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OBJETIVO: abordar aspectos relevantes de la educación en El Salvador, mediante un análisis de los hechos históricos ocurridos entre 1821 y 1940. MÉTODO: se realizó la revisión de los archivos digitales del Diario Oficial, así como también de otros documentos que contienen información relacionada con el tema en cuestión. RESULTADOS: para su estudio se han considerado tres momentos: la independencia de Centroamérica, la separación de la Federación Centroamericana y el triunfo de los liberales sobre los conservadores. CONCLUSIÓN: esta consideración permitió concluir que, la posición que se asume en relación a la educación de los habitantes de un país está determinada por las condiciones predominantes del contexto.

The advent of targeted therapy has transformed the treatment paradigm and survival of patients with metastatic non-small cell lung cancer (NSCLC) with driver mutations. The development of acquired resistances during treatment with tyrosine kinase inhibitors (TKIs) impedes a prolonged survival in many patients. This fact is leading to the use of locally ablative therapies such as stereotactic ablative radiotherapy (SABR) to counter these resistances. SABR is a non-invasive treatment that can be delivered in multiple locations and has already proven effective in oligometastatic disease. Clinical evidence suggests that the combination of SABR with TKIs prolongs progression-free survival (PFS) in metastatic NSCLC patients with mutations in epidermal growth factor receptor (EGFR), with international guidelines recommending their use in unfavorable scenarios such as oligoprogressive disease. In this publication, we have reviewed the available evidence on EGFR-TKIs resistance mechanisms and the combination of SABR with TKI in metastatic NSCLC with EGFR mutations. We also describe the utility and clinical recommendations of this combination in oligometastatic and oligoprogressive disease.

Gluten proteins are responsible for the wheat breadmaking quality. However, gluten is also related to human pathologies for which the only treatment is a gluten-free diet (GFD). GFD has gained popularity among individuals who want to reduce their gluten intake. Tritordeum is a cereal species that originated after crossing durum wheat with wild barley and differs from bread wheat in its gluten composition. In this work, we have characterized the immunogenic epitopes of tritordeum bread and results from a four-phase study with healthy adults for preferences of bread and alterations in the gut microbiota after consuming wheat bread, gluten-free bread, and tritordeum bread are reported. Tritordeum presented fewer peptides related to gluten proteins, CD-epitopes, and IgE binding sites than bread wheat. Participants rated tritordeum bread higher than gluten-free bread. Gut microbiota analysis revealed that the adherence to a strict GFD involves some minor changes, especially altering the species producing short-chain fatty acids. However, the short-term consumption of tritordeum bread does not induce significant changes in the diversity or community composition of the intestinal microbiota in healthy individuals. Therefore, tritordeum bread could be an alternative for healthy individuals without wheat-related pathologies who want to reduce their gluten consumption without harming their gut health., This research was supported by grant PID2019-110847RB-I00 funded by MCIN/AEI/10.13039/501100011033, and grants AT-5985 and P20_01005 funded by Consejería de Transformación Económica, Industria, Conocimiento y Universidades (Junta de Andalucía), and the European Regional Development Fund (FEDER). C.H. is a recipient of a Juan de la Cierva fellowship “Grant IJC2019-040423-I” from the Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033.

