Improved False Causal Loop Detection in Polychronous Specificationof Embedded Software

As opposed to single clocked synchronous programming paradigms, polychronous formalism allows specification of concurrent data flow computation on signals such that various data flows can evolve asynchronous with respect to each other. Explicit constraints and constraints implied by the syntactic structures impart certain intrinsic properties to models specified polychronously. One of the major steps in designing a synthesis engine for polychronous specifications is the characterization of specified models into categories such as inherently sequential or inherently multi-threaded. In this paper, we are concerned with sequentially implementable polychronous specification where computation is divided into a totally ordered sequence of logical instants. Data flow computation within an instant happens based on the implied data flow order. This order or data dependency often varies from one instant to another. Thus determining if there is an instant at which the data flow order forms a causal cycle is an important problem. In the current polychronous compilers, such as SIGNAL compiler and EmCodeSyn, this is solved without due effort, by rejecting any program which has a buffer-free structural cycle. However, a clocked dependency graph can be used to construct logical constraints representing the instants with a possible causal loop. The satisfiability of such constraints would imply that such a loop is realizable and hence the specification has a possible deadlock. The reachability of this instant with a given set of initial conditions would verify if the program should be rejected. In the past, the work on such constraints and their satisfiability has not been implemented even though for pure Boolean signals and clocks this could have been done using a satisfiability solver. With the advent to SAT modulo theory (SMT) solvers, this can now be extended to a more general class of specifications. Moreover, model checking on an abstraction of the specification can provide more information about the reachability of instants at which cyclic data dependency is realized. This paper presents an improved polychronous synthesis tool accepting a much larger class of specifications than could be done before. In our experimental results, we demonstrate the capabilities of our causality analysis methods and show that our synthesis tool performs better than previous strategies, including our own past work

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

SMT based false causal loop detection during code synthesis from Polychronous specifications

International audiencePolychronous specifications express concurrent, multi-clocked models which capture multiple threads of computation operating relatively asynchronous to each other. A clock of a variable in this context, is the totally ordered set of instants at which events occur on that variables. However, the notion of instant here is logical as opposed to real-time instants. The instants of different clocks may be partially ordered. The executable code synthesis from Polychronous specifications relies on computation of schedules through clock calculus. Unfortunately, it is often hard to distinguish from true causal loops which cause deadlocks from apparent causal loops which do not. The SIGNAL compiler in the Polychrony tool-set currently rejects all programs with apparent causal loops, thus rejecting a large set of valid specifications. A recently developed polychronous formalism MRICDF and its tool-set EmCodeSyn do the same. Even in the Polychrony literature, the deadlock causing loop detection based on Boolean satisfiability is not enough to discern all possible false loops, thereby still rejecting a lot of valid specifications. In order to not reject programs whose apparent loops are never realizable, a theory of reals or integers or other data types are required. In this paper, we formulate the detection of false loops in MRICDF as a decision problem in Satisfiability Modulo Theory (SMT). Due to recent interests in SMT solvers, a number of efficient solvers are available which offer a greater expressiveness in dealing with non Boolean constraints and allow us to discern false loops from realizable causalities in reasonable computation time. This paper proposes an SMT based synthesis technique which demonstrates that several polychronous specifications rejected by the Polychrony/EmCodeSyn synthesis tools due to their inability to identify only true causal loops, can be synthesized as correct sequential embedded software

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

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

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology