.22; P = 0.017). CONCLUSION: This is the first prospective multicenter study confirming the hypothesis that children with clinically relevant NMI face an increased risk for severe RSV-disease. It seems reasonable to include NMI as a cofactor into the decision algorithm of passive immunization.

Crowdsourcing malaria parasite quantification: an online game for analyzing images of infected thick blood smears

Background: There are 600,000 new malaria cases daily worldwide. The gold standard for estimating the parasite burden and the corresponding severity of the disease consists in manually counting the number of parasites in blood smears through a microscope, a process that can take more than 20 minutes of an expert microscopist’s time. Objective: This research tests the feasibility of a crowdsourced approach to malaria image analysis. In particular, we investigated whether anonymous volunteers with no prior experience would be able to count malaria parasites in digitized images of thick blood smears by playing a Web-based game. Methods: The experimental system consisted of a Web-based game where online volunteers were tasked with detecting parasites in digitized blood sample images coupled with a decision algorithm that combined the analyses from several players to produce an improved collective detection outcome. Data were collected through the MalariaSpot website. Random images of thick blood films containing Plasmodium falciparum at medium to low parasitemias, acquired by conventional optical microscopy, were presented to players. In the game, players had to find and tag as many parasites as possible in 1 minute. In the event that players found all the parasites present in the image, they were presented with a new image. In order to combine the choices of different players into a single crowd decision, we implemented an image processing pipeline and a quorum algorithm that judged a parasite tagged when a group of players agreed on its position. Results: Over 1 month, anonymous players from 95 countries played more than 12,000 games and generated a database of more than 270,000 clicks on the test images. Results revealed that combining 22 games from nonexpert players achieved a parasite counting accuracy higher than 99%. This performance could be obtained also by combining 13 games from players trained for 1 minute. Exhaustive computations measured the parasite counting accuracy for all players as a function of the number of games considered and the experience of the players. In addition, we propose a mathematical equation that accurately models the collective parasite counting performance. Conclusions: This research validates the online gaming approach for crowdsourced counting of malaria parasites in images of thick blood films. The findings support the conclusion that nonexperts are able to rapidly learn how to identify the typical features of malaria parasites in digitized thick blood samples and that combining the analyses of several users provides similar parasite counting accuracy rates as those of expert microscopists. This experiment illustrates the potential of the crowdsourced gaming approach for performing routine malaria parasite quantification, and more generally for solving biomedical image analysis problems, with future potential for telediagnosis related to global health challenges.

Modelo Híbrido para la Ayuda al Capitán

En esta Tesis se plantea una nueva forma de entender la evacuación apoyándonos en tecnologías existentes y accesibles que nos permitirán ver este proceso como un ente dinámico. Se trata de una metodología que implica no solo el uso de herramientas de análisis que permitan la definición de planes de evacuación en tiempo real, sino que también se apunta hacia la creación de una infraestructura física que permita alimentar con información actualizada al sistema de forma que, según la situación y la evolución de la emergencia, sea posible realizar planes alternativos que se adapten a las nuevas circunstancias. En base a esto, el sistema asimilará toda esa información y aportará soluciones que faciliten la toma de decisiones durante toda la evolución del incidente. Las aportaciones originales de esta Tesis son múltiples y muy variadas, pudiéndolas resumir en los siguientes puntos: 1. Estudio completo del estado del arte: a. Detección y análisis de diferentes proyectos a nivel internacional que de forma parcial tratan algunos aspectos desarrollados en la Tesis. b. Completo estudio a nivel mundial del software desarrollado total o parcialmente para la simulación del comportamiento humano y análisis de procesos de evacuación. Se ha generado una base de datos que cataloga de forma exhaustiva estas aplicaciones, permitiendo realizar un completo análisis y posibilitando la evolución futura de los contenidos de la misma. En la tesis se han analizado casi un centenar de desarrollos, pero el objetivo es seguir completando esta base de datos debido a la gran utilidad y a las importantes posibilidades que ofrece. 2. Desarrollo de un importante capítulo que trata sobre la posibilidad de utilizar entornos virtuales como alternativa intermedia al uso de simuladores y simulacros. En esta sección se divide en dos bloques: a. Ensayos en entornos reales y virtuales. b. Ensayos en entornos virtuales (pruebas realizadas con varios entornos virtuales). 3. Desarrollo de e-Flow net design: paquete de herramientas desarrolladas sobre Rhinoceros para el diseño de la red de evacuación basada en los elementos definidos en la tesis: Nodes, paths, Relations y Areas. 