Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution

Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highly trained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to equip practitioners with the technical dexterity required to manage emergencies. The aim of this article is to review ECMO SBT activities and technology followed by a novel solution to current challenges. ECMO simulation: The commonly-used simulation approach is easy-to-build as it requires a functioning ECMO machine and an altered circuit. Complications are simulated through manual circuit manipulations. However, scenario diversity is limited and often lacks physiological and/or mechanical authenticity. It is also expensive to continuously operate due to the consumption of highly specialized equipment. Technological aid: Commercial extensions can be added to enable remote control and to automate circuit manipulation, but do not improve on the realism or cost-effectiveness. A modular ECMO simulator: To address those drawbacks, we are developing a standalone modular ECMO simulator that employs affordable technology for high-fidelity simulation.Peer reviewe

TCP-Aware Backpressure Routing and Scheduling

In this work, we explore the performance of backpressure routing and scheduling for TCP flows over wireless networks. TCP and backpressure are not compatible due to a mismatch between the congestion control mechanism of TCP and the queue size based routing and scheduling of the backpressure framework. We propose a TCP-aware backpressure routing and scheduling that takes into account the behavior of TCP flows. TCP-aware backpressure (i) provides throughput optimality guarantees in the Lyapunov optimization framework, (ii) gracefully combines TCP and backpressure without making any changes to the TCP protocol, (iii) improves the throughput of TCP flows significantly, and (iv) provides fairness across competing TCP flows

A Priority-based Fair Queuing (PFQ) Model for Wireless Healthcare System

Healthcare is a very active research area, primarily due to the increase in the elderly population that leads to increasing number of emergency situations that require urgent actions. In recent years some of wireless networked medical devices were equipped with different sensors to measure and report on vital signs of patient remotely. The most important sensors are Heart Beat Rate (ECG), Pressure and Glucose sensors. However, the strict requirements and real-time nature of medical applications dictate the extreme importance and need for appropriate Quality of Service (QoS), fast and accurate delivery of a patient’s measurements in reliable e-Health ecosystem. As the elderly age and older adult population is increasing (65 years and above) due to the advancement in medicine and medical care in the last two decades; high QoS and reliable e-health ecosystem has become a major challenge in Healthcare especially for patients who require continuous monitoring and attention. Nevertheless, predictions have indicated that elderly population will be approximately 2 billion in developing countries by 2050 where availability of medical staff shall be unable to cope with this growth and emergency cases that need immediate intervention. On the other side, limitations in communication networks capacity, congestions and the humongous increase of devices, applications and IOT using the available communication networks add extra layer of challenges on E-health ecosystem such as time constraints, quality of measurements and signals reaching healthcare centres. Hence this research has tackled the delay and jitter parameters in E-health M2M wireless communication and succeeded in reducing them in comparison to current available models. The novelty of this research has succeeded in developing a new Priority Queuing model ‘’Priority Based-Fair Queuing’’ (PFQ) where a new priority level and concept of ‘’Patient’s Health Record’’ (PHR) has been developed and integrated with the Priority Parameters (PP) values of each sensor to add a second level of priority. The results and data analysis performed on the PFQ model under different scenarios simulating real M2M E-health environment have revealed that the PFQ has outperformed the results obtained from simulating the widely used current models such as First in First Out (FIFO) and Weight Fair Queuing (WFQ). PFQ model has improved transmission of ECG sensor data by decreasing delay and jitter in emergency cases by 83.32% and 75.88% respectively in comparison to FIFO and 46.65% and 60.13% with respect to WFQ model. Similarly, in pressure sensor the improvements were 82.41% and 71.5% and 68.43% and 73.36% in comparison to FIFO and WFQ respectively. Data transmission were also improved in the Glucose sensor by 80.85% and 64.7% and 92.1% and 83.17% in comparison to FIFO and WFQ respectively. However, non-emergency cases data transmission using PFQ model was negatively impacted and scored higher rates than FIFO and WFQ since PFQ tends to give higher priority to emergency cases. Thus, a derivative from the PFQ model has been developed to create a new version namely “Priority Based-Fair Queuing-Tolerated Delay” (PFQ-TD) to balance the data transmission between emergency and non-emergency cases where tolerated delay in emergency cases has been considered. PFQ-TD has succeeded in balancing fairly this issue and reducing the total average delay and jitter of emergency and non-emergency cases in all sensors and keep them within the acceptable allowable standards. PFQ-TD has improved the overall average delay and jitter in emergency and non-emergency cases among all sensors by 41% and 84% respectively in comparison to PFQ model

High-speed, in-band performance measurement instrumentation for next generation IP networks

Facilitating always-on instrumentation of Internet traffic for the purposes of performance measurement is crucial in order to enable accountability of resource usage and automated network control, management and optimisation. This has proven infeasible to date due to the lack of native measurement mechanisms that can form an integral part of the network‟s main forwarding operation. However, Internet Protocol version 6 (IPv6) specification enables the efficient encoding and processing of optional per-packet information as a native part of the network layer, and this constitutes a strong reason for IPv6 to be adopted as the ubiquitous next generation Internet transport. In this paper we present a very high-speed hardware implementation of in-line measurement, a truly native traffic instrumentation mechanism for the next generation Internet, which facilitates performance measurement of the actual data-carrying traffic at small timescales between two points in the network. This system is designed to operate as part of the routers' fast path and to incur an absolutely minimal impact on the network operation even while instrumenting traffic between the edges of very high capacity links. Our results show that the implementation can be easily accommodated by current FPGA technology, and real Internet traffic traces verify that the overhead incurred by instrumenting every packet over a 10 Gb/s operational backbone link carrying a typical workload is indeed negligible

Remote real-time monitoring of subsurface landfill gas migration

The cost of monitoring greenhouse gas emissions from landfill sites is of major concern for regulatory authorities. The current monitoring procedure is recognised as labour intensive, requiring agency inspectors to physically travel to perimeter borehole wells in rough terrain and manually measure gas concentration levels with expensive hand-held instrumentation. In this article we present a cost-effective and efficient system for remotely monitoring landfill subsurface migration of methane and carbon dioxide concentration levels. Based purely on an autonomous sensing architecture, the proposed sensing platform was capable of performing complex analytical measurements in situ and successfully communicating the data remotely to a cloud database. A web tool was developed to present the sensed data to relevant stakeholders. We report our experiences in deploying such an approach in the field over a period of approximately 16 months