Data centers are a fundamental infrastructure in the Big-Data era, where applications and services demand a high amount of data and minimum response times. The interconnection network is an essential ...subsystem in the data center, as it must guarantee high communication bandwidth and low latency to the communication operations of applications, otherwise becoming the system bottleneck. Simulation is widely used to model the network functionality and to evaluate its performance under specific workloads. Apart from the network modeling, it is essential to characterize the end-nodes communication pattern, which will help identify bottlenecks and flaws in the network architecture. In previous works, we proposed the VEF traces framework: a set of tools to capture communication traffic of MPI-based applications and generate traffic traces used to feed network simulator tools. In this paper, we extend the VEF traces framework with new communication workloads such as deep-learning training applications and online data-intensive workloads.
The Spanish Quality Assurance Program applied to the process of donation after brain death entails an internal stage consisting of a continuous clinical chart review of deaths in critical care units ...(CCUs) performed by transplant coordinators and periodical external audits to selected centers. This paper describes the methodology and provides the most relevant results of this program, with information analyzed from 206,345 CCU deaths. According to the internal audit, 2.3% of hospital deaths and 12.4% of CCU deaths in Spain yield potential donors (clinical criteria consistent with brain death). Out of the potential donors, 54.6% become actual donors, 26% are lost due to medical unsuitability, 13.3% due to refusals to donation, 3.1% due to maintenance problems and 3% due to other reasons. Although the national pool of potential donors after brain death has progressively decreased from 65.2 per million population (pmp) in 2001 to 49 pmp in 2010, the number of actual donors after brain death has remained at about 30 pmp. External audits reveal that the number of actual donors could be 21.6% higher if all potential donors were identified and preventable losses avoided. We encourage other countries to develop similar comprehensive approaches to deceased donation performance.
The Spanish Quality Assurance Program applied to the process of donation after brain death represents a systematic, continuous and sustainable approach for a comprehensive assessment of this process, allowing for the estimation of the potential of donation, the analysis of performance and the identification of areas for improvement.
Treatment of multidrug-resistant Acinetobacter baumannii (MDRAB) infection presents a challenge because of the scarcity of available options. Even though combination therapy (CT) is frequently used ...in clinical practice, data are needed to support its use instead of monotherapy (MT).
A prospective observational study was conducted in 28 Spanish hospitals. Patients with sepsis caused by MDRAB, defined according to strict criteria, and who received active antibiotic treatment (according to in vitro susceptibility testing) for at least 48 h, were included. The main outcome variable was all-cause 30 day mortality after initiation of targeted therapy. Multivariate analysis, including a propensity score (for receiving CT), was performed by Cox regression.
One hundred and one patients were included in the analysis; 68 (67.3%) received MT and 33 (32.7%) received CT. Pneumonia was the most common infection (50.5%), 68.6% of cases being associated with mechanical ventilation. Colistin (67.6%) and carbapenems (14.7%) were the most common drugs used in MT; colistin plus tigecycline (27.3%) and carbapenem plus tigecycline (12.1%) were the most frequent combinations. Crude 30 day mortality was 23.5% and 24.2% for the MT and CT groups, respectively (RR = 1.03; 95% CI 0.49-2.16; P = 0.94). Multivariate analysis of 30 day survival showed no trend towards reduced 30 day mortality with CT (HR = 1.35; 95% CI 0.53-3.44; P = 0.53). Subgroup analysis showed similar results.
Our data do not support an association of CT with reduced mortality in MDRAB infections. More data for specific types of infection and combinations are needed.
Human exposure to arsenicals is associated with inflammatory-related diseases including different kinds of cancer as well as non-cancerous diseases like neuro-degenerative diseases, atherosclerosis, ...hypertension, and diabetes. Interindividual susceptibility has been mainly addressed by evaluating the role of genetic polymorphism in metabolic enzymes in inorganic arsenic (iAs) metabolism. Glutathione S-transferase omega 1-1 (GSTO1-1), which had been associated with iAs metabolism, is also known to participate in inflammatory and apoptotic cellular responses. The polymorphism A140D of GSTO1-1 has been not only associated with distinct urinary profile of arsenic metabolites in populations chronically exposed to iAs in drinking water, but also with higher risk of childhood leukemia and lung disease in non-exposed populations, suggesting that GSTO1-1 involvement in other physiologic processes different from toxics metabolism could be more relevant than is thought. We evaluated the association of the presence of A140D and E208K polymorphisms of GSTO1-1 gene with the expression of genes codifying for proteins involved in the inflammatory and apoptotic response in a human population chronically exposed to iAs through drinking water. A140D polymorphism was associated with higher expression of genes codifying for IL-8 and Apaf-1 mainly in heterozygous individuals, while E208K was associated with higher expression of IL-8 and TGF-β gene, in both cases, the association was independently of iAs exposure level; however, the exposure to iAs increased slightly but significantly the influence of A140D and E208K polymorphisms on such genes expression. These results suggest an important role of GSTO1-1 in the inflammatory response and the apoptotic process and indicate that A140D and E208K polymorphisms could increase the risk of developing inflammatory and apoptosis-related diseases in As-exposed populations.
