OpenFlow Multi-Table Lookup Architecture for Multi-Gigabit Software Defined Networking (SDN)

The proposed multi-table lookup architecture provides SDN-based, high-performance packet classification in an OpenFlow v1.1+ SDN switch. The objective of the demonstration is to show the functionality of the architecture deployed on the NetFPGA SUME Platform.

Network Connectivity Proxy: Architecture, Implementation, and Performance Analysis

Several studies in the last decade have pointed out that many devices, such as computers, are often left powered on even when idle, just to make them available and reachable on the network, leading to large energy waste. The concept of network connectivity proxy (NCP) has been proposed as an effective means to improve energy efficiency. It impersonates the presence of networked devices that are temporally unavailable, by carrying out background networking routines on their behalf. Hence, idle devices could be put into low-power states and save energy. Several architectural alternatives and the applicability of this concept to different protocols and applications have been investigated. However, there is no clear understanding of the limitations and issues of this approach in current networking scenarios. This paper extends the knowledge about the NCP by defining an extended set of tasks that the NCP can carry out, by introducing a suitable communication interface to control NCP operation, and by designing, implementing, and evaluating a functional prototype.

State architecture: subsidiarity, devolution, federalism and independence

This chapter examines the current ‘architecture’ of the British state, in particular the way in which governmental power is distributed among the nations of the United Kingdom. The theme of this chapter will be to show how the continuing (and, as James Bryce argued, inevitable) tension between centripetal and centrifugal forces can be usefully applied to power relations between the various nations of the United Kingdom, and between these nations and Europe, providing a basis for analyzing how these nations are drawn or impelled by some forces towards a centralized unitary polity, whilst at the same time other forces tend towards dispersion of power. The resulting pattern might be analyzed along a spectrum from centralization to independence, with subsidiarity, devolution and federalism being seen as weigh stations along the way, but given how complex the variations in the distribution of power between these nations and the centre have become over time, the construction of any static architectural blueprint of the British state is bound to be misleading. Indeed, the architectural metaphor, with its implications of stability might usefully be rethought.

Impact of an enhanced antibiotic stewardship on reducing methicillin-resistant Staphylococcus aureus in primary and secondary healthcare settings

The objective of this study was to evaluate the impact of restricting high-risk antibiotics on methicillin-resistant Staphylococcus aureus (MRSA) incidence rates in a hospital setting. A secondary objective was to assess the impact of reducing fluoroquinolone use in the primary-care setting on MRSA incidence in the community. This was an interventional, retrospective, ecological investigation in both hospital and community (January 2006 to June 2010). Segmented regression analysis of interrupted time-series was employed to evaluate the intervention. The restriction of high-risk antibiotics was associated with a significant change in hospital MRSA incidence trend (coefficient=-0·00561, P=0·0057). Analysis showed that the intervention relating to reducing fluoroquinolone use in the community was associated with a significant trend change in MRSA incidence in community (coefficient=-0·00004, P=0·0299). The reduction in high-risk antibiotic use and fluoroquinolone use contributed to both a reduction in incidence rates of MRSA in hospital and community (primary-care) settings. 

A modified method for measuring antibiotic use in healthcare settings: implications for antibiotic stewardship and benchmarking

Objectives: To determine whether adjusting the denominator of the common hospital antibiotic use measurement unit (defined daily doses/100 bed-days) by including age-adjusted comorbidity score (100 bed-days/age-adjusted comorbidity score) would result in more accurate and meaningful assessment of hospital antibiotic use. 

Methods: The association between the monthly sum of age-adjusted comorbidity and monthly antibiotic use was measured using time-series analysis (January 2008 to June 2012). For the purposes of conducting internal benchmarking, two antibiotic usage datasets were constructed, i.e. 2004-07 (first study period) and 2008-11 (second study period). Monthly antibiotic use was normalized per 100 bed-days and per 100 bed-days/age-adjusted comorbidity score. 

Results: Results showed that antibiotic use had significant positive relationships with the sum of age-adjusted comorbidity score (P = 0.0004). The results also showed that there was a negative relationship between antibiotic use and (i) alcohol-based hand rub use (P = 0.0370) and (ii) clinical pharmacist activity (P = 0.0031). Normalizing antibiotic use per 100 bed-days contributed to a comparative usage rate of 1.31, i.e. the average antibiotic use during the second period was 31% higher than during the first period. However, normalizing antibiotic use per 100 bed-days per age-adjusted comorbidity score resulted in a comparative usage rate of 0.98, i.e. the average antibiotic use was 2% lower in the second study period. Importantly, the latter comparative usage rate is independent of differences in patient density and case mix characteristics between the two studied populations. 

Conclusions: The proposed modified antibiotic measure provides an innovative approach to compare variations in antibiotic prescribing while taking account of patient case mix effects.