Celiac disease (CD) is a genetically predisposed, T cell-mediated and autoimmune-like disorder caused by dietary exposure to the storage proteins of wheat and related cereals. A gluten-free diet (GFD) is the only treatment available for CD. The celiac immune response mediated by CD4+ T-cells can be assessed with a short-term oral gluten challenge. This study aimed to determine whether the consumption of bread made using flour from a low-gluten RNAi wheat line (named E82) can activate the immune response in DQ2.5-positive patients with CD after a blind crossover challenge. The experimental protocol included assessing IFN-γ production by peripheral blood mononuclear cells (PBMCs), evaluating gastrointestinal symptoms, and measuring gluten immunogenic peptides (GIP) in stool samples. The response of PBMCs was not significant to gliadin and the 33-mer peptide after E82 bread consumption. In contrast, PBMCs reacted significantly to Standard bread. This lack of immune response is correlated with the fact that, after E82 bread consumption, stool samples from patients with CD showed very low levels of GIP, and the symptoms were comparable to those of the GFD. This pilot study provides evidence that bread from RNAi E82 flour does not elicit an immune response after a short-term oral challenge and could help manage GFD in patients with CD., This research was funded by The Spanish Ministry of Science and Innovation, Agencia Estatal de Investigación (Project PID2019-110847RB-I00), Consejería de Transformación Económica, Industria, Conocimiento y Universidades, Junta de Andalucía (Project P20_01005), and “ERDF A way of making Europe”, by the “European Union”.

Los meningiomas son los tumores cerebrales primarios más comunes, si bien el meningioma intraóseo primario constituye un subtipo de meningioma extradural infrecuente. Normalmente son asintomáticos pero pueden causar proptosis o síntomas neurológicos en función del tamaño y de la localización. El hallazgo más común en pruebas de imagen es la hiperostosis aun- que también se puede observar un patrón lítico o incluso mixto, por lo que debe ser considerado en el diagnóstico diferencial de tumores óseos escleróticos craneales. Aunque la mayoría son benignos, son más propensos a desarrollar malignidad que losmeningiomas intradurales. Las técnicas de imagen (TC y RM) son muy útiles en el diagnóstico preoperatorio y valoración de estructuras anatómicas adyacentes. La resección quirúrgica seguida de reconstrucción craneal es el tratamiento de elección. Palabras clave: cráneo, extradural, intraóseo, meningioma, osteolítico, tumor óseo

Objective: Breakthrough cancer pain (BTcP) is still underestimated and a percentage of patients are not adequately treated, affecting their quality of life. The aim of this review was to generate a series of expert recommendations based on clinical experience and current scientifi c data on the management of BTcP.

To evaluate responses to different sourdough breads, six groups of rats were fed a conventional refined wheat bread with no sourdough content (C_WhB); a leavened spelt bread baked with Rebola sourdough (Re_SpB); a durum wheat bread with Rebola sourdough (Re_DuB); or a multigrain bread leavened with Rebola (Re_MGB), Carla (Ca_MGB), or San Francisco sourdough (SF_MGB). Compared to C_WhB-fed rats, Re_SpB-, Re_DuB-, and Re_MGB-fed animals showed lower postprandial blood glucose levels, whereas SF_MGB-fed rats displayed a decreased postprandial blood insulin response and glucose and insulin products. The 3 week intake of Ca_MGB decreased blood triacylglycerols and the relative apparent absorption (RAA) of Fe2+, Cu2+, and Zn2+, whereas Re_MGB-fed animals showed lower serum levels of the MCP-1 inflammatory marker and decreased the Fe RAA. The 3 week consumption of the multigrain bread produced sourdough-specific effects. Thus, Re_MGB-fed animals displayed higher insulin concentrations than Ca_MGB- and SF_MGB-fed rats and decreased blood MCP-1 levels compared to those of Ca_MGB-fed animals. In addition, Ca_MGB-fed rats showed lower serum triacylglycerol concentrations than those of Re_MGB- and SF_MGB-fed animals, whereas SF_MGB-fed rats displayed higher RAA values of Ca2+, Cu2+, Fe2+, Mg2+, and Zn2+ than their Re_MGB and Ca_MGB counterparts. These sourdough-specific effects could be related to changes in the contents of sugars and organic acids, acidity, microbial composition, and proteolytic activity among sourdoughs. Hence, the consumption of sourdough breads improved postprandial blood glucose and insulin responses and produced sourdough-specific effects on RAA and serum insulin and triacylglycerol and MCP-1 levels in rats, showing that SF_MGB has the most promising beneficial effects.

