Service Level Agreement-based adaptation management for Internet Service Provider (ISP) using Fuzzy Q-learning

Internet access is the vital catalyst for online users, and the number of mobile subscribers is predicted to grow from dramatically in the next few years. This huge demand is the main issue facing the Internet Service Providers (ISPs) who need to handle users’ expectations along with their current resources. An adaptive mechanism within the ISPs architecture is a promising solution to handle such situation. A Service Level Agreement (SLA)is the legal catalyst to monitor any contract violation between end users and ISPs and is embedded within a Quality of Service (QoS) framework. It strengthens and advances the quality of control over the user’s application and network resources and can be further stretched to fulfill the QoS terms through negotiation and re-negotiation. Moreover, the present literature does not focus on the combination of rule-based approaches and adaptation together to update the established learning repository. Therefore, this mainstream of this research in the context of SLAs is to fill in this gap by addressing the combination of rule-base uncertainties and iteration of the learning ability. The key to the proposed architecture is the utilization of self - * capabilities designed to have self-management over uncertainties and the provision of self-adaptive interactions. Thus, the Monitor, Analyse, Plan, Execute and Knowledge Base (MAPE-K) approach is able to deal with this problem together with the integration of Fuzzy and Q-Learning algorithms. The proposed architecture is in the context of autonomic computing. An adaptation manager is the main proposed component to update admission control on the ISP current resources and the ability to manage SLAs. A general methodology type-2 fuzzy logic is applied to ensure the uncertainties and precise decision-making are well addressed in this research. The proposed solution, demonstrating Q-Learning works adaptive with QoS parameters, e.g. Latency, Availability and Packet Loss. With the combination of fuzzy and Q-Learning, we demonstrate that the proposed adaptation manager is able to handle the uncertainties and learning abilities. Q-Learning is able to identify the initial state from various ISPs iterations and update them with appropriate actions, reflecting the reward configurations. The higher the iterations process the higher is the increase the learning ability,rewards and exploration probability. The research outcomes benefit the SLA framework by incorporating the information for SLA policies and Service Level Objectives (SLOs). Lastly, an important contribution is the ability to demonstrate that the MAPE-K approach is a contender for ISP SLA-based frameworks for QoS provision

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use