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OBJECTION: Inflammatory conditions and immune disorders may worsen the prognosis of chronic heart failure (CHF) patients. The aim of this study was to evaluate the prognostic value of a new indicator, C-NLR, composed of C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), for the risk of all-cause mortality in HF patients with different ejection fractions. METHODS: A total of 1221 CHF patients admitted to the First Affiliated Hospital of Kunming Medical University from January 2017 to October 2021 were enrolled in this study. All patients were divided into 2 groups according to the median C-NLR. Kaplan-Meier survival curves were used to compare the all-cause mortality among CHF patients with different ejection fractions. Cox proportional hazards analysis was used to evaluate the relationships between variables and mortality. The predictive value of the C-NLR was assessed by using receiver operating characteristic (ROC) analyses. RESULTS: We collected data from 1192 patients with CHF. Kaplan-Meier survival analysis revealed that patients with low LCR levels had better overall survival (OS). After multivariate adjustment Cox proportional hazards analysis, the level of C-NLR was still independently related to mortality. CONCLUSIONS: C-NLR was a competent independent predictor in HF with different ejection fractions, and routine measurement of C-NLR would help clinical doctors identify patients with a poor prognosis.
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Insuficiência Cardíaca , Neutrófilos , Humanos , Neutrófilos/metabolismo , Prognóstico , Estudos Retrospectivos , Linfócitos/metabolismo , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/metabolismoRESUMO
The chemical rules for predicting and understanding topological states in stacked kagome and honeycomb lattices are studied in both analytical and numerical ways. Starting with a minimal five-band tight-binding model, all the topological states are sorted into five groups, which are determined by the interlayer and intralayer hopping parameters. Combined with the model, an algorithm is designed to obtain a series of experimentally synthesized topological semimetals with kagome and honeycomb layers, i.e., IAMX family (IA = Alkali metal element, M = Rare earth metal element, X = Carbon group element), in the inorganic crystal structure database. A follow-up high-throughput calculation shows that IAMX family materials are all nodal-line semimetals and they will be Weyl semimetals after taking spin-orbit coupling into consideration. To have further insights into the topology of the IAMX family, a detailed chemical rule analysis is carried out on the high-throughput calculations, including the lattice constants of the structure, intralayer and interlayer couplings, bond strengths, electronegativity, and so on, which are consistent with the tight-binding model. This study provides a way to discover and modulate topological properties in stacked kagome and honeycomb crystals and offers candidates for studying topology-related properties like topological superconductors and axion insulators.
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Objective: Explainable machine learning (XAI) was introduced in this study to improve the interpretability, explainability and transparency of the modelling results. The survex package in R was used to interpret and compare two survival models - the Cox proportional hazards regression (coxph) model and the random survival forest (rfsrc) model - and to estimate overall survival (OS) and its determinants in heart failure (HF) patients using these models. Methods: We selected 1159 HF patients hospitalised at the First Affiliated Hospital of Kunming Medical University. First, the performance of the two models was investigated using the C-index, the integrated C/D AUC, and the integrated Brier score. Second, a global explanation of the whole cohort was carried out using the time-dependent variable importance and the partial dependence survival profile. Finally, the SurvSHAP(t) and SurvLIME plots and the ceteris paribus survival profile were used to obtain a local explanation for each patient. Results: By comparing the C-index, the C/D AUC, and the Brier score, this study showed that the model performance of rfsrc was better than coxph. The global explanation of the whole cohort suggests that the C-reactive protein, lg BNP (brain natriuretic peptide), estimated glomerular filtration rate, albumin, age and blood chloride were significant unfavourable predictors of OS in HF patients in both the cxoph and the rfsrc models. By including individual patients in the model, we can provide a local explanation for each patient, which guides the clinician in individualising the patient's treatment. Conclusion: By comparison, we conclude that the model performance of rfsrc is better than that of coxph. These two predictive models, which address not only the whole population but also selected patients, can help clinicians personalise the treatment of each HF patient according to his or her specific situation.
