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BACKGROUND: Atrial fibrillation (AF) is acknowledged as a disease continuum. Despite catheter ablation being recommended as a primary therapy for AF, the high recurrence rates have tempered the initial enthusiasm. Insulin resistance (IR) has been established as an independent predictor for the onset of AF. However, the correlation between non-insulin-based IR indices and late AF recurrence in patients undergoing radiofrequency catheter ablation remains unknown. METHODS: A retrospective cohort of 910 AF patients who underwent radiofrequency catheter ablation was included in the analysis. The primary endpoint was late AF recurrence during the follow-up period after a defined blank period. The relationship between non-insulin-based IR indices and the primary endpoint was assessed using multivariate Cox hazards regression models and restricted cubic splines (RCS). Additionally, the net reclassification improvement and integrated discrimination improvement index were calculated to further evaluate the additional predictive value of the four IR indices beyond established risk factors for the primary outcome. RESULTS: During a median follow-up period of 12.00 months, 189 patients (20.77%) experienced late AF recurrence, which was more prevalent among patients with higher levels of IR. The multivariate Cox hazards regression analysis revealed a significant association between these IR indices and late AF recurrence. Among the four indices, METS-IR provided the most significant incremental effect on the basic model for predicting late AF recurrence. Multivariable-adjusted RCS curves illustrated a nonlinear correlation between METS-IR and late AF recurrence. In subgroup analysis, METS-IR exhibited a significant correlation with late AF recurrence in patients with diabetes mellitus (HR: 1.697, 95% CI 1.397 - 2.063, P < 0.001). CONCLUSION: All the four non-insulin-based IR indices were significantly associated with late AF recurrence in patients undergoing radiofrequency catheter ablation. Addressing IR could potentially serve as a viable strategy for reducing the late AF recurrence rate.
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Fibrilación Atrial , Ablación por Catéter , Resistencia a la Insulina , Recurrencia , Humanos , Fibrilación Atrial/cirugía , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Masculino , Femenino , Ablación por Catéter/efectos adversos , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Anciano , Factores de Tiempo , Medición de Riesgo , Resultado del Tratamiento , Biomarcadores/sangre , Valor Predictivo de las Pruebas , Glucemia/metabolismoRESUMEN
Ultrafast electron diffraction using MeV energy beams(MeV-UED) has enabled unprecedented scientific opportunities in the study of ultrafast structural dynamics in a variety of gas, liquid and solid state systems. Broad scientific applications usually pose different requirements for electron probe properties. Due to the complex, nonlinear and correlated nature of accelerator systems, electron beam property optimization is a time-taking process and often relies on extensive hand-tuning by experienced human operators. Algorithm based efficient online tuning strategies are highly desired. Here, we demonstrate multi-objective Bayesian active learning for speeding up online beam tuning at the SLAC MeV-UED facility. The multi-objective Bayesian optimization algorithm was used for efficiently searching the parameter space and mapping out the Pareto Fronts which give the trade-offs between key beam properties. Such scheme enables an unprecedented overview of the global behavior of the experimental system and takes a significantly smaller number of measurements compared with traditional methods such as a grid scan. This methodology can be applied in other experimental scenarios that require simultaneously optimizing multiple objectives by explorations in high dimensional, nonlinear and correlated systems.
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We present an experimental demonstration of ultrafast electron diffraction (UED) with THz-driven electron bunch compression and time-stamping that enables UED probes with improved temporal resolution. Through THz-driven longitudinal bunch compression, a compression factor of approximately four is achieved. Moreover, the time-of-arrival jitter between the compressed electron bunch and a pump laser pulse is suppressed by a factor of three. Simultaneously, the THz interaction imparts a transverse spatiotemporal correlation on the electron distribution, which we utilize to further enhance the precision of time-resolved UED measurements. We use this technique to probe single-crystal gold nanofilms and reveal transient oscillations in the THz near fields with a temporal resolution down to 50 fs. These oscillations were previously beyond reach in the absence of THz compression and time-stamping.
