Sincronización de redes de telecomunicación mediante técnicas de aprendizaje estadístico

Las redes de transmisión actuales, con los ingentes flujos de datos y las crecientes restricciones en latencias y variaciones de retardo, se ven compelidas a ser operadas de una manera síncrona, es decir todos los equipos tienen que seguir el mismo patrón de tiempo de manera que las velocidades de transmisión y recepción en los enlaces de comunicaciones estén ajustadas. Cualquier desajuste implica pérdida de datos y de calidad, por lo que muchos operadores han construido una red paralela para suministrar la distribución de la referencia de sincronización, que si bien se apoya sobre la red de transmisión, sigue unos criterios y topologías diferentes a ésta. El escenario básico de aplicación de la presente Tesis consiste en una red sincronización establecida en una red de telecomunicación construida sobre una capa física de fibra óptica. Típicamente, en una red de telecomunicaciones, la señal portadora de sincronización se degrada progresivamente a lo largo de los enlaces de la red, por lo que es necesaria su regeneración antes de un límite máximo de etapas. Dicha regeneración requiere un tipo de equipamiento relativamente caro, y se debe evitar en la medida de lo posible. Además, la señal de sincronización puede sufrir los cortes y reencaminamientos que afectan a la red de telecomunicaciones, y por tanto, cualquier diseño ha de tenerlos en cuenta a fin de dotar a la señal de sincronización de una disponibilidad adecuada. El presente trabajo tiene como objetivo sistematizar el conocimiento y la metodología para el establecimiento de una correcta red de sincronización, de forma que se maximice la disponibilidad de la señal de temporización en una red de telcomunicaciones, al tiempo que se satisfacen los requisitos de calidad de servicio asociados a la sincronización. Dado que el aprendizaje basado en muestras es una alternativa atractiva para la obtención de modelos en aplicaciones en las que las relaciones entre los diferentes parámetros del sistema son de difícil obtención analítica, tal y como se da en el presente trabajo, las contribuciones de esta Tesis comprenden la aplicación de técnicas de aprendizaje estadístico a distintos ámbitos de las redes de sincronización, tales como la predicción en términos de disponibilidad del comportamiento de los elementos de red, la búsqueda de las rutas más cortas a lo largo de una red de telecomunicación, y la estimación de la degradación introducida por un elemento de red en la señal de referencia temporal. Así, en la presente Tesis, en primer lugar, se han elaborado modelos de predicción de fallos en los elementos de una red de fibra óptica (nodos y enlaces) a partir de datos históricos, utilizando para ello Máquinas de Vectores Soporte con diferentes núcleos para capturar efectos en escalas diferentes y con impacto en la tasa de fallos, se ha probado la validez de los esquemas de predicción y que la complejidad computacional requerida es moderada. En segundo lugar, se ha utilizado una red bayesiana para modelar la red de telecomunicaciones bajo estudio y, a partir de la misma, estimar las disponibilidades de rutas y circuitos de comunicaciones. Ello ha permitido desarrollar algoritmos para la obtención de la ruta más fiable. Por último, se ha realizado un módulo basado en redes neuronales que es capaz de comprobar que la ruta obtenida según el criterio de la disponibilidad garantiza también la calidad necesaria en términos de sincronización. Estas contribuciones permiten la implantación práctica en sistemas reales de comunicaciones de esquemas de sincronización similares a los propuestos, los cuales permiten obtener significativas mejoras en sus prestaciones, con una complejidad computacional moderada. _____________________________________Current transmission networks handle huge flows of data with growing restrictions on latencies and variations delay, and are compelled to be operated synchronously, which implies that all data communications must follow the same time pattern so that transmission and reception speeds at the communication links are adjusted. Any mismatch implies loss of data and quality impairment. Therefore many operators have built a parallel network to provide distribution for synchronization reference signal, which is actually based on the transmission network, but follows different criteria and topologies. The basic scenario for the application of this Thesis is a synchronization network established on a telecommunications network and is built over an optical fiber optic physical layer. Typically, in a telecommunications network, the carrier signal synchronization degrades gradually over the links of the network, making necessary quality restoration stages. This requires expensive equipment, and should be avoided as far as possible. In addition, the signal synchronization may suffer cuts and rerouting that affect the telecommunications network, and any design has to take them into account in order to give the synchronization signal an adequate availability. This Thesis aims to systematize knowledge and the methodology for establishing a proper network synchronization, maximizing the signal timing availability on a telecommunication network, while meeting the quality requirements associated with the synchronization. Statistical learning techniques are an attractive alternative for obtaining models in applications where relationships among the different parameters of the system are difficult to be analytically obtained. The contributions of this Thesis include the application of statistical learning techniques to different areas of synchronization networks, such as the prediction in terms of availability of the network elements behaviour, finding shorter routes along a network telecommunications, and the estimation of the degradation introduced by a network signal in the temporal reference. Thus, in this Thesis, models have first been developed in order to predict failures in the elements of a n optical fiber network (nodes and links) from historical data. The use of Support Vector Machines with different kernels to capture effects on different scales and impact on the failure rate, has proven the validity of the schemes and demonstrated that the computational complexity required is moderate. Secondly, a network Bayesian framework has been used to model the telecommunications network under study, in order to calculate the availability of communication paths and circuits. With this framework, it has been possible to develop algorithms for obtaining the most reliable routes. Finally a module based on neural networks has been built, which is able to verify that the path obtained under the most reliable approach also guarantees the required quality in terms of timing. These contributions allow the practical implementation of synchronization schemes similar to those proposed in real communications systems, which can yield significant improvements in their capabilities with a moderate computational complexit

