Mobility through Heterogeneous Networks in a 4G Environment

Serving and Managing users in a heterogeneous environment. 17th WWRF Meeting in Heidelberg, Germany, 15 - 17 November 2006. [Proceeding presented at WG3 - Co-operative and Ad-hoc Networks]The increase will of ubiquitous access of the users to the requested services points towards the integration of heterogeneous networks. In this sense, a user shall be able to access its services through different access technologies, such as WLAN, Wimax, UMTS and DVB technologies, from the same or different network operators, and to seamless move between different networks with active communications. In this paper we propose a mobility architecture able to support this users’ ubiquitous access and seamless movement, while simultaneously bringing a large flexibility to access network operators

A Cross-System Approach for Multimedia Services with IP Multicast in 4G Networks

The increased demand for multimedia services by mobile end users in recent years have driven both Broadcast and Wireless Network operators to develop new systems and architectures for the deployment of such services. The proposed solutions are nonetheless limited either in terms of QoS or Capabilities to deliver new interactive services. This paper highlights strengths and drawbacks of the existing technologies in terms of QoS, Security and Mobility. In order to fill the gap between current solutions we propose a new architecture that builds itself on the synergies created by a heterogeneous network made of existing delivering technologies, such as 3GPP/MBMS and DVB, where services can be delivered to end-users in the most appropriate way for end-users and operators alike. A prototype implementation is further described.EU project - IST-2002- 506997 Daidalos I

Permeability of the blood-brain barrier through the phases of ischaemic stroke and relation with clinical outcome: protocol for a systematic review

Introduction: Ischaemic stroke is the most prevalent type of stroke and is characterised by a myriad of pathological events triggered by a vascular arterial occlusion. Disruption of the blood-brain barrier (BBB) is a key pathological event that may lead to fatal outcomes. However, it seems to follow a multiphasic pattern that has been associated with distinct biological substrates and possibly contrasting outcomes. Addressing the BBB permeability (BBBP) along the different phases of stroke through imaging techniques could lead to a better understanding of the disease, improved patient selection for specific treatments and development of new therapeutic modalities and delivery methods. This systematic review will aim to comprehensively summarise the existing evidence regarding the evolution of the BBBP values during the different phases of an acute ischaemic stroke and correlate this event with the clinical outcome of the patient. Methods and analysis: We will conduct a computerised search on Medline, EMBASE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science. In addition, grey literature and ClinicalTrials.gov will be scanned. We will include randomised controlled trials, cohort, cross-sectional and case-controlled studies on humans that quantitatively assess the BBBP in stroke. Retrieved studies will be independently reviewed by two authors and any discrepancies will be resolved by consensus or with a third reviewer. Reviewers will extract the data and assess the risk of bias of the selected studies. If possible, data will be combined in a quantitative meta-analysis following the guidelines provided by Cochrane Handbook for Systematic Reviews of Interventions. We will assess cumulative evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Ethics and dissemination: Ethical approval is not needed. All data used for this work are publicly available. The result obtained from this work will be published in a peer-reviewed journal and disseminated in relevant conferences.info:eu-repo/semantics/publishedVersio

The effect of sodium fluorescein angiography on erythrocyte properties

© 1998 – IOS Press. All rights reservedSodium fluorescein angiography is a widely used routine ophthalmological diagnostic procedure which enables the study of chorioretinal microcirculation and consists of the injection of sodium fluorescein into the systemic bloodstream. The aim of the present study was to evaluate whether or not fluorescein interferes with erythrocyte properties during the angiographic procedure. In a group of 37 patients, 26 with non-insulin-dependent diabetes mellitus (DM) with and without retinopathy, and 11 without diabetes mellitus (non-DM) although affected by other ophthalmological diseases, all undergoing routine angiography, blood samples were drawn before (T0) and 30 min (T30) after fluorescein injection. The erythrocyte aggregation index (EAI), membrane lipid fluidity and erythrocyte acetylcholinesterase activity were determined in both groups. After fluorescein injection there was no statistical change in EAI and erythrocyte membrane fluidity in either group. Erythrocyte acetylcholinesterase activity, a marker of membrane protein integrity, decreased significantly (p < 0:01) in the DM group. Membrane lipid fluidity did not change with fluorescein injection, however, (i) in the DM group erythrocyte membranes became more rigid than in the non-DM (DPH: p < 0:01); (ii) EAI and membrane lipid fluidity became significantly correlated (r = 0:6263, p < 0:05) in non-DM patients at T30. In conclusion, fluorescein administration for angiographic procedures seems to interact with erythrocyte membrane, namely, in diabetic patients, which may interfere with the blood flow in the microcirculation

Hemorheological effects of sodium fluorescein in rats

© 2001 – IOS Press. All rights reservedSodium fluorescein is widely used in clinical practice for the study of the retinal circulation by angiography. It has been reported several hemorheological and microvascular abnormalities induced by this compound. The aim of this work was to analyse the hemorheological effects of intravenous sodium fluorescein in an animal model. Twenty male 10–16 weeks-old Wistar rats were used, under systemic anaesthesia. The animals were divided in 2 groups of 10 each: (1) intravenous injection of sodium fluorescein (14 mg/kg of body weight) – Group NaF, (2) controls (injection of NaCl 0.9%) – Group CTRL. A blood sample was drawn by aortic puncture after 60 minutes and hemorheological parameters determined: hematocrit, hemoglobin, metahemoglobin, carboxyhemoglobin, plasma viscosity, erythrocyte deformability, membrane fluidity and acetylcholinesterase activity. In the Group NaF there was a 20% reduction of the AChE activity (p < 0.05) and an increase in PV (p < 0.05). Concerning hemoglobin status, a three-fold increase in COHb (p < 0.001) was shown. In conclusion, the NaF injection in the animal model produces hemorheological abnormalities similar to those reported in the human

