Stochastic Testing Simulator for Integrated Circuits and MEMS: Hierarchical and Sparse Techniques

Process variations are a major concern in today's chip design since they can significantly degrade chip performance. To predict such degradation, existing circuit and MEMS simulators rely on Monte Carlo algorithms, which are typically too slow. Therefore, novel fast stochastic simulators are highly desired. This paper first reviews our recently developed stochastic testing simulator that can achieve speedup factors of hundreds to thousands over Monte Carlo. Then, we develop a fast hierarchical stochastic spectral simulator to simulate a complex circuit or system consisting of several blocks. We further present a fast simulation approach based on anchored ANOVA (analysis of variance) for some design problems with many process variations. This approach can reduce the simulation cost and can identify which variation sources have strong impacts on the circuit's performance. The simulation results of some circuit and MEMS examples are reported to show the effectiveness of our simulatorComment: Accepted to IEEE Custom Integrated Circuits Conference in June 2014. arXiv admin note: text overlap with arXiv:1407.302

Prospective study of a molecular selection profile for RAS wild type colorectal cancer patients receiving irinotecan-cetuximab

Background: The aim of our study was to evaluate whether a panel of biomarkers, prospectively analysed might be able to predict patients' clinical outcome more accurately than RAS status alone. Methods: K-RAS (exons 2, 3, 4) wild type colorectal cancer patients, candidates to second/third-line cetuximab with chemotherapy were prospectively allocated into 2 groups on the basis of their profile: favourable (BRAF and PIK3CA exon 20 wild type, EGFR GCN ≥ 2.6, HER-3 Rajkumar score ≤ 8, IGF-1 immunostaining < 2) or unfavourable (any of the previous markers altered or mutated). After the introduction of N-RAS status (exons 2, 3, 4) only RAS wild type patients were considered eligible. Results: Forty-six patients were enrolled. Seventeen patients (37%) were allocated to the favourable and 29 patients (63%) to the unfavourable profile. RR in the favourable and unfavourable group was 11/17 (65%) and 2/29 (7%) (p = 0.007) respectively. The favourable group also showed an improved PFS (8months vs. 3months, p < 0.0001) and OS (15months vs. 6months, p < 0.0001). Conclusions: Our results suggest that prospective selection of optimal candidates for cetuximab treatment is feasible and may be able to improve clinical outcom

Does antenatal care attendance prevent anemia in pregnancy at term?

Background: Anemia in pregnancy is one of the public health problems in the developed and developing world. If uncontrolled it is a major indirect cause of maternal and perinatal morbidity and mortality. This is worst in settings with poor prenatal practices. Quality prenatal interventions therefore are expected to prevent or ameliorate this disorder in pregnancy. Nigerian scientific literatures are full of data on anemia in pregnancy, but few of them are on the influence of prenatal care on maternal anemia. This study, therefore, sought to appraise the role of antenatal care (ANC) services in the prevention of anemia in pregnancy at term in Nigerian women.Objectives: The aim was to estimate the prevalence of anemia at first antenatal visit and determine if antenatal attendance prevents anemia at term among prenatal Nigerian women. To measure the hematocrit levels at booking and at term respectively and compare the proportion anemic at booking with the proportion anemic at term.Materials and Methods: A retrospective cross‑sectional comparative study of 3442 prenatal women in a mission hospital in South‑South Nigeria from 2009 to 2013. Venous blood hematocrit was estimated from each woman at booking and at term, and the prevalence of anemia for the two periods were compared.Results: There were 1205 subjects with hematocrit of below 33% at booking, an anemia prevalence of 32.2% at booking in this population. At term or delivery at term 736 (21.4% odds ratio [OR] =2.3, P &lt; 0.0001) of the 1052 subjects that fulfilled the study criteria had their anemia corrected, a 69.9% prevention, while 316 (9.2%, OR = 0.43, P &lt; 0.0001) persisted despite their antenatal attendance. The subjects were similar in most of the confounding factors like parity, social class, mean age, body mass index and gestational age at delivery (P value: all &gt; 0.05).Conclusion: The prevalence of anemia in pregnancy is still high in our setting. Quality ANC appeared a valuable preventive intervention that should be made widely available, accessible and affordable to all pregnant women.Key words: Antenatal care, anemia prevention, South‑South Nigeria, term pregnanc

