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.

Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation

Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.

Comparison of engineering failures and seismic responses of 500 kV transformer-bushing systems in the 2022 Luding earthquake

Cemented and mechanically clamped types of end fittings(fitting-C and fitting-M)are commonly used in transformer bushings.During the Luding Ms 6.8 earthquake that occurred in China on September 5,2022,all transformer bushings with the two types of end fittings in a 500 kV substation were damaged.Post-earthquake field investigations were conducted,and the failures of the two types of bushings were compared.Two elementary simulation models of the transformer-bushing systems were developed to simulate the engineering failures,and further compute their seismic responses for comparison.The results indicate that the hitch lugs of the connection flange are structurally harmful to seismic resistance.Fitting-M can decrease the bending stiffness of the bushing due to the flexible sealing rubber gasket.Since it provides a more flexible connection that dissipates energy,the peak accelerations and relative displacements at the top of the bushing are significantly lower than those of the bushing with fitting-C.Compared with fitting-C,fitting-M transfers the high-stress areas from the connection flange to the root of the porcelain,so the latter becomes the most vulnerable component.Fitting-M increases the failure risk of the low-strength porcelain,indicating the unsuitability of applying it in high-intensity fortification regions.

Efficacy and safety of Yangxinshi tablet for chronic heart failure:A systematic review and meta-analysis

BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023.Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.RESULTS Twenty RCTs and 1845 patients were included.The meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.

Risk-Balanced Routing Strategy for Service Function Chains of Cyber-Physical Power System Considering Cross-Space Cascading Failure

Cyber-physical power system(CPPS)has significantly improved the operational efficiency of power systems.However,cross-space cascading failures may occur due to the coupling characteristics,which poses a great threat to the safety and reliability of CPPS,and there is an acute need to reduce the probability of these failures.Towards this end,this paper first proposes a cascading failure index to identify and quantify the importance of different information in the same class of communication services.On this basis,a joint improved risk-balanced service function chain routing strategy(SFC-RS)is proposed,which is modeled as a robust optimization problem and solved by column-and-constraint generation(C-CG)algorithm.Compared with the traditional shortest-path routing algorithm,the superiority of SFC-RS is verified in the IEEE 30-bus system.The results demonstrate that SFC-RS effectively mitigates the risk associated with information transmission in the network,enhances information transmission accessibility,and effectively limits communication disruption from becoming the cause of cross-space cascading failures.

Evaluation of G3BP1 in the prognosis of acute and acute-on-chronic liver failure after the treatment of artificial liver support system

BACKGROUND The increased expression of G3BP1 was positively correlated with the prognosis of liver failure.AIM To investigate the effect of G3BP1 on the prognosis of acute liver failure(ALF)and acute-on-chronic liver failure(ACLF)after the treatment of artificial liver support system(ALSS).METHODS A total of 244 patients with ALF and ACLF were enrolled in this study.The levels of G3BP1 on admission and at discharge were detected.The validation set of 514 patients was collected to verify the predicted effect of G3BP1 and the viability of prognosis.RESULTS This study was shown that lactate dehydrogenase(LDH),alpha-fetoprotein(AFP)and prothrombin time were closely related to the prognosis of patients.After the ALSS treatment,the patient’amount of decreased G3BP1 index in difference of G3BP1 between the value of discharge and admission(difG3BP1)<0 group had a nearly 10-fold increased risk of progression compared with the amount of increased G3BP1 index.The subgroup analysis showed that the difG3BP1<0 group had a higher risk of progression,regardless of model for end-stage liver disease high-risk or low-risk group.At the same time,compared with the inflam matory marks[tumor necrosis factor-α,interleukin(IL)-1βand IL-18],G3BP1 had higher discrimination and was more stable in the model analysis and validation set.When combined with AFP and LDH,concordance index was respectively 0.84 and 0.8 in training and validation cohorts.CONCLUSION This study indicated that G3BP1 could predict the prognosis of ALF or ACLF patients treated with ALSS.The combination of G3BP1,AFP and LDH could accurately evaluate the disease condition and predict the clinical endpoint of patients.