Ethanol and erythrocyte membrane interaction : a hemorheologic perspective

© 1999 – IOS Press. All rights reservedPrevious studies have documented structural and functional changes induced by ethanol–erythrocyte membrane interaction. In order to perform an in vitro study on the effect of different ethanol concentrations on erythrocyte hemorheologic properties, blood samples were collected from 21 male donors at the Hospital of Santa Maria. Whole blood aliquots were incubated with ethanol solutions of rising concentrations. The following parameters were measured: erythrocyte aggregation, haemoglobin, carboxyhaemoglobin and methaemoglobin concentrations, hematocrit, plasma osmolality and erythrocyte membrane fluidity (fluorescence polarisation probes TMA-DPH and DPH). With ethanol blood concentrations of 45 mM a rise in plasma osmolality (0.352 Osm/kg H2O vs 0.310 Osm/kg H2O; p < 0.001) was verified. With 67 mM concentration a decrease of erythrocyte aggregation (11.03 vs 12.81; p < 0.05) and an increase in plasma osmolality (0.380 Osm/kg H2O vs 0.310 Osm/kg H2O;p < 0.001) were obtained. In conclusion, ethanol only changes erythrocyte aggregation for a concentration of 67 mM. These data could lead to future changes in therapeutic approaches to situations such as alcoholic coma

Recurrence in intracranial atherosclerotic disease: a stenosis-based analysis

BACKGROUND: Intracranial atherosclerotic disease is a common cause of stroke; its incidence and prevalence vary widely by ethnicity. The aim of our study was to analyze the recurrence rate of cerebrovascular events in patients with symptomatic and asymptomatic intracranial stenosis (IS). METHODS: We conducted a historical cohort study including all patients admitted in our hospital for stroke or transient ischemic attack (TIA) during 2011 and 2012 with information on intracranial circulation (ultrasonography and/or computed tomography angiography). We identified patients with symptomatic and asymptomatic IS and studied the recurrence of cerebrovascular events (TIA or ischemic stroke within the territory of the stenosis) for a minimum follow-up period of 6 months after the diagnosis of IS. For the recurrence rate estimation, patients with other potentially embolic diseases (in cervical arteries or heart) were excluded. We calculated the rate of recurrence of cerebrovascular events and performed Kaplan-Meier survival curves for symptomatic and asymptomatic IS. RESULTS: We investigated 1302 patients, mean age was 72.41 years (standard deviation 12.75). We identified 218 IS in 158 patients, 77 were symptomatic and 141 were asymptomatic. The recurrence rate of cerebrovascular events was 12.32 per 100 patient-years, with a mean time to recurrence of 1.73 months for symptomatic intracranial stenosis (SIS) and .88 per 100 patient-years for asymptomatic IS (P < .001). CONCLUSIONS: These results indicate a high risk of early recurrence of stroke in the territory of a SIS, highlighting the importance of its early diagnosis and aggressive treatment.info:eu-repo/semantics/publishedVersio

Impairment of the erythrocyte membrane fluidity in survivors of acute myocardial infarction : a prospective study

© 1999 – IOS Press. All rights reservedErythrocytes have to constantly adapt themselves to the varying circulatory system shear stress forces and capillaries diameter. Membrane lipid and protein content have an important role in determining the erythrocyte shape and are main determinants of the membrane solid and fluid behavior which enables the erythrocyte to respond to the outer environment modifications. Membrane fluidity is an inverse index of membrane microviscosity. The aim of the present work is to evaluate prospectively in three periods of time (discharge, after 6 months and one year later) in survivors of an acute myocardial infarction (AMI) the erythrocyte membrane fluidity (outer and inner bilayer) and establish a relation with the cardiovascular events or need of coronary revascularization during a two year clinical follow up. Sixty survivors of acute myocardial infarction were recruited during 1994–96 and were prospectively studied in three periods (discharge, 6 months and after one year), and were compared with a control group (n = 36). Membrane lipid fluidity was determined by means of fluorescence polarization with two probes: 1,6-diphenyl-1,2,5-hexatriene (DPH) and 1,4-trimethylamine 6-phenyl hexa-1,3,5-triene (TMA-DPH), for the characterisation of the hydrophobic and external polar region, respectively. The hydrophobic region was more rigidified (p < 0:01) in the erythrocytes from AMI patients, in relation to the control group. During the time of the study there was a progressive erythrocyte membrane rigidification (DPH p < 0:001; TMA-DPH p < 0:001). We found no relation between erythrocyte membrane fluidity and the coronary risk factors, cardiovascular events or the need of coronary revascularization during the clinical follow-up. In conclusion, after the myocardial infarction erythrocyte membrane of AMI survivors becomes more rigid with time, which could contribute to the decreased erythrocyte deformability and the increased blood viscosity previously described in this group of patients

[Carotid atherosclerosis and white matter hypodensities: a controversial relationship]

INTRODUCTION: White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin. MATERIAL AND METHODS: We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors. RESULTS: 472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 - 1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 - 2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 - 7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 - 1.328, p = 0.877) and white matter hypodensities of presumed vascular origin. DISCUSSION: Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin. CONCLUSION: Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin

Nocturnal Blood Pressure Dipping in Acute Ischemic Stroke

OBJECTIVES: We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke. MATERIALS AND METHODS: We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non-dippers, and reverse dippers). Recanalization was assessed by transcranial color-coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow-up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale. RESULTS: A total of 304 patients were included, mean age 72.80 ± 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non-dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3-month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non-dippers, 15.52% for dippers, and 5.88% for extreme dippers, P = 0.033. CONCLUSIONS: Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers.info:eu-repo/semantics/publishedVersio