Room temperature operation of germanium-silicon single-photon avalanche diode.

The ability to detect single photons has led to the advancement of numerous research fields1-11. Although various types of single-photon detector have been developed12, because of two main factors-that is, (1) the need for operating at cryogenic temperature13,14 and (2) the incompatibility with complementary metal-oxide-semiconductor (CMOS) fabrication processes15,16-so far, to our knowledge, only Si-based single-photon avalanche diode (SPAD)17,18 has gained mainstream success and has been used in consumer electronics. With the growing demand to shift the operation wavelength from near-infrared to short-wavelength infrared (SWIR) for better safety and performance19-21, an alternative solution is required because Si has negligible optical absorption for wavelengths beyond 1 µm. Here we report a CMOS-compatible, high-performing germanium-silicon SPAD operated at room temperature, featuring a noise-equivalent power improvement over the previous Ge-based SPADs22-28 by 2-3.5 orders of magnitude. Key parameters such as dark count rate, single-photon detection probability at 1,310 nm, timing jitter, after-pulsing characteristic time and after-pulsing probability are, respectively, measured as 19 kHz µm-2, 12%, 188 ps, ~90 ns and <1%, with a low breakdown voltage of 10.26 V and a small excess bias of 0.75 V. Three-dimensional point-cloud images are captured with direct time-of-flight technique as proof of concept. This work paves the way towards using single-photon-sensitive SWIR sensors, imagers and photonic integrated circuits in everyday life.

Utility of rotational thromboelastometry in the management of massive haemorrhage at a regional Australian hospital.

BACKGROUND: Rotational thromboelastometry (ROTEM) allows targeted and individualised blood product replacement. OBJECTIVES: The study aimed to determine the impact of ROTEM-guided transfusion on the clinical course of patients with acute massive haemorrhage in a regional Australian hospital. METHODS/MATERIALS: A retrospective review of all patients with acute massive haemorrhage that compared the characteristics, blood product use, and clinical outcomes of patients with massive haemorrhage before and after the introduction of ROTEM-guided transfusion. RESULTS: In per-protocol analysis, the 31/97 (32%) with ROTEM-guided transfusion used less packed red blood cells (median [interquartile range]: 6 [6-8] vs. 8 [6-12] units, p = 0.03) than patients whose transfusion was not ROTEM-guided. They were also less likely to receive fresh frozen plasma (2/31 [6%] vs. 45/66 [68%], p < 0.0001) or platelets (2/31 [6%] vs. 31/66 [47%], p < 0.0001); they were, however, more likely to receive fibrinogen products (26/31 [84%] vs. 38/66 [58%], p = 0.01). Patients receiving ROTEM-guided transfusion had lower in-hospital mortality (6/31 [19%] vs. 20/66 [30%], odds ratio 0.55 [95% confidence interval]: 0.20-1.55, p = 0.26) although this did not achieve statistical significance in this small cohort. CONCLUSION: ROTEM-guided massive transfusion of patients with acute haemorrhage in this regional Australian hospital led to a reduction in packed red blood cell, fresh frozen plasma, and platelet utilisation and may also have reduced mortality.

In situ investigation of water on MXene interfaces.

A continuum of water populations can exist in nanoscale layered materials, which impacts transport phenomena relevant for separation, adsorption, and charge storage processes. Quantification and direct interrogation of water structure and organization are important in order to design materials with molecular-level control for emerging energy and water applications. Through combining molecular simulations with ambient-pressure X-ray photoelectron spectroscopy, X-ray diffraction, and diffuse reflectance infrared Fourier transform spectroscopy, we directly probe hydration mechanisms at confined and nonconfined regions in nanolayered transition-metal carbide materials. Hydrophobic (K+) cations decrease water mobility within the confined interlayer and accelerate water removal at nonconfined surfaces. Hydrophilic cations (Li+) increase water mobility within the confined interlayer and decrease water-removal rates at nonconfined surfaces. Solutes, rather than the surface terminating groups, are shown to be more impactful on the kinetics of water adsorption and desorption. Calculations from grand canonical molecular dynamics demonstrate that hydrophilic cations (Li+) actively aid in water adsorption at MXene interfaces. In contrast, hydrophobic cations (K+) weakly interact with water, leading to higher degrees of water ordering (orientation) and faster removal at elevated temperatures.

Increasing and high prevalence of moderate to severe obstructive sleep apnea in acute ischemic stroke in Taiwan.

STUDY OBJECTIVES: The prevalence of obstructive sleep apnea (OSA) after stroke is variable, likely due to the time of examination and patient population. Although risk factors for OSA are well established, those for OSA in patients with ischemic stroke have not yet been fully identified. Therefore, we examined the prevalence of OSA and identified risk factors for OSA in the acute stage of ischemic stroke in the Taiwanese population. METHODS: A total of 103 patients with acute ischemic stroke were screened for OSA by performing polysomnography. The demographic and clinical data, Epworth Sleepiness Scale score, and other stroke risk factors were recorded. Sleep parameters, namely sleep efficiency, sleep stages, apnea-hypopnea index, and oxygen desaturation index were recorded. Logistic regression analysis was conducted to determine clinical and demographic risk factors for moderate to severe OSA in patients with stroke. RESULTS: We determined that 91.2% of the patients had OSA in the acute stage of ischemic stroke, and 70% of the patients had moderate to severe OSA. Multivariate logistic regression analysis revealed that patients aged ≥65 years had a significantly higher risk of moderate to severe OSA (adjusted OR: 3.04, 95% CI: 1.20-7.69, p < 0.05) compared with patients with ischemic stroke aged <50 years. CONCLUSION: OSA is highly prevalent among patients with ischemic stroke in the acute stage, and those aged ≥65 years had a significantly increased risk of moderate to severe OSA. In clinical practice, routine PSG screening of OSA may be necessary among older patients with stroke.

Using oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy in stage II colorectal cancer: a propensity score matching study from Taiwan.

BACKGROUND: Early-stage colorectal cancer had excellent outcomes after curative resection, typically. However, a perplexing survival paradox between stage II and stage III was noted. This paradox could be influenced by the administration of routine postoperative adjuvant chemotherapy and the presence of high-risk factors in stage II CRC. The objective of the study was to investigate the influence of high-risk factors on patients with stage II CRC and assess the efficacy of oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy for stage II CRC patients. METHODS: A retrospective study was conducted using propensity score matching at a single medical institution. A total of 1544 patients with stage II colorectal cancer who underwent radical surgery between January 2004 and January 2009 were included. The intervention used was tegafur/uracil plus leucovorin as adjuvant chemotherapy. The main outcome measures were disease-free survival and overall survival. RESULTS: After propensity score matching, 261 patients were included in three groups: no-treatment, half-year treatment, and one-year treatment. The clinical characteristics of each group tended to be more consistent. The Cox proportional hazard models showed that tegafur/uracil treatment or not was a significant independent factor for oncological outcome. Kaplan-Meier analysis also showed significantly better disease-free survival and overall survival. Further investigation revealed that tegafur/uracil duration was an independent factor for oncological outcome. While the survival curve did not reach statistical significance, the one-year UFT treatment group demonstrated the best treatment trend. CONCLUSIONS: This study suggests that tegafur/uracil plus leucovorin is a feasible adjuvant chemotherapy regimen for patients with stage II colorectal cancer after curative surgical treatment. Prolonged tegafur/uracil plus leucovorin treatment for 12 months showed a trend towards better outcomes in patients with stage II colorectal cancer.

A rotating ring disc electrode study of photo(electro)catalyst for nitrogen fixation.

There are numerous reports of photo(electro)catalysts demonstrating activity for nitrogen reduction to ammonia and a few reports of photo(electro)catalysts demonstrating activity for nitrogen oxidation to nitric acid. However, progress in advancing solar-to-fertilizer applications is slow, due in part to the pace of catalyst screening. Most evaluations of photo(electro)catalysts activity occur using batch reactors. This is because common product analyses require accumulation of ammonia or nitric acid in the reactor to overcome instrument detection limits. The primary aim here is to examine the use of an electroanalytical method, rotating ring disk electrode voltammetry (RRDE), to detect ammonia produced by a nitrogen fixing photo(electro)catalyst. To examine the potential for RRDE, we investigated a photo(electro)catalyst known to reduce nitrogen to ammonia (titania), while varying the applied electrochemical potential and degree of illumination on the disk. We show that the observed ammonia oxidation at the ring electrode corresponds strongly with ammonia measurements obtained from the bulk electrolyte. Indicating that RRDE may be effective for catalyst screening. The chief limitation of this approach is the need for an alkaline electrolyte. In addition, this approach does not rule out the presence of adventitious ammonia.

Design of a Completely Vertical, Polarization-Independent Two-Dimensional Grating Coupler with High Coupling Efficiency.

An efficient optical coupler to transfer the signal between an optical fiber and a silicon waveguide is essential for realizing the applications of silicon photonic integrated circuits such as optical communication and optical sensing. In this paper, we numerically demonstrate a two-dimensional grating coupler based on a silicon-on-insulator platform to obtain completely vertical and polarization-independent couplings, which potentially ease the difficulty of packaging and measurement of photonic integrated circuits. To mitigate the coupling loss induced by the second-order diffraction, two corner mirrors are respectively placed at the two orthogonal ends of the two-dimensional grating coupler to create appropriate interference conditions. Partial single-etch is assumed to form an asymmetric grating to obtain high directionalities without a bottom mirror. The two-dimensional grating coupler is optimized and verified with finite-difference time-domain simulations, achieving a high coupling efficiency of -1.53 dB and a low polarization-dependent loss of 0.015 dB when coupling to a standard single-mode fiber at approximately 1310 nm wavelength.

Cerium/Ascorbic Acid/Iodine Active Species for Redox Flow Energy Storage Battery.

In this study, we developed a novel cerium/ascorbic acid/iodine active species to design a redox flow battery (RFB), in which the cerium nitrate hexahydrate [Ce(NO3)3·6H2O] was used as a positive Ce3+/Ce4+ ion pair, and the potassium iodate (KIO3) containing ascorbic acid was used as a negative I2/I- ion pair. In order to improve the electrochemical activity and to avoid cross-contamination of the redox pair ions, the electroless plating and sol-gel method were applied to modify the carbon paper electrode and the Nafion 117 membrane. The electrocatalytic and electrochemical properties of the composite electrode using methanesulfonic acid as a supporting electrolyte were assessed using the cyclic voltammetry (CV) test. The results showed that the Ce (III)/Ce (IV) active species presented a symmetric oxidation/reduction current ratio (1.09) on the C-TiO2-PdO composite electrode. Adding a constant amount of ascorbic acid to the iodine solution led to a good reversible oxidation/reduction reaction. Therefore, a novel Ce/ascorbic acid/I RFB was developed with C-TiO2-PdO composite electrodes and modified Nafion 117-SiO2-SO3H membrane using the staggered-type flow channel, of which the energy efficiency (EE%) can reach about 72%. The Ce/ascorbic acid/I active species can greatly reduce the electrolyte cost compared to the all-vanadium redox flow battery system, and it therefore has greater development potential.

Understanding the role of religion in shaping cross-national and domestic attitudes and interest in abortion, homosexuality, and pornography using traditional and Google search data.

Over the last 20 years, internet usage has increased substantially, providing an inexpensive source of data that may be less prone to bias and could provide a greater number of meso and macro units. However, validating big data and their usefulness has been challenging. This study uses established sources to validate Google Trends' search interest in the "Bible" across US Designated Market Areas and "Ramadan" across nations, establishing a potential new source of religion data. We then use these measures to show that people from religiously conservative US areas and countries are more likely to disapprove of homosexuality, abortion and pornography. Conversely, Americans from conservative religious areas are also more likely to search for these topics; and cross-national interest in Islam is associated with increased interest in pornography. Our study offers insight into Google Trends' potential for social science research and a roadmap on how to use these data.

Synthesis of a Tridecasaccharide Lipooligosaccharide Antigen from the Opportunistic Pathogen Mycobacterium kansasii.

The outer surfaces of mycobacteria, including the organism that causes tuberculosis, are decorated with an array of immunomodulatory glycans. Among these are lipooligosaccharides (LOSs), a class of molecules for which the function remains poorly understood. We describe the chemical synthesis of the glycan portion of a tridecasaccharide LOS from the opportunistic pathogen Mycobacterium kansasii. The target contains a number of unusual structural motifs that complicate its assembly and is the most complex mycobacterial LOS glycan to be synthesized to date when considering size and number of unique monosaccharides and glycosidic linkages. These studies not only provide a roadmap for the preparation of additional members of this family of glycans, but also provides a valuable probe for use in structure-activity relationship investigations.

Influence of carbonaceous species on aqueous photo-catalytic nitrogen fixation by titania.

