Characterization of voltage noise in big, small and single-ISA heterogeneous systems

Sensitivity of the microprocessor to voltage fluctuations is becoming a major concern with growing emphasis on designing power-efficient microprocessors. Voltage fluctuations that exceed a certain threshold cause "emergencies" that can lead to timing errors in the processor, thus risking reliability. To guarantee correctness under such conditions, large voltage guardbands are employed, at the cost of reduced performance and wastage of power. Trends in microprocessor technology indicate that worst-case operating voltage margins are not sustainable. Since voltage emergencies occur only infrequently, resilient architectures with aggressive guardbands are needed. However, to enable the exploration of the design space of resilient processors, it is important to have a deep understanding of the characteristics of voltage noise in different system configurations. Prior research in this area has mostly focused on systems with very few cores. Given the increasing relevance of large multi-core systems, this thesis presents a detailed characterization of voltage noise on chip multi-processors, consisting of large number of cores. The data indicates that while the worst case voltage droop increases with increase in the number of cores, the frequency of occurrence of the droops is not greatly impacted, emphasizing the feasibility of employing resilient microarchitectures with aggressive voltage margins. The thesis also presents a comparative study of voltage noise in CMPs consisting of either high-performant out-of-order cores and power-efficient in-order cores. The study highlights that the out-of-order cores experience much larger voltage variations when compared to the in-order cores, but offer a clear advantage in terms of performance. Experiments indicate that in-order configurations that offer equivalent performance to the out-of-order cores result in large energy-delay product, indicating the trade-offs involved in designing for performance, power and reliability. The thesis also presents a study of voltage noise in single-ISA heterogeneous configurations, to highlight the benefits of such systems towards lowering the worst-case voltage margins, which improve both performance and power. The experimental results indicate that the worst-case voltage droop in such heterogeneous systems lies in between the out-of-order and in-order cores and provide reasonable power-efficiency and performance. Further, the work highlights the importance of exploring the design-space of heterogeneous systems considering reliability as an important design criteria.Computer Science

Association of Cytomegalovirus DNA and Immunologic Markers of Cardiovascular Disease.

BackgroundPersons living with human immunodeficiency virus (HIV) (PLWH) with high cytomegalovirus (CMV)-specific interferon (IFN) γ response have increased numbers of endothelium homing receptor (CX3CR1)+-expressing cells that are associated with cardiovascular disease. The current study was performed to investigate the effect of cellular levels of CMV DNA on these markers.MethodsEighty paired peripheral blood mononuclear cell samples were collected ≥12 months apart from 40 CMV-seropositive PLWH with suppressed HIV RNA, who started antiretroviral therapy at median of 3-months of infection. The samples were assessed for CMV-specific IFN-γ response by means of enzyme-linked immunospot assay, and participants were classified as low responders (LRs) or high responders (HRs) based on IFN-γ production (≤100 or >100 spot-forming units [SFUs]/105 cells).ResultsOf the 40 participants, 26 (65%) were HRs and 14 (35%) LRs at baseline, which did not change over time or by CMV levels (median at first/second time points, 383/308 SFUs/106 cells for HRs vs 21/41 SFUs/106 for LRs). A decrease in IFN-γ over time was associated with higher CMV DNA levels (P < .01). High CMV response was also associated with increased CD28+CD27-CD4+ T cells expressing CX3CR1 (P < .001). Similarly, increased IFN-γ production was associated with increased CMV-specific CX3CR1+CD28+CD27-CD4+ and CD8+ T cells (P < .001).ConclusionsThese findings demonstrate that levels of CMV-specific IFN-γ response in PLWH are stable over time, and that HRs have increased circulating T cells expressing CX3CR1 that may put them at increased risk of cardiovascular disease and other inflammatory diseases

Evaluation of vitamin D3 in patients of polycystic ovary syndrome and their correlation

Background: Polycystic ovary syndrome (PCOS) is enigma faced by young females since the onset of urbanization. As on day, PCOS is the most common endocrine disorder in the women of reproductive age affecting 4-10%. This study done to measure serum vitamin D3 levels of PCOS patients and to identify its association with factors associated with various symptoms and signs in PCOS.Methods: Institutional based prospective observational study conducted on 70 patients of PCOS, both suspected and already diagnosed, attending gynecology OPD of Department of obstetrics and gynecology of NSCB Medical College Jabalpur from 1 March 2015 to 31 August 2016. Diagnosis of PCOS was made by Rotterdam 2003 criteria. A detailed assessment was done and preformed proforma was filled. Serum Vitamin D3 levels were estimated by standard lab technique ‘Liquid Chromatography Tandem Mass Spectrometry’ and categorized into vitamin D3 sufficient >30ng/dl, insufficient 20-29ng/dl and deficient <20ng/dl. Categorical data was coded numerically before the analysis. For comparison of frequency distribution chi square test or fisher’s exact test were applied as appropriate.Results: Prevalence of Vitamin D3 deficiency in patients of PCOS was found to be 84.3%.Conclusions: The present study concludes that there is correlation between vitamin D3 and PCOS, screening and correction of vitamin D3 deficiency may prevent PCOS and its manifestations. Hence, it is speculated that improvement of vitamin D3 levels at a younger age can contribute to prevention of PCOS

Expression of Ki-67 in premalignant and malignant lesion of cervix in tertiary care hospital in Uttar Pradesh

Background: cancer is fast emerging as one of the most common causes of death related morbidities throughout the world. As far as India is concerned. Ki-67 is an ideal marker to assess the cellular proliferation. The study aimed to evaluate the proliferative activity by using Ki-67 in premalignant and malignant lesion of cervix. To study the various histomorphology features of cervical lesion and grading it into cervical intraepithelial neoplasia and malignant lesion. To access the expression of Ki 67 in different grade of lesions. Methods: The study was carried in 60 cases of cervical biopsy that included 30 cases of CIN 1, CIN2 and 30 cases of CIN 3, SCC. Ki-67 staining was done on all cases which were diagnosed histologically as CIN or cervical carcinoma. The result was categorized in grading 1,2,3. Results: Ki-67 expression was studied in all cases. There was an increase in the intensity of Ki-67 from CIN to carcinoma. The focal positivity in low grade lesion to diffuse positivity in higher grade lesion was seen in our study. Conclusions: In this study, Ki-67 expression was helpful in differentiating dysplastic lesion from carcinoma and helps in confirming the histopathological diagnosis. Therefore Ki-67 marker could be used as biomarker in the evaluation of the proliferative activity and progressive potential of dysplastic and neoplastic changes

Child Drawing: A Projective Tool for Dental Anxiety Assessment

INTRODUCTION: Assessment of child’s anxiety is important in order to determine the success of dental treatment. Drawing, a nonverbal, self-report, projective and non-invasive technique may prove be helpful and needs to be explored in order to access anxiety in children requiring dental treatment.AIM: To investigate the applicability of children’s drawings as an indicator to measure their level of anxiety.MATERIALS &amp; METHOD: A cross-sectional study was conducted in a total of hundred children between age group of 4-6 years. Children were asked to draw dental operatory on A4 sheet and colour it with basic set of 12 colours. The drawing was scored using Child Drawing: Hospital (projective scale) scale and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scorings.RESULTS: Child Drawing: Hospital scale scoring had a positive correlation with pulse oximeter reading (involuntary) (p-value = 0.125) and a negative correlation with Venham picture test (p-value = 0.140).CONCLUSION: Drawing may be statistically significant projective tool significant to assess child anxiety in dental setting

Unusual clinical presentation and complications following preoperative embolization of a large adrenal tumor

Authors present a case of a young female presenting with secondary amenorrhea which on further investigation revealed a large intra-abdominal mass, likely arising from the left adrenal gland. As the tumor was highly vascular with large feeders, she was referred for pre-operative embolization to reduce the blood loss during surgery. Post embolization, the patient suffered from an unusual complication of tumor rupture along with excessive secretion of catecholamines resulting in myocarditis and myocardial infarction. Patient ultimately died of the myocardial infarction. Preoperative embolization of a large, hypervascular adrenal mass lesion is not devoid of unusual complications like tumor rupture and subsequent cardiovascular complications even if the tumor is hormonally inactive. This complication is extremely rare and has never been reported in adrenal tumors after embolization

