• Title/Summary/Keyword: three critical points

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The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

  • Kim, Hee Jin;Chun, Byung Chul;Kwon, AmyM;Lee, Gyeong-Ho;Ryu, Sungweon;Oh, Soo Yeon;Lee, Jin Beom;Yoo, Se Hwa;Kim, Eui Sook;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.349-355
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    • 2015
  • Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.

Critical Temperature for Grain Filling of Japonica Rice in Korea (우리나라 자포니카 벼 품종의 등숙 한계온도 분석)

  • Woonho Yang;Shingu Kang;Dae-Woo Lee;Mi-jin Chae
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.68 no.4
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    • pp.225-235
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    • 2023
  • Critical temperature for grain filling of three Korean japonica rice varieties was analyzed by late transplantation to induce a low temperature during grain filling period in a field study. The grain filling percentage (GFP) and grain dry weight (GDW) showed a sigmoid development for the first and second transplants in 2020 and first to third transplants in 2021. For the third transplant in 2020 and fourth transplant in 2021, the GFP and GDW reached a peak at 42 days after heading (DAH), and then decreased or remained unchanged. In non-linear regression analyses, 95% of the final GFP and GDW appeared at 49 - 62 DAH for the second transplant in 2020 and at 37 - 46 DAH and 30 - 36 DAH for the second and third transplants in 2021, respectively. At these time points, the critical seven-day moving temperature (7dMovT) was 8.4~9.4℃ for the second transplant in 2020 and 9.4~10.9℃ for the second and third transplants in 2021, depending on the grain filling traits and varieties of rice. The lowest 7dMovT was 8.4 - 8.7℃ in the three varieties. The observed lowest 7-day mean temperature (7dMT) accompanying increases in the GFP and GDW was 9.4 - 10.1℃, depending on the varieties in the third transplant of 2020 and fourth transplant of 2021. In the two transplants mentioned above, the highest 7dMT that showed no increase or decrease in grain filling traits was 8.7 - 9.1℃. The critical temperature for grain filling of japonica rice was 8.4 - 8.7℃ based on the 7dMovT and 9.1 - 9.4℃ based on the 7dMT. The previous 7dMT of 10℃ is recommended to determine the marginal harvest time for safe rice cropping since the temperature was the highest among the lowest temperature that accompanied an increase in grain filling traits.

Are "Unstable" Burst Fractures Really Unstable?

  • Woo, Jun Hyuk;Lee, Hyun Woo;Choi, Hong June;Kwon, Young Min
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.944-949
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    • 2021
  • Objective : The stability is an important factor to decide the treatment plan in thoracolumbar burst fracture patients. Patients with an unstable burst fracture generally need operative management. Decrease in vertebral body height, local kyphosis, involvement of posterior column, and/or canal compromise are considered important factors to determine the treatment plan. On the other hand, in thoracolumbar injury classification system (TLICS), surgery is recommended in patients with TLICS of more than 5 points. The purpose of this study was to apply the TLICS score in patients with thoracolumbar burst fractures and to distinguish the differences of treatment plan on burst fracture. Methods : All patients, diagnosed as a thoracolumbar burst fracture between January 2006 and February 2019 were included in this study. Unstable thoracolumbar burst fracture was defined as burst fracture with neurologic deficit, three-column injury, kyphosis over 30 degrees, decrease of anterior body height over 40 percent and canal comprise more than 50%. TLICS score was measured with morphology, neurological involvement and posterior ligamentous complex integrity. The existence of instability was compared with TLICS score. Results : Total 233 patients (131 men, 102 women) were included in this study. In Denis classification, 51 patients (21.9%) diagnosed as stable burst fracture while 182 patients (78.1%) had unstable burst fracture. According to TLICS, 72 patients (30.9%) scored less than 4, while 161 patients (69.1%) scored 4 or more. All the patients with stable burst fracture scored 2 in TLICS. Twenty-one patients (9.0) scored 2 in TLICS but diagnosed as unstable burst fracture. Thirteen patients had over 40% of vertebra body compression, four patients had more than 50% of canal compromise, three patients had both body compression over 40% and kyphosis over 30 degrees, one patients had both body compression and canal compromise. Fifteen patients presented kyphosis over 30 degrees, and three (20%) of them scored 2 in TLICS. Seventy-three patients presented vertebral body compression over 40% and 17 (23.3%) of them scored 2 in TLICS. Fifty-three patients presented spinal canal compromise more than 50%, and five (9.4%) of them scored 2 in TLICS. Conclusion : Although the instability of thoracolumbar burst fracture was regarded as a critical factor for operability, therapeutic strategies by TLICS do not exactly match with the concept of instability. According to the concept of TLICS, it should be reconsidered whether the unstable burst fracture truly unstable to do operation.

