Meeting the requirements to deploy cloud RAN over optical networks

Radio access network (RAN) cost savings are expected in future cloud RAN (C-RAN). In contrast to traditional distributed RAN architectures, in C-RAN, remote radio heads (RRHs) from different sites can share baseband processing resources from virtualized baseband unit pools placed in a few central locations (COs). Due to the stringent requirements of the several interfaces needed in C-RAN, optical networks have been proposed to support C-RAN. One of the key elements that needs to be considered are optical transponders. Specifically, sliceable bandwidth-variable transponders (SBVTs) have recently shown many advantages for core optical transport networks. In this paper, we study the connectivity requirements of C-RAN applications and conclude that dynamicity, fine granularity, and elasticity are needed. However, there is no SBVT implementation that supports those requirements, and thus, we propose and assess an SBVT architecture based on dynamic optical arbitrary generation/measurement. We consider different long-term evolution-advanced configurations and study the impact of the centralization level in terms of the capital expense and operating expense. An optimization problem is modeled to decide which COs should be equipped and which equipment, including transponders, needs to be installed. The results show noticeable cost savings from installing the proposed SBVTs compared to installing fixed transponders. Finally, compared to the maximum centralization level, remarkable cost savings are shown when a lower level of centralization is considered.Peer ReviewedPostprint (author's final draft

A review of flash glucose monitoring in type 2 diabetes

Abstract Background Continuous glucose monitoring systems are increasingly being adopted as an alternative to self-monitoring of blood glucose (SMBG) by persons with diabetes mellitus receiving insulin therapy. Main body The FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, United Kingdom) consists of a factory-calibrated sensor worn on the back of the arm which measures glucose levels in the interstitial fluid every minute and stores the reading automatically every 15 min. Swiping the reader device over the sensor retrieves stored data and displays current interstitial glucose levels, a glucose trend arrow, and a graph of glucose readings over the preceding 8 h. In patients with type 2 diabetes (T2D) receiving insulin therapy, pivotal efficacy data were provided by the 6-month REPLACE randomized controlled trial (RCT) and 6-month extension study. Compared to SMBG, the flash system significantly reduced the time spent in hypoglycemia and frequency of hypoglycemic events, although no significant change was observed in glycosylated hemoglobin (HbA1c) levels. Subsequent RCTs and real-world chart review studies have since shown that flash glucose monitoring significantly reduces HbA1c from baseline. Real-world studies in both type 1 diabetes or T2D populations also showed that flash glucose monitoring improved glycemic control. Higher (versus lower) scanning frequency was associated with significantly greater reductions in HbA1c and significant improvements in other measures such as time spent in hypoglycemia, time spent in hyperglycemia, and time in range. Additional benefits associated with flash glucose monitoring versus SMBG include reductions in acute diabetes events, all-cause hospitalizations and hospitalized ketoacidosis episodes; improved well-being and decreased disease burden; and greater treatment satisfaction. Conclusion T2D patients who use flash glucose monitoring might expect to achieve significant improvement in HbA1c and glycemic parameters and several associated benefits

Meeting the requirements to deploy cloud RAN over optical networks

Radio access network (RAN) cost savings are expected in future cloud RAN (C-RAN). In contrast to traditional distributed RAN architectures, in C-RAN, remote radio heads (RRHs) from different sites can share baseband processing resources from virtualized baseband unit pools placed in a few central locations (COs). Due to the stringent requirements of the several interfaces needed in C-RAN, optical networks have been proposed to support C-RAN. One of the key elements that needs to be considered are optical transponders. Specifically, sliceable bandwidth-variable transponders (SBVTs) have recently shown many advantages for core optical transport networks. In this paper, we study the connectivity requirements of C-RAN applications and conclude that dynamicity, fine granularity, and elasticity are needed. However, there is no SBVT implementation that supports those requirements, and thus, we propose and assess an SBVT architecture based on dynamic optical arbitrary generation/measurement. We consider different long-term evolution-advanced configurations and study the impact of the centralization level in terms of the capital expense and operating expense. An optimization problem is modeled to decide which COs should be equipped and which equipment, including transponders, needs to be installed. The results show noticeable cost savings from installing the proposed SBVTs compared to installing fixed transponders. Finally, compared to the maximum centralization level, remarkable cost savings are shown when a lower level of centralization is considered.Peer Reviewe

