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Advancements in silicon processing are responsible for the exponential growth in computing performance and algorithmic development. With the end of Dennard scaling, conventional computing architectures, like CPU, are unable to keep up with the increasing computation requirements of modern algorithms. Hardware accelerators are designed for each such computation-heavy algorithm and incorporated into the system; a modern System-On-Chip (SoC) for phones can have up to 30 different accelerators. Modern high-compute applications such as 5G, machine learning, and autonomous driving vehicles require accelerators to keep up with their rapidly evolving standards and computation needs. However, with the rising design costs at newer technology nodes, the iterative development of inflexible accelerators becomes prohibitively expensive. Reconfigurable architectures, with their ability to adapt to rapidly-evolving standards as well as their ability to accommodate several such high-performance applications in the system, provide an ideal solution. The motivation of this dissertation is to develop such a Coarse Grain Reconfigurable Architecture called Universal Digital Signal Processor (UDSP) which could replace accelerator blocks in an SoC, and develop a hardware management system to enable concurrent multiprogram functionalities in the reconfigurable architectures. UDSP consists of 196 Compute Elements (CEs) and a statistics-based scalable, delayless, high speed routing network. It is developed using an algorithm-driven framework to allow for faster development of each successive revision of the design. The tileable and scalable nature of UDSP allowed us to put together 4 UDSP dies on a 10�m fine-pitch interposer Silicon Interconnect Fabric, as a 2�2 UDSP Multi-Chip Module (MCM), quadrupling the number of compute resources. The UDSP 2 � 2 assembly has a peak throughput of 3,450 Giga-Operations per second (GOPs) or 1,725 Giga-Multiply Accumulates per second (GMACs) at 1.1GHz clock frequency while consuming 6W power including 0.38pJ/bit to transfer data across dies in TSMC 16nm. It achieves a peak efficiency of 785GMACs/J (0.42V, 315MHz). UDSP lies within 4.2� energy efficiency and 6.4� area efficiency gap relative to ASICs at nominal operation conditions (0.8V, 1.1GHz).Multiprogram tenancy on conventional reconfigurable arrays requires high manual effort from the programmer to foresee and account for runtime program dynamics during compilation. The inability to predict runtime and multiprogram dynamics places the recompilation time of programs in the critical timing path, leading to long reconfiguration times, poor active resource utilization, and low acceleration performance. We developed an active hardware resource management system for reconfigurable arrays that automatically accounts for multi-program dynamics at runtime, eases the workload of the programmer, and improves the array’s performance. These hardware management techniques enable dynamic runtime relocation of programs on the Runtime Reconfigurable Array (RTRA) with minimal reconfiguration latency overhead, which allows the array to offer Accelerator as a Service (ACAS). The ACAS architecture virtualizes the array by spatially and temporally scheduling multiple programs on its available resources, thus achieving higher active utilization for the mapped programs on the array. ACAS allows developers to compile programs for acceleration on reconfigurable array without requiring additional manual steps for runtime resource planning at compile time. Provided with high program pressure, ACAS exceeds 90% active utilization of arrays. For signal processing workloads, our simulated 9�12 RTRA uses a 3� smaller area and delivers 3.2−4.3� more throughput than a 18�18 UDSP and the 18�18 RTRA delivers 8 − 14� more throughput as compared to its equivalent-sized 18 � 18 UDSP counterpart.

Hospital food hygiene plays an important role in patients’ health. Studies have proved that improper practices and lack of knowledge are major contributing factors of foodborne diseases. This study has been conducted with an aim to determine knowledge, attitude and practices of hospital kitchen staff towards safe food handling in a tertiary care teaching hospital in Pune. A cross sectional study was conducted in the central kitchen of the hospital.Data was collected from 20 food handlers (the entire staff working in the central kitchen) through a pre- validated questionnaire. Data was collected in May- June 2022. Most of food handlers had studied up till high school and their mean age group was 36.2 years. The average work experience of respondents was 16.5 years. The result of the questionnaire showed that majority of food handlers have a fair knowledge in safe food handling procedures, have a good attitude and practices. However, the results also strongly emphasize the need of more frequent food hygiene training of hospital food handlers. It also suggests that non-food handlers such as the nursing staff or kitchen supervisor should also be involved in the training. Some aspects of food handlers’ safety behaviour also needs to be emphasized.

To compare the efficacy of tezepelumab with other approved biologics via indirect treatment comparisons (ITCs) in patients aged ≥ 12 years with severe uncontrolled asthma. Data from randomized controlled trials (RCTs) identified from a systematic literature review were synthesized using two different ITC approaches: network meta-analysis (NMA) and simulated treatment comparison (STC). Outcomes of interest were annualized asthma exacerbation rate (AAER) and AAER for exacerbations leading to hospitalization or emergency room visit. To address potential heterogeneity between study populations, various subgroup analyses were performed for the NMA (based on blood eosinophil count, fractional exhaled nitric oxide level, and presence of allergic asthma), and for the STC, models were adjusted for potential treatment effect modifiers. Sensitivity analyses were performed to assess the impact of study design (exclusion of non-placebo-controlled studies and non-phase 3 or 4 studies). Results were reported as rate ratios (RRs) with 95% credible/confidence intervals and ranking statistics were computed for the NMAs. Sixteen RCTs were included in at least one of the ITCs. All biologics (tezepelumab, dupilumab, benralizumab, mepolizumab, reslizumab, and omalizumab) had similar efficacy, with no statistically significant RRs for either exacerbation outcome; however, tezepelumab was favorably associated with numerically lower AAERs and was ranked first in the network for both types of exacerbation outcome. This trend was consistent in the subgroup and sensitivity analyses. As with the primary NMA, the STC results did not demonstrate any significant differences between biologics, but point estimates were favorable towards tezepelumab. Heterogeneity between trials was observed among eligibility criteria and clinically important patient characteristics; however, the impact on findings is expected to be low, based on consistency across analyses. Findings from both ITCs (NMA and STC) support the use of tezepelumab in a broad patient population of severe uncontrolled asthma of any phenotype.

Over the years, there has been a revolutionary and steep gain in the interest of veganism. Nowadays, social media has become an integral element in people's lives. Users are spending more time on these platforms than before. Given the tremendous power of social media influencers on consumers and their impact on eating habits, their influence on converting consumers to veganism is intended to be studied. This work evaluates the behavior of online users in connection with their social media followings, measured through hashtag followings, and eventually compared through a community analysis.

Background. Interlocking nailing is considered a gold standard surgical treatment of mid-shaft closed diaphyseal tibial fractures. With increasing exposure of orthopaedic surgeons to radiation, we propose a solution to this health hazard through a study wherein we perform the surgery without any radiation or C-arm exposure. Material and methods. This prospective study was done at GMC Jammu from January 2017 to February 2020 and included 218 patients, with 18 patients having bilateral tibia fractures in the age group 15 to 58 years (mean of 37.6 years), including 63.7% males (n=139) and 36.3% females (n=79). The 236 extra-articular closed tibial mid-diaphyseal fractures were operated on and intramedullary tibial nailing was performed without a single C-arm exposure. Postoperative x-rays were done and reduction assessed by standard acceptable criteria. Results. Among 236 cases in which nailing was done, 227 (96%) patients were successfully distally locked, including 128 (56.3%) locked through the jig and 99 (43.6%) by “hit and trial method.” All cases met acceptability criteria set for management of tibia by nailing. Conclusions. 1.This study strengthens the proof that closed extra-articular diaphyseal fractures of the tibia can be managed by nailing without using the C-arm with excellent results. 2.The C-arm is always available for cases where distal locking could not be achieved. 3. The technique has a great role in centres with limited facilities of intra-operative radiography in emergency operation theatres.

Primary Care Medical Home (PCMH) redesign efforts are intended to enhance primary care's ability to improve population health and well-being. PCMH transformation that is focused on "high-value elements" (HVEs) for cost and utilization may improve effectiveness.The objective of this study was to determine if a focus on achieving HVEs extracted from successful primary care transformation models would reduce cost and utilization as compared with a focus on achieving PCMH quality improvement goals.A stratified, cluster randomized controlled trial with 2 arms. All practices received equal financial incentives, health information technology support, and in-person practice facilitation. Analyses consisted of multivariable modeling, adjusting for the cluster, with difference-in-difference results.Eight primary care clinics that were engaged in PCMH reform.We examined: (1) total claims payments; (2) emergency department (ED) visits; and (3) hospitalizations among patients during baseline and intervention years.In total, 16,099 patients met the inclusion criteria. Intervention clinics had significantly lower baseline ED visits (P=0.02) and claims paid (P=0.01). Difference-in-difference showed a decrease in ED visits greater in control than intervention (ED per 1000 patients: +56; 95% confidence interval: +96, +15) with a trend towards decreased hospitalizations in intervention (-15; 95% confidence interval: -52, +21). Costs were not different. In modeling monthly outcome means, the generalized linear mixed model showed significant differences for hospitalizations during the intervention year (P=0.03).The trial had a trend of decreasing hospitalizations, increased ED visits, and no change in costs in the HVE versus quality improvement arms.