Industrial wireless sensor networks (IWSNs) are used to acquire sensor data that need realtime processing, therefore they require predictable behavior and real-time guarantees. To be cost effective, ...IWSNs are also expected to be low cost and low power. In this context, Bluetooth low energy (BLE) is a promising technology, as it allows implementing low-cost industrial networks. As BLE is a shortrange technology, a multihop mesh network is needed to cover a large area. Nevertheless, the recently published Bluetooth mesh networking specifications do not provide support for real-time communications over multihop mesh networks. To overcome this limitation, this paper proposes the multihop real-time BLE (MRT-BLE) protocol, a real-time protocol developed on top of BLE, that allows for bounded packet delays over mesh networks. MRT-BLE also provides priority support. This paper describes in detail the MRT-BLE protocol and how to implement it on commercial-off-the-shelf devices. Two kinds of performance evaluation for the MRT-BLE protocol are provided. The first one is a worst case end-to-end delay analysis, while the second one is based on the experimental results obtained through measurements on a real testbed.
Summary Background Our previous study in patients with cerebellar ataxias of different causes showed significant benefit of riluzole after 8 weeks. We aimed to confirm these results in patients with ...spinocerebellar ataxia or Friedreich's ataxia in a 1-year trial. Methods Patients with spinocerebellar ataxia or Friedreich's ataxia (2:1 ratio) from three Italian neurogenetic units were enrolled in this multicentre, double-blind, placebo-controlled trial, and randomly assigned to riluzole (50 mg orally, twice daily) or placebo for 12 months. The randomisation list was computer-generated and a centralised randomisation system was implemented. Participants and assessing neurologists were masked to treatment allocation. The primary endpoint was the proportion of patients with improved Scale for the Assessment and Rating of Ataxia (SARA) score (a drop of at least one point) at 12 months. An intention-to-treat analysis was done. This trial is registered at ClinicalTrials.gov , number NCT01104649. Findings Between May 22, 2010, and Feb 25, 2013, 60 patients were enrolled. Two patients in the riluzole group and three in the placebo group withdrew their consent before receiving treatment, so the intention-to-treat analysis was done on 55 patients (19 with spinocerebellar ataxia and nine with Friedreich's ataxia in the riluzole group, and 19 with spinocerebellar ataxia and eight with Friedreich's ataxia in the placebo group). The proportion with decreased SARA score was 14 (50%) of 28 patients in the riluzole group versus three (11%) of 27 in the placebo group (OR 8·00, 95% CI 1·95–32·83; p=0·002). No severe adverse events were recorded. In the riluzole group, two patients had an increase in liver enzymes (less than two times above normal limits). In two participants in the riluzole group and two participants in the placebo group, sporadic mild adverse events were reported. Interpretation Our findings lend support to the idea that riluzole could be a treatment for cerebellar ataxia. Longer studies and disease-specific trials are needed to confirm whether these findings can be applied in clinical practice. Funding Agenzia Italiana del Farmaco.
Automated driving requires correct perception of the surrounding environment in any driving condition. To achieve this result, not only are many more sensors than in current Advanced Driver Assistant ...Systems (ADAS) needed, but such sensors are also of different types, such as radars, ultrasonic sensors, LiDARs, and video cameras. Given the high number of sensors and the bandwidth requirements of some of them, high-bandwidth automotive-grade networks are required. Ethernet technology is a suitable candidate, as it offers a broad selection of automotive-grade Ethernet physical layers, with transmission speeds ranging from 10 Mbps to 10 Gbps. In addition, the Time-Sensitive Networking (TSN) family of standards offers several features for Ethernet-based networks that are suitable for automotive communications, such as high reliability, bounded delays, support for scheduled traffic, etc. In this context, this paper provides an overview of Ethernet-based in-car networking and discusses novel trends and future developments in automotive communications.
