Analytical evaluation of adaptive-modulation-based opportunistic cognitive radio in Nakagami-m fading channels

The performance of adaptive modulation for cognitive radio with opportunistic access is analyzed by considering the effects of spectrum sensing, primary user (PU) traffic, and time delay for Nakagami- m fading channels. Both the adaptive continuous rate scheme and the adaptive discrete rate scheme are considered. Numerical examples are presented to quantify the effects of spectrum sensing, PU traffic, and time delay for different system parameters

Novel Fine-Tuned Attribute Weighted Na\"ive Bayes NLoS Classifier for UWB Positioning

In this paper, we propose a novel Fine-Tuned attribute Weighted Na\"ive Bayes (FT-WNB) classifier to identify the Line-of-Sight (LoS) and Non-Line-of-Sight (NLoS) for UltraWide Bandwidth (UWB) signals in an Indoor Positioning System (IPS). The FT-WNB classifier assigns each signal feature a specific weight and fine-tunes its probabilities to address the mismatch between the predicted and actual class. The performance of the FT-WNB classifier is compared with the state-of-the-art Machine Learning (ML) classifiers such as minimum Redundancy Maximum Relevance (mRMR)- $k$-Nearest Neighbour (KNN), Support Vector Machine (SVM), Decision Tree (DT), Na\"ive Bayes (NB), and Neural Network (NN). It is demonstrated that the proposed classifier outperforms other algorithms by achieving a high NLoS classification accuracy of $99.7\%$ with imbalanced data and $99.8\%$ with balanced data. The experimental results indicate that our proposed FT-WNB classifier significantly outperforms the existing state-of-the-art ML methods for LoS and NLoS signals in IPS in the considered scenario

Cooperative backscatter NOMA with imperfect SIC: Towards energy efficient sum rate maximization in sustainable 6G networks

The combination of backscatter communication with non-orthogonal multiple access (NOMA) has the potential to support low-powered massive connections in upcoming sixth-generation (6G) wireless networks. More specifically, backscatter communication can harvest and use the existing RF signals in the atmosphere for communication, while NOMA provides communication to multiple wireless devices over the same frequency and time resources. This paper has proposed a new resource management framework for backscatter-aided cooperative NOMA communication in upcoming 6G networks. In particular, the proposed work has simultaneously optimized the base station’s transmit power, relaying node, the reflection coefficient of the backscatter tag, and time allocation under imperfect successive interference cancellation to maximize the sum rate of the system. To obtain an efficient solution for the resource management framework, we have proposed a combination of the bisection method and dual theory, where the sub-gradient method is adopted to optimize the Lagrangian multipliers. Numerical results have shown that the proposed solution provides excellent performance. When the performance of the proposed technique is compared to a brute-forcing search technique that guarantees optimal solution however, is very time-consuming, it was seen that the gap in performance is actually 0%. Hence, the proposed framework has provided performance equal to a cumbersome brute-force search technique while offering much less complexity. The works in the literature on cooperative NOMA considered equal time distribution for cooperation and direct communication. Our results showed that optimizing the time-division can increase the performance by more than 110% for high transmission powers

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication