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Radiofrequency ablation (RFA) of medium-sized (3–5 cm) hepatocellular carcinoma (HCC) is suboptimal. Switching monopolar RFA (SW-RFA) enlarges the ablative volume to better cover larger tumors. This study aims to compare the long-term outcomes of medium-sized HCC treated by either SW-RFA or single-monopolar RFA (S-RFA). We retrospectively reviewed 139 cases (147 medium-size HCC) between 2008 and 2014. Under propensity score matching, a total of 43 paired patients with medium-size HCC and balanced clinical variables treated by either SW-RFA or S-RFA were selected for comparison. SW-RFA showed a higher rate of achieving an adequate safety margin (p = 0.002). After a mean follow-up period of 40.4 months, SW-RFA produced significantly lower global RFA failure rates (p < 0.001) and better overall survival (p = 0.005) compared to S-RFA. SW-RFA was independently associated with a decreased risk of global RFA failure (hazard ratio [HR]: 0.136, 95% confidence interval [CI]: 0.030–0.607, p = 0.009) and improved overall survival (HR: 0.337, 95% CI: 0.152–0.747, p = 0.007). By last follow-up, the SW-RFA group maintained a superior tumor-free rate (p = 0.010) and fewer progressions to Barcelona Clinic Liver Cancer stage C (p = 0.011). Major complication rates were comparable in both groups (SW-RFA: 2.3% vs. S-RFA: 4.7%, p = 1.000). The switching multi-monopolar ablation technique could be beneficial for patients with medium-sized HCCs given sustained control of larger tumors with better overall survival. • Switching monopolar ablation could provide a sustained local tumor control and better overall survival than single-monopolar ablation for the medium-sized hepatocellular carcinoma. • Compared to single-monopolar ablation, switching monopolar ablation could create a larger homogeneous coagulation volume by using a shorter total ablation time to achieve a higher rate of adequate safety margin for a medium-sized HCC. • Patients with medium-sized HCC can be maintained at a higher rate of tumor-free status and at a lower risk of progression into BCLC stage C in the follow-up period after ablation by switching monopolar than by single-monopolar ablation.

Alpha-methylacyl-coenzyme A-racemase (AMACR), also known as p504s, is overexpressed in prostatic adenocarcinoma and is frequently used in combination with basal cell markers to aid in diagnosing difficult prostate adenocarcinoma cases. In this retrospective method comparison study, we examined the sensitivity and specificity of the ready-to-use anti-p504s (SP116) Rabbit Monoclonal Primary Antibody compared to the monoclonal rabbit anti-human AMACR clone 13H4 in prostatic adenocarcinoma samples. De-identified prostatic adenocarcinoma tissue samples were stained with either the SP116 or 13H4 antibody clone in combination with the VENTANA Basal Cell Cocktail (34βE12+p63) and scored as positive or negative for prostatic adenocarcinoma. The scoring pathologist was blinded to the known historical diagnosis of each sample. The scoring pathologist correctly diagnosed each sample regardless of which p504s clone was used. Both assays using either clone were 100% concordant in their sensitivity and specificity. This study demonstrates that the ready-to-use anti-p504s (SP116) Rabbit Monoclonal Primary Antibody is equivalent to clone 13H4 concentrate when used according to package insert instructions in combination with the VENTANA Basal Cell Cocktail (34βE12+p63) to aid pathologists in the diagnosis of prostatic adenocarcinoma.

Objectives The objectives of this study were to determine the primary technique effectiveness (PTE), to compare the complete response and local recurrence rates between conspicuous and inconspicuous tumors using single and switching electrodes of real-time virtual sonography (RVS)-assisted radiofrequency ablation (RFA) in conspicuous and inconspicuous hepatic tumors under conventional ultrasonography (US). Subjects and method We compared the complete ablation of inconspicuous tumors with and without anatomical landmark (N = 54) with conspicuous liver tumors (N = 272). Conventional US imaging was done initially, and then these images were fused with CT or MRI arterial-venous-wash-out cross-sectional studies and synchronized with real-time US images. Results RVS-assisted RFA was technically feasible in all patients. The PTE rate after the first ablation was 94% (245/261) for conspicuous tumors, 88% (7/8) in inconspicuous tumors with landmark, and 78% (36/46) in inconspicuous tumors without landmark. The complete response (p = 0.1912 vs. p = 0.4776) and local recurrence rate (p = 0.1557 vs. p = 0.7982) were comparable in conspicuous tumors of both HCC and liver metastasis group when single or multiple switching was used. The cumulative local recurrence in the conspicuous and inconspicuous tumors of the HCC group (p = 0.9999) was almost parallel after 12 (10% vs. 4%) and 24 (13% vs. 4%) months of follow-up. In the liver metastasis group, the cumulative local recurrence for conspicuous tumors (p = 0.9564) was nearly equal after 12 and 24 months of monitoring (24% vs. 27%) while no recurrence was incurred for the inconspicuous tumors. Conclusion RVS-assisted RFA is an effective tool for the treatment of conspicuous and inconspicuous HCC and hepatic metastasis.

To observe the time-effect relationship of moxibustion for primary dysmenorrhea (PD) due to stagnation and congelation of cold-damp, thus explore the optimal choice of moxibustion duration, and provide evidence for achieving satisfactory efficacy in moxibustion treatment. A total of 90 patients with PD due to stagnatin and congelation of cold-damp were divided into three groups by the random number table method, with 30 cases in each group. All the patients in the three groups were given moxibustion treatment at Guanyuan (CV 4), 20 min in group A, 40 min in group B and 60 min in group C. The changes in the pain measurement score in the three groups were observed after treatment. After treatment, there were significant differences in the clinical efficacy among the three groups (P

This brief presents an energy-efficient elliptic curve cryptography (ECC) processor for Internet of Things (IoT) security applications. The proposed processor supports dual-field computations, and employs various design techniques across the algorithm, architecture, and arithmetic circuit levels to minimize power and energy consumption. The proposed elliptic curve point multiplication (ECPM) algorithm employs signed binary representation (SBR) with the m-ary method to reduce both area and energy consumption, while avoiding attack from simple power analysis (SPA). In addition, the proposed hybrid modular arithmetic architecture effectively increases the hardware utilization to reduce both area and energy cost. Finally, the proposed processor uses an energy-efficient data flow to further minimize memory overhead for group operations. The proposed ECC processor achieves 51.6% and 50.5% lower energy consumption for each $GF(p)$ and $GF(2^{m})$ ECPM operation, respectively, when compared to state-of-the-art ECC designs.

Background Two types of screw trajectories are commonly used in lumbar surgery. Both traditional trajectory (TT) and cortical bone trajectory (CBT) were shown to provide equivalent pull-out strengths of a screw. CBT utilizing a laterally-directed trajectory engaging only cortical bone in the pedicle is widely used in minimal invasive spine posterior fusion surgery. It has been demonstrated that CBT exerts a lower likelihood of violating the facet joint, and superior pull-out strength than the TT screws, especially in osteoporotic vertebral body. No design yet to apply this trajectory to dynamic fixation. To evaluate kinetic and kinematic behavior in both static and dynamic CBT fixation a finite element study was designed. This study aimed to simulate the biomechanics of CBT-based dynamic system for an evaluation of CBT dynamization. Methods A validated nonlinearly lumbosacral finite-element model was used to simulate four variations of screw fixation. Responses of both implant (screw stress) and tissues (disc motion, disc stress, and facet force) at the upper adjacent (L3-L4) and fixed (L4-L5) segments were used as the evaluation indices. Flexion, extension, bending, and rotation of both TT and CBT screws were simulated in this study for comparison. Results The results showed that the TT static was the most effective stabilizer to the L4-L5 segment, followed by CBT static, TT dynamic, and the CBT dynamic, which was the least effective. Dynamization of the TT and CBT fixators decreased stability of the fixed segment and alleviate adjacent segment stress compensation. The 3.5-mm diameter CBT screw deteriorated stress distribution and rendered it vulnerable to bone-screw loosening and fatigue cracking. Conclusions Modeling the effects of TT and CBT fixation in a full lumbosacral model suggest that dynamic TT provide slightly superior stability compared with dynamic CBT especially in bending and rotation. In dynamic CBT design, large diameter screws might avoid issues with loosening and cracking.

