Circuit Modification Research Articles

Advances in microbial whole-cell sensors for the detection of aromatic compounds

The inherent stability and recalcitrance of benzene ring structures render aromatic compounds a major ecological concern and a substantial risk to human health. Hence, developing a facile and efficacious detection technique for aromatic compounds is essential. As our comprehension of aromatic compound characteristics deepens, microbial cell-based biosensors have emerged as increasingly popular tools in the detection of aromatic compounds. This article introduces the operational principles of microbial whole-cell biosensors and elucidates the construction techniques and applications of electroactive biofilm-based microbial whole-cell sensors, transcription factor-based microbial whole-cell sensors, and degradation gene promoter-dependent microbial whole-cell sensors in the detection of aromatic compounds. In addition, we review the methodologies for improving the performance of microbial whole-cell sensors based on surface display, logic gate construction, genetic circuit modification, and quorum sensing signal amplification.

Strategies to attenuate maladaptive inflammatory response associated with cardiopulmonary bypass.

Cardiopulmonary bypass (CPB) initiates an intense inflammatory response due to various factors: conversion from pulsatile to laminar flow, cold cardioplegia, surgical trauma, endotoxemia, ischemia-reperfusion injury, oxidative stress, hypothermia, and contact activation of cells by the extracorporeal circuit. Redundant and overlapping inflammatory cascades amplify the initial response to produce a systemic inflammatory response, heightened by coincident activation of coagulation and fibrinolytic pathways. When unchecked, this inflammatory response can become maladaptive and lead to serious postoperative complications. Concerted research efforts have been made to identify technical refinements and pharmacologic interventions that appropriately attenuate the inflammatory response and ultimately translate to improved clinical outcomes. Surface modification of the extracorporeal circuit to increase biocompatibility, miniaturized circuits with sheer resistance, filtration techniques, and minimally invasive approaches have improved clinical outcomes in specific populations. Pharmacologic adjuncts, including aprotinin, steroids, monoclonal antibodies, and free radical scavengers, show real promise. A multimodal approach incorporating technical, circuit-specific, and pharmacologic strategies will likely yield maximal clinical benefit.

Myelin plasticity in the ventral tegmental area is required for opioid reward

All drugs of abuse induce long-lasting changes in synaptic transmission and neural circuit function that underlie substance-use disorders1,2. Another recently appreciated mechanism of neural circuit plasticity is mediated through activity-regulated changes in myelin that can tune circuit function and influence cognitive behaviour3–7. Here we explore the role of myelin plasticity in dopaminergic circuitry and reward learning. We demonstrate that dopaminergic neuronal activity-regulated myelin plasticity is a key modulator of dopaminergic circuit function and opioid reward. Oligodendroglial lineage cells respond to dopaminergic neuronal activity evoked by optogenetic stimulation of dopaminergic neurons, optogenetic inhibition of GABAergic neurons, or administration of morphine. These oligodendroglial changes are evident selectively within the ventral tegmental area but not along the axonal projections in the medial forebrain bundle nor within the target nucleus accumbens. Genetic blockade of oligodendrogenesis dampens dopamine release dynamics in nucleus accumbens and impairs behavioural conditioning to morphine. Taken together, these findings underscore a critical role for oligodendrogenesis in reward learning and identify dopaminergic neuronal activity-regulated myelin plasticity as an important circuit modification that is required for opioid reward.

Impact of grading capacitor on transient recovery voltage due to shunt reactor de-energization for different values of current chopping

This paper investigates the impact of grading capacitors on transient recovery voltage (TRV) during shunt reactor switching in high voltage systems, considering different levels of current chopping. Shunt reactor de-energization can result in voltage surges and instability due to current chopping effects. The study utilizes simulation models using ATP-Draw software to assess the effectiveness of grading capacitors in mitigating TRV under various operating conditions as well as of using a proposed method to mitigate the excessive TRV across the circuit breaker. The findings provide valuable insights into managing TRV during shunt reactor switching, enhancing power system stability and reliability. The results obtained showed that the TRV across the circuit breaker decreased by 61.5% by using circuit modification as well as adding a grading capacitor.