Evaluation of Physiological Parameters in Response to Endurance Exercise of Zanskar Ponies Adapted to High Altitude of Ladakh Region

Zanskar pony, a native horse breed of Ladakh mainly used for transportation in Trans-Himalayan region of India, is well adapted to high altitude hypobaric hypoxia environment. Due to extreme conditions of the Ladakh region, better endurance of these ponies under hypoxic and extreme cold conditions is of utmost concern for their recruitment in Indian Army. In the present study, 12 young trained Zanskar ponies were evaluated during endurance exercise at an altitude of 3292 meter above mean sea level. The animals were subjected to carriage transport with 65-70Kg load or riding on a track of 5-6 Km. Physiological parameters viz., pulse rate (PR), heart rate (HR), rectal temperature (RT), respiratory rate (RR) and oxygen saturation (SaO2) were recorded in Zanskar ponies during pre-exercise (T0), post- exercise (T1) and post recovery (T2, 2 hours post resting) stages. Results showed marked increase in PR, HR, RR and RT post exercise time points. The mean values of PR increased from 49.83±4.62 to 73.67±21.54 per minute, HR from 48±13.60 to 75±15.82 beats/min, RR from 37.83±9.70 to 57.67±13.48 per min and RT from 99.62±0.34 101.04±0.53 °F from pre stress to post endurance stress. The mean SaO2 level reduced significantly (88.58±6.75 at T0 versus 64.00±18.70 at T1 and 54.42±14.79 at T2) post exercise. This indicated limited availability of arterial oxygen for tissues which could be vital factor for adverse change in some of physio-biochemical parameters. Though the trend of physiological response was similar for all the 12 animals, still variation at individual animal level was observed during endurance stress. In future, some of these physiological parameters along with biochemical and molecular parameters could be evaluated as potential biomarkers in selecting ponies with superior endurance trait specifically under hypoxic conditions

Title: Ultrasound (US) Imaging Use in the Management of the Difficult Tracheal Intubation

The ultrasound has been in clinical use since the early 1900s, but its use in the airway has not been published extensively so far. Combining the skills of USG with thorough knowledge of regional anatomy can prove to be a boon to improving the quality of care being delivered to patients. Preoperative use of USG at different levels of the neck combined with the risk assessment methods can help to organize predictors of difficult airway and difficult laryngoscopy. Basic comprehension of USG physics, transducer selection, and probe orientation and a better understanding of airway anatomy contribute to the accuracy of ultrasound interpretation. In day-to-day practice, there is a potential for failed tracheal intubations followed by failure of gaining adequate access to the airway, thus posing challenges to anesthesiologists. Besides predicting difficult airway, USG provides an incentive to properly place an endotracheal tube (ETT) to an adequate depth, estimation of the size of ETT particularly helpful in children and obese, laryngeal mask airway (LMA) confirmation, surgical airways, and post-extubation stridor assessment and thus prevents the risk of reintubation. With the promising and increasing number of evidence exists, there is potential for incorporation of upper airway USG into further standard of care assessment, monitoring, and imaging modalities

First documented cure of a suggestive exogenous reinfection in polymyositis with same but multidrug resistant M. tuberculosis

BACKGROUND: MDR Mycobacterium tuberculosis is the major cause of treatment failure in tuberculosis patients, especially in immunosuppressed. We described a young polymyositis patient on immunosuppressive therapy who was started with antituberculosis therapy as a susceptible strain of M. tuberculosis was isolated from a single cutaneous abscess in his neck and from regional lymph nodes. CASE PRESENTATION: He had non-reactive miliary tuberculosis and multiple cutaneous abscesses 6 months later with the same strain, which was resistant this time to 9 antituberculosis drugs. We described clinical presentation, radiological and laboratory work-up, treatment and follow-up as the patient was cured after 1.5 years with 6 antituberculosis drugs. CONCLUSION: To our knowledge, this is the first reported case where an immunosuppressed patient with suggestive exogenous reinfection within 6 months with the same but MDR strain of M. tuberculosis was cured. Intense management and regular follow up were important since the patient was a potent source of MDR M. tuberculosis infection and there was limited choice for therapy