Exascale integrated modeling of low-order wavefront sensing and control for the Roman Coronagraph instrument.

Astronomical instruments to detect exoplanets require extreme wavefront stability. For these missions to succeed, comprehensive and precise modeling is required to design and analyze suitable coronagraphs and their wavefront control systems. In this paper, we describe techniques for integrated modeling at scale that is, to the best of our knowledge, 1000 times faster than previously published works. We show how this capability has been used to validate performance and perform uncertainty quantification for the Roman Coronagraph instrument. Finally, we show how this modeling capacity may be necessary to design and build the next generation of space-based coronagraph instruments.

Health-Related Quality of Life in Stroke Survivors in Relation to the Type of Inpatient Rehabilitation in Serbia: A Prospective Cohort Study.

Background and objectives: Health-related quality of life after stroke is an important public health issue. The objective of the study was to investigate the relationship between the perceived health-related quality of life in stroke survivors in relation to the type of inpatient rehabilitation. Materials and Methods: Using a random selection method out of a total of 688 patients, every fourth survivor who had a stroke in the period from 1 January 2017 to 31 December 2019 was selected from the admission protocol of the Clinic for Rehabilitation and Physical Medicine of the Clinical Centre Nis, Serbia. A total of 160 first-ever stroke survivors were included (80 underwent additional inpatient rehabilitation and 80 underwent only inpatient rehabilitation in a tertiary health institution) in a twelve-month prospective study. The EuroQuol-5 Dimension (EQ5D) questionnaire and Stroke Impact Scale were used for the assessment. Multivariate linear regression analysis was done. Results: Multivariate linear regression analysis showed that additional inpatient rehabilitation from six up to eight weeks after discharge was significantly associated with better self-reported health condition by 3.9 times (from 1.9 to 8.2), significantly decreased the ranks of EQ5D by 1.78 times (from 1.02 to 3.11), and showed a higher health-related quality of life. We determined a significant increase of strength, emotions, mobility, and participation role in survivors who underwent additional inpatient rehabilitation compared with those who did not. Conclusions: There was a significant difference in health-related quality of life perceived by stroke survivors who underwent additional hospital rehabilitation in relation to those who underwent only inpatient rehabilitation.

[Functional recovery of post stroke patients with hemiparesis after stroke of different aetiology].

INTRODUCTION: Medical rehabilitation focuses on improvement of functional recovery in post stroke patients. The aim of the work was to analyze functional recovery in a cohort of post stroke patients with hemiparesis three months after stroke. MATERIAL AND METHODS: A prospective, cohort study included 30 patients from the city of Nis aged 40 to 69. The study was conducted at the Department of Physical Medicine and Rehabilitation in Nis. from March 1 to June 30, 2009. The aetiology of stroke was determined by the nuclear magnetic resonance. The average values, standard deviation, and t-test were calculated. RESULTS: Of the total sample of 30 patients, 23 (77%, 16 men and 7 women) had left hemiparesis and 7 (23%, 4 men and 3 women) had right hemiparesis. The average age of the patients was 58.93 +/- 6.86. Fourteen (47%) patients were not able to move, 10 (33%) patients could move when they were assisted by someone and only 6 (20%) patients could move independently. Twenty-six (88%) patients were not able to take care of themselves without assistance and 4 (13%) patients could take care of themselves. The average Barthel Index score on admission to the Department of Physical Medicine and Rehabilitation was 57 and 3 months after discharge it was 79; the determined difference was statistically significant (p < 0.01). At the end of the study, 57% of all the patients could walk without assistance. CONCLUSION: These results suggest that disabled post stroke patients may attain significant functional improvements in response to early rehabilitation as well as to prolonged rehabilitation therapy.

Epidemiology of end-stage renal disease and hemodialysis treatment in Serbia at the turn of the millennium.

The study presents the epidemiological features of patients treated with renal replacement therapy (RRT) in Serbia from 1997 to 2009 and compares the results of hemodialysis treatment in 1999 and 2009. Epidemiological data were obtained from the National Registry of RRT patients and data on hemodialysis treatment from special surveys conducted in 1999 and 2009. Within the period 1997-2009 the incidence of patients on RRT increased from 108 to 179 per million population (pmp), prevalence rose from 435 to 699 pmp, while mortality rate fell from 20.7% to 16.7%. The frequency of patients with glomerulonephritis decreased, while that of patients with diabetes and hypertensive nephropathy increased. In late 2009 there were 5208 patients receiving RRT in Serbia. Within the examined period new hemodialysis and reverse osmosis equipment were purchased, high-flux dialyzers with synthetic membranes were increasingly used and the number of patients receiving hemodiafiltration increased to 17.6%. Kt/V greater than 1.2 was recorded in 16% of the patients in 1999 but 52% in 2009. Options for correction of anemia and mineral disorders have also improved. The percentage of patients with HbsAg (13.8% vs. 4.8%) as well as anti-hepatitis C virus antibodies positive patients (23.2% vs. 12.7%) was significantly lower in 2009 than in 1999. Both the incidence and prevalence of RRT patients in Serbia are rising continuously, while the mortality rate is falling. More favorable conditions for dialysis treatment have brought about significant improvement in the results over the last 10 years.

