Design of variation-tolerant synchronizers for multiple clock and voltage domains

PhD ThesisParametric variability increasingly affects the performance of electronic circuits as the fabrication technology has reached the level of 32nm and beyond. These parameters may include transistor Process parameters (such as threshold voltage), supply Voltage and Temperature (PVT), all of which could have a significant impact on the speed and power consumption of the circuit, particularly if the variations exceed the design margins. As systems are designed with more asynchronous protocols, there is a need for highly robust synchronizers and arbiters. These components are often used as interfaces between communication links of different timing domains as well as sampling devices for asynchronous inputs coming from external components. These applications have created a need for new robust designs of synchronizers and arbiters that can tolerate process, voltage and temperature variations. The aim of this study was to investigate how synchronizers and arbiters should be designed to tolerate parametric variations. All investigations focused mainly on circuit-level and transistor level designs and were modeled and simulated in the UMC90nm CMOS technology process. Analog simulations were used to measure timing parameters and power consumption along with a “Monte Carlo” statistical analysis to account for process variations. Two main components of synchronizers and arbiters were primarily investigated: flip-flop and mutual-exclusion element (MUTEX). Both components can violate the input timing conditions, setup and hold window times, which could cause metastability inside their bistable elements and possibly end in failures. The mean-time between failures is an important reliability feature of any synchronizer delay through the synchronizer. The MUTEX study focused on the classical circuit, in addition to a number of tolerance, based on increasing internal gain by adding current sources, reducing the capacitive loading, boosting the transconductance of the latch, compensating the existing Miller capacitance, and adding asymmetry to maneuver the metastable point. The results showed that some circuits had little or almost no improvements, while five techniques showed significant improvements by reducing τ and maintaining high tolerance. Three design approaches are proposed to provide variation-tolerant synchronizers. wagging synchronizer proposed to First, the is significantly increase reliability over that of the conventional two flip-flop synchronizer. The robustness of the wagging technique can be enhanced by using robust τ latches or adding one more cycle of synchronization. The second approach is the Metastability Auto-Detection and Correction (MADAC) latch which relies on swiftly detecting a metastable event and correcting it by enforcing the previously stored logic value. This technique significantly reduces the resolution time down from uncertain synchronization technique is proposed to transfer signals between Multiple- Voltage Multiple-Clock Domains (MVD/MCD) that do not require conventional level-shifters between the domains or multiple power supplies within each domain. This interface circuit uses a synchronous set and feedback reset protocol which provides level-shifting and synchronization of all signals between the domains, from a wide range of voltage-supplies and clock frequencies. Overall, synchronizer circuits can tolerate variations to a greater extent by employing the wagging technique or using a MADAC latch, while MUTEX tolerance can suffice with small circuit modifications. Communication between MVD/MCD can be achieved by an asynchronous handshake without a need for adding level-shifters.The Saudi Arabian Embassy in London, Umm Al-Qura University, Saudi Arabi

Application of Cortical Learning Algorithms to Movement Classification

Classifying the objects’ trajectories extracted from Closed-Circuit Television (CCTV) feeds is a key video analytic module to systematize or rather help to automate both the real-time monitoring and the video forensic process. Machine learning algorithms have been heavily proposed to solve the problem of movement classification. However, they still suffer from various limitations such as their limited ability to cope with multi-dimensional data streams or data with temporal behaviour. Recently, the Hierarchical Temporal Memory (HTM) and its implementation, the Cortical Learning Algorithms (CLA) have proven their success to detect temporal anomalies from a noisy data stream. In this paper, a novel CLA-based movement classification algorithm has been proposed and devised to detect abnormal movements in realistic video surveillance scenarios. Tests applied on twenty-three videos have been conducted and the proposed algorithm has been evaluated and compared against several state-of-the-art anomaly detection algorithms. Our algorithm has achieved 66.29% average F-measure, with an improvement of 15.5% compared to the k-Nearest Neighbour Global Anomaly Score (kNN-GAS) algorithm. The Independent Component Analysis-Local Outlier Probability (ICA-LoOP) scored 42.75%, the Singular Value Decomposition Influence Outlier (SVD-IO) achieved 34.82%, whilst the Connectivity Based Factor algorithm (CBOF) scored 8.72%. The proposed models have empirically portrayed positive potential and had exceeded in performance when compared to state-of-the-art algorithms

