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Interconnect delay is a key factor that affects the chip performance in layer assignment. Particularly in the advanced process technologies of 5nm and beyond, interconnect delay has grown significantly due to the increase of circuit scale. Moreover, coupling effect existed in wires reduces the accuracy of delay evaluation. On the other hand, the size of vias is often ignored in layer assignment, which enlarges the mismatch between global routing and detailed routing. To solve these problems, we propose VPT, a timing-aware layer assignment algorithm considering via pillars, which includes the following five key techniques: 1) via pillar structure combined with non-default-rule (NDR) wires is adopted to form a net delay optimization system for advanced process technologies; 2) a synthetical model that can adapt to varying types and sizes of both vias and wires is designed to evaluate overflow effectively; 3) a sorting strategy is devised to reduce uncertainty of layer assignment flow and improve stability of the proposed algorithm; 4) an awareness strategy based on multi-aspect congestion assessment is designed to reduce overflow significantly; 5) a net scalpel algorithm is devised to minimize the maximum delay of nets, so that the timing behaviors can be improved systematically. Experimental results on multiple benchmarks confirm that the proposed algorithm leads to lower delay and less overflow, while achieving the best solution quality among the existing algorithms with the shortest runtime.

Pin access is increasingly important in advanced nodes. Neighboring or cell-boundary pins can have degraded pin accessibility, causing design rule violations (DRCs) during routing, which are runtime-expensive to resolve. Conventional physical design tool flow uses pessimistic and/or inaccurate understanding of pin access during the placement stage and keeps the location of cells fixed during routing. This can leave pin access issues unsolvable and block further routing solution improvement. The timeliness of our present work is confirmed by the recent ICCAD-2020 CAD Contest, Problem B formulation from Synopsys, Inc. HuY20. The organizers give a succinct motivation for what we study – to eliminate preserved margins and misalignment issues from conventional placement models. In this work, we develop an in-route, pin access-driven local placement refinement. Experiments across industry designs in a wide range of advanced technology nodes confirm that our optimization can significantly improve routing convergence (i.e., subsequent detailed routing runtime and initial detailed routing DRCs). Our optimization can reduce congestion and wirelength without timing degradation.

In stark contrast to the conventional charge density wave (CDW) materials, the one-dimensional CDW on the In/Si(111) surface exhibits immediate damping of the CDW oscillation during the photoinduced phase transition. Here, by successfully reproducing the experimentally observed photoinduced CDW transition on the In/Si(111) surface by performing real-time time-dependent density functional theory (rt-TDDFT) simulations, we demonstrate that photoexcitation promotes valence electrons from Si substrate to empty surface bands composed primarily of the covalent p-p bonding states of the long In-In bonds, generating interatomic forces to shorten the long bonds and in turn drives coherently the structural transition. We illustrate that after the structural transition, the component of these surface bands occurs a switch among different covalent In bonds, causing a rotation of the interatomic forces by about {\pi}/6 and thus quickly damping the oscillations in feature CDW modes. These findings provide a deeper understanding of photoinduced phase transitions., Comment: 11 pages,3 figures

Photoinduced phase transition (PIPT) is always treated as a coherent process, but ultrafast disordering in PIPT is observed in recent experiments. Utilizing the real-time time-dependent density functional theory method, here we track the motion of individual vanadium (V) ions during PIPT in VO

Laser-induced nonthermal melting in semiconductors has been studied over the last four decades, but the underlying mechanism is still under debate. Here, by utilizing an advanced real-time time-dependent density functional theory simulation, we reveal that the photoexcitation-induced ultrafast nonthermal melting in silicon occurs via homogeneous nucleation with random seeds originating from a self-amplified local dynamic instability at the photoexcited states rather than by simultaneously breaking of all bonds, as suggested by the inertial model, phonon instability, or Coulombic repulsion mechanisms. Due to this local dynamic instability, any initial small random thermal displacements of atoms can be amplified by a charge transfer of photoexcited carriers, which in turn creates a local self-trapping center for the excited carriers and yields the random nucleation seeds. This finding provides fresh insights into photoinduced ultrafast nonthermal melting., 27 pages,8 figures

