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.

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:A new era of cardiac resynchronization therapy?

The recent systematic review and meta-analysis provided a comprehensive focus on the current state of cardiac resynchronization therapy(CRT).The authors determined the feasibility of physiological left bundle branch area pacing(LBBAP)in patients indicated for CRT through a careful analysis of trials.They found that LBBAP was associated with significant reductions in QRS duration,New York Heart Association functional class,B-type natriuretic peptide levels,and pacing thresholds as well as improvements in echocardiographic parameters compared to biventricular pacing.

Applying the Shearlet-Based Complexity Measure for Analyzing Mass Transfer in Continuous-Flow Microchannels

Continuous-flow microchannels are widely employed for synthesizing various materials,including nanoparticles,polymers,and metal-organic frameworks(MOFs),to name a few.Microsystem technology allows precise control over reaction parameters,resulting in purer,more uniform,and structurally stable products due to more effective mass transfer manipulation.However,continuous-flow synthesis processes may be accompanied by the emergence of spatial convective structures initiating convective flows.On the one hand,convection can accelerate reactions by intensifying mass transfer.On the other hand,it may lead to non-uniformity in the final product or defects,especially in MOF microcrystal synthesis.The ability to distinguish regions of convective and diffusive mass transfer may be the key to performing higher-quality reactions and obtaining purer products.In this study,we investigate,for the first time,the possibility of using the information complexity measure as a criterion for assessing the intensity of mass transfer in microchannels,considering both spatial and temporal non-uniformities of liquid’s distributions resulting from convection formation.We calculate the complexity using shearlet transform based on a local approach.In contrast to existing methods for calculating complexity,the shearlet transform based approach provides a more detailed representation of local heterogeneities.Our analysis involves experimental images illustrating the mixing process of two non-reactive liquids in a Y-type continuous-flow microchannel under conditions of double-diffusive convection formation.The obtained complexity fields characterize the mixing process and structure formation,revealing variations in mass transfer intensity along the microchannel.We compare the results with cases of liquid mixing via a pure diffusive mechanism.Upon analysis,it was revealed that the complexity measure exhibits sensitivity to variations in the type of mass transfer,establishing its feasibility as an indirect criterion for assessing mass transfer intensity.The method presented can extend beyond flow analysis,finding application in the controlling of microstructures of various materials(porosity,for instance)or surface defects in metals,optical systems and other materials that hold significant relevance in materials science and engineering.

Bunch-length measurement at a bunch-by-bunch rate based on time–frequency-domain joint analysis techniques and its application

This paper presents a new technique for measuring the bunch length of a high-energy electron beam at a bunch-by-bunch rate in storage rings.This technique uses the time–frequency-domain joint analysis of the bunch signal to obtain bunch-by-bunch and turn-by-turn longitudinal parameters,such as bunch length and synchronous phase.The bunch signal is obtained using a button electrode with a bandwidth of several gigahertz.The data acquisition device was a high-speed digital oscilloscope with a sampling rate of more than 10 GS/s,and the single-shot sampling data buffer covered thousands of turns.The bunch-length and synchronous phase information were extracted via offline calculations using Python scripts.The calibration coefficient of the system was determined using a commercial streak camera.Moreover,this technique was tested on two different storage rings and successfully captured various longitudinal transient processes during the harmonic cavity debugging process at the Shanghai Synchrotron Radiation Facility(SSRF),and longitudinal instabilities were observed during the single-bunch accumulation process at Hefei Light Source(HLS).For Gaussian-distribution bunches,the uncertainty of the bunch phase obtained using this technique was better than 0.2 ps,and the bunch-length uncertainty was better than 1 ps.The dynamic range exceeded 10 ms.This technology is a powerful and versatile beam diagnostic tool that can be conveniently deployed in high-energy electron storage rings.

A New Device for Gas-Liquid Flow Measurements Relying on Forced Annular Flow

A new measurement device,consisting of swirling blades and capsule-shaped throttling elements,is proposed in this study to eliminate typical measurement errors caused by complex flow patterns in gas-liquid flow.The swirling blades are used to transform the complex flow pattern into a forced annular flow.Drawing on the research of existing blockage flow meters and also exploiting the single-phase flow measurement theory,a formula is introduced to measure the phase-separated flow of gas and liquid.The formula requires the pressure ratio,Lockhart-Martinelli number(L-M number),and the gas phase Froude number.The unknown parameters appearing in the formula are fitted through numerical simulation using computational fluid dynamics(CFD),which involves a comprehensive analysis of the flow field inside the device from multiple perspectives,and takes into account the influence of pressure fluctuations.Finally,the measurement model is validated through an experimental error analysis.The results demonstrate that the measurement error can be maintained within±8%for various flow patterns,including stratified flow,bubble flow,and wave flow.

