| 1. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
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| 2. |
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| 3. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 4. |
- Murray, Christopher J. L., et al.
(författare)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 5. |
- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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| 6. |
- Ahmad, Amais, et al.
(författare)
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IMI – Oral biopharmaceutics tools project – Evaluation of bottom-up PBPK prediction success part 4 : Prediction accuracy and software comparisons with improved data and modelling strategies
- 2020
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Ingår i: European journal of pharmaceutics and biopharmaceutics. - : Elsevier BV. - 0939-6411 .- 1873-3441. ; 156, s. 50-63
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Tidskriftsartikel (refereegranskat)abstract
- Oral drug absorption is a complex process depending on many factors, including the physicochemical properties of the drug, formulation characteristics and their interplay with gastrointestinal physiology and biology. Physiological-based pharmacokinetic (PBPK) models integrate all available information on gastro-intestinal system with drug and formulation data to predict oral drug absorption. The latter together with in vitro-in vivo extrapolation and other preclinical data on drug disposition can be used to predict plasma concentration-time profiles in silico. Despite recent successes of PBPK in many areas of drug development, an improvement in their utility for evaluating oral absorption is much needed. Current status of predictive performance, within the confinement of commonly available in vitro data on drugs and formulations alongside systems information, were tested using 3 PBPK software packages (GI-Sim (ver.4.1), Simcyp® Simulator (ver.15.0.86.0), and GastroPlusTM (ver.9.0.00xx)). This was part of the Innovative Medicines Initiative (IMI) Oral Biopharmaceutics Tools (OrBiTo) project.Fifty eight active pharmaceutical ingredients (APIs) were qualified from the OrBiTo database to be part of the investigation based on a priori set criteria on availability of minimum necessary information to allow modelling exercise. The set entailed over 200 human clinical studies with over 700 study arms. These were simulated using input parameters which had been harmonised by a panel of experts across different software packages prior to conduct of any simulation. Overall prediction performance and software packages comparison were evaluated based on performance indicators (Fold error (FE), Average fold error (AFE) and absolute average fold error (AAFE)) of pharmacokinetic (PK) parameters.On average, PK parameters (Area Under the Concentration-time curve (AUC0-tlast), Maximal concentration (Cmax), half-life (t1/2)) were predicted with AFE values between 1.11 and 1.97. Variability in FEs of these PK parameters was relatively high with AAFE values ranging from 2.08 to 2.74. Around half of the simulations were within the 2-fold error for AUC0-tlast and around 90% of the simulations were within 10-fold error for AUC0-tlast. Oral bioavailability (Foral) predictions, which were limited to 19 APIs having intravenous (i.v.) human data, showed AFE and AAFE of values 1.37 and 1.75 respectively. Across different APIs, AFE of AUC0-tlast predictions were between 0.22 and 22.76 with 70% of the APIs showing an AFE > 1. When compared across different formulations and routes of administration, AUC0-tlast for oral controlled release and i.v. administration were better predicted than that for oral immediate release formulations. Average predictive performance did not clearly differ between software packages but some APIs showed a high level of variability in predictive performance across different software packages. This variability could be related to several factors such as compound specific properties, the quality and availability of information, and errors in scaling from in vitro and preclinical in vivo data to human in vivo behaviour which will be explored further. Results were compared with previous similar exercise when the input data selection was carried by the modeller rather than a panel of experts on each in vitro test. Overall, average predictive performance was increased as reflected in smaller AAFE value of 2.8 as compared to AAFE value of 3.8 in case of previous exercise.
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| 7. |
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| 8. |
- Fiorani, Matteo, et al.
(författare)
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Abstraction Models for Optical 5G Transport Networks
- 2016
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Ingår i: Journal of Optical Communications and Networking. - : Optical Society of America. - 1943-0620 .- 1943-0639. ; 8:9, s. 656-665
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Tidskriftsartikel (refereegranskat)abstract
- The orchestration of radio, transport, and cloud resources is a key enabler for efficient service delivery in 5G networks. Orchestration can be achieved with a hierarchical software-defined networking (SDN) control architecture in which a global orchestrator operates above the domain controllers. In such an architecture, the abstraction of resources between the controllers and the orchestrator plays a fundamental role for the system performance. In order to reduce the orchestrator complexity, the controllers should hide as much detail as possible from the orchestrator. On the other hand, the more details are available to the orchestrator the more optimal resource orchestration strategy can be obtained. In order to assess this trade-off, we recently proposed two transport abstraction models, namely big switch (BiS) and virtual link (VL), for centralized radio access networks (C-RANs) with orchestration of radio and transport resources. We observed that VL can provide a more efficient resource orchestration than BiS at the expense of an increased implementation complexity. The contribution of this paper is twofold. We extend the BiS and VL models to make them applicable to any orchestration scenario. Then, we propose a new transport abstraction model, referred to as optical transport transformation (OTT), that aims at achieving efficient resource orchestration with a reduced implementation complexity. We compare the performance of these new abstraction models in a C-RAN use case in which backhaul and fronthaul traffic are carried over a dense wavelength division multiplexing (DWDM) network. Our results prove that in a C-RAN the best choice for the transport abstraction model depends on the availability and the reachability of the radio resources. If radio resources are scarce compared to transport resources, complex transport abstraction models are not needed and a BiS abstraction is the best choice. On the other hand, if radio resources are widely available and reachable, an OTT model guarantees the best overall performance.
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| 9. |
- Fiorani, Matteo, et al.
(författare)
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Transport Abstraction Models for an SDN-Controlled Centralized RAN
- 2015
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Ingår i: IEEE Communications Letters. - 1089-7798 .- 1558-2558. ; 19:8, s. 1406-1409
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Tidskriftsartikel (refereegranskat)abstract
- In a centralized radio access network (C-RAN) scenario the joint coordination of radio (e.g., remote radio units, baseband units) and transport (e.g., optical cross connects) resources can be achieved via software defined networking (SDN) control plane, where a global orchestrator harmonizes the use of resources across all network segments. The more accurate the information about each domain (i.e., the abstraction of wireless and transport resources) is, the better will be the outcome of the orchestration work. This letter presents three transport resources abstraction models along with their corresponding orchestration policies. Their performance are compared showing that there is not a single best abstraction strategy that fits all the cases. If radio resources are scarce compared to transport resources, complex transport abstraction models are not needed. Contrariwise, if enough radio resources are widely available, more detailed abstraction models are required for achieving good network performance, but at the expense of an increased implementation complexity.
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| 10. |
- Frank, TD, et al.
(författare)
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Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
- 2019
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Ingår i: The lancet. HIV. - 2352-3018. ; 6:12, s. E831-E859
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Tidskriftsartikel (refereegranskat)
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| 11. |
- Griswold, Max G., et al.
(författare)
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Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2018
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
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Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
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| 12. |
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| 13. |
- Kinyoki, DK, et al.
(författare)
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Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
- 2020
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Ingår i: Nature medicine. - : Springer Science and Business Media LLC. - 1546-170X .- 1078-8956. ; 26:5, s. 750-759
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Tidskriftsartikel (refereegranskat)abstract
- A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
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| 14. |
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| 15. |
- Natalino Da Silva, Carlos, 1987, et al.
(författare)
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Storage Protection with Connectivity and Processing Restoration for Survivable Cloud Services
- 2021
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Ingår i: Proceedings - International Conference on Computer Communications and Networks, ICCCN. - 1095-2055. ; 2021-July
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Konferensbidrag (refereegranskat)abstract
- The operation and management of software-based communication systems and services is a big challenge for infrastructure and service providers. The challenge is mainly associated with the larger number of configurable elements and the higher dynamicity in the software-based systems compared to the classical ones. On the other hand, the modularity and programmability in software-based networks enabled by technologies like Software Defined Networking (SDN) and Network Function Virtualization (NFV) provide new opportunities for operators to realize advanced network and service management strategies beyond the classical techniques. In our work, we elaborate on these new opportunities and propose a novel strategy for the management of survivable cloud services. In particular, we leverage the flexibility of SDN and NFV to combine proactive protection and reactive restoration mechanisms and we put forward a novel strategy for enhancing the survivability of cloud services. Through comprehensive evaluations, we demonstrate that the proposed strategy offers significant benefits in terms of availability and restorability of services while reducing, at the same time, the overhead caused by the relocation of cloud services in case of failures.
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| 16. |
- Nichols, Emma, et al.
(författare)
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Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:1, s. 88-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists.Methods: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugarsweetened beverages).Findings: In 2016, the global number of individuals who lived with dementia was 43.8 million (95% uncertainty interval [UI] 3 7. 8-51.0), increased from 20.2 million (17. 4-23 5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1.7% (1.0-2.4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27.0 million, 95% UI 23 .3-31. 4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2.4 million (95% UI 2.1-2.8) deaths. Overall, 28.8 million (95% UI 24. 5-34. 0) DALYs were attributed to dementia; 6.4 million (95% UI 3 .4-10. 5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages.Interpretation: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide.
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| 17. |
- Nikam, Vikrant, et al.
(författare)
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VNF Service Chaining in Optical Data Center Networks
- 2017
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Ingår i: 2017 IEEE CONFERENCE ON NETWORK FUNCTION VIRTUALIZATION AND SOFTWARE DEFINED NETWORKS (NFV-SDN)<em></em>. - : IEEE.
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Konferensbidrag (refereegranskat)abstract
- Virtualized network function (VNF) service chaining in optical datacenter networks (DCN) is a more complex problem than that in packet-switched networks, as it introduces additional constraints related to the optical network. For example, in an optical DCN one needs to make sure that optical network resources are efficiently utilized, which requires multiplexing of several VNF chains to fill the optical pipes. In this paper, we first propose a novel and flexible DCN architecture based on optical circuit switching technology supporting service chaining in the optical domain. Then, we formulate the problem of VNF service chaining in the proposed optical DCN using integer linear problem (ILP) formulation and heuristic methods. We also numerically investigate the performance of the proposed architecture and the service chaining methods using a set of examples.
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| 18. |
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| 19. |
- Raza, Muhammad Rehan, et al.
(författare)
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Benefits of Programmability in 5G Transport Networks
- 2017
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Konferensbidrag (refereegranskat)abstract
- This paper shows how programmability can improve operators’ revenues and it presents a dynamic resource slicing policy that leads to more than one order of magnitude better resource utilization levels than convectional (static) allocation strategies.
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| 20. |
- Raza, Muhammad Rehan, et al.
(författare)
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Dynamic Resource Sharing for C-RANs with Joint Orchestration of Radio and Transport
- 2016
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Ingår i: ECOC 2016 42th European Conference on Optical Communication Proceedings, September 18 - 22, 2016, Düsseldorf, Germany. - : VDE Verlag GmbH. - 9783800742745 ; , s. 1001-1003
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Konferensbidrag (refereegranskat)abstract
- We present a resource allocation strategy for centralized radio access network architectures able to adapt to the wireless network capacity requirements. Both simulation and emulation results show that it is possible to reuse up to 33.3% of the transport resources.
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| 21. |
- Raza, Muhammad Rehan, et al.
(författare)
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Dynamic Slicing Approach for Multi-Tenant 5G Transport Networks
- 2018
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Ingår i: Journal of Optical Communications and Networking. - : Optical Society of America. - 1943-0620 .- 1943-0639. ; 10:1, s. A77-A90
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Tidskriftsartikel (refereegranskat)abstract
- Software defined networking allows network providers to share their physical network (PN) among multiple tenants by means of network slicing, where several virtual networks (VNs) are provisioned on top of the physical one. In this scenario, PN resource utilization can be improved by introducing advanced orchestration functionalities that can intelligently assign and redistribute resources among the slices of different tenants according to the temporal variation of the VN resource requirements. This is a concept known as dynamic slicing. This paper presents a solution for the dynamic slicing problem in terms of both mixed integer linear programming formulations and heuristic algorithms. The benefits of dynamic slicing are compared against static slicing, i.e., an approach without intelligent adaptation of the amount of resources allocated to each VN. Simulation results show that dynamic slicing can reduce the VN rejection probability by more than 1 order of magnitude compared to static slicing. This can help network providers accept more VNs into their infrastructure and potentially increase their revenues. The benefits of dynamic slicing come at a cost in terms of service degradation (i.e., when not all the resources required by a VN can be provided), but the paper shows that the service degradation level introduced by the proposed solutions is very small.