Ultrafast photoexcitation can induce a nonequilibrium dynamic with electron-lattice interaction, offering an effective way to study photoinduced phase transitions (PIPTs) in solids. The issue that atomic displacements after photoexcitation belong to coherent change or disordered process, has become a controversy in the PIPT community. Using real-time time-dependent density functional theory (rt-TDDFT) simulations, we obtain both the coherent and the disordered PIPTs (dimer dissociation) in IrTe2 with the different electronic occupations. More importantly, we found that in the disordered phase transition, there exists a local correlation between different dimers regarding their dissociation status. One can define vertical groups across the layers. The dimers in the same group will dissociate in a correlated fashion: they either all dissociate, or all not dissociate. On the other hand, the dimers in neighboring groups will have an anti-correlation: if the dimers in one group dissociate, the dimers in the neighboring group tend not to be dissociated, and vice versus., Comment: 13 pages,5 figures

Species of Clavaria (Clavariaceae, Agaricales) collected from China were studied using morphological and molecular methods. Two species, C. aspersa and C. hupingshanensis, are here described as new to science; the former possesses simple, scattered to gregarious or with pairs slightly fascicled, white basidiomata, whereas the latter has simple, gregarious to caespitose clusters, rose-white to seashell-pink basidiomata. In addition, C. amoenoides is described as a newly recorded species for China; this species is characterized by simple, very pale orange-yellow to picric-yellow basidiomata. A phylogenetic analysis was conducted based on a combined dataset of internal transcribed spacer, nuclear ribosomal RNA large subunit and the RNA polymerase Ⅱ second largest subunit sequences. The phylogenetic reconstruction resolved accessions of the three species into three independent lineages within the Clavaria. The morphology of the three species is described in detail and is illustrated with line drawings and photographs. Holotypes of the new species are deposited in the Mycological Herbarium of Hunan Normal University. The sequences newly generated in this study have been deposited in GenBank. An updated key to the known Clavaria species in China is provided.

The hot carrier cooling occurs in most photoexcitation-induced phase transitions (PIPTs), but its role has often been neglected in many theoretical simulations as well as in proposed mechanisms. Here, by including the previously ignored hot carrier cooling in real-time time-dependent density functional theory (rt-TDDFT) simulations, we investigated the role of hot carrier cooling in PIPTs. Taking IrTe2 as an example, we reveal that the cooling of hot electrons from the higher energy levels of spatially extended states to the lower energy levels of the localized Ir-Ir dimer antibonding states strengthens remarkably the atomic driving forces and enhances atomic kinetic energy. These two factors combine to dissolute the Ir-Ir dimers on a timescale near the limit of atomic motions, thus initiating a deterministic kinetic phase transition. We further demonstrate that the subsequent cooling induces nonradiative recombination of photoexcited electrons and holes, leading to the ultrafast recovery of the Ir-Ir dimers observed experimentally. These findings provide a complete picture of the atomic dynamics in optically excited structural phase transitions., Comment: 20 pages, 8 figures

Background The association of postimplant tricuspid regurgitation (TR) and heart failure (HF) hospitalization in patients without HF and preexisting abnormal TR and TR pressure gradient (PG) remain unclear. Hypothesis This study aimed to explore the clinical outcomes of progressive postimplant TR after permanent pacemaker (PPM) implantation. Methods A total of 1670 patients who underwent a single ventricular or dual‐chamber transvenous PPM implantation at our hospital between January 2003 and December 2017 were included in the study. Patients with prior valvular surgery, history of HF, and baseline abnormal TR and TRPG were excluded. Finally, a total of 1075 patients were enrolled in this study. Progressive TR was defined as increased TR grade of ≥2 degrees and TRPG of >30 mmHg after implant. Results In 198 (18.4%) patients (group 1) experienced progressive postimplant TR and elevated TRPG, whereas 877 patients (group 2) did not have progressive postimplant TR. Group 1 had larger change in postimplant TRPG (group 1 vs. group 2; 12.8 ± 9.6 mmHg vs. 1.1 ± 7.6 mmHg; p

