Characterisation of noisy speech channels in 2G and 3G mobile networks

As the wireless cellular market reaches competitive levels never seen before, network operators need to focus on maintaining Quality of Service (QoS) a main priority if they wish to attract new subscribers while keeping existing customers satisfied. Speech Quality as perceived by the end user is one major example of a characteristic in constant need of maintenance and improvement. It is in this topic that this Master Thesis project fits in. Making use of an intrusive method of speech quality evaluation, as a means to further study and characterize the performance of speech codecs in second-generation (2G) and third-generation (3G) technologies. Trying to find further correlation between codecs with similar bit rates, along with the exploration of certain transmission parameters which may aid in the assessment of speech quality. Due to some limitations concerning the audio analyzer equipment that was to be employed, a different system for recording the test samples was sought out. Although the new designed system is not standard, after extensive testing and optimization of the system's parameters, final results were found reliable and satisfactory. Tests include a set of high and low bit rate codecs for both 2G and 3G, where values were compared and analysed, leading to the outcome that 3G speech codecs perform better, under the approximately same conditions, when compared with 2G. Reinforcing the idea that 3G is, with no doubt, the best choice if the costumer looks for the best possible listening speech quality. Regarding the transmission parameters chosen for the experiment, the Receiver Quality (RxQual) and Received Energy per Chip to the Power Density Ratio (Ec/N0), these were subject to speech quality correlation tests. Final results of RxQual were compared to those of prior studies from different researchers and, are considered to be of important relevance. Leading to the confirmation of RxQual as a reliable indicator of speech quality. As for Ec/N0, it is not possible to state it as a speech quality indicator however, it shows clear thresholds for which the MOS values decrease significantly. The studied transmission parameters show that they can be used not only for network management purposes but, at the same time, give an expected idea to the communications engineer (or technician) of the end-to-end speech quality consequences. With the conclusion of the work new ideas for future studies come to mind. Considering that the fourth-generation (4G) cellular technologies are now beginning to take an important place in the global market, as the first all-IP network structure, it seems of great relevance that 4G speech quality should be subject of evaluation. Comparing it to 3G, not only in narrowband but also adding wideband scenarios with the most recent standard objective method of speech quality assessment, POLQA. Also, new data found on Ec/N0 tests, justifies further research studies with the intention of validating the assumptions made in this work.Com o mercado das redes móveis a atingir níveis de competitividade nunca antes vistos, existe a crescente necessidade por parte dos operadores de rede em focar-se na Qualidade de Serviço (QoS) como principal prioridade, no sentido de atrair novos clientes ao mesmo tempo que asseguram a satisfação dos seus actuais assinantes. A percepção da Qualidade de Voz, por parte do utilizador, é apenas um exemplo de uma característica de QoS em constante necessidade de manutenção e melhoramento. Sendo nesta temática em que se insere a Tese de Mestrado. Aplicando um método intrusivo de avaliação de qualidade de voz, como meio para um estudo mais aprofundado e, ao mesmo tempo, caracterizando o desempenho dos codecs de voz para as tecnologias de segunda-geração (2G) e terceira-geração (3G). Investigando nova informação que possa ser retirada da correlação entre codecs com bit rates semelhantes, juntamente com a exploração de determinados 'parâmetros de transmissão os quais podem auxiliar na avaliação da qualidade de voz. Devido a algumas limitações ligadas ao analisador de áudio (requisito neste tipo de aplicações), existiu a necessidade de procurar um sistema distinto para gravação das amostras de teste. Embora o sistema escolhido não seja padronizado para este tipo de ensaios, após vários testes e consequente optimização dos parâmetros do sistema, os resultados finais consideram-se credíveis e satisfatórios. Os testes efectuados incluem um conjunto de codecs de elevado e baixo bit rate, onde a comparação e análise dos resultados levam a concluir que codecs de voz 3G têm melhor desempenho, sob aproximadamente as mesmas condições, comparativamente com os 2G. Reforçando a ideia generalizada que 3G é, sem dúvida, a melhor escolha se o utilizador procura uma solução superior a nível de qualidade de voz. No que diz respeito aos parâmetros de transmissão escolhidos para a experiência, RxQual (Qualidade do sinal Recebido pela estacão móvel) e Ec/N0 (razão entre Energia por chip e a Densidade Espectral de Potência), estes foram sujeitos a testes de correlação com a qualidade de voz. Os resultados de RxQual foram sujeitos a comparação com estudos prévios de outros investigadores, confirmando este parâmetro como um indicador de qualidade de voz bastante fiável. Quanto a Ec/N0, não é possível declará-lo como um indicador de qualidade de voz, no entanto, este demonstra limites claros para os quais os valores de Mean Opinion Score (MOS) decrescem significativamente. Os parâmetros de transmissão estudados demonstram não só que podem ser utilizados com objectivos de gestão de rede mas como também podem fornecer, ao engenheiro (ou técnico), informação relativa ao impacto que poderá existir na qualidade de voz. Com a finalização deste trabalho é possível constatar que novos estudos devem ser efectuados. Considerando que a tecnologia de quarta-geração (4G) começa agora a dar os seus primeiros passos no mercado das redes móveis, como a primeira com arquitectura de rede totalmente orientada para IP, parece de grande importância que esta tecnologia seja sujeita a avaliação. Comparando-a com 3G, não só para banda-estreita (300 a 3400 Hz) como também para cenários de banda-larga (50 a 7000Hz), aplicando o mais recente método normalizado de avaliação de qualidade de voz, o POLQA. Por fim, também se verifica como pertinente uma continuação do estudo relativo a Ec/N0 a fim de validar as ilações retiradas neste trabalho

Nursing diagnosis: impaired physical mobility in patients with stroke

The study aimed to investigate the occurrence of Nursing Diagnosis Impaired Physical Mobility in patients with stroke. This exploratory study was developed at rehabilitation units from November 2007 to march 2008, through an interview and physical examination. Nursing diagnoses were made using NANDA Taxonomy II. A total 121 patients were evaluated. Subjects' average age was 62.1 years, 52.3% were males with an average 1.5 stroke events in 3.4 years. The diagnosis was present in 90%, with an average of 5.8 defining characteristic. Difficulty turning was the most present characteristic and there were 3.4 related factors per patient, and most reported decreased strength and endurance besides neuromuscular impairment (100%). There should be a closer look towards this diagnosis when planning interventions after a stroke with aiming at health promotion for these patients.O estudo teve como objetivo investigar a ocorrência do diagnóstico de enfermagem Mobilidade Física Prejudicada em pacientes com AVE. Estudo exploratório, desenvolvido em unidades de reabilitação, de novembro de 2007 a março de 2008, por meio de entrevista e exame físico. A Taxonomia II da NANDA foi utilizada para a identificação do diagnóstico. Foram avaliados 121 indivíduos, com idade média de 62,1 anos, 52,3% homens, com média de 1,5 episódio de AVE em 3,4 anos. O diagnóstico esteve presente em 90%, com média de 5,8 características definidoras. Dificuldade para virar-se foi a característica mais presente, e 3,4 fatores foram relacionados por paciente, com destaque para a Força muscular diminuída, além de Prejuízos neuromusculares (100%). Destaca-se a necessidade de enfocar-se esse diagnóstico no planejamento das intervenções após o AVE, com vistas à promoção da saúde desses pacientes.El estudio tuvo como objetivo investigar la ocurrencia del diagnóstico de enfermería Movilidad física disminuida en pacientes con AVE. Estudio exploratorio, desarrollado en unidades de rehabilitación, desde noviembre de 2007 a marzo de 2008, a través de entrevistas y exámenes físicos. Para la identificación del diagnóstico se utilizó la Taxonomía II de la NANDA. Fueron evaluados 121 individuos, con edad media de 63,1 años, 52,3% hombres, con un promedio de 1,5 episodios de AVE en 3,4 años. El diagnóstico se verificó en el 90%, con una media de 5,8 características distintivas. La dificultad para darse vuelta fue la característica más presente, con 3,4 factores relacionados por paciente, con relevancia de la fuerza muscular disminuida, además de trastornos neuromusculares (100%). Se destaca la necesidad de enfocarse ese diagnóstico en el planeamiento de las intervenciones posteriores al AVE, en vistas a la mejoría de la salud de dichos pacientes

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Comparison of questionnaire and accelerometer-based assessments of physical activity in patients with heart failure with preserved ejection fraction: clinical and prognostic implications

Objective. (i) To compare daily physical activity (PA) levels evaluated by the International Physical Activity Questionnaire (IPAQ) and by triaxial accelerometry in heart failure with preserved ejection fraction (HFpEF) patients; (ii) to describe daily PA patterns based in objective measurements; and (iii) to observe the association between prognostic indicators and PA measurements. Design. This is a cross-sectional study with 24 stable HFpEF patients. PA was assessed through the IPAQ short version and triaxial accelerometer. Time spent in moderate-to-vigorous PA (MVPA) from IPAQ was computed as self-reported walking and MVPA. Prognostic indicators were: distance on the 6-minute-walking test (6MWT), oxygen consumption (VO2) during the test, quality of life (QoL), BNP plasma level, and E/e' ratio. Results. Compared to accelerometry, IPAQ underestimated sedentary time (253 ± 156 vs. 392 ± 104 min/day, p = .001) and overestimated MVPA (44 ± 56 vs. 19.3 ± 26 min/day, p < .001). Accelerometer-derived data showed that HFpEF patients spent 50% of their waking time in sedentary behaviours and 2.5% in MVPA. Of measured surrogate prognostic markers, functional capacity (6MWT, r = 0.652, p = .04; VO2, r = 0.512, p = .02) and QoL (r=-0.490, p = .04) were correlated with MVPA. Conclusions. The IPAQ underestimated sedentary time and over-estimated MVPA in HFpEF patients. Using accelerometer-derived data, HFpEF patients spent only a minority of their time involved in MVPA, which was the only PA pattern positively associated with prognostic indicators.info:eu-repo/semantics/publishedVersio

