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Software-defined networking (SDN) allows flexible and centralized control in cloud data centers. An elastic set of distributed SDN controllers is often required to provide sufficient yet cost-effective processing capacity. However, this introduces a new challenge: Request Dispatching among the controllers by SDN switches. It is essential to design a dispatching policy for each switch to guide the request distribution. Existing policies are designed under certain assumptions, including a single centralized agent, global network knowledge, and a fixed number of controllers, which often cannot be satisfied in practice. This article proposes MADRina, Multiagent Deep Reinforcement Learning for request dispatching, to design policies with high dispatching adaptability and performance. First, we design a multiagent system to address the limitation of using a centralized agent with global network knowledge. Second, we propose a Deep Neural Network-based adaptive policy to enable request dispatching over an elastic set of controllers. Third, we develop a new algorithm to train the adaptive policies in a multiagent context. We prototype MADRina and build a simulation tool to evaluate its performance using real-world network data and topology. The results show that MADRina can significantly reduce response time by up to 30% compared to existing approaches.
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http://dx.doi.org/10.1109/TCYB.2023.3266448 | DOI Listing |
Air Med J
August 2025
Department of Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan.
Objective: To evaluate whether the keyword method-requesting the dispatch of a doctor helicopter (DH) based on information obtained from the emergency call before emergency medical technicians make contact with patients-is useful for other disease category, using data from the Japan DH Registry (JDHR).
Methods: Patients (N = 41,592) enrolled in JDHR were included in the study. The following data were collected for each subject: time from emergency call to DH staff-patient contact, DH request method (keyword or not), gender, age, vital signs at the time of emergency medical technician contact, medical intervention details, disease category details which were determined by the JDHR classification, hospitalization duration, and 1-month outcome.
Int J Emerg Med
July 2025
Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
Background: More than a third of out-of-hospital cardiac arrests in the European Union do not benefit from cardiopulmonary resuscitation by emergency medical services (EMS), most often because the patient shows signs of obvious death. To preserve limited resources, it is crucial for dispatch centres to identify such cases and thereby reduce over-triage. The aim of this study was to assess the ability of clinically trained dispatchers to detect obvious deaths among all suspected out-of-hospital cardiac arrests within a criteria-based dispatch system.
View Article and Find Full Text PDFCureus
May 2025
Emergency Medicine, Medical Corporation Eiseikai Association, Minami-Tama Hospital, Tokyo, JPN.
Background and objectives In recent years, the number of emergency transports for older patients has significantly increased, raising concerns about the strain on emergency medical services. This study aimed to assess whether the use of hospital ambulances can enhance collaboration between home medical care and hospitals while reducing the reliance on fire department ambulances for interhospital transfers. Methods This retrospective observational study analyzed 3,983 hospital ambulance dispatches from December 1, 2014, to March 31, 2024.
View Article and Find Full Text PDFBMC Emerg Med
May 2025
Department of Psychiatric Nursing, Kermanshah University of Medical Science, Kermanshah, Iran.
Background: Telephone Cardiopulmonary Resuscitation (T-CPR), administered by Emergency Medical Dispatchers (EMDs) to bystanders at the scene of an out-of-hospital cardiac arrest (OHCA), faces significant challenges. These challenges arise when collaboration for CPR is difficult due to the bystander's condition or when the patient's condition is not visible. Limited research exists on T-CPR, which is why our study aims to explore the experiences of Kermanshah EMDs in providing T-CPR.
View Article and Find Full Text PDFHealth Soc Care Deliv Res
May 2025
School of Psychological Sciences, University of Surrey, Guildford, Surrey, UK.
Background: The use of bystander video livestreaming from scene in emergency medical services is becoming increasingly common to inform decisions about the resources and support required. Possible benefits include clinical and financial gains, but evidence is sparse. We aimed to investigate the feasibility of conducting a definitive randomised controlled trial of its use in major trauma incidents.
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