A Framework for Enhanced QoS Support in IEEE 802.11e Networks

IEEE 802.11 based WLANs have became popular, but they can only provide best effort services and so they are poorly suitable for multimedia applications. Recently IEEE 802.11e standard has been proposed to support quality of service. The new standard introduces a so-called Hybrid Coordination Function containing two medium access mechanisms: contention-based channel access and controlled channel access. In this paper we propose a novel framework to better support QoS guarantees for multimedia applications. It comprises QoS Manager, Admission Control, Enhanced Scheduler, Predictor and Feedback System. The scheduler adopted supports real-time applications, variable packet sizes and variable bit rate traffic streams. We show that this framework is suitable to be used by applications requesting Application Level Contracts which will be translated in Resource Level Contracts to the scheduler subsystem. The QoS manager component is able to dynamically manage available resources under different load conditions

Improving the QoS of IEEE 802.11e networks through imprecise computation

IEEE 802.11e HCCA reference scheduler is based on fixed value parameters that do not adapt to traffic changes, thus quality of service (QoS) for multimedia applications is a challenge, especially in the case of variable bit rate (VBR) streams, that requires dynamic resource assignment. This paper is focused on immediate dynamic TXOP HCCA (IDTH) scheduling algorithm and its new evolution immediate dynamic TXOP HCCA plus (IDTH+). Their reclaiming mechanisms, refined by the monitoring of transmission duration, aim at overcoming the limits of fixed preallocation of resources by varying the stations transmission time and avoiding waste of resources. Simulations and theoretical analysis based on the imprecise computation model show that the integration of IDTH and IDTH+ can achieve improved network performance in terms of transmission queues length, mean access delay and packets drop rate, and to efficiently manage bursty traffic. Moreover, the performance improvements of IDTH+ with respect to IDTH are highlighted

A communication platform demonstrator for new generation railway traffic management systems: Testing and validation

Current rail traffic management and control systems cannot be easily upgraded to the new needs and challenges of modern railway systems because they do not offer interoperable data structures and standardized communication interfaces. To meet this need, the Horizon 2020 Shift2Rail OPTIMA project has developed a communication platform for testing and validating the new generation of traffic management systems (TMS), whose main innovative features are the interoperability of the data structures used, standardization of communications, continuous access to real-time and persistent data from heterogeneous data sources, modularity of components and scalability of the platform. This paper presents the main components, their functions and characteristics, then describes the testing and validation of the platform, even when federated with other innovative TMS modules developed in separate projects. The successful validation of the system has confirmed the achievement of the objectives set and allowed a new set of objectives to be defined for the reference platform for the railway TMS/Traffic Control systems

A communication platform demonstrator for new generation railway traffic management systems: Testing and validation

\ua9 2023 The Author(s). Current rail traffic management and control systems cannot be easily upgraded to the new needs and challenges of modern railway systems because they do not offer interoperable data structures and standardized communication interfaces. To meet this need, the Horizon 2020 Shift2Rail OPTIMA project has developed a communication platform for testing and validating the new generation of traffic management systems (TMS), whose main innovative features are the interoperability of the data structures used, standardization of communications, continuous access to real-time and persistent data from heterogeneous data sources, modularity of components and scalability of the platform. This paper presents the main components, their functions and characteristics, then describes the testing and validation of the platform, even when federated with other innovative TMS modules developed in separate projects. The successful validation of the system has confirmed the achievement of the objectives set and allowed a new set of objectives to be defined for the reference platform for the railway TMS/Traffic Control systems

Treatment of squamous cell carcinoma of the anal canal: A new strategies with anti-EGFR therapy and immunotherapy

The incidence of squamous cell carcinoma of the anal canal (SCAC) is increasing in both sexes but the standard treatment remains that of 20 years ago. However, interesting data have recently emerged on the use of anti-epidermal growth factor receptor (EGFR) agents and immunotherapy in advanced disease. Thus, new avenues of research are opening up that will hopefully lead to more effective therapeutic strategies. We provide an overview of the latest studies published on this tumor and discuss the possible future therapeutic options for combination therapy, anti-EGFR treatment and radiotherapy

Melanoma metastasis mimicking gastric cancer: a challenge that starts from diagnosis

The gastrointestinal tract is an uncommon site of metastasis in melanoma. However, when the primary melanoma cannot be found, the diagnosis of gastric melanoma by endoscopic biopsy is problematic mainly because some tumors are amelanotic and do not contain melanin granules detectable by microscopy. A 56-year-old Caucasian man with melanoma was referred to us following an initial histopathological diagnosis via gastroscopy of poorly differentiated primary gastric carcinoma. A computerized tomography (CT) scan showed metastatic disease and on the basis of this information we started palliative chemotherapy. However, the atypical presentation of the disease with subcutaneous metastases prompted us to make a more in-depth evaluation. Immunohistochemical evaluation modified the diagnosis to melanoma. After only one cycle of chemotherapy, treatment was changed to dabrafenib + trametinib, which was better tolerated and initially induced a partial response. The patient is currently in good clinical condition 20 months after diagnosis. Our case report highlights the difficulty in diagnosing melanoma of the gastrointestinal tract and indicates the need for pathologists and clinicians to consider such a possibility when they are faced with a diagnosis of poorly differentiated gastric cancer and unusual sites of metastasis

Prognosis of screen-detected breast cancers: results of a population based study

BACKGROUND: The reduced mortality rate from breast carcinoma among women offered screening mammography is demonstrated after 15–20 years of follow-up. However, the assessment of 5-year overall and event-free survival could represent an earlier measure of the efficacy of mammography screening program (MSP). METHODS: All cases of breast cancer diagnosed in the Province of Modena between years 1996 and 2000 in women aged 50 to 69 years, were identified through the Modena Cancer Registry (MCR). Stage of disease and treatment information were obtained from clinical records. All the events occurring up to June 30, 2003 were retrieved by experienced monitors. Five-year overall and event-free survival were the principal end-points of the study. RESULTS: During a 5-year period, 587 primary breast cancers were detected by the MSP and 471 primary breast cancers were diagnosed out of the MSP. The screen-detected breast cancers were smaller, more likely node negative, with low histological grade, low proliferative activity and positive receptors status. Furthermore, the breast cancer diagnosed through the MSP more frequently received a conservative surgery. The 5-year survival rate was 94% in the screen-detected group, versus 84% in the other group (p = 0.0001). The rate of 5-year event-free survival was 89% and 75% for the MSP participants and not participants, respectively (p = 0.0001). CONCLUSIONS: Our data confirm a favourable outcome of screen-detected breast cancers in terms of five-year overall and event-free survival, which reflect the good quality assurance parameters of the MSP. Finally, a cancer registry should be implemented in every area covered by screening programs

Emergency hernia repair in the elderly. multivariate analysis of morbidity and mortality from an Italian registry

Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in elderly patients who underwent emergency surgery for complicated hernia in 38 Italian hospitals. Pre-operative, surgical and postoperative data were recorded for each patient. ASA score, Charlson's comorbidity index, P-POSSUM and CR-POSSUM were assessed. Results 259 patients were recruited, mean age was 80 years. A direct repair without mesh was performed in 62 (23.9%) patients. Explorative laparotomy was performed in 56 (21.6%) patients and bowel resection was necessary in 44 (17%). Mortality occurred in seven (2.8%) patients. Fifty-five (21.2%) patients developed complications, 12 of whom had a major one. At univariate and multivariate analyses, Charlson's comorbidity index >= 6, altered mental status, and need for laparotomy were associated with major complications and mortality Conclusion Emergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson's comorbidity index could be adopted to select patients for elective operation