Modification of Polycrystalline PV String for Charging on Electric Scooter

Electric scooters rely on batteries to power BLDC motors, which are traditionally recharged through the household electricity grid. However, alternatives like solar energy are being explored to reduce dependency on conventional power sources. A challenge arises due to the discrepancy in voltage compatibility between standard solar panels and scooter batteries. Typically, a 36 V scooter battery requires a higher voltage input than the 18 V output of a single solar panel. This requires modifications to align solar cell design with battery voltage requirements. This study implements a PZEM-015 sensor for monitoring battery energy consumption. The contribution of this study is twofold: to develop and optimise solar cell modification for effective battery charging and to assess battery consumption concerning speed and travel duration. Testing reveals that a series circuit modification yields an average voltage of 39.2 V and an average current of 0.55 A, resulting in 21.8 Wp of power output. Analysis of scooter performance indicates that maintaining speeds between 4.16 m/s and 5.55 m/s significantly extends travel time and conserves battery energy. These findings highlight the potential of modified solar PV in enhancing electric scooter efficiency and sustainability.

AC-Modulated XPS Enables to Externally Control the Electrical Field Distributions on Metal Electrode/Ionic Liquid Devices.

X-Ray Photoelectron Spectroscopy (XPS) has been utilized to extract local electrical potential profiles by recording core-level binding energy shifts upon application of the AC [square-wave (SQW)] bias with different frequencies. An electrochemical system consisting of a coplanar capacitor with a polyethylene membrane (PEM) coated with the Ionic Liquid (IL) N,N-diethyl-N-methyl-N-(2-methoxyethyl) ammonium bis(trifluoromethanesulfonyl)imide (DEME-TFSI) as the electrolyte is investigated. Analyses are carried out in operando, such that XPS measurements are recorded simultaneously with current measurements. ILs have complex charging/discharging processes, in addition to the formation of Electrical Double Layers (EDL) at the interfaces, and certain properties of these processes can be captured using AC modulation within appropriate time windows of observation. Herein, we select two frequencies, namely, 10 kHz and 0.1 Hz, to separate effects of the fast polarization and slow migratory motions, respectively. Moreover, the local potential developments after adding two equivalent series resistors at three different physical positions of the device have been carefully evaluated from the binding energy shifts in the F 1s peak representing the anion of the IL. This circuit modification allows us to quantify the AC currents passing through the device, as well as the system's impedance, in addition to revealing the potential variations due the IR drops. The complex AC-modulated local XPS data recorded can also be faithfully reproduced using the unmodulated F 1s spectrum and by convoluting it with electrical circuit output provided by the LT-Spice software. The outcome of these efforts is a more realistic equivalent circuit model, which can be related to chemical/physical makeup of the electrochemical system. An important finding of this methodology emerges as the possibility to induce additional local electrical field developments within the device, the directions of which can be reversed controllably.

Detour-RS: Reroute Attack Vulnerability Assessment with Awareness of the Layout and Resource

