Dynamic Quality of Service in Software-Defined Networks

Quality of service is a necessary function of today’s networks. A proper quality of service ensures that packets are delivered effectively and fast. In traditional networks, quality of service has to be manually configured on each piece of hardware in the network. This manual procedure makes the process of implementing a quality of service in a network costly. Not to mention, if part of the configuration is incorrect, or a mistake is made during the configuration, everything must be corrected on each piece of affected hardware. In this paper, I will be exploring the effect of using a software-defined network controller and a quality of service to handle certain flows of traffic in a network. The main tool used is the OpenFlow defined queue. Queues and flow rules will allow a switch to control individual flows and the network resources that each flow consumes. Factors that will be explored are the bandwidth usage of a flow and the time taken by the network to implement new flow rules. While bandwidth usage is taken into account in traditional networks, changing a quality of service is a new dynamic

A safer place for patients: learning to improve patient safety

1 Every day over one million people are treated successfully by National Health Service (NHS) acute, ambulance and mental health trusts. However, healthcare relies on a range of complex interactions of people, skills, technologies and drugs, and sometimes things do go wrong. For most countries, patient safety is now the key issue in healthcare quality and risk management. The Department of Health (the Department) estimates that one in ten patients admitted to NHS hospitals will be unintentionally harmed, a rate similar to other developed countries. Around 50 per cent of these patient safety incidentsa could have been avoided, if only lessons from previous incidents had been learned. 2 There are numerous stakeholders with a role in keeping patients safe in the NHS, many of whom require trusts to report details of patient safety incidents and near misses to them (Figure 2). However, a number of previous National Audit Office reports have highlighted concerns that the NHS has limited information on the extent and impact of clinical and non-clinical incidents and trusts need to learn from these incidents and share good practice across the NHS more effectively (Appendix 1). 3 In 2000, the Chief Medical Officer’s report An organisation with a memory 1 , identified that the key barriers to reducing the number of patient safety incidents were an organisational culture that inhibited reporting and the lack of a cohesive national system for identifying and sharing lessons learnt. 4 In response, the Department published Building a safer NHS for patients3 detailing plans and a timetable for promoting patient safety. The goal was to encourage improvements in reporting and learning through the development of a new mandatory national reporting scheme for patient safety incidents and near misses. Central to the plan was establishing the National Patient Safety Agency to improve patient safety by reducing the risk of harm through error. The National Patient Safety Agency was expected to: collect and analyse information; assimilate other safety-related information from a variety of existing reporting systems; learn lessons and produce solutions. 5 We therefore examined whether the NHS has been successful in improving the patient safety culture, encouraging reporting and learning from patient safety incidents. Key parts of our approach were a census of 267 NHS acute, ambulance and mental health trusts in Autumn 2004, followed by a re-survey in August 2005 and an omnibus survey of patients (Appendix 2). We also reviewed practices in other industries (Appendix 3) and international healthcare systems (Appendix 4), and the National Patient Safety Agency’s progress in developing its National Reporting and Learning System (Appendix 5) and other related activities (Appendix 6). 6 An organisation with a memory1 was an important milestone in the NHS’s patient safety agenda and marked the drive to improve reporting and learning. At the local level the vast majority of trusts have developed a predominantly open and fair reporting culture but with pockets of blame and scope to improve their strategies for sharing good practice. Indeed in our re-survey we found that local performance had continued to improve with more trusts reporting having an open and fair reporting culture, more trusts with open reporting systems and improvements in perceptions of the levels of under-reporting. At the national level, progress on developing the national reporting system for learning has been slower than set out in the Department’s strategy of 2001 3 and there is a need to improve evaluation and sharing of lessons and solutions by all organisations with a stake in patient safety. There is also no clear system for monitoring that lessons are learned at the local level. Specifically: a The safety culture within trusts is improving, driven largely by the Department’s clinical governance initiative 4 and the development of more effective risk management systems in response to incentives under initiatives such as the NHS Litigation Authority’s Clinical Negligence Scheme for Trusts (Appendix 7). However, trusts are still predominantly reactive in their response to patient safety issues and parts of some organisations still operate a blame culture. b All trusts have established effective reporting systems at the local level, although under-reporting remains a problem within some groups of staff, types of incidents and near misses. The National Patient Safety Agency did not develop and roll out the National Reporting and Learning System by December 2002 as originally envisaged. All trusts were linked to the system by 31 December 2004. By August 2005, at least 35 trusts still had not submitted any data to the National Reporting and Learning System. c Most trusts pointed to specific improvements derived from lessons learnt from their local incident reporting systems, but these are still not widely promulgated, either within or between trusts. The National Patient Safety Agency has provided only limited feedback to trusts of evidence-based solutions or actions derived from the national reporting system. It published its first feedback report from the Patient Safety Observatory in July 2005

A large potentiation effect of serum on the in vitro potency of tulathromycin against Mannheimia haemolytica and Pasteurella multocida

