Explore the vast range of titles available.

State-of-art NPUs are typically architected as a self-contained sub-system with multiple heterogeneous hardware computing modules, and a dataflow-driven programming model. There lacks well-established methodology and tools in the industry to evaluate and compare the performance of NPUs from different architectures. We present an event-based performance modeling framework, VPU-EM, targeting scalable performance evaluation of modern NPUs across diversified AI workloads. The framework adopts high-level event-based system-simulation methodology to abstract away design details for speed, while maintaining hardware pipelining, concurrency and interaction with software task scheduling. It is natively developed in Python and built to interface directly with AI frameworks such as Tensorflow, PyTorch, ONNX and OpenVINO, linking various in-house NPU graph compilers to achieve optimized full model performance. Furthermore, VPU-EM also provides the capability to model power characteristics of NPU in Power-EM mode to enable joint performance/power analysis. Using VPU-EM, we conduct performance/power analysis of models from representative neural network architecture. We demonstrate that even though this framework is developed for Intel VPU, an Intel in-house NPU IP technology, the methodology can be generalized for analysis of modern NPUs.

Railroad Savings & Loan Association Tuesday announced plans to close its four offices inside K mart stores in Wichita. The closings, tentatively scheduled for Sept. 30, will not disrupt customers. Their accounts will be immediately transferred to Railroad Savings' downtown Wichita office located at 110 S. Main. In making the announcement Railroad Savings President Gary L. Baugh said: \"Although we like the concept of convenience branches and have enjoyed the support of K mart management, we have decided that these offices don't complement our strategic plan for the association's successful statewide agent network. (excerpt)

Cancer chemotherapy-associated febrile neutropenia (FN) is a common condition that is deadly when bacteremia is present. Detection of bacteremia depends on culture, which takes days, and no accurate predictive tools applicable to the initial evaluation are available. We utilized metabolomics and transcriptomics to develop multivariable predictors of bacteremia among FN patients. We classified emergency department patients with FN and no apparent infection at presentation as bacteremic (cases) or not (controls), according to blood culture results. We assessed relative metabolite abundance in plasma, and relative expression of 2,560 immunology and cancer-related genes in whole blood. We used logistic regression to identify multivariable predictors of bacteremia, and report test characteristics of the derived predictors. For metabolomics, 14 bacteremic cases and 25 non-bacteremic controls were available for analysis; for transcriptomics we had 7 and 22 respectively. A 5-predictor metabolomic model had an area under the receiver operating characteristic curve of 0.991 (95%CI: 0.972,1.000), 100% sensitivity, and 96% specificity for identifying bacteremia. Pregnenolone steroids were more abundant in cases and carnitine metabolites were more abundant in controls. A 3-predictor gene expression model had corresponding results of 0.961 (95%CI: 0.896,1.000), 100%, and 86%. Genes involved in innate immunity were differentially expressed. Classifiers derived from metabolomic and gene expression data hold promise as objective and accurate predictors of bacteremia among FN patients without apparent infection at presentation, and can provide insights into the underlying biology. Our findings should be considered illustrative, but may lay the groundwork for future biomarker development.

PurposeMany patients with cancer seek care for pain in the emergency department (ED). Prospective research on cancer pain in this setting has historically been insufficient. We conducted this study to describe the reported pain among cancer patients presenting to the ED, how pain is managed, and how pain may be associated with clinical outcomes.MethodsWe conducted a multicenter cohort study on adult patients with active cancer presenting to 18 EDs in the USA. We reported pain scores, response to medication, and analgesic utilization. We estimated the associations between pain severity, medication utilization, and the following outcomes: 30-day mortality, 30-day hospital readmission, and ED disposition.ResultsThe study population included 1075 participants. Those who received an opioid in the ED were more likely to be admitted to the hospital and were more likely to be readmitted within 30 days (OR 1.4 (95% CI: 1.11, 1.88) and OR 1.56 (95% CI: 1.17, 2.07)), respectively. Severe pain at ED presentation was associated with increased 30-day mortality (OR 2.30, 95% CI: 1.05, 5.02), though this risk was attenuated when adjusting for clinical factors (most notably functional status).ConclusionsPatients with severe pain had a higher risk of mortality, which was attenuated when correcting for clinical characteristics. Those patients who required opioid analgesics in the ED were more likely to require admission and were more at risk of 30-day hospital readmission. Future efforts should focus on these at-risk groups, who may benefit from additional services including palliative care, hospice, or home-health services.

