Scalable Traffic-Aware Virtual Machine Management for Cloud Data Centers

Virtual Machine (VM) management is a powerful mechanism for providing elastic services over Cloud Data Centers (DC)s. At the same time, the resulting network congestion has been repeatedly reported as the main bottleneck in DCs, even when the overall resource utilization of the infrastructure remains low. However, most current VM management strategies are traffic-agnostic, while the few that are traffic-aware only concern a static initial allocation, ignore bandwidth oversubscription, or do not scale. In this paper we present S-CORE, a scalable VM migration algorithm to dynamically reallocate VMs to servers while minimizing the overall communication footprint of active traffic flows. We formulate the aggregate VM communication as an optimization problem and we then define a novel distributed migration scheme that iteratively adapts to dynamic traffic changes. Through extensive simulation and implementation results, we show that S-CORE achieves significant (up to 87%) communication cost reduction while incurring minimal overhead and downtime. Index Terms—Virtual Machine, Migration, Consolidation, Communication Cost, Scalable, Traffic-Aware, Data Center Networ

Parameter selection for and implementation of a web-based decision-support tool to predict extubation outcome in premature infants

BACKGROUND: Approximately 30% of intubated preterm infants with respiratory distress syndrome (RDS) will fail attempted extubation, requiring reintubation and mechanical ventilation. Although ventilator technology and monitoring of premature infants have improved over time, optimal extubation remains challenging. Furthermore, extubation decisions for premature infants require complex informational processing, techniques implicitly learned through clinical practice. Computer-aided decision-support tools would benefit inexperienced clinicians, especially during peak neonatal intensive care unit (NICU) census. METHODS: A five-step procedure was developed to identify predictive variables. Clinical expert (CE) thought processes comprised one model. Variables from that model were used to develop two mathematical models for the decision-support tool: an artificial neural network (ANN) and a multivariate logistic regression model (MLR). The ranking of the variables in the three models was compared using the Wilcoxon Signed Rank Test. The best performing model was used in a web-based decision-support tool with a user interface implemented in Hypertext Markup Language (HTML) and the mathematical model employing the ANN. RESULTS: CEs identified 51 potentially predictive variables for extubation decisions for an infant on mechanical ventilation. Comparisons of the three models showed a significant difference between the ANN and the CE (p = 0.0006). Of the original 51 potentially predictive variables, the 13 most predictive variables were used to develop an ANN as a web-based decision-tool. The ANN processes user-provided data and returns the prediction 0–1 score and a novelty index. The user then selects the most appropriate threshold for categorizing the prediction as a success or failure. Furthermore, the novelty index, indicating the similarity of the test case to the training case, allows the user to assess the confidence level of the prediction with regard to how much the new data differ from the data originally used for the development of the prediction tool. CONCLUSION: State-of-the-art, machine-learning methods can be employed for the development of sophisticated tools to aid clinicians' decisions. We identified numerous variables considered relevant for extubation decisions for mechanically ventilated premature infants with RDS. We then developed a web-based decision-support tool for clinicians which can be made widely available and potentially improve patient care world wide

Clinical performance of a diode laser fluorescence device for the detection of occlusal caries in primary teeth

Objectives. To correlate the DIAGNOdentTM readings (LF) with those of direct visual (DV) examination, indirect visual (IDV) examination, bitewing radiography (BWR), and pit and fissure opening (PFO) for the detection of occlusal caries in primary teeth; to determine the validity of this device using PFO as reference; and to evaluate its reliability. Methods. Two calibrated operators examined 130 teeth with 405 examination sites using DV, IDV and radiographic examinations, and LF. Of the 405 sites, 155 were visually scored for caries after pit and fissure opening. Results. Pit and fissure opening was found to significantly correlate with all methods (rhoLF = 0.48, rhoBWX = 0.48, rhoDV = 0.44, rhoIDV = 0.41). For enamel lesions, higher sensitivity (0.76) was found with DV, while higher specificity (0.88) with the LF. For lesions into dentin, however, higher sensitivity (0.78) was found with the LF, while higher specificity (0.98) with the BWR. The device's accuracy was found to be 0.61 for enamel lesions, while for lesions into dentin 0.70, and its reliability was excellent (ICC = 0.97). Conclusion. The LF device presented high reliability in the detection of occlusal caries in primary teeth and its performance was similar to DV and radiographic examinations. © 2008 BSPD, IAPD and Blackwell Publishing Ltd

