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Funding Acknowledgements Type of funding sources: None. Background/Introduction Two-dimensional (2D) myocardial strain analysis can be used to evaluate the prognosis of patients with acute myocardial infarction and has comparable predictive power as conventional echocardiographic parameters such as left ventricular ejection fraction (LV EF). Three-dimensional (3D) myocardial strain analysis is also expected to have similar clinical usefulness and overcome several inherent limitations of 2D strain analysis. However, no large-scale studies have been reported to date. Purpose We aimed to clarify the prognostic significance of 3D strain analysis in patients with ST-segment elevation myocardial infarction (STEMI) who are most likely to benefit from 3D strain analysis. Methods Patients who underwent successful revascularization for STEMI from June 2011 to April 2017 were retrospectively recruited. In addition to conventional echocardiographic parameters, 3D global area strain (GAS), 3D global longitudinal strain (GLS), as well as 2D GLS were obtained. To evaluate the clinical outcomes, we constructed a composite outcome consisting of all-cause death or re-hospitalisation due to acute decompensation of heart failure. Results From June 2011 to April 2017, 632 patients were retrospectively recruited in our hospital. Of these patients, 545 patients (86.2%) had a reliable 3D strain analysis. The clinical course of each patient was followed up for a maximum of 96 months (median 49.5 months). During follow-up periods, 55 (10.1%) among 545 patients experienced the composite outcome of all-cause death or re-hospitalisation due to acute decompensation of heart failure. Patients with adverse events were older, had more underlying diseases such as obesity, dyslipidemia, previous history of stroke, or chronic kidney disease. (all, p < 0.05) LV EF was significantly lower, while 2D GLS, 3D GLS, and 3D GAS were significantly higher in patients with poor outcomes. (all, p < 0.001) The area under the receiver operating characteristic curve (AUC) values of LV EF, 2D GLS, 3D GLS, and 3D GAS were 0.70, 0.71, 0.67, and 0.65, respectively. (all, p < 0.05) Kaplan-Meier analysis of composite outcomes based on the best cut-off values of each parameter demonstrated similar results. (Figure 1) In the Cox proportional hazard model, the hazard ratios of LV EF, 2D GLS, and 3D GLS were 3.0, 5.5, and 2.0, respectively. (all, p < 0.05) The maximum likelihood-ratio test was performed to evaluate the additional prognostic value of 2D GLS or 3D GLS over the basic prognostic model consisting of baseline clinical characteristics and LV EF, and the likelihood ratio was 15.9 for 2D GLS (p < 0.001) and 1.49 for 3D GLS (p = 0.22). Conclusion(s) 3D strain could be reliably measured in the majority of the patients and had a significant prognostic value. However, the predictive power of the 3D strain was lower than that of the 2D strain. The clinical implications of 3D strain indices should be investigated further. Abstract Figure.

Introduction Diabetes mellitus (DM) aggravates the clinical features and the prognosis of heart failure (HF) patients. However, the impact of DM on the ventricular systolic function of HF patients is not well delineated. Purpose The present study aimed to investigate the impact of DM on HF, regarding the systolic function presented by the global longitudinal strain (GLS). Methods In 4312 patients with acute HF, left ventricle (LV) and right ventricle (RV) GLS were acquired by speckle-tracking echocardiography. HF patients with DM were compared to those without DM from the entire cohort (n=4312), as well as the propensity-score matched cohort (n=3034). Results Our cohort consisted of 1750 DM patients (40.6%). Both LV-GLS and LVEF were significantly lower within the patients with DM (10.1±4.8% vs. 11.3±5.1%, p Comparison between heart failure patients with and without diabetes in the matched cohort Matched cohort p-value HFrEF (matched) p-value HFpEF (matched) p-value No-DM (n=1517) DM (n=1517) No-DM (n=823) DM (n=801) No-DM (n=652) DM (n=669) Age, years 71±14 71±11 0.962 69±14 70±11 0.305 75±11 74±10 0.061 Ischemic heart disease, n (%) 545 (35) 575 (37) 0.275 375 (36) 402 (39) 0.238 150 (34) 147 (34) 0.945 GFR, mL/min/1.73m2 56±27 55±27 0.282 58±28 56±27 0.253 54±27 54±26 1.000 HbA1C, % 5.7±0.4 7.3±1.4 Figure 1. Outcome by DM status Conclusions DM is associated with the impaired LV systolic function presented by GLS in HF patients, even with the adjustment of LVEF. The result indicates that GLS is a more sensitive marker of systolic function than LVEF, in terms of the DM status among the HF patients.

Introducción: En la actualidad, se considera que el injerto microvascularizado de peroné es la mejor opción de tratamiento para las reconstrucciones mandibulares de defectos óseos mayores de 6 cm. No obstante, debido a su limitada altura, presenta una importante desventaja en cuanto a la rehabilitación protésica, particularmente en aquellos casos de resecciones mandibulares parciales con una hemimandíbula contralateral dentada. Material y métodos: Presentamos un caso clínico de mixoma mandibular tratado mediante resección quirúrgica y reconstrucción mandibular primaria mediante injerto microvascularizado de peroné, al que se sometió a distracción osteogénica vertical para optimizar la posterior rehabilitación implantológica. Resultados: La discrepancia de altura se solucionó completamente y se colocaron tres implantes osteointegrados en el área distraída, lo cual permitió una rehabilitación protésica muy satisfactoria, tanto estética como funcionalmente. Conclusiones: La distracción osteogénica vertical de peroné constituye una excelente opción terapéutica para igualar la altura del peroné a la del reborde alveolar de la hemimandíbula dentada contralateral, tras la reconstrucción de defectos mandibulares extensos, de cara a una posterior rehabilitación implantológica, lo que permite llevar a cabo ésta con resultados, tanto funcionales como estéticos, muy satisfactorios. Además, no presenta los inconvenientes de otras técnicas empleadas en estos pacientes, como el peroné en doble barra (mayor dificultad técnica y mayor riesgo de trombosis en el pedículo) y el empleo de injertos "onlay" (morbilidad añadida en la zona de toma del injerto).Introduction: Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it doesn't offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. Materials and methods: We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma. The distraction device was applied intraorally. Distraction of 0.5 mm per day was performed followed by 3 months of consolidation period. Results: The vertical discrepancy between the fibula and the native hemimandible was corrected. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. Conclusions: We believe that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumour surgery.

Cellulose paper has been discovered as a smart material including actuating behavior and electro-active paper (EAPap) with application of electric field. To control the electro-active motion, the EAPap requires electronic components on the paper. However, conventional lithography technique cannot apply to the paper to fabricate electronic components due to its hydrophilic nature, water absorption, and flexibility. For this reason, a micro-contact printing (MCP) technique was employed to fabricate Au patterns on the EAPap. Large number of Au-islands and irregular edge patterns were observed on the transferred Au-pattern when the self-assembled monolayer (SAM) was fabricated on the cellulose surface. Therefore, SAM was fabricated on the Au-surface. The surface quality of the transferred Au was strongly dependent on the solvent polarity. Better surface morphology of the transferred Au-pattern was obtained with the polar solvent compared with nonpolar solvent.

Background It has not been well evaluated whether late gadolinium enhanced (LGE)-MRI can provide prognostic information in patients who underwent coronary artery bypass graft (CABG) surgery, especially in patients with preserved left ventricular ejection fraction (LVEF). Further, long-term follow-up data after MRI and CABG surgery are not available. The purpose of this study was to evaluate the impact of myocardial viability assessment by LGE-MRI on prognosis in patients who underwent CABG surgery.

A home network message specification for white goods based on power line communication is proposed. It is designed for white goods such as air conditioners, refrigerators, washing machines etc. The proposed home network message specification is composed of a virtual device service and a device-specific attribute. For practical implementation, an application software and two types of power line modules are used.

Background Hypercholesterolemia is a major risk factor for incident coronary artery disease and the prevalence of heart failure (HF). The causal relationship between low total cholesterol (TC) levels and poor clinical outcome in patients with acute HF has not been investigated. This study evaluated the effect of cholesterol levels on the long-term outcome in patients hospitalized due to acute HF. Methods and Results We analyzed a cohort of 2,797 HF patients who were eligible for analysis in 3,200 patients of the Korean Heart Failure Registry. Patients were stratified into quartiles of TC (Q1 190 mg/dL). Propensity score matching was performed with the patients in Q1 and Q4. Patients with lower serum TC had lower blood pressure, lower hemoglobin, lower serum sodium, and higher natriuretic peptide levels than patients with higher TC levels. Low TC was associated with increased risks for death and readmission due to HF; the adjusted hazard ratio (HR) of Q1 compared with Q4 was 1.57 (95% confidence interval [CI] 1.30–1.90). However, propensity score matching analysis revealed that low cholesterol itself did not affect outcome (HR 1.12, 95% CI 0.85–1.48). Conclusions Low TC is strongly associated with mortality and morbidity in patients with HF. However, low TC seemed to be a secondary result of the patient’s state rather than an independent risk factor for poor outcome.

Low-pass filters with tunable cut-off frequencies are useful in variable-bandwidth communication systems, zero-crossing detection circuits and many other applications. The complex heterodyne approach that has been applied to band-pass and notch filters, can also be applied to design low-pass and high- pass tunable filters. Using a half-band fixed filter as the prototype, the complex heterodyne approach yields a fully tunable low-pass filter that can tune the cut-off frequency from nearly DC to the Nyquist frequency.

Two techniques have been recently proposed for implementing tunable notch filters using a complex heterodyne approach. Both techniques rely on the rotating of poles and zeros in the z-plane much like a simple combination lock: clockwise once, counter-clockwise twice, then clockwise once. In the first approach, all of the poles and zeros are rotated; in the second approach, the upper semi-plane poles and zeros (positive poles and zeros) are rotated separately from the lower semi-plane poles and zeros (negative poles and zeros). Both standard arithmetic and residue number arithmetic (RNS) implementations have been suggested. In this paper we show how these tunable complex heterodyne notch filters can be turned into adaptive notch filters suitable for communications and control systems applications. A simple detection circuit is proposed to identify the interference signal to be attenuated and a specialized numerically controlled oscillator (NCO) is proposed to interface between the detection circuit and the tunable complex heterodyne notch filter. The result is an adaptive notch filter with outstanding attenuation and tuning properties.

The heterodyne signals for a complex heterodyne filter based upon M/2 equally-spaced heterodyne frequencies between DC and the Nyquist frequency can be generated from taking integer powers of the M/sup th/ root of one. In residue number systems (RNS) based on prime moduli of the form Mk+1, where k is an integer, the Mth root of one and its powers can be represented by integer values within the RNS. These M/sup th/-root residue number systems (MRNS) are ideal for implementing complex heterodyne filters that allow for the tuning of digital filters between DC and the Nyquist frequency. Using MRNS exact arithmetic can be carried out on these complex signals with errors only occurring at the output when MRNS is converted to binary. The result is a tunable linear-phase filter that is convenient to implement and uses less hardware than conventional tunable filters.

A simple heterodyne process is used to convert very complicated fixed-coefficient digital filters into tunable digital filters that adjust the center frequency or the bandwidth of a filter by adjusting a single heterodyne frequency. This paper provides a complete catalog of practical tunable heterodyne filter for low-pass, high-pass, band-pass, and band-elimination (notch) filters. Tunability is provided from DC to the Nyquist frequency, although full-tunability of the low-pass and high-pass filters requires a certain amount of over design for the prototype filter. The tunable parameter can easily be made adaptive by using a simple adaptive algorithm discussed in the paper.

Complex arithmetic allows the separation of poles and zeros in the top half of the z-plane from the poles and zeros in the bottom half of the z-plane. Heterodyne techniques can then be used to move the poles and zeros in the top half of the plane counter-clockwise and the poles and zeros in the bottom half of the z-plane clockwise thus maintaining complex-conjugate poles and zeros and hence real-coefficient transfer functions. Using this approach, narrow-band, band-pass and notch filters can be tuned very efficiently. These filters can be easily designed in Matlab using inverse Chebyshev (cheby2) or elliptical (ellip) design techniques. For odd order band-pass filters or for Butterworth or Chebyshev band-pass filters, we need to rotate only the poles and complex zeros, leaving the real zeros in place.

