| 1. |
- Jung, Christian, et al.
(författare)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 2. |
- Baiocchi, Gian Luca, et al.
(författare)
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International consensus on a complications list after gastrectomy for cancer
- 2019
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Ingår i: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 22:1, s. 172-189
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Tidskriftsartikel (refereegranskat)abstract
- Background: Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus. Methods: The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications. Results: A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet. Conclusion: The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.
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| 3. |
- Billenahalli, Shreejith, et al.
(författare)
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A wavelength sharing and assignment heuristic to minimize the number of wavelength converters in resilient WDM networks
- 2009
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Ingår i: Proceedings of the 2009 7th International Workshop on the Design of Reliable Communication Networks, DRCN 2009. - 9781424450473 ; , s. 319-326
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Konferensbidrag (refereegranskat)abstract
- With the successful introduction of reconfigurable optical add-drop multiplexers (ROADMs) and related technologies, WDM networks are now growing in the number of optical nodes, wavelengths, and lambda services supported. In addition, shared path protection mechanisms - whereby lambda services are allowed to share protection wavelength channels - are possible at the optical (WDM) layer. Efficient strategies must be devised to both determine the set of services that must share a common protection wavelength channel and assign wavelengths to every service. One objective of these strategies is to minimize the total number of wavelength converters (WCs), which are required every time the wavelength continuity constraint cannot be met. This paper presents a scalable and efficient heuristic, whose goal is to minimize the number of WCs in resilient WDM networks supporting static sets of shared path protection lambda services. The heuristic comprises a set of polynomial algorithms that are executed sequentially to obtain a sub-optimal solution. In small size instances of the problem, the heuristic is compared against the optimal solution obtained from ILP formulation. For large size instances - tens of thousands of lambda services and hundreds of nodes - the heuristic yields an average number of WCs that is close to be linear in the number of services, despite the fact that the wavelength sharing factor increases.
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| 4. |
- Cerutti, Isabella, et al.
(författare)
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Plug and Play Networking with Optical Nodes
- 2006
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Ingår i: ICTON 2006. ; , s. 133-138
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Plug and play optical (PPO) nodes may be used to facilitate the deployment of optical networks. PPO nodes must be able to learn about the signal propagation properties of the surrounding optical fibers and make their wavelength routing decisions based on the collected data. This paper discusses what are the open challenges that must be overcome to provide cost effective and performing ad hoc networking solutions based on PPO nodes.
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| 5. |
- Cerutti, Isabella, et al.
(författare)
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Plug and play optical nodes : network functionalities and built-in fiber characterization techniques
- 2007
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Ingår i: Journal of Optical Networking. - 1536-5379. ; 6:6, s. 642-653
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Tidskriftsartikel (refereegranskat)abstract
- \textlessp\textgreater\textlessa href$=$"http://www.osa-jon.org/virtual_issue.cfm?vid$=$26"\textgreaterFeature Issue on Photonics in Switching\textless/a\textgreater\textless/p\textgreaterPlug and play optical (PPO) nodes may be used to facilitate the deployment of optical networks. PPO nodes must be able to learn about the signal propagation properties of the surrounding optical fibers and make their wavelength-routing decisions based on the collected data. We discuss what are the open challenges that must be overcome to provide optical networking solutions based on cost-effective PPO nodes. Three possible PPO node hardware architectures with trade-offs in complexity, cost, and functionality are presented along with their built-in fiber characterization techniques.
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| 6. |
- Das, Shovan, et al.
(författare)
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A Link State Advertisement Protocol for Optical Transparency Islands
- 2007
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Ingår i: 2007 WORKSHOP ON HIGH PERFORMANCE SWITCHING AND ROUTING. ; , s. 1-6
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Konferensbidrag (refereegranskat)abstract
- Plug and play optical (PPO) nodes enable fast, re-configurable, and flexible ad hoc deployment of optical networks. Once plugged, the PPO nodes provide all-optical circuits between client nodes to alleviate the electronic processing bottleneck of high speed networks. To offer these wavelength routing functionalities to client nodes the PPO nodes must self-adjust to possible changes of the optical physical topology and fiber propagation characteristics. To discover such changes the PPO nodes must make use of a link state advertisement (LSA) protocol that is scalable in the number of plugged PPO nodes. This paper describes a scalable LSA protocol with constrained message flooding to match the limited propagation reach of the optical signal, i.e., the PPO node transparency island (TI). Scalability is thus achieved naturally by limiting the link state advertisement scope to only those PPO nodes that need to receive the link updates. As discussed in the paper, the proposed protocol appears to be a viable solution when the TI size is relatively small, e.g., in optical networks without signal regeneration.
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| 7. |
- Das, Shovan, et al.
(författare)
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Optical Corridor Routing Protocols
- 2007
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Ingår i: ICTON 2007. ; , s. 188-192
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The scalability of routing and resource advertisement protocols is a key issue in large optical networks. A commonly used solution is based on the hierarchical approach adopted in IP/MPLS-TE networks, i.e., multiple areas or autonomous systems are pre-established to contain the geographical scope of the resource advertisement protocols and the related routing information. With arbitrarily pre-established areas, routing decision might be sub-optimal. Thus, special care must be paid by the network designer to subdivide effectively the network into areas. This paper presents and discusses an alternative routing technique that attempts to improve both optimality and scalability of routing and resource advertisement protocols without requiring the use of manually pre-established areas.
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| 8. |
- Haugaa, Kristina Hermann, et al.
