Improving Performance in Combinatorial Optimization Problems with Inequality Constraints: An Evaluation of the Unbalanced Penalization Method on D-Wave Advantage

Combinatorial optimization problems are one of the target applications of current quantum technology, mainly because of their industrial relevance, the difficulty of solving large instances of them classically, and their equivalence to Ising Hamiltonians using the quadratic unconstrained binary optimization (QUBO) formulation. Many of these applications have inequality constraints, usually encoded as penalization terms in the QUBO formulation using additional variables known as slack variables. The slack variables have two disadvantages: (i) these variables extend the search space of optimal and suboptimal solutions, and (ii) the variables add extra qubits and connections to the quantum algorithm. Recently, a new method known as unbalanced penalization has been presented to avoid using slack variables. This method offers a trade-off between additional slack variables to ensure that the optimal solution is given by the ground state of the Ising Hamiltonian, and using an unbalanced heuristic function to penalize the region where the inequality constraint is violated with the only certainty that the optimal solution will be in the vicinity of the ground state. This work tests the unbalanced penalization method using real quantum hardware on D-Wave Advantage for the traveling salesman problem (TSP). The results show that the unbalanced penalization method outperforms the solutions found using slack variables and sets a new record for the largest TSP solved with quantum technology.Comment: 8 pages, 7 figures, conferenc

Computational quantitative flow ratio to assess functional severity of coronary artery stenosis

Background: Computational quantitative flow ratio (QFR) based on 3-dimensional quantitative coronary angiography (3D QCA) analysis offers the opportunity to assess the significance of coronary artery disease (CAD) without using an invasive pressure wire or inducing hyperemia. This study aimed to evaluate the diagnostic performance of QFR compared to wire-based fractional flow reserve (FFR) and to validate the previously reported QFR cut-off value of >0.90 to safely rule out functionally significant CAD. Methods: QFR was retrospectively derived from standard-care coronary angiograms. Correlation and agreement of fixed-flow QFR (fQFR) and contrast-flow QFR (cQFR) models with invasive wire-based FFR was calculated. Diagnostic performance of QFR was evaluated at different QFR cut-off values defining significant CAD (FFR Results: 101 vessels in 96 patients who underwent FFR were studied. Mean FFR was 0.87 +/- 0.08 and 21 of 101 (21%) vessels had an FFR 0.80 defining non-significant CAD, respectively. fQFR > 0.90 was present in 34 (34%) and cQFR > 0.90 in 39 (39%) vessels. For both QFR models, none of the vessels with QFR >0.90 had an FFR = 0.80. Conclusions: QFR appears to be a safe and effective gatekeeper to wire-based FFR when applying a QFR threshold of >0.90 to rule out significant CAD. Further prospective research is required to establish QFR in the real-life setting of functional CAD assessment in the catheterization laboratory. (c) 2018 The Authors. Published by Elsevier B.V

Frequency and characteristics of pulmonary nodules in children at computed tomography

Detail viewDemolished ; site on Q Street where Embassy Suites now stand

Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

BACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or bypass surgery (381), and 450 patients with unstable angina were randomly assigned to coronary stenting (226) or bypass surgery (224). All patients had multivessel disease considered to be equally treatable by either technique. Freedom from major adverse events, including death, myocardial infarction, and cerebrovascular events, at 1 year was not different in unstable patients (91.2% versus 88.9%) and stable patients (90.4% versus 92.6%) treated, respectively, with coronary stenting or bypass surgery. Freedom from repeat revascularization at 1 year was similar in unstable and stable angina treated with stenting (79.2% versus 78.9%) or bypass surgery (96.3% versus 96%) but was significantly higher in both unstable and stable patients treated with stenting (16.8% versus 16.9%) compared with bypass surgery (3.6% versus 3.5%). Neither the difference in costs between stented or bypassed stable or unstable angina ($2594 versus$3627) nor the cost-effectiveness was significantly different at 1 year. CONCLUSIONS: There was no difference in rates of death, myocardial infarction, and cerebrovascular event at 1 year in patients with unstable angina and multivessel disease treated with either stented angioplasty or bypass surgery compared with patients with stable angina. The rate of repeat revascularization of both unstable and stable angina was significantly higher in patients with stents

Ischemic patterns assessed by positron emission tomography predict adverse outcome in patients with idiopathic dilated cardiomyopathy

Although patients with idiopathic dilated cardiomyopathy (DCM) have no coronary artery disease, regional impairment of myocardial perfusion combined with preserved metabolism has been found using positron emission tomography (PET). Our aim was to assess the prognostic relevance of PET-mismatch between stress myocardial perfusion and glucose uptake on clinical outcome in DCM. In 24 patients with DCM who underwent both myocardial perfusion and metabolism PET scanning, "mismatch" was assessed and the association with clinical outcome (hospitalization, mortality, and heart transplantation) was investigated. Mismatch was found in 16 patients (66.7%). Univariate analysis showed that the presence of mismatch was associated with adverse outcome (P = 0.03). After adjustment for sex and age, the association remained significant with an adjusted relative risk of 10.4 (95% CI 1.1-103; P = 0.04) for death, heart transplant, or hospitalization. Univariate analysis also showed that a higher extent of mismatch was significantly associated with adverse outcome (P = 0.02). After adjusting for sex and age, the association remained significant with an adjusted relative risk of 6.5 [95% CI 1.2-36; P = 0.03] for death, heart transplantation, or hospitalization. PET stress perfusion-metabolism mismatch, indicative for ischemia, is frequently found in DCM patients and related to a poorer outcome

Improving Performance in Combinatorial Optimization Problems with Inequality Constraints: An Evaluation of the Unbalanced Penalization Method on D-Wave Advantage

Combinatorial optimization problems are one ofthe target applications of current quantum technology, mainly because of their industrial relevance, the difficulty of solving large instances of them classically, and their equivalence to Ising Hamiltonians using the quadratic unconstrained binary optimization (QUBO) formulation. Many of these applications have inequality constraints, usually encoded as penalization terms in the QUBO formulation using additional variables known as slack variables. The slack variables have two disadvantages: (i) these variables extend the search space of optimal and suboptimal solutions, and (ii) the variables add extra qubits and connections to the quantum algorithm. Recently, a new method known as unbalanced penalization has been presented to avoid using slack variables. This method offers a trade-off between additional slack variables to ensure that the optimal solution is given by the ground state of the Ising Hamiltonian, and using an unbalanced heuristic function to penalize the region where the inequality constraint is violated with the only certainty that the optimal solution will be in the vicinity of the ground state. This work tests the unbalanced penalization method using real quantum hardware on D-Wave Advantage for the traveling salesman problem (TSP). The results show that the unbalanced penalization method outperforms the solutions found using slack variables and sets a new record for the largest TSP solved with quantu

Left ventricular restoration devices post myocardial infarction

Even in the era of percutaneous reperfusion therapy, left ventricular (LV) remodeling after myocardial infarction (MI) leading to heart failure remains a major health concern. Contractile dysfunction of the infarcted myocardium results in an increased pressure load, leading to maladaptive reshaping of the LV. Several percutaneous transcatheter procedures have been developed to deliver devices that restore LV shape and function. The purposes of this review are to discuss the spectrum of transcatheter devices that are available or in development for attenuation of adverse LV remodeling and to critically examine the available evidence for improvement of functional status and cardiovascular outcomes

Long-term Outcomes of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Systematic Review and Meta-analysis

This project includes articles that were screened for doi:10.1001/jamapsychiatry.2019.3986. Please note that the files contain some duplicates