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- Babich, T, et al.
(författare)
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Ceftazidime, Carbapenems, or Piperacillin-tazobactam as Single Definitive Therapy for Pseudomonas aeruginosa Bloodstream Infection: A Multisite Retrospective Study
- 2020
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Ingår i: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - : Oxford University Press (OUP). - 1537-6591. ; 70:11, s. 2270-2280
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe optimal antibiotic regimen for Pseudomonas aeruginosa bacteremia is controversial. Although β-lactam monotherapy is common, data to guide the choice between antibiotics are scarce. We aimed to compare ceftazidime, carbapenems, and piperacillin-tazobactam as definitive monotherapy.MethodsA multinational retrospective study (9 countries, 25 centers) including 767 hospitalized patients with P. aeruginosa bacteremia treated with β-lactam monotherapy during 2009–2015. The primary outcome was 30-day all-cause mortality. Univariate and multivariate, including propensity-adjusted, analyses were conducted introducing monotherapy type as an independent variable.ResultsThirty-day mortality was 37/213 (17.4%), 42/210 (20%), and 55/344 (16%) in the ceftazidime, carbapenem, and piperacillin-tazobactam groups, respectively. Type of monotherapy was not significantly associated with mortality in either univariate, multivariate, or propensity-adjusted analyses (odds ratio [OR], 1.14; 95% confidence interval [CI], 0.52–2.46, for ceftazidime; OR, 1.3; 95% CI, 0.67–2.51, for piperacillin-tazobactam, with carbapenems as reference in propensity adjusted multivariate analysis; 542 patients). No significant difference between antibiotics was demonstrated for clinical failure, microbiological failure, or adverse events. Isolation of P. aeruginosa with new resistance to antipseudomonal drugs was significantly more frequent with carbapenems (36/206 [17.5%]) versus ceftazidime (25/201 [12.4%]) and piperacillin-tazobactam (28/332 [8.4%] (P = .007).ConclusionsNo significant difference in mortality, clinical, and microbiological outcomes or adverse events was demonstrated between ceftazidime, carbapenems, and piperacillin-tazobactam as definitive treatment of P. aeruginosa bacteremia. Higher rates of resistant P. aeruginosa after patients were treated with carbapenems, along with the general preference for carbapenem-sparing regimens, suggests using ceftazidime or piperacillin-tazobactam for treating susceptible infection.
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- Dlas, M. P. I., et al.
(författare)
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Delay-Constrained Framework for Road Safety and Energy-Efficient Intelligent Transportation Systems
- 2018
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Ingår i: 2017 European Conference on Optical Communication (ECOC). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781538656242 ; , s. 1-3
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Konferensbidrag (refereegranskat)abstract
- We propose a novel approach that exploits a delay-constrained framework to meet stringent delay requirements and achieves energy-savings in Intelligent Transportation Systems (ITS). Analytical results show 40% energy-savings in a network that delivers delay-sensitive safety information over ITS.
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- Chen, Jiajia, et al.
(författare)
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Cost vs. reliability performance study of fiber access network architectures
- 2010
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Ingår i: IEEE Communications Magazine. - 0163-6804 .- 1558-1896. ; 48:2, s. 56-65
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Tidskriftsartikel (refereegranskat)abstract
- Fiber to the home is the future-proof technology for broadband access networks. Several fiber access network architectures have been developed (e.g., point-to-point, active optical network, and passive optical network). PON is considered the most promising solution due to the relatively low deployment cost and high resource efficiency. Meanwhile, because of the growing demand for reliable service delivery, fault management is becoming more significant in all parts of communications networks. However, there is a trade-off between the cost of protection and the level of service reliability. Since economical aspects are most critical in the access part of networks, improving reliability performance by duplication of network resources (and capital expenditures) could be too expensive. Therefore, recent work has focused on PON protection schemes with reduced CAPEX. The future trend will probably migrate toward minimizing operational expenditures during the access network lifetime. The main contributions of this article include providing a general method for CAPEX and OPEX analysis that can be applied to any type of fiber access network with consideration of changed component cost in time and variable take rates, and comparing the total cost (i.e., sum of CAPEX and OPEX) for the selected representative architectures with and without protection for business and residential users in relation to reliability performance. The aim is to give a guideline for the design of the most cost-effective protection schemes, while maintaining acceptable service reliability.
