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The highly strained, phenylene‐derived organic cages are typically regarded as very rigid entities, yet their deformation potential and supramolecular properties remain underexplored. Herein, we report a pliable conjugated phenylene nanocage by synergistically merging rigid and flexible building blocks. The anisotropic cage molecule contains branched phenylene chains capped by a calix[6]arene moiety, the delicate conformational changes of which endow the cage with a remarkably deformable cavity. When complexing with fullerene guests, the cage showcases excellent guest‐adaptivity, with its cavity volume capable of swelling by as much as 85 %. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the short‐term (1 week after completion of treatment) effect of office‐based vergence and anti‐suppression therapy (OBVAT) on the Office Control Score when compared to observation alone in children with small‐to‐moderate angle intermittent exotropia (IXT). Methods: In this single‐masked (examiner masked), two‐arm, single‐centre randomised clinical trial, 40 participants, 6 to <18 years of age with untreated IXT, were randomly assigned to OBVAT or observation alone. Participants assigned to therapy received 60 min of OBVAT with home reinforcement once per week for 16 weeks. Therapy included vergence, accommodation and anti‐suppression techniques. The primary outcome measure was the comparison of the distance Office Control Score between the two groups at the primary outcome visit (i.e., 17‐week follow‐up visit). Results: At the primary outcome visit, the OBVAT group (n = 20) had a significantly better distance Office Control Score (adjusted mean difference: −0.9; 95% CI: −0.2 to −1.5; p = 0.008; partial eta squared: 0.19) than the observation group (n = 16). Participants from the OBVAT group were more likely than those from the observation group to have ≥1 point of improvement at the 17‐week visit (OBVAT group: 75%; Observation group: 25%; p = 0.006). Conclusions: In this randomised clinical trial of participants aged 6 to <18 years with IXT, we found that the OBVAT group had a significantly better distance Office Control Score than the observation group at the 17‐week visit. This study provides the first data from a randomised clinical trial demonstrating the effectiveness of OBVAT for improving the control of IXT. Eye care practitioners should consider OBVAT as a viable, non‐surgical treatment option for IXT. A full‐scale randomised clinical trial investigating the long‐term effectiveness of OBVAT in treating IXT is warranted. [ABSTRACT FROM AUTHOR]

Achieving sustainable development is an issue of global concern. Accounting for the gross ecosystem product (GEP) value can specifically quantify the value of ecosystems for people, which is conducive to the formulation of sustainable management decisions. We have improved the GEP framework accounting method for the first time and evaluated the ecosystem service value of 36 cities in three provinces in the northeast (TPN) of China from 2000 to 2019, which provides decision‐making references for the sustainable development of TPN. The main accounting results and policy recommendations are as follows: (1) The ecological value of Northeast China is in an upward stage—GEP has increased from 3.1 trillion yuan in 2000 to 4.5 trillion yuan in 2019, with climate regulation and water conservation functions being the main driving factors for GEP. (2) Based on the dual analysis of GEP and gross domestic product (GDP), there is still high room for improvement in most cities in the TPN region. While ensuring the protection of ecosystem services, cities can convert ecological value into economic value through carbon trading, water rights trading, ecological compensation, and other methods based on ecological characteristics, which is conducive to the sustainable development of GDP and GEP in the TPN region in the future. (3) The cold and hot spot analysis of GEP also provides decision‐making basis for the planning of future ecosystem service protection areas in the TPN region. [ABSTRACT FROM AUTHOR]

The mechanistic understanding of electrochemical CO2 reduction reaction (CO2RR) requires a rapid and accurate characterisation of product distribution to unravel the activity and selectivity, which is yet hampered by the lack of advanced correlative approaches. Here, we present the time‐resolved identification of CO2RR products by using the synchronised electrochemistry‐mass spectrometry (sEC‐MS). Transients in product formation can be readily captured in relation to electrochemical conditions. Moreover, a soft ionisation (SI) strategy is developed in MS for the direct observation of CO, immune to the interference of CO2 fragments. With the sEC‐MS‐SI, the kinetic information, such as Tafel slopes and onset potentials, for a myriad of CO2RR products are revealed and we show the hysteresis seen for the evolution of some species may originate from the potential‐driven changes in surface coverage of intermediates. This work provides a real‐time picture of the dynamic formation of CO2RR products. [ABSTRACT FROM AUTHOR]

