Run-time scheduling and execution of loops on message passing machines

Sparse system solvers and general purpose codes for solving partial differential equations are examples of the many types of problems whose irregularity can result in poor performance on distributed memory machines. Often, the data structures used in these problems are very flexible. Crucial details concerning loop dependences are encoded in these structures rather than being explicitly represented in the program. Good methods for parallelizing and partitioning these types of problems require assignment of computations in rather arbitrary ways. Naive implementations of programs on distributed memory machines requiring general loop partitions can be extremely inefficient. Instead, the scheduling mechanism needs to capture the data reference patterns of the loops in order to partition the problem. First, the indices assigned to each processor must be locally numbered. Next, it is necessary to precompute what information is needed by each processor at various points in the computation. The precomputed information is then used to generate an execution template designed to carry out the computation, communication, and partitioning of data, in an optimized manner. The design is presented for a general preprocessor and schedule executer, the structures of which do not vary, even though the details of the computation and of the type of information are problem dependent

β Decay and isomeric properties of neutron-rich Ca and Sc isotopes

The isomeric and β-decay properties of neutron-rich Sc53-57 and Ca53,54 nuclei near neutron number N=32 are reported, and the low-energy level schemes of Sc53,54,56 and Ti53-57 are presented. The low-energy level structures of the 21Sc isotopes are discussed in terms of the coupling of the valence 1f7/2 proton to states in the corresponding 20Ca cores. Implications with respect to the robustness of the N=32 subshell closure are discussed, as well as the repercussions for a possible N=34 subshell closure

Reducing disease burden and health inequalities arising from chronic disease among indigenous children: an early childhood caries intervention in Aotearoa/New Zealand

BACKGROUND Maaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance. METHODS/DESIGN The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui. This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm. Discussion The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes. This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family, thus reducing oral health disparities. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000111976.John R Broughton, Joyce Te H Maipi, Marie Person, W Murray Thomson, Kate C Morgaine, Sarah-Jane Tiakiwai, Jonathan Kilgour, Kay Berryman, Herenia P Lawrence, Lisa M Jamieso

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Early childhood caries (ECC): A Waikato-Tainui Kaupapa Maaori approach to reducing chronic illness dental decay amongst tamariki and mokopuna “He awa o Mokopuna oranga niho”

Early childhood caries (ECC) are a significant health concern for Indigenous Maaori children in Aotearoa New Zealand. In an effort to address the significant impact of ECC on the health of Indigenous children, the Health Research Council (HRC) funded a randomised control trial (RCT) “Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention”. The study reported here, was a unique oral health collaborative Indigenous study in Australia, Canada, and Aotearoa New Zealand. A qualitative study was carried out to explore the experiences of waahine Maaori (Maaori women) of a randomised control trial to improve the oral health of their peepi (baby, babies). In addition, this study sought to understand the knowledge of, attitude toward, and practice of waahine Maaori for the oral health for their peepi (baby, babies); and to see if waahine Maaori were able to express their experiences and understandings within kawa/tikanga Maaori. The Kaupapa Maaori Research (KMR) philosophical framework utilised kaanohi-ki-te-kaanohi (face to face) interviews, puuraakau (stories, narratives) and adapted Motivational Interviewing (MI) to engage with waahine Maaori and whaanau (family, extended family) participants. The Te Niho Taniwha (TNT) iwi (tribe) Kaupapa Maaori model was developed as part of Kaupapa Waikato-Tainui to bring together a theoretical framework for the Waikato-Tainui iwi. The results reveal three key themes: Taonga Tuku Iho (gifts, knowledge, beliefs, values, and practices), Oranga Kai (Eating well) and Tamariki/Mokopuna ora (Health service access). Through the methodology, waahine Maaori shared experiences about ways to improve the oral health of their tamariki/peepi/mokopuna (children/baby, babies/grandchildren). Tuupuna (grandparents, ancestors), maatua (parents, fathers) and whaanau were seen to have an influential role in the outcomes of tamariki/peepi/mokopuna. The recommendations provided are focussed on achieving improved outcomes for Indigenous children and address practice, policy, and research. By adopting whaanau ora (maximising health and wellbeing for families) approaches to address ECC amongst Indigenous Maaori, particularly tamariki/peepi/mokopuna to achieve Mokopuna ora (health and wellbeing for future generation).