Position Of Device Research Articles

Effects of Body Positioning When Assessing Lymphedema of the Lower Limb Using Bioimpedance Spectroscopy.

Background: Bioimpedance spectroscopy (BIS) measurements are conventionally performed in supine position with a lead device attached to gel-backed electrodes, and more recently, with a stand-on device that uses fixed stainless-steel electrodes under the hands and feet. The aim of this study was to assess and compare BIS measurements made in supine, sitting, and standing positions using lead and stand-on impedance devices in participants with and without unilateral leg lymphedema. Materials and Methods: Participants with self-ascribed unilateral leg lymphedema (n = 24) and healthy controls (n = 71) were recruited using a cross-sectional study design. Triplicate BIS measurements were taken for each device in each position. Results: Impedance measurements with either device were reliable with coefficient of variation of 0.6% or lower. The magnitude of mean differences in absolute impedance values between devices were between 1% and 6% dependent on condition. L-Dex scores between the two devices were highly correlated (r = 0.82) and ∼70% of participants in the lymphedema group were classified as having lymphedema using the recommended cut-off with either device. There was no significant interleg difference of controls using the lead device; however, small, but significant differences (p = 0.0001) were found when using the stand-on device. Conclusion: The findings demonstrate that reliable impedance measurements of the legs can be made with either device in lying, sitting, or standing positions. However, data between the devices were not directly interchangeable. Although the risk of misidentification was small, reference ranges appropriate to the device and measurement position should be used when converting data to L-Dex scores.

The "velocity barrier" in giant slalom skiing: An experimental proof of concept.

Alpine skiing involves the conversion of potential energy into kinetic energy, with the "velocity barrier" (VB) at each moment corresponding to the maximal velocity at which the athlete can ski while staying within the boundaries of the gates and maintaining control. Nevertheless, this concept has never been proven by evidence. The aim of this study was to experimentally test the existence of the VB and clarify its relationship with skier's force production/application capacities. Fourteen skiers were equipped with ski-mounted force plates and a positional device and ran a 2-turn Giant Slalom section starting from eight different heights on the slope. Three conditions were selected for further analysis: minimal entrance velocity (vmin ); entrance velocity allowing the better section time (VB); maximal entrance velocity (vmax ). Entrance velocity, section time, mean force output, ratio of force application effectiveness, velocity normalized energy dissipation, and path length were compared between the three conditions. Moreover, skier's mechanical energy and velocity curves were compared all along the section between the three conditions using SPM analysis. The section time was reduced in VB compared to vmin (p < 0.001) and vmax (p = 0.002). Skiers presented an incapacity to increase force output beyond the VB (p = 0.441) associated with a lower force application effectiveness (p = 0.005). Maximal entrance velocity was associated to higher energy dissipation (p < 0.001) and path length (p = 0.005). The present study experimentally supports the existence of the VB. The force production/application capacities seem to limit the skiing effectiveness beyond the VB, associated to increased energy dissipations and path length.

Probabilistic indoor tracking of Bluetooth Low-Energy beacons

We construct a practical and real-time probabilistic framework for fine target tracking. In our scenario, a Bluetooth Low-Energy (BLE) device navigating in the environment publishes BLE packets that are captured by stationary BLE sensors. The aim is to accurately estimate the live position of the BLE device emitting these packets. The framework is built upon a hidden Markov model (HMM), the components of which are determined with a combination of heuristic and data-driven approaches. In the data-driven part, we rely on the fingerprints formed priorly by extracting received signal strength indicators (RSSI) from the packets. These data are then transformed into probabilistic radio-frequency maps that are used for measuring the likelihood between an RSSI data and a position. The heuristic part involves the movement of the tracked object. Having no access to any inertial information of the object, this movement is modeled with Gaussian densities with variable model parameters that are to be determined heuristically. The practicality of the framework comes from the associated small parameter set used to discretize the components of the HMM. By tuning these parameters, such as the grid size of the area, the mask size and the covariance of the Gaussian; a probabilistic filtering becomes tractable for discrete state spaces. The filtering is then performed by the forward algorithm given the instantaneous sequential RSSI measurements. The performance of the system is evaluated by taking the mean squared errors of the most probable positions at each time step to their corresponding ground-truth positions. We report the statistics of the error distributions and see that we achieve promising results. The approach is also finally evaluated by its runtime and memory usage.