Laparoscopic ventral hernia repair (LVHR) is a widely practiced treatment for primary (PH) and incisional (IH) hernias, with acceptable outcomes. Prevention of recurrence is crucial and still highly ...debated. Purpose of this study was to evaluate predictive factors of recurrence following LVHR with intraperitoneal onlay mesh with a single type of mesh for both PH and IH. A retrospective, multicentre study of data collected from patients who underwent LVHR for PH and IH with an intraperitoneal monofilament polypropylene mesh from January 2014 to December 2018 at 8 referral centers was conducted, and statistical analysis for risk factors of recurrence and post-operative outcomes was performed. A total of 1018 patients were collected, with 665 cases of IH (65.3%) and 353 of PH (34.7%). IH patients were older (p < 0.001), less frequently obese (p = 0.031), at higher ASA class (p < 0.001) and presented more frequently with large, swiss cheese type and border site defects (p < 0.001), compared to PH patients. Operative time and hospital stay were longer for IH (p < 0.001), but intraoperative and early post-operative complications and reinterventions were comparable. IH group presented at major risk of recurrence than PH (6.7% vs 0.9%, p < 0.001) and application of absorbable tacks resulted a significative predictive factor for recurrence increasing the risk by 2.94 (95% CI 1.18-7.31). LVHR with a light-weight polypropylene mesh has low intra- and post-operative complications and is appropriate for both IH and PH. Non absorbable tacks and mixed fixation system seem to be preferable to absorbable tacks alone.
Objectives
To evaluate, in a prospective study, high-resolution ultrasound (HRUS) changes of nerve segments in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and their relationships ...with clinical and electrodiagnostic (EDX) characteristics.
Methods
Twenty-three consecutive patients with CIDP were included in a 3-year follow-up (FU) study. Each patient underwent neurologic examination, EDX and HRUS study. HRUS was performed on median, ulnar and peroneal nerves, yielding a total of 319 scanned nerve segments. INCAT and MRC-sum scores, motor nerve conduction velocity (NCV), compound muscle action potential (cMAP) amplitude, and nerve cross-sectional area (NCSA) were collected at baseline and at FU end, and were used for statistical analysis. Twenty-two healthy individuals, matched to patients for age and BMI, served as controls.
Results
NCSA was higher in patients than in controls (
p
< 0.0001) and showed significant direct correlation with disease severity, and inverse correlation with NCV and cMAP amplitude, both at baseline and at FU end. Disease duration, clinical scores and EDX were predictors of NCSA enlargement at both time points. During FU, NCSA increased in 51% of nerve segments (
p
= 0.006), in correlation with INCAT increase and with NCV and cMAP reduction. Considering EDX changes in subgroups that reflect the different types of nerve damage, NCSA significantly increased in those nerve segments that from normal EDX switched to prevalent myelinopathic EDX characteristics.
Conclusions
Peripheral nerve size tends to increase over time in patients with CIDP, in correlation with clinical and EDX changes, in particular in those nerve segments that undergo a predominantly demyelinating damage.
Bluetooth Low Energy (BLE) is a wireless technology for low-power, low-cost and lowcomplexity short-range communications. On top of the BLE stack, the Bluetooth Mesh profile can be adopted to handle ...large networks with mesh topologies. BLE is a promising candidate for the implemention of Industrial Wireless Sensor Networks (IWSNs), thanks to its wide diffusion (e.g., on smartphones and tablets) and the lower cost of the devices compared to other wireless industrial communication technologies. However, neither the BLE nor the Bluetooth Mesh specifications can provide real-time messages with bounded delays. To overcome this limitation, this work proposes RESEMBLE, a real-time stack developed on top of BLE that is able to realize low-cost IWSNs over mesh topologies. RESEMBLE offers support to both real-time and non-real-time communications on the same network. Moreover, RESEMBLE provides clock synchronization, thus allowing for Time Division Multiple Access (TDMA) transmissions. The clock synchronization provided by RESEMBLE can be also exploited by the upper layers’ industrial applications to implement timecoordinated actions.
