A PROPOSED DUAL SIZE DESIGN FOR ENERGY MINIMIZATION IN SUB-THRESHOLD CIRCUITS

Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static timing analysis. Other gates are subjected to the genetic algorithm to perform an optimal downsizing assignment taking into account the previous assignments. The algorithm is applied for different downsizing factors to determine the optimal dual size for low energy operation without a performance degradation. Experimental results are obtained for some ISCAS-85 benchmark circuits such as 74283, 74L85, ALU74181, and 16 bit ripple carry adder. The proposed design shows an energy per cycle saving ranged from (29.6% to 56.59%) depending on the utilization of available slack time from the off-critical paths

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

An Evaluation Of The Explicit Fuzzy Method Using Parametric And Non-Parametric Approaches For Supervised Classification Of Multispectral Remote Sensing Data

Fuzzy Classification is of great interest because of its capacity to provide more useful information for Geographic Information Systems. This paper describes an Explicit Fuzzy Supervised Classification method, which consists of three steps. The explicit fuzzyfication is the first step where the pixel is transformed into a matrix of membership degrees representing the fuzzy inputs of the process. Then, in the second step, a MIN fuzzy reasoning rule followed by a rescaling operation are applied to deduce the fuzzy outputs, or in other words, the fuzzy classification of the pixel. Finally, a defuzzyfication step is carried out to produce a hard classification. The classification results ofLandsat TM data show the promising performance of the method and, particularly, the classification time. These results are compared with those produced by the Maximum Likelihood method and a non-parametric method based on the use of Artificial Neural Networks

A New Quantum Radial Wavelet Neural Network Model Applied to Analysis and Classification of EEG Signals

In this paper, a new model of multi-level transfer function radial wavelet neural network using quantum computing is achieved. This model is applied to analyze and classify the electroencephalographic (EEG) signals. The independent component analysis (ICA) is used as processing after normalization of these signals. Some features are extracted from the data using the clustering technique (CT). A new factor that combines the accuracy and the time of classification is suggested to evaluate the performance of the proposed model with other previous models. This factor represents the accuracy to time ratio (ATR). The average accuracy of the proposed quantum radial wavelet neural network (QRWNN) model is 90.5619125 % at 50 minutes. The ATR value is 1.8112, which shows the superiority of the proposed model

COMPUTER-AIDED DESIGN OF ALGORITHMIC STATE MACHINE

The Algorithmic State Machine (ASM) is a method used to solve more complex industrial problems. The basic advantage of this method is to convert these problems to simpler circuits which consist only from the basic elements which are AND, OR and NOT gates, which can be implemented easily by using the Programmable Logic Array (PLA) circuits. The entry variables (number of inputs and states) for such problems are large, this made the theoretical (manual) solution is hard to solve. This research constructs a computer package called (ASM-CAD) to make the entire design using C++ and TC++ programming languages. Key Words: Algorithmic State Machine (ASM) method.Programmable Logic Array (PLA) circuit. Quine-McCluskey is a programmable method. 1