Search Results (9)

Background/Objectives: The diagnosis of coronary artery spasm (CAS) frequently requires invasive provocation testing, typically utilising acetylcholine (ACh). Although the left coronary artery (LCA) is routinely assessed as a part of the testing protocol, assessment of the right coronary artery (RCA) is often avoided since it requires the insertion of a temporary pacing wire. We sought to compare the prevalence of inducible CAS in the LCA and RCA, among patients with CAS undergoing multivessel spasm provocation testing with ACh. Methods: A local multi-institutional ANOCA (angina and non-obstructive coronary arteries) database was analysed, which included 316 patients with angina and suspected CAS who underwent provocation testing (single vessel n = 266, multivessel n = 50) with incremental bolus doses of intracoronary ACh (25, 50, 100 μg in the LCA; 25, 50 μg in the RCA). CAS was defined as >90% constriction of the epicardial coronary artery as assessed visually on coronary angiography. Results: In the 50 patients (55 ± 10 years, 77% female) who underwent multivessel spasm provocation testing, CAS was induced in 20 patients (40%), with ACh provoking CAS only in the LCA system in 45%, only in the RCA system in 35%, and both LCA/RCA in 20%. Conclusions: These findings demonstrate that assessing only the LCA may miss up to one-third of CAS cases. Therefore, it is essential to routinely evaluate the RCA, particularly when no inducible spasm is detected in the LCA. Full article

If we look at the chronology of transitions between successive stages of industrialization, it is impossible not to notice a significant acceleration. There were 100 years between the industrial revolutions from 2.0 to 3.0, and only half a century passed from the conventional 3.0 to 4.0. Assuming that progress will inevitably continue to accelerate, and given that 2011 is the set date for the start of the fourth industrial revolution, we can expect Industry 5.0 by 2035. In recent years, Industrial Internet of Things (IIoT) applications proliferated, which include multiple network elements connected by wired and wireless communication technologies, as well as sensors and actuators placed in strategic locations. The significant pace of development of the industry of advantages in predicting threats to infrastructure will be related to the speed of analyzing the huge amount of data on threats collected not locally, but globally. This article sheds light on the potential role of artificial intelligence (AI) techniques, including machine learning (ML) and deep learning (DL), to significantly impact IIoT cyber threat prediction in Industry 5.0. Full article

This article presents a novel approach to designing and validating a fully electronic braking pedal, addressing the growing integration of electronics in vehicles. With the imminent rise of brake-by-wire (BBW) technology, the brake pedal requires electronification to keep pace with industry advancements. This research explores technologies and features for the next-generation pedal, including low-power consumption electronics, cost-effective sensors, active adjustable pedals, and a retractable pedal for autonomous vehicles. Furthermore, this research brings the benefits of the water injection technique (WIT) as the base for manufacturing plastic pedal brakes towards reducing cost and weight while enhancing torsional stiffness. Communication with original equipment manufacturers (OEMs) has provided valuable insights and feedback, facilitating a productive exchange of ideas. The findings include two sensor prototypes utilizing inductive technology and printed-ink gauges. Significantly, reduced power consumption was achieved in a Hall-effect sensor already in production. Additionally, a functional BBW prototype was developed and validated. This research presents an innovative approach to pedal design that aligns with current electrification trends and autonomous vehicles. It positions the braking pedal as an advanced component that has the potential to redefine industry standards. In summary, this research significantly contributes to the electronic braking pedal technology presenting the critical industry needs that have driven technical studies and progress in the field of sensors, electronics, and materials, highlighting the challenges that component manufacturers will inevitably face in the forthcoming years. Full article

Coxiella burnetii is one of the most common causes of blood culture-negative infective endocarditis (IE). However, only a few cases of cardiac implantable electronic devices (CIED) infection have been reported in the literature. Herein, we present a case of CIED-related blood culture-negative infection attributed to C. burnetii. A 54-year-old male was admitted to our hospital due to prolonged fatigue, a low-grade fever lasting more than a month, and weight loss. Three years ago, he received an implantable cardiac defibrillator (ICD) as a primary prevention measure against sudden cardiac death. An initial transthoracic and transesophageal echocardiography showed a dilated left ventricle with severely impaired systolic function, while the ventricular pacing wire was inside the right ventricle with a large echogenic mass (2.2 × 2.5 cm) adherent to it. Repeated blood cultures were negative. The patient underwent transvenous lead extraction. A transesophageal echocardiography after the extraction revealed multiple vegetations on the tricuspid valve with moderate to severe valve regurgitation. A surgical replacement of the tricuspid valve was determined after a multidisciplinary heart team approach. Serology tests showed increased IgG antibodies in phase I (1:16,394) and phase II (1:8192), and a definite diagnosis of CIED infection was made based on the serological tests. Full article

