Protocol Specific Embedded Operating System

Sulautettujen järjestelmien määrä kuten niiden sisältämä älykkyyskin ovat viime vuosina kasvaneet merkittävästi. Sulautettujen ohjelmistojen yleistymistä ja monipuolistumista on edesauttanut sulautettujen laitteistojen prosessointitehon merkittävä kehittyminen, jonka myötä entistä vaativampien ohjelmistojen totetuttaminen sulautetusti on mahdollistunut. Seuraavana sulautettujen järjestelmien kehitysaskeleena on nähtävissä järjestelmien kommunikointikyvyn paraneminen ja siten uusien ja uudentyyppisten sulautettujen ratkaisujen toteuttaminen. VTT on päättänyt tutkia sulautettujen järjestelmien kommunikointia ja kehittää sulautettun protokolla-alustan. Tutkimuksen perusta on CVOPS protokollajärjestelmä, jota jatkokehittämällä pyritään toteuttamaan sulautettu protokollajärjestelmä, µCVOPS. Tässä diplomityössä esitetään kommunikaation sulautetulle järjestelmälle asettamia vaatimuksia, järjestelmän suunnittelu ja prototyypitys sulautetulla laitteistolla. Prototyypitykseen on käytetty sulautettua DragonBall mikrokontrolleria jonka käyttöjärjestelmänä käytettiin sulautettua Linux:a. Tälle alustalle on tehty CVOPS:sta modifioitu versio, jolla µCVOPS:ia pystytään simuloimaan.

Architecture for a Session Initiation Protocol Based Presence Client

Mitä on läsnäolo? Tämä työ määrittelee läsnäolon tietyn henkilön, laitteen tai palvelun halukkuudeksi kommunikoida. Nykyään on olemassa lukuisia läsnäolotietoa levittäviä sovelluksia, joista jokainen käyttää erilaista protokollaa tehtävän suorittamiseen. Vasta viime aikoina sovellusten kehittäjät ovat huomanneet tarpeen yhdelle sovellukselle, joka kykenee tukemaan lukuisia läsnäoloprotokollia. Session Initiation Protocol (SIP) voi levittää läsnäolotietoa muiden ominaisuuksiensa lisäksi. Kun muita protokollia käytetään vain reaaliaikaiseen viestintään ja läsnäolotiedon lähetykseen, SIP pystyy moniin muihinkin asioihin. Se on alunperin suunniteltu aloittamaan, muuttamaan ja lopettamaan osapuolien välisiä multimediaistuntoja. Arkkitehtuurin toteutus käyttää kahta Symbian –käyttöjärjestelmän perusominaisuutta: asiakas-palvelin rakennetta ja kontaktitietokantaa. Asiakaspalvelin rakenne erottaa asiakkaan protokollasta tarjoten perustan laajennettavalle usean protokollan arkkitehtuurille ja kontaktitietokanta toimii läsnäolotietojen varastona. Työn tuloksena on Symbianin käyttöjärjestelmässä toimiva läsnäoloasiakas.

Mobile Protocol Stack Simulator

Nykypäivän maailma tukeutuu verkkoihin. Tietokoneverkot ja langattomat puhelimet ovat jo varsin tavallisia suurelle joukolle ihmisiä. Uusi verkkotyyppi on ilmestynyt edelleen helpottamaan ihmisten verkottunutta elämää. Ad hoc –verkot mahdollistavat joustavan verkonmuodostuksen langattomien päätelaitteiden välille ilman olemassa olevaa infrastruktuuria. Diplomityö esittelee uuden simulaatiotyökalun langattomien ad hoc –verkkojen simulointiin protokollatasolla. Se esittelee myös kyseisten verkkojen taustalla olevat periaatteet ja teoriat. Lähemmin tutkitaan OSI-mallin linkkikerroksen kaistanjakoprotokollia ad hoc –verkoissa sekä vastaavan toteutusta simulaattorissa. Lisäksi esitellään joukko simulaatioajoja esimerkiksi simulaattorin toiminnasta ja mahdollisista käyttökohteista.

