RRAM-based CAM combined with time-domain circuits for hyperdimensional computing.

Content addressable memory (CAM) for search and match operations demands high speed and low power for near real-time decision-making across many critical domains. Resistive RAM (RRAM)-based in-memory computing has high potential in realizing an efficient static CAM for artificial intelligence tasks, especially on resource-constrained platforms. This paper presents an XNOR-based RRAM-CAM with a time-domain analog adder for efficient winning class computation. The CAM compares two operands, one voltage and the second one resistance, and outputs a voltage proportional to the similarity between the input query and the pre-stored patterns. Processing the summation of the output similarity voltages in the time-domain helps avoid voltage saturation, variation, and noise dominating the analog voltage-based computing. After that, to determine the winning class among the multiple classes, a digital realization is utilized to consider the class with the longest pulse width as the winning class. As a demonstrator, hyperdimensional computing for efficient MNIST classification is considered. The proposed design uses 65 nm CMOS foundry technology and realistic data for RRAM with total area of 0.0077 mm2, consumes 13.6 pJ of energy per 1 k query within 10 ns clock cycle. It shows a reduction of ~ 31 × in area and ~ 3 × in energy consumption compared to fully digital ASIC implementation using 65 nm foundry technology. The proposed design exhibits a remarkable reduction in area and energy compared to two of the state-of-the-art RRAM designs.

Human Vital Signs Detection Methods and Potential Using Radars: A Review.

Continuous monitoring of vital signs, such as respiration and heartbeat, plays a crucial role in early detection and even prediction of conditions that may affect the wellbeing of the patient. Sensing vital signs can be categorized into: contact-based techniques and contactless based techniques. Conventional clinical methods of detecting these vital signs require the use of contact sensors, which may not be practical for long duration monitoring and less convenient for repeatable measurements. On the other hand, wireless vital signs detection using radars has the distinct advantage of not requiring the attachment of electrodes to the subject's body and hence not constraining the movement of the person and eliminating the possibility of skin irritation. In addition, it removes the need for wires and limitation of access to patients, especially for children and the elderly. This paper presents a thorough review on the traditional methods of monitoring cardio-pulmonary rates as well as the potential of replacing these systems with radar-based techniques. The paper also highlights the challenges that radar-based vital signs monitoring methods need to overcome to gain acceptance in the healthcare field. A proof-of-concept of a radar-based vital sign detection system is presented together with promising measurement results.

Neuroendocrine Cell Hyperplasia of Infancy. Clinical Score and Comorbidities.

Rationale: Neuroendocrine cell hyperplasia of infancy (NEHI) is an important form of children's interstitial and diffuse lung disease for which the diagnostic strategy has evolved. The prevalence of comorbidities in NEHI that may influence treatment has not been previously assessed.Objectives: To evaluate a previously unpublished NEHI clinical score for assistance in diagnosis of NEHI and to assess comorbidities in NEHI.Methods: We performed a retrospective chart review of 199 deidentified patients with NEHI from 11 centers. Data were collected in a centralized Research Electronic Data Capture registry and we performed descriptive statistics.Results: The majority of patients with NEHI were male (66%). The sensitivity of the NEHI Clinical Score was 87% (95% confidence interval [CI], 0.82-0.91) for all patients from included centers and 93% (95% CI, 0.86-0.97) for those with complete scores (e.g., no missing data). Findings were similar when we limited the population to the 75 patients diagnosed by lung biopsy (87%; 95% CI, 0.77-0.93). Of those patients evaluated for comorbidities, 51% had gastroesophageal reflux, 35% had aspiration or were at risk for aspiration, and 17% had evidence of immune system abnormalities.Conclusions: The NEHI Clinical Score is a sensitive tool for clinically evaluating NEHI; however, its specificity has not yet been addressed. Clinicians should consider evaluating patients with NEHI for comorbidities, including gastroesophageal reflux, aspiration, and immune system abnormalities, because these can contribute to the child's clinical picture and may influence clinical course and treatment.

A Nanowatt Real-Time Cardiac Autonomic Neuropathy Detector.

This paper presents an electrocardiogram (ECG) processor on chip for full ECG feature extraction and cardiac autonomic neuropathy (CAN) classification. Full ECG extraction is performed using absolute value curve length transform (A-CLT) for $\text{QRS}_{\text{peak}}$ detection and using low-pass differentiation for other ECG features such as $\text{QRS}_{\text{on}}$, $\text{QRS}_{\text{off}}$, Pwave, and Twave. The proposed QRS detector attained a sensitivity of 99.37% and predictivity of 99.38%. The extracted $\text{QRS}_{\text{peak}}$ to $\text{QRS}_{\text{peak}}$ intervals (RR intervals) along with QT intervals enable CAN severity detection, which is a cardiac arrhythmia usually seen in diabetic patients leading to increased risk of sudden cardiac death. This paper presents the first hardware real-time implementation of CAN severity detector that is based on RR variability and QT variability analysis. RR variability metrics are based on mean RR interval and root mean square of standard differences of the RR intervals. The proposed architecture was implemented in 65-nm technology and consumed 75 nW only at 0.6 V, when operating at 250 Hz. Ultralow power dissipation of the system enables it to be integrated into wearable healthcare devices.

Autoimmune lymphoproliferative syndrome-like disease in patients with LRBA mutation.

Mutations in LPS-responsive and beige-like anchor (LRBA) gene were recently described in patients with combined immunodeficiency, enteropathy and autoimmune cytopenia. Here, we extend the clinical and immunological phenotypic spectrum of LRBA associated disorders by reporting on three patients from two unrelated families who presented with splenomegaly and lymphadenopathy, cytopenia, elevated double negative T cells and raised serum Fas ligand levels resembling autoimmune lymphoproliferative syndrome (ALPS) and one asymptomatic patient. Homozygous loss of function mutations in LRBA were identified by whole exome analysis. Similar to ALPS patients, Fas mediated apoptosis was impaired in LRBA deficient patients, while apoptosis in response to stimuli of the intrinsic mitochondria mediated apoptotic pathway was even enhanced. This manuscript illustrates the phenotypic overlap of other primary immunodeficiencies with ALPS-like disorders and strongly underlines the necessity of genetic diagnosis in order to provide early correct diagnosis and subsequent care.

Adaptive technique for P and T wave delineation in electrocardiogram signals.

The T and P waves of electrocardiogram signals are excellent indicators in the analysis and interpretation of cardiac arrhythmia. As such, the need to address and develop an accurate delineation technique for the detection of these waves is necessary. In this paper, we present a novel robust and adaptive T and P wave delineation method for real-time analysis and nonstandard ECG morphologies. The proposed method is based on ECG signal filtering, value estimation of different fiducial points, applying backward and forward search windows as well as adaptive thresholds. Simulations and evaluations prove the accuracy of the proposed technique in comparison to those proposed techniques in the literature. The mean error for the T peak, T offset, P peak and P offset values are found to be 9.8, 2.3, 7.3 and 3.5 milliseconds, respectively, based on the Physionet QT database, rendering our algorithm as an excellent candidate for ECG signal analysis.

Intrauterine upper limb ischemia: an unusual presentation of fetal thrombophilia-a case report and review of the literature.

Upper limb ischemia presenting in neonatal period is extremely rare. Moreover, presenting newborn with evidence of intrauterine upper limb vascular occlusion is even rarer. It needs prompt intervention to restore perfusion and avoid morbidity. We present a newborn with right upper limb brachial artery thrombosis causing ischemia that was noted at birth and appeared later to be homozygous for factor V Leiden and glycoprotein IIIa with no other identifiable risk factors. In this report, we present the case, its successful medical management, proper counseling, and review of the literature. We recommend investigating the neonates and their parents for thrombophilia mutations when they present with unusual vascular occlusion site as newborns.

The Thr224Asn mutation in the VPS45 gene is associated with the congenital neutropenia and primary myelofibrosis of infancy.

Severe congenital neutropenia as well as primary myelofibrosis are rare in infancy. Elucidation of the underlying mechanism is important because it extends our understanding of the more common adult forms of these disorders. Using homozygosity mapping followed by exome sequencing, we identified a Thr224Asn mutation in the VPS45 gene in infants from consanguineous families who suffered from life-threatening neutropenia, which was refractory to granulocyte CSF, from defective platelet aggregation and myelofibrosis. The mutation segregated in the families, was not present in controls, affected a highly conserved codon, and apparently destabilized the Vps45 protein, which was reduced in the patients' leukocytes. Introduction of the corresponding mutation into yeast resulted in reduced cellular levels of Vps45 and also of the cognate syntaxin Tlg2, which is required for membrane traffic through the endosomal system. A defect in the endosomal-lysosomal pathway, the homologous system in humans, was suggested by the absence of lysosomes in the patients' fibroblasts and by the depletion of α granules in their platelets. Importantly, accelerated apoptosis was observed in the patients' neutrophils and bone marrow. This is the first report of a Vps45-related disease in humans, manifesting by neutropenia, thrombasthenia, myelofibrosis, and progressive bone marrow failure.