Background & aims: Transarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC) patients. Variceal bleeding is a life-threatening complication and may alter the initial treatment plan. This study was aimed to elucidate the risk factors for variceal bleeding in HCC patients receiving TACE treatment. Methods: From 2005 to 2016, a total of 1233 treatment-naive HCC patients receiving first time TACE treatment in Chang Gung Memorial Hospital, Linkou medical center were recruited. Pre-TACE status including baseline characteristics, prior history of ascites, and parameters for liver function evaluation were analyzed. All the variables were compared between patients with and without variceal bleeding. Results: Among the 1233 patients, the median age was 63.7 (range 25.8–91.5) years old, and 73.5% were male. Variceal bleeding events were documented in 19 patients (1.5%) within 3 months post TACE treatment. Patients with younger age, cirrhosis, pre-treatment ascites and advanced fibrosis status (higher MELD score, CTP score, ALBI grade, FIB-4 and APRI score) were more likely to encounter post-treatment variceal bleeding. Multivariate Cox regression analysis revealed existence of ascites (adjusted HR: 4.859 (1.947–12.124), p = 0.001), and higher FIB-4 score (adjusted HR: 4.481 (1.796–11.179), p = 0.001) were the independent predictive factors for variceal bleeding. Patients with post-TACE variceal bleeding are more likely to encounter tumor progression (42.1% vs. 20.3%, p = 0.039) and mortality owing to GI bleeding (15.8% vs. 3%, p = 0.032). Conclusion: The incidence of post-TACE variceal bleeding was 1.5%. Patients with post-TACE variceal bleeding have poorer TACE treatment response. The pre-treatment ascites and FIB-4 score are the independent predictors for post-TACE variceal bleeding. Keywords: Ascites, Gastrointestinal bleeding, Mortality, Portal hypertension, Treatment response

The impact of prolonged post-ablation fever (PAF) defined as persistent fever > 24 h after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) had not been described before. This study aims to investigate the impact of prolonged PAF on early tumor recurrence in HCC patients after RFA. From 2013 to 2015, a total of 135 patients with HCC meeting Milan criteria and all the tumors having confirmed complete ablation after RFA were enrolled. Study endpoint was any HCC recurrence within 1 year after ablation. Cox regression analysis was applied for multivariate analysis to determine the independent predictors of 1-year tumor recurrence. Post-ablation fever occurred in 42 (31.1%) patients after RFA, while prolonged PAF was found in 22 (16.3%) patients. Fifty-eight (42.8%) patients occurred any tumor recurrence within 1 year after complete ablation. Patients with prolonged PAF had a significantly higher rate of HCC recurrence within 1 year (72.7% vs. 37.1%, p = 0.002) and had a significantly shorter time-to-recurrence interval (19.6 vs. 40.5 months, Log rank test, p = 0.002) than those who had no prolonged PAF. Multivariate analysis by Cox regression showed the previous HCC recurrence history (aHR: 1.792, p = 0.0284), baseline AFP > 20 ng/ml (aHR: 1.868, p = 0.0211) and prolonged PAF (aHR: 2.092, p = 0.0138) were associated with early recurrence. Prolonged PAF may associate with early HCC recurrence after complete ablation by RFA. Patients with prolonged PAF need to be more clinical attentions.

