Is the Roux Limb a Determinant for Meal Size After Gastric Bypass Surgery?

The Roux-Y gastric bypass (RYGBP) is an effective weight-reducing procedure but the involved mechanisms of action are obscure. The Roux limb is the intestinal segment that following surgery is the primary recipient for food intake. The aims of the study were to explore the mechanosensory and biomechanical properties of the Roux limb and to make correlations with preferred meal size. Ten patients participated and were examined preoperatively, 6 weeks and 1 year after RYGBP. Each subject ingested unrestricted amounts of a standardized meal and the weight of the meal was recorded. On another study day, the Roux limb was subjected to gradual distension by the use of an intraluminal balloon. Luminal volume–pressure relationships and thresholds for induction of sensations were monitored. At 6 weeks and 1 year post surgery, the subjects had reduced their meal sizes by 62% and 41% (medians), respectively, compared to preoperative values. The thresholds for eliciting distension-induced sensations were strongly and negatively correlated to the preferred meal size. Intraluminal pressure during Roux limb distension, both at low and high balloon volumes, correlated negatively to the size of the meal that the patients had chosen to eat. The results suggest that the Roux limb is an important determinant for regulating food intake after Roux-Y bypass bariatric surgery

Transparent Control Independence (TCI)

Superscalar architectures have been proposed that exploit control independence, reducing the performance penalty of branch mispredictions by preserving the work of future mispredictionindependent instructions. The essential goal of exploiting control independence is to completely decouple future mispredictionindependent instructions from deferred misprediction-dependent instructions. Current implementations fall short of this goal because they explicitly maintain program order among misprediction-independent and misprediction-dependent instructions. Explicit approaches sacrifice design efficiency and ultimately performance. We observe it is sufficient to emulate program order. Potential misprediction-dependent instructions are singled out a priori and their unchanging source values are checkpointed. These instructions and values are set aside as a “recovery program”. Checkpointed source values break the data dependencies with comingled misprediction-independent instructions – now long since gone from the pipeline – achieving the essential decoupling objective. When the mispredicted branch resolves, recovery is achieved by fetching the self-sufficient, condensed recovery program. Recovery is effectively transparent to the pipeline, in that speculative state is not rolled back and recovery appears as a jump to code. A coarse-grain retirement substrate permits the relaxed order between the decoupled programs. Transparent control independence (TCI) yields a highly streamlined pipeline that quickly recycles resources based on conventional speculation, enabling a large window with small cycle-critical resources, and prevents many mispredictions from disrupting this large window. TCI achieves speedups as high as 64 % (16 % average) and 88% (22 % average) for 4-issue and 8-issue pipelines, respectively, among 15 SPEC integer benchmarks. Factors that limit the performance of explicitly ordered approaches are quantified