Frustrated with Code Quality Issues? LLMs can Help!

As software projects progress, quality of code assumes paramount importance as it affects reliability, maintainability and security of software. For this reason, static analysis tools are used in developer workflows to flag code quality issues. However, developers need to spend extra efforts to revise their code to improve code quality based on the tool findings. In this work, we investigate the use of (instruction-following) large language models (LLMs) to assist developers in revising code to resolve code quality issues. We present a tool, CORE (short for COde REvisions), architected using a pair of LLMs organized as a duo comprised of a proposer and a ranker. Providers of static analysis tools recommend ways to mitigate the tool warnings and developers follow them to revise their code. The \emph{proposer LLM} of CORE takes the same set of recommendations and applies them to generate candidate code revisions. The candidates which pass the static quality checks are retained. However, the LLM may introduce subtle, unintended functionality changes which may go un-detected by the static analysis. The \emph{ranker LLM} evaluates the changes made by the proposer using a rubric that closely follows the acceptance criteria that a developer would enforce. CORE uses the scores assigned by the ranker LLM to rank the candidate revisions before presenting them to the developer. CORE could revise 59.2% Python files (across 52 quality checks) so that they pass scrutiny by both a tool and a human reviewer. The ranker LLM is able to reduce false positives by 25.8% in these cases. CORE produced revisions that passed the static analysis tool in 76.8% Java files (across 10 quality checks) comparable to 78.3% of a specialized program repair tool, with significantly much less engineering efforts

Chronic infarct size after spontaneous coronary artery dissection: implications for pathophysiology and clinical management

Aims: To report the extent and distribution of myocardial injury and its impact on left ventricular systolic function with cardiac magnetic resonance imaging (CMR) following spontaneous coronary artery dissection (SCAD) and to investigate predictors of myocardial injury. Methods and results: One hundred and fifty-eight angiographically confirmed SCAD-survivors (98% female) were phenotyped by CMR and compared in a case–control study with 59 (97% female) healthy controls (44.5 ± 8.4 vs. 45.0 ± 9.1 years). Spontaneous coronary artery dissection presentation was with non-ST-elevation myocardial infarction in 95 (60.3%), ST-elevation myocardial infarction (STEMI) in 52 (32.7%), and cardiac arrest in 11 (6.9%). Left ventricular function in SCAD-survivors was generally well preserved with small reductions in ejection fraction (57 ± 7.2% vs. 60 ± 4.9%, P < 0.01) and increases in left ventricular dimensions (end-diastolic volume: 85 ± 14 mL/m2 vs. 80 ± 11 mL/m2, P < 0.05; end-systolic volume: 37 ± 11 mL/m2 vs. 32 ± 7 mL/m2, P <0.01) compared to healthy controls. Infarcts were small with few large infarcts (median 4.06%; range 0–30.9%) and 39% having no detectable late gadolinium enhancement (LGE). Female SCAD patients presenting with STEMI had similar sized infarcts to female Type-1 STEMI patients age <75 years. Multivariate modelling demonstrated STEMI at presentation, initial TIMI 0/1 flow, multivessel SCAD, and a Beighton score >4 were associated with larger infarcts [>10% left ventricular (LV) mass]. Conclusion: The majority of patients presenting with SCAD have no or small infarctions and preserved ejection fraction. Patients presenting with STEMI, TIMI 0/1 flow, multivessel SCAD and those with features of connective tissue disorders are more likely to have larger infarcts

Standing tall after DeBakey Type I aortic dissection extending to left iliac artery

This report describes DeBakey Type I aortic dissection in a middle-aged hypertensive female who had undergone mitral tissue valve replacement a decade previously. The patient had severe abrupt onset tearing pain in her throat, back, and chest, for which she got admitted in a community hospital, where because of no changes in her ECG and biomarkers, the dissection of aorta was missed. She was subjected to coronary angiography more than 6 weeks later for pain in her left shoulder, which demonstrated normal vessels. She then underwent multi-detector computerised tomography aortogram (MD CTA) that revealed aortic dissection involving ascending, the arch, and descending thoracic and abdominal aorta. The patient declined surgical intervention and has been provided medical therapy in the form of high dose oral beta-blocker and losartan. The patient continues to be stable for the past 18 weeks since the index event. The report highlights the importance of detecting aortic dissection by keeping high index of clinical suspicion in a patient with abrupt onset tearing pain in the throat/back and employment of MD CTA

All-Optical UAV-Based Triple-Hop FSO-FSO-VLC Cooperative System for High-Speed Broadband Internet Access in High-Speed Trains

