Technology independent ASIC based time to digital converter

This paper proposes a design methodology for a synthesizable, fully digital TDC architecture. The TDC was implemented using a hardware description language (HDL), which improves portability between platforms and technologies and significantly reduces design time. The proposed design flow is fully automated using TCL scripting and standard CAD tools configuration files. The TDC is based on a Tapped Delay Line architecture and explores the use of Structured Data Path (SDP) as a way to improve the TDL linearity by homogenizing the routing and parasitic capacitances across the multiple TDL’s steps. The studied approach also secures a stable, temperature independent measurement operation. The proposed TDC architecture was fabricated using TSMC 180nm CMOS process technology, with a 50MHz reference clock and a supply voltage of 1.8V. The fabricated TDC achieved an 111ps RMS resolution and a single-shot precision of 54ps (0.48 LSB) and 279ps (2.51 LSB), with and without post-measurement software calibration, respectively. The DNL across the channel is mostly under 0.3 LSB and a maximum of 8 LSB peak-to-peak INL was achieved, when no calibration is applied.- (037902

Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study

Abstract Acute neurological emergencies are highly prevalent in intensive care units (ICUs) and impose a substantial burden on patients. This study aims to describe the epidemiology of patients requiring neurocritical care in Brazil, and their differences based on primary acute neurological diagnoses and to identify predictors of mortality and unfavourable outcomes, along with the disease burden of each condition at intensive care unit admission. This prospective cohort study included patients requiring neurocritical care admitted to 36 ICUs in four Brazilian regions who were followed for 30 days or until ICU discharge (Aug-Sep in 2018, 1 month). Of 4245 patients admitted to the participating ICUs, 1194 (28.1%) were patients with acute neurological disorders requiring neurocritical care and were included. Patients requiring neurocritical care had a mean mortality rate 1.7 times higher than ICU patients not requiring neurocritical care (17.21% versus 10.1%, respectively). Older age, emergency admission, higher number of potential secondary injuries, and worse APACHE II, SAPS III, SOFA, and Glasgow coma scale scores on ICU admission are independent predictors of mortality and poor outcome among patients with acute neurological diagnoses. The estimated total DALYs were 4482.94 in the overall cohort, and the diagnosis with the highest DALYs was traumatic brain injury (1634.42). Clinical, epidemiological, treatment, and ICU outcome characteristics vary according to the primary neurologic diagnosis. Advanced age, a lower GCS score and a higher number of potential secondary injuries are independent predictors of mortality and unfavourable outcomes in patients requiring neurocritical care. The findings of this study are essential to guide education policies, prevention, and treatment of severe acute neurocritical diseases

Restrição de crescimento fetal e cromossomopatias: 5 anos de resultados de DPN no INSA

As anomalias do crescimento fetal são uma importante causa de morbilidade e mortalidade perinatais. Os fatores envolvidos na restrição de crescimento fetal (RCF) podem ser maternos, placentários e fetais. Nos fatores fetais, as cromossomopatias estão descritas entre 6 e 32% dos fetos com RCF. Avaliar o tipo e significado das cromossomopatias, na etiologia da RCF, e do seu valor diagnóstico em pré-natal. Avaliar o impacto da introdução da metodologia de microarray no DPN por comparação com o cariotipo. Procedeu-se ao estudo retrospetivo das amostras recebidas, entre nov-2013 e nov-2018, com indicação clínica de RCF isolado ou associado a alterações ecográficas. O Diagnóstico Rápido de Aneuploidias (DRA) foi usado como teste inicial seguido por estudos por citogenética clássica ou por microarray. No período considerado recebemos 56 amostras com indicação de RCF, com idade gestacional entre as 11 e as 34 semanas. Em parte das amostras foi pedido DRA, estudo citogenético ou pesquisa de microdeleções e noutras foi pedido DRA e estudo por microarray. Foram identificadas 6 alterações cromossómicas em 31 casos com estudo citogenétco/pesquisa de microdeleções. Nos casos com microarray foram detetadas 5/25 alterações. Nos 11 (19,6% dos casos) fetos portadores de cromossomopatia, cinco apresentavam RCF isolado, ou associado a alterações do líquido amniótico, e os outros seis apresentavam RCF associada a outras malformações fetais, designadamente do foro cardíaco. As cromossomopatias identificadas nestes fetos incluíram trissomias 18, triploidias e ganhos/perdas de material genómico nos casos estudados por microarray. Nestes últimos, quatro alterações não seriam detetáveis por cariotipo, revelando o maior valor diagnóstico daquela metodologia. A triploidia é comum nos casos de RCF e constitui cerca de 27% das anomalias encontradas nesta coorte podendo, assim, a RCF ser considerada como bom marcador desta situação. Globalmente, a frequência de anomalias encontrada (cerca de 20%) revela a importância do diagnóstico genético em fetos com RCF.N/