Human papillomavirus 16 E6 induces FoxM1B in oral keratinocytes through GRHL2

High-risk human papillomavirus (HPV) is a major risk factor for oral and pharyngeal cancers (OPCs), yet the detailed mechanisms by which HPV promotes OPCs are not understood. Forkhead box M1B (FoxM1B) is an oncogene essential for cell cycle progression and tumorigenesis, and it is aberrantly overexpressed in many tumors. We previously showed that FoxM1B was the putative target of an epithelial-specific transcription factor, Grainyhead-like 2 (GRHL2). In the current study, we demonstrate that HPV type 16 (HPV-16) E6 induces FoxM1B in human oral keratinocytes (HOKs) and tonsillar epithelial cells (TECs) in part through GRHL2. FoxM1B was barely detectable in cultured normal human oral keratinocytes (NHOKs) and progressively increased in immortalized HOKs harboring HPV-16 genome (HOK-16B) and tumorigenic HOK-16B/BaP-T cells. Retroviral expression of HPV-16 E6 and/or E7 in NHOKs, TECs, and hypopharyngeal carcinoma cells (FaDu) revealed induction of FoxM1B and GRHL2 by the E6 protein but not E7. Both GRHL2 and FoxM1B were strongly induced in the epidermis of HPV-16 E6 transgenic mice and HPVoral squamous cell carcinomas. Ectopic expression of FoxM1B led to acquisition of transformed phenotype in HOK-16B cells. Loss of FoxM1B by lentiviral short hairpin RNA vector or chemical inhibitor led to elimination of tumorigenic characteristics of HOK-16B/BaP-T cells. Luciferase reporter assay revealed that GRHL2 directly bound and regulated the FoxM1B gene promoter activity. Using epithelial-specific Grhl2 conditional knockout mice, we exposed wild-type (WT) and Grhl2 KO mice to 4-nitroquinolin 1-oxide (4-NQO), which led to induction of FoxM1B in the tongue tissues and rampant oral tumor development in the WT mice. However, 4-NQO exposure failed to induce tongue tumors or induction of FoxM1B expression in Grhl2 KO mice. Collectively, these results indicate that HPV-16 induces FoxM1B in part through GRHL2 transcriptional activity and that elevated FoxM1B level is required for oropharyngeal cancer development

An Overview Of Healthcare Administrative, Responsibility With The Optometrist, Nursing And Public Health Settings

A significant amount of resources will be required for large-scale public awareness initiatives about eye and vision health. These efforts will also require a presence from the federal government as well as coordination with a wide range of partners from both the public and commercial sectors. In general, the public awareness campaigns that are the most successful are those that are vast in scope and involve multiple facets. These campaigns typically involve a variety of outreach activities, stakeholders and sponsors, instructional materials, messaging, and media platforms. The responsibility that the healthcare administrator has with regard to the optometry, nursing, and public health sectors was demonstrated throughout this. Nursing in public health is a broad profession with a lack of hard and fast defined boundaries. The public health nurse does not engage in "hands on" nursing; rather, she is concerned with the prevention of illness, damage, or disability, as well as the promotion of health awareness and wellness

Quality of life and depression among chronic kidney disease patients: a tertiary care center cross-sectional study

BackgroundChronic kidney disease (CKD) is a severe health condition that involves a decline in kidney function, leading to high mortality rates in Saudi Arabia and globally. It often coexists with chronic non-communicable conditions such as hypertension and diabetes. As CKD progresses, patients experience psychological distress, anxiety, and depression, which can negatively impact their health and quality of life. This can lead to reduced treatment adherence, increased mortality, and poor quality of life.ObjectiveThis study sought to assess the prevalence of depression among CKD patients, investigate how quality of life (QoL) and depression vary across CKD stages, and examine the relationship between depression and QoL at different disease stages. This study was conducted at a tertiary care center in Jeddah, Saudi Arabia.MethodsThis cross-sectional research, conducted in Jeddah, Saudi Arabia, from February to May 2024, included 95 CKD patients who met the CKD diagnostic criteria as confirmed by a nephrologist. Pregnant women, dialysis patients, and patients under the age of 18 were excluded from the research. Patients’ contact information was gathered from electronic medical records at King Abdulaziz University Hospital (KAUH), and consent was sought over the phone. Depression was assessed in non-dialysis CKD patients using the Patient Health Questionnaire (PHQ-9), and health-related quality of life (HRQoL) was assessed using the 12-Item Short-Form Health Survey (SF-12) score. Demographic information, previous medical comorbidities, and estimated glomerular filtration rate (eGFR) were also considered. The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) CKD classification was used to classify patients into stages. The research sought to give a full evaluation of patients’ mental and physical health.ResultsA total of 95 patients were included in this study, with a predominance of male gender (58.9%) and those who were aged 60 years and above (50.5%). Most patients were non-smokers (78.9%), and 45.3% were classified as non-obese patients. Comorbidities were widespread among these patients, especially hypertension (82.1%) and diabetes (74.7%). Regarding severity level measured by PHQ-9, the median score was 12.0, 28.4% of the patients were classified as having moderate depression, and the correlation between depression and physical activity (PCS12) and mental health (MCS12) was significantly negative. Multiple linear regression analysis showed that depression was significantly associated with lower physical and mental capacity scores, alongside older age and female gender.ConclusionThis study emphasized the substantial impact of depressive symptoms among obese patients, highlighting the interplay between mental health and chronic physical conditions. Our findings suggest that specific risk factors such as fatigue, chronic illness, including hypertension, and prior mental health history are associated with increased vulnerability to depression. These insights underscore the importance of integrating routine mental health screening and individualized intervention strategies into patient care, particularly for those with comorbid conditions. Future research is needed to further explore the causal relationships and to inform more effective, targeted public health

