A novel control loop enables Dynamic Adaptive Voltage Scaling in a demonstrator with digital cores tightly coupled with monitors and Dynamic Controller. Control loop robustness is validated by Markov ...chains and experimental results. Monitors allow circuits to execute instructions from workloads in fault-free way with power savings up to 50%.
This work demonstrates the fundamental aspects of Mission Profile Recording as an alternative to intrusive, aging monitoring systems to cope with oxide breakdown and electromigration degradation ...mechanisms. A functional prototype is designed, implemented and fully tested on several wafers to achieve a full proof-of-concept. This study offers new perspectives towards product hardening and qualification with respect to an adaptive approach to real user-based workloads.
Aggressive speed roadmap for consumer product requires performance boost with power management policies under wear-out, process, voltage and temperature variations. In-Situ timing Monitors is a ...promising solution for adaptive wear-out management solutions and more generally it helps minimize all voltage margins related to manufacturing variations and operating conditions. A complete insertion of monitor scheme in industrial digital flow is presented. The impact of arbitrarily selection of path under monitoring is widely discussed. The coverage (amount of path monitored in reference PVT vs worst critical path monitored in arbitrary PVT) is at first order dependent on voltage. Measurement of time detection windows of inserted monitors is presented for 28FDSOI and 40nm bulk technologies from ST-Microelectronics. In addition, a counter of ISM warnings is implemented and measurements are shown for different workloads, temperatures, frequency operations and ISM time windows on large samplings.
: Background: Endocannabinoids may participate in the homeostasis of arterial pressure. Recently, anandamide, the most extensively studied endocannabinoid, has been proposed as a key mediator in the ...peripheral arterial vasodilation of cirrhosis.
Objectives: To determine if circulating levels of anandamide are related to the extent of the peripheral arterial vasodilation, the severity of portal hypertension and the degree of liver and renal dysfunction of patients with cirrhosis.
Methods: Plasma levels of anandamide and several systemic, portal and renal hemodynamic parameters were determined in 18 patients with cirrhosis and eight healthy subjects (control group).
Results: Plasma levels of anandamide were elevated in patients compared to the control group (P<0.05), nevertheless, no differences between patients with ascites and well‐compensated patients were found. There was no correlation between anandamide concentration and arterial pressure, cardiac output and systemic vascular resistance, Child–Pugh's score, portal pressure, renal vascular resistance, plasma renin activity or plasma aldosterone concentration.
Conclusions: Circulating levels of anandamide are increased in cirrhotic patients. However, this elevation was unrelated to the extent of arterial vasodilation, the severity of portal hypertension or the degree of hepatic and renal dysfunction. Although a local hormonal action cannot be excluded, our results do not support a relevant contribution of this system in the hemodynamic disturbance of cirrhosis.
Background & Aims: The association of prazosin to propranolol enhances the decrease in portal pressure but may cause hypotension and sodium retention. The aim of this study was to compare the portal ...pressure reduction and safety of the combination of propranolol plus prazosin with that of propranolol plus isosorbide-5-mononitrate (ISMN).
Methods: Fifty-six portal-hypertensive cirrhotics received randomly propranolol plus prazosin (n = 28) or propranolol plus ISMN (n = 28) orally for 3 months. Hemodynamics and liver and renal function were assessed at baseline and after 3 months.
Results: Propranolol plus prazosin caused a greater reduction in hepatic venous pressure gradient (HVPG) than propranolol plus ISMN (−24.2% ± 11% vs. −16.1% ± 11%;
P < 0.01). A reduction in HVPG of >20% was significantly more frequent in the propranolol plus prazosin group than in the propranolol plus ISMN group (85% vs. 53%;
P < 0.05). Neither treatment modified hepatic blood flow, quantitative liver function test results, glomerular filtration rate, plasma renin activity, or plasma aldosterone level. Side effects occurred in 13 patients receiving propranolol plus prazosin compared with 7 receiving propranolol plus ISMN (
P = 0.16).
Conclusions: Propranolol plus prazosin has a greater portal pressure–lowering effect than propranolol plus ISMN. Both therapies were safe for liver and renal function. However, the combination of propranolol plus prazosin caused a greater decrease in arterial pressure and was less well tolerated than propranolol plus ISMN.
GASTROENTEROLOGY 1998;115:116-123
The levels of expression of Heat shock protein 70 (Hsp 70) in sporozoites of a wild-type parent strain and 2 precocious lines of Eimeria tenella, were compared to investigate the relationship between ...the heat shock proteins expressed by the parasite and virulence of the strain. Hsp70 expression was analyzed in sporozoites by immunohistochemical techniques, immunoblot, and flow cytometric analyses. One band of 70 kDa was identified and the variation of the Hsp70 expression levels was quantified by optical densitometric analyses. The results showed a significant gradual decrease in the Hsp70 expression in sporozoites of E. tenella as attenuation progressed, suggesting that the Hsp70 expressed in the excysted sporozoites of E. tenella might be involved in parasite pathogenicity. In addition, the cytoplasmic distribution of the Hsp70, which was observed in the entire sporozoites of the wild strain, was reduced to the anterior portion in the precocious lines.
