Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be.
SUMMARYSatellite plays an important role in global information infrastructure (GII) and next generation networks (NGNs). Similarly, satellite communication systems have great advantages to support IPv6 (Internet Protocol version 6) networks as a technology that allows universal access to broadband e-services (audio, video, VPN, etc.). In the context of DVB-S2 (digital video broadcast-satellite) and DVB-RCS (digital video broadcast-return channel via satellite) standards, this paper presents the current SatSix project (satellitebased communications systems within IPv6 networks) within the European 6th Framework Programme, which is implementing innovative concepts and effective solutions (in relation with the economical cost) for broadband satellite systems and services using the technology presented above. This project is promoting the introduction of the IPv6 protocol into satellite-based communication systems.Moreover, through SatSix, the industry is addressing the next generation Internet, IPv6. It also enhances its competitive position in satellite broadband multimedia systems by exploiting the common components defined by the European DVB-S2 and DVB-RCS satellite broadband standards.
It is estimated by 2050 that one-third of Europe's population will be over 60. Life expectancy has on average already risen by 2.5 years per decade and the number of old people aged 80+ is expected to grow by 180%. Nowadays, there are 5.5 million cases of Alzheimer-afflicted people in Europe and more new cases being added every year. In fact Alzheimer's disease has been called the "plague of the twenty-first century". There is currently no cure for this disease; however, prevention and early diagnosis may play a huge role in delaying the onset of the worst effects of this severe disease. Modern technologies could have an important role to satisfy main needs of people with dementia. Nonetheless, despite recent advancements in information and communication technologies and growing sales numbers, industry has been rather reluctant to standardise access technologies and to implement them in a "Design for All approach". Because of this, in last years, there have been launched in Europe a great number of initiatives, both public and private, which try to improve the situation of those persons who suffer this ailment and that will be detailed in this chapter.
Background Systemic lupus erythematosus (SLE) is a clinically heterogeneous disorder with a waxing and waning clinical course. Reliable markers of clinical disease flare have been difficult to identify, impeding the selection of optimal therapies, which leads to suboptimal disease control and cumulative organ damage. Objectives Our goal was to identify immune markers associated with impending vs delayed flare in SLE patients in the absence of confounding immunosuppressive medications. Methods As part of the Biomarkers of Lupus Disease (BOLD) study, 41 SLE patients with non-organ-threatening, moderately severe disease activity were enrolled, background immunosuppressants (IS) discontinued, intramuscular steroids given until disease suppression, and followed until clinical flare. Patients met ≥4 ACR SLE criteria and had SLEDAI ≥6 or BILAG ≥2 B or 1 A scores at baseline. Samples were procured at baseline, time of disease suppression, and serially until flare (defined as requiring new treatment and ≥1 new BILAG B or ≥4 point SLEDAI increase). Cellular immunophenotyping markers and 52 soluble mediators were measured using xMAP multiplex technology or sandwich ELISA. Random forest was used to generate predictive models and applied as described [1]. Results Forty SLE patients flared within 24 weeks, with 21 flaring within 60 days (early) and 13 flaring later than 90 days (late) after stopping background IS. Patients who flared early were more likely to be of African-American descent, while Native American patients were more likely to flare late. At baseline those who flared early had higher levels of bicarbonate, increased frequencies of monocytes and neutrophils expressing the activated conformation of CD11b, monocytes (p=0.028) and neutrophil (p=0.002), as well as greater frequency of activated naïve B cells. SLE patients who flared late had higher baseline plasma levels of IL-1RA (p=0.03) and TNFRI (p=0.04). At the flare visit this group had higher levels of BLyS (p=0.01), IL-7 (p=0.03), and IFNg (p=0.04). Predictive models were generated and tested using random forest models. The best prediction model for the course of flare based on three immunophenotyping parameters achieved 87% accuracy with a positive predictive value of 0.78 (95% CI, 0.52 – 0.94) and a negative predictive value of 0.80 (0.44 – 0.97). The model indicates that absence of the activated monocyte population (activated CD11bhi) and the activated naïve B cell subpopulation (CD86hi) led to a drastically reduced likelihood of an early flare. Conclusions SLE patients who flare earlier after withdrawal of ineffective immuno-suppressants and transient steroid treatment have increased measures of innate and/or adaptive immune system activation, while SLE patients who flare later have increased evidence of regulatory pathway engagement through shedding of IL-1RA. References Genuer R, et al. Pattern Recogn Lett. 2010;31(14):2225-36. Disclosure of Interest : J. Guthridge: None declared, R. Lou: None declared, S. Kamp: None declared, M. Munroe:...
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