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Gliomas constitute a diverse and complex array of tumors within the central nervous system (CNS), characterized by a wide range of prognostic outcomes and responses to therapeutic interventions. This literature review endeavors to conduct a thorough investigation of gliomas, with a particular emphasis on glioblastoma (GBM), beginning with their classification and epidemiological characteristics, evaluating their relative importance within the CNS tumor spectrum. We examine the immunological context of gliomas, unveiling the intricate immune environment and its ramifications for disease progression and therapeutic strategies. Moreover, we accentuate critical developments in understanding tumor behavior, focusing on recent research breakthroughs in treatment responses and the elucidation of cellular signaling pathways. Analyzing the most novel transcriptomic studies, we investigate the variations in gene expression patterns in glioma cells, assessing the prognostic and therapeutic implications of these genetic alterations. Furthermore, the role of epigenetic modifications in the pathogenesis of gliomas is underscored, suggesting that such changes are fundamental to tumor evolution and possible therapeutic advancements. In the end, this comparative oncological analysis situates GBM within the wider context of neoplasms, delineating both distinct and shared characteristics with other types of tumors.

Fetal growth restriction (FGR) is a complication diagnosed in about 10% of pregnancies and is associated with significant perinatal mortality and morbidity. Both the diagnosis and the correct management of cases of intrauterine growth restriction remain a challenge of modern obstetrics. A normal placental development is essential for a proper intrauterine physical and neurological growth of the fetus throughout pregnancy. Various pathophysiological situations may reflect in abnormal placental development linked with severe pregnancy disorders. In this paper we aim to exemplify sonographic aspects in various placental pathology associated with FGR along with the recommended management. Placental insufficiency is the most common risk factor for FGR and it cannot be directly measured and objectified, remaining a diagnostic of exclusion. The risk for perinatal adverse outcomes in placenta accreta spectrum cases is increased through the pathological implantation especially in depth. In pregnancies complicated with placental insufficiency, secondary macroscopic lesions can be noted, as parabasal and intervillous thrombosis, hematomas, extensive fibrin deposits and infarcts areas. Even if, over time, multiple studies have targeted methods of preventing intrauterine growth restriction through actions on the mother, the effectiveness of no treatment has been demonstrated.

Abstract SiGeSn nanocrystals (NCs) in oxides are of considerable interest for photo-effect applications due to the fine-tuning of the optical bandgap by quantum confinement in NCs. We present a detailed study regarding the silicon germanium tin (SiGeSn) NCs embedded in a nanocrystalline hafnium oxide (HfO2) matrix fabricated by using magnetron co-sputtering deposition at room temperature and rapid thermal annealing (RTA). The NCs were formed at temperatures in the range of 500–800 °C. RTA was performed to obtain SiGeSn NCs with surfaces passivated by the embedding HfO2 matrix. The formation of NCs and β-Sn segregation were discussed in relation to the deposition and processing conditions by employing HRTEM, XRD and Raman spectroscopy studies. The spectral photosensitivity exhibited up to 2000 nm in short-wavelength infrared (SWIR) depending on the Sn composition was obtained. Comparing to similar results on GeSn NCs in SiO2 matrix, the addition of Si offers a better thermal stability of SiGeSn NCs, while the use of HfO2 matrix results in better passivation of NCs increasing the SWIR photosensitivity at room temperature. These results suggest that SiGeSn NCs embedded in an HfO2 matrix are a promising material for SWIR optoelectronic devices.

This paper explores the digital landscape shaped by tech giants Google, Meta (formerly Facebook), and TikTok, emphasizing their influence on information sharing, communication, and entertainment. A case study on Luxury Anis Srl, an e-commerce company, illustrates its strategic use of Google Ads, Meta Ads, and TikTok Ads from 2021 to 2023. The study delves into campaign types and their evolution, focusing on the pivotal Performance Max campaign. Key performance metrics, including Click-Through Rate (CTR), Conversion Rate, Cost Per Click (CPC), and Return on Investment (ROI), are analyzed. The study concludes with insights for future campaigns, emphasizing the importance of continual evaluation, adaptation, and strategic planning in the ever-evolving realm of digital advertising. The Luxury Anis case study showcases the significance of adeptly utilizing specific tools and understanding market dynamics for successful outcomes in digital advertising.