Cybersecurity Alert Prioritization in a Critical High Power Grid With Latent Spaces

High-Power electric grid networks require extreme security in their associated telecommunication network to ensure protection and control throughout power transmission. Accordingly, supervisory control and data acquisition systems form a vital part of any critical infrastructure, and the safety of the associated telecommunication network from intrusion is crucial. Whereas events related to operation and maintenance are often available and carefully documented, only some tools have been proposed to discriminate the information dealing with the heterogeneous data from intrusion detection systems and to support the network engineers. In this work, we present the use of deep learning techniques, such as Autoencoders or conventional Multiple Correspondence Analysis, to analyze and prune the events on power communication networks in terms of categorical data types often used in anomaly and intrusion detection (such as addresses or anomaly description). This analysis allows us to quantify and statistically describe highseverity events. Overall, portions of alerts around 5-10% have been prioritized in the analysis as first to handle by managers. Moreover, probability clouds of alerts have been shown to configure explicit manifolds in latent spaces. These results offer a homogeneous framework for implementing anomaly detection prioritization in power communication networks

Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

SLE can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in >50% of SLE patients. To describe the GI manifestations of SLE in the RELESSER (Registry of SLE Patients of the Spanish Society of Rheumatology) cohort and to determine whether these are associated with a more severe disease, damage accrual and a worse prognosis. METHODS: We conducted a nationwide, retrospective, multicentre, cross-sectional cohort study of 3658 SLE patients who fulfil =4 ACR-97 criteria. Data on demographics, disease characteristics, activity (SLEDAI-2K or BILAG), damage (SLICC/ACR/DI) and therapies were collected. Demographic and clinical characteristics were compared between lupus patients with and without GI damage to establish whether GI damage is associated with a more severe disease. RESULTS: From 3654 lupus patients, 3.7% developed GI damage. Patients in this group (group 1) were older, they had longer disease duration, and were more likely to have vasculitis, renal disease and serositis than patients without GI damage (group 2). Hospitalizations and mortality were significantly higher in group 1. Patients in group 1 had higher modified SDI (SLICC Damage Index). The presence of oral ulcers reduced the risk of developing damage in 33% of patients. CONCLUSION: Having GI damage is associated with a worse prognosis. Patients on a high dose of glucocorticoids are at higher risk of developing GI damage which reinforces the strategy of minimizing glucocorticoids. Oral ulcers appear to decrease the risk of GI damage. © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology

Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID‑19

Background. COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods. A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results. The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR [CI 95%], p): RNAemia (3.92 [1.183–12.968], 0.025), viral RNA load (N1) (1.962 [1.244–3.096], 0.004); viral RNA load (N2) (2.229 [1.382–3.595], 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia). Conclusions. SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.This work was supported by awards from the Canadian Institutes of Health Research, the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding initiative (CIHR OV2 – 170357), Research Nova Scotia (DJK), Atlantic Genome/Genome Canada (DJK), Li-Ka Shing Foundation (DJK), Dalhousie Medical Research Foundation (DJK), the “Subvenciones de concesión directa para proyectos y programas de investigación del virus SARS‐CoV2, causante del COVID‐19”, FONDO–COVID19, Instituto de Salud Carlos III (COV20/00110, CIBERES, 06/06/0028), (AT) and fnally by the “Convocatoria extraordinaria y urgente de la Gerencia Regional de Salud de Castilla y León, para la fnanciación de proyectos de investigación en enfermedad COVID-19” (GRS COVID 53/A/20) (CA). DJK is a recipient of the Canada Research Chair in Translational Vaccinology and Infammation. APT was funded by the Sara Borrell Research Grant CD018/0123 funded by Instituto de Salud Carlos III and co-fnanced by the European Development Regional Fund (A Way to Achieve Europe programme). The funding sources did not play any role neither in the design of the study and collection, not in the analysis, in the interpretation of data or in writing the manuscript

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

Post-Franco Theatre

In the multiple realms and layers that comprise the contemporary Spanish theatrical landscape, “crisis” would seem to be the word that most often lingers in the air, as though it were a common mantra, ready to roll off the tongue of so many theatre professionals with such enormous ease, and even enthusiasm, that one is prompted to wonder whether it might indeed be a miracle that the contemporary technological revolution – coupled with perpetual quandaries concerning public and private funding for the arts – had not by now brought an end to the evolution of the oldest of live arts, or, at the very least, an end to drama as we know it

Variations in echocardiography after bariatric surgery. Biliopancreatic diversion vs vertical gastrectomy

