A survey of distributed data aggregation algorithms

Distributed data aggregation is an important task, allowing the de- centralized determination of meaningful global properties, that can then be used to direct the execution of other applications. The resulting val- ues result from the distributed computation of functions like count, sum and average. Some application examples can found to determine the network size, total storage capacity, average load, majorities and many others. In the last decade, many di erent approaches have been pro- posed, with di erent trade-o s in terms of accuracy, reliability, message and time complexity. Due to the considerable amount and variety of ag- gregation algorithms, it can be di cult and time consuming to determine which techniques will be more appropriate to use in speci c settings, jus- tifying the existence of a survey to aid in this task. This work reviews the state of the art on distributed data aggregation algorithms, providing three main contributions. First, it formally de nes the concept of aggrega- tion, characterizing the di erent types of aggregation functions. Second, it succinctly describes the main aggregation techniques, organizing them in a taxonomy. Finally, it provides some guidelines toward the selection and use of the most relevant techniques, summarizing their principal characteristics.

Improving diagnostic yield in obscure gastrointestinal bleeding - how virtual chromoendoscopy may be the answer

Background and aim: A significant proportion of patients presenting with obscure gastrointestinal bleeding (OGIB) have negative small bowel capsule endoscopy (SBCE) examinations, and yet remain at risk of rebleeding. We aimed to evaluate whether a second-look review of SBCE images using flexible spectral color enhancement (FICE) may improve the detection of potentially bleeding lesions. Materials and methods: This was a retrospective, single-center study including consecutive patients with OGIB subjected to SBCE, whose standard white light examination was nondiagnostic. Each SBCE was reviewed using FICE 1. New findings were labeled as either P1 or P2 lesions according to bleeding potential. Patients were followed up to assess the incidence of rebleeding. Results: A total of 42 consecutive patients were included. Sixteen patients (38%) experienced rebleeding after a mean follow-up of 26 months. Review of SBCE images using FICE 1 enabled the identification of previously unrecognized P2 lesions, mainly angioectasias, in nine patients (21%) and P1 lesions, mainly erosions, in 26 patients (62%). Among patients who experienced rebleeding, 13/16 (81%) were diagnosed with P1 lesions with FICE 1 (P=0.043), whereas 3/16 (19%) had confirmed nondiagnostic SBCE and only 1/16 (6%) had newly diagnosed P2 (plus P1) lesions. An alternative source of bleeding outside the small bowel was found in only 3/16 (19%) patients with rebleeding during the follow-up. Conclusion: In a significant proportion of patients with OGIB, FICE 1 may detect potentially bleeding lesions previously missed under conventional white light SBCE. Review of nondiagnostic SBCE with FICE 1 may be a valuable strategy to obviate the need for further investigations in patients with OGIB, particularly for those who experience rebleeding.

Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications

OBJECTIVE: Anomalous origin of the left coronary artery from the right pulmonary artery (AOLCARPA), is a rare entity that is usually associated with other defects. Of the 20 cases of AOLCARPA reported in the literature, 14 (70%) had associations. We describe four patients with AOLCARPA without associated defects, but with a peculiar intramural aortic trajectory. METHODS: Fifty-five patients with anomalous origin of the left coronary artery were operated upon at INCOR-FMUSP. Four of the patients had the anomalous origin from the right pulmonary artery (RPA) without associated defects but with intramural aortic trajectory. Clinical and laboratory examinations were analyzed, as well as surgical findings. RESULTS: All patients had congestive heart failure (CHF) and 3 also had angina pectoris. Two patients had a murmur of mitral regurgitation, signs of myocardial infarction on the ECG and cardiomegaly. The shortening fraction varied from 9% to 23%. The hemodynamic study confirmed the diagnosis of anomalous origin of the coronary artery, but the intramural trajectory and the origin from the RPA were established only at surgery. In 3 patients, the technique of side-to-side anastomosis was performed with a good outcome. One patient, who underwent end-to-side anastomosis, died 6 months after the surgery. CONCLUSION: Association with other defects usually occurs in the AOLCARPA, and the intramural aortic trajectory is difficult to clinically diagnose but easy to surgically correct.