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Identifying multiple rival reaction products and transient species formed during ultrafast photochemical reactions and determining their time-evolving relative populations are key steps toward understanding and predicting photochemical outcomes. Yet, most contemporary ultrafast studies struggle with clearly identifying and quantifying competing molecular structures/species among the emerging reaction products. Here, we show that mega-electronvolt ultrafast electron diffraction in combination with ab initio molecular dynamics calculations offer a powerful route to determining time-resolved populations of the various isomeric products formed after UV (266 nm) excitation of the five-membered heterocyclic molecule 2(5H)-thiophenone. This strategy provides experimental validation of the predicted high (â¼50%) yield of an episulfide isomer containing a strained three-membered ring within â¼1 ps of photoexcitation and highlights the rapidity of interconversion between the rival highly vibrationally excited photoproducts in their ground electronic state.
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Vertically stacked van der Waals (vdW) heterostructures exhibit unique electronic, optical, and thermal properties that can be manipulated by twist-angle engineering. However, the weak phononic coupling at a bilayer interface imposes a fundamental thermal bottleneck for future two-dimensional devices. Using ultrafast electron diffraction, we directly investigated photoinduced nonequilibrium phonon dynamics in MoS2/WS2 at 4° twist angle and WSe2/MoSe2 heterobilayers with twist angles of 7°, 16°, and 25°. We identified an interlayer heat transfer channel with a characteristic timescale of ~20 picoseconds, about one order of magnitude faster than molecular dynamics simulations assuming initial intralayer thermalization. Atomistic calculations involving phonon-phonon scattering suggest that this process originates from the nonthermal phonon population following the initial interlayer charge transfer and scattering. Our findings present an avenue for thermal management in vdW heterostructures by tailoring nonequilibrium phonon populations.
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BACKGROUND: Pulsed-field ablation (PFA) is a nonthermal method for achieving selective cell death with little inflammation response. However, there are no reports of PFA for septal reduction therapy (SRT). OBJECTIVE: The purpose of this study was to investigate the effectiveness and safety of PFA for SRT. METHODS: A novel transvenous intraseptal PFA method with 3-dimensional (3D) guidance was introduced in Yorkshire pigs. Electrocardiographic parameters, transthoracic echocardiography, and histopathology were used to evaluated. RESULTS: The maximum injury diameter of intramyocardial PFA increased with electric field intensity. After PFA, bipolar electrogram amplitude and pacing threshold measured by the PFA electrodes significantly decreased (F = 6.945, P = .007) or increased (F = 5.842, P = .024), respectively. In the ablated septal region, motion amplitude and systolic wall thickening rate significantly decreased and remained at low levels (motion amplitude: F = 20.793, P = .000; systolic wall thickening rate: F = 14.343, P = .000); however, septal thickness did not significantly change after PFA (F = 1.503, P = .248). Histologic examination showed specific cardiomyocyte death with gradually increased hyperchromatic cytoplasm and nuclear pyknosis, without obvious inflammatory cell infiltration in acute phase. TUNEL stain for fragmented DNA showed extensively positive in the ablation region 24 hours after PFA. During PFA, no sustained ventricular arrhythmia or atrioventricular conduction block occurred. CONCLUSION: A novel intraseptal PFA method with 3D guidance was described. Intraseptal PFA resulted in effective myocardial injury and local hypokinesis without significant acute edema. Histologic examination showed widely programmed cardiomyocyte death with little inflammatory cell infiltration.