Background: The current practices regarding the management of antithrombotic therapy during the early postoperative course of cardiac surgery are not well described. Methods: An online survey with multiple-choice questions was sent to cardiac anesthesiologists and intensivists from France. Results: The response rate was 27% (n = 149), with 2/3 of the respondents having less than 10 years of experience. A total of 83% of the respondents reported using an institutional protocol for antithrombotic management. A total of 85% (n = 123) of the respondents regularly used low-molecular-weight heparin (LMWH) during the immediate postoperative course. For 23%, 38%, 9%, and 22% of the physicians, LMWH administration was initiated between the 4th and 6th hour, between the 6th and 12th hour, between the 12th and 24th hour, and on postoperative day 1, respectively. The main reasons for not using LMWH (n = 23) were a perceived increased risk of perioperative bleeding (22%), poor reversal compared with unfractionated heparin (74%), local habits and the refusal of surgeons (57%), and its overly complex management (35%). The modalities of LMWH use were widely varied among the physicians. Chest drains were mostly removed within 3 days of surgery with an unchanged dose of antithrombotic therapy. Regarding temporary epicardial pacing wire removal anticoagulation, 54%, 30%, and 17% of the respondents left the dose unchanged, suspended the anticoagulation, or lowered the anticoagulation dose, respectively. Conclusion: LMWH was inconsistently used after cardiac surgery. Further research is warranted to provide high-quality evidence regarding the benefits and safety of LMWH use early after cardiac surgery. Full article

Increasing operators’ experience and improvement of the technique have resulted in a drastic reduction in complications following transcatheter aortic valve replacement (TAVR) in patients with lower surgical risk. In parallel, the procedure was considerably simplified, with a routine default approach including local anesthesia in the catheterization laboratory, percutaneous femoral approach, radial artery as the secondary access, prosthesis implantation without predilatation, left ventricle wire pacing and early discharge. Thus, the “simplified” TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety. The minimalist strategy must not become dogmatic and careful pre-, per- and post-procedural evaluation of patients with well-defined protocols guarantee optimal care following TAVR. This review aims to evaluate the benefits and limits of the simplified TAVR procedure in a current and future vision. Full article

We propose a method to achieve autonomous gait transition according to speed for a quadruped robot pacing at medium speeds. We verified its effectiveness through experiments with the simulation model and the robot we developed. In our proposed method, a central pattern generator (CPG) is applied to each leg. Each leg is controlled by a PD controller based on output from the CPG. The four CPGs are coupled, and a hard-wired CPG network generates a pace pattern by default. In addition, we feed the body tilt back to the CPGs in order to adapt to the body oscillation that changes according to the speed. As a result, our model and robot achieve stable changes in speed while autonomously generating a walk at low speeds and a rotary gallop at high speeds, despite the fact that the walk and rotary gallop are not preprogramed. The body tilt angle feedback is the only factor involved in the autonomous generation of gaits, so it can be easily used for various quadruped robots. Therefore, it is expected that the proposed method will be an effective control method for quadruped robots. Full article

Background: Rapid ventricular pacing is mandatory for optimal balloon positioning during aortic valvuloplasty (BAV) in patients with severe aortic stenosis. We aimed to assess the safety and efficacy of direct left ventricular (LV) guidewire pacing in comparison with regular pacing induced by temporary pacemaker (PM) placement in the right ventricle. Methods: Direct rapid LV pacing was provided with a 0.035″ guidewire. Baseline clinical characteristics, echocardiographic and procedural data, as well as complication rates, were compared between the two groups. Results: A total of 202 patients undergoing BAV were enrolled (49.5% with direct LV guidewire pacing). The pacing success rate was 100%. In the direct LV guidewire pacing group, we found a lower radiation dose, shorter fluoroscopy and overall procedural time (0.16 vs. 0.28 Gy, p = 0.02; 5.4 vs. 10.3 min, p = 0.01; 17 vs. 25 min, p = 0.01; respectively). In addition, the complication rate was lower in that group (cardiac tamponades, vascular access site complications, blood transfusions rate, and in-hospital mortality: 0% vs. 3.9%; 4.0% vs. 15.7%; 2.0% vs. 12.7%; 2.0% vs. 9.8%, p = 0.01 for all, respectively). Conclusions: Direct rapid LV guidewire pacing is a simple, safe and effective option for BAV with a reduced complication rate compared to a temporary PM placed in the right ventricle. Full article

To meet the performance and scalability demands of the fast-paced technological growth towards exascale and big data processing with the performance bottleneck of conventional metal-based interconnects (wireline), alternative interconnect fabrics, such as inhomogeneous three-dimensional integrated network-on-chip (3D NoC) and hybrid wired-wireless network-on-chip (WiNoC), have emanated as a cost-effective solution for emerging system-on-chip (SoC) design. However, these interconnects trade off optimized performance for cost by restricting the number of area and power hungry 3D routers and wireless nodes. Moreover, the non-uniform distributed traffic in a chip multiprocessor (CMP) demands an on-chip communication infrastructure that can avoid congestion under high traffic conditions while possessing minimal pipeline delay at low-load conditions. To this end, in this paper, we propose a low-latency adaptive router with a low-complexity single-cycle bypassing mechanism to alleviate the performance degradation due to the slow 2D routers in such emerging hybrid NoCs. The proposed router transmits a flit using dimension-ordered routing (DoR) in the bypass datapath at low-loads. When the output port required for intra-dimension bypassing is not available, the packet is routed adaptively to avoid congestion. The router also has a simplified virtual channel allocation (VA) scheme that yields a non-speculative low-latency pipeline. By combining the low-complexity bypassing technique with adaptive routing, the proposed router is able to balance the traffic in hybrid NoCs to achieve low-latency communication under various traffic loads. Simulation shows that the proposed router can reduce applications’ execution time by an average of 16.9% compared to low-latency routers, such as SWIFT. By reducing the latency between 2D routers (or wired nodes) and 3D routers (or wireless nodes), the proposed router can improve the performance efficiency in terms of average packet delay by an average of $45\%$ (or $50\%$ ) in 3D NoCs (or WiNoCs). Full article