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).

A new interacting capillary bundle model on the multiphase flow in micropores of tight rocks

Surfactants are widely used in the fracturing fluid to enhance the imbibition and thus the oil recovery rate. However, current numerical models cannot capture the physics behind capillary imbibition during the wettability alteration by surfactants. Although the interacting capillary bundle(ICB) model shows potential in characterizing imbibition rates in different pores during wettability alteration, the existing ICB models neglect the influence of wettability and viscosity ratio on the imbibition behavior, making it difficult to accurately describe the oil-water imbibition behavior within the porous media. In this work,a new ICB mathematical model is established by introducing pressure balance without assuming the position of the leading front to comprehensively describe the imbibition behavior in a porous medium under different conditions, including gas-liquid spontaneous imbibition and oil-water imbibition.When the pore size distribution of a tight rock is known, this new model can predict the changes of water saturation during the displacement process in the tight rock, and also determine the imbibition rate in pores of different sizes. The water saturation profiles obtained from the new model are validated against the waterflooding simulation results from the CMG, while the imbibition rates calculated by the model are validated against the experimental observations of gas-liquid spontaneous imbibition. The good match above indicates the newly proposed model can show the water saturation profile at a macroscopic scale while capture the underlying physics of the multiphase flow in a porous medium at a microscopic scale. Simulation results obtained from this model indicate that both wettability and viscosity ratio can affect the sequence of fluid imbibition into pores of different sizes during the multiphase flow, where less-viscous wetting fluid is preferentially imbibed into larger pores while more-viscous wetting fluid tends to be imbibed into smaller pores. Furthermore, this model provides an avenue to calculate the imbibition rate in pores of different sizes during wettability alteration and capture the non-Darcy effect in micro-and nano-scale pores.

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.

Optimized CUDA Implementation to Improve the Performance of Bundle Adjustment Algorithm on GPUs

The 3D reconstruction pipeline uses the Bundle Adjustment algorithm to refine the camera and point parameters. The Bundle Adjustment algorithm is a compute-intensive algorithm, and many researchers have improved its performance by implementing the algorithm on GPUs. In the previous research work, “Improving Accuracy and Computational Burden of Bundle Adjustment Algorithm using GPUs,” the authors demonstrated first the Bundle Adjustment algorithmic performance improvement by reducing the mean square error using an additional radial distorting parameter and explicitly computed analytical derivatives and reducing the computational burden of the Bundle Adjustment algorithm using GPUs. The naïve implementation of the CUDA code, a speedup of 10× for the largest dataset of 13,678 cameras, 4,455,747 points, and 28,975,571 projections was achieved. In this paper, we present the optimization of the Bundle Adjustment algorithm CUDA code on GPUs to achieve higher speedup. We propose a new data memory layout for the parameters in the Bundle Adjustment algorithm, resulting in contiguous memory access. We demonstrate that it improves the memory throughput on the GPUs, thereby improving the overall performance. We also demonstrate an increase in the computational throughput of the algorithm by optimizing the CUDA kernels to utilize the GPU resources effectively. A comparative performance study of explicitly computing an algorithm parameter versus using the Jacobians instead is presented. In the previous work, the Bundle Adjustment algorithm failed to converge for certain datasets due to several block matrices of the cameras in the augmented normal equation, resulting in rank-deficient matrices. In this work, we identify the cameras that cause rank-deficient matrices and preprocess the datasets to ensure the convergence of the BA algorithm. Our optimized CUDA implementation achieves convergence of the Bundle Adjustment algorithm in around 22 seconds for the largest dataset compared to 654 seconds for the sequential implementation, resulting in a speedup of 30×. Our optimized CUDA implementation presented in this paper has achieved a 3× speedup for the largest dataset compared to the previous naïve CUDA implementation.

COMPLETE KAHLER METRICS WITH POSITIVE HOLOMORPHIC SECTIONAL CURVATURES ON CERTAIN LINE BUNDLES(RELATED TO A COHOMOGENEITY ONE POINT OF VIEW ON A YAU CONJECTURE)

In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.

