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351-080 - CCIE Data Center Written (Beta) - Dump Information

Vendor : Cisco
Exam Code : 351-080
Exam Name : CCIE Data Center Written (Beta)
Questions and Answers : 120 Q & A
Updated On : October 22, 2018
PDF Download Mirror : 351-080 Brain Dump
Get Full Version : Pass4sure 351-080 Full Version


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351-080 Questions and Answers

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351-080 CCIE Data Center Written (Beta)

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351-080 exam Dumps Source : CCIE Data Center Written (Beta)

Test Code : 351-080
Test Name : CCIE Data Center Written (Beta)
Vendor Name : Cisco
Q&A : 120 Real Questions

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Cisco Cisco CCIE Data Center

The GPU Accelerated information core takes Flight: Cisco Heads to NVIDIA GTC Europe | killexams.com Real Questions and Pass4sure dumps

Welcome lower back! There wasn’t a great deal lead time between my closing weblog and this one, but the Cisco “commute computer virus” has taken dangle and it stops for no one. This time our Cisco world world tour takes us to Munich, Germany. Cisco is happy to be becoming a member of NVIDIA at their each year GPU expertise convention (GTC)  in Europe and proud to aid the demonstrate as a platinum sponsor.

As most of you understand in case you join me on my running a blog experience we all the time devote a bit time for minutiae. So here we go:

  • The Neues Kino Gabriel in Munich is surely the oldest cinema on the planet. It has existed for the reason that 1906.
  • The BMW manufacturing unit found in Munich actually has its personal zip code.
  • and naturally, considering that it’s October

  • during Oktoberfest the city raises escalator speeds to circulate crowds quicker from aspect A to B.
  • Now that we’ve gotten minutiae out of the way and you’re all prepped to experience the rushing escalators through Munich, you’re probably questioning what Cisco will be doing in Germany. well, right here we go.

    Cisco and NVIDIA at GTC Europe

    over the last 12 months Cisco and NVIDIA have worked collectively to increase and provide customer options that span from huge information to Win10 migration. This 12 months, despite the fact, we now have became our attention to AI/ML and brought to market the Cisco u.s.a.C480 ML M5.  With the addition of the C480 ML to the USAportfolio Cisco is placing the need of valued clientele to without difficulty consume AI/ML and shorten time to insights on the forefront of our AI/ML method.

    At NVIDIA GTC we showcasing how Cisco can allow enterprise environments to greater conveniently run effective computing device gaining knowledge of/deep getting to know-based mostly analytics on infrastructure that fits in seamlessly into on-prem information facilities.

    all the pleasure nonetheless doesn’t cease there.  Cisco is bringing the full GPU Accelerated statistics core to Europe and you don’t wish to fail to see all of the fabulous opportunities to imagine the probabilities:

    machine learning solutions on Cisco UCS

    See tips to capitalize on the adaptability of Cisco computer researching computing options to energy synthetic intelligence workloads at scale and to extract more intelligence out of information and make better decisions.

    GPU Accelerated virtual Workspaces

    Cisco will demonstrate the vigour of Cisco UCS & NVIDIA GPUs to give clients with a wealthy and immersive adventure for Microsoft Window 10 and picture-intensive applications.

    Quadro® digital DC Workstations

    Cisco, in collaboration with our accomplice EBB3, will show the power of Cisco UCS & NVIDIA GPU’s for prime-efficiency image virtual workstations.

    Cisco and EBB3 will reveal you how a GPU accelerated digital laptop can assist free clients from the confines of a physical vicinity, deliver materials from a data core, and provide secure access on any gadget, anywhere.

    Cisco united statesC480 ML Rack Server

    Designed for the most compute-intensive part of the AI and ML lifecycle: deep researching. This server integrates NVIDIA GPUs and high-pace interconnect technology mixed with big storage capability and up to 100-Gbps community connectivity. cease with the aid of the sales space at GTC Europe to look the newest addition to the Cisco AI/ML portfolio.

    Infrastructure choices for computer discovering and Deep researching

    Wednesday October tenth | 14:30 -15:15

    Vikas Ratna – Product manager, CiscoRavi Mishra – Sr. Technical advertising and marketing Engineer, Cisco

    in this session, you'll study what elements to trust when making infrastructure choices and what the benefits of on-premise infrastructure are for computer studying and deep studying.

    study greater concerning the session and the demos here

    Willkommen in München, @bhcopeland out!


