Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study

Introduction Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care. Methods This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty). Results Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%. Conclusion 40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning

Spatial data infrastructures with FOSS

200 σ.Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) "Γεωπληροφορική"Η παρούσα διπλωματική εργασία έχει ως στόχο τη διερεύνηση της κατάστασης που επικρατεί για τα γεωχωρικά δεδομένα σε εθνικό επίπεδο και η πρόοδος που έχει πραγματοποιηθεί ως προς την εναρμόνιση με την Ευρωπαϊκή Οδηγία στην Ελλάδα και τη δημιουργία Εθνικής Υποδομής Γεωχωρικών Πληροφοριών. Για το σκοπό αυτό, ξεκινήσαμε ορίζοντας την έννοια της Υποδομής Γεωχωρικών Πληροφοριών, ενώ τονίστηκε η αναγκαιότητα, αλλά και τα οφέλη από την σύσταση της. Ακολούθως, μελετήθηκε η Ευρωπαϊκή Οδηγία INSPIRE που επιβάλλει τη δημιουργία Εθνικών Υποδομών Γεωχωρικών Πληροφοριών και αναλύθηκαν οι συνιστώσες της. Στη συνέχεια διερευνήθηκε η υφιστάμενη κατάσταση και παρουσιάζονται οι προσπάθειες για ελεύθερη διάθεση και διαλειτουργικότητα των εθνικών γεωχωρικών δεδομένων. Στα πλαίσια της εργασίας, προτάθηκε ο σχεδιασμός μιας Υποδομής Γεωχωρικών Πληροφοριών που θα στηρίζεται αποκλειστικά σε ΕΛ/ΛΑΚ (Ελεύθερο Λογισμικό/Λογισμικό Ανοιχτού Κώδικα) και αναλύθηκαν οι συνιστώσες της. Για το σκοπό αυτό, εισάγεται η έννοια του ΕΛ/ΛΑΚ και αναλύεται η σημασία της χρήσης του για την ανάπτυξη κοινωφελών συστημάτων, παρουσιάζονται τα δομικά στοιχεία μιας Υποδομής Γεωγραφικών Πληροφοριών και αναφέρονται οι σημαντικότερες εφαρμογές από τα ΕΛ/ΛΑΚ που μπορούν να αξιοποιηθούν στην ανάπτυξη μιας ΥΓΕΠ. Τέλος, αναπτύχθηκαν, ενδεικτικά, τα συστατικά μέρη μιας πρότυπης Υποδομής Γεωχωρικών Πληροφοριών αποδεικνύοντας την εφικτότητα του εγχειρήματος και την ωφέλεια από μια τέτοια προσέγγιση. Η ανάπτυξη βασίστηκε εξ’ ολοκλήρου σε ΕΛ/ΛΑΚ. Παρατίθενται λεπτομέρειες της υλοποίησης και τα προβλήματα που συναντήσαμε.This thesis aims to investigate the current situation of geospatial data at national level, the progress made towards the harmonization with the European Directive in Greece and the creation of a National Spatial Data Infrastructure. To this end, we define the concept of Spatial Data Infrastructure and stress the needs that lead to its establishment as well as the expected benefits. Next, we study the European Directive INSPIRE which requires the formation of a National Spatial Data Infrastructure and analyze its components. Subsequently we examine the current situation and present the efforts towards free availability and interoperability of national geospatial data. In this work we propose the design of a Spatial Data Infrastructure based solely on FOSS (Free and Open Source Software) and analyze its components. In this direction, the concept of FOSS is introduced and the importance of its usage for public benefit projects is outlined. The main elements of a possible Spatial Data Infrastructure are described and the FOSS components that can be utilized for its implementation are mentioned. Finally, we developed as a prototype the fundamental blocks of a Spatial Data Infrastructure, demonstrating the feasibility of the project and the benefits of such an approach. Our implementation is based entirely on FOSS and is described thoroughly together with the problems we encountered.Βασιλική Σ. Μπεζάτ

High level synthesis of Smith-Waterman dataflow implementations

The paper presents the results of design explorations for the implementation of the Smith-Waterman (S-W) algorithm executing DNA and protein sequences alignment. Both design explorations studies and the corresponding FPGA implementations are obtained by writing a dynamic dataflow program implementing the algorithm and by direct high-level synthesis (HLS) to FPGA HDL. The main feature of the obtained implementation is a low-latency, pipelinable multistage processing element (PE), providing a substantial decrease in the resource utilization and an increase in the computation throughput when compared to state of the art solutions. The implementation solution is also fully scalable and can be efficiently reconfigured according to the DNA sequence sizes and to system performance requirements. The FPGA design presented in the paper can efficiently scale up to 250 MHz obtaining 14746 Alignments/s using a single S-W core with 4 PEs, and up to 31.8 Mega-Alignments/min using 36 S-W cores on the same FPGA for sequences of 160×100 nucleotides

Early Recognition and Risk Stratification in Cardiogenic Shock: Well Begun Is Half Done

Cardiogenic shock is a complex syndrome manifesting with distinct phenotypes depending on the severity of the primary cardiac insult and the underlying status. As long as therapeutic interventions fail to divert its unopposed rapid evolution, poor outcomes will continue challenging health care systems. Thus, early recognition in the emergency setting is a priority, in order to avoid delays in appropriate management and to ensure immediate initial stabilization. Since advanced therapeutic strategies and specialized shock centers may provide beneficial support, it seems that directing patients towards the recently described shock network may improve survival rates. A multidisciplinary approach strategy commands the interconnections between the strategic role of the ED in affiliation with cardiac shock centers. This review outlines critical features of early recognition and initial therapeutic management, as well as the utility of diagnostic tools and risk stratification models regarding the facilitation of patient trajectories through the shock network. Further, it proposes the implementation of precise criteria for shock team activation and the establishment of definite exclusion criteria for streaming the right patient to the right place at the right time. © 2023 by the authors

Trace-based manycore partitioning of stream-processing applications

Application performance on these processor array platforms is highly sensitive to how functionality is physically placed on the device, as this choice crucially determines communication latencies and congestion patterns of the on-chip inter-core communication. The problem of identifying the best, or just a good enough, partitioning and placement does not, in general, admit to an analytic solution, and its combinatorial nature makes solving it by pure experimentation impractical. This paper presents an approach that maps stream programs onto processor arrays using trace analysis as a technique for evaluating candidate solutions and for suggesting alternatives

Infection as an under-recognized precipitant of acute heart failure: prognostic and therapeutic implications

As the prevalence of heart failure (HF) continues to rise, prompt diagnosis and management of various medical conditions, which may lead to HF exacerbation and result in poor patient outcomes, are of paramount importance. Infection has been identified as a common, though under-recognized, precipitating factor of acute heart failure (AHF), which can cause rapid development or deterioration of HF signs and symptoms. Available evidence indicates that infection-related hospitalizations of patients with AHF are associated with higher mortality, protracted length of stay, and increased readmission rates. Understanding the intricate interaction of both clinical entities may provide further therapeutic strategies to prevent the occurrence of cardiac complications and improve prognosis of patients with AHF triggered by infection. The purpose of this review is to investigate the incidence of infection as a causative factor in AHF, explore its prognostic implications, elucidate the underlying pathophysiological mechanisms, and highlight the basic principles of the initial diagnostic and therapeutic interventions in the emergency department. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature

Gut Failure: A Review of the Pathophysiology and Therapeutic Potentials in the Gut–Heart Axis

Despite considerable advances in the field, heart failure (HF) still poses a significant disease burden among affected individuals since it continues to cause high morbidity and mortality rates. Inflammation is considered to play a key role in disease progression, but the exact underlying pathophysiological mechanisms involved have not yet been fully elucidated. The gut, as a potential source of inflammation, could feasibly explain the state of low-grade inflammation seen in patients with chronic HF. Several derangements in the composition of the microbiota population, coupled with an imbalance between favorable and harmful metabolites and followed by gut barrier disruption and eventually bacterial translocation, could contribute to cardiac dysfunction and aggravate HF. On the other hand, HF-associated congestion and hypoperfusion alters intestinal function, thereby creating a vicious cycle. Based on this evidence, novel pharmaceutical agents have been developed and their potential therapeutic use has been tested in both animal and human subjects. The ultimate goal in these efforts is to reverse the aforementioned intestinal derangements and block the inflammation cascade. This review summarizes the gut-related causative pathways implicated in HF pathophysiology, as well as the associated therapeutic interventions described in the literature. © 2023 by the authors

Automated design flow for coarse-grained reconfigurable platforms: An RVC-CAL multi-standard decoder use-case

Specialized hardware infrastructures for efficient multi-application runtime reconfigurable platforms require to address several issues. The higher is the system complexity, the more error prone and time consuming is the entire design flow. Moreover, system configuration along with resource management and mapping are challenging, especially when runtime adaptivity is required. In order to address these issues, the Reconfigurable Video Coding Group within the MPEG group has developed the MPEG RMC standards ISO/IEC 23001-4 and 23002-4, based on the dataflow Model of Computation. In this paper, we propose an integrated design flow, leveraging on Xronos, TURNUS, and the Multi-Dataflow Composer tool, capable of automatic synthesis and mapping of reconfigurable systems. In particular, an RVC MPEG-4 SP decoder and the RVC Intra MPEG-4 SP decoder have been implemented on the same coarse-grained reconfigurable platform, targeting a Xilinx Virtex 5 330 FPGA board. Results confirmed the potentiality of the approach, capable of completely preserving the single decoders functionality and of providing, in addition, considerable power/area benefits with respect to the parallel implementation of the considered decoders on the same platform