The antimicrobial properties of tulathromycin were investigated for M.haemolytica and P.multocida. Three invitro indices of antimicrobial activity, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill curves, were established for six isolates of each organism. Each index was measured in two growth media: Mueller-Hinton broth (MHB) and calf serum. It was shown that MICs and MBCs were markedly lower in serum than in MHB. MHB:serum ratios for MIC were 47:1 (M.haemolytica) and 53:1 (P.multocida). For both serum and MHB, adjustment of pH led to greater potency at alkaline compared to acid pH. Tulathromycin MIC was influenced by size of inoculum count, being 4.0- to 7.7-fold greater for high compared to low initial counts. It was concluded that for the purpose of determining dosages for therapeutic use, pharmacodynamic data for tulathromycin should be derived in biological fluids such as serum. It is hypothesized that invitro measurement of MIC in broth, conducted according to internationally recommended standards, may be misleading as a basis for estimating the invivo potency of tulathromycin

Visualising & Animating Vectorthotic Products

Healthy Step has a successful foot orthotics and rehabilitation range. The company currently one of main manufacturer of a number of products and sells through distributers through them to the NHS. There is a growing area of business in the private market and internet (direct to the patient) sales. There is a perceived opportunity to develop a new brand of devices based upon the existing range that: • quality and performance – and would therefore carry a higher price point • available to clinics and clinicians – allowing clinics to set their own prices and be unaffected by Healthy Step’s direct to patient internet sales. • Focus on the business aspirations of the clinician and/or their practice. • Allowing them to realise greater profit by “selling”/prescribing quality, branded, performance devices that deliver adaptable clinical treatments with a quality retail feel and offering. The Company recently invested in a new mid range 3D printing machine to be used for mass customised product development and employed a Product Design placement student to further develop the services they offer. They also are keen to further develop 3D visualization of the web presence and exhibition through 3D Animation and Design visualisation

Regulation of Adipocyte Transcription by PPARgamma Ligands

Rosiglitazone (rosi) is a powerful insulin sensitizer, but serious toxicities have curtailed its widespread clinical use. Rosi functions as a high-affinity ligand for PPARgamma, the adipocyte-predominant nuclear receptor (NR). The classic model of NR action, involving binding of ligand to the NR on DNA, explains positive regulation of gene expression, but both ligand-dependent transcriptional repression and indirect regulation are not well understood. We have addressed these issues by studying the direct effects of rosiglitazone on gene transcription, using global run-on sequencing (GRO-seq). Rosi-induced changes in gene body transcription were pronounced after 10 minutes and correlated with steady-state mRNA levels as well as with transcription at nearby enhancers (eRNAs). Up-regulated eRNAs occurred almost exclusively at PPARg binding sites, to which rosi treatment recruited coactivators including MED1, p300, and CBP, without changes in binding of the corepressor NCoR. By contrast, down-regulated eRNAs fell in sites devoid of PPARg but enriched for a variety of other TFs in the C/EBP and AP-1 families. These enhancers lost coactivator binding upon rosi treatment, suggesting that rosi treatment causes redistribution of coactivators to PPARg sites and away from enhancers containing other TFs, leading to transcriptional repression at these eRNAs and their target genes. We also investigated the function of MRL-24, a compound that has been shown to lack PPARg transactivation activity and regulate a distinct subset of PPARg target genes while functioning as an equally effective insulin sensitizer as rosi. Though our goal was to identify whether MRL-24 regulates the same functional enhancers marked by eRNAs as rosi, we instead found that MRL-24 does not control a distinct subset of target genes, but rather acts as a partial agonist for PPARg. Together, these studies further our understanding of transcriptional regulation by modulation of PPARg activity, including insights into determining functional enhancers and mechanisms of transcriptional repression by activation of a NR

The Virtual Physiological Human: Ten Years After

Biomedical research and clinical practice are struggling to cope with the growing complexity that the progress of health care involves. The most challenging diseases, those with the largest socioeconomic impact (cardiovascular conditions; musculoskeletal conditions; cancer; metabolic, immunity, and neurodegenerative conditions), are all characterized by a complex genotype–phenotype interaction and by a “systemic” nature that poses a challenge to the traditional reductionist approach. In 2005 a small group of researchers discussed how the vision of computational physiology promoted by the Physiome Project could be translated into clinical practice and formally proposed the term Virtual Physiological Human. Our knowledge about these diseases is fragmentary, as it is associated with molecular and cellular processes on the one hand and with tissue and organ phenotype changes (related to clinical symptoms of disease conditions) on the other. The problem could be solved if we could capture all these fragments of knowledge into predictive models and then compose them into hypermodels that help us tame the complexity that such systemic behavior involves. In 2005 this was simply not possible—the necessary methods and technologies were not available. Now, 10 years later, it seems the right time to reflect on the original vision, the results achieved so far, and what remains to be done

