An artificial neural network stratifies the risks of reintervention and mortality after endovascular aneurysm repair:a retrospective observational study

Background Lifelong surveillance after endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) is considered mandatory to detect potentially life-threatening endograft complications. A minority of patients require reintervention but cannot be predictively identified by existing methods. This study aimed to improve the prediction of endograft complications and mortality, through the application of machine-learning techniques. Methods Patients undergoing EVAR at 2 centres were studied from 2004-2010. Pre-operative aneurysm morphology was quantified and endograft complications were recorded up to 5 years following surgery. An artificial neural networks (ANN) approach was used to predict whether patients would be at low- or high-risk of endograft complications (aortic/limb) or mortality. Centre 1 data were used for training and centre 2 data for validation. ANN performance was assessed by Kaplan-Meier analysis to compare the incidence of aortic complications, limb complications, and mortality; in patients predicted to be low-risk, versus those predicted to be high-risk. Results 761 patients aged 75 +/- 7 years underwent EVAR. Mean follow-up was 36+/- 20 months. An ANN was created from morphological features including angulation/length/areas/diameters/ volume/tortuosity of the aneurysm neck/sac/iliac segments. ANN models predicted endograft complications and mortality with excellent discrimination between a low-risk and high-risk group. In external validation, the 5-year rates of freedom from aortic complications, limb complications and mortality were 95.9% vs 67.9%; 99.3% vs 92.0%; and 87.9% vs 79.3% respectively (p0.001) Conclusion This study presents ANN models that stratify the 5-year risk of endograft complications or mortality using routinely available pre-operative data.

Numerical analysis of artificial neural network and volterra-based nonlinear equalizers for coherent optical OFDM

One major drawback of coherent optical orthogonal frequency-division multiplexing (CO-OFDM) that hitherto remains unsolved is its vulnerability to nonlinear fiber effects due to its high peak-to-average power ratio. Several digital signal processing techniques have been investigated for the compensation of fiber nonlinearities, e.g., digital back-propagation, nonlinear pre- and post-compensation and nonlinear equalizers (NLEs) based on the inverse Volterra-series transfer function (IVSTF). Alternatively, nonlinearities can be mitigated using nonlinear decision classifiers such as artificial neural networks (ANNs) based on a multilayer perceptron. In this paper, ANN-NLE is presented for a 16QAM CO-OFDM system. The capability of the proposed approach to compensate the fiber nonlinearities is numerically demonstrated for up to 100-Gb/s and over 1000km and compared to the benchmark IVSTF-NLE. Results show that in terms of Q-factor, for 100-Gb/s at 1000km of transmission, ANN-NLE outperforms linear equalization and IVSTF-NLE by 3.2dB and 1dB, respectively.

A hydrogen-bonded polar network in the core of the glucagon-like peptide-1 receptor is a fulcrum for biased agonism:lessons from class B crystal structuress

The glucagon-like peptide 1 (GLP-1) receptor is a class B G protein-coupled receptor (GPCR) that is a key target for treatments for type II diabetes and obesity. This receptor, like other class B GPCRs, displays biased agonism, though the physiologic significance of this is yet to be elucidated. Previous work has implicated R2.60190 , N3.43240 , Q7.49394 , and H6.52363 as key residues involved in peptide-mediated biased agonism, with R2.60190 , N3.43240 , and Q7.49394 predicted to form a polar interaction network. In this study, we used novel insight gained from recent crystal structures of the transmembrane domains of the glucagon and corticotropin releasing factor 1 (CRF1) receptors to develop improved models of the GLP-1 receptor that predict additional key molecular interactions with these amino acids. We have introduced E6.53364 A, N3.43240 Q, Q7.49493N, and N3.43240 Q/Q7.49 Q/Q7.49493N mutations to probe the role of predicted H-bonding and charge-charge interactions in driving cAMP, calcium, or extracellular signal-regulated kinase (ERK) signaling. A polar interaction between E6.53364 and R2.60190 was predicted to be important for GLP-1- and exendin-4-, but not oxyntomodulin-mediated cAMP formation and also ERK1/2 phosphorylation. In contrast, Q7.49394 , but not R2.60190 /E6.53364 was critical for calcium mobilization for all three peptides. Mutation of N3.43240 and Q7.49394 had differential effects on individual peptides, providing evidence for molecular differences in activation transition. Collectively, this work expands our understanding of peptide-mediated signaling from the GLP-1 receptor and the key role that the central polar network plays in these events.

