The Pediatric Emergency Care Applied Research Network: a history of multicenter collaboration in the United States.

In this article, we review the history and progress of a large multicenter research network pertaining to emergency medical services for children. We describe the history, organization, infrastructure, and research agenda of the Pediatric Emergency Care Applied Research Network (PECARN), and highlight some of the important accomplishments since its inception. We also describe the network's strategy to grow its research portfolio, train new investigators, and study how to translate new evidence into practice. This strategy ensures not only the sustainability of the network in the future, but the growth of research in emergency medical services for children in general

Resilient network design: Challenges and future directions

This paper highlights the complexity and challenges of providing reliable services in the evolving communications infrastructure. The hurdles in providing end-to-end availability guarantees are discussed and research problems identified. Avenues for overcoming some of the challenges examined are presented. This includes the use of a highly available network spine embedded in a physical network together with efficient crosslayer mapping to offer survivability and differentiation of traffic into classes of resilience. © 2013 Springer Science+Business Media New York

Adapting structuration theory to understand the role of reflexivity: Problematization, clinical audit and information systems

This paper is an exploratory account of the further development and application of a hybrid framework, StructurANTion, that is based on Structuration Theory and Actor Network Theory (ANT). The use of social theories in general and their use in information systems (IS) research in particular is explored leading to the use of the framework to examine the concept of what are termed humanchine networks in the context of clinical audit, within a healthcare Primary Care Trust (PCT). A particular focus is on the manner in which information systems-based reflexivity contributes to both entrenching a networks’ structurated order as well as contributing to its emancipatory change. The case study compares clinic-centric and patientcentric audit and seeks to further extend the understanding of the role of information and information systems within structurated humanchine activity systems. Conclusions indicate that the use of more socially informed IS methods and approaches can incorporate more emancipatory ideals and lead to greater adoption and usage of more relevant and useful clinical information systems and practices

Controlling Network Latency in Mixed Hadoop Clusters: Do We Need Active Queue Management?

With the advent of big data, data center applications are processing vast amounts of unstructured and semi-structured data, in parallel on large clusters, across hundreds to thousands of nodes. The highest performance for these batch big data workloads is achieved using expensive network equipment with large buffers, which accommodate bursts in network traffic and allocate bandwidth fairly even when the network is congested. Throughput-sensitive big data applications are, however, often executed in the same data center as latency-sensitive workloads. For both workloads to be supported well, the network must provide both maximum throughput and low latency. Progress has been made in this direction, as modern network switches support Active Queue Management (AQM) and Explicit Congestion Notifications (ECN), both mechanisms to control the level of queue occupancy, reducing the total network latency. This paper is the first study of the effect of Active Queue Management on both throughput and latency, in the context of Hadoop and the MapReduce programming model. We give a quantitative comparison of four different approaches for controlling buffer occupancy and latency: RED and CoDel, both standalone and also combined with ECN and DCTCP network protocol, and identify the AQM configurations that maintain Hadoop execution time gains from larger buffers within 5%, while reducing network packet latency caused by bufferbloat by up to 85%. Finally, we provide recommendations to administrators of Hadoop clusters as to how to improve latency without degrading the throughput of batch big data workloads.The research leading to these results has received funding from the European Unions Seventh Framework Programme (FP7/2007–2013) under grant agreement number 610456 (Euroserver). The research was also supported by the Ministry of Economy and Competitiveness of Spain under the contracts TIN2012-34557 and TIN2015-65316-P, Generalitat de Catalunya (contracts 2014-SGR-1051 and 2014-SGR-1272), HiPEAC-3 Network of Excellence (ICT- 287759), and the Severo Ochoa Program (SEV-2011-00067) of the Spanish Government.Peer ReviewedPostprint (author's final draft

Datacenter Traffic Control: Understanding Techniques and Trade-offs

Datacenters provide cost-effective and flexible access to scalable compute and storage resources necessary for today's cloud computing needs. A typical datacenter is made up of thousands of servers connected with a large network and usually managed by one operator. To provide quality access to the variety of applications and services hosted on datacenters and maximize performance, it deems necessary to use datacenter networks effectively and efficiently. Datacenter traffic is often a mix of several classes with different priorities and requirements. This includes user-generated interactive traffic, traffic with deadlines, and long-running traffic. To this end, custom transport protocols and traffic management techniques have been developed to improve datacenter network performance. In this tutorial paper, we review the general architecture of datacenter networks, various topologies proposed for them, their traffic properties, general traffic control challenges in datacenters and general traffic control objectives. The purpose of this paper is to bring out the important characteristics of traffic control in datacenters and not to survey all existing solutions (as it is virtually impossible due to massive body of existing research). We hope to provide readers with a wide range of options and factors while considering a variety of traffic control mechanisms. We discuss various characteristics of datacenter traffic control including management schemes, transmission control, traffic shaping, prioritization, load balancing, multipathing, and traffic scheduling. Next, we point to several open challenges as well as new and interesting networking paradigms. At the end of this paper, we briefly review inter-datacenter networks that connect geographically dispersed datacenters which have been receiving increasing attention recently and pose interesting and novel research problems.Comment: Accepted for Publication in IEEE Communications Surveys and Tutorial

Matrix modification for enhancing the transport properties of the human cartilage endplate to improve disc nutrition.

