Design of a parallel vector access unit for SDRAM memory systems

Journal ArticleParallel Vector Access is a technique that exploits the regularity of vector or stream accesses to perform them efficiently in parallel on a multi-bank memory system. The performance of applications that have vector accesses may be improved using a memory controller that performs scatter/gather operations so that only the vector or stream elements that are accessed by the application are transmitted across the system bus. These scatter/gather operations can be speeded up by broadcasting vector operations to all banks of memory in parallel, each of which implements an algorithm to determine which elements of the requested vector they contain. This thesis presents the mathematical foundations behind one such algorithm for controller are investigated. The the performance of such a memory controller on vector kernels is studied by gate level simulation and the results analyzed. Because of the parallel approach, the PVA is able to load elements up to 32.8 times faster than a conventional memory system and 3.3 times faster than a pipelined vector unit, without hurting normal cache line fill performance

Validation of the Modified Vacs Index in a HIV Infected South Indian Population Initiated on a Naco - Art Regimen: A Cohort Study

OBJECTIVES : We aimed to validate the Modified VACS index as a prognostic index derived from baseline blood parameters, by predicting patient mortality in HIV patients who had been initiated on a NACO- ART regimen over a 1 year period from 1st June 2012 to 31st May 2013 and compare the predicted mortality with actual mortality using a standardised mortality ratio following a two year period. METHODS : We recruited patients by retrospective analysis from the time period 1st June 2012 to 31st May 2013, who had been initiated on a NACO-ART regimen in the Infectious Diseases (ID) clinic, after a diagnosis of HIV/AIDS. The modified VACS index scores were calculated for the patients in the cohort and the predicted mortality was derived by a logistic regression analysis from these scores. The predicted mortality was compared with actual mortality after following up outcomes following a two year period from 1st June 2013 to 31st May 2015 using a standardised mortality ratio. An ROC curve was also plotted to derive the discriminant function of the modified VACS index. RESULTS : A total of 251 patients initiated on anti-retroviral therapy from 1st June 2012 to 31st May 2013 were recruited in the study. Thirteen deaths were reported at the end of the study period with forty five patients being lost to follow up. Deaths and patients lost to follow up were grouped in an unfavourable outcome group for the purpose of logistic regression analysis. A mean higher score was consistently found in the group with the ‘Unfavourable’ outcomes as compared to the ‘Alive’ group (44.8103 ± 22.46358 as compared to 31.7306 ± 20.39250) which was found to be significant using an independent samples t-test. The C-statistic of the ROC curve was 0.66 which implied a suboptimal discriminant function with a sensitivity of 70%, specificity of 58%, positive predictive value of 35% and negative predictive value of 85.4%. Actual mortality was noted to be lesser than predicted by the modified VACS index (5.18% as compared to 18.5%) which is 28% of the predicted value. The CD-4 count was the only component variable which showed a significant association with outcome (p value = 0.000)

Donor IFNL4 Genotype Is Associated with Early Post-Transplant Fibrosis in Recipients with Hepatitis C

Background and Aims Early post-transplant hepatic fibrosis is associated with poor outcomes and may be influenced by donor/recipient genetic factors. The rs368234815 IFNL4 polymorphism is related to the previously described IL28B polymorphism, which predicts etiology-independent hepatic fibrosis. The aim of this study was to identify the impact of donor and/or recipient IFNL4 genotype on early fibrosis among patients transplanted for hepatitis C (HCV). Methods Clinical data were collected for 302 consecutive patients transplanted for HCV. 116 patients who had available liver biopsies and donor/recipient DNA were included. 28% of these patients with stage 2 fibrosis or greater were compared to patients without significant post-transplant fibrosis with respect to clinical features as well as donor/recipient IFNL4 genotype. Results The IFNL4 TT/TT genotype was found in 26.0% of recipients and 38.6% of donors. Patients who developed early post-transplant fibrosis had a 3.45 adjusted odds of having donor IFNL4 TT/TT genotype (p = 0.012). Donor IFNL4 TT/TT genotype also predicted decreased overall survival compared to non-TT/TT genotypes (p = 0.016). Conclusions Donor IFNL4 TT/TT genotype, a favorable predictor of spontaneous HCV clearance pre-transplant, is associated with increased early post-transplant fibrosis and decreased survival

Primary Mesenteric Carcinoid Tumor Presenting with Carcinoid Syndrome

Neuroendocrine neoplasms (NENs) are a diverse group of tumors arising throughout the body with a common origin from neuroendocrine cells. Well-differentiated NENs, also known as neuroendocrine tumors (NETs), are generally indolent and are often found incidentally, while poorly differentiated tumors are more aggressive. Carcinoid tumors are NETs arising from the gastrointestinal tract and less commonly from the lungs, thymus, and kidneys. NETs in the mesentery arise from metastasis from primary tumor, and carcinoid syndrome in this setting results from concomitant metastasis to the liver. Primary mesenteric carcinoid tumors are very rare. We present a 64-year-old man with carcinoid syndrome from a mesenteric carcinoid tumor without evidence of liver metastasis or other primary tumor sites

Identification and genome characterization of genotype B and genotype C bovine parainfluenza type 3 viruses isolated in the United States

