Can regadenoson pharmacologic SPECT be performed effectively in patients with left bundle branch block or paced rhythm patients? A retrospective comparison to adenosine SPECT

Purpose: Regadenoson (REG) is currently becoming the stress agent of choice in patients undergoing pharmacologic single photon emission computed tomography (SPECT). However, in patients with left bundle branch block (LBBB) and ventricular paced rhythm (VPR), hesitation exists amongst clinicians to use REG-SPECT due to the concern that the increased heart rate could cause false positive SPECT results. We sought to evaluate the comparability of A-SPECT and REG-SPECT in patients with LBBB and VPR. Methods: Retrospective study of 30 patients who served as their own controls. All 30 patients who underwent REG-SPECT (Grp 1) were compared to their prior A-SPECT (Grp 2) done within two years prior to REG-SPECT. Heart rate (HR) and blood pressure (BP) parameters, ECG, stress perfusion and gated variables, SPECT ischemia, and side-effects were evaluated. Statistical significance was set at P < 0.05. Results: Grp 1 and Grp 2 were comparable in hemodynamic parameters with increase in HR and decrease in systolic and diastolic BP with administration of adenosine and REG stress agents. However, there were no significant differences found in hemodynamic parameters and II degree AV block between the groups. All normal A-SPECT were found to be normal with REG-SPECT. No differences could be found between the two groups among SPECT parameters. Muscle pain was significantly higher in REG (10.0% vs. 0.0%, P = 0.083) and so was the use of aminophylline (16.7% vs. 0.0%, P = 0.025) to relieve the side-effect. Conclusion: REG-SPECT can be administered in patients with LBBB and VPR patients based on favorable and comparable hemodynamic responses and arrhythmia occurrences to A-SPECT. REG-SPECT can also be used for adequate interpretation of presence or absence of SPECT ischemia particularly in the LAD territory without any concern for false positive perfusion defects.

ART2 Networks Used for Paced ECG Analysis

The PQRST segment which include the major information in a heart beatis detected and used as the input pattern to cluster by ART2 model. The parametersof pacemaker which consist of pulse, QRS characteristics, clustering results andprogrammed parameters are combined in analyzing paced ECG (PECG) synthetically.

The Effects of Externally Paced Exercise on Executive Function and Stress in College-Aged Students

Purpose The purpose of the study was to investigate the acute effect of a beginner martial art class and aerobic exercise on executive function(EF)in college-aged young adults.There is overwhelming evidence that demonstrates acute as well as long-term aerobic exercise improves EF.Nevertheless,there is limited research comparing externally paced exercise(EPE)to self-paced exercise(SPE)such as walking on improving EF.EPE requires greater cortical demand than SPE to execute a motor plan.Methods Eight men and eight women,aged 24.2±2.8 years,participated in a Repeated Measures Crossover Design.Pre-and post-testing of EF with the Stroop and Tower of London(ToL)and stress level were measured after each of the two 1-h conditions:the SPE consisted of a walk(aerobic exercise)and the EPE was a beginner martial art class.Results There were significant main effects for the martial art class for the Stroop’s mean reaction time for congruent trials(P=0.01)with a large-effect size.The mean reaction time for incongruent trials was significant(P=0.05)with a medium-effect size.The ToL’s mean solution time(P=0.003)and mean execution time(P=0.002)were also significant with large-effect sizes.Stress levels were not significantly improved following either condition.Conclusion The martial art class significantly improved all the major domains of EF,while aerobic exercise of a similar intensity did not demonstrate any measured significant changes.The physiological benefits of physical exercise are well documented;however,the cognitive enhancing capability of EPE should also be appreciated given the results of this study.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Left bundle branch area pacing combined with implantable cardioverter-defibrillator treatment for heart failure after myocardial infarction

Left bundle branch area pacing(LBBAP)has emerged as a new physiological pa-cing mode.Previous studies have confir-med the feasibility and efficacy of LBBAP for cardi-ac resynchronization therapy(CRT)in heart failure(HF)patients with left bundle branch block(LBBB)and a narrower QRS duration(QRSd)to have a higher percentage of super responders,and lower pacing thresholds than biventricular pacing(BiVP).

Left bundle branch pacing set to outshine biventricular pacing for cardiac resynchronization therapy?

The deleterious effects of long-term right ventricular pacing necessitated the search for alternative pacing sites which could prevent or alleviate pacinginduced cardiomyopathy.Until recently,biventricular pacing(BiVP)was the only modality which could mitigate or prevent pacing induced dysfunction.Further,BiVP could resynchronize the baseline electromechanical dssynchrony in heart failure and improve outcomes.However,the high non-response rate of around 20%-30%remains a major limitation.This non-response has been largely attributable to the direct non-physiological stimulation of the left ventricular myocardium bypassing the conduction system.To overcome this limitation,the concept of conduction system pacing(CSP)came up.Despite initial success of the first CSP via His bundle pacing(HBP),certain drawbacks including lead instability and dislodgements,steep learning curve and rapid battery depletion on many occasions prevented its widespread use for cardiac resynchronization therapy(CRT).Subsequently,CSP via left bundle branch-area pacing(LBBP)was developed in 2018,which over the last few years has shown efficacy comparable to BiVP-CRT in small observational studies.Further,its safety has also been well established and is largely free of the pitfalls of the HBP-CRT.In the recent metanalysis by Yasmin et al,comprising of 6 studies with 389 participants,LBBPCRT was superior to BiVP-CRT in terms of QRS duration,left ventricular ejection fraction,cardiac chamber dimensions,lead thresholds,and functional status amongst heart failure patients with left bundle branch block.However,there are important limitations of the study including the small overall numbers,inclusion of only a single small randomized controlled trial(RCT)and a small follow-up duration.Further,the entire study population analyzed was from China which makes generalizability a concern.Despite the concerns,the meta-analysis adds to the growing body of evidence demonstrating the efficacy of LBBP-CRT.At this stage,one must acknowledge that the fact that still our opinions on this technique are largely based on observational data and there is a dire need for larger RCTs to ascertain the position of LBBPCRT in management of heart failure patients with left bundle branch block.

车企背后的巨人--整车零部件供应商麦格纳集团的生意经

它是全球最多元化的汽车零部件供应商,除了轮胎和玻璃之外,所有汽车零部件都能制造。麦格纳跺跺脚,半个汽车行业都要抖三抖。提起加拿大的麦格纳国际集团,相信国内车友会感到些许陌生,很少有人知道阿斯顿马丁Rapide四门轿跑、奔驰G级、宝马5系、丰田Supra、捷豹I-PACE和E-PACE、路虎等众多名车从研发到生产都是由它一手包办的。凭借强大的设计、研发、规模化代工生产能力,麦格纳在业界有着“代工皇帝”“车圈富士康”的称号。其在全球有343家工厂,员工超过17万人;仅在中国就有65家工厂.

2019年捷豹I-PACE动力电池报警

故障现象 一辆2019年捷豹路虎生产的捷豹I-PACE纯电动SUV,VIN码为SADHA2B16K1F21^(****),行驶里程为44471km,车主反映该车无法挂挡行驶,且仪表台上显示“检测到电池故障”的提醒信息。

Analysis of the Effect of Extracorporeal Diaphragmatic Pacing Combined with Noninvasive Ventilator on the Respiratory Function and Prognosis of COPD Patients

Objective: To investigate the effect of extracorporeal diaphragmatic pacing combined with noninvasive ventilators on the respiratory function and prognosis of chronic obstructive pulmonary disease (COPD) patients. Methods: A total of 50 COPD patients were selected between January 2023 to December 2023 and randomly grouped into an observation group and a control group, with 25 cases. The observation group was given extracorporeal diaphragm pacing combined with a noninvasive ventilator, while the control group was given a conventional treatment mode. After the treatment, the results of each index in the two groups were compared. Results: Compared with the diaphragm function indexes of the two groups, the data of the observation group were more dominant (P < 0.05). The rehospitalization rate of the observation group was lower than that of the control group (P < 0.05). The COPD assessment test (CAT) and mMRC (Modified Medical Research Council) Dyspnoea scale scores after treatment between the two groups were significantly different (P < 0.05). Compared with the control group, the lung function indexes of the observation group were more dominant (P < 0.05). Conclusion: Extracorporeal diaphragmatic pacing combined with a noninvasive ventilator promoted the improvement of the patient’s prognosis and improved their respiratory function.

The Impact of Cardiac Pacing Site on Patient's Cardiac Function and Psychological State

With the widespread application of artificial permanent pacemakers in clinical practice,there have been new changes in the indications for pacemaker implantation.The current clinical indications include high atrioventricular block,sick sinus syndrome,cardiac resynchronization therapy for heart failure,and implantation of cardioverter defibrillators for ventricular arrhythmias.The implantation of a pacemaker can improve the quality of life and prognosis of patients with arrhythmia.In the past,permanent pacemaker implantation was performed in clinical practice,and the right ventricular pacing electrode was often fixed at the apex of the right ventricle,which belongs to non physiological pacing.Through long-term clinical follow-up,it was found that apex pacing can easily cause abnormal depolarization of the left ventricle,asynchronous contraction of the myocardium,and ultimately lead to myocardial fibrosis,which has adverse effects on the patient's cardiac function and psychological state.In recent years,Scholars have found that pacing in the right ventricular outflow tract septum is closer to the atrioventricular node and closer to the His bundle Purkinje fibers.The pacing impulse almost simultaneously expands towards both ventricles,closer to the physiological pacing state,thereby reducing the occurrence of cardiovascular events in patients.This article explores the impact of pacing in different parts of the heart on the cardiac function and psychological state of patients based on clinical data from the past three years.