    Workspace Of the long run On reveal these days at the Dimension records Digital office center of Excellence In Silicon Valley | killexams.com Real Questions and Pass4sure dumps

    The capital of innovation will host an enterprise expertise playground featuring products from Apple, Cisco and VMware

    big apple, Oct. eleven, 2018 /PRNewswire/ -- Dimension facts, a USD 8 billion international technology integrator, managed features company and member of the NTT neighborhood, announces the outlet of a Digital office center of Excellence at the NTT world Innovation center in Silicon Valley.

    Dimension facts emblem (PRNewsfoto/Dimension records)

    extra

    via its ubiquitous mesh of voice, video, end-person computing, mobility and security applied sciences, the workspace of the longer term enables continuous innovation of fresh enterprise fashions, strategies and effects. The core of Excellence brings to lifestyles integrated products and services from main technology organizations including Apple, Cisco and VMware – demonstrating how Dimension statistics collaborates with businesses to power nice business consequences and assist the optimal use of technology tailor-made to their entertaining wants.

    founded within the innovation capital of the area, the middle showcases advanced digital place of work applied sciences similar to Cisco collaboration and security tools, and VMware Workspace ONE, the intelligence-driven digital workspace platform, and demonstrates how Apple devices are most appropriate for company with Dimension records managed services offerings to assist corporations convey an anyplace, each time cell event.

    center visitors will have the ability to have interaction with specialists as they explore the newest innovations reworking the way forward for work. the following technologies are on screen, brought collectively via Dimension records Endpoint Lifecycle management (ELM) services to enhance the consumer journey and supply rich analytics:  

  • safety options to keep away from phishing attacks, protect compromised credentials and discover rogue applications
  • modern collaboration options to wirelessly latest, whiteboard, video or audio convention and annotate shared content material
  • intelligent, enterprise-grade wireless charging stations that give cloud management and analytics
  • Cloud-based house utilization analytics
  • solutions to streamline the provisioning and management of endpoints in a shared ambiance, empowering frontline worker's
  • platforms to surface statistics on space and technology utilization, displaying meeting schedules and workplace analytics
  • solutions to simply and securely convey and manage any app on any equipment via integrating access manage, software administration and multi-platform endpoint management
  • "because the workforce becomes more far off and mobile, so does our reliance on pervasive, comfy connectivity and collaboration," noted furnish Sainsbury, Senior vice chairman, Americas options at Dimension facts. "Being in a position to create a comfortable digital office it really is agile and on-the-go is more and more vital for brand new companies. The Digital office core of Excellence offers a window into what the future of work will look like, as groups assist varied personalised workstyles. The effectiveness of which relies on a seamless, at ease and productive experience."  

    technologies featured on the core include Cisco safety Connector, Cisco Webex Board, Chargifi, CoWorkr sensors, GroundControl, Teem Workspace journey Platform and VMware Workspace ONE, amongst others.  

    About Dimension DataFounded in 1983, Dimension records is a USD eight billion global chief in designing, optimizing, and managing contemporary evolving technology environments. This enables its purchasers to leverage information in a digital age, turn it into information, and extract insights. Headquartered in Johannesburg, Dimension information employs 28,000 individuals across 47 nations. The business brings together the world's most desirable technology supplied by way of market leaders and area of interest innovators with the carrier guide that clients need for his or her businesses – from consulting, technical, and support features to a completely-managed provider. Dimension information is a proud member of the NTT group. consult with us at http://www.dimensiondata.com

    Contact:Evan JordanSenior Public relations ManagerDimension facts(704) 943-9345evan.jordan@dimensiondata.com

    Story Continues


    New IBM, Cisco data core Partnership: details, evaluation | killexams.com Real Questions and Pass4sure dumps

    No outcomes found, are attempting new keyword!Competes With HP, Oracle, Dell alternate options. Cisco techniques Inc. (NASDAQ:CSCO) and IBM Corp. (NYSE:IBM) have launched VersaStack, a new statistics center answer that combines Cisco's UCS (Unified Compute S...

