Low-Power High-Performance Ternary Content Addressable Memory Circuits

Ternary content addressable memories (TCAMs) are hardware-based parallel lookup tables with bit-level masking capability. They are attractive for applications such as packet forwarding and classification in network routers. Despite the attractive features of TCAMs, high power consumption is one of the most critical challenges faced by TCAM designers. This work proposes circuit techniques for reducing TCAM power consumption. The main contribution of this work is divided in two parts: (i) reduction in match line (ML) sensing energy, and (ii) static-power reduction techniques. The ML sensing energy is reduced by employing (i) positive-feedback ML sense amplifiers (MLSAs), (ii) low-capacitance comparison logic, and (iii) low-power ML-segmentation techniques. The positive-feedback MLSAs include both resistive and active feedback to reduce the ML sensing energy. A body-bias technique can further improve the feedback action at the expense of additional area and ML capacitance. The measurement results of the active-feedback MLSA show 50-56% reduction in ML sensing energy. The measurement results of the proposed low-capacitance comparison logic show 25% and 42% reductions in ML sensing energy and time, respectively, which can further be improved by careful layout. The low-power ML-segmentation techniques include dual ML TCAM and charge-shared ML. Simulation results of the dual ML TCAM that connects two sides of the comparison logic to two ML segments for sequential sensing show 43% power savings for a small (4%) trade-off in the search speed. The charge-shared ML scheme achieves power savings by partial recycling of the charge stored in the first ML segment. Chip measurement results show that the charge-shared ML scheme results in 11% and 9% reductions in ML sensing time and energy, respectively, which can be improved to 19-25% by using a digitally controlled charge sharing time-window and a slightly modified MLSA. The static power reduction is achieved by a dual-VDD technique and low-leakage TCAM cells. The dual-VDD technique trades-off the excess noise margin of MLSA for smaller cell leakage by applying a smaller VDD to TCAM cells and a larger VDD to the peripheral circuits. The low-leakage TCAM cells trade off the speed of READ and WRITE operations for smaller cell area and leakage. Finally, design and testing of a complete TCAM chip are presented, and compared with other published designs

Case 9 : Managing Expectations: Lyme Disease

Increasing cases of Lyme disease are creating public outcry. The Public Health Agency of Canada (PHAC) has been tasked with the surveillance and guidance for this tick-borne disease but has not seen additional funding. Evidence-based analysis has indicated the most impactful use of resources would be spent on prevention and awareness. Despite this information, the push for increasing the healthcare budget to allow for more Lyme disease funding is growing. A desire to increase resources for acute care in the hopes of better diagnostic testing, more freely prescribed antibiotics, and dedicated Lyme clinics is being put forward from advocacy groups. As climate change worsens, Lyme incidences rising in the foreseeable future is probable. As the president of PHAC, managing different stakeholders within and outside of the organization while managing expectations is crucial. The ability to engage and inform while maintaining a positive public perception is key, as this will lay the framework for other initiatives to launch in the future. Balancing this delicate situation while maintaining an evidence-based approach will take caution and strategic skills

A Case Report of Successful Physiological Pacing in a Patient With Lamin A/C Cardiomyopathy

BACKGROUND: Lamin A/C (LMNA) mutations account for 5-8% of familial dilated cardiomyopathies, and can manifest with conduction abnormalities and ventricular arrhythmias in 78% of patients. Therefore, when suspected, it is important to implant the correct type of device. CASE SUMMARY: A 52-year-old gentleman with a family history of cardiomyopathy, presented with asymptomatic atrial fibrillation and complete atrioventricular block associated with a narrow QRS interval. Investigations confirmed dilated and severely impaired left ventricular systolic function. He underwent successful conduction system pacing in combination with a primary prevention defibrillator. Genetic screening confirmed LMNA cardiomyopathy. During 3 years follow up, his left ventricular function remained unchanged with stable conduction system capture and he received appropriate therapy from his device for ventricular tachycardia. DISCUSSION: His-bundle pacing promotes rapid and synchronous activation of the ventricles via the intrinsic conduction system of the heart. In selected individuals with LMNA cardiomyopathy, conduction system pacing is viable alternative to conventional cardiac resynchronization therapy using coronary sinus tributaries

