Transjugular intrahepatic portosystemic shunts (TIPS) in children

The transjugular intrahepatic portosystemic shunt procedure is an accepted treatment for adults with complications of portal hypertension. We performed a retrospective review of all pediatric TIPS placements performed at the University of California, San Francisco between 1990 and 1996. Twelve procedures were attempted in nine children, with a mean age (+/- SD) of 9.4 +/- 3.9 years (range, 5 to 15 years) and a mean weight of 31 +/- 18 kg (range, 16 to 70 kg). The indications for TIPS placement were portal hypertension complicated by chronic variceal hemorrhage not controlled with sclerotherapy (n = 7) and hypersplenism with thrombocytopenia (n = 2). TIPS placement was successfully completed initially in seven of nine (78%) patients. Unfavorable vascular anatomy was the cause of failure in two cases. The seven patients who underwent successful TIPS placement were followed up for an average of 136 days (range, 1 to 800 days); two still have patent shunts, three underwent liver transplantation, one had a splenorenal shunt after stenosis, and one died of underlying liver disease. Variceal bleeding was controlled in four of five patients who successfully underwent TIPS placement. Shunt occlusion occurred in four patients; patency was restored by transjugular shunt revision in three, and a splenorenal shunt was performed in one.     

Analyzing the Next Generation Software Defined Radio for Future Architectures

Commercial and research work in the field of software defined radio (SDR) has produced designs which have been able to deliver the efficiency and computational power needed to process 3G wireless technologies. Though efficient 3G processing has been achieved by these designs, next generation 4G SDR technology requires 10–1000x more computational performance but limits the power budget increase to 2–5x. In this paper, we present a breakdown of the major 4G kernels and analyze two methods of increasing performance and reducing power consumption. Specifically, we consider the effect of SIMD width and reduction in number of register file accesses on the performance and energy consumption of a SDR architecture, SODA. We show that by increasing SIMD width we can gain almost 2–8x performance increase while increasing total energy used by 1–2x for different SIMD widths. We also show that by reducing SIMD register accesses we can reduce the total energy used by 5–20% for the 4G kernels.     

Power: a first-class architectural design constraint

Power is a design constraint not only for portable computers and mobile communication devices but also for high-end systems, and the design process should not subordinate it to performance     

Overview of complementary GaAs technology for high-speed VLSIcircuits

A self-aligned complementary GaAs (CGaAs) technology (developed at Motorola) for low-power, portable, digital and mixed-mode circuits is being extended to address high-speed VLSI circuit applications. The process supports full complementary, unipolar (pseudo-DCFL), source-coupled, and dynamic (domino) logic families. Though this technology is not yet mature, it is years ahead of CMOS in terms of fast gate delays at low power supply voltages. Complementary circuits operating at 0.9 V have demonstrated power-delay products of 0.01 μW/MHz/gate. Propagation delays of unipolar circuits are as low as 25 ps. Logic families can be mixed on a chip to trade power for delay. CGaAs is being evaluated for VLSI applications through the design of a PowerPC-architecture microprocessor     

Improving the Reliability of MLC NAND Flash Memories Through Adaptive Data Refresh and Error Control Coding

NAND Flash memory has become the most widely used non-volatile memory technology. We focus on multi-level cell (MLC) NAND Flash memories because they have high storage density. Unfortunately MLC NAND Flash memory also has reliability problems due to narrower threshold voltage gap between logical states. Errors in these memories can be classified into data retention (DR) errors and program interference (PI) errors. DR errors are dominant if the data storage time is longer than 1 day and these errors can be reduced by refreshing the data. PI errors are dominant if the data storage time is less than 1 day and these errors can be handled by error control coding (ECC). In this paper we propose a combination of data refresh policies and low cost ECC schemes that are cognizant of application characteristics to address the errors in MLC NAND Flash memories. First, we use Gray code based encoding to reduce the error rates in the four subpages (MSB-even, LSB-even, MSB-odd, LSB-odd) of a 2-bit MLC NAND Flash memory. Next, we apply data refresh techniques where the refresh interval is a function of the program/erase (P/E) frequency of the application. We show that an appropriate choice of refresh interval and BCH based ECC scheme can minimize memory energy while satisfying the reliability constraint.     