Protocol per a la implantació d'eines didàctiques virtuals: competències i habilitats adquirides pels estudiants

L"adaptació al nou espai europeu d"educació superior (EEES) ha plantejat alguns canvis en l"enfocament de la formació universitària al nostre país. On abans era el docent el protagonista, ara és l"estudiant el que pren el rol d"actor principal de la seva formació, i l"aprenentatge s"orienta cap a una autonomia i reflexió més grans. En aquest escenari, les noves tecnologies ofereixen un ampli ventall d"opcions per millorar els processos formatius. En aquests sentit, el Grup d"Innovació Docent G IDEA ha participat activament en aquest procés d"adaptació des de ja fa uns quants anys, i ha creat una sèrie de recursos docents digitals que han estat àmpliament provats en diversos ensenyaments de la Facultat d"Economia i Empresa de la Universitat de Barcelona. L"objectiu d"aquest article és presentar el protocol dissenyat per l"equip d"investigadors del G IDEA per implantar aquestes eines didàctiques (webquestes i exercicis tutoritzats), i també els resultats d"una enquesta de satisfacció sobre les competències i habilitats adquirides pels nostres estudiants en la utilització dels recursos. Els resultats mostren, d"una banda, que no ha estat possible crear un mateix protocol aplicable a tots els recursos, a causa de les diferències en els objectius didàctics de les distintes eines docents implantades. D"altra banda, la valoració que els estudiants fan de la utilització de les eines és molt positiva, tot i que hi ha algunes diferències entre els recursos analitzats. Conèixer la valoració que l"alumnat fa d"aquests recursos permet al grup d"investigadors poder-los millorar i adequar al perfil dels estudiants perquè aquests en puguin treure el màxim profit possible.

Cost evaluation and comparison of three decision strategies for cardiac revascularization : results of the suspected CAD protocol of the European CMR registry

Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness. Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD. Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.

A System-Level Simulation Model for a Protocol Processor

As the development of integrated circuit technology continues to follow Moore’s law the complexity of circuits increases exponentially. Traditional hardware description languages such as VHDL and Verilog are no longer powerful enough to cope with this level of complexity and do not provide facilities for hardware/software codesign. Languages such as SystemC are intended to solve these problems by combining the powerful expression of high level programming languages and hardware oriented facilities of hardware description languages. To fully replace older languages in the desing flow of digital systems SystemC should also be synthesizable. The devices required by modern high speed networks often share the same tight constraints for e.g. size, power consumption and price with embedded systems but have also very demanding real time and quality of service requirements that are difficult to satisfy with general purpose processors. Dedicated hardware blocks of an application specific instruction set processor are one way to combine fast processing speed, energy efficiency, flexibility and relatively low time-to-market. Common features can be identified in the network processing domain making it possible to develop specialized but configurable processor architectures. One such architecture is the TACO which is based on transport triggered architecture. The architecture offers a high degree of parallelism and modularity and greatly simplified instruction decoding. For this M.Sc.(Tech) thesis, a simulation environment for the TACO architecture was developed with SystemC 2.2 using an old version written with SystemC 1.0 as a starting point. The environment enables rapid design space exploration by providing facilities for hw/sw codesign and simulation and an extendable library of automatically configured reusable hardware blocks. Other topics that are covered are the differences between SystemC 1.0 and 2.2 from the viewpoint of hardware modeling, and compilation of a SystemC model into synthesizable VHDL with Celoxica Agility SystemC Compiler. A simulation model for a processor for TCP/IP packet validation was designed and tested as a test case for the environment.

Multimorbidity in primary care : protocol of a national cross-sectional study in Switzerland.

