As silicon field-effect transistors encounter increasing scaling challenges, digital system designers are shifting their attention towards multi-valued logic (MVL), specifically ternary logic. The ...graphene nanoribbon field-effect transistor (GNRFET) emerges as a compelling alternative among post-MOSFET technologies for the implementation of ternary logic. This paper delves into the computational intricacies of ternary logic, underscores the outstanding features of GNRFET technology, and introduces a novel GNRFET-based 1-trit ternary multiplier (TMUL) requiring only 26 transistors. The performance of the design is assessed using the Synopsis HSPICE simulator with a 32-nm GNRFET model file operating at VDD = 0.9 V. The proposed TMUL surpasses existing designs due to its efficient paths with a minimal number of transistors for each output transition, a singular power supply voltage, and an extended voltage division scheme. In comparison to other contemporary TMUL designs, the proposed design exhibits a notable enhancement, showcasing a 21.42 % reduction in delay, a 33.11 % decrease in power-delay-product (PDP), and a 58.17 % decrease in energy-delay-product (EDP). Additionally, the design is subjected to thorough testing under diverse conditions including process, voltage, temperature (PVT) fluctuations, and load variations, validating its reliability and robustness.
SARS-CoV-2 induced coagulopathy can lead to thrombotic complications such as stroke. Cerebral venous sinus thrombosis (CVST) is a less common type of stroke which might be triggered by COVID-19. We ...present a series of CVST cases with SARS-CoV-2 infection.
In a multinational retrospective study, we collected all cases of CVST in SARS-CoV-2 infected patients admitted to nine tertiary stroke centers from the beginning of the pandemic to June 30th, 2020. We compared the demographics, clinical and radiological characteristics, risk factors, and outcome of these patients with a control group of non-SARS-CoV-2 infected CVST patients in the same seasonal period of the years 2012–2016 from the country where the majority of cases were recruited.
A total of 13 patients fulfilled the inclusion criteria (62% women, mean age 50.9 ± 11.2 years). Six patients were discharged with good outcomes (mRS ≤ 2) and three patients died in hospital. Compared to the control group, the SARS-CoV-2 infected patients were significantly older (50.9 versus 36.7 years, p < 0.001), had a lower rate of identified CVST risk factors (23.1% versus 84.2%, p < 0.001), had more frequent cortical vein involvement (38.5% versus 10.5%, p: 0.025), and a non-significant higher rate of in-hospital mortality (23.1% versus 5.3%, p: 0.073).
CVST should be considered as potential comorbidity in SARS-CoV-2 infected patients presenting with neurological symptoms. Our data suggest that compared to non-SARS-CoV-2 infected patients, CVST occurs in older patients, with lower rates of known CVST risk factors and might lead to a poorer outcome in the SARS-CoV-2 infected group.
•Coagulopathy is a known feature of SARS-CoV-2 infection.•Only few cases of CVST associated with SARS-CoV-2 infection have been reported.•A series of 13 cases of CVST associated with SARS-CoV-2 has been described.•CVST patients with SARS-CoV-2 infection, were older and had a lower rate of identified CVST risk factors.•Cortical veins involvement and in-hospital mortality were more frequent in SARS-CoV-2 infected CVST patients.
Acute rejection (AR) undermines the life-extending benefits of kidney transplantation and is diagnosed using the invasive biopsy procedure. T cell-mediated rejection (TCMR), antibody-mediated ...rejection (ABMR), or concurrent TCMR + ABMR (Mixed Rejection MR) are the three major types of AR. Development of noninvasive biomarkers diagnostic of AR due to any of the three types is a useful addition to the diagnostic armamentarium.
We developed customized RT-qPCR assays and measured urinary cell mRNA copy numbers in 145 biopsy-matched urine samples from 126 kidney allograft recipients. We determined whether the urinary cell three-gene signature diagnostic of TCMR (Suthanthiran et al., 2013) discriminates patients with no rejection biopsies (NR, n = 50) from those with ABMR (n = 28) or MR (n = 20) biopsies.
The urinary cell three-gene signature discriminated all three types of rejection biopsies from NR biopsies (P < 0.0001, One-way ANOVA). Dunnett's multiple comparisons test yielded P < 0.0001 for NR vs. TCMR; P < 0.001 for NR vs. ABMR; and P < 0.0001 for NR vs. MR. By bootstrap resampling, optimism-corrected area under the receiver operating characteristic curve (AUC) was 0.749 (bias-corrected 95% confidence interval CI, 0.638 to 0.840) for NR vs. TCMR (P < 0.0001); 0.780 (95% CI, 0.656 to 0.878) for NR vs. ABMR (P < 0.0001); and 0.857 (95% CI, 0.727 to 0.947) for NR vs. MR (P < 0.0001). All three rejection categories were distinguished from NR biopsies with similar accuracy (all AUC comparisons P > 0.05).
The urinary cell three-gene signature score discriminates AR due to TCMR, ABMR or MR from NR biopsies in human kidney allograft recipients.
To identify the pattern, distribution, and causes of ocular injuries among the security personnel participating in counterinsurgency operations (CIOps).
This was a multicentric, retrospective review ...of chart records of patients reporting to three hospitals located in the geographic region affected by CIOps. The hospital registry was examined for all patients diagnosed with any type of ocular trauma between January 1, 2016, and December 31, 2019. A standardized proforma was filled out using the case records, and entries were validated.