We present a Vehicle Model (VM) that has 17 degrees of freedom and includes nonlinear tire and powertrain subsystems. Implemented as a relatively small piece of C++ code, the model runs vehicle dynamics 2000 times faster than real time at a simulation time step of $1 \times 10^{-3}, \text {s}$ on a single core of a commodity CPU. When executed on the GPU, one can perform 300000 vehicle simulations in real-time. These properties make the model a good candidate for reinforcement learning, model predictive control, model predictive path integral control, path planning, state estimation, and traffic simulation tasks. The model is expressive in that it can capture the dynamics of vastly different vehicles. This is demonstrated by first calibrating the model to mimic the dynamics of a 1/ $6^{th}$ scale vehicle called the Autonomy Research Testbed (ART) vehicle, which has a mass of approximately 5.8 kg. Subsequently, the model is calibrated to mimic the dynamics of a heavy-duty High Mobility Multipurpose Wheeled Vehicle (HMMWV), which has a mass of 2097 kg. The Bayesian calibration process discussed can $(i)$ handle real-life measurement noise, and $(ii)$ provide model parameter probability distributions. The vehicle model, which is open source and freely available in a public repository, can also be imported into Python owing to SWIG wrapping.

Abstract Background The Kleihauer–Betke (KB) test allows the detection of fetal red blood cells (containing fetal hemoglobin, HbF) in the maternal blood to identify and quantify potential fetal-maternal hemorrhages. In certain cases, detecting fetal red blood cells with conventional staining is difficult. False-positive results or overestimation of the quantity of fetal red blood cells may occur in cases of maternal hemoglobinopathy. In this study, we developed a new staining protocol to facilitate the reading of difficult smears and improve the precision of the quantification of fetal red blood cells; we also analyzed the performance of this new method. This study assessed blood samples with and without hemoglobin abnormalities, which present difficulties when interpreting the KB test. Methods The new staining formula is based on an improved elution technique and the use of a different stain instead of hematoxylin. To test this staining method, 16 samples from patients with abnormal hemoglobin electrophoresis and 14 samples from patients with normal hemoglobin electrophoresis were analyzed using the KB test with the classical staining method and the new staining method. In addition, a second series was prepared using the same samples spiked with fetal red blood cells from newborn blood, to compare the accuracy of the two methods in identifying fetal red blood cells. Results In the 60 slides analyzed with both staining methods, we found that the new technique improved the accuracy from 78 to 85%; lowered the coefficient of variation between the operators, which decreased from 20.7% to 12.7%; increased the specificity in our population from 56 to 70%; and decreased the number of false-positive cases by 30%. Conclusions We successfully developed a new staining technique that facilitates the reading of difficult slides and improves the specificity of the detection of fetal red blood cells. This technique is recommended as a secondary method to use before sending the sample for additional exploration.

Abstract Climate policymakers across the world seek inputs from the research community to determine appropriate policies to reduce greenhouse gas emissions. However, the reports of the Intergovernmental Panel on Climate Change (IPCC), which perform the largest available analytical exercise in this area, offer scarce analytics on climate policy design. Here, we explore how, despite its ‘neutral, policy-relevant but not policy-prescriptive’ principle, the IPCC’s analytical scenario process in Working Group III on Mitigation has adopted an implicitly prescriptive policy position in favour of carbon pricing. Drawing on the example of alternative climate-economic modelling using the E3ME-FTT framework, we explore a pathway for the IPCC process that could cater for diverse ranges of more realistic granular policies. We conclude that, to become truly policy-relevant, the IPCC’s climate mitigation work is in urgent need of reform to provide more effective support for policy design.