    351-080 CCIE Data Center Written (Beta)

    Study Guide Prepared by Killexams.com Cisco Dumps Experts


    Killexams.com 351-080 Dumps and Real Questions

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    351-080 exam Dumps Source : CCIE Data Center Written (Beta)

    Test Code : 351-080
    Test Name : CCIE Data Center Written (Beta)
    Vendor Name : Cisco
    Q&A : 120 Real Questions

    where will I locate material for 351-080 examination?
    The 351-080 exam is supposed to be a completely diffcult exam to clean But I cleared it remaining week in my first attempt. The killexams.Com Q&As guided me well and I was properly prepared. Advice to other students - dont take this exam lightly and look at very well.


    frightened of failing 351-080 examination!
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    first rate source of actual test questions, accurate solutions.
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    it's far super best to prepare 351-080 exam with actual take a look at questions.
    killexams.com provided me with legitimate exam questions and answers. The whole lot become correct and real, so I had no hassle passing this examination, even though I didnt spend that masses time studying. Even when you have a totally fundamental statistics of 351-080 examination and services, you could pull it off with this package deal. I was a bit burdened basically because of the large amount of statistics, however as I stored going through the questions, things started out out falling into place, and my confusion disappeared. All in all, I had a wonderful enjoy with killexams.com, and wish that so will you.


    351-080 real exam questions and Answers!
    I have exceeded the 351-080 exam with this! This is the primary time I used killexams.com, however now I realise its now not gonna be the ultimate one! With the practice assessments and real questions, taking this exam became notably clean. That is a tremendous way to get licensed - which might be now not anything like something else. If youve been thru any in their tests, youll recognize what I suggest. 351-080 is tough, but killexams.com is a blessing!


    Are there properly sources for 351-080 test guides?
    Im very happy to have discovered killexams.com online, and even more satisfied that i bought 351-080 package simply days before my examination. It gave the first-rate preparation I wanted, when you consider that I didnt have a whole lot time to spare. The 351-080 trying out engine is certainly appropriate, and everything objectives the areas and questions they test at some point of the 351-080 examination. it may appear extraordinary to pay for a draindump nowadays, when you may discover nearly something at no cost on line, but accept as true with me, this one is really worth every penny! im very satisfied - each with the guidance procedure and even extra so with the end result. I passed 351-080 with a completely strong rating.


    Try out these real 351-080 Latest and updated dumps.
    I am very satisfied with this package deal as I got over 96% on this 351-080 examination. I study the reliable 351-080 manual a touch, however I guess killexams.com turned into my predominant training useful resource. I memorized most of the questions and solutions, and additionally invested the time to absolutely recognize the eventualities and tech/practice focused elements of the examination. I think that by means of itself buying the killexams.com package deal does now not guarantee that youll pass your examination - and some checks are virtually hard. Yet, in case you examine their substances hard and certainly put your mind and your heart into your examination education, then killexams.com truly beats any other examination prep options to be had obtainable.


    It is great ideal to prepare 351-080 exam with actual test questions.
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    [OPTIONAL-CONTENTS-3]

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    Detroit Medical Center's cardiology program faces problems | killexams.com real questions and Pass4sure dumps

    {{title}} {{/content}} ]]> Updated Oct. 8

    The forced resignations of physician leaders in the Detroit Medical Center's cardiology department adds drama to a federal investigation and other woes that have beset a program once viewed as a model for emergency heart care for an underserved population and a cash cow for the for-profit hospital system.

    With the recent contract terminations of three top cardiologists, the resignation of Ted Schreiber, M.D., DMC's founding Cardiovascular Center president, and the federal investigation, the current problems have many roots that go back years.

    Hospital insiders say they include difficult-to-meet production goals for heart and vascular procedures, high profit expectations by DMC parent company Tenet Healthcare Inc., layoffs of key staff when profit margins dipped, the creation of Cardio Team One in 2008 that requires 24-7 coverage by cardiologists.

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    {{abstract}} Read more >

    {{/content.1}} ]]> But two large issues exposed weaknesses in the financially successful program, more than six sources told Crain's.

    They are an investigation by the U.S. Department of Justice, launched in 2016, and what prompted the investigation: the 2014 death of Radieh Alsafi, a 47-year-old Iraqi woman, hours after an angioplasty at DMC Harper University Hospital.

    In January 2017, Alsafi's estate filed a medical malpractice and wrongful death lawsuit against Tenet, two DMC hospitals, cardiologist Delair Gardi and two former DMC cardiology fellows. Gardi, one of the top producers at DMC, heads up Heart and Vascular Consultants, which has offices in Detroit and Livonia. One of Gardi's attorneys, David Williams in the Southfield office of Jaffe Raitt Heuer & Weiss, confirmed to Crain's that the civil lawsuit is still pending.

    While quality for DMC's Cardio Team One has been high for a range of complex heart and vascular procedures, outcomes over the past five years have declined somewhat and been uneven because of staff cuts, several patient deaths and a growing number of unnecessary or risky procedures conducted by some cardiologists, six DMC doctors and other sources told Crain's.