[Backgound] The ingestion of wheat and other cereals are related to several gut disorders. The specific components responsible for non-celiac wheat-sensitivity (NCWS) may include gluten and other compounds. Tritordeum is a new cereal derived from crossing durum wheat with a wild barley species, which differs from bread wheat in its gluten composition. In the present work, we examined the response of NCWS patients to tritordeum bread Gastrointestinal symptoms as well as tritordeum acceptability, gluten immunogenic peptides excretion, and the composition and structure of the intestinal microbiota were evaluated., [Results] Gastrointestinal symptoms of the subjects showed no significant change between the gluten-free bread and the tritordeum bread. Participating subjects rated tritordeum bread higher than the gluten-free bread. Analysis of the bacterial gut microbiota indicated that tritordeum consumption does not alter the global structure and composition of the intestinal microbiota, and only a few changes in some butyrate-producing bacteria were observed. [Conclusions] All the results derived from acceptability, biochemical and microbiological tests suggest that tritordeum may be tolerated by a sub-set of NCWS sufferers who do not require strict exclusion of gluten from their diet. © 2020 Society of Chemical Industry., This research was funded by Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidad, project AT-5985 and the European Regional Development Fund (FEDER).

Objectives This study aimed to develop mapping algorithms from the Expanded Prostate Cancer Index Composite (EPIC) and the Short-Form (SF) Health Surveys to the Patient-Oriented Prostate Utility Scale (PORPUS), an econometric instrument specifically developed for patients with prostate cancer. Methods Data were drawn from 2 cohorts concurrently administering PORPUS, EPIC-50, and SF-36v2. The development cohort included patients who had received a diagnosis of localized or locally advanced prostate cancer from 2017 to 2019. The validation cohort included men who had received a diagnosis of localized prostate cancer from 2014 to 2016. Linear regression models were constructed with ln(1 − PORPUS utility) as the dependent variable and scores from the original and brief versions of the EPIC and SF as independent variables. The predictive capacity of mapping models constructed with all possible combinations of these 2 instruments was assessed through the proportion of variance explained (R2) and the agreement between predicted and observed values. Validation was based on the comparison between estimated and observed utility values in the validation cohort. Results Models constructed with EPIC-50 with and without SF yielded the highest predictive capacity (R2 = 0.884, 0.871, and 0.842) in comparison with models constructed with EPIC-26 (R2 = 0.844, 0.827, and 0.776). The intraclass correlation coefficient was excellent in the 4 models (>0.9) with EPIC and SF. In the validation cohort, predicted PORPUS utilities were slightly higher than those observed, but differences were not statistically significant. Conclusions Mapping algorithms from both the original and the abbreviated versions of the EPIC and the SF Health Surveys allow estimating PORPUS utilities for economic evaluations with cost-utility analyses in patients with prostate cancer.

Ground level concentrations of nitrogen oxide (NOx) can act as an indicator of air quality in the urban environment. In cities with relatively good air quality, and where NOx concentrations rarely exceed legal limits, adverse health effects on the population may still occur. Therefore, detecting small deviations in air quality and deriving methods of controlling air pollution are challenging. This study presents different data analytical methods which can be used to monitor and effectively evaluate policies or measures to reduce nitrogen oxide (NOx) emissions through the detection of pollution episodes and the removal of outliers. This method helps to identify the sources of pollution more effectively, and enhances the value of monitoring data and exceedances of limit values. It will detect outliers, changes and trend deviations in NO2 concentrations at ground level, and consists of four main steps: classical statistical description techniques, statistical process control techniques, functional analysis and a functional control process. To demonstrate the effectiveness of the outlier detection methodology proposed, it was applied to a complete one-year NO2 dataset for a sub-urban site in Dublin, Ireland in 2013. The findings demonstrate how the functional data approach improves the classical techniques for detecting outliers, and in addition, how this new methodology can facilitate a more thorough approach to defining effect air pollution control measures. Ministerio de Industria y Competitividad | Ref. RTI2018-096296-B-C21