The mediator complex usually cooperates with transcription factors to be involved in RNA polymerase II‐mediated gene transcription. As one component of this complex, MED27 has been reported in our previous studies to promote thyroid cancer and melanoma progression. However, the precise function of MED27 in breast cancer development remains poorly understood. Here, we found that MED27 was more highly expressed in breast cancer samples than in normal tissues, especially in triple‐negative breast cancer, and its expression level was elevated with the increase in pathological stage. MED27 knockdown in triple‐negative breast cancer cells inhibited cancer cell metastasis and stemness maintenance, which was accompanied by downregulation of the expression of EMT‐ and stem traits‐associated proteins, and vice versa in non‐triple‐negative breast cancer. Furthermore, MED27 knockdown sensitized breast cancer cells to epirubicin treatment by inducing cellular apoptosis and reducing tumorsphere‐forming ability. Based on RNA‐seq, we identified KLF4 as the possible downstream target of MED27. KLF4 overexpression reversed the MED27 silencing‐mediated arrest of cellular metastasis and stemness maintenance capacity in breast cancer in vitro and in vivo. Mechanistically, MED27 transcriptionally regulated KLF4 by binding to its promoter region at positions −156 to +177. Collectively, our study not only demonstrated the tumor‐promoting role of MED27 in breast cancer progression by transcriptionally targeting KLF4, but also suggested the possibility of developing the MED27/KLF4 signaling axis as a potential therapeutic target in breast cancer. [ABSTRACT FROM AUTHOR]

This study is the first attempt to integrate flood resilience into the electric vehicle (EV) charging station planning process. Instead of fully avoiding flood‐prone areas, an optimized placement considering the magnitude of flood inundations can minimize the impact of flood hazards and simultaneously maximize the socio‐economic benefit of EV charging station networks. In this study, an integrated framework of the non‐dominated sorting genetic algorithm‐III (NSGA‐III) and the technique for order of preference by similarity to ideal solution (TOPSIS) is proposed to optimize the charging station locations by maximizing the charging convenience, minimizing the impact of flood hazards, and minimizing the impact of existing charging stations. The NSGA‐III is applied to solve the multi‐objective location optimization of charging stations. TOPSIS is subsequently used to determine the best solution from the feasible candidates generated by the NSGA‐III. A case study conducted in the Waikiki area demonstrates that the proposed optimization framework can effectively deal with the trade‐off between the impact of flood hazards and the charging service of a charging station network. This study provides new insights into best practices for dealing with multiple conflicting objectives in EV charging station planning under climate change. [ABSTRACT FROM AUTHOR]

Reductive homocoupling transformations mediated by bases and TMSCN have been used as a strategy for synthesis of 1,2‐disubstituted ethanones. This protocol provides a method for synthesizing functionalized ethanones from aldehydes in one pot without transition metals. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most common types of cancer in women, and histopathological imaging is considered the gold standard for its diagnosis. However, the great complexity of histopathological images and the considerable workload make this work extremely time‐consuming, and the results may be affected by the subjectivity of the pathologist. Therefore, the development of an accurate, automated method for analysis of histopathological images is critical to this field. In this article, we propose a deep learning method guided by the attention mechanism for fast and effective classification of haematoxylin and eosin‐stained breast biopsy images. First, this method takes advantage of DenseNet and uses the feature map's information. Second, we introduce dilated convolution to produce a larger receptive field. Finally, spatial attention and channel attention are used to guide the extraction of the most useful visual features. With the use of fivefold cross‐validation, the best model obtained an accuracy of 96.47% on the BACH2018 dataset. We also evaluated our method on other datasets, and the experimental results demonstrated that our model has reliable performance. This study indicates that our histopathological image classifier with a soft attention‐guided deep learning model for breast cancer shows significantly better results than the latest methods. It has great potential as an effective tool for automatic evaluation of digital histopathological microscopic images for computer‐aided diagnosis. [ABSTRACT FROM AUTHOR]

Asthenozoospermia is detected in 40% of infertile men, and characterised by low sperm motility. MicroRNAs (miRNAs) play essential roles in spermatogenesis, but little is known regarding the function of seminal plasma miRNAs in asthenozoospermia. In this study, we collected seminal plasma samples from patients with asthenospermia and healthy men and employed high‐throughput sequence technology to identify differentially expressed miRNAs. Thirteen altered miRNAs were confirmed by qRT‐PCR. Six of these miRNAs were upregulated, and seven were downregulated. Five of the miRNAs (hsa‐miR‐34c‐5p, hsa‐miR‐34b‐5p, hsa‐miR‐146b‐5p, hsa‐miR‐449a and has‐miR‐765) had been characterised previously, and eight of the others (miR‐5000‐3p, miR‐4289, miR‐6514‐3p, miR‐6882‐5p and miR‐6739‐5p, miR‐135a‐5p, miR‐509‐3p and miR‐196b‐5p) were identified in asthenospermia for the first time in this study. These miRNAs were significantly associated with PI3K‐Akt signaling pathway, MAPK signaling pathway, HIF‐1 signaling pathway and FoxO signaling pathway. The identified dysregulated miRNA may be the key to the development of new and enhanced diagnosis and prognosis technologies for asthenospermia, and may also provide new therapeutic possibilities in the field of personalised medicine. [ABSTRACT FROM AUTHOR]

A fully conjugated figure‐of‐eight nanohoop is presented with facile synthesis. The molecule's lemniscular skeleton features the combination of two strained oligoparaphenylene loops and a flexible cyclooctatetrathiophene core. Its rigid yet guest‐adaptive cavities enable the formation of the peanut‐like 1:2 host–guest complexes with C60 or C70, which have been confirmed by X‐ray crystallography and characterized in solution. Further computational studies suggest notable geometric variations and non‐covalent interactions of the cavities upon binding with different fullerenes, as well as overall conjugation comparable to cycloparaphenylenes. [ABSTRACT FROM AUTHOR]

Background: Left bundle branch pacing (LBBP) can produce near normalization of QRS duration. This has recently emerged as alternative technique to right ventricular pacing and His bundle pacing. Hypothesis: The purpose of this study is to evaluate clinical outcomes of LBBP compared to right ventricular apical pacing (RVAP). Methods: A total of 70 AVB patients with indications for ventricular pacing were retrospectively studied. LBBP was attempted in 33 patients, classified as LBBP group. The other patients were classified as RVAP group. Pacing parameters, electrocardiogram and echocardiogram characteristics, heart failure hospitalization (HFH), and atrial fibrillation (AF) were evaluated perioperatively and at follow‐ups. Patients were followed in the device clinic for a minimum of 12 months and up to 24 months at a 3–6 monthly interval. Results: LBBP was successful in 29 of 33(87.9%) patients while all 37 of the remaining patients successfully underwent RVAP. Paced QRS duration was significantly narrower in the LBBP group compare to RVAP(110.75 ± 6.77 ms vs. 154.29 ± 6.96 ms, p =.000) at implantation, and the difference persisted during follow‐ups. Pacing thresholds (at implantation: 0.68 ± 0.22 V in the LBBP group and 0.73 ± 0.23 V in the RVAP group, p =.620) remained low and stable during follow‐ups. The cardiac function in the LBBP group remained stable during follow‐ups (LVEF%:55.08 ± 4.32 pre‐operation and 54.17 ± 4.34 at the end of follow‐up, p =.609), and better than RVAP group (LVEF%: 54.17 ± 4.34 vs. 50.14 ± 2.14, p =.005). Less HFH was observed in the LBBP group (2/29,6.89%) compared to RVAP group (10/37,27.03%). Conclusions: The present investigation demonstrates the safety and feasibility of LBBP that produces narrower paced QRS duration than RVAP. LBBP is associated with reduction in the occurrence of pacing‐induced left ventricular dysfunction and HFH compared to RVAP in patients requiring permanent pacemakers. [ABSTRACT FROM AUTHOR]