Development and validation of a predictive model for acute-onchronic liver failure after transjugular intrahepatic portosystemic shunt

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a cause of acute-onchronic liver failure(ACLF).AIM To investigate the risk factors of ACLF within 1 year after TIPS in patients with cirrhosis and construct a prediction model.METHODS In total,379 patients with decompensated cirrhosis treated with TIPS at Nanjing Drum Tower Hospital from 2017 to 2020 were selected as the training cohort,and 123 patients from Nanfang Hospital were included in the external validation cohort.Univariate and multivariate logistic regression analyses were performed to identify independent predictors.The prediction model was established based on the Akaike information criterion.Internal and external validation were conducted to assess the performance of the model.RESULTS Age and total bilirubin(TBil)were independent risk factors for the incidence of ACLF within 1 year after TIPS.We developed a prediction model comprising age,TBil,and serum sodium,which demonstrated good discrimination and calibration in both the training cohort and the external validation cohort.CONCLUSION Age and TBil are independent risk factors for the incidence of ACLF within 1 year after TIPS in patients with decompensated cirrhosis.Our model showed satisfying predictive value.

Palliative care for end-stage liver disease and acute on chronic liver failure:A systematic review

BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliative care(PC)is pronounced in patients grappling with ESLD and acute on chronic liver failure(ACLF).Unfortunately,the historical underutilization of PC in ESLD patients,despite their substantial needs and those of their family caregivers,underscores the imperative of seamlessly integrating PC principles into routine healthcare practices across the entire disease spectrum.AIM To comprehensively investigate the evidence surrounding the benefits of incorporating PC into the comprehensive care plan for individuals confronting ESLD and/or ACLF.METHODS A systematic search in the Medline(PubMed)database was performed using a predetermined search command,encompassing studies published in English without any restrictions on the publication date.Subsequently,the retrieved studies were manually examined.Simple descriptive analyses were employed to summarize the results.RESULTS The search strategies yielded 721 references.Following the final analysis,32 fulllength references met the inclusion criteria and were consequently incorporated into the study.Meticulous data extraction from these 32 studies was undertaken,leading to the execution of a comprehensive narrative systematic review.The review found that PC provides significant benefits,reducing symptom burden,depressive symptoms,readmission rates,and hospital stays.Yet,barriers like the appeal of transplants and misconceptions about PC hinder optimal utilization.Integrating PC early,upon the diagnosis of ESLD and ACLF,regardless of transplant eligibility and availability,improves the quality of life for these patients.CONCLUSION Despite the substantial suffering and poor prognosis associated with ESLD and ACLF,where liver transplantation stands as the only curative treatment,albeit largely inaccessible,PC services have been overtly provided too late in the course of the illness.A comprehensive understanding of PC's pivotal role in treating ESLD and ACLF is crucial for overcoming these barriers,involving healthcare providers,patients,and caregivers.

Modeling Expected Failure Considering Repair Time and Degradation: A Rail System Case Study

The repeated failures of any equipment or systems are modeled as a renewal process. The management needs an assessment of the number of future failures to allocate the resources needed for fast repairs. Based on the idea of expectation by conditioning, special Volterra-type integral equations are derived for general types of repairs, considering the length of repair and reduced degradation of the idle object. In addition to minimal repair and failure replacement, partial repairs are also discussed when the repair results in reduction of the number of future failures or decreases the effective age of the object. Numerical integration-based algorithm and simulation study are performed to solve the resulting integral equation. Since the geometry degradation in different dimensions of a rail track and controlling and maintaining defects are of importance, a numerical example using the rail industry data is conducted. Expected number of failures of different failure type modes in rail track is calculated within a two-year interval. Results show that within a two-year period, anticipated occurrences of cross level failures, surface failures, and DPI failures are 2.4, 3.8, and 5.8, respectively.

King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever

BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.

Pegaspargase induced multiple organ failure with acute lymphoblastic leukemia:A case report

BACKGROUND The introduction of pegaspargase has greatly advanced the treatment of acute lymphoblastic leukemia(ALL).In the literature,only one case of pegaspargaseinduced multiple organ failure has been reported,and the patient died due to multiple organ failure.CASE SUMMARY Herein,we present a rare case of a 40-year-old man with ALL who developed multiple organ failure after treatment with pegaspargase.The patient had two rare phenomena reflecting poor prognosis,including the discrepancy between clinical manifestations and liver function and persistently low alpha-fetoprotein(AFP)levels from subacute liver failure.However,the patient was successfully treated using a multidisciplinary team approach.CONCLUSION This is the first case report of successful treatment of pegaspargase-induced multiple organ failure.The findings emphasize the importance of a multidisciplinary team approach in treating pegaspargase-induced multiple organ failure.