Prostate cancer is the most frequent genitourinary tumor worldwide. Maintaining an optimum bone health throughout the natural course of prostate cancer is an important aspect in the management of this disease, particularly in this at risk population of older and frail patients who experience bone loss related to androgen-deprivation therapy (ADT) and/or patients who develop bone metastases. The number of treatment options for advanced prostate cancer that combine ADT with docetaxel, new hormonal agents and/or radiotherapy has increased substantially in recent years. Bisphosphonates and other bone targeted agents such as denosumab have shown an improvement in bone mineral density and are suited for patients with treatment-related osteoporosis and/or bone metastases with an increased risk of skeletal-related events (SREs). In this context, the aim of this review is to analyse key aspects of bone health and therapies that can prevent the occurrence of SREs throughout the clinical course of prostate cancer, and how to combine them with new available treatments in this setting.

Tritordeum is a novel cereal obtained from the hybridization between durum wheat and a wild barley. This study evaluates acceptance, digestibility and immunotoxic properties of tritordeum, a novel cereal for food processing. Nineteen healthy volunteers participated in a study with different diets to compare tritordeum bread with wheat and gluten-free breads.; Results: Tritordeum breads had a similar acceptance to the wheat bread usually consumed, and the acceptance was significantly higher than the gluten-free bread and standardized wheat bread supplied in the study. There was no evidence for gastrointestinal symptoms among volunteers during the study. The reductions in the numbers of immunogenic epitopes in tritordeum in comparison with wheat were 78% for α-gliadins, 57% for γ-gliadins and 93% for ω-gliadins. The analysis of gluten immunogenic peptides (GIP) in stool samples showed a significantly lower excretion in the tritordeum ingestion phase than in the wheat ingestion phase.; Conclusions: These results suggest that tritordeum may be an option of interest for general food processing, and especially for those who want to reduce their intake of gluten. However, it is not suitable for celiac disease sufferers as it contains gluten. © 2017 Society of Chemical Industry.; © 2017 Society of Chemical Industry.

The aim of the present work was to compare the impact on the gut microbiota composition and in the systemic inflammation of two types of breads denominated as industrial and celta with different composition (wheat flour vs . complex flour and seeds) and fermentation process (2 h vs. 24 h). Faecal and blood samples of 10 mice were collected at: (1) - basal, (2) - after 21 days of industrial bread intake and (3) - after another 21 days of celta bread exposure. Significant differences in the gut microbiota composition were detected after the consumption of both breads, whereas the celta bread increased the concentration of Akkermansia and Mucispirillum , the industrial bread favour the Bacteroidetes proliferation and additionally systemic inflammation. In conclusion, the more consumed industrial processed bread might provoke systemic inflammation, probably in relation with its composition and manufacture process.

La presente investigación tuvo como objetivos, determinar los parámetros geomorfológicos e hidrológicos, análisis granulométrico, que permitieron estimar la carga en suspensión y de arrastre de fondo, asimismo las metodologías utilizadas para estimar la producción de sedimentos en la cuenca de Yucaes. Se emplearon metodologías para calcular las curvas Intensidad - Duración - Frecuencia (curvas I-D-F), así como los métodos empleados para calcular el caudal máximo promedio (244.89 m3/s) y se empleó la curva granulométrica para determinar el diámetro medio (Dm= 9.2 mm), la rugosidad del río (n= 0.063).También, se utilizaron metodologías para estimar la capacidad de transporte de sedimentos de una corriente como la Ecuación Universal Modificada de Pérdida de Suelo (MUSLE), el método propuesto por Gracia, la USBR, Schoklitsch, Mizuyama &Shimohigashi, Smart &Jaeggi, Bathurst et al., Meunier, Rickenmann, etc.