4. Desarrollo de e-Flow Simulator: Conjunto de herramientas que transforman Rhinoceros en un simulador 3D de comportamiento humano. Este simulador, de desarrollo propio, incorpora un novedoso algoritmo de comportamiento a nivel de individuo que incluye aspectos que no se han encontrado en otros simuladores. Esta herramienta permite realizar simulaciones programadas de grupos de individuos cuyo comportamiento se basa en el análisis del entorno y en la presencia de referencias dinámicas. Incluye otras importantes novedades como por ejemplo: herramientas para análisis de la señalización, elementos de señalización dinámica, incorporación sencilla de obstáculos, etc. También se ha creado una herramienta que posibilita la implementación del movimiento del propio escenario simulando la oscilación del mismo, con objeto de reflejar la influencia del movimiento del buque en el desplazamiento de los individuos. 5. En una fase avanzada del desarrollo, se incorporó la posibilidad de generar un vídeo de toda la simulación, momento a partir del cual, se han documentado todas las pruebas (y se continúan documentando) en una base de datos que recoge todas las características de las simulaciones, los problemas detectados, etc. Estas pruebas constituyen, en el momento en que se ha cerrado la redacción de la Tesis, un total de 81 GB de datos. Generación y análisis de rutas en base a la red de evacuación creada con e-Flow Net design y las simulaciones realizadas con e-Flow Net simulator. a. Análisis para la optimización de la configuración de la red en base a los nodos por área existentes. b. Definición de procesos previos al cálculo de rutas posibles. c. Cálculo de rutas: i. Análisis de los diferentes algoritmos que existen en la actualidad para la optimización de rutas. ii. Desarrollo de una nueva familia de algoritmos que he denominado “Minimum Decision Algorithm (MDA)”, siendo los algoritmos que componen esta familia: 1. MDA básico. 2. MDA mínimo. 3. MDA de no interferencia espacial. 4. MDA de expansión. 5. MDA de expansión ordenada para un único origen. 6. MDA de expansión ordenada. iii. Todos estos algoritmos se han implementado en la aplicación e-Flow creada en la Tesis para el análisis de rutas y que constituye el núcleo del Sistema de Ayuda al Capitán. d. Determinación de las alternativas para el plan de evacuación. Tras la definición de las rutas posibles, se describen diferentes procesos existentes de análisis por ponderación en base a criterios, para pasar finalmente a definir el método de desarrollo propio propuesto en esta Tesis y cuyo objetivo es responder en base a la población de rutas posibles obtenidas mediante los algoritmos MDA, qué combinación de rutas constituyen el Plan o Planes más adecuados para cada situación. La metodología creada para la selección de combinaciones de rutas que determinan un Plan completo, se basa en cuatro criterios básicos que tras su aplicación ofrecen las mejores alternativas. En esta fase también se incluye un complejo análisis de evolución temporal que incorpora novedosas definiciones y formulaciones. e. Derivado de la definición de la metodología creada en esta Tesis para la realización de los análisis de evolución temporal, se ha podido definir un nuevo teorema matemático que se ha bautizado como “Familia de cuadriláteros de área constante”. 7. Especificación de la infraestructura física del Sistema de Ayuda al Capitán: parte fundamental de sistema es la infraestructura física sobre la que se sustentaría. Esta infraestructura estaría compuesta por sensores, actuadores, aplicaciones para dispositivos móviles, etc. En este capítulo se analizan los diferentes elementos que la constituirían y las tecnologías implicadas. 8. Especificación de la infraestructura de servicios. 9. Creación del Blog Virtual Environments (http://epcinnova-virtualenvironments.blogspot.com.es/) en el que se han publicado todas las pruebas realizadas en el capítulo que analiza los entornos virtuales como alternativa a los simuladores y a los ensayos en laboratorio o los simulacros, incluyendo en muchos casos la posibilidad de que el visitante del blog pueda realizar la simulación en el entorno virtual. Este blog también incluye otras secciones que se han trabajado durante la Tesis: • Recopilación de diferentes entornos virtuales existentes. • Diagrama que recopila información sobre accidentes tanto en el ámbito marítimo como en el terrestre (en desarrollo). • Esquema propuesto para el acopio de información obtenida a partir de un simulacro. 10. Esta Tesis es la base para el proyecto e-Flow (nombre de una de las aplicaciones que desarrolladas en esta obra), un proyecto en el que el autor de esta Tesis ha trabajado como Project Manager. En el proyecto participa un consorcio de empresas y la UPM, y tiene como objetivo trasladar a la realidad gran parte de los planteamientos e ideas presentadas en esta Tesis. Este proyecto incluye el desarrollo de la infraestructura física y de servicios que permitirán, entre otras cosas, implementar en infraestructuras complejas una plataforma que posibilita la evacuación dinámica y un control ubicuo de los sistemas de monitorización y actuación implementados. En estos momentos se está finalizando el proyecto, cuyo objetivo final es la implementación de un piloto en un Hospital. También destacamos los siguientes avances a nivel de difusión