Recent decades have witnessed a remarkable pace of innovation and performance improvements in integrated circuits (ICs), which have become indispensable in an array of critical applications ranging from military infrastructure to personal healthcare. Meanwhile, recent developments have brought physical security to the forefront of concern, particularly considering the valuable assets handled and stored within ICs. Among the various invasive attack vectors, micro-probing attacks have risen as a particularly menacing threat. These attacks leverage advanced focused ion beam (FIB) systems to enable post-silicon secret eavesdropping and circuit modifications with minimal traceability. As an evolved variant of micro-probing attacks, reroute attacks possess the ability to actively disable built-in shielding measures, granting access to the security-sensitive signals concealed beneath. To address and counter these emerging challenges, we introduce a layout-level framework known as Detour-RS. This framework is designed to automatically assess potential vulnerabilities, offering a systematic approach to identifying and mitigating exploitable weaknesses. Specifically, we employed a combination of linear and nonlinear programming-based approaches to identify the layout-aware attack costs in reroute attempts given specific target assets. The experimental results indicate that shielded designs outperform non-shielded structures against reroute attacks. Furthermore, among the two-layer shield configurations, the orthogonal layout exhibits better performance compared to the parallel arrangement. Furthermore, we explore both independent and dependent scenarios, where the latter accounts for potential interference among circuit edit locations. Notably, our results demonstrate a substantial near 50% increase in attack cost when employing the more realistic dependent estimation approach. In addition, we also propose time and gas consumption metrics to evaluate the resource consumption of the attackers, which provides a perspective for evaluating reroute attack efforts. We have collected the results for different categories of target assets and also the average resource consumption for each via, required during FIB reroute attack.

A novel approach to retrograde autologous priming for infant, pediatric and adult populations undergoing congenital heart surgery.

Retrograde Autologous Priming (RAP) of cardiopulmonary bypass (CPB) circuits is an effective way to reduce prime volume, commonly through the transfer of prime into separate reservoirs or circuit manipulation. We describe a simple and safe technique for RAP without the need for any circuit modifications or manipulations. For this technique, a separate roller pump for ultrafiltration (UF) is used. After adequate heparinization and arterial cannulation, the UF pump is initiated slowly, removing prime through the effluent of the UF, replacing with the patient's blood from the aortic cannula. Once the arterial line and UF circuit are autologous primed, the arterial head displaces reservoir crystalloid toward the UF circuit at a flow rate equal to the UF pump, displacing the crystalloid prime with blood from the UF circuit, autologous priming the boot and oxygenator with blood, crystalloid again being removed by the effluent. After venous cannulation, the venous line prime is replaced with autologous blood, the crystalloid removed by the effluent of the UF circuit via the arterial head. During RAP, if the patient becomes hypovolemic, either autologous volume is transfused back to the patient, or CPB is initiated, without the need for circuitry modifications. The patient population in this sample consisted of 63 patients ranging between 6.1kg and 115.6kg. The smaller the patient, the less blood volume available for RAP and therefore the less prime volume able to be removed. Overall percent removal increases as our patients size increases compared to total circuit volume. This RAP technique is a safe and effective way to achieve a standardized asanguinous prime for many regardless of patient or circuit size in the absence of contraindications such as low starting hematocrit, emergency surgery or physiologic instability. Most importantly, this potentially reduces the amount of hemodilution patients see from CPB initiation and therefore the lowest nadir hematocrit and consequently the amount of required homologous blood products needed during surgery.

Digitizing images of electrical-circuit schematics

Electrical-circuit schematics are a foundational tool in electrical engineering. A method that can automatically digitalize them is desirable since a knowledge base of such schematics could preserve their functional information as well as provide a database that one can mine to predict more operationally efficient electrical circuits using data analytics and machine learning. We present a workflow that contains a novel pattern-recognition methodology and a custom-trained Optical Character Recognition (OCR) model that can digitalize images of electrical-circuit schematics with minimal configuration. The pattern-recognition and OCR stages of the workflow yield 86.4% and 99.6% success rates, respectively. We also present an extendable option toward predictive circuit-design efficiencies, subject to a large database of images being available. Thereby, data gathered from our pattern-recognition workflow are used to draw network graphs, which are in turn employed to form matrix equations that contain the voltages and currents for all nodes in the circuit in terms of component values. These equations could be applied to a database of electrical-circuit schematics to predict new circuit designs or circuit modifications that offer greater operational efficiency. Alternatively, these network graphs could be converted into simulation programs with integrated circuit emphasis netlists to afford more accurate and computationally automated simulations.

Breakthroughs in synthetic controlling strategies for precision in CAR-T therapy.