Positioning of a Photovoltaic Device on a Real Two-Dimensional Plane in Optical Wireless Power Transmission by Means of Infrared Differential Absorption Imaging

In optical wireless power transmission (OWPT), detection and positioning of the photovoltaic device (PV) in real space is essential before power transmission. One of the candidates for the robust detection of PVs is differential absorption imaging, which has been proposed by the authors. In this method, raw images are captured using absorbable (λON) and non-absorbable (λOFF) wavelengths of the PV. Then, the PV is detected from the differential image of these. In this report, the positioning of a PV on a real two-dimensional plane was investigated by means of this differential imaging. Primarily, stereo imagery was utilized for positioning. Non-stereo positioning was also investigated, in which the azimuth angle (direction) was estimated from the position of the PV in the differential image, and ranging was performed using its apparent size. There are diffuse and non-diffuse (specular) options for the λOFF reflection of the rear surface of the PV. Positioning accuracy was measured with regard to this characteristic as well as the attitude angle. Especially for a PV with specular characteristics, even though its positioning accuracy was affected by its attitude angle, the accuracy could be improved by increasing the irradiation light power. On the other hand, direction determination was stable for a wide angular range of attitudes.

Development of SDR-based network positioning technology. LTE reference signals reception and processing validation

Introduction. The positioning of devices according to the base stations reference signals of LTE cellular radio networks deployed everywhere is an important area of research and development that is in demand due to dense urban development with unreliable signal reception from global navigation satellite systems. The instrument for experimental approbation of technical solutions is the software and hardware of the SDR software defined radio technology. This work continues the study on the use of SDR technology for network positioning problems in terms of the experimental testing of the device for receiving reference signals of the LTE standard.Materials and methods. The correctness of the software implementation of the LTE reference signal processing procedures was verified in the course of laboratory tests that showed the accuracy of primary measurements in units of meters allowing us to speak about the satisfactory performance of the implemented SDR layout of the user device that receives the LTE reference signals.Results. Insufficient synchronization accuracy of SDR models of base stations for navigation tasks confirmed the need for hardware-software implementation of the subsystem for generating LTE reference signals in HDL for FPGAs.Discussion and conclusions. The next stage of research in the field of SDR network positioning technology is field testing of the implemented sub-system for generating LTE reference signals with sufficient synchronization accuracy of eNB models for navigation tasks.

Value of a novel Y-Z magnetic totally implantable venous access port in improving the success rate of one-time needle insertion.

A totally implantable venous access port (TIVAP) is a commonly used intravenous infusion device for patients receiving chemotherapy or long-term infusion therapy. To improve the success rate of one-time insertion of the Huber needle, we developed a novel Y-Z magnetic TIVAP (Y-Z MTIVAP), which we produced using three-dimensional printing technology. The Y-Z MTIVAP includes a magnetic port body and a magnetic positioning device. For testing, we established four venous port implantation models using the two types of TIVAPs and two implantation depth ranges (≤5 mm and >5 mm). Twenty nurses performed Huber needle puncture with the four models, and we recorded the number of attempts required for successful needle insertion, the operation time, and the operator's satisfaction. The success rate for one-time needle insertion with the Y-Z MTIVAP was significantly higher than that with the traditional TIVAP at either depth range (100% vs. 75% at ≤5 mm, p = 0.047; 95% vs. 35% at >5 mm, p < 0.001). With increasing implantation depth, the success rate for one-time insertion was significantly reduced with the traditional TIVAP (75% at ≤5 mm vs. 35% vs. >5 mm, p = 0.025), but the success rate with the Y-Z MTIVAP was not significantly affected (100% vs. 95%, p = 1.000). The operation time with the Y-Z MTIVAP was significantly shorter than that with the traditional TIVAP at either depth range (both p < 0.001), and 90% of operators reported that the Y-Z MTIVAP was superior to the traditional TIVAP. The theoretical design of Y-Z MTIVAP is feasible, and the preliminary in vitro simulation experiment shows that it can significantly improve puncture success rate and shortened operation time.