In this paper, we proposed an unmanned aerial vehicle (UAV) based all optical triple hop mixed free space optical-free space optical-visible light communication (FSO-FSO-VLC) system for broadband internet access in high-speed train applications. The system consists of triple hops from gateway to the UAV, UAV to train and train to the end user. Two decode and forward relays are mounted on the UAV and train respectively to transmit the data between the gateway to the end-users. The first hop between gateway to UAV consist of FSO link which follows M-distribution. The second hop between the UAV to train consists of FSO link and is modelled using Gamma-Gamma distribution which takes into account both atmospheric turbulence and pointing errors due to position/orientation deviation. The third hop between the train and end user is connected using VLC link and it is mathematically modelled using Lambertian emission distribution. The relays map the incoming signal on the FSO links and send it down to the user inside the train via the VLC downlink. We derived the closed form expressions for average bit error rate and outage probability of the proposed system. This paper investigates the effects of atmospheric turbulence, field of view, beam divergence angle, displacement deviation variance, optical concentrator gain, number of access point, and modulation schemes on system performance. First time, we proposed all-optical system which offers high data rate and low transmission delay

Arterial Tortuosity.

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Risks and benefits of percutaneous coronary intervention in spontaneous coronary artery dissection

Objective: To investigate percutaneous coronary intervention (PCI) practice in an international cohort of patients with spontaneous coronary artery dissection (SCAD). To explore factors associated with complications and study angiographic and longer term outcomes. Methods: SCAD patients (n=215, 94% female) who underwent PCI from three national cohort studies were investigated and compared with a matched cohort of conservatively managed SCAD patients (n=221). Results: SCAD-PCI patients were high risk at presentation with only 8.8% undergoing PCI outside the context of ST-elevation myocardial infarction/cardiac arrest, thrombolysis in myocardial infarction (TIMI) 0/1 flow or proximal dissections. PCI complications occurred in 38.6% (83/215), with 13.0% (28/215) serious complications. PCI-related complications were associated with more extensive dissections (multiple vs single American Heart Association coronary segments, OR 1.9 (95% CI: 1.06-3.39),p=0.030), more proximal dissections (proximal diameter per mm, OR 2.25 (1.38-3.67), p=0.001) and dissections with no contrast penetration of the false lumen (Yip-Saw 2 versus 1, OR 2.89 (1.12-7.43), p=0.028). SCAD-PCI involved long lengths of stent (median 46mm, IQR: 29-61mm). Despite these risks, SCAD-PCI led to angiographic improvements in those with reduced TIMI flow in 84.3% (118/140). Worsening TIMI flow was only seen in 7.0% (15/215) of SCAD-PCI patients. Post-PCI major adverse cardiovascular and cerebrovascular events (MACCE) and left ventricular function outcomes were favourable. Conclusion: While a conservative approach to revascularisation is favoured, SCAD cases with higher risk presentations may require PCI. SCAD-PCI is associated with longer stent lengths and a higher risk of complications but leads to overall improvements in coronary flow and good medium-term outcomes in patients

Prevalence and Disease Spectrum of Extracoronary Arterial Abnormalities in Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection (SCAD) has been associated with fibromuscular dysplasia (FMD) and other extracoronary arterial abnormalities. However, the prevalence, severity, and clinical relevance of these abnormalities remain unclear. To assess the prevalence and spectrum of FMD and other extracoronary arterial abnormalities in patients with SCAD vs controls. This case series included 173 patients with angiographically confirmed SCAD enrolled between January 1, 2015, and December 31, 2019. Imaging of extracoronary arterial beds was performed by magnetic resonance angiography (MRA). Forty-one healthy individuals were recruited to serve as controls for blinded interpretation of MRA findings. Patients were recruited from the UK national SCAD registry, which enrolls throughout the UK by referral from the primary care physician or patient self-referral through an online portal. Participants attended the national SCAD referral center for assessment and MRA. Both patients with SCAD and healthy controls underwent head-to-pelvis MRA (median time between SCAD event and MRA, 1 [IQR, 1-3] year). The diagnosis of FMD, arterial dissections, and aneurysms was established according to the International FMD Consensus. Arterial tortuosity was assessed both qualitatively (presence or absence of an S curve) and quantitatively (number of curves ≥45%; tortuosity index). Of the 173 patients with SCAD, 167 were women (96.5%); mean (SD) age at diagnosis was 44.5 (7.9) years. The prevalence of FMD was 31.8% (55 patients); 16 patients (29.1% of patients with FMD) had involvement of multiple vascular beds. Thirteen patients (7.5%) had extracoronary aneurysms and 3 patients (1.7%) had dissections. The prevalence and degree of arterial tortuosity were similar in patients and controls. In 43 patients imaged with both computed tomographic angiography and MRA, the identification of clinically significant remote arteriopathies was similar. Over a median 5-year follow-up, there were 2 noncardiovascular-associated deaths and 35 recurrent myocardial infarctions, but there were no primary extracoronary vascular events. In this case series with blinded analysis of patients with SCAD, severe multivessel FMD, aneurysms, and dissections were infrequent. The findings of this study suggest that, although brain-to-pelvis imaging allows detection of remote arteriopathies that may require follow-up, extracoronary vascular events appear to be rare