Exploring the hot-carrier effect on the wireless transceivers

Phase noise can be regarded as the most severe cause of performance degradation in the wireless communication systems. The hot-carriers (HCs), found in the CMOS synchronization circuits, are the high-energy charge carriers that degrade the MOSFET devices’ performance by increasing the threshold voltage required to operate the MOSFETs. The HC effect manifests itself as the phase noise whose level increases with the continued MOSFET operation and such increases result in the performance degradation of the voltage-controlled oscillator (VCO) built on the MOSFETs. The HC effect is particularly evident in the short-channel MOSFET devices. In this dissertation, we analyze the wireless transceiver performances in the presence of the synchronization errors induced by the HC effect, for both single-carrier and multi-carrier communication systems. We derive the relationship between the corresponding system performances and the HC effect in terms of a crucial parameter, the MOSFET threshold voltage. We employ a new phase noise model for the wireless systems influenced by the HC effect, which is based on a new precise phase noise mask function. In addition, we analyze the impact of the phase noise arising from the HC effect on the single-carrier wireless systems in terms of the BER and the signal-to-interference-plus-noise ratio (SINR). We derive the exact BER expression and show the SINR degradation for the QPSK systems that suffer from the phase noise. We apply Monte Carlo simulations to verify our analysis. To study the HC effect thoroughly, we simplify the BER expression as a new asymptotical analysis as the signal-to-noise ratio approaches to infinity and obtain the lower bound of the achievable BER for the single-carrier wireless systems. For multi-carrier systems, we focus our discussions on the orthogonal frequency division multiplexing (OFDM) systems. According to our simulations, we show that the bit-error-rate (BER) evaluation for OFDM using our new phase noise model in the presence of the HCs can be very different up to three orders-of-magnitude from the existing models disregarding the HCs. We have also found that the ICI self-cancellation coding is very effective for combating the phase noise in the OFDM systems

Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience.

AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of -54.6 ± 7.6°C, temperature at 30 s of -38.6 ± 7.2°C, time to -40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach -40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤-54.0°C (AUC 0.71; P < 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon

Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience

\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of &lt;1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of -54.6 \ub1 7.6\ub0C, temperature at 30 s of -38.6 \ub1 7.2\ub0C, time to -40\ub0C of 34.1 \ub1 13.7 s, and time to isolation of 49.8 \ub1 33.2 s. Independent predictors for achieving PVI included time to reach -40\ub0C [odds ratio (OR) 1.34; P &lt; 0.001] and nadir temperature (OR 1.24; P &lt; 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P &lt; 0.001] and nadir temperature of ≤-54.0\ub0C (AUC 0.71; P &lt; 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon

Faculty perspectives on introduction of competency-based medical education curriculum

CONTEXT: Global adoption of competency-based medical education (CBME) is a paradigm shift in India. Faculties play a key role in implementation by identifying and solving the challenges in CBME. AIMS: Perspectives of the faculties were undertaken to known about CBME implementation. SETTINGS AND DESIGN: Qualitative study design. SUBJECTS AND METHODS: The study included 270 medical faculties who were trained in CBME from May to September 2019. A prevalidated, closed, quantitative questionnaire was administered to faculties. Likert's 3-point scale was used for rating. STATISTICAL ANALYSIS USED: Data were analyzed based on percentage. RESULTS: Ninety-seven percent of faculties perceived that CBME should be the current method of approach, 88% perceived the need of more resources, 61% were better prepared to face the challenges in implementation of CBME, 47% perceived that training in CBME reduced resistance to accept CBME, and 45% needed more clarification on self-directed learning (SDL), assessment, and certification of skills. CONCLUSIONS: Implementation requires more resources and more clarity about SDL, assessment, and certification skill

Blood Biomarkers and Structural Imaging Correlations Post-Traumatic Brain Injury: A Systematic Review.

BACKGROUND: Blood biomarkers are of increasing importance in the diagnosis and assessment of traumatic brain injury (TBI). However, the relationship between them and lesions seen on imaging remains unclear. OBJECTIVE: To perform a systematic review of the relationship between blood biomarkers and intracranial lesion types, intracranial lesion injury patterns, volume/number of intracranial lesions, and imaging classification systems. METHODS: We searched Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, and Cumulative Index to Nursing and Allied Health Literature from inception to May 2021, and the references of included studies were also screened. Heterogeneity in study design, biomarker types, imaging modalities, and analyses inhibited quantitative analysis, with a qualitative synthesis presented. RESULTS: Fifty-nine papers were included assessing one or more biomarker to imaging comparisons per paper: 30 assessed imaging classifications or injury patterns, 28 assessed lesion type, and 11 assessed lesion volume or number. Biomarker concentrations were associated with the burden of brain injury, as assessed by increasing intracranial lesion volume, increasing numbers of traumatic intracranial lesions, and positive correlations with imaging classification scores. There were inconsistent findings associating different biomarkers with specific imaging phenotypes including diffuse axonal injury, cerebral edema, and intracranial hemorrhage. CONCLUSION: Blood-based biomarker concentrations after TBI are consistently demonstrated to correlate burden of intracranial disease. The relation with specific injury types is unclear suggesting a lack of diagnostic specificity and/or is the result of the complex and heterogeneous nature of TBI.No funding was sort for the production of this article. DM reports grants from National Institute for Health Research (NIHR; UK), during the conduct of the study; grants, personal fees and non-financial support from GlaxoSmithKline, personal fees from Neurotrauma Sciences, personal fees from Lantmaanen AB, personal fees from Pressura, personal fees from Pfizer, outside the submitted work. AM declares consulting fees from PresSura Neuro, Integra Life Sciences and NeuroTrauma Sciences. EC, KA (Amrein) and AB report grants Higher Education Institutional Excellence Programme – Grant No. 20765-3/2018/FEKUTSTRAT , FIKP II/S , EFOP- 3.6.2.-16-2017-00008 , GINOP-2.3.2-15-2016-00048 , and GINOP-2.3.3-15-2016- 00032 and the Hungarian Brain Research Program 2.0 Grant No. 2017-1.2.1-NKP- 2017-00002. VFJN is supported by an Academy of Medical Sciences/The Health Foundation Clinician Scientist Fellowship and holds a grant funded by Roche pharmaceuticals