White blood cell count and mortality in patients with acute pulmonary embolism

Although associated with adverse outcomes in other cardiovascular diseases, the prognostic value of an elevated white blood cell (WBC) count, a marker of inflammation and hypercoagulability, is uncertain in patients with pulmonary embolism (PE). We therefore sought to assess the prognostic impact of the WBC in a large, state-wide retrospective cohort of patients with PE. We evaluated 14,228 patient discharges with a primary diagnosis of PE from 186 hospitals in Pennsylvania. We used random-intercept logistic regression to assess the independent association between WBC count levels at the time of presentation and mortality and hospital readmission within 30 days, adjusting for patient and hospital characteristics. Patients with an admission WBC count <5.0, 5.0-7.8, 7.9-9.8, 9.9-12.6, and >12.6 × 10(9) /L had a cumulative 30-day mortality of 10.9%, 6.2%, 5.4%, 8.3%, and 16.3% (P < 0.001), and a readmission rate of 17.6%, 11.9%, 10.9%, 11.5%, and 15.0%, respectively (P < 0.001). Compared with patients with a WBC count 7.9-9.8 × 10(9) /L, adjusted odds of 30-day mortality were significantly greater for patients with a WBC count <5.0 × 10(9) /L (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14-2.03), 9.9-12.6 × 10(9) /L (OR 1.55, 95% CI 1.26-1.91), or >12.6 × 10(9) /L (OR 2.22, 95% CI 1.83-2.69), respectively. The adjusted odds of readmission were also significantly increased for patients with a WBC count <5.0 × 10(9) /L (OR 1.34, 95% CI 1.07-1.68) or >12.6 × 10(9) /L (OR 1.29, 95% CI 1.10-1.51). In patients presenting with PE, WBC count is an independent predictor of short-term mortality and hospital readmission.

Book Review: Benedetta Brevini, Arne Hintz, and Patrick Mccurdy (eds.): Beyond Wikileaks. Implications for the Future of Communications, Journalism and Society

This is a review of the highly informative and thought-provoking book, Beyond WikiLeaks: Implications for the Future of Communications, Journalism and Society, co-edited by Benedetta Brevini, Arne Hintz and Patrick McCurdy (Palgrave Macmillan, 2013).

SLA-Driven Simulation of Multi-Tenant Scalable Cloud-Distributed Enterprise Information Systems

Cloud Computing is an enabler for delivering large-scale, distributed enterprise applications with strict requirements in terms of performance. It is often the case that such applications have complex scaling and Service Level Agreement (SLA) management requirements. In this paper we present a simulation approach for validating and comparing SLA-aware scaling policies using the CloudSim simulator, using data from an actual Distributed Enterprise Information System (dEIS). We extend CloudSim with concurrent and multi-tenant task simulation capabilities. We then show how different scaling policies can be used for simulating multiple dEIS applications. We present multiple experiments depicting the impact of VM scaling on both datacenter energy consumption and dEIS performance indicators.

Stratégies de ménages et développement communal: LforS learning and simulation game

Au travers de stratégies appropriées, les ménages, appelés ici Unités de Production et de Consommation (UPC), cherchent à faire face à différents évènements et à améliorer leur situation économique et sociale tout en tenant compte des conditions écologiques. Au travers de l’Assemblée Générale Communale (AGC), les UPC peuvent créer des conditions cadres locales plus ou moins favorables aux stratégies qu’ils poursuivent. Par le développement d’une stratégie d’investissement communale mise en œuvre par l’AGC et une bonne coordination entre les UPC, les joueurs peuvent optimiser leurs investissements au niveau des ménages. Vainqueur est l’UPC qui à la fin du jeu dispose du plus grand patrimoine.