Necrostatin‐1 (Nec‐1) has previously been shown to protect neurons from death in traumatic and ischemic brain injuries. This study tests the hypothesis that Nec‐1 protects neural cells against traumatic and ischemic brain injuries through inhibition of the Bcl‐2/adenovirus E1B 19‐kDa interacting protein 3 (BNIP3). We have used biochemical and morphological techniques to determine the inhibition of Nec‐1 on BNIP3‐induced cell death and to identify its mechanism of action in in vivo and in vitro models of neurodegeneration. Here we show that Nec‐1 significantly increased neuronal viability following prolonged exposure to hypoxia in vitro, and attenuated myelin damage and neuronal death in traumatic brain injury and cerebral ischemia in Sprague‐Dawley rats. Nec‐1 alleviated traumatic brain injury‐induced up‐regulation of BNIP3 in mature oligodendrocytes. In isolated mitochondria, Nec‐1 prevented BNIP3 from integrating into mitochondria by modifying its binding sites on the mitochondria. Consequently, Nec‐1 robustly inhibited BNIP3‐induced collapse of mitochondrial membrane potential and reduced the opening probability of mitochondrial permeability transition pores. Nec‐1 also preserved mitochondrial ultrastructure and suppressed BNIP3‐induced nuclear translocation of apoptosis‐inducing factor. In conclusion, Nec‐1 protects neurons and oligodendrocytes against traumatic and ischemic brain injuries by targeting the BNIP3‐induced cell death pathway, and is a novel inhibitor for BNIP3. Cover Image for this issue: https://doi.org/10.1111/jnc.15056. [ABSTRACT FROM AUTHOR]

Background: The mutations of KCNMA1 BK‐type K+ channel have been identified in patients with various movement disorders. The underlying pathophysiology and corresponding therapeutics are lacking. Objectives: To report our clinical and biophysical characterizations of a novel de novo KCNMA1 variant, as well as an effective therapy for the patient's dystonia‐atonia spells. Methods: Combination of phenotypic characterization, therapy, and biophysical characterization of the patient and her mutation. Results: The patient had >100 dystonia‐atonia spells per day with mild cerebellar atrophy. She also had autism spectrum disorder, intellectual disability, and attention deficit hyperactivity disorder. Whole‐exome sequencing identified a heterozygous de novo BK N536H mutation. Our biophysical characterization demonstrates that N536H is a gain‐of‐function mutation with markedly enhanced voltage‐dependent activation. Remarkably, administration of dextroamphetamine completely suppressed the dystonia‐atonia spells. Conclusions: BK N536H is a gain‐of‐function that causes dystonia and other neurological symptoms. Our stimulant therapy opens a new avenue to mitigate KCNMA1‐linked movement disorders. © 2020 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

The case‐control study was designed to investigate the genetic effects of interferon‐gamma (IFN‐γ) rs2069727 and rs1861494 polymorphisms on ankylosing spondylitis (AS) susceptibility in a Chinese Han population. Blood samples were collected from 108 AS patients and 110 healthy controls. IFN‐γ polymorphisms were genotyped by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP). Hardy‐Weinberg equilibrium (HWE) test was performed in control group. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using chi‐square test to evaluate the association between AS susceptibility and IFN‐γ polymorphisms, and the results were adjusted by logistic regressive analysis. The frequency of rs2069727 CC genotype was much higher in cases than that in controls, suggested its significant association with increased AS risk (adjusted OR = 5.899, 95% CI = 1.563‐22.261; P =.009). In addition, C allele also showed close association with increased risk of AS (adjusted OR = 2.052, 95% CI = 1.286‐1.704, P = 0.003). While the genotype and allele frequencies of IFN‐γ rs1861494 polymorphism were not significantly different between patients and controls (P > 0.05 for all), IFN‐γ rs2069727 polymorphism is significantly associated with increased AS risk in a Chinese Han Population. [ABSTRACT FROM AUTHOR]

The training workflow of neural networks can be quite complex, potentially time‐consuming, and require specific hardware to accomplish operation needs. This study presents a novel analytical video‐based approach for vehicle tracking and vehicle volume estimation at nighttime using a monocular traffic surveillance camera installed over the road. To build this approach, we employ computer vision‐based algorithms to detect vehicle objects, perform vehicle tracking, and vehicle counting in a predefined detection zone. To address low‐illumination conditions, we adapt and employ image noise reduction techniques, image binary conversion, image projective transformation, and a set of heuristic reasoning rules to extract the headlights of each vehicle, pair them belonging to the same vehicle, and track moving candidate vehicle objects continuously across a sequence of video frames. The robustness of the proposed method was tested in various scenarios and environmental conditions using a publicly available vehicle dataset as well as own labeled video data. [ABSTRACT FROM AUTHOR]