Analysis of The Effect of Bundled Nursing Intervention on Lung Cancer Patients with a High Risk of PICC-Related Thrombosis

Objective: To explore the effect of bundled nursing intervention on lung cancer patients with a high risk of PICC-related thrombosis. Methods: Eighty-six PICC patients were selected and randomly divided into a control group and an observation group of 43 patients each. The control group received general nursing care and the observation group received bundled nursing intervention based on the control group. The occurrence of venous thrombosis, quality of life score, Zung self-rating depression scale (SDS) score, self-rating anxiety (SAS) score, and nursing satisfaction after treatment were compared between the two groups. Results: The incidence rate of PICC-related venous thrombosis in the observation group (2/4.652%) was lower than that of the control group (13/30.231%) after nursing intervention (P < 0.05). After the intervention, the quality-of-life scores of the observation group were higher than those of the control group (P < 0.001). After the intervention, the SDS and SAS scores of the observation group were lower than those of the control group (P < 0.001). The nursing satisfaction rate of the observation group (41/ 4.652%) was higher than that of the control group (35/18.604%) (P < 0.05). The difference is statistically significant. Conclusion: In the care of lung cancer patients with a high risk of PICC-related thrombosis, bundled nursing care achieved better results.

His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing:a prospective crossover comparison

BACKGROUND His bundle pacing(HBP)and left bundle branch pacing(LBBP)both provide physiologic pacing which maintain left ventricular synchrony.They both improve heart failure(HF)symptoms in atrial fibrillation(AF)patients.We aimed to assess the intra-patient comparison of ventricular function and remodeling as well as leads parameters corresponding to two pacing modalities in AF patients referred for pacing in intermediate term.METHODS Uncontrolled tachycardia AF patients with both leads implantation successfully were randomized to either modality.Echocardiographic measurements,New York Heart Association(NYHA)classification,quality-of-life assessments and leads parameters were obtained at baseline and at each 6-month follow up.Left ventricular function including the left ventricular endosystolic volume(LVESV),left ventricular ejection fraction(LVEF)and right ventricular(RV)function quantified by tricuspid annular plane systolic excursion(TAPSE)were all assessed.RESULTS Consecutively twenty-eight patients implanted with both HBP and LBBP leads successfully were enrolled(69.1±8.1 years,53.6% male,LVEF 59.2%±13.7%).The LVESV was improved by both pacing modalities in all patients(n=23)and the LVEF was improved in patients with baseline LVEF at less than 50%(n=6).The TAPSE was improved by HBP but not LBBP(n=23).CONCLUSION In this crossover comparison between HBP and LBBP,LBBP was found to have an equivalent effect on LV function and remodeling but better and more stable parameters in AF patients with uncontrolled ventricular rates referred for atrioventricular node(AVN)ablation.HBP could be preferred in patients with reduced TAPSE at baseline rather than LBBP.

MAXWELL-EINSTEIN METRICS ON COMPLETIONS OF CERTAIN C* BUNDLES

In this paper,we prove that for some completions of certain fiber bundles there is a Maxwell-Einstein metric conformally related to any given Kahler class.

Bundles策略在预防全麻患者术中低体温中的应用

目的:探讨Bundles策略在预防全麻患者术中低体温中的应用效果。方法:将2021年7月1日~10月31日拟行全麻腹部手术的300例成年患者随机分为G1常规保温组和G2 Bundles保温组各150例,G1常规保温组术中实施常规保温方式,G2 Bundles保温组实施基于循证干预措施和可能引发热量损失途径制订预防术中低温的Bundles干预策略。比较两组不同时间的体温、血氧饱和度(SpO_(2))、心率、血压、呼吸,统计两组寒战、低体温、躁动、术中出血、异常心律事件发生率,记录气管导管拔管时间、PACU停留时间。结果:G2 Bundles保温组术中及术后体温、SpO_(2)、心率、呼吸等均高于G1常规保温组,而同期血压低于G1常规保温组(P<0.05);G2 Bundles保温组寒战、低体温、躁动、术中出血事件、异常心律事件发生率均低于G1常规保温组(P<0.05);G2 Bundles保温组气管导管拔管时间、PACU停留时间均短于G1常规保温组(P<0.01)。结论:将Bundles策略应用于全麻患者术中,有助于预防低体温、调节患者心电指标,减少不良事件。