Congenital atresia of the ostium of the left coronary artery. Diagnostic difficulty and successful surgical revascularization in two patients

We report two cases of congenital atresia of the ostium of the left coronary artery. Case 1: a six-month-old infant presenting with serious cardiac insufficiency. A noninvasive diagnosis of dilated myocardiopathy was established and the clinical picture was pharmacologically compensated. When the patient was nine months of age, a hemodynamic study was performed that revealed congenital atresia of the ostium of the left coronary artery; the infant immediately underwent a successful anastomosis of the internal mammary artery with the left coronary artery. Case 2: an eleven-year-old asymptomatic boy with a history of heart murmur from the age of six months on, was refered for surgery with a diagnosis of anomalous origin of the left coronary artery from pulmonary trunk. A definitive diagnosis of atresia of the left coronary ostium was only established during surgery. Successful surgical revascularization with the left internal mammary artery, and left ventricular aneurysmectomy were performed.

Efficacy of a diagnostic strategy for patients with chest pain and no ST-segment elevation in the emergency room

PURPOSE: To evaluate the efficacy of a systematic model of care for patients with chest pain and no ST segment elevation in the emergency room. METHODS: From 1003 patients submitted to an algorithm diagnostic investigation by probability of acute ischemic syndrome. We analyzed 600 ones with no elevation of ST segment, then enrolled to diagnostic routes of median (route 2) and low probability (route 3) to ischemic syndrome. RESULTS: In route 2 we found 17% acute myocardial infarction and 43% unstable angina, whereas in route 3 the rates were 2% and 7%, respectively. Patients with normal/non--specific ECG had 6% probability of AMI whereas in those with negative first CKMB it was 7%; the association of the 2 data only reduced it to 4%. In patients in route 2 the diagnosis of AMI could only be ruled out with serial CKMB measurement up to 9 hours, while in route 3 it could be done in up to 3 hours. Thus, sensitivity and negative predictive value of admission CKMB for AMI were 52% and 93%, respectively. About one-half of patients with unstable angina did not disclose objective ischemic changes on admission. CONCLUSION: The use of a systematic model of care in patients with chest pain offers the opportunity of hindering inappropriate release of patients with ACI and reduces unnecessary admissions. However some patients even with normal ECG should not be released based on a negative first CKMB. Serial measurement of CKMB up to 9 hours is necessary in patients with medium probability of AMI.

Fetal tachyarrhythmia with 1:1 atrioventricular conduction. Adenosine infusion in the umbilical vein as a diagnostic test

This is the report of a case of fetal tachyarrhythmia with 1:1 atrioventricular conduction detected by pre-natal echocardiography in a fetus at 25-weeks gestation. Adenosine infusion via cordocentesis was performed as a diagnostic test to differentiate between atrioventricular nodal reentrant supraventricular tachyarrhythmia and atrial flutter. After infusion, transient 2:1 atrioventricular dissociation was obtained and the diagnosis of atrial flutter was made. Transplacental therapy with digoxin and amiodarone was then successfully used.

Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions

OBJECTIVE: To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period. METHODS: From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type. RESULTS: The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45%) patients, neoplastic in 4 (20%), resulting from hypothyroidism in 3 (15%), tuberculous in 2 (10%), due to cholesterol in 1 (5%), and chylopericardial in 1 (5%). The biopsy was positive in 30% of the patients, and the etiology could not be defined in 45% of the patients. CONCLUSION: Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic.

Diagnostic value of the tilt-table test for the assessment of syncope in children and adolescents

OBJECTIVE - To assess the diagnostic value, the characteristics, and feasibility of tilt-table testing in children and adolescents. METHODS - From August 1991 to June 1997, we retrospectively assessed 94 patients under the age of 18 years who had a history of recurring syncope and presyncope of unknown origin and who were referred for tilt-table testing. These patients were divided into 2 groups: group I (children) - 36 patients with ages ranging from 3 to 12 (mean of 9.19±2.31) years; group II (adolescents) - 58 patients with ages ranging from 13 to 18 (mean of 16.05±1.40) years. We compared the positivity rate, the type of hemodynamic response, and the time period required for the test to become positive in the 2 groups. RESULTS - The positivity rates were 41.6 % and 50% for groups I and II, respectively. The pattern of positive hemodynamic response that predominated in both groups was the mixed response. The mean time period required for the test to become positive was shorter in group I (11.0±7.23 min) than in group II (18.44±7.83 min). No patient experienced technical difficulty or complications. CONCLUSION - No difference was observed in regard to feasibility, positivity rate, and pattern of positive response for the tilt-table test in children and adolescents. Pediatric patients had earlier positive responses.

