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).

Unilateral branch retinal artery occlusion in association with COVID-19:a case report

Dear Editor,I am Kunihiko Hirosawa of the Department of Ophthalmology at Juntendo University Hospital.I am writing to present a case of concomitant Coronavirus Disease 2019(COVID-19)with branch retinal artery occlusion(BRAO).BRAO presents as a sudden,painless loss of vision on the afflicted side and is most often focal in nature[1].

DCFNet:An Effective Dual-Branch Cross-Attention Fusion Network for Medical Image Segmentation

Automatic segmentation of medical images provides a reliable scientific basis for disease diagnosis and analysis.Notably,most existing methods that combine the strengths of convolutional neural networks(CNNs)and Transformers have made significant progress.However,there are some limitations in the current integration of CNN and Transformer technology in two key aspects.Firstly,most methods either overlook or fail to fully incorporate the complementary nature between local and global features.Secondly,the significance of integrating the multiscale encoder features from the dual-branch network to enhance the decoding features is often disregarded in methods that combine CNN and Transformer.To address this issue,we present a groundbreaking dual-branch cross-attention fusion network(DCFNet),which efficiently combines the power of Swin Transformer and CNN to generate complementary global and local features.We then designed the Feature Cross-Fusion(FCF)module to efficiently fuse local and global features.In the FCF,the utilization of the Channel-wise Cross-fusion Transformer(CCT)serves the purpose of aggregatingmulti-scale features,and the Feature FusionModule(FFM)is employed to effectively aggregate dual-branch prominent feature regions from the spatial perspective.Furthermore,within the decoding phase of the dual-branch network,our proposed Channel Attention Block(CAB)aims to emphasize the significance of the channel features between the up-sampled features and the features generated by the FCFmodule to enhance the details of the decoding.Experimental results demonstrate that DCFNet exhibits enhanced accuracy in segmentation performance.Compared to other state-of-the-art(SOTA)methods,our segmentation framework exhibits a superior level of competitiveness.DCFNet’s accurate segmentation of medical images can greatly assist medical professionals in making crucial diagnoses of lesion areas in advance.

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.

A Light and Simplified Branch Bending Method for Young Pear Trees

Aiming at high cost and low efficiency of conventional branch bending method in the modern intensive planting and labor-saving cultivation mode of young pear trees,this paper provides a new branch bending method with wide source of raw materials,cheap price and simple operation,which is also suitable for the management of low-age branches in the process of high grafting and upgrading of traditional big trees.

Adsorption Effect of Phosphate Modified Grape Branch Biochar on Cd2

Two major problems facing agriculture at present are soil pollution and the disposal of solid wastes generated during plant growth. The method of preparing biochar from solid wastes produced by plants is a means of maximizing the use of resources to combat the problem of soil pollution. In this study, we did not choose straw in the traditional sense but the waste branches from grape pruning, which has higher lignin cellulose, as the raw material. The biochar derived from grape branches pyrolyzed at 300˚C for two hours was utilized as a raw material to prepare modified biochar with varying concentrations of phosphoric acid. The adsorption performance and mechanism of Cd2 were explored through experiments involving different concentrations, addition amounts, reaction times, kinetic analyses, and isothermal adsorption tests. The findings indicated that the optimal adsorption of Cd2 occurred with a 20% phosphoric acid concentration, achieving the highest adsorption rate of 84.62%. At a dosage of 10 g/L, the maximum adsorption capacity reached 7.02 mg/g. The adsorption kinetics and isothermal adsorption of Cd2 on biochar modified with 0.2% phosphoric acid (0.2 PB) closely followed the pseudo-first-order kinetics model (R2 > 0.98) and the Freundlich model (R2 > 0.97), respectively. This suggests that the adsorption process involves both physical and chemical mechanisms. SEM and FTIR analyses revealed that phosphoric acid modification primarily increased the biochar’s specific surface area and enhanced certain original functional groups. The adsorption process predominantly involved rapid ion diffusion and chemical adsorption, as confirmed by kinetic analysis and isothermal adsorption model analysis. In summary, the adsorption efficiency of 0.2 PB significantly improved, showing potential and feasibility for heavy metal remediation in soil. This supports the environmentally friendly concept of “treating waste with waste”.

Layout Design of Conductive Heat Channel by Emulating Natural Branch Systems

To design effective and easy-to-manufacture conductive heat channels, a heuristic method by emulating the natural branch systems is suggested. The design process of the method is divided into two steps, which are the principal channel design and the lateral channel design. During the process, the width of each channel is controlled by the bifurcation law, and the end point of the channel is located at the point with the maximum temperature while the start points of the principal channel and the lateral channel are respectively determined by the location of the heat sink and the law of the minimum thermal resistance. Four design examples with different boundary conditions are studied by the suggested method, and the design results are compared with that of the traditional structural topology optimization method. Not only lower maximum temperature and relatively uniform distribution of temperature are obtained by the suggested method, but also straight channels are achieved without gray element, which is easy to manufacture. The suggested method inspired by the natural branch systems can provide an effective solution for heat channel design in the heat dissipation structures.

Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt to reduce hepatic encephalopathy

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) is currently used for the treatment of complications of portal hypertension. The incidence of hepatic encephalopathy(HE) remains a problem in TIPS placement. It has been reported that the right branch mainly receives superior mesenteric venous blood while the left branch mainly receives blood from the splenic vein. We hypothesized that targeted puncture of the left portal vein would divert the non-nutritive blood from the splenic vein into the TIPS shunt; therefore, targeted puncture of the left branch of the intrahepatic portal vein during TIPS may reduce the risk of HE.AIM To evaluate the influence of targeted puncture of left branch of portal vein in TIPS on HE.METHODS A retrospective analysis of 1244 patients with portal-hypertension-related complications of refractory ascites or variceal bleeding who underwent TIPS from January 2000 to January 2013 was performed. Patients were divided into group A(targeting left branch of portal vein, n = 937) and group B(targeting right branch of portal vein, n = 307). TIPS-related HE and clinical outcomes were analyzed.RESULTS The symptoms of ascites and variceal bleeding disappeared within a short time.By the endpoint of follow-up, recurrent bleeding and ascites did not differ significantly between groups A and B(P = 0.278, P = 0.561, respectively).Incidence of HE differed significantly between groups A and B at 1 mo(14.94% vs36.80%, χ~2 = 4.839, P = 0.028), 3 mo(12.48% vs 34.20%, χ~2 = 5.054, P = 0.025), 6 mo(10.03% vs 32.24%, χ~2 = 6.560, P = 0.010), 9 mo(9.17% vs 31.27%, χ~2 = 5.357, P =0.021), and 12 mo(8.21% vs 28.01, χ~2 = 3.848, P = 0.051). There were no significant differences between groups A and B at 3 years(6.61% vs 7.16%, χ~2 = 1.204, P =0.272) and 5 years(5.01% vs 6.18%, χ~2 = 0.072, P = 0.562). The total survival rate did not differ between groups A and B(χ~2 = 0.226, P = 0.634, log-rank test).CONCLUSION Targeted puncture of the left branch of the intrahepatic portal vein during TIPS may reduce the risk of HE but has no direct influence on prognosis of portalhypertension-related complications.

Analysis of the role of branching angle in the dynamic rupture process on a 3-D branching fault system

The fault branching phenomenon,which may heavily influence the patterns of rupture propagation in fault systems,is one of the geometric complexities of fault systems that is widely observed in nature.In this study,we investigate the effect of the branching angle on the rupture inclination and the interaction between branch planes in two-fork branching fault systems by numerical simulation and theoretical analysis based on Mohr’s circle.A friction law dependent on normal stress is used,and special attention is paid to studying how ruptures on the upper and lower branch planes affect the stress and rupture on each other separately.The results show that the two branch planes affect each other in different patterns and that the intensity of the effect changes with the branching angle.The rupture of the lower branch plane has a negative effect on the rupture of the upper branch plane in the case of a small branching angle but has almost no negative effect in the case of a large branching angle.The rupture of the upper branch plane,however,suppresses the rupture of the lower branch plane regardless of whether the branching angle is large or small.

Parallelization of a Branch and Bound Algorithm on Multicore Systems

The general m-machine permutation flowshop problem with the total flow-time objective is known to be NP-hard for m ≥ 2. The only practical method for finding optimal solutions has been branch-and-bound algorithms. In this paper, we present an improved sequential algorithm which is based on a strict alternation of Generation and Exploration execution modes as well as Depth-First/Best-First hybrid strategies. The experimental results show that the proposed scheme exhibits improved performance compared with the algorithm in [1]. More importantly, our method can be easily extended and implemented with lightweight threads to speed up the execution times. Good speedups can be obtained on shared-memory multicore systems.

PpTCP18 is upregulated by lncRNA5 and controls branch number in peach (Prunus persica) through positive feedback regulation of strigolactone biosynthesis

Branch number is an important agronomic trait in peach(Prunus persica)trees because plant architecture affects fruit yield and quality.Although breeders can select varieties with different tree architecture,the biological mechanisms underlying architecture remain largely unclear.In this study,a pillar peach(‘Zhaoshouhong’)and a standard peach(‘Okubo’)were compared.‘Zhaoshouhong’was found to have significantly fewer secondary branches than‘Okubo’.Treatment with the synthetic strigolactone(SL)GR24 decreased branch number.Transcriptome analysis indicated that PpTCP18(a homologous gene of Arabidopsis thaliana BRC1)expression was negatively correlated with strigolactone synthesis gene expression,indicating that PpTCP18 may play an important role in peach branching.Yeast one-hybrid,electrophoretic mobility shift,dual-luciferase assays and PpTCP18-knockdown in peach leaf buds indicated that PpTCP18 could increase expression of PpLBO1,PpMAX1,and PpMAX4.Furthermore,transgenic Arabidopsis plants overexpressing PpTCP18 clearly exhibited reduced primary rosette-leaf branches.Moreover,lncRNA sequencing and transient expression analysis revealed that lncRNA5 targeted PpTCP18,significantly increasing PpTCP18 expression.These results provide insights into the mRNA and lncRNA network in the peach SL signaling pathway and indicate that PpTCP18,a transcription factor downstream of SL signaling,is involved in positive feedback regulation of SL biosynthesis.This role of PpTCP18 may represent a novel mechanism in peach branching regulation.Our study improves current understanding of the mechanisms underlying peach branching and provides theoretical support for genetic improvement of peach tree architecture.

Nonreciprocity of energy transfer in a nonlinear asymmetric oscillator system with various vibration states

The nonreciprocity of energy transfer is constructed in a nonlinear asymmetric oscillator system that comprises two nonlinear oscillators with different parameters placed between two identical linear oscillators.The slow-flow equation of the system is derived by the complexification-averaging method.The semi-analytical solutions to this equation are obtained by the least squares method,which are compared with the numerical solutions obtained by the Runge-Kutta method.The distribution of the average energy in the system is studied under periodic and chaotic vibration states,and the energy transfer along two opposite directions is compared.The effect of the excitation amplitude on the nonreciprocity of the system producing the periodic responses is analyzed,where a three-stage energy transfer phenomenon is observed.In the first stage,the energy transfer along the two opposite directions is approximately equal,whereas in the second stage,the asymmetric energy transfer is observed.The energy transfer is also asymmetric in the third stage,but the direction is reversed compared with the second stage.Moreover,the excitation amplitude for exciting the bifurcation also shows an asymmetric characteristic.Chaotic vibrations are generated around the resonant frequency,irrespective of which linear oscillator is excited.The excitation threshold of these chaotic vibrations is dependent on the linear oscillator that is being excited.In addition,the difference between the energy transfer in the two opposite directions is used to further analyze the nonreciprocity in the system.The results show that the nonreciprocity significantly depends on the excitation frequency and the excitation amplitude.

