The 2021 American College of Cardiology/American Heart Association/Society for Cardiac Angiography and Interventions guideline for coronary artery revascularization. A worldwide call for consistency and logic

2023 ACC/AHA Chronic Coronary Disease Guideline - An opportunity to reestablish coronary artery bypass recommendations

Coronary artery bypass (CABG) has evolved over the decades, supported by scientific evidence from robust studies. The downgrade of the recommendation for CABG in patients with multivessel coronary artery disease proposed by the 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization and the 2023 ACC/AHA Chronic Coronary Disease Guidelines has brought this discussion to the fore, with prestigious cardiothoracic surgery societies such as AATS and STS not supporting these recommendations. The purpose of this article is to broaden this discussion in light of published studies.

Locomotion design of transverse ledge brachiation robot with active wrist joint for lateral posture compensation

A transverse ledge brachiation robot is designed to move transversely along a ledge on a vertical wall by generating energy from the swinging motion of its lower limbs. This method reduces the force required by the upper limbs to propel the robot forward. However, previously developed robots often encounter a common issue: lateral posture deviation, which is typically caused by slippage when the grippers grasp the ledge. Without compensation, this deviation can increase the risk of falling during continuous brachiation cycles. To address this problem, we propose an active wrist joint mechanism utilizing a feedback control approach as the compensator to effectively correct gripper position deviations. In our robot design, we develop a motion control strategy that coordinates the upper and lower limbs in order to maintain the swing energy that can be transferred to the subsequent cycles. Then we propose a potential energy-based phase switching condition in the motion control strategy in order to simplify the computation process. Simulation results demonstrate that the optimized parameter for compensation effectively maintains the gripper's position relative to the ledge throughout 55 brachiation cycles. Furthermore, experiment validation shows that this posture compensation reduces deviation by one-third compared to results without compensation. This study has demonstrated a 68% improvement in energy consumption efficiency for continuous transverse brachiation compared to the previous generation, as well as a 37% improvement over transverse ricochetal brachiation locomotion.

Role of Brain-Derived Neurotrophic Factor in Anxiety or Depression After Percutaneous Coronary Intervention

Anxiety or depression after percutaneous coronary intervention (PCI) is one of the key clinical problems in cardiology that need to be solved urgently. Brain-derived neurotrophic factor (BDNF) may be a potential biomarker for the pathogenesis and treatment of anxiety or depression after PCI. This article reviews the correlation between BDNF and cardiovascular system and nervous system from the aspects of synthesis, release and action site of BDNF, and focuses on the latest research progress of the mechanism of BDNF in anxiety or depression after PCI. It includes the specific mechanisms by which BDNF regulates the levels of inflammatory factors, reduces oxidative stress damage, and mediates multiple signaling pathways. In addition, this review summarizes the therapeutic potential of BDNF as a potential biomarker for anxiety or depression after PCI.