The study evaluated the symptoms, acceptance, and digestibility of bread made from transgenic low-gliadin wheat, in comparison with gluten free bread, in Non-coeliac gluten sensitivity (NCGS) patients, considering clinical/sensory parameters and gut microbiota composition. This study was performed in two phases of seven days each, comprising a basal phase with gluten free bread and an E82 phase with low-gliadin bread. Gastrointestinal clinical symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire, and stool samples were collected for gluten immunogenic peptides (GIP) determination and the extraction of gut microbial DNA. For the basal and E82 phases, seven and five patients, respectively, showed undetectable GIPs content. The bacterial 16S rRNA gene V1-V2 hypervariable regions were sequenced using the Illumina MiSeq platform and downstream analysis was done using a Quantitative Insights into Microbial Ecology (QIIME) pipeline. No significant differences in the GSRS questionnaires were observed between the two phases. However, we observed a significantly lower abundance of some gut genera Oscillospira, Dorea, Blautia, Bacteroides, Coprococcus, and Collinsella, and a significantly higher abundance of Roseburia and Faecalibacterium genera during the E82 phase compared with the basal phase. The consumption of low-gliadin bread E82 by NCGS subjects induced potentially positive changes in the gut microbiota composition, increasing the butyrate-producing bacteria and favoring a microbial profile that is suggested to have a key role in the maintenance or improvement of gut permeability., The Spanish Ministry of Economy and Competitiveness (Projects AGL2013-48946-C3-1-R, AGL2013-48946-C and AGL2016-80566-P) and the European Regional Development Fund (FEDER) supported this research.

Background Glomus tumors are benign slow-growing hypervascular neoplasms. The role of radiosurgery for the treatment of these tumors has increased. The purpose of this study was to show our experience with glomus tumors and to analyze different prognostic factors. Methods Data from 39 adult patients were retrospectively analyzed. All of them underwent head frame stereotactic radiosurgery with linear accelerator (LINAC). Tumor and symptomatic control were calculated using the Kaplan–Meier method. Bivariate statistical analyses were performed to examine different prognostic factors. Results The median follow-up was 71 months. The radiological local and symptomatic control was achieved in 37 patients (94.8%) and 29 patients (74.3%), respectively. Toxicity was detected in 4 patients (10%). In the bivariate analysis, dose coverage and maximum dose were associated with tumor control with an odds ratio (OR) of 5.29 (p = .041) and 2.67 (p = .056), respectively. Conclusion Stereotactic radiosurgery is a safe and efficient treatment for glomus tumors that is associated with high probability of radiological and symptomatic control and low incidence of morbidity. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Tritordeum is a novel cereal obtained from the hybridization between durum wheat and a wild barley. This study evaluates acceptance, digestibility and immunotoxic properties of tritordeum, a novel cereal for food processing. Nineteen healthy volunteers participated in a study with different diets to compare tritordeum bread with wheat and gluten-free breads.Tritordeum breads had a similar acceptance to the wheat bread usually consumed, and the acceptance was significantly higher than the gluten-free bread and standardized wheat bread supplied in the study. There was no evidence for gastrointestinal symptoms among volunteers during the study. The reductions in the numbers of immunogenic epitopes in tritordeum in comparison with wheat were 78% for α-gliadins, 57% for γ-gliadins and 93% for ω-gliadins. The analysis of gluten immunogenic peptides (GIP) in stool samples showed a significantly lower excretion in the tritordeum ingestion phase than in the wheat ingestion phase.These results suggest that tritordeum may be an option of interest for general food processing, and especially for those who want to reduce their intake of gluten. However, it is not suitable for celiac disease sufferers as it contains gluten. © 2017 Society of Chemical Industry.

