Interactive pre-surgical design of optimal extra-cardiac Fontan connections starting with cardiac MRI reconstructions of the Glenn anastomosis

Pre-surgical planning for Fontan procedures involves time-consuming patient-specific vascular segmentation and non-intuitive virtual surgical modeling which has encumbered utility in the clinic by surgeons. We present an interactive platform to design virtual surgical options and visualize pericardial enlargement strategy for Fontan connections, starting with patient-specific vascular templates

A Centralized Cluster-Based Hierarchical Approach for Green Communication in a Smart Healthcare System

The emergence of the Internet of Things (IoT) has revolutionized our digital and virtual worlds of connected devices. IoT is a key enabler for a wide range of applications in today's world. For example, in smart healthcare systems, the sensor-embedded devices monitor various vital signs of the patients. These devices operate on small batteries, and their energy need to be utilized efficiently. The need for green IoT to preserve the energy of these devices has never been more critical than today. The existing smart healthcare approaches adopt a heuristic approach for energy conservation by minimizing the duty-cycling of the underlying devices. However, they face numerous challenges in terms of excessive overhead, idle listening, overhearing, and collision. To circumvent these challenges, we have proposed a cluster-based hierarchical approach for monitoring the patients in an energy-efficient manner, i.e., green communication. The proposed approach organizes the monitoring devices into clusters of equal sizes. Within each cluster, a cluster head is designated to gather data from its member devices and broadcast to a centralized base station. Our proposed approach models the energy consumption of each device in various states, i.e., idle, sleep, awake, and active, and also performs the transitions between these states. We adopted an analytical approach for modeling the role of each device and its energy consumption in various states. Extensive simulations were conducted to validate our analytical approach by comparing it against the existing schemes. The experimental results of our approach enhance the network lifetime with a reduced energy consumption during various states. Moreover, it delivers a better quality of data for decision making on the patient's vital signs

Vitamin D levels as an important predictor for type 2 diabetes mellitus and weight regain post-sleeve gastrectomy

Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m2). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits

Intravitreal aflibercept for diabetic macular oedema: Moorfields’ real-world 12-month visual acuity and anatomical outcomes

OBJECTIVES:: To assess structural and functional outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in treatment-naive patients. DESIGN:: This is a retrospective, real-life, cohort study. PARTICIPANTS AND METHODS:: In all, 92 diabetic patients (102 eyes) receiving intravitreal anti-vascular endothelial growth factor therapy were included. A total of 99 aflibercept-treated eyes were included in the statistical analysis. Each patient had corrected visual acuity in Early Treatment Diabetic Retinopathy Study letters and optical coherence tomography central foveal thickness and macular volume performed at baseline and 12 months. Patients were initiated on a loading phase of five monthly intravitreal aflibercept injections, followed by injections if needed as per clinicians' discretion. RESULTS:: The mean number of aflibercept injections received was 6.92. At baseline, the mean visual acuity (standard deviation; Snellen) was 59.7 (16.1) (20/63) Early Treatment Diabetic Retinopathy Study letters, the mean central foveal thickness (standard deviation) was 431 (129) µm, while the mean macular volume (standard deviation) was 9.53 (1.79) mm3. At 12 months, the mean visual acuity (standard deviation; Snellen) was 69.6 (15.2; 20/40) Early Treatment Diabetic Retinopathy Study letters (p < .0001). Mean central foveal thickness (standard deviation) was 306 (122) μm (p < .0001) and mean macular volume (standard deviation) was 8.43 (1.58) mm3 (p < .0001) at 12 months; 33 (33.67%) eyes gained ⩾15 Early Treatment Diabetic Retinopathy Study letters at month 12, and 50 (55.55%) eyes had a decrease in central foveal thickness of ⩾100 µm. CONCLUSION:: There was a significant improvement in visual acuity and in anatomical outcomes in aflibercept-treated eyes at 12 months after commencing treatment for diabetic macular oedema in real-life settings

The lateral septum mediates kinship behavior in the rat

Kinship behavior in rodents has been documented in the laboratory setting but the neural mechanisms that mediate kinship behavior are not known. Here, the authors show that the lateral septum has a key role in organizing mammalian kinship behavior

Measurement of the Relative Branching Fraction of Υ(4S)\Upsilon(4S) to Charged and Neutral B-Meson Pairs

We analyze 9.7 x 10^6 B\bar{B}$ pairs recorded with the CLEO detector to determine the production ratio of charged to neutral B-meson pairs produced at the Y(4S) resonance. We measure the rates for B^0 -> J/psi K^{(*)0} and B^+ -> J/psi K^{(*)+} decays and use the world-average B-meson lifetime ratio to extract the relative widths f+-/f00 = Gamma(Y(4S) -> B+B-)/Gamma(Y(4S) -> B0\bar{B0}) = = 1.04 +/- 0.07(stat) +/- 0.04(syst). With the assumption that f+- + f00 = 1, we obtain f00 = 0.49 +/- 0.02(stat) +/- 0.01(syst) and f+- = 0.51 +/- 0.02(stat) +/- 0.01(syst). This production ratio and its uncertainty apply to all exclusive B-meson branching fractions measured at the Y(4S) resonance.Comment: 11 pages postscript, also available through http://w4.lns.cornell.edu/public/CLN

Study of the Decays B0 --> D(*)+D(*)-

The decays B0 --> D*+D*-, B0 --> D*+D- and B0 --> D+D- are studied in 9.7 million Y(4S) --> BBbar decays accumulated with the CLEO detector. We determine Br(B0 --> D*+D*-) = (9.9+4.2-3.3+-1.2)e-4 and limit Br(B0 --> D*+D-) < 6.3e-4 and Br(B0 --> D+D-) < 9.4e-4 at 90% confidence level (CL). We also perform the first angular analysis of the B0 --> D*+D*- decay and determine that the CP-even fraction of the final state is greater than 0.11 at 90% CL. Future measurements of the time dependence of these decays may be useful for the investigation of CP violation in neutral B meson decays.Comment: 21 pages, 5 figures, submitted to Phys. Rev.

Precise Measurement of B^{0}\to \bar{B^{0} Mixing Parameters at the Υ(\Upsilon(S)$

We describe a measurement of B^0-B^0bar mixing parameters exploiting a method of partial reconstruction of the decay chains B0 -> D^{*-}\pi^+ and B0 -> D^{*-}\rho^+. Using 9.6 x 10^6 BBbar pairs collected at the Cornell Electron Storage Ring, we find \chi_d = 0.198 +- 0.013 +- 0.014, |y_d|<0.41 at 95% confidence level, and |Re(\epsilon_B)|<0.034 at 95% confidence level.Comment: 11 pages postscript, also available through http://w4.lns.cornell.edu/public/CLN

Measurement of B(/\c->pKpi)

The /\c->pKpi yield has been measured in a sample of two-jet continuum events containing a both an anticharm tag (Dbar) as well as an antiproton (e+e- -> Dbar pbar X), with the antiproton in the hemisphere opposite the Dbar. Under the hypothesis that such selection criteria tag e+e- -> Dbar pbar (/\c) X events, the /\c->pkpi branching fraction can be determined by measuring the pkpi yield in the same hemisphere as the antiprotons in our Dbar pbar X sample. Combining our results from three independent types of anticharm tags, we obtain B(/\c->pKpi)=(5.0+/-0.5+/-1.2)