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Fibrilación Atrial , Bloqueo Atrioventricular , Ablación por Catéter , Animales , Porcinos , Ecocardiografía/métodos , Electrocardiografía/métodos , Ablación por Catéter/métodos , Bloqueo Atrioventricular/cirugía , Electrodos , Fibrilación Atrial/cirugíaRESUMEN
Understanding how microscopic spin configuration gives rise to exotic properties at the macroscopic length scale has long been pursued in magnetic materials1-5. One seminal example is the Einstein-de Haas effect in ferromagnets1,6,7, in which angular momentum of spins can be converted into mechanical rotation of an entire object. However, for antiferromagnets without net magnetic moment, how spin ordering couples to macroscopic movement remains elusive. Here we observed a seesaw-like rotation of reciprocal lattice peaks of an antiferromagnetic nanolayer film, whose gigahertz structural resonance exhibits more than an order-of-magnitude amplification after cooling below the Néel temperature. Using a suite of ultrafast diffraction and microscopy techniques, we directly visualize this spin-driven rotation in reciprocal space at the nanoscale. This motion corresponds to interlayer shear in real space, in which individual micro-patches of the film behave as coherent oscillators that are phase-locked and shear along the same in-plane axis. Using time-resolved optical polarimetry, we further show that the enhanced mechanical response strongly correlates with ultrafast demagnetization, which releases elastic energy stored in local strain gradients to drive the oscillators. Our work not only offers the first microscopic view of spin-mediated mechanical motion of an antiferromagnet but it also identifies a new route towards realizing high-frequency resonators8,9 up to the millimetre band, so the capability of controlling magnetic states on the ultrafast timescale10-13 can be readily transferred to engineering the mechanical properties of nanodevices.
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By designing a liquid crystal cell with comb electrode structure, the alignment modulation of nematic liquid crystal in the cell can be realized after the electric field is applied. In different orientation regions, the incident laser beam can deflect at different angles. At the same time, by changing the incident angle of the laser beam, the reflection modulation of the laser beam on the interface of the liquid crystal molecular orientation change can be realized. Based on the above discussion, we then demonstrate the modulation of liquid crystal molecular orientation arrays on nematicon pairs. In different orientation regions of liquid crystal molecules, nematicon pairs can exhibit various combinations of deflections, and these deflection angles are modulable under external fields. Deflection and modulation of nematicon pairs have potential applications in optical routing and optical communication.
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Understanding the source of polycyclic aromatic hydrocarbons (PAHs) is crucial for determining their structural, degradational, and burial characteristics in lake sediments. Here, we used a sediment core to determine the changing sources and burial characteristics of 16 PAHs from Dianchi Lake, southwest China. The ∑16PAH concentrations ranged from 105.10 to 1248.05 ng g-1 (448.97 ± 351.25 ng g-1), exhibiting a sharp increase since 1976. Our results showed that the depositional flux of PAHs has increased by approximately 3.72 times over the past 114 years (1895-2009). The C/N ratio, stable isotopes (δ13Corg and δ15N), and n-alkanes data all indicated that allochthonous contributors of organic carbon have substantially increased since the 1970s, playing an important role in the increase in sedimentary PAHs. Positive matrix factorization indicated that petrogenic sources, coal and biomass combustion, and traffic emissions were the main sources of PAHs. The relationships between PAHs from different sources and total organic carbon (TOC) varied with the sorption characteristics. The effect of TOC on the absorption of high-molecular-weight aromatic PAHs from fossil fuels was significant. A higher risk of lake eutrophication is accompanied by higher allochthonous organic matter imports, which might stimulate an increase in sedimentary PAHs through algal biomass blooms.
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Background: Whether statins can reduce major cardiovascular adverse events (MACE) in patients with coronary artery spasm (CAS) is controversial. And most of the relevant research to date has been conducted in Asia. Methods: We systematically searched electronic databases for studies on the effect of statins on MACE in patients with CAS in Asia and published up to September 2022. We included data on MACE in a statin therapy patient group and a no-statin therapy control group. We then evaluated the effect of statin therapy on MACE in patients with CAS in Asia by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 16.0 software and TSA software. Results: A total of 10 studies (n = 9333 patients) were included in the final analysis. Meta-analysis showed that the use of statins had a significant effect on MACE in CAS patients (with RR, 0.70; 95% CI, 0.49-0.99), and the sensitivity analysis further confirmed this finding. Subgroup analysis suggested that the correlation between statin therapy and reduced MACE endpoint was stronger in Japanese patients and patients followed up for more than 4 years. But our TSA results indicated that the available samples were insufficient and further research is needed. Conclusions: Our meta-analysis suggests that statin therapy can reduce MACE in patients with CAS in Asia, and the correlation between the two was stronger in Japanese patients and patients followed up for more than 4 years.
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Enfermedades Cardiovasculares , Vasoespasmo Coronario , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Infarto del Miocardio , Humanos , Asia/epidemiología , Enfermedades Cardiovasculares/inducido químicamente , Vasoespasmo Coronario/diagnóstico , Vasoespasmo Coronario/tratamiento farmacológico , Vasoespasmo Coronario/epidemiología , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversosRESUMEN
Strong coupling between light and mechanical strain forms the foundation for next-generation optical micro- and nano-electromechanical systems. Such optomechanical responses in two-dimensional materials present novel types of functionalities arising from the weak van der Waals bond between atomic layers. Here, by using structure-sensitive megaelectronvolt ultrafast electron diffraction, we report the experimental observation of optically driven ultrafast in-plane strain in the layered group IV monochalcogenide germanium sulfide (GeS). Surprisingly, the photoinduced structural deformation exhibits strain amplitudes of order 0.1% with a 10 ps fast response time and a significant in-plane anisotropy between zigzag and armchair crystallographic directions. Rather than arising due to heating, experimental and theoretical investigations suggest deformation potentials caused by electronic density redistribution and converse piezoelectric effects generated by photoinduced electric fields are the dominant contributors to the observed dynamic anisotropic strains. Our observations define new avenues for ultrafast optomechanical control and strain engineering within functional devices.
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BACKGROUND: Many clinical studies have shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce cardiovascular risks, such as heart failure, myocardial infarction and cardiovascular death. OBJECTIVE: To investigate the use of SGLT2i for the prevention of primary and secondary cardiovascular outcomes. METHODS: Pubmed, Embase and Cochrane libraries databases were searched and meta-analysis was performed using Revman 5.4. RESULTS: Eleven studies with a total of 34,058 cases were analyzed. SGLT2i significantly reduced major adverse cardiovascular events (MACE) in patients with prior myocardial infarction (MI) (OR 0.83, 95% CI 0.73-0.94, p = 0.004), no prior MI (OR 0. 82, 95% CI 0.74-0.90, p<0.0001), prior coronary atherosclerotic disease (CAD) (OR 0.82, 95% CI 0.73-0.93, p = 0.001) and no prior CAD (OR 0.82, 95% CI 0.76-0.91, p = 0.0002) compared with placebo. In addition, SGLT2i significantly reduced hospitalization due to heart failure (HF) in patients with prior MI (OR 0.69, 95% CI 0.55-0.87, p = 0.001), no prior MI (OR 0.63, 95% CI 0.55-0. 72, p<0.00001), prior CAD (OR 0.65, 95% CI 0.53-0.79, p<0.0001) and no prior CAD (OR 0.65, 95% CI 0.56-0.75, p<0.00001) compared with placebo. SGLT2i reduced cardiovascular mortality and all-cause mortality events. MI (OR 0.79, 95% CI 0.70-0.88, p<0.0001), renal damage (OR 0.73, 95% CI 0.58-0.91, p = 0.004), all-cause hospitalization (OR 0.89, 95% CI 0.83-0.96, p = 0.002), systolic and diastolic blood pressure were all significantly reduced in patients receiving SGLT2i. CONCLUSION: SGLT2i was effective in prevention of primary and secondary cardiovascular outcomes.
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Enfermedades Cardiovasculares , Insuficiencia Cardíaca , Infarto del Miocardio , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/etiología , Insuficiencia Cardíaca/tratamiento farmacológico , Infarto del Miocardio/complicaciones , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéuticoRESUMEN
One central challenge in understanding phonon thermal transport is a lack of experimental tools to investigate frequency-resolved phonon transport. Although recent advances in computation lead to frequency-resolved information, it is hindered by unknown defects in bulk regions and at interfaces. Here, a framework that can uncover microscopic phonon transport information in heterostructures is presented, integrating state-of-the-art ultrafast electron diffraction (UED) with advanced scientific machine learning (SciML). Taking advantage of the dual temporal and reciprocal-space resolution in UED, and the ability of SciML to solve inverse problems involving O ( 10 3 ) $\mathcal{O}({10^3})$ coupled Boltzmann transport equations, the frequency-dependent interfacial transmittance and frequency-dependent relaxation times of the heterostructure from the diffraction patterns are reliably recovered. The framework is applied to experimental Au/Si UED data, and a transport pattern beyond the diffuse mismatch model is revealed, which further enables a direct reconstruction of real-space, real-time, frequency-resolved phonon dynamics across the interface. The work provides a new pathway to probe interfacial phonon transport mechanisms with unprecedented details.
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Surface sediments and sediment core had been collected from Erhai Lake, Southwest China to study the concentrations, toxicity risks, and sources of polycyclic aromatic hydrocarbons (PAHs). The average concentrations of Σ16PAHs, seven carcinogenic PAHs (carPAHs), and carcinogenic toxic equivalents (TEQcar) in the surface sediments and sediment core were 1634.50 ± 488.56 ng g-1 and 436.72 ± 128.17 ng g-1, 67.18-293.65 ng g-1 and 91.07-265.90 ng g-1, and 34.89 ± 13.17 ng g-1 and 36.99 ± 7.52 ng g-1, respectively. The Σ16PAHs and carPAHs concentrations in surface sediments were higher in the southern lake. The Σ16PAHs and TEQcar in the sediment core peaked in the 2010s and 1980s. The spatiotemporal variations in TEQcar and carPAHs were similar. Positive matrix factorization revealed that traffic emissions contributed 35.71 % of the TEQcar, whereas coal and biomass combustion contributed 12.89 % in the surface sediments. The contribution of gasoline and fossil fuel to TEQcar significantly increased from 19.2 % (1890s) to 66.5 % (1990s), that of benz[a]pyrene (coal combustion) decreased, and those of benz[b]fluoranthene and indeno[1,2,3-cd]pyrene (petroleum combustion and traffic emissions) increased from 1.92 % to 3.93 % and from 1.54 % to 2.52 % in the sediment cores, respectively, owing to changes in energy consumption.
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Hidrocarburos Policíclicos Aromáticos , Contaminantes Químicos del Agua , Hidrocarburos Policíclicos Aromáticos/análisis , Contaminantes Químicos del Agua/toxicidad , Contaminantes Químicos del Agua/análisis , Lagos , Pirenos , Carcinógenos/análisis , China , Carbón Mineral/análisis , Sedimentos Geológicos , Monitoreo del AmbienteRESUMEN
Background: The long-term success rate of nonparoxysmal atrial fibrillation (AF) treated with pulmonary vein isolation (PVI) alone is not ideal. This may indicate atrial fibrosis as a major cause of recurrence. Therefore, the aim of this study is to investigate the efficacy of left atrial substrate modification (LASM) by targeting low-voltage area. Methods: A total of 157 consecutive patients with drug-refractory nonparoxysmal AF who underwent radiofrequency ablation during hospitalization in the Third People's Hospital of Chengdu from April 2017 to August 2021 were prospectively included. Stepwise ablation was performed in two different orders: LASM first (n=53) and PVI first (n=104) group. All patients underwent ablation during AF, and the procedural endpoint was AF termination during ablation. In the LASM first group, LASM was performed first and if AF was terminated, PVI was not performed. Similarly, in the PVI first groups, LASM was performed if AF was not terminated. The primary outcome were AF termination and freedom from AF. The secondary outcome was adverse events. Cox regression analysis was used to define predictors of AF termination, and Kaplan-Meier analysis was used to assess differences between groups in AF freedom. Results: The baseline characteristics of the two groups were similar. At a median follow-up of 16 months, the 112 patients (39 in LASM first group and 73 in PVI first group) with AF termination had a higher success rate than the 45 patients who had no AF termination (78.6% vs. 57.8%; P<0.01). The AF termination rate (24/53, 45.3% vs. 12/104, 11.5%; P<0.01) and AF freedom (20/24, 83.3% vs. 7/12, 58.3%; P=0.13) by LASM alone was higher than PVI alone. There were 3 cases of heart failure and 1 case of stroke (4/53) in the LASM first group, and 1 case of pericardial tamponade, 5 cases of heart failure and 1 case of stroke (7/104) in the LASM first group (7.5% vs. 6.7%; P>0.05). Conclusions: LASM provides higher immediate success and a slightly better long-term success rate compared to PVI. Patients who terminated AF were more likely to have AF freedom than those who did not. AF termination during procedure may improve symptoms and reduce hospitalization.
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Hierarchical domain structures associated with oxygen octahedra tilting patterns were observed in lead-free (Bi1/2Na1/2)TiO3ceramics using aberration-corrected high-resolution transmission electron microscopy (HRTEM). Three types of domains are induced by distinct mechanisms: the 'orientation-domain' is induced at micrometer scale formed by different tilting orientations of the oxygen octahedra, the 'meso-chemical-domain' occurs at a few tens of nanometer scale by chemical composition variation on the A-site in the ABO3perovskite structure, and the 'nano-cluster-region' runs across several unit-cells with apparent A-site cation segregation with oxygen vacancies clustering around Na cations. Based on HRTEM amplitude contrast imaging (ACI), the correlation between the oxygen octahedral tilting pattern and compositional non-stoichiometry was established. The role of the hierarchical domain structure associated with the tilting patterns of the oxygen octahedra on the ferroelectric behavior of (Bi1/2Na1/2)TiO3is also discussed.
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Conventional phase diagram generation involves experimentation to provide an initial estimate of the set of thermodynamically accessible phases and their boundaries, followed by use of phenomenological models to interpolate between the available experimental data points and extrapolate to experimentally inaccessible regions. Such an approach, combined with high throughput first-principles calculations and data-mining techniques, has led to exhaustive thermodynamic databases (e.g. compatible with the CALPHAD method), albeit focused on the reduced set of phases observed at distinct thermodynamic equilibria. In contrast, materials during their synthesis, operation, or processing, may not reach their thermodynamic equilibrium state but, instead, remain trapped in a local (metastable) free energy minimum, which may exhibit desirable properties. Here, we introduce an automated workflow that integrates first-principles physics and atomistic simulations with machine learning (ML), and high-performance computing to allow rapid exploration of the metastable phases to construct "metastable" phase diagrams for materials far-from-equilibrium. Using carbon as a prototypical system, we demonstrate automated metastable phase diagram construction to map hundreds of metastable states ranging from near equilibrium to far-from-equilibrium (400 meV/atom). We incorporate the free energy calculations into a neural-network-based learning of the equations of state that allows for efficient construction of metastable phase diagrams. We use the metastable phase diagram and identify domains of relative stability and synthesizability of metastable materials. High temperature high pressure experiments using a diamond anvil cell on graphite sample coupled with high-resolution transmission electron microscopy (HRTEM) confirm our metastable phase predictions. In particular, we identify the previously ambiguous structure of n-diamond as a cubic-analog of diaphite-like lonsdaelite phase.