Association Between Glucose Level And Prevalence of Headache Among Saudi Population: A Cross-Sectional Study

Objective: To investigate the association between glucose levels and the prevalence of headaches among the adult Saudi population. Methods: This research will employ a cross-sectional study design, which involves collecting data from a sample of the Saudi population at a single point in time. This design allows for the investigation of the association between glucose levels and headache prevalence in a cost-effective and time-efficient manner. Results: The study included 574 participants. The most frequent weight among them was 51-65 kg (n= 196, 34.1%), followed by 66-75 kg (n= 130, 22.6%). The most frequent height among study participants was 151-160 cm (n= 229, 39.9%), followed by 161-170 cm (n= 195, 34%). The most frequent age among study participants was less than 25 years (n= 203, 35.4%), followed by 25-30 years (n= 143, 24.9%). The most frequent nationality among study participants was Saudi (n= 547, 95.3%), followed by non-Saudi (n= 27, 4.7%). The most frequent gender among study participants was female (n= 351, 61.1%), followed by male (n= 223, 38.9%). The perceived blood sugar level intake varied among study participants, with most having normal blood sugar levels. Participants were asked if they smoked. Most were not smoking (n=482, 84%), and non-smoking were (n=92, 26%). Participants were asked about the nature of the headache. The most frequent were they don’t have (n= 345, 60.1%), followed by sharp (n= 116, 20.2%), and the least was continuous (n=113, 19.7%). Participants were asked about a kind of headache. The most frequent were they don’t have (n= 367, 63.9%), followed by stress headaches (n= 116, 20.2%), and the lowest cluster (n=15, 2.6%). Conclusion: The results of the study showed that most of the participants were Saudis. Most of them are women. In addition, the majority of people have normal fasting blood sugar levels. Their physical activity is moderate and the majority are non-smokers. In addition, most of the study participants had good and effective social communication

Impact Of Bariatric Surgery on Gastroesophageal Reflux Disease: A Cross-Sectional Study

Objective: To assess the occurrence of GERD after bariatric surgery and surgery impact on GERD. Methods: This research employs a cross-sectional study design to investigate the impact of bariatric surgery on Gastroesophageal Reflux Disease (GERD) among individuals who have undergone various types of bariatric surgeries. Results: The study included 302 participants. The most frequent weight among them was more than 96 kg (n= 130, 43%) followed by 76-85 kg (n= 51, 16.9%). The most frequent height among study participants was 1.61-1.70 m (n= 100, 33.1%) followed by 1.51-1.60 m (n= 99, 32.8%). The most frequent body mass index (BMI) value among study participants was more than 35 kg/m2 (n= 126, 41.7%) followed by 25-29.9 kg/m2 (n= 67, 22.2%). The most frequent age among study participants was 26-36 years (n= 104, 34.4%) followed by 15-25 years (n= 83, 27.5%). The most frequent gender among study participants was Female (n= 162, 53.6%) followed by Male (n= 140, 46.4%). Participants were asked about the type of obesity surgery. The most frequent was Gastric sleeve (n=222, 73.5%), followed by Gastric bypass (n=33, 10.9%).   Conclusion: Study results showed that most of the study participants are extremely obese according to their BMI. The most common obesity surgery type was a Gastric sleeve followed by a Gastric bypass. The most of participants were a non-smoker. Most of them had weight loss. In addition, most of the study participants had good social connection

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)