Background and aims Sorafenib is the first proved target therapy that shows significant survival benefit in advanced hepatocellular carcinoma. This study was aimed to investigate whether add-on sorafenib be beneficial for those experienced transarterial chemoembolization refractoriness. Methods From 2005 to 2016, a total of 656 treatment-naive hepatocellular carcinoma patients receiving transarterial chemoembolization treatment were recruited. Transarterial chemoembolization refractoriness was defined as progressive disease after two consecutive of transarterial chemoembolization treatment within 6 months. Patient's baseline characteristics, tumor burden, and parameters for liver function evaluation during treatment were analyzed. All the variables were compared between patients with and without transarterial chemoembolization refractoriness, as well as with and without add-on sorafenib. Results Among the 656 patients, the median age was 62.5 (range 27.3-91.5) years old, and 74.5% were male. Transarterial chemoembolization refractoriness events were documented in 202 patients (30.8%). After multivariate logistic regression analysis, tumor size ≧5 cm, baseline alpha-fetoprotein level ≧200 mg/dl, elevation of alpha-fetoprotein ≧20%, and elevation of Child-Turcotte-Pugh score ≧2 points after first transarterial chemoembolization were the independent predictive factors for transarterial chemoembolization refractoriness. Twenty-two patients (10.9%) received add-on sorafenib treatment and 146 (72.3%) patients continued transarterial chemoembolization treatment alone. After 1:2 propensity score matching, patients with add-on sorafenib therapy had significantly longer median overall survival than transarterial chemoembolization treatment alone (23.1 vs. 11.0 months, log-rank P = 0.001). Conclusion The tumor size, baseline alpha-fetoprotein, and elevation of alpha-fetoprotein and Child-Turcotte-Pugh score after first transarterial chemoembolization were the predictors for transarterial chemoembolization refractoriness. For patients with transarterial chemoembolization refractoriness, add-on sorafenib achieved better survival benefit than transarterial chemoembolization treatment alone.

Although targeted agents are recommended as the first-line treatments for advanced hepatocellular carcinoma (aHCC), systemic chemotherapy or hepatic arterial infusion chemotherapy (HAIC) are still being used in Asian countries. Beside economic considerations, it was found that targeted drugs could not significantly prolong overall survival in aHCC patients with distant metastasis. In addition, chemotherapy could achieve complete response in a small proportion of patients. Here, we aimed to investigate whether combination of three previously identified single nucleotide polymorphism (SNP) predictors (GALNT14-rs9679162, WWOX-rs13338697, and rs6025211) could guide our choice between systemic chemotherapy, HAIC, and targeted agents in aHCC patients. A cohort of 237 real-world aHCC patients (171 receiving systemic chemotherapy followed by various anticancer treatments including sorafenib; 66 receiving HAIC) were included for outcome analysis. By combining the three SNP markers with or without addition of two clinical criteria (tumor diameter 10.5 months). In conclusion, pre-test for the 3-SNP signature in aHCC patients could identify potential systemic chemotherapy or HAIC responders. Chemotherapy non-responders still benefited from subsequent sorafenib treatment. Accordingly, we propose a roadmap for aHCC patients when chemotherapy or HAIC is to be used.

Background An increasing number of studies support cancer stem cells as the reason for chemoresistance to sorafenib therapy in hepatocellular carcinoma (HCC), but the mechanism is still unclear. In this study, the mechanism of sorafenib resistance in cancer stem cells was examined by in vitro experiments and xenograft mouse model. Methods The expression of cancer stem cell markers in the Chang liver cell line and PLC/PRF/5 and HepG2 hepatoma cell lines were compared by immunoblot assay before and after sorafenib treatment in vitro. As a xenograft mouse model, subcutaneous injection of hepatoma cells followed by sorafenib therapy was performed in NU/NU mice. The effects of sorafenib therapy on tumor growth and cancer stem cell markers were studied. Angiogenesis associated with cancer stem cells was studied by immunoblot and immunohistochemistry assay. Results The expression of cancer stem cell markers was higher in PLC/PRF/5 and HepG2 cells than Chang liver cells, indicating that these hepatoma cells had more stemness-related characteristics. The cancer stem cell markers were upregulated in the hepatoma cell lines following sorafenib treatment in vitro. In the xenograft model, tumors from PLC/PRF/5 and HepG2 cells with high E-cadherin expression were more resistance to sorafenib therapy. However, the expression of cancer stem cell markers was not significantly different after sorafenib therapy in these tumors. Furthermore, we found that sorafenib therapy induced angiogenesis within tumors from high E-cadherin expressing hepatoma cells. Conclusion The mechanism of chemoresistance in sorafenib therapy in HCC may be the tumor angiogenesis associated with high E-cadherin expression in cancer stem cells.

