Embedded fuzzing: a review of challenges, tools, and solutions

Today’s complex applications must face the distribution of data and code among different network nodes. Computation in distributed contexts is demanding increasingly powerful languages and execution environments, able to provide programmers with appropriate abstractions and tools. Java is a wide-spread language that allows developers to build complex software, even distributed, but it cannot handle the migration of computations (i.e. threads), due to intrinsic limitations of many traditional JVMs. After analyzing the approaches in the literature, this paper presents our thread migration framework (called Mobile JikesRVM), implemented on top of the IBM Jikes Research Virtual Machine (RVM): exploiting some of the innovative techniques in the JikesRVM, we implemented an extension of its scheduler that allows applications to easily capture the state of a running thread and makes it possible to restore it elsewhere (i.e. on a different hardware architecture or operating system), but still with a version of the framework installed). Our thread serialization mechanism provides support for both proactive and reactive migration, available also for multi-threaded Java applications, and tools to deal with the problems of resource relocation management. With respect to previous approaches, we implemented Mobile JikesRVM without recompiling its JVM (Java Virtual Machine) source code, but simply extending JikesRVM functionalities with a full Java package to be imported when thread migration is needed.

The results of a study on the effectiveness of an execution environment for the formal definition of Ada are presented. The environment is based on a logic programming approach, that is the translation of the formal definition into an executable logic program. Some experimental performance measurements for a prototype execution environment which has been developed using the same approach for a simple concurrent language are given, and their usefulness in predicting the performance of the environment for the formal definition of Ada is discussed.

Response to the critique of “Keratocystic odontogenic tumor: systematic review with analysis of 72 additional cases from Mumbai, India”

The objective of this review was to synthesize the experiences of health professionals who have experienced grief as a result of a pediatric patient dying. There has been some research into health professionals' grief experiences associated with the death of pediatric patients, but there has not been a review that synthesizes the findings of these experiences. Other related reviews have focused on prenatal, perinatal or adult deaths or the coping strategies employed by health professionals. This review highlights the complexities of experiences faced by pediatric health professionals. Qualitative studies involving pediatric health professionals working in any healthcare setting who had experienced grief from the death of a patient were considered for inclusion. Studies were conducted in any country, at any time and published in English. The search was conducted in PubMed, CINAHL, Embase, PsycINFO, Scopus and ProQuest Dissertations and Theses. The search was completed in January 2019. The review followed principles of meta-aggregation in line with the JBI approach. Methodological quality assessment was based on representation of participants' voices and congruence between research methodology and both research question and analysis of data. Meta-aggregation led to three synthesized findings from 12 qualitative studies that met the inclusion and methodological quality criteria. Studies predominantly included nurses working in a hospital, with sample sizes ranging from six to 25 participants. The synthesized findings were physical, behavioral, psychological or spiritual symptoms; compounding grief; and alleviating grief. Physical, behavioral, psychological, or spiritual symptoms highlighted the various characteristics of grief experiences by health professionals. Compounding grief was the largest synthesized finding and incorporated the various factors that contributed to a poorer experience of grief. Alleviating grief showed the limited identified factors that improved the experience of grief. Methodological quality led to synthesized findings receiving a ConQual rating of low or moderate. The synthesized findings from this review highlight the varied reported experiences of grief in health professionals. The methodological quality and reporting of studies, however, led to decreased confidence in the synthesized findings and recommendations arising from this review. Healthcare professionals should be aware of the potential for experiencing grief when a patient dies and the compounding and alleviating factors associated with this. Further research could expand participant and language limitations, and improve methodological quality and reporting.

