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Valvular heart disease (VHD) leading to inadequate hemodynamic circulation is a major cause of cardiovascular morbidity and mortality worldwide. Right ventricular-pulmonary artery (RV–PA) coupling integrates the ability of RV contractility to adapt to increased pulmonary arterial afterload. If the right ventricle cannot adapt to the elevated afterload by increasing its contractile function, RV-PA uncoupling occurs. RV-PA uncoupling has been shown to be associated with poor outcomes in VHD. This review summarizes the prognostic significance of RV-PA coupling in patients with VHD.

The integration of a photodetector that converts optical signals into electrical signals is essential for scalable integrated lithium niobate photonics. Two-dimensional materials provide a potential high-efficiency on-chip detection capability. Here, we demonstrate an efficient on-chip photodetector based on a few layers of MoTe2 on a thin film lithium niobate waveguide and integrate it with a microresonator operating in an optical telecommunication band. The lithium-niobate-on-insulator waveguides and micro-ring resonator are fabricated using the femtosecond laser photolithography-assisted chemical–mechanical etching method. The lithium niobate waveguide-integrated MoTe2 presents an absorption coefficient of 72% and a transmission loss of 0.27 dB µm−1 at 1550 nm. The on-chip photodetector exhibits a responsivity of 1 mA W−1 at a bias voltage of 20 V, a low dark current of 1.6 nA, and a photo–dark current ratio of 108 W−1. Due to effective waveguide coupling and interaction with MoTe2, the generated photocurrent is approximately 160 times higher than that of free-space light irradiation. Furthermore, we demonstrate a wavelength-selective photonic device by integrating the photodetector and micro-ring resonator with a quality factor of 104 on the same chip, suggesting potential applications in the field of on-chip spectrometers and biosensors.

We demonstrate high-extraction-rate Ta2O5-core/SiO2-clad photonic waveguides on silicon fabricated by the photolithography-assisted chemo-mechanical etching technique. Low-confinement waveguides of larger than 70% coupling efficiency with optical fibers and medium propagation loss around 1 dB/cm are investigated in the experiment. Monolithic microring resonators based on Ta2O5 waveguides have shown the quality factors to be above 105 near 1550 nm. The demonstrated Ta2O5 waveguides and their fabrication method hold great promise in various cost-effective applications, such as optical interconnecting and switching.

Introduction and Objectives: Cholangiocarcinoma (CCA) is characterized by early distant invasion and metastasis, whereas the underlying mechanism is still obscure. Increasing evidence shows that collagen type Ι alpha 1 (COL1A1) is a gene associated with the progression of multiple diseases. Here, we attempted to investigate the role of COL1A1 in CCA. Materials and Methods: The expression of COL1A1 between tumor tissues and adjacent normal tissues obtained from CCA patients was detected by Western blot and immunofluorescence, followed by analysis of its clinical significance. Then, the biological effects of COL1A1 overexpression or knockdown on CCA cells were evaluated in vitro and in vivo. Finally, molecular mechanism of COL1A1 in regulating the invasion and metastasis of CCA cells was determined by a series of experiments. Results: COL1A1 expression was significantly higher in CCA pathological tissues than in corresponding adjacent normal tissues. Analysis of 83 CCA patients showed that higher expression of COL1A1 was correlated with poorer patient prognosis. Notably, overexpression or knockdown experiments revealed that COL1A1 contributed to the migration and invasion, as well as epithelial-to-mesenchymal transition (EMT), in CCA cells. Further investigations demonstrated that matrix metalloproteinase-2 (MMP2) promoted COL1A1 upregulation via the integrin alpha Ⅴ pathway, therefore affecting ECM remodelling and inducing EMT in CCA cells. Moreover, COL1A1 expression was positively related to PD-1 and PD-L1 in CCA, and COL1A1 increased PD-L1 expression by activating the NF-κB pathway. Conclusions: COL1A1 plays an important role in regulating CCA progression and may act as a promising biomarker and therapeutic target for CCA.