Dual-chamber pacing confers better myocardial performance and improves clinical outcomes compared to single-chamber pacing

The deleterious effects of long term right ventricular pacing are increasingly being recognized today.Current clinical practice favors the implantation of dual-chamber permanent pacemaker which maintains atrioventricular synchrony and is associated with better quality of life.However,despite the popular belief and common sense surrounding the superiority of dual-chamber pacing over single chamber pacing,the same has never been conclusively verified in clinical trials.Some observational evidence however,does exists which supports the improved cardiac hemodynamics,lower the rate of atrial fibrillation,heart failure and stroke in dual-chamber pacing compared to single-chamber pacing.In the index study by Haque et al,right ventricular pacing,particularly in ventricular paced,ven-tricular sensed,inhibited response and rate responsive pacemaker adversely im-pacted the left ventricular functions over 9-months compared to dual pacing,dual sensing,dual responsive and rate responsive pacemaker.Although there are key limitations of this study,these findings does support a growing body of evidence reinstating the superiority of dual chamber pacing compared to single chamber pacing.

Design and application of thickness measurement calibration system based on laser displacement sensor

This study aims to improve the accuracy and safety of steel plate thickness calibration.A differential noncontact thickness measurement calibration system based on laser displacement sensors was designed to address the problems of low precision of traditional contact thickness gauges and radiation risks of radiation-based thickness gauges.First,the measurement method and measurement structure of the thickness calibration system were introduced.Then,the hardware circuit of the thickness system was established based on the STM32 core chip.Finally,the system software was designed to implement system control to filter algorithms and human-computer interaction.Experiments have proven the excellent performance of the differential noncontact thickness measurement calibration system based on laser displacement sensors,which not only considerably improves measurement accuracy but also effectively reduces safety risks during the measurement process.The system offers guiding significance and application value in the field of steel plate production and processing.

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 pacing mode.Previous studies have confirmed the feasibility and efficacy of LBBAP for cardiac 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).

Management of a patient with an unusual trajectory of a temporary trans-venous pacing lead

Perforation of the right ventricle during placement of pacing wires is a welldocumented complication and can be potentially fatal.Use of temporary pacemaker,helical screw leads and steroids use prior to implant are recognised as risk factors for development of post-permanent pacemaker effusion.We reported an unusual case of pacing wire perforating interventricular septum into the left ventricle that occurred during the implant procedure performed in another institution.After the preoperative work-up and transfer to our tertiary cardiothoracic centre,the patient underwent successful surgical management.In conclusion,early recognition and timely diagnosis using advanced multimodality imaging can guide surgical intervention and prevent unfavourable consequences of device-related complications.

Enhancing Energy Efficiency with a Dynamic Trust Measurement Scheme in Power Distribution Network

The application of Intelligent Internet of Things(IIoT)in constructing distribution station areas strongly supports platform transformation,upgrade,and intelligent integration.The sensing layer of IIoT comprises the edge convergence layer and the end sensing layer,with the former using intelligent fusion terminals for real-time data collection and processing.However,the influx of multiple low-voltage in the smart grid raises higher demands for the performance,energy efficiency,and response speed of the substation fusion terminals.Simultaneously,it brings significant security risks to the entire distribution substation,posing a major challenge to the smart grid.In response to these challenges,a proposed dynamic and energy-efficient trust measurement scheme for smart grids aims to address these issues.The scheme begins by establishing a hierarchical trust measurement model,elucidating the trust relationships among smart IoT terminals.It then incorporates multidimensional measurement factors,encompassing static environmental factors,dynamic behaviors,and energy states.This comprehensive approach reduces the impact of subjective factors on trust measurements.Additionally,the scheme incorporates a detection process designed for identifying malicious low-voltage end sensing units,ensuring the prompt identification and elimination of any malicious terminals.This,in turn,enhances the security and reliability of the smart grid environment.The effectiveness of the proposed scheme in pinpointing malicious nodes has been demonstrated through simulation experiments.Notably,the scheme outperforms established trust metric models in terms of energy efficiency,showcasing its significant contribution to the field.