Problem: "Does the use of PHR improve the health of their users?" Background: The Personal Health Record (PHR) is an electronic application through which individuals can manage and share their lifelong health information. An immediate source of reliable information concerning the past health conditions of the patient might enable the physician to make more accurate diagnosis, preventing medical error. Although PHRs can be shared with health providers, they are used by the patient for self-care and record keeping, matching population’s growing demand to play an active role in their health care. Aim: Our study aims to understand the impact of PHRs on patient’s health. Methods: A systematic review was performed. The unit of analysis was original articles evaluating the impact of PHRs. The sources of information were Pubmed, ISI and Scopus. A hand search was not performed. The articles were analysed considering the study type; PHR’s characteristics; patient’s description, health status, opinion and response; the costs and doctor-patient communication. We set our inclusion and exclusion criteria. The inclusion criteria were articles that evaluated the benefits of PHRs in health care; their effect on certain diseases or populations; their acceptance among populations; articles that reported PHRs as a tool for the physician or evaluated them as a bridge between patient and physician. Exclusion criteria: articles dated before 1990, with no available 2 abstract, not written in English or Portuguese, about electronic systems of health care providers or electronic health records. From the 698 articles, only 158 full-texts fulfilled the inclusion and exclusion criteria. They were read and confronted with our variables. We got results from 44 papers. SPSS® was used to perform all needed statistical analysis. Results: We obtained the frequencies of all variables, performed one smaple t-tests and chi-square tests. We considered as statistically significant results with p<0.05. We observed that this is a topic increasingly discussed in the scientific community, as the number of papers increased exponentially since 2005. Internet PHRs are the most used, followed by paper-based and USB-pen ones. Most PHRs were supported by medical. Many PHRs are used in the treatment of chronic diseases. PHRs improved the use of medication and patient/doctor relation. Conclusion: The results obtained allow us to conclude that PHRs, in fact, improve the health of their users, confirming our belief that further research would be extremely relevant. KEY-WORDS Personal Health Records; Personal Child Health Records; PHR; Health Impact.

In order to increase the efficiency of existing software many works are incorporating GPU processing. However, despite the current advances in GPU languages and tools, taking advantage of their parallel architecture is still far more complex than programming standard multi-core CPUs. Performance profiling and analysis of known applications provides a useful insight of the hardware architecture and memory hierarchy. Afterwards, this analysis can be used to identify potential bottlenecks and tune other software so it can make a more efficient usage of the available resources. In this work we implement a small signal processing library which will be used to characterize the performance of most recent NVIDIA GPU architectures. The methodology used in our signal processing library is based on a series of building blocks that enable us to easily design several well-known algorithms with little effort. The library was built paying special attention to flexibility and adaptability. In this work we also show how a generic approach can be used to easily design these GPU algorithms while obtaining competitive performance, which results specially interesting from the productivity standpoint.

Systematic review and meta-analysis of ipsilateral and contralateral carotid web prevalence in embolic supratentorial strokes of undetermined source

Explaining evidence-based medicine

Community-based mental health studies have revealed that the point prevalence of depressive disorders in the elderly population of the world varies between 10% and 20%, depending on cultural situations. A retrospective study based on analysis of various study reports was conducted, to determine the median prevalence rates of depressive disorders in the elderly population of India and various other countries in the world. All the studies that constituted the sample were conducted between 1955 and 2005. Included are only community-based, cross-sectional surveys and some prospective studies that had not excluded depression at baseline. These studies were conducted on a homogenous community of the elderly population in the world, who were selected by a simple random sampling technique. After applying the inclusion and exclusion criteria on published and indexed articles, 74 original research studies that surveyed a total of 487 275 elderly individuals, in the age group of 60 years and above, residing in various parts of the world, were included for the final analysis. The median prevalence rate and its corresponding interquartile range were calculated. The chi-square test and chi-square for linear trend were applied. A P value of <.05 was considered as statistically significant. The median prevalence rate of depressive disorders in the world for the elderly population was determined to be 10.3% (interquartile range [IQR], 4.7%-16.0%). The median prevalence rate of depression among the elderly Indian population was determined to be 21.9% (IQR, 11.6%–31.1%). Although there was a significant decrease in the trend of world prevalence of geriatric depression, it was significantly higher among Indians, in recent years, than the rest of the world.