Chimeric antigen receptors (CAR) are synthetic receptors engineered to target a user-defined antigen. They comprise an extracellular single-chain variable fragmentfor target recognition and intracellular signalling domains commonly derived from immune cells. CAR-T cells have proven to be successful in therapy of some cancers. CAR-T cells are activated upon antigen-priming and subsequent intracellular signalling. However, tonic signalling in CAR-T cells remains a challenge in developing CAR-T therapeutics of high efficacy as it causes early T-cell exhaustion, limiting therapeutic persistence. Moreover, a poor choice of target antigen leads to off-target cytotoxicity, often hampering the host's survival. In addition, conventional methods of delivering CAR gene circuits utilise viral vectors, such as lentiviruses and retroviruses, which insert the CAR gene circuits into transcriptionally active sites in the genome. This increases the risks of malignant transformation due to improper genome integration. Optimisation in CAR-T engineering, from the architecture of CAR gene circuits to the structure of CAR and the behaviour of CAR-T cells, is paramount to ensure high efficacy, persistence, and precision in CAR-T therapy. This review provides insights into engineering CAR-T cells for precision in cancer therapy by highlighting the key strategies recently developed to optimise the function and efficiency of CARs. The delivery method of CAR gene circuits, circuit and structural modification of CAR, T-cell phenotype manipulation and T-cell arming will be discussed to accentuate their interplay in regulating CAR-T therapy's safety, precision, and efficacy.

Analysis and design research of digital electronic clocks

A digital electronic clock stands as a pinnacle of modern timing technology, built on digital circuits that offer precise hour, minute, and second tracking and display capabilities. The evolution of integrated circuits, combined with the ubiquitous application of quartz crystal oscillators, has propelled the digital electronic clock into myriad sectors including science, transportation, and finance. These clocks, appreciated for their precision, clarity, stability, and other attributes, vastly differ from their mechanical predecessors. Absent of mechanical transmission devices, they promise longevity and exact timekeeping. Such digitization serves as the foundational technological support for crafting large machinery and precision tools. Delving into the intricacies of digital electronic clocks and broadening their utilization holds substantial real-world relevance. This discourse employs a top-down hierarchical circuit design approach, segmenting the comprehensive circuit into distinct modules. This method not only streamlines its configuration, rendering it user-friendly and legible, but also ensures that each segmented circuit operates as an autonomous entity. This modularity facilitates smoother simulations and circuit modifications, enhancing adaptability and efficiency.

Repetitive spreading depolarization induces gene expression changes related to synaptic plasticity and neuroprotective pathways.

Spreading depolarization (SD) is a slowly propagating wave of profound depolarization that sweeps through cortical tissue. While much emphasis has been placed on the damaging consequences of SD, there is uncertainty surrounding the potential activation of beneficial pathways such as cell survival and plasticity. The present study used unbiased assessments of gene expression to evaluate that compensatory and repair mechanisms could be recruited following SD, regardless of the induction method, which prior to this work had not been assessed. We also tested assumptions of appropriate controls and the spatial extent of expression changes that are important for in vivo SD models. SD clusters were induced with either KCl focal application or optogenetic stimulation in healthy mice. Cortical RNA was extracted and sequenced to identify differentially expressed genes (DEGs). SDs using both induction methods significantly upregulated 16 genes (vs. sham animals) that included the cell proliferation-related genes FOS, JUN, and DUSP6, the plasticity-related genes ARC and HOMER1, and the inflammation-related genes PTGS2, EGR2, and NR4A1. The contralateral hemisphere is commonly used as control tissue for DEG studies, but its activity could be modified by near-global disruption of activity in the adjacent brain. We found 21 upregulated genes when comparing SD-involved cortex vs. tissue from the contralateral hemisphere of the same animals. Interestingly, there was almost complete overlap (21/16) with the DEGs identified using sham controls. Neuronal activity also differs in SD initiation zones, where sustained global depolarization is required to initiate propagating events. We found that gene expression varied as a function of the distance from the SD initiation site, with greater expression differences observed in regions further away. Functional and pathway enrichment analyses identified axonogenesis, branching, neuritogenesis, and dendritic growth as significantly enriched in overlapping DEGs. Increased expression of SD-induced genes was also associated with predicted inhibition of pathways associated with cell death, and apoptosis. These results identify novel biological pathways that could be involved in plasticity and/or circuit modification in brain tissue impacted by SD. These results also identify novel functional targets that could be tested to determine potential roles in the recovery and survival of peri-infarct tissues.