Failure behaviors of anisotropic shale with a circular cavity subjected to uniaxial compression

Layered rock formations are frequently encountered during the excavation of underground structures. The stability of such structures is influenced not only by the stress concentration caused by the cavities in the strata but also by the anisotropy of the layered rock mass. The interaction between them can lead to critical structural failure, such as rupture, collapse, or significant deformation within the adjacent rock mass, thereby jeopardizing operational safety. However, the coupling law and mechanism between the stress concentration resulting from the cavities and the anisotropy of a layered rock mass remain unclear. In this study, a uniaxial compression test was performed on shale specimens containing a circular hole to investigate the effects of layer inclination and circular holes on the mechanical properties, elastic energy storage, and failure behaviors of these specimens. The failure mechanism of the rock surrounding the hole was analyzed on the basis of the single plane of weakness theory and the Kirsch solution. The test results indicated pronounced anisotropy in the compressive strength, elastic modulus, and elastic strain energy of the specimens, with distinct “V”, “M” and “U”-shaped patterns correlated with varying layer inclination angles. In addition, the combined effect of stress concentration and layer inclination resulted in different failure types, which were classified into four groups according to their failure behavior. Theoretical analysis revealed that failure around circular holes in layered rock is affected by a range of variables, such as layer inclination, layer strength, lateral pressure coefficient, azimuth, and loading stress.

Prognostic value of combined detection of alpha-fetoprotein,plasma prothrombin activity,and serum prealbumin in acute-on-chronic liver failure

BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.

Prediction of posthepatectomy liver failure in patients withhepatocellular carcinoma through ultrasound elastography

In this article,we comment on the article by Cheng et al published in recently.Posthepatectomy liver failure(PHLF)remains a leading cause of hepatectomyrelated mortality and can be evaluated according to liver reserve function.Liver stiffness(LS)measured by ultrasonic elastography and spleen area demonstrate a strong correlation with hepatic proliferation,fibrosis,and portal vein congestion,thus indirectly reflecting liver reserve function.This article highlights a meticulous study aimed at investigating the potential of two-dimensional shear wave elastography in assessing LS,as well as its integration with spleen area,surgical factors,and laboratory indicators,for predicting the risk of PHLF in hepatocellular carcinoma patients.In this article,we discussed the non-invasive elastography modality by ultrasound and magnetic resonance imaging to assess LS.Based on literature data,we subsequently suggested that several risk factors may contribute to PHLF,including excessive intrahepatic neutrophil accumulation,the formation of neutrophil extracellular traps,end-stage liver disease scores,and albumin-bilirubin scores.Therefore,a more comprehensive study incor-porating detailed information requires further investigation.

Predicting post-hepatectomy liver failure using a nomogram based on portal vein width,inflammatory indices,and the albumin-bilirubin score

BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identify potential high-risk PHLF patients as early as possible through preoperative evaluation.AIM To identify risk factors for PHLF and develop a prediction model.METHODS This study included 248 patients with HCC at The Second Affiliated Hospital of Air Force Medical University between January 2014 and December 2023;these patients were divided into a training group(n=164)and a validation group(n=84)via random sampling.The independent variables for the occurrence of PHLF were identified by univariate and multivariate analyses and visualized as nomograms.Ultimately,comparisons were made with traditional models via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS In this study,portal vein width[odds ratio(OR)=1.603,95%CI:1.288-1.994,P≤0.001],the preoperative neutrophil-to-lymphocyte ratio(NLR)(OR=1.495,95%CI:1.126-1.984,P=0.005),and the albumin-bilirubin(ALBI)score(OR=8.868,95%CI:2.144-36.678,P=0.003)were independent risk factors for PHLF.A nomogram prediction model was developed using these factors.ROC and DCA analyses revealed that the predictive efficacy and clinical value of this model were better than those of traditional models.CONCLUSION A new Nomogram model for predicting PHLF in HCC patients was successfully established based on portal vein width,the NLR,and the ALBI score,which outperforms the traditional model.

Using fracture mechanics method to analyze the failure mechanism and equilibrium equation of interfacial loess-mudstone landslides

Loess-mudstone landslides are common in the Loess Plateau.Investigations into the mechanical theory of loess-mudstone landslides have become a challenging undertaking due to the distinctive interfacial properties of loess-mudstone and the unique water sensitivity characteristics of mudstone.Hence,it is imperative to develop innovative mechanical models and mathematical equations specifically tailored to loess-mudstone landslides.In this study,we analyze the fracture mechanism of the loess-mudstone sliding zone using plastic fracture mechanics and develop a unique fracture yield model.To calculate the energy release rate during the expansion of the loess-mudstone interface tip region,the shear fracture energy G is applied,which reflects both the yield failure criterion and the fracture failure criterion.To better understand the instability mechanism of loess-mudstone landslides,equilibrium equations based on G are established for tractive,compressive,and tensile loess-mudstone landslides.Based on the equilibrium equation,the critical length Lc of the sliding zone can be used for the safety evaluation of loess-mudstone landslides.In this way,this study proposes a new method for determining the failure mechanism and equilibrium equation of loessmudstone landslides,which resolves their starting mechanism,mechanical equilibrium equations,and safety evaluation indicators,thus justifying the scientific significance and practical value of this research.