Some anti-cancer treatments (e. g., immunotherapies) determine, on the long term, a durable survival in a small percentage of treated patients; in graphical terms, long-term survivors typically give ...rise to a plateau in the right tail of the survival curve. In analysing these datasets, medians are unable to recognize the presence of this plateau. To account for long-term survivors, both value-frameworks of ASCO and ESMO have incorporated
corrections that upgrade the framework scores when a survival plateau is present. However, the empiric nature of these
corrections is self-evident. To capture the presence of a survival plateau by quantitative methods, two approaches have thus far been proposed: the milestone method and the area-under-the-curve (AUC) method. The first approach identifies a long-term time-point in the follow-up ("milestone") at which survival percentages are extracted. The second approach, which is based on the measurement of AUC of survival curves, essentially is the rearrangement of previous methods determining mean lifetime survival; similarly to the milestone method, the application of AUC can be "restricted" to a pre-specified time-point of the follow-up. This Mini-Review examines the literature published on this topic. The main characteristics of these two methods are highlighted along with their advantages and disadvantages. The conclusion is that both the milestone method and the AUC method are able to capture the presence of a survival plateau.
Spastic gait is a key feature in patients with hereditary spastic paraparesis, but the gait characterization and the relationship between the gait impairment and clinical characteristics have not ...been investigated.
To describe the gait patterns in hereditary spastic paraparesis and to identify subgroups of patients according to specific kinematic features of walking.
We evaluated fifty patients by computerized gait analysis and compared them to healthy participants. We computed time-distance parameters of walking and the range of angular motion at hip, knee, and ankle joints, and at the trunk and pelvis. Lower limb joint moments and muscle co-activation values were also evaluated.
We identified three distinct subgroups of patients based on the range of motion values. Subgroup one was characterized by reduced hip, knee, and ankle joint range of motion. These patients were the most severely affected from a clinical standpoint, had the highest spasticity, and walked at the slowest speed. Subgroup three was characterized by an increased hip joint range of motion, but knee and ankle joint range of motion values close to control values. These patients were the most mildly affected and had the highest walking speed. Finally, subgroup two showed reduced knee and ankle joint range of motion, and hip range of motion values close to control values. Disease severity and gait speed in subgroup two were between those of subgroups one and three.
We identified three distinctive gait patterns in patients with hereditary spastic paraparesis that correlated robustly with clinical data. Distinguishing specific features in the gait patterns of these patients may help tailor pharmacological and rehabilitative treatments and may help evaluate therapeutic effects over time.
Recent work on automotive communications based on the Time-Sensitive Networking (TSN) standards proposed an approach to handle all the real-time frames in a uniform way regardless of their arrival ...pattern. According to such an approach, instead of binding all the frames of the same flow to a traffic class, each periodic or event-driven frame is scheduled based on its absolute deadline according to the Earliest Deadline First (EDF) algorithm. The approach does not impose additional frame overhead and does not require complex offline configurations that would be unsuitable for event-driven traffic. However, EDF scheduling cannot support time-driven communications. To solve this problem, this paper proposes a framework that combines the flexibility of online EDF frame scheduling for both periodic and event-driven traffic with the ability to guarantee temporal isolation to time-driven traffic. The paper describes the design of the proposed approach and the performance obtained using the OMNeT++ simulation environment.
Inflammatory bowel diseases (IBDs) are generally not considered a risk factor for the development of lymphoma. When considering IBD treatments, there is good evidence supporting thiopurines ...(azathioprine, 6-mercaptopurine) as a risk factor for lymphoma. Conversely, the association between the use of anti-TNF agents and the development of lymphoma remains undetermined. In this systematic review, we analyzed the evidence coming from observational studies supporting an association between the use of anti-TNF drugs and lymphoma in patients with IBDs.
This systematic review was performed according with MOOSE and PRISMA statements. We searched observational studies conducted on IBD patients, using MEDLINE, EMBASE, and Google Scholar, published in English language, within the period ranging from January 1st, 1999 to June 30th, 2018. An assessment of the methodologic shortcomings of selected studies was performed as well.
Fourteen studies met the eligibility criteria and were included in the review. Only four studies found a significant association of anti-TNF drug with lymphoma or groups of cancers including lymphoma. However, the methodologic shortcomings of all the included studies made their results unreliable, irrespectively of whether their findings supported an association or not.
Current evidence from observational studies does not allow excluding or confirming an association of the exposure to anti-TNF treatments with lymphoma in IBD patients.
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