Glomus tumors are benign slow-growing hypervascular neoplasms. The role of radiosurgery for the treatment of these tumors has increased. The purpose of this study was to show our experience with glomus tumors and to analyze different prognostic factors.Data from 39 adult patients were retrospectively analyzed. All of them underwent head frame stereotactic radiosurgery with linear accelerator (LINAC). Tumor and symptomatic control were calculated using the Kaplan-Meier method. Bivariate statistical analyses were performed to examine different prognostic factors.The median follow-up was 71 months. The radiological local and symptomatic control was achieved in 37 patients (94.8%) and 29 patients (74.3%), respectively. Toxicity was detected in 4 patients (10%). In the bivariate analysis, dose coverage and maximum dose were associated with tumor control with an odds ratio (OR) of 5.29 (p = .041) and 2.67 (p = .056), respectively.Stereotactic radiosurgery is a safe and efficient treatment for glomus tumors that is associated with high probability of radiological and symptomatic control and low incidence of morbidity. © 2015 Wiley Periodicals, Inc. Head Neck 38: E798-E804, 2016.

Se presentan algunas de las características bioéticas diferenciales que son propias de la atención primaria y que tipifican la relación médico paciente y el tipo de atención sanitaria propia de este nivel. Mediante el examen de frecuentes interrogantes que pueden enfrentar los Médicos de Familia en el manejo de individuos enfermos o con factores de riesgo, se abordan las posibles contradicciones entre los principios éticos fundamentales y el papel de los actores implicados en la atención sanitaria. Se concluye que el Médico de Familia, en su proceder ético y bioético, debe generar un espacio de respeto profesional y moral para el paciente y la sociedad, favoreciendo la capacidad de comprender la información y la toma de decisiones. El acto asistencial y las acciones sanitarias de protección, son 2 modalidades del acto médico que deben ser diferenciados para brindar una atención profesional y responsable a los pacientesSome of the differential bioethic characteristics which are typical of primary health care and that typify the physician-patient relations and the kind of health care at this level are presented. The possible contradictions existing between the fundamental ethic principles and the role of the actors involved in health care are approached by analyzing the frequent questions family physicians may face in the management of sick individuals or of subjects with risk factors. It is concluded that the family physician in his ethic and bioethic conduct should generate a space of professional and moral respect for the patient and for the society that favors the capacity of understanding the information and the decision making

Se siguieron durante 3 años 1 412 pacientes hipertensos por el Médico de la Familia para su clasificación, según estadio hipertensivo y grupo de riesgo recomendados por el sexto reporte, así como su evaluación de la conducta terapéutica. Se apreció que el 56,9 % de los pacientes evaluables, tenían cifras tensionales inferiores a 140/90. Las categorías normal alto e hipertensivo estadio I representaron el 90,2 % de los casos. Los grupos de riesgo B y C reúnen al 97,7 % de los casos. Existió una relación significativa entre estadios hipertensivos y grupos de riesgo (p = 0,00465412). En el grupo A, el 60,0 % de los pacientes mantuvo cifras tensionales normales altas; en los grupos de riesgo B y C, el estadio hipertensivo I fue el más frecuente. Una proporción significativa de pacientes en estadio normal alto (p = 0,00030047) e hipertensivo I (p = 0,00011824), tienen una terapéutica inadecuada con un uso insuficiente de las modificaciones de estilo de vidaFor 3 years, 1 412 hypertensive patients were followed up by the Family Physician for their classification, according to the hypertensive stage and the risk group recommended by the sixth report, as well as for the evaluation of the therapeutic behaviour. It was observed that 56.9 % of the examined patients had readings below 140/90. The normal high blood pressure and hipertensive stage I categories represented 90.2 % of the cases. Risk groups B and C accounted for 97.7 % of cases. There was a significant relation ship between hypertensive stages and risk groups (p = 0.00465412). In group A, 60.0 % of patients kept normal headings. In risk groups B and C, the stage I hypertensive was the most frequent. A significant proportion of patients in normal high (p = 0.00030047) and hypertensive I stages (p = 0.00011824) has an inadequate therapeutics with insufficient modifications of the life style.

