Conversion of THz refractive index variation to detectable voltage change realized by a graphene-based Brewster angle device.

The Brewster effect has been previously reported as an essential mechanism for terahertz (THz) wave sensing application. However, generally in a sensing application, a complex rotation apparatus is required for detecting the slight change in Brewster angle. Here, we propose a graphene-based Brewster angle device operating at a specific terahertz frequency capable of sensing the refractive index at a fixed incident angle. In other words, our sensing device could avoid the impact of Brewster angle shift and eliminate the need for high-precision rotating equipment, which is usually required in traditional sensing applications. The conversion from the refractive index to a Volt-level detectable voltage roots from the tunability of graphene's Fermi level in the external electrical field. A linear correlation between the output voltage and the background refractive index is observed and theocratically analyzed. Furthermore, we present the improvement of our device in terms of sensing range and sensitivity by adjusting the permittivity of the dielectric substrate. As a demonstration of our proposed device, a detection range of 1.1-2.4 and a sensitivity of 20.06 V/RIU for refractive index is achieved on a high-resistance silicon substrate operating at 0.3 THz.

Arrhythmogenesis of surgical atrial incisions and lesions in Maze procedure: insights from high-resolution mapping of atrial tachycardias.

BACKGROUND: Atrial tachycardias (ATs) frequently develop after a surgical Maze procedure. We aimed to elucidate the electrophysiologic mechanisms and their arrhythmogenic substrates of these ATs. METHODS AND RESULTS: We retrospectively reviewed 20 patients (14 females, mean age of 55.5 ± 8.6 years) with post-Maze ATs who underwent high-resolution mapping at three institutions. The slow conduction areas, reentry circuits, voltage signals, complex electrograms, and their correlation with the surgical incisions and lesions placed in the surgical Maze procedures were analyzed. Thirty-six ATs with a mean cycle length of 260.0 ± 67.6 ms were mapped in these patients. Among them, 22 (61.1%) were anatomical macro-reentrant ATs (AMAT), 12 (33.3%) non-AMATs (localized ATs), and 2 (5.6%) focal ATs, respectively. Epicardial conduction bridges were observed in 6/20 (30.0%) patients and 7/36 (19.4%) ATs. Different arrhythmogenic substrates were identified in these ATs, including slow conduction regions within the previous lesion areas or between the incisions and anatomical structures, the prolonged activation pathways caused by the short lesions connecting the tricuspid annulus, and the circuits around the long incisions and/or lesions. CONCLUSIONS: Reentry is the main mechanism of the post-Maze ATs. The pro-arrhythmic substrates are most likely caused by surgical incisions and lesions. The slow conduction regions and the protected channels yielded from these areas are the major arrhythmogenic factors.

Chemometrics applied quantitative analysis of iron oxide mixtures by terahertz spectroscopy.

A quantitative analysis method for corrosion products based on terahertz spectroscopy is proposed in this paper. Mixture samples consisting of three major corrosion products (magnetite, hematite, and goethite) were prepared in 51 different concentrations. The refractive index spectra measured by terahertz time-domain spectroscopy were projected to the 2D score diagram by performing principal component analysis. The Euclidean distances between the mixtures and pure analyte on the diagram were used to build a concentration prediction model. The results indicate that the established model can precisely predict the concentration of magnetite, which is essential for a stability evaluation of the corrosion system.

Enhancing the efficiency of graphene-based THz modulator by optimizing the Brewster angle.

The gate-controllable electronical property of graphene provides a possibility of active tuning property for THz modulator. However, the common modulation technology which only depends on voltage cannot solve the problem of power consumption limitation in communication applications. Here, we demonstrated a Brewster angle-controlled graphene-based THz modulator, which could achieve a relatively high modulation depth with low voltage. First, we explored the complex relationships among the Brewster angles, reflection coefficients and the conductivities of graphene. Then, we further investigated the optimal incident angle selection based on the unusual reflection effect which occurs at Brewster angle. Finally, an improved scheme by dynamically adjusting the incident angle was proposed in this paper. It would make it possible that the modulator could achieve a modulation depth of more than 90% with a Fermi level as low as 0.2eV at any specific frequency in the range of 0.4THz-2.2THz. This research will help to realize a THz modulator with high-performance and ultra-low-power in quantities of applications, such as sensing and communication.