Background. The management of a recurrent inguinal hernia varies depending on multiple factors. In the case of recurrent inguinal hernias after open anterior repair, the laparoscopic approach is recommended. TEP and TAPP procedures are considered to have similar results. The purpose of the study is to evaluate on our sample if there are differences between primary inguinal hernia cases and recurrent hernia after laparoscopic TAPP and TEP procedures. Materials and Methods. We retrospectively reviewed the medical records of 300 patients who underwent laparoscopic inguinal hernia repairs at our hospital from March 2013 to March 2023. Results. Of the 300 patients, 39 of them (13%) had recurrent hernias after open anterior procedures. The mean age of patients with recurrent hernias was 56.82 years, compared to 50.47 years in those with primary hernias. In 27 cases we used the TAPP approach (69%), while in the remaining 12 cases the TEP approach (31%). Operative time for recurrent hernias was 72.69 minutes as opposed to 58.49 minutes for primary hernias. The percentage of peritoneal tears was higher for recurrent hernias (38%) than for primary hernias (18%). Conclusions. Surgery for inguinal hernia recurrence, is often more complex and time-consuming than for a primary hernia. However, postoperative results are favorable, with a low complication rate. Out of the two minimally invasive approach options, TAPP is our choice, especially due to the increased incidence of peritoneal tears.

Obesity is an important condition affecting the quality of life of numerous patients and increasing their associated risk for multiple diseases, including tumors and immune-mediated disorders. Inflammation appears to play a major role in the development of obesity and represents a central point for the activity of cellular and humoral components in the adipose tissue. Macrophages play a key role as the main cellular component of the adipose tissue regulating the chronic inflammation and modulating the secretion and differentiation of various pro- and anti-inflammatory cytokines. Inflammation also involves a series of signaling pathways that might represent the focus for new therapies and interventions. Weight loss is essential in decreasing cardiometabolic risks and the degree of associated inflammation; however, the latter can persist for long after the excess weight is lost, and can involve changes in macrophage phenotypes that can ensure the metabolic adjustment. A clear understanding of the pathophysiological processes in the adipose tissue and the interplay between obesity and chronic inflammation can lead to a better understanding of the development of comorbidities and may ensure future targets for the treatment of obesity.

Aging is accompanied by a loss of muscle mass and function, termed sarcopenia, which causes numerous morbidities and economic burdens in human populations. Mechanisms implicated in age-related sarcopenia or frailty include inflammation, muscle stem cell depletion, mitochondrial dysfunction, and loss of motor neurons, but whether there are key drivers of sarcopenia are not yet known. To gain deeper insights into age-related muscle loss, we performed transcriptome profiling on lower limb muscle biopsies from 72 young, elderly, and frail human subjects using bulk RNA-seq (N = 72) and single-nuclei RNA-seq (N = 17). This combined approach revealed changes in gene expression that occur with age and frailty in multiple cell types comprising mature skeletal muscle. Notably, we found increased expression of the genes MYH8 and PDK4, and decreased expression of the gene IGFN1, in aged muscle. We validated several key genes changes in fixed human muscle tissue using digital spatial profiling. We also identified a small population of nuclei that express CDKN1A, present only in aged samples, consistent with p21cip1-driven senescence in this subpopulation. Overall, our findings identify unique cellular subpopulations in aged and sarcopenic skeletal muscle, which will facilitate the development of new therapeutic strategies to combat age-related frailty.

We present Atos, a dynamic scheduling framework for multi-node-GPU systems that supports PGAS-style lightweight one-sided memory operations within and between nodes. Atos's lightweight GPU-to-GPU communication enables latency hiding and can smooth the interconnection usage for bisection-limited problems. These benefits are significant for dynamic, irregular applications that often involve fine-grained communication at unpredictable times and without predetermined patterns. Some principles for high performance: (1) do not involve the CPU in the communication control path; (2) allow GPU communication within kernels, addressing memory consistency directly rather than relying on synchronization with the CPU; (3) perform dynamic communication aggregation when interconnections have limited bandwidth. By lowering the overhead of communication and allowing it within GPU kernels, we support large, high-utilization GPU kernels but with more frequent communication. We evaluate Atos on two irregular problems: Breadth-First-Search and PageRank. Atos outperforms the state-of-the-art graph libraries Gunrock, Groute and Galois on both single-node-multi-GPU and multi-node-GPU settings.

