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Off-Label and Unlicensed Medication Use and Associated Adverse Drug Events in a Pediatric Emergency DepartmentPhan, Hanna, Leder, Marc, Fishley, Matthew, Moeller, Matthew, Nahata, Milap 01 June 2010 (has links)
Objectives: The study objectives were to (1) determine the types and frequency of off-label (OL) or unlicensed (UL) medications used in a pediatric emergency department (PED) and before admission, (2) describe OL/UL-associated adverse drug events (ADEs) resulting in admission to the PED and those occurring during patient care in PED, and (3) determine the outcomes of these ADEs. Methods: Medical records of patients 18 years or younger admitted to the PED over a 5-month period were reviewed. Off-label/UL use of medications was determined based on Food and Drug Administration-approved labeling. The Adverse Drug Reaction Probability Scale was used to determine ADE causality. Data were analyzed using descriptive statistics. Results: A total of 2191 patients with 6675 medication orders were evaluated. About 26.2% (n = 1712) of medication orders were considered as OL/ UL use; 70.5% (n = 1208) of these medications were ordered as part of treatment in the PED, and the remaining 29.5% (n = 504) were home medications before their PED evaluation. Inhaled bronchodilators (30.4%), antimicrobials (14.8%), and antihistamines/antiemetics (9.1%) were the most common OL/UL medication classes. The frequency of ADEs among licensed medication use was greater compared with OL/UL use by 2-fold. Reported overall rate of ADEs was 0.6% (n = 40). Of these 40 ADEs, 5 resulted from the use of an OL/UL medication, 3 from home medication use, and 2 from PED-prescribed medications. Conclusions: The frequency of reported ADEs associated with OL/UL medications was less than the frequency of ADEs from licensed medication use, with overall ADE frequency of less than 1%.
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Distributed algorithms for optimized resource management of LTE in unlicensed spectrum and UAV-enabled wireless networksChallita, Ursula January 2018 (has links)
Next-generation wireless cellular networks are morphing into a massive Internet of Things (IoT) environment that integrates a heterogeneous mix of wireless-enabled devices such as unmanned aerial vehicles (UAVs) and connected vehicles. This unprecedented transformation will not only drive an exponential growth in wireless traffic, but it will also lead to the emergence of new wireless service applications that substantially differ from conventional multimedia services. To realize the fifth generation (5G) mobile networks vision, a new wireless radio technology paradigm shift is required in order to meet the quality of service requirements of these new emerging use cases. In this respect, one of the major components of 5G is self-organized networks. In essence, future cellular networks will have to rely on an autonomous and self-organized behavior in order to manage the large scale of wireless-enabled devices. Such an autonomous capability can be realized by integrating fundamental notions of artificial intelligence (AI) across various network devices. In this regard, the main objective of this thesis is to propose novel self-organizing and AI-inspired algorithms for optimizing the available radio resources in next-generation wireless cellular networks. First, heterogeneous networks that encompass licensed and unlicensed spectrum are studied. In this context, a deep reinforcement learning (RL) framework based on long short-term memory cells is introduced. The proposed scheme aims at proactively allocating the licensed assisted access LTE (LTE-LAA) radio resources over the unlicensed spectrum while ensuring an efficient coexistence with WiFi. The proposed deep learning algorithm is shown to reach a mixed-strategy Nash equilibrium, when it converges. Simulation results using real data traces show that the proposed scheme can yield up to 28% and 11% gains over a conventional reactive approach and a proportional fair coexistence mechanism, respectively. In terms of priority fairness, results show that an efficient utilization of the unlicensed spectrum is guaranteed when both technologies, LTE-LAA and WiFi, are given equal weighted priorities for transmission on the unlicensed spectrum. Furthermore, an optimization formulation for LTE-LAA holistic traffic balancing across the licensed and the unlicensed bands is proposed. A closed form solution for the aforementioned optimization problem is derived. An attractive aspect of the derived solution is that it can be applied online by each LTE-LAA small base station (SBS), adapting its transmission behavior in each of the bands, and without explicit communication with WiFi nodes. Simulation results show that the proposed traffic balancing scheme provides a better tradeoff between maximizing the total network throughput and achieving fairness among all network ows compared to alternative approaches from the literature. Second, UAV-enabled wireless networks are investigated. In particular, the problems of interference management for cellular-connected UAVs and the use of UAVs for providing backhaul connectivity to SBSs are studied. Speci cally, a deep RL framework based on echo state network cells is proposed for optimizing the trajectories of multiple cellular-connected UAVs while minimizing the interference level caused on the ground network. The proposed algorithm is shown to reach a subgame perfect Nash equilibrium upon convergence. Moreover, an upper and lower bound for the altitude of the UAVs is derived thus reducing the computational complexity of the proposed algorithm. Simulation results show that the proposed path planning scheme allows each UAV to achieve a tradeoff between minimizing energy efficiency, wireless latency, and the interference level caused on the ground network along its path. Moreover, in the context of UAV-enabled wireless networks, a UAV-based on-demand aerial backhaul network is proposed. For this framework, a network formation algorithm, which is guaranteed to reach a pairwise stable network upon convergence, is presented. Simulation results show that the proposed scheme achieves substantial performance gains in terms of both rate and delay reaching, respectively, up to 3.8 and 4-fold increase compared to the formation of direct communication links with the gateway node. Overall, the results of the different proposed schemes show that these schemes yield significant improvements in the total network performance as compared to current existing literature. In essence, the proposed algorithms can also provide self-organizing solutions for several resource management problems in the context of new emerging use cases in 5G networks, such as connected autonomous vehicles and virtual reality headsets.