PACE模式在现在分词作状语教学中的应用

语法教学是英语教学中必不可少的部分。PACE 模式较传统语法教学更加注重依托语境进行语法知识的输入加工、注重师生互动,更加强调学生的语言输出能力。本文以“现在分词作状语的用法”为例,探讨 PACE 模式“呈现 - 注意 - 共建 - 扩展”四个阶段在英语语法教学中的应用,总结其对语法教学的启发,旨在为语法教学提供思路,在课堂上提高语法教学的效率,促进学生语法能力的培养。

捷豹路虎(中国)投资有限公司召回部分进口捷豹I-PACE系列纯电汽车

日前,捷豹路虎(中国)投资有限公司根据《缺陷汽车产品召回管理条例》和《缺陷汽车产品召回管理条例实施办法》的要求,向国家市场监督管理总局备案了召回计划。决定自即日起,召回2018年6月21日至10月2日期间生产的部分进口2019款捷豹I-PACE系列纯电汽车,共计113辆。

Relevance of Depression/Anxiety and Health-related Quality of Life in Paced Patients

Depression/anxiety is commonly present in paced patients and is associated with increased cardiovascular morbidity and mortality. The high prevalence of depression/anxiety in paced patients supports a strategy of increased awareness and treatment for depression/anxiety in paced patients. Health-related quality of life （HRQoL） is being increasingly considered as an expected out-come of therapeutic interventions and rehabilitation programs in clinical cardi- ology including patients before and after pacemaker（PM） implantation. This multispeciahy consensus document reviews the evidence linking depression/anxiety with arrhythmia and cardiac pacing; HRQoL and cardiac pacing, at the same time, provides recommendations for healthcare providers for the treatment of depression/anxiety. （S Chin J Cardiol 2009; 10（4） ： 190 -195）

智能化民航安保的研究热点与发展趋势

随着民用航空运输规模快速增长,智慧民航背景下的民航安保工作逐步转向开放式、全流程的自助服务,日益复杂的安全需求亦决定了传统安保向智能化安保的转变趋势。目前,国内外学者对智能化民航安保展开了大量研究,为系统把握智能化民航安保的研究热点和发展趋势,以中国知网和Web of Science核心集合数据库中1229篇智能化民航安保研究相关文献为数据源,利用CiteSpace软件,从国家和机构分布、主要期刊来源分布、关键词聚类以及关键词突现等方面进行可视化文献计量分析,总结并探讨该领域的研究热点和发展趋势。研究表明:(1)1998—2021年,国内外学者对智能化民航安保的研究趋势基本一致,总体发文量呈波动式上涨,自2019年起有所降低;(2)从国家和机构分布来看,发文量最多的国家为中国和美国,共占比37.04%,欧洲国家在该领域的研究合作更为密切;国内主要研究机构包括中国民航大学、中国民航科学技术研究院、中国民用航空飞行学院等,国外主要研究机构包括荷兰代尔夫特理工大学、美国伊利诺伊大学等;(3)该领域的热点主题包括民用航空营运安全保卫研究、民用机场安全保卫研究和安全检查研究,其中,仿真技术和网络信息安全是民用航空营运安全保卫的热点研究方向,应急疏散和基于主体的模型(agent-based modeling,ABM)是民用机场安全保卫的热点研究方向,旅客差异化、毫米波安检门、机器学习与现有安检技术结合是安全检查的热点研究方向,我国在智能化民航安保领域经济分析和网络信息安全方面的研究有待加强;(4)智能识别技术在预警和报警方面的研究、仿真技术结合虚拟现实技术进行安保人员培训或演练的研究值得关注。网络信息安全和安全评价模型的优化是当前智能化民航安保研究的主流趋势。

Quantitative estimation of enzymatic released specific oligosaccharides from Hericium erinaceus polysaccharides using CE-LIF