Measuring small longitudinal phase shifts via weak measurement amplification

Weak measurement amplification,which is considered as a very promising scheme in precision measurement,has been applied to various small physical quantities estimations.Since many physical quantities can be converted into phase signals,it is interesting and important to consider measuring small longitudinal phase shifts by using weak measurement.Here,we propose and experimentally demonstrate a novel weak measurement amplification-based small longitudinal phase estimation,which is suitable for polarization interferometry.We realize one order of magnitude amplification measurement of a small phase signal directly introduced by a liquid crystal variable retarder and show that it is robust to the imperfection of interference.Besides,we analyze the effect of magnification error which is never considered in the previous works,and find the constraint on the magnification.Our results may find important applications in high-precision measurements,e.g.,gravitational wave detection.

Research progress on micro-force measurement of a hydrate particle system

It remains a great challenge to understand the hydrates involved in phenomena in practical oil and gas systems.The adhesion forces between hydrate particles,between hydrate particles and pipe walls,and between hydrate particles and reservoir particles are essential factors that control the behaviors of clathrate hydrates in different applications.In this review,we summarize the typical micro-force measurement apparatus and methods utilized to study hydrate particle systems.In addition,the adhesion test results,the related understandings,and the applied numerical calculation models are systematically discussed.

Selective his bundle pacing eliminates crochetage sign:A case report

BACKGROUND Crochetage sign is a specific electrocardiographic manifestation of ostium secundum atrial septal defects(ASDs),which is associated with the severity of the left-to-right shunt.Herein,we reported a case of selective his bundle pacing(SHBP)that eliminated crochetage sign in a patient with ostium secundum ASD.CASE SUMMARY A 77-year-old man was admitted with a 2-year history of chest tightness and shortness of breath.Transthoracic echocardiography revealed an ostium secundum ASD.Twelve-lead electrocardiogram revealed atrial fibrillation with a prolonged relative risk interval,incomplete right bundle branch block,and crochetage sign.The patient was diagnosed with an ostium secundum ASD,atrial fibrillation with a second-degree atrioventricular block,and heart failure.The patient was treated with selective his bundle pacemaker implantation.After the procedure,crochetage sign disappeared during his bundle pacing on the electrocardiogram.CONCLUSION S-HBP eliminated crochetage sign on electrocardiogram.Crochetage sign may be a manifestation of a conduction system disorder.

Improved spatio-temporal alignment measurement method for hull deformation

In this paper,an improved spatio-temporal alignment measurement method is presented to address the inertial matching measurement of hull deformation under the coexistence of time delay and large misalignment angle.Large misalignment angle and time delay often occur simultaneously and bring great challenges to the accurate measurement of hull deformation in space and time.The proposed method utilizes coarse alignment with large misalignment angle and time delay estimation of inertial measurement unit modeling to establish a brand-new spatiotemporal aligned hull deformation measurement model.In addition,two-step loop control is designed to ensure the accurate description of dynamic deformation angle and static deformation angle by the time-space alignment method of hull deformation.The experiments illustrate that the proposed method can effectively measure the hull deformation angle when time delay and large misalignment angle coexist.

Unknown Environment Measurement Mapping by Unmanned Aerial Vehicle Using Kalman Filter-Based Low-Cost Estimated Parallel 8-Beam LIDAR

The measurement and mapping of objects in the outer environment have traditionally been conducted using ground-based monitoring systems,as well as satellites.More recently,unmanned aerial vehicles have also been employed for this purpose.The accurate detection and mapping of a target such as buildings,trees,and terrains are of utmost importance in various applications of unmanned aerial vehicles(UAVs),including search and rescue operations,object transportation,object detection,inspection tasks,and mapping activities.However,the rapid measurement and mapping of the object are not currently achievable due to factors such as the object’s size,the intricate nature of the sites,and the complexity of mapping algorithms.The present system introduces a costeffective solution for measurement and mapping by utilizing a small unmanned aerial vehicle(UAV)equipped with an 8-beam Light Detection and Ranging(LiDAR)system.This approach offers advantages over traditional methods that rely on expensive cameras and complex algorithm-based approaches.The reflective properties of laser beams have also been investigated.The system provides prompt results in comparison to traditional camerabased surveillance,with minimal latency and the need for complex algorithms.The Kalman estimation method demonstrates improved performance in the presence of noise.The measurement and mapping of external objects have been successfully conducted at varying distances,utilizing different resolutions.