13…67 GHz Frequency Mixer

Introduction. The requirements for the performance of measuring devices, including their operating frequency, are constantly becoming stricter. This encourages the creation of wide-band microcircuits for application in microwave blocks of devices, such as vector network analyzers (VNA) and spectrum analyzers (SA). One of such microcircuits, used in the receiver system, is a frequency mixer. The operating range of the mixer determines the operating range of the measuring instrument. Aim. Research and development of an ultra-wideband integrated circuit for a 13…67 GHz frequency mixer based on the GaAs QSBD technology by Micran JSC. Materials and methods. An analysis of existing classic and modified circuit transformers used in mixers was conducted. A modification of the transformer circuit, which allowed a frequency range of 10…70 GHz to be achieved,was proposed. Based on the obtained transformer and GaAs diode technology of Micran JSC, a complete mixer topology was developed and produced. An electrodynamic analysis of the integrated circuit was carried out; measurements were performed using a VNA up to 67 GHz. Results. A wideband mixer with a frequency range of 10…67 GHz is developed. A circuit design is proposed based on a balanced circuit with modified transformers and an intermediate frequency output circuit. The calculated dependences and measurement results of the integrated circuit of the mixer are presented. The mixer exhibits a conversion loss of less than 10 dB in the range of 10…67 GHz. Conclusion. A new broadband transformer with a range of operating frequencies from 10 to 70 GHz was developed. On its basis, a mixer microcircuit was simulated and manufactured. This microcircuit can be used in the receiving and transmitting units of modern measuring instruments. In terms of its characteristics, the proposed microcircuit is an analog of the Marki Mikrowave MM1-1467L mixer.

Stabilization of unstable reentrant atrial tachycardias via fractionated continuous electrical activity ablation (CHAOS study).

Unstable reentrant atrial tachycardias (ATs) (i.e., those with frequent circuit modification or conversion to atrial fibrillation) are challenging to ablate. We tested a strategy to achieve arrhythmia stabilization into mappable stable ATs based on the detection and ablation of rotors. All consecutive patients from May 2017 to December 2019 were included. Mapping was performed using conventional high-density mapping catheters (IntellaMap ORION, PentaRay NAV, or Advisor HD Grid). Rotors were subjectively identified as fractionated continuous (or quasi-continuous) electrograms on 1-2 adjacent bipoles, without dedicated software. In patients without detectable rotors, sites with spatiotemporal dispersion (i.e., all the cycle length comprised within the mapping catheter) plus non-continuous fractionation on single bipoles were targeted. Ablation success was defined as conversion to a stable AT or sinus rhythm. Ninety-seven patients with reentrant ATs were ablated. Of these, 18 (18.6%) presented unstable circuits. Thirteen (72%) patients had detectable rotors (median 2 [1-3] rotors per patient); focal ablation was successful in 12 (92%). In the other 5 patients, 17 sites with spatiotemporal dispersion were identified and targeted. Globally, and excluding 1 patient with spontaneous AT stabilization, ablation success was achieved in 16/17 patients (94.1%). One-year freedom from atrial arrhythmias was similar between patients with unstable and stable ATs (66.7% vs. 65.8%, p = 0.946). Most unstable reentrant ATs show detectable rotors, identified as sites with single-bipole fractionated quasi-continuous signals, or spatiotemporal dispersion plus non-continuous fractionation. Ablation of these sites is highly effective to stabilize the AT or convert it into sinus rhythm.