Understanding inter-firm networks and types of innovation in SMEs:a social network perspective

Innovation is one of the key drivers for gaining competitive advantages in any firms. Understanding knowledge transfer through inter-firm networks and its effects on types of innovation in SMEs is very important in improving SMEs innovation. This study examines relationships between characteristics of inter-firm knowledge transfer networks and types of innovation in SMEs. To achieve this, social network perspective is adopted to understand inter-firm knowledge transfer networks and its impact on innovation by investigating how and to what extend ego network characteristics are affecting types of innovation. Therefore, managers can develop the firms'network according to their strategies and requirements. First, a conceptual model and research hypotheses are proposed to establish the possible relationship between network properties and types of innovation. Three aspects of ego network are identified and adopted for hypotheses development: 1) structural properties which address the potential for resources and the context for the flow of resources, 2) relational properties which reflect the quality of resource flows, and 3) nodal properties which are about quality and variety of resources and capabilities of the ego partners. A questionnaire has been designed based on the hypotheses. Second, semistructured interviews with managers of five SMEs have been carried out, and a thematic qualitative analysis of these interviews has been performed. The interviews helped to revise the questionnaire and provided preliminary evidence to support the hypotheses. Insights from the preliminary investigation also helped to develop research plan for the next stage of this research.

The PHAR-QA project: competency framework for pharmacy practice—first steps, the results of the European Network Delphi round 1

PHAR-QA, funded by the European Commission, is producing a framework of competences for pharmacy practice. The framework is in line with the EU directive on sectoral professions and takes into account the diversity of the pharmacy profession and the on-going changes in healthcare systems (with an increasingly important role for pharmacists), and in the pharmaceutical industry. PHAR-QA is asking academia, students and practicing pharmacists to rank competences required for practice. The results show that competences in the areas of drug interactions, need for drug treatment and provision of information and service were ranked highest whereas those in the areas of ability to design and conduct research and development and production of medicines were ranked lower. For the latter two categories, industrial pharmacists ranked them higher than did the other five groups

A Bayesian neural network algorithm identifies patients in whom post-EVAR surveillance may be unnecessary

Lifelong surveillance is not cost-effective after endovascular aneurysm repair (EVAR), but is required to detect aortic complications which are fatal if untreated (type 1/3 endoleak, sac expansion, device migration). Aneurysm morphology determines the probability of aortic complications and therefore the need for surveillance, but existing analyses have proven incapable of identifying patients at sufficiently low risk to justify abandoning surveillance. This study aimed to improve the prediction of aortic complications, through the application of machine-learning techniques. Patients undergoing EVAR at 2 centres were studied from 2004–2010. Aneurysm morphology had previously been studied to derive the SGVI Score for predicting aortic complications. Bayesian Neural Networks were designed using the same data, to dichotomise patients into groups at low- or high-risk of aortic complications. Network training was performed only on patients treated at centre 1. External validation was performed by assessing network performance independently of network training, on patients treated at centre 2. Discrimination was assessed by Kaplan-Meier analysis to compare aortic complications in predicted low-risk versus predicted high-risk patients. 761 patients aged 75 +/− 7 years underwent EVAR in 2 centres. Mean follow-up was 36+/− 20 months. Neural networks were created incorporating neck angu- lation/length/diameter/volume; AAA diameter/area/volume/length/tortuosity; and common iliac tortuosity/diameter. A 19-feature network predicted aor- tic complications with excellent discrimination and external validation (5-year freedom from aortic complications in predicted low-risk vs predicted high-risk patients: 97.9% vs. 63%; p < 0.0001). A Bayesian Neural-Network algorithm can identify patients in whom it may be safe to abandon surveillance after EVAR. This proposal requires prospective study.

Artificial neural network nonlinear equalizer for coherent optical OFDM

We propose a novel low-complexity artificial neural network (ANN)-based nonlinear equalizer (NLE) for coherent optical orthogonal frequency-division multiplexing (CO-OFDM) and compare it with the recent inverse Volterra-series transfer function (IVSTF)-based NLE over up to 1000 km of uncompensated links. Demonstration of ANN-NLE at 80-Gb/s CO-OFDM using 16-quadrature amplitude modulation reveals a Q-factor improvement after 1000-km transmission of 3 and 1 dB with respect to the linear equalization and IVSTF-NLE, respectively.