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A refractive index sensor based on Fano resonances in metal-insulator-metal (MIM) waveguides coupled with rectangular and dual side rings resonators is proposed. The sensing properties are numerically simulated by the finite element method (FEM). For the interaction of the narrow-band spectral response and the broadband spectral response caused by the side-coupled resonators and the rectangular resonator, respectively, the transmission spectra exhibit a sharp and asymmetric profile. Results are analyzed using the coupled-mode theory based on the transmission line theory. The coupled mode theory is employed to explain the Fano resonance effect. The results show that with an increase in the refractive index of the fill dielectric material in the slot of the system, the Fano resonance peak exhibits a remarkable red shift. Through the optimization of structural parameters, we achieve a theoretical value of the refractive index sensitivity (S) as high as 1160 nm/RIU, and the corresponding sensing resolution is 8.62 × 10 –5 RIU. In addition, the coupled MIM waveguide structure can be easily extended to other similar compact structures to realize the sensing task and integrated with other photonic devices at the chip scale. This work paves the way toward the sensitive nanometer scale refractive index sensor for design and application.

Objective Cardiopulmonary resuscitation (CPR) is vital for saving patients experiencing cardiac arrest. Teaching CPR skills through short videos offers numerous advantages. However, potential inaccuracies or misinformation could mislead the public and impact the effectiveness of CPR education. This study aims to evaluate the quality and accuracy of CPR instructional videos shared on three major short video platforms in China (TikTok, Bilibili, and REDnote), analyze common irregular or erroneous practices, and provide valuable suggestions for content optimization. Methods The collected videos were evaluated using a five-point scoring criterion based on 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). The videos were categorized into three levels: excellent, moderate, and poor, based on their video quality scores for CPR procedures and non-procedural content. Further categorization was made by video duration (≤5 min as short; >5 min as long). Additionally, the most critical and prevalent irregularities or errors were documented, and a detailed analysis of the most popular video from each platform was carried out. The relationship between video quality and popularity, and video duration and popularity were examined separately. Results A total of 100 CPR instructional videos were analyzed. While 86% of the videos were produced by healthcare professionals, substantial errors were identified in critical areas such as the extra time spent removing foreign body airway obstruction (67%), and incorrect hand position during compression (62%). Other issues with non-procedural content were identified, including video acceleration (13%), lack of step-by-step explanations (61%), etc. Statistical analysis revealed no significant differences in popularity across videos of different quality or duration ( p  = 0.876 among video quality groups for CPR procedures, p  = 0.988 among video quality groups for non-procedural content, p  = 0.260 between video duration groups). Conclusions This study identified the necessity for improvements in CPR procedures and non-procedural content of CPR instructional videos. To enhance video quality, measures such as rigorous review mechanisms, public feedback and promotion of certified high-quality videos are recommended.

The recent study by Thu et al. investigating the interplay between frailty, sarcopenia, and physical status in patients undergoing emergency laparotomy (EmLap) provides valuable insights into preoperative risk stratification. The authors’ efforts to disentangle these complex factors in predicting mortality are commendable, particularly their emphasis on frailty and poor physical status as independent prognostic markers. However, several underappreciated aspects of this relationship warrant further discussion to refine clinical applicability and guide future research (1).

Background: Parkinson's disease (PD), a prevalent and progressive neurodegenerative disorder, currently lacks effective and satisfactory pharmacological treatments. Computational drug repurposing represents a promising and efficient strategy for drug discovery, aiming to identify new therapeutic indications for existing pharmaceuticals. Methods: We employed a drug-target network approach to computationally repurpose FDA-approved drugs from databases such as DrugBank. A literature review was conducted to select candidates not previously reported as pharmacoprotective against PD. Subsequent in vitro evaluation utilized Cell Counting Kit-8 (CCK8) assays to assess the neuroprotective effects of the selected compounds in the SH-SY5Y cell model of Parkinson's disease induced by 1-methyl-4-phenylpyridinium (MPP+). Furthermore, an in vivo mouse model of Parkinson's disease induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was developed to investigate the mechanisms of action and therapeutic potential of the identified drug candidates. Results: Our approach identified 176 drug candidates, with 