For decades, reports have suggested that photo-catalytic nitrogen fixation by titania in an aqueous environment is possible. Yet a consensus does not exist regarding how the reaction proceeds. Furthermore, the presence of an aqueous protonated solvent and the similarity between the redox potential for nitrogen and proton reduction suggest that ammonia production is unlikely. Here, we re-investigate photo-catalytic nitrogen fixation by titania in an aqueous environment through a series of photo-catalytic and electrocatalytic experiments. Photo-catalytic testing reveals that mineral phase and metal dopants play a marginal role in promoting nitrogen photofixation, with ammonia production increasing when the majority phase is rutile and with iron dopants. However, the presence of a trace amount of adsorbed carbonaceous species increased the rate of ammonia production by two times that observed without adsorbed carbon based species. This suggests that carbon species play a potential larger role in mediating the nitrogen fixation process over mineral phase and metal dopants. We also demonstrate an experimental approach aimed to detect low-level ammonia production from photo-catalysts using rotating ring disk electrode experiments conducted with and without illumination. Consistent with the photocatalysis, ammonia is only discernible at the ring with rutile phase titania, but not with mixed-phase titania. Rotating ring disk electrode experiments may also provide a new avenue to attain a higher degree of precision in detecting ammonia at low levels.

Improved Left Ventricular Strain and Dyssynchrony After Pulmonary Artery Banding in an Infant with End-Stage Dilated Cardiomyopathy: Insights from Three-Dimensional Speckle Tracking.

Pulmonary artery banding may benefit infants with dilated cardiomyopathy. We present the case of an infant with end-stage dilated cardiomyopathy and intractable heart failure who received pulmonary artery banding. Serial follow-up through two-dimensional and three-dimensional echocardiography revealed gradual improvement in the left ventricular ejection fraction and favorable remodeling. The result of three-dimensional speckle tracking suggested that this benefit is associated with improvements in global strain and intraventricular dyssynchrony.

The Role of Adventitious Carbon in Photo-catalytic Nitrogen Fixation by Titania.

Photo-catalytic fixation of nitrogen by titania catalysts at ambient conditions has been reported for decades, yet the active site capable of adsorbing an inert N2 molecule at ambient pressure and the mechanism of dissociating the strong dinitrogen triple bond at room temperature remain unknown. In this work in situ near-ambient-pressure X-ray photo-electron spectroscopy and density functional theory calculations are used to probe the active state of the rutile (110) surface. The experimental results indicate that photon-driven interaction of N2 and TiO2 is observed only if adventitious surface carbon is present, and computational results show a remarkably strong interaction between N2 and carbon substitution (C*) sites that act as surface-bound carbon radicals. A carbon-assisted nitrogen reduction mechanism is proposed and shown to be thermodynamically feasible. The findings provide a molecular-scale explanation for the long-standing mystery of photo-catalytic nitrogen fixation on titania. The results suggest that controlling and characterizing carbon-based active sites may provide a route to engineering more efficient photo(electro)-catalysts and improving experimental reproducibility.

Identification of 2-oxohistidine Interacting Proteins Using E. coli Proteome Chips.

Cellular proteins are constantly damaged by reactive oxygen species generated by cellular respiration. Because of its metal-chelating property, the histidine residue is easily oxidized in the presence of Cu/Fe ions and H2O2 via metal-catalyzed oxidation, usually converted to 2-oxohistidine. We hypothesized that cells may have evolved antioxidant defenses against the generation of 2-oxohistidine residues on proteins, and therefore there would be cellular proteins which specifically interact with this oxidized side chain. Using two chemically synthesized peptide probes containing 2-oxohistidine, high-throughput interactome screening was conducted using the E. coli K12 proteome microarray containing >4200 proteins. Ten interacting proteins were identified, and successfully validated using a third peptide probe, fluorescence polarization assays, as well as binding constant measurements. We discovered that 9 out of 10 identified proteins seemed to be involved in redox-related cellular functions. We also built the functional interaction network to reveal their interacting proteins. The network showed that our interacting proteins were enriched in oxido-reduction processes, ion binding, and carbon metabolism. A consensus motif was identified among these 10 bacterial interacting proteins based on bioinformatic analysis, which also appeared to be present on human S100A1 protein. Besides, we found that the consensus binding motif among our identified proteins, including bacteria and human, were located within α-helices and faced the outside of proteins. The combination of chemically engineered peptide probes with proteome microarrays proves to be an efficient discovery platform for protein interactomes of unusual post-translational modifications, and sensitive enough to detect even the insertion of a single oxygen atom in this case.

