Missed opportunities for ovarian salvage in children: an 8-year review of surgically managed ovarian lesions at a tertiary pediatric surgery centre

INTRODUCTION: The aetiology and management of ovarian pathology in children differs between antenatal and postnatal lesions. However, all lesions may present acutely due to adnexal torsion. In this setting, opportunities to preserve fertility with ovary-sparing surgery (OSS) may be missed. Some studies suggest that pediatric and adolescent gynaecology (PAG) input in care is associated with OSS. METHODS: A retrospective cohort study of children undergoing surgery for ovarian pathology at a tertiary pediatric surgery centre over an 8-year period (2011-2018). Patient factors, lesion characteristics and PAG involvement were examined for association with OSS using multivariate logistic regression. RESULTS: Thirty-five patients with ovarian pathology managed surgically were included. Ten were infants with lesions detected antenatally; all were managed by pediatric surgeons (PS) alone at median age 2 weeks (1 day-25 weeks). Twenty-five patients presented postnatally at median age 11 (0.75-15) years. In total, there were 16 cases of adnexal torsion, each managed primarily by PS. Twelve underwent oophorectomy and six (50%) of these cases had viable ovarian tissue on histology. Furthermore, two infants with large simple cysts were similarly managed by unnecessary oophorectomy based on histology. Overall rate of OSS was 46% and PAG involvement was the only factor associated with ovarian salvage. CONCLUSION: Differences in surgical management between PAGs and PS may be attributable to the different patient populations they serve. We recommend improving the knowledge of PS trainees in OSS approaches for adnexal torsion and large benign lesions

Dynamic Power Management for Reactive Stream Processing on the SCC Tiled Architecture

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Dynamic voltage and frequency scaling} (DVFS) is a means to adjust the computing capacity and power consumption of computing systems to the application demands. DVFS is generally useful to provide a compromise between computing demands and power consumption, especially in the areas of resource-constrained computing systems. Many modern processors support some form of DVFS. In this article we focus on the development of an execution framework that provides light-weight DVFS support for reactive stream-processing systems (RSPS). RSPS are a common form of embedded control systems, operating in direct response to inputs from their environment. At the execution framework we focus on support for many-core scheduling for parallel execution of concurrent programs. We provide a DVFS strategy for RSPS that is simple and lightweight, to be used for dynamic adaptation of the power consumption at runtime. The simplicity of the DVFS strategy became possible by sole focus on the application domain of RSPS. The presented DVFS strategy does not require specific assumptions about the message arrival rate or the underlying scheduling method. While DVFS is a very active field, in contrast to most existing research, our approach works also for platforms like many-core processors, where the power settings typically cannot be controlled individually for each computational unit. We also support dynamic scheduling with variable workload. While many research results are provided with simulators, in our approach we present a parallel execution framework with experiments conducted on real hardware, using the SCC many-core processor. The results of our experimental evaluation confirm that our simple DVFS strategy provides potential for significant energy saving on RSPS.Peer reviewe