NVP: A Network Virtualization Proxy for Software Defined Networking

The combination of Network Function Virtualization (NFV) and Software Defined Networking (SDN) can improve the control and utilization of network resources. However, this issue still requires proper solutions to virtualize large-scale networks, which would allow the use of SDN and Virtualization in real environments.Thus, this paper proposes a virtualization architecture for SDN that relies on a proxy-based approach. The NVP (Network Virtualization Proxy) is a virtualization proxy that intercepts messages exchanged between controllers and switches SDN enabling network virtualization. An implementation of the proposal was developed as a proof of concept and load testing was performed showing that the solution can provide network virtualization in a scalable manner, using less than 2.5 MB of memory to manage 100 switches performing simultaneous requests, whereas FlowVisor requires more than 200 MB

Severe form of lymphocutaneous sporotrichosis: a case report

Sporotrichosis is the most frequent subcutaneous mycosis in Latin America. It is caused by species of the genus Sporothrix. Infection in humans occurs through the entry of the fungus into the skin. Zoonotic outbreaks involving cats in the transmission of the disease have been frequently reported. The lymphocutaneous form is the most commonly observed and the upper limbs are the most affected sites. We report a case of a 64-year-old healthy female patient with a lymphocutaneous form with rapid progression of lesions, which was refractory to initial treatment with itraconazole. Treatment with liposomal amphotericin B was performed with a satisfactory resolution, but aesthetic and functional sequelae in the left upper limb were installed

Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

Background: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. Methods: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. Findings: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change −0·2% [95% UI −1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by −15·4% [–16·8 to −14·3], while avoidable MSVI showed no change (0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]). Interpretation: Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. Funding: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

Uma abordagem SDN para virtualização de redes

The virtual SDN networks (vSDNs) have emerged from the association of virtualization and Software-Dened Networking (SDN), providing greater control and better use of network resources. Several studies have already shown the feasibility and benets of this approach. However, the issue still lacks solutions that can virtualize a network in a scalable, intuitive and simplied manner. Thus, this thesis proposes an SDN approach to network virtualization with the aim of reducing the limitations on vSDNs. Therefore, it is suggested to adopt in network virtualization the separation between data plans (distributed) and control (centralized), the global network view and use of ow abstraction to manage the communication between the dierent points. To support our proposition, three solutions were developed: the CIM-SDN (Common Information Model for Software-Dened Networking), to enable the use of formal representation of the new elements of vSDNs; The NVP (Network Virtualization Proxy), to provide greater scalability by separating the control plane into centralized and decentralized parts; And Graph Virtualization Layer (GVL), to provide greater use of abstractions between the hypervisor and controllers, thereby simplifying the understanding and use of the network. Proof of concept tests was carried out for the three proposed solutions, demonstrating the feasibility of the approach.As Redes Virtuais Denidas por Software (virtual SDN networks - vSDNs) surgiram da associac~ao de virtualizac~ao e Redes Denidas por Software (Software-Dened Networking - SDN), proporcionando maior controle e melhor utilização dos recursos de rede. Vários trabalhos ja mostraram a viabilidade e benefícios dessa abordagem. No entanto, o tema ainda carece de soluções que possam virtualizar uma rede de forma escalável, intuitiva e simplificada. Desta forma, esta Tese propõe uma abordagem SDN para a virtualização de redes com o objetivo de reduzir as limitações em vSDNs. Sendo assim, sugere-se adotar na virtualização de rede a separação entre planos de dados (distribuído) e controle (centralizado), visão global da rede e uso de abstração de fluxo para gerir a comunicação entre os diferentes pontos. Para sustentar nossa proposição, três soluções foram desenvolvidas: o CIM-SDN (Common Information Model for Software-Dened Networking), para viabilizar o uso de representação formal dos novos elementos das vSDNs; o NVP (Network Virtualization Proxy), para prover maior escalabilidade através da separação do plano de controle em partes centralizadas e descentralizadas; e o GVL (Graph Virtualization Layer), para fornecer maior uso de abstrações entre o hypervisor e os controladores simplicando, assim, o entendimento e uso da rede. Foram realizadas provas de conceitos para as três soluções propostas, demonstrando a viabilidade da abordagem

Sec-Health: A Blockchain-Based Protocol for Securing Health Records

Storing and sharing health records through electronic systems pose security risks. To address them, several countries&#x2019; regulations have established that healthcare information systems must fulfill security properties (confidentiality, access control, integrity, revocation and anonymity) and complementary ones (emergency access and interoperability). Upon tackling these issues, several proposals present security limitations and/or address specific properties only. We propose Sec-Health, a blockchain-based protocol that secures health records, addressing all of the main security and complementary properties defined in current regulations. We show that Sec-Health is a suitable solution by analyzing it under several attack scenarios and describing how it overcomes the problems of existing solutions. Furthermore, we evaluate a Sec-Health Proof of Concept, showing that it can reduce from 26&#x0025; up to 90&#x0025; the time to access health records, and reduce up to 50&#x0025; client-side memory overhead, compared to related work