Wireless Channel Model and LDM-Based Transmission with Unequal Error Protection for Inside Train Communications

Although the deployment of wireless systems is widespread, there are still sectors where they are not used due to their lack of reliability in comparison to wired systems. Sectors like industry or vehicle communications consider their environment hostile because the wireless signals suffer a lot of interferences. One of such environments is the railway sector, where wiring removal will allow more flexibility for both control and monitoring systems. This thesis analyzes wireless communications inside train cars, aiming at modelling their behavior and at proposing techniques to increase the reliability of the critical signals among train systems, wich can coexist with other lower priority systems. After proposing a novel model of an inside train wireless channel, a transmission system based on Layered Division Multiplexing (LDM) has been proposed which theoretically promises higher capacities than traditional TDM or FDM. This capacity gain is used to provide higher reliability to critical data using Unequal Error Protection (UEP) while maintaining the same bit rate as equivalent TDM or FDM based systems. In the final part of the thesis, simulation results of the proposed LDM system are provided, combined with Alamouti space time coding and different coding rates. Multiantenna extensions of the proposed LDM schemes are also simulated, providing BER and throughput results. These results will be used to shed light about how to reduce BER of an inside train wireless communication system.Aunque el despliegue de los sistemas inalámbricos está muy extendido, aun hay sectores donde no se utiliza por la poca fiabilidad que proporcionan comparado con los sistemas cableados. Sectores como la industria o las comunicaciones vehiculares consideran el entorno donde trabajan como entorno hostil, debido a que las señales inalámbricas sufren muchas interferencias. Uno de estos entornos es el de las comunicaciones en ferrocarril donde la eliminación de cables permitiría mayor flexibilidad entre los sistemas de control y monitorización. En esta tesis se analiza el canal de comunicación inalámbrico dentro de los trenes, con el objetivo de modelar su comportamiento y proponer técnicas que permitan aumentar la fiabilidad de la información de tipo crítico transmitida entre los sistemas del tren, repercutiendo lo menos posible en otros sistemas de menor prioridad. Tras proponer el modelo de canal inalámbrico dentro del tren, se ha propuesto un sistema de transmisión basado en Layered Division Multiplexing (LDM) que analizándolo teóricamente promete mayores capacidades que los tradicionales TDM o FDM. Esta capacidad se utilizará para obtener mayor redundancia de los datos críticos usando Unequal Error Protection (UEP) manteniendo la misma tasa de transferencia bits que los sistemas basados en TDM/FDM. En la parte final de la tesis, se obtienen resultados de las simulaciones realizadas con el sistema LDM propuesto, combinada con codificación espacio temporal como Alamouti y diferentes ratios de codificación. También se han simulado configuraciones multiantena obteniendo resultados de BER y throughput. Estos resultados servirán para arrojar luz sobre cómo reducir el BER en las comunicaciones inalámbricas dentro de los trenes.Haririk gabeko sistemak oso hedatuak dauden arren oraindik erabiltzen ez dituen sektoreak badaude ematen duten fidagarritasuna txikia delako kableatutako sistemekin alderatuz. Industria bezalako sektoreek edo ibilgailuetako komunikazioek lan egiten duten ingurua oso zaratatsua izaten da eta seinaleek interferentzia asko jasaten dituzte. Tesi honetan tren barruko haririk gabeko komunikazio kanala aztertzen da, bere portaera aztertu eta modelatzeko asmotan. Jakintza honekin zein teknika izan daitekeen erabilgarriak aztertuko da datuen fidagarritasuna handitzeko helburuarekin, lehentasun gutxiago duten sistemetan eragin txikiena izanik. Modeloa atera ondoren proposatu den transmisio sistema Layered Division Multiplexing (LDM) izan da, non azterketa teorikoek TDM edo FDM sistemek baino kapazitate gehiago dutela frogatzen dute. Kapazitate hau sistemaren datu kritikoei erredundantzia gehiago emateko erabiliko da Unequal Error Protection (UEP) erabiliz, TDM/FDM sistemetan bidaltzen den bit tasa kopurua mantenduz. Tesiaren azken partean, proposatutako LDM sistemaren simulazio emaitzak ematen dira, Alamouti espazio denbora kodifikazioarekin konbinatuak eta kodigo ratio desberdinekin. Antena anitzezko konfigurazioak ere simulatu dira BER eta throughput emaitzak lortuz. Emaitza hauek haririk gabeko tren barruko komunikazioetan BER-a nola gutxitu daitekeen jakiten lagunduko digute

Fully Pipelined Implementation of Tree-Search Algorithms for Vector Precoding

The nonlinear vector precoding (VP) technique has been proven to achieve close-to-capacity performance in multiuser multiple-input multiple-output (MIMO) downlink channels. The performance benefit with respect to its linear counterparts stems from the incorporation of a perturbation signal that reduces the power of the precoded signal. The computation of this perturbation element, which is known to belong in the class of NP-hard problems, is the main aspect that hinders the hardware implementation of VP systems. To this respect, several tree-search algorithms have been proposed for the closest-point lattice search problem in VP systems hitherto. Nevertheless, the optimality of these algorithms has been assessed mainly in terms of error-rate performance and computational complexity, leaving the hardware cost of their implementation an open issue. The parallel data-processing capabilities of field-programmable gate arrays (FPGA) and the loopless nature of the proposed tree-search algorithms have enabled an efficient hardware implementation of a VP system that provides a very high data-processing throughput