The recovery of motor function in post stroke patients.

PURPOSE: The purpose of the paper was to assess physical recovery in post stroke patients. WORK METHOD: Prospective cohort study was conducted. The study involved 30 post stroke patients from the city of Nis, aged 40-69. To assess the functional status of the Barthel index (BI) was used. Functional status and BI scores were determined by two times, on admission to the Clinic for rehabilitation and three months after discharge from the Clinic. WORK RESULTS: A total number of patients was 30 (20 men and 10 women). There were twice more men than women (66.7% vs 33.3%, p < 0.001). The average age of all patients was 58.93 +/- 6.86. The majority of patients, were from the age group 60 to 69 years. Left-side hemiparesis had 23(77.%) of all patients (16 men and 7 women). Right-side hemiparesis had 7 (23%) patients (4 men and 3 women). Ischemic as a cause of stroke was found in 92% of patients and hemorrhage in 8%. The values of BI score on admission ranged from 30 to 100, with a mean BI score in all patients on admission to the Clinic was the 57. Three months after discharge from rehabilitation in all patients there was an increase in BI score in relation to the value of BI on admission. The average value of BI score was 79. The determined difference is statistically significant (p < 0.01). DISCUSSION: All the patients achieved an increase in BI score indicating their improved status after the applied rehabilitation treatment. CONCLUSION: At the end of the study 57% of the patients could move independently. Patients with a left-sided lesions had better self care of patients with right-sided lesions. Mobility was better in patients with left-sided lesions at the start of rehabilitation. On completion of the rehabilitation, patients with right-sided lesions still needed external help.

[Risk factors for stroke].

INTRODUCTION: Stroke is the third cause of mortality both in men and in women throughout the world. In Serbia, stroke is the first cause of mortality in women older than 55 years of age and the second cause of death in men of the same age. Both ischemic heart diseases and ischemic stroke correlate with the same predisposing, potentially modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity, diabetes mellitus). Stroke does not usually occur on its own. Patients with stroke have a high prevalence of associated medical problems. These conditions may predict the stroke ("preexisting conditions"), occur for the first time after stroke ("post-stroke complications"), or present as manifestations of preexisting medical conditions after stroke. RISK FACTORS: Risk factors for stroke are divided into the three groups: risk factors which cannot be influenced on such as: age, gender, positive family history of stroke, race: those which are modifiable such as: hypertension, diabetes mellitus, smoking cigarettes, obesity, physical inactivity and the third group consists of potential risk factors for stroke (consumption of alcohol, hormones, changes in fibrinolysis, changes in blood. CONCLUSION: Stroke remains a leading cause of long-term disability and premature death of both men and women. Consequently, stroke survivors are often handicapped and doomed to sedentary lifestyle which restrains performance of activities of daily living, increases the risk for falls, and may contribute to a higher risk for recurrent stroke and cardiovascular disease. Prevention of stroke is still a great medical and social problem. Further studies are required to investigate potential risk factors for the occurrence of stroke as well as the measures of primary and secondary prevention.

[Low power laser in the treatment of the acute low back pain].

BACKGROUND/AIM: Acute low back pain (ALBP) is one of the most frequent painful conditions in the human population. The objective of the paper was to compare the efficacy of the low power laser (LPL) in the pain and the muscular spasm reduction with conservative methods of physical medicine. METHOD: The prospective cohort study was done. The study involved 70 patients, both men and women, from 25 to 64 years of age with the diagnosis of ALBP. Two groups were formed. There were 40 patients in the first group and they were treated with the LPL with frequency of 73 Hz. The second group was the control one and it consisted of 30 patients who were treated with conservative methods of physical medicine (electrotherapy: diadynamic currents CP +/- 3 and CP +/- 3, interferent currents--90 Hz for 15 min; electrophoresis with novocaine). The ALBP were diagnosed by clinical examination and by the nuclear magnetic resonance imaging (NMRI). The low power laser--Gallium Arsenide (GaAs) was used. The laser sonde consisted of 4 laser diodes, each powered of 15 mW, wavelength 904 nm and with frequency 73 Hz. The total period of time for each treatment was 10 minutes and the total dose per treatment was 15 J. The intensity of acute low back pain was assessed by Roland's scale. The degree of the spasm was assessed in the relaxed position and during movements. Results. The average score in the first group before the onset of rehabilitation was 3.3 +/- 1.1 (Me = 3.0), and in the control group was 3.43 +/- 0.89 (Me = 3.0). After five treatments in patients who were treated with LPL the average score in Roland's scale was decreased (1.12 +/- 1.3, Me = 2.0) and in the control group there were no changes. After 10 treatments with the LPL the analgesic effect was obtained in 82.5% of patients from the first group and in 20% of patients in the control group. The analgesic effect in patients of the first group was obtained after 7.5 +/- 2.1 treatments and in the second group after 17.9 +/- 3.2 treatments. The difference was statistically significant (t = 15.652173, p < 0.001). The spasm disappeared in 92.5% of patients in the first group and in 20% of patients in the control group after 7.02 +/- 2.2 and 17.9 +/- 3.2 treatments respectively. The difference was statistically significant (t = 15.652173, p < 0.001). CONCLUSION: The pain and spasm reduction were obtained in the greater number of patients by usage of the LPL than by usage of conservative methods of physical medicine.

