Enhanced transport protocols

The book presents mechanisms, protocols, and system architectures to achieve end-to-end Quality-of-Service (QoS) over heterogeneous wired/wireless networks in the Internet. Particular focus is on measurement techniques, traffic engineering mechanisms and protocols, signalling protocols as well as transport protocol extensions to support fairness and QoS. It shows how those mechanisms and protocols can be combined into a comprehensive end-to-end QoS architecture to support QoS in the Internet over heterogeneous wired/wireless access networks. Finally, techniques for evaluation of QoS mechanisms such as simulation and emulation are presented. The book is aimed at graduate and post-graduate students in Computer Science or Electrical Engineering with focus in data communications and networking as well as for professionals working in this area

Recurrent presence of the PLCG1 S345F mutation in nodal peripheral T-cell lymphomas

This work was supported by grants from Asociación Española contra el Cancer (AECC), Ministerio de Economía y Competitividad (MINECO) (SAF2013-47416-R), Instituto Salud Carlos III (ISCIII) – Fondos FEDER, MINECO-AES(RD012/0036/0060, PI10/00621, CP11/00018). RM is supported by the Fundación Conchita Rábago de la Fundación Jiménez Díaz, Madrid (Spain). JG-R is supported by a predoctoral grant from the Fundacion Investigacion Biomedica Puerta de Hierro. Salary support to SG is provided by ISCIII-FEDER (CP11/00018). MS-B is supported by a Miguel Servet contract from ISCIII-FEDER (CP11/00018). The Instituto de Investigación Marqués de Valdecilla (IDIVAL) is partly funded by the Sociedad para el Desarrollo Regional de Cantabria (SODERCAN)

Enhanced recovery in colorectal surgery: a multicentre study

<p>Abstract</p> <p>Background</p> <p>Major colorectal surgery usually requires a hospital stay of more than 12 days. Inadequate pain management, intestinal dysfunction and immobilisation are the main factors associated with delay in recovery. The present work assesses the short and medium term results achieved by an enhanced recovery program based on previously published protocols.</p> <p>Methods</p> <p>This prospective study, performed at 12 Spanish hospitals in 2008 and 2009, involved 300 patients. All patients underwent elective colorectal resection for cancer following an enhanced recovery program. The main elements of this program were: preoperative advice, no colon preparation, provision of carbohydrate-rich drinks one day prior and on the morning of surgery, goal directed fluid administration, body temperature control during surgery, avoiding drainages and nasogastric tubes, early mobilisation, and the taking of oral fluids in the early postoperative period. Perioperative morbidity and mortality data were collected and the length of hospital stay and protocol compliance recorded.</p> <p>Results</p> <p>The median age of the patients was 68 years. Fifty-two % of the patients were women. The distribution of patients by ASA class was: I 10%, II 50% and III 40%. Sixty-four % of interventions were laparoscopic; 15% required conversion to laparotomy. The majority of patients underwent sigmoidectomy or right hemicolectomy. The overall compliance to protocol was approximately 65%, but varied widely in its different components. The median length of postoperative hospital stay was 6 days. Some 3% of patients were readmitted to hospital after discharge; some 7% required repeat surgery during their initial hospitalisation or after readmission. The most common complications were surgical (24%), followed by septic (11%) or other medical complications (10%). Three patients (1%) died during follow-up. Some 31% of patients suffered symptoms that delayed their discharge, the most common being vomiting or nausea (12%), dyspnoea (7%) and fever (5%).</p> <p>Conclusion</p> <p>The following of this enhanced recovery program posed no risk to patients in terms of morbidity, mortality and shortened the length of their hospital stay. Overall compliance to protocol was 65%. The following of this program was of benefit to patients and reduces costs by shortening the length of hospital stay. The implantation of such programmes is therefore highly recommended.</p

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

EuQoS: End-to-End Quality of Service over Heterogeneous Networks

The EuQoS (End-to-End QoS over Heterogeneous Networks) IST Integrated European Project aimed to define a Next Generation Network architecture that builds, uses and manages end-to-end QoS across different administrative domains and heterogeneous networks (UMTS, xDSL, Ethernet, WiFi, Satellite and IP/MPLS). The EuQoS architecture preserves the openness and the decentralized decision model of the actual Internet, runs on off-the-shelf hardware and network equipment, and allows end users to request various services without changing the Application Signaling protocol, while meeting regulators’ and users’ Net Neutrality requirements. This paper presents the key elements of the EuQoS architecture and describes the main results obtained in field trials performed on a fully-functional EuQoS system prototype developed over a pan-European testbed. Furthermore, the paper discusses the main strengths of the system and the issues related to its actually deployment on a large scale, from both technical and market points of view