Reassessment of the hydrocarbons in Prince William Sound and the Gulf of Alaska: identifying the source using partial least-squares

There has been considerable exchange in the literature regarding the source of the background hydrocarbons in Prince William Sound and the Gulf of Alaska. Page and coworkers suggest oil-based sources while Short and coworkers suggest coal. The multivariate statistical methodology of partial least-squares (PLS) has been used to reassess the percentage contribution of coal, seep oil, shales, and rivers to the hydrocarbon loading in the Gulf of Alaska. Data have kindly been provided by Short (NOAA) and Page (Bowdoin College, for Exxon), and these have been analyzed using selected sites as sources in order to develop signatures. These signatures are based on 40 and 136 compounds, respectively, and include the PAH and terpane/sterane biomarkers in the case of the Exxon data. The principal components describing these sources are then fitted to the data for other sites around the Prince William Sound (PWS) and Gulf of Alaska (GoA) to determine the proportion of the variability described by each source. Using the Exxon data, a mixed source of coal, seep oil, eroding shales, and rivers (1 and 2) sources described approximately 13%, 18%, 24%, 26%, and 20%, respectively, of the variance in PWS and GoA data. The rivers 1 signature was very similar to that of coal, while rivers 2 was more similar to the eroding shales. New coal data (Short, unpublished work) also indicated considerable overlap with the Exxon seep oil. With the NOAA data, spatial plots of the explained variance indicate that the prespill background has a wide range of explained fits. There is considerable overlap in the signatures developed from the data, and Coomans' Plots identify those compounds which are the most diagnostic: for the Exxon seep oil signature, naphthalene and methyl- and dimethylnaphthalene are the best markers, whereas for the NOAA prespill background, Exxon coals and shales are best defined by the larger PAHs such as benzo[ghi]perylene. The evidence suggests mixed sources whose contributions vary significantly across the sampling area.     

Patency of 24-gauge peripheral intermittent infusion devices: a comparison of heparin and saline flush solutions

The purpose of this study was to compare the effectiveness of heparin and normal saline flush solutions in maintaining the patency of 24-gauge peripheral intermittent infusion devices (PIIDs). A prospective, non-randomized, sequential, blinded study design was conducted on a pediatric and a neonatal intensive care unit. The sample consisted of 134 catheters in 61 patients. Heparin and saline flush groups were similar for age, PIID placement site, irritating substances infused, and initial IV function. The median duration of catheters flushed with heparin was 42 hours and with saline was 35.3 hours. Kaplan-Meier Survival Analysis indicated that the duration of catheters flushed with heparin was significantly longer than those flushed with saline (p = .02). More catheters flushed with saline were removed because of problems (p = .027). Results of this study suggest that heparin is more effective than saline in maintaining the patency of small, 24-gauge catheters.     

Circuit and microarchitectural techniques for reducing cache leakage power

On-chip caches represent a sizable fraction of the total power consumption of microprocessors. As feature sizes shrink, the dominant component of this power consumption will be leakage. However, during a fixed period of time, the activity in a data cache is only centered on a small subset of the lines. This behavior can be exploited to cut the leakage power of large data caches by putting the cold cache lines into a state preserving, low-power drowsey mode. In this paper, we investigate policies and circuit techniques for implementing drowsy data caches. We show that with simple microarchitectural techniques, about 80%-90% of the data cache lines can be maintained in a drowsy state without affecting performance by more than 0.6%, even though moving lines into and out of a drowsy state incurs a slight performance loss. According to our projections, in a 70-nm complementary metal-oxide-semiconductor process, drowsy data caches will be able to reduce the total leakage energy consumed in the caches by 60%-75%. In addition, we extend the drowsy cache concept to reduce leakage power of instruction caches without significant impact on execution time. Our results show that data and instruction caches require different control strategies for efficient execution. In order to enable drowsy instruction caches, we propose a technique called cache subbank prediction, which is used to selectively wake up only the necessary parts of the instruction cache, while allowing most of the cache to stay in a low-leakage drowsy mode. This prediction technique reduces the negative performance impact by 78% compared with the no-prediction policy. Our technique works well even with small predictor sizes and enables a 75% reduction of leakage energy in a 32-kB instruction cache.     

High-power diode-laser-pumped CW solid-state lasers usingstable-unstable resonators

We present a novel design for an efficient, high power (>100 W), continuous-wave (CW) Nd:YAG laser with diffraction-limited performance. It uses side-pumped, sidecooled, zigzag slab which is incorporated in a stable-unstable resonator that has a variable reflectivity output coupler. A geometric magnification of at least 1.3 in the unstable direction can be achieved. Modeled performance characteristics are presented     

Nocturnal hemodialysis (NHD) adapted to the in-centre setting--a pilot study

The authors report on a 42-year-old female inpatient with bipolar I disorder, whose dysphoric mania responded rapidly and completely while her antimanic medication (lithium, carbamazepine, clozapine, haloperidol and clonazepam) was supplemented by 20 mg of paroxetine daily. The practical and theoretical importance of this case is briefly discussed.