5G Infrastructure Network Slicing: E2E Mean Delay Model and Effectiveness Assessment to Reduce Downtimes in Industry 4.0

Fifth Generation (5G) is expected to meet stringent performance network requisites of the Industry 4.0. Moreover, its built-in network slicing capabilities allow for the support of the traffic heterogeneity in Industry 4.0 over the same physical network infrastructure. However, 5G network slicing capabilities might not be enough in terms of degree of isolation for many private 5G networks use cases, such as multi-tenancy in Industry 4.0. In this vein, infrastructure network slicing, which refers to the use of dedicated and well isolated resources for each network slice at every network domain, fits the necessities of those use cases. In this article, we evaluate the effectiveness of infrastructure slicing to provide isolation among PLs in an industrial private 5G network. To that end, we develop a queuing theory-based model to estimate the E2E mean packet delay of the infrastructure slices. Then, we use this model to compare the E2E mean delay for two configurations, i.e., dedicated infrastructure slices with segregated resources for each PL against the use of a single shared infrastructure slice to serve the performance-sensitive traffic from PLs. Also we evaluate the use of TSN against bare Ethernet to provide layer 2 connectivity among the 5G system components. We use a complete and realistic setup based on experimental and simulation data of the scenario considered. Our results support the effectiveness of infrastructure slicing to provide isolation in performance among the different slices. Then, using dedicated slices with segregated resources for each PL might reduce the number of the production downtimes and associated costs as the malfunctioning of a PL will not affect the network performance perceived by the performance-sensitive traffic from other PLs. Last, our results show that, besides the improvement in performance, TSN technology truly provides full isolation in the transport network compared to standard Ethernet thanks to traffic prioritization, traffic regulation, and bandwidth reservation capabilities.

Male Subfertility; Challenges and advancement in the andrology clinic at Khyber Pakhtunkhwa, Pakistan

Objective: This study is aimed to discuss the challenges in dealing the infertile male and advances in the treatment of male infertility. Material and methods: The study included infertile male patients who presented to andrology outpatient as primary or secondary infertility between December 2018 and January 2021. The data detailed different aspects of challenges and advances in male infertility treatment. The data analysisone with SPSS. Results: Total 289 patients included, most of them (74%) presented as primary infertility and a quarter presented as secondary infertility. The mean delay in presentation was 6.8 years which were due to treatment from non-andrologist doctors of different specialities (53.9%), hakims (15.2%), quacks (13.8%), gynaecologists (10.3%) and some were reluctant to tell their problem (6.5%). The diagnosis was N.O.A (42.9%), unexplained infertility (24.2%), varicocele (22.8%), OA (6.2%), OAT syndrome (2.7%) and CABVD (1%). Different treatment option opted were vasography plus vasovasostomy or vasoepididmostomy (31.1%), ART (23.9%), MSV (22.8%) and medical treatment (22.1%). Vasography plus vasovasostomy or vasoepididmostomy and medical treatment were the available options provided. There was no ART facility and those who were counseled for referral either their unwillingness or cost resulted in a hurdle in their provision. Conclusion: There are still a number of challenges in treating infertile men. Recently provision of medical and microsurgical treatment at andrology clinic resulted in proper treatment of a large number of infertile men who previously received treatment from un- related facilities.

HEPATITIS B AND HEPATITIS C SEROPOSITIVE SURGICAL CASES AND ITS IMPACT ON PERIOPERATIVE BLOOD TRANSFUSION

Objective: To evaluate the frequency of Hepatitis B and Hepatitis C on our surgical patients and its impact on operation theater delay, change of anesthesia plan and requirement of perioperative blood and blood products transfusion. Study Design: Cross sectional, analytical study. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital, Okara, from Apr to Sep 2019. Methodology: After the approval of the hospital ethical review committee, 154 patients with either Hepatitis B or Hepatitis C undergoing various surgeries were included in our study. Data was analyzed using SPSS-20. Results: The overall frequency of chronic liver disease was 154 (4.71%). A total of 23 (0.70%) were found to be seropositive as viral Hepatitis B and 127 (3.88%) as Hepatitis C; whereas 4 (0.12%) patients were diagnosed to have both virus serology positive. There was mean delay of 26.2 ± 8.29 minutes in 78 (52%) patients. The anesthetist had to change the plan of anesthesia for only 1 (0.7%) patient. There was also no difference in frequency of change of anesthesia plan (p=0.35); delay in surgery (p=0.16) and blood transfusion between the patients with Hepatitis B or Hepatitis C infection (p=0.72). Conclusion: The frequency of Hepatitis B and Hepatitis C was lower (4.71%) in our surgical patients with no effect of Hepatitis B and Hepatitis C on blood loss, peri-operative transfusion, delay in surgery or change in anesthesia plan.

