Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made impl...Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made implantation an easier process with reduced operative risks and pump-related adverse events. Considering the beneficial effects of these devices in the clinical setting, it seemed logical to address the long-term effect of the continuous flow pumps on diastolic dysfunction. Methods: This study addresses the effect of HeartMate IITM(HMII) support for 284+/-97 days on echocardiographic parameters of diastolic function. Data from fifteen patients was retrospectively studied status post left ventricular assist device (LVAD) implantation. The data at approximately 1-year post implantation was compared with that obtained prior to implantation. Statistical analyses were performed using the Microsoft Excel Program/MSExcel Stats. Echocardiographic measurements were carried out in accordance with the American Society of Echocardiography guidelines. Results: Of all the echocardiographic parameters assessed only E/Ea and calculated left atrial pressure (LAP) showed a statistically significant decrease. Two parameters that showed a trend towards significance are Ea (septal) and global functional index (p = 0.05). Conclusions: Continuous Flow LVAD support appears to improve diastolic dysfunction. This study has limitations in that we used a single type of continuous flow device (HeartMate IITM) and was conducted as a retrospective analysis. Further studies with larger populations and longer support are required to validate this finding.展开更多
Confucius＇s ＂No Child Left Behind＂ education ideology which was put forward two thousand years ago reflected the importance of education for educators and the simple pursuit of educational equity at that time. Educ...Confucius＇s ＂No Child Left Behind＂ education ideology which was put forward two thousand years ago reflected the importance of education for educators and the simple pursuit of educational equity at that time. Education Fair is the current composition content of China＇s basic education dream. Practicing ＂No Child Left Behind＂ education is the cornerstone to achieve China＇s fair education dream. Making implementing continuing education in order to achieve ＂No Child Left Behind＂ equitable education as a research issue, based on analyzing the status and problems of educational equity issues under the perspective of NCLB, the author explored the realistic way through multi-channel and diverse continuing education to achieve ＂No Child Left Behind ＂equitable education.展开更多
Heart transplantation is commonplace, the supply is limited. Many exciting changes in the field of mechanical circulatory support have occurred in the past few years, including the axial flow pump. Left ventricular as...Heart transplantation is commonplace, the supply is limited. Many exciting changes in the field of mechanical circulatory support have occurred in the past few years, including the axial flow pump. Left ventricular assist device(LVAD) therapy is ever evolving. As the use of LVAD therapy increases it is important to understand the indications, surgical considerations and outcomes.展开更多
Continuous flow intersections (CFIs), also known as displaced left turns (DLTs), are a type of alternative intersection designed to improve operations at locations with heavy left-turn movements by reallocating these ...Continuous flow intersections (CFIs), also known as displaced left turns (DLTs), are a type of alternative intersection designed to improve operations at locations with heavy left-turn movements by reallocating these vehicles to the left side of opposing traffic. Currently, simulation is commonly used to evaluate operational performance of CFIs. However, this approach requires significant on-site data collection and is highly dependent on the analyst’s ability to correctly model the intersection and driver behavior. Recently, connected vehicle (CV) trajectory data has become widely available and presents opportunities for the direct measurement of traffic signal performance measures. This study utilizes CV trajectory data to analyze the performance of a CFI located in West Valley City, UT. Over 4500 trajectories and 105,000 GPS points are analyzed from August 2021 weekday data. Trajectories are linear-referenced to generate Purdue Probe Diagrams (PPDs) and extended PPDs to estimate split failures (SF), arrivals on green (AOG), traditional Highway Capacity Manual (HCM) level of service (LOS), and the distribution of stops. The estimated operational performance showed effective progression during the PM peak period at all the critical internal storage areas with AOG levels at exit traffic signals between 83% and 100%. In contrast, all external approaches with longer queue storage areas had AOG values ranging from 2% to 81% during the same time period. The presented analytical techniques and summary graphics provide practitioners with tools to evaluate the performance of any CFI where CV trajectories are available without the need for on-site data collection.展开更多
文摘Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made implantation an easier process with reduced operative risks and pump-related adverse events. Considering the beneficial effects of these devices in the clinical setting, it seemed logical to address the long-term effect of the continuous flow pumps on diastolic dysfunction. Methods: This study addresses the effect of HeartMate IITM(HMII) support for 284+/-97 days on echocardiographic parameters of diastolic function. Data from fifteen patients was retrospectively studied status post left ventricular assist device (LVAD) implantation. The data at approximately 1-year post implantation was compared with that obtained prior to implantation. Statistical analyses were performed using the Microsoft Excel Program/MSExcel Stats. Echocardiographic measurements were carried out in accordance with the American Society of Echocardiography guidelines. Results: Of all the echocardiographic parameters assessed only E/Ea and calculated left atrial pressure (LAP) showed a statistically significant decrease. Two parameters that showed a trend towards significance are Ea (septal) and global functional index (p = 0.05). Conclusions: Continuous Flow LVAD support appears to improve diastolic dysfunction. This study has limitations in that we used a single type of continuous flow device (HeartMate IITM) and was conducted as a retrospective analysis. Further studies with larger populations and longer support are required to validate this finding.
文摘Confucius＇s ＂No Child Left Behind＂ education ideology which was put forward two thousand years ago reflected the importance of education for educators and the simple pursuit of educational equity at that time. Education Fair is the current composition content of China＇s basic education dream. Practicing ＂No Child Left Behind＂ education is the cornerstone to achieve China＇s fair education dream. Making implementing continuing education in order to achieve ＂No Child Left Behind＂ equitable education as a research issue, based on analyzing the status and problems of educational equity issues under the perspective of NCLB, the author explored the realistic way through multi-channel and diverse continuing education to achieve ＂No Child Left Behind ＂equitable education.
文摘Heart transplantation is commonplace, the supply is limited. Many exciting changes in the field of mechanical circulatory support have occurred in the past few years, including the axial flow pump. Left ventricular assist device(LVAD) therapy is ever evolving. As the use of LVAD therapy increases it is important to understand the indications, surgical considerations and outcomes.
文摘Continuous flow intersections (CFIs), also known as displaced left turns (DLTs), are a type of alternative intersection designed to improve operations at locations with heavy left-turn movements by reallocating these vehicles to the left side of opposing traffic. Currently, simulation is commonly used to evaluate operational performance of CFIs. However, this approach requires significant on-site data collection and is highly dependent on the analyst’s ability to correctly model the intersection and driver behavior. Recently, connected vehicle (CV) trajectory data has become widely available and presents opportunities for the direct measurement of traffic signal performance measures. This study utilizes CV trajectory data to analyze the performance of a CFI located in West Valley City, UT. Over 4500 trajectories and 105,000 GPS points are analyzed from August 2021 weekday data. Trajectories are linear-referenced to generate Purdue Probe Diagrams (PPDs) and extended PPDs to estimate split failures (SF), arrivals on green (AOG), traditional Highway Capacity Manual (HCM) level of service (LOS), and the distribution of stops. The estimated operational performance showed effective progression during the PM peak period at all the critical internal storage areas with AOG levels at exit traffic signals between 83% and 100%. In contrast, all external approaches with longer queue storage areas had AOG values ranging from 2% to 81% during the same time period. The presented analytical techniques and summary graphics provide practitioners with tools to evaluate the performance of any CFI where CV trajectories are available without the need for on-site data collection.
