Packet backbone design differences between commercial network and Container Trial System of LTE/SAE

The mobile networks of earlier and current generations, or 2G and 3G networks, provide users voice and packet services with higher transmission rates and good quality over the same core network. When developing the next generation of mobile networks the current quality of services needs to be maintained. This thesis concentrates on the next generation mobile network, especially on the evolution of the packet network part. The new mobile network has requirements for the common packet backbone network, Mobile Packet Backbone Network, which is additionally discussed in this study. The next generation mobile network, called LTE/SAE, is currently under testing. The test system is called Container Trial System. It is a mini sized LTE/SAE site. The LTE/SAE is studied in this thesis concentrating on the evolved packet core, the SAE part of the composition. The empirical part of the study compares the LTE/SAE Container Trial System and commercial network designs and additionally produces documentation for internal personnel and customers. The research is performed by comparing the documentations and specifications of both the Container Trial System and commercial network. Since the LTE commercial network is not yet constructed, the comparison is done theoretically. The purpose is furthermore to find out if there are any design issues that could be done differently in the next version of the Container Trial System.

Analisi e ottimizzazione di un container management system nel settore automotive: Il caso Robert Bosch GmbH.

Il presente elaborato descrive l’attività di progetto svolta durante il periodo di tirocinio presso la business unit “automotive technologies” della Robert Bosch GmbH: la Robert Bosch GmbH Branch in Italy che ha sede a Torino, e che si configura come fornitore di componenti per l’industria automotive. La funzione logistica è l’ufficio in cui si è svolta l’esperienza di tirocinio, che si è sviluppato nell’ambito del progetto di Container Management System. In particolare, è stato analizzato il sistema di gestione dei Returnable Packaging relativi ai componenti che vengono forniti agli stabilimenti dei clienti localizzati in Italia. L’elaborato è composto da due parti: una parte teorica e una parte pratica. La parte teorica espone gli strumenti teorici sui quali si fondano i contenuti sviluppati nella parte pratica. La parte pratica è volta a descrivere l’attività di progetto da un punto di vista strettamente operativo. Il primo capitolo illustra i motivi che hanno determinato l’avvio del progetto. Sono poi messi in evidenza quali sono gli obiettivi intermedi e finali che si intendono raggiungere, declinandoli in termini di organizzazione del lavoro. Sono qui esposte le basi teoriche del metodo utilizzato e della disciplina a cui si fa riferimento. Viene inoltre dato spazio alla trattazione di alcuni topic nell’ambito dei Returnable Packaging, approfondendo l’argomento per il settore automotive. Il secondo capitolo descrive la struttura organizzativa, i settori di business e le attività svolte dal gruppo Robert Bosch GmbH nel mondo e in Italia. Viene dato particolare rilievo alla sede di Torino ed alla divisione logistica di quest’ultima, in modo tale da descrivere il contesto entro il quale si sviluppa il progetto. Il capitolo presenta infine gli attori che operano nella catena logistica analizzata, descrivendone le attività svolte e caratterizzando la rete logistica studiata al fine di definire i confini entro i quali si sviluppa il progetto. Il terzo capitolo presenta l’analisi effettuata sul caso in esame, descrivendone le modalità operative per ciascuna fase. Il quarto capitolo presenta delle osservazioni sull’analisi effettuata, la validazione tecnico econimica delle soluzioni proposte e le considerazioni conclusive.

Konttipaikannuksen toteutus konttitrukkiin

Diplomityössä perehdytään konttipaikannustekniikkaan, historiaan ja useisiin tekniikoihin joilla järjestelmiä voidaan toteuttaa. Huomiota on kiinnitetty erityisesti GPS paikannukseen ja satelliittien hyödyntämiseen merkintälaskussa. Lisäksi huomiota on kiinnitetty eri anturi tyyppeihin joita tullaan tarvitsemaan. Käytännön sovelluksena työssä on toteutettu konttipaikannus järjestelmä konttitrukkiin. Työssä on tarkasteltu eri teknisiä mahdollisuuksia ja niiden yhdistämistä niin, että saadaan toimiva sovellus.