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

OBJECTIVE: To access the incidence of diagnostic errors in the initial evaluation of children with cardiac murmurs. METHODS: We evaluated our 7-years of experience in a public pediatric cardiology outpatient clinic. Of 3692 patients who were sent to the hospital, 2603 presented with a heart murmur and were investigated. Patients for whom a disagreement existed between the initial and final diagnoses were divided into the following 2 groups: G1 (n=17) with an initial diagnosis of an innocent murmur and a final diagnosis of cardiopathy, and G2 (n=161) with an initial diagnosis of cardiopathy and a final diagnosis of a normal heart. RESULTS: In G1, the great majority of patients had cardiac defects with mild hemodynamic repercussions, such as small ventricular septal defect and mild pulmonary stenosis. In G2, the great majority of structural defects were interventricular communication, atrial septal defect and pulmonary valve stenosis. CONCLUSION: A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6% of cases. The majority of these misdiagnoses were in patients with an initial diagnosis of cardiopathy, which was not confirmed through later complementary examinations. Clinical cardiovascular examination is an excellent resource in the evaluation of children suspected of having cardiopathy. Immediate outpatient discharge of children with an initial diagnosis of an innocent heart murmur seems to be a suitable approach.

Desarrollo de Algoritmos Numéricos para el Estudio de la Propagación no Lineal de Ondas en Aplicaciones Aeroespaciales y Astrofísicas. Develop to Numerical Algorithms to Study non-Linear Waves Propagation in Aerospace and Astrophysics Applications.

En este proyecto se desarrollarán algoritmos numéricos para sistemas no lineales hiperbólicos-parabólicos de ecuaciones diferenciales en derivadas parciales. Dichos sistemas tienen aplicación en propagación de ondas en ámbitos aeroespaciales y astrofísicos.Objetivos generales: 1)Desarrollo y mejora de algoritmos numéricos con la finalidad de incrementar la calidad en la simulación de propagación e interacción de ondas gasdinámicas y magnetogasdinámicas no lineales. 2)Desarrollo de códigos computacionales con la finalidad de simular flujos gasdinámicos de elevada entalpía incluyendo cambios químicos, efectos dispersivos y difusivos.3)Desarrollo de códigos computacionales con la finalidad de simular flujos magnetogasdinámicos ideales y reales.4)Aplicación de los nuevos algoritmos y códigos computacionales a la solución del flujo aerotermodinámico alrededor de cuerpos que ingresan en la atmósfera terrestre. 5)Aplicación de los nuevos algoritmos y códigos computacionales a la simulación del comportamiento dinámico no lineal de arcos magnéticos en la corona solar. 6)Desarrollo de nuevos modelos para describir el comportamiento no lineal de arcos magnéticos en la corona solar.Este proyecto presenta como objetivo principal la introducción de mejoras en algoritmos numéricos para simular la propagación e interacción de ondas no lineales en dos medios gaseosos: aquellos que no poseen carga eléctrica libre (flujos gasdinámicos) y aquellos que tienen carga eléctrica libre (flujos magnetogasdinámicos). Al mismo tiempo se desarrollarán códigos computacionales que implementen las mejoras de las técnicas numéricas.Los algoritmos numéricos se aplicarán con la finalidad de incrementar el conocimiento en tópicos de interés en la ingeniería aeroespacial como es el cálculo del flujo de calor y fuerzas aerotermodinámicas que soportan objetos que ingresan a la atmósfera terrestre y en temas de astrofísica como la propagación e interacción de ondas, tanto para la transferencia de energía como para la generación de inestabilidades en arcos magnéticos de la corona solar. Estos dos temas poseen en común las técnicas y algoritmos numéricos con los que serán tratados. Las ecuaciones gasdinámicas y magnetogasdinámicas ideales conforman sistemas hiperbólicos de ecuaciones diferenciales y pueden ser solucionados utilizando "Riemann solvers" junto con el método de volúmenes finitos (Toro 1999; Udrea 1999; LeVeque 1992 y 2005). La inclusión de efectos difusivos genera que los sistemas de ecuaciones resulten hiperbólicos-parabólicos. La contribución parabólica puede ser considerada como términos fuentes y tratada adicionalmente tanto en forma explícita como implícita (Udrea 1999; LeVeque 2005).Para analizar el flujo alrededor de cuerpos que ingresan en la atmósfera se utilizarán las ecuaciones de Navier-Stokes químicamente activas, mientras la temperatura no supere los 6000K. Para mayores temperaturas es necesario considerar efectos de ionización (Anderson, 1989). Tanto los efectos difusivos como los cambios químicos serán considerados como términos fuentes en las ecuaciones de Euler. Para tratar la propagación de ondas, transferencia de energía e inestabilidades en arcos magnéticos de la corona solar se utilizarán las ecuaciones de la magnetogasdinámica ideal y real. En este caso será también conveniente implementar términos fuente para el tratamiento de fenómenos de transporte como el flujo de calor y el de radiación. Los códigos utilizarán la técnica de volúmenes finitos, junto con esquemas "Total Variation Disminishing - TVD" sobre mallas estructuradas y no estructuradas.