    Moreover, cuts at DMC the past three years have reduced staff in some departments to "skeleton levels," according to cardiologist Mahir Elder and Schreiber, two of the four cardiologists accused last week by DMC of violating unspecified standards of conduct.

    Schreiber, Elder, Amir Kaki and Tamal Mohamad have been top cardiologists at DMC for years. Schreiber is the former president of DMC's Cardiovascular Center and head of Cardio Team One. Elder was medical director of the cardiac care unit at DMC Harper Hospital and a two-time Crain's Health Care Hero. Mohamad was chief of cardiology and medical director of the cardiac care unit at DMC Detroit Receiving. Kaki was medical director of the cardiac catheter lab at DMC Cardiovascular Center and practices at DMC Sinai-Grace Hospital.

    Sources told Crain's that Schreiber and Kaki began practicing last week at Ascension St. John Hospital in Detroit, and possibly other hospitals, and are negotiating directorship contracts with St. John. An official for Ascension St. John declined comment.

    Tenet DMC takes action Last Monday, DMC CEO Tony Tedeschi and DMC hospital President Scott Steiner emailed more than 5,000 employees to announce DMC had terminated cardiologists Elder, Kaki and Mohamad from their administrative positions. They also announced the resignation of Schreiber from the staff. DMC accused the four of unspecified misconduct related to complaints made by other doctors and employees.

    The four doctors have denied DMC's allegations. Elder and Schreiber told Crain's they were punished for speaking out about staffing and quality concerns they contend are jeopardizing patient safety. A DMC spokesman has denied that the cardiologists were demoted for any other reason than a failure to maintain Tenet's standards of conduct.

    "Any suggestion that these leadership transitions were made for reasons other than violations of our standards of conduct is false," a statement from DMC said. "The leadership transition is the result of a thorough review led by outside counsel into complaints from other physicians and team members."

    In a subsequent statement to Crain's provided after this story was published, a Tenet spokesman said: "This is a decision we did not take lightly and made after informing the Department of Justice of the physicians' conduct." DMC and Tenet are under a three-year corporate integrity agreement and must report all compliance matters.

    Crain's reached out to the four doctors or their representatives for explanations. They said they had reported quality problems within their department that included substandard care by other doctors and employees and said they felt obligated to do so because of concerns for patient safety.

    In an interview with Crain's last Tuesday, Elder said poor quality and lack of staffing at DMC have led to preventable patient deaths; inexperienced and unskilled doctors conducted heart procedures that led to poor outcomes and death in some cases; and staff and service cost-cutting have created patient safety problems. When contacted later in the week, Elder declined further comment.

    But the staff cuts and quality problems are not limited to the cardiology program, several sources said.

    An orthopedic surgeon told Crain's last week that DMC surgeons continue to see examples of dirty surgical instruments and trays that have to be sent back to the sterile processing department.

    In 2016 and 2017, the Michigan Department of Licensing and Regulatory Affairs and the Centers for Medicare and Medicaid Services investigated reports of dirty surgical instruments and infection control problems. DMC was cited for multiple violations of federal and state quality regulations. DMC later was given a clean bill of health and has since restructured its sterile processing department.

    "The surgical instrument sterilization process at the DMC is significantly better, and I don't believe that there's another health system around that is as focused on this process as the DMC," Joseph Lelli, surgeon in chief at Children's Hospital of Michigan, said in a statement.

    A second source confirmed that an orthopedic surgeon conducting a knee replacement operation opened a surgical kit and it had "bloody" instruments in it. The surgeon expressed frustration but completed the surgery after receiving a replacement kit.

    The surgeon, Hussein Darwische, said the case was an example of safety processes working as intended.

    "As the lead surgeon in the case you reference, I can tell you that the process worked and the only surgical instruments that ever went into my OR were sterile. I feel confident in what the DMC has done to help keep my patients safe," Darwische said in a written statement.

    "While no process is perfect, we have a very reliable process with checks and balances so that any errors detected never reaches the patient," Brian Little, specialist in chief, DMC Orthopedics, said in a statement in response to Crain's inquiries.

    Officials from Tenet in Dallas did not provide executives to comment on this story.

    According to sources who requested anonymity, Elder, Kaki and several other principals and founding members of DMC's Cardio Team One were on the verge of resigning their positions early last week. They felt frustrated because they said DMC and Tenet have ignored serious quality issues, failed to take action against several substandard cardiologists and also have cut staffing to what they consider unsafe levels.

