Int-FLBCC: Model for Load Balancing in Cloud Computing using Fuzzy Logic Type-2 and Admissible Orders.

Dynamic consolidation of virtual machines (VMs) is an effective way to improve resource utilization and power efficiency in cloud computing, directly affecting Quality of Service aspects. This paper presents Int-FLBCC, a new proposal with exploring a Type-2 Fuzzy Logic approach to address the uncertainties and inaccuracies in determining resource usage, aiming at energy savings with minimal performance degradation. Validation results in a simulated cloud computing environment showed improvements in energy efficiency of 8.83% with IQR_XY and 22.43% with MAD_XY. For fulfillment of Service Level Agreements (SLA), the best values achieved were 9.06% with MAD_XY and 25% of THR_Lex1

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A contribution to the Int-FLBCC exploring Fuzzy Consensus via penalty functions.

The dynamic consolidation of resources in the infrastructures provided by Computing Clouds is a widely used strategy to improve energy efficiency in Cloud Computing. Determining when it is best to relocate Virtual Machines (VMs) from overloaded hosts, or that are under a very low load, is an aspect that directly influences resource utilization and the quality of service offered by the CN infrastructure. As an important step in the study and research efforts, a Systematic Literature Review was carried out through the formulation of a search string, an inclusion criterion and four exclusion criteria. At the end of this stage, eight works were selected, presenting their main characteristics and the strategies used to manage resources in the NC. In this scenario, this work aims to design an approach for the consolidation of resources in a NC environment, which considers the treatment of information related to Computing Power, Communication Cost and RAM Consumption. Based on these features, the proposed approach extends the Int-FLBCC, which consists of an Interval Valued Fuzzy Logic approach, adding a degree of reliability to the results obtained with an evaluation through consensus measures. Evaluations were carried out exploring two fronts: (i) where consensus measures and penalties in fuzzy values are explored, based on membership functions; and (ii) which considers the imprecision inherent to the Interval Valued Fuzzy Sets related to input and output variables. The resulted evaluations point to promising results in the treatment of imprecision through the functions developed in Int-FLBCC, and also, due to the exploitation of fuzzy consensus, greater reliability is generated in the treatment of the uncertainty present in the information captured from an infrastructure typical of Cloud Computing.Sem bolsaA consolidação dinâmica de recursos nas infraestruturas disponibilizadas pelas Nuvens Computacionais é uma estratégia bastante utilizada para melhorar a eficiência energética na Computação em Nuvem (CN). Determinar quando é melhor realocar Máquinas Virtuais (MVs) de hosts sobrecarregados, ou que estejam com uma carga muito baixa, é um aspecto que influencia diretamente na utilização de recursos e na qualidade de serviço oferecida pela infraestrutura de CN. Enquanto etapa importante dos esforços de estudo e pesquisa, foi realizada uma Revisão Sistemática da Literatura através da formulação de uma string de pesquisa, um critério de inclusão e quatro critérios de exclusão. Ao final desta etapa, foram selecionados oito trabalhos, sendo apresentadas suas principais características e as estratégias usadas para o gerenciamento de recursos na CN. Considerando este contexto, este trabalho tem por objetivo a concepção de uma abordagem para a consolidação de recursos em um ambiente de CN, que considere o tratamento de informações relacionadas ao Poder Computacional, Custo de Comunicação e Consumo de Memória RAM. Para tal, a abordagem proposta estende o Int-FLBCC, que consiste em uma abordagem de Lógica Fuzzy Valorada Intervalarmente, acrescentando um grau de confiabilidade aos resultados obtidos com uma avaliação através de medidas de consenso. Foram feitas avaliações explorando duas frentes: (i) onde são exploradas medidas de consenso e penalidades em valores fuzzy, a partir das funções de pertinência; e (ii) que considera a imprecisão inerente aos conjuntos fuzzy valorados intervalarmente referente às variáveis de entrada e saída. As avaliações realizadas apontam resultados promissores no tratamento da imprecisão através das funções desenvolvidas no Int-FLBCC, e ainda, em virtude da exploração do consenso fuzzy, é gerada uma maior confiabilidade no tratamento da incerteza presente nas informações capturadas de uma infraestrutura típica de CN

Int-FLBCC: Model for Load Balancing in Cloud Computing using Fuzzy Logic Type-2 and Admissible Orders.

Dynamic consolidation of virtual machines (VMs) is an effective way to improve resource utilization and power efficiency in cloud computing, directly affecting Quality of Service aspects. This paper presents Int-FLBCC, a new proposal with exploring a Type-2 Fuzzy Logic approach to address the uncertainties and inaccuracies in determining resource usage, aiming at energy savings with minimal performance degradation. Validation results in a simulated cloud computing environment showed improvements in energy efficiency of 8.83% with IQR_XY and 22.43% with MAD_XY. For fulfillment of Service Level Agreements (SLA), the best values achieved were 9.06% with MAD_XY and 25% of THR_Lex1

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology