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We present an area-efficient, asynchronous, single-input, and multiple-output Rapid Single Flux Quantum (RSFQ) pulse round-robin distribution network. We adopt the structure of a two-output toggle flip flop (TFF) where incoming pulses are temporarily stored in a SQUID loop in the form of magnetic flux quanta and then directed to outputs in a round-robin fashion. To support additional toggle outputs, we design a new circuit based on TFFs to distribute pulses in a round-robin mechanism to more than two outputs. We also elaborate on our design methodology that can support a different number of outputs while minimizing the number of JJs and power consumption. We then demonstrate a three- and four-output round-robin distribution network constructed with only 14-JJs and 18-JJs with $14.85 ~\mu W$ and 18.86- $\mu W$ power dissipation, respectively. Our four-output design has 40%–70% fewer JJ compared to a similar-functioning four-output network composed of TFFs, DFFs, splitters, and mergers. Our design also consumes 38%–70% less power and has a 16%–64% reduced delay compared to the same four-output TFF network. Finally, we demonstrate the usability of our four-output design in the context of a periodic counting network and pulse generator.

Temporal computing promises to mitigate the stringent area constraints and clock distribution overheads of traditional superconducting digital computing. To design a scalable, area- and power-efficient superconducting network on chip (NoC), we propose packet-switched superconducting temporal NoC (PaST-NoC). PaST-NoC operates its control path in the temporal domain using race logic (RL), combined with bufferless deflection flow control to minimize area. Packets encode their destination using RL and carry a collection of data pulses that the receiver can interpret as pulse trains, RL, serialized binary, or other formats. We demonstrate how to scale up PaST-NoC to arbitrary topologies based on 2 × 2 routers and 4 × 4 butterflies as building blocks. As we show, if data pulses are interpreted using RL, PaST-NoC outperforms state-of-the-art superconducting binary NoCs in throughput per area by as much as $5\times$ for long packets.

We propose a generalized architecture for the first rapid-single-flux-quantum (RSFQ) associative memory circuit. The circuit employs hyperdimensional computing (HDC), a machine learning (ML) paradigm utilizing vectors with dimensionality in the thousands to represent information. HDC designs have small memory footprints, simple computations, and simple training algorithms compared to superconducting neural network accelerators (SNNAs), making them a better option for scalable SFQ machine learning (ML) solutions. The proposed superconducting HDC (SHDC) circuit uses entirely on-chip RSFQ memory which is tightly integrated with logic, operates at 33.3 GHz, is applicable to general ML tasks, and is manufacturable at practically useful scales given current SFQ fabrication limits. Tailored to a language recognition task, SHDC consists of $\sim$2–20 M Josephson junctions (JJs) and consumes up to three times less power than an analogous CMOS HDC circuit while achieving 78–84% higher throughput. SHDC is capable of outperforming the state of the art RSFQ SNNA, SuperNPU, by 48-99% for all benchmark NN architectures tested while occupying up to 90% less area and consuming up to nine times less power. To the best of the authors' knowledge, SHDC is currently the only superconducting ML approach feasible at practically useful scales for real-world ML tasks and capable of online learning.

This paper presents a superconducting, magnetically-coupled, shuttle-flux shift register (SF-SR) that stores single flux quantum (SFQ) pulses. This shift register has a DC bias operating margin of ±34% at 10 GHz, with a power dissipation of $3.6~\mu W$ and 38% fewer Josephson junctions (JJs) when scaled up to multiple stages compared to a data flip-flop (DFF) based shift register. The clock input is inductively coupled and is independent from the data input. We then present three applications for our SF-SR. In the first application, we add two non-destructive readout (NDRO) cells to construct a buffer that temporarily stores the temporal information of a series of race logic (RL) pulses. The second application is a pseudo-random number generator based on a linear function shift register (LFSR). The third application is N parallel SF-SRs that can act similar to a deserializer or instead can emulate a single SF-SR of N times higher clock frequency. These three applications motivate deep shift registers with many shifting intervals, which our SF-SR can implement with fewer JJs and lower power consumption compared to DFF-based shift registers.