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The ratio of fibrinogen to albumin (FAR) is considered a new inflammatory biomarker and a predictor of cardiovascular disease risk. However, its prognostic value for patients with chronic heart failure (CHF) with different ejection fractions (EFs) remains unclear. A total of 916 hospitalized patients with CHF from January 2017 to October 2021 in the First Affiliated Hospital of Kunming Medical University were included in the study. Death occurred in 417 (45.5%) patients out of 916 patients during a median follow-up time of 750 days. Among these patients, 381 patients suffered from HFrEF (LVEF <40%) and 535 patients suffered from HFpEF or HFmrEF (HFpEF plus HFmrEF, LVEF ≥ 40%). Patients were categorized into high-level FAR (FAR-H) and low-level FAR (FAR-L) groups based on the optimal cut-off value of FAR (9.06) obtained from receiver operating characteristic (ROC) curve analysis. Upon analysing the Kaplan - Meier plots, the incidence of death was significantly higher in all patients with FAR-H and patients in both HF subgroups (p < 0.001). The multivariate Cox proportional hazard analyses indicated that the FAR was an independent predictor of all-cause mortality, regardless of heart failure subtype. (HR 1.115, 95% CI 1.089-1.142, p < 0.001; HFpEF plus HFmrEF, HR 1.109, 95% CI 1.074-1.146, p < 0.0001; HFrEF, HR 1.138, 95% CI 1.094-1.183, p < 0.0001) The optimal cut-off value of FAR in predicting all-cause mortality was 9.06 with an area under the curve value of 0.720 (95% CI: 0.687-0.753, p < 0.001), a sensitivity of 68.8% and a specificity of 65.6%. After adjusting for the traditional indicators (LVEF, Lg BNP, etc.), the new model with the FAR had better prediction ability in patients with CHF. Elevated FAR is an independent predictor of death in CHF and is not related to the HF subtype.
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Insuficiência Cardíaca , Humanos , Prognóstico , Insuficiência Cardíaca/epidemiologia , Volume Sistólico , IncidênciaRESUMO
The 2D electron system (2DES) at the KTaO3 surface or heterointerface with 5d orbitals hosts extraordinary physical properties, including a stronger Rashba spin-orbit coupling (RSOC), higher superconducting transition temperature, and potential of topological superconductivity. Herein, a huge enhancement of RSOC under light illumination achieved at a superconducting amorphous-Hf0.5 Zr0.5 O2 /KTaO3 (110) heterointerfaces is reported. The superconducting transition is observed with Tc = 0.62 K and the temperature-dependent upper critical field reveals the interaction between spin-orbit scattering and superconductivity. A strong RSOC with Bso = 1.9 T is revealed by weak antilocalization in the normal state, which undergoes sevenfold enhancement under light illumination. Furthermore, RSOC strength develops a dome-shaped dependence of carrier density with the maximum of Bso = 12.6 T achieved near the Lifshitz transition point nc ≈ 4.1 × 1013 cm-2 . The highly tunable giant RSOC at KTaO3 (110)-based superconducting interfaces show great potential for spintronics.
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van der Waals (vdW) ferromagnetic heterojunctions, characterized by an ultraclean device interface and the absence of lattice matching, have emerged as indispensable and efficient building blocks for future spintronic devices. In this study, we present a seldom observed antisymmetric magnetoresistance (MR) behavior with three distinctive resistance states in a lateral van der Waals (vdW) structure comprising Fe3GeTe2 (FGT)/graphite/FGT. In contrast to traditional spin valves governed by the magnetization configurations of ferromagnetic electrodes (FEs), this distinct feature can be attributed to the interaction between FGT and the FGT/graphite interface, which is primarily influenced by the internal spin-momentum locking effect. Furthermore, modulation of the MR behavior is accomplished by employing the coupling between antiferromagnetic and ferromagnetic materials to adjust the coercive fields of two FEs subsequent to the in situ growth of an FGT oxide layer on FGT. This study elucidates the device physics and mechanism of property modulation in lateral spin valves and holds the potential for advancing the development of gate-tunable spintronic devices and next-generation integrated circuits.
