Approximate logic synthesis: a survey

Approximate computing is an emerging paradigm that, by relaxing the requirement for full accuracy, offers benefits in terms of design area and power consumption. This paradigm is particularly attractive in applications where the underlying computation has inherent resilience to small errors. Such applications are abundant in many domains, including machine learning, computer vision, and signal processing. In circuit design, a major challenge is the capability to synthesize the approximate circuits automatically without manually relying on the expertise of designers. In this work, we review methods devised to synthesize approximate circuits, given their exact functionality and an approximability threshold. We summarize strategies for evaluating the error that circuit simplification can induce on the output, which guides synthesis techniques in choosing the circuit transformations that lead to the largest benefit for a given amount of induced error. We then review circuit simplification methods that operate at the gate or Boolean level, including those that leverage classical Boolean synthesis techniques to realize the approximations. We also summarize strategies that take high-level descriptions, such as C or behavioral Verilog, and synthesize approximate circuits from these descriptions

Addressing the carbon-crime blind spot : a carbon footprint approach

Governments estimate the social and economic impacts of crime, but its environmental impact is largely unacknowledged. Our study addresses this by estimating the carbon footprint of crime in England and Wales and identifies the largest sources of emissions. By applying environmentally extended input-output analysis–derived carbon emission factors to the monetized costs of crime, we estimate that crime committed in 2011 in England and Wales gave rise to over 4 million tonnes of carbon dioxide equivalents. Burglary resulted in the largest proportion of the total footprint (30%), because of the carbon associated with replacing stolen/damaged goods. Emissions arising from criminal justice system services also accounted for a large proportion (21% of all offenses; 49% of police recorded offenses). Focus on these offenses and the carbon efficiency of these services may help reduce the overall emissions that result from crime. However, cutting crime does not automatically result in a net reduction in carbon, given that we need to take account of potential rebound effects. As an example, we consider the impact of reducing domestic burglary by 5%. Calculating this is inherently uncertain given that it depends on assumptions concerning how money would be spent in the absence of crime. We find the most likely rebound effect (our medium estimate) is an increase in emissions of 2%. Despite this uncertainty concerning carbon savings, our study goes some way toward informing policy makers of the scale of the environmental consequences of crime and thus enables it to be taken into account in policy appraisals

The Global Alliance for Infections in Surgery: Defining a Model for Antimicrobial Stewardship-Results From an International Cross-Sectional Survey

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p \u3c 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal

MicroRNA-138 is a potential regulator of memory performance in humans

Genetic factors underlie a substantial proportion of individual differences in cognitive functions in humans, including processes related to episodic and working memory. While genetic association studies have proposed several candidate "memory genes," these currently explain only a minor fraction of the phenotypic variance. Here, we performed genome-wide screening on 13 episodic and working memory phenotypes in 1318 participants of the Berlin Aging Study II aged 60 years or older. The analyses highlight a number of novel single nucleotide polymorphisms (SNPs) associated with memory performance, including one located in a putative regulatory region of microRNA (miRNA) hsa-mir-138-5p (rs9882688, P-value = 7.8 x 10(-9)). Expression quantitative trait locus analyses on next-generation RNA-sequencing data revealed that rs9882688 genotypes show a significant correlation with the expression levels of this miRNA in 309 human lymphoblastoid cell lines (P-value = 5 x 10(-4)). In silico modeling of other top-ranking GWAS signals identified an additional memory-associated SNP in the 3' untranslated region (3' UTR) of DCP1B, a gene encoding a core component of the mRNA decapping complex in humans, predicted to interfere with hsa-mir-138-5p binding. This prediction was confirmed in vitro by luciferase assays showing differential binding of hsa-mir-138-5p to 3' UTR reporter constructs in two human cell lines (HEK293: P-value = 0.0470; SH-SY5Y: P-value = 0.0866). Finally, expression profiling of hsa-mir-138-5p and DCP1B mRNA in human post-mortem brain tissue revealed that both molecules are expressed simultaneously in frontal cortex and hippocampus, suggesting that the proposed interaction between hsa-mir-138-5p and DCP1B may also take place in vivo. In summary, by combining unbiased genome-wide screening with extensive in silico modeling, in vitro functional assays, and gene expression profiling, our study identified miRNA-138 as a potential molecular regulator of human memory function

2016 Wses Guidelines On Acute Calculous Cholecystitis

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The HAC Trial (Harmonic for Acute Cholecystitis) Study. Randomized, double-blind, controlled trial of Harmonic(H) versus Monopolar Diathermy (M) for laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in adults

<p>Abstract</p> <p>Background</p> <p>In the developmental stage of laparoscopic cholecystectomy (LC) it was considered 'unsafe' or 'technically difficult' to perform laparoscopic cholecystectomy for acute cholecystitis (AC). With increasing experience in laparoscopic surgery, a number of centers have reported on the use of laparoscopic cholecystectomy for acute cholecystitis, suggesting that it is technically feasible but at the expense of a high conversion rate, which can be up to 35 per cent and common bile duct lesions.</p> <p>The HARMONIC SCALPEL(R) (H) is the leading ultrasonic cutting and coagulating surgical device, offering surgeons important benefits including: minimal lateral thermal tissue damage, minimal charring and desiccation.</p> <p>Harmonic Scalpel technology reduces the need for ligatures with simultaneous cutting and coagulation: moreover there is not electricity to or through the patient Harmonic Scalpel has a greater precision near vital structures and it produces minimal smoke with improved visibility in the surgical field.</p> <p>In retrospective series LC performed with H was demonstrated feasible and effective with minimal operating time and blood loss: it was reported also a low conversion rate (3.9%).</p> <p>However there are not prospective randomized controlled trials showing the advantages of H compared to MD (the commonly used electrical scalpel) in LC.</p> <p>Methods/Design</p> <p>Aim of this RCT is to demonstrate that H can decrease the conversion rate compared to MD in LC for AC, without a significant increase of morbidity.</p> <p>The patients will be allocated in two groups: in the first group the patient will be submitted to early LC within 72 hours after the diagnosis with H while in the second group will be submitted to early LC within 72 hours with MD.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier: NCT00746850</p

2016 Wses Guidelines On Acute Calculous Cholecystitis

Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.1

Single-step hydrogen production from NH3, CH4, and biogas in stacked proton ceramic reactors

Proton ceramic reactors offer efficient extraction of hydrogen from ammonia, methane, and biogas by coupling endothermic reforming reactions with heat from electrochemical gas separation and compression. Preserving this efficiency in scale-up from cell to stack level poses challenges to the distribution of heat and gas flows and electric current throughout a robust functional design. Here, we demonstrate a 36-cell well-balanced reactor stack enabled by a new interconnect that achieves complete conversion of methane with more than 99% recovery to pressurized hydrogen, leaving a concentrated stream of carbon dioxide. Comparable cell performance was also achieved with ammonia, and the operation was confirmed at pressures exceeding 140 bars. The stacking of proton ceramic reactors into practical thermo-electrochemical devices demonstrates their potential in efficient hydrogen production.This work was supported by Norway’s Ministry of Petroleum and Energy through the Gassnova project CLIMIT grant 618191 in partnership with Engie SA, Equinor, ExxonMobil, Saudi Aramco, Shell, and TotalEnergies and the Research Council of Norway NANO2021 project DynaPro grant 296548

Surgeons’ perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons’ preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting

Background Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons. Method A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Each expert followed a precise analysis and grading of the studies selected for review. Statements and recommendations were discussed and voted at the Consensus Conference of the 6th World Society of Emergency Surgery held in Nijmegen (The Netherlands) in June 2019. Conclusions Complicated inflammatory bowel disease requires a multidisciplinary approach because of the complexity of this patient group and disease spectrum in the emergency setting, with the aim of obtaining safe surgery with good functional outcomes and a decreasing stoma rate where appropriate.Peer reviewe