Introducción: la obesidad se ha convertido en un problema de salud a nivel mundial por su relación con la morbimortalidad cardiovascular. La cirugía bariátrica se plantea como una de las soluciones para la corrección del exceso de peso y mejoría de las cardiopatías asociadas. Objetivo: comparar la gastrectomía vertical con la derivación biliopancreática de tipo Scopinaro para observar la repercusión de los cambios que se producen en la estructura cardiaca tras la cirugía. Además, evaluar el resultado quirúrgico en función de la escala BAROS. Material y métodos: se recogieron los resultados de la ecocardiografía incluida en el estudio preoperatorio de los pacientes candidatos a cirugía bariátrica de nuestro hospital, intervenidos en un periodo de 2 años, junto a los datos antropométricos y de comorbilidad. Estos se compararon con los resultados postoperatorios medidos a los 3 años de la cirugía. Resultados: finalmente se seleccionaron 26 pacientes (13 GV y 13 DBP), con una edad media de 42 años. GV: IMC inicial de 44,6 ± 7,1; IMC final de 31,8 ± 11,3 (p 0,05); HTA: 38% vs. 19% (p 0.05); HTA: 38.5% vs 19.2% (p < 0.05), preoperatively and postoperatively, respectively. Conclusions: no significant differences were found between the two groups studied with different techniques, although a slight deterioration in diastolic function was found in both groups. The comorbidities associated with obesity improved in both groups, and the surgery was scored as positive. The scant variation revealed by echocardiography prompts to reconsider its systematic preoperative use in these patients given the low cost-benefit ratio.Sin financiación1.057 JCR (2020) Q4, 77/88 Nutrition & Dietetics0.310 SJR (2020) Q3, 1653/2446 Medicine (miscellaneous)No data IDR 2020UE

Worse outcome and distinct mutational pattern in follicular lymphoma with anti-HBc positivity

This study was supported in part by Instituto de Salud Carlos III FIS-FEDER PI15/0459, FIS-FEDER PI19/00034, GIL-EAD GLD18/00117, 2017SGR205, PT20/00023, and Xarxa de Banc de Tumors de Catalunya sponsored by Pla Director d'Oncologia de Catalunya. The authors also acknowledge the Biobank of the Fundación MD Anderson International supported by the Instituto de Salud Carlos III grant PT17/ 0015/0008.Epidemiological studies have demonstrated the association between hepatitis B virus (HBV) infection and B-cell non-Hodgkin lymphoma (NHL), mainly for diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). We studied a cohort of 121 patients with FL for HBV infection status, clinical features, and gene mutational profile. Anti-HBc was detectable in 16 patients (13.2%), although all had undetectable HBV DNA. AntiHBcore (anti-HBc) cases presented with older age at diagnosis than anti-HBc cases (68.1 vs 57.2 years; P 5.007) and higher b2-microglobulin (56.3% vs 28.9%; P 5.04). All patients included in the study fulfilled criteria for treatment and received therapy with rituximab or rituximab-containing chemotherapy. There were no episodes of HBV reactivation or HBV hepatitis during treatment and/or maintenance. Remarkably, anti-HBc patients had significantly lower 10-year progression-free survival (PFS; 12.9% vs 58.3%; P,.0001) and overall survival (OS; 22.0% vs 86.2%; P,.0001), that remained at multivariate analysis. Gene mutational profiling of all cases showed that anti-HBc cases had higher incidence of ARID1A mutations and absence of EP300 mutations, 2 key epigenetic regulators in FL. Overall, our study shows that FL patients with resolved HBV infection have a worse outcome independently of other well-known clinical risk factors and a distinct gene mutational profile

Impact of uterine manipulator on oncological outcome in endometrial cancer surgery.

There are limited data available to indicate whether oncological outcomes might be influenced by the uterine manipulator, which is used at the time of hysterectomy for minimally invasive surgery in patients with endometrial cancer. The current evidence derives from retrospective studies with limited sample sizes. Without substantial evidence to support its use, surgeons are required to make decisions about its use based only on their personal choice and surgical experience. To evaluate the use of the uterine manipulator on oncological outcomes after minimally invasive surgery, for apparent early-stage endometrial cancer. We performed a retrospective multicentric study to assess the oncological safety of uterine manipulator use in patients with apparent early-stage endometrial cancer, treated with minimally invasive surgery. The type of manipulator, surgical staging, histology, lymphovascular space invasion, International Federation of Gynecology and Obstetrics stage, adjuvant treatment, recurrence, and pattern of recurrence were evaluated. The primary objective was to determine the relapse rate. The secondary objective was to determine recurrence-free survival, overall survival, and the pattern of recurrence. A total of 2661 women from 15 centers were included; 1756 patients underwent hysterectomy with a uterine manipulator and 905 without it. Both groups were balanced with respect to histology, tumor grade, myometrial invasion, International Federation of Gynecology and Obstetrics stage, and adjuvant therapy. The rate of recurrence was 11.69% in the uterine manipulator group and 7.4% in the no-manipulator group (P In this study, the use of a uterine manipulator was associated with a worse oncological outcome in patients with uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics I-II) who underwent minimally invasive surgery. Prospective trials are essential to confirm these results