DAPHNE: An Open and Extensible System Infrastructure for Integrated Data Analysis Pipelines

Integrated data analysis (IDA) pipelines—that combine data management (DM) and query processing, high-performance computing (HPC), and machine learning (ML) training and scoring—become increasingly common in practice. Interestingly, systems of these areas share many compilation and runtime techniques, and the used—increasingly heterogeneous—hardware infrastructure converges as well. Yet, the programming paradigms, cluster resource management, data formats and representations, as well as execution strategies differ substantially. DAPHNE is an open and extensible system infrastructure for such IDA pipelines, including language abstractions, compilation and runtime techniques, multi-level scheduling, hardware (HW) accelerators, and computational storage for increasing productivity and eliminating unnecessary overheads. In this paper, we make a case for IDA pipelines, describe the overall DAPHNE system architecture, its key components, and the design of a vectorized execution engine for computational storage, HW accelerators, as well as local and distributed operations. Preliminary experiments that compare DAPHNE with MonetDB, Pandas, DuckDB, and TensorFlow show promising results

EPIDEMIOLOGICAL ASPECTS OF CONGENITAL HEART MALFORMATIONS IN CHILDREN AND THEIR IMPLICATIONS IN DEVELOPING A CLINICAL MONITORING REGISTRY

Introduction. With an estimated incidence of 6 cases to 1000 births worldwide, congenital cardiac malformations (CHM) are one of the main causes of death during the fi rst year of life. The main issues regarding CHM management in Romania are the lack of data that describe the true incidence on population level, lack of standardized diagnosis and CHM reporting at national level. In Romania we see only local attempts at establishing such a CHM registry. Objectives. Measuring and analysing the incidence of CHM in children within the Pediatric Cardiovascular center of the Emergency Cardiovascular and Transplant Institute in Targu Mures (IUBCvT) in order to determine de rate of enrollment, conturing the registration and follow-up form for CHM. Material and methods. We have conducted a retrospective, descriptive study concerning children discharged between 2008-2013, with a main diagnosis or comorbidity belonging to the category Q20-Q28 (Congenital cardiac malformations – ICD 10 AM), belonging to the Pediatric Cardiovascular center of IUBCvT. The study group was made up of 839 new-borns discharged from the Neonatology clinic of the Mures County Emergency Clinical Hospital (SCJU) and 2181 children discharged from IUBCvT. Results. The incidence of CHM in new-borns discharged from SCJU varied between 5.23% and 11.47%. Of the total 839 new-borns, 139 underwent surgery in the IUBCvT within the fi rst 30 days of life. The most frequent malformations found were interatrial communication (46.52%), persistent ductus arteriosus (22.10%), interventricular communication (9.04%). Disease group based morbidity within the IUBCvT demonstrates the large share of interventricular communication (20.05%), interatrial communication (15.98%) respectively of persistent ductus arteriosus (13.05%). Of the 1255 children that underwent surgery, the most frequent procedures (17.93%) were conducted for interatrial communication. Conclusions. Establishing a CHM clinical registry is important for the screening, diagnosing, monitoring of congenital cardiac malformations as well as aiding in choosing the right treatment path

ASPECTELE EPIDEMIOLOGICE ALE MALFORMAŢIILOR CARDIACE CONGENITALE LA COPII ŞI IMPLICAŢIILE ACESTORA ÎN ELABORAREA UNUI REGISTRU CLINIC DE MONITORIZARE

Introducere. Cu o incidenţă estimată la nivel mondial de 6 în 1.000 de nou-născuţi, malformaţiile cardiace congenitale (MCC) sunt una dintre principalele cauze ale mortalităţii în primul an de viaţă. Principalele probleme în managementul malformaţiilor cardiace congenitale (MCC), în România, sunt lipsa de date care să descrie incidenţa reală la nivel populaţional, lipsa de standardizare în diagnosticul şi raportarea MCC la nivel naţional. În România, există doar încercări locale de a dezvolta un registru de malformaţii cardiace. Obiective. Măsurarea şi analiza incidenţei MCC la copii în Centrul Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Tg. Mureş (IUBCvT) în vederea determinării ratei de înrolare, stabilirea formularului de înregistrare şi urmărire al Registrului Clinic de Monitorizare al MCC. Material şi metodă. A fost realizat un studiu descriptiv retrospectiv al copiilor externaţi cu un diagnostic principal sau comorbiditate din categoria Q20-Q28 (Malformaţii cardiace congenitale – ICD 10 AM), în perioada 2008- 2013, la nivelul Centrului Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Târgu-Mureş. Lotul de studiu a cuprins un număr de 839 de nou-născuţi externaţi din secţia Neonatologie a Spitalului Clinic Judeţean de Urgenţă Târgu-Mureş (SCJU), respectiv 4.423 de copii externaţi din IUBCvT. Rezultate. Incidenţa MCC la nivelul nou-născuţilor externaţi din SCUJ a variat între 5,23% şi 11,47%. Din cei 839 nou-născuţi, 139 au fost operaţi în cadrul IUBCvT în primele 30 zile de viaţă. Cele mai frecvente malformaţii sunt Comunicaţie interauriculară (46,52%), Permeabilitatea canalului arterial (22,10%), Comunicaţia inter ventriculară (9,04%). Morbiditatea spitalizată pe grupe de boli la nivelul IUBCvT demonstrează ponderea ridicată a Comunicaţiei interventriculare (20,05%), a Comunicaţiei interauriculare (15,98%) şi a Permeabilităţii canalului arterial (13,05%). Din cei 1.255 de copii la care s-a intervenit chirurgical, cele mai frecvente intervenţii chirurgicale (17,93%) au fost pen tru Comunicaţie interauriculară. Concluzii. Întocmirea unui Registru al MCC este importantă pentru depistarea, diagnosticul, monitorizarea şi instituirea unei atitudini terapeutice adecvate

The Detection of Proximal Colon Polyps and Its Importance in Screening Colonoscopy

Background: Colon polyps are precursors of colorectal cancer (CRC), therefore their endoscopic detection is very important. A shift of in the localization of colorectal polyps toward the proximal colon has been recently observed in Western countries

Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease

Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskinesias, including diphasic dyskinesia. Methods: In this retrospective study, we analyzed the characteristics of patients with APD who had at least 30 min of diphasic dyskinesia (DID) in 3 consecutive days, were considered responders and were treated with LCIG in our clinic. Patients were evaluated before and after PEG and at 6, 12 and 18 months, when the changes in the therapy were recorded, and they completed a 7-point Global Patient Impression of Improvement (PGI-I) scale. Results: Forty patients fulfilled the inclusion criteria—out of which, 34 performed all visits. There was a substantial difference between the calculated and real LCIG (1232 ± 337 mg vs. 1823 ± 728 mg). The motor fluctuations and most dyskinesias improved significantly after starting LCIG, but an increasing number of patients needed longer daily administrations of LCIG (24 instead of 16 h). Conclusions: Patients with APD with complex dyskinesias must be tested in dedicated hospitals, and they need a special therapeutic approach. The properly adapted LCIG treatment regarding the dose and time of administration completed with well-selected add-on medication should offer improvement for patients who want to or can only choose this DAT vs. others

Starting with 24-h levodopa carbidopa intestinal gel at initiation in a large cohort of advanced Parkinson’s disease patients

Abstract Continuous intra-jejunal infusion of levodopa-carbidopa intestinal gel (LCIG) is a long-term proven and effective treatment in advanced Parkinson’s Disease (APD). Efficacy and safety of 16-h administration of LCIG has already been established. Additional benefits of 24-h LCIG administration have been reported in several case series and small clinical studies. The aim of this retrospective study was to compare the characteristics of patients who needed 24-h LCIG from the beginning of the DAT (device-aided treatment) with those who remained with the standard 16-h LCIG treatment and to identify particular motives if any. We initiated LCIG in 150 patients out of which in case of 62 patients (41,3%) due to unsatisfactory initial clinical benefits continuous 24-h LCIG was deemed necessary. Despite the subjective complaints and more severe clinical condition, at baseline evaluation we found statistically significant differences between 16-h LCIG cohort and 24-h LCIG cohort only in case of incidence of freezing (47% vs 65%, p = 0.03) and sudden off (32% vs 48%, p = 0.04). Wake hours/daytime LCIG does not always sufficiently improve the patient's quality of life in some patients due to persistent nighttime troublesome symptoms. Instead of labeling the patient as a non-responder, it is worth trying the 24-h LCIG dosage in a carefully selected group of patients, as there is currently no consensus on reliable criteria that serve the decision in these patients

Levodopa-Carbidopa Intestinal Gel in Advanced Parkinson’s Disease: Observations and Dilemmas after 10 Years of Real-Life Experience

Advanced Parkinson’s disease (APD) cannot be treated efficiently using the classical medications however, in recent decades invasive therapeutical methods were implemented and confirmed as effective. One of these methods makes it possible to continue the levodopa (LD) supplementation as a gel administered directly into the upper intestine. However, there are a number of unanswered questions regarding this method. Therefore, we retrospectively analyzed a 10-year period of selected patients that were treated with levodopa/carbidopa intestinal gel (LCIG). We included all APD patients with motor fluctuations and dyskinesia at presentation. LCIG treatment was started in 150 patients: on average these patients received LD for 10.6 ± 4.4 years with a frequency of 5.2 ± 1.0/day until the introduction of LCIG. The estimated and the real LCIG dose differed significantly (mean: 1309 ± 321 mg vs. 1877 ± 769 mg). The mean duration of LCIG administration was 19.8 ± 3.6 h, but in a number of 62 patients we had to administer it for 24 h, to maximize the therapeutic benefit. A carefully and individually adjusted LCIG treatment improves the quality of life of APD patients, but questions remain unresolved even after treating a large number of patients. It is important to share the ideas and observations based on the real-life experience related to the optimal timing, the appropriate dose and duration of administration of the LCIG

DAPHNE: An Open and Extensible System Infrastructure for Integrated Data Analysis Pipelines

Integrated data analysis (IDA) pipelines—that combine data management (DM) and query processing, high-performance computing (HPC), and machine learning (ML) training and scoring—become increasingly common in practice. Interestingly, systems of these areas share many compilation and runtime techniques, and the used—increasingly heterogeneous—hardware infrastructure converges as well. Yet, the programming paradigms, cluster resource management, data formats and representations, as well as execution strategies differ substantially. DAPHNE is an open and extensible system infrastructure for such IDA pipelines, including language abstractions, compilation and runtime techniques, multi-level scheduling, hardware (HW) accelerators, and computational storage for increasing productivity and eliminating unnecessary overheads. In this paper, we make a case for IDA pipelines, describe the overall DAPHNE system architecture, its key components, and the design of a vectorized execution engine for computational storage, HW accelerators, as well as local and distributed operations. Preliminary experiments that compare DAPHNE with MonetDB, Pandas, DuckDB, and TensorFlow show promising results