Measurement and Analysis of Vibration Effect of Free-falling Corner Cube Driving Mechanism in Free Fall Absolute Gravimeter

The vibration interference of the reference corner cube runs through the free flight process of the free-falling corner cube,which is superimposed on the whole laser interference fringes.Thus,it is necessary to solve the interference fringes with the entire fringe to analyze the quantitative influence of vibration on gravity measurements.

A new centrality measure based on neighbor loop structure for network dismantling

Nearly all real-world networks are complex networks and usually are in danger of collapse.Therefore,it is crucial to exploit and understand the mechanisms of network attacks and provide better protection for network functionalities.Network dismantling aims to find the smallest set of nodes such that after their removal the network is broken into connected components of sub-extensive size.To overcome the limitations and drawbacks of existing network dismantling methods,this paper focuses on network dismantling problem and proposes a neighbor-loop structure based centrality metric,NL,which achieves a balance between computational efficiency and evaluation accuracy.In addition,we design a novel method combining NL-based nodes-removing,greedy tree-breaking and reinsertion.Moreover,we compare five baseline methods with our algorithm on ten widely used real-world networks and three types of model networks including Erd€os-Renyi random networks,Watts-Strogatz smallworld networks and Barabasi-Albert scale-free networks with different network generation parameters.Experimental results demonstrate that our proposed method outperforms most peer methods by obtaining a minimal set of targeted attack nodes.Furthermore,the insights gained from this study may be of assistance to future practical research into real-world networks.

A fast forward computational method for nuclear measurement using volumetric detection constraints

Owing to the complex lithology of unconventional reservoirs,field interpreters usually need to provide a basis for interpretation using logging simulation models.Among the various detection tools that use nuclear sources,the detector response can reflect various types of information of the medium.The Monte Carlo method is one of the primary methods used to obtain nuclear detection responses in complex environments.However,this requires a computational process with extensive random sampling,consumes considerable resources,and does not provide real-time response results.Therefore,a novel fast forward computational method(FFCM)for nuclear measurement that uses volumetric detection constraints to rapidly calculate the detector response in various complex environments is proposed.First,the data library required for the FFCM is built by collecting the detection volume,detector counts,and flux sensitivity functions through a Monte Carlo simulation.Then,based on perturbation theory and the Rytov approximation,a model for the detector response is derived using the flux sensitivity function method and a one-group diffusion model.The environmental perturbation is constrained to optimize the model according to the tool structure and the impact of the formation and borehole within the effective detection volume.Finally,the method is applied to a neutron porosity tool for verification.In various complex simulation environments,the maximum relative error between the calculated porosity results of Monte Carlo and FFCM was 6.80%,with a rootmean-square error of 0.62 p.u.In field well applications,the formation porosity model obtained using FFCM was in good agreement with the model obtained by interpreters,which demonstrates the validity and accuracy of the proposed method.

Microstructural and thermal properties of coal measure sandstone subjected to high temperatures

To study the microscopic structure,thermal and mechanical properties of sandstones under the influence of temperature,coal measure sandstones from Southwest China are adopted as the research object to carry out high-temperature tests at 25℃-1000℃.The microscopic images of sandstone after thermal treatment are obtained by means of polarizing microscopy and scanning electron microscopy(SEM).Based on thermogravimetric(TG)analysis and differential scanning calorimetric(DSC)analysis,the model function of coal measure sandstone is explored through thermal analysis kinetics(TAK)theory,and the kinetic parameters of thermal decomposition and the thermal decomposition reaction rate of rock are studied.Through the uniaxial compression experiments,the stress‒strain curves and strength characteristics of sandstone under the influence of temperature are obtained.The results show that the temperature has a significant effect on the microstructure,mineral composition and mechanical properties of sandstone.In particular,when the temperature exceeds 400℃,the thermal fracture phenomenon of rock is obvious,the activity of activated molecules is significantly enhanced,and the kinetic phenomenon of the thermal decomposition reaction of rock appears rapidly.The mechanical properties of rock are weakened under the influence of rock thermal fracture and mineral thermal decomposition.These research results can provide a reference for the analysis of surrounding rock stability and the control of disasters caused by thermal damage in areas such as underground coal gasification(UCG)channels and rock masses subjected to mine fires.