    The sources also said DMC has reduced the number of security guards, especially at night, and there is a lower nurse-to-patient ratio than two years ago. For example, DMC has only one scrub technician for cardiac surgery at Harper, Hutzel and Detroit Receiving hospitals. Technicians and nurses multitask now; besides caring for patients, they also answer phones, do patient transportation and clerk work because of staff cuts.

    DMC also has uses one "stat," or quick turnaround, lab for multiple hospitals, which causes delays in emergency lab results, the sources said.

    In a statement Friday, Tedeschi responded: "Making changes in physician leadership is never easy. We are focused on bringing world-class physician leaders to the DMC's cardiology program and an important part of what we're looking for is doctors who can uphold the culture that the DMC was founded on. The 11,000 men and women of the DMC are committed to providing safe, high quality care to the people of Detroit."

    Under the terms of a $513 million settlement with the U.S. Department of Justice in 2016, Tenet must comply with a corporate integrity agreement and report to the DOJ a variety of internal compliance issues.

    The settlement was based on alleged bribes, kickbacks and health care fraud of Medicaid patients at Tenet's former Atlanta subsidiaries.

    A profit center Since the mid-2000s, DMC's cardiology program has been one of the hospital's largest profit centers, according to DMC sources and data provided by American Hospital Directory of Louisville. Those profit margins have declined in recent years, hospital insiders say.

    One of the reasons DMC's cardiology program became so profitable is that it moved from being an academic-based program to private practice under former CEO Mike Duggan, now mayor of Detroit.

    Sources familiar with the history of Wayne State's cardiology department told Crain's the medical school had more than 15 practicing cardiologists at DMC in the mid-2000s. Now it has five, and they are limited in what procedures they can do at DMC.

    Kim Williams Sr., M.D., former director of Wayne State's cardiology department from 2010-2013, confirmed there was a transition of academic cardiologists to private cardiologists over a 10-year period. He said the numbers of Wayne State cardiologists dropped from 10 to four under his watch.

    "Private practices were put in charge by DMC for most of the services," said Williams, who now is head of cardiology at Rush University Medical Center in Chicago. "That meant (private doctors were) paid directors and had control of the schedule. We had less people, and that enabled the hospital to generate more revenue. ... The last time I heard, about 40 percent of the income from the hospital system was coming from cardiology services."

    When Schreiber was hired in 2004 from Beaumont Hospital by Duggan, DMC's cardiology program was in "total disarray and providing mediocre service to the inner-city residents of Detroit," Schreiber said in a statement to Crain's. He quickly instituted quality controls, increased staffing and began recruiting private cardiologists to boost volume, sources said.

    Schreiber and DMC were rewarded with great success, improving outcomes and generating high profits for DMC, which nearly went bankrupt in 2004, and now sports one of the best "door-to-balloon" treatment times in the nation at about 50 minutes. The faster emergency patients can be sent to the cardiac cath lab to receive angioplasty or other vascular or heart procedures, the greater chances they have to save tissue and live.

    The Journal of the American Heart Association published a study recently that concluded that the probability for survival of cardiac arrest patients in the city of Detroit has been improved by 70 percent since Cardio Team One was created, Schreiber said in a statement.

    But in recent years, two sources told Crain's, Schreiber became increasingly concerned that hospital administrators were more interested in boosting revenue and profits and not as concerned with maintaining quality. For example, when Schreiber wanted to remove bad cardiologists from the procedure or on-call rotation, management objected because some of those doctors were high producers and given more time for patients, sources said.

    Nationally, while once a highly profitable service line at hospitals, cardiology has been facing declining volume, declining reimbursement and declining profit margins. Moreover, reimbursement per cardiac catheterization procedure is down, primarily driven by lower payments from Medicare, which represents more than half of the annual 600,000 procedures each year.

    Despite an aging population, Williams said the decline in catheterization procedures have occurred because of improved stent technology and the use of beta blockers and other medical treatments of patients. A stent is wire mesh device placed in an artery during an angioplasty to widen it to improve blood flow.

    "Everything has been done to reduce repeat procedures," Williams said.

    For example, he said cardiologists once needed 75 interventions to maintain competency for board certification. "There is a movement to lower it to 50 because there aren't as many to do."

    But there has been much pressure placed on cardiologists at DMC to increase profitable cardiac catheterization volume, sources said, adding that cardiology revenue and profits have dropped more at DMC than at other competing hospitals.

    Cardiologist Joel Kahn, who was recruited by Duggan and Schreiber in 2011 to be DMC's corporate director of preventive cardiology, told Crain's that DMC cardiologists who did not meet weekly procedure quotas were subject to pressure and ridicule.