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| 22. |
- Raza, Muhammad Rehan, et al.
(författare)
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Priority-Aware Service Orchestration Using Big Data Analytics for Dynamic Slicing in 5G Transport Networks
- 2017
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Ingår i: 2017 European Conference on Optical Communication (ECOC). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781538656242
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Konferensbidrag (refereegranskat)abstract
- We demonstrate how to efficiently scale up/down resource slices allocated to tenants with different service priorities. Experimental results show that our proposed strategy - based on big data analytics - lowers service degradation by more than 51%, compared to priority unaware approaches.
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| 23. |
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| 24. |
- Rostami, Ahmad, et al.
(författare)
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An end-to-end programmable platform for dynamic service creation in 5g networks
- 2017
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Ingår i: 2017 Optical Fiber Communications Conference and Exhibition, OFC 2017 - Proceedings. - : IEEE. - 9781943580231
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Konferensbidrag (refereegranskat)abstract
- We demonstrate how SDN and NFV can bring end-to-end programmability to heterogeneous technology domains including optical transport, radio and cloud networks, which can in turn be leveraged for agile and resource-optimized service creation.
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| 25. |
- Rostami, Ahmad, et al.
(författare)
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First experimental demonstration of orchestration of optical transport, RAN and cloud based on SDN
- 2015
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Ingår i: Conference on Optical Fiber Communication, Technical Digest Series. - : Optical Society of America. - 9781557529374
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Konferensbidrag (refereegranskat)abstract
- We design and experimentally demonstrate the first resource orchestration across DWDM optical transport, radio access networks (RANs) and cloud domains based on SDN. The orchestration enables agile service creation and optimized resource allocation.
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| 26. |
- Rostami, Ahmad, et al.
(författare)
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Orchestration of RAN and transport networks for 5G : An SDN approach
- 2017
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Ingår i: IEEE Communications Magazine. - : Institute of Electrical and Electronics Engineers Inc.. - 0163-6804 .- 1558-1896. ; 55:4, s. 64-70
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Tidskriftsartikel (refereegranskat)abstract
- The fifth generation of mobile networks is planned to be commercially available in a few years. The scope of 5G goes beyond introducing new radio interfaces, and will include new services like low-latency industrial applications, as well as new deployment models such as cooperative cells and densification through small cells. An efficient realization of these new features greatly benefit from tight coordination among radio and transport network resources, something that is missing in current networks. In this article, we first present an overview of the benefits and technical requirements of resource coordination across radio and transport networks in the context of 5G. Then, we discuss how SDN principles can bring programmability to both the transport and radio domains, which in turn enables the design of a hierarchical, modular, and programmable control and orchestration plane across the domains. Finally, we introduce two use cases of SDN-based transport and RAN orchestration, and present an experimental implementation of them in a testbed in our lab, which confirms the feasibility and benefits of the proposed orchestration.
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| 27. |
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| 28. |
- Takita, Hiroyuki, et al.