Estudio de la competitividad e internacionalización de la navegabilidad del río Magdalena

La infraestructura colombiana es uno de los mayores problemas a los cuales se enfrenta el comercio en el país, debido a la situación en que se encuentran las carreteras, la falta de vías fluviales, férreas y las condiciones geográficas que se presentan. Es por esto que el gobierno plantea dentro del Plan Nacional de Desarrollo (PND), inversiones en infraestructura para mejorar las condiciones de esta, permitiendo atender las demandas de comercio. Uno de los mayores proyectos a los que se enfrenta el país es la “recuperación de la navegabilidad del río Magdalena” con el cual se pretenden ahorrar costos de transporte, optimizar las cantidades trasladadas y hacer efectivo y eficiente el comercio en Colombia. El presente trabajo, destaca la importancia que tiene esta vía fluvial, las ventajas que se obtendrán al recuperar el río y las obras a realizar para mejorar sus condiciones actuales.

Influence of temperature on the motility of Pseudomonas oryzihabitans and control of Globodera rostochiensis

The motility and efficacy of Pseudomonas oryzihabitans as a biocontrol agent against the potato cyst nematode Globodera rostochiensis were studied with respect to temperature. The influence of soil moisture on bacterial movement was also tested. In a closed container trial, P. oryzihabitans significantly reduced invasion of second stage juveniles (J2) of G. rostochiensis in potato roots, its effect being more marked at 25 and 21 degreesC than at 17 degreesC. P. oryzihabitans motility in vitro was optimal at 26 degreesC and inhibited at temperatures below 18 degreesC. In soil, both temperature and matric potential affected bacterial movement. At 16 degreesC its movement and survival were suppressed, but they were unaffected at 25 degreesC. At both temperatures the biocontrol agent moved faster in the wetter (- 0.03 MPa) than in the drier soil (- 0.1 MPa). These results suggest that temperature is a key factor in determining the potential of P. or.yzihabitans as a biocontrol agent. (C) 2003 Elsevier Science Ltd. All rights reserved.

Influence of temperature on the motility of Pseudomonas oryzihabitans and control of Globodera rostochiensis

The motility and efficacy of Pseudomonas oryzihabitans as a biocontrol agent against the potato cyst nematode Globodera rostochiensis were studied with respect to temperature. The influence of soil moisture on bacterial movement was also tested. In a closed container trial, P. oryzihabitans significantly reduced invasion of second stage juveniles (J2) of G. rostochiensis in potato roots, its effect being more marked at 25 and 21 degreesC than at 17 degreesC. P. oryzihabitans motility in vitro was optimal at 26 degreesC and inhibited at temperatures below 18 degreesC. In soil, both temperature and matric potential affected bacterial movement. At 16 degreesC its movement and survival were suppressed, but they were unaffected at 25 degreesC. At both temperatures the biocontrol agent moved faster in the wetter (- 0.03 MPa) than in the drier soil (- 0.1 MPa). These results suggest that temperature is a key factor in determining the potential of P. or.yzihabitans as a biocontrol agent. (C) 2003 Elsevier Science Ltd. All rights reserved.

Diseño y aplicación de una metodología prospectiva para la determinación de los condicionantes futuros del crecimiento de los grandes buques portacontenedores