Branched fibrous amidoxime adsorbent with ultrafast adsorption rate and high amidoxime utilization for uranium extraction from seawater

Direct collection of uranium from low uranium systems via adsorption remains challenging.Fibrous sorbent materials with amidoxime(AO)groups are promising adsorbents for uranium extraction from seawater.However,low AO adsorption group utilization remains an issue.We herein fabricated a branched structure containing AO groups on polypropylene/polyethylene spun-laced nonwoven(PP/PE SNW)fibers using grafting polymerization induced by radiation(RIGP)to improve AO utilization.The chemical structures,thermal properties,and surface morphologies of the raw and treated PP/PE SNW fibers were studied.The results show that an adsorptive functional layer with a branching structure was successfully anchored to the fiber surface.The adsorption properties were investigated using batch adsorption experiments in simulated seawater with an initial uranium concentration of 500μg·L^(−1)(pH 4,25℃).The maximum adsorption capacity of the adsorbent material was 137.3 mg·g^(−1)within 24 h;moreover,the uranyl removal reached 96%within 240 min.The adsorbent had an AO utilization rate of 1/3.5 and was stable over a pH range of 4–10,with good selectivity and reusability,demonstrating its potential for seawater uranium extraction.

Enhanced adsorption of target branched compounds including antibiotic norfloxacin frameworks on mild steel surface for efficient protection: An experimental and molecular modelling study

In this study, an approach was proposed to employ new target branched compounds(TBCs) including multiple antibiotic norfloxacin frameworks for intensified adsorption films to achieve super protection of mild steel in HCl medium. Thus, the TBCs containing bis/tri norfloxacin skeletons were synthesized by multi-step preparation route. In addition, the reference linear compound(RLC) including a single norfloxacin part was also synthesized. The chemical structures of these compounds were confirmed by various means. It was demonstrated that the TBCs could form the tough adsorption films on the surface of mild steel, which could be processed mainly through chemisorption effect. The electrochemical analysis suggested that the TBCs displayed superior corrosion inhibition performance for low carbon steel in1.0 mol·L^(-1) HCl solution over the RLC(RLC, 87.80%;TBC1, 97.63%;TBC2, 98.35%), which was further understood by the molecular modelling. The isotherm adsorption plots were employed to analyze the spontaneous adsorption process of the TBCs on low carbon steel surface, and a prominent chemisorption could be inferred by the standard Gibbs free energy changes of the adsorption.

Research Progress and Application of Plant Branching

Plant branching development plays an important role in plant morphogenesis(aboveground plant type),the number and angle of branches are important agronomic characters that determine crop plant type.Effective branches determine the number of panicles or pods of crops and then control the yield of crops.With the rapid development of plant genomics and molecular genetics,great progress has been made in the study of branching development.In recent years,a series of important branching-related genes have been validated from Arabidopsis thaliana,rice,pea,tomato and maize mutants.It is reviewed that plant branching development is controlled by genetic elements and plant hormones,such as auxin,cytokinin and lactones(or lactone derivatives),as well as by environment and genetic elements.Meanwhile,shoot architecture in crop breeding was discussed in order to provide theoretical basis for the study of crop branching regulation.

The Making of an Inclusive Museum:The Example of‘General Branch Museum System’of Datong Museum,China

A museum is a not-for-profit,permanent institution in the service of society that researches,collects,conserves,interprets and exhibits tangible and intangible heritage.In order to effectively integrate public cultural resources,many museums at home and abroad have begun to explore general branch museum system.This mode develops rapidly in China and forms many models.However,the general branch museum system of each museum has its own characteristics.Based on this,this paper mainly introduced the example of“general branch museum system”of Datong Museum,China.For the time being,Datong Museum is implementing“general branch museum system”.Datong Museum is located in Shanxi Province,China.It is a comprehensive museum and now it is a national first-level museum.There are more than 170,000 cultural relics in Datong Museum.Besides the general one,the other nine branches have opened to the public.It is different from the National Museum Wales,the Smithsonian Institution,and the Cathedral Museum Complex in Toscana District.Led by theme of integration of the main,not only each of the nine branch museums bears its own specific theme and distinct characteristics,but they also link and complement each other.In future,we will further explore the exhibitions of other thematic displays to tell the complete history of Datong,and supplement the untold historical stories,as well as boost recognition of cultural identity and cultural confidence of the public.