Feasibility, appropriateness, meaningfulness and effectiveness of nursing interventions on the well-being of people with Parkinsonʼs disease and their caregivers living in the community: a mixed-methods systematic review protocol

Study question What are the various inclusion criteria for the definition of unexplained infertility used for recruitment to clinical trials, and is there homogeneity of these definitions? Summary answer There is a need to standardise the definition of unexplained infertility when recruiting for clinical trials to optimise interpretation of results and allow appropriate meta-analysis. What is known already Unexplained infertility (UI) is a diagnosis of exclusion. The pathology underlying this diagnosis is likely to include different subtle contributing factors. Unfortunately there is no universally accepted definition of unexplained infertility. NICE in the UK, and ACOG/ASRM both have lists of recommended investigations but no specific minimum standards to define UI. Even the ICMART definition is ambiguous, describing ‘apparently normal’ ovarian function and ejaculate. This may lead to heterogeneity between inclusion criteria in relevant research studies. This introduces selection bias and renders meta-analysis of trial results less meaningful. A single definition would improve the quality of research for this important diagnosis. Study design, size, duration A systematic review of primary research investigating definitions of unexplained infertility in humans. A thorough search of online databases Medline and Embase was performed from inception to November 2021. A bespoke Excel spreadsheet was used to collect data for baseline study characteristics and outcome data. Results are reported as percentages. Participants/materials, setting, methods The search strategy included all primary research on heterosexual couple unexplained infertility in human participants. Papers with specified inclusion criteria were included and no date or language restrictions were applied. From 663 results, title and abstract screening identified 83 duplicates and 6 studies unsuitable for the review. A further 275 papers were excluded after full-text screening. 241 papers remained and their inclusion criteria recorded and analysed. Main results and the role of chance Only 35.7% of papers specified duration of infertility. Timescales varied from 1 year (46.5%), 2 years (39.5%) or 3 years (14%). 85% papers specified that semen analysis should be ‘normal’. Of these, 40% used the most recent WHO criteria. No other national or international criteria for grading semen analysis was identified. 90% studies required fallopian tube patency as an inclusion criteria. Of these, 65.4% specified bilateral patency. Methods for demonstrating patency included hysterosalpingogram (HSG) (15.7%), laparoscopy (18.4%), a combination of either (29.5%) or both (24.4%) of these or hystero-contrast-salpingography (0.9%). 11.5% papers did not specify an imaging modality. 48.5% included studies mentioned uterine cavity assessment, 65% of these using HSG to assess the cavity, other methods mentioned include ultrasound (26.5%) or hysteroscopy (15.4%). Only 5.4% papers required either exclusion of or evidence of only minimal endometriosis 80.5% of included papers required evidence of regular ovulation. 58.7% used luteal serum progesterone levels, 41.2% required regular cycles (patient-reported) and 17.5% used basal body temperature pattern assessment. Other methods mentioned by a minority of papers include endometrial biopsy, ultrasound follicular tracking, serum and urinary luteinising hormone levels. 44% studies required normal endocrine profiles of which 66% measured prolactin and FSH and 50% measured thyroid function. Limitations, reasons for caution The strength of this study is that we included all primary research papers studying unexplained infertility with no time limitations. Included studies originated from across the world. This is a thorough representation of criteria used across all clinical trials for unexplained infertility. Wider implications of the findings Only 63/241 (26%) studies included duration of infertility, tubal patency, proof of ovulation and semen analysis in their inclusion criteria. This demonstrates the need for standardisation of the definition of unexplained infertility. If future research can apply the same inclusion criteria this will reduce selection bias and allow appropriate meta-analysis. Trial registration number NA