Durante las últimas décadas se observa una tendencia sostenida al crecimiento en las dimensiones de los grandes buques portacontenedores, que produce, que las infraestructuras portuarias y otras destinadas al tráfico de contenedores deban adaptarse para poder brindar los servicios correspondientes y mantenerse competitivas con otras para no perder el mercado. Esta situación implica importantes inversiones y modificaciones en los sistemas de transporte de contenedores por el gran volumen de carga que se debe mover en un corto periodo de tiempo, lo que genera la necesidad de tomar previsiones relacionadas con la probable evolución a futuro de las dimensiones que alcanzarán los grandes buques portacontenedores. En relación a los aspectos citados surge la inquietud de determinar los condicionantes futuros del crecimiento de los grandes buques portacontenedores, con una visión totalizadora de todos los factores que incidirán en los próximos años, ya sea como un freno o un impulso a la tendencia que se verifica en el pasado y en el presente. En consideración a que el tema a tratar y resolver se encuentra en el futuro, con un horizonte de predicción de veinte años, se diseña y se aplica una metodología prospectiva, que permite alcanzar conclusiones con mayor grado de objetividad sobre probables escenarios futuros. La metodología prospectiva diseñada, conjuga distintas herramientas metodológicas, cualitativas, semi-cuantitativas y cuantitativas que se validan entre sí. Sobre la base del pasado y el presente, las herramientas cuantitativas permiten encontrar relaciones entre variables y hacer proyecciones, sin embargo, estas metodologías pierden validez más allá de los tres a cuatro años, por los vertiginosos y dinámicos cambios que se producen actualmente, en las áreas política, social y económica. Las metodologías semi-cuantitativas y cualitativas, empleadas en forma conjunta e integradas, permiten el análisis de circunstancias del pasado y del presente, obteniendo resultados cuantitativos que se pueden proyectar hacia un futuro cercano, los que integrados en estudios cualitativos proporcionan resultados a largo plazo, facilitando considerar variables cualitativas como la creciente preocupación por la preservación del medio ambiente y la piratería. La presente tesis, tiene como objetivo principal “identificar los condicionantes futuros del crecimiento de los grandes buques portacontenedores y determinar sus escenarios”. Para lo cual, la misma se estructura en fases consecutivas y que se retroalimentan continuamente. Las tres primeras fases son un enfoque sobre el pasado y el presente, que establece el problema a resolver. Se estudian los antecedentes y el estado del conocimiento en relación a los factores y circunstancias que motivaron y facilitaron la tendencia al crecimiento de los grandes buques. También se estudia el estado del conocimiento de las metodologías para predecir el futuro y se diseña de una metodología prospectiva. La cuarta fase, denominada Resultados, se desarrolla en distintas etapas, fundamentadas en las fases anteriores, con el fin de resolver el problema dando respuestas a las preguntas que se formularon para alcanzar el objetivo fijado. En el proceso de esta fase, con el objeto de predecir probables futuros, se aplica la metodología prospectiva diseñada, que contempla el análisis del pasado y el presente, que determina los factores cuya influencia provocó el crecimiento en dimensiones de los grandes buques hasta la actualidad, y que constituye la base para emplear los métodos prospectivos que permiten determinar qué factores condicionarán en el futuro la evolución de los grandes buques. El probable escenario futuro formado por los factores determinados por el criterio experto, es validado mediante un modelo cuantitativo dinámico, que además de obtener el probable escenario futuro basado en las tendencias de comportamiento hasta el presente de los factores determinantes considerados, permite estudiar distintos probables escenarios futuros en función de considerar un cambio en la tendencia futura de los factores determinantes. El análisis del pasado indica que la tendencia al crecimiento de los grandes buques portacontenedores hasta el presente, se ha motivado por un crecimiento económico mundial que se tradujo en un aumento del comercio internacional, particularmente entre los países de Asia, con Europa y Estados Unidos. Esta tendencia se ha visto favorecida por el factor globalización y la acelerada evolución tecnológica que ha permitido superar los obstáculos que se presentaron. Es de destacar que aún en periodos de crisis económicas, con pronósticos de contracciones en el comercio, en los últimos años continuó la tendencia al crecimiento en dimensiones, en busca de una economía de escala para el transporte marítimo de contenedores, en las rutas transoceánicas. La investigación de la evolución de los grandes buques portacontenedores en el futuro, se efectúa mediante el empleo de una metodología prospectiva en la que el criterio experto se valida con un método cuantitativo dinámico, y además se fundamenta en una solida base pre-prospectiva. La metodología diseñada permite evaluar con un alto grado de objetividad cuales serán los condicionantes que incidirán en el crecimiento en tamaño de los grandes buques portacontenedores en el escenario con mayor probabilidad de acontecer en los próximos veinte años (2032), y también en otros escenarios que podrían presentarse en el caso de que los factores modifiquen su tendencia o bien se produzcan hechos aleatorios. El resultado se sintetiza en que la tendencia al crecimiento de los grandes buques portacontenedores en los próximos 20 años se verá condicionada por factores en relación a los conceptos de oferta (los que facilitan u obstaculizan la tendencia), demanda (los que motivan o impulsan la tendencia) y factores externos (los que desestabilizan el equilibrio entre oferta y demanda). La tendencia al crecimiento de los grandes buques portacontenedores se verá obstaculizada / limitada principalmente por factores relacionados a las infraestructuras, resultando los pasos y/o canales vinculados a las rutas marítimas, los limitantes futuros al crecimiento en dimensiones de los grandes buques portacontenedores; y la interacción buque / infraestructura (grúas) un factor que tenderá a obstaculizar esta tendencia de los grandes portacontenedores. El desarrollo económico mundial que estimula el comercio internacional y los factores precio del petróleo y condicionantes medioambientales impulsarán la tendencia al crecimiento de los grandes buques portacontenedores. Recent years have seen a sustained tendency towards the growth in the dimensions of large container ships. This has meant that port and other infrastructure used for container traffic has had to be adapted in order to provide the required services and to maintain a competitive position, so as not to lose market share. This situation implies the need for major investments in modifications to the container transport system, on account of the large volume of traffic to be handled in a short period of time. This in turn has generated a need to make provision for the probable future evolution of the ultimate dimensions that will be reached by large container ships. Such considerations give rise to the question of what are the future determinants for the growth of large container ships, requiring an overall vision of all the factors that will apply in future years, whether as a brake on or an incentive to the growth tendency which has been seen in the past and present In view of the fact that the theme to be dealt with and resolved relates to the future, with a forecasting horizon of some 20 years, a foresight methodology has been designed and applied so as to enable conclusions about probable future scenarios to be reached with a greater degree of objectivity. The designed methodology contains different methodological tools, both qualitative, semi-quantitative and quantitative, which are internally consistent. On the basis of past and present observations, the quantitative elements enable relationships to be established and forecasts to be made. Nevertheless such an approach loses validity more than three or four years into the future, on account of the very rapid and dynamic changes which may be seen at present in political, social and economic spheres. The semi-quantitative and qualitative methodologies are used coherently together and allow the analysis of past and present conditions, thus obtaining quantitative results which for short-term projections, which when integrated with the qualitative studies provide results for the long-term, facilitating the consideration of qualitative variables such as the increasing importance of environmental protection and the impact of piracy. The principal objective of the present thesis is "to identify the future conditions affecting the growth of large container ships and to determine possible scenarios". The thesis is structured in consecutive and related phases. The first three phases focus on the past and present in order to determine the problem to be resolved. The background is studied in order to establish the state of knowledge about the factors and circumstances which have motivated and facilitated the growth tendency for large container ships and the methodologies that have been used. In this way a specific foresight methodology is designed. The fourth phase, Results, is developed in distinct stages based on the previous phases, so as to resolve the problem posed and responding to the questions that arise. In this way the determined objective is reached. The fourth phase sees the application of the methodology that has been designed in order to predict posible futures. This includes analysis of the past and present factors which have caused the growth in the dimensions of large container ships up to the present. These provide the basis on which to apply the foresight methods which enable the future factors which will condition the development of such large container ships. The probable future scenarios are made up of the factors identified by expert judgement (using the Delphi technique) and validated by means of a dynamic quantitative model. This model both identifies the probable future scenarios based on past and present factors and enables the different future scenarios to be analysed as a function of future changes in the conditioning factors. Analysis of the past shows that the growth tendency up to the present for large container ships has been motivated by the growth of the world economy and the consequent increased international trade, especially between the countries of Asia with Europe and the United States. This tendency has been favoured by the trend towards globalization and by the rapid technical evolution in ship design, which has allowed the obstacles encountered to be overcome. It should be noted that even in periods of economic crisis, with an expectation for reduced trade, as experienced in recent years, the tendency towards increased ship dimensions has continued in search of economies of scale for the maritime transport of containers on transoceanic routes. The present investigation of the future evolution of large container ships has been done using a foresight methodology in which the expert judgement is validated by a dynamic quantitative methodology, founded on a firm pre-foresight analysis. The methodology that has been designed permits the evaluation, with a high degree of objectivity, of the future factors that will affect the growth of large container ships for the most probable scenario expected in the next 20 years (up to 2032). The evaluation applies also to other scenarios which may arise, in the event that their component factors are modified or indeed in the light of random events. In summary, the conclusión is that the tendency for growth in large container ships in the future 20 years will be determined by: factors related to supply, which slow or halt the tendency; factors related to demand, which encourage the tendency and finally, external factors which interrupt the equilibrium between supply and demand. The tendency for increasing growth in large container ships will be limited or even halted by factors related to infrastructure, including the natural and man-made straits and canals used by maritime transport. In addition the infrastructure required to serve such vessels both in port (including cranes and other equipment) and related transport, will tend to slow the growth tendency. The factors which will continue to encourage the tendency towards the growth of large container ships include world economic development, which stimulates international trade, and an increasing emphasis on environmental aspects.