    "During my time at DMC (until 2013) I experienced a culture of numbers and productivity that was stronger than culture of quality and patient care," Kahn said.

    Kahn said he is not surprised that Schreiber, while responsible for building volume and quality in the low-performing cardiology program, ultimately objected to staffing cutbacks. Kahn said he has known Schreiber since the late 1980s, when they practiced together at Beaumont Hospital in Royal Oak.

    At DMC, "there were weekly reviews of targets for production," said Kahn, noting that every Wednesday morning Schreiber and Duggan held meetings with 70 or more doctors and executives to talk about production. "(Administrators) made it very clear only acceptable behavior was to make or exceed numbers — at any cost."

    In 2013, Kahn said one cardiology meeting he attended at Harper Hospital was especially memorable. He said DMC administrators were upset that weekly angioplasty volume was down by 15 procedures to 152.

    "What should be tracked is how many procedures met guideline indications and how many violated them," Kahn said. Focusing on production only "is a sticky issue as meeting a quota or goal by selecting people for dangerous procedures that have other options is abusive and injures some people."

    A DMC cardiologist, who asked for anonymity, said cardiac catheterization procedures have dropped at DMC for several years. For example, procedures at Sinai-Grace Hospital have declined by 90 percent from about 40 cases per week to about seven, primarily because the DOJ investigation. The source said Harper cardiac cath procedures have slowed and are about 10 percent lower than they were several years ago.

    Overall, however, cardiac catheterization inpatient and outpatient charges at Harper and Sinai-Grace hospitals have steadily increased from $134.2 million in 2015, $140.2 million in 2016 and $145.3 million in 2017, according to Medicare cost reports filed by the hospitals and provided to Crain's by American Hospital Directory.

    However, Sinai-Grace catheterization charges declined from $32.3 million in 2015 to $27.5 million in 2016 and stabilized in 2017, AHD said.

    Another cardiologist, who also asked for anonymity, said patient outcomes also have declined because of an increase in unqualified cardiologists, nurses being responsible for a higher number of patients and support staff being cut or given multiple job assignments.

    On what might happen if procedure volume dropped that resulted in declining revenue and profitability, Kahn said: "I suspect that if numbers dropped, there would be pressure to do more procedures not based on national guidelines."

    Emails Crain's has obtained and reviewed between DMC and Tenet executives, along with emails written by DMC-based cardiologists, show there has been much disagreement about how to solve quality problems that have led to several patient deaths.

    Raid and investigation The DOJ investigation had widened this year from looking at various problems with DMC's cardiology program to the use of employed nurses to provide services to private practice doctors. Tenet disclosed the DOJ investigation in a federal securities filing in February, but it has declined interviews on the subject.

    Sources familiar with the case tell Crain's that the DOJ investigation began two summers ago with FBI agents raiding the Livonia and Detroit offices of cardiologist Delair Gardi, who practices at hospitals affiliated with DMC and St. Mary's Hospital in Livonia and is one of DMC's largest cardiovascular volume producers.

    FBI agents sought documents on Gardi and others in his practice. Three sources told Crain's that federal investigators seized boxes of documents at his two offices and also at St. Mary's Hospital and at DMC hospitals. Officials for DMC and St. Mary's declined comment.

    After this story was published Sunday, a Tenet spokesperson provided the following written statement: "The Department of Justice investigation of Dr. Gardi is unrelated to the Detroit Medical Center or Tenet."

    Gardi has been unavailable for comment the past month. Williams confirmed the civil lawsuit against Gardi, DMC and Tenet is still pending. However, he told Crain's in an email statement that the DOJ now is conducting a civil investigation into Gardi. He declined further comment.

    Crain's has also reviewed legal documents and emails related to a medical malpractice lawsuit filed in January 2017 against Gardi, two fellows, Tenet and DMC by the estate of Radieh Alsafi, who died after an angioplasty procedure performed by Gardi.

    Alsafi came to the Harper Hospital emergency department on July 20, 2014. Her symptoms improved with medication and she was transferred to the intensive care unit and later to a medical floor, according to the lawsuit.

    However, Alsafi refused to receive stents in an angioplasty procedure and wanted only medical management, according to nurses' notes, the lawsuit said. Several doctors and nurses examined her over the next few hours and noted no chest pain, no edema and no shortness of breath.

