A successful transatrial repair in redo surgery of postinfarction inferoposterior ventricular septal rupture

A successful transatrial repair in redo surgery of postinfarction posterior ventricular septal rupture (VSR) was performed after an infarct exclusion technique through left ventriculotomy incision of the infarcted area. For the infarct lesion, this approach provides excellent results with sufficient closure of the VSR and prevention of the ventricular remodeling for five years. A right atrial approach for postinfarction posterior VSR is very useful for avoiding any further ventriculotomy in an already impaired ventricle, securing a stable suture, and preserving the left ventricular geometry and function

Phenomenology of Higgs bosons in the Zee-Model

To generate small neutrino masses radiatively, the Zee-model introduces two Higgs doublets and one weak-singlet charged Higgs boson to its Higgs sector. From analyzing the renormalization group equations, we determine the possibile range of the lightest CP-even Higgs boson ($h$) mass and the Higgs boson self-couplings as a function of the cut-off scale beyond which either some of the coupling constants are strong enough to invalidate the perturbative analysis or the stability of the electroweak vacuum is no longer guaranteed. Using the results obtained from the above analysis, we find that the singlet charged Higgs boson can significantly modify the partial decay width of $h \to \gamma \gamma$ via radiative corrections, and its collider phenomenology can also be drastically different from that of the charged Higgs bosons in the usual two-Higgs-doublet models.Comment: Added a paragraph and a figure in Section V, corrected typos, added references. (RevTeX, 45 pages, 16 figures included.) To appear in Physical Review

Noise robust automatic charge state recognition in quantum dots by machine learning and pre-processing, and visual explanations of the model with Grad-CAM

Charge state recognition in quantum dot devices is important in preparation of quantum bits for quantum information processing. Towards auto-tuning of larger-scale quantum devices, automatic charge state recognition by machine learning has been demonstrated. In this work, we propose a simpler method using machine learning and pre-processing. We demonstrate the operation of the charge state recognition and evaluated an accuracy high as 96%. We also analyze the explainability of the trained machine learning model by gradient-weighted class activation mapping (Grad-CAM) which identifies class-discriminative regions for the predictions. It exhibits that the model predicts the state based on the change transition lines, indicating human-like recognition is realized.Comment: 15 pages, 6 figure

チョウ カイテン イジョウショウ オ トモナッタ オウコウ ケッチョウガン ニ タイシテ フククウキョウ ホジョカ ケッチョウ セツジョジュツ オ シコウ シタ 1レイ

A ６４-year-old woman with complaint of intermittent abdominal pain for one year was admitted to our hospital. She had been diagnosed as transverse colon cancer by barium enema and colonoscopy at the former hospital. Abdominal enhanced CT showed that the duodenal third portion was not detected at the back of superior mesenteric vessel. She underwent laparoscopic surgery based on a diagnosis of transverse colon cancer with intestinal malrotation. We could perform laparoscopic-assisted transverse colectomy using abdominal enhanced CT which was effective for not only preoprerative diagnosis of accompany of intestinal malrotation but also anatomical anomalies of vessels. The right sided colon which was not fixed to the retroperitoneum in cases with intestinal malrotation could be pulled out easily from the small incision wound. We also considered that colectomy and dissection of its lymph nodes to these cases could be safety performed using by laparoscopy and through small laparotomy

Early-phase changes of extravascular lung water index as a prognostic indicator in acute respiratory distress syndrome patients

Background: The features of early-phase acute respiratory distress syndrome (ARDS) are leakage of fluid into the extravascular space and impairment of its reabsorption, resulting in extravascular lung water (EVLW) accumulation. The current study aimed to identify how the initial EVLW values and their change were associated with mortality. Methods: This was a post hoc analysis of the PiCCO Pulmonary Edema Study, a multicenter prospective cohort study that included 23 institutions. Single-indicator transpulmonary thermodilution-derived EVLW index (EVLWi) and conventional prognostic factors were prospectively collected over 48 h after enrollment. Associations between 28-day mortality and each variable including initial (on day 0), mean, maximum, and Δ (subtracting day 2 from day 0) EVLWi were evaluated. Results: We evaluated 192 ARDS patients (median age, 69 years (quartile, 24 years); Sequential Organ Failure Assessment (SOFA) score on admission, 10 (5); all-cause 28-day mortality, 31%). Although no significant differences were found in initial, mean, or maximum EVLWi, Δ-EVLWi was significantly higher (i.e., more reduction in EVLWi) in survivors than in non-survivors (3.0 vs. ?0.3 mL/kg, p = 0.006). Age, maximum, and Δ-SOFA scores and Δ-EVLW were the independent predictors for survival according to the Cox proportional hazard model. Patients with Δ-EVLWi > 2.8 had a significantly higher incidence of survival than those with Δ-EVLWi ? 2.8 (log-rank test, χ2 = 7.08, p = 0.008). Conclusions: Decrease in EVLWi during the first 48 h of ARDS may be associated with 28-day survival. Serial EVLWi measurements may be useful for understanding the pathophysiologic conditions in ARDS patients. A large multination confirmative trial is required

Comparisons of Portable Sleep Monitors of Different Modalities: Potential as Naturalistic Sleep Recorders.

Background:Humans spend more than one-fourth of their life sleeping, and sleep quality has been significantly linked to health. However, the objective examination of ambulatory sleep quality remains a challenge, since sleep is a state of unconsciousness, which limits the reliability of self-reports. Therefore, a non-invasive, continuous, and objective method for the recording and analysis of naturalistic sleep is required.Objective:Portable sleep recording devices provide a suitable solution for the ambulatory analysis of sleep quality. In this study, the performance of two activity-based sleep monitors (Actiwatch and MTN-210) and a single-channel electroencephalography (EEG)-based sleep monitor (SleepScope) were compared in order to examine their reliability for the assessment of sleep quality.Methods:Twenty healthy adults were recruited for this study. First, data from daily activity recorded by Actiwatch and MTN-210 were compared to determine whether MTN-210, a more affordable device, could yield data similar to Actiwatch, the de facto standard. In addition, sleep detection ability was examined using data obtained by polysomnography as reference. One simple analysis included comparing the sleep/wake detection ability of Actiwatch, MTN-210, and SleepScope. Furthermore, the fidelity of sleep stage determination was examined using SleepScope in finer time resolution.Results:The results indicate that MTN-210 demonstrates an activity pattern comparable to that of Actiwatch, although their sensitivity preferences were not identical. Moreover, MTN-210 provides assessment of sleep duration comparable to that of the wrist-worn Actiwatch when MTN-210 was attached to the body. SleepScope featured superior overall sleep detection performance among the three methods tested. Furthermore, SleepScope was able to provide information regarding sleep architecture, although systemic bias was found.Conclusion:The present results suggest that single-channel EEG-based sleep monitors are the superior option for the examination of naturalistic sleep. The current results pave a possible future use for reliable portable sleep assessment methods in an ambulatory rather than a laboratory setting