Limited effect of patient and disease characteristics on compliance with hospital antimicrobial guidelines

Objective: Physicians frequently deviate from guidelines that promote prudent use of antimicrobials. We explored to what extent patient and disease characteristics were associated with compliance with guideline recommendations for three common infections. Methods: In a 1-year prospective observational study, 1,125 antimicrobial prescriptions were analysed for compliance with university hospital guidelines. Results: Compliance varied significantly between and within the groups of infections studied. Compliance was much higher for lower respiratory tract infections (LRTIs; 79%) than for sepsis (53%) and urinary tract infections (UTIs; 40%). Only predisposing illnesses and active malignancies were associated with more compliant prescribing, whereas alcohol/ intravenous drug abuse and serum creatinine levels > 130 mu mol/l were associated with less compliant prescribing. Availability of culture results had no impact on compliance with guidelines for sepsis but was associated with more compliance in UTIs and less in LRTIs. Narrowing initial broad-spectrum antimicrobial therapy to cultured pathogens was seldom practised. Most noncompliant prescribing concerned a too broad spectrum of activity when compared with guideline-recommended therapy. Conclusion: Patient characteristics had only a limited impact on compliant prescribing for a variety of reasons. Physicians seemed to practise defensive prescribing behaviour, favouring treatment success in current patients over loss of effectiveness due to resistance in future patients

Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study

Background: There is evidence that cancer survivors are at increased risk of second primary cancers. Changes in the prevalence of risk factors and diagnostic techniques may have affected more recent risks.&lt;p&gt;&lt;/p&gt; Methods: We examined the incidence of second primary cancer among adults in the West of Scotland, UK, diagnosed with cancer between 2000 and 2004 (n = 57,393). We used National Cancer Institute Surveillance Epidemiology and End Results and International Agency for Research on Cancer definitions of multiple primary cancers and estimated indirectly standardised incidence ratios (SIR) with 95% confidence intervals (CI).&lt;p&gt;&lt;/p&gt; Results: There was a high incidence of cancer during the first 60 days following diagnosis (SIR = 2.36, 95% CI = 2.12 to 2.63). When this period was excluded the risk was not raised, but it was high for some patient groups; in particular women aged &#60;50 years with breast cancer (SIR = 2.13, 95% CI = 1.58 to 2.78), patients with bladder (SIR = 1.41, 95% CI = 1.19 to 1.67) and head &#38; neck (SIR = 1.93, 95% CI = 1.67 to 2.21) cancer. Head &#38; neck cancer patients had increased risks of lung cancer (SIR = 3.75, 95% CI = 3.01 to 4.62), oesophageal (SIR = 4.62, 95% CI = 2.73 to 7.29) and other head &#38; neck tumours (SIR = 6.10, 95% CI = 4.17 to 8.61). Patients with bladder cancer had raised risks of lung (SIR = 2.18, 95% CI = 1.62 to 2.88) and prostate (SIR = 2.41, 95% CI = 1.72 to 3.30) cancer.&lt;p&gt;&lt;/p&gt; Conclusions: Relative risks of second primary cancers may be smaller than previously reported. Premenopausal women with breast cancer and patients with malignant melanomas, bladder and head &#38; neck cancers may benefit from increased surveillance and advice to avoid known risk factors

Efficacy of biofeedback-assisted pelvic floor muscle training in females with pelvic floor dysfunction

Background: Stress urinary incontinence (SUI), fecal incontinence (FI) and/or pelvic floor dyssynergia, with pelvic organ prolapse (POP) are described as pelvic floor dysfunction (PFD). Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of PFD either alone or combined with biofeedback assisted pelvic floor muscle training (BF-assisted PFMT). Clinical practice regarding BF-assisted PFMT is controversial.Aims: To evaluate the efficacy of BF-assisted PFMT in females with mild to moderate PFD after a maximum duration of up to twelve weeks.Materials and subjects: 52 females with PFD were classified into 2 groups: Group 1(26 females with (SUI)) and Group 2 (26 females with (FI)) with or without stages I and II (POP). Females older than 20 years old and pelvic floor muscles grade 3–4 were included. Each group was divided in two equal groups (13 patients each): intervention group: performed BF-assisted PFMT and home exercise program (HEP) and control group: performed (HEP). All females were evaluated before and after the end of PFMT program by assessment questionnaires, PFM strength measurements using PFMs grading according to modified oxford score (MOS) and PFM contraction manometric measurements.Results: Participation rate was 90%. A Significant improvement was detected in 19 females (79.2%) in the intervention group compared to 7 females (31.8%) in the control group. Initial clinical and electrophysiological assessments were predictive for female improvement.Conclusion: Biofeedback-assisted PFMT is an effective therapy compared to PFMT alone for wellmotivated females with mild to moderate PFD

Determination of elemental composition of air particulates and soils in Khartoum area

Investigations were carried out for elemental composition of air particulates in the background air and near roadsides in Khartoum area. Investigations were also performed for the elemental composition of soils at the same locations. A cyclone and a dichotomous virtual impactor wereused to measure the air particulates. The cyclone was adjusted to collect particles having an aerodynamic diameter of 2.5!m. The virtual impactor, through its fine channel, was capable of collecting airborne particles with an aerodynamic diameter of 2.5 &mu;m. Energy Dispersive X-Ray Fluorescence (EDXRF) analysis was used to study the elemental concentrations of the air and soil samples. The analysis of the results indicated that all elements in the proximity of roadsides have elevated concentrations compared to the background air levels. Enrichment factors were calculated relative to crust rock and Khartoum soil. The results showed that the elements K, Ca,Ti, Fe, and Sr in the aerosols have their origin from the soil, while the elements Zn, Ni and Pb have their source from automobile emissions. The results also indicated a correlation between lead and bromine. The lead to bromine ratio was found to be within the range of those derived from vehicular exhaust, and in good agreement with the ratios obtained from some other countries

IN VITRO-IN VIVO BIO-EQUIVALENCE CORRELATION STUDY OF ATENOLOL, AND ITS BRANDS OF IMMEDIATE RELEASE TABLET UNDER BIO-WAIVER CONDITIONS

Objective: The aim of present study is to examine the in vitro-in vivo correlation (IVIVC) of immediate release product. Atenolol 100mg and its brands of immediate release dosage forms. Atenolol is clearly classified into BCS class III, and could be evaluated under bio waiver conditions. Methods: The in vitro parameters employed were hardness, weight uniformity, friability, disintegration time, absolute drug content, dissolution rate (in 0.1 N Hydrochloric acid, phosphate buffer and acetate buffer at 37ºC), and dissolution efficiencies were also analyzed. The in-vitro dissolution study was performed on the brands, according to FDA, USP&nbsp; dissolution profile in three different PH (1.2), (4.5), and (6.8) at 37ºC, using the USP apparatus II. A non linear relation was established which is typical for immediate release formulation, of class III. Results: All Atenolol brands released about 90% drug in PH (6.8), where about 87% in PH (4.5), reference drug released about 91% and test drug released about 87% in pH (1.2). Dissolution efficiency of &nbsp;the entire brands differed by less than 10% from the innovator brand. According to MINITAM 14 statistical program, there was significant relationship between in vitro and in vivo data of reference Atenolol product. Conclusion: By applying level A in vitro-in vivo correlation, study concluded that there is no linear correlation between percent of drug released and percent of drug absorbed, this may be due to uncontrollable permeability rate for class three Atenolol. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; Peer Review History: Received 20 September 2019; &nbsp;&nbsp;Revised 16 December; Accepted 7 January, Available online 15 January 2020 Academic Editor: Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reviewer's Comments: Average Peer review marks at initial stage: 3.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Dr. Hayriye Eda Şatana Kara, Gazi University, Turkey, [email protected] Dr. Nicola Micale, University of Messina, Italy, [email protected] Similar Articles: FAST DISSOLVING DRUG DELIVERY SYSTEMS: FORMULATION, PREPARATION TECHNIQUES AND EVALUATION FAST DISSOLVING TABLETS: A PROMISING APPROACH FOR DRUG DELIVERY DEVELOPMENT AND EVALUATION OF FAST DISSOLVING THIN FILMS OF ARIPIPRAZOLE TABLET GRANULATION: CURRENT SCENARIO AND RECENT ADVANCE

IN VITRO-IN VIVO BIO-EQUIVALENCE CORRELATION STUDY OF METRONIDAZOLE, AND ITS BRANDS OF IMMEDIATE RELEASE TABLET UNDER BIO-WAIVER CONDITIONS