The intending island service restoration method is one of the core technologies of self-healing control for smart distribution systems, which aims to maximize the restoration of the out-of-service loads in the out-of-service area without faults quickly. For this reason, a topology-weighted directional traversal intending island recovery method considering the uncertainty of distributed generation sources is proposed. First, divide the network level of the power-loss feeder and calculate the interval power flow of the feeder before the fault, and obtain the power flow direction when the active and reactive power of the faulted branch is the smallest so as to determine whether the distributed generation supply in the non-faulty power-loss area can restore all load power supply. If not, to determine the island recovery plan, continue to compare the distributed generation supply and the load capacity at all levels, and give priority to recovering loads with higher importance levels and smaller network levels. The traversal of the topological authority and direction effectively reduces the island recovery time and can make full use of the distributed generation output to maximize the recovery of the non-faulty power-loss area. Taking the PG&E 69-node system as an example and using the BFGS trust region algorithm to calculate the island power flow without unbalanced nodes for verification, the results show that this method consumes less time and can restore more load power supply than the existing island recovery method, which verifies the method’s effectiveness and reasonability.

The objective of this study is to identify the attractive quality factors affecting MOBA game design, thus meeting consumers’ requirements and effectively improving their satisfaction. The factor analysis was carried out based on the results of 116 subjects’ evaluation of various quality attributes. According to the principal components analysis, the coefficient values of gameplay factor, usability factor, sociability factor, and sensuality factor were 0.302, 0.347, 0.442, and 0.345 respectively, and had a positive effect on satisfaction. Among these factors, sociability factor had slightly higher satisfaction evaluation than other factors. With Arena of Valor as the object of research, the application feasibility of the study was explored and verified by case study.

Background: Secondary prevention of hepatocellular carcinoma (HCC) among patients with chronic hepatitis C (CHC) who achieve sustained virologic response (SVR) with interferon-based therapy has been proved effective. However, tertiary prevention with PegIFN/RBV therapy of HCC recurrence seems limited effect in CHC-HCC patients post curative therapies. This study aims to investigate the timing and impact of PegIFN/RBV treatment on prevention of HCC recurrence in patients after RFA treatment. Methods: From 2013 to 2016, a total of 137 CHC-HCC patients from a 508 patient based cohort receiving complete RFA treatment in Chang Gung Memorial Hospital, Linkou Medical Center were retrospectively recruited. Pre-RFA patient demographics were analyzed by cox regression analysis for prediction on tumor recurrence. Statistics analysis was performed with SPSS V.20 (IBM, USA). Results: The mean age of the 137 patients were 69.6 year-old and 71.5% of patients were cirrhotic. After propensity score matching, one hundred and two patients were enrolled into the analysis. Fifty-one patients (50%) received PegIFN/RBV therapy and twenty-seven patients (52.9%) achieved SVR. Patients who could achieve SVR had lower tumor recurrence rate than non-SVR and untreated groups (29.6% vs. 66.7% vs. 49.0%, P = 0.030). The effect is more prominent in those achieve SVR prior to compared with after RFA despite not reach statistically significant (26.1% vs. 50.0%, P = 0.334). Conclusion: Timely treatment with SVR achievement has the lowest tumor recurrence rate in CHC-HCC patients. Secondary prevention might be even more important than tertiary prevention in CHC patients, especially regarding prevention of post RFA HCC recurrence. Keywords: Radiofrequency ablation, Haptocellular carcinoma, Peginterferon and ribavirin, Prognosis