Background To make a radiobiological comparison, for high risk prostate cancer (T3a, PSA > 20 ng/ml or Gleason > 7) of two radiotherapy treatment techniques. One technique consists of a treatment in three phases of the pelvic nodes, vesicles and prostate using a conventional fractionation scheme of 2 Gy/fraction (SIMRT). The other technique consists of a treatment in two phases that gives simultaneously different dose levels in each phase, 2 Gy/fraction, 2.25 Gy/fraction and 2.5 Gy/fraction to the pelvic nodes, vesicles and prostate, respectively (SIBIMRT). Materials and methods The equivalent dose at fractionation of 2 Gy (EQD 2 ), calculated using the linear quadratic model with α / β prostate = 1.5 Gy, was the same for both treatment strategies. For comparison the parameters employed were D95, mean dose and Tumour Control Probabilities for prostate PTV and D15, D25, D35, D50, mean dose and Normal Tissue Complication Probabilities for the rectum and bladder, with physical doses converted to EQD 2 . Parameters were obtained for α / β prostate = 1.5, 3 and 10 Gy and for α / β oar = 1, 2, 3, 4, 6 and 8. Results For prostate PTV, both treatment strategies are equivalent for α / β prostate = 1.5 Gy but for higher α / β prostate , EQD 2 and TCP, decrease for the SIBIMRT technique. For the rectum and bladder when α / β oar ≤ 2 Gy, EQD 2 and NTCP are lower for the SIMRT technique or equal in both techniques. For α / β oar ≥ 2–3 Gy, EQD 2 and NTCP increase for the SIMRT treatment. Conclusions A comparison between two radiotherapy techniques is presented. The SIBIMRT technique reduces EQD 2 and NTCP for α / β oar from 2 to 8 Gy.

We describe the multi-layer GRIPhoN architecture which provides dynamic bandwidth at the OTN and wavelength layers for private-line customers. We propose and demonstrate an automated restoration approach for wavelength connections using dynamic re-provisioning.

Cloud service providers use replication across geographically distributed data centers to improve end-to-end performance as well as to offer high reliability under failures. Content replication often involves the transfer of huge data sets over the wide area network and demands high backbone transport capacity. In this paper, we discuss how a Globally Reconfigurable Intelligent Photonic Network (GRIPhoN) between data centers could improve operational flexibility for cloud service providers. The proposed GRIPhoN architecture is an extension of earlier work [34] and can provide a bandwidth-on-demand service ranging from low data rates (e.g., 1 Gbps) to high data rates (e.g., 10-40 Gbps). The inter-data center communication network which is currently statically provisioned could be dynamically configured based on demand. Today's backbone optical networks can take several weeks to provision a customer's private line connection. GRIPhoN would enable cloud operators to dynamically set up and tear down their connections (sub-wavelength or wavelength rates) within a few minutes. GRIPhoN also offers cost-effective restoration capabilities at wavelength rates and automated bridge-and-roll of private line connections to minimize the impact of planned maintenance activities.

We describe RFC, a new capability that minimizes customer outages during software and hardware upgrades in ISP networks. RFC is being used by a large Tier-1 ISP to upgrade access routers supporting thousands of customers.

We demonstrate a simple cost-effective broadcast overlay for WDM PON which uses a single directly modulated superluminescent diode to deliver an RF video or baseband gigabit-Ethernet service to all 32 users.

We describe a ROADM architecture for a dynamically reconfigurable photonic network and demonstrate the performance of a photonic-layer bridge-and-roll that could improve the operational flexibility of optical transport networks.

Rickettsia conorii infection is endemic in the Mediterranean basin, where it is known as Mediterranean spotted fever, also known as Boutonneuse fever and Marseilles fever. We report the case of a 66-year-old diabetic man who presented a severe form of the disease, complicated by acute renal failure, thrombocytopenia and encephalitis. Diagnosis was confirmed by indirect immunofluorescence assay. Despite appropriate treatment, severe neurological sequelae have remained. Medical literature on encephalitis caused by R. conorii is also reviewed.

