Miracle-dz/UniFAR-FTUs huggingface dataset:
Power delivery network design and optimization for 3D stacked die designs

Power delivery network (PDN) design is already a challenging problem for single die designs using advanced process technologies. For systems created using stacked dies with TSVs, several additional issues that affect power delivery and reliability have to be addressed. In stacked die configuration, the dies higher up in the stack-up experience additional drop and noise in their power supply as it propagates through the TSV networks of one or more dies placed lower in the stack-up. For the lower dies, the presence of the TSV farm and associated metals/vias affects the homogeneity of their own power delivery network. And if multiple dies share power and ground domains, then there could be an inter-die propagation of supply noise. So it becomes important that a PDN design and optimization flow for stacked die designs models and analyzes the presence of multiple dies and also the switching and the noise impact from the dies on each other. The analysis could be concurrent or model based, depending upon whether full databases for all the chips are available or their electrically equivalent models such as Chip Power Model (CPM) are available, respectively. For both of these approaches, a DC and time-domain analysis has to be done at the chip layout level to accurately predict the power/ground noise in the stacked die design. These analyses need to done starting early, in order to enable prototyping and design trade-off decisions. In this paper, a prototyping and verification solution for multi-die TSV based designs is outlined along with results from various design decisions undertaken.
Phenytoin induced chorea in a pediatric patient: An interaction between phenytoin, phenobarbital and clobazam

A 3-year-old female patient developed chorea possibly due to an interaction between phenytoin, phenobarbital and clobazam used for generalized tonic clonic seizures. Phenytoin withdrawal resulted in recovery within 24 hours. Post reaction computerized tomography (CT)-scan of brain was normal. Combined use of anti-seizure drugs and interactions between them may be responsible for the reaction. Therapeutic drug monitoring is important while prescribing two or more anti-seizure drugs.
Mild phenotype in a 15‐year‐old boy with Pallister–Killian syndrome

Pallister–Killian syndrome is a rare disorder characterized by multiple congenital anomalies, coarse face, pigmentary skin changes, seizures, severe mental retardation, and the presence of an extra metacentric chromosome i(12p) confined to skin fibroblasts only. Here, we report on an unusual case of i(12p) in a 15‐year‐old boy presenting with mild mental retardation, minor facial features (long face, prognathism, short neck), normal weight, length, and OFC parameters as well as hyperpigmented streaks. The boy attended normal school until the age of 14 years. Because of hyperpigmented stripes, chromosome analysis was performed on skin fibroblasts. This study showed that 37% of the cells had an additional isochromosome for the short arm of chromosome 12. This observation illustrates the phenotypic variability of i(12p) and emphasizes the importance of skin fibroblasts chromosome analysis in patients with pigmentary skin changes. © 2002 Wiley‐Liss, Inc.
A Programmed Ependymal Denudation Precedes Congenital Hydrocephalus in the hyh Mutant Mouse

Hydrocephalic hyh mice are born with moderate hydrocephalus and a normal cerebral aqueduct. At about the fifth postnatal day the aqueduct becomes obliterated and severe hydrocephalus develops. The aim of the present investigation was to investigate the mechanism of this hydrocephalus, probably starting during fetal life when the cerebral aqueduct is still patent. By use of immunocytochemistry and scanning electron microscopy, mutant (n = 54) and normal (n = 61) hyh mouse embryos were studied at various developmental stages to trace the earliest microscopic changes occurring in the brains of embryos becoming hydrocephalic. The primary defect begins at an early developmental stage (E-12) and involves cells lining the brain cavities, which detach following a well-defined temporo-spatial pattern. This ependymal denudation mostly involves the ependyma of the basal plate derivatives. There is a relationship between ependymal denudation and ependymal differentiation evaluated by the expression of vimentin and glial fibrillary acidic protein. The ependymal cells had a normal appearance before and after detachment, suggesting that their separation from the ventricular wall might be due to abnormalities in cell adhesion molecules. The process of detachment of the ventral ependyma, clearly visualized under scanning electron microscope, is almost completed before the onset of hydrocephalus. Furthermore, this ependymal denudation does not lead to aqueductal stenosis during prenatal life. Thus, the rather massive ependymal denudation appears to be the trigger of hydrocephalus in this mutant mouse, raising the question about the mechanism responsible for this hydrocephalus. It seems likely that an uncontrolled bulk flow of brain fluid through the extended areas devoid of ependyma may be responsible for the hydrocephalus developed by the hyh mutant embryos. The defect in these embryos also includes loss of the hindbrain floor plate and a delayed in the expression of Reissner fiber glycoproteins by the subcommissural organ.
Multiple personality disorder in The Netherlands: a clinical investigation of 71 patients.