BACKGROUND: Bovine parainfluenza 3 viruses (BPI3V) are respiratory pathogens of cattle that cause disease singly but are often associated with bovine respiratory disease complex (BRDC) in conjunction with other viral and bacterial agents. Bovine vaccines currently contain BPI3V to provide protection against the virus, but there is no current information regarding the BPI3V strains that are circulating in the U.S. RESULTS: A project was initiated to sequence archival BPI3V isolates to study viral evolution over time. This was done with a deep sequencing protocol that generated sequences of multiple RNA virus genomes simultaneously. Analysis of the BPI3V sequences revealed that, in addition to the genotype A (BPI3Va) viruses previously described in the United States, there were two additional genotypes of BPI3V circulating that had been described only in Australia (BPI3Vb) and Asia (BPI3Vc). The U.S. BPI3Vb and BPI3Vc isolates showed some divergence from the Australian and Asian strains; the BPI3Vb were 93 % similar to the Australian Q5592 strain and the BPI3Vc viruses were 98 % similar to the 12Q061 strain that was described in South Korea. Overall, the three genotypes were 82 to 84 % identical to each other and 80 % identical to the most similar human PI3V. Cross-neutralization studies using an APHIS/NVSL BPI3V reference serum showed that neutralization titers against the genotype B and C viruses were 4- to ≥16-fold less then the titer against the APHIS BPI3Va reference strain, SF-4. CONCLUSIONS: This study clearly demonstrated that BPI3Vb and BPI3Vc strains, previously thought to be foreign to the U.S., are indeed circulating in domestic livestock herds. Based on virus neutralization using polyclonal antisera, there were antigenic differences between viruses from these genotypes and the BPI3Va viruses that are included in currently marketed bovine vaccines. Further study of these viruses is warranted to determine pathogenic potential and cross-protection afforded by vaccination

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006

<p>Abstract</p> <p>Background</p> <p>Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use.</p> <p>Methods</p> <p>A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant.</p> <p>Results</p> <p>Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas.</p> <p>Conclusions</p> <p>Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions.</p

Identification and genome characterization of genotype B and genotype C bovine parainfluenza type 3 viruses isolated in the United States

BACKGROUND: Bovine parainfluenza 3 viruses (BPI3V) are respiratory pathogens of cattle that cause disease singly but are often associated with bovine respiratory disease complex (BRDC) in conjunction with other viral and bacterial agents. Bovine vaccines currently contain BPI3V to provide protection against the virus, but there is no current information regarding the BPI3V strains that are circulating in the U.S. RESULTS: A project was initiated to sequence archival BPI3V isolates to study viral evolution over time. This was done with a deep sequencing protocol that generated sequences of multiple RNA virus genomes simultaneously. Analysis of the BPI3V sequences revealed that, in addition to the genotype A (BPI3Va) viruses previously described in the United States, there were two additional genotypes of BPI3V circulating that had been described only in Australia (BPI3Vb) and Asia (BPI3Vc). The U.S. BPI3Vb and BPI3Vc isolates showed some divergence from the Australian and Asian strains; the BPI3Vb were 93 % similar to the Australian Q5592 strain and the BPI3Vc viruses were 98 % similar to the 12Q061 strain that was described in South Korea. Overall, the three genotypes were 82 to 84 % identical to each other and 80 % identical to the most similar human PI3V. Cross-neutralization studies using an APHIS/NVSL BPI3V reference serum showed that neutralization titers against the genotype B and C viruses were 4- to ≥16-fold less then the titer against the APHIS BPI3Va reference strain, SF-4. CONCLUSIONS: This study clearly demonstrated that BPI3Vb and BPI3Vc strains, previously thought to be foreign to the U.S., are indeed circulating in domestic livestock herds. Based on virus neutralization using polyclonal antisera, there were antigenic differences between viruses from these genotypes and the BPI3Va viruses that are included in currently marketed bovine vaccines. Further study of these viruses is warranted to determine pathogenic potential and cross-protection afforded by vaccination

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Metabolic abnormalities and genitourinary tract anatomical alternations in patients with recurrent urolithiasis

Background: Preventing the recurrence of episodes of stone formation is the focus of interest for patients. This retrospective study aimed to determine the prevalence of metabolic abnormalities and anatomical alterations of the genitourinary tract in patients with recurrent urolithiasis. Methods: Patients who had recurrent renal calculi were included. Laboratory assessment was performed on two 24-hour samples of urine. The first 24-hour urine was a random specimen and the second was obtained after the patient had been on a sodium-, oxalate- and calcium-restricted diet for at least one week. The patients with hypercalciuria further underwent fasting and calcium load testing and were assessed in terms of parathyroid hormone levels. Urine culturing was conducted to rule out urinary tract infection. All patients were evaluated with ultrasound and intravenous pyelography for any anatomical abnormalities. Results: A total of 30 patients (20 male and 10 females) were included in the study. The most frequently found metabolic alterations were hypercalciuria, low urinary volume, urinary tract infection and hyperoxaluria. Anatomic alterations were found in 26.5% of patients, mainly in the form of renal cysts, pelvi-ureteric junction obstructions, horse shoe kidneys and atrophic kidney. Conclusions: 80% of patients with recurrent stone disease had some measure of metabolic abnormality to account for the disease. The use of two 24-hour urine samples significantly improved the detection rate of metabolic abnormalities compared to a single sample. The major limitation of this study was the small number of patients as well as the short study duration. [Arch Clin Exp Surg 2017; 6(2.000): 81-85