Background while both negative and positive impacts of caregiving on health have been reported, findings regarding caregiver’s mortality may be biased by the lack of consideration of changes in their health and caregiving status during follow-up. This study examines the impact of caregiving on the risk of death in older men, allowing for caregiving-transition by individuals and adjusting for changes over time in their health status. Methods data from 1639 men age ≥70 years old from the Concord Health and Ageing in Men Project (CHAMP) were collected between baseline (2005–07), 2-year and 5-year follow-up and linked to death records up to 30 September 2015. A time-varying Cox proportional hazards model was used to examine the risk of death from caregiving between 2005 and 2015, adjusting for baseline education, history of myocardial infarction, congestive heart failure, and risk factors which may change over time (age, income, self-rated overall health, number of morbidities, physical disability, depression and anxiety). Results the average follow-up was 7.39 years (SD = 2.95) with 495 deaths observed. There was no significant difference in all-cause mortality between caregivers and non-caregivers in the multivariable model (HR: 0.95, 95% CI: 0.67–1.32, P = 0.73). Conclusions this study addressed the dynamic caregiving role and covariates which has been rarely considered in the literature. While there is concern that when older people take on a caring role their health suffers, we found no difference in mortality between older male caregivers and non-caregivers when we accounted for transitions in their caregiving status. NHMRC and Ageing and Alzheimer’s Institute, Australia

To investigate the outcomes of radiofrequency ablation (RFA) following artificial ascites (AA) and artificial pleural effusion (AP) creation for hepatocellular carcinoma (HCC) in high-risk locations. Eligible patients were divided into 2 study periods (non-AAAP and AAAP groups) with AAAP performed in the latter period. Local tumor progression, primary technique effectiveness and complications were compared between patients with and without AAAP. Cumulative probability of local tumor progression and overall survival were estimated with Kaplan–Meier curves. One hundred thirty-eight patients with 195 tumors were evaluated. AAAP was performed in 48 patients with 76 tumors. Local tumor progression rates at 12 and 24 months were 9.3% and 22.2% in the non-AAAP group versus 5.5% and 9% in the AAAP group (p

Background and Aim Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) leads to a worse prognosis. We aimed to develop a nomogram based on noninvasive pretreatment clinical data to predict EHM of HCC sooner. Methods Three cohorts containing 1820, 479, and 988 HCC patients were enrolled from three hospitals in different regions in Taiwan and served as the training and validation cohorts. Pretreatment clinical data were analyzed by Cox regression modeling for independent risk factors of EHM. Results Platelet count ≥ 200 × 103/μL, serum alfa-fetoprotein ≥ 100 ng/dL, tumor size ≥ 3 cm, tumor number > 1, and macrovascular invasion were independent risk factors for EHM and were used to develop a nomogram. This nomogram had concordance indices of 0.733 (95% confidence interval [CI]: 0.688-0.778) and 0.739 (95% CI: 0.692-0.787) for the prediction of EHM during a 5-year follow-up duration in the training and validation cohorts, respectively. A nomogram score > 61 implied a high risk of EHM (hazard ratio [HR] = 3.83; 95% CI: 2.77-5.31, P

The sequencing of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR mutation-positive (EGFRm+) non-small cell lung cancer (NSCLC) remains a matter of controversy. This cohort study analyzed the overall survival (OS) and progression-free survival (PFS) of afatinib compared with erlotinib and gefitinib first-line. EGFRm+, advanced NSCLC patients treated with either afatinib, erlotinib or gefitinib were retrospectively analyzed. A total of 107 patients were included. There was no statistically significant difference in PFS among the 3 groups. In the ≥ 60 years age group, the afatinib group had longer survival compared to the gefitinib group (p = 0.01). Median OS were 19.1, 22.9, and 35.6 months for gefitinib, erlotinib, and afatinib groups, respectively, with statistical significance between the gefitinib and afatinib groups (p = 0.009). Patients on afatinib also had longer median OS than erlotinib and gefitinib pooled together (35.5 versus 21.4 months; hazard ratio = 0.54, p = 0.016), despite similar median PFS. In conclusion, afatinib is a better choice compared to gefitinib or erlotinib for EGFRm+ patients. The OS obtained with afatinib is just 3 months shorter than osimertinib in the FLAURA trial. Direct comparison studies with osimertinib are still needed to determine optimal sequencing.