CASE 5: A Stakeholder Analysis: Developing an Indigenous-Specific Intercultural Competency Training Module (Part A)

The case focuses on developing an Indigenous-specific intercultural competency training module and outlines the steps needed to achieve this, with particular emphasis on the importance of conducting a stakeholder analysis and developing a stakeholder engagement plan. The protagonist of the case, Nia Singh, heads up the Intercultural Education Program at the Southwestern Ontario Intercultural Education Centre. After working at the organization as an intercultural education specialist for several years, Nia is looking to expand her project portfolio by redesigning the Intercultural Education Program’s pre-existing Indigenous intercultural competency training module. Nia determines the objective of the new training module will be to educate health care workers about the importance of intercultural competency within health care organizations. Specifically, the module will focus on Indigenous populations and will aim to improve the quality of care they receive so their long-term health outcomes ultimately improve. Nia works with her colleague, Steven Miller, to complete a stakeholder analysis and engagement plan, and they use four different steps to accomplish this: 1) brainstorming all possible stakeholders who have a vested interest in the training module; 2) prioritizing and categorizing each stakeholder as a core stakeholder, involved stakeholder, supportive stakeholder, or peripheral stakeholder; 3) determining the level of engagement required for each stakeholder; and 4) determining which engagement strategies to use for each stakeholder. After completing the stakeholder analysis and engagement plan, Nia and Steven arrange to interview the key stakeholders in order to gather additional opinions, ideas, and perspectives related to developing the training module. These stakeholders include health care workers, Indigenous community members, and other relevant informants. Once the interview process is complete, Nia and Steven develop a pilot version of the training module that is ready to be implemented on a small scale. However, Nia and Steven know they still have their work cut out for them in terms of identifying an effective implementation strategy. This case is intended to be a skills practice case with the primary objective of having students learn about conducting a stakeholder analysis and then learn about stakeholder engagement. By examining this case and completing the learning team activity, students will be able to understand the importance of stakeholder analysis and stakeholder engagement as they relate to developing an Indigenous-specific intercultural competency training module. Once students have acquired this knowledge, they will be able to apply stakeholder analyses and engagement strategies to developing a variety of public health programs. However, given that the training module focuses on Indigenous populations, the case will focus on concepts related to health equity and the barriers faced by Indigenous people when they access health care services. A secondary learning objective is for students to acquire knowledge pertaining to intercultural competency, particularly in terms of its significance within the field of public health and how it can be used as a strategy for reducing health disparities for other marginalized populations

CASE 7: Implementation Research: A Strategy for Developing Indigenous-Specific Intercultural Competency Training Programs (Part B)

Nia Singh is an intercultural education specialist and leads the Intercultural Safety Training Program (ISTP) at the Southwestern Ontario Intercultural Education Centre (SOIEC). She has undertaken significant work with the ISTP developing and implementing training sessions and webinars to help clients make their workplace more culturally competent. Nia has recently observed that the ISTP could greatly benefit from including training materials to help health care practitioners provide improved health care to Indigenous patients. Indigenous people face numerous social, political, historical barriers while accessing healthcare services in Canada. Cultural differences can also lead healthcare practitioners to discriminate against their Indigenous patients and consequently, lead to worsening health outcomes (Harfield et al., 2018). Therefore, seeing the need for an Indigenous-specific program aimed at improving the intercultural competence and awareness of health care professionals, Nia contacted relevant stakeholders to help her research and develop a training module. With the background research and stakeholder input complete, Nia is finalizing the training module and delivery plan. She is now faced with the task of optimally implementing the training and assessing the challenges that may arise as the training is disseminated to its intended audience. During the implementation phase of the process, Nia collaborates with prospective clients to ensure the training module is used effectively and successfully fosters important dialogue about health equity and patientcentred care among health care professionals. At the end of the case, Nia decides to collaborate with the Middlesex-London Public Health Unit’s Indigenous Health Coordinator, Vanessa Anderson, to draft an implementation research proposal so she can assess the impact of the new training program and evaluate it as it is disseminated in a practical, real-world setting. This case is intended to provide students practice with contextualizing an implementation research plan so they can assess an Indigenous-specific cultural safety training program through an Indigenous lens. In addition, it will help students consider the value of multiple stakeholder perspectives while implementing these types of programs