BACKGROUND: Selected molecular biomarkers were incorporated into the US cancer registry reporting for patients with brain tumors beginning in 2018. We investigated the completeness and validity of these variables and described the epidemiology of molecularly defined brain tumor types. METHODS: Brain tumor patients with histopathologically confirmed diagnosis in 2018 were identified within the Central Brain Tumor Registry of the United States and NCIs Surveillance, Epidemiology, and End Results Incidence databases. The brain molecular markers (BMM) site-specific data item was assessed for coding completeness and validity. 1p/19q status, MGMT promoter methylation, WHO grade data items, and new ICD-O-3 codes were additionally evaluated. These data were used to profile the characteristics and age-adjusted incidence rates per 100 000 population of molecularly defined brain tumors with 95% confidence intervals (95% CI). RESULTS: BMM completeness across the applicable tumor types was 75%-92% and demonstrated favorable coding validity. IDH-wildtype glioblastomas incidence rate was 1.74 (95% CI: 1.69-1.78), as compared to 0.14 for WHO grade 2 (95% CI: 0.12-0.15), 0.15 for grade 3 (95% CI: 0.14-0.16), and 0.07 for grade 4 (95% CI: 0.06-0.08) IDH-mutant astrocytomas. Irrespective of WHO grade, IDH mutation prevalence was highest in adolescent and young adult patients, and IDH-mutant astrocytomas were more frequently MGMT promoter methylated. Among pediatric-type tumors, the incidence rate was 0.06 for H3K27M-mutant diffuse midline gliomas (95% CI: 0.05-0.07), 0.03 for SHH-activated/TP53-wildtype medulloblastomas (95% CI: 0.02-0.03), and

We introduce a GPU B-Tree that supports snapshots and offers updates, point queries, and linearizable multipoint queries. The supported operations can be performed in a phase-concurrent, asynchronous, or fully-concurrent fashion. Our B-Tree uses cache-line-sized nodes linked together to form a version list and a GPU epoch-based reclamation scheme to reclaim older nodes' versions safely. Our data structure supports snapshots with minimal overhead in point queries (1.04× slower) and insertions (1.11× slower) versus a B-Tree that does not support versioning. Our linearizable B-Tree performs similarly to the non-linearizable baseline for read-heavy workloads and 2.39× slower for write-heavy workloads when performing concurrent range queries and insertions. In addition, we introduce different GPU-aware snapshot scopes that allow the use of our data structure for phase-concurrent (synchronous), stream-concurrent (asynchronous), and on-device fully-concurrent operations.