Abstract Background Biliary complications, especially non‐anastomotic stricture (NAS), are the main complications after liver transplantation. Insufficient sampling and no recognized animal models obstruct the investigation. Thus, the mechanisms and alterations that occur during endoscopic treatment (ET) of NAS remain unclear. Methods Samples were obtained with endoscopic forceps from the hilar bile ducts of NAS patients receiving continuous biliary stent implantation after diagnosis. Retrospective analysis of multiple studies indicated that the duration of ET for NAS was approximately 1–2 years. Thus, we divided the patients into short‐term treatment (STT) and long‐term treatment (LTT) groups based on durations of less or more than 1 year. Samples were subjected to single‐cell RNA sequencing. Transcriptomic differences between STT and normal groups were defined as the NAS mechanism. Similarly, alterations from STT to LTT groups were regarded as endoscopic‐treatment‐induced evolution. Results In NAS, inflammation and immune‐related pathways were upregulated in different cell types, with nonimmune cells showing hypoxia pathway upregulation and immune cells showing ATP metabolism pathway upregulation, indicating heterogeneity. We confirmed a reduction in bile acid metabolism‐related SPP1+ epithelial cells in NAS. Increases in proinflammatory and profibrotic fibroblast subclusters indicated fibrotic progression in NAS. Furthermore, immune disorders in NAS were exacerbated by an increase in plasma cells and dysfunction of NK and NKT cells. ET downregulated multicellular immune and inflammatory responses and restored epithelial and endothelial cell proportions. Conclusions This study reveals the pathophysiological and genetic mechanisms and evolution of NAS induced by ET, thereby providing preventive and therapeutic insights into NAS. Highlights For the first time, single‐cell transcriptome sequencing was performed on the bile ducts of patients with biliary complications. scRNA‐seq analysis revealed distinct changes in the proportion and phenotype of multiple cell types during Nonanastomotic stricture (NAS) and endoscopic treatment. A reduction in bile acid metabolism‐related SPP1+ epithelial cells and VEGFA+ endothelial cells, along with explosive infiltration of plasma cells and dysfunction of T and NK cells in NAS patients. SPP1+ macrophages and BST2+ T cells might serve as a surrogate marker for predicting endoscopic treatment.

Semantic segmentation, which is a fundamental task in computer vision. Every pixel will have a specific semantic class assigned to it through semantic segmentation methods. Embedded systems and mobile devices are difficult to deploy high-accuracy segmentation algorithms. Despite the rapid development of semantic segmentation, the balance between speed and accuracy must be improved. As a solution to the above problems, we created a cross-scale fusion attention mechanism network called CFANet, which fuses feature maps from different scales. We first design a novel efficient residual module (ERM), which applies both dilation convolution and factorized convolution. Our CFANet is mainly constructed from ERM. Subsequently, we designed a new multi-branch channel attention mechanism (MCAM) to refine the feature maps at different levels. Experiment results show that CFANet achieved 70.6% mean intersection over union (mIoU) and 67.7% mIoU on Cityscapes and CamVid datasets, respectively, with inference speeds of 118 FPS and 105 FPS on NVIDIA RTX2080Ti GPU cards with 0.84M parameters.

Pulmonary regurgitation usually leads to right heart dilatation and eventually right heart dysfunction, which is associated with a poor prognosis. Transcatheter pulmonary valve replacement is a developing treatment for pulmonary valve dysfunction that can take the place of traditional surgery and make up for the shortcomings of a large injury. Echocardiography plays a significant role in assessing ventricular function; however, conventional echocardiographic parameters have several limitations. Speckle tracking echocardiography has been regarded as a more accurate tool for quantifying cardiac function than conventional echocardiography. Therefore, the aim of this review was to summarize the application of speckle tracking echocardiography for evaluating right and left ventricular functions in patients after transcatheter pulmonary valve replacement.

Heart failure with preserved ejection fraction (HFpEF) is defined as HF with left ventricular ejection fraction (LVEF) not less than 50%. HFpEF accounts for more than 50% of all HF patients, and its prevalence is increasing year to year with the aging population, with its prognosis worsening. The clinical assessment of cardiac function and prognosis in patients with HFpEF remains challenging due to the normal range of LVEF and the nonspecific symptoms and signs. In recent years, new echocardiographic techniques have been continuously developed, particularly speckle-tracking echocardiography (STE), which provides a sensitive and accurate method for the comprehensive assessment of cardiac function and prognosis in patients with HFpEF. Therefore, this article reviewed the clinical utility of STE in patients with HFpEF.

ObjectivesBoth right ventricular free wall longitudinal strain (RVFWLS) and right ventricular global longitudinal strain (RVGLS) using two-dimensional speckle tracking echocardiography (2D-STE) has been demonstrated to predict adverse outcomes in patients with repaired tetralogy of Fallot (r-TOF). However, RVGLS may be affected by left ventricular (LV) function owing to the fact that the interventricular septum is also a part of the left ventricle. Therefore, the aim of our study was to compare the predictive value of RVFWLS with that of RVGLS in patients with r-TOF.Materials and methodsA total of 179 patients with r-TOF were included in this study. RVFWLS, RVGLS, and left ventricle global longitudinal strain (LVGLS) were evaluated by 2D-STE. The adverse clinical events were death or r-TOF-related rehospitalization. Prognostic performance was evaluated by C-statistic and Akaike information criterion (AIC).ResultsThirty-one patients developed poor outcomes during a median follow-up period of 2.8 years. Compared with patients without end-point events, those with end-point events had higher incidence of moderate/severe pulmonary regurgitation, larger right heart sizes, and lower RV fractional area change (RVFAC), RVFWLS, RVGLS, and LVGLS than those without. Multivariate Cox regression analysis revealed that RVFAC, RVFWLS, RVGLS, and LVGLS were predictive of poor outcomes in patients with r-TOF after adjustment for transannular patch and QRS duration. A Cox model using RVFWLS (C index = 0.876, AIC = 228) was found to predict unfavorable outcomes more accurately than a model with RVGLS (C index = 0.856, AIC = 243), RVFAC (C index = 0.811, AIC = 248), and LVGLS (C index = 0.830, AIC = 248).ConclusionAlthough both RVGLS and RVFWLS are associated with adverse events, RVFWLS provides superior prognostic value than that of RVGLS in patients with r-TOF.

BackgroundAlthough the left atrium (LA) plays a key role in the pathophysiology and disease progression of heart failure with preserved ejection fraction (HFpEF), the impact of type 2 diabetes mellitus (T2DM) on LA function and stiffness in HFpEF patients remains unclear. Furthermore, the prognostic value of different phases of LA function and stiffness is less well-established in HFpEF patients.MethodsThis study prospectively enrolled 164 HFpEF patients who were in sinus rhythm at the time of echocardiography, including 61 (37%) HFpEF patients with T2DM. LA reservoir, conduit, and pump function were assessed using two-dimensional volume indices and speckle tracking echocardiography. The LA stiffness was calculated as the ratio of early mitral inflow velocity-to-early annular tissue velocity (E/e’) and LA reservoir function. The primary end point was a combined outcome of heart failure hospitalization or death.ResultsLeft atrium reservoir function [measured by peak LA strain (LAS-peak)] and LA pump function (measured by LAS-active) remained significantly lower in the HFpEF patients with T2DM compared with those without T2DM, even after adjustment for potential confounders. In addition, the LA stiffness of HFpEF patients with T2DM was higher than those without T2DM. After a median follow-up of 13.7 months, 46 patients (28.1%) reached the composite end point. LAS-peak (hazard ratios: 0.88; 95% confidence interval: 0.81–0.95; P = 0.001) was significantly associated with the risk of heart failure hospitalization or death after adjusting for demographic and clinical characteristics, LV global longitudinal strain, E/e’, and LA volume index. In contrast, other LA function and stiffness parameters did not independently predict the risk of adverse events. Kaplan-Meier analysis showed that HFpEF patients with T2DM and low LAS-peak (

Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application of imaging modalities to the heart, our understanding of these tumors is limited to case reports and autopsy studies. The advent and improvement of various imaging technologies have enabled the non-invasive evaluation of benign PCTs. Although echocardiography is the most commonly used imaging examination, it is not the best method to describe the histological characteristics of tumors. At present, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) are often used to assess benign PCTs providing detailed information on anatomical and tissue features. In fact, each imaging modality has its own advantages and disadvantages, multimodality imaging uses two or more imaging types to provide valuable complementary information. With the widespread use of multimodality imaging, these techniques play an indispensable role in the management of patients with benign PCTs by providing useful diagnostic and prognostic information to guide treatment. This article reviews the multimodality imaging characterizations of common benign PCTs.

Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. Echocardiography is the imaging technique of first choice to assess LA structure and function due to its better availability, accessibility and safety over cardiac computed tomography and cardiac magnetic resonance. Therefore, the aim of this review is to summarize the recent research progress of evaluating LA size by three-dimensional echocardiography and LA function by speckle tracking echocardiography (STE) in predicting the occurrence and recurrence of AF and determining the risk of stroke in AF. In addition, we summarized the role of traditional echocardiography in detecting AF patients that are at high risk of heart failure or cardiovascular death.

Background: Right ventricular longitudinal strain of free wall (RV FWLS) assessed by two-dimensional speckle-tracking echocardiography (2D-STE) is recognized as an independent predictor of poor prognosis in patients with heart failure with preserved ejection fraction (HFpEF). However, the prognostic implications of three-dimensional STE (3D-STE) parameters in patients with HFpEF have not been well-established. The purpose of our study was to determine whether 3D-STE parameters were the more powerful predictors of poor outcomes in HFpEF patients compared with 2D-STE indices.Methods: Eighty-one consecutive patients with HFpEF were studied by 2D-STE and 3D-STE. RV volumes, ejection fraction (EF) and 3D-RVFWLS were measured by 3D-STE. 2D-RVFWLS was determined by 2D-STE. Patients were followed for the primary end point of heart failure (HF)-related hospitalization and death for HF.Results: After a median follow-up period of 17 months, 39 (48%) patients reached the end point of cardiovascular events. Compared with HFpEF patients without end-point events, those with end-point events had lower RVEF and 3D-RVFWLS (P < 0.05). Separate multivariate Cox regression analyses revealed that 3D-RVFWLS (HR 5.73; 95% CI 2.77–11.85; P < 0.001), RVEF (HR 3.47; 95% CI 1.47–8.21; P = 0.005), and 2D-RVFWLS (HR 3.17; 95% CI 1.54–6.53; P = 0.002) were independent predictors of adverse outcomes. The models with 3D-RVFWLS (AIC = 246, C-index = 0.75) and RVEF (AIC = 247, C-index = 0.76) had similar predictive performance for future clinical events as with 2D-RVFWLS (AIC = 248, C-index = 0.74).Conclusions: 3D-STE parameters are powerful predictors of poor outcomes, providing a similar predictive value as 2D-STE indices in patients with HFpEF. These findings support the potential of RV 3D-STE to identify HFpEF patients at higher risk for adverse cardiac events.

Patients with heart failure (HF) have high morbidity and mortality. Accurate assessment of right ventricular (RV) function has important prognostic significance in patients with HF. However, conventional echocardiographic parameters of RV function have limitations in RV assessments due to the complex geometry of right ventricle. In recent years, speckle tracking echocardiography (STE) has been developed as promising imaging technique to accurately evaluate RV function. RV longitudinal strain (RVLS) using STE, as a sensitive index for RV function evaluation, displays the powerfully prognostic value in patients with HF. Therefore, the aim of the present review was to summarize the utility of RVLS in patients with HF.

Integrated thin-film lithium niobate (LN) electro-optic (EO) modulators of broad bandwidth, low insertion loss, low cost and high production rate are essential elements in contemporary interconnection industries and disruptive applications. Here, we demonstrated the design and fabrication of a high performance thin-film LN EO modulator using photolithography assisted chemo-mechanical etching (PLACE) technology. Our device shows a 3-dB bandwidth over 50 GHz, along with a comparable low half wave voltage-length product of 2.16 Vcm and a fiber-to-fiber insertion loss of 2.6 dB. The PLACE technology supports large footprint, high fabrication uniformity, competitive production rate and extreme low device optical loss simultaneously, our result shows promising potential for developing high-performance large-scale low-loss photonic integrated devices.

The respiratory chain is very important for bacterial survival and pathogenicity, yet the roles of the respiratory chain in P. aeruginosa remain to be fully elucidated. Here, we not only proved experimentally that the operon PA4427-PA4431 of Pseudomonas aeruginosa PAO1 encodes respiratory chain complex III (cytobc1), but also found that it played important roles in virulence and pathogenicity. PA4429–31 deletion reduced the production of the virulence factors, including pyocyanin, rhamnolipids, elastase, and extracellular polysaccharides, and it resulted in a remarkable decrease in pathogenicity, as demonstrated in the cabbage and Drosophila melanogaster infection models. Furthermore, RNA-seq analysis showed that PA4429–31 deletion affected the expression levels of the genes related to quorum-sensing systems and the transport of iron ions, and the iron content was also reduced in the mutant strain. Taken together, we comprehensively illustrated the function of the operon PA4427–31 and its application potential as a treatment target in P. aeruginosa infection.

The large-scale cascade hydropower plants in southwestern China now challenge a multi-market environment in the new round of electricity market reform. They not only have to supply the load for the local provincial market, but also need to deliver electricity to the central and eastern load centers in external markets, which makes the generation scheduling much more complicated, with a correlated uncertain market environment. Considering the uncertainty of prices and correlation between multiple markets, this paper has proposed a novel optimization model of long-term generation scheduling for cascade hydropower plants in multiple markets to seek for the maximization of overall benefits. The Copula function is introduced to describe the correlation of stochastic prices between multiple markets. The price scenarios that obey the Copula fitting function are then generated and further reduced by using a scenario reduction strategy that combines hierarchical clustering and inconsistent values. The proposed model is applied to perform the long-term generation scheduling for the Wu River cascade hydropower plants and achieves an increase of 106.93 million yuan of annual income compared with the conventional scheduling model, without considering price scenarios, showing better performance in effectiveness and robustness in multiple markets.

Texture classification is an important topic for many applications in machine vision and image analysis, and Gabor filter is considered one of the most efficient tools for analyzing texture features at multiple orientations and scales. However, the parameter settings of each filter are crucial for obtaining accurate results, and they may not be adaptable to different kinds of texture features. Moreover, there is redundant information included in the process of texture feature extraction that contributes little to the classification. In this paper, a new texture classification technique is detailed. The approach is based on the integrated optimization of the parameters and features of Gabor filter, and obtaining satisfactory parameters and the best feature subset is viewed as a combinatorial optimization problem that can be solved by maximizing the objective function using hybrid ant lion optimizer (HALO). Experimental results, particularly fitness values, demonstrate that HALO is more effective than the other algorithms discussed in this paper, and the optimal parameters and features of Gabor filter are balanced between efficiency and accuracy. The method is feasible, reasonable, and can be utilized for practical applications of texture classification.

With the rapid development of the internet of things (IoT), traditional industries are setting off a massive wave of digitization. In the era of the Internet of Everything, millions of devices and links in IoT pose more significant challenges to data management. Most existing solutions employ centralized systems to control IoT devices, which brings about the privacy and security issues in IoT data management. Recently, blockchain has attracted much attention in the field of IoT due to its decentralization, traceability, and non-tamperability. However, it is non-trivial to apply the current blockchain techniques to IoT due to the lack of scalability and high resource costs. Different blockchain platforms have their particular advantages in the scenario of IoT data management. In this paper, we propose a cross-chain framework to integrate multiple blockchains for efficient and secure IoT data management. Our solution builds an interactive decentralized access model which employs a consortium blockchain as the control station. Other blockchain platforms customized for specific IoT scenarios run as the backbone of all IoT devices. It is equivalent to opening the off-chain channels on the consortium blockchain. Our model merges transactions in these channels for confirmation based on the notary mechanism. Finally, we implement a prototype of the proposed model based on hyperledge Fabric and IOTA Tangle. We evaluate the performance of our method through extensive experiments. The results demonstrate the effectiveness and efficiency of our framework.

Abstract Background Exposure to particulate matter (PM) is a significant risk factor for increased cardiopulmonary morbidity and mortality. The mechanism of PM-mediated pathophysiology remains unknown. However, PM is proinflammatory to the endothelium and increases vascular permeability in vitro and in vivo via ROS generation. Objectives We explored the role of tight junction proteins as targets for PM-induced loss of lung endothelial cell (EC) barrier integrity and enhanced cardiopulmonary dysfunction. Methods Changes in human lung EC monolayer permeability were assessed by Transendothelial Electrical Resistance (TER) in response to PM challenge (collected from Ft. McHenry Tunnel, Baltimore, MD, particle size >0.1 μm). Biochemical assessment of ROS generation and Ca2+ mobilization were also measured. Results PM exposure induced tight junction protein Zona occludens-1 (ZO-1) relocation from the cell periphery, which was accompanied by significant reductions in ZO-1 protein levels but not in adherens junction proteins (VE-cadherin and β-catenin). N-acetyl-cysteine (NAC, 5 mM) reduced PM-induced ROS generation in ECs, which further prevented TER decreases and atteneuated ZO-1 degradation. PM also mediated intracellular calcium mobilization via the transient receptor potential cation channel M2 (TRPM2), in a ROS-dependent manner with subsequent activation of the Ca2+-dependent protease calpain. PM-activated calpain is responsible for ZO-1 degradation and EC barrier disruption. Overexpression of ZO-1 attenuated PM-induced endothelial barrier disruption and vascular hyperpermeability in vivo and in vitro. Conclusions These results demonstrate that PM induces marked increases in vascular permeability via ROS-mediated calcium leakage via activated TRPM2, and via ZO-1 degradation by activated calpain. These findings support a novel mechanism for PM-induced lung damage and adverse cardiovascular outcomes.