TCP congestion control adjusts the sending rate in order to protect Internet from the continuous traffic and ensure fair coexistence among multiple flows. Especially, loss-based congestion control algorithms were mainly used, which worked relatively well for past Internet with low bandwidth and small bottleneck buffer size. However, the modern Internet uses considerably more sophisticated network equipment and advanced transmission technologies, and loss-based congestion control can cause performance degradation due to excessive queueing delay and packet loss. Therefore, Google introduced a new congestion control in 2016, Bottleneck Bandwidth Round-trip propagation time (BBR). In contrast with traditional congestion control, BBR tries to operate at the Kleinrock’s optimal operating point, where delivery rate is maximized and latency is minimized. However, when BBR and loss-based congestion control algorithms coexist on the same bottleneck link, most of bottleneck bandwidth is occupied by flows that use a particular algorithm, and excessive packet retransmission can occur. Therefore, this paper proposes a BBR congestion window scaling (BBR-CWS) scheme to improve BBR’s inter-protocol fairness with a loss-based congestion control algorithm. Through Mininet experiment results, we confirmed that fairness between BBR-CWS and CUBIC improved up to 73% and has the value of 0.9 or higher in most bottleneck buffer environments. Moreover, the number of packet retransmissions was reduced by up to 96%, compared to the original BBR.
Objectives: On November 5, 2021, Pfizer Inc. announced Paxlovid (nirmatrelvir+ritonavir) as a treatment method that could reduce the risk of hospitalization or death for patients with confirmed coronavirus disease 2019 (COVID-19).Methods: From February 6, 2022 to April 2, 2022, the incidence of COVID-19 and the effects of treatment with Paxlovid were analyzed in 2,241 patients and workers at 5 long-term care facilities during the outbreak of the Omicron variant of severe acute respiratory syndrome coronavirus 2 in South Korea.Results: The rate of severe illness or death in the group given Paxlovid was 51% lower than that of the non-Paxlovid group (adjusted risk ratio [aRR], 0.49; 95% confidence interval [CI], 0.24−0.98). Compared to unvaccinated patients, patients who had completed 3 doses of the vaccine had a 71% reduced rate of severe illness or death (aRR, 0.29; 95% CI, 0.13−0.64) and a 65% reduced death rate (aRR, 0.35; 95% CI, 0.15−0.79).Conclusion: Patients given Paxlovid showed a lower rate of severe illness or death and a lower fatality rate than those who did not receive Paxlovid. Patients who received 3 doses of the vaccine had a lower rate of severe illness or death and a lower fatality rate than the unvaccinated group.
Multipath transmission control protocol (MPTCP) is a promising transport layer protocol that enables a device to utilize multiple communication interfaces simultaneously, thereby achieving high throughput. A congestion control algorithm (CCA) employed in MPTCP constitutes a key part that controls the data flow through different subflows (SFs). There are two fundamental challenges associated with MPTCP CCAs. First, MPTCP flows should have an advantage over single-path flows; second, MPTCP flows should be fair, indicating that SFs sharing a common bottleneck should occupy a capacity fairly close to that required by a single-path flow. Several MPTCP CCAs have been developed; however, they have failed to satisfy these challenges in all scenarios. Recently, Google has introduced the bottleneck bandwidth and round-trip-time (BBR), a new CCA for single-path TCP, achieving high throughput with minimum delay by employing a network model. In the present paper, we propose a novel MPTCP CCA based on BBR named coupled multipath BBR (C-MPBBR) that satisfies the fundamental challenges by exploiting the concept of network modeling in BBR. C-MPBBR addresses the first challenge by closing the lowbandwidth SFs by tracking the delivery rate and bottleneck bandwidth (BtlBW). Then, it satisfies the second challenge through identifying those SFs that share a common bottleneck and dividing the BtlBW share corresponding to a SF among them. We implemented C-MPBBR in the Linux kernel, tested it on a wide range of scenarios by the Mininet emulation experiments, and the real-world Internet, and confirmed that the proposed C-MPBBR outperforms the existing MPTCP CCAs in terms of successfully satisfying the fundamental challenges by ensuring both throughput and fairness.
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