The Evolution and Reform of Summary Trials in Canadian Military Justice

There is a place where a Canadian citizen can be sent to 30 days detention, by someone who is not a judge, without being represented by counsel, and without having a meaningful right to appeal. It is the summary trial system of the Canadian Armed Forces. This thesis analyses that system and suggests reforms. It is aimed at those who have an interest in improving the administration of military justice at the unit level but want to sufficiently understand the issues before doing so. Through a classic legal approach with elements of legal history and comparative law, this study begins by setting military justice in the Canadian legal firmament. The introductory chapter also explains fundamental concepts, first and foremost the broader notion of discipline, for which summary trial is one of the last maintaining tools. Chapter II describes the current system. An overview of its historical background is first given. Then, each procedural step is demystified, from investigation until review. Chapter III identifies potential breaches of the Charter, highlighting those that put the system at greater constitutional risk: the lack of judicial independence, the absence of hearing transcript, the lack of legal representation and the disparity of treatment between ranks. Alternatives adopted in the Canadian Armed Forces and in foreign jurisdictions, from both common law and civil law traditions, in addressing similar challenges are reviewed in Chapter IV. Chapter V analyses whether the breaches could nevertheless be justified in a free and democratic society. Its conclusion is that, considering the availability of reasonable alternatives, it would be hard to convince a court that the current system is a legitimate impairment of the individual’s legal rights. The conclusion Chapter presents options to address current challenges. First, the approach of ‘depenalization’ taken by the Government in recent Bill C-71 is analysed and criticised. The ‘judicialization’ approach is advocated through a series of 16 recommendations designed not only to strengthen the constitutionality of the system but also to improve the administration of military justice in furtherance of service members’ legal rights.

Effect of the Novel Thienopyridine Prasugrel Compared With Clopidogrel on Spontaneous and Procedural Myocardial Infarction in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction 38 An Application of the Classification System From the Universal Definition of Myocardial Infarction

Background-Prasugrel is a novel thienopyridine that reduces new or recurrent myocardial infarctions (MIs) compared with clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention. This effect must be balanced against an increased bleeding risk. We aimed to characterize the effect of prasugrel with respect to the type, size, and timing of MI using the universal classification of MI. Methods and Results-We studied 13 608 patients with acute coronary syndrome undergoing percutaneous coronary intervention randomized to prasugrel or clopidogrel and treated for 6 to 15 months in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction (TRITON-TIMI 38). Each MI underwent supplemental classification as spontaneous, secondary, or sudden cardiac death (types 1, 2, and 3) or procedure related (Types 4 and 5) and examined events occurring early and after 30 days. Prasugrel significantly reduced the overall risk of MI (7.4% versus 9.7%; hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.67 to 0.85; P < 0.0001). This benefit was present for procedure-related MIs (4.9% versus 6.4%; HR, 0.76; 95% CI, 0.66 to 0.88; P = 0.0002) and nonprocedural (type 1, 2, or 3) MIs (2.8% versus 3.7%; HR, 0.72; 95% CI, 0.59 to 0.88; P = 0.0013) and consistently across MI size, including MIs with a biomarker peak >= 5 times the reference limit (HR. 0.74; 95% CI, 0.64 to 0.86; P = 0.0001). In landmark analyses starting at 30 days, patients treated with prasugrel had a lower risk of any MI (2.9% versus 3.7%; HR, 0.77; P = 0.014), including nonprocedural MI (2.3% versus 3.1%; HR, 0.74; 95% CI, 0.60 to 0.92; P = 0.0069). Conclusion-Treatment with prasugrel compared with clopidogrel for up to 15 months in patients with acute coronary syndrome undergoing percutaneous coronary intervention significantly reduces the risk of MIs that are procedure related and spontaneous and those that are small and large, including new MIs occurring during maintenance therapy. (Circulation. 2009; 119: 2758-2764.)

A randomised controlled trial of methadone maintenance treatment versus wait list control in an Australian prison system

Objectives: The aim was to determine whether methadone maintenance treatment reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners. Methods: All eligible prisoners seeking drug treatment were randomised to methadone or a waitlist control group from 1997 to 1998 and followed up after 4 months. Heroin use was measured by hair analysis and self report; drugs used and injected and syringe sharing were measured by self report. Hepatitis C and HIV incidence was measured by serology. Results: Of 593 eligible prisoners, 382 (64%) were randomised to MMT (n = 191) or control (n = 191). 129 treated and 124 control subjects were followed up at 5 months. Heroin use was significantly lower among treated than control subjects at follow up. Treated subjects reported lower levels of drug injection and syringe sharing at follow up. There was no difference in HIV or hepatitis C incidence. Conclusions: Consideration should be given to the introduction of prison methadone programs particular where community based programs exist. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access

Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

Randomized trial of pacemaker and lead system for safe scanning at 1.5 Tesla.