científico-tecnológico: • Ponencia en el “52 congreso de la Ingeniería Naval en España” presentando un artículo “e-Flow- Sistema integral inteligente de soporte a la evacuación”. En este artículo se trata tanto el proyecto e-Flow del que soy Project Manager, como esta Tesis Doctoral, al ser temas estrechamente vinculados. En 2014 se publicó en dos números de la Revista Ingeniería Naval el artículo presentado a estas jornadas. • Co-autor en el artículo “E-Flow: A communication system for user notification in dynamic evacuation scenarios” presentado en el 7th International Conference on Ubicuous Computing & Ambient Intelligence (UCAMI) celebrado en Costa Rica. Por último, una de las aportaciones más interesantes, es la definición de un gran número de líneas de investigación futuras en base a todos los avances realizados en esta Tesis. ABSTRACT With this Thesis a new approach for understanding evacuation process is considered, taking advantage of the existing and open technologies that will allow this process to be interpreted as a dynamic entity. The methodology involves not only tools that allows on.-time evacuation plans, but also creates a physical insfrastructure that makes possible to feed the system with information on real time so, considering in each moment the real situation as well as the specific emergency development it will be feasible to generate alternative plans that responds to the current emergency situation. In this respect, the system will store all this information and will feedback with solutions that will help the decision making along the evacuation process. The innovative and singular contributions of this Thesis are numerous and rich, summarised as follows: 1.- Complete state-of-art study: a. Detection and analysis of different projects on an international level that, although partially, deal with some aspects developed in this Thesis. b. Thorough study at a international level of the developed software - total or partially done - for the simulation of the human behaviour and evacuation processes analysis. A database has been generated that classifies in detail these applications allowing to perform a full analysis and leading to future evolution of its contents. Within the Thesis work, almost a hundred of developments have been analysed but the purpose is to keep up updating this database due to the broad applications and possibilities that it involves. 2. Development of an important chapter that studies the possibility of using virtual scenarios as mid-term alternative for the use of simulations. This section is divided in two blocks: a. Trials in virtual and real scenarios b. Trials in virutal scenarios (trials performed with several ones). 3. E-Flow net design development: Set of tools developed under Rhinoceros for the evacuation net design based on the elements defined in the Thesis: Nodes, Paths, Relations, Areas 4. E-Flow simulator development: Set of tools that uses Rhinoceros as a 3D simulator of human behaviour. This simulator, of my own design, includes a new and original algorithm of human behaviour that involves aspects that are not found in other simulators. This tool allows to perform groups programmed simulations which behaviour is based on their enviroment analysis and presence of dynamic references. It includes other important innovations as for example: tools for signals analysis, dynamic signal elements, easy obstacle adding etc... More over, a tool that allows the own scenario movement implementation has been created by simulating the own oscillation movement, with the purpose of playing the vessel movement's influences in the individuals' displacements. 5. In an advanced stage of the development, the possibility of generating a video recording of all the simulation was also integrated, then from that moment all tests have been filed (and keep on doing so) in a database that collects all simulation characteristics, failures detected, etc. These stored tests amounts to a total of 81 GB at the moment of finishing the Thesis work. Generation and analysis of paths regarding the evacuation net created with E-Flow design and the simulations performed with E-Flow net Simulator. a. Analysis for the optimisation of the network configuration based in the existing nodes per area. b. Definition of the processes previous to the calculation of the feasible paths c. Paths calculation: i. Analysis of the different algorithms on existance nowadays for the routes optimisation. ii. Development of a new family of algorithms that I have called “Minimum Decision Algorithm (MDA)”, being composed of: 1. MDA basic 2. MDA minimum 3. MDA of not spacial interference 4. MDA of expansion (es de extenderse) o enlargement ( es de crecimiento) 5. MDA of organised expansion for a single origin (of organised enlargement for a single origin) 6. MDA of organised expansion (of organised enlargement) iii. All these algorithms have been implemented in the E-Flow application created in the Thesis dfor the routes analysis and it is the core of the Captain's support system. d. Determination of the alternatives for the evacuation plan. After defining all possible paths, different processes of analysis existing for weighing-based criteria are described, thus to end defining the own development method proposed in this Thesis and that aims to respond in an agreggation of possible routes basis obtained by means of the MDA algorithms what is the routes' combination more suitable for the Plan or Plans in every situation. The methodology created fot the selection of the combinations of routes that determine a complete Plan is baesd in four basic criteria that after applying, offer the best alternatives. In this stage a complex analysis of the progress along time is also included, that adds original and innovative defintions and formulations. e. Originated from the methodology created in this Thesis for the perfoming of the analysy of the progress along time, a new mathematic theorem has been defined, that has been called as "Family of quadrilateral of constant area". 