OBJECTIVE The aim of this study was to describe the phenomenology of multiple personality disorder as presented in a group of Dutch patients. METHOD Seventy-one patients with multiple personality disorder were interviewed with the Dutch version of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D); following the SCID-D, the Structured Trauma Interview was administered. Before the interview, patients completed the Dissociative Experiences Scale. RESULTS The presenting characteristics of the patients showed a striking resemblance to those in several large North American series. Patients had spent an average of 8.2 years in the mental health system prior to correct diagnosis. Patients presented with many different symptoms and frequently received other psychiatric or neurological diagnoses. A history of childhood physical and/or sexual abuse was reported by 94.4% of the subjects, and 80.6% met criteria for posttraumatic stress disorder. CONCLUSIONS Patients with multiple personality disorder have a stable set of core symptoms throughout North America as well as in Europe. To improve the detection of patients at high risk for multiple personality disorder, standardized instruments for inquiry about dissociative pathology should be used as part of routine diagnostic assessment.
Association between dental fear and dental attendance among adults in Finland

Objective. Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Material and methods. The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: “How afraid are you of visiting a dentist? ” Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Results. Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. Conclusion. Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.
Evolution of larval competitiveness and associated life‐history traits in response to host shifts in a seed beetle

Resource competition is frequently strong among parasites that feed within small discrete resource patches, such as seeds or fruits. The properties of a host can influence the behavioural, morphological and life‐history traits of associated parasites, including traits that mediate competition within the host. For seed parasites, host size may be an especially important determinant of competitive ability. Using the seed beetle, Callosobruchus maculatus, we performed replicated, reciprocal host shifts to examine the role of seed size in determining larval competitiveness and associated traits. Populations ancestrally associated with either a small host (mung bean) or a large one (cowpea) were switched to each other's host for 36 generations. Compared to control lines (those remaining on the ancestral host), lines switched from the small host to the large host evolved greater tolerance of co‐occurring larvae within seeds (indicated by an increase in the frequency of small seeds yielding two adults), smaller egg size and higher fecundity. Each change occurred in the direction predicted by the traits of populations already adapted to cowpea. However, we did not observe the expected decline in adult mass following the shift to the larger host. Moreover, lines switched from the large host (cowpea) to the small host (mung bean) did not evolve the predicted increase in larval competitiveness or egg size, but did exhibit the predicted increase in body mass. Our results thus provide mixed support for the hypothesis that host size determines the evolution of competition‐related traits of seed beetles. Evolutionary responses to the two host shifts were consistent among replicate lines, but the evolution of larval competition was asymmetric, with larval competitiveness evolving as predicted in one direction of host shift, but not the reverse. Nevertheless, our results indicate that switching hosts is sufficient to produce repeatable and rapid changes in the competition strategy and fitness‐related traits of insect populations.
Bacterial Macroscopic Rope-like Fibers with Cytopathic and Adhesive Properties*

We present a body of ultrastructural, biochemical, and genetic evidence that demonstrates the oligomerization of virulence-associated autotransporter proteins EspC or EspP produced by deadly human pathogens enterohemorrhagic and enteropathogenic Escherichia coli into novel macroscopic rope-like structures (>1 cm long). The rope-like structures showed high aggregation and insolubility, stability to anionic detergents and high temperature, and binding to Congo Red and thioflavin T dyes. These are properties also exhibited by human amyloidogenic proteins. These macroscopic ropes were not observed in cultures of nonpathogenic Escherichia coli or isogenic espP or espC deletion mutants of enterohemorrhagic or enteropathogenic Escherichia coli but were produced by an Escherichia coli K-12 strain carrying a plasmid expressing espP. Purified recombinant EspP monomers were able to self-assemble into macroscopic ropes upon incubation, suggesting that no other protein was required for assembly. The ropes bound to and showed cytopathic effects on cultured epithelial cells, served as a substratum for bacterial adherence and biofilm formation, and protected bacteria from antimicrobial compounds. We hypothesize that these ropes play a biologically significant role in the survival and pathogenic scheme of these organisms.
A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome.