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Structuring Disincentives for Online CriminalsLeontiadis, Nektarios 01 August 2014 (has links)
This thesis considers the structural characteristics of online criminal networks from a technical and an economic perspective. Through large-scale measurements, we empirically describe some salient elements of the online criminal infrastructures, and we derive economic models characterizing the associated monetization paths enabling criminal profitability. This analysis reveals the existence of structural choke points: components of online criminal operations being limited in number, and critical for the operations’ profitability. Consequently, interventions targeting such components can reduce the opportunities and incentives to engage in online crime through an increase in criminal operational costs, and in the risk of apprehension. We define a methodology describing the process of distilling the knowledge gained from the empirical measurements on the criminal infrastructures towards identifying and evaluating appropriate countermeasures. We argue that countermeasures, as defined in the context of situational crime prevention, can be effective for a long-term reduction in the occurrence of online crime.
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Influenza Virus Evades NK Cell Responses by Enhancing Ly49:MHC-I InteractionsMahmoud, Ahmad Bakur January 2016 (has links)
Natural killer (NK) cells are a type of innate immune cell that can identify and eliminate viral infected cells and cancer cells. NK cells express an array of inhibitory and activating receptors such as natural cytotoxicity receptors, the mouse Ly49 or human KIR family, and NKR-P1 family. The integration of signals that NK cells receive through these receptors controls their activation and ability to kill target cells. Both Ly49 and KIR recognize MHC-I molecules on healthy cells Ly49:MHC-I engagement is essential for functional NK cell development. In the absence of these interactions NK cell is consider as ‘uneducated’ or ‘unlicensed’. Ly49 receptor interactions with MHC-I are critical in an effective NK cell response against cancer. However, the role of unlicensed NK cells in NK-mediated control of viruses is poorly understood.
Using NKCKD mice, we sought to determine how the loss of Ly49:MHC-I education, and the concomitant loss of inhibition via MHC-I, affected survival against influenza infection. In this study, we show that Ly49-deficient mice exhibit lower viral load and greater protection than WT mice when infected with influenza. However, this protection was lost when Ly49I was transgenically restored to these mice. Similarly, MHC-I-deficient mice, that also lack educated NK cells, were resistant to influenza infection, and lost this protection when NK cells were depleted before challenge. Based on the markedly reduced inflammation in the Ly49-deficient mice compared to the WT, we conclude that the Ly49-deficient NK cells are swifter and more effective in clearing influenza, resulting in less viral burden and consequentially less need for a dangerously aggressive inflammatory response. Furthermore, influenza infection enhanced MHC-I expression on lung epithelial cells, which could be responsible for inhibition of NK cells. Consequently, blockade of inhibitory Ly49C/I receptors protected WT mice from lethal influenza infection. Additionally, Perforin-deficient NKCKD succumbed to the infection demonstrating that NK cell directly eliminate influenza-infected cells. Collectively, these results confirm that influenza is capable of inhibiting NK cells through MHC-I engagement of KIR/Ly49, and suggests that blocking this interaction may provide a viable therapeutic avenue for severe influenza cases.
these results challenge our understanding of basic NK cell function and suggest that, rather than subdividing NK cells into ‘licensed’ and ‘unlicensed’ based on their expression of self-specific Ly49 receptors, a more accurate depiction of these NK subsets would be ‘cancer-specialized’ and ‘pathogen-specialized’. While further work is required to fully test this paradigm of cancer- and pathogen-specialized NK cells, I hope that my findings will stimulate a new appreciation for the role of NK cells in virus control, and lead to a better understanding of this critical immune cell.