Organic light emitting diode (OLED) has been well researched and optimized during the past decades. OLED display is widely applied in the mobile phone, wearable bracelet, and TV et.al, and now it has begun to expand the field of automotive OLED displays. As another branch of OLED technology, the OLED lighting technology in automotive application market is also widely concerned. OLED inherently has the characteristics of planar light source, lightness, independently addressable segments, flexibility and transparency, which have brought impact and innovation to the traditional automotive lighting. Simultaneously, automotive lighting also puts forward more stringent requirements on the reliability and quality of the light sources. In this article, we will completely analyze the special requirements existed in different car lighting and discuss the advantages and disadvantages of OLED lighting, combined with current technologies. Also, OLED lighting technology in car application is highly anticipated in the future. [ABSTRACT FROM AUTHOR]

Superhydrophobic polycaprolactone (PCL) membranes with hierarchical structure were fabricated via alternate electrospinning/electrospraying techniques. Electrospun PCL/methyl silicone oil (PCL/MSO) nanofibers were employed as substrate. PCL/MSO‐PCL microspheres (PCL/MSO‐PCLMS) hierarchical membrane was prepared via electrosprayed PCLMS as an additional layer on the substrate. Field emission scanning electron microscopy images showed the formation of hierarchical PCL/MSO‐PCLMS membranes. Compared to pure PCL fibers substrate (120 ± 1.3°), the water contact angle (WCA) of MSO‐modified PCL membrane was 142 ± 0.7°. The most interesting observation was that the WCA of PCLMS without any modification could be achieved to 146 ± 2.8°. On this basis, PCL/MSO‐PCLMS hierarchical membrane possessed superhydrophobic surface with 150 ± 0.6° of WCA. The excellent surface roughness and air‐pocket capacity of hierarchical membranes would make the membranes more hydrophobic. The maximum oil (n‐hexane) adsorption capacity of PCL/MSO‐PCLMS membrane was 32.53 g g−1. Oil–water separation efficiencies of the superhydrophobic membranes were all higher than 99.93% after 10 cycles. The hierarchically structured PCL superhydrophobic membranes indicate the potential applications of environmentally friendly biopolymers as separation membranes. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2019, 57, 421–430 The combination of polycaprolactone (PCL) microspheres and PCL/methyl silicone oil fiber via alternate electrospinning/electrospraying techniques which imitate lotus‐leaf‐like papillae is used to construct the superhydrophobic hierarchical membranes. The superhydrophobicity is achieved by the modification of morphological structures of PCL and incorporation of small quantities of additives. The excellent adsorption capacity for n‐hexane suggests its potential applications as an environmentally friendly biopolymer in the field of separation membranes. [ABSTRACT FROM AUTHOR]

The reactive power absorption of conventional line commutated converter–high-voltage direct current transmission systems challenges on the voltage stability of AC/DC power systems. Many online dynamic voltage stability assessment approaches have been put forward to AC power systems, but the impact of DC transmissions is seldom taken into account for AC/DC power systems. In this study, an online dynamic voltage stability assessment method of AC/DC power systems is proposed. The proposed method models the converter as an equivalent AC voltage source in series with the internal impedance by utilising the control mode model of DC transmission systems and the measured data of the converter bus. The equivalent AC voltage source can identify the dynamic of DC transmissions. Then the AC/DC power system can be modelled by the equivalent AC power system. Based on the nodal equivalent method, the proposed method establishes a voltage stability index of the equivalent AC power systems for the dynamic voltage stability assessment of AC/DC power systems. The simulation demonstrated the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

The high voltage direct-current (HVDC) transmission is developed rapidly to transmit the clean energy to distant load centres. There will be serious power shortage accidents for the cities if the fault occurs on the HVDC transmission line. Demand response is one of the effective methods to cope with frequency accident. In this study, the control of central air conditioning loads is applied to respond the fault on the HVDC transmission line. The authors focus on the modelling of the central air conditioning loads including the chiller, the inlet and outlet chilled water temperature variation, the heat exchange between chilled water and air, and the space thermal model of the room. When the fault occurs, the chiller will be cut-off immediately. After a period of time, the chiller is turn on to decrease the impact to the users, and the ampere rating of the chiller is restricted to avoid the load shock to the power systems. Simulation results show that the control of central air conditioning loads can respond the accident immediately and the load shock can be avoided in the period of power restoration. Additionally, the users' comfort is not affected obviously. [ABSTRACT FROM AUTHOR]

