Future networks such as 6G are projected to incorporate in-network intelligence toward achieving a zero-touch network. In this regard, several approaches proposed for the organizational architecture ...of future networks. Similar to microservice-based service design, a multi-agent-based network automation architecture was proposed as a competing paradigm for service-oriented architecture. The proposed architecture outlines the design guideline for intelligent network systems using agents as atomic and autonomous service units that can be used as building blocks. As a continuation of this approach, we design a Quality of Service (QoS) agent to control and manage stringent services such as remote surgery. QoS agent is intelligent that can capture and respond proactively to network traffic and workload distribution, showing hourly and seasonal patterns. QoS agents can be used as a building block along with traffic classification and traffic prediction agents for an intelligent networking system. For evaluation, a campus network is designed using a NetSim environment considering a three-tier network architecture. The QoS agent dynamically finds the best path for a particular service depending on the requirements. The agent communicates with the traffic prediction agent and traffic classifier agent to collect information about the network and services. Moreover, the QoS agent also observes the network states. Using these values along with existing network topology knowledge, it ranks the available paths to proactively allocate the best path for a service. Evaluation results suggest that with the appropriate accuracy of traffic prediction, the proposed approach can autonomously adapt in allocating a path for a given service.
To assess the association between meeting the World Health Organization (WHO) maternal antenatal care attendance guidelines and early and middle childhood cognition among impoverished Ethiopian ...children.
A total of 1914 impoverished Ethiopian children from the Young Lives longitudinal cohort study were included. Childhood cognition was assessed via the Cognitive Development Assessment (CDA) and Peabody Picture Vocabulary Test (PPVT) at ages 4-5 years; PPVT, Early Grade Reading Assessment (EGRA), and Math Test at ages 7-8 years; and PPVT, Math Test, and Reading Test at ages 11-12 years. Linear regression models were used to examine the association between maternal antenatal care attendance and childhood academic achievement test scores.
In the univariable analysis, children of mothers who received the WHO recommended 4+ antenatal care visits or received the WHO recommended first antenatal care visit during the first trimester scored higher on all academic achievement tests. In the multivariable analysis, children of mothers who received 4+ antenatal care visits scored significantly higher on the CDA at ages 4-5 years and Math Test at ages 7-8 years. Children of mothers who received antenatal care in the first trimester scored higher on the CDA at ages 4-5 years and Math Test scores at ages 11-12 years. Children of mothers who received both antenatal care in the first trimester and 4+ antenatal care visits scored significantly higher on the CDA at ages 4-5 years and Math Test at both ages 7-8 and 11-12 years.
Children of mothers who received the WHO recommended number and timing of antenatal care visits had significantly higher academic achievement scores across multiple domains during early and middle childhood. Promotion of antenatal care visit attendance may improve cognition through middle childhood.
To examine the impact of antenatal psychosocial stressors, including maternal common mental disorders (CMD), upon low birth weight, stillbirth and neonatal mortality, and other perinatal outcomes in ...rural Ethiopia. A population-based sample of 1065 pregnant women was assessed for symptoms of antenatal CMD (Self-Reporting Questionnaire-20: SRQ-20), stressful life events during pregnancy (List of Threatening Experiences: LTE) and worry about the forthcoming delivery. In a sub-sample of 654 women from six rural sub-districts, neonatal birth weight was measured on 521 (79.7%) singleton babies within 48 h of delivery. Information about other perinatal outcomes was obtained shortly after birth from the mother's verbal report and via the Demographic Surveillance System. After adjusting for potential confounders, none of the psychosocial stressors were associated with lower mean birth weight, stillbirth or neonatal mortality. Increasing levels of antenatal CMD symptoms were associated both with prolonged labour (>24 h) (SRQ 1-5: RR 1.4; 95% CI 1.0-1.9, SRQ greater-than-or-equal 6: RR 1.6; 95% CI 1.0-2.6) and delaying initiation of breast-feeding more than eight hours (SRQ 1-5: RR 1.4; 95% CI 0.8 to 2.4, SRQ greater-than-or-equal 6: RR 2.8; 95% CI 1.3-6.1). Worry about delivery was also associated with labour longer than 24 h (RR 1.5; 95% CI 1.0-2.1). This study provides preliminary evidence of important public health consequences of poor maternal mental health in low-income countries but does not replicate the strong association with low birth weight found in South Asia.