INTRODUCTION: With the ageing of the population and the general improvement of care, an increasing number of people are living with multiple chronic health conditions or 'multimorbidity'. Multimorbidity often implies multiple medical treatments. As a consequence, the risk of adverse events and the time spent by patients for their treatments increase exponentially. In many cases, treatment guidelines traditionally defined for single conditions are not easily applicable. Primary care for individuals with multimorbidity requires complex patient-centred care and good communication between the patient and the general practitioner (GP). This often includes prioritising among the different chronic conditions. METHODS AND ANALYSIS: The main objectives of this study are to describe the burden related to multimorbidity (disease-related burden and burden of treatment) in primary care and to identify the factors influencing it. Other objectives include evaluating patients' perception of treatment burden and quality of life, assessing factors influencing that perception, and investigating prioritisation in the management of multimorbidity from the perspectives of GPs and patients. For this cross-sectional study, patient enrolment will take place in GP's private practices across Switzerland. A convenient sample of 100 GPs will participate; overall, 1000 patients with at least three chronic health conditions will be enrolled. Data will be collected as paper-based questionnaires for GPs and delayed telephone interview questionnaires for patients. GPs will provide demographic and practice-related data. In addition, each GP will complete a paper-based questionnaire for each patient that they enrol. Each patient will complete a telephone interview questionnaire. ETHICS AND DISSEMINATION: This study has been approved by the research ethics committee of Canton Vaud, Switzerland (Protocol 315/14). The results of the study will be reported in international peer-reviewed journals.

PERC rule to exclude the diagnosis of pulmonary embolism in emergency low-risk patients: study protocol for the PROPER randomized controlled study.

BACKGROUND: The diagnosis of Pulmonary Embolism (PE) in the emergency department (ED) is crucial. As emergency physicians fear missing this potential life-threatening condition, PE tends to be over-investigated, exposing patients to unnecessary risks and uncertain benefit in terms of outcome. The Pulmonary Embolism Rule-out Criteria (PERC) is an eight-item block of clinical criteria that can identify patients who can safely be discharged from the ED without further investigation for PE. The endorsement of this rule could markedly reduce the number of irradiative imaging studies, ED length of stay, and rate of adverse events resulting from both diagnostic and therapeutic interventions. Several retrospective and prospective studies have shown the safety and benefits of the PERC rule for PE diagnosis in low-risk patients, but the validity of this rule is still controversial. We hypothesize that in European patients with a low gestalt clinical probability and who are PERC-negative, PE can be safely ruled out and the patient discharged without further testing. METHODS/DESIGN: This is a controlled, cluster randomized trial, in 15 centers in France. Each center will be randomized for the sequence of intervention periods: a 6-month intervention period (PERC-based strategy) followed by a 6-month control period (usual care), or in reverse order, with 2 months of "wash-out" between the 2 periods. Adult patients presenting to the ED with a suspicion of PE and a low pre test probability estimated by clinical gestalt will be eligible. The primary outcome is the percentage of failure resulting from the diagnostic strategy, defined as diagnosed venous thromboembolic events at 3-month follow-up, among patients for whom PE has been initially ruled out. DISCUSSION: The PERC rule has the potential to decrease the number of irradiative imaging studies in the ED, and is reported to be safe. However, no randomized study has ever validated the safety of PERC. Furthermore, some studies have challenged the safety of a PERC-based strategy to rule-out PE, especially in Europe where the prevalence of PE diagnosed in the ED is high. The PROPER study should provide high-quality evidence to settle this issue. If it confirms the safety of the PERC rule, physicians will be able to reduce the number of investigations, associated subsequent adverse events, costs, and ED length of stay for patients with a low clinical probability of PE. TRIAL REGISTRATION: NCT02375919 .

Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy.