BACKGROUND Many patients with the antiphospholipid antibody syndrome and recurrent thrombosis receive doses of warfarin adjusted to achieve an international normalized ratio (INR) of more than 3.0. However, there are no prospective data to support this approach to thromboprophylaxis. METHODS We performed a randomized, double-blind trial in which patients with antiphospholipid antibodies and previous thrombosis were assigned to receive enough warfarin to achieve an INR of 2.0 to 3.0 (moderate intensity) or 3.1 to 4.0 (high intensity). Our objective was to show that high-intensity warfarin was more effective in preventing thrombosis than moderate-intensity warfarin. RESULTS A total of 114 patients were enrolled in the study and followed for a mean of 2.7 years. Recurrent thrombosis occurred in 6 of 56 patients (10.7 percent) assigned to receive high-intensity warfarin and in 2 of 58 patients (3.4 percent) assigned to receive moderate-intensity warfarin (hazard ratio for the high-intensity group, 3.1; 95 percent confidence interval, 0.6 to 15.0). Major bleeding occurred in three patients assigned to receive high-intensity warfarin and four patients assigned to receive moderate-intensity warfarin (hazard ratio, 1.0; 95 percent confidence interval, 0.2 to 4.8). CONCLUSIONS High-intensity warfarin was not superior to moderate-intensity warfarin for thromboprophylaxis in patients with antiphospholipid antibodies and previous thrombosis. The low rate of recurrent thrombosis among patients in whom the target INR was 2.0 to 3.0 suggests that moderate-intensity warfarin is appropriate for patients with the antiphospholipid antibody syndrome.
Cost comparison of linezolid versus vancomycin for treatment of complicated skin and skin-structure infection caused by methicillin-resistant Staphylococcus aureus in Quebec.

BACKGROUND In Canada, complicated skin and skin-structure infection (cSSSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) is usually treated with antibiotics in hospital, with a follow-up course at home for stable patients. The cost implications of using intravenous and oral linezolid instead of intravenous vancomycin in Canadian clinical practice have not been examined. OBJECTIVES To evaluate the potential treatment cost impact for the Quebec health care system of linezolid versus vancomycin for MRSA-related cSSSI therapy, using a net impact analysis approach. METHODS Health care resource use associated with linezolid and vancomycin therapy was estimated for patients in Quebec, based on expert opinion. Costs were assigned to health care resources (antibiotics, medical supplies, laboratory testing and health care professional time) based on unit prices. The base-case analysis assumed 14 days of antibiotic treatment for both agents; five days in hospital followed by nine days at home. Therapy duration, length of inpatient treatment and discharge rates were varied in sensitivity analyses. RESULTS Antibiotic costs were higher for linezolid than for vancomycin, for both inpatient ($874 versus $144, respectively) and outpatient therapy ($1,356 versus $1,242, respectively). Compared with vancomycin, lower costs for antibiotic preparation, administration and monitoring of linezolid offset drug acquisition costs. Total treatment costs were $3,850 for linezolid versus $5,189 for vancomycin. Results were sensitive to the number of treatment days spent at home and the discharge rate. CONCLUSION Using linezolid instead of vancomycin to treat MRSA-related cSSSI, for hospital and home courses combined, may reduce health care resource utilization and costs in Quebec.
High-Temperature Electrical and Thermal Aging Performance and Application Considerations for SiC Power DMOSFETs

The temperature dependence and stability of three different commercially-available unpackaged SiC Dmosfets have been measured. On-state resistances increased to 6 or 7 times their room temperature values at 350 °C. Threshold voltages almost doubled after tens of minutes of positive gate voltage stressing at 300 °C, but approached their original values again after only one or two minutes of negative gate bias stressing. Fortunately, the change in drain current due to these threshold instabilities was almost negligible. However, the threshold approaches zero volts at high temperatures after a high temperature negative gate bias stress. The zero gate bias leakage is low until the threshold voltage reduces to approximately 150 mV, where-after the leakage increases exponentially. Thermal aging tests demonstrated a sudden change from linear to nonlinear output characteristics after 24–100 h air storage at 300 °C and after 570–1000 h in N2 atmosphere. We attribute this to nickel oxide growth on the drain contact metallization which forms a heterojunction p-n diode with the SiC substrate. It was determined that these state-of-the-art SiC mosfet devices may be operated in real applications at temperatures far exceeding their rated operating temperatures.
Fructose: Pure, White, and Deadly? Fructose, by Any other Name, is a Health Hazard

The worldwide consumption of sucrose, and thus fructose, has risen logarithmically since 1800. Many concerns about the health hazards of calorie-sweetened beverages, including soft drinks and fruit drinks and the fructose they provide, have been voiced over the past 10 years. These concerns are related to higher energy intake, risk of obesity, risk of diabetes, risk of cardiovascular disease, risk of gout in men, and risk of metabolic syndrome. Fructose appears to be responsible for most of the metabolic risks, including high production of lipids, increased thermogenesis, and higher blood pressure associated with sugar or high fructose corn syrup. Some claim that sugar is natural, but natural does not assure safety.
Impact of the 21-Gene Recurrence Score Assay in adjuvant chemotherapy selection for node-negative, hormone receptor-positive breast cancer in the Chinese population.