Comparative in vitro validation of VistaProof and DIAGNOdent Pen for occlusal caries detection in permanent teeth

Purpose: Current caries diagnostic tools are neither very accurate nor very reliable for the detection of carious lesions of different depths. Thus, the development of new devices and techniques is needed. The aim of this in vitro study was to validate a newer fluorescence device, VistaProof (VP), and compare it with DIAGNOdent Pen (DP), direct visual (DV) and indirect visual methods (IDV), with respect to accuracy and reliability for the detection of occlusal caries in permanent teeth. Methods: and Materials: One hundred seven sites on 41 occlusal surfaces of recently extracted premolars were selected and classified into lesion categories according to Ekstrand's clinical criteria, by direct and indirect visual examination. The fluorescence of the sites was also measured by the two devices, and the teeth were ground through the sites for histological evaluation of their lesion depth. One calibrated examiner of high reliability (intraclass correlation coefficient [ICC]<0.85) made all of the evaluations. Sensitivity, specificity, and accuracy of each detection method were estimated based on histological examination as the reference method, estimated using cutoff limits calculated on the basis of best agreement between the devices' values and histological examination. McNemar tests and receiver operating characteristic (ROC) curve analyses were used to compare the validity measures of all detection methods at α=0.05, while the ICC was used to test the reproducibility of the methods based on a second measurement one week after the first. Results: There was no statistically significant difference (p<0.05) between the accuracy of DP and VPs for both enamel and dentin lesions. The areas under the ROC curves (AUC) for the two devices were also found not to be different (p<0.05). The reliability of DP was statistically significantly better than VP (p>0.05). Conclusion: The validity of both fluorescence devices were not found to be significantly different and not better than visual methods for the detection of noncavitated carious lesions. © 2012 Operative Dentistry, Inc

Combined validity of DIAGNOdentTM and visual examination for in vitro detection of occlusal caries in primary molars

The purpose of this in vitro investigation was to compare in primary molars, the validity of DIAGNOdentTM 2095 on occlusal caries diagnosis used either separately or in combination with direct and/or indirect visual examinations, based on histological examination as the reference method. In 24 extracted primary molars, 111 occlusal pits were examined for caries by one trained operator (intraexaminer reliability k>0.80), using the following examination methods: direct visual (DV), indirect visual (IDV), radiographic (XR), and fluorescence (DD) with the DIAGNOdentTM. The extent of caries was then determined histologically. Sensitivity, specificity, accuracy, and the area under the ROC curve (AUC) were calculated for each method separately as well as for the combination of DD with DV and/or IDV. The DD accuracy was found both for lesions into enamel and into dentin to be 0.70 while the accuracy of the DD combination with DV and IDV was found to be 0.89. The DD AUC for lesions into enamel and into dentin, 0.68, were not statistically significant different from the other methods (p>0.5), however the AUC of the combination of DD with DVand IDV, found to be 0.82, was higher than all the other methods, and this was statistically significant for enamel lesions. The validity of DIAGNOdentTM for occlusal caries diagnosis in primary molars was much higher when the DD was used in combination with direct and indirect visual examination, than when used by itself. © 2010 Springer-Verlag London Ltd

Dental late effects of antineoplastic treatment on childhood cancer survivors: Radiographic findings

Background: Dental anomalies are common late side effects of childhood cancer therapy and may lead to anatomical, functional, and aesthetic sequelae. Aim: The study aimed to record dental late effects of antineoplastic treatment and associate them with disease and treatment characteristics in order to identify possible risk factors. Design: Orthopantomograms of 70 survivors aged 4-21 years, who were treated at ages 0-10 years for any type of malignancy and completed antineoplastic treatment at least one year before, were examined. Incidence of developmental disturbances was recorded. Their severity was calculated, and odds ratios for the development of severe defects were estimated. Results: Root defects presented in 62% of the participants, with impaired root growth being the most common (58%). Increased incidence was associated with combination treatment protocols, irradiation to the head and neck region, and administration of antimetabolites, steroids, and vincristine. Mean DeI value was 17.46 with risk factors for the development of severe root defects being diagnosis of acute lymphoblastic leukemia, combination treatment protocols, administration of cyclophosphamide and steroids, and hemopoietic stem cell transplantation. Conclusions: Root defects are common among childhood cancer survivors, with their incidence and severity being affected by multiple disease and treatment characteristics. © 2021 BSPD, IAPD and John Wiley & Sons Lt

