Objective There has been an endeavor in recent years, to administer surfactant by minimally invasive techniques to neonates with surfactant deficiency. The objective of this study was to compare the need for intubation and mechanical ventilation after surfactant delivery, using Less Invasive Surfactant Administration (LISA) technique and Intubation SURfactant Extubation (InSurE), in preterm infants with respiratory distress syndrome (RDS). Methods We conducted a pilot randomized control trial (RCT) at a tertiary care center over a period of 18 months. Preterm neonates with RDS (gestational age 28–36 weeks) were randomized to receive surfactant within 6 h of birth by InSurE or LISA. The primary outcome was need for intubation and mechanical ventilation within 72 h of birth. Infants were followed until discharge for adverse events and complications. Results A total of 40 infants were analyzed (20 in each group). There was no difference in the need for intubation and mechanical ventilation within 72 h of birth between the two groups [InSurE, 6 (30%) and LISA, 6 (30%), relative risk 1.0, 95% confidence interval 0.51–1.97]. About 15% of infants in both groups had adverse events during the procedure. There was no statistically significant difference in the rates of major complications or duration of respiratory support, hospital stay and mortality. Conclusion We found LISA to be feasible and equally effective as InSurE for surfactant administration in the treatment of RDS in preterm infants. Future larger RCTs are required to compare the efficacy and long-term outcomes of LISA with the standard invasive methods of surfactant administration.

We propose three orthogonal techniques to secure Register-Transfer-Level (RTL) Intellectual Property (IP). In the first technique, the key-based RTL obfuscation scheme is proposed at an early design phase during High-Level Synthesis (HLS). Given a control-dataflow graph, we identify operations on non-critical paths and leverage synthesis information during and after HLS to insert obfuscation logic. In the second approach, we propose a robust design lockout mechanism for a key-obfuscated RTL IP when an incorrect key is applied more than the allowed number of attempts. We embed comparators on obfuscation logic output to check if the applied key is correct or not and a finite-state machine checker to enforce design lockout. Once locked out, only an authorized user (designer) can unlock the locked IP. In the third technique, we design four variants of the obfuscating module to camouflage the RTL design. We analyze the security properties of obfuscation, design lockout, and camouflaging. We demonstrate the feasibility on four datapath-intensive IPs and one crypto core for 32-, 64-, and 128-bit key lengths under three design corners (best, typical, and worst) with reasonable area, power, and delay overheads on both ASIC and FPGA platforms.

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