The 21-Gene Recurrence Score Assay has been intensively studied and recommended by major guidelines for treatment decision in early breast cancer. Its impact in adjuvant chemotherapy selection for Chinese population has not been revealed.The prospective part of this study enrolled consecutive node-negative, hormone receptor-positive patients who underwent 21-gene RS testing at Breast Surgery Department of PUMCH (n=134) between May 2012 and August 2013(21-gene RS group). Risk categories were assigned based on the RS and on standard clinicopathologic criteria according to St. Gallen and Adjuvant! Online. The chemotherapy selection and the oncologists' confidence in decision-making before and after RS testing were recorded. The retrospective part of this study compared the chemotherapy decision in the 21-gene RS group and a control group without RS testing (diagnosed between Jan 2011 and Apr 2012,n=170). A total of 304 patients were included in the analysis (134 21-gene RS group, 170 controls). Based on RS, 97 patients were classified as low risk, 29 patients as intermediate risk, and 8 patients as high risk. Tumor grade (P=0.002), PR expression (P<0.001) and Ki-67 index (P<0.001) were significantly different between the 3 risk cohorts.Comparing the St. Gallen guidelines and RS, there was a 41% concordance between risk groups. By using Adjuvant! Online, the correlation between the predicted BCSM and RS was nominal (r=0.10). A total of 29% 21-gene RS group patients changed their treatment decisions after RS testing (P<0.001, 95% CI, 0.18 to 0.49) with 6% (8/134) patients changing to receive chemotherapy besides endocrine therapy and 23% (31/134) changing to reject chemotherapy. After RS testing, more than one half of the oncologists increased their confidence level in treatment recommendation. In the control group, 67.6% (115/170) patients chose chemotherapy plus endocrine therapy. The chemotherapy percentage was much higher than that of 21-gene RS group (30/134, 22%). This is the first study to demonstrate a reduction in the use of adjuvant chemotherapy in women with node-negative hormone receptor-positive breast cancer, based on use of the RS. The RS had an impact on the physicians' treatment decision-making.
The role of aminoglycosides in combination with a beta-lactam for the treatment of bacterial endocarditis: a meta-analysis of comparative trials.

BACKGROUND The addition of an aminoglycoside to a beta-lactam for the treatment of patients with infective endocarditis has been supported by data from laboratory and animal studies. PURPOSE We sought to review the evidence from the available comparative clinical trials regarding the role of aminoglycosides in combination with a beta-lactam for the treatment of bacterial endocarditis caused by Gram-positive cocci. DATA SOURCES The studies for our meta-analysis were retrieved from searches of the PubMed and Cochrane Central Register of Controlled Trials databases, as well as from the references cited in relevant articles. No limits were set regarding the language and date of publication of the studies. STUDY SELECTION Included studies were prospective studies that provided comparative data regarding the effectiveness of the treatment and/or mortality in patients receiving monotherapy with a beta-lactam or beta-lactam/aminoglycoside combination therapy. DATA EXTRACTION Two independent reviewers performed the literature search, study selection and extraction of data from relevant studies. DATA SYNTHESIS No clinical trial comparing beta-lactam monotherapy with beta-lactam/aminoglycoside combination therapy for the treatment of enterococcal endocarditis was found. We performed a meta-analysis of five available comparative trials [four randomized controlled trials (RCTs) and one comparative prospective trial], which included 261 patients with bacterial endocarditis in native valves due to Staphylococcus aureus (four studies) or streptococci of the viridans group (one study). There was no statistically significant difference between beta-lactam monotherapy and beta-lactam/aminoglycoside combination therapy regarding mortality [odds ratio (OR) = 0.59, 95% confidence interval (95% CI) = 0.21-1.66], treatment success (OR = 1.25, 95% CI = 0.49-3.05), treatment success without surgery (OR = 1.66, 95% CI = 0.64-4.30) or relapse of endocarditis (OR = 0.79, 95% CI = 0.15-4.29). Nephrotoxicity was less common in the beta-lactam monotherapy arm than in the beta-lactam/aminoglycoside combination therapy arm (OR = 0.38, 95% CI = 0.16-0.88, P = 0.024). No difference between the two treatment arms was found in subanalyses of the four studies that included only patients with staphylococcal infections in terms of mortality (OR = 0.69, 95% CI = 0.26-1.86, fixed effects model), treatment success (OR = 1.27, 95% CI = 0.47-3.43, fixed effects model) or relapse (OR = 0.76, 95% CI = 0.12-4.92, fixed effects model). LIMITATIONS The relatively small number of available comparative trials was the major limitation of this meta-analysis. CONCLUSIONS The limited evidence from the available prospective comparative studies does not offer support for the addition of an aminoglycoside to beta-lactam treatment of patients with endocarditis caused by Gram-positive cocci. A large multicentre RCT is necessary to reach a definitive conclusion on this issue.