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Performance evaluation of cognitive radio networks under licensed and unlicensed spectrum bandsZahed, Salah M.B., Awan, Irfan U., Cullen, Andrea J., Younas, M. January 2014 (has links)
One of the major challenges of Cognitive Radio (CRNs) is the spectrum handoff issue. Spectrum handoff happens when a Primary Users (PUs) appears in a spectrum band that is occupied by a Secondary User (SU). In such a case, SU should empty this spectrum band and perform a handoff procedure and search for an available free one. This process will be continued until the SU completes its data transmission. To avoid multiple spectrum handoffs, the spectrum handoff procedure should be performed in the unlicensed channels rather than the licensed channels. Thus, the number of handoffs can be reduced as no more spectrum handoffs will occur since all users have priority in this type of spectrum channel. This technique will help secondary users' QoS from degradation. This paper proposes a prioritized spectrum handoff decision scheme in a mixture spectrum environment of unlicensed and licensed channels, in order to reduce the handoff delay. The licensed channels in the proposed scheme have been modelled using a pre-emptive resume priority (PRP) M/M/C queue. In contrast, the unlicensed channels have been modelled using an M/M/C retrial priority queue. In order to examine the performance of the implemented model, the handoff and new SUs are considered with equal and different priorities. Experimental results show that the prioritized handoff scheme outperforms the other scheme in terms of average handoff delay under various traffic arrival rates as well as the number of licensed and unlicensed channels used.
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Revisitando uma prática de formação à luz de referenciais freireanos: uma experiência com professores sem habilitação em Moçambique ÁfricaAntoniuk, Mariana 10 August 2015 (has links)
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Previous issue date: 2015-08-10 / In developing countries such as Brazil and Mozambique, the lack of properly trained and licensed teachers is a serious issue. As such, there is an urgent need in these places to provide training for these educators, many of whom have never had access to a formal, quality education. The goal of this study is analyze one experience with untrained teachers and educators in Mozambique with Paulo Freire's concepts, in order to improve the quality of their teaching and, consequently, raise the level of education within the country. The study and y personal experience researching and coordinating three separate teacher-training projects in Mozambique during 2011, 2013, and 2014. Additionally, the study w y y developed by Paulo Freire (1970, 1977, 1997, 2003a, 2003b, 2011, 2014a, 2014b), as well as the writings of António Nóvoa (1995, 1997), Carlos Marcelo García (1999, 2009), and Vera Placco (2008). This study takes a qualitative j experience and fieldwork along with other early-childhood educators in Mozambique. The results and conclusions of this study demonstrate that the success of training teachers who have never been formally trained depends on the dialogue, as knowledge building process, on the respect the identity of each teacher and the critical reflection on his or her education methods / A realidade de professores sem habilitação ainda é uma questão a ser enfrentada no Brasil e em países subdesenvolvidos, como Moçambique. Torna-se urgente a necessidade de uma formação para esses educadores, que não tiveram acesso à escolaridade. O objetivo desta pesquisa é analisar uma experiência de formação de professores sem habilitação, em Moçambique, na África, com o crivo de conceitos da pedagogia de Paulo Freire. Tomo como objeto de análise três momentos de formação de professores que coordenei em Moçambique, nos anos de 2011, 2013 e 2014, e, como fundamentos, a educação crítico-libertadora, cuja principal referência é o educador Paulo Freire (1970, 1977, 1997, 2003a, 2003b, 2011, 2014a, 2014b). Também serão consultadas as produções de António Nóvoa (1995,1997), Carlos Marcelo García (1999, 2009) e Vera Placco (2008). Trata-se de uma pesquisa de abordagem qualitativa, a partir de uma intervenção realizada pela pesquisadora junto a professores de educação infantil de Moçambique. Os resultados desse trabalho demonstraram que o êxito da formação de professores sem habilitação depende do diálogo, assumido como processo de construção de conhecimento, do respeito pela identidade desses professores e da reflexão crítica sobre a prática docente
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High-Speed Downlink Shared Channel in Unlicensed Frequency Bands / HS-DSCH i olicensierade frekvensbandZetterberg, Kristina January 2004 (has links)