Objective: The aim of present study is to examine the in-vitro in-vivo correlation (IVIVC) of immediate release product. Metronidazole 500mg and its brands of immediate release dosage forms. Metronidazole is clearly classified into BCS class I, and could be evaluated under bio waiver conditions. Methods: The in vitro parameters employed were hardness, weight uniformity, friability, disintegration time, absolute drug content, dissolution rate (in 0.1 N Hydrochloric acid, phosphate buffer and acetate buffer at 37ºC), and dissolution efficiencies were also analyzed. The in-vitro dissolution study was performed on the brands, according to FDA,USP dissolution profile in three different PH (1.2), (4.5), and (6.8) at37ºC, using the USP apparatus II, then f1, f2 were determined for the time intervals of 10, 15, 30, 45 and 60 minutes, and dissolution efficiencies were calculated. MINITAB 14 statistical program used for in vitro in vivo correlation, level A was done for reference product. Results: A non linear relation was established which is typical for immediate release formulation, of class 1. There was significant relationship between in vitro and in vivo data of reference metronidazole product, Correlation and distribution of data with correlation coefficient (r=0.724, 0.837, 0.707), nonlinear relationship with p-value (&gt;0.05) =(0.167, 0.098, 0.182), there is no out lines, no lake of fits at P-Values=0.0040, 006, 0.026.Conclusion: Study concluded that there is no linear correlation between percent of drug released and percent of drug absorbed ,this may be due to uncontrollable gastric emptying rate for class one Metronidazole.                          Peer Review History: Received 2 January 2020;   Revised 1 February; Accepted 3 March, Available online 15 March 2020 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia,  Indonesia, [email protected] Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 4.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Dr. Hayriye Eda Şatana Kara, Gazi University, Turkey, [email protected] Dr. Mohamed Ismail Nounou, Appalachian College of Pharmacy, Oakwood, Virginia, USA, [email protected] Similar Articles: IN VITRO-IN VIVO BIO-EQUIVALENCE CORRELATION STUDY OF ATENOLOL, AND ITS BRANDS OF IMMEDIATE RELEASE TABLET UNDER BIO-WAIVER CONDITION

Adjuvant radiotherapy for primary breast cancer in BRCA1 and BRCA2 mutation carriers and risk of contralateral breast cancer with special attention to patients irradiated at younger age

The purpose of this study was to estimate the influence of adjuvant radiotherapy for primary breast cancer (BC) on the risk of contralateral BC (CBC) in BRCA1 or BRCA2(BRCA1/2) mutation carriers, with special attention to patients irradiated at age younger than 40 years. Additionally, tendencies in locoregional treatments and rates of contralateral risk-reducing mastectomy over time were explored. In this retrospective cohort study, 691 BRCA1/2-associated BC patients treated between 1980 and 2013 were followed from diagnosis until CBC or censoring event including ipsilateral BC recurrence, distant metastasis, contralateral risk-reducing mastectomy, other invasive cancer diagnosis, death, or loss to follow up. Hazard ratios (HR) for CBC associated with radiotherapy were estimated using Cox regression. Median follow-up time was 8.6 years [range 0.3–34.3 years]. No association between radiotherapy for primary BC and risk of CBC was found, neither in the total population (HR 0.82, 95 % CI 0.45–1.49) nor in the subgroup of patients younger than 40 years at primary diagnosis (HR 1.36, 95 % CI 0.60–3.09). During follow-up, the number of patients at risk decreased substantially since a large proportion of patients were censored after contralateral risk-reducing mastectomy or BC recurrence. Over the years, increasing preference for mastectomy without radiotherapy compared to breast-conserving surgery with radiotherapy was found ranging from less than 30 % in 1995 to almost 50 % after 2010. The rate of contralateral risk-reducing mastectomy increased over the years from less than 40 % in 1995 to more than 60 % after 2010. In this cohort of BRCA1/2-associated BC patients, no association between radiotherapy for primary BC and risk of CBC was observed in the total group, nor in the patients irradiated before the age of 40 years. The number of patients at risk after 10 and 15 years of follow-up, however, was too small to definitively exclude harmful effects of adjuvant radiotherapy