Towards hardware as a reconfigurable, elastic, and specialized service

As modern Data Center workloads become increasingly complex, constrained, and critical, mainstream CPU-centric computing has had ever more difficulty in keeping pace. Future data centers are moving towards a more fluid and heterogeneous model, with computation and communication no longer localized to commodity CPUs and routers. Next generation data-centric Data Centers will compute everywhere, whether data is stationary (e.g. in memory) or on the move (e.g. in network). While deploying FPGAs in NICS, as co-processors, in the router, and in Bump-in-the-Wire configurations is a step towards implementing the data-centric model, it is only part of the overall solution. The other part is actually leveraging this reconfigurable hardware. For this to happen, two problems must be addressed: code generation and deployment generation. By code generation we mean transforming abstract representations of an algorithm into equivalent hardware. Deployment generation refers to the runtime support needed to facilitate the execution of this hardware on an FPGA. Efforts at creating supporting tools in these two areas have thus far provided limited benefits. This is because the efforts are limited in one or more of the following ways: They i) do not provide fundamental solutions to a number of challenges, which makes them useful only to a limited group of (mostly) hardware developers, ii) are constrained in their scope, or iii) are ad hoc, i.e., specific to a single usage context, FPGA vendor, or Data Center configuration. Moreover, efforts in these areas have largely been mutually exclusive, which results in incompatibility across development layers; this requires wrappers to be designed to make interfaces compatible. As a result there is significant complexity and effort required to code and deploy efficient custom hardware for FPGAs; effort that may be orders-of-magnitude greater than for analogous software environments. The goal of this dissertation is to create a framework that enables reconfigurable logic in Data Centers to be targeted with the same level of effort as for a single CPU core. The underlying mechanism to this is a framework, which we refer to as Hardware as a Reconfigurable, Elastic and Specialized Service, or HaaRNESS. In this dissertation, we address two of the core challenges of HaaRNESS: reducing the complexity of code generation by constraining High Level Synthesis (HLS) toolflows, and replacing ad hoc models of deployment generation by generalizing and formalizing what is needed for a hardware Operating System. These parts are unified by the back-end of HLS toolflows which link generated compute pipelines with the operating system, and provide appropriate APIs, wrappers, and software runtimes. The contributions of this dissertation are the following: i) an empirically guided set of systematic transformations for generating high quality HLS code; ii) a framework for instrumenting HLS compiler to identify and remove optimization blockers; iii) a framework for RTL simulation and IP generation of HLS kernels for rapid turnaround; and iv) a framework for generalization and formalization of hardware operating systems to address the {\it ad hoc}'ness of existing deployment generation and ensure uniform structure and APIs

Risk assessment of gallstone among indoor patients of chronic liver diseases secondary to Hepatitis C.

Introduction: Gallstones (GS) are widely reported as the major cause of mortality and morbidity globally.1 The frequency of GS in patients with chronic liver disease (CLD) is considerably higher than in the general population.1-7 Moreover, prevailing risk of gallstone is associated with disease frequency and severity in advance stages of CLD.1,3 The predictable local incidence of gallstones in CLD patients is approximately 24-31%.6-7 HCV is presumed to be the major cause of CLD in the local settings6-7. Despite high prevalence of GS and HCV CLD in our population, the occurrence of GS in HCV CLD cases has not been assessed so far. Objective: To assess gallstone disease in indoor patients of chronic liver diseases secondary to Hepatitis-C.Methodology: This cross-sectional study was carried out at Department of Gastroenterology, Liaquat National Hospital (LNH), Institute for postgraduate medical studies and health sciences, Karachi from January 2013 to July 2013. Totalof145 patients of chronic liver disease (CLD) secondary to Hepatitis C Virus (HCV) of either gender, regardless of duration of disease, having age more than 30 years were selected purposively. Structured questionnaire used for data collection. Ultrasonography was done to diagnose gallstones. The routine investigations such as platelet count, anti HCV antibodies, and prothrombin time (PT) were performed. SPSS version 20 was used to analyze data. Variables like gallstone was presented through percentages and frequencies, age as mean and SD. After stratification of age, gender and severity of liver disease, chi-square test was applied and p-value less than 0.05 was considered statistically significant.Results: The mean age of patients (n=145) was 54.8±9.4 years, whereas mean of males was 53.9±9.3 years and females were 56.2±9.5years. Among total cases86(59.3%) were males and59(40.7%) were females. The gallstones in male patients (n= 30, 58.8%) was higher than female patients (n=21, 41.2%). However, this difference with regards to gender, was not statistically significant (p-value=0.9). The Child-Pugh score with gallstones patients was (10.0±2.1) slightly higher than patients without gallstone (10.7±2.1). In patients with gallstone, Child’sPughclass-Cwasfoundin51(54.3%) patients, class-Bin37(39.4, %) and class-A in 6 (6.3%) patients. Conclusion: HCV infection is independent risk factor for gallstones in cirrhotic patients. Laparoscopic cholecystectomy in Child-Pugh A and B patients with symptomatic gallstone disease is a safe procedure. Keywords: Gallstones, HCVCLD, Child-Turcotte-Pugh, Cholecystectom

