Trade-off between power and bandwidth consumption in a reconfigurable xhaul network architecture

The increasing number of wireless devices, the high required traffic bandwidth, and power consumption will lead to a revolution of mobile access networks, which is not a simple evolution of traditional ones. Cloud radio access network technologies are seen as promising solution in order to deal with the heavy requirements defined for 5G mobile networks. The introduction of the common public radio interface (CPRI) technology allows for a centralization in BaseBand unit (BBU) of some access functions with advantages in terms of power consumption saving when switching off algorithms are implemented. Unfortunately, the advantages of the CPRI technology are to be paid with an increase in required bandwidth to carry the traffic between the BBU and the radio remote unit (RRU), in which only the radio functions are implemented. For this reason, a tradeoff solution between power and bandwidth consumption is proposed and evaluated. The proposed solution consists of: 1) handling the traffic generated by the users through both RRU and traditional radio base stations (RBS) and 2) carrying the traffic generated by the RRU and RBS (CPRI and Ethernet flows) with a reconfigurable network. The proposed solution is investigated under the lognormal spatial traffic distribution assumption. After proposing resource dimensioning analytical models validated by simulation, we show how the sum of the bandwidth and power consumption may be minimized with the deployment of a given percentage of RRU. For instance we show how in 5G traffic scenarios this percentage can vary from 30% to 50% according to total traffic amount handled by a switching node of the reconfigurable network

Previsão de Carga para Configuração Dinâmica de Aglomerados de Servidores Web

Atualmente, há uma crescente conscientização sobre computação verde em sistemas computacionais. Uma das grandes fontes de demanda energética nesses sistemas são os aglomerados de servidores web. Este trabalho avalia uma política para antecipar a carga e configurar o número de servidores ativos de forma que seja mantido uma qualidade de serviço satisfatória, enquanto se reduz o uso de energia. Experimentos são feitos em um protótipo de cluster para validar a técnica empregada

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

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

Optical transport for Industry 4.0

Industry 4.0 represents a new industrial revolution that will dramatically change the landscape in many sectors, including manufacturing and logistics. Robotics, machine intelligence, and new forms of connectivity are key ingredients of this paradigm. 5G mobile networks are expected to play a crucial role, supporting a lower cost per transported bit in air and a lower latency compared with 4G. 5G radio ensures different performance levels in very heterogeneous coverage situations, including a mix of indoor and outdoor contexts. Mobile network evolution requires new transport networks to address the new challenging requirements: increasing transmission capacity, compatibility with latency-critical applications, significantly reduced cost with respect to conventional metro network segments, lower energy consumption, and, in some cases, switching capabilities. Optical communications and networking will play a key role in these new transport scenarios, where tailored transmission techniques and network architectures are needed. This paper discusses the requirements and challenges that Industry 4.0 scenarios pose to optical communications and networking architectures. Performance of optical transmission schemes, tailored to support these new radio access networks, are detailed and benchmarked. A network test bed, focused on transport for vertical use cases, is described. Experimental results demonstrate the compliance of the proposed optical transport network with a latency-critical cloud robotics application, which presents industry-grade connectivity needs.The authors acknowledge Stephane Lessard, Teresa Pepe, Marzio Puleri, Eris Seder, Stefano Stracca, Francesco Testa, and Fabio Ubaldi, for relevant discussions and information about their research work. This work has been partially supported by the EC H2020 5GPPP 5Growth project (grant 856709)

Previsão de Carga para Configuração Dinâmica de Aglomerados de Servidores Web

Atualmente, há uma crescente conscientização sobre computação verde em sistemas computacionais. Uma das grandes fontes de demanda energética nesses sistemas são os aglomerados de servidores web. Este trabalho avalia uma política para antecipar a carga e configurar o número de servidores ativos de forma que seja mantido uma qualidade de serviço satisfatória, enquanto se reduz o uso de energia. Experimentos são feitos em um protótipo de cluster para validar a técnica empregada