(författare)
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Patients' knowledge and attitudes regarding living with implantable electronic devices : results of a multicentre, multinational patient survey conducted by the European Heart Rhythm Association
- 2018
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Ingår i: Europace. - : OXFORD UNIV PRESS. - 1099-5129 .- 1532-2092. ; 20:2, s. 386-391
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs from seven European countries, 88% were over 50 years of age. Most patients (90%) knew what device they were implanted with and felt sufficiently informed about the indications for therapy. As many as 42% of patients needed additional information on the battery replacement and limitations in physical activity. The self-reported incidence of complications was 9%, and among these, a quarter of the respondents felt insufficiently informed about the possibility of complications and their management. The majority of patients (83%) were followed by face-to-face visits, which was the most commonly preferred follow-up strategy by the patients. Nearly 75% of the patients reported improved quality of life after device implantation, but about 40% had worries about their device. Less than 20% had discussed with their physician or thought about device handling in the end-of-life circumstances or end-stage disease. Notably, almost 20% of the ICD patients did not wish to answer the question regarding what they wanted to be done with their ICD in case of end-stage disease, indicating the challenges in approaching these issues.
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| 9. |
- Monti, Paolo
(författare)
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Achieving reliable networking for the generic autonomous platform for sensor systems : (GAP4S)
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Networks of wireless integrated sensors are often used to monitorparameters distributed in the environment. These parameters arerelated to a variety of applications such as security, patientmonitoring, chemical and biological hazard detection. Some solutionsrely on replaceable batteries with a limited life-time to providelong-term sensor operation. Others envision short transmission rangesensors (few meters) that harvest their energy from variousenvironmental sources (e.g., solar, vibrations, acoustic noise). TheGeneric Autonomous Platform for Sensors (GAP4S) project explores anapproach for wireless sensors that is complementary to these andother pre-existing solutions. In GAP4S, the wireless sensor micro-battery is remotely rechargedvia a microwave signal. Medium transmission ranges in the tens tohundreds of meters are possible. Within these wireless transmissionranges, a base-station collects data transmitted by the sensors andacts as the access point to a wider (typically wired) communicationnetwork, e.g., the Internet. The authorized user can, therefore,remotely connect to, monitor, and manage both the sensor network andthe individual sensors. An essential component of GAP4S is itsend-to-end network reliability solution, which ensures the deliveryof data generated at the sensor to the interested user across boththe wireless and wired segments. This dissertation investigates ways to achieve reliable networkingfor GAP4S over both the wireless and the wired segments. A speciallydesigned solution is provided in each segment. In the wireless segment, error-free transmissions from the sensornode to the base-station is achieved using automatic repeat request(ARQ) protocols at layer 2. Two classes of ARQ protocols aredesigned and compared. The first is the conventional ARQ, wherebythe data frame is retransmitted by the originating sensor untilsuccessfully received by the base-station. The second class takesadvantage of cooperative radio communications, wherebymultiple neighboring sensor nodes may combine their efforts duringthe retransmission process. The ARQ protocols are compared in termsof their saturation throughput, i.e., the maximum data flow that thesensor node can sustain constrained to the available energy amount.In a variety of scenarios --- current and future expected circuitenergy consumptions --- the cooperative ARQ protocols may more thandouble the saturation throughput when compared to conventional ARQprotocols. Equivalently, it can be said that the energy required tooperate the system may be reduced by half. In the wired segment, fault tolerant networking is achieved by meansof protection switching at layer 3. Given the increasinglywidespread use of Wavelength Division Multiplexed (WDM) backbonenetworks, the protection switching scheme is designed to operate inconjunction with WDM. Optical circuits are made reliable by means ofa Shared Path Protection (SPP) switching scheme. The SPP scheme isgeneralized to guarantee Differentiated levels of Reliability (DiR)to the user. In the SPP-DiR combined scheme the desired level ofreliability may be guaranteed while minimizing the required networkresources, i.e., wavelengths. This feature makes it possible tosupport more optical connections and users when compared to otherexisting protection switching schemes.
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| 10. |
- Monti, Paolo, et al.
(författare)
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New Dimensions for Survivable Service Provisioning in Optical Backbone and Access Networks
- 2012
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Ingår i: Resilient Optical Network Design. - : IGI Global. - 9781613504260 - 1613504268 ; , s. 227-252
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Bokkapitel (refereegranskat)abstract
- Originally, networks were engineered to provide only one type of service, i.e. either voice or data, soonly one level of resiliency was requested. This trend has changed, and today’s approach in serviceprovisioning is quite different. A Service Level Agreement (SLA) stipulated between users and serviceproviders (or network operators) regulates a series of specific requirements, e.g., connection set-up timesand connection availability that has to be met in order to avoid monetary fines. In recent years this hascaused a paradigm shift on how to provision these services. From a “one-solution-fits-all” scenario, wewitness now a more diversified set of approaches where trade-offs among different network parameters(e.g., level of protection vs. cost and/or level of protection vs. blocking probability) play an important role.This chapter aims at presenting a series of network resilient methods that are specifically tailored for adynamic provisioning with such differentiated requirements. Both optical backbone and access networksare considered. In the chapter a number of provisioning scenarios - each one focusing on a specificQuality of Service (QoS) parameter - are considered. First the effect of delay tolerance, defined as theamount of time a connection request can wait before being set up, on blocking probability is investigatedwhen Shared Path Protection is required. Then the problem of how to assign “just-enough” resources tomeet each connection availability requirement is described, and a possible solution via a Shared PathProtection Scheme with Differentiated Reliability is presented. Finally a possible trade off between deploymentcost and level of reliability performance in Passive Optical Networks (PONs) is investigated. The presented results highlight the importance of carefully considering each connection’s QoS parameterswhile devising a resilient provisioning strategy. By doing so the benefits in terms of cost saving andblocking probability improvement becomes relevant, allowing network operators and service providersto maintain satisfied customers at reasonable capital and operational expenditure levels.
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