A Self-calibration Bundle Adjustment Algorithm Based on Block Matrix Cholesky Decomposition Technology

In this study,the problem of bundle adjustment was revisited,and a novel algorithm based on block matrix Cholesky decomposition was proposed to solve the thorny problem of self-calibration bundle adjustment.The innovation points are reflected in the following aspects:①The proposed algorithm is not dependent on the Schur complement,and the calculation process is simple and clear;②The complexities of time and space tend to O(n)in the context of world point number is far greater than that of images and cameras,so the calculation magnitude and memory consumption can be reduced significantly;③The proposed algorithm can carry out self-calibration bundle adjustment in single-camera,multi-camera,and variable-camera modes;④Some measures are employed to improve the optimization effects.Experimental tests showed that the proposed algorithm has the ability to achieve state-of-the-art performance in accuracy and robustness,and it has a strong adaptability as well,because the optimized results are accurate and robust even if the initial values have large deviations from the truth.This study could provide theoretical guidance and technical support for the image-based positioning and 3D reconstruction in the fields of photogrammetry,computer vision and robotics.

Enhancing the awakening to family engagement bundle with music therapy

Survivors of prolonged intensive care unit(ICU)admissions may present undesirable long-term outcomes.In particular,physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation and sedation.One of the strategies to prevent the aforementioned outcomes involves the implementation of a bundle composed by:(1)Spontaneous awakening trial;(2)Spontaneous breathing trial;(3)Choosing proper sedation strategies;(4)Delirium detection and management;(5)Early ICU mobility;and(6)Family engagement(ABCDEF bundle).The components of this bundle contribute in shortening length of stay on mechanical ventilation and reducing incidence of delirium.Since the first description of the ABCDEF bundle,other relevant therapeutic factors have been proposed,such as introducing music therapy.This mini-review describes the current evidence supporting the use of the ABCDEF bundle,as well as current knowledge on the implementation of music therapy.

Characterization of retinal ganglion cell damage at single axon bundle level in mice by visible-light optical coherence tomography fibergraphy

Retinal ganglion cells(RGCs)receive synaptic inputs through their dendritic trees in the inner plexiform layer(IPL)and convey the visual information via their axons which form the optic nerve to the brain(Sanes and Masland,2015).In glaucoma,RGCs and their axons degenerate and die,leading to irreversible vision loss and eventually blindness if left untreated(Quigley,2016).

Effect of mold and core preheating temperature on corrosion resistance of casting Al-12Si alloy U-shaped cooling channel

Temperature has an important impact on the corrosion resistance of mold with cooling channels prepared by casting method.The effect of preheating temperature of the mold and the carbon fiber core on the roughness and corrosion resistance of U-shaped cooling channels made of Al-12Si alloy was examined in depth.The experimental results suggest that as the preheating temperature increased from 273 K to 573 K,the roughness of the inner wall of the cooling channel reduced from 96.6μm to 77.0μm.When the preheating temperature continued to increase to 723 K,the roughness increased to 85.3μm.The wetting between the Al melt and the carbon fiber will reduce micro bubbles and waves on the channel wall as the preheating temperature rises,thereby reducing the roughness.However,with the further increase of preheating temperature,it will increase the solidification time of the Al melt.At this time,the carbon fiber and Al melt will take more time to react,which increases the roughness of the channel wall to a certain extent.The results of exfoliation corrosion show that the larger roughness will aggravate exfoliation corrosion.The prolongation of high temperature reaction time between the carbon fiber and the Al melt will lead to the segregation of Si,which is easy to cause intergranular corrosion.Therefore,reasonable preheating temperature has an important impact on the roughness and corrosion resistance of U-shaped cooling channels.