Better understanding of the emergency care needs of patients with cancer will inform outpatient and emergency department (ED) management. To provide a benchmark description of patients who present to the ED with active cancer. This multicenter prospective cohort study included 18 EDs affiliated with the Comprehensive Oncologic Emergencies Research Network (CONCERN). Of 1564 eligible patients, 1075 adults with active cancer were included from February 1, 2016, through January 30, 2017. Data were analyzed from February 1 through August 1, 2018. The proportion of patients reporting symptoms (eg, pain, nausea) before and during the ED visit, ED and outpatient medications, most common diagnoses, and suspected infection as indicated by ED antibiotic administration. The proportions observed, admitted, and with a hospital length of stay (LOS) of no more than 2 days were identified. Of 1075 participants, mean (SD) age was 62 (14) years, and 51.8% were female. Seven hundred ninety-four participants (73.9%; 95% CI, 71.1%-76.5%) had undergone cancer treatment in the preceding 30 days; 674 (62.7%; 95% CI, 59.7%-65.6%) had advanced or metastatic cancer; and 505 (47.0%; 95% CI, 43.9%-50.0%) were 65 years or older. The 5 most common ED diagnoses were symptom related. Of all participants, 82 (7.6%; 95% CI, 6.1%-9.4%) were placed in observation and 615 (57.2%; 95% CI, 54.2%-60.2%) were admitted; 154 of 615 admissions (25.0%; 95% CI, 21.7%-28.7%) had an LOS of 2 days or less (median, 3 days; interquartile range, 2-6 days). Pain during the ED visit was present in 668 patients (62.1%; 95% CI, 59.2%-65.0%; mean [SD] pain score, 6.4 [2.6] of 10.0) and in 776 (72.2%) during the prior week. Opioids were administered in the ED to 228 of 386 patients (59.1%; 95% CI, 18.8%-23.8%) with moderate to severe ED pain. Outpatient opioids were prescribed to 368 patients (47.4%; 95% CI, 3.14%-37.2%) of those with pre-ED pain, including 244 of 428 (57.0%; 95% CI, 52.2%-61.8%) who reported quite a bit or very much pain. Nausea in the ED was present in 336 (31.3%; 95% CI, 28.5%-34.1%); of these, 160 (47.6%; 95% CI, 12.8%-17.1%) received antiemetics in the ED. Antibiotics were administered in the ED to 285 patients (26.5%; 95% CI, 23.9%-29.2%). Of these, 209 patients (73.3%; 95% CI, 17.1%-21.9%) were admitted compared with 427 of 790 (54.1%; 95% CI, 50.5%-57.6%) not receiving antibiotics. This initial prospective, multicenter study profiling patients with cancer who were treated in the ED identifies common characteristics in this patient population and suggests opportunities to optimize care before, during, and after the ED visit. Improvement requires collaboration between specialists and emergency physicians optimizing ED use, improving symptom control, avoiding unnecessary hospitalizations, and appropriately stratifying risk to ensure safe ED treatment and disposition of patients with cancer.

Potential participants were identified by means of a daily hospital census, and patients were approached for enrollment irrespective of disease severity, except for those with unstable arrhythmias, congestive heart failure with a left ventricular ejection fraction of <25%, receiving mechanical ventilation, oxygen requirement of >5 L/min at rest, or other comorbidities that precluded participation in exercise, including orthopedic conditions and severe dementia. All participants received a comprehensive bundled care for readmission reduction during hospitalization and after discharge that was comprised of a uniform duration of 5 days of systemic steroids and antibiotics, disease management education, follow-up in the COPD clinic within 10 ± 2 days, smoking cessation counseling when applicable, home health or palliative care when suitable, and referrals to traditional PR (2). Baseline Characteristics of Patients in the Video Telehealth Pulmonary Rehabilitation and Unexposed Arms Telehealth PR (n = 80) Unexposed (n = 160) Age, yr 64.5 (10.1) 63.4 (11.8) Sex, F 49 (61.3%) 92 (57.5%) Race, African American 26 (32.5%) 57 (35.6%) Body mass index, kg/m2 29.0 (10.2) 28.2 (8.2) Current smoker 21 (26.3%) 60 (37.5%) FEV1% predicted* 45.4 (18.1) 48.6 (21.1) FEV1/FVC* 0.52 (0.15) 0.57 (0.15) Domiciliary oxygen use 43 (53.8%) 44 (27.5%) Coronary artery disease 16 (20.0%) 31 (19.4%) Atrial fibrillation 8 (10.0%) 13 (8.1%) Congestive heart failure 10 (12.5%) 24 (15.0%) Hypertension 55 (68.8%) 111 (69.4%) Diabetes mellitus 22 (27.5%) 46 (28.8%) Depression 16 (20.0%) 40 (25.0%) Anxiety 15 (18.8%) 32 (20.0%) Hospitalizations in prior 12 mo 0.9 (1.4) 0.9 (1.7) ER visits in prior 6 mo 1.0 (1.5) 0.7 (1.4) Length of stay, d† 4 (2) 4 (3) LACE index 10.7 (2.8) 10.6 (3.0) Definition of abbreviations: ER = emergency room; LACE = length of stay, acuity of admission, comorbidities, and ER visits in the previous 6 months; PR = pulmonary rehabilitation. A retrospective study of a comprehensive care plan comprised of smoking cessation and inhaler education; pulmonary consultation; comorbidity assessment; palliative care assessment; mucus clearance device and inhaler selection based on clinical assessment of patient dexterity, competence, and peak inspiratory flow; and close outpatient follow-up showed a 16% reduction in all-cause readmissions (4).

