Search

Genetically determined leukoencephalopathies comprise a group of rare inherited white matter disorders. The majority are progressive diseases resulting in early death. We performed a cross-sectional pilot study including 55 parents from 36 families to assess the level of stress experienced by parents of patients with genetically determined leukoencephalopathies, aged 1 month to 12 years. Thirty-four mothers and 21 fathers completed the Parenting Stress Index–4th Edition. One demographic questionnaire was completed per family. Detailed clinical data was gathered on all patients. Statistical analysis was performed with total stress percentile score as the primary outcome. Mothers and fathers had significantly higher stress levels compared with the normative sample; 20% of parents had high levels of stress whereas 11% had clinically significant levels of stress. Mothers and fathers had comparable total stress percentile scores. We identified pediatric behavioral difficulties and gross motor function to be factors influencing stress in mothers. Our study is the first to examine parental stress in this population and highlights the need for parental support early in the disease course. In this pilot study, we demonstrated that using the Parenting Stress Index–4th Edition to assess stress levels in parents of patients with genetically determined leukoencephalopathies is feasible, leads to valuable and actionable results, and should be used in larger, prospective studies.

We performed a systematic review to describe the prevalence of multicomponent blood transfusion and, as a secondary objective, to determine patient characteristics and outcomes associated with multicomponent transfusion. There is a lack of literature on the epidemiology of multicomponent transfusion as most studies concentrate on a single blood product and its utilisation. Patient care and blood management can be optimised by better understanding the patients who receive multicomponent transfusions. The databases Medline, EMBASE and the Cochrane Library of Systematic Reviews were searched. Observational cohort and cross-sectional studies of hospital patients reporting on multicomponent transfusion prevalence or on patient characteristics and outcomes associated with multicomponent transfusion were included. A descriptive synthesis of studies was performed. A total of 37 eligible studies were included. It was found that multicomponent transfusion prevalence varied greatly by patient population and by the combination of blood products given in the multicomponent transfusion. Multicomponent-transfused patients included burn, cardiac surgery, liver surgery and transplant, cancer, infectious diseases, trauma and intensive care unit patients. Five studies found associations between multicomponent transfusion and adverse health outcomes; however, these findings are likely confounded by indication. The overall quality of evidence was low given a fair-to-poor individual study quality, inconsistent multicomponent transfusion prevalence estimates and confounding by indication. Further research is needed to better understand the epidemiology of multicomponent transfusion, including studies on multicomponent transfusion in haematological cancer patients and studies looking for patient characteristics that can better predict multicomponent transfusion need.

The Astronautics ZS-1 is a high speed minisupercomputer system designed for scientific and engineering applications. The ZS-1 central processor uses a decoupled architecture which splits instruction words into two streams, one for fixed-point/memory-address computation and the other for floating-point operations. The two instruction streams are then processed in parallel, with architectural queues providing communication between the streams. Pipelining is used extensively throughout the ZS-1. The combination of decoupling and pipelining provides overall, sustained performance of about one third a CRAY-XMP-1 on compiled double-precision Fortran. The authors give a description of the decoupled architecture and discuss other forms of parallelism used in the ZS-1. A discussion of static and dynamic instruction scheduling is also included. >

The Astronautics ZS-1 is a high speed, 64-bit computer system designed for scientific and engineering applications. The ZS-1 central processor uses a decoupled architecture, which splits instructions into two streams---one for fixed point/memory address computation and the other for floating point operations. The two instruction streams are then processed in parallel. Pipelining is also used extensively throughout the ZS-1.This paper describes the architecture and implementation of the ZS-1 central processor, beginning with some of the basic design objectives. Descriptions of the instruction set, pipeline structure, and virtual memory implementation demonstrate the methods used to satisfy the objectives. High performance is achieved through a combination of static (compile-time) instruction scheduling and dynamic (run-time) scheduling. Both types of scheduling are illustrated with examples.