Memory Organization for a Fuzzy Controller.

  • Jee, K.D.S.;Poluzzi, R.;Russo, B.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1041-1043
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    • 1993
  • Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)+dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

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A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing (의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구)

  • Yoo, Dong-Keun
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.97-114
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    • 1996
  • INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

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A Study on System of Mental Healthcare Service in Germany (독일 정신보건의료서비스체계에 관한 연구)

  • Moon, Ha Ni;Noh, Jai Sung;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.20 no.3
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    • pp.17-25
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    • 2014
  • Purpose: Mental health facilities are facing a new social environment. To provide appropriate patient care environment, mental health and mental healthcare is changing the paradigm. In this situation, this study research and analysis mental healthcare service system and mental healthcare facility in Germany. The reason is that Germany has cosistently been building mental healthcare service system and mental healthcare facility for patient. Therefore, it aims to suggest a fundamental resource for amental healthcare service system and mental healthcare facility for mental healtn. Methods: This study was conducted literature researches and field studies. Literature researches for mental healthcare service system and facilities. Field study is to identify the characteristic and configuration of mental healtncare facilities. Results: Findings of this study can be summerrized inth three points. First, In Germany, Mental healthcare facility is critical environment in the community. And, the facilities are being turned into reasonable and alternative environment. Second, Facilities of Mental healthcare and service system designed by various level and configurations that can be providing places for people with mental problems. Third, Mental healthcare facilities consist of healing environment for patient. Implications: The future study on finding of the specific environment planning citeria in mental healthcare facility on the basis of findings of present study.

A Didactical Analysis on the Degree of Freedom (자유도의 교수학적 분석)

  • Kim, Changil;Jeon, Youngju
    • Journal of the Korean School Mathematics Society
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    • v.23 no.3
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    • pp.239-257
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    • 2020
  • This study analyzes the degree of freedom with three aspects: as academic knowledge, in the curriculum focused on textbooks, and students' understanding of the degree of freedom. The results provide five critical points. First, we need discussions on whether to include the degree of freedom in the curriculum. Second, we need to reconsider the current way textbooks are described. Third, there should be a didactical analysis to advance students' understanding of the concept of the degree of freedom. Fourth, there are limitations in learning the concept of the degree of freedom in the current textbook learning environment. Fifth, a didactical check of sampling distribution such as sample mean, sample variance, and sample standard deviation is required. The implications were drawn that the emphasis on statistical reasoning education in the curriculum and careful consideration of introducing the t-distribution curriculum was required.

Nonlinear dynamic performance of long-span cable-stayed bridge under traffic and wind