BackgroundOsteoarthritis (OA) is a disabling condition that affects more than one-third of people older than 65 years. Currently, 80% of these patients report movement limitations, 20% are unable to perform major activities of daily living, and approximately 11% require personal care. In 2014, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommended, as the first step in the pharmacological treatment of knee osteoarthritis, a background therapy with chronic symptomatic slow-acting osteoarthritic drugs such as glucosamine sulfate, chondroitin sulfate, and hyaluronic acid. The latter has been extensively evaluated in clinical trials as intra-articular and oral administration. Recent reviews have shown that studies on oral hyaluronic acid generally measure symptoms using only subjective parameters, such as visual analog scales or quality of life questionnaires. As a result, objective measures are lacking, and data validity is generally impaired. ObjectiveThe main goal of this pilot study with oral hyaluronic acid is to evaluate the feasibility of using objective tools as outcomes to evaluate improvements in knee mobility. We propose ultrasound and range of motion measurements with a goniometer that could objectively correlate changes in joint mobility with pain reduction, as assessed by the visual analog scale. The secondary objective is to collect data to estimate the time and budget for the main double-blind study randomized trial. These data may be quantitative (such as enrollment rate per month, number of screening failures, and new potential outcomes) and qualitative (such as site logistical issues, patient reluctance to enroll, and interpersonal difficulties for investigators). MethodsThis open-label pilot and feasibility study is conducted in an orthopedic clinic (Timisoara, Romania). The study includes male and female participants, aged 50-70 years, who have been diagnosed with symptomatic knee OA and have experienced mild joint discomfort for at least 6 months. Eight patients must be enrolled and treated with Syalox 300 Plus (River Pharma) for 8 weeks. It is a dietary supplement containing high-molecular-weight hyaluronic acid, which has already been marketed in several European countries. Assessments are made at the baseline and final visits. ResultsRecruitment and treatment of the 8 patients began on February 15, 2018, and was completed on May 25, 2018. Data analysis was planned to be completed by the end of 2018. The study was funded in February 2019. We expect the results to be published in a peer-reviewed clinical journal in the last quarter of 2024. ConclusionsThe data from this pilot study will be used to assess the feasibility of a future randomized clinical trial in OA. In particular, the planned outcomes (eg, ultrasound and range of motion), safety, and quantitative and qualitative data must be evaluated to estimate in advance the time and budget required for the future main study. Finally, the pilot study should provide preliminary information on the efficacy of the investigational product. Trial RegistrationClinicalTrials.gov NCT03421054; https://clinicaltrials.gov/study/NCT03421054 International Registered Report Identifier (IRRID)RR1-10.2196/13642

Semantic segmentation models trained on annotated data fail to generalize well when the input data distribution changes over extended time period, leading to requiring re-training to maintain performance. Classic unsupervised domain adaptation (UDA) attempts to address a similar problem when there is target domain with no annotated data points through transferring knowledge from a source domain with annotated data. We develop an online UDA algorithm for semantic segmentation of images that improves model generalization on unannotated domains in scenarios where source data access is restricted during adaptation. We perform model adaptation by minimizing the distributional distance between the source latent features and the target features in a shared embedding space. Our solution promotes a shared domain-agnostic latent feature space between the two domains, which allows for classifier generalization on the target dataset. To alleviate the need of access to source samples during adaptation, we approximate the source latent feature distribution via an appropriate surrogate distribution, in this case a Gaussian mixture model (GMM).

The substantial heterogeneity exhibited by head and neck cancer (HNC), encompassing diverse cellular origins, anatomical locations, and etiological contributors, combined with the prevalent late-stage diagnosis, poses significant challenges for clinical management. Genomic sequencing endeavors have revealed extensive alterations in key signaling pathways that regulate cellular proliferation and survival. Initiatives to engineer therapies targeting these dysregulated pathways are underway, with several candidate molecules progressing to clinical evaluation phases, including FDA approval for agents like the EGFR-targeting monoclonal antibody cetuximab for K-RAS wild-type, EGFR-mutant HNSCC treatment. Non-coding RNAs (ncRNAs), owing to their enhanced stability in biological fluids and their important roles in intracellular and intercellular signaling within HNC contexts, are now recognized as potent biomarkers for disease management, catalyzing further refined diagnostic and therapeutic strategies, edging closer to the personalized medicine desideratum. Enhanced comprehension of the genomic and immunological landscapes characteristic of HNC is anticipated to facilitate a more rigorous assessment of targeted therapies benefits and limitations, optimize their clinical deployment, and foster innovative advancements in treatment approaches. This review presents an update on the molecular mechanisms and mutational spectrum of HNC driving the oncogenesis of head and neck malignancies and explores their implications for advancing diagnostic methodologies and precision therapeutics.