Hypothesized role of pregnancy hormones on HER2+ breast tumor development

Breast cancer incidence rates have declined among older but not younger women; the latter are more likely to be diagnosed with breast cancers carrying a poor prognosis. Epidemiological evidence supports an increase in breast cancer incidence following pregnancy with risk elevated as much as 10 years postpartum. We investigated the association between years since last full-term pregnancy at the time of diagnosis (≤10 or >10 years) and breast tumor subtype in a case series of premenopausal Hispanic women (n = 627). Participants were recruited in the United States, Mexico, and Spain. Cases with known estrogen receptor (ER), progesterone receptor (PR), and HER2 status, with one or more full-term pregnancies ≥1 year prior to diagnosis were eligible for this analysis. Cases were classified into three tumor subtypes according to hormone receptor (HR+ = ER+ and/or PR+; HR− = ER− and PR−) expression and HER2 status: HR+/HER2−, HER2+ (regardless of HR), and triple negative breast cancer (TNBC). Case-only odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for HER2+ tumors in reference to HR+/HER2− tumors. Participants were pooled in a mixed-effects logistic regression model with years since pregnancy as a fixed effect and study site as a random effect. When compared to HR+/HER2− cases, women with HER2+ tumors were more likely be diagnosed in the postpartum period of ≤10 years (OR=1.68; 95% CI, 1.12–2.52). The effect was present across all source populations and independent of the HR status of the HER2+ tumor. Adjusting for age at diagnosis (≤45 or >45 years) did not materially alter our results (OR=1.78; 95% CI, 1.08–2.93). These findings support the novel hypothesis that factors associated with the postpartum breast, possibly hormonal, are involved in the development of HER2+ tumors

Relation of outcomes to ABC (Atrial Fibrillation Better Care) pathway adherent care in European patients with atrial fibrillation: an analysis from the ESC-EHRA EORP Atrial Fibrillation General Long-Term (AFGen LT) Registry

International audienceAbstract Aims There has been an increasing focus on integrated, multidisciplinary, and holistic care in the treatment of atrial fibrillation (AF). The ‘Atrial Fibrillation Better Care’ (ABC) pathway has been proposed to streamline integrated care in AF. We evaluated the impact on outcomes of an ABC adherent management in a contemporary real-life European-wide AF cohort. Methods and results Patients enrolled in the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry with baseline data to evaluate ABC criteria and available follow-up data were considered for this analysis. Among the original 11 096 AF patients enrolled, 6646 (59.9%) were included in this analysis, of which 1996 (30.0%) managed as ABC adherent. Patients adherent to ABC care had lower CHA2DS2-VASc and HAS-BLED scores (mean ± SD, 2.68 ± 1.57 vs. 3.07 ± 1.90 and 1.26 ± 0.93 vs. 1.58 ± 1.12, respectively; P < 0.001). At 1-year follow-up, patients managed adherent to ABC pathway compared to non-adherent ones had a lower rate of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death (3.8% vs. 7.6%), CV death (1.9% vs. 4.8%), and all-cause death (3.0% vs. 6.4%) (all P < 0.0001). On Cox multivariable regression analysis, ABC adherent care showed an association with a lower risk of any TE/ACS/CV death [hazard ratio (HR): 0.59, 95% confidence interval (CI): 0.44–0.79], CV death (HR: 0.52, 95% CI: 0.35–0.78), and all-cause death (HR: 0.57, 95% CI: 0.43–0.78). Conclusion In a large contemporary cohort of European AF patients, a clinical management adherent to ABC pathway for integrated care is associated with a significant lower risk for cardiovascular events, CV death, and all-cause death