Purpose To assess the prostate motion from day-to-day setup, as well as during irradiation time, to calculate planning target volume (PTV) margins. PTV margins differ depending on the clinical implementation of an image-guided system. Three cases were considered in this study: daily bony anatomy match, center of gravity of the implanted marker seeds calculated with a limited number of imaged days, and daily online correction based on implanted marker seeds. Methods and Materials A cohort of 30 nonrandomized patients and 1,330 pairs of stereoscopic kV images have been used to determine the prostate movement. The commercial image guided positioning tool employed was ExacTrac X-Ray 6D (BrainLAB AG, Feldkirchen, Germany). Results Planning target volume margins such that a minimum of 95% of the prescribed dose covers the clinical target volume for 90% of the population are presented. PTV margins based on daily bony anatomy match, including intrafraction correction, would be 11.5, 13.5, and 4.5 mm in the anterior–posterior, superior–inferior, and right–left directions, respectively. This margin can be further reduced to 8.1, 8.6, and 4.8 mm (including intrafraction motion) if implanted marker seeds are used. Finally, daily on line correction based on marker seeds would result in the smallest of the studied margins: 4.7, 6.2, and 1.9 mm. Conclusion Planning target volume margins are dependent on the local clinical use of the image-guided RT system available in any radiotherapy department.

The DARPA Core Optical Networks (CORONET) program envisions a highly dynamic network environment requiring fast provisioning and restoration for a wide variety of bandwidth-on-demand services in IP-over-optical networks. This paper builds on previously reported work on the development of fast provisioning and restoration protocols to meet CORONET requirements. Two separate CORONET testbed implementations are described: an emulation testbed and a cloud application testbed. The emulation testbed is a software implementation of a 100-node, global scale control plane network designed to investigate and validate the performance of CORONET provisioning and restoration protocols for the transport layer. The cloud application testbed is implemented on a four-node network in AT&T's Software Defined Network (SDN) Wide Area Network (SWAN) testbed and is designed to show the utility of CORONET fast provisioning for cloud computing applications. In particular, we demonstrate dynamic provisioning of inter-datacenter capacity for virtual machine load balancing under the control of an SDN orchestrator. "Lessons learned" and further challenges are summarized.

Planned maintenance is a fact of life in IP networks. Examples of maintenance activities include updating router software as well as processor upgrades, memory upgrades, installation of additional line cards, and other hardware upgrades. While planned maintenance is clearly necessary, it is also costly. Software upgrades, for example, require rebooting the router. Due to the time required to reboot the router, and then synchronize state (such as BGP routing information) with network neighbors, the upgrade process can yield outages of 10--15 minutes.

We describe bandwidth-on-demand in an evolved multilayer, software-defined networking (SDN) based cloud services model. We present motivation for using a multilayer architecture for the wide-area network (WAN). Our laboratory testbed is described, and both the hardware and management architecture are presented. We also show an initial proof-of-concept demonstration of this capability.

Feature Issue on ConvergenceWe provide a comprehensive description of the Packet-Aware Transport Network (PATN) architecture first introduced in [IEEE Commun. Mag. (3) 120 (2004)]. The PATN architecture provides a more efficient transport of data services such as Ethernet and IP than traditional time-division multiplexing- (TDM) centric access network architectures. The PATN architecture builds upon several emerging technologies and improvements in silicon processing to seamlessly converge multiple network functions onto a single platform, optimize network utilization, and reduce operating costs. The PATN architecture is also designed to support all existing TDM voice, private line, and data services. To validate this architecture we implemented a comprehensive test bed that provides a microcosm of local, metro, and long-distance transport networks. We describe this evaluation methodology and present experimental results of key aspects of the PATN.

This paper presents the packet-aware transport network (PATN). We also present customer premise capabilities critical to providing new Ethernet services. Experimental results for various services from the customer premise with the PATN architecture are also presented.

We describe bandwidth-on-demand in an evolved multi-layer, SDN-based Cloud Services model. We also show an initial proof-of-concept demonstration of this capability.