Modelling and managing service-level agreements in the context of 5G neutral hosting platforms

This project has received funding from the European Union’s Horizon 2020 research andinnovation programme under grant agreement No 761508 (5GCity project) and theSpanish national project 5GCity (TEC2016-76795-C6-1-R)This document contains the study and development of Service-Level Agreement (SLA) management mechanisms in the context of a 5G neutral host platform. The infrastructure involved in a neutral host platform is evaluated by an SLA Manager that handles the database of agreements for all the users, and verifies if the monitored data complies with the thresholds stated in the Service-Level Objectives (SLO) agreed in the SLAs. Neutral host is a platform that has different levels of virtualization over a 5G infrastructure. It starts from a sliced network infrastructure for logic separation between tenants, which in the next level of virtualization, can host 5G services with Network Functions Virtualization (NFV) techniques. This virtual platform runs on top of a physical infrastructure that not only covers data centres like in cloud platforms, but also includes access networks, edge computing and distributed cloud elements. Evaluating through all this infrastructure adds new levels of complexity for monitoring and obtaining an accurate value for any Key Performance Indicator, or high-level parameters for Quality of Service. This challenge is faced with a software module, called SLA Manager, which identifies the different involved infrastructure elements and creates monitoring jobs according to highlevel requirements described in each SLO to obtain low-level infrastructure data. This data is then computed to obtain a high-level value to compare latter with an SLO threshold and verify if there is a violation. Availability is the main KPI on which this study focuses. A generic SLA template body is presented for being stored in a NoSQL database solution, able to adapt to any new service deployed over new technologies that may be deployed by the neutral host, and to add flexibility and scalability to the solution. Results show that the accuracy and reliability of the high-level objectives stated in the SLOs obey the standards required for 5G applications. The system quickly detects any outage and gives feedback to the platform to recover and avoid any violation. Delay times for detection are observed in order to provide exact measurements for availability levels. The report ends with conclusions and future development lines, as well as ethical and sustainability considerations the study involves

Modelling and managing service-level agreements in the context of 5G neutral hosting platforms

This project has received funding from the European Union’s Horizon 2020 research andinnovation programme under grant agreement No 761508 (5GCity project) and theSpanish national project 5GCity (TEC2016-76795-C6-1-R)This document contains the study and development of Service-Level Agreement (SLA) management mechanisms in the context of a 5G neutral host platform. The infrastructure involved in a neutral host platform is evaluated by an SLA Manager that handles the database of agreements for all the users, and verifies if the monitored data complies with the thresholds stated in the Service-Level Objectives (SLO) agreed in the SLAs. Neutral host is a platform that has different levels of virtualization over a 5G infrastructure. It starts from a sliced network infrastructure for logic separation between tenants, which in the next level of virtualization, can host 5G services with Network Functions Virtualization (NFV) techniques. This virtual platform runs on top of a physical infrastructure that not only covers data centres like in cloud platforms, but also includes access networks, edge computing and distributed cloud elements. Evaluating through all this infrastructure adds new levels of complexity for monitoring and obtaining an accurate value for any Key Performance Indicator, or high-level parameters for Quality of Service. This challenge is faced with a software module, called SLA Manager, which identifies the different involved infrastructure elements and creates monitoring jobs according to highlevel requirements described in each SLO to obtain low-level infrastructure data. This data is then computed to obtain a high-level value to compare latter with an SLO threshold and verify if there is a violation. Availability is the main KPI on which this study focuses. A generic SLA template body is presented for being stored in a NoSQL database solution, able to adapt to any new service deployed over new technologies that may be deployed by the neutral host, and to add flexibility and scalability to the solution. Results show that the accuracy and reliability of the high-level objectives stated in the SLOs obey the standards required for 5G applications. The system quickly detects any outage and gives feedback to the platform to recover and avoid any violation. Delay times for detection are observed in order to provide exact measurements for availability levels. The report ends with conclusions and future development lines, as well as ethical and sustainability considerations the study involves

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk