Mechanisms of left ventricular systolic dysfunction in light chain amyloidosis: a multiparametric cardiac MRI study.

Background: Cardiac systolic dysfunction is a poor prognostic marker in light-chain (AL) cardiomyopathy, a primary interstitial disorder; however, its pathogenesis is poorly understood. Purpose: This study aims to analyze the effects of extracellular volume (ECV) expansion, a surrogate marker of amyloid burden on myocardial blood flow (MBF), myocardial work efficiency (MWE), and left ventricular (LV) systolic dysfunction in AL amyloidosis. Methods: Subjects with biopsy-proven AL amyloidosis were prospectively enrolled (April 2016-June 2021; Clinicaltrials.gov ID NCT02641145) and underwent cardiac magnetic resonance imaging (MRI) to quantify rest MBF by perfusion imaging, LV ejection fraction (LVEF) by cine MRI, and ECV by pre- and post-contrast T1 mapping. The MWE was estimated as external cardiac work from the stroke volume and mean arterial pressure normalized to the LV myocardial mass. Results: Rest MBF in 92 subjects (62 ± 8 years, 52 men) with AL amyloidosis averaged 0.87 ± 0.21 ml/min/g and correlated with MWE (r = 0.42; p < 0.001). Rest MBF was similarly low in subjects with sustained hematologic remission after successful AL amyloidosis therapy (n = 21), as in those with recently diagnosed AL amyloidosis. Both MBF and MWE decreased by ECV tertile (p < 0.01 for linear trends). The association of ECV with MWE comprised a direct effect (84% of the total effect; p < 0.001) on MWE from adverse interstitial remodeling assessed by ECV and an indirect effect (16% of the total effect; p < 0.001) mediated by MBF. There was a significant base-to-apex gradient of rest MBF in subjects with higher amyloid burden. Conclusions: In AL amyloidosis, both MBF and MWE decrease as cardiac amyloid burden and ECV expansion increase. Both structural and vascular changes from ECV expansion and myocardial amyloid burden appear to contribute to lower MWE.

A novel method for the evaluation of right ventricular dysfunction in acute pulmonary embolism: Myocardial work indices.

PURPOSE: The presence of right ventricular dysfunction indicates a higher risk status in patients with pulmonary embolism (PE). The RV strain evaluated by speckle-tracking echocardiography seems to be more reliable method in the evaluation of RV dysfunction as compared to standard echocardiographic measures. In this study, we aimed to determine the value of myocardial-work indices in evaluating serial changes of RV function in acute PE. METHODS: Our study comprised 83 consecutive acute PE patients who admitted to our tertiary cardiovascular hospital. Echocardiography was performed within the first 24-hours of hospitalization, and RV and LV myocardial-work parameters were obtained along with standard echocardiographic parameters. The change in the RV/LVr detected on tomography was selected as the primary outcome measure, and its' predictors were analyzed with classical linear regression and a generalized additive model (GAM). RESULTS: Among the LV-RV strain and myocardial work parameters, the RV global longitudinal strain (GLS) has borderline statistical significance in predicting the RV/LVr change whereas the RV global work efficiency (RV-GWE) strongly predicted RV/LVr change (p: 0.049 and <0.001, respectively). CONCLUSION: In this study, classical linear regression and GAM analyses showed that RV-GWE seems to offer a better prediction of RV/LVr change in patients with acute PE.

A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study.

The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1-70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3-27.1%; p = 0.000) and flexibility and balance (12.3-73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.

Left bundle branch area pacing versus conventional pacing in patients with advanced atrioventricular conduction abnormalities: a prospective cohort study.

BACKGROUND: Left bundle branch area pacing (LBBAP) is an emerging pacing method that may prevent the deleterious effects of right ventricular pacing. The aim of this study is to compare the effects of LBBAP with right ventricular septal pacing (RVSP) in patients with advanced atrioventricular conduction abnormalities and preserved left ventricular ejection fraction. METHODS: The effect of pacing was evaluated by echocardiographic indices of dyssynchrony, including global myocardial work efficiency (GWE) and peak systolic dispersion (PSD). The primary endpoint was GWE postprocedural, at 3, 6, and 12 months after the procedure. RESULTS: Twenty patients received LBBAP and 18 RVSP. Complete follow-up was accomplished in 37 patients (97.4%) due to the death of a patient (RVSP arm) from nonrelated cause. GWE was significantly increased in the group of LBBAP compared to RVSP at all time points (90.8% in LBBAP versus 85.8% in RVSP group at 12 months, p = 0.01). PSD was numerically lower in the LBBAP arm at all time points, yet not statistically significant (56.4 msec in LBBP versus 65.1 msec in RVSP arm at 12 months, p = 0.178). The implantation time was increased (median 93 min in LBBAP versus 45 min in RVSP group, p < 0.01), along with fluoroscopy time and dose area product (DAP), in the arm of LBBAP. There were no severe perioperative acute complications in either group. CONCLUSIONS: LBBAP is an emerging and safe technique for patients with a pacing indication. Despite the longer procedural and fluoroscopy time, as well as higher DAP, LBBAP seems to offer better left ventricular synchrony compared to RVSP, according to GWE measurements.

Work, Self, and Society: A Socio-historical Study of Morita Therapy.

Morita therapy is known as a psychotherapy grounded in the culture of Japan, particularly its Buddhist culture. Its popularity in Japan and other East Asian countries is cited as an example of the relevance and importance of culture and religion in psychotherapy. To complement such interpretations, this study adopts a socio-historical approach to examine the role and significance of work in Morita's theory and practice within the broader work environment and culture of the 1920s and 1930s in Japan. Morita conceptualized shinkeishitsu as a personality disease and a social illness caused by an alienating work environment. He proposed a remedy that emphasized the subjective emotional experience of work. To his primarily middle-class clients and readers, Morita's reconciliation between the self and society and that between autonomy and compliance was persuasive and useful, providing a philosophy whereby they could integrate into the work environment without loss of self-worth. The socio-historical character of Morita therapy is vital to understanding its power and appeal during Morita's time. Moreover, it sheds light on the complex interrelationships between work, mental health, and society.

Understanding the impact of sisu on workforce and well-being: A machine learning-based analysis.

This study investigates the construct of sisu, a Finnish attribute representing mental resilience and fortitude when confronted with difficult situations. By leveraging advanced analytical methods and explainable Artificial Intelligence, we gain insights into how sisu factors influence well-being, work efficiency, and overall health. We investigate how the beneficial aspects of sisu contribute significantly to mental and physical health, satisfaction, and professional accomplishments. Conversely, we analyze the harmful sisu and its adverse impacts on the same domains. Our findings, including intriguing trends related to age, educational level, emotional states, and gender, pave the way for developing tailored solutions and initiatives to nurture the beneficial aspects of sisu and curtail the damaging consequences of sisu within professional settings and personal welfare.

"We are working for seven days a week" :Time motion study of accredited social health activists from central India.

Background: The role of Accredited Social Health Activist (ASHA) the key worker is primely surrounded to be mainly a link-worker or facilitator, a community health worker, and a social activist under National Rural Health Mission (NRHM). This study was conducted to study the workload and work pattern of ASHAs and identify the causes for improving work. Methods: This was an observational cross-sectional study conducted using a time-motion study as the tool among seventeen ASHAs from two primary health centers (PHC) in central India for four months. An ASHA's work pattern and workload were studied by constructing a 24-h recall. An focus group discussion (FGD) was conducted with the ASHAs to identify the factors affecting their effective functioning, after which content analysis was done. Result: It was observed that activities under National programs consumed most of the time of ASHAs, followed by Maternal-Child Health (MCH) activities and Register maintenance. There was no homogenous work distribution among ASHAs. In content analysis, 30 concepts were categorized into four themes (responses from villages- an important drive, work pressure, survey a double-edged sword, demands of ASHAs). Conclusion: We conclude that the ASHAs are overburdened, and hence, not effectively utilizing their role as social activists. Clarity about job responsibilities, training, support, and coordination among seniors, frontiers trust-building can improve their work efficiency.

Optimising Complex Surgical Trays Based on PDSA Cycles.

Objective: To investigate the application of a multidisciplinary collaboration model to optimise the configuration management of orthopaedic external device sets in general hospitals. Methods: A pretest-post-test study design was used. Sixty patients who underwent unilateral total knee arthroplasty and 60 patients who underwent posterior lumbar interbody fusion between March and May 2022 were recruited as the control stage. Additionally, a total of 120 patients, 60 of each, who underwent the two procedures between September and November 2022, were recruited as the experimental stage. For the control stage, conventional external equipment management was used, and for the experimental stage, an external device management programme was implemented based on multidisciplinary collaboration with the control stage. Based on the PDSA cycle, the configuration management of orthopaedic external device sets was optimised, and the differences in collating and counting external devices, nurses' overtime in the external device stage and orthopaedic surgeon satisfaction were compared between the two stages. Results: Compared with the control stage, the collation count took less time (8.65 ± 0.25 min vs 5.37 ± 0.13 min; 13.55 ± 1.10 min vs 7.85 ± 0.82 min), the number of overtime hours was shorter (175.80 ± 12.19 min vs 96.68 ± 13.66 min) and orthopaedic surgeon satisfaction was improved (4.58 ± 0.62 vs 4.10 ± 0.68; 4.33 ± 0.73 vs 3.87 ± 0.77; 4.20 ± 0.71 vs 3.82 ± 0.71; 4.12 ± 0.69 vs 3.87 ± 0.72; 4.05 ± 0.68 vs 3.79 ± 0.68) in the experimental stage (all P < 0.05). Conclusion: Multidisciplinary collaboration offers various benefits for optimising the configuration of external device sets, such as reducing the time taken for the preoperative sorting and counting of external devices, enhancing nurses' work efficiency and improving surgeons' job satisfaction; therefore, it is worthy of reference in clinical practice.

Left bundle branch pacing preserved left ventricular myocardial work in patients with bradycardia.

Background: Left bundle branch pacing (LBBP) is an emerging physiological pacing modality. Left ventricular (LV) myocardial work (MW) incorporates afterload and LV global longitudinal strain to estimate global and segmental myocardial contractility. However, the effect of LBBP on LV MW remains unknown. This study aimed to evaluate the impact of LBBP on LV MW in patients receiving pacemaker for bradyarrhythmia. Methods: We prospectively enrolled 70 bradycardia patients with normal LV systolic function receiving LBBP (n = 46) and non-selective His-bundle pacing (NS-HBP) (n = 24). For comparative analysis, patients receiving right ventricular pacing (RVP) (n = 16) and control subjects (n = 10) were enrolled. Two-dimensional speckle tracking echocardiography was performed. The LV pressure-strain loop was non-invasively constructed to assess global LV MW. Results: After 6-month follow-up, LBBP group (with >40% ventricular pacing during 6 months) had shorter peak strain dispersion (PSD) compared with RVP group, and higher LV global longitudinal strain compared with RVP group and NS-HBP group, but had no difference in left intraventricular mechanical dyssynchrony, including septal-to-posterior wall motion delay and PSD, compared with NS-HBP group. During ventricular pacing, LBBP group had higher global MW index (GWI) (2,189 ± 527 vs. 1,493 ± 799 mmHg%, P = 0.002), higher global constructive work (GCW) (2,921 ± 771 vs. 2,203 ± 866 mmHg%, P = 0.009), lower global wasted work (GWW) (211 ± 161 vs. 484 ± 281 mmHg%, P < 0.001) and higher global MW efficiency (GWE) (91.4 ± 5.0 vs. 80.9 ± 8.3%, P < 0.001) compared with RVP group, and had lower GWW (211 ± 161 vs. 406 ± 234 mmHg%, P < 0.001) and higher GWE (91.4 ± 5.0 vs. 86.4 ± 8.1%, P < 0.001) compared with NS-HBP group. Conclusions: In this study we found that in patients with mid-term (6-month) high ventricular pacing burden (>40%), LBBP preserved more LV MW compared with NS-HBP and RVP. Further studies are warranted to assess the association between LV MW and long-term clinical outcomes in LBBP with high ventricular pacing burden.

Fully automated volumetric modulated arc therapy planning for locally advanced rectal cancer: feasibility and efficiency.

BACKGROUND: Volumetric modulated arc therapy (VMAT) for locally advanced rectal cancer (LARC) has emerged as a promising technique, but the planning process can be time-consuming and dependent on planner expertise. We aimed to develop a fully automated VMAT planning program for LARC and evaluate its feasibility and efficiency. METHODS: A total of 26 LARC patients who received VMAT treatment and the computed tomography (CT) scans were included in this study. Clinical target volumes and organs at risk were contoured by radiation oncologists. The automatic planning program, developed within the Raystation treatment planning system, used scripting capabilities and a Python environment to automate the entire planning process. The automated VMAT plan (auto-VMAT) was created by our automated planning program with the 26 CT scans used in the manual VMAT plan (manual-VMAT) and their regions of interests. Dosimetric parameters and time efficiency were compared between the auto-VMAT and the manual-VMAT created by experienced planners. All results were analyzed using the Wilcoxon signed-rank sum test. RESULTS: The auto-VMAT achieved comparable coverage of the target volume while demonstrating improved dose conformity and uniformity compared with the manual-VMAT. V30 and V40 in the small bowel were significantly lower in the auto-VMAT compared with those in the manual-VMAT (p < 0.001 and < 0.001, respectively); the mean dose of the bladder was also significantly reduced in the auto-VMAT (p < 0.001). Furthermore, auto-VMAT plans were consistently generated with less variability in quality. In terms of efficiency, the auto-VMAT markedly reduced the time required for planning and expedited plan approval, with 93% of cases approved within one day. CONCLUSION: We developed a fully automatic feasible VMAT plan creation program for LARC. The auto-VMAT maintained target coverage while providing organs at risk dose reduction. The developed program dramatically reduced the time to approval.

Interrelationships between Peak Strain Dispersion, Myocardial Work Indices, Isovolumetric Relaxation and Systolic-Diastolic Coupling in Middle-Aged Healthy Subjects.

In echocardiography, peak strain dispersion (PSD) is the standard deviation of the time to peak longitudinal strain for each left ventricular (LV) segment during systole. It assesses the coordination and synchrony of LV segment contractility. Global work efficiency (GWE) and global wasted work (GWW) quantify LV myocardial work and, if impaired, the coupling between LV systolic contraction and early relaxation. Isovolumetric relaxation (IVRT) measures the duration of initial LV relaxation, while the ratio of early diastolic recoil to systolic excursion (E'VTI/S'VTI) describes systolic-diastolic coupling. We evaluated these parameters in 69 healthy subjects and found that PSD correlated negatively with GWE (r = -0.49, p < 0.0001) and E'VTI/S'VTI (r = -0.44, p = 0.0002), but positively with GWW (r = 0.4, p = 0.0007) and IVRT (r = 0.53, p < 0.0001). GWE correlated negatively with GWW (r = -0.94, p < 0.0001) and IVRT (r = -0.30, p = 0.0127), but positively with E'VTI/S'VTI (r = 0.3, p = 0.0132). In addition, E'VTI/S'VTI was negatively correlated with GWW (r = -0.35, p = 0.0032) and IVRT (r = -0.36, p = 0.0024). These associations remained significant after adjustment for sex, age and LV mass index of the subjects. In conclusion, there is an interaction between measures of LV asynchrony, myocardial work, diastolic function and its systolic-diastolic coupling in middle-aged healthy subjects. The clinical value of these interactions requires further investigation.

Modelling the significance of psychological, social, and situational factors on work efficiency and the preference for working from home in Southeast Asia.

The shift in work paradigm owing to the implementation of new policies in the developing countries of Southeast Asia to reduce the spread of COVID-19 has created new challenges for both employers and employees. The study aimed to address the lack of extensive research on the effects of psychological, social, and situational factors on the work-from-home shift in Southeast Asia. This study incorporates the job characteristic theory, emphasizing how specific job characteristics influence motivation and performance. The study emphasizes the importance of creating an innovative and supportive work environment, improving digital capabilities, and promoting sustainable development through high-skill jobs to enhance remote employees' productivity. Valid responses from 288 full-time employees who have the option to work remotely were collected through online survey. The findings indicate that self-discipline, digital capability, and perceived organizational support significantly influence the preference for remote work. Managers should focus on motivating employees, providing support, and establishing a digital infrastructure to maximize productivity. Training and recruitment strategies should adapt to the changing work culture, while social support is crucial for encouraging innovative problem-solving. Trusting employees with autonomy and providing appropriate technologies fosters collaboration, efficiency, and creativity in different work settings.

Comparison of work efficiency in factory workers: pre & post covid lockdown - a cross sectional study.

BACKGROUND: The COVID-19 pandemic's impact on economies worldwide has caused changes in work patterns, reduced productivity, and job losses, particularly affecting factory workers. Lockdown measures have also led to reduced physical activity levels, which is a significant risk factor for chronic diseases. This study aims to investigate efficiency of factory workers pre and post lockdown periods. The findings will contribute to identifying evidence-based strategies to minimize the negative impact of lockdown measures on factory workers' productivity and health. MATERIALS AND METHODS: A cross-sectional study was conducted to assess the work performance of employees in a medicine manufacturing unit. Data was collected from factory workers online and study period was January 2021 to April 2022. Survey includes close ended questions regarding work performance of employees before lockdown period (Before 20/03/2020) and performance after lockdown period (After August 2020). The sample size of 196 employees selected through simple random sampling. A questionnaire consisting of demographic factors, work details, and work performance was prepared using pretested standard tools, including the Individual Work Performance Questionnaire (IWPQ), the World Health Organization Health and Work Performance Questionnaire (HPQ), and the Stanford Presenteeism Scale (SPS-6). The collected data was analysed using descriptive statistics and a paired t-test. RESULTS: The study found that prior to lockdown, 99% of employees consistently had higher performance, with 71.4% ranking in the top 10. However, after lockdown, the percentage of employees with high performance decreased to 91.8%, with only 63.3% ranking in the top 10. These differences were statistically significant, indicating a decrease in work efficiency of 8.1%. Before lockdown, employees worked longer hours, including on off days, while after lockdown, a small proportion missed work due to various reasons, resulting in better quality work. CONCLUSION: In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the work efficiency of factory workers. The findings indicate a decrease in work efficiency after the lockdown, coupled with an increase in employee stress. This suggests that the pandemic has brought about unique challenges for factory workers that need to be addressed to maintain their well-being and productivity. This study emphasizes the importance of creating a supportive work environment that prioritizes the mental and physical health of employees, especially during times of crisis.

Left Ventricular Systolic Function After 3 Months of SGLT2 Inhibitor Therapy in Heart Failure Patients with Reduced Ejection Fraction.

Not much is known about the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on echocardiographic parameters of left ventricular (LV) systolic function in patients with heart failure and reduced ejection fraction (HFrEF).We prospectively included 59 outpatients with HFrEF: 41 patients received SGLT2i with OMT (SGLT2i+ group), whereas eighteen patients received OMT without SGLT2i (SGLT2i- group). Myocardial work index (MWI), 3D ejection fraction (3D LVEF), and global longitudinal strain (GLS) were measured at baseline and after 3 months following treatment. At 3-month follow-up, the SGLT2i+ group showed significantly greater improvement in MWI than the SGLT2i- group. In both groups, there was a significant improvement in 3D LVEF and LV GLS, circulating NT-proBNP levels, and NYHA functional class, with significantly greater improvement in the SGLT2i+ group.In conclusion, the addition of SGLT2i to fully optimized background medical therapy resulted in a greater improvement of LV systolic function among outpatients with HFrEF.

A study on the impact of road traffic noise exposure on work efficiency of housewives.

Housewives are individuals who take on the caregiving role in the family in virtually every society and while discharging their duties experience serious psychological difficulties due to external environmental pollutants like air, noise, etc., which influences their efficiency of performing household activities. This study hypothesizes a causal association between perception of traffic noise and the reduction in performance of housewives in their daily household activities. A simple mediation model was utilized for the study with traffic noise perception as the exposure variable. The sensitivity to traffic noise, annoyance caused due to traffic noise, and the effect of traffic noise on housewives were evaluated using questionnaire survey. Of the respondents, 57.33% reported high level of traffic noise perception, while 65.81% reported high annoyance due to traffic noise perception. Of the respondents, 88.69% reported higher levels of agreement with regard to negative effect of traffic noise on their household activities. The results supported the hypothesis with respondents belonging to high and moderate noise perception groups reporting a higher reduction in performance as compared to those belonging to the low noise perception group at higher values of sensitivity. There was no significant direct effect among those who perceived traffic noise as high and moderate. However, the indirect path revealed that there was a significantly higher reduction in performance among those belonging to the high and moderate noise perception group as compared to those belonging to the low noise perception group while those who perceived traffic noise as high and moderate did not differ significantly only at higher levels of sensitivity. Using OGRS computational tool, a sensitivity value of 5.586 was identified as the Johnson-Neyman boundary of significance for the direct effect. The results from the study highlight the need for including environmental noise related regulations with regard to residential structures by the concerned authorities and also the need for undertaking more rigorous studies by health authorities and organizations so that the effects are minimized if not eliminated completely.

Reduction of multiple-caregiver assistance through the long-term use of a transfer support robot in a nursing facility.

The long-term use of transfer support robots in nursing facilities is an important option for improving the efficiency of care work. The "Resyone" transfer support robot is a combination of an electric care bed and a wheelchair, and the wheelchair half of the bed can be detached at the touch of a button. The purpose of this study was to investigate how the long-term use of Resyone would improve the performance of transfer assists, such as reducing the need for multiple caregivers. One Resyone was installed in a nursing facility in Japan and 17 caregivers used it for more than 11 months. The time and number of caregivers required for each transfer assist were surveyed for three 1-week periods: 1 week before (Phase 1) and at 3 weeks (Phase 2) and 11 months (Phase 3) after the introduction of Resyone. In Phase 1, approximately 60% of all transfer assists were performed by two caregivers, but in Phase 2, this was reduced to approximately 20%, and finally, in Phase 3, all transfer assists were performed by a single caregiver. These results suggested that the long-term use of Resyone was associated with improved work efficiency in transfer assistance in a nursing facility.

Speckle tracking imaging evaluation of left ventricular myocardial work comparing right ventricular septal pacing with His-Purkinje system area pacing.

Aims: We sought to objectively assess left ventricular myocardial work (MW) parameters after right ventricular septal pacing (VSP) and His-Purkinje system area pacing (HPSAP) procedures. Materials and methods: Patients undergoing double-chamber pacemaker implantation for III-degree atrioventricular block (III° AVB) were assessed 1 year after implantation. VSP and HPSAP groups (20 and 23 patients, respectively) were compared against 40 healthy age-matched volunteers. Two-dimensional ultrasound speckle tracking imaging was used to obtain the global myocardial work index (GWI), global myocardial work efficiency (GWE), global myocardial constructive work (GCW), global myocardial wasted work (GWW), left ventricular stratified strain, and peak strain dispersion (PSD). Results: GWI, GWE, and GCW parameters were improved in HPSAP compared to VSP, while GWW was significantly larger in the VSP group compared to the HPSAP group (all p < 0.05). HPSAP outperformed the VSP group in comparisons of global left ventricular longitudinal strain and stratified strain. Compared to controls, the GCW of all segmental myocardium (17/17 segments) in the VSP group was significantly reduced, while 70.59% (12/17 segments) in the HPSAP group was lower than the control group. GCW in the left ventricular segment of the HPSAP group was bigger than the VSP group (29.41%; 5/17 segments) and mainly concentrated in the ventricular septum and inferior wall. Conclusion: Our findings suggest that HPSAP performance outcomes are improved over VSP after 1 year, especially in left ventricular contractile synchrony, and HPSAP is beneficial to the effective myocardial work of the left ventricle.