Percutaneous transhepatic biliary stenting

Objective: Bilary stenting with endoprosthesis is a palliative procedure to relieve malignant biliary obstruction. Percutaneous transhepatic technique has been employed whenever endoscopic technique was not possible or had failed.SETTING: Angiography/intervention suite, department of radiology, Aga Khan University hospital, Karachi.Methods: We present retrospective analysis of 17 patients with malignant jaundice who were treated with percutaneous techniques after the endoscopic route had failed.Results: The success rate was 94% with placement of single plastic stent in 14 patients, double stents in 3 patients and self-expandable stent in one patient. The overall complication rate was 41% including sepsis, liver abscess, biloma formation, biliary leakage and stent occlusion. There was one procedure related death due to severe sepsis.CONCLUSION: Percutaneous transhepatic biliary stenting is an alternative procedure to relieve malignant biliary obstruction with high complication rate and should be reserved for selected patients in whom endoscopic route has failed

Assessing Faculty Preference Regarding Online Tools for Assessment in Medical Education: A Cross-Sectional Multi-Center Study

Purpose: E-assessment is a novel practice in developing countries; hence it is essential to determine the online platforms and tools preferred by health sciences education faculty for online assessment. The purpose of this study was to assess the preference of faculty in medical and dental education regarding the online tools for e-assessment of undergraduate students. Methods: This cross-sectional, descriptive study was conducted from June until August 2020 on the faculty of medical and dental undergraduate programs of private and public sector institutes across Karachi, with a sample size of 152. Data was collected through convenience sampling using a validated questionnaire and was analyzed using SPSS version 23. Mean and standard deviation was calculated for numerical data while frequencies and percentages analyzed for categorical data. Results: A total of 125 faculty members participated in the study, having mean age of 37.8±9.99 years, with the majority affiliated with medical program (78%), working in private institutes (58.4%), and teaching basic sciences (64%). Faculty of both basic and clinical sciences preferred Question and Answer (Zoom) for formative assessment (37.6% and 20.8% respectively). Although most faculty were found to not use any online tool for summative assessment, nonetheless, Socrative was preferred for this purpose (23.2% basic sciences, 12.8% clinical sciences). Almost 68% of the faculty faced difficulties in conducting e-assessments and reported that their issues were not resolved effectively (48.2%). Conclusion: Formative assessment was found to be preferably conducted by the Question-and-Answer feature of Zoom. Even though most of the faculty reported not utilizing any online tool for conducting summative assessment, it was found that quiz-based platforms were preferred

Increment of High-Grade Gliomas Among Pediatric and Young Adult Population

Background/Objective:  Glioblastomas are among the commonest primary brain cancers. This study aimed to assess the trend shift of high-grade glioma in our setting among the young and pediatric population. Materials and Methods:  This is a descriptive and cross-sectional study; it was carried out at the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, between duration. All cases with suspected brain tumors, irrespective of age or gender were assessed for glioblastoma. Once a solid tumor was identified on imaging with consistent features of glioblastoma, a provisional diagnosis was established. After that, the patient underwent a brain biopsy. Patients' gender, demographics, clinical presentation, radiologic records, etc. were collected in a predefined proforma. Results:  22 patients were diagnosed with glioblastoma with a high frequency of patients between the age range of 20 to 30 years. The most common location of the tumor was subcortical near the midline. There was slight male predominance. 8 patients had levels of KPS at presentation < 70 and among those two were infants, four were in a vegetative state, and two had a loss of consciousness secondary to increased intracranial pressure. The recurrence rate among those who came back for follow-ups was 27.2%. Conclusion:  Though it is a short study with short follow-up results were astonishing due to perhaps trend shift among Glioblastoma patients, a further detailed workup is needed in different dimensions especially molecular level and genetics to know exactly about the disease and the national registry should be carried and alarmed to identify the problem at once, counter effectively and make a future strategy

Success Rate of Endoscopic Third Ventriculostomy (ETV) in Non-Communicating Hydrocephalus in Pediatric Age Group

Objective:  To evaluate success rate of the endoscopic third Ventriculostomy (ETV) in non-communicating type of hydrocephalus in pediatric age group. Material and Methods:  This study was carried in the department of neurosurgery at Liaquat university hospital, Jamshoro in which an endoscopic third Ventriculostomy procedure was performed in patients (n = 55) with non-communicating hydrocephalus from October 2016 to April 2017. Post-operative follow-up was done on the 15th day post-operative to assess clinical and radiological improvement. Results:  55 patients were included in this study, 26 (47.27%) males and 29 (52.73%) females. The mean age was 3.96 years. The most common etiology was aqueductal stenosis 28 (50.90%) patients followed by posterior fossa tumors in 18 (32.72%) patients. The operative technique was successful in 41 (74.55%) patients. Out of 41 successful patients, 34 (82.92%) patients had clinical as well as radiological improvement whereas 7 (17.07%) patients had clinical improvement only. Conclusion:  The success rate of ETV was 74.55% in the non-communicating hydrocephalus in the pediatric age group in our study. Endoscopic third Ventriculostomy is an effective treatment for non-Communicating hydrocephalus in pediatric age groups by diversion of CSF intracranially. This procedure provides shunt freedom and can be used alternative to shunts in pediatric age groups with non-communicating hydrocephalus