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Materials that break multiple symmetries allow the formation of four-fermion condensates above the superconducting critical temperature (Tc). Such states can be stabilized by phase fluctuations. Recently, a fermionic quadrupling condensate that breaks the Z2 time-reversal symmetry was reported in Ba1-xKxFe2As2. A phase transition to the new state of matter should be accompanied by a specific heat anomaly at the critical temperature where Z2 time-reversal symmetry is broken ([Formula: see text]). Here, we report on detecting two anomalies in the specific heat of Ba1-xKxFe2As2 at zero magnetic field. The anomaly at the higher temperature is accompanied by the appearance of a spontaneous Nernst effect, indicating the breakdown of Z2 symmetry. The second anomaly at the lower temperature coincides with the transition to a zero-resistance state, indicating the onset of superconductivity. Our data provide the first example of the appearance of a specific heat anomaly above the superconducting phase transition associated with the broken time-reversal symmetry due to the formation of the novel fermion order.
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The coupling between van der Waals-layered magnetic and superconducting materials holds the possibility of revealing novel physical mechanisms and realizing spintronic devices with new functionalities. Here, we report on the realization and investigation of a maximum â¼17-fold magnetoresistance (MR) enhancement based on a vertical magnetic tunnel junction of Fe3GeTe2 (FGT)/NbSe2/FGT near the NbSe2 layer's superconducting critical temperature (TC) of 6.8 K. This enhancement is attributed to the band splitting in the atomically thin NbSe2 spacer layer induced by the magnetic proximity effect on the material interfaces. However, the band splitting is strongly suppressed by the interlayer coupling in the thick NbSe2 layer. Correspondingly, the device with a thick NbSe2 layer displays no MR increase near TC but a current dependent on transport properties at extremely low temperatures. This work carefully investigates the mechanism of MR enhancement, paving an efficient way for the modulation of spintronics' properties and the achievement of spin-based integrated circuits.
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The iron-based superconductor is emerging as a promising platform for Majorana zero mode, which can be used to implement topological quantum computation. One of the most significant advances of this platform is the appearance of large vortex level spacing that strongly protects Majorana zero mode from other low-lying quasiparticles. Despite the advantages in the context of physics research, the inhomogeneity of various aspects hampers the practical construction of topological qubits in the compounds studied so far. Here we show that the stoichiometric superconductor LiFeAs is a good candidate to overcome this obstacle. By using scanning tunneling microscopy, we discover that the Majorana zero modes, which are absent on the natural clean surface, can appear in vortices influenced by native impurities. Our detailed analysis reveals a new mechanism for the emergence of those Majorana zero modes, i.e. native tuning of bulk Dirac fermions. The discovery of Majorana zero modes in this homogeneous material, with a promise of tunability, offers an ideal material platform for manipulating and braiding Majorana zero modes, pushing one step forward towards topological quantum computation.
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For iron-based superconductors, the phase diagrams under pressure or strain exhibit emergent phenomena between unconventional superconductivity and other electronic orders, varying in different systems. As a stoichiometric superconductor, LiFeAs has no structure phase transitions or entangled electronic states, which manifests an ideal platform to explore the pressure or strain effect on unconventional superconductivity. Here, we observe two types of superconducting states controlled by orientations of local wrinkles on the surface of LiFeAs. Using scanning tunneling microscopy/spectroscopy, we find type-I wrinkles enlarge the superconducting gaps and enhance the transition temperature, whereas type-II wrinkles significantly suppress the superconducting gaps. The vortices on wrinkles show a C2 symmetry, indicating the strain effects on the wrinkles. By statistics, we find that the two types of wrinkles are categorized by their orientations. Our results demonstrate that the local strain effect with different directions can tune the superconducting order parameter of LiFeAs very differently, suggesting that the band shifting induced by directional pressure may play an important role in iron-based superconductivity.