7. Specification of the physiscal infrastructure of the Captain's help system: essential part is this physical infrastructure that will support it. This system will be made of sensors, actuators, apps for mobile devices etc... Within this chapter the different elements and technologies that make up this infrastructure will be studied. 8. Specification for the services infrastructure. 9. Start up of the Blog. " Virtual Environments (http://epcinnova-virtualenvironments.blogspot.com.es/)" in which all tests performed have been published in terms of analysis of the virtual enviroments as alternative to the simulators as well as to the laboratory experiments or simulations, including in most of the cases the possibility that the visitor can perform the simulation within the virtual enviroment. This blog also includes other sections that have been worked along and within this Thesis: - Collection of different virtual scenarios existent. - Schema that gathers information concerning accidents for maritime and terrestrial areas (under development) - Schema proposed for the collecting of information obtained from a simulation. 10. This Thesis is the basis of the E-Flow project (name of one of the applications developed in this work), a project in which the Thesis' author has worked in as Project Manager. In the project takes part a consortium of firms as well as the UPM and the aim is to bring to real life most part of the approaches and ideas contained in this Thesis. This project includes the development of the physical infrastructure as well as the services that will allow, among others, implement in complex infrastrucutres a platform that will make possible a dynamic evacuation and a continuous control of the monitoring and acting systems implemented. At the moment the project is getting to an end which goal is the implementation of a pilot project in a Hospital. We also would like to highlight the following advances concerning the scientific-technology divulgation: • Talk in the " 52th Congress of the Naval Engineering in Spain" with the article "E-Flow . Intelligent system integrated for supporting evacuation". This paper is about project E-Flow which I am Project Manager of, as well as this Thesis for the Doctorate, being both closely related. Two papers published In 2014 in the Naval Engineering Magazine. • Co-author in the article “E-Flow: A communication system for user notification in dynamic evacuation scenarios” [17] introduced in the 7th International Conference on Ubicuous Computing & Ambient Intelligence (UCAMI) held in Costa Rica. Last, but not least, one of the more interesting contributions is the defintion of several lines of research in the future, based on the advances made in this Thesis.

Sinus rhythm restoration with electrical cardioversion: acute effect of shock configuration and subsequent modifications in peripheral flow and sleep.

Atrial fibrillation (AF) is a widespread arrhythmia, associated with higher risk of stroke, sleep disorders and dementia. In some conditions, electrical cardioversion (ECV) represents the best choice for rhythm control. Nowadays, there is a growing interest in developing new devices for screening and monitoring of AF patients. We aimed to improve acute efficacy of ECV procedure and to explore the feasibility of the use of new wearable devices for monitoring in candidates to AF ECV. We compared antero-apical pads vs antero-posterior patches approach for AF ECV, and we elaborated a decision algorithm to improve acute efficacy. After, we evaluated the feasibility of the use of new wearable devices for monitoring of candidates to AF ECV. In particular, we analysed the effect of AF ECV on heart rate variability and vascular age parameters derived from PPG signals registered with Empatica (CE 1876/MDD 93/42/EEC), and on EEG pattern registered with Neurosteer (Israel). From December 2005 to September 2019, 492 patients were enrolled. We evaluated acute efficacy of the two approaches for AF ECV and we elaborated a decision algorithm based on body surface area, weight, and height. The decision algorithm improved first shock efficacy (93.2% vs. 87.2%, p=0.025). From 1st November 2021 to 1st April 2022, 24 patients were enrolled in PPEEG-AF pilot study. Considering vascular age parameters, a significant reduction in TPR and a wave was observed (p<0.001). Considering sleep patterns, a tendency to higher coherence was observed in registrations acquired during AF, or considering signals registered for each patient independently from AF. The new decision algorithm improved acute efficacy and reduced costs associated with adhesive patches. Significant modifications were observed on vascular age parameters measured before and after ECV, and a possible AF effect on sleep pattern was noticed. More data are necessary to confirm these preliminary results.