The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Variable packet size buffered crossbar (CICQ) switches

Abstract — One of the most widely used architectures for packet switches is the crossbar. A special version of a it is the buffered crossbar, where small buffers are associated with the crosspoints. The advantages of this organization, when compared to the unbuffered architecture, is that it needs much simpler and slower scheduling circuits, while it can shape the switched traffic according to a given set of Quality of Service (QoS) criteria in a more efficient way. Furthermore, by supporting variable length packets throughout a buffered crossbar: a) there is no need for segmentation and reassembly circuits, b) no internal speedup is necessary, and c) synchronization between the input and output clock domains is simplified. In this paper we present an architecture, a hardware implementation analysis, and a performance evaluation of such a buffered crossbar. The proposed organization is simple, yet powerful and can be easily implemented using today’s technologies. Our evaluation shows that it outperforms most of the existing packet switch architectures, while its hardware cost is kept to a minimum. 1

VineTalk: Simplifying Software Access and Sharing of FPGAs in Datacenters

FPGA-based accelerators are becoming a first class citizen in data centers. Adding FPGAs in data centers can lead to higher compute densities with improved energy efficiency for latency critical workloads, such as financial applications. However deployment of FPGAs in datacenters is hindered, as both developers and cloud providers face difficulties. Application writers need to deal with FPGA interfacing as well as application logic/algorithms. On the other hand, cloud providers are reluctant to deploy FPGAs in large scale, due to the FPGAs lack of sharing that results in reduced utilization and questionable ROI. In this paper, we introduce VineTalk, a framework that reduces the programming effort associated with FPGA-based accelerators and FPGA virtualization. We integrate VineTalk with the Xilinx SDAccel development framework and we map it to the Kintex UltraScale FPGA. Our preliminary evaluation with a use-case of financial applications shows that VineTalk can offer effective FPGA sharing introducing less than 4% overhead to application execution time

Variable packet size buffered crossbar (CICQ) switches

Summarization: One of the most widely used architectures for packet switches is the crossbar. A special version of a it is the buffered crossbar, where small buffers are associated with the crosspoints. The advantages of this organization, when compared to the unbuffered architecture, is that it needs much simpler and slower scheduling circuits, while it can shape the switched traffic according to a given set of Quality of Service (QoS) criteria in a more efficient way. Furthermore, by supporting variable length packets throughout a buffered crossbar: a) there is no need for segmentation and reassembly circuits, b) no internal speedup is necessary, and c) synchronization between the input and output clock domains is simplified. In this paper we present an architecture, a hardware implementation analysis, and a performance evaluation of such a buffered crossbar. The proposed organization is simple, yet powerful and can be easily implemented using today’s technologies. Our evaluation shows that it outperforms most of the existing packet switch architectures, while its hardware cost is kept to a minimum.Παρουσιάστηκε στο: IEEE International Conference on Communication

Dating the Origin and Estimating the Transmission Rates of the Major HIV-1 Clusters in Greece: Evidence about the Earliest Subtype A1 Epidemic in Europe

Our aim was to estimate the date of the origin and the transmission rates of the major local clusters of subtypes A1 and B in Greece. Phylodynamic analyses were conducted in 14 subtype A1 and 31 subtype B clusters. The earliest dates of origin for subtypes A1 and B were in 1982.6 and in 1985.5, respectively. The transmission rate for the subtype A1 clusters ranged between 7.54 and 39.61 infections/100 person years (IQR: 9.39, 15.88), and for subtype B clusters between 4.42 and 36.44 infections/100 person years (IQR: 7.38, 15.04). Statistical analysis revealed that the average difference in the transmission rate between the PWID and the MSM clusters was 6.73 (95% CI: 0.86 to 12.60; p = 0.026). Our study provides evidence that the date of introduction of subtype A1 in Greece was the earliest in Europe. Transmission rates were significantly higher for PWID than MSM clusters due to the conditions that gave rise to an extensive PWID HIV-1 outbreak ten years ago in Athens, Greece. Transmission rate can be considered as a valuable measure for public health since it provides a proxy of the rate of epidemic growth within a cluster and, therefore, it can be useful for targeted HIV prevention programs

Transmission Dynamics of HIV-1 Drug Resistance among Treatment-Naïve Individuals in Greece: The Added Value of Molecular Epidemiology to Public Health

The presence of human immunodeficiency virus type 1 (HIV-1) drug resistance among drug-naïve patients remains stable, although the proportion of patients with virological failure to therapy is decreasing. The dynamics of transmitted resistance among drug-naïve patients remains largely unknown. The prevalence of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was 16.9% among treatment-naïve individuals in Greece. We aimed to investigate the transmission dynamics and the effective reproductive number (Re) of the locally transmitted NNRTI resistance. We analyzed sequences with dominant NNRTI resistance mutations (E138A and K103N) found within monophyletic clusters (local transmission networks (LTNs)) from patients in Greece. For the K103N LTN, the Re was >1 between 2008 and the first half of 2013. For all E138A LTNs, the Re was >1 between 1998 and 2015, except the most recent one (E138A_4), where the Re was >1 between 2006 and 2011 and approximately equal to 1 thereafter. K103N and E138A_4 showed similar characteristics with a more recent origin, higher Re during the first years of the sub-epidemics, and a declining trend in the number of transmissions during the last two years. In the remaining LTNs the epidemic was still expanding. Our study highlights the added value of molecular epidemiology to public health