Enhanced transport protocols

The book presents mechanisms, protocols, and system architectures to achieve end-to-end Quality-of-Service (QoS) over heterogeneous wired/wireless networks in the Internet. Particular focus is on measurement techniques, traffic engineering mechanisms and protocols, signalling protocols as well as transport protocol extensions to support fairness and QoS. It shows how those mechanisms and protocols can be combined into a comprehensive end-to-end QoS architecture to support QoS in the Internet over heterogeneous wired/wireless access networks. Finally, techniques for evaluation of QoS mechanisms such as simulation and emulation are presented. The book is aimed at graduate and post-graduate students in Computer Science or Electrical Engineering with focus in data communications and networking as well as for professionals working in this area

Migrants' Access to Social Protection in Spain

From traditional country of emigration, Spain became a country of immigration in a relatively short period, practically catching up with the rest of Western European countries in terms of percentage of population of foreign origin by 2010. The hybrid nature of its welfare regime, a combination of social insurance schemes and universalistic programs, determined the eligibility of foreign populations to each specific social protection scheme. In basic terms, foreigners can access Spanish social protection schemes through their participation in the labour market (for social insurance programs), and their residence in Spanish territory (for schemes based on a universalistic logic). The international agreements signed by Spain are a key aspect as well in determining welfare entitlements for foreigners, particularly in the case of nationals from other EU member states and Latin America. The strong reliance on contributory schemes, and the significant role played by the underground economy, leave economic migrants (particularly undocumented ones) without much social protection. The economic crisis initiated in 2008 implied an increase in immigrants’ vulnerability, but their actual welfare take-up decreased due to their more limited access to the formal labour market, and the restrictive conditions of targeted social assistance schemes.This chapter is part of the project “Migration and Transnational Social Protection in (Post)Crisis Europe (MiTSoPro)” that has received funding from the European Research Council (ERC) under the European Union’s 2020 research and innovation programme (Grant agreement No. 680014). In addition to this chapter, readers can find a series of indicators comparing national social protection and diaspora policies across 40 countries on the following website: http://labos.ulg.ac.be/socialprotection/. We wish to thank Angeliki Konstantinidou for her assistance in compiling the international migration data used in this chapter

Derived immune and ancestral pigmentation alleles in a 7,000-year-old Mesolithic European

Ancient genomic sequences have started to reveal the origin and the demographic impact of farmers from the Neolithic period spreading into Europe. The adoption of farming, stock breeding and sedentary societies during the Neolithic may have resulted in adaptive changes in genes associated with immunity and diet. However, the limited data available from earlier hunter-gatherers preclude an understanding of the selective processes associated with this crucial transition to agriculture in recent human evolution. Here we sequence an approximately 7,000-year-old Mesolithic skeleton discovered at the La Braña-Arintero site in León, Spain, to retrieve a complete pre-agricultural European human genome. Analysis of this genome in the context of other ancient samples suggests the existence of a common ancient genomic signature across western and central Eurasia from the Upper Paleolithic to the Mesolithic. The La Braña individual carries ancestral alleles in several skin pigmentation genes, suggesting that the light skin of modern Europeans was not yet ubiquitous in Mesolithic times. Moreover, we provide evidence that a significant number of derived, putatively adaptive variants associated with pathogen resistance in modern Europeans were already present in this hunter-gatherer.The POPRES data were obtained from dbGaP (accession number # 2038). The Danish National Research Foundation, ERC Starting Grant (260372) to TM-B, and (310372) to MGN, FEDER and Spanish Government Grants BFU2009-13409-C02-02, BFU2012-38236 to AN, BFU2011-28549 to TM-B, BFU2012-34157 to CL-F, ERC (Marie Cure Actions) to MEA, NIH NRSA postdoctoral fellowship (F32GM106656) to CWKC, NIH (R01-HG007089) to JN, NSF postdoctoral fellowship (DBI-1103639) to MD