Total Knee Arthroplasty in a Patient with Ipsilateral Painless Hip Arthrodesis: Technical Surgical Tips and a Novel Method for Intraoperative Navigation-Assisted Planning.

Total knee arthroplasty (TKA) in the setting of a previous ipsilateral hip fusion/arthrodesis is an uncommon and challenging procedure. There is little information available in the literature on the challenges and techniques available to perform TKA in these patients. For a traditional TKA procedure, the patient is placed in the supine position and various knee-positioning devices are used to allow for adequate knee and hip flexion, which is required for surgical exposure and tibia preparation. Ipsilateral hip arthrodesis presents two major challenges: (1) Hip flexion is crucial for adequate knee flexion while the patient is supine during the TKA procedure, and (2) the use of advanced technology, specifically computer navigation and robotic-assisted surgery techniques, is limited due to the inability to acquire the hip center of rotation during surgery, due to the lack of hip motion. Therefore, equipment and positioning must be adjusted by the surgeon to facilitate TKA in these patients. This article reports the case of a 72-year-old male patient with a long-standing, painless right hip arthrodesis, presenting with end-stage osteoarthritis of the right knee, leg-length discrepancy, and an 11.6° difference between the mechanical and anatomical axes of the femur. We describe the unique surgical planning as well as the surgical positioning options that allow for adequate knee flexion and proper surgical exposure. Furthermore, we describe a novel method of computer-assisted navigation for intra-operative planning and execution utilizing a reflected tibia as a template for the distal femoral cut.

Comparison of child and ATD belt fit and posture on belt-positioning boosters during self-selected, holding device, and nominal conditions

ObjectivePediatric anthropomorphic test devices (ATDs) are important tools for the assessment of child occupant protection and should represent realistic child belt fit and posture on belt-positioning boosters. Previous comparisons have been made to children in either self-selected or nominal postural conditions. This study compares belt fit and postural measurements between pediatric ATDs and a single cohort of children assuming different postures on boosters: self-selected, holding a portable electronic device, and nominal. MethodsA cohort of children (n = 25) were evaluated in a stationary vehicle on five boosters and in three postural conditions: nominal, self-selected, and a representative holding electronic device position. The Hybrid III 6- and 10-year-old and Q-Series 6- and 10-year-old ATDs were evaluated in the same five boosters and in two postural conditions: nominal and a representative holding electronic device position. A 3D coordinate measurement device was used to quantify belt fit (shoulder belt score, lap belt score, maximum gap size, and gap length) and anatomic landmark positions (head, suprasternale, ASIS, and patella). Landmark positions and belt fit were compared between ATDs and children for each booster and postural condition, and Pearson correlations (r) were assessed across boosters. ResultsATDs generally represented Nominal child postures across boosters. In the Device condition, ATDs were seldom able to be positioned to represent both the torso and head position of children, due to limited ATD spinal flexibility. When the torso position was matched, the ATD head was more rear by 63 mm. Correlations between Nominal child and ATD belt fit and belt gap metrics were generally weak and not significant, with the exception of lap belt score (all ATDs p < 0.07, r = 0.8549–0.9857). DiscussionATDs were generally able to represent realistic child postures and lap belt fit in Nominal and short duration Self-selected postures in a laboratory setting. However, these results display the potential difficulty of utilizing ATDs to represent more naturalistic child postures, especially the more forward head positions and flexed spinal posture associated with utilizing a portable electronic device.

Artificial Intelligence to Assess Tracheal Tubes and Central Venous Catheters in Chest Radiographs Using an Algorithmic Approach With Adjustable Positioning Definitions.