Air conditioning is a load with thermal inertia, and short time control will not cause an obvious negative impact on user power consumption. Compared with the traditional mini-split-type air conditioner, it has the advantages of flexible control method, strong controllability, large power of the monomer, and so on. This paper studies the application potential of emergency control of central air conditioning in safe and stable operation of large power grid. Firstly, the working principle of central air conditioner and the model of central air conditioning are introduced. On this basis, the emergency control strategy of central air conditioning is put forward. Furthermore, the control strategy of central air conditioning response control signal of safety and stability control or frequency deviation signal is put forward. Finally, a practical engineering case is given to illustrate the feasibility of the proposed strategy and its application in a large power grid. [ABSTRACT FROM AUTHOR]

Background and Purpose: Activation of the human pregnane X receptor (PXR; NR1I2) has potential therapeutic uses for inflammatory bowel disease (IBD). Imperatorin (IMP), a naturally occurring coumarin, is the main bioactive ingredient of Angelica dahurica Radix, which is regularly used to treat the common cold and intestinal disorders. However, there are no data on the protective effects of IMP against IBD.Experimental Approach: The effects of IMP on PXR-modulated cytochrome P450 3A4 (CYP3A4) expression were assessed using a PXR transactivation assay, a mammalian two-hybrid assay, a competitive ligand-binding assay, analysis of CYP3A4 mRNA and protein expression levels and measurement of CYP3A4 activity using a cell-based reporter gene assay and in vitro model. The inhibitory effects of IMP on NF-κB activity were evaluated by a reporter assay and NF-κB p65 nuclear translocation. The anti-IBD effects of IMP were investigated in a dextran sulphate sodium (DSS)-induced colitis mouse model. Colon inflammatory cytokines were assessed by elisa.Key Results: IMP activated CYP3A4 promoter activity, recruited steroid receptor coactivator 1 to the ligand-binding domain of PXR and increased the expression and activity of CYP3A4. PXR knockdown substantially reduced IMP-induced increase in CYP3A4 expression. Furthermore, IMP-mediated PXR activation suppressed the nuclear translocation of NF-κB and down-regulated LPS-induced expression of pro-inflammatory genes. Nevertheless, PXR knockdown partially reduced the IMP-mediated inhibition of NF-κB. IMP ameliorated DSS-induced colitis by PXR/NF-κB signalling.Conclusions and Implications: IMP acts as a PXR agonist to attenuate DSS-induced colitis by suppression of the NF-κB-mediated pro-inflammatory response in a PXR/NF-κB-dependent manner. [ABSTRACT FROM AUTHOR]

Near‐defect‐free block Inconel718‐NiCrAlY composites prepared by laser engineered net shaping are investigated in this study. XRD, SEM, and EDS are applied to analyze the phase composition and microstructure characteristics. The mechanical properties are evaluated by microhardness tester and friction‐wear tester. The results show that NiAl brittle intermetallic compounds precipitate in the matrix when NiCrAlY content reaches 60% or more. With the increase of NiCrAlY ratio, the distribution of NiAl changes from intergranular precipitation to intragranular precipitation, and the dendrites growth directions become chaotic. The microhardness of composites improves as the NiCrAlY content rises, reaching to 419 HV for 100%NiCrAlY, and solid solution strengthening has better strengthening effect on microhardness than precipitation strengthening. The wear loss has a clear decrease only when 80% or more NiCrAlY is added, with the maximum wear loss drop of 15.66% for 100%NiCrAlY. The wear mechanisms change from the coexistence of adhesive wear and abrasive wear to mainly abrasive wear with micro brittle fractures when NiCrAlY content is high. [ABSTRACT FROM AUTHOR]