Research on the Efficiency of Working Status Based on Wearable Devices in Different Light Environments.

According to the working scenes, a proper light environment can enable people to maintain greater attention and meditation. A posture detection system in different working scenes is proposed in this paper, and different lighting conditions are provided for changes in body posture. This aims to stimulate the nervous system and improve work efficiency. A brainwave acquisition system was used to capture the participants' optimal attention and meditation. The posture data are collected by ten miniature inertial measurement units (IMUs). The gradient descent method is used for information fusion and updating the participant's attitude after sensor calibration. Compared with the optical capture system, the reliability of the system is verified, and the correlation coefficient of both joint angles is as high as 0.9983. A human rigid body model is designed for reconstructing the human posture. Five classical machine learning algorithms, including logistic regression, support vector machine (SVM), decision tree, random forest, and k-nearest neighbor (KNN), are used as classification algorithms to recognize different postures based on joint angles series. The results show that SVM and random forest achieve satisfactory classification effects. The effectiveness of the proposed method is demonstrated in the designed systematic experiment.

Inhomogeneous Distribution of Regional Myocardial Work Efficiency Predicts Early Left Ventricular Remodeling After Acute Anterior Myocardial Infarction Treated With Primary Percutaneous Intervention.

Background: This study aimed to investigate the hypothesis that specific pattern of myocardial work (MW) distribution in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) could provide prognostic value for predicting left ventricular (LV) remodeling. Methods: A total of 98 first anterior wall STEMI patients treated with primary percutaneous coronary intervention [85 men (86.7%), mean age: 58 ± 12 years] were enrolled. Transthoracic echocardiography was performed 24-72 h after angioplasty and during 3-month follow-up. MW was estimated from the left ventricular pressure-strain loop derived from speckle tracking echocardiography and simultaneous noninvasive brachial artery cuff pressure. The primary endpoint was early LV remodeling, defined as an increase in LV end-diastolic volume ≥20% compared with baseline at 3 months after STEMI. Major adverse cardiac events and combined clinical outcomes were recorded. Results: LV remodeling was present in 32 patients (33%), who exhibited lower global and culprit-regional work index (WI), constructive work (CW), work efficiency (WE), and specifically, greater differences of WE (delta-WE) and CW (delta-CW) between the culprit and non-culprit region than those without LV remodeling both at the acute phase and follow-up (all P < 0.0125). During follow-up, all global and regional WI, CW, and WE were improved (P < 0.0125 compared with baseline), with less improvement in patients with LV remodeling. In multivariate analysis, baseline delta-WE (odds ratio: 2.304; 95% CI: 1.093-4.856, P = 0.028) and peak troponin I level (odds ratio: 1.035; 95%CI: 1.008-1.063, P = 0.010) were independently associated with early LV remodeling. Patients with greater delta-WE at baseline were associated with a higher incidence of heart failure and combined clinical outcomes during follow-up. Conclusion: After reperfused acute anterior STEMI, patients with LV remodeling presented with more inhomogeneous MW distribution. The absolute difference of WE between culprit and non-culprit territory at the acute phase is an independent predictor for early LV remodeling. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT05107102.

Work Efficiency and Economic Efficiency of Actual Driving Test of Proton Exchange Membrane Fuel Cell Forklift.

A 3.5 tonne forklift containing proton exchange membrane fuel cells (PEMFCs) and lithium-ion batteries was manufactured and tested in a real factory. The work efficiency and economic applicability of the PEMFC forklift were compared with that of a lithium-ion battery-powered forklift. The results showed that the back-pressure of air was closely related to the power density of the stack, whose stability could be improved by a reasonable control strategy and membrane electrode assemblies (MEAs) with high consistency. The PEMFC powered forklift displayed 40.6% higher work efficiency than the lithium-ion battery-powered forklift. Its lower use-cost compared to internal engine-powered forklifts, is beneficial to the commercialization of this product.