Background and importanceThe characteristics of the patient who requires health care are different between primary care (PC) and hospital care (HC). The COVID-19 pandemic has impacted on public ...access to health services. Therefore, prescribing patterns and consumption of antimicrobials in both contexts could have changed.Aim and objectivesTo assess the impact of the COVID-19 pandemic on antimicrobial consumption in PC and HC.Material and methodsDescriptive cross-sectional study that evaluated the antimicrobial consumption (ATC J01) in adult patients 1 year before (March 2019–February 2020) and 1 year after (March 2020–February 2021) the arrival of the COVID-19 pandemic.Antimicrobial consumption rates were expressed in defined daily doses per 1000 inhabitants-day (DID). In PC we included the reference population of our area and in HC the number of patients discharged. The impact was assessed by the difference in DID between both periods and care settings.Data on antimicrobial prescribing in PC were obtained from a public database with anonymised data on the total number of items of each drug prescribed. Hospital data were obtained from the clinical unit of pharmacy.ResultsBetween March 2020 and February 2021 antimicrobial consumption decreased –36.0% (7.3 vs 11.4 DID) in PC and increased +37.5 (16.5 vs 12.0 DID) in HC, both compared to the same period of the previous year.The most prescribed antimicrobials in PC before the COVID-19 pandemic were amoxicillin, amoxicillin/clavulanate, doxycycline, azithromycin, ciprofloxacin, and between March 2020 and February 2021 these were amoxicillin/clavulanate, amoxicillin, doxycycline, ciprofloxacin and azithromycin.The most prescribed antimicrobial used in HC before the COVID-19 pandemic were amoxicillin/clavulanate, levofloxacin, piperacillin/tazobactam, ceftriaxone and ciprofloxacin, and between March 2020 and February 2021 these were amoxicillin/clavulanate, ceftriaxone, azithromycin, piperacillin/tazobactam and meropenem.Comparing the COVID period with the previous year, in PC the antimicrobial that most decreased in consumption was phenoxymethylpenicillin (–66.59%). Amoxicillin decreased by –52.13%, clarithromycin (–50.60%), moxifloxacin (–45.98%), levofloxacin (–44.42%), amoxicillin/clavulanate (–35.55%) and azithromycin (–29.05%). For HC the antimicrobial that most increased in consumption was azithromycin (+721.42%), followed by amoxicillin (+602.0%), ceftriaxone (+184.34%), vancomycin (+116.9%) and amikacin (+88.79%). Meropenem DID increased by +52.94%.Conclusion and relevanceThe COVID-19 pandemic has impacted on the increase in antimicrobial use in HC along with a proportional decrease in PC.Antimicrobial prescription patterns in PC remain stable. The increase in amoxicillin/clavulanate over amoxicillin may be related to non-contact patient care (telemedicine).In HC, antimicrobial stewardship strategies can help return the consumption of broad-spectrum antibiotics to acceptable levels.References and/or acknowledgementsConflict of interestNo conflict of interest
Modern high-speed interconnection networks include support for the provision of quality of service (QoS) to the applications. The output scheduling algorithm plays an important role in the QoS ...provision, choosing the packets to be delivered from the output buffers. InfiniBand, one of the most used interconnection technologies, includes a table-based scheduler composed of a high- and a low-priority tables, and a counter limiting the number of high priority traffic flows that may be delivered before giving the opportunity to low priority ones. Therefore, the performance of the traffic flows in the network largely depends on the table configuration since the switch scheduler uses this information to allow/deny packets being forwarded, according to the QoS provision scheme. As far as we know, there is no study on the influence of these configurations to the traffic flows performance. In this paper, we present an offline analysis tool to accurately determine the expected end-to-end latency and bandwidth of the traffic flows in an InfiniBand-based network using the information contained in the high- and low-priority tables. Moreover, we present a methodology to aid network administrators in configuring the QoS provision in a real InfiniBand cluster. Finally, we evaluate the analysis tool, comparing its results with those obtained from a real cluster and from simulation.