To develop and validate an artificial intelligence algorithm for the positioning assessment of tracheal tubes (TTs) and central venous catheters (CVCs) in supine chest radiographs (SCXRs) by using an algorithm approach allowing for adjustable definitions of intended device positioning. Positioning quality of CVCs and TTs is evaluated by spatially correlating the respective tip positions with anatomical structures. For CVC analysis, a configurable region of interest is defined to approximate the expected region of well-positioned CVC tips from segmentations of anatomical landmarks. The CVC/TT information is estimated by introducing a new multitask neural network architecture for jointly performing type/existence classification, course segmentation, and tip detection. Validation data consisted of 589 SCXRs that have been radiologically annotated for inserted TTs/CVCs, including an experts' categorical positioning assessment (reading 1). In-image positions of algorithm-detected TT/CVC tips could be corrected using a validation software tool (reading 2) that finally allowed for localization accuracy quantification. Algorithmic detection of images with misplaced devices (reading 1 as reference standard) was quantified by receiver operating characteristics. Supine chest radiographs were correctly classified according to inserted TTs/CVCs in 100%/98% of the cases, thereby with high accuracy in also spatially localizing the medical device tips: corrections less than 3 mm in >86% (TTs) and 77% (CVCs) of the cases. Chest radiographs with malpositioned devices were detected with area under the curves of >0.98 (TTs), >0.96 (CVCs with accidental vessel turnover), and >0.93 (also suboptimal CVC insertion length considered). The receiver operating characteristics limitations regarding CVC assessment were mainly caused by limitations of the applied CXR position definitions (region of interest derived from anatomical landmarks), not by algorithmic spatial detection inaccuracies. The TT and CVC tips were accurately localized in SCXRs by the presented algorithms, but triaging applications for CVC positioning assessment still suffer from the vague definition of optimal CXR positioning. Our algorithm, however, allows for an adjustment of these criteria, theoretically enabling them to meet user-specific or patient subgroups requirements. Besides CVC tip analysis, future work should also include specific course analysis for accidental vessel turnover detection.

The One-Way Linear Effect, a first order optical effect

In the One-Way Linear Effect, the round-trip time interval T0′ taken by light to propagate around a moving linear closed contour, is measured by a device. If the contour changes velocity by Δv, the round-trip interval T′(X′,Δv) turns out to depend on the device position X′ and Δv. The variation ΔT′=T′(X′,Δv)−T0′, related to Δv/c, is experimentally observable by means of standard interferometry, ring laser techniques, or high precision time-delay detectors of light pulses. Being sensitive to velocity variations, if experimentally confirmed the One-Way Linear Effect may have relevant applications in inertial guidance systems and related areas. Furthermore, the One-Way Linear Effect can be used to confirm Lorentz invariance by testing relative simultaneity versus absolute simultaneity.

The feasibility study of stress position device simulating standing weight-bearing applied in computed tomography examination.

In order to simulate weight-bearing Computed Tomography (CT) examination, this study designed a simple stress position device. By analyzing the relevant data of stress position footprints and weight-bearing position footprints, the feasibility of the stress position device to simulate standing weight-bearing was verified. This study randomly selected 25 volunteers for standing weight-bearing and stress position footprints collection, and measured the relevant indicators of stress position footprints and standing weight-bearing position footprints. Two foot and ankle surgeons conducted two measurements respectively on the footprints. Intra-observer and inter-observer reliability were calculated using intra-class correlation coefficients (ICC). Pearson correlation coefficient, ICC, scatter plot analysis, and paired t-test were used to analyze the stress and weight-bearing position data. The intra-observer and inter-observer measurement values were reliable. There was a certain degree of correlation between the stress position footprints and weight-bearing position footprints in terms of Pearson correlation coefficient, ICC, and scatter plot analysis. Paired t-tests showed significant differences in Clarke angle (t 2.636, p .012), C-S index (t 10.568, p .000), arch indx (t 2.176, p .035), and arch lower angle (t 6.246, p .000). The stress position device can generate a certain degree of stress, and after further optimization and improvement of the stress position device, it is feasible to apply it to weight-bearing CT examination in clinical settings.

Sensitivity investigation of 100-MeV proton irradiation to SiGe HBT single event effect

The single event effect (SEE) sensitivity of silicon–germanium heterojunction bipolar transistor (SiGe HBT) irradiated by 100-MeV proton is investigated. The simulation results indicate that the most sensitive position of the SiGe HBT device is the emitter center, where the protons pass through the larger collector-substrate (CS) junction. Furthermore, in this work the experimental studies are also carried out by using 100-MeV proton. In order to consider the influence of temperature on SEE, both simulation and experiment are conducted at a temperature of 93 K. At a cryogenic temperature, the carrier mobility increases, which leads to higher transient current peaks, but the duration of the current decreases significantly. Notably, at the same proton flux, there is only one single event transient (SET) that occurs at 93 K. Thus, the radiation hard ability of the device increases at cryogenic temperatures. The simulation results are found to be qualitatively consistent with the experimental results of 100-MeV protons. To further evaluate the tolerance of the device, the influence of proton on SiGe HBT after gamma-ray (60Coγ) irradiation is investigated. As a result, as the cumulative dose increases, the introduction of traps results in a significant reduction in both the peak value and duration of the transient currents.

Physics-informed deep learning for traffic state estimation based on the traffic flow model and computational graph method

Traffic state estimation (TSE) is a critical task for intelligent transportation systems. However, it is extremely challenging because the traffic data quality is often affected by the installation position of devices, data collection frequency, interference during the transmission process, etc., thus causing the problem of data sparsity or data missing. To address the issue of traffic state estimation under the scenario of data sparsity, we propose a TSE model that combines the computational graph with physics-informed deep learning (PIDL) methods. Firstly, we apply the computational graph method to determine the parameters of the traffic fundamental diagram. These parameters are embedded into the computational graph framework, and their values are determined through the forward propagation of variables and the backward propagation of errors. Next, we employ the PIDL method to realize TSE (taking the LWR model based on the Greenshields fundamental diagram as an example). The PIDL leverages the advantages of data-driven and model-driven approaches to achieve accurate traffic state estimation. Case studies are conducted using the NGSIM dataset under two sparse data scenarios: loop detectors and probe vehicles. Experimental results demonstrate that PIDL can accurately reconstruct the traffic state of the entire road segment based on partially observed data. Furthermore, compared to pure deep learning methods and other baseline models, PIDL performs better in situations with sparse data, thereby proving the feasibility of integrating domain knowledge with deep learning frameworks. This paper fully acknowledges the issue of data sparsity in TSE and effectively addresses it by applying the PIDL method to achieve precise TSE, which holds significant implications for the control and management of real traffic flow.

The CathCam: A Novel Angioscopic Solution for Endovascular Interventions.

Peripheral arterial diseases are commonly managed with endovascular procedures, which often face limitations in device control and visualization under X-ray fluoroscopy guidance. In response, we developed the CathCam, an angioscope integrated into an expandable cable-driven parallel mechanism to enhance real-time visualization, precise device positioning and catheter support for successful plaque crossing. The primary objective of this study was to assess and compare the performance of the novel CathCam with respect to conventional catheters and the CathPilot (i.e., CathCam without the angioscope), for applications in crossing chronic total occlusions (CTO). We first assessed the system in 3D-printed phantom models, followed by an ex vivo evaluation with CTO samples from a patient's superficial femoral artery. We measured and compared success rates, crossing times, and fluoroscopy times in both experiments. The CathCam demonstrated a 100% success rate in phantom experiments and a 75% success rate in ex vivo experiments with CTO samples, compared to conventional catheters, with 35% and 25% success rates, respectively. The average crossing times for the CathCam and the conventional catheter were 31s and 502s for the phantom experiments and 210s and 511s for the actual CTO lesions. The Cathcam also showed to be a reliable endovascular imaging approach in an in vivo experiment. Compared to conventional catheters, the CathCam significantly increased the success rate and reduced crossing and fluoroscopy times in both phantom and ex vivo setups. CathCam can potentially improve clinical outcomes for minimally invasive endovascular interventions by offering high-resolution real-time imaging alongside accurate device control.

Charge‐Mediated Copper‐Iodide‐Based Artificial Synaptic Device with Ultrahigh Neuromorphic Efficacy

In the realm of artificial intelligence, ultrahigh‐performance neuromorphic computing plays a significant role in executing multiple complex operations in parallel while adhering to a more biologically plausible model. Despite their importance, developing an artificial synaptic device to match the human brain's efficiency is an extremely complex task involving high energy consumption and poor parallel processing latency. Herein, a simple molecule, copper‐iodide‐based artificial synaptic device demonstrating core synaptic functions of human neural networks is introduced. Exceptionally high carrier mobility and dielectric constant in the developed device lead to superior efficacies in neuromorphic characteristics with ultrahigh paired‐pusle facilitation index (&gt;195). The results demonstrate biomimetic capabilities that exert a direct influence on neural networks across multiple timescales, ranging from short‐ to long‐term memory. This flexible reconfiguration of neural excitability provided by the copper‐iodide‐based synaptic device positions it as a promising candidate for creating advanced artificial intelligence systems.

A two-step in situ measurement method for temperature and thermal stress of power device based on a single Raman peak

Temperature and thermal stress are primary factors leading to the performance failure of power devices. Thus, simultaneously determining the temperature and stress variation of the working devices has become the premise of revealing the failure mechanism. However, the existing methods are still unsatisfactory for in-situ temperature-stress decoupling measurement. To solve this problem, a two-step decoupling method based on a single Raman peak is proposed. In the calibration step, the effective temperature - Raman shift coefficients at different positions of the power devices were measured in the OFF state, and the contribution ratio of temperature and thermal stress to the single peak shift can be determined by analyzing the difference of effective temperature - Raman shift coefficients with intrinsic temperature - Raman shift coefficient. In the in-situ measurement step, the temperature rise and thermal stress variation can be calculated based on the Raman peak shift of the target semiconductor layer and the calibrated contribution ratio. A measurement of the GaN high electron mobility transistor was used to further illustrate the advantages of the proposed method. Compared with the previous multi-peak decoupling method, the temperature and thermal stress distributions of the working device obtained by the two-step decoupling method make more physical sense, and the measurement uncertainty of temperature and stress can be reduced to 1/4 and 1/3 of the previous method respectively. The consistency with the thermo-stress simulation further verifies the reliability and accuracy of the proposed method.

In-silico modelling of multi-strike insertion and torsional resistance of tapered revision hip stems: Insight into spline design philosophy.

Despite the clinical success of tapered splined titanium stems, a knowledge gap still exists between spline design and its primary mechanical stability, which is critical to the long-term success of revision hip arthroplasty. Additionally, almost all published pre-clinical studies relied on resource-intensive benchtop and cadaveric testing. Hence, the present study developed a novel computational model to investigate effects of spline geometry and configuration on axial and torsional stability of tapered stem. Dynamic explicit Finite Element Analysis coupled with a state-of-the-art adaptive meshing technique was used to simulate the highly non-linear contacts and large bony material deformations. Hybridising primary straight splines with secondary angled splines results in 41% and 10% increases of peak insertion force and post-seating moment than the predicate device for the same seating position. The primary straight splines cut at multiple circumferential bony locations, enhancing torsional stability; while the alternatively placed secondary angled splines form wedges with the bone, providing reliable seating and additional torsional resistance. To the best knowledge of the author, this is the first in-silico investigation of its kind to simulate multi-strike seating and torsional resistance of revision hip stems, offering an effective and efficient platform for future multi-factorial parametric study and uncertainty quantification.

