Pre-Congestion Notification marking

Pre-Congestion Notification (PCN) builds on the concepts of RFC 3168, "The addition of Explicit Congestion Notification to IP". However, Pre-Congestion Notification aims at providing notification before any congestion actually occurs. Pre-Congestion Notification is applied to \ud real-time flows (such as voice, video and multimedia streaming) in DiffServ networks. As described in [CL-DEPLOY], it enables "pre" congestion control through two procedures, flow admission control and flow pre-emption. The draft proposes algorithms that determine when a \ud PCN-enabled router writes Admission Marking and Pre-emption Marking in a packet header, depending on the traffic level. The draft also proposes how to encode these markings. We present simulation results with PCN working in an edge-to-edge scenario using the marking algorithms described. Other marking algorithms will be investigated in the future. \u

Development and Feasibility of a Smartphone, ECG and GPS Based System for Remotely Monitoring Exercise in Cardiac Rehabilitation

Background Despite its efficacy and cost-effectiveness, exercise-based cardiac rehabilitation is undertaken by less than one-third of clinically eligible cardiac patients in every country for which data is available. Reasons for non-participation include the unavailability of hospital-based rehabilitation programs, or excessive travel time and distance. For this reason, there have been calls for the development of more flexible alternatives. Methodology and Principal Findings We developed a system to enable walking-based cardiac rehabilitation in which the patient's single-lead ECG, heart rate, GPS-based speed and location are transmitted by a programmed smartphone to a secure server for real-time monitoring by a qualified exercise scientist. The feasibility of this approach was evaluated in 134 remotely-monitored exercise assessment and exercise sessions in cardiac patients unable to undertake hospital-based rehabilitation. Completion rates, rates of technical problems, detection of ECG changes, pre- and post-intervention six minute walk test (6 MWT), cardiac depression and Quality of Life (QOL) were key measures. The system was rated as easy and quick to use. It allowed participants to complete six weeks of exercise-based rehabilitation near their homes, worksites, or when travelling. The majority of sessions were completed without any technical problems, although periodic signal loss in areas of poor coverage was an occasional limitation. Several exercise and post-exercise ECG changes were detected. Participants showed improvements comparable to those reported for hospital-based programs, walking significantly further on the post-intervention 6 MWT, 637 m (95% CI: 565–726), than on the pre-test, 524 m (95% CI: 420–655), and reporting significantly reduced levels of cardiac depression and significantly improved physical health-related QOL. Conclusions and Significance The system provided a feasible and very flexible alternative form of supervised cardiac rehabilitation for those unable to access hospital-based programs, with the potential to address a well-recognised deficiency in health care provision in many countries. Future research should assess its longer-term efficacy, cost-effectiveness and safety in larger samples representing the spectrum of cardiac morbidity and severity

Functional claudication distance: a reliable and valid measurement to assess functional limitation in patients with intermittent claudication

BACKGROUND: Disease severity and functional impairment in patients with intermittent claudication is usually quantified by the measurement of pain-free walking distance (intermittent claudication distance, ICD) and maximal walking distance (absolute claudication distance, ACD). However, the distance at which a patient would prefer to stop because of claudication pain seems a definition that is more correspondent with the actual daily life walking distance. We conducted a study in which the distance a patient prefers to stop was defined as the functional claudication distance (FCD), and estimated the reliability and validity of this measurement. METHODS: In this clinical validity study we included patients with intermittent claudication, following a supervised exercise therapy program. The first study part consisted of two standardised treadmill tests. During each test ICD, FCD and ACD were determined. Primary endpoint was the reliability as represented by the calculated intra-class correlation coefficients. In the second study part patients performed a standardised treadmill test and filled out the Rand-36 questionnaire. Spearman's rho was calculated to assess validity. RESULTS: The intra-class correlation coefficients of ICD, FCD and ACD were 0.940, 0.959, and 0.975 respectively. FCD correlated significantly with five out of nine domains, namely physical function (rho = 0.571), physical role (rho = 0.532), vitality (rho = 0.416), pain (rho = 0.416) and health change (rho = 0.414). CONCLUSION: FCD is a reliable and valid measurement for determining functional capacity in trained patients with intermittent claudication. Furthermore it seems that FCD better reflects the actual functional impairment. In future studies, FCD could be used alongside ICD and ACD

High methylmercury in Arctic and subarctic ponds is related to nutrient levels in the warming eastern Canadian Arctic

Permafrost thaw ponds are ubiquitous in the eastern Canadian Arctic, yet little information exists on their potential as sources of methylmercury (MeHg) to freshwaters. They are microbially active and conducive to methylation of inorganic mercury, and are also affected by Arctic warming. This multiyear study investigated thaw ponds in a discontinuous permafrost region in the Subarctic taiga (Kuujjuarapik-Whapmagoostui, QC) and a continuous permafrost region in the Arctic tundra (Bylot Island, NU). MeHg concentrations in thaw ponds were well above levels measured in most freshwater ecosystems in the Canadian Arctic (>0.1 ng L−1). On Bylot, ice-wedge trough ponds showed significantly higher MeHg (0.3−2.2 ng L−1) than polygonal ponds (0.1−0.3 ng L−1) or lakes (<0.1 ng L−1). High MeHg was measured in the bottom waters of Subarctic thaw ponds near Kuujjuarapik (0.1−3.1 ng L−1). High water MeHg concentrations in thaw ponds were strongly correlated with variables associated with high inputs of organic matter (DOC, a320, Fe), nutrients (TP, TN), and microbial activity (dissolved CO2 and CH4). Thawing permafrost due to Arctic warming will continue to release nutrients and organic carbon into these systems and increase ponding in some regions, likely stimulating higher water concentrations of MeHg. Greater hydrological connectivity from permafrost thawing may potentially increase transport of MeHg from thaw ponds to neighboring aquatic ecosystems

Acquisition de tolérance au nickel d'un biofilm naturel exposé en microcosmes

International audienceIl est aujourd'hui bien connu que les activités minières peuvent être à l'origine d'apport de métaux dans l'environnement. Cependant, si des contaminations peuvent avoir des effets néfastes sur les communautés biologiques, celles-ci peuvent dans certains cas, acquérir une tolérance leur permettant de résister aux pressions anthropiques. En effet, les organismes sensibles aux contaminants d'une communauté peuvent disparaître au profit d'espèces plus tolérantes. Le biofilm est un modèle biologique intéressant, car il est sédentaire, ubiquiste et à la base de la chaîne trophique. Afin de juger de sa potentielle acquisition de tolérance aux métaux, des expériences de toxicité ont été effectuées autour du concept du PICT (Pollution Induced Community Tolerance). Du biofilm issu d'un étang a ainsi été exposé en microcosmes à quatre concentrations en nickel (0 à 25 µM [Ni]T) pendant 28 jours (phase de sélection). Durant cette phase et pour chaque pas de temps, plusieurs paramètres ont été étudiés pour caractériser la réponse du biofilm : (1) la bioaccumulation ; (2) les enzymes extracellulaires ; (3) les polysaccharides ; (4) les protéines ; et (5) la taxonomie. En parallèle, l'évolution de leur tolérance dans le temps a été étudiée (phase de détection). Des tests de toxicité aiguë sur 6 h ont ainsi été effectués afin d'établir des courbes de toxicité en utilisant le rendement photosynthétique comme biomarqueur d'effet. Tous ces résultats mis ensemble vont permettre d'identifier les paramètres et réponses clés qui permettront de mieux utiliser le biofilm comme outil de biosuivi des contaminations métalliques dans les écosystèmes aquatiques

Enseignement de l’index de pression systolique : un appel à l’action

International audienc

Intérêts cliniques de la mesure ambulatoire de l’activité physique et de la capacité de marche dans l’artériopathie oblitérante des membres inférieurs

National audienc