Although mitochondrial fission has been reported to increase proliferative capacity and collagen production, it can also contribute to mitochondrial impairment, which is detrimental to cell survival. The aim of the present study was to investigate the role of mitochondrial fission in cardiac fibroblasts (CF) activation and explore the mechanisms involved in the maintenance of mitochondrial health under this condition. For this, changes in the levels of mitochondrial fission/fusion-related proteins were assessed in transforming growth factor beta 1 (TGF-β1)-activated CF, whereas the role of mitochondrial fission during this process was also elucidated, as were the underlying mechanisms. The interaction between mitochondrial fission and mitophagy, the main defense mechanism against mitochondrial impairment, was also explored. The results showed that the mitochondria in TGF-β1-treated CF were noticeably more fragmented than those of controls. The expression of several mitochondrial fission-related proteins was markedly upregulated, and the levels of fusion-related proteins were also altered, but to a lesser extent. Inhibiting mitochondrial fission resulted in a marked attenuation of TGF-β1-induced CF activation. The TGF-β1-induced increase in glycolysis was greatly suppressed in the presence of a mitochondrial inhibitor, whereas a glycolysis-specific antagonist exerted little additional antifibrotic effects. TGF-β1 treatment increased cellular levels of reactive oxygen species (ROS) and triggered mitophagy, but this effect was reversed following the application of ROS scavengers. For the signals mediating mitophagy, the expression of Pink1, but not Bnip3l/Nix or Fundc1, exhibited the most significant changes, which could be counteracted by treatment with a mitochondrial fission inhibitor. Pink1 knockdown suppressed CF activation and mitochondrial fission, which was accompanied by increased CF apoptosis. In conclusion, mitochondrial fission resulted in increased glycolysis and played a crucial role in CF activation. Moreover, mitochondrial fission promoted reactive oxygen species (ROS) production, leading to mitophagy and the consequent degradation of the impaired mitochondria, thus promoting CF survival and maintaining their activation.

A prominent circadian variation is present in atrial fibrillation (AF) attacks that may be related to the expression of circadian clock genes. Little is known about the expression of circadian clock genes in AF. We prospectively enrolled 73 patients who had received pacemaker implantation, in order to define the burden of atrial high-rate episodes (AHREs) accurately. AF was diagnosed clinically in 43 (59%) patients (15 with persistent AF and 28 with paroxysmal AF). The expression levels of circadian clock genes of peripheral blood leukocytes were checked. There were more males and patients with a larger left atrial (LA) size and lower expression levels of BMAL1, CRY2, NR1D1, NR1D2, PER2, RORA, RORC, and TIM genes in persistent AF group than in other groups. There was a significant correlation between higher AHRE burden and larger LA size and between higher AHRE burden and decreased expression of circadian clock genes in patients with AF. LA volume and the expression of CRY1, NR1D1, and RORA are significantly associated with AHRE burden. However, the underlying mechanism needs to be elucidated in further studies.

Author(s): Liu, WH; Luo, JW; Li, SS; Wang, LW | Abstract: Photoinduced phase transitions can have complex and intriguing behaviors more than material ground-state dynamics. Understanding the underlying mechanism can help us to design new ways to manipulate the materials. A variety of mechanisms has been proposed to explain the photoinduced phase transitions of IrTe2, but a consensus has yet to be reached. Here, we study the photo-induced phase transitions of IrTe2 by performing the real-time time-dependent density functional theory (rt-TDDFT) simulations in combination with the occupation constrained DFT method. We reveal that the microscopic driving force for the photo-induced phase transitions arises from the tendency to lower the energy levels occupied by the excited carriers, through the increase or decrease of the associated atomic pair distances, depending on whether the newly occupied states are antibonding or bonding states, respectively. The geometric constraints between different bonds represented by the Poisson ratio can bring together different tendencies from different atomic pairs, thus forming a complex intriguing dynamic picture depending on the intensity of the excitation. We also find that phonons don't play a primary role, but can assist the phase transition. These findings imply that one can control the structural phase transitions by selectively exciting photocarriers into designated atomic states using appropriate photon sources.

BackgroundThe association of post-implant tricuspid regurgitation (TR) and heart failure (HF) hospitalization in patients without HF and preexisting abnormal TR and TR pressure gradient (PG) remain unclear. This study aimed to explore the clinical outcomes about progressive post-implant TR after permanent pacemaker (PPM) implantation.Methods A total of 1,670 patients who underwent a single ventricular or dual-chamber transvenous PPM implantation at our hospital between January 2003 and December 2017 were included in the study. Patients with prior valvular surgery, heart failure (HF), and baseline abnormal TR and TRPG were excluded. Finally, a total of 1,075 patients were enrolled in this study. Progressive TR was defined as increased TR grade of ≥2 degrees and/or TRPG of >30 mmHg after implant.Results198 (18.4%) patients (group 1) experienced progressive post-implant TR and/or elevated TRPG. Group 1 had l larger changes in post-implant TRPG (group 1 vs. group 2; 12.8 ± 9.6 mmHg vs. 1.1 ± 7.6 mmHg; p < 0.001) than group 2 without progressive post-implant TR. Group 1 had a higher incidence of HF hospitalization compared to group 2 (13.6% vs. 4.7%; p < 0.001). Pre-implant TRPG (HR: 1.075; 95% confidence interval (CI): 1.032-1.121; p = 0.001) and post-implant left atrial dimension (HR: 1.076; 95% CI: 1.038-1.114; p < 0.001) were independent predictors of progressive post-implant TR. ConclusionsAfter a transvenous ventricular-based PPM implantation, 18.4% of patients experienced progressive post-implant TR and/or elevated TRPG. Higher pre-implant TRPG and larger post-implant LA dimension were independent predictors of progressive post-implant TR.