Masticatory myofascial pain disorders (MMPD) are a common group of orofacial pain conditions affecting the muscles of mastication, with headache and cervical disorders as well as chronic widespread pain and psychosocial disorders being common comorbid conditions. As their pathophysiology is multifactorial in nature, a multimodal and interdisciplinary approach should be considered. Overall treatment goals include decreasing pain and disability, increasing mandibular range of motion, and improving quality of life. This article describes a complex case exhibiting common characteristics of MMPD while additionally reviewing the literature on classification, pathophysiology, and evidence-based treatment planning.

Study objective: To compare the relative utility of blue dye visualization with a glucose oxidase test strip method for detecting aspiration of enteral feedings. Design: Tracheally intubated adults were prospectively [...]

Exercise-induced bronchoconstriction (EIB) with or without underlying asthma is a condition with complex pathophysiology, where many factors play a role in its development and clinical presentation. EIB can be impacted by various environmental factors including climate, environmental allergens, air pollution, and altitude. Although it might be hard to escape one’s environment, patients should nevertheless be counseled on how the environment could impact their symptoms. Patient education regarding environmental factors could help overcome impediments to exercise and improve performance.

•Loss-of-function variants generating premature termination codons associate with bleeds; RNA levels differ between replicate cell cultures.•No PTC-truncated proteins were detected; ENG Q436X (but not R93X) induced cell stress and had pathogenic AlphaMissense readthrough scores.

AbstractObjectives:This study’s goal was to determine the perceived risks of infection as well as the perceived risks of hospitalization and death from COVID-19 in Ecuador and Kenya. It also assessed the factors associated with the risk-related perceptions.Methods:Cross-sectional studies with samples from the adult populations in both countries were conducted to assess the perceived risks of contracting COVID-19. Data were collected online using the Qualtrics platform (Qualtrics, Provo, Utah, United States) from samples of 1050 heads of households, aged 18 years or older, in each country. A total of 3 statistical analyses were conducted: summary statistics, correlation, and linear regression.Results:The average perceived risks of COVID-19 infection, hospitalization, and death in the Kenyan sample were 27.1%, 43.2%, and 17.2%, respectively, and the values for the Ecuadorian sample were 34%, 32.8%, and 23.3%, respectively. The Pearson’s correlation coefficients between the risk measures in each country were less than 0.38. Risk measures were associated with several sociodemographic variables (e.g., income, gender, location), but not with age.Conclusions:The perceived risks of COVID-19 infection, hospitalization, and death in Kenya and Ecuador were significantly higher relative to the statistics reported; however, no strong association existed between perceived risk and age, which is a key factor in adverse health outcomes, including death, among COVID-19 infected individuals.

Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain.Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests.Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients.Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.

Rönn: Primorigen Biosciences: Co-inventor on pending patent. No financial ties., Co-inventor on pending patent. No financial ties. Patents & Royalties. Guibentif:Primorigen Biosciences: Co-inventor on pending patent. No financial ties., Co-inventor on pending patent. No financial ties. Patents & Royalties. Garcia:Primorigen Biosciences: Employment. Woods:Primorigen Biosciences: Co-inventor on pending patent., Co-inventor on pending patent. Patents & Royalties, Membership on an entity’s Board of Directors or advisory committees.

No relevant conflicts of interest to declare.

Objective. To evaluate the effect of "traffic-light" nutritional labeling on the purchase of soft drinks and on their nutritional content in Ecuador. Methods. Two databases were used: the first was provided by Ecuador's National Agency for Health Regulation, Control, and Surveillance; the second was obtained from the international market research company Kantar World Panel. A before/after study was conducted of introducing traffic-light labeling, using Student's t-tests to evaluate changes in average nutritional content and the purchase of soft drinks. Multiple linear regression methods were used to evaluate changes in purchases resulting from the introduction of traffic-light labeling. Results. After labeling, average per capita consumption of soft drinks declined by 0.003 L/month--a small change with respect to average per capita consumption of 1.678 L/month. The results of the Student's t-tests indicated that this difference was not statistically significant. Furthermore, the regression analyses found no empirical evidence that traffic-light labeling affected soft drink consumption. With regard to sugar content, an average reduction of 0.93 gm/100 ml of beverage was observed. Conclusions. No empirical evidence was found that implementation of traffic-light labeling changed soft-drink purchase habits in Ecuador, but there is evidence that it reduced sugar content in carbonated beverages in the country. [ABSTRACT FROM AUTHOR]