Abstract
Background
Physiology-guided treatment strategy improves clinical outcomes of patients with coronary artery disease. However, it has not been fully evaluated whether such guideline-based ...strategy is useful for patients with diffuse coronary artery disease as well, which is known to be one of the major factors affecting morbidity and mortality.
Purpose
The aim of this study was to clarify clinical outcomes of patients with diffuse coronary artery disease whose treatment strategy was based on coronary physiology.
Methods
From an international multicentre registry of iFR-pullback, consecutive 1067 patients (1185 vessels) with stable angina were included in whom coronary lesions were deferred or revascularized according to the iFR cutoff: 0.89. The physiological pattern of disease was classified according to the iFR-pullback recording as predominantly physiologically diffuse (n=463) or predominantly physiologically focal (n=722). Major adverse cardiovascular events (MACEs), defined as a composite of cardiac death, non-fatal myocardial infarction, and ischemia-driven target lesion revascularization during follow-up period, were compared between diffuse and focal groups, in both deferred and revascularized groups, respectively.
Results
Mean age was 67.1±10.7 years and 75.8% of patients were men. Median iFR was 0.88 (interquartile range: 0.80 to 0.92). At a median follow-up period of 18 months, no significant differences in MACEs were found between diffuse and focal groups, in both iFR-based deferred and revascularized groups. In the deferred group (n=480), MACEs occurred in 6.9% patients (15/217) in the diffuse group and 8.0% patients (21/263) in the focal group (p=0.44). In the revascularized group (n=705), MACEs occurred in 8.9% patients (22/246) in the diffuse group and 7.2% patients (33/459) in the focal group (p=0.49).
Conclusions
Despite potentially higher risks in patients with diffuse coronary artery disease, clinical outcomes of those patients were comparable to those of patients without diffuse disease, as long as treatment strategy was based on the physiology guidance, which is globally recommended by international guidelines.
Funding Acknowledgement
Type of funding source: None
•New non-resonant micro-electromagnetic energy harvester based on combined free/impact motion is presented.•It shows a unique dynamic behaviour.•The power generated increases with both input ...amplitude and frequency.•The harvester simple design promotes size minimization.•The harvester is well suited for human-powered micro devices.
This paper presents design, simulation, and experimentation of a novel micro-electromagnetic vibration energy harvester based on free/impact motion. Power harvesting is simply achieved from relative oscillation between a permanent magnet allowed to move freely inside a tube-carrying electrical coil with two end stoppers and directly connected to the vibration source. The proposed harvester with free/impact motion shows a non-resonant behaviour in which the output power continuously increase with the input frequency and/or amplitude. In addition, the allowable free motion permits significant power scavenging at low frequencies. Hence, the proposed harvester is well suited for the applications involved variable large amplitude–low frequency vibrations such as human-powered devices. A nonlinear mathematical model of the proposed harvester including electromagnetic and impact characteristics is derived and used further for a case study model prediction. A unique way of oscillation is observed, in which four modes of magnet/tube relative motion appear over the range of exciting amplitudes and frequencies. Two experiments are conducted on different fabricated prototypes. The first shows the effect of different magnet shapes on the harvesting performance, and the second is carried out to investigate the performance of two different size prototypes with variable large amplitude-low frequency vibrations. A harvester with cylindrical total size of D9×L12mm can generate RMS power of 71.8μW at (2.5Hz and 5.2ms−2) and 113.3μW at (3.33Hz and 12.38ms−2). Another of D7×L12mm size can generate RMS power of 28.4μW at (2.5Hz and 5.2ms−2) and 82.9μW at (3.33Hz and 12.38ms−2). Comparison with some previously fabricated low frequency energy harvesters is made which shows the advantageous of the new harvester in size minimization as well as the significant power raise with the input amplitude.
Natural sounds are reportedly restorative, but most research has used one-off experiments conducted in artificial conditions. Research based on field experiments is still in its infancy. This study ...aimed to generate hypotheses on the restorative effects of listening to natural sounds on surgeons, representing professionals working in stressful conditions.
Each of four surgeons (two experts and two residents) participated six times in an experiment where they took a 10-min break listening to natural sounds (four times) or without natural sounds (twice) after a surgical operation. We measured their skin conductance level, an indicator of sympathetic arousal, continuously during the break (measurement occasions
= 2520) and assessed their mood using two questionnaires before and after the break (
= 69 and
= 42). We also interviewed them after the break.
Based on statistical Linear Mixed-Effects modeling, we developed two hypotheses for further, more detailed studies: (H1) Listening to natural sounds after an operation improves surgeons' mood. (H2) Inexperienced surgeons' tension persists so long that the effect of natural sounds on their sympathetic arousal is negligible.
This risk-free, easy-to-use means of stress alleviation through natural sounds could benefit highly-stressed people working indoors.
This paper presents study of an electromagnetic vibration energy harvesting configuration that can work effectively at low frequencies. Unlike the conventional form of vibration energy harvesters in ...which the mass is directly connected to a vibrating frame with spring suspension, in the proposed configuration a permanent magnet mass is allowed to move freely within a certain distance inside a frame-carrying coil and make impacts with spring end stops. The free motion distance allows matching lower vibration frequencies with an increase in the relative amplitude at resonance. Hence, significant power could be generated at low frequencies. A nonlinear mathematical model including impact and electromagnetic induction is derived. Study of the dynamic behaviour and investigation of the system performance is carried out with the aid of case study simulation. The proposed harvester shows a unique dynamic behaviour in which different ways of response of the internal relative oscillation appear over the range of input frequencies. A mathematical condition for the response type at which the higher relative amplitude appears is derived, followed by an investigation of the system resonant frequency and relative amplitude. The resonant frequency shows a dependency on the free motion distance as well as the utilized mass and spring stiffness. Simulation and experimental comparisons are carried out between the proposed harvester and similar conventional one tuned at the same input frequency. The power generated by the proposed harvesting configuration can reach more than 12 times at 11Hz in the simulation case and about 10 times at 10Hz in the experimental case. Simulation comparison also shows that this power magnification increases by matching lower frequencies which emphasize the advantages of the proposed configuration for low frequency operation.
•We present an electromagnetic vibration energy harvester based on free/impact motion.•The proposed harvester has a resonant behaviour. However, it shows a unique way of oscillation.•Its resonant frequency can be shifted to lower range with an increase in the resonant relative amplitude•Simulation and experimental comparison between the proposed harvester and similar conventional one shows its advantages at low frequencies.
Vocalization significantly impacts daily human activities by affecting cognitive, physical, and emotional aspects. Physical and social barriers can restrict individuals' ability to express themselves ...vocally despite its importance. To address this issue, the authors have proposed an innovative method to enhance vocal agency through laryngeal vibratory and auditory stimuli. However, prior research has predominantly examined the effectiveness of this technique in scenarios involving loud vocalizations, and the validity of this method has thus yet to be sufficiently verified. In this study, we examined the effects of vibratory stimuli on the sense of agency in the case of general vocalizations. Findings revealed that vibratory stimuli applied to areas not directly involved in vocalization, such as the wrist, failed to foster a sense of vocal agency, in stark contrast to the effects observed with stimuli applied to the larynx. These results underscore the importance of directing vibratory stimuli to anatomical regions integral to vocalization to enhance vocal agency effectively. This research has substantial potential to influence the development of interactive and virtual reality technologies and support individuals experiencing speech difficulties.
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