Despite that the Triglycerides/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio has been associated with insulin resistance and cardiovascular disease, some outcomes differ between populations.
...The objective of this study was to evaluate the association between TG/HDL-C ratio and cardio-metabolic risk factors in both obese and normal weight women.
Cross sectional, from January to December of 2015.
Two hundred and fifty three women aged 40 to 60 years. Anthropometric and laboratory measurements were performed. Insulin resistance was measured by the homeostasis model assessment for insulin resistance (HOMA-IR). All participants underwent a Doppler ultrasound to measure intima-media thickness of carotid artery (cIMT).
TG/HDL-C ratio correlated with body mass index (r=0.194, p=0.01), and visceral adipose tissue (r=0.193, p=0.002). Additionally, TG/HDL-C correlated with glucose (r=0.367, p=0.001), insulin (r=0.354, p=0.001) and HOMA-IR (r=0.396 p=0.001). TG/HDL-C was associated with prediabetes, Odds Ratio (OR) was 1.83 (95%CI 1.07-3.13) and insulin resistance 3.27 (95%CI 1.78-6.01), and this risk remains in normal weight women 4.7 (95%CI 1.2-17.81) for prediabetes and 4.38 (95%CI 1.42-13.84) for insulin resistance. No significant risk for cIMT.
A TG/HDL-C ratio ≥ 3.0 is a potential risk factor for prediabetes and insulin resistance in women 40-60 years, even in normal weight women.
Cataclastic rocks, as clay-rich fault gouges, are commonly present in brittle rock masses when fault zones appear during geological engineering projects. Highly deformed rocks that are of poor ...mechanical quality can lead to technical, safety, and economic problems in rock engineering. The aim of this study is to characterise the resistant behaviour of a highly deformed clay-rich gouge >40 m wide with a marked tectonic fabric that indicates strength anisotropy. We present the results of consolidated-undrained (CU) triaxial tests that were performed at low confining pressures (50, 150, and 300 kPa) on several sets of foliated gouge specimens with four different orientations in the tectonic fabric. Specimens were collected from the encapsulated rock cores of two research boreholes drilled through the Alhama de Murcia Fault (AMF), a main regional fault located in SE Spain. The strain–stress relationships and failure modes were established, indicating that the gouge behaves as hard soil or very soft rock. The test results were adjusted at each orientation using the non-linear Hoek and Brown criteria by considering the fault gouge as an intact material or as a tectonised rockmass. Here, we use the Geological Strength Index (GSI) as an indicator of the rockmass strength that depends on the direction of the tectonic fabric. However, the results from specimens with tectonic fabric that is oriented most favourably for failure were not the weakest in terms of rock strength. Such an anomalous result could be the result of asymmetry in the roughness of the weakness planes that is related to the original gouge microstructure characterised by the strong reorientation of clays in an S-C′ like tectonic fabric.
Our results will be useful for practical applications that are related to the stability of slopes and/or shallow underground excavations in brittle fault zones, and provide an inexpensive and easy way to preliminarily evaluate the anisotropic behaviour of this type of brittle fault zones for future engineering projects.
•Strength of a foliated clay-rich fault gouge is controlled by roughness within the weak planes.•Gouge microstructure defined by strong reorientation of clays in a S-C’ fabric controls the roughness of the weakness planes•Strength of clay gouges shows a medium to low anisotropy.•GSI is a sensitive index with which the strength anisotropy of tectonised rocks can be investigated.
Simulation is often used in order to evaluate the behavior and the performance of computing systems. Specifically, in the field of high-performance interconnection networks for HPC clusters the ...simulation has been extensively considered to verify and validate network operation models and to evaluate their performance. Nevertheless, experiments conducted to evaluate network performance using simulation tools should be fed with realistic network traffic from real benchmarks and/or applications. This approach has grown in popularity because it allows to evaluate the simulation model under realistic traffic situations. In this paper, we propose a family of tools for modeling realistic workloads which capture the behavior of MPI applications into self-related traces called VEF traces. The main novelty of this approach is that it replays the MPI collective operations with their corresponding messages, offering an MPI message-based task simulation framework. The proposed framework neither provides a network simulator nor depends on any specific simulation platform. Besides, this framework allows us to use the generated traces by any third-party network simulator working at message level.
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