Addressing the sensitivity of permanent magnet synchronous motors to external disturbances, a novel sliding mode control (NSMC) strategy is proposed to suppress sliding mode jitter and enhance speed regulation performance. First, an advanced non-singular fast terminal sliding mode (ANFTSM) surface and a new adaptive power rate reaching law (NAPRRL) were developed. A new switching function replaces the conventional sign function to enhance the system’s disturbance immunity and dynamic response speed. Then, the system’s anti-interference performance was further enhanced by introducing an improved novel sliding mode observer (INSMO) for feedback compensation of the aggregate disturbance. Finally, MATLAB/Simulink simulations and experimental validations demonstrate that the NSMC control strategy exhibits superior performance in both the start-up response and load disturbance phases, with enhanced dither-resistance, rapid dynamic response, and disturbance suppression capabilities.

not-yet-known not-yet-known not-yet-known unknown The Efficiency of using KardiaMobile 6L in the Cardiac Electrophysiology Clinic Bahjat Z. Ghazzal MD1, Marwan M. Refaat, MD2 1 Division of Cardiology, Department of Internal Medicine, University of Massachusetts Chan Medical School , Worcester, Massachusetts, USA 2 Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Running Title: The Efficiency of KardiaMobile 6L in Clinic Words: 719 (excluding the title page and references) Keywords: Electrocardiogram, cardiac arrhythmias, cardiology, cardiovascular diseases, Utilization Time, Efficiency Funding: None Disclosures: None Corresponding Author: Marwan M. Refaat, MD, FACC, FAHA, FHRS, FASE, FESC, FACP, FRCP Tenured Professor of Medicine Tenured Professor of Biochemistry and Molecular Genetics Member, Division of Cardiology/ Section of Cardiac Electrophysiology Director, Cardiovascular Fellowship ProgramAmerican University of Beirut Faculty of Medicine and Medical Center PO Box 11-0236, Riad El-Solh 1107 2020- Beirut, Lebanon US Address: 3 Dag Hammarskjold Plaza, 8th Floor, New York, NY 10017, USA Office: +961-1-350000/+961-1-374374 Extension 5353 or Extension 5366 (Direct) Electrocardiography (ECG) is an essential diagnostic tool in cardiology, allowing for the detection and management of various cardiac conditions. Traditional 12-lead ECGs, while comprehensive, can be time-consuming and may impact clinic efficiency. This may be particularly important in outpatient cardiology clinics, where time can often be a scarce resource. A survey distributed at the 2022 ESC congress found that while most cardiologists believe that consultations should last 30 to 45 minutes, they often have only 20 minutes or less.1 Although the effects of time pressure have not been extensively studied in cardiology and cardiac electrophysiology outpatient clinics, research in primary care has linked it to increased physician stress, burnout, intent to leave the practice2 in addition to lower diagnosis rates and higher follow-up care rates3. Research has also shown that increasing system efficiency and improving patient cycle time in primary care clinics can improve patient experience and access as well as staff satisfaction.4 Thus, the introduction of KardiaMobile 6-lead ECG (Figure 1), a more portable and user-friendly device, could present an opportunity to streamline ECG collection and potentially improve clinic time utilization. The study by Gaddam et al. explores this potential by comparing room utilization times between KardiaMobile 6-lead ECG and the standard 12-lead ECG in a cardiology clinic setting. In their study, Gaddam et al. conducted a single-center, non-randomized trial involving 100 patients aged 18 to 89, excluding those with resting tremor. The participants were divided into two groups: one underwent ECG collection using KardiaMobile 6-lead ECG, and the other using the traditional 12-lead ECG. The primary outcome measured was room utilization time, with secondary outcomes including the need for additional 12-lead ECGs. The results demonstrated a significant reduction in room utilization time with KardiaMobile 6-lead ECG (7.27 minutes) compared to the 12-lead ECG (10.33 minutes, p < 0.001). Only 16% of visits in the KardiaMobile 6-lead ECG group required an additional 12-lead ECG, indicating that KardiaMobile 6-lead ECG is sufficient for most clinical needs. The primary benefit of 6-lead ECGs lies in their portability and ease of use, making them suitable for continuous monitoring and rapid assessment in both clinical and non-clinical settings. Although research on this subject is still limited, a recent prospective study of 1,015 participants found that the KardiaMobile 6-lead ECG demonstrates a high level of agreement with 12-lead ECGs for certain parameters like PR interval, QRS duration, and cardiac axis, but may be less effective for detecting conditions that require detailed precordial lead information, such as left ventricular hypertrophy or specific ischemic changes.5 Other studies have also corroborated acceptable agreement in certain ECG parameters between 6-lead and 12-lead ECG’s, however, highlighting the 12-lead ECG’s advantage in certain situations where broader and more detailed data collection is required.6,7 While this study was well-conducted, minor limitations exist. The study follows a non-randomized design, which may potentially introduce selection bias and the team members were non-blinded, which may introduce observer bias. Additionally, the relatively small sample size and single-center nature of the study may limit generalizability. It must also be noted that nearly half of the patients in each group (KardiaMobile 6-lead ECG vs. 12-lead ECG) visited the clinic for atrial fibrillation and/or atrial flutter follow-up, conditions that can be detected with just a 1-lead ECG. Finally, while the study shows a statistically significant reduction in average room utilization time by 3.07 minutes, it does not assess whether this reduction translated to meaningful improvements in tangible clinic efficiency outcomes. Despite these limitations, the study provides valuable insights into the potential benefits of integrating KardiaMobile 6-lead ECG into clinical practice. It could lead to improved clinical workflows, allowing clinicians to see more patients without compromising the quality of care. This device may also be particularly beneficial in remote or resource-limited settings where traditional 12-lead ECGs are impractical. Future research should focus on larger, randomized trials to validate these findings and explore the long-term benefits and potential limitations of KardiaMobile 6-lead ECG in diverse clinical environments. Furthermore, investigating the use of KardiaMobile 6-lead ECG in specific patient populations, such as those with complex arrhythmias or comorbidities associated with arrhythmias such as cardiomyopathies and heart failure, could provide additional insights into its clinical utility.8,9 The development of guidelines and protocols for integrating KardiaMobile 6-lead ECG into routine practice will be essential to maximize its benefits and ensure patient safety. Legend Figure 1: Kardia 6L Electrocardiogram (Mountain View, CA) References: https://doi.org/10.1016/j.jelectrocard.2021.03.008 1. Sala O, Moscatelli S. Time matters. Global assessment of quality, duration and mismatch between real practice working conditions and physician needs performing outpatients cardiological consultations. European Heart Journal . 2022;43. doi: 10.1093/eurheartj/ehac544.28352. Prasad K, Poplau S, Brown R, Yale S, Grossman E, Varkey AB, Williams E, Neprash H, Linzer M, for the Healthy Work Place I. Time Pressure During Primary Care Office Visits: a Prospective Evaluation of Data from the Healthy Work Place Study. Journal of General Internal Medicine . 2020;35:465-472. doi: 10.1007/s11606-019-05343-63. Freedman S, Golberstein E, Huang TY, Satin DJ, Smith LB. Docs with their eyes on the clock? The effect of time pressures on primary care productivity. J Health Econ . 2021;77:102442. doi: 10.1016/j.jhealeco.2021.1024424. Robinson J, Porter M, Montalvo Y, Peden CJ. Losing the wait: improving patient cycle time in primary care. BMJ Open Quality . 2020;9:e000910. doi: 10.1136/bmjoq-2019-0009105. Azram M, Ahmed N, Leese L, Brigham M, Bowes R, Wheatcroft SB, Ngantcha M, Stegemann B, Crowther G, Tayebjee MH. Clinical validation and evaluation of a novel six-lead handheld electrocardiogram recorder compared to the 12-lead electrocardiogram in unselected cardiology patients (EVALECG Cardio). European Heart Journal - Digital Health . 2021;2:643-648. doi: 10.1093/ehjdh/ztab0836. Madias JE. A Comparison of 2-Lead, 6-Lead, and 12-Lead ECGs in Patients With Changing Edematous States: Implications for the Employment of Quantitative Electrocardiography in Research and Clinical Applications. CHEST . 2003;124:2057-2063. doi: 10.1378/chest.124.6.20577. Orchard JJ, Orchard JW, Raju H, La Gerche A, Puranik R, Semsarian C. Comparison between a 6‑lead smartphone ECG and 12‑lead ECG in athletes. Journal of Electrocardiology . 2021;66:95-97. doi: 8. El Moheb M, Nicolas J, Khamis AM, Iskandarani G, Akl EA, Refaat M. Implantable Cardiac Defibrillators for patients with non-ischaemic cardiomyopathy. Cochrane Database Syst Rev Dec 2018; 12: CD012738 9. Pascual-Figal D, Wachter R, Senni M, Bao W, Noè A, Schwende H, Butylin D, Prescott MF; TRANSITION Investigators. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study. JACC Heart Fail. Aug 2020; S2213-1779(20)30336-X.

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The first catalytic asymmetric total synthesis of (+)-propolisbenzofuran B, enabled by a highly enantioselective rhodium-catalyzed hy-drogenation of a tetrasubstituted olefin, was described. Other noteworthy aspects include the construction of the central hydrodiben-zo[b,d]furan core through a sequence of Zn(II)-mediated regioselective benzofuran formation and Dieckmann condensation, as well as C-H oxidations, involving a visible light-induced Fe(III)-catalyzed benzylic C(sp3)-H oxidation. Additionally, the absolute configuration was confirmed by X-ray analysis of a carbonate intermediate.

Perforation of jejunum as a rare Complication of Pericardiocentesis: a case reportFatemeh Bahrami, MD, Resident of Cardiology, Imam Khomeini Hospital Complex, Department of Cardiology Tehran University of Medical Sciences, Tehran, Iran.Iran Email :[email protected]: +989120476225Fax: +982634835376Contributor role: Accompanying operator of procedureMaryam Mehrpooya, MD, Associate Professor of Interventional Cardiology, Imam Khomeini Hospital Complex, Department of Cardiology, Tehran University of Medical Science, Tehran, Iran.Iran Email: [email protected]

LC-MS intact mass analysis and LC-MS/MS peptide mapping are foundational assays for developing biologic drugs and other commercial protein products. Certain PTM types, such as truncation and oxidation, increase the difficulty of precise proteoform characterization owing to inherent limitations in peptide and intact protein analyses. Top-down MS (TDMS) can resolve this ambiguity via fragmentation of specific proteoforms. We optimized our existing flow-programmed denaturing online buffer exchange ((fp)dOBE) approach to improve ESI sensitivity and increase TDMS sampling time for industrial applications. Using bovine alpha-lactalbumin (αLac), we tested data-dependent (DDA) and targeted strategies with 14 different MS/MS scan types featuring combinations of collisional- and electron-based fragmentation as well as proton transfer charge reduction. This large dataset was processed using a new software platform, named TDAcquireX, that improves proteoform characterization through TDMS data aggregation. (fp)dOBE-based DDA-TDMS analysis readily identified truncated proteoforms. For targeted TDMS, we used Sliding Window fragment ion deconvolution to analyze composite proteoform (cPrSM) results. This strategy facilitates probability-based noise filtering of individual fragments, simultaneously increasing matched fragments while decreasing total fragment masses. Using this strategy, we characterized oxidation positional isomers on αLac, finding ETD fragmentation uniquely provided accurate relative occupancy ratios by oxidation-specific challenges.

We conducted a clinical trial with 200 type 2 diabetes patients to evaluate mμSORS for non-invasive blood glucose measurement. Using Optical Coherence Tomography, we studied skin thickness and optical attenuation in 172 diabetic and 26 healthy subjects. Results showed thicker stratum corneum and stratum spinosum in diabetics. Epidermal thickness increased with age and BMI, decreased with skin brightness, and varied minimally with gender. Optical attenuation in stratum spinosum was lower in diabetics, decreased with increasing a*, and was minimally affected by gender and BMI but increased with age in the upper dermis. These findings support mμSORS for accurate non-invasive glucose monitoring.

As the threat of climate change and associated heatwaves grows, we need to understand how natural populations will respond. Inter-generational non-genetic inheritance may play a key role in rapid adaptation, but whether such mechanisms are truly adaptive and sufficient to protect wild populations is unclear. The contribution of paternal effects in particular is not fully understood, even though the male reproductive system may be highly sensitive to heatwaves. We used the zebrafish Danio rerio to investigate the effects of heatwaves on male fertility and assess potential adaptive benefits to their offspring in a number of large-scale heatwave experiments. Heatwave conditions had negative effects on male fertility by reducing gamete quality and fertilisation success, and we found indications of an adaptive effect on hatching in offspring produced by heatwave-exposed males. Our findings highlight the importance of including male and female fertility when determining species ability to cope with extreme conditions and suggest that parental effects provide limited adaptive benefits.

Type Ⅲ redundancy of the foramen ovale flap (RFOF) mimics hemodynamic changes of mitral stenosis(MS), which has not been particularly highlighted in previous literature. This type of MS carries a favorable prognosis.

The interaction between the structure and soil is the key factor for infrastructure stabilization in permafrost engineering. In this study, the shear mechanical behavior of the interface between concrete and permafrost under different normal stiffness, temperature and water content is investigated by using the interface direct shear test under temperature-controlled conditions. The results show that with the increase of temperature and water content, the initial shear stiffness of the interface shear stress-shear displacement curve gradually increases, and the interface shear strength gradually increases. Different normal stiffnesses have a small effect on the morphology of the interfacial shear stress-shear displacement curve, but have a significant effect on the peak shear strength. The peak shear strength increases significantly with the increase of normal stiffness, and this trend is more obvious with the decrease of temperature. The corresponding interfacial cohesion and friction angle also increase with the increase of normal stiffness.

Title pageRemimazolam for Simultaneous Percutaneous Mitral Valve Clip and Percutaneous Left Atrial Appendage Closure in an Elderly Patient with Impaired Cardiac Function: A Case Report

not-yet-known not-yet-known not-yet-known unknown One of the most difficult challenges for wildlife managers is reliably estimating wildlife populations. Camera traps combined with spatial capture recapture (SCR) models are a popular tool for population estimation. They have limitations, however, including long data processing times. Drones with thermal imagery are an emerging tool for estimating wildlife populations, but how they compare to other methods remain poorly studied. We compared the use of camera traps and SCR models to drone surveys for estimating population densities of Sitka black-tailed deer (Odocoileus hemionus sitkensis) on Afognak Island, Alaska. We deployed 26 camera traps from 1 September until 6 October 2022 and individually identified males using antler characteristics, for the SCR model. At the same site we conducted three drone surveys between October and December 2022, obtained deer counts, and identified sex composition. The estimated density from the SCR model was 3.7 males ± 0.8 (SE) /km2, and 14.1 ± 3.1 adults/km2 of clear-cut forest. Results from the drone survey produced similar estimates with 2.1 ± 0.9 males/km2 and 13.4 ± 1.6 adults / km2. The similarity in estimates suggests that both methods converged on an accurate representation of the population in this habitat, but these methods diverge in levels of sampling effort, duration, and financial cost. Camera traps offer further insights on behavior and home-range size but require longer data processing times, can be subject to malfunctions, and are difficult to deploy and maintain in remote areas. Drones are subject to legal restrictions, have difficulty in closed canopy habitat and can be initially costly, but they provide results faster and require less data analysis. Camera traps and drones are useful for determining population dynamics but are subject to their limitations. Wildlife managers should make survey decisions based on their specific goals, habitat type, focal species ecology and financial limitations.

Living in a seasonal environment poses challenges for small mammals, such as bats, reliant on insects as their primary food source. Bats may adeptly navigate these energetic challenges by reducing their metabolism and body temperature, entering a state of torpor. Particularly during the winter, bats remain torpid for extended periods, but are dependent on sufficient energy reserves to survive until spring. With the onset of autumn and declining temperature, bats face the challenge of building their fat deposits during a time of decreasing food availability. Bats may therefore transition to cooler roosts to initiate torpor, thereby reducing energy expenditure. However, little is still known about torpor use or roost selection by bats in autumn. This study explores the factors influencing roost selection and torpor use and --duration in two bat species during this critical transition period between the breeding and overwintering season. We show that date in autumn is a stronger driver of torpor use than prevailing ambient temperature, and that bats employ specific strategies in which they first increase daytime torpor use before also increasing the use of nighttime torpor during the pre-hibernation fattening period, most likely to facilitate rapid fat accumulation. Notably, bats commenced nighttime torpor use after spending entire days in torpor. These findings underscore the dynamic nature of torpor and the energy-saving strategies employed during the crucial pre-hibernation period, marking the transition from summer to winter.

Aquifer-Stream Interactions (ASIs) play a critical role in effective groundwater management, yet their complex dynamics remain poorly understood in channelized lowland perennial streams. This study presents a multi-scale, multi-technique investigation of ASIs along two streams in Shelby County, Tennessee, overlying the confined Memphis aquifer. The goal is to define a suitable methodology for characterizing ASIs in this specific hydrological setting, serving as a starting point for developing a standardized approach. The methodology includes an initial evaluation of various field techniques, followed by extensive surveys using potentiomanometers, electromagnetic induction (EMI), vertical temperature profilers (VTPs), and complementary techniques such as seepage meters, bank tests, and well-data analyses. Results reveal distinct hydrogeomorphic behaviors across and along the streams, challenging the ASI homogeneity notions typically assumed in groundwater models. Nonconnah Creek exhibited streambed colmation and negligible hydraulic gradients, resulting in disconnection from the aquifer during low flows, except for a 300-m losing reach with high downward gradients, potentially degrading the Memphis aquifer. In contrast, the Loosahatchie River displays relatively homogeneous streambed properties and small, upward hydraulic gradients, suggesting uniform ASIs along the surveyed reaches. EMI proved highly effective for mapping streambed sediments quickly, while potentiomanometers accurately measure small head differences critical for understanding ASI dynamics. VTPs were less practical due to extended data-collection times and vulnerability to flooding. This study emphasizes the importance of site-specific, multi-scale investigations using diverse techniques to accurately characterize ASIs in lowland streams, highlighting the confounding influences of geological formations, anthropogenic alterations, and depositional processes on groundwater-surface water interactions. The findings contribute to refining local water balances, informing groundwater management strategies, and underscoring the need for incorporating local-scale field data into regional groundwater models. The proposed methodology serves as a foundation for developing a standardized approach for characterizing ASIs in lowland channelized perennial streams, adaptable for similar stream systems worldwide.

The majority of river restoration initiatives are driven by new environmental policies. However, evaluation of management styles for ecosystem services (ESs) within river policies and their implications for restoration has been rarely investigated. This paper aims to evaluate the way in which environmental policy manages river ESs and river restoration initiatives. A content analysis-based approach applied to policy documents was undertaken on China’s River Chief (CRC) policy. ESs attributes were summarized according to categories, values, relationships, and stakeholders. Subsequently, a hierarchical evaluation indicator system, along with its graded keywords, was developed. The occurrence frequencies of these keywords in policy documents were then used to measure the policy regulatory degrees of ESs indicators. The reference values extracted from literature statistics of peer-reviewed papers served as a template to clarify the ESs management style. We found that the CRC policy primarily relied on the management of ESs categories and stakeholders, followed by ESs relationships, with extremely limited consideration of river ESs values. Moreover, the bundle of those ESs incorporated into the policy significantly differ from the typical structure of the ESs provided by rivers. For stakeholders, the CRC policy relies heavily on the authorities and the farm/business operators to manage the rivers. This case study showed a partial and pattern-mismatch management style of river ESs, which will hamper the holistic restoration of rivers. We concluded that the proposed policy document-based evaluation approach can help to identify the policy deficiency in relation to river ESs management, and river restoration possibilities.

Single-cell proteomics (SCP) aims to characterize the proteome of individual cells, providing insights into complex biological systems. It reveals subtle differences in distinct cellular populations that bulk proteome analysis might overlook, which is essential for understanding disease mechanisms and developing targeted therapies. Mass spectrometry (MS) methods in SCP allow the identification and quantification of thousands of proteins from individual cells and this review highlights the role of data-independent acquisition MS (DIA-MS) in SCP. One major hurdle in SCP is the limited material in single-cell samples, but DIA-based techniques offer multiple potential solutions for their analysis. Utilizing wide precursor isolation windows to fragment multiple peptides simultaneously, DIA-based methods improve sensitivity, quantitative accuracy, and reproducibility at a cost in data analysis complexity. DIA methods can also be combined with sample multiplexing methods to increase the sample throughput, currently a key limitation in SCP. Challenges remain for interpreting sample multiplexed data from DIA-based SCP experiments, particularly with regards to isobaric tagging methods. Even still, we believe that DIA-based SCP approaches will play a major role in our understanding of systems biology.

Primary Squamous Cell Carcinoma of the Gallbladder: Case ReportSahar Dashti1, Maryam Garousi1, Elahe Mirzaee1, Navid Abdi2, Mastaneh Sanei1**: Corresponding Author : email: [email protected] ,Department of Radiation Oncology, School of Medicine, IranUniversity of Medical Sciences, Tehran, Iran1: Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran2: Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

In a sample 110 Mexican origin infants (M = 7.24; SD = 2.06; range, 3.78 - 13.04) we examine the bidirectional covariation of mother and infant positive and negative affect across the day. Further, we examine maternal emotion regulation as a potential moderator of the linkage between mother-infant affect, and infant-mother affect. Using an Ecological Momentary Assessment design, mothers reported on their positive and negative affect three times a day, for six days. Analyses employed a multi-level modeling approach to examine moment-to-moment covariation. Results indicated both mother and infant negative affect, and mother and infant positive affect to significantly covary. Interestingly, maternal emotional regulation did not moderate either the covariation of negative or positive mother-infant affect. These analyses represent one of the first examinations of daily covariation in mother-infant dyadic affect.