Acoustic-actuated optical coherence angiography.

Optical coherence tomography (OCT) angiography requires high sensitivity and image penetration for detailed microvascular monitoring. Unfortunately, no effective contrast-medium-enhanced scheme is currently available for imaging improvement. We here propose the simultaneous use of gas-filled microbubbles (MBs) and acoustic actuation to enhance the imaging contrast of OCT angiography. OCT-synchronized acoustic actuation was applied in the presence of MBs, and different moving object tracking angiographic algorithms were tested in in vitro tubing and in vivo mouse experiments. This scheme significantly enhanced the OCT angiography performance, including its sensitivity and penetration, and should advance the utilization of OCT as an effective microvascular diagnostic tool.

Synthesis of peptides containing 2-oxohistidine residues and their characterization by liquid chromatography-tandem mass spectrometry.

Protein oxidation by reactive oxygen species has been associated with aging and neurodegenerative disorders, and histidine is one of the major oxidation targets due to its metal-chelating property and susceptibility to metal-catalyzed oxidation. 2-Oxohistidine, the major product of histidine oxidation, has been recently identified as a stable marker of oxidative damage in biological systems, but its biophysical and biochemical properties are understudied, partly because of difficulties in its chemical synthesis. We developed an efficient method to generate a 2-oxohistidine side chain using metal-catalyzed oxidation, applicable to both monomers and peptides. By optimizing reagent ratios and pH buffering in Cu(2+) /ascorbate/O2 reaction system, we improved the yield more than tenfold compared to reported conditions, which allowed us to obtain homogeneously modified 2-oxohisidine peptides for further studies. Analysis of 2-oxohistidine-containing model peptides by liquid chromatography-tandem mass spectrometry demonstrated increased retention time in reverse-phase chromatography and general stability of 2-oxohistidine under electrospray ionization and collision-induced dissociation. Thus, large-scale analysis of 2-oxohistidine-modified proteome should be feasible using shotgun protein mass spectrometry, and we were able to observe such peptides in proteomics datasets. The feasibility of acquiring purified peptide probes and peptide antigens containing 2-oxohistidine will help advance the study of this non-enzymatic posttranslational modification.

Sense of Coherence as a Mediator Between Functional Status and Health-Related Quality of Life in Patients With Heart Failure.

BACKGROUND: Poor functional status relating to heart failure (HF) negatively affects health-related quality of life (HRQOL). Patients with HF, especially those with New York Heart Association (NYHA) Class III or IV HF, often exhibit poor HRQOL because of physical limitations and HF-related symptoms. Although sense of coherence (SOC) has been reported to be a determinant of HRQOL, its role as a mediator between functional status and HRQOL remains unclear, and few studies have explored the prevalence of HF in patients in NYHA Classes I and II. PURPOSE: This study was designed to investigate SOC as a mediator between different functional status classes and HRQOL in patients with HF. METHODS: A cross-sectional study was conducted on patients with HF recruited from a hospital in northern Taiwan from April 2020 to September 2020. The Minnesota Living with Heart Failure Questionnaire and a questionnaire on sociodemographic characteristics; functional classification in terms of NYHA Classes I, II, and III; and SOC were administered. The PROCESS v3.5 (by Andrew F. Hayes) macro was applied to analyze the effects, and Model 4 was used to examine the mediating role of SOC on the relationship between NYHA functional class and HRQOL. RESULTS: Of the 295 participants, SOC was found to mediate the effects of functional status on HRQOL more significantly in patients in Class II than those in Class III but not more significantly in patients in Class I than those in Class III. A weaker mediating effect of SOC was noted on the relationship between functional status and HRQOL in patients with HF in NYHA Class II than those in Class III. CONCLUSIONS: In patients with HF, poor functional status often reduces HRQOL significantly. SOC mediates the relationship between functional status and HRQOL more significantly in those in NYHA Class II than those in Class III. Nursing staff should work to increase patients' SOC by strengthening their coping capacity and improving their functional status to improve their HRQOL.

Characterization of Hair Metabolome in 5xFAD Mice and Patients with Alzheimer's Disease Using Mass Spectrometry-Based Metabolomics.

