Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A simple mechanism to deal with sequential code in dataflow architectures

The aim of this work is to propose a simple and efficient mechanism to deal with the problem of executing sequential code in a pure dataflow machine. Our results is obtained with a simulator of Wolf [4] architecture. The implemented mechanism improved the architecture performance when executing sequential code and we expect that this improvement could be better if we use some heuristics to deal with some special groups of instructions such as branch operations. Further research will show us if this is true

Towards interoperability in P2Pworld: An indexing middleware for multi-protocol peer-to-peer data sharing

Despite the abundant availability of protocols and application for peer-to-peer file sharing, several drawbacks are still present in the field. Among most notable drawbacks is the lack of a simple and interoperable way to share information among independent peer-to-peer networks. Another drawback is the requirement that the shared content can be accessed only by a limited number of compatible applications, making impossible their access to others applications and system. In this work we present a new approach for peer-to-peer data indexing, focused on organization and retrieval of metadata which describes the shared content. This approach results in a common and interoperable infrastructure, which provides a transparent access to data shared on multiple data sharing networks via a simple API. The proposed approach is evaluated using a case study, implemented as a cross-platform extension to Mozilla Firefox browser, and demonstrates the advantages of such interoperability over conventional distributed data access strategies. © 2009 IEEE

A tool to simplify the management of homogeneous and heterogeneous grids

To simplify computer management, several system administrators are adopting advanced techniques to manage software configuration on grids, but the tight coupling between hardware and software makes every PC an individual managed entity, lowering the scalability and increasing the costs to manage hundreds or thousands of PCs. This paper discusses the feasibility of a distributed virtual machine environment, named Flexlab: a new approach for computer management that combines virtualization and distributed system architectures as the basis of a management system. Flexlab is able to extend the coverage of a computer management solution beyond client operating system limitations and also offers a convenient hardware abstraction, decoupling software and hardware, simplifying computer management. The results obtained in this work indicate that FlexLab is able to overcome the limitations imposed by the coupling between software and hardware, simplifying the management of homogeneous and heterogeneous grids. © 2009 IEEE

Politics and Female Sterilization in Northeast Brazil

Brazilian fertility has fallen rapidly in the last three decades, even in the Northeast, the country's poorest region. Female sterilization has become the most common contraceptive method in this region, where 44 percent of married women aged 15-49 years were sterilized as of 1996. While in other regions sterilizations were generally paid for by the patient, politicians and physicians arranged and paid for the large majority of these surgical procedures in the Northeast. The authors present evidence that this phenomenon is the result of the use of sterilization as an electoral good by politicians and physicians in local contexts where politicians regularly provide goods and services to the poor in exchange for votes. This systemic behavior seems to have been little affected by 1997 legislation that regulated family planning, made sterilization legal, and was intended to increase the use of other methods of contraception. Copyright 2004 The Population Council, Inc..

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted