BACKGROUND: Vector Flow Mapping (VFM) and Energy Loss (EL) evaluation are emerging echocardiographic techniques that offer detailed insights into cardiac function. This study aimed to explore the relationship between EL parameters and B-type natriuretic peptide (BNP) levels, a well-established marker of heart failure severity.
METHODS: Our study prospectively enrolled 62 patients experiencing shortness of breath and suspected heart failure, who underwent echocardiography and had BNP levels measured between January 2018 and August 2020. Patients were stratified based on BNP levels, and their clinical and echocardiographic characteristics were evaluated. Univariate and multivariate regression analyses were performed to assess the correlation between BNP levels and various echocardiographic variables, including VFM parameters.
RESULTS: Patients were stratified into two groups based on their BNP levels: BNP < 200 pg/ml (n = 53) and BNP ≥ 200 pg/ml (n = 9). Patients with BNP ≥ 200 pg/ml presented significantly different clinical and echocardiographic characteristics, such as older age, larger left ventricular mass and volume indices, higher pulmonary artery systolic pressure, higher E/e\' ratio, and larger EL parameters. Multivariate regression analysis demonstrated the E/e\' ratio and ELA (EL during Atrial contraction phase/A wave ratio as significant determinants of logBNP. Receiver operating characteristic curve analysis showed ELA/A > 36.0 J/m2 as a significant predictor of high BNP with 89% sensitivity and 85% specificity. ELA/A demonstrated an incremental diagnostic value over elevated left atrial pressure for predicting high BNP (C statistic = 0.98 vs 0.74, P = 0.006).
CONCLUSIONS: This study provides novel insights into the potential utility of EL parameters as auxiliary indicators of cardiac load, thereby enhancing our understanding of heart failure.

The unstable flow of a shaft tubular pump device (STPD) leads to energy loss, thereby reducing its efficiency. The aim of this study is to investigate the distribution pattern of energy loss in STPDs. This paper reveals that the two components with the highest proportion of energy loss are the impeller and the outlet passage. Furthermore, turbulent entropy production is the primary cause of energy loss. Due to the wall effect, the energy loss in the impeller mainly occurs near the hub and shroud. Additionally, the presence of a tip leakage vortex near the shroud further contributes to the energy loss in the region near the shroud. This results in the energy loss proportion exceeding 40% in the region with a volume fraction of 14% near the shroud. In the outlet passage, the energy loss mainly occurs in the front region, with a volume fraction of 30%, and the energy loss in this part accounts for more than 65%. Finally, this study reveals the locations of the vortex in the STPD under different flow-rate conditions, and when the distribution of energy loss is visualized, it is found that the energy loss occurs high in the vortex regions.

Two new Y6 derivatives of symmetrical YBO-2O and asymmetrical YBO-FO nonfullerene acceptors (NFAs) are prepared with a simplified synthetic procedure by incorporating octyl and fluorine substituents onto the terminal 2-(3-oxo-2,3-dihydro-1H-inden-1-ylidene)malononitrile (INCN) moiety. By moving the alkyl substituents on the Y6 core to the terminal INCN moiety, the lowest unoccupied molecular orbital of the YBO NFAs increases without decreasing solubility, resulting in high open-circuit voltages of the devices. Molecular dynamics simulation shows that YBO-2O/-FO preferentially form core-core and terminal-terminal dimeric interactions, demonstrating their tighter packing structure and higher electron mobility than Y6, which is consistent with 2D grazing incidence X-ray scattering and space charge limited current measurements. In blend films, the hole transfer (HT) from YBO-2O/-FO to the polymer donor PM6 is studied in detail by transient absorption spectroscopy, demonstrating efficient HT from YBO-FO to PM6 with their suitable energy level alignment. Despite the simplified synthesis, YBO-FO demonstrates photovoltaic performance similar to that of Y6, exhibiting a power conversion efficiency of 15.01%. Overall, this design strategy not only simplifies the synthetic procedures but also adjusts the electrical properties by modifying the intermolecular packing and energy level alignment, suggesting a novel simplified molecular design of Y6 derivatives.

The energy loss of the multi-stage centrifugal pump was investigated by numerical analysis using the entropy generation method with the RNG k-ε turbulence model. Entropy generation due to time-averaged motion and velocity fluctuation was mainly considered. It was found that the entropy generation of guide vanes and impellers account for 71.2% and 23.3% of the total entropy generation under the designed flow condition. The guide vanes are the main hydraulic loss domains and their entropy generation is about 9 W/K, followed by impellers. There are vortices at the tongue of the guide vane inlet as well as flow separations in the impellers, which lead to entropy generation. The fluid impacts the outer surface of the guide vanes, resulting in the increase in entropy generation. There are refluxes near the guide vane tongues which also increase the entropy generation of this part. The entropy generation distribution of the guide vanes and impellers was investigated, which found that the positive guide vane has more entropy generation compared with the reverse guide. The entropy generation of the blade suction surface is higher compared with the pressure surface. This study indicated that the entropy generation method has distinct advantages in the assessment of hydraulic loss.

UNASSIGNED: Functional follow-up modalities of hypertrophic cardiomyopathy (HCM) with left ventricular (LV) outflow tract obstruction (LVOTO) subjected to alcohol septal ablation (ASA) are limited.
UNASSIGNED: This retrospective cohort study included patients of HCM with LVOTO who underwent ASA and four-dimensional (4D) flow cardiac magnetic resonance imaging (MRI) both before and after ASA. We analyzed energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root, and compared between pre- and post-ASA measurements.
UNASSIGNED: Of the 26 included patients, 10 (39%) were male, and median age was 71 (interquartile range 58-78) years. ASA significantly reduced not only LVOT pressure gradient (70 [19-50] to 9 [3-16], P < 0.001), but also energy loss during one cardiac cycle within the three-chamber plane of the LV and aortic root (80 [65-99] to 56 [45-70], P < 0.001). A linear association was observed between the reductions of energy loss and pressure gradient (R2  = 0.58, P < 0.001).
UNASSIGNED: ASA significantly reduced energy loss within the LV and aortic root as quantified by 4D flow MRI, reflecting the decreased cardiac workload. This approach is a promising candidate for serial functional follow-up in patients undergoing ASA.

Using blood speckle tracking (BST) based on high-frame-rate echocardiography (HFRE), we compared right ventricle (RV) flow dynamics in children with atrial septal defects (ASDs) and repaired tetralogy of Fallot (rTOF). Fifty-seven children with rTOF with severe pulmonary insufficiency (PI) (n = 21), large ASDs (n = 11) and healthy controls (CTL, n = 25) were included. Using a flow phantom, we studied the effects of imaging plane and smoothing parameters on 2-D energy loss (EL). RV diastolic EL was similar in ASD and rTOF, but both were greater than in CTL. Locations of high EL were similar in all groups in systole, occurring in the RV outflow tract and around the tricuspid valve leaflets in early diastole. An additional apical early diastolic area of EL was noted in rTOF, corresponding to colliding tricuspid inflow and PI. The flow phantom revealed that EL varied with imaging plane and smoothing settings but that the EL trend was preserved if kept consistent.

Objective: Pulmonary hypertension related to congenital heart disease (PH-CHD) is a devastating disease caused by hemodynamic disorders. Previous hemodynamic research in PH-CHD mainly focused on wall shear stress (WSS). However, energy loss (EL) is a vital parameter in evaluation of hemodynamic status. We investigated if EL of the pulmonary artery (PA) is a potential biomechanical marker for comprehensive assessment of PH-CHD. Materials and Methods: Ten PH-CHD patients and 10 age-matched controls were enrolled. Subject-specific 3-D PA models were reconstructed based on computed tomography. Transient flow, WSS, and EL in the PA were calculated using non-invasive computational fluid dynamics. The relationship between body surface area (BSA)-normalized EL ( E . ) and PA morphology and PA flow were analyzed. Results: Morphologic analysis indicated that the BSA-normalized main PA (MPA) diameter (DMPAnorm), MPA/aorta diameter ratio (DMPA/DAO), and MPA/(left PA + right PA) [DMPA/D(LPA+RPA)] diameter ratio were significantly larger in PH-CHD patients. Hemodynamic results showed that the velocity of the PA branches was higher in PH-CHD patients, in whom PA flow rate usually increased. WSS in the MPA was lower and E . was higher in PH-CHD patients. E . was positively correlated with DMPAnorm, DMPA/DAO, and DMPA/D(LPA+RPA) ratios and the flow rate in the PA. E . was a sensitive index for the diagnosis of PH-CHD. Conclusion: E . is a potential biomechanical marker for PH-CHD assessment. This hemodynamic parameter may lead to new directions for revealing the potential pathophysiologic mechanism of PH-CHD.

In this paper, an analytical study of internal energy losses for the non-Darcy Poiseuille flow of silver-water nanofluid due to entropy generation in porous media is investigated. Spherical-shaped silver (Ag) nanosize particles with volume fraction 0.3%, 0.6%, and 0.9% are utilized. Four illustrative models are considered: (i) heat transfer irreversibility (HTI), (ii) fluid friction irreversibility (FFI), (iii) Joule dissipation irreversibility (JDI), and (iv) non-Darcy porous media irreversibility (NDI). The governing equations of continuity, momentum, energy, and entropy generation are simplified by taking long wavelength approximations on the channel walls. The results represent highly nonlinear coupled ordinary differential equations that are solved analytically with the help of the homotopy analysis method. It is shown that for minimum and maximum averaged entropy generation, 0.3% by vol and 0.9% by vol of nanoparticles, respectively, are observed. Also, a rise in entropy is evident due to an increase in pressure gradient. The current analysis provides an adequate theoretical estimate for low-cost purification of drinking water by silver nanoparticles in an industrial process.

Energy loss (E loss) consisting of radiative recombination loss (ΔE 1 and ΔE 2) and nonradiative recombination loss (ΔE 3) is considered as an important factor for organic solar cells (OSCs). Herein, two N-functionalized asymmetrical small molecule acceptors (SMAs), namely N7IT and N8IT are designed and synthesized, to explore the effect of N on reducing E loss with sulfur (S) as a comparison. N7IT-based OSCs achieve not only a higher PCE (13.8%), but also a much lower E loss (0.57 eV) than those of the analogue (a-IT)-based OSCs (PCE of 11.5% and E loss of 0.72 eV), which are mainly attributed to N7IT\'s significantly enhanced charge carrier density (promoting J SC) and largely suppressed nonradiative E loss by over 0.1 eV (enhancing V OC). In comparison, N8IT, with an extended π-conjugated length, shows relatively lower photovoltaic performance than N7IT (but higher than a-IT) due to the less favorable morphology caused by the excessively large dipole moment of the asymmetrical molecule. Finally, this work sheds light on the structure-property relationship of the N-functionalization, particularly on its effects on reducing the E loss, which could inspire the community to design and synthesize more N-functionalized SMAs.

BACKGROUND: The use of low-level laser therapy is growing in the field of dentistry especially in orthodontics to speed up tooth movement and in implantology to aid osseointegration. In these dental applications, the laser energy needs to penetrate through the periodontium to the target site to stimulate photobiomodulation. The percentage of energy loss when laser is transmitted through the periodontium has not been previously studied. With the use of an 808-nanometer diode laser, the aim was to investigate the percentage loss of laser energy when transmitted through the periodontium to the extraction socket.
METHODS: The percentage energy loss of an 808-nm diode laser through the periodontium was measured in 27 tooth sockets by using a specifically designed photodiode ammeter.
RESULTS: For each millimeter of increased bone thickness there was 6.81% reduction in laser energy (95% confidence interval, 5.02% to 8.60%). The gingival thickness had no statistically significant effect on energy penetration.
CONCLUSIONS: Energy penetration depends markedly on bone thickness and is independent of gingival thickness.
CONCLUSIONS: To the best of the authors\' knowledge, this study is one of the first to investigate laser penetration through the periodontium. Evidence from this study showed that laser energy penetration through the periodontium is markedly affected by bone thickness but less so by gingival thickness. Clinicians need to be aware of the biological factors that could affect laser energy penetration to the target site and adjust their laser dosages accordingly. These findings may guide dental practitioners in selecting the appropriate laser dosage parameters for low-level laser therapy.