Hair emerged as a biospecimen for long-term investigation of endogenous metabolic perturbations, reflecting the chemical composition circulating in the blood over the past months. Despite its potential, the use of human hair for metabolomics in Alzheimer's disease (AD) research remains limited. Here, we performed both untargeted and targeted metabolomic approaches to profile the key metabolic pathways in the hair of 5xFAD mice, a widely used AD mouse model. Furthermore, we applied the discovered metabolites to human subjects. Hair samples were collected from 6-month-old 5xFAD mice, a stage marked by widespread accumulation of amyloid plaques in the brain, followed by sample preparation and high-resolution mass spectrometry analysis. Forty-five discriminatory metabolites were discovered in the hair of 6-month-old 5xFAD mice compared to wild-type control mice. Enrichment analysis revealed three key metabolic pathways: arachidonic acid metabolism, sphingolipid metabolism, and alanine, aspartate, and glutamate metabolism. Among these pathways, six metabolites demonstrated significant differences in the hair of 2-month-old 5xFAD mice, a stage prior to the onset of amyloid plaque deposition. These findings suggest their potential involvement in the early stages of AD pathogenesis. When evaluating 45 discriminatory metabolites for distinguishing patients with AD from nondemented controls, a combination of l-valine and arachidonic acid significantly differentiated these two groups, achieving a 0.88 area under the curve. Taken together, these findings highlight the potential of hair metabolomics in identifying disease-specific metabolic alterations and developing biomarkers for improving disease detection and monitoring.

Seasonal and source characteristics of organophosphorus flame retardants in air and house dust in Taiwan residential microenvironments: Implications for young children's exposure and risk assessment using a probabilistic approach.

Organophosphate flame retardants (OPFRs) are prevalent in multiple industries. They have gradually replaced brominated flame retardants in recent years. Eleven OPFRs were collected from indoor air and house dust in two primary activity spaces--bedrooms and living rooms. The aim of the present study was to explore the potential sources of, and health risks associated with, OPFR exposure in young children using integrated and probabilistic approaches. The level of 11 indoor air OPFRs (466 ng/m3) in the bedroom was greater than that measured in the living room (379 ng/m3), and these values contrasted with those detected in dust. The air OPFRs in the warmer season were higher than those measured in the cold season; the inverse was true for those detected in house dust. In both activity spaces, the composition profiles indicated that tris(1-chloro-2-propyl)phosphate in indoor air (39%) and tris(2-butoxyethyl)phosphate in house dust (67%) were the dominant congeners. The average daily exposure dose (ADD) of OPFRs via air inhalation and dust ingestion did not differ significantly between preschool and school-aged children or based on sex. The Monte-Carlo-simulated 95th percentile ADD of the OPFRs in dust ingested by preschool children was 1.4 times higher. The OPFR exposure from air inhalation and dust ingestion in Taiwanese children is currently an acceptable non-carcinogenic risk and a negligible carcinogenic risk to Taiwan residents.

Heart Murmur Classification Using a Capsule Neural Network.

The healthcare industry has made significant progress in the diagnosis of heart conditions due to the use of intelligent detection systems such as electrocardiograms, cardiac ultrasounds, and abnormal sound diagnostics that use artificial intelligence (AI) technology, such as convolutional neural networks (CNNs). Over the past few decades, methods for automated segmentation and classification of heart sounds have been widely studied. In many cases, both experimental and clinical data require electrocardiography (ECG)-labeled phonocardiograms (PCGs) or several feature extraction techniques from the mel-scale frequency cepstral coefficient (MFCC) spectrum of heart sounds to achieve better identification results with AI methods. Without good feature extraction techniques, the CNN may face challenges in classifying the MFCC spectrum of heart sounds. To overcome these limitations, we propose a capsule neural network (CapsNet), which can utilize iterative dynamic routing methods to obtain good combinations for layers in the translational equivariance of MFCC spectrum features, thereby improving the prediction accuracy of heart murmur classification. The 2016 PhysioNet heart sound database was used for training and validating the prediction performance of CapsNet and other CNNs. Then, we collected our own dataset of clinical auscultation scenarios for fine-tuning hyperparameters and testing results. CapsNet demonstrated its feasibility by achieving validation accuracies of 90.29% and 91.67% on the test dataset.