[Assessment of health-related quality of life in patients after acute myocardial infarction].

INTRODUCTION: Acute myocardial infarction has negative influence on patient's quality of life. The objective of the paper was to assess the health-related quality of life in the patients one month and twelve months after acute myocardial infarction and to compare it with the healthy controls. MATERIAL AND METHODS: A prospective cohort study involved 160 patients aged from 30 to 79 and 240 healthy controls. The health-related quality of life was assessed with the Serbian version of these questionnaires: EuroQuol-5-Dimension and EuroQuolVAS. Angina pectoris was ranked according to the classification of Canadian Cardiovascular Society. Multivariate logistic regression analysis was used. RESULTS: The healthy controls had significantly higher average scores in EuroQuolVAS compared with the patients one month after acute myocardial infarction (74.35 +/- 9.42 vs 60.50 +/- 12.03, p<0.001), as well as twelve months afte acute myocardial infarction (74.35 +/- 9.42 vs 69.83 +/- 12.06, p<0.001). Significantly lower average ranges in EuroQuol-5-Dimension questionnaire and higher quality of life were found twelve months after acute myocardial infarction than one month after acute myocardial infarction (1.41 +/- 0.26 vs 1.53 +/- 0.26, p<0.001). The average ranges of angina pectoris were significantly lower in all the patients twelve months after acute myocardial infarction compared with the first month (0.78 +/- 0.51 vs 0.91 +/- 0.44, p<0.01). The multivariate regression analysis confirmed thrombolytic therapy, percutaneous transluminal angioplasty and age to be important factors influencing health-related quality of life. CONCLUSION: The patients assessed their health condition to be significantly higher twelve months after acute myocardial infarction than one month after it. The health-related quality of life was significantly higher in patients who had undergone the percutaneous intervention than in those who had been treated with the thrombolytic therapy.

[Renal replacement therapy in adult dominant polycystic kidney disease--multicentre study].

INTRODUCTION: Adult polycystic kidney disease (APKD) is the most common hereditary kidney disease in humans. The course of the disease is accompanied by numerous complications. OBJECTIVE The aim was to assess the prevalence, clinical course and outcome of adult dominant polycystic kidney disease (ADPKD) patients on renal replacement therapy. METHOD: Medical data on 700 haemodialyzed (HD) and 500 transplanted patients treated in 10 Serbian centres from 1996 to 2000 were retrospectively analyzed. While ADPKD patients accounted for 13% of HD patients in Serbia in 2000, in the period between 1996 and 2000, the percent of patients with ADPKD in the population of patients starting HD in 8 examined centres changed from 13.5% to 6.9%. RESULTS: The total number of 180 ADPKD patients on HD was analyzed (96 males; aged 55 years at HD onset). Their HD lasted between 1 and 22 years: males started HD 1.3 years earlier and spent on HD 1.1 years less than females. In 53% of HD patients one or more family members had ADPKD but the cause of death was unknown for many family members. Hypertension was present in 75% of ADPKD patients, anaemia in 37% and other organ involvement (usually liver) was found in 53 patients. Fifty patients experienced AV fistula thrombosis and a vascular prosthesis had to be used in 9 of them. A hundred and two HD patients died (aged between 38 and 78 years, on HD for 5.3 years). The causes of death were stroke (19.6%), cardiovascular diseases (29%), infections, while 5% of patients died with the picture of acute abdomen. Among 500 transplanted patients, there were 20 patients with ADPKD (11 males, ages between 35 and 56 years at the time of transplantation) and 14 of them received graft from cadaver donor. Uni- or bilateral nephrectomy was done in 4 patients in the pretransplant preparation, and in another two early after transplantation due to urinary infection. Three patients restarted HD in the first 3 months after transplantation due to acute tubular necrosis and 10 patients died 56.5 months after the transplantation. The known causes of death were cardiovascular disease (3 patients), severe gastrointestinal bleeding (2 patients), infection (2 patients) and cancer (2 patients). CONCLUSION: The obtained results showed that it was possible to provide a favourable outcome of patients with APBB on renal replacement therapy in spite of numerous complications.