Towards the Practical Implementation of Throughput-Optimal Traffic Engineering in Software Defined Networks

Broadband Wireless Networking topics: 5G, wireless underground sensor networks, software defined networkingThe new emerging networking paradigm of Software Defined Networks, a solution that separates the network control plane from the data forwarding plane, has been the main focus of recently research works. Nevertheless, Traffic Engineering is an important problem to optimize the network performance, especially for a centralized controlled network such as the SDN, by dynamically analyzing, predicting, and regulating the behavior of data transmitted over that network. Therefore, a first version of a new TE management tool called TECS-SENNA - Traffic Engineering Control System for SDN/OpenFlow Networks - is being developed. The connection of TEs with the tool provides a dynamically and globally optimized network resource allocation in such a way that the overall performance can be improved, including throughput, latency, stability, and load balancing, while satisfying the per-flow QoS requirements.El nuevo paradigma de redes emergente llamado Software Defined Networks, una solución que separa el plano de control del plano de envío de datos, ha sido el único foco principal de las recientes investigaciones. Sin embargo, la ingeniería de tráfico es un problema importante para optimizar el rendimiento de la red, especialmente para redes centralizadas y controladas como las redes SDN, analizando, prediciendo y regulando dinámicamente el comportamiento de los datos transmitidos a través de la red. Por eso, en este proyecto se ha construido una primera versión de una nueva herramienta de gestión de ingeniería de trafico llamada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networkds. La conexión de ingeniería de tráfico con la herramienta proporciona una optimización de la asignación de recursos de red de manera global y dinámica, para que el rendimiento pueda ser mejorado, incluyendo la candencia, la latencia, la estabilidad y el equilibrio de carga, y satisfaciendo los requisitos por flujo de la cualidad de servicio.El nou paradigma de xarxes emergent anomenat Software Defined Networks, una solució que separa el pla de control del pla d’enviament de dades, ha estat l’únic focus principal de les recerques recentment. Però l’enginyeria de trànsit és un problema important per tal d’optimitzar el rendiment de la xarxa, especialment per xarxes centralitzades i controlades com les xarxes SDN, analitzant, fent prediccions i regulant dinàmicament el comportament de les dades transmeses a través de la xarxa. Per això, en aquest projecte s’ha construït una primera versió d’una nova eina de gestió d’enginyeria de trànsit anomenada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networks. La connexió de l’enginyeria de trànsit amb l’eina proporciona una optimització de l’assignació de recursos de xarxa de manera global i dinàmica per tal que el rendiment pugui ser millorat, incloent la cadència, la latència, l’estabilitat i l’equilibri de càrrega i satisfent els requisits per flux de qualitat de servei

Use of tocilizumab in kidney transplant recipients with COVID-1

Acute respiratory distress syndrome associated with coronavirus infection is related to a cytokine storm with large interleukin-6 (IL-6) release. The IL-6-receptor blocker tocilizumab may control the aberrant host immune response in patients with coronavirus disease 2019 (COVID-19) . In this pandemic, kidney transplant (KT) recipients are a high-risk population for severe infection and showed poor outcomes. We present a multicenter cohort study of 80 KT patients with severe COVID-19 treated with tocilizumab during hospital admission. High mortality rate was identified (32.5%), related with older age (hazard ratio [HR] 3.12 for those older than 60 years, P = .039). IL-6 and other inflammatory markers, including lactic acid dehydrogenase, ferritin, and D-dimer increased early after tocilizumab administration and their values were higher in nonsurvivors. Instead, C-reactive protein (CRP) levels decreased after tocilizumab, and this decrease positively correlated with survival (mean 12.3 mg/L in survivors vs. 33 mg/L in nonsurvivors). Each mg/L of CRP soon after tocilizumab increased the risk of death by 1% (HR 1.01 [confidence interval 1.004-1.024], P = .003). Although patients who died presented with worse respiratory situation at admission, this was not significantly different at tocilizumab administration and did not have an impact on outcome in the multivariate analysis. Tocilizumab may be effective in controlling cytokine storm in COVID-19 but randomized trials are needed

Tratamientos psicológicos empíricamente apoyados para adultos: Una revisión selectiva

Antecedentes: los tratamientos psicológicos han mostrado su eficacia, efectividad y eficiencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científico generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda. Background: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help

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)

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

Towards the Practical Implementation of Throughput-Optimal Traffic Engineering in Software Defined Networks

Broadband Wireless Networking topics: 5G, wireless underground sensor networks, software defined networkingThe new emerging networking paradigm of Software Defined Networks, a solution that separates the network control plane from the data forwarding plane, has been the main focus of recently research works. Nevertheless, Traffic Engineering is an important problem to optimize the network performance, especially for a centralized controlled network such as the SDN, by dynamically analyzing, predicting, and regulating the behavior of data transmitted over that network. Therefore, a first version of a new TE management tool called TECS-SENNA - Traffic Engineering Control System for SDN/OpenFlow Networks - is being developed. The connection of TEs with the tool provides a dynamically and globally optimized network resource allocation in such a way that the overall performance can be improved, including throughput, latency, stability, and load balancing, while satisfying the per-flow QoS requirements.El nuevo paradigma de redes emergente llamado Software Defined Networks, una solución que separa el plano de control del plano de envío de datos, ha sido el único foco principal de las recientes investigaciones. Sin embargo, la ingeniería de tráfico es un problema importante para optimizar el rendimiento de la red, especialmente para redes centralizadas y controladas como las redes SDN, analizando, prediciendo y regulando dinámicamente el comportamiento de los datos transmitidos a través de la red. Por eso, en este proyecto se ha construido una primera versión de una nueva herramienta de gestión de ingeniería de trafico llamada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networkds. La conexión de ingeniería de tráfico con la herramienta proporciona una optimización de la asignación de recursos de red de manera global y dinámica, para que el rendimiento pueda ser mejorado, incluyendo la candencia, la latencia, la estabilidad y el equilibrio de carga, y satisfaciendo los requisitos por flujo de la cualidad de servicio.El nou paradigma de xarxes emergent anomenat Software Defined Networks, una solució que separa el pla de control del pla d’enviament de dades, ha estat l’únic focus principal de les recerques recentment. Però l’enginyeria de trànsit és un problema important per tal d’optimitzar el rendiment de la xarxa, especialment per xarxes centralitzades i controlades com les xarxes SDN, analitzant, fent prediccions i regulant dinàmicament el comportament de les dades transmeses a través de la xarxa. Per això, en aquest projecte s’ha construït una primera versió d’una nova eina de gestió d’enginyeria de trànsit anomenada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networks. La connexió de l’enginyeria de trànsit amb l’eina proporciona una optimització de l’assignació de recursos de xarxa de manera global i dinàmica per tal que el rendiment pugui ser millorat, incloent la cadència, la latència, l’estabilitat i l’equilibri de càrrega i satisfent els requisits per flux de qualitat de servei