The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials

Introduction/objectives: This systematic review aimed to critically appraise the evidence on resin infiltration for the clinical management of proximal caries lesions in primary and permanent teeth. Data: Search terms included resin infiltration, micro-invasive and proximal caries. Potentially eligible studies involved proximal caries lesions treated with resin infiltration. Risk of bias assessment was performed using the Cochrane risk of bias tool and the quality of evidence was assessed with GRADE. Sources: Electronic Database search of published and unpublished literature was performed in April 22, 2018 within the following databases: MEDLINE via Pubmed, Cochrane Central Register of Controlled Trials, LILACS via BIREME, Open Grey, Clinical Trials.gov and National Research Register. Study selection: Of 135 articles initially retrieved, 10 were eligible for inclusion in the systematic review comprising the results of 9 studies, while 5 randomized controlled trials (RCTs) (6 articles) with unclear risk of bias contributed to the meta-analyses. Random effects meta-analyses were implemented and lesion progression treatment effects were estimated through Odds Ratios (ORs) along with associated 95% Confidence Intervals (95% CIs). Conclusions: Overall, there was strong evidence that proximal caries lesion progression was less likely to occur in permanent teeth following treatment with resin infiltration plus oral hygiene measures as compared to non- invasive methods (oral hygiene instructions) for follow up 18 months to 2 years (3 studies: OR = 0.14; 95% CI: 0.08, 0.25; P < 0.001) as well as 3 years (4 studies: OR = 0.15; 95% CI: 0.06, 0.36; P < 0.001). The quality of the evidence was rated as moderate to low respectively. © 2018 Elsevier Lt

Urinary Catecholamine Levels and Gingivitis in Children

THIS STUDY INVESTIGATED THE RELATIONSHIP between gingivitis and emotionally stressful states measured by the urinary catecholamines in children. Three-hundred and fourteen (314) children, boys and girls, aged 6 to 8 years were included in the study. Gingivitis was recorded by the gingival bleeding index and dental plaque by the plaque control record index. Proximal decayed surfaces, faulty restorations, and stainless steel crowns were diagnosed clinically and radiographically. Information concerning systemic and socioeconomic factors was collected by a questionnaire. A 24-hour urine sample was collected for each subject and analyzed by the HPLC technique to assay the catecholamine content. The multiple-regression analysis was carried out to test whether gingivitis was affected by the studied variables. The 95% probability was used. The results showed that epinephrine, norepinephrine, and dopamine did not have a significant association with gingival index. Dental plaque and proximal decayed surfaces significantly affected gingivitis. Of the socioeconomic factors, mother's education had a significant association with gingivitis when all factors were included in the analysis. The data suggest that emotionally stressful states may not increase the probability of developing gingivitis in children of this age

Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10year-old children

Background: School based oral health education through traditional lecturing has been found successful only in improving oral health knowledge, while has low effectiveness in oral hygiene and gingival health. The aim of this study was to evaluate the effectiveness of experiential learning (EL) oral health education to traditional lecturing (TL), on enhancing oral health knowledge, attitude and behavior as well as oral hygiene, gingival health and caries of 10-year-old children. Methods: Eighty-four children were recruited for the EL and 100 for the TL group from 3 locations in Greece. Data regarding oral health knowledge, attitude and behavior were collected via questionnaires. Data regarding dental plaque, gingivitis and caries were collected by clinical examination. The evaluation using questionnaires and clinical examination was assessed at baseline and 6 and 18months afterwards. Two calibrated pediatric dentists examined the students using a periodontal probe and artificial light. Modified hygiene index (HI) was used for dental plaque recording, the simplified gingival index (GI-S) was used for gingivitis and DMFT, based on BASCD criteria, for dental caries. Based on a dedicated manual, the teacher applied in the classroom the oral health educational program using EL. Results: EL group had statistically significant better hygiene than the TL at 6months (p < 0.05). Within the same group, both groups had enhanced oral health knowledge at 6 and 18months (p < 0.05) and improved oral health behavior (p > 0.05) and attitude (p > 0.05) at 6months in comparison to baseline. Conclusion: EL program was found more successful than TL in oral hygiene improvement. Both oral health education programs improved the oral health knowledge, attitude and behavior of children. © 2015 Angelopoulou et al.; licensee BioMed Central