Correlations of serum cystatin C and glomerular filtration rate with vascular lesions and severity in acute coronary syndrome.

BACKGROUND: The aim of this study was to evaluate the predictive value of cystatin C (CysC) and estimated glomerular filtration rate (eGFR) regarding vascular lesions and their severity in patients with acute coronary syndrome (ACS). METHODS: According to the results of coronary angiography, 195 ACS patients were divided into a single-vascular-lesion group (91 cases), a dual-vascular-lesion group (67 cases), and a multiple-vascular-lesion group (37 cases) to assess the severity of coronary artery disease according to Gensini scores and to analyze the correlations of CysC and eGFR level with vascular lesions and severity in ACS patients. RESULTS: Intergroup comparisons of univariate and multivariate regression analyses showed that CysC was positively correlated with vascular lesions (P < 0.05), but eGFR showed no correlation. Regarding the severity of vascular lesions, CysC was positively correlated with Gensini score (Pearson's correlation coefficient r = 0.1811, P < 0.05), but eGFR was not correlated (P > 0.05). CONCLUSIONS: Serum CysC levels could reflect the severity of vascular lesions in ACS patients, and a high CysC level had predictive value regarding the severity of vascular lesions in ACS.

Ensemble learning prediction framework for EGFR amplification status of glioma based on terahertz spectral features.

Epidermal growth factor receptor (EGFR) plays a pivotal role in the initiation and progression of gliomas. In particular, in glioblastoma, EGFR amplification emerges as a catalyst for invasion, proliferation, and resistance to radiotherapy and chemotherapy. Current approaches are not capable of providing rapid diagnostic results of molecular pathology. In this study, we propose a terahertz spectroscopic approach for predicting the EGFR amplification status of gliomas for the first time. A machine learning model was constructed using the terahertz response of the measured glioma tissues, including the absorption coefficient, refractive index, and dielectric loss tangent. The novelty of our model is the integration of three classical base classifiers, i.e., support vector machine, random forest, and extreme gradient boosting. The ensemble learning method combines the advantages of various base classifiers, this model has more generalization ability. The effectiveness of the proposed method was validated by applying an individual test set. The optimal performance of the integrated algorithm was verified with an area under the curve (AUC) maximum of 85.8 %. This signifies a significant stride toward more effective and rapid diagnostic tools for guiding postoperative therapy in gliomas.

Biomedical applications of terahertz spectra in clinical and molecular pathology of human glioma.

Gliomas are the most common type of primary tumor originating in the central nervous system of adults. Tumor histological type, pathological grade, and molecular pathology are significant prognosis and predictive factors. In this study, we were aiming to predict histological type and molecular pathological features based on terahertz time-domain spectroscopy technology. Nine gliomas with different grades, one meningioma, and one lymphoma were enrolled. There were significant differences in terahertz absorption coefficient between normal brain tissue, tumoral-periphery, and tumoral-center tissue in specific frequency bands (0.2-1.4 THz). Histological type, pathological grade, and glioma-specific biomarkers were closely related to the terahertz absorption coefficient in both tumoral-periphery and tumoral-center tissues. Interestingly, tumoral-periphery showed more obvious differences than tumoral-center tissues in almost all aspects. All the results show that the terahertz technology has potential application value in the intraoperative real-time glioma recognition and diagnosis of glioma histological and molecular pathological features.

Use of acoustic cardiography to assess left ventricular electromechanical synchronization during left bundle branch pacing.

Background: Left bundle branch pacing (LBBP) is a physiological pacing that captures the main left bundle or its proximal branch. Electromechanical activation time (EMAT) is an acoustic cardiographic metric that provides a simple method for evaluating left ventricular (LV) synchrony. Prolonged EMAT reflects impaired LV electromechanical coupling. Objective: The purpose of this study was to explore whether EMAT can confirm that LBBP produces more satisfactory LV electromechanical synchronization than conventional right ventricular pacing modalities. Methods: Patients with standard pacing indications and narrow QRS duration were recruited for this study. Unipolar pacing under 3 different modalities-right ventricular apical pacing (RVAP), right ventricular high septal pacing (RVHSP), and LBBP-were successively performed in each patient. Pacing parameters, echocardiographic characteristics, and acoustic cardiographic parameters at different pacing modalities and during normal rhythm were collected. Results: A total of 55 patients were enrolled, and all had successful LBBP. Left ventricular activation time (LVAT) was significantly associated with EMAT, with LVAT vs EMAT correlation coefficient of 0.665 (P <.001). LVAT during LBBP was shorter than that during RVHSP (51.93 ± 2.732 ms vs 85.59 ± 2.240 ms; P <.001). EMAT of LBBP was significantly lower than either RVAP or RVHSP (95.44 ± 1.794 ms vs 143.32 ± 2.376 ms, and 132.22 ± 1.872 ms; both P <.001) but was similar to that of intrinsic rhythm (95.37 ± 2.271 ms; P = .862). Conclusion: We found EMAT significantly prolonged in RVHSP and RVAP but not in the LBBP mode. This finding indicates superior electromechanical synchronization in patients having LBBP. EMAT measurement could be an additional method for identifying the ideal pacing position.

Prediction of IDH mutation status of glioma based on terahertz spectral data.

Gliomas are the most common type of primary tumor in the central nervous system in adults. Isocitrate dehydrogenase (IDH) mutation status is an important molecular biomarker for adult diffuse gliomas. In this study, we were aiming to predict IDH mutation status based on terahertz time-domain spectroscopy technology. Ninety-two frozen sections of glioma tissue from nine patients were included, and terahertz spectroscopy data were obtained. Through Least Absolute Shrinkage and Selection Operator (LASSO), Principal component analysis (PCA), and Random forest (RF) algorithms, a predictive model for predicting IDH mutation status in gliomas was established based on the terahertz spectroscopy dataset with an AUC of 0.844. These results indicate that gliomas with different IDH mutation status have different terahertz spectral features, and the use of terahertz spectroscopy can establish a predictive model of IDH mutation status, providing a new way for glioma research.

The WNT/ß-catenin signalling pathway induces chondrocyte apoptosis in the cartilage injury caused by T-2 toxin in rats.

We investigated whether the WNT/ß-catenin signalling pathway is involved in paediatric Kashin-Beck disease (KBD) and T-2-toxin-induced cartilage injury in rats to better understand the mechanism of KBD. One hundred twenty-two children were selected and assigned to the case (31), internal control (41), and external control (50) groups. The serum ß-catenin and bone morphogenetic protein 2（BMP2）levels in each group were measured and compared. Thirty-six rats were randomly assigned to three groups, which received no intervention, T-2 toxin, or solvent. After 18 weeks, the expression of LDL receptor related proteins 5 (LRP5), ß-catenin, BMP2, BAX, BCL2, APAF1, and caspase 9 was measured and compared. The serum BMP2 levels were significantly elevated in the children with KBD and in the rats treated with T-2 toxin. In the T-2 toxin group, LRP5 and ß-catenin expression was reduced, whereas BAX, APAF1, and caspase 9 expression was increased. In conclusion, the WNT/ß-catenin signalling pathway is suppressed in KBD, which induces chondrocyte apoptosis, leading to cartilage injury. Therefore, BMP2 may play a role in the pathogenesis of KBD.

The levels of urine CTX-II, C2C, and PYD in children patients with Kashin-Beck disease in Qinghai Province of China.