Polysaccharides exhibit multiple pharmacological activities which are closely related to their structural features.Therefore,quantitatively quality control of polysaccharides based on their chemical charac-teristics is important for their application in biomedical and functional food sciences.However,poly-saccharides are mixed macromolecular compounds that are difficult to isolate and lack standards,making them challenging to quantify directly.In this study,we proposed an improved saccharide mapping method based on the release of specific oligosaccharides for the assessment of Hericium eri-naceus polysaccharides from laboratory cultured and different regions of China.Briefly,a polysaccharide from H.erinaceus was digested by b-(1-3)-glucanase,and the released specific oligosaccharides were labeled with 8-aminopyrene-1,3,6-trisulfonic-acid(APTS)and separated by using micellar electrokinetic chromatography(MEKC)coupled with laser induced fluorescence(LIF),and quantitatively estimated.MEKC presented higher resolution compared to polysaccharide analysis using carbohydrate gel elec-trophoresis(PACE),and provided great peak capacity between oligosaccharides with polymerization degree of 2(DP2)and polymerization degree of 6(DP6)in a dextran ladder separation.The results of high performance size exclusion chromatography coupled with multi-angle laser light scattering and refractive index detector(HPSEC-MALLS-RI)showed that 12 h was sufficient for complete digestion of polysaccharides from H.erinaceus.Laminaritriose(DP3)was used as an internal standard for quantifi-cation of all the oligosaccharides.The calibration curve for DP3 showed a good linear regression(R2>0.9988).The limit of detection(LOD)and limit of quantification(LOQ)values were 0.05 mg/mL and 0.2 mg/mL,respectively.The recovery for DP3 was 87.32(±0.03)%in the three independent injections.To sum up,this proposed method is helpful for improving the quality control of polysaccharides from H.erinaceus as well as other materials.

互动观念下的PACE模式在汉语语法教学中的应用

师生共同互动建构语言理解是影响汉语二语学习的关键因素。以往的语法教学研究,多关注学习者可理解输入的形式和量,往往忽略了教师和学习者以及同伴之间的有效互动。这样使得语言教学的“输入”和“输出”相分离,学习者很难在真实情景中达成交际。PACE语法教学模式强调通过互动来共同建构对语法的理解和使用,从而培养学习者的跨文化语言交际能力。基于PACE语法教学模式,结合汉语的特征,探索以学习者形成性评估和反思性学习为基础的汉语APACEA语法教学模式以及线上远程教学实践案例,实现汉语语法教学的优化路径。此教学法也存在一定局限性,仅适用于相对离散并大量存在于汉语教学中的语言结构。

管住嘴迈开腿:身体活动当量标签促进健康行为及其认知机制

身体活动当量标签(physical activity calorie equivalent,PACE)提供关于食物的两种信息,即能量值以及消耗该能量所需要的身体活动量,它被认为是一种应对日益严重的肥胖问题的有效策略。PACE标签可以有效降低消费者在实验室实验和现场实验中的不健康食物选择和能量摄入,促进健康食物的选择,同时提高运动意愿和运动行为,即PACE标签可以促进健康行为。PACE标签起效应的认知机制包括两条路径,即PACE标签-心理模拟-情绪-行为路径和PACE标签-心理模拟-健康目标-行为路径。未来研究可以进一步深入探讨两条路径的适用群体和适用条件,PACE标签可能产生的消极影响,以及综合不同的饮食干预和调节方法帮助消费者形成可持续的健康饮食习惯和运动习惯。

Lead helix winding tricuspid chordae tendineae: A case report

BACKGROUND As left bundle branch pacing(LBBP)is more like physiological pacing,LBBP has emerged as a novel pacing strategy that uses the native conduction system to improve ventricular synchronization with stable pacing parameters.LBBP has been revealed associated with a significantly reduced risk of new-onset atrial fibrillation and heart failure compared with conventional permanent pacemaker implantation.CASE SUMMARY A 64-year-old man was admitted with a 24-h history of chest distress and shortness of breath,which continued unabated.The patient had no symptoms of chest pain,dizziness,syncope,nausea nor vomiting.There were no abnormalities found in routine examinations after admission.Twelve-lead electrocardiogram presented a result of 2:1 atrioventricular block.Coronary angiography was performed the next day and no abnormality was found.Finally,the patient agreed to received LBBP and signed the informed consent.During the process of withdrawing the Medtronic Model 3830 lead into sheath,we found the lead helix was wrapped around the chordae tendineae of the septal valve of tricuspid.Attempts to rotate the 3830 lead failed to release the lead helix from the chordae tendineae,and ultimately we used radiofrequency ablation to ablate the wrapped chordae tendineae.CONCLUSION Radiofrequency ablation effectively solved this problem without complications.It is an effective and reliable method to resolve lead winding chordae.

Cardiac Resynchronization Therapy in Heart Failure in Sub-Saharan Africa Environment: Experience of the Principal Hospital of Dakar (Senegal)

Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.

Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case

Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.