Design and Development of Alternative Vectorthotic Insole: Technical Report

This CVF funded product design and development project for orthotic range aspires to be as effective as a functional foot orthotic. It is adaptable and customisable to meet the needs of the busy clinical environment as an off the shelf solution. Healthy Step has a successful foot orthotics and rehabilitation range. There is a growing area of business in the private market and internet sales. There is a perceived opportunity to develop a new brand of devices based upon the existing range that: • Exude quality and performance – and would therefore carry a higher price point • Are only available to clinics and clinicians – allowing clinics to set their own prices and be unaffected by Healthy Step’s direct to patient internet sales. • Are not available direct to the patients. • Focus on the business aspirations of the clinician and/or their practice. • Allowing them to realise greater profit by “selling”/prescribing quality, branded, performance devices that deliver adaptable clinical treatments with a quality retail feel and offering. Heel, ball and arch orthotic components of the existing vectorthotic were improved during the this project. Completion was a great live experience for the team although some issue with the printing tolerances as it had an impact on the first phase of iterations especially the snap fit parts of the orthotic but with product testing and feedback from the client these were overcome. The project resulted the company investing in a mid range 3D printing device and relevant software & hardware,an a placement student. They also start offering customized products and bespoke 3D printing services to their customers

Feeding wet distillers grains plus solubles with and without a direct-fed microbial to determine performance, carcass characteristics, and fecal shedding of Escherichia coli O157:H7 in feedlot heifers

Citation: Wilson, B. K., Holland, B. P., Step, D. L., Jacob, M. E., VanOverbeke, D. L., Richards, C. J., . . . Krehbiel, C. R. (2016). Feeding wet distillers grains plus solubles with and without a direct-fed microbial to determine performance, carcass characteristics, and fecal shedding of Escherichia coli O157:H7 in feedlot heifers. Journal of Animal Science, 94(1), 297-305. doi:10.2527/jas2015-9601The inclusion of wet distillers grains plus solubles (WDGS) in feedlot diets has become a common practice in many regions of the United States due to the expanded production of byproducts and fluctuating corn prices related to ethanol production and other factors. In addition, societal concerns over the continued use of antimicrobials in agriculture production combined with an enhanced interest in disease and pathogen prevention in the food supply have led to an increased interest in use of direct-fed microbials (DFM) in growing and finishing cattle. Direct-fed microbials have been shown to improve ADG and feed efficiency, alter ruminal fermentation, and decrease fecal shedding of potential harmful pathogens in feedlot cattle in some experiments. The objective of this experiment was to evaluate the effects of WDGS inclusion with or without a DFM containing Lactobacillus acidophilus (1 x 10(6) cfu . heifer(-1) . d(-1)) combined with Propionibacterium freudenreichii (1 x 10(9) cfu , heifer(-1) . d(-1)) on the performance, carcass characteristics, and Escherichia coli O157:H7 shedding in feedlot heifers. In early August, 288 crossbred heifers (initial BW = 295 +/- 28 kg) were assigned to 1 of 4 treatments (12 pens per treatment; 6 heifers per pen) in a randomized complete block design with a 2 x 2 factorial arrangement of treatments. Body weights and fecal grab samples were obtained at approximately 28-d intervals throughout the experiment. Across the feeding period, heifers fed 30% WDGS tended (P = 0.09) to have greater ADG and had greater carcass-adjusted ADG (P = 0.05) compared with heifers fed dry-rolled corn (DRC). Dry matter intake was not affected (P = 0.65) by diet, although carcass-adjusted G:F tended (P = 0.10) to be improved for heifers fed WDGS. Heifers fed 30% WDGS tended (P 0.10) on performance or carcass merit in the present experiment. The incidence of E. coli O157:H7 throughout the experiment was low, with only 18 positive samples across all sampling periods. Neither WDGS inclusion nor the inclusion of L. acidophilus combined with P. freudenreichii in the diet had any effect (P > 0.10) on E. coli O157:H7 shedding in this experiment. Feeding 30% WDGS to feedlot heifers improved animal performance compared to the DRC-based control diet

Second consultation on developing standards for identifying evidence-based practices in reproductive health

The STEP UP consortium and the High Impact Practices initiative, together with other partners, supported three consultation meetings to inform the use of appropriate standards of evidence for recommending best practices in reproductive health (RH). The second consultation, reported here, brought together researchers and funders to review the research designs and methodologies that can be used to generate evidence on the impact of FP/RH interventions and on their implementation; the mechanisms and structures through which such evidence is reviewed and translated into recommendations; and the implications for organizing and funding evidence generation to maximize its quality and utility. Drawing from the presentations, three plenary discussions were held which reflected a diversity of views on what constitutes high-quality evidence, which type of evidence is appropriate for which type of recommendations, and which approaches should be followed to translate evidence into practice recommendations. Recommendations for consolidating standards of evidence and formulating guidelines for high-impact practices in FP/RH programming and policymaking are presented in this report