A total of 131 ocular injuries fulfilled the criteria of the study. The mean age of the patients was 32.46 ± 10.2 years. All the patients were males. The causes of the injuries were explosive blasts in 60 eyes (45.80%), gunshot wounds in 15 eyes (11.42%), stone pelting in 16 eyes (12.21%), training-related causes in 26 eyes (29.84%), vehicular accidents in 13 eyes (9.92%), and battery blast in one eye (0.76%). Among the type of injuries, open globe injuries included 66 eyes (50.38%), closed globe injuries included 35 eyes (26.72%), isolated lid lacerations included 14 eyes (10.68%), and isolated chemical injury was seen in two eyes (1.52%). Optic nerve head avulsion was seen in two eyes (1.52%).
The study revealed a considerable number of ocular injuries related to combat, with explosive bursts being the leading cause. The incidence of ocular injuries was found to be highest in zone 1. This study emphasizes the importance of the need for soldiers deployed in active CIOps regions to wear protective eyewear, such as ballistic goggles or military combat eye protection, to reduce the risk of ocular injuries.
The designing of the efficient memory cell is mandatory for the today's portable applications. ...it is a great challenge to design a static random-access memory (SRAM) cell in ultra-DSM regime for ...the low-power and high-performance systems. ...designing of the SRAM cell is crucial for the low-power and high-performance systems for the enhanced SNM values at different operating states 7. The different power supplies were applied for the active, and idle modes of the cell. ...extra care was taken for the supply voltage value for the states. ...it is commonly used element in many applications, where signal value is required for a time.
Escherichia coli O157:H7 (O157) has been linked to numerous foodborne disease outbreaks. The ability to rapidly sequence and analyze genomes is important for understanding epidemiology, virulence, ...survival, and evolution of outbreak strains. In the current study, we performed comparative genomics to determine structural and functional features of the genome of a foodborne O157 isolate NADC 6564 and infer its evolutionary relationship to other O157 strains.
The chromosome of NADC 6564 contained 5466 kb compared to reference strains Sakai (5498 kb) and EDL933 (5547 kb) and shared 41 of its 43 Linear Conserved Blocks (LCB) with the reference strains. However, 18 of 41 LCB had inverse orientation in NADC 6564 compared to the reference strains. NADC 6564 shared 18 of 19 bacteriophages with reference strains except that the chromosomal positioning of some of the phages differed among these strains. The additional phage (P19) of NADC 6564 was located on a 39-kb insertion element (IE) encoding several hypothetical proteins, an integrase, transposases, transcriptional regulators, an adhesin, and a phosphoethanolamine transferase (PEA). The complete homologs of the 39-kb IE were found in E. coli PCN061 of porcine origin. The IE-encoded PEA showed low homology (32-33%) to four other PEA in NADC 6564 and PEA linked to mobilizable colistin resistance in E. coli but was highly homologous (95%) to a PEA of uropathogenic, avian pathogenic, and enteroaggregative E. coli. NADC 6564 showed slightly higher minimum inhibitory concentration of colistin compared to the reference strains. The 39-kb IE also contained dndBCDE and dptFGH operons encoding DNA S-modification and a restriction pathway, linked to oxidative stress tolerance and self-defense against foreign DNA, respectively. Evolutionary tree analysis grouped NADC 6564 with lineage I O157 strains.
These results indicated that differential phage counts and different chromosomal positioning of many bacteriophages and genomic islands might have resulted in recombination events causing altered chromosomal organization in NADC 6564. Evolutionary analysis grouped NADC 6564 with lineage I strains and suggested its earlier divergence from these strains. The ability to perform S-DNA modification might affect tolerance of NADC 6564 to various stressors.
The benefit of mechanical thrombectomy (MT) in patients with stroke presenting with mild deficits (National Institutes of Health Stroke Scale NIHSS score <6) owing to emergency large-vessel occlusion ...(ELVO) remains uncertain.
To assess the outcomes of patients with mild-deficits ELVO (mELVO) treated with MT vs best medical management (bMM).
We retrospectively pooled patients with mELVO during a 5-year period from 16 centers. A meta-analysis of studies reporting efficacy and safety outcomes with MT or bMM among patients with mELVO was also conducted. Data were analyzed between 2013 and 2017.
We identified studies that enrolled patients with stroke (within 24 hours of symptom onset) with mELVO treated with MT or bMM.
Efficacy outcomes included 3-month favorable functional outcome and 3-month functional independence that were defined as modified Rankin Scale scores of 0 to 1 and 0 to 2, respectively. Safety outcomes included 3-month mortality and symptomatic and asymptomatic intracranial hemorrhage (ICH).
We evaluated a total of 251 patients with mELVO who were treated with MT (n = 138; 65 women; mean age, 65.2 years; median NIHSS score, 4; interquartile range IQR, 3-5) or bMM (n = 113; 51 women; mean age, 64.8; median NIHSS score, 3; interquartile range IQR, 2-4). The rate of asymptomatic ICH was lower in bMM (4.6% vs 17.5%; P = .002), while the rate of 3-month FI (after imputation of missing follow-up evaluations) was lower in MT (77.4% vs 88.5%; P = .02). The 2 groups did not differ in any other efficacy or safety outcomes. In multivariable analyses, MT was associated with higher odds of asymptomatic ICH (odds ratio OR, 11.07; 95% CI, 1.31-93.53; P = .03). In the meta-analysis of 4 studies (843 patients), MT was associated with higher odds of symptomatic ICH in unadjusted analyses (OR, 5.52; 95% CI, 1.91-15.49; P = .002; I2 = 0%). This association did not retain its significance in adjusted analyses including 2 studies (OR, 2.06; 95% CI, 0.49-8.63; P = .32; I2 = 0%). The meta-analysis did not document any other independent associations between treatment groups and safety or efficacy outcomes.
Our multicenter study coupled with the meta-analysis suggests similar outcomes of MT and bMM in patients with stroke with mELVO, but no conclusions about treatment effect can be made. The clinical equipoise can further be resolved by a randomized clinical trial.
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