Background Patients with cancer frequently visit the emergency department (ED) and are at high risk for hospitalization due to severe illness from cancer progression or treatment side effects. With an aging population and rising cancer incidence rates worldwide, it is crucial to understand how EDs and other acute care venues manage oncologic emergencies. Insights from other nations and health systems may inform resources necessary for optimal ED management and novel care delivery pathways. We described clinical management of oncologic emergencies and their contribution to ED visits and hospitalizations worldwide. Methods We performed a systematic review of peer-reviewed original research studies published in the English language between January 1st, 2003, to December 31st, 2022, garnered from PubMed, Web of Science, and EMBASE. We included all studies investigating adult (≥ 18 years) cancer patients with emergency visits. We examined chief complaints or predictors of ED use that explicitly defined oncologic emergencies. Results The search strategy yielded 49 articles addressing cancer-related emergency visits. Most publications reported single-site studies ( n  = 34/49), with approximately even distribution across clinical settings- ED ( n  = 22/49) and acute care hospital/ICU ( n  = 27/49). The number of patient observations varied widely among the published studies (range: 9 – 87,555 patients), with most studies not specifying the cancer type ( n  = 33/49), stage ( n  = 41/49), or treatment type ( n  = 36/49). Most studies ( n  = 31/49) examined patients aged ≥ 60 years. Infection was the most common oncologic emergency documented ( n  = 22/49), followed by pain ( n  = 20/49), dyspnea ( n  = 19/49), and gastrointestinal (GI) symptoms ( n  = 17/49). Interventions within the ED or hospital ranged from pharmacological management with opioids ( n  = 11/49), antibiotics ( n  = 9/49), corticosteroids ( n  = 5/49), and invasive procedures (e.g., palliative stenting; n  = 13/49) or surgical interventions ( n  = 2/49). Conclusion Limited research specifically addresses oncologic emergencies despite the international prevalence of ED presentations among cancer patients. Patients with cancer presenting to the ED appear to have a variety of complaints which could result from their cancers and thus may require tailored diagnostic and intervention pathways to provide optimal acute care. Further acute geriatric oncology research may clarify the optimal management strategies to improve the outcomes for this vulnerable patient population.

Background Patients with cancer visit the emergency department often and have a high rate of admission compared to other patients. Admission rates by institution may vary widely, even after accounting for patient and hospital-specific characteristics. Objectives To review the variables that affect admission rates among patients with cancer in the emergency department. Methods We performed a secondary analysis of a prospective cohort study of patients with cancer at 18 emergency departments between March 1, 2016, and January 30, 2017, to examine differences in patient populations between hospitals with varying admission rates. We calculated the percentage admitted by hospital and used it to categorize hospitals into quartiles. We compared outcomes, patient demographics, and disease characteristics between the admission quartiles using linear or logistic regression. Results A total of 1075 patients were included. The median age of our sample was 64, and 51% of patients were female, 84% were white, and 13% were Black. Of the 1075 patients, 615 (57.2%) were admitted as inpatients with a range from 21.2 to 81.7% by hospital. Differences between admission quartiles were found for education, mode of arrival, and recent chemotherapy ( p  < 0.05). There were no significant differences among quartiles in age, gender, race, or ECOG score. We found significant difference between admission quartiles in 30-day emergency department revisits. Differences in readmission rates and mortality did not appear to be significant between the various quartiles. Conclusions In our study, we observed several differences among patients with cancer receiving care at hospitals with different admission rates. These included patients’ education level, mode of arrival, and whether they had received recent chemotherapy. Emergency Severity Index (ESI) score may have also contributed to admission rate variability. Further study into unmeasured factors influencing hospital admissions, such as local culture, resources, and pathways, could identify generalizable findings to reduce avoidable admissions and reduce variation among similar patients in different hospitals.