Abstract: Background: Conventional cardiac resynchronization therapy (CRT, Bi‐V) is associated with no response in about 40% patients due to an insufficient resynchronization. Some studies showed triple‐site ventricular (Tri‐V) pacing had greater benefits compared with Bi‐V pacing, but the results of these studies were conflicting. We hypothesized that Tri‐V pacing had greater benefits on long‐term outcomes compared with Bi‐V pacing in patients with heart failure. Methods: PubMed, EMBASE, and the Cochrane Library were searched for clinical studies with related outcomes. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were calculated to compare the change in left ventricular ejection fraction (LVEF), left ventricular geometry, functional capacity, and quality of life between Tri‐V pacing group and control group. Results: Five trials with 251 patients were included in the analysis. Patients in the Tri‐V pacing group had a greater improvement in LVEF (WMD 4.04; 95% CI 2.15‐5.92, P < .001) and NYHA classes (WMD −0.27; 95% CI −0.42 to −0.11, P = .001) compared with control group. However, there were no significant differences in left ventricular geometry, six‐min walk distance, or Minnesota Living With Heart Failure Questionnaire score between the two groups. The subgroup analyses showed there might be a greater improvement in LVEF in the Tri‐V pacing group in patients with QRS duration ≥ 155 ms (WMD 5.60; 95% CI 3.09‐8.10, P < .001). Conclusions: The present analysis suggests that Tri‐V pacing has greater benefits in terms of an improvement in LVEF and functional capacity in patients with systolic heart failure, especially in patients with the duration of QRS ≥ 155 ms. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that galectin-3 is an important mediator of cardiac fibrosis. The aim of this study was to investigate the utility of galectin-3 in identifying early left ventricular remodeling (LVRM) in patients with hypertension. A total of 107 patients with hypertension and 108 controls were enrolled in this study. The levels of galectin-3 were significantly greater in hypertension patients with LVRM compared with those without LVRM. Multivariate regression analysis demonstrated that body mass index and galectin-3 were independent predictors of LVRM in the hypertension group. Only left ventricular mass was independently correlated with serum galectin-3 levels in patients with hypertension. The receiver operating characteristic analysis showed an area under the curve for galectin-3 of 0.698 (P<.001), with an optimal cutoff of 9.43 ng/mL. Therefore, galectin-3 is independently correlated with LVRM and can be regarded as a valuable biomarker of early cardiac remodeling of hypertension. [ABSTRACT FROM AUTHOR]

Background Fragmented QRS complexes (fQRS) were associated with left ventricular mass (LVM) in hypertensive patients. Our study aimed to investigate the association between fQRS and left ventricular hypertrophy (LVH) in hypertensive patients. Methods Two hundred thirty-six hypertensive patients were divided into fQRS group and non-fQRS group. fQRS were defined as the presence of an additional R wave, notching in the R or S wave, or the presence of >1 R' in two contiguous leads. Echocardiography was used to detect LVH. Results Patients with fQRS had higher levels of LVM than patients without fQRS (181.55 ± 65.64 g vs. 149.21 ± 35.08 g, P < 0.001). Receiver operating characteristic curves showed areas under the curve was 0.62 for fQRS (95% CI 0.54-0.69, P = 0.003). In univariate analyses, the presence of fQRS on ECG was positively associated with LVM. Multiple regression analyses found fQRS was associated with LVM, independently. Conclusion fQRS is a common electrocardiographic phenomenon in patients with hypertension. Although the diagnostic value for LVH is limited, the presence of fQRS on ECG is associated with a higher risk for worse LVH. [ABSTRACT FROM AUTHOR]

This article describes a coordinated ramp metering algorithm for systematically mitigating freeway congestion. A preemptive hierarchical control scheme with a three-priority-layer structure is employed in this algorithm. Ramp metering is formulated as a multiobjective optimization problem to enhance system performance. These optimization objectives include promptly tackling freeway congestion, sufficiently utilizing on-ramp storage capacities, and preventing on-ramp vehicles from overflowing to local streets, balancing on-ramp vehicle equity, and maximizing traffic throughputs for the entire system. Instead of relying heavily on accurate estimates of freeway traffic flow evolvement, this new approach models ramp meter control as a linear program and uses real-time traffic sensor measurements for minimizing the indeterminate impacts from the mainstream flow capacities. VISSIM-based simulation experiments are performed to examine its practicality and effectiveness using geometric and traffic demand data from one real-world freeway segment. The simulation test results show that the proposed ramp metering approach performed well in optimizing overall freeway system operations under various traffic conditions. The system-wide optimal control performance can be achieved to quickly mitigate freeway congestion, prevent traffic from overflowing to local streets, and maximize overall traffic throughputs. The proposed ramp metering approach can dynamically assemble relevant ramp meters to work together and effectively coordinate the individual meter rates to leverage their response strengths for minimizing time to clear the congestion. This study demonstrates that utilization of existing freeway infrastructure can be optimized through the proposed algorithm. [ABSTRACT FROM AUTHOR]