End-to-End QoS Enhancement ofHSDPA End-User Multi-flow Traffic Using RAN Buffer Management

High speed downlink packet access (HSDPA) was introduced to UMTS radio access segment to provide higher capacity for new packet switched services. As a result, packet switched sessions with multiple diverse traffic flows such as concurrent voice and data, or video and data being transmitted to the same user are a likely commonplace cellular packet data scenario. In HSDPA, radio access network (RAN) buffer management schemes are essential to support the end-to-end QoS of such sessions. Hence in this paper we present the end-to-end performance study of a proposed RAN buffer management scheme for multi-flow sessions via dynamic system-level HSDPA simulations. The scheme is an enhancement of a time-space priority (TSP) queuing strategy applied to the node B MAC-hs buffer allocated to an end user with concurrent real-time (RT) and non-real-time (NRT) flows during a multi-flow session. The experimental multi- flow scenario is a packet voice call with concurrent TCP-based file download to the same user. Results show that with the proposed enhancements to the TSP-based RAN buffer management, end-to-end QoS performance gains accrue to the NRT flow without compromising RT flow QoS of the same end user session

A Dynamic Buffer Management Scheme for End-to-End QoS Enhancement of Multi-flow Services in HSDPA

End-user multi-flow services support is a crucial aspect of current and next generation mobile networks. This paper presents a dynamic buffer management strategy for HSDPA end-user multi-flow traffic with aggregated real-time and non-real-time flows. The scheme incorporates dynamic priority switching between the flows for transmission on the HSDPA radio channel. The end-to-end performance of the proposed strategy is investigated with an end-user multi-flow session of simultaneous VoIP and TCP-based downlink traffic using detailed HSDPA system-level simulations. Compared to an equivalent static buffer management scheme, the results show that end-to-end throughput performance gains in the non-real-time flow and better HSDPA channel utilization is attainable without compromising the real-time VoIP flow QoS constraints

General Nurses’ Experiences of End-Of-Life Care in the Acute Hospital Setting

Approximately 90% of the UK population spend some time in hospital in their final year of life, and more than half of the population die in hospital. This review aims to explore the experiences of general nurses when providing end-of-life care to patients in the acute hospital setting. Nine studies were identified through a literature search, and each was then analysed and evaluated until themes emerged. Six themes were drawn from the literature: lack of education and knowledge, lack of time with patients, barriers arising in the culture of the health-care setting, communication barriers, symptom management, and nurses' personal issues. The themes cause concern about the quality of end-of-life care being provided in the acute care setting. The literature appears to be consistent in the view that terminally ill patients are best cared for in specialised care settings, such as palliative care units and hospices. However, increasing demands on health services will result in greater numbers of dying patients being admitted to the acute hospital setting. It is therefore paramount that general nurses' educational needs are met to ensure they develop clinical competence to provide high-quality holistic end-of-life care.

Advances in joint modelling: A review of recent developments with application to the survival of end stage renal disease patients

The use of joint modelling approaches is becoming increasingly popular when an association exists between survival and longitudinal processes. Widely recognized for their gain in efficiency, joint models also offer a reduction in bias compared with naïve methods. With the increasing popularity comes a constantly expanding literature on joint modelling approaches. The aim of this paper is to give an overview of recent literature relating to joint models, in particular those that focus on the time-to-event survival process. A discussion is provided on the range of survival submodels that have been implemented in a joint modelling framework. A particular focus is given to the recent advancements in software used to build these models. Illustrated through the use of two different real-life data examples that focus on the survival of end-stage renal disease patients, the use of the JM and joineR packages within R are demonstrated. The possible future direction for this field of research is also discussed. © 2013 International Statistical Institute.

Substrates modified by advanced glycation end-products cause dysfunction and death in retinal pericytes by reducing survival signals mediated by platelet-derived growth factor

AIMS/HYPOTHESIS: Premature death of retinal pericytes is a pathophysiological hallmark of diabetic retinopathy. Among the mechanisms proposed for pericyte death is exposure to AGE, which accumulate during diabetes. The current study used an in vitro model, whereby retinal pericytes were exposed to AGE-modified substrate and the mechanisms underlying pericyte death explored. METHODS: Pericytes were isolated from bovine retinal capillaries and propagated on AGE-modified basement membrane (BM) extract or non-modified native BM. The extent of AGE modification was analysed. Proliferative responses of retinal pericytes propagated on AGE-modified BM were investigated using a 5-bromo-2-deoxy-uridine-based assay. The effect of extrinsically added platelet-derived growth factor (PDGF) isoforms on these proliferative responses was also analysed alongside mRNA expression of the PDGF receptors. Apoptotic death of retinal pericytes grown on AGE-modified BM was investigated using terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling labelling, mitochondrial membrane depolarisation and by morphological assessment. We also measured both the ability of PDGF to reverse Akt dephosphorylation that was mediated by AGE-modified BM, and increased pericyte apoptosis. RESULTS: Retinal pericytes exposed to AGE-modified BM showed reduced proliferative responses in comparison to controls (p

CD2AP is associated with end-stage renal disease in patients with type 1 diabetes

CD2-associated protein (CD2AP) is essential for podocyte function. CD2AP mutations have been found in patients with focal segmental glomerulosclerosis, a disease histologically resembling diabetic nephropathy and often progressing to end-stage renal disease (ESRD). We hypothesised that variations in the CD2AP gene may contribute to susceptibility to glomerular injury in diabetes and investigated if single-nucleotide polymorphisms (SNPs) in CD2AP are associated with diabetic nephropathy in patients with type 1 diabetes. The discovery cohort consisted of 2,251 Finnish patients with type 1 diabetes. SNPs were selected from the HapMap database to cover the CD2AP gene. The associations between genotyped SNPs and diabetic nephropathy or ESRD were analysed with the chi-squared test and logistic regression. Three SNPs were selected for replication in cohorts from Denmark, Italy, the United Kingdom and Ireland. None of the 15 successfully genotyped SNPs were associated with diabetic nephropathy when compared to patients with normal albumin excretion rate. However, when genotype frequencies in patients with ESRD were compared with all other patients, two CD2AP SNPs, rs9369717 and rs9349417, were found to be associated with ESRD. The meta-analysis of the original and two additional European cohorts resulted in significant p values

Simulation of three-dimension cutting force and tool deflection in the end milling operation based on finite element method

This paper presents a 3D simulation system which is employed in order to predict cutting forces and tool deflection during end-milling operation. In order to verify the accuracy of 3D simulation, results (cutting forces and tool deflection) were compared with those based on the theoretical relationships, in terms of agreement with experiments. The results obtained indicate that the simulation is capable of predicting the cutting forces and tool deflection.