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Braiding Majorana zero modes is essential for fault-tolerant topological quantum computing. Iron-based superconductors with nontrivial band topology have recently emerged as a surprisingly promising platform for creating distinct Majorana zero modes in magnetic vortices in a single material and at relatively high temperatures. The magnetic field-induced Abrikosov vortex lattice makes it difficult to braid a set of Majorana zero modes or to study the coupling of a Majorana doublet due to overlapping wave functions. Here we report the observation of the proposed quantum anomalous vortex with integer quantized vortex core states and the Majorana zero mode induced by magnetic Fe adatoms deposited on the surface. We observe its hybridization with a nearby field-induced Majorana vortex in iron-based superconductor FeTe0.55Se0.45. We also observe vortex-free Yu-Shiba-Rusinov bound states at the Fe adatoms with a weaker coupling to the substrate, and discover a reversible transition between Yu-Shiba-Rusinov states and Majorana zero mode by manipulating the exchange coupling strength. The dual origin of the Majorana zero modes, from magnetic adatoms and external magnetic field, provides a new single-material platform for studying their interactions and braiding in superconductors bearing topological band structures.
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Majorana zero modes (MZMs) are spatially localized, zero-energy fractional quasiparticles with non-Abelian braiding statistics that hold promise for topological quantum computing. Owing to the particle-antiparticle equivalence, MZMs exhibit quantized conductance at low temperature. By using variable-tunnel-coupled scanning tunneling spectroscopy, we studied tunneling conductance of vortex bound states on FeTe0.55Se0.45 superconductors. We report observations of conductance plateaus as a function of tunnel coupling for zero-energy vortex bound states with values close to or even reaching the 2e 2/h quantum conductance (where e is the electron charge and h is Planck's constant). By contrast, no plateaus were observed on either finite energy vortex bound states or in the continuum of electronic states outside the superconducting gap. This behavior of the zero-mode conductance supports the existence of MZMs in FeTe0.55Se0.45.
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Iron-chalcogenide superconductors have emerged as a promising Majorana platform for topological quantum computation. By combining topological band and superconductivity in a single material, they provide significant advantage to realize isolated Majorana zero modes. However, iron-chalcogenide superconductors, especially Fe(Te,Se), suffer from strong inhomogeneity which may hamper their practical application. In addition, some iron-pnictide superconductors have been demonstrated to have topological surface states, yet no Majorana zero mode has been observed inside their vortices, raising a question of universality about this new Majorana platform. In this work, through angle-resolved photoemission spectroscopy and scanning tunneling microscopy/spectroscopy measurement, we identify Dirac surface states and Majorana zero modes, respectively, for the first time in an iron-pnictide superconductor, CaKFe4As4. More strikingly, the multiple vortex bound states with integer-quantization sequences can be accurately reproduced by our model calculation, firmly establishing Majorana nature of the zero mode.
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Connate topological superconductor (TSC) combines topological surface states with nodeless superconductivity in a single material, achieving effective p-wave pairing without interface complication. By combining angle-resolved photoemission spectroscopy and in-situ molecular beam epitaxy, we studied the momentum-resolved superconductivity in ß-Bi2Pd film. We found that the superconducting gap of topological surface state (ΔTSSâ¯â¼â¯3.8â¯meV) is anomalously enhanced from its bulk value (Δbâ¯â¼â¯0.8â¯meV). The ratio of 2ΔTSS/kBTcâ¯â¼â¯16.3, is substantially larger than the BCS value. By measuring ß-Bi2Pd bulk single crystal as a comparison, we clearly observed the upward-shift of chemical potential in the film. In addition, a concomitant increasing of surface weight on the topological surface state was revealed by our first principle calculation, suggesting that the Dirac-fermion-mediated parity mixing may cause this anomalous superconducting enhancement. Our results establish ß-Bi2Pd film as a unique case of connate TSCs with a highly enhanced topological superconducting gap, which may stabilize Majorana zero modes at a higher temperature.