Towards the Practical Implementation of Throughput-Optimal Traffic Engineering in Software Defined Networks

Broadband Wireless Networking topics: 5G, wireless underground sensor networks, software defined networkingThe new emerging networking paradigm of Software Defined Networks, a solution that separates the network control plane from the data forwarding plane, has been the main focus of recently research works. Nevertheless, Traffic Engineering is an important problem to optimize the network performance, especially for a centralized controlled network such as the SDN, by dynamically analyzing, predicting, and regulating the behavior of data transmitted over that network. Therefore, a first version of a new TE management tool called TECS-SENNA - Traffic Engineering Control System for SDN/OpenFlow Networks - is being developed. The connection of TEs with the tool provides a dynamically and globally optimized network resource allocation in such a way that the overall performance can be improved, including throughput, latency, stability, and load balancing, while satisfying the per-flow QoS requirements.El nuevo paradigma de redes emergente llamado Software Defined Networks, una solución que separa el plano de control del plano de envío de datos, ha sido el único foco principal de las recientes investigaciones. Sin embargo, la ingeniería de tráfico es un problema importante para optimizar el rendimiento de la red, especialmente para redes centralizadas y controladas como las redes SDN, analizando, prediciendo y regulando dinámicamente el comportamiento de los datos transmitidos a través de la red. Por eso, en este proyecto se ha construido una primera versión de una nueva herramienta de gestión de ingeniería de trafico llamada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networkds. La conexión de ingeniería de tráfico con la herramienta proporciona una optimización de la asignación de recursos de red de manera global y dinámica, para que el rendimiento pueda ser mejorado, incluyendo la candencia, la latencia, la estabilidad y el equilibrio de carga, y satisfaciendo los requisitos por flujo de la cualidad de servicio.El nou paradigma de xarxes emergent anomenat Software Defined Networks, una solució que separa el pla de control del pla d’enviament de dades, ha estat l’únic focus principal de les recerques recentment. Però l’enginyeria de trànsit és un problema important per tal d’optimitzar el rendiment de la xarxa, especialment per xarxes centralitzades i controlades com les xarxes SDN, analitzant, fent prediccions i regulant dinàmicament el comportament de les dades transmeses a través de la xarxa. Per això, en aquest projecte s’ha construït una primera versió d’una nova eina de gestió d’enginyeria de trànsit anomenada TECS-SENNA – Traffic Engineering Control System for SDN/OpenFlow Networks. La connexió de l’enginyeria de trànsit amb l’eina proporciona una optimització de l’assignació de recursos de xarxa de manera global i dinàmica per tal que el rendiment pugui ser millorat, incloent la cadència, la latència, l’estabilitat i l’equilibri de càrrega i satisfent els requisits per flux de qualitat de servei

Impact of Social Isolation Due to COVID-19 on Daily Life Activities and Independence of People over 65: a Cross-Sectional Study

The mandatory confinement caused by the COVID-19 pandemic has significantly affected the older adult population. The main objective of this study is to assess independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADDL) of people over 65 years of age during social, preventive, and compulsory isolation due to COVID-19, identifying and quantifying the activities of personal independence that present difficulties in their execution. Design: A cross-sectional study. Settings: Private’s health insurance Hospital, Córdoba, Argentina. Participants: A total of 193 participants with mean age of 76.56 years (121 women and 72 men) who met inclusion criteria were included in the study. Interventions: A personal interview was conducted between July and December 2020. Sociodemographic data were collected, and perceived independence was assessed. Outcomes measures: The Barthel index and the Lawton and Brody scale were used to assess independence of basic and instrumental activities of daily living. Results: Minimal limitations were noted with function. The activities that represented the greatest difficulties were going up and down stairs (22%) and moving around (18%), and the greatest difficulties in instrumental activities of daily living were shopping (22%) and preparing food (15%). Conclusions: COVID-19 has caused isolation, leading to functional limitations for many, especially older adults. Perceived declines in function and mobility may lead to decreased independence and safety for the older adult; therefore, preventative planning and programming should be considered.Fil: Frutos, María Laura. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Pérez Cruzado, David. Universidad de Málaga. Facultad de Ciencias de la Salud; EspañaFil: Lunsford, Dianna. Gannon University. Health Sciences Faculty; USAFil: García Orza, Santiago. Hospital Comarcal de la Axarquía; EspañaFil: Cantero Téllez, Raquel. Universidad de Málaga. Facultad de Ciencias de la Salud; Españ