Reducing publication delay to improve the efficiency and impact of conservation science

Evidence-based decision-making is most effective with comprehensive access to scientific studies. If studies face significant publication delays or barriers, the useful information they contain may not reach decision-makers in a timely manner. This represents a potential problem for mission-oriented disciplines where access to the latest data is required to ensure effective actions are undertaken. We sought to analyse the severity of publication delay in conservation science—a field that requires urgent action to prevent the loss of biodiversity. We used the Conservation Evidence database to assess the length of publication delay (time from finishing data collection to publication) in the literature that tests the effectiveness of conservation interventions. From 7,447 peer-reviewed and non-peer-reviewed studies of conservation interventions published over eleven decades, we find that the raw mean publication delay was 3.2 years (±2SD = 0.1) and varied by conservation subject. A significantly shorter delay was observed for studies focused on Bee Conservation, Sustainable Aquaculture, Management of Captive Animals, Amphibian Conservation, and Control of Freshwater Invasive Species (Estimated Marginal Mean range from 1.4–1.9 years). Publication delay was significantly shorter for the non-peer-reviewed literature (Estimated Marginal Mean delay of 1.9 years ± 0.2) compared to the peer-reviewed literature (i.e., scientific journals; Estimated Marginal Mean delay of 3.0 years ± 0.1). We found publication delay has significantly increased over time (an increase of ~1.2 years from 1912 (1.4 years ± 0.2) to 2020 (2.6 years ± 0.1)), but this change was much weaker and non-significant post-2000s; we found no evidence for any decline. There was also no evidence that studies on more threatened species were subject to a shorter delay—indeed, the contrary was true for mammals, and to a lesser extent for birds. We suggest a range of possible ways in which scientists, funders, publishers, and practitioners can work together to reduce delays at each stage of the publication process.

Efficient Routing Algorithm using MLP and RBX in a Four Model Neural Networks

Two important paradigms which are contradicting by nature namely: the efficient routing information diffusion and adaptability to dynamic network conditions using wireless routing protocols have been researched in recent years. One way of solving this issue is by using the past experiences of a node in network traffic condition through intelligent algorithm to predict the network traffic condition in the future. In this methodology we propose an algorithm which is used to to predict one hop delay per packet during routing process using neural networking. The one hop delay that is predicted is then further used by the participating nodes for information diffusion during routing. Experimental analysis indicate that using tapped delay line radial basis function and tapped delay line multilayer perceptron, it is possible to predict mean delays as a time series. The inputs used for prediction are mean delay time series with traffic loads and mean delay time series itself. The pros and cons of the proposed work are also present in this paper.

Impact of cardio-oncology strategies in the management of breast cancer patients

Background Cardio-oncology has arisen as one of the most rapidly expanding fields of cardiovascular medicine. The accumulated evidence on the possibilities of early diagnosis of cardiotoxicity provided by imaging techniques as well as on the benefits of preventive and therapeutic interventions is also increasing. Objective This study reported our echocardiography lab's initial experience of a cardio-oncology follow-up program. Methods We prospectively studied the outcomes of 107 patients diagnosed with breast cancer who attended our follow-up program between 2017 and 2020. An echocardiographic monitoring were realised according to the chemotherapy protocol. Cancer therapy-related cardiac dysfunction (CTRCD) is defined, according to the european society of cardiology (ESC) guidelines of 2016, as a drop of left ventricular ejection fraction (LVEF) by >10 percentage points from baseline to a value <50%. A new entity named subclinical systolic dysfunction, is defined by a drop of global longitudinal strain (GLS) by >15% from baseline, however, LVEF remains >50%. The diagnosis should be confirmed by a second echocardiogram after 2–3 weeks. Results We enrolled 107 patients diagnosed with breast cancer and receiving anthracycline and/or trastuzumab. 27 patients were excluded for many reasons: 17 patients were lost to follow-up, 10 patients had an inadequate echo-imaging (8 had a follow-up without measurement of GLS and 2 patients were poorly echogenic). Only eighty patients were finally retained. The average age of our patients was 49.9±10.8 years. The mean left ventricular ejection fraction (LVEF) was at 64±4.4%. The incidence of CTRCD was 6%. the mean delay of diagnosis from the onset of chemotherapy was 174 days. It was reversible in 60% of cases after the initiation of a cardioprotective treatment which allowed the anti-cancer treatment pursuit. The incidence of subclinical cardiac dysfunction was 25%. The mean delay between the initiation of anti-cancer treatment and the diagnosis was 314.5 days. A cardioprotective treatment with Bblockers and angiotensin-converting enzyme (ACE) inhibitors was prescribed and all these patients recovered a normal GLS with a mean delay of three months and pursuied their chemotherapy. Conclusion We showed that timely cardiovascular evaluation, intervention and close monitoring in the context of a structured service allowed the majority of patients (99%) to pursue their anti-cancer treatment and to avoid the evolution to CTRCD in patients diagnosed with subclinical cardiac dysfunction. FUNDunding Acknowledgement Type of funding sources: None. Treated subclinical cardiac dysfunction

EP.TU.270Improving Treatment Escalation Plan (TEP) Completion Rate for General Surgical Patients

Aims Treatment Escalation Plan (TEP) is essential for recognition of patients’ ceiling for care in the event of clinical deterioration. It should be clearly documented to ensure continuity of care, especially during Covid-19 pandemic. This audit aims to evaluate and improve the TEP filling rate for general surgical patients. Methods A prospective data collection was performed for one week in July 2020 in general surgical wards. Data on patients’ gender, age, presence of DNACPR form and date of TEP completion were collected from patients’ clinical notes. Data was analysed using SPSS statistic software. Educational posters were displayed in the ward and presentation was done to emphasise the importance of TEP documentation. Second audit cycle was done in August 2020 to assess for improvement in TEP filling rate. Results In the first cycle, 60 patients were included with a mean age of 60. Only 11.7% patients had TEP form filled in with a mean delay of 2.7 days since admission. In the second cycle, 57 patients were included with a mean age of 66. 28.1% patients had TEP form documented with a mean delay of 1.7 days. This has shown a 140% improvement in completion rate of TEP form and 59% reduction in the delay in TEP documentation. Conclusions TEP is essential to ensure that patients received optimal care when their condition deteriorate. Simple intervention such as educational posters will help to improve the TEP completion rate. However, continuous auditing is required to ensure improvement in TEP documentation for surgical patients.

Management Landscape of Pediatric Hidradenitis Suppurativa

<b><i>Introduction:</i></b> Pediatric hidradenitis suppurativa (HS) is an understudied condition, and the literature describing the provider landscape for this disease is limited. We aim to characterize healthcare utilization in a cohort of pediatric HS patients at an academic institution. <b><i>Methods:</i></b> Patients diagnosed with HS before age 18 were identified via retrospective chart review using ICD-9/10 codes for HS. Data on demographics and HS providers were collected. <b><i>Results:</i></b> We found that half of the pediatric HS patients first presented to primary care with their HS symptoms. There was a mean delay in diagnosis of 2 years. Dermatologists and pediatricians were the principal HS care providers, and dermatologists most frequently prescribed treatment or procedures (63%). We also found a low rate of utilization of the HS specialty clinic (11%). Females, patients with more severe disease, and patients with earlier age of onset were more likely to be seen by a dermatologist. <b><i>Conclusions:</i></b> Dermatologists play a pivotal role in pediatric HS management as principal care providers for patients. Increasing HS awareness among primary care providers, including pediatricians, is critical for early diagnosis and initiation of treatment.

Non-ischemic cerebral enhancing lesions after intracranial aneurysm endovascular repair: a retrospective French national registry

BackgroundNon-ischemic cerebral enhancing (NICE) lesions are exceptionally rare following aneurysm endovascular therapy (EVT).ObjectiveTo investigate the presenting features and longitudinal follow-up of patients with NICE lesions following aneurysm EVT.MethodsPatients included in a retrospective national multicentre inception cohort were analysed. NICE lesions were defined, using MRI, as delayed onset punctate, nodular or annular foci enhancements with peri-lesion edema, distributed in the vascular territory of the aneurysm EVT, with no other confounding disease.ResultsFrom a pool of 58 815 aneurysm endovascular treatment procedures during the study sampling period (2006–2019), 21/37 centres identified 31 patients with 32 aneurysms of the anterior circulation who developed NICE lesions (mean age 45±10 years). Mean delay to diagnosis was 5±9 months, with onset occurring a month or less after the index EVT procedure in 10 out of 31 patients (32%). NICE lesions were symptomatic at time of onset in 23 of 31 patients (74%). After a mean follow-up of 25±26 months, 25 patients (81%) were asymptomatic or minimally symptomatic without disability (modified Rankin Scale (mRS) score 0–1) at last follow-up while 4 (13%) presented with mild disability (mRS score 2). Clinical follow-up data were unavailable for two patients. Follow-up MRI (available in 27 patients; mean time interval after onset of 22±22 months) demonstrated persistent enhancement in 71% of cases.ConclusionsThe clinical spectrum of NICE lesions following aneurysm EVT therapy spans a wide range of neurological symptoms. Clinical course is most commonly benign, although persistent long-term enhancement is frequent.

Patients Admitted for Variant Alpha COVID-19 Have Poorer Outcomes than Those Infected with the Old Strain

Objectives: The variant alpha COVID-19 rapidly spread across Europe in early 2021. While this variant’s increased infectivity has been proven, little is known of its clinical presentation and outcomes compared to the old strain. Methods: We identified patients admitted to the Cannes General Hospital for variant alpha-related COVID-19 infection from January to April 2021. Their main demographic parameters, inflammatory markers and clinical characteristics were recorded. Patients admitted from October to December 2020 for 20E (EU1) COVID-19 were selected as controls. Differences between groups were analyzed. Results: We included 157 patients (mean age 73 years; 58% men; mean delay of symptoms 6.9 days). Comorbidities were present in 92% (mainly hypertension, diabetes and obesity or overweight). The prevalence of comorbidities did not differ between groups. In 28% of cases, patients either died or required transfer to the Intensive Care Unit (ICU). The cause of death or of transfer to the ICU was presumably associated with severe pneumonia. Variant alpha COVID-19 had 3.8-fold higher risk of death or transfer to the ICU compared to the old strain. Discussion: Patients infected with variant alpha COVID-19, despite similar background characteristics, had a higher risk of unfavorable outcomes than those infected with the old strain, suggesting increased virulence related to this variant.