(författare)
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Application of the nested enzyme-within-enterocyte (NEWE) turnover model for predicting the time course of pharmacodynamic effects
- 2020
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Ingår i: CPT. - : Wiley. - 2163-8306. ; 9:11, s. 617-627
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Tidskriftsartikel (refereegranskat)abstract
- The gut wall consists of many biological elements including enterocytes. Rapid turnover, a prominent feature of the enterocytes, has generally been ignored in the development of enterocyte-targeting drugs, although it has a comparable rate to other kinetic rates. Here, we investigated the impact of enterocyte turnover on the pharmacodynamics of enterocyte-targeting drugs by applying a model accounting for turnover of enterocytes and target proteins. Simulations showed that the pharmacodynamics depend on enterocyte lifespan when drug-target affinity is strong and half-life of target protein is long. Inter-individual variability of enterocyte lifespan, which can be amplified by disease conditions, has a substantial impact on the variability of response. However, our comprehensive literature search showed that the enterocyte turnover causes a marginal impact on currently approved enterocyte-targeting drugs due to their relatively weak target affinities. This study proposes a model-informed drug development approach for selecting enterocyte-targeting drugs and their optimal dosage regimens.
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| 29. |
- Yaghoubi, Forough, 1988-, et al.
(författare)
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Consistency-Aware Weather Disruption-Tolerant Routing in SDN-Based Wireless Mesh Networks
- 2018
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Ingår i: IEEE Transactions on Network and Service Management. - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 1932-4537. ; 15:2, s. 582-595
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Tidskriftsartikel (refereegranskat)abstract
- Wireless network solutions, a dominant enabling technology for the backhaul segment, are susceptible to weather disturbances that can substantially degrade network throughput and/or delay, compromising the stringent 5G requirements. These effects can be alleviated by centralized rerouting realized by software defined networking architecture. However, careless frequent reconfigurations can lead to inconsistencies in the network states due to asynchrony between different switches, which can create congestion and limit the rerouting gain. The aim of this paper is to minimize the total data loss during rain disturbance by proposing an algorithm that decides on the timing, the sequence, and the paths for rerouting of network flows considering the imposed congestion during reconfiguration. At each time sample, the central controller decides whether to adopt the optimal routes at a switching cost, defined as the imposed congestion, or to keep using existing, sub-optimal routes at a throughput loss. To find optimal solutions with minimal data loss in a static scenario, we formulate a dynamic programming problem that utilizes perfect knowledge of rain attenuation for the whole rain period. For dynamic scenarios with unknown future rain attenuation, we propose an online consistency-aware rerouting algorithm, called consistency-aware rerouting with prediction (CARP), which uses the temporal correlation of rain fading to estimate future rain attenuation. Simulation results on synthetic and real networks validate the efficiency of our CARP algorithm, substantially reducing data loss and increasing network throughput with a fewer number of rerouting actions compared to a greedy and a regular rerouting benchmarking approaches.
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| 30. |
- Yaghoubi, Forough, 1988-, et al.
(författare)
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Consistency-aware Weather Disruption-tolerant Routing in SDNbased Wireless Mesh Networks
- 2017
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Ingår i: IEEE Transactions on Network and Service Management. - : IEEE Communications Society. - 1932-4537.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Although, wireless solutions continue to be a dominant enabling technology in the future backhaul segment, they are susceptible to weather disturbances that may substantially degrade network throughput, or delay, compromising the 5G requirements. These effects can be alleviated by centralized rerouting realized by software defined networking (SDN) architecture. However, careless frequent reconfigurations may lead to inconsistencies in network states due to asynchrony between different switches, which may create congestion and limit the gain of frequent rerouting. In this paper, we focus on the rerouting process during rain disturbance considering the minimum total congestion imposed during the update of routing tables as a switching cost. At each time sample, the central controller has the possibility to adopt the optimal routes at a switching cost or to keep using previous routes at the expense of a throughput loss due to route sub- optimality. To find optimal solutions with minimal data loss in a static scenario, we formulate a dynamic programming problem that utilizes perfect knowledge of the rain attenuation for the whole rain period (off-line policy with full knowledge). For dynamic scenarios where the future rain attenuation data cannot be known, we propose an online consistency-aware rerouting algorithm, called optimal control action with prediction (OCAP), which uses the temporal correlation of rain fading to estimate the future rain attenuation. Simulation results on synthetic and real networks validate the efficiency of our OCAP algorithm, substantially reducing congestion and increasing network throughput with a fewer number of rerouting actions compared to benchmarks approaches.
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| 31. |
- Yaghoubi, Forough, 1988-, et al.