Application of ultrasound elastography and splenic size in predicting post-hepatectomy liver failure:Unveiling new clinical perspectives

In this article,we discuss the study by Cheng et al,published in the World Journal of Gastroenterology,focusing on predictive methods for post-hepatectomy liver failure(PHLF).PHLF is a common and serious complication,and accurate prediction is critical for clinical management.The study examines the potential of ultrasound elastography and splenic size in predicting PHLF.Ultrasound elastography reflects liver functional reserve,while splenic size provides additional predictive value.By integrating these factors with serological markers,we developed a comprehensive prediction model that effectively stratifies patient risk and supports personalized clinical decisions.This approach offers new insights into predicting PHLF.These methods not only assist clinicians in identifying high-risk patients earlier but also provide scientific support for personalized treatment strategies.Future research will aim to validate the model's accuracy with larger sample sizes,further enhancing the clinical application of these non-invasive indicators.

Effect of insomnia on anxiety and depression:Mediation of cognitive failures and moderated mediation of neuroticism

BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.

Dyssynchronous heart failure models in canines:New insights into electrocardiographic,echocardiographic and histological features

Background:We investigated the similarities and differences between two experi-mental approaches using tachy-pacing technology to induce desynchronized heart failure in canines.Methods:A total of eight dogs were included in the experiment,four were tachy-paced in right ventricle apex(RVAP)and 4 were paced in right atrium after the ablation of left bundle branch to achieve left bundle branch block(RAP+LBBB).Three weeks of follow-up were conducted to observe the changes in cardiac function and myocar-dial staining was performed at the end of the experiment.Results:Both experimental approaches successfully established heart failure with reduced ejection fraction models,with similar trends in declining cardiac function.The RAP+LBBB group exhibited a prolonged overall ventricular activation time,de-layed left ventricular activation,and lesser impact on the right ventricle.The RVAP approach led to a reduction in overall right ventricular compliance and right ventricu-lar enlargement.The RAP+LBBB group exhibited significant reductions in left heart compliance(LVGLS,%:RAP+LBBB−12.60±0.12 to−5.93±1.25;RVAP−13.28±0.62 to−8.05±0.63,p=0.023;LASct,%:RAP+LBBB−15.75±6.85 to−1.50±1.00;RVAP−15.75±2.87 to−10.05±6.16,p=0.035).Histological examination revealed more pronounced fibrosis in the left ventricular wall and left atrium in the RAP+LBBB group while the RVAP group showed more prominent fibrosis in the right ventricular myocardium. Conclusion : Both approaches establish HFrEF models with comparable trends. The RVAP group shows impaired right ventricular function, while the RAP+LBBB group exhibits more severe decreased compliance and fibrosis in left ventricle.

A New Approach for the Calculation of Slope Failure Probability with Fuzzy Limit-State Functions

This study presents an innovative approach to calculating the failure probability of slopes by incorporating fuzzylimit-state functions,a method that significantly enhances the accuracy and efficiency of slope stability analysis.Unlike traditional probabilistic techniques,this approach utilizes a least squares support vector machine(LSSVM)optimized with a grey wolf optimizer(GWO)and K-fold cross-validation(CV)to approximate the limit-statefunction,thus reducing computational complexity.The novelty of this work lies in its application to one-dimensional(1D),two-dimensional(2D),and three-dimensional(3D)slope models,demonstrating its versatility andhigh precision.The proposed method consistently achieves error margins within 3%of Monte Carlo simulation(MCS)results,while substantially reducing computation time,particularly for 2D and 3D models.This makes theapproach highly practical for real-world engineering applications.Furthermore,by applying fuzzy mathematics tohandle uncertainties in geotechnical properties,the method offers a more realistic and comprehensive understandingof slope stability.As water is the main factor influencing the stability of slopes,this aspect is investigatedby calculating the phreatic line after the change in water level.Relevant examples are used to show that the failureprobability of a slope under water wading condition can increase by more than 20%(increase rates in 1D,2D and3D conditions being 25%,27%and 31%,respectively)compared with the natural condition.The influence ofdiverse fuzzy membership functions—linear,normal,and Cauchy—on failure probability is also considered.Thisresearch not only provides a strategy for better calculation of the slope failure probability but also pioneers theintegration of computational intelligence,fuzzy logic and fluid-dynamics in geotechnical engineering,presentingan innovative and efficient tool for slope stability analysis.