BACKGROUND: Magnetic resonance imaging (MRI) of pacemakers is a relative contraindication because of the risks to the patient from potentially hazardous interactions between the MRI and the pacemaker system. Chest scans (ie, cardiac magnetic resonance scans) are of particular importance and higher risk. The previously Food and Drug Administration-approved magnetic resonance conditional system includes positioning restrictions, limiting the powerful utility of MRI. OBJECTIVE: To confirm the safety and effectiveness of a pacemaker system designed for safe whole body MRI without MRI scan positioning restrictions. METHODS: Primary eligibility criteria included standard dual-chamber pacing indications. Patients (n = 263) were randomized in a 2:1 ratio to undergo 16 chest and head scans at 1.5 T between 9 and 12 weeks postimplant (n = 177) or to not undergo MRI (n = 86) post-implant. Evaluation of the pacemaker system occurred immediately before, during (monitoring), and after MRI, 1-week post-MRI, and 1-month post-MRI, and similarly for controls. Primary end points measured the MRI-related complication-free rate for safety and compared pacing capture threshold between MRI and control subjects for effectiveness. RESULTS: There were no MRI-related complications during or after MRI in subjects undergoing MRI (n = 148). Differences in pacing capture threshold values from pre-MRI to 1-month post-MRI were minimal and similar between the MRI and control groups. CONCLUSIONS: This randomized trial demonstrates that the Advisa MRI pulse generator and CapSureFix MRI 5086MRI lead system is safe and effective in the 1.5 T MRI environment without positioning restrictions for MRI scans or limitations of body parts scanned.

Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial.

BACKGROUND Breast cancer survivors suffer physical impairment after oncology treatment. This impairment reduces quality of life (QoL) and increase the prevalence of handicaps associated to unhealthy lifestyle (for example, decreased aerobic capacity and strength, weight gain, and fatigue). Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival. Nowadays, technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional. It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective resource to improve fitness and reduce musculoskeletal disorders of these women. METHODS / DESIGN This study will use a two-arm, assessor blinded, parallel randomized controlled trial design. People will be eligible if: their diagnosis is of stages I, II, or IIIA breast cancer; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence; and they have an interest in improving lifestyle. Participants will be randomized into e-CUIDATE or usual care groups. E-CUIDATE give participants access to a range of contents: planning exercise arranged in series with breathing exercises, mobility, strength, and stretching. All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs. The control group will be asked to maintain their usual routine. Study endpoints will be assessed after 8 weeks (immediate effects) and after 6 months. The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life questionnaire. The secondary outcomes: pain (algometry, Visual Analogue Scale, Brief Pain Inventory short form); body composition; physical measurement (abdominal test, handgrip strength, back muscle strength, and multiple sit-to-stand test); cardiorespiratory fitness (International Fitness Scale, 6-minute walk test, International Physical Activity Questionnaire-Short Form); fatigue (Piper Fatigue Scale and Borg Fatigue Scale); anxiety and depression (Hospital Anxiety and Depression Scale); cognitive function (Trail Making Test and Auditory Consonant Trigram); accelerometry; lymphedema; and anthropometric perimeters. DISCUSSION This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer. If this treatment option is effective, telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01801527.

Bridge to life: the Lifebridge B2T extracorporeal life support system in an in vitro trial.

Extracorporeal life support systems (ECLS) have become common in cardiothoracic surgery, but are still "Terra Incognita" in other medical fields due to the fact that perfusion units are normally bound to cardiothoracic centres. The Lifebridge B2T is an ECLS that is meant to be used as an easy and fast-track extracorporeal cardiac support to provide short-term perfusion for the transport of a patient to a specialized centre. With the Lifebridge B2T it is now possible to provide extracorporeal bypass for patients in hospitals without a perfusion unit. The Lifebridge B2T was tested on three calves to analyze the handling, performance and security of this system. The Lifebridge B2T safely can be used clinically and can provide full extracorporeal support for patients in cardiac or pulmonary failure. Flows up to 3.9 +/- 0.2l/min were reached, with an inflow pressure of -103 +/- 13mmHg, using a 21Fr. BioMedicus (Medtronic, Minneapolis, MN, USA) venous cannula. The "Plug and Play" philosophy, with semi-automatic priming, integrated check-list, a long battery time of over two hours and instinctively designed user interface, makes this device very interesting for units with high-risk interventions, such as catheterisation labs. If a system is necessary in an emergency unit, the Lifebridge can provide a high security level, even in centres not acquainted with cardiopulmonary bypass.