(författare)
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Impact of Correlated Failures on Design and Reliability Performance of Wireless Networks
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Annan publikation (populärvet., debatt m.m.)abstract
- Design of reliable wireless backhaul networks is challenging due to the inherent vulnerability of wireless backhauling to random fluctuations of the wireless channel, such as those caused by rain. Considerable studies deal with modifying and designing the network topology to meet the reliability requirements in a cost-efficient manner. However, these studies ignore the correlation among link failures, particularly those caused by weather disturbances. Consequently, the resulting topology designs may fail to meet the network reliability requirements under correlated failure scenarios. To fill this gap, we study the design of cost-efficient and reliable wireless backhaul networks under correlated failures with a focus on rain disturbances. We first propose a new model to consider the pairwise correlation among links along a path. The model is verified on real data, indicating an approximation closer to reality than the existing independent model. Second, we model the correlation among different paths by defining a penalty cost. Considering the newly formalized link and path correlation, we formulate the network topology design problem as a quadratic integer program to find the optimal solutions. As the problem is shown to be NP-hard, two lightweight heuristic algorithms are developed to find near-optimal solutions in a reasonable time. Performance evaluation shows that correlation aware design substantially improves the resiliency under rain disturbances at a slightly increased cost compared to independent failure approaches.
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| 32. |
- Yaghoubi, Forough, 1988-, et al.
(författare)
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Mitigation of Rain Impact on Microwave Backhaul Networks
- 2016
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Ingår i: 2016 IEEE International Conference on Communications Workshops (ICC). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781509004485 ; , s. 134-139, s. 134-139
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Konferensbidrag (refereegranskat)abstract
- Microwave backhaul networks are a cost-efficient option to support increasing capacity demands of mobile networks. However, inherent vulnerability of wireless backhauling to random fluctuations of the wireless channel complicates the design of reliable backhaul links. Long-lasting channel fluctuations such as rain fading may bring significant network performance degradation, and therefore, need to be carefully treated. This paper proposes a novel rain detection algorithm utilizing both temporal and spatial correlation of link status, aiming at efficiently distinguishing between long-term and short-term channel fading. With this distinction, a central controller decides whether network-wide strategies, such as rerouting, are required to mitigate the effects of rain. The accuracy of the proposed detection method is evaluated by measuring false alarm and misdetection probabilities. Numerical results show high rain detection accuracy of the proposed algorithm. Consequently, the impact of imperfect rain detection on the network throughput performance and on the overhead imposed to the central controller becomes negligible.
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| 33. |
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| 34. |
- Yaghoubi, Forough, et al.
(författare)
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Resilient SDN-Based Routing Against Rain Disruptions for Wireless Networks
- 2020
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Ingår i: Guide to Disaster-Resilient Communication Networks; Rak, J., Hutchison, D. (eds). - Cham : Springer International Publishing. - 9783030446857 ; , s. 507-522
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Rain is a relatively frequent long-term event that can reduce the wireless networks throughput and availability. Depending on the rain rate, the communication link may fail completely, bringing about further instability problems of end-to-end paths. One of the effective solutions for reducing the impact of a long-term event such as rain is rerouting. However, the first step for mitigating these effects is to detect the presence and identify the type of long-term event to be able to act correctly. Therefore, it is vital to use an accurate and fast rain detection algorithm that can trigger the rerouting process. Throughout years, many algorithms were proposed to implement efficient and fast routing. Nowadays, software-defined networking (SDN) paradigm eases the deployment of centralized routing approaches by shifting the forwarding intelligence and management to a centralized controller and keeping the network elements as simple as possible. SDN is a promising solution that provides network programmability and facilitates dynamic quality-of-service provisioning. The global view captured by SDN eases reconfiguration and management of the whole backhaul network, which is particularly important in the case of large-scale disturbances of varying intensity and coverage due to weather. This chapter presents models for capturing the impact of rain on wireless channel attenuation, scrutinizes algorithms for rain detection, and discusses different rerouting approaches for mitigating the rain impact.
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