    Early on the morning of July 22, Gardi conducted a catheterization procedure on Alsafi. It was later found that a consent form signed by two nurses earlier that morning contained "language regarding stents." It is not clear, however, how the nurses knew Alsafi had changed her mind because Alsafi, who is from Iraq, didn't speak English and the nurses didn't speak Arabic. The catheterization procedure was conducted despite Alsafi's previous statements she didn't want stents, the lawsuit said.

    A few hours after the operation, Alsafi began experiencing problems. She died at 7:29 p.m.

    Williams said the charges leveled against Gardi in that lawsuit have been investigated by the DOJ.

    "That case has also been reviewed by numerous experts/cardiologists who supported the treatment provided to that patient by Dr. Gardi," Williams said in an email statement to Crain's. "After that thorough investigation, the Department of Justice declined to pursue the matter. As the numerous experts opined, the patient was very ill, with end-stage cancer and the treatment provided was appropriate."

    However, another cardiologist hired by Alsafi's estate found that the care provided by Gardi "deviated from the standard of care" in 18 ways, according David Koenisberg, M.D., a doctor licensed in Illinois, in a Jan. 1, 2017, affidavit.

    The Alsafi case also include court filings, dated Sept. 24, that confirm that a DOJ investigation is continuing. Two sources said the investigation is looking at whether testing and stenting procedures conducted by Gardi and some of his partners or associates and also at DMC and St. Mary's hospitals were unnecessary.

    Two sources told Crain's that the DOJ has investigated whether Gardi billed health insurance payers at 100 percent for services provided by nurse practitioners, when midlevel providers are only allowed to bill at 85 percent of a physician's rate, sources familiar with the case said. They said Gardi also allowed nurse practitioners to conduct services as a physician when he was out of the country.

    Williams declined to provide additional information to Crain's about the details the DOJ investigation into Gardi, who is still practicing at DMC.

    The DOJ investigation also is looking at whether administrators at DMC Sinai-Grace Hospitals made excessive payments to cardiologists to cover emergencies on a 24-hour basis. Two sources told Crain's that executives at Sinai-Grace paid cardiologists up to $3,000 a day to be at the hospital for the 24-hour shift, but many times doctors went home during the night and were not immediately available for emergencies.

    Most hospitals, including Beaumont and DMC, pay specialists like cardiologists, thoracic surgeons and neurologists $1,500 per day to be on call, meaning they need to be close enough to the hospital to respond within 30 minutes.

    However, DMC's Cardio Team One promises in-house cardiologists on a 24-hour basis.

    One DMC doctor, who asked for anonymity, said Tenet informed DMC to stop paying the $3,000 and allow doctors them to go home. The practice has stopped at Sinai-Grace, which has led to a dramatic reduction in procedures, two sources said. In a compliance review of time sheets, DMC found only two of 10 cardiologists were staying the full 24 hours as required by the payments.

    For example, two sources said one patient had a heart attack in Sinai-Grace emergency department. The ER physician called the in-house cardiologist and he did not show up quickly enough and the patient died.

    DMC reaction to DOJ, anonymous complaints Two sources also told Crain's that DMC's advisory board has met at least once in the past two months with Tenet board members and executives to discuss the investigation, cost-cutting at DMC, anonymous quality complaints and the compliance investigation.

    A DMC source told Crain's that Tenet also recently has taken serious anonymous complaints filed under the anonymous MIDAS internal complaint system. This led, in part, to DMC's contract terminations of the three cardiologists and the resignation of Schreiber. Others say the complaints were an excuse for the terminations, as it is common for hospital workers to complain about one another.

    Earlier this year, Tenet hired Latham and Watkins LLC, a Los Angeles-based law firm, to review employee and doctor complaints, compliance and quality-related issues at several DMC hospitals, according to several reliable sources familiar with the investigation. A spokesman for Latham and Watkins was unavailable for comment.

    The Latham and Watkins lawyer also has been speaking the past several months with doctors, nurses and others about the complaints and issues related to the federal investigation, three sources said.

    "DMC's cardiology program faces problems" originally appeared in Crain's Detroit Business.


    Google Opens Cloud Dataflow To All Developers, Launches European Zone For BigQuery | killexams.com real questions and Pass4sure dumps

    Google is launching a couple of updates to its cloud-based big data products at the Hadoop Summit in Brussels today. These include the launch of the open beta of Cloud Dataflow, Google’s new service for processing huge amounts of data, as well as an update to BigQuery, which will make the company’s bid data database service available in Google’s European data centers and introduces row-level permissions.

    Cloud Dataflow made its debut during Google’s annual developer conference last June. Until today, the service remained in private alpha, however. Now, any developer who is interested in giving the service a try can start using it, but because this is still a beta product, there is no SLA available yet.