Due to the emergence of AMD GPUs and their adoption in upcoming exascale systems (e.g. Frontier), it is pertinent to have scientific applications and communication middlewares ported and optimized for these systems. Radeon Open Compute (ROCm) platform is an open-source suite of libraries tailored towards writing high-performance software for AMD GPUs. GPU-aware MPI, has been the de-facto standard for accelerating HPC applications on GPU clusters. The state-of-the-art GPU-aware MPI libraries have evolved over the years to support NVIDIA CUDA platforms. Due to the recent emergence of AMD GPUs, it is equally important to add support for AMD ROCm platforms. Existing MPI libraries do not have native support for ROCm-aware communication. In this paper, we take up the challenge of designing a ROCm-aware MPI runtime within the MVAPICH2-GDR library. We design an abstract communication layer to interface with CUDA and ROCm runtimes. We exploit hardware features such as PeerDirect, ROCm IPC, and large-BAR mapped memory to orchestrate efficient GPU-based communication. We further augment these mechanisms by designing software-based schemes yielding optimized communication performance. We evaluate the performance of MPI-level point-to-point and collective operations with our proposed ROCm-aware MPI Library and Open MPI with UCX on a cluster of AMD GPUs. We demonstrate 3–6\(\times \) and 2\(\times \) higher bandwidth for intra- and inter-node communication, respectively. With the rocHPCG application, we demonstrate approximately 2.2\(\times \) higher GFLOPs/s. To the best of our knowledge, this is the first research work that studies the tradeoffs involved in designing a ROCm-aware MPI library for AMD GPUs.

A 63-year-old female patient with a history of pulmonary heart disease underwent radiofrequency ablation because of a persistent atrial flutter. Endocardial mapping with the carto3 system confirmed atrial flutter counterclockwise reentry around the tricuspid annulus. Routine ablation of the cavo-tricuspid isthmus line to bi-directional block was performed. However, tachycardia with the same cycle length was induced again. After remapping, the tachycardia was confirmed to be focal atrial tachycardia located in the crista terminalis. After ablation, the tachycardia was terminated and could not be induced again.

Background: Taiwan medical centers mainly use "Central Pharmacy" to carry out pharmaceutical operations and human resources management. The pharmacy is a 24-hour medication supply center for all units in the Hospital. Therefore, how to make the pharmacy run continuously in the potential impact of COVID-19 pandemic is an important issue in the epidemic prevention of the medical center. The purpose of this study is to design to reduce the incidence of cross or cluster infection in the event of nosocomial infection and to maintain the continuous operation of pharmaceutical service.Methods: The planning of "isolation and triage" of pharmaceutical operations is based on the epidemic level of COVID-19, the closing situation of outpatient service, the number of outpatients receiving medicine service and the number of inpatient beds.Results: After the overall planning, in the case of the low epidemic level (level A1), the emergency pharmacy took advance deployment, and fixed personnel was assigned to work in fixed location in the isolation, while other units started the isolation mode in the case of the moderate epidemic level (level B). Grouping mode was added for the severe epidemic level (level C). Different management measures should be planned according to the different level of risk area evaluated by the infection control center.Conclusions: In this study, the risk reduction management mechanism of "isolation and triage" was effectively used to make proper manpower allocation and work planning for all pharmaceutical service in Hospital.

In recent years, Artificial Intelligence (AI) has revolutionized almost every field – from automotive industry to electrical industry, continuously affecting the dynamics of society and the lives of consumers. Among the countless applications of AI, AI at the edge provides the ideal solution for specific workload acceleration. Despite the development of various techniques for surveillance in maritime scenarios, automatic maritime vehicle classification of visual surveillance remains a challenge owing to the small dataset, as well as complex, unconstrained, and diverse nature of such scenarios. To date, only a few studies have investigated edge computing in maritime vehicle classification with edge device. In this paper, data augmentation is applied to deal with the small dataset problem because of a lack of images of military ships. Furthermore, the implementation of deep-learning-based edge computing in maritime vehicle classification through the use of NVIDIA Jetson Nano is proposed.