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Engineering novel states of matter with light is at the forefront of materials research. An intensely studied direction is to realize broken-symmetry phases that are "hidden" under equilibrium conditions but can be unleashed by an ultrashort laser pulse. Despite a plethora of experimental discoveries, the nature of these orders and how they transiently appear remain unclear. To this end, we investigate a nonequilibrium charge density wave (CDW) in rare-earth tritellurides, which is suppressed in equilibrium but emerges after photoexcitation. Using a pump-pump-probe protocol implemented in ultrafast electron diffraction, we demonstrate that the light-induced CDW consists solely of order parameter fluctuations, which bear striking similarities to critical fluctuations in equilibrium despite differences in the length scale. By calculating the dynamics of CDW fluctuations in a nonperturbative model, we further show that the strength of the light-induced order is governed by the amplitude of equilibrium fluctuations. These findings highlight photoinduced fluctuations as an important ingredient for the emergence of transient orders out of equilibrium. Our results further suggest that materials with strong fluctuations in equilibrium are promising platforms to host hidden orders after laser excitation.
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INTRODUCTION: Left atrial appendage (LAA) thrombus in patients with atrial fibrillation is usually detected by transesophageal echocardiography (TEE). Intracardiac echocardiography (ICE) can be a suitable alternative to detect thrombosis. However, the effectiveness of the two methods for detecting LAA thrombus is still unclear, we performed a meta-analysis that compared ICE versus TEE for LAA thrombosis. METHODS: We searched PubMed, Cochrane Library, and Embase for published abstracts and manuscripts on June 1, 2020. The analysis was performed using RevMan 5.3, STATA 15, and Meta-Disc 1.4. RESULTS: Eight studies consists of 1108 patients (TEE = 558 vs. ICE = 550) were included. The average sensitivity of ICE and TEE to diagnose LAA thrombus is 1.0 (95% CI: 0.91-1.00) versus 0.68 (95% CI: 0.49-0.83), and specificity of ICE and TEE to diagnosis of LAA thrombus is 1.0 (95% CI: 0.99-1.00) versus 0.98 (95% CI: 0.96-0.99). The AUC of ICE and TEE is 0.9846 (SEAUC = 0.0196) and 0.9655 (SEAUC = 0.0401), and the Q* statistics is 0.9462 (SEQ* = 0.0406) and 0.9127 (SEQ * = 0.0616), respectively. Z test was performed on Q* statistics (Z = 0.45, p > .05). CONCLUSION: The ICE and TEE have similar diagnostic efficacy for LAA thrombosis, but the ICE has higher sensitivity. Compared with TEE, ICE may be more advantages and prospects for clinical application.
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Apéndice Atrial , Fibrilación Atrial , Cardiopatías , Trombosis , Apéndice Atrial/diagnóstico por imagen , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/diagnóstico por imagen , Ecocardiografía Transesofágica , Cardiopatías/diagnóstico por imagen , Humanos , Trombosis/diagnóstico por imagen , Trombosis/etiologíaRESUMEN
Vertically stacked transition metal dichalcogenide-graphene heterostructures provide a platform for novel optoelectronic applications with high photoresponse speeds. Photoinduced nonequilibrium carrier and lattice dynamics in such heterostructures underlie these applications but have not been understood. In particular, the dependence of these photoresponses on the twist angle, a key tuning parameter, remains elusive. Here, using ultrafast electron diffraction, we report the simultaneous visualization of charge transfer and electron-phonon coupling in MoS2-graphene heterostructures with different stacking configurations. We find that the charge transfer timescale from MoS2 to graphene varies strongly with twist angle, becoming faster for smaller twist angles, and show that the relaxation timescale is significantly shorter in a heterostructure as compared to a monolayer. These findings illustrate that twist angle constitutes an additional tuning knob for interlayer charge transfer in heterobilayers and deepen our understanding of fundamental photophysical processes in heterostructures, of importance for future applications in optoelectronics and light harvesting.