    As Google’s director of product management Tom Kershaw tells me, Google’s philosophy with regard to big data is to take away as much complexity as possible. What the industry has suffered from in the past is that big data is very difficult to work with,” he noted. Businesses are starting to understand that there is a lot of value in all the data they produce, but Kershaw argues that developers are still having a hard time using the tools they need to work with all of this information. “This has to be democratized,” he said. “We’ve taken our big data portfolio and made it much easier to use.”

    Cloud Dataflow, which can process data both as streams and in batches, automatically scales according to the developer’s needs, for example (though it’s worth noting that Google plans to implement some controls so cost can’t get out of hand when a developer pushes more data through the system than necessary). Developers write their Cloud Dataflow code once and then Google handles all the infrastructure for them.

    While Cloud Dataflow is new, BigQuery has now been around since 2010. Starting today, however, its users can also host their data in Google’s European data centers. Kershaw tells me a lot of Google’s customers have been asking for this. Given the concerns around data sovereignty in Europe, it’s actually surprising that Google didn’t roll this feature out earlier.

    The other update to BigQuery is that the database now supports row-level permissions. That may sound like a minor update, but Kershaw rightly argues that it’s actually a very important new feature.

    In many companies, different departments now need to access the same data, but while the marketing department may need to work with some tables and tables in your database, for example, you may not want to give them access to sensitive business data. Today, this typically means IT will make a copy of the data and share this copy with another department. Once you’ve made this copy, though, the different datasets are out of sync. “When we create datasets that are copied, we create outdated data — and wrong data,” Kershaw said. “You end up running analytics on this data and it’s wrong and old.” With row-level permissions, the administrators can now ensure that different departments only get access to the information they need without the drawbacks of making copies.

    With this update, BigQuery can now also ingest up to 100,000 rows per second and table. That’s a lot of information, but not an unusual number when you analyze huge log files — something that’s become a major use case for BigQuery, Kershaw tells me.

    Google’s big data lineup currently consists of BigQuery, Cloud Dataflow and the messaging service Cloud Pub/Sub. Given Google’s interest and in-house expertise in this area, chances are we will see more updates and new tools for working with large amounts of data at Google I/O next month.


    Google launches Cloud Dataflow service in beta, adds row permissions in BigQuery | killexams.com real questions and Pass4sure dumps

    Google today is making one of its cloud services, the Cloud Dataflow data-processing system, available in beta for engineers to try out.

    Announced in June, Cloud Dataflow can handle batch and streaming workloads alike. It could come in handy for the dirty work of wrangling complex data — often referred to extract, transform, load (ETL) — before analysts can query it all.

    Google has been accepting applications for a private alpha of the service for the past few months, but now anyone can try it.

    “Today, nothing stands between you and the satisfaction of seeing your processing logic, applied in streaming or batch mode (your choice), via a fully managed processing service,” Google product manager William Vambenepe wrote in a blog post on the new feature. “Just write a program, submit it and Cloud Dataflow will do the rest. No clusters to manage, Cloud Dataflow will start the needed resources, autoscale them (within the bounds you choose) and terminate them as soon as the work is done.”

    Cloud Dataflow relies on Google Compute Engine for raw computing power, as well as Google Cloud Storage and BigQuery for storing and accessing data. In other words, it’s an abstraction of several components of the Google Cloud Platform, a portfolio of cloud infrastructure tools that competes with Microsoft Azure and Amazon Web Services, among others.

    Perhaps it’s not surprising that Amazon, the leader of the market, has also been building helpful abstractions of its underlying cloud-infrastructure services — Amazon’s Lambda event-driven computing service comes to mind. But Google is coming up quick, and Cloud Dataflow could be an appealing service for developers looking to build data-rich programs.

    Google has been preparing for this rollout. In December, Google issued an open-source Java software-development kit (SDK) for Cloud Dataflow. And in January the company announced that it was collaborating with Hadoop distribution vendor Cloudera to make the Dataflow programming model compatible with Spark.

    Also today, Google introduced new features for BigQuery, its managed data-analysis service. The service now lets users tack on permissions for access to specific rows of data in tables. Google has bumped up BigQuery’s default ingestion limit to 100,000 rows per second for each table. And it’s now possible for BigQuery users to isolate data in Google data centers in specific places around the world, including the company’s three zones in Europe.



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    Cisco 351-080 Exam (CCIE Data Center Written (Beta)) Detailed Information



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