Monitoring beam charge during FLASH irradiations

In recent years, FLASH irradiation has attracted significant interest in radiation research. Studies have shown that irradiation at ultra-high dose rates (FLASH) reduces the severity of toxicities in normal tissues compared to irradiation at conventional dose rates (CONV), as currently used in clinical practice. Most pre-clinical work is currently carried out using charged particle beams and the beam charge monitor described here is relevant to such beams. Any biological effect comparisons between FLASH and CONV irradiations rely on measurement of tissue dose. While well-established approaches can be used to monitor, in real time, the dose delivered during CONV irradiations, monitoring FLASH doses is not so straightforward. Recently the use of non-intercepting beam current transformers (BCTs) has been proposed for FLASH work. Such BCTs have been used for decades in numerous accelerator installations to monitor temporal and intensity beam profiles. In order to serve as monitoring dosimeters, the BCT output current must be integrated, using electronic circuitry or using software integration following signal digitisation. While sensitive enough for FLASH irradiation, where few intense pulses deliver the requisite dose, the inherent insensitivity of BCTs and the need for a wide detection bandwidth makes them less suitable for use during CONV “reference” irradiations. The purpose of this article is to remind the FLASH community of a different mode of BCT operation: direct monitoring of charge, rather than current, achieved by loading the BCT capacitively rather than resistively. The resulting resonant operation achieves very high sensitivities, enabling straightforward monitoring of output during both CONV and FLASH regimes. Historically, such inductive charge monitors have been used for single pulse work; however, a straightforward circuit modification allows selective resonance damping when repetitive pulsing is used, as during FLASH and CONV irradiations. Practical means of achieving this are presented, as are construction and signal processing details. Finally, results are presented showing the beneficial behaviour of the BCT versus an (Advanced Markus) ionisation chamber for measurements over a dose rate range, from <0.1 Gys−1 to >3 kGys−1.

Re-Imagining the Cooling Systems for Markets in Developing Countries: A Conceptual Analysis of a Footstep Powered Cooler

Preserving perishable food items like fruits and vegetables in local markets of developing countries is a significant challenge due to the lack of affordable and sustainable cooling solutions, resulting in high food loss, economic burden, and environmental waste. This paper presents a conceptual analysis of a footstep-powered cooler (FPC) system that harnesses the energy generated from footstep movement to power refrigeration systems. The study developed a Minimal Viable Product (MVP) consisting of a piezoelectric plate connected to a voltage doubler circuit to measure the energy generated per step. Results showed that a single footstep on a 0.15 x 0.15 m tile with four piezoelectric plates connected in series generated 0.8 J of energy. However, when extrapolated to the scale of a market, the energy generated from footsteps fell significantly short of the energy requirements for refrigeration. The study suggests optimizing tile placement, exploring other piezoelectric materials, and improving energy extraction efficiency through circuit modifications as potential strategies to enhance energy output to meet the required energy demands. While footstep-generated energy alone may not be sufficient, it represents a promising and sustainable approach to preserving perishable food in local markets, reducing food loss, and improving overall efficiency in the food supply chain.

Sequence of penalties method to study excited states using VQE

We propose an extension of the variational quantum eigensolver (VQE) that leads to more accurate energy estimations and can be used to study excited states. The method is based on the introduction of a sequence of increasing penalties in the cost function. This approach does not require circuit modifications and thus can be applied with no additional depth cost. Through numerical simulations, we show that we are able to produce variational states with desired physical properties, such as total spin and charge. We assess its performance both on classical simulators and on currently available quantum devices, calculating the potential energy curves of small molecular systems in different physical configurations. Finally, we compare our method to the original VQE and to another extension, obtaining a better agreement with exact simulations for both energy and targeted physical quantities.

Realization of the TOW-THOMAS Biquad Active Filter

The Tow-Thomas Biquad Circuit provides the filter designers with a valuable building block for building higher order active filters. It is a flexible circuit structure in which the transfer function properties are easily manipulated by modifying the passive RC elements that connect the operational amplifiers. It can be easily defined in its low-pass and bandpass operations. Above all, we can easily fabricate the possible filters inside a single chip with very slight modification of the standard Tow-Thomas Circuit.