Background Bradyarrhythmia requiring pacemaker placement is a relatively common complication after surgical ablation for atrial fibrillation (AF). We report our experience with surgical ablation ...procedures using various energy modalities and lesion sets in an attempt to identify the risk factors associated with postoperative pacemaker requirement. Methods Intraoperative data were collected prospectively, and preoperative and postoperative data were collected retrospectively. Energy modality and lesion sets used were dependent on availability on the date of the procedure and surgeon preference. Results From October 1999 to October 2009, 701 patients underwent surgical ablation for AF at our institution. Forty-five patients (7.6%) required early postoperative pacemaker placement. There were no significant differences in baseline characteristics or associated procedures between patients who required pacemaker placement and those who did not. Ninety-day mortality was greater in patients requiring pacemaker placement (15.6% versus 6.6%; p = 0.025). In multivariable analysis, a pacemaker requirement was more likely with the use of microwave energy (odds ratio OR 2.87; confidence interval CI, 1.41 to 5.84; p = 0.004) and a right atrial lesion set (OR, 2.82; CI, 1.07 to 7.45 ; p = 0.036). Conclusions In conclusion, over our 10-year experience with surgical AF ablations, the incidence of pacemaker requirement was much lower than that reported in series of classic “cut and sew” Maze procedures, even among patients undergoing full biatrial ablations. Although biatrial ablation is currently our favored approach to patients with long-standing or persistent AF, right atrial lesion sets increase the risk of this complication and should be used judiciously.
Periodic Automatic Replenishment (PAR) is an inventory management policy that assists the healthcare sector in keeping the right amount of stock on hand to avoid excess stock and the potential for ...products to expire. Traditionally, hospitals rely on the experience and firsthand knowledge of stock management technicians to keep their store supplies with enough equipment. However, manual management based on "gut feeling" and/or nursing feedback may lead to missing products or incorrect stock orders. Extracting accurate data is often too complex or time-consuming, resulting in a lack of critical reporting data to manage product inventories across the organization properly. However, adopting forecasting techniques and incorporating them into traditional PAR management policies can provide efficient solutions for controlling hospital warehouse inventory at the lowest cost. We have proposed a deep learning-based framework to monitor inventories to reduce costs and variation, create efficiencies, and improve the quality of patient care in hospitals. Furthermore, the proposed forecasting framework's performance is assessed using a real-world scenario within a hospital. The findings indicate that the system is capable of accurately tracking the usage of medical equipment, which results in a significant reduction in the unavailability of assets.
Existing gestational weight gain (GWG) charts vary considerably in their choice of exclusion/inclusion criteria, and it is unclear to what extent these criteria create differences in the charts’ ...percentile values.
We aimed to establish the impact of including/excluding pregnancies with adverse neonatal outcomes when constructing GWG charts.
This is an individual participant data analysis from 31 studies from low- and middle-income countries. We created a dataset that included all participants and a dataset restricted to those with no adverse neonatal outcomes: preterm < 37 wk, small or large for gestational age, low birth weight < 2500 g, or macrosomia > 4000 g. Quantile regression models were used to create GWG curves from 9 to 40 wk, stratified by prepregnancy BMI, in each dataset.
The dataset without the exclusion criteria applied included 14,685 individuals with normal weight and 4831 with overweight. After removing adverse neonatal outcomes, 10,479 individuals with normal weight and 3466 individuals with overweight remained. GWG distributions at 13, 27, and 40 wk were virtually identical between the datasets with and without the exclusion criteria, except at 40 wk for normal weight and 27 wk for overweight. For the 10th and 90th percentiles, the differences between the estimated GWG were larger for overweight (∼1.5 kg) compared with normal weight (<1 kg). Removal of adverse neonatal outcomes had minimal impact on GWG trajectories of normal weight. For overweight, the percentiles estimated in the dataset without the criteria were slightly higher than those in the dataset with the criteria applied. Nevertheless, differences were <1 kg and virtually nonexistent at the end of pregnancy.
Removing pregnancies with adverse neonatal outcomes has little or no influence on the GWG trajectories of individuals with normal and overweight.