  • Han, Wanshui;Ma, Lin;Cai, C.S.;Chen, Suren;Wu, Jun
    • Wind and Structures
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    • v.20 no.2
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    • pp.249-274
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    • 2015
  • Long-span cable-stayed bridges exhibit some features which are more critical than typical long span bridges such as geometric and aerodynamic nonlinearities, higher probability of the presence of multiple vehicles on the bridge, and more significant influence of wind loads acting on the ultra high pylon and super long cables. A three-dimensional nonlinear fully-coupled analytical model is developed in this study to improve the dynamic performance prediction of long cable-stayed bridges under combined traffic and wind loads. The modified spectral representation method is introduced to simulate the fluctuating wind field of all the components of the whole bridge simultaneously with high accuracy and efficiency. Then, the aerostatic and aerodynamic wind forces acting on the whole bridge including the bridge deck, pylon, cables and even piers are all derived. The cellular automation method is applied to simulate the stochastic traffic flow which can reflect the real traffic properties on the long span bridge such as lane changing, acceleration, or deceleration. The dynamic interaction between vehicles and the bridge depends on both the geometrical and mechanical relationships between the wheels of vehicles and the contact points on the bridge deck. Nonlinear properties such as geometric nonlinearity and aerodynamic nonlinearity are fully considered. The equations of motion of the coupled wind-traffic-bridge system are derived and solved with a nonlinear separate iteration method which can considerably improve the calculation efficiency. A long cable-stayed bridge, Sutong Bridge across the Yangze River in China, is selected as a numerical example to demonstrate the dynamic interaction of the coupled system. The influences of the whole bridge wind field as well as the geometric and aerodynamic nonlinearities on the responses of the wind-traffic-bridge system are discussed.

A case study on the development and application of flipped learning based clinical dental hygiene curriculum (플립러닝 기반의 임상치위생학 교육과정 개발 및 적용 사례연구)

  • Jeong, Su-Ra;Kim, Mi-Sun;Kim, Eun-Jeong;Choi, Yong-Keum
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.2
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    • pp.155-166
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    • 2020
  • Objectives: The purpose of this study is to prove, through the design and operation of a teaching learning model for clinical dental hygiene and practice III, the effectiveness of the flipped learning PARTNER model. Methods: A professional council was formed, composed of three professors of dental hygiene and one professor of education; each member was an expert with a Ph.D. From December 2018 to February 2019. Results: Learning preferences for the clinical learning hygiene curriculum based on flip learning showed that it had higher accessibility than traditional teaching methods. Subjects' motivation to learn was improved through flip learning, their critical thinking ability was improved through active discussion and flip team discussion, and their self-directed learning ability was also improved. Participation increased through flipped learning, and subjects' skill abilities showed their highest score by improving their performance through the whole lecture. A high satisfaction of 4.54 out of 5 points was achieved. Conclusions: It was confirmed that the development and operation of a flipped learning-based clinical hygiene curriculum can provide an effective and satisfactory learning process.

A VLSI Architecture of Systolic Array for FET Computation (고속 퓨리어 변환 연산용 VLSI 시스토릭 어레이 아키텍춰)

  • 신경욱;최병윤;이문기
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.25 no.9
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    • pp.1115-1124
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    • 1988
  • A two-dimensional systolic array for fast Fourier transform, which has a regular and recursive VLSI architecture is presented. The array is constructed with identical processing elements (PE) in mesh type, and due to its modularity, it can be expanded to an arbitrary size. A processing element consists of two data routing units, a butterfly arithmetic unit and a simple control unit. The array computes FFT through three procedures` I/O pipelining, data shuffling and butterfly arithmetic. By utilizing parallelism, pipelining and local communication geometry during data movement, the two-dimensional systolic array eliminates global and irregular commutation problems, which have been a limiting factor in VLSI implementation of FFT processor. The systolic array executes a half butterfly arithmetic based on a distributed arithmetic that can carry out multiplication with only adders. Also, the systolic array provides 100% PE activity, i.e., none of the PEs are idle at any time. A chip for half butterfly arithmetic, which consists of two BLC adders and registers, has been fabricated using a 3-um single metal P-well CMOS technology. With the half butterfly arithmetic execution time of about 500 ns which has been obtained b critical path delay simulation, totla FFT execution time for 1024 points is estimated about 16.6 us at clock frequency of 20MHz. A one-PE chip expnsible to anly size of array is being fabricated using a 2-um, double metal, P-well CMOS process. The chip was layouted using standard cell library and macrocell of BLC adder with the aid of auto-routing software. It consists of around 6000 transistors and 68 I/O pads on 3.4x2.8mm\ulcornerarea. A built-i self-testing circuit, BILBO (Built-In Logic Block Observation), was employed at the expense of 3% hardware overhead.

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