EPIDEMIOLOGICAL AND CLINICAL PROFILE OF STRONGYLOIDIASIS - EXPERIENCE FROM A TERTIARY CARE CENTRE

Objectives: The objective of the study was to study the clinical presentations, predisposing factors, and underlying conditions associated with Strongyloidiasis. Methods: A prospective observational study was conducted from 2018 to 2021on patients who presented with medical complaints in a tertiary care hospital, and 19 were diagnosed with strongyloidiasis by stool wet mount examination. Other relevant details were collected to analyze the risk factors. Results: A total of 19 cases were found positive for strongyloidiasis. Males 13 (68.4%) were more and females 6 (31.6%), and most of them were above 50 years age group (73.7%). Among the cases, respiratory symptoms (42.1%) were predominantly observed, followed by gastrointestinal (31.6%). Multiple predisposing factors such as chronic obstructive pulmonary disease, corticosteroid usage, TB, diabetes, alcohol, and asthma have been identified in strongyloidiasis cases. Peripheral eosinophilia is a frequent finding in the complete blood picture. Conclusions: Strongyloidiasis should be strongly suspected in every immune compromised patient presenting with gastrointestinal, respiratory manifestations, or peripheral eosinophilia, and asymptomatic immune competent patients with comorbid conditions

Managing age diversity at the workplace: Global perspectives

Workplace diversity has been one of the most critical issues over the past few years. It is a difficult subject for managers to tackle in the space of work. Organizations are facing an inherent age gap among their employees, which raises new issues for professionals. With the rapid changes and developments in technology, the elderly employees are generally perceived as those “missing agility and repelling new technology.” There are other grounds on which the age of employees has been discussed as a determinant of varying levels of behavioral and work-related outcomes. It is essential for businesses to figure out the means to manage and balance the age diversity at the workplace. However, the biggest obstacles that professionals may face when trying to implement this include modifications in areas such as job characteristics, working time, and management styles. This study discusses the global perspectives on age diversity at the workplace and provides actionable recommendations for organizations to develop an inclusive environment for higher levels of efficiency and effectiveness

Vidur: A Large-Scale Simulation Framework For LLM Inference

Optimizing the deployment of Large language models (LLMs) is expensive today since it requires experimentally running an application workload against an LLM implementation while exploring large configuration space formed by system knobs such as parallelization strategies, batching techniques, and scheduling policies. To address this challenge, we present Vidur - a large-scale, high-fidelity, easily-extensible simulation framework for LLM inference performance. Vidur models the performance of LLM operators using a combination of experimental profiling and predictive modeling, and evaluates the end-to-end inference performance for different workloads by estimating several metrics of interest such as latency and throughput. We validate the fidelity of Vidur on several LLMs and show that it estimates inference latency with less than 9% error across the range. Further, we present Vidur-Search, a configuration search tool that helps optimize LLM deployment. Vidur-Search uses Vidur to automatically identify the most cost-effective deployment configuration that meets application performance constraints. For example, Vidur-Search finds the best deployment configuration for LLaMA2-70B in one hour on a CPU machine, in contrast to a deployment-based exploration which would require 42K GPU hours - costing ~218K dollars. Source code for Vidur is available at https://github.com/microsoft/vidur