Multiuser MIMO amplify-and-forward relaying schemes with vector precoding

A two-hop multiuser multiple-input multiple-output (MIMO) amplify-and-forward (AF) relay scenario is analyzed in this paper, where the main design challenge resides on the selection of the interdependent precoding and relaying matrices. After analyzing the optimal joint iterative linear design of the precoding and relaying matrices, two simpler non-iterative approaches are proposed and derived: hop-by-hop minimum mean squared error (MMSE) minimization and block diagonal geometric mean decomposition (BD-GMD). The combination of these two techniques and vector precoding (VP) is then proposed to greatly improve the performance of the systems. Provided simulation results prove that the combination of non-linear precoding and simpler matrix design strategies can outperform the optimal and complex joint iterative design with linear transmission

Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19: a cohort study

Background: Critically ill patients with coronavirus disease 19 (COVID-19) have a high fatality rate likely due to a dysregulated immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose. Methods: This is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from 12th March to 29th June 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the frst 48 h of ICU admission) with those who did not receive early corticosteroids (delayed group) or any corticosteroids at all (never group). Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications. Results: A total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n=485) had lower ICU mortality (30.3% vs. never 36.6% and delayed 44.2%) and lower 7-day mortality (7.2% vs. never 15.2%) compared to non-early treated patients. They also had higher number of ventilator-free days, less length of ICU stay, and less secondary infections than delayed treated patients. There were no diferences in medical complications between groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens. Conclusion: Early use of corticosteroids in critically ill patients with COVID-19 is associated with lower mortality than no or delayed use, and fewer complications than delayed use. Keywords: COVID-19, Intensive Care Unit, Corticosteroids, Critically ill patient, Cohort study, Outcomes, Ventilatorfree days, Mortalit

High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure

Purpose: Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasive mechanical ventilation, on adult patients with COVID-19. Methods: We conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs). Main exposure was the use of high-flow nasal oxygen (conservative group), while early invasive mechanical ventilation (within the first day of ICU admission; early intubation group) served as the comparator. The primary outcome was ventilator-free days at 28 days. ICU length of stay and all-cause in-hospital mortality served as secondary outcomes. We used propensity score matching to adjust for measured confounding. Results: Out of 468 eligible patients, a total of 122 matched patients were included in the present analysis (61 for each group). When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (mean difference: 8.0 days; 95% confidence interval (CI): 4.4 to 11.7 days) and a reduction in ICU length of stay (mean difference: - 8.2 days; 95% CI - 12.7 to - 3.6 days). No difference was observed in all-cause in-hospital mortality between groups (odds ratio: 0.64; 95% CI: 0.25 to 1.64). Conclusions: The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when compared to early initiation of invasive mechanical ventilation. Future studies should confirm our findings

Predictors of failure with high-flow nasal oxygen therapy in COVID-19 patients with acute respiratory failure: a multicenter observational study

Purpose: We aimed to describe the use of high-flow nasal oxygen (HFNO) in patients with COVID-19 acute respiratory failure and factors associated with a shift to invasive mechanical ventilation. Methods: This is a multicenter, observational study from a prospectively collected database of consecutive COVID-19 patients admitted to 36 Spanish and Andorran intensive care units (ICUs) who received HFNO on ICU admission during a 22-week period (March 12-August 13, 2020). Outcomes of interest were factors on the day of ICU admission associated with the need for endotracheal intubation. We used multivariable logistic regression and mixed effects models. A predictive model for endotracheal intubation in patients treated with HFNO was derived and internally validated. Results: From a total of 259 patients initially treated with HFNO, 140 patients (54%) required invasive mechanical ventilation. Baseline non-respiratory Sequential Organ Failure Assessment (SOFA) score [odds ratio (OR) 1.78; 95% confidence interval (CI) 1.41-2.35], and the ROX index calculated as the ratio of partial pressure of arterial oxygen to inspired oxygen fraction divided by respiratory rate (OR 0.53; 95% CI: 0.37-0.72), and pH (OR 0.47; 95% CI: 0.24-0.86) were associated with intubation. Hospital site explained 1% of the variability in the likelihood of intubation after initial treatment with HFNO. A predictive model including non-respiratory SOFA score and the ROX index showed excellent performance (AUC 0.88, 95% CI 0.80-0.96). Conclusions: Among adult critically ill patients with COVID-19 initially treated with HFNO, the SOFA score and the ROX index may help to identify patients with higher likelihood of intubation

Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study

Background: Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone. Methods: Prospective, multicenter, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory Sequential Organ Failure Assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate, and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP. Results: A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41/100) and 22 (40/100) patients from the HFNO and HFNO + awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95/100 CI 0.53–1.43), p equal 0.60]. Patients treated with HFNO + awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0–2.5) vs 2 IQR 1.0–3.0] days (p equal 0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95/100 CI 0.40–2.72), p equal 0.92].Conclusion: In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality

Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study

Background: Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone. Methods: Prospective, multicenter, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory Sequential Organ Failure Assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate, and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP. Results: A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO + awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95% CI 0.53-1.43), p = 0.60]. Patients treated with HFNO + awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0-2.5) vs 2 IQR 1.0-3.0] days (p = 0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95% CI 0.40-2.72), p = 0.92]. Conclusion: In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality