409 research outputs found
GTM User Modeling for aIGA Weight Tuning in TTS Synthesis
No full textUnit Selection Text-to-Speech Synthesis (US-TTS) systems produce synthetic speech based on the retrieval of previous recorded speech units from a speech database (corpus) driven by a weighted cost function (Black & Campbell, 1995). To obtain high quality synthetic speech these weights must be optimized efficiently. To that effect, in previous works, a technique was introduced for weight tuning based on evolutionary perceptual tests by means of Active Interactive Genetic Algorithms (aiGAs) (Alías, Llorà, Formiga, Sastry & Goldberg, 2006) aiGAs mine models that map subjective preferences from users by partial ordering graphs, synthetic fitness and Evolutionary Computation (EC) (Llorà, Sastry, Goldberg, Gupta & Lakshmi, 2005). Although aiGA propose an effective method to map single user preferences, as far as we know, the methodology to extract common solutions among different individual preferences (hereafter denoted as common knowledge) has not been tackled yet. Furthermore, there is an ambiguity problem to be solved when different users evolve to different weight configurations. In this review, Generative Topographic Mapping (GTM) is introduced as a method to extract common knowledge from aiGA models obtained from user preferences. </jats:p
Delirium in Australian hospitals: a prospective study
No full textObjectives. Australian data regarding delirium in older hospitalized patients are limited. Hence, this study aimed to determine the prevalence and incidence of delirium among older patients admitted to Australian hospitals and assess associated outcomes. Method. A prospective observational study (n = 493) of patients aged ≥70 years admitted to four Australian hospitals was undertaken. Trained research nurses completed comprehensive geriatric assessments using standardized instruments including the Confusion Assessment Method to assess for delirium. Nurses also visited the wards daily to assess for incident delirium and other adverse outcomes. Diagnoses of dementia and delirium were established through case reviews by independent physicians. Results. Overall, 9.7% of patients had delirium at admission and a further 7.6% developed delirium during the hospital stay. Dementia was the most important predictor of delirium at (OR = 3.18, 95% CI: 1.65-6.14) and during the admission (OR = 4.82; 95% CI: 2.19-10.62). Delirium at and during the admission predicted increased in-hospital mortality (OR = 5.19, 95% CI: 1.27-21.24; OR = 31.07, 95% CI: 9.30-103.78). Conclusion. These Australian data confirm that delirium is a common and serious condition among older hospital patients. Hospital clinicians should maintain a high index of suspicion for delirium in older patients
Material didático em educação a distância: fragmentação da docência ou autoria
No full textThe article aims to present an understanding of the production of teaching materials for courses in Distance Education (DE). From the perception that the teaching material is an important part of most projects of this practice, we aim to perceive the concept of education underlying this production. We also search to investigate models that tend to prevail in contemporary practices of distance education in Brazil. The investigation, still in progress, discusses two possible construction of educational material for distance education: the first, industrially and fragmented built , with emphasis on the transmission of knowledge and information, and the second possibility, assuming an accomplishment in a more artisanal and dynamic way based on teacher autonomy and authorship in the materials presented. The study focused on two specific courses DL UFJF belonging to the model of the Open University of Brazil (UAB) in order to compare two systems course in full operation. Questionnaires were administered to teachers of both courses, and interviews with teachers of the course that has pre-produced learning material. The results point to the effort made by professors to be the author of their disciplines, even when pushed to the use of educational materials developed without their participation
Oral anticoagulant use and appropriateness in elderly patients with atrial fibrillation in complex clinical conditions: CONVENIENCE study
No full textNon-valvular atrial fibrillation (NVAF) is the most common arrhythmia in older patients. Although direct-acting oral anticoagulants (DOAC) are the antithrombotic treatment of choice, irrespective of age, certain factors may limit their use. The aim of the ACONVENIENCE study was to consult the opinion of a multidisciplinary panel of experts on the appropriateness of using OACs in elderly patients (>75 years) with NVAF associated with certain complex clinical conditions. A consensus project was performed on the basis of a systematic review of the literature, and application of a two-round Delphi survey. The agreement of 79 panellists on 30 Delphi-type statements was evaluated, and their opinion on the appropriateness of different oral anticoagulants in 16 complex clinical scenarios was assessed. A total of 27 consensus statements were agreed upon, including all statements addressing anticoagulation in older patients and in patients at high risk of bleeding complications, and most of those addressing frailty, dementia, risk of falling, and complex cardiac situations. It was almost unanimously agreed upon that advanced age should not influence the anticoagulation decision. Apixaban was the highest-rated therapeutic option in 14/16 situations, followed by edoxaban. There is a high degree of agreement on anticoagulation in older patients with NVAF. Age should not be the single limiting factor when prescribing OACs, and the decision should be made based on net clinical benefit and a comprehensive geriatric assessment. Apixaban, followed by edoxaban, was considered the most appropriate treatment in the various complex clinical situations examined
Anemia is a mortality prognostic factor in patients initially hospitalized for acute heart failure
No full textAnemia is a risk factor related to morbidity and mortality in patients with chronic heart failure (HF). Less is known about its influence in patients in an early stage of HF. Our aim is to investigate the prognostic role of anemia in patients initially hospitalized for acute HF. We reviewed all consecutive patients admitted within a 18-month period with a main diagnosis of acute HF. We collected demographic, clinical and treatment data. Anemia is defined as Hemoglobin <12/13 g/dL upon admission in female/male patients, respectively. 719 patients were included (55.5% female), with a mean age of 78.7 ± 9 years. Anemia was present in 59.6% of patients upon admission, with a mean Hb of 10.4 ± 1.4 g/dL. Multivariate analysis confirms the relationship between the presence of anemia and older age, a previous diagnostic history of diabetes, and the presence of chronic kidney disease. In-hospital mortality is similar for anemic and non-anemic patients (6.8 vs 3.8%, p = n.s.) However, the difference is significant when one-year mortality is evaluated (31% in anemic patients vs 19% in non-anemic patients, p < 0.001). Cox regression analysis confirms the association between anemia and higher risk of one-year mortality, as well as with older age and a higher Charlson comorbidity index. Our study confirms that the presence of anemia is an independent factor for mid-term (1-year) mortality even in patients experiencing a first admission due to acute HF
Tratamiento farmacológico inicial del paciente con insuficiencia cardíaca con función sistólica reducida: ¿es importante el orden de inicio y las dosis conseguidas?
No full textDigoxina en insuficiencia cardíaca reducida y ritmo sinusal. ¿Cuándo debemos indicarla en el año 2018?
No full textExtracting User Preferences by GTM for aiGA Weight Tuning in Unit Selection Text-to-Speech Synthesis
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