IntroductionIntravascular imaging, especially optical coherence tomography (OCT), has significantly improved percutaneous coronary intervention (PCI), yet its routine clinical application faces challenges. This case series introduces the Gentuity® High-Frequency Optical Coherence Tomography (HF-OCT), a novel device designed to enhance intracoronary imaging with a significantly faster pullback and smaller catheter size, potentially offering enhanced navigability in complex lesions. We aimed to assess the image quality of Gentuity® HF-OCT in complex vessel conditions, as well as presenting a case series to illustrate the application of the device in various clinical scenarios.MethodsIn this case series, we included all patients who underwent intracoronary HF-OCT imaging at our center. The primary endpoint was image quality assessed by clear image length (CIL). Image quality was assessed in relation to (1) lesion severity assessed by minimum lumen area (MLA); (2) vessel size, differentiating between larger (diameter ≥ 4 mm) and smaller vessel segments; (3) pre- vs. post-PCI conditions, and (4) vessel tortuosity, categorized into none, moderate, and severe.ResultsTwenty-four HF-OCT runs from 14 patients were included. No significant differences in CIL were observed across lesion severity terciles (p = 0.449), between small and large vessel segments [mean CIL% difference 1.3%; confidence interval (CI), −9.3 to 11.8; p = 0.802], and pre- vs. post-PCI conditions (mean CIL difference −3.9 mm; CI, −14.0 to 6.1; p = 0.373). Vessel tortuosity significantly impacted image quality, with clear reductions in CIL observed in cases of moderate (74.8; CI, 73.5 to 76.0; vs. 63.9; CI, 56.2 to 71.5; p = 0.043) and severe tortuosity (74.8; CI, 73.5 to 76.0; vs. 65.0; CI, 62.1 to 67.9; p = 0.002) compared to vessels with no tortuosity. Overall, the HF-OCT demonstrated excellent catheter deliverability and crossability, with very satisfactory image quality and no significant adverse events.ConclusionThe Gentuity® HF-OCT is a new OCT device capable of navigating both small- and large-diameter vessels, with similar image quality, but vessel tortuosity seems to have an impact on image quality. It appears to be as usable as conventional OCT for pre-PCI diagnosis and OCT-guided PCI, potentially bringing additional benefits in terms of deliverability, lesion crossover and ease of use in routine clinical practice.

BackgroundA dietary supplement containing Pelargonium sidoides extract, propolis, zinc, and honey has been recently developed and proven to be an effective adjuvant in clinical practice for seasonal diseases and the treatment of respiratory tract disorders. ObjectiveThis trial aims to verify the efficacy of the tested dietary supplement in a pediatric population with acute tonsillopharyngitis/rhinopharyngitis (ATR). MethodsThe trial includes children aged between 3 and 10 years with ATR ≤48 h, a negative rapid test for beta-hemolytic streptococcus or culture identification of nasal and/or pharyngeal exudates, and SARS-CoV-2 infection. The dietary supplement tested is an oral solution already on the market based on Pelagon P-70 (equivalent to Pelargonium sidoides d.e. 133.3 mg/100 ml), propolis, zinc, and honey. The product is administered at 5 ml 3 times a day for 6 days for children younger than 6 years and 10 ml 3 times a day for 6 days for children older than 6 years. The study design is open label, randomized, and controlled, with the tested dietary supplement plus standard of care (SoC) versus SoC alone. Patients are enrolled from 3 sites in Romania. The change in Tonsillitis Severity Score and number of treatment failures (using ibuprofen or high-dose paracetamol as rescue medication) are the primary end points. Based on the Tonsillitis Severity Score and the 2-sample comparison of the means formula with a 5% significance level, 80% power, and a minimally clinically important difference of 2 (SD 3.85) points, 120 patients are required. To account for potential screening failures and dropouts, we need to screen a population of approximately 150 children. ResultsPatient enrollment began on June 3, 2021 (first patient’s first visit), and ended on August 12, 2021 (last patient’s last visit). The data collection period was from June 3, 2021, to September 16, 2021. The study was funded in February 2023. Data analysis is currently ongoing (April 2024). We expect the results to be published in a peer-reviewed clinical journal in the third quarter of 2024 and presented at scientific meetings in the last quarter of 2024. ConclusionsThe data from this trial may help identify new adjuvant treatments for children with ATR when streptococcal infection is excluded by a negative rapid test, thereby avoiding unnecessary antibiotic administration. Trial RegistrationClinicalTrials.gov NCT04899401 https://clinicaltrials.gov/study/NCT04899401 International Registered Report Identifier (IRRID)DERR1-10.2196/53703

Objective Recurrent bacterial vaginosis (RBV) after antibiotic treatment has relapse rates of 35% within 3 months and 60% within 12 months. A medical device containing polycarbophil, lauryl glucoside, and glycerides (PLGG) inhibits bacterial growth and has mucoadhesive properties. This study examined the efficacy of the device in women with RBV. Methods This post-market clinical follow-up study comprised two phases. The first phase was an interventional, open-label, non-controlled, multicenter study enrolling 56 women. The second phase was an observational 10-month follow-up without treatment. Results After three cycles of PLGG treatment, recurrence was identified in 8 of 54 evaluable patients (14.81%). A positive effect on lactobacilli in the vaginal secretions was observed in 26 of 39 patients (66.67%). Among 35 patients observed after stopping PLGG treatment, one case of RBV (2.86%) was observed after 4 months, and an additional six cases (17.14%) were observed after 10 ± 2 months. Therefore, no recurrence was evidenced in 12 subjects (34.28%) at the end of the study. Conclusion The use of PLGG vaginal ovules in the treatment of BV reduces the rate of recurrence and apparently produces a positive effect on the vaginal microbiota.

A woman with recent personalized external aortic root support implant presented in cardiogenic shock with bilateral coronary ostial occlusion and aortic inflammation requiring emergency coronary angioplasty. Subsequent computed tomography with positron emission tomography scanning demonstrated aortitis with extensive inflammation adjacent to the personalized external aortic root support mesh, the first report of this important complication.

We present Atos, a task-parallel GPU dynamic scheduling framework that is especially targeted at dynamic irregular applications. Compared to the dominant Bulk Synchronous Parallel (BSP) frameworks, Atos exposes additional concurrency by supporting task-parallel formulations of applications with relaxed dependencies, achieving higher GPU utilization, which is particularly significant for problems with concurrency bottlenecks. Atos also offers implicit task-parallel load balancing in addition to data-parallel load balancing, providing users the flexibility to balance between them to achieve optimal performance. Finally, Atos allows users to adapt to different use cases by controlling the kernel strategy and task-parallel granularity. We demonstrate that each of these controls is important in practice. We evaluate and analyze the performance of Atos vs. BSP on three applications: breadth-first search, PageRank, and graph coloring. Atos implementations achieve geomean speedups of 3.44x, 2.1x, and 2.77x and peak speedups of 12.8x, 3.2x, and 9.08x across three case studies, compared to a state-of-the-art BSP GPU implementation. Beyond simply quantifying the speedup, we extensively analyze the reasons behind each speedup. This deeper understanding allows us to derive general guidelines for how to select the optimal Atos configuration for different applications. Finally, our analysis provides insights for future dynamic scheduling framework designs.

Modern unified programming models (such as CUDA and SYCL) that combine host (CPU) code and GPU code into the same programming language, same file, and same lexical scope lack adequate support for GPU code specialization, which is a key optimization in real-time graphics. Furthermore, current methods used to implement specialization do not translate to a unified environment. In this paper, we create a unified shader programming environment in C++ that provides first-class support for specialization by co-opting C++'s attribute and virtual function features and reimplementing them with alternate semantics to express the services required. By co-opting existing features, we enable programmers to use familiar C++ programming techniques to write host and GPU code together, while still achieving efficient generated C++ and HLSL code via our source-to-source translator.

