Laparoscopic Morcellation of Didelphic Uterus With Cervical and Renal Aplasia

Laparoscopic morcellation of the obstructed hemiuterus may be the preferred treatment of this congenital anomaly following failure of a surgical cervical fistula

Data Parallel C++

Learn how to accelerate C++ programs using data parallelism. This open access book enables C++ programmers to be at the forefront of this exciting and important new development that is helping to push computing to new levels. It is full of practical advice, detailed explanations, and code examples to illustrate key topics. Data parallelism in C++ enables access to parallel resources in a modern heterogeneous system, freeing you from being locked into any particular computing device. Now a single C++ application can use any combination of devices—including GPUs, CPUs, FPGAs and AI ASICs—that are suitable to the problems at hand. This book begins by introducing data parallelism and foundational topics for effective use of the SYCL standard from the Khronos Group and Data Parallel C++ (DPC++), the open source compiler used in this book. Later chapters cover advanced topics including error handling, hardware-specific programming, communication and synchronization, and memory model considerations. Data Parallel C++ provides you with everything needed to use SYCL for programming heterogeneous systems. What You'll Learn Accelerate C++ programs using data-parallel programming Target multiple device types (e.g. CPU, GPU, FPGA) Use SYCL and SYCL compilers Connect with computing’s heterogeneous future via Intel’s oneAPI initiative Who This Book Is For Those new data-parallel programming and computer programmers interested in data-parallel programming using C++

Data Parallel C++

Learn how to accelerate C++ programs using data parallelism. This open access book enables C++ programmers to be at the forefront of this exciting and important new development that is helping to push computing to new levels. It is full of practical advice, detailed explanations, and code examples to illustrate key topics. Data parallelism in C++ enables access to parallel resources in a modern heterogeneous system, freeing you from being locked into any particular computing device. Now a single C++ application can use any combination of devices—including GPUs, CPUs, FPGAs and AI ASICs—that are suitable to the problems at hand. This book begins by introducing data parallelism and foundational topics for effective use of the SYCL standard from the Khronos Group and Data Parallel C++ (DPC++), the open source compiler used in this book. Later chapters cover advanced topics including error handling, hardware-specific programming, communication and synchronization, and memory model considerations. Data Parallel C++ provides you with everything needed to use SYCL for programming heterogeneous systems. What You'll Learn Accelerate C++ programs using data-parallel programming Target multiple device types (e.g. CPU, GPU, FPGA) Use SYCL and SYCL compilers Connect with computing’s heterogeneous future via Intel’s oneAPI initiative Who This Book Is For Those new data-parallel programming and computer programmers interested in data-parallel programming using C++

742-4 Radial Artery Graft: Angiographic Follow-up

Interest in the use of the radial artery (RA) as a coronary bypass graft has increased. Attention to harvesting and use of perioperative calcium channel inhibitors have ameliorated problems with spasm noted in earlier studies. Since 1993, 72 patients (pts) underwent grafting using a free RA from the non-dominant forearm. Re-angiography was performed in 24 pts to date and is the subject of this study. Pts ranged from 39–79 years (mean 55.5); all had 2 or 3 vessel disease and an average of 3 grafts/pt were constructed (range 2–4). Left internal thoracic artery (L1TA) was used in all cases except 1. The RA was a single graft in 19 including 2 to the LAD system, 12 to the circumflex system and 5 to the RCA. The RA-was sequential in 5 cases. Of the 24 pts catheterized an average of 9 weeks post-op 24/24 RA's were patent: 1 (sequential) RA had a mid-graft stenosis. There was no spasm seen in any RA. RA distal diameters (2.6mm) were well matched to the recipient vessel (RV) (2.2mm). The ratio RV/graft diameter was 0.83 for the radial artery similar to the ratio for the L1TA (0.90).ConclusionThe RA is a viable coronary conduit, easily harvested and has excellent early patency rates

POTENTIAL FOR BIAS IN STUDIES OF THE INFLUENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION ON THE RECOGNITION, INCIDENCE, CLINICAL COURSE, AND MICROBIOLOGY OF PELVIC INFLAMMATORY DISEASE