Background The impact of electrocardiography (ECG) morphology on clinical outcomes in patients with non-ST segment elevation myocardial infarction (NSTEMI) receiving percutaneous coronary intervention (PCI) is unknown. This study investigated whether different ST morphologies had different clinical outcomes in patients with NSTEMI receiving PCI. Methods This retrospective study analyzed record-linked data of 362 patients who had received PCI for NSTEMI between January 2008 and December 2010. ECG revealed ST depression in 67 patients, inverted T wave in 91 patients, and no significant ST-T changes in 204 patients. The primary endpoint was long-term all-cause mortality. The secondary endpoint was long-term cardiac death and non-fatal major adverse cardiac events. Results Compared to those patients whose ECG showed an inverted T wave and non-specific ST-T changes, patients whose ECG showed ST depression had more diabetes mellitus, advanced chronic kidney disease (CKD) and left main artery disease, as well as more in-hospital mortality, cardiac death and pulmonary edema during hospitalization. Patients with ST depression had a significantly higher rate of long-term total mortality and cardiac death. Finally, multiple stepwise Cox regression analysis showed that an advanced Killip score, age, advanced CKD, prior percutaneous transluminal coronary angioplasty and ST depression were independent predictors of the primary endpoint. Conclusions Among NSTEMI patients undergoing coronary angiography, those with ST depression had more in-hospital mortality and cardiac death. Long-term follow-up of patients with ST depression consistently reveals poor outcomes.

Aims Anticoagulation therapy is indicated to prevent stroke in atrial flutter (AFL) and atrial fibrillation (AF) patients. However, the outcomes of solitary AFL patients may differ from those with AFL who develop AF during follow-up. This study aimed to investigate the differences in clinical outcomes: (i) among patients with solitary AFL, AF, and AFL developing AF thereafter and (ii) between solitary AFL patients with vs. without anticoagulation therapy. Methods and results This nationwide cohort study enrolled patients with solitary AFL, solitary AF, and AFL developing AF from a 12 years National Health Insurance Research Database in Taiwan. There were 230 367 patients without anticoagulation therapy in the solitary AF cohort, 8064 in the solitary AFL cohort, and 4495 in the AFL with AF cohort. The AFL with AF and solitary AF cohorts had higher incidences of ischaemic stroke and major bleeding than the solitary AFL cohort. Solitary AFL patients with anticoagulation therapy had a lower ischaemic stroke rate than those without (P

As very large-scale integration technology shrinks to fewer tracks per standard cell, e.g., from 10 to 7.5-track libraries (and lesser for 7 nm), there has been a rapid increase in the usage of multiple-row cells like two- and three-row flip-flops, buffers, etc., for design closure. Additionally, the usage of multibit flip-flops or flop trays to save power creates large cells that further complicate critical design tasks, such as placement. Detailed placement happens to be a key optimization transform, which is repeatedly invoked during the design closure flow to improve design parameters, such as wirelength, timing, and local wiring congestion. Advanced node designs, with hundreds of thousands of multiple-row cells, require a paradigm change for this critical design closure transform. The traditional approach of fixing multiple-row cells during detailed placement and only optimizing the locations of single-row standard cells can no longer obtain appreciable quality of results. It is imperative to have new techniques that can simultaneously optimize both multiple- and single-row height cell locations during detailed placement. In this paper, we propose a new density-aware detailed placer for heterogeneous-sized netlists. Our approach consists of a chain move scheme that generalizes the movement of heterogeneous-sized cells, a nested dynamic programming-based approach for ordered double-row placement and a network flow-based formulation to solve ordered multiple-row placement for wirelength and density optimization. Experimental results demonstrate the effectiveness of these techniques in wirelength minimization and density smoothing compared with the most recent detailed placers for designs with heterogeneous-sized cells.

Obstructive sleep apnea syndrome (OSAS) is an important risk factor for atrial fibrillation (AF). GJA1 gene encoding connexin43, a major protein in cardiac gap junctions, plays a crucial role in the synchronized contraction of the heart and in cardiac arrhythmia. However, little is known regarding the role of GJA1 expression in the incidence of AF in patients with OSAS. All prospectively enrolled OSAS patients underwent polysomnography, electrocardiography, a 24-h Holter test, and echocardiography. Moderate-to-severe OSAS was defined as an apnea-hypopnea index (AHI) ≥ 15. Exosomes were purified from the plasma of all OSAS patients and incubated in HL-1 cells to investigate the effect of exosomes from patients with and without AF on GJA1 expression. A total of 129 patients were recruited for this study, 26 were excluded due to an AHI &lt, 15. Of the 103 enrolled patients, 21 had AF, and 82 did not. Multivariate analysis showed diabetes mellitus, lower sleep efficiency, lower left ventricular ejection fraction, and larger left atrial (LA) size were independent predictors of AF occurrence in OSAS patients. The area under the receiver operating characteristic curve for LA with a size ≥38.5 mm for predicting AF occurrence in OSAS patients was 0.795 (95% confidence interval [0.666, 0.925]), p &lt, 0.001). GJA1 expression in HL-1 cells incubated with exosomes from OSAS patients with AF was lower than that with exosomes from patients without AF after controlling for age and sex and was negatively correlated with the AHI and oxygen desaturation index (ODI), especially during the non-rapid eye movement period (NREM) of OSAS patients with AF (all p &lt, 0.05). LA size was an independent predictor of AF occurrence in OSAS patients. The AHI and ODI in the NREM period of OSAS patients with AF were negatively correlated with GJA1 expression in HL-1 cells, which offers a hint that GJA1 may play a crucial role in the development of AF in patients with OSAS.

Ecological research on the Qinghai–Tibet Plateau (QTP) has become a hotspot in recent years, and a great number of related research papers have been published. Here, a bibliometrics method was utilized to analyze 4315 papers from the Web of Science published from 1990 to 2019, and a comprehensive overview based on metrics, including the publication growth, first author’ institutions and countries, research areas, international cooperation, high-impact journals and papers, and research hotspots and topics, is presented. The results revealed the following: (1) The number of published papers has grown exponentially, with China and India being the main research countries. However, China and the USA have the greatest weights in country cooperation. The Chinese Academy of Sciences has a relatively strong influence and plays the leading role in institutional cooperation. Wang Shiping, Zhang Zhenhua, Luo Caiyun, and seven other authors are highly influential. GLOBAL CHANGE BIOLOGY is the scientific journal that has published the greatest number of papers on the subject, and ‘Environmental Sciences & Ecology’ is the key research area; (2) Grazing, Precipitation, Soil moisture, Aboveground biomass, and Temperature are the top five core keywords. The research hotspots were mainly ecosystem services, biodiversity research, forest protection, and ecological adaptation under the background of climate change; and (3) Both new and old research topics appear in the periods 1990–1999, 2000–2009, 2010–2014, and 2015–2019, but all the periods focused on the impacts of rising temperature on natural elements, such as soil, forests, rivers, and lakes. Many recent also focused on the harmonious coexistence of human beings and nature. On the basis of these findings, some research suggestions and agendas are proposed for future research on the QTP. This is the first visualization and analysis of the hotspots and trends in ecological research on the QTP.

To investigate the postprocedural cardiovascular events and vascular outcomes, including hand ischemia and neurological compromise, after transulnar (TU) catheterization in ipsilateral radial artery occlusion.Previous randomized trials have shown that the transulnar (TU) approach for coronary angiogram and intervention has safety and outcomes similar to those of the transradial (TR) approach. However, the safety of the TU procedure when ipsilateral radial artery occlusion occurs is unknown.We retrospectively reviewed 87 TU cases with ipsilateral radial artery occlusion confirmed by a forearm angiogram. Eighty percent of these patients had a history of ipsilateral radial artery cannulation or surgery. We avoided the use of over-sized sheaths or applied a sheathless approach during surgery.No ulnar artery occlusion was observed by subsequent Doppler ultrasound or pulse oximetry. No patient developed hand ischemia or serious complications requiring surgery or blood transfusion during the follow-up period of 32.2 ± 24.0 months. Review of the preprocedural forearm angiograms showed that 95.7% of the patients possessed significant collaterals supplying flow from the interosseous artery to the occluded radial artery remnant. Thus, the blood circulation to the palmar arch and digital vessels was maintained even when the ulnar artery was temporarily occluded by an in-dwelling ulnar arterial sheath.TU catheterization was safe in patients with coexisting ipsilateral radial artery occlusions and feasible for use in complex intervention procedures. Cautious manipulation of ulnar artery cannulation and hemostasis helped decrease the risk of hand ischemia.

Supplemental Digital Content is available in the text, Atrial fibrillation (AF) is a major independent risk factor of stroke and anticoagulation therapy is needed in patients with AF after ischemic stroke. However, the detection rate of AF is low after ischemic stroke. Developing a prediction model for newly diagnosed AF after ischemic stroke will help to assess the subclinical AF. We identified 98,103 patients with diabetes mellitus (DM) and 261,893 patients without DM, who were not AF history and admitted for newly ischemic stroke from the National Health Insurance Research Database in Taiwan. The prediction model for 3-year incidence of AF after ischemic stroke was derived from multivariate logistic regression and also the accuracy rate of the prediction model was compared with CHA2DS2-VASC and CHADS2 scores as a reference. Four thousand nine hundred seventy six patients in the DM cohort and 16,127 patients in the non-DM cohort developed AF during 3 years of follow-up. The variables in the point-based prediction model for non-DM patients (range: -3–28), included age, heart failure, coronary artery disease, gout, obstructive pulmonary disease, hypertension, female, and statin use, while those for DM patients (range: -2–30) included age, heart failure, coronary artery disease, chronic kidney disease, hypertension, obstructive pulmonary disease, and statin use. Compared to the CHADS2 and CHA2DS2-VASc scoring systems, this scoring system was better at predicting 3-year risk of AF after ischemic stroke in both cohorts. This model might be useful in evaluating the benefit of insertable cardiac monitor implantation and anticoagulation agents in individual patients after ischemic stroke.

Background. Left atrial enlargement is a mortality and heart failure risk factor in primary mitral regurgitation (MR) patients. Pig models of MR have shown differential expression of genes linked to the renin-angiotensin system. Therefore, the aim of this study was to investigate the key genes of the renin-angiotensin that are expressed differentially in the left atrial myocardium in MR patients. Methods. Quantitative RT-PCR was used to compare gene expression in the renin-angiotensin system in the left atrium in MR patients, aortic valve disease patients, and normal subjects. Results. Plasma angiotensin II concentrations did not significantly differ between MR patients and aortic valve disease patients (P=0.582). Compared to normal controls, however, MR patients had significantly downregulated expressions of angiotensin-converting enzyme, angiotensin I converting enzyme 2, type 1 angiotensin II receptor, glutamyl aminopeptidase, angiotensinogen, cathepsin A (CTSA), thimet oligopeptidase 1, neurolysin, alanyl aminopeptidase, cathepsin G, leucyl/cystinyl aminopeptidase (LNPEP), neprilysin, and carboxypeptidase A3 in the left atrium. The MR patients also had significantly upregulated expressions of MAS1 oncogene (MAS1) and mineralocorticoid receptor compared to normal controls. Additionally, in comparison with aortic valve disease patients, MR patients had significantly downregulated CTSA and LNPEP expression and significantly upregulated MAS1 expression in the left atrium. Conclusions. Expressions of genes in the renin-angiotensin system, especially CTSA, LNPEP, and MAS1, in the left atrium in MR patients significantly differed from expressions of these genes in aortic valve disease patients and normal controls. Notably, differences in expression were independent of circulating angiotensin II levels. The results of this study provide a rationale for pharmacological therapies or posttranslational regulation therapies targeting genes expressed differentially in the renin-angiotensin system to remedy structural remodeling associated with atrial enlargement and heart failure progression in patients with MR.

