Device Options Research Articles

Series Multiblood Pump Design With Dual Activation for Pediatric Patients With Heart Failure.

The translational development of pediatric ventricular assist devices (VADs) lags years behind adult device options, negatively impacting pediatric patient outcomes. To address this need, we are developing a novel, series-flow, double-blood pump VAD that integrates an axial and centrifugal pump into a single device. The axial pump is used for initial circulatory assistance in younger patients; then, an internal activation mechanism triggers the centrifugal pump to activate in line with the axial pump, providing additional pressure and flow to match pediatric patient growth cycles. Here, we focused on the design and improvement of the device flow paths through computational analysis and in vitro hydraulic testing of a prototype. We estimated pressure-flow generation, fluid scalar stresses, and blood damage levels. In vitro hydraulic tests correlated well with shear stress transport (SST) predictions, with an average deviation of 4.5% for the complex, combined flow path. All data followed expected pump performance trends. The device exceeded target levels for blood damage in the blade tip clearances, and this must be both investigated and addressed in the next design phase. These study findings establish a strong foundation for the future development of the Drexel Double-Dragon VAD.

Role of Mechanical Circulatory Support in Complex High-Risk and Indicated Percutaneous Coronary Intervention: Current Indications, Device Options, and Potential Complications.

Improved expertise and technological advancements have enabled the safe and effective performance of complex and high-risk-indicated percutaneous coronary intervention (CHIP) in patients previously considered inoperable or high-risk. Mechanical circulatory support (MCS) devices play a crucial role in stabilizing hemodynamics during percutaneous coronary intervention (PCI) -related ischemia, thereby reducing the risk of major adverse events and achieving a more complete revascularization. However, the use of MCS devices in protected PCI is not without risks, including peri-procedural myocardial infarction (MI), bleeding, and access-related complications. Despite numerous observational studies, there is a significant lack of randomized clinical trials comparing different MCS devices in various CHIP scenarios and evaluating their long-term safety and efficacy profiles. This review aims to summarize the current evidence regarding the benefits of MCS devices during CHIPs, offer a practical guide for selecting appropriate devices based on clinical scenarios, and highlight the unanswered questions that future trials need to address.

One-hundred Consecutive Physician-Modified Fenestrated Endovascular Aneurysm Repair of Pararenal and Thoracoabdominal Aortic Aneurysms Using the Terumo TREO Stent Graft

ObjectiveFenestrated endovascular aortic aneurysm repair (FEVAR) has been widely applied for the treatment of pararenal (PAA) and thoracoabdominal aortic aneurysms (TAAA). If custom-made devices or off-the-shelf devices are not available, physician-modified endografts (PMEG) are an alternative device option. Several different endograft platforms have been used for PMEG; however, minimal data exists on utilizing the Terumo TREO Abdominal stent-graft system in this setting. The purpose of this study was to evaluate our single-center experience treating PAA and TAAA with a physician-modified FEVAR using the TREO platform. MethodsA prospective database of consecutive patients with PAA and TAAA treated at a single-center with a FEVAR utilizing a PMEG device between March 2021 and September 2023 was queried for those having a Terumo TREO device implanted. Demographics, operative details, and postoperative complications were analyzed. Rates of technical success, type I or III endoleak, branch vessel status, reintervention, and 2-year survival were also assessed. ResultsOf the 153 patients who underwent FEVAR with a PMEG device during the study period, 100 had repair using a Terumo TREO stent-graft. The mean age of the cohort was 73.7±7.0years with the majority suffering from hypertension (n=94, 94%), coronary artery disease (n=51, 51%), and COPD (n=40, 40%). Thirty-four patients (34%) had a prior failed EVAR device in place. Mean aneurysm size was 66.0±13.7mm, with 58 (50%) patients classified as PAA and 30 (30%) patients as an extent IV TAAA. Six (6%) patients presented with symptomatic/ruptured aneurysms. The average number of target arteries incorporated per patient was 3.8±0.6. Overall technical success was 99%, procedure time was 218±116 minutes, contrast volume was 82±21mL, and cumulative air kerma was 3,054±1,560mGy. Postoperative complications were present in 20 patients (20%) and 2 patients (2%) died within 30-days. Rates of type I or III endoleak, branch vessel stenosis/occlusion, and reintervention were 2%, 1%, and 7%, respectively. Two-year overall survival was 87%. ConclusionsTreatment of pararenal and extent IV TAAA using a physician-modified fenestrated Terumo TREO endograft is safe and effective. This large, early experience using the Terumo TREO platform supports preferential use of this device in this setting due to the device design and low likelihood of type I or III endoleak.

Wearable device for continuous sweat lactate monitoring in sports: a narrative review.

In sports science, the use of wearable technology has facilitated the development of new approaches for tracking and assessing athletes' performance. This narrative review rigorously explores the evolution and contemporary state of wearable devices specifically engineered for continuously monitoring lactate levels in sweat, an essential biomarker for appraising endurance performance. Lactate threshold tests have traditionally been integral in tailoring training intensity for athletes, but these tests have relied on invasive blood tests that are impractical outside a laboratory setting. The transition to noninvasive, real-time monitoring through wearable technology introduces an innovative approach, facilitating continuous assessment without the constraints inherent in traditional methodologies. We selected 34 products from a pool of 246 articles found through a meticulous search of articles published up to January 2024 in renowned databases: PubMed, Web of Science, and ScienceDirect. We used keywords such as "sweat lactate monitoring," "continuous lactate monitoring," and "wearable devices." The findings underscore the capabilities of noninvasive sweat lactate monitoring technologies to conduct long-term assessments over a broad range of 0-100mM, providing a safer alternative with minimal infection risks. By enabling real-time evaluations of the lactate threshold (LT) and maximal lactate steady state (MLSS), these technologies offer athletes various device options tailored to their specific sports and preferences. This review explores the mechanisms of currently available lactate monitoring technologies, focusing on electrochemical sensors that have undergone extensive research and show promise for commercialization. These sensors employ amperometric reactions to quantify lactate levels and detect changes resulting from enzymatic activities. In contrast, colorimetric sensors offer a more straightforward and user-friendly approach by displaying lactate concentrations through color alterations. Despite significant advancements, the relationship between sweat lactate and blood lactate levels remains intricate owing to various factors such as environmental conditions and the lag between exercise initiation and sweating. Furthermore, there is a marked gap in research on sweat lactate compared to blood lactate across various sports disciplines. This review highlights the need for further research to address these shortcomings and substantiate the performance of lactate sweat monitoring technologies in a broader spectrum of sports environments. The tremendous potential of these technologies to supplant invasive blood lactate tests and pioneer new avenues for athlete management and performance optimization in real-world settings heralds a promising future for integrating sports science and wearable technology.

Aqueous aluminum ion system: A future of sustainable energy storage device

The world is predicted to face a lack of lithium supply by 2030 due to the ever-increasing demand in energy consumption, which creates the urgency to develop a more sustainable post-lithium energy storage technology. An alternative battery system that uses Earth-abundant metals, such as an aqueous aluminum ion battery (AAIB), is one of the most promising post-lithium battery technologies not only because of its safety and sustainability but also because of their high theoretical energy density in addition to their natural abundance in the Earth's crust. However, the commercialization of AAIB is confronted with many challenges as the three-electron transfer reactions of Al3+/Al are difficult to realize, and its charge transfer mechanism is still controversial. Delicate engineering of every battery part, from cathode, anode, and electrolyte, must be done simultaneously and carefully to realize these systems to meet the requirements of real-life applications. This review discusses the recent advancements in various AAIB designs where different approaches were carried out to realize the trivalent Al-ion transfer. Advanced battery systems with added functionalities in the context of AAIB, such as electrochromic, paper-based, wearable, and biobattery, will also be discussed. As a secondary energy device option, developments in the Al-ion supercapacitors are also highlighted. Finally, the review highlights the challenges and prospects for further research in this growing field.

Effectiveness of Acid Mine Water Testing Using Sparing at PT. Bara Alam Utama

Sparing is a remote monitoring tool (telemetry) and is carried out in real-time via various different devices, as well as storing and displaying it on many device options. This research uses a quantitative descriptive method, which aims to present data related to the research object. The data sources used in this research consist of primary and secondary data sources. Where primary data is obtained from direct observation and measurements regarding pH values, Total Suspended Solid (TSS), Iron (Fe) and Manganese (Mn) metal content. Secondary data was obtained through literature relevant to the research and documentation during the research. The results obtained in May 2022 were 31.0 and 32.2 mg/l, in November 2022 upstream and downstream, namely 19 and 26.8 mg/l. Meanwhile, the pH value of the water in May 2022 in the upstream river still met The quality book is 6.03, while the pH value in the upstream and downstream rivers is 7.3 and 7.1, while in November 2022 the upstream and downstream pH will be 6.43 and 7.11. The iron (Fe) and manganese content is also relatively small both upstream and downstream, namely in May 0.323 and 0.284 mg/l and in November 2022 0.612 and 0.124. Meanwhile, the results of the river pollution capacity are TSS on the Kungkilan River, namely (28.89 - 36.13 mg/L) and the Lematang River, namely (27.00 - 30.25 mg/L).

Integration of implantable device therapy in patients with heart failure. A clinical consensus statement from the Heart Failure Association (HFA) and European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).

Implantable devices form an integral part of the management of patients with heart failure (HF) and provide adjunctive therapies in addition to cornerstone drug treatment. Although the number of these devices is growing, only few are supported by robust evidence. Current devices aim to improve haemodynamics, improve reverse remodelling, or provide electrical therapy. A number of these devices have guideline recommendations and some have been shown to improve outcomes such as cardiac resynchronization therapy, implantable cardioverter-defibrillators and long-term mechanical support. For others, more evidence is still needed before large-scale implementation can be strongly advised. Of note, devices and drugs can work synergistically in HF as improved disease control with devices can allow for further optimization of drug therapy. Therefore, some devices might already be considered early in the disease trajectory of HF patients, while others might only be reserved for advanced HF. As such, device therapy should be integrated into HF care programmes. Unfortunately, implementation of devices, including those with the greatest evidence, in clinical care pathways is still suboptimal. This clinical consensus document of the Heart Failure Association (HFA) and European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) describes the physiological rationale behind device-provided therapy and also device-guided management, offers an overview of current implantable device options recommended by the guidelines and proposes a new integrated model of device therapy as a part of HF care.

Real-world onabotulinumtoxinA treatment patterns in patients with overactive bladder.

Utilization patterns of third-line onabotulinumtoxinA for overactive bladder (OAB) symptoms-including discontinuation and use of other therapeutic options during or after treatment-are not well understood. This retrospective analysis of administrative claims was designed to characterize the unmet need for OAB treatment. A retrospective claims analysis of Optum's deidentified Clinformatics® Data Mart Database (2009-2021) was performed among patients with diagnosis of OAB newly starting onabotulinumtoxinA injection (2015-2017). Study measures were evaluated during an 18-month pretreatment baseline and over a minimum of 36 months of follow-up. These included number of injections, days between injections, other measures of onabotulinumtoxinA utilization, use of second-line pharmacologic treatments, use of device and surgical treatment options, and complications. Of 2505 eligible patients, 535 (21.4%; 66.8 ± 13.3 y, 87.3% females) continued onabotulinumtoxinA throughout the study. The remaining 1970 (78.6%; 71.4 ± 11.6 y, 79.1% females) were considered discontinuers. Of continuers, 57% received ≥5 treatments. Of discontinuers, 84% received ≤2 treatments. Anticholinergics and β3-adrenoceptor agonist medication use declined in all patients from baseline to follow-up; however, the absolute reduction in the proportion with any medication fill was similar across continuers versus discontinuers (21% vs. 18%, p < 0.0001). Sacral neuromodulation was initiated by 15/535 (3%) of continuers and 137/1970 (7%) of discontinuers (p < 0.0001). No patients initiated percutaneous tibial neuromodulation. Early discontinuation of onabotulinumtoxinA therapy for OAB is common and most discontinuers do not receive alternative treatments. Providers have the opportunity to educate OAB patients with un- or undertreated symptoms regarding alternative options.