As the human immunodeficiency virus (HIV) epidemic affects more women, clinicians are increasingly observing pelvic inflammatory disease (PID) in HIV-infected women. The extent to which PID is a factor in the recognition of HIV or HIV is a factor in the recognition of PID is unknown. Even less is known about how HIV infection influences the development, clinical course, and microbiology of PID. The paucity of existing data largely results from difficulties in designing studies that are free of bias. Several biases may distort studies of the effect of HIV on the recognition, incidence, clinical presentation and course, and microbiology of PID. Selection bias, diagnostic bias, and confounding bias are the most likely causes of invalid conclusions in studies of the influence of HIV infection on these aspects of PID, for three major reasonsFactors that determine patientsʼ health care seeking behavior may be related to HIV status; the diagnosis of PID tends to be imprecise; and extraneous factors that cause or prevent PID may be distributed differently in HIV-infected and HIV-uninfected women. Appropriate study design and analytic techniques can eliminate, reduce, or estimate the magnitude and direction of these biases, thereby yielding more valid conclusions. To interpret properly existing and future studies of the influence of HIV infection on PID, clinicians must consider several biases that may distort results

Association Between Senior Obstetrician Supervision of Resident Deliveries and Mode of Delivery

OBJECTIVE: In December 2012, the Mount Sinai Hospital implemented a program to have senior obstetricians (more than 20 years of experience) supervise residents on labor and delivery during the daytime. The objective of this study was to estimate the association of resident supervision by senior obstetricians with mode of delivery. METHODS: This was a retrospective cohort study of all resident deliveries at Mount Sinai from July 2011 to June 2015. We included all patients with live, term, singleton, vertex fetuses. We compared delivery outcomes between patients delivered before December 2012 and patients delivered December 2012 and later using logistic regression analysis to control for age, body mass index, parity, induction, and prior cesarean delivery. During the study period there were no other specific departmental initiatives to increase forceps deliveries aside from having six obstetricians with significant experience in operative deliveries supervise and teach residents on labor and delivery. RESULTS: There were 5,201 live, term, singleton, vertex deliveries under the care of residents, 1,919 (36.9%) before December 2012 and 3,282 (63.1%) December 2012 or later. The rate of forceps deliveries significantly increased from 0.6% to 2.6% (adjusted odds ratio [OR] 8.44, 95% confidence interval [CI] 3.1-23.1), and the rate of cesarean deliveries significantly decreased from 27.3% to 24.5% (adjusted OR 0.68, 95% CI 0.55-0.83). There were no statistically significant differences in the rates of third-or fourth-degree lacerations or 5-minute Apgar scores less than 7. Among nulliparous women, the forceps rate increased from 1.0% to 3.4% (adjusted OR 4.87, 95% CI 1.74-13.63) and the cesarean delivery rate decreased from 25.6% to 22.7% (adjusted OR 0.69, 95% CI 0.53-0.89). The increase in forceps deliveries and the decrease in cesarean deliveries were seen only in daytime hours (7 AM to 7 PM), that is, the shift that was covered by senior obstetricians. CONCLUSION: Having senior obstetricians supervise resident deliveries is significantly associated with an increased rate of forceps deliveries and a decreased rate of cesarean deliveries

The Association between Solo versus Group Obstetrical Practice Model and Delivery Outcomes

Objective To determine if women under the care of obstetricians in solo practice have different delivery outcomes from women in a group practice. Study Design This is a retrospective cohort of live, term, singleton, vertex (LTSV) deliveries at one hospital from 2011 to 2015. We compared outcomes between women whose obstetrician was in solo practice with women in a group practice model. Results There were 18,214 LTSV deliveries by private obstetricians. Solo obstetricians were more likely to deliver at night (41.0 vs. 37.5%, p = 0.002) and less likely to induce labor (22.6 vs. 30.6%, p < 0.001). Solo obstetricians had a significantly higher rate of cesarean delivery (35.7 vs. 27.2%, adjusted odds ratio, aOR: 1.53, 95% confidence interval, CI [1.32, 1.78]), but also had a significantly lower rate of shoulder dystocia (0.4 vs. 1.4, aOR: 0.42, 95% CI [0.19, 0.89]), third or fourth degree lacerations (1.6 vs. 2.4%, aOR: 0.56, 95% CI [0.35, 0.914]), and neonatal intensive care unit admission rates (3.2 vs. 6.2%, aOR: 0.57, 95% CI [0.42, 0.77]). Conclusion In a large, tertiary care hospital, solo obstetricians have similar neonatal outcomes as group obstetricians. Their higher cesarean delivery rate is balanced by fewer shoulder dystocias and third/fourth degree lacerations, indicating a more conservative approach to labor management. Patient outcomes should not be a reason to discourage a solo practice model