BACKGROUND: Enhanced recovery after surgery (ERAS) programmes have been shown to decrease complications and hospital stay. The cost-effectiveness of such programmes has been demonstrated for colorectal surgery. This study aimed to assess the economic outcomes of a standard ERAS programme for pancreaticoduodenectomy. METHODS: ERAS for pancreaticoduodenectomy was implemented in October 2012. All consecutive patients who underwent pancreaticoduodenectomy until October 2014 were recorded. This group was compared in terms of costs with a cohort of consecutive patients who underwent pancreaticoduodenectomy between January 2010 and October 2012, before ERAS implementation. Preoperative, intraoperative and postoperative real costs were collected for each patient via the hospital administration. A bootstrap independent t test was used for comparison. ERAS-specific costs were integrated into the model. RESULTS: The groups were well matched in terms of demographic and surgical details. The overall complication rate was 68 per cent (50 of 74 patients) and 82 per cent (71 of 87 patients) in the ERAS and pre-ERAS groups respectively (P = 0·046). Median hospital stay was lower in the ERAS group (15 versus 19 days; P = 0·029). ERAS-specific costs were euro922 per patient. Mean total costs were euro56 083 per patient in the ERAS group and euro63 821 per patient in the pre-ERAS group (P = 0·273). The mean intensive care unit (ICU) and intermediate care costs were euro9139 and euro13 793 per patient for the ERAS and pre-ERAS groups respectively (P = 0·151). CONCLUSION: ERAS implementation for pancreaticoduodenectomy did not increase the costs in this cohort. Savings were noted in anaesthesia/operating room, medication and laboratory costs. Fewer patients in the ERAS group required an ICU stay.

Optimized exosome isolation protocol for cell culture supernatant and human plasma.

Extracellular vesicles represent a rich source of novel biomarkers in the diagnosis and prognosis of disease. However, there is currently limited information elucidating the most efficient methods for obtaining high yields of pure exosomes, a subset of extracellular vesicles, from cell culture supernatant and complex biological fluids such as plasma. To this end, we comprehensively characterize a variety of exosome isolation protocols for their efficiency, yield and purity of isolated exosomes. Repeated ultracentrifugation steps can reduce the quality of exosome preparations leading to lower exosome yield. We show that concentration of cell culture conditioned media using ultrafiltration devices results in increased vesicle isolation when compared to traditional ultracentrifugation protocols. However, our data on using conditioned media isolated from the Non-Small-Cell Lung Cancer (NSCLC) SK-MES-1 cell line demonstrates that the choice of concentrating device can greatly impact the yield of isolated exosomes. We find that centrifuge-based concentrating methods are more appropriate than pressure-driven concentrating devices and allow the rapid isolation of exosomes from both NSCLC cell culture conditioned media and complex biological fluids. In fact to date, no protocol detailing exosome isolation utilizing current commercial methods from both cells and patient samples has been described. Utilizing tunable resistive pulse sensing and protein analysis, we provide a comparative analysis of 4 exosome isolation techniques, indicating their efficacy and preparation purity. Our results demonstrate that current precipitation protocols for the isolation of exosomes from cell culture conditioned media and plasma provide the least pure preparations of exosomes, whereas size exclusion isolation is comparable to density gradient purification of exosomes. We have identified current shortcomings in common extracellular vesicle isolation methods and provide a potential standardized method that is effective, reproducible and can be utilized for various starting materials. We believe this method will have extensive application in the growing field of extracellular vesicle research.

Paediatric end-of-life care needs in Switzerland: current practices, and perspectives from parents and professionals. A study protocol.

AIM: To present a protocol for a multi-phase study about the current practice of end-of-life care in paediatric settings in Switzerland. BACKGROUND: In Switzerland, paediatric palliative care is usually provided by teams, who may not necessarily have specific training. There is a lack of systematic data about specific aspects of care at the end of a child's life, such as symptom management, involvement of parents in decision-making and family-centred care and experiences and needs of parents, and perspectives of healthcare professionals. DESIGN: This retrospective nationwide multicentre study, Paediatric End-of-LIfe CAre Needs in Switzerland (PELICAN), combines quantitative and qualitative methods of enquiry. METHODS: The PELICAN study consists of three observational parts, PELICAN I describes practices of end-of-life care (defined as the last 4 weeks of life) in the hospital and home care setting of children (0-18 years) who died in the years 2011-2012 due to a cardiac, neurological or oncological disease, or who died in the neonatal period. PELICAN II assesses the experiences and needs of parents during the end-of-life phase of their child. PELICAN III focuses on healthcare professionals and explores their perspectives concerning the provision of end-of-life care. CONCLUSION: This first study across Switzerland will provide comprehensive insight into the current end-of-life care in children with distinct diagnoses and the perspectives of affected parents and health professionals. The results may facilitate the development and implementation of programmes for end-of-life care in children across Switzerland, building on real experiences and needs. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01983852.