<p>In the standardized air interface for third generation mobile communication systems, WCDMA release 5, a concept called High Speed Downlink Packet Access (HSDPA) is introduced. HSDPA enables faster transmissions from base stations to mobile users by using a shared, high-capacity channel called the High-Speed Downlink Shared Channel (HS-DSCH) that is designed for best effort services. The HS-DSCH is developed for usage in the frequency band licensed for third generation communication systems. As the use of licensed frequency bands is costly it may be interesting to make use of the unlicensed frequency bands at 2.4 GHz and 5 GHz with higher interference and stricter regulations. Using HS- DSCH in unlicensed frequency bands would lead to smaller costs and a new kind of usage of the HS-DSCH. </p><p>In order to transmit in unlicensed frequency bands, some requirements set up by the public authorities must be followed. This means that the maximum transmit power used by the HS-DSCH must be decreased and, on the 5 GHz frequency band, that features to avoid disturbing radar systems have to be implemented. The HS- DSCH has a bandwidth of 5 MHz. To use the available frequency spectra more efficiently, multiple carriers could be used. </p><p>Wireless Local Area Networks (WLANs) are the most common way to transfer data in unlicensed frequency bands today. Assessments and simulations of WLAN and the HS-DSCH in unlicensed frequency bands show that WLAN can provide higher bitrates than the HS-DSCH for low loads. HS-DSCH can however provide a larger coverage per base station, and is more bandwidth effective than WLAN. Using a larger bandwidth is necessary for HS-DSCH to compete with WLAN, which uses a bandwidth approximately four times as large as the HS-DSCH bandwidth. The usage of the HS-DSCH in unlicensed frequency bands also has the advantage that the services provided by the third generation communication systems can be accessed easily.</p>
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Security in Unlicensed Mobile AccessEriksson, Martin January 2005 (has links)
<p>Unlicensed Mobile Access (UMA) provides transparent access to 2G and 3G networks for Mobile Stations over the unlicensed radio interface. Unlicensed radio tehnologies such as Bluetooth or WLAN technology connects the Mobile Station to the fixed IP network of the home or office and delivers high bandwith to the Mobile Station.</p><p>The purpose of this report is to examine if subscribers can feel as secure using UMA as they do when using any of the alternetive mobile technologies that UMA supports. The security evaluation is performed by first investigating the current security level of GSM, GPRS and UMTS and then compares them to the security mechanisms of UMA.</p><p>This evaluation noticed two distinct flaws in UMA that could compromise security. The conclusion is that these flaws do not have a major inpact and UMA does provide a general higher level of security than the 2G and 3G counterparts.</p>
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High-Speed Downlink Shared Channel in Unlicensed Frequency Bands / HS-DSCH i olicensierade frekvensbandZetterberg, Kristina January 2004 (has links)
In the standardized air interface for third generation mobile communication systems, WCDMA release 5, a concept called High Speed Downlink Packet Access (HSDPA) is introduced. HSDPA enables faster transmissions from base stations to mobile users by using a shared, high-capacity channel called the High-Speed Downlink Shared Channel (HS-DSCH) that is designed for best effort services. The HS-DSCH is developed for usage in the frequency band licensed for third generation communication systems. As the use of licensed frequency bands is costly it may be interesting to make use of the unlicensed frequency bands at 2.4 GHz and 5 GHz with higher interference and stricter regulations. Using HS- DSCH in unlicensed frequency bands would lead to smaller costs and a new kind of usage of the HS-DSCH. In order to transmit in unlicensed frequency bands, some requirements set up by the public authorities must be followed. This means that the maximum transmit power used by the HS-DSCH must be decreased and, on the 5 GHz frequency band, that features to avoid disturbing radar systems have to be implemented. The HS- DSCH has a bandwidth of 5 MHz. To use the available frequency spectra more efficiently, multiple carriers could be used. Wireless Local Area Networks (WLANs) are the most common way to transfer data in unlicensed frequency bands today. Assessments and simulations of WLAN and the HS-DSCH in unlicensed frequency bands show that WLAN can provide higher bitrates than the HS-DSCH for low loads. HS-DSCH can however provide a larger coverage per base station, and is more bandwidth effective than WLAN. Using a larger bandwidth is necessary for HS-DSCH to compete with WLAN, which uses a bandwidth approximately four times as large as the HS-DSCH bandwidth. The usage of the HS-DSCH in unlicensed frequency bands also has the advantage that the services provided by the third generation communication systems can be accessed easily.
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Security in Unlicensed Mobile AccessEriksson, Martin January 2005 (has links)
Unlicensed Mobile Access (UMA) provides transparent access to 2G and 3G networks for Mobile Stations over the unlicensed radio interface. Unlicensed radio tehnologies such as Bluetooth or WLAN technology connects the Mobile Station to the fixed IP network of the home or office and delivers high bandwith to the Mobile Station. The purpose of this report is to examine if subscribers can feel as secure using UMA as they do when using any of the alternetive mobile technologies that UMA supports. The security evaluation is performed by first investigating the current security level of GSM, GPRS and UMTS and then compares them to the security mechanisms of UMA. This evaluation noticed two distinct flaws in UMA that could compromise security. The conclusion is that these flaws do not have a major inpact and UMA does provide a general higher level of security than the 2G and 3G counterparts.
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