Model-based deep learning for fiber bundle infrared image restoration

As the representative of flexibility in optical imaging media,in recent years,fiber bundles have emerged as a promising architecture in the development of compact visual systems.Dedicated to tackling the problems of universal honeycomb artifacts and low signal-to-noise ratio(SNR)imaging in fiber bundles,the iterative super-resolution reconstruction network based on a physical model is proposed.Under the constraint of solving the two subproblems of data fidelity and prior regularization term alternately,the network can efficiently“regenerate”the lost spatial resolution with deep learning.By building and calibrating a dual-path imaging system,the real-world dataset where paired low-resolution(LR)-high-resolution(HR)images on the same scene can be generated simultaneously.Numerical results on both the United States Air Force(USAF)resolution target and complex target objects demonstrate that the algorithm can restore high-contrast images without pixilated noise.On the basis of super-resolution reconstruction,compound eye image composition based on fiber bundle is also embedded in this paper for the actual imaging requirements.The proposed work is the first to apply a physical model-based deep learning network to fiber bundle imaging in the infrared band,effectively promoting the engineering application of thermal radiation detection.

Masquerading bundle branch block with intermittent right ventricular pacing in a patient with acute coronary syndrome

The relatively uncommon masquerading bundle branch block(MBBB),a concept initially introduced in 1958 by UNGER,et al.[1]and colleagues,refers to a conduction abnormality that consists of the right bundle branch block(RBBB)pattern in the precordial leads,whereas in the limb leads it resembles a left bundle branch block(LBBB).

Deep learning framework for multi‐round service bundle recommendation in iterative mashup development

Recent years have witnessed the rapid development of service‐oriented computing technologies.The boom of Web services increases software developers'selection burden in developing new service‐based systems such as mashups.Timely recommending appropriate component services for developers to build new mashups has become a fundamental problem in service‐oriented software engineering.Existing service recom-mendation approaches are mainly designed for mashup development in the single‐round scenario.It is hard for them to effectively update recommendation results according to developers'requirements and behaviours(e.g.instant service selection).To address this issue,the authors propose a service bundle recommendation framework based on deep learning,DLISR,which aims to capture the interactions among the target mashup to build,selected(component)services,and the following service to recommend.Moreover,an attention mechanism is employed in DLISR to weigh selected services when rec-ommending a candidate service.The authors also design two separate models for learning interactions from the perspectives of content and invocation history,respectively,and a hybrid model called HISR.Experiments on a real‐world dataset indicate that HISR can outperform several state‐of‐the‐art service recommendation methods to develop new mashups iteratively.

Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery

Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.

Acute hospital-community hospital care bundle for elderly orthopedic surgery patients:A propensity score-matched economic analysis

BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.

Effects of Hydrothermal Environment on the Deformation of the Thin Bamboo Bundle Veneer Laminated Composites

To overcome warping in thin bamboo bundle veneer laminated composites(TBLC),their hydrothermal deformation characteristics were systematically investigated in this study.It was found that TBLCs accelerated the release of internal stress in the thickness direction in a hydrothermal environment,which increased their warpage.TBLCs showed increased warpage in the width and diagonal directions upon increasing the temperature.The warpage of Type E increased by 155.88%and 66.67%in the width and diagonal directions,respectively,when the temperature increased from 25
C to 100
C.The symmetrical TBLC with cross-lay-up and odd layers displayed better hydrothermal stability.We revealed that the deformation of the TBLCs could be regulated under the synergistic effect of water and temperature.These results provide a scientific basis for improving the uniformity of bamboo bundle composite materials and for developing thin bamboo bundle fiber composite materials with designable structures and controllable performance.