DEVELOPMENT OF GENERAL REQUIREMENTS FOR TRACKED AND WHEELED EQUIPMENT NOISE DETERMINATION DEVICE

In the work, an analysis of the existing requirements for the noise of wheeled and tracked machinery, an analysis of existing methods of noise assessment, an analysis of existing requirements for noise detection devices, and also the general requirements for a device for determining the noise of tracked and wheeled vehicles, used during tests by developers (manufacturers) of defense goods in Ukraine. The purpose of the article is to improve the laboratory-testing base of the Armed Forces of Ukraine (hereinafter referred to as the Armed Forces of Ukraine) by equipping it with modern test equipment, which will allow obtaining quantitative values of characteristics (parameters) that are subject to evaluation during tests of weapons and military equipment (hereinafter referred to as OMT) and their components The method of conducting research is the theory of system analysis, synthesis of organizational and technical systems, comparison, generalization. The characteristics of the specified device and configuration options are considered. The main parameters for assessing the noise level of automotive and armored vehicles, which are subject to registration (measurement), have been determined. Methods of noise level assessment are considered. The results of the work can be used when choosing a noise meter to solve the tasks of testing, to determine the acoustic visibility of OVT and to meet the requirements of environmental protection.&#x0D; The practical significance of the obtained results lies in the provision of tests, in particular, of military equipment on tracked or wheeled chassis.

Orthotic Devices for the Foot and Ankle.

Millions of Americans wear ankle-foot orthotic devices for protection, pain relief, and deformity correction. Inquiries about off-the-shelf and custom devices are a common reason for evaluation with a foot and ankle surgeon or general orthopaedic surgeon. Despite limited high-quality evidence for their use, these devices can have a notable clinical impact on physical function. An up-to-date understanding of orthotic device options and their appropriate use in managing musculoskeletal pathologies applies to all orthopaedic providers. This review aims to categorize orthosis types and provide specific device recommendations for common adult conditions such as flatfoot, cavovarus foot, and ankle instability. Collaboration with a certified orthotist can help patients achieve functional and recreational goals with the use of appropriately designed and applied orthoses.

Wireless broadband acousto-mechanical sensing system for continuous physiological monitoring.

The human body generates various forms of subtle, broadband acousto-mechanical signals that contain information on cardiorespiratory and gastrointestinal health with potential application for continuous physiological monitoring. Existing device options, ranging from digital stethoscopes to inertial measurement units, offer useful capabilities but have disadvantages such as restricted measurement locations that prevent continuous, longitudinal tracking and that constrain their use to controlled environments. Here we present a wireless, broadband acousto-mechanical sensing network that circumvents these limitations and provides information on processes including slow movements within the body, digestive activity, respiratory sounds and cardiac cycles, all with clinical grade accuracy and independent of artifacts from ambient sounds. This system can also perform spatiotemporal mapping of the dynamics of gastrointestinal processes and airflow into and out of the lungs. To demonstrate the capabilities of this system we used it to monitor constrained respiratory airflow and intestinal motility in neonates in the neonatal intensive care unit (n = 15), and to assess regional lung function in patients undergoing thoracic surgery (n = 55). This broadband acousto-mechanical sensing system holds the potential to help mitigate cardiorespiratory instability and manage disease progression in patients through continuous monitoring of physiological signals, in both the clinical and nonclinical setting.

Effectiveness of vertical error budget model for portable multi-beam echo-sounder in shallow water bathymetric survey

With the increasing availability of portable survey equipment and platforms, hydrographic data acquisition now offers a diverse range of device options and installation methods. Tailoring the mounting and installation of hydrographic survey devices to fit the boat or platform dimensions has become common practice. The use of portable equipment is essential, given the wide selection of combined options available in the market. Consequently, sensor offsets and device performance differ for each survey conducted, necessitating the constant verification of accuracy performance.This paper examines the capabilities of portable multibeam echosounder (MBES) deployments on various types of survey boats. The investigation focuses on error budget modeling and field tests. A model is developed to estimate the propagated uncertainty resulting from different sources of measurement uncertainties. The model primarily considers vertical sources of error in MBES surveys, as they have the most significant impact on hydrographic data quality. To validate the model, field tests are conducted at two different locations using different boat and device configurations. The results demonstrate that the modeled uncertainties align with the measured standard deviations, particularly in the Pramuka area, where the standard deviation of data acquired at the widest beam angle of ±60° is 0.25m, close to the predicted value of 0.28m. However, in the Patimban area, the model overestimates the uncertainty, predicting 0.27m compared to the measured standard deviation of 0.17m.

Diffused trenches for high fill-factor Low-Gain Avalanche Diodes

Low-Gain Avalanche Diodes (LGADs) are a class of silicon detectors that have been specifically designed for the fast detection of minimum ionizing particles (mips) in High-Energy Physics experiments. While they provide timing resolution on the order of a few tens of picoseconds, they cannot achieve high spatial resolution due to the intrinsic characteristics of their structures. Thus, active R&D is on-going to develop detectors based on LGADs to improve their spatial resolution while maintaining the timing performance of the LGADs. Such devices are, for example, AC-coupled LGADs and Deep-Junction LGADs. Another device option is the Trench-Isolated LGAD (TI LGAD), where trenches etched at the periphery of the pixels isolate them while providing a high fill-factor. In this paper we present a variation of this latter approach, demonstrating its feasibility by means of 2-dimensional TCAD simulations.

Terahertz metamaterial filter with enhanced sensing sensitivity using the suspended structure design

This paper presents a method to improve refractive index sensing sensitivity using a suspended structure design with a suspended silver split ring resonator metamaterial structure on a silica substrate, which is important in improving detection sensitivity compared to a planar structure. Its basic unit has two metal cleavage rings attached back-to-back to an etched dielectric substrate. Due to the enhancement of the electric field around the gap of the surface-modularized metal structure and the expansion effect of the electric field of the etched layer, the sensitivity is enhanced from 162.5 GHz/RIU of the planar structure to 342.5 GHz/RIU with a sensing sensitivity enhancement factor of 2.1 times compared to the planar metamaterial with an unetched substrate. When the refractive index of the surrounding environment is changed from n = 1 to n = 1.4, the resonance center produces 0.137 THz redshift. Based on this, a more practical structural design is proposed to improve the refractive index sensing sensitivity while reducing the fabrication difficulty. This work provides new ideas for the research of terahertz (THz) metamaterials with high refractive index sensitivity and offers more device options for THz sensing applications.

Simulation analysis of high-throughput oyster cryopreservation at three scales of production.

Cryopreservation and germplasm repositories offer a variety of potential benefits to aquaculture industries. Despite this, no comprehensive repository systems exist for any prominent aquaculture species. A species that could greatly benefit from the use of cryopreserved sperm and repository storage is the eastern oyster, Crassostrea virginica. High-throughput cryopreservation protocols already exist for this species, and the easy transport of frozen sperm could facilitate selective breeding programs that address pressing challenges currently faced in the industry, such as mortality due to low-salinity conditions. This study addressed the gap between cryopreservation protocols and repository development in the oyster industry by creating simulation models to evaluate cryopreservation needs at three different scales of production. The effects of high-throughput device options and three key parameters (straws per oyster, batch size, and number of operators) on production capacity, time, and cost were evaluated. Recommendations for decisions concerning cryopreservation pathways and repository creation were given at each scale of production. Relative values of broodstock, juvenile oysters, and oyster sperm sold at hatcheries were also discussed. In general, repositories operating at higher production levels benefited from the economy of scale, could use automated high-throughput equipment options, and could hire more labor without drastically increasing production costs.

0568 Trends in OSA Disease Severity Over Nearly Two Decades: Update on the VA San Diego Experience

Abstract Introduction The Veterans Health Administration (VA) is one of the largest integrated healthcare systems in the United States. Key risk factors for obstructive sleep apnea (OSA) include aging, weight, and male gender, all of which are highly prevalent in the VA population and help to explain the higher rates of OSA in the VA. The Pulmonary Sleep Program at the VA San Diego Healthcare System (VASDHS) started a patient database over twenty years ago for its home sleep apnea testing (HSAT) program. An analysis of ten years of diagnostic HSAT data was reported on over 12,500 patients in 2014. This analysis focuses on an update on the last four years and a comparison to 2014. Methods A retrospective review of the local clinical database of HSAT diagnostic testing was conducted. The database contained 8,928 sleep studies from 2018 to 2022. Invalid studies were removed. Only initial diagnostic studies were included. Results Of the 8,928 diagnostic studies, 2,564 tested negative for OSA (28.7%). Of the 6,364 positive cases, 43.3% were mild, 28.8% were moderate, and 27.9% were severe. The percentages of each OSA severity level were stable across these years (mild: 42%-45%; moderate: 27%-32%; and severe: 26%-29%). The mean AHI did not significantly change from 2018 (24.1+/-20.6) to 2022 (25.1+/-21.2) (overall mean 24.4+/-20.3; range: 5-140). Conclusion Based on this extensive retrospective review of diagnostic testing at a single, high-volume HSAT program, it appears that OSA severity levels have stabilized over these past five years, with the highest percentage of mild OSA cases (~43%) followed by moderate (~29%) and severe (~28%). Our facility saw a significant decrease in severe cases (60% to 30%) and increase in mild OSA (7% to 35%) from 2004 to 2013. Today, over 4 out of every 10 new OSA diagnoses are mild, which has significant treatment implications given that adherence to the two primary medical device options is suboptimal. Identifying patient-centered treatment options for these patients is a priority. Support (if any) VA RR&amp;D D2651-R and the Sleep Medicine Section of the VA San Diego Healthcare System supported this project.

Impact of Weight on Ventricular Assist Device Outcomes in Dilated Cardiomyopathy Patients in Pediatric Centers: An ACTION Registry Study.

Ventricular assist device (VAD) options vary for children in different weight groups. This study evaluates contemporary device usage and outcomes for children based on weight. Data from the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry were examined for patients with dilated cardiomyopathy (DCM) in 4 weight cohorts: <8 kg, 8-20 kg, 21-40 kg, and >40 kg, for devices implanted 3/2013-10/2020. Adverse event rates and ultimate outcome (deceased, alive on device, transplanted, or ventricular recovery) were analyzed. 222 DCM patients were identified with 24% in cohort 1, 23% in cohort 2, 15% in cohort 3, and 38% in cohort 4. Of 272 total implants, paracorporeal pulsatile devices were most common (95%) in cohorts 1 and 2 and intracorporeal continuous devices (81%) in cohorts 3 and 4. Stroke was noted in 17%, 12%, 6%, and 4% of cohorts, respectively (Cohort 1 vs. 4 and 2 vs. 4 - p = 0.01; other comparisons - not significant). Incidences of major bleeding, device malfunction, and infection was not different. All cohorts had >90% positive outcomes. Stroke incidence was higher in smaller cohorts, but other outcomes were similar. Positive outcomes were attained in over 90% across all weight groups, demonstrating excellent outcomes using current VADs in this DCM population.

Evolving 3D-Printing Strategies for Structural and Cosmetic Components in Upper Limb Prosthesis

The evolution of prosthetic limbs continues to develop, with novel manufacturing techniques being evaluated, including additive manufacturing. Additive manufacturing (AM), or 3D-printing, holds promise for enabling personalized and tailored medical device options. The requirements for personalized medicine, coupled with the limitations of small-batch manufacturing, have made the technique viable for exploration. In this manuscript, an approach is presented for incorporating additive manufacturing for prostheses, both as a final part and in applications as an intermediate manufacturing step. As a result, through the use of these methods a multi-gesture capable electromyographic prosthesis was designed and manufactured, currently being evaluated in clinical trials for pediatric patients. This paper explored the results of this unique method of applying additive manufacturing techniques, and assessed how the blend of different manufacturing techniques improved performance and reduced device weight. Creating unique and aesthetic cosmetic coverings for the device was achieved through using additive manufacturing as an intermediate manufacturing component and, then, applying thermoforming. Cosmesis components saw a 33% reduction in weight from this change in manufacturing. The approach is explored to blend multiple manufacturing techniques to create cosmesis components and structural components for the prosthesis. The techniques serve the design intent to reduce reported challenges with upper limb prosthesis devices and to encourage device retention. Recommendations for manufacturing strategies are discussed, including the limitations.

Biventricular assist devices and total artificial heart: Strategies and outcomes.

In contrast to the advanced development of the left ventricular assist device (LVAD) therapy for advanced heart failure, the mechanical circulatory support (MCS) with biventricular assist device (BVAD) and total artificial heart (TAH) options remain challenging. The treatment strategy of BVAD and TAH therapy largely depends on the support duration. For example, an extracorporeal centrifugal pump, typically referred to as a temporary surgical extracorporeal right ventricular assist device, is implanted for the short term with acute right ventricular failure following LVAD implantation. Meanwhile, off-label use of a durable implantable LVAD is a strategy for long-term right ventricular support. Hence, this review focuses on the current treatment strategies and clinical outcomes based on each ventricle support duration. In addition, the issue of heart failure post-heart transplantation (post-HT) is explored. We will discuss MCS therapy options for post-HT recipients.

Feasibility of Rescue Colonoscopy Using a Short-type Enteroscope (SIF-H290S) without Overtube after Incomplete Colonoscopy: A Single-center Retrospective Pilot Study.

Recently, a newly designed short-type single-balloon enteroscope (SBE), SIF-H290S, has been developed with a smaller outer diameter and a longer working length than conventional colonoscopes. It has passive bending and high-force transmission, making insertion easier. However, it is difficult to perform rescue colonoscopy with an SBE after incomplete colonoscopy in the same session. Therefore, this study evaluated the feasibility of consecutive rescue colonoscopy using SIF-H290S without overtube after incomplete colonoscopy. This was a single-center retrospective study. We included 19 rescue colonoscopies (19 patients) with SIF-H290S without overtube performed by 11 endoscopists in the SIF group and 38 rescue colonoscopies (38 patients) using a small-caliber colonoscope (PCF-PQ260L) were randomly selected for the control group from procedures performed by the same 11 endoscopists. We compared the cecal intubation rate and other outcomes, such as insertion time, between the two groups. The median age of the patients was 72 and 69 years, with 8 and 26 males in the SIF and control groups, respectively. The median body mass index was 21.6 and 22.7 kg/m2 in the SIF and control groups, respectively. There were no significant differences in the patient backgrounds between the groups, except for the reason for incomplete colonoscopy (p = 0.048). The cecal intubation rate was 78.9% (15/19 procedures) and 92.1% (35/38 procedures) in the SIF and control groups, respectively. This study revealed the real-world experience and feasibility of rescue colonoscopy using SIF-H290S, which could be a potential rescue device option after incomplete colonoscopy.