To avoid producing unroutable placement solutions, many state-of-the-art routability-driven placers iteratively invoke global routers to evaluate their placement solutions, and then perform routability optimization. However, using a global router to evaluate hard-to-route placement solutions may spend considerable runtime and it cannot guarantee that a placement is truly unroutable to any router. This paper presents an unroutable placement recognizer based on a window-based unroutable region recognition algorithm and a length-bounded unroutable panel recognition (UPR) algorithm, which can confirm some placements that are exactly unroutable among a set of hard-to-route placements. In addition, if a placement is recognized to be unroutable, the recognizer can report a lower bound of total overflow for the placement. The experimental results reveal that the unroutable region recognition algorithm can find out 16 placements that are definitely unroutable among 23 widely used hard-to-route global routing benchmarks. Moreover, when a scenic constraint is considered, the UPR algorithm can find out a few more placements that are also unroutable.

Background This study aimed to evaluate the longitudinal changes in cardiac structure and function in incident-automated peritoneal dialysis (APD) patients. Methods We conducted a 2-year prospective, randomized, open-label, parallel-group study to compare the efficacy of icodextrin solution versus glucose-based solution. Echocardiography was performed at baseline, 1 and 2 years. Echocardiographic parameters over 2 years were evaluated for each group, using the Friedman test. Generalized linear regression analysis was used to test the associations between baseline clinical variables and echocardiographic changes, and a multivariate model was used to analyze cardiac function between the two groups. Results A total of 43 APD patients were enrolled in the beginning of this study. Twenty patients in the icodextrin group (ICO) and 18 patients in the glucose group (GLU) completed the study. In left ventricular (LV) systolic function measurements, ejection fraction (EF) increased significantly in the GLU group. Measurements of LV diastolic function and septal early mitral annulus velocity (EMV) increased significantly from baseline to 24-months in the ICO group (5.43–5.51 ms). The GLU group showed a significant decrease in peak early diastolic velocity (EDV) (70.67–68.25 cm/s), but a significant increase in septal EMV (5.94–7.57 ms) from baseline to 24-months. No significant association was found between the baseline clinical variables and echocardiographic changes within 24 months in the generalized linear regression analysis. Multivariate models were used to investigate changes in the four primary endpoints, namely, myocardial performance index (MPI), left ventricular ejection fraction (LVEF), deceleration time (DT), and E/e′ ratio. These primary endpoints show no significant association with the baseline values in both the ICO and GLU groups. Conclusion The present study demonstrates that long-dwell icodextrin solution can maintain reasonable cardiac structure and function in incident-APD patients. Trial registration ISRCTN14931270 (retrospectively registered on 23/03/2018).

Traditional solutions to antenna effect, such as jumper insertion and diode insertion performed at post-route stage may produce extra vias and degrade circuit performance. Previous work suggests combining layer assignment, jumper insertion, and diode insertion together to achieve a better design quality with less additional cost. Based on our observations on global and local antenna violations, this paper proposes an antenna-safe single-net layer assignment (AS-SLA), which first enumerates all antenna-safe layer assignment solutions of a net, and then extracts the minimum-cost one for the net. AS-SLA can minimize via count and separators as well. In addition, an antenna avoidance layer assignment flow (AALA) adopting AS-SLA as its kernel not only avoids global antenna violations, but also eliminates local antenna violations. Experimental results reveal that, in 16 benchmarks, AALA can yield ten antenna-violation-free assignments, while the algorithms of other works yield no antenna-violation-free assignment. However, AALA performs about seven times slower than other antenna-aware layer assignment algorithm. Accordingly, two acceleration techniques are proposed to reduce the runtime of AALA by 57.6%.

Modern global routers employ various routing methods to improve routing speed and quality. Maze routing is the most time-consuming process for existing global routing algorithms. This paper presents two bounded-length maze routing (BLMR) algorithms (optimal-BLMR and heuristic-BLMR) that perform much faster routing than traditional maze routing algorithms. In addition, a rectilinear Steiner minimum tree aware routing scheme is proposed to guide heuristic-BLMR and monotonic routing to build a routing tree with shorter wirelength. This paper also proposes a parallel multithreaded collision-aware global router based on a previous sequential global router (SGR). Unlike the partitioning-based strategy, the proposed parallel router uses a task-based concurrency strategy. Finally, a 3-D wirelength optimization technique is proposed to further refine the 3-D routing results. Experimental results reveal that the proposed SGR uses less wirelength and runs faster than most of other state-of-the-art global routers with a different set of parameters , , , . Compared to the proposed SGR, the proposed parallel router yields almost the same routing quality with average 2.71 and 3.12-fold speedup on overflow-free and hard-to-route cases, respectively, when running on a 4-core system.