Optimización en el cómputos de algoritmos de cuadratura para funciones especiales. Optimization of quadrature algorithms for special functions.

En nuestro proyecto anterior aproximamos el cálculo de una integral definida con integrandos de grandes variaciones funcionales. Nuestra aproximación paraleliza el algoritmo de cómputo de un método adaptivo de cuadratura, basado en reglas de Newton-Cote. Los primeros resultados obtenidos fueron comunicados en distintos congresos nacionales e internacionales; ellos nos permintieron comenzar con una tipificación de las reglas de cuadratura existentes y una clasificación de algunas funciones utilizadas como funciones de prueba. Estas tareas de clasificación y tipificación no las hemos finalizado, por lo que pretendemos darle continuidad a fin de poder informar sobre la conveniencia o no de utilizar nuestra técnica. Para llevar adelante esta tarea se buscará una base de funciones de prueba y se ampliará el espectro de reglas de cuadraturas a utilizar. Además, nos proponemos re-estructurar el cálculo de algunas rutinas que intervienen en el cómputo de la mínima energía de una molécula. Este programa ya existe en su versión secuencial y está modelizado utilizando la aproximación LCAO. El mismo obtiene resultados exitosos en cuanto a precisión, comparado con otras publicaciones internacionales similares, pero requiere de un tiempo de cálculo significativamente alto. Nuestra propuesta es paralelizar el algoritmo mencionado abordándolo al menos en dos niveles: 1- decidir si conviene distribuir el cálculo de una integral entre varios procesadores o si será mejor distribuir distintas integrales entre diferentes procesadores. Debemos recordar que en los entornos de arquitecturas paralelas basadas en redes (típicamente redes de área local, LAN) el tiempo que ocupa el envío de mensajes entre los procesadores es muy significativo medido en cantidad de operaciones de cálculo que un procesador puede completar. 2- de ser necesario, paralelizar el cálculo de integrales dobles y/o triples. Para el desarrollo de nuestra propuesta se desarrollarán heurísticas para verificar y construir modelos en los casos mencionados tendientes a mejorar las rutinas de cálculo ya conocidas. A la vez que se testearán los algoritmos con casos de prueba. La metodología a utilizar es la habitual en Cálculo Numérico. Con cada propuesta se requiere: a) Implementar un algoritmo de cálculo tratando de lograr versiones superadoras de las ya existentes. b) Realizar los ejercicios de comparación con las rutinas existentes para confirmar o desechar una mejor perfomance numérica. c) Realizar estudios teóricos de error vinculados al método y a la implementación. Se conformó un equipo interdisciplinario integrado por investigadores tanto de Ciencias de la Computación como de Matemática. Metas a alcanzar Se espera obtener una caracterización de las reglas de cuadratura según su efectividad, con funciones de comportamiento oscilatorio y con decaimiento exponencial, y desarrollar implementaciones computacionales adecuadas, optimizadas y basadas en arquitecturas paralelas.