Equilíbrio Dinâmico e Mobilidade Explicam a Qualidade de Vida na ICFEP, Superando Todos os Outros Componentes da Aptidão Física

Background Physical fitness is an important determinant of quality of life (QoL) in heart failure with preserved ejection fraction (HFpEF) patients. However, how the different physical fitness components correlate with the specific dimensions of QoL in HFpEF patients remains unknown. Objective To evaluate the association between different physical fitness components and QoL dimensions in HFpEF patients, and, assess which physical fitness components were independently associated to QoL. Methods Patients with HFpEF were assessed for physical fitness [dynamic balance and mobility (8-foot-up-and go test), upper body strength (handgrip), cardiorespiratory fitness (CRF) (6-minute-walking test) and body composition (body mass index)] and for QoL (Minnesota Living With Heart Failure Questionnaire). Partial correlation was used to verify the association between physical fitness components and QoL dimensions. The determination of independent predictors in QoL dimensions was assessed through stepwise multivariate linear regression analysis. Statistical significance was set at p<0.05. Results Both CRF and dynamic balance and mobility are significantly associated with the total score and physical dimensions of QoL (p<0.05), but only dynamic balance and mobility were concomitantly associated with the emotional dimension (r=0.597; p=0.004). Dynamic balance and mobility were independently associated with total score (β=0.651; r2=0.424; p=0.001), physical (β=0.570; r2=0.324; p=0.04) and emotional (β=0.611; r2=0.373 p=0.002) dimensions of QoL. Conclusion Our data suggests that dynamic balance and mobility better assess QoL than CRF, which is commonly measured in clinical practice. Whether interventions specifically targeting dynamic balance and mobility have different impacts on QoL remains unknown. (Arq Bras Cardiol. 2020; 114(4):701-707).CIAFEL recebeu apoio da FCT através do financiamento [UID/DTP/00617/2019]. A UnIC é financiada pela FCT através do financiamento [UID/IC/00051/2019] e [UID/ DTP/00617/2019]. Este trabalho foi financiado pelos projetos [PTDC/MEC-CAR/30011/2017] [POCI-01- 0145FEDER-030011]. Cristine Schmidt recebeu financiamento individual da CAPES [BEX 0554/14-6]info:eu-repo/semantics/publishedVersio

ACIDENTE VASCULAR ENCEFÁLICO: PERFIL DE INDICADORES DE RISCO

El conocimiento de los indicadores de riesgo auxilia en la construcción de estrategias más eficaces de intervención en las personas con accidente cerebrovascular (ACE) El objetivo del estudio fue identificar los indicadores de riesgo en los clientes que sobrevivieron a esta enfermedad. Estudio transversal, realizado con 121 clientes que frecuentaban unidades de rehabilitación en Fortaleza. Datos recogidos de noviembre del 2007 a marzo del 2008, a través de entrevista. El promedio de edad fue 61,6 años (± 12,4). La mayoría era del sexo masculino (52,9%). Los clientes presentaron en promedio 1,4 (±1,0) episodios de ACV. De los indicadores de riesgo, el de mayor presencia fue la hipertensión arterial (85,1%), seguido por el sedentarismo (58,7%), y dislipidemias (29,8%). Se concluye que la hipertensión arterial fue el indicador de riesgo más percibido y que las medidas de control de esa enfermedad deben ser implementadas para reducir el riesgo de nuevos ACV

Ações primárias em saúde cardiovascular: avaliação de indicadores de risco em escolares

Estudos sobre indicadores de risco cardiovasculares são importantes em escolares. O objetivo do estudo foi associaros valores da pressão arterial sistólica (PAS) e da pressão arterial diastólica (PAD) com os dados antropométricosíndice de massa corporal (IMC), relação cintura-quadril (RCQ), pregas cutâneas tricipital e subescapular,sedentarismo, etilismo, tabagismo e história familiar de alterações cardiovasculares nos escolares que mantiveramvalores da pressão arterial acima do percentil 90 em três avaliações da saúde cardiovascular. Estudo de coorte,realizado em uma escola pública de Fortaleza, no período de 2004 a 2006. Foram avaliados os indicadores de risco e apressão arterial de 480 escolares. Os escolares que apresentaram, na primeira avaliação, valores iniciais da pressãoarterial acima do percentil 90 foram acompanhados em mais duas avaliações, com vistas a se confirmar alterações dapressão arterial. A amostra foi composta por 85 escolares. Nas crianças os valores da PAS estiveram correlacionadoscom a idade e a altura. Já a PAD esteve correlacionada com o perímetro do quadril, peso e altura. Nos adolescentes,os valores da PAS e da PAD estiveram correlacionados com a altura. Reforça-se a importância de estudos que avalieme acompanhem os indicadores de risco e a pressão arterial de escolares