Traditional digital heterodyne circuits store samples of a quarter cosine wave in a look-up-table (LUT) and utilize digital multiplier hardware to multiply samples of the cosine times the input samples to the heterodyne unit resulting in an output that is the product of the input signal and the cosine wave. However, by storing the canonic-sign-digit (CSD) shift and add sequences in the LUT, rather than the samples of the cosine, it is possible to implement the entire digital heterodyne circuit with only two adder/subtractor units and three switches. The new circuit represents a considerable savings in hardware yet provides identical performance when compared to the traditional digital heterodyne circuit. Such circuits are very important in modern communications systems where they provide up-conversion, down-conversion, FSK and PSK modulation and other critical functions associated with digital communications systems and software radios.

Generalized multiprotocol label switching (GMPLS) promises a unified control plane for a variety of switching technologies by separating the control plane from the forwarding plane. In this paper, a brief overview of the ongoing research on different aspects of GMPLS is first presented. Then a comparison is conducted between the network access layer (NAL) and the optical/physical layer in GMPLS, based on the restoration capabilities and the performance analysis of channel connectivity and the traffic aggregation in the two layers. Finally, the logical channel connections of the IP/NAL layer are compared to the physical channel connections of the optical/physical layer where the probability of blocking (P/sub b/) is calculated, considering both wavelength conversion and nonwavelength conversion cases.

This paper addresses the required extensions to the multiprotocol label switching (MPLS) signaling protocols, resource reservation protocol with traffic engineering extensions (RSVP-TE) and label distribution protocol (LDP), to support MPLS network multicasting functionalities. These extensions to the signaling protocols enable MPLS networking to conduct all required multicasting features that IP multicasting protocols are capable of, while adding on the feature benefits of MPLS traffic engineering.

Multiprotocol label switching (MPLS) and multiprotocol lambda switching (MP/spl lambda/S) are at the forefront of next generation wide area network routing/switching technologies. Both technologies show promising functionalities and capabilities. While MPLS and MP/spl lambda/S provide similar functions, they excel or are limited in areas due to their inherent designs and functional domains. Even though the two technologies show strengths and limitations, their coexistence will result in significant redundancy in several technical aspects. This paper investigates the similarities and differences of MPLS and MP/spl lambda/S providing an analytical and comprehensive comparison within service and coverage, resource utilization, and restoration speed and complexity.

Purpose: We sought to evaluate whether coronary artery disease (CAD) evaluated by coronary computed tomographic angiography (CCTA) and photon emission computed tomography (SPECT) are related to the risk of future ischemic stroke in patients with suspected CAD. Methods: From 1874 consecutive patients undergoing both 64-slice CCTA and SPECT for the evaluation of CAD between 2004 and 2011, 516 patients with history of CAD, 148 patients with history of ischemic stroke, and 56 patients with lack of clinical information were excluded. Among them (n=1154), follow-up information was obtained for the occurrence of ischemic stroke in 1137 subjects (98.5%). Kaplan-Meier survival model and cox proportional hazards model were used for the analysis. Results: During a median follow-up of 26 months (interquartile range 14 to 43 months), ischemic stroke occurred in 25 of 1137 patients (2.2%). The presence of CAD on CCTA was associated with a >4-fold hazard increase for ischemic stroke (unadjusted HR 4.38, 95% CI 1.03-18.64, p = 0.029). Furthermore, CAD involving two or more vessels on CCTA demonstrated a >3-fold hazard increase for ischemic stroke compared to 1-vessel involvement (unadjusted HR 3.68, 95% CI 1.57-8.62, p = 0.003). In contrast, the presence of perfusion defect (PD) on SPECT was not associated with ischemic stroke (unadjusted HR 0.87, 95% CI 0.36-2.09, p = 0.747). PD with summed stress score (SSS) ≥8 did not show the hazard increase for ischemic stroke compared to that with SSS