This paper shows new insights on the stochastic nature of aging-related timing impact in digital circuits. Varying critical paths through aging trigger the need for aging compensation control loop ...based on an unsupervised machine learning algorithm. Adaptive Resonance Theory (ART) algorithm is favored for its ability to handle the stability-plasticity dilemma.
The present report concerns our attempts to further study the effect of quinolone coccidiostats on the sporulation of
Eimeria tenella oocysts by analyzing the meiotic behaviour of the chromosomes. To ...that end, synaptonemal complexes were analyzed by TEM applied to intact meiotic chromosomes. These were isolated after disruption of oocysts, which were harvested from decoquinate-medicated and non-medicated (control) birds. In oocysts from control birds, synaptonemal complexes appeared as the 14 bivalents of the normal karyotype. However, in oocysts from medicated birds, our synaptonemal complex analysis revealed a reciprocal translocation, which was observed as an irregular pairing of chromosome axes 5 and 12 resulting in quadrivalent and trivalent configurations. This finding suggests breakage points in chromosomes 5 and 12 and exchange of chromosomal segments. Furthermore, breakpoints in chromosome 12 resulted in telomere deletion. The chromosomal aberrations described in the present study may result in reduced sporulation since chromosomes involved in translocations segregate abnormally during meiosis. In addition, the results reported provide new evidence of the inhibitory effect of quinolones on the sporulation of
E. tenella oocysts, since sporocysts were not formed.
Abstract Context Beta-lactamases are bacterial enzymes that protect microorganisms from the lethal effects of β-lactam antibiotics. The production of beta-lactamases is the most important mechanism ...of resistance to these antibiotics, especially in Gram-negative bacteria. Objective Review the magnitude of the problem of extended-spectrum beta-lactamases (ESBLs) in the urological setting and present the fundamental action guidelines on the issue, the main risk factors and the prevention strategies. Acquisition of evidence A structured search strategy for patient, problem, intervention, comparison and result was conducted in the PubMed-Medline database to identify the most relevant studies related to the management of patients with urinary tract infection by ESBL-producing microorganisms. We also present a caseload analysis of our center on this issue. Summary of the evidence ESBLs are found in Enterobacteria, mainly Klebsiella sp. and Escherichia coli and are characterized by their hydrolytic ability compared with beta-lactam antibiotics, which entails resistance to penicillin, cephalosporin and aztreonam. They are also associated with resistance to other antibiotics. There is a high risk of infection and colonization by ESBL producers in patients with prolonged hospital stays or who required invasive devices. The prior use of antibiotics and stays in residential care are also risk factors. Prevention programs should focus on preventing nosocomial infection. It is essential that a restrictive policy on the use of antibiotics be implemented. The therapy of choice for severe infections is focused on carbapenems, although their indiscriminate use should be avoided. In uncomplicated lower urinary tract infections, fosfomycin and nitrofurantoin are the best treatment alternatives. Conclusion ESBL-producing strains constitute a true global health problem. Prevention strategies should focus on nosocomial infection. We should not forget, however, that the appearance of these pathogens in community-acquired infections is increasingly frequent. Therapeutic decisions should be based on an understanding of the local distribution of microorganisms and their resistance patterns.
Abstract Introduction The training and learning of residents in laparoscopic surgery has legal, financial and technological limitations. Simulation is an essential tool in the training of residents ...as a supplement to their training in laparoscopic surgery. The training should be structured in an appropriate environment, with previously established and clear objectives, taught by professionals with clinical and teaching experience in simulation. The training should be conducted with realistic models using animals and ex vivo tissue from animals. It is essential to incorporate mechanisms to assess the objectives during the residents’ training progress. Objective We present the training model for laparoscopic surgery for urology residents at the University Hospital Valdecilla. The training is conducted at the Virtual Hospital Valdecilla, which is associated with the Center for Medical Simulation in Boston and is accredited by the American College of Surgeons. Material and method The model is designed in 3 blocks, basic for R1, intermediate for R2–3 and advanced for R4–5, with 9 training modules. The training is conducted in 4-h sessions for 4 afternoons, for 3 weeks per year of residence. Residents therefore perform 240 h of simulated laparoscopic training by the end of the course. For each module, we use structured objective assessments to measure each resident's training progress. Results Since 2003, 9 urology residents have been trained, in addition to the 5 who are currently in training. The model has undergone changes according to the needs expressed in the student feedback. The acquisition of skills in a virtual reality model has enabled the safe transfer of those skills to actual practice. Conclusions A laparoscopic surgery training program designed in structured blocks and with progressive complexity provides appropriate training for transferring the skills acquired using this model to an actual scenario while maintaining patient safety.