Background and Objectives: Cancer and coronary artery disease (CAD) often coexist. Compared to quantitative coronary angiography (QCA), fractional flow reserve (FFR) has emerged as a more reliable method of identifying significant coronary stenoses. We aimed to assess the specific management, safety and outcomes of FFR-guided percutaneous coronary intervention (PCI) in cancer patients with stable CAD. Materials and Methods: FFR was used to assess cancer patients that underwent coronary angiography for stable CAD between September 2008 and May 2016, and were found to have ≥50% stenosis by QCA. Patients with lesions with an FFR > 0.75 received medical therapy alone, while those with FFR ≤ 0.75 were revascularized. Procedure-related complications, all-cause mortality, nonfatal myocardial infarction, or urgent revascularizations were analyzed. Results: Fifty-seven patients with stable CAD underwent FFR on 57 lesions. Out of 31 patients with ≥70% stenosis as measured by QCA, 14 (45.1%) had an FFR ≥ 0.75 and lesions were reclassified as moderate and did not receive PCI nor DAPT. Out of 26 patients with

In optimizing the vibrodiagnostics of thermal power plants, a mathematical model was developed and used to increase the power plants’ safety and operational characteristics. The choice of diagnostic condition parameters of the components was made based on optimization characteristics that affect the accuracy of the solution and operational readiness of the thermal power plant. The research aimed to develop a universal model by analyzing more optimized vibrodiagnostics of the turbogenerator, which achieves high operational reliability, high safety, an extension of service life, an extension of working life, a reduction of overhaul time, etc. The application of the model represents the concept of optimization with the checking of condition parameters, which is applied to turbogenerator assemblies that have a continuous change of condition parameters as a function of the monitoring time, for which the functional dependence between the intensity of the parameter change and the operating time can be determined.

Inguinal hernia repair represents one of the most frequent pathologies with surgical addressability. From the multitude of surgical procedures, a limited number still keep their indication in the current treatment of hernias. Open surgery, the exclusive repair method until recently, is associated with laparoscopic techniques with benefits that are at least superposable on those in open repair. We conducted a study, analyzing several types of procedures in open surgery and comparing them to each other, but also with the TAPP approach, which is still at the beginning in our service. The non-mesh procedures scored poorly in terms of recurrence, the duration of the surgical intervention, and complications of the pain type, the Lichtenstein procedure was frequently associated with non-infectious inflammatory complications, and the TAPP, which is still in the learning curve, presented a prolonged duration of the surgical intervention. The Lichtenstein procedure maintains its usefulness and represents the most frequent technique for sanctioning inguinal hernia, the non-mesh processes, less used lately, are more frequently preferred in situations where hernia strangulation is associated with a septic complication. Open surgery hernia repair remains a feasible option in the era of minimal invasiveness, especially under the conditions of performing a tension-free technique, for specific categories of patients or surgical services remaining the first intention solution.

Abstract Background High empathy levels in health professionals represent an important factor in patient satisfaction and compliance, reducing patient anxiety and pain, enhancing diagnostic and clinical results and strengthening patient empowerment. Our purpose was to determine empathy level and to identify which of the socioeconomic status (SES) and psychological factors were able to predict highest empathy levels in a Romanian sample of community nurses. Methods Community nurses were invited in January-February 2023 to provide an answer to an online survey, using an advertisement in a professional network. 1580 participants voluntarily agreed to take part in this study, with a response rate of 85.8%. The survey included the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and socio-economic status items. A multivariate model for the prediction of belonging to the highest quartile of empathy as opposed to lowest quartile was constructed using SES and psychological variables as factors. Results The mean (SD) empathy level was 49.1 (6.7), with 74.7% of participants over the threshold of high empathy level. In the multivariate analysis, predictors of belonging to the highest quartile of TEQ, as opposed to the lowest quartile were: low self-perceived stress level (OR = 2.098, 95%CI 1.362–3.231), higher experience as a community nurse (OR = 1.561, 95%CI 1.120–2.175) and higher levels of the theory of mind (OR = 1.158, 95%CI 1.118–1.199), when controlling for gender, age, relationship status, presence of children in families, education, and income. Conclusions Training programs targeting to increase emotional competences, reduce levels of stress and encourage personnel retention have the potential to increase the quality of community nursing in Romania.

The serviceable laser technology in medical field has created working protocols in upper labial frenulum surgery. In this article, based on literature research available on PubMed we have reviewed the protocols, advantaged and disadvantages of using different types of lasers by performing upper labial frenectomy.