Repair and regeneration of peripheral nerve injuries that ablate branch points

The peripheral nervous system has an extensive branching organization, and peripheral nerve injuries that ablate branch points present a complex challenge for clinical repair. Ablations of linear segments of the PNS have been extensively studied and routinely treated with autografts, acellular nerve allografts, conduits, wraps, and nerve transfers. In contrast, segmental-loss peripheral nerve injuries, in which one or more branch points are ablated so that there are three or more nerve endings, present additional complications that have not been rigorously studied or documented. This review discusses:(1) the branched anatomy of the peripheral nervous system,(2) case reports describing how peripheral nerve injuries with branched ablations have been surgically managed,(3) factors known to influence regeneration through branched nerve structures,(4) techniques and models of branched peripheral nerve injuries in animal models, and(5) conclusions regarding outcome measures and studies needed to improve understanding of regeneration through ablated branched structures of the peripheral nervous system.

Anomalous diffusion in branched elliptical structure

Diffusion in narrow curved channels with dead-ends as in extracellular space in the biological tissues,e.g.,brain,tumors,muscles,etc.is a geometrically induced complex diffusion and is relevant to different kinds of biological,physical,and chemical systems.In this paper,we study the effects of geometry and confinement on the diffusion process in an elliptical comb-like structure and analyze its statistical properties.The ellipse domain whose boundary has the polar equationρ(θ)=b/√1−e^(2)cos^(2)θ with 0<e<1,θ∈[0,2π],and b as a constant,can be obtained through stretched radius r such that Υ=rρ(θ)with r∈[0,1].We suppose that,for fixed radius r=R,an elliptical motion takes place and is interspersed with a radial motion inward and outward of the ellipse.The probability distribution function(PDF)in the structure and the marginal PDF and mean square displacement(MSD)along the backbone are obtained numerically.The results show that a transient sub-diffusion behavior dominates the process for a time followed by a saturating state.The sub-diffusion regime and saturation threshold are affected by the length of the elliptical channel lateral branch and its curvature.

Diagnostic value of methylated branched chain amino acid transaminase 1/IKAROS family zinc finger 1 for colorectal cancer

BACKGROUND The diagnostic value of combined methylated branched chain amino acid transaminase 1(BCAT1)/IKAROS family zinc finger 1(IKZF1)in plasma for colorectal cancer(CRC)has been explored since 2015.Recently,several related studies have published their results and showed its diagnostic efficacy.AIM To analyze the diagnostic value of methylated BCAT1/IKZF1 in plasma for screening and postoperative follow-up of CRC.METHODS The candidate studies were identified by searching the PubMed,Embase,Cochrane Library,CNKI,and Wanfang databases from May 31,2003 to June 1,2023.Sensitivity,specificity,and diagnostic accuracy were calculated by merging ratios or means.RESULTS Twelve eligible studies were included in the analysis,involving 6561 participants.The sensitivity of methylated BCAT1/IKZF1 in plasma for CRC diagnosis was 60%[95%confidence interval(CI)53-67]and specificity was 92%(95%CI:90-94).The positive and negative likelihood ratios were 8.0(95%CI:5.8-11.0)and 0.43(95%CI:0.36-0.52),respectively.Diagnostic odds ratio was 19(95%CI:11-30)and area under the curve was 0.88(95%CI:0.85-0.91).The sensitivity and specificity for CRC screening were 64%(95%CI:59-69)and 92%(95%CI:91-93),respectively.The sensitivity and specificity for recurrence detection during follow-up were 54%CONCLUSION The detection of methylated BCAT1/IKZF1 in plasma,as a non-invasive detection method of circulating tumor DNA,has potential CRC diagnosis,but the clinical application prospect needs to be further explored.