Poor solute transport through the cartilage endplate (CEP) impairs disc nutrition and could be a key factor that limits the success of intradiscal biologic therapies. Here we demonstrate that treating the CEP with matrix metalloproteinase-8 (MMP-8) reduces the matrix constituents that impede solute uptake and thereby improves nutrient diffusion. Human CEP tissues harvested from four fresh cadaveric lumbar spines (age range: 38-66 years old) were treated with MMP-8. Treatment caused a dose-dependent reduction in sGAG, localized reductions to the amount of collagen, and alterations to collagen structure. These matrix modifications corresponded with 16-24% increases in the uptake of a small solute (376 Da). Interestingly, the effects of MMP-8 treatment depended on the extent of non-enzymatic glycation: treated CEPs with high concentrations of advanced glycation end products (AGEs) exhibited the lowest uptake compared to treated CEPs with low concentrations of AGEs. Moreover, AGE concentrations were donor-specific, and the donor tissues with the highest AGE concentrations appeared to have lower uptake than would be expected based on the initial amounts of collagen and sGAG. Finally, increasing solute uptake in the CEP improved cell viability inside diffusion chambers, which supports the nutritional relevance of enhancing the transport properties of the CEP. Taken together, our results provide new insights and in vitro proof-of-concept for a treatment approach that could improve disc nutrition for biologic therapy: specifically, matrix reduction by MMP-8 can enhance solute uptake and nutrient diffusion through the CEP, and AGE concentration appears to be an important, patient-specific factor that influences the efficacy of this approach

Precise Proximal Femur Fracture Classification for Interactive Training and Surgical Planning

We demonstrate the feasibility of a fully automatic computer-aided diagnosis (CAD) tool, based on deep learning, that localizes and classifies proximal femur fractures on X-ray images according to the AO classification. The proposed framework aims to improve patient treatment planning and provide support for the training of trauma surgeon residents. A database of 1347 clinical radiographic studies was collected. Radiologists and trauma surgeons annotated all fractures with bounding boxes, and provided a classification according to the AO standard. The proposed CAD tool for the classification of radiographs into types "A", "B" and "not-fractured", reaches a F1-score of 87% and AUC of 0.95, when classifying fractures versus not-fractured cases it improves up to 94% and 0.98. Prior localization of the fracture results in an improvement with respect to full image classification. 100% of the predicted centers of the region of interest are contained in the manually provided bounding boxes. The system retrieves on average 9 relevant images (from the same class) out of 10 cases. Our CAD scheme localizes, detects and further classifies proximal femur fractures achieving results comparable to expert-level and state-of-the-art performance. Our auxiliary localization model was highly accurate predicting the region of interest in the radiograph. We further investigated several strategies of verification for its adoption into the daily clinical routine. A sensitivity analysis of the size of the ROI and image retrieval as a clinical use case were presented.Comment: Accepted at IPCAI 2020 and IJCAR

Investigating the feasibility of a distributed, mapping-based, approach to solving subject interoperability problems in a multi-scheme, cross-service, retrieval environment

The HILT project is researching the problems of facilitating interoperability of subject descriptions in a distributed multi-scheme environment. HILT Phase I found a UK community consensus in favour of utilising an inter-scheme mapping service to improve interoperability. HILT Phase II investigated the approach by building a pilot server, and identified a range of issues that would have to be tackled if an operational service was to be successful. HILT Phase III will implement a centralised version of an M2M pilot, but will aim to design it so that the possibility of a move to a distributed service remains open. This aim will impact on likely future research concerns in Phase III and beyond. Wide adoption of a distributed approach to the problem could lead to the creation of a framework within which regional, national, and international efforts in the area can be harmonised and co-ordinated

Online Network Mobility Exercises for Male Hockey Players During an Adolescent Growth Spurt

Why do adolescents going through a growth spurt, competing heavily in sport, need to do mobility exercises, what exercises are appropriate for this stage in growth and can we support their compliance to prevent possible injury with a mobile phone and online network? Adolescent boys in the midst of a growth spurt increase in a short time height and weight which challenges mobility. Tissues are at risk of injury for physical changes in tissue, lack of active movement control and over use or load. Efficiency in movement is a basal need and that need is heightened with physical stress and load increase as in hockey. Mobility exercises are simple yet essential for wellbeing and longevity in sport participation. Training mobility is not a new concept nor an unused one but it is the exercise often bypassed if suppressed for time, lack of interest or knowledge. Training mobility is specific as is the individual training, due to life style, sport, and physiological, biolog-ical, and training history. Regaining neuromuscular efficiency through mobility train-ing is worth the time and effort when the option of injury and its repercussions are concerned. With online network availability, direction of exercises are visually ready to support improvement in mobility