Absent Pulmonary Valve Syndrome: Prenatal Diagnosis, Association and Outcome

Objective: To analyze the spectrum of prenatally diagnosed absent pulmonary valve syndrome (APVS) and the outcome from diagnosis onwards. Fetuses with APVS and tetralogy of Fallot (TOF/APVS) and with APVS and intact ventricular septum(APVS/IVS) were included. Method: Multicenter retrospective study of the International Prenatal Cardiology Collaboration Group(IPCCG). Clinical und echocardiographic databases of nine referral centers were rewiewed from 2012-2016. Various clinical und echocardiographic parameters were retrieved. Results: The cohort included 71 cases, 59 with TOF/APVS and twelve with APVS/IVS. In 3% of cases the diagnosis was achieved within the first trimester. Association with hydrops fetalis was high within the first trimester (69%). No fetus with known outcome survived after first trimester diagnosis. Karyotype anomalies occured in 44% with microdeletion 22q11.2 beeing the most frequent (21%). Intrauterine fetal demis (IUD) occured in 14.5%. Pulmonary artery dimensions were increased in all cases of TOF/IVS. Survival to birth was 49.1% in TOF/APVS und 37.5% in APVS/IVS. Survival beyond the neonatal period in actively managed neonates was 40% in TOF/APVS and 37.5% in APVS/IVS. Conclusion: Diagnosis of APVS ist feasible within the first triester. Outcomes remain guarded, especially if first trimester diagnosis ist included into the analysis due to associated karyotypic anomalies and the presence of hydrops fetalis

A Hybrid Multi-GPU Implementation of Simplex Algorithm with CPU Collaboration

The simplex algorithm has been successfully used for many years in solving linear programming (LP) problems. Due to the intensive computations required (especially for the solution of large LP problems), parallel approaches have also extensively been studied. The computational power provided by the modern GPUs as well as the rapid development of multicore CPU systems have led OpenMP and CUDA programming models to the top preferences during the last years. However, the desired efficient collaboration between CPU and GPU through the combined use of the above programming models is still considered a hard research problem. In the above context, we demonstrate here an excessively efficient implementation of standard simplex, targeting to the best possible exploitation of the concurrent use of all the computing resources, on a multicore platform with multiple CUDA-enabled GPUs. More concretely, we present a novel hybrid collaboration scheme which is based on the concurrent execution of suitably spread CPU-assigned (via multithreading) and GPU-offloaded computations. The experimental results extracted through the cooperative use of OpenMP and CUDA over a notably powerful modern hybrid platform (consisting of 32 cores and two high-spec GPUs, Titan Rtx and Rtx 2080Ti) highlight that the performance of the presented here hybrid GPU/CPU collaboration scheme is clearly superior to the GPU-only implementation under almost all conditions. The corresponding measurements validate the value of using all resources concurrently, even in the case of a multi-GPU configuration platform. Furthermore, the given implementations are completely comparable (and slightly superior in most cases) to other related attempts in the bibliography, and clearly superior to the native CPU-implementation with 32 cores.Comment: 12 page

Improved Task Scheduling for Virtual Machines in the Cloud based on the Gravitational Search Algorithm

The rapid and convenient provision of the available computing resources is a crucial requirement in modern cloud computing environments. However, if only the execution time is taken into account when the resources are scheduled, it could lead to imbalanced workloads as well as to significant under-utilisation of the involved Virtual Machines (VMs). In the present work a novel task scheduling scheme is introduced, which is based on the proper adaptation of a modern and quite effective evolutionary optimization method, the Gravitational Search Algorithm (GSA). The proposed scheme aims at optimizing the entire scheduling procedure, in terms of both the tasks execution time and the system (VMs) resource utilisation. Moreover, the fitness function was properly selected considering both the above factors in an appropriately weighted function in order to obtain better results for large inputs. Sufficient simulation experiments show the efficiency of the proposed scheme, as well as its excellence over related approaches of the bibliography, with similar objectives.Comment: 8 page

The Evolution and Developing Importance of Fetal Magnetic Resonance Imaging in the Diagnosis of Congenital Cardiac Anomalies: A Systematic Review

Magnetic Resonance Imaging (MRI) is a reliable method, with a complementary role to Ultrasound (US) Echocardiography, that can be used to fully comprehend and precisely diagnose congenital cardiac malformations. Besides the anatomical study of the fetal cardiovascular system, it allows us to study the function of the fetal heart, remaining, at the same time, a safe adjunct to the classic fetal echocardiography. MRI also allows for the investigation of cardiac and placental diseases by providing information about hematocrit, oxygen saturation, and blood flow in fetal vessels. It is crucial for fetal medicine specialists and pediatric cardiologists to closely follow the advances of fetal cardiac MRI in order to provide the best possible care. In this review, we summarize the advance in techniques and their practical utility to date

Exploring the Potential Role of Upper Abdominal Peritonectomy in Advanced Ovarian Cancer Cytoreductive Surgery Using Explainable Artificial Intelligence

The Surgical Complexity Score (SCS) has been widely used to describe the surgical effort during advanced stage epithelial ovarian cancer (EOC) cytoreduction. Referring to a variety of multi-visceral resections, it best combines the numbers with the complexity of the sub-procedures. Nevertheless, not all potential surgical procedures are described by this score. Lately, the European Society for Gynaecological Oncology (ESGO) has established standard outcome quality indicators pertinent to achieving complete cytoreduction (CC0). There is a need to define what weight all these surgical sub-procedures comprising CC0 would be given. Prospectively collected data from 560 surgically cytoreduced advanced stage EOC patients were analysed at a UK tertiary referral centre.We adapted the structured ESGO ovarian cancer report template. We employed the eXtreme Gradient Boosting (XGBoost) algorithm to model a long list of surgical sub-procedures. We applied the Shapley Additive explanations (SHAP) framework to provide global (cohort) explainability. We used Cox regression for survival analysis and constructed Kaplan-Meier curves. The XGBoost model predicted CC0 with an acceptable accuracy (area under curve [AUC] = 0.70; 95% confidence interval [CI] = 0.63–0.76). Visual quantification of the feature importance for the prediction of CC0 identified upper abdominal peritonectomy (UAP) as the most important feature, followed by regional lymphadenectomies. The UAP best correlated with bladder peritonectomy and diaphragmatic stripping (Pearson’s correlations > 0.5). Clear inflection points were shown by pelvic and para-aortic lymph node dissection and ileocecal resection/right hemicolectomy, which increased the probability for CC0. When UAP was solely added to a composite model comprising of engineered features, it substantially enhanced its predictive value (AUC = 0.80, CI = 0.75–0.84). The UAP was predictive of poorer progression-free survival (HR = 1.76, CI 1.14–2.70, P: 0.01) but not overall survival (HR = 1.06, CI 0.56–1.99, P: 0.86). The SCS did not have significant survival impact. Machine Learning allows for operational feature selection by weighting the relative importance of those surgical sub-procedures that appear to be more predictive of CC0. Our study identifies UAP as the most important procedural predictor of CC0 in surgically cytoreduced advanced-stage EOC women. The classification model presented here can potentially be trained with a larger number of samples to generate a robust digital surgical reference in high output tertiary centres. The upper abdominal quadrants should be thoroughly inspected to ensure that CC0 is achievable

Absent pulmonary valve syndrome - diagnosis, associations and outcome in 71 prenatally diagnosed cases

To analyze the spectrum of prenatally diagnosed absent pulmonary valve syndrome (APVS) and the outcome from diagnosis onwards. Fetuses with APVS and tetralogy of Fallot (TOF/APVS) and with APVS and intact ventricular septum (APVS/IVS) were included.status: publishe