BACKGROUND: Kashin-Beck disease (KBD) is an endemic and chronic osteoarthropathy. At present, the diagnosis of KBD mainly depends on the X-ray examination and which could not reflect early damage of cartilage sensitively. So, the aim of this study was to find effective and sensitive biomarkers for early diagnosis of pediatric KBD. METHODS: A total of 122 children aged 7-15 years old from 3 villages of Qinghai Province were eligible for the study. Thirty-one, 41, and 50 children were assigned in case, internal, and external control groups, respectively. The levels of CTX-II, C2C, and PYD in urine were measured by using ELISA and compared statistically. In addition, the receiver operating characteristic curve (ROC) analysis was used to assess the performance of diagnostic biomarkers. RESULTS: There were significant differences in levels of CTX-II, C2C, and PYD in urine of subjects among three groups. The levels of CTX-II and PYD in the case group were significantly higher than those in external and internal control groups. On the contrary, the level of C2C in the case group was lower than that in the external control group. Compared to the external control group, the area under the curve (AUC) of CTX-II, C2C, and PYD were 0.857, 0.837, and 0.79, and the AUC of CTX-II significantly higher than that of PYD. Compared to the internal control group, the AUC of CTX-II, C2C, and PYD were 0.911, 0.875, and 0.839, and there were no significant differences in the AUC among three indicators. CONCLUSION: Both CTX-II and PYD in urine could be used as biomarkers for early diagnosis of pediatric KBD, and the prediction accuracy of CTX-II was relatively superior.

Analysis of the risk factors for contrast-induced nephropathy in over-aged patients receiving coronary intervention.

Contrast-induced nephropathy has been the common cause of hospital-acquired acute kidney injury in the elderly patients. This study aimed to analyze the risk factors for contrast-induced nephropathy in over-aged patients undergoing coronary angiography or percutaneous coronary intervention. A total of 470 over-aged patients (≥80 years old) were judged as the contrast-induced nephropathy group ( n = 46) and non-contrast-induced nephropathy group ( n = 424) according to the postoperative 48-h serum creatinine levels. The patients' clinical information such as hypertension grade, number and degree of coronary artery stenosis, and death rate was compared. The risk factors for contrast-induced nephropathy were also analyzed. The hypertension grade in the contrast-induced nephropathy group was significantly higher than that in the non-contrast-induced nephropathy group ( P = 0.004). The degree of coronary artery stenosis was significantly more in the contrast-induced nephropathy group compared with the non-contrast-induced nephropathy group ( P = 0.003). The death rate of the contrast-induced nephropathy group (15.8%) was significantly higher than that of the non-contrast-induced nephropathy group (0.6%; P = 0.000). The percentage of patients with abnormal urine microalbumin was significantly bigger in the contrast-induced nephropathy group (62.5%) when comparing to the non-contrast-induced nephropathy group (23.6%; P = 0.00). Besides, there was also significant difference in the emergency/selective operation between the contrast-induced nephropathy group and non-contrast-induced nephropathy group ( P = 0.001). Further, hypertension grade ( P = 0.019), emergency/selective operation ( P = 0.025), degree of coronary artery stenosis ( P = 0.038), eGFR ( P = 0.034), and urine microalbumin ( P = 0.005) were the risk factors for contrast-induced nephropathy. Hypertension grade, emergency/selective operation, degree of coronary artery stenosis, eGFR, and urine microalbumin were the risk factors for contrast-induced nephropathy in over-aged patients receiving coronary angiography and percutaneous coronary intervention, providing guidance for the clinical prevention of contrast-induced nephropathy. Impact statement In this work, we evaluated the risk factors for contrast-induced nephropathy (CIN) in over-aged patients receiving coronary angiography (CAG) and percutaneous coronary intervention (PCI). We found that hypertension grade, emergency/selective operation, degree of coronary artery stenosis, eGFR, and urine microalbumin were the risk factors for CIN in over-aged patients receiving CAG and PCI. This study provides guidance for the clinical prevention of CIN in over-aged patients undergoing coronary intervention, highlighting that a perioperative comprehensive management strategy is needed to improve the prognosis.