Introduction: Commonly found in daily practice, acromioclavicular (AC) joint injury mostly presents as minor sprains and occurs five times more frequently in men than in women, with the highest incidence in the 20 to 30 years old age group. The management depends on its grade and severity but the treatment of choice for type III AC joint injury remains unclear. Considering the absence of an algorithm for correctly diagnosing and treating type III injuries, this systematic review aims to compare the conservative and operative treatment for this pathology.Materials and Methods:This systematic review was conducted based on the PRISMA guideline. Literature research was primarily performed using Pubmed, EMBASE, and Cochrane Library to search for studies on the management of type III acromioclavicular injuries up to July 23 rd, 2019. The inclusion criteria were type III acromioclavicular injuries type III, with the intervention of conservative as compared to operative management. Outcomes were measured radiologically and by functional assessment using subjective questions (Poigenfurst’s Criteria and the Oxford Shoulder Score). Studies with the pathologies other than type III acromioclavicular injuries were excluded from the analysis.Results:A list of inclusion and exclusion criteria previously agreed by the authors was utilized to screen the full text. This selection process yielded 5 final articles from 2011-2017 to be included in this systematic review, with 173 patients undergoing conservative (68) and operative treatment (105). One of the studies were of level II. The mean basic data ranges of the studies were as follows: patients’ age was 25-54 years old, and the follow-up time ranged from 3 – 10 years. Surgical techniques are done by modified Weaver and Dunn technique, tight rope system, K-wire fixation, and coracoacromial ligament suturing, double button technique, and hook plate fixation. Three of the study reported that conservative treatment was superior and one study reported that nonoperative was better in radiographic evaluation, but not significant. Two studies that only performed operative treatment reported that the patient can return to normal activity around a few months and one study told that after removing hook plat the Constant-Murley shoulder function scores is significantly raised. Calcification as the complication happened more than 70% of patients in operative treatment and 30% in conservative.Discussion: Acromioclavicular joint injuries present mostly minor sprains, with the highest incidence in the 20-30 year old age group. The difficulty lies in the different definitions of type III acromioclavicular injuries used in the current studies. There are multiple classifications for the description of AC injuries and the common classifications for AC injuries are using Rockwood et al. classifications. Treatment for type 1 and 2 is conservative and type 4–6 is mainly surgical, but there is no clear consensus on treatment of type 3 injuries. Four study reported conservative treatment was superior and had better radiographic results (poigenfurst’s criteria and the oxford shoulder score). Operative treatment was comparable, but was associated with more complications, such as calcifications.Conclusion:This systematic review reports successful outcome from 4 studies using conservative treatment. However, this review showed no conclusive evidence for the treatment. Therefore more study is expected in the future in order to assess the functional outcomes, using standard and validated measures, including patient assessed functional outcomes, as well as resource implications.

Schistosomiasis remains a major cause of global parasitic morbidity. Current control strategies focus on pharmaceutical approaches using Mass Drug Administration (MDA) to distribute praziquantel in endemic areas of sub-Saharan Africa. Our paper systematically reviewed the literature on non-pharmaceutical interventions for enhanced schistosomiasis control. We conducted a systematic review of peer-reviewed English language literature using PubMed, Embase and Web of Science. Our search terms were limited to the year 2000 to March 2019 to reflect the period of the Millennium and Sustainable Development Goals. We initially identified 1733 publications, which were reduced to 1324 after screening by title and abstract. After the inclusion and exclusion criteria, a total of 1312 studies were excluded. Following this, we had a total of 12 articles, which we later screened by full text. Out of the twelve articles, seven were excluded for being systematic reviews or examining clinical and nutritional aspects of schistosomiasis control. We finally remained with five studies that met our inclusion criteria. Our paper indicates a gap in non-pharmaceutical based interventions for schistosomiasis control. We propose that future research addresses this gap by engaging communities in participatory approaches such as environmental sanitation, Water, Sanitation and Hygiene (WASH), health education and economic empowerment.

Effects of aromatherapy on dysmenorrhea: A systematic review and meta-analysis

Composite aortic root replacement is a standard procedure for various aortic root pathologies. This systematic review was set to identify the postoperative outcomes for composite mechanical root replacement (mCRR) compared to composite biological root replacement (bCRR). We systematically reviewed four major databases for all papers assessing outcomes in composite root replacement. Articles selected were chosen by two reviewers. Amongst our inclusion and exclusion criteria, all pediatric populations were excluded as were studies with a cohort less than 50 patients. We identified seven studies that conformed to our inclusion criteria and incorporated 2240 patients. In-hospital mortality was higher but non-significant in the mechanical group (6.1 vs 4.2% respectively). There was no significant difference demonstrated in the risk of in-hospital stroke, late stroke and re-operation in either groups. Additionally, there was no significant difference in: endocarditis, 1-year mortality, 5-year mortality, mean cardiopulmonary or aortic cross-clamp time. Composite mechanical root offers no superiority to composite biological root. There is a significant increase in the perioperative bleeding amongst composite mechanical root cohort. There is a need for further randomized control trail to assess the efficacy of either methods.