Peroxisome Proliferator-Activated Receptor-γ as a Target and Regulator of Epigenetic Mechanisms in Nonalcoholic Fatty Liver Disease

Peroxisome proliferator-activated receptor-γ (PPARγ) belongs to the superfamily of nuclear receptors that control the transcription of multiple genes. Although it is found in many cells and tissues, PPARγ is mostly expressed in the liver and adipose tissue. Preclinical and clinical studies show that PPARγ targets several genes implicated in various forms of chronic liver disease, including nonalcoholic fatty liver disease (NAFLD). Clinical trials are currently underway to investigate the beneficial effects of PPARγ agonists on NAFLD/nonalcoholic steatohepatitis. Understanding PPARγ regulators may therefore aid in unraveling the mechanisms governing the development and progression of NAFLD. Recent advances in high-throughput biology and genome sequencing have greatly facilitated the identification of epigenetic modifiers, including DNA methylation, histone modifiers, and non-coding RNAs as key factors that regulate PPARγ in NAFLD. In contrast, little is still known about the particular molecular mechanisms underlying the intricate relationships between these events. The paper that follows outlines our current understanding of the crosstalk between PPARγ and epigenetic regulators in NAFLD. Advances in this field are likely to aid in the development of early noninvasive diagnostics and future NAFLD treatment strategies based on PPARγ epigenetic circuit modification.

Experience with percutaneous right ventricular support in the early post-left ventricular assist device implantation period (clinical case report and literature reviews)

Implantable left ventricular assist device (LVAD) is a state-of-the-art treatment for adults and children with end-stage heart failure. The early and late period after LVAD implantation can be severely complicated. Right ventricular failure (RVF) still remains a common complication after LVAD implantation. RVF is the cause of reduced post-implant survival. We suggest that an additional temporary or permanent right ventricular assist device (RVAD) is an effective treatment for LVAD-associated RVF. In this clinical case report, we describe the medical history of a pediatric patient (14 years old) with severe heart failure (PediMACS Level 1) against a background of dilated cardiomyopathy. The patient required peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) prior to urgent LVAD (HM3) implantation. In the early post-LVAD implantation (1 POD) period, the patient presented with hemodynamic and echocardiographic events of acute RVF that was resistant to drug therapy (inotropic/vasopressor support, iNO) and required mechanical circulatory support (MCS) with a preoperatively implanted VA-ECMO. In the LVAD-associated RVF scenario, VA-ECMO as a means of total cardiac bypass is a non-physiological MCS method and, therefore, undesirable. In this clinical situation, our solution was to use a paracorporeal centrifugal blood pump for temporary right heart support. A RVAD was assembled using percutaneous cannulation in two sites and a modification of the pre-existing VA-ECMO circuit. For RVAD, we used an ECMO cannula previously installed through the femoral vein (26 F) and added a reverse venous cannula (22 F) through the right internal jugular vein into the pulmonary trunk. To facilitate the passage of the return cannula into the pulmonary artery, we used a contralateral sheath (6 F, 40 cm) and an Amplatz Super Stiff guidewire under radiological control. The oxygenator was removed from the circuit on day 2 of RVAD. Central hemodynamics (reduction in right atrial pressure (RAP) to 10 mm Hg, increase in pulmonary capillary wedge pressure (PCWP) to 14 mm Hg), as well as right ventricular (RV) and left ventricular (LV) volume characteristics all improved. These observations allowed us to optimize the performance of the implantable LVAD (increase in flow rate to 4.2 l/min or 2.1 l/min/m2). The duration of paracorporeal RVAD after LVAD implantation was 7 days with an average flow rate of 2.3 ± 0.2 l/min. Postoperative treatment in the intensive care unit (ICU) lasted for 15 days. The patient was discharged from the hospital on postoperative day 34.