Although maternal common mental disorder (CMD) appears to be a risk factor for infant undernutrition in South Asian countries, the position in sub-Saharan Africa (SSA) is unclear
A population-based ...cohort of 1065 women, in the third trimester of pregnancy, was identified from the demographic surveillance site (DSS) in Butajira, to investigate the effect of maternal CMD on infant undernutrition in a predominantly rural Ethiopian population. Participants were interviewed at recruitment and at two months post-partum. Maternal CMD was measured using the locally validated Self-Reported Questionnaire (score of > or = six indicating high levels of CMD). Infant anthropometry was recorded at six and twelve months of age.
The prevalence of CMD was 12% during pregnancy and 5% at the two month postnatal time-point. In bivariate analysis antenatal CMD which had resolved after delivery predicted underweight at twelve months (OR = 1.71; 95% CI: 1.05, 2.50). There were no other statistically significant differences in the prevalence of underweight or stunted infants in mothers with high levels of CMD compared to those with low levels. The associations between CMD and infant nutritional status were not significant after adjusting for pre-specified potential confounders.
Our negative finding adds to the inconsistent picture emerging from SSA. The association between CMD and infant undernutrition might be modified by study methodology as well as degree of shared parenting among family members, making it difficult to extrapolate across low- and middle-income countries.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
► 335 maize varieties were evaluated in Ethiopia and Tanzania. ► Genotypic variability for stover fodder quality, grain and stover yields and their interrelationship. ► We observed significance ...difference for most traits in almost all trials. ► In most cases, we observed desirable relationship among traits. ► The study suggested the possibility for simultaneous improvement of grain yield and stover traits.
Maize stover left after grain harvest constitutes an important source for livestock feed in most parts of East Africa, particularly during the dry season. In spite of its wide use and greater importance, breeding programs have given little attention to the improvement of stover quality and quantity. The objectives of this study were to assess the genetic variability of experimental and released (checks) maize varieties for stover feed quantity and quality, and their relationship with grain yield. Results from different trials conducted across locations using randomized complete block design (RCBD) in different sites in Ethiopia and Tanzania from 2004 to 2006 showed higher genotypic variation for grain and stover yields and stover feed quality traits. This confirmed the existence of exploitable genetic variation not only for grain yield but also for stover fodder quality and quantity. Positive relationship was also observed between grain and stover yields but the relation between stover fodder quality traits and grain yield, in most cases, was weak. Generally, the study pinpointed the possibility for simultaneous improvement of grain yield and stover traits to address the high demand existing for dual purpose food-feed type of maize genotypes in maize-livestock mixed farming system of East Africa.
Quality control (QC) analysis is an important component in maize breeding and seed systems. Genotyping by next-generation sequencing (GBS) is an emerging method of SNP genotyping, which is being ...increasingly adopted for discovery applications, but its suitability for QC analysis has not been explored. The objectives of our study were 1) to evaluate the level of genetic purity and identity among two to nine seed sources of 16 inbred lines using 191 Kompetitive Allele Specific PCR (KASP) and 257,268 GBS markers, and 2) compare the correlation between the KASP-based low and the GBS-based high marker density on QC analysis. Genetic purity within each seed source varied from 49 to 100 % for KASP and from 74 to 100 % for GBS. All except one of the inbred lines obtained from CIMMYT showed 98 to 100 % homogeneity irrespective of the marker type. On the contrary, only 16 and 21 % of the samples obtained from EIAR and partners showed greater than or equai to95 % purity for KASP and GBS, respectively. The genetic distance among multiple sources of the same line designation varied from 0.000 to 0.295 for KASP and from 0.004 to 0.230 for GBS. Five lines from CIMMYT showed less than or equai to 0.05 distance among multiple sources of the same line designation; the remaining eleven inbred lines, including two from CIMMYT and nine from Ethiopia showed higher than expected genetic distances for two or more seed sources. The correlation between the 191 KASP and 257,268 GBS markers was 0.88 for purity and 0.93 for identity. A reduction in the number of GBS markers to 1,343 decreased the correlation coefficient only by 0.03. Our results clearly showed high discrepancy both in genetic purity and identity by the origin of the seed sources (institutions) irrespective of the type of genotyping platform and number of markers used for analyses. Although there were some numerical differences between KASP and GBS, the overall conclusions reached from both methods was basically similar, which clearly suggests that smaller subset of preselected and high quality markers are sufficient for QC analysis that can easily be done using low marker density genotyping platforms, such as KASP. Results from this study would be highly relevant for plant breeders and seed system specialists.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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