Development of a testing device for external wrist bridging dynamic fixators used for distal radius fractures

BackgroundStabilization of extra-articular distal radius fractures by wrist joint bridging (WB) dynamic fixation allows for early motion of the wrist, but relies on exact positioning of the device. In fact, physiological movement appeared to be compromised with even distinctly aberrant positioning of such device. To investigate this issue in more detail, we developed an in-vitro testing apparatus suitable for assessing the forces required for flexion and extension of the wrist. MethodsThe experimental set-up enables the transmission of the translational movement of the traverse of a universal testing machine into the main physiological movement (flexion and extension) of the wrist. An external WB dynamic fixator was assembled to an artificial saw bone wrist model prior and after performing a wedge-shaped osteotomy on the distal radius about 1.5 cm proximal to the joint line, i.e. generation of a fracture model. The functionality of the fixator was evaluated under either condition and the effect of misalignment of the external WB dynamic fixator was quantified by purposeful violation of the manufacture's instructions. Results were statistically analyzed using the generalized linear mixed model. FindingsSignificantly higher loading was noted as the degree of misalignment increased. The normalized force was significantly higher at a misalignment of 20° compared to 10° (10°: 4.13; 20°: 6.93, P < 0.001). InterpretationThe proposed set-up turned out to allow highly reproducible and sensitive recording of the reaction forces during flexion and extension of the wrist and thus is feasible for the evaluation and comparison of different external WB devices.

Direct current cardioversion practices following percutaneous left atrial appendage closure.

Among patients with non-valvular atrial fibrillation (AF) and percutaneous left atrial appendage closure (LAAC) undergoing direct current cardioversion (DCCV), the need for and use of LAA imaging and oral anticoagulation (OAC) is unclear. The purpose of this study is to evaluate the real-world use of transesophageal echocardiography (TEE) or cardiac computed tomography angiography (CCTA) before DCCV and use of OAC pre- and post-DCCV in patients with AF status post percutaneous LAAC. This retrospective single center study included all patients who underwent DCCV after percutaneous LAAC from 2016 to 2022. Key measures were completion of TEE or CCTA pre-DCCV, OAC use pre- and post-DCCV, incidence of left atrial thrombus (LAT) or device-related thrombus (DRT), incidence of peri-device leak (PDL), and DCCV-related complications (stroke, systemic embolism, device embolization, major bleeding, or death) within 30 days. A total of 76 patients with AF and LAAC underwent 122 cases of DCCV. LAAC consisted of 47 (62%), 28 (37%), and 1 (1%) case of Watchman 2.5, Watchman FLX, and Lariat, respectively. Among the 122 DCCV cases, 31 (25%) cases were identified as "non-guideline based" due to: (1) no OAC for 3 weeks and no LAA imaging within 48 h before DCCV in 12 (10%) cases, (2) no OAC for 4 weeks following DCCV in 16 (13%) cases, or (3) both in 3 (2%) cases. Among the 70 (57%) cases that underwent TEE or CCTA before DCCV, 16 (23%) cases had a PDL with a mean size of 3.0 ± 1.1 mm, and 4 (6%) cases had a LAT/DRT on TEE resulting in cancellation. There were no DCCV-related complications within 30 days. There is a widely varied practice pattern of TEE, CCTA, and OAC use with DCCV after LAAC, with a 6% rate of LAT/DRT. LAA imaging before DCCV appears prudent in all cases, especially within 1 year of LAAC, to assess for device position, PDL, and LAT/DRT.

Optimal Configuration of Reactive Power in Distribution Network with Power Electronic Transformer

Traditional means of reactive power regulation are limited to adjusting the ratio of the On-Load Tap Changer or changing the access position of the reactive power compensation device and its access capacity. In order to save the cost of putting in reactive power compensation devices, this paper proposes to use the characteristics of the reactive power output function on both sides of the power electronic transformer to regulate the system reactive power distribution. For this purpose, a reactive power optimization model including distributed power supplies and power electronic transformers is constructed with the objectives of minimizing voltage excursions, maximizing voltage stability margins and minimizing active losses in the network. At the same time, based on the characteristics of decision variables, cross-feedback hybrid optimization algorithm is used to solve different types of variables, and an improved wolf pack algorithm using Tent chaotic map and Levy flight strategy is proposed to improve the solution efficiency of the algorithm. The experimental results conclude that the proposed model and algorithm are valid, and the algorithm has significant advantages in terms of model solution time and global search capability when compared with the traditional Wolf Pack algorithms and Particle Swarm Optimization algorithms.