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- MacHuca, C. M., et al.
(författare)
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Cost-efficient protection in TDM PONs
- 2012
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Ingår i: IEEE Communications Magazine. - 0163-6804 .- 1558-1896. ; 50:8, s. 110-117
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Tidskriftsartikel (refereegranskat)abstract
- Reliability in optical access networks is becoming a crucial issue for both operators and users due to the enormous increase of capacity and the importance of uninterrupted access to network services. Consequently, the growing number of users requesting penalties for connection interruptions is motivating for investing in protection mechanisms in fiber access networks. The investments involved depend on several aspects such as technology and covered area (population density, distance, type of users, etc.). Moreover, the passive optical network is considered one of the most beneficial fiber access solutions from the capital expenditures point of view; in particular, we are witnessing a wide deployment of TDM PONs. Keeping in mind that cost is a major issue in the access part of the network, in this article we propose a cost-efficient way to provide protection in a TDM PON considering different deployment scenarios in respect to population density in the access network area. The cost efficiency is obtained by taking advantage of investment cost reduction caused by sharing the same duct by both working and protection fibers. In order to evaluate the investment associated with the deployment of the proposed protection schemes, we take into account three different approaches: provide protection in the access network from the beginning, invest initially on an unprotected architecture keeping in mind a future upgrade with protection resources, and roll out an unprotected access network and, if needed in the future, invest in deployment of protection resources. The cost parameters considered in this article include investment in the infrastructure and installation, as well as the operational expenditures associated with failure reparation and service interruption penalties. Our results confirm that the proposed reliable PON architectures can achieve significant reduction of service interruption at very low increase in investment cost, leading to a great decrease of the total cost of ownership. Finally, some useful guidance for cost-efficient deployment of protection in fiber access networks is provided along with a sensitivity study to point out the key cost factors.
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- MacHuca, C. M., et al.
(författare)
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Fiber access networks : Reliability and power consumption analysis
- 2011
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Ingår i: ONDM 2011 - 15th Conference on Optical Network Design and Modeling. - Bologna. - 9783901882425 ; , s. 5753402-
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Konferensbidrag (refereegranskat)abstract
- Optical access networks are being widely deployed due to their high capacity and scalability. The reliability of these networks is a key issue because of the impact of failures on both the number of interrupted services and significance of the service interruptions for the community. Consequently, the service interruption penalties that a network operator would need to pay are directly related to the network reliability performance. Nowadays, penalties are paid to business customers when the service interruption time is longer than the value of the Service Level Agreement agreed with the operator. However, the number of users requesting penalties increases, which has triggered the need of protection mechanisms in access networks. In this paper, the investments required to offer protection for different planning approaches will be compared for different optical access technologies (TDM, WDM, AON and P2P). The evaluation of the costs associated to each scenario such as infrastructure, equipment, power consumption, failure reparation etc. is presented. The overall cost reduction when investing on infrastructure protection is highlighted.
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| 10. |
- Machuca, C. M., et al.
(författare)
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PON protection architectures achieving total cost reduction
- 2010
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Ingår i: 2010 Asia Communications and Photonics Conference and Exhibition, ACP 2010. - 9781424471119 ; , s. 707-708
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Konferensbidrag (refereegranskat)abstract
- A new way to provide protection in TDM PONs is proposed and evaluated. It is shown that very low investment is needed to provide protection. In this way the total cost can be reduced due to the diminution of the OPEX related to the failure management.
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