Surgical management of traumatic extra dural hematoma in children: Experiences and analysis from 24 consecutively treated patients in a developing country

Background: Children with epidural hematoma (EDH) present differently thanadults. The outcome of treatment is also different. We aim to report our experiences with EDH in pediatric age group in terms of mode of injury, presenting features, management, and outcomes. We also aim to identify different prognostic indicators in pediatric patients with EDH. Methods: We prospectively collected data from 24 consecutively surgically treated pediatric patients. The data collected included presenting features, radiological imaging, details of management, and outcomes. Descriptive analysis was performed and different variables were tested for any statistical significance with Glasgow Outcome Score (GOS). Results: There were 19 male and 5 female patients. The mean GlasgowComa Scale (GCS) score at presentation was 9.3 ± 4.4. Falls were the mostcommon cause of EDH. Outcome assessment was done at 3 month follow up.A total of 15 patients had a GOS score of 5, 4 patients had a GOS score of4, 2 patients had a GOS score of 3, while 3 patients had a GOS score of 1.On univariate analysis, admitting GCS score, patient’s age, the time frominjury to admission and injury to surgery, anisocoric pupils at presentation andeffacement of basal cisterns were significantly associated with the outcome ofGOS score. Conclusion: Falls are the most common mode of injury leading to EDH inchildren. Lower GCS at presentation, younger age at trauma, increased timesince trauma to surgery and admission, anisocoria and effacement of basalcisterns are statistically significant variables in surgically treated pediatric patients of EDH that confer a poorer prognosis. A timely surgical intervention can result in excellent outcomes

Significance of Agricultural Finance in Agricultural and Rural Development of Pakistan “A Case Study of Qambar Shahdadkot District”

The purpose of this study is to investigate the significance of agricultural finance on agricultural and rural development of Pakistan. The study was based on primary data; the data was collected from Borrowers and Non Borrowers of agricultural finance from district Qambar shahdadkot, Sindh Province of Pakistan. Borrowers of agricultural finance include formal and non formal sources of finance. The results shows that the total revenue of Agricultural Finance borrowers was 76000 rupees while the non borrowers agricultural revenue was 61750 rupees and the variable cost for agricultural finance borrowers was a little bit high then non borrowers as 41652 and 34342 rupees respectively, it was because of availability of capital, the farmers who borrowing agricultural finance and providing inputs on time and in proper were getting better production. Most of the farmers agreed that agricultural finance was helpfull for improving living standard useful for household and rural development; it facilitates farmers in use of agricultural inputs on time and getting best agricultural production. Keywords: Agricultural Finance, rural development, Borrowers and Non Borrowers, total revenue, total cost, Variable costs, capital

A Semi-Physiological Three-Compartment Model Describes Brain Uptake Clearance and Efflux of Sucrose and Mannitol after IV Injection in Awake Mice

Purpose To evaluate a three-compartmental semi-physiological model for analysis of uptake clearance and efflux from brain tissue of the hydrophilic markers sucrose and mannitol, compared to non-compartmental techniques presuming unidirectional uptake. Methods Stable isotope-labeled [13C]sucrose and [13C]mannitol (10 mg/kg each) were injected as IV bolus into the tail vein of awake young adult mice. Blood and brain samples were taken after different time intervals up to 8 h. Plasma and brain concentrations were quantified by UPLC-MS/MS. Brain uptake clearance (Kin) was analyzed using either the single-time point analysis, the multiple time point graphical method, or by fitting the parameters of a three-compartmental model that allows for symmetrical exchange across the blood-brain barrier and an additional brain efflux clearance. Results The three-compartment model was able to describe the experimental data well, yielding estimates for Kin of sucrose and mannitol of 0.068 ± 0.005 and 0.146 ± 0.020 μl.min−1.g−1, respectively, which were significantly different (p \u3c 0.01). The separate brain efflux clearance had values of 0.693 ± 0.106 (sucrose) and 0.881 ± 0.20 (mannitol) μl.min−1.g−1, which were not statistically different. Kin values obtained by single time point and multiple time point analyses were dependent on the terminal sampling time and showed declining values for later time points. Conclusions Using the three-compartment model allows determination of Kin for small molecule hydrophilic markers with low blood-brain barrier permeability. It also provides, for the first time, an estimate of brain efflux after systemic administration of a marker, which likely represents bulk flow clearance from brain tissue