Protocol de conservació ex situ del Centre Ictiològic del Parc Natural del Delta de l'Ebre

En aquest Treball de Fi de Grau es pretén establir un protocol per a la conservació ex situ de les espècies que hi ha en el Centre Ictiològic del Parc Natural del Delta de l’Ebre. Les espècies que es troben en el CI són espècies vulnerables o en perill: espinós, samaruc, fartet, rabosa, llopet de riu i tritó palmat. Els objectius d’aquest protocol són: que el CI tingui un protocol propi, aprendre com funciona tot el centre, totes les espècies, com alimentar-les, com manipular-les i com tractar-les durant tot el seu cicle de vida. Un altre objectiu és el de veure si a finals d’any s’obté una alta població de cada espècie, quines són reintroduïdes, les patologies sorgides i els valors dels paràmetres químics de les basses naturals exteriors. El protocol s’elabora a partir de les pràctiques realitzades durant l’estiu del 2013 i els coneixements adquirits, la bibliografia i les dades del CI. Gràcies a això s’ha elaborat el treball. S’ha tractat la conservació ex situ; la problemàtica que sofreixen les espècies; cadascuna d’aquestes espècies; com funciona el CI a nivell de centre i a nivell de personal; les tasques que hi ha diàriament, setmanalment i ocasionalment segons les necessitats de l’estoc; el maneig sanitari; les patologies i com tractar-les; i l’anàlisi genètic. Els resultats obtinguts d’aquest protocol són els resultats numèrics obtinguts de l’any 2013 que són: 1. El gran nombre de cries nascudes de samaruc i fartet, menys de raboseta de riu, poques d’espinós i tritó palmat, i menys de llopet que tot just comença ara en el CI. 2. El total d’uns 5700 individus reitnroduits (samaruc, raboseta de riu i espinós de Girona). 3. La patologia més sorgida és el punt blanc. 4. I els paràmetres químics (amoni, nitrits, nitrats i fòsfor) no són molt elevats. La conclusió final i més important a la que arribo en fer el protocol és la gran importància que té el CI per a conservar aquestes espècies que no es saben apreciar fins que comencen a desparèixer. La existència del CI és més aviat una mesura correctora de tots els impactes que han sofert els habitatges de les espècies tractades i de la introducció d’espècies exòtiques que són una amenaça per les autòctones.

Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol.

INTRODUCTION: Cerebral palsy (CP) is the most common physical disability in childhood. It is a disorder resulting from sensory and motor impairments due to perinatal brain injury, with lifetime consequences that range from poor adaptive and social function to communication and emotional disturbances. Infants with CP have a fundamental disadvantage in recovering motor function: they do not receive accurate sensory feedback from their movements, leading to developmental disregard. Constraint-induced movement therapy (CIMT) is one of the few effective neurorehabilitative strategies shown to improve upper extremity motor function in adults and older children with CP, potentially overcoming developmental disregard. METHODS AND ANALYSIS: This study is a randomised controlled trial of children 12-24 months corrected age studying the effectiveness of CIMT combined with motor and sensory-motor interventions. The study population will comprise 72 children with CP and 144 typically developing children for a total of N=216 children. All children with CP, regardless of group allocation will continue with their standard of care occupational and physical therapy throughout the study. The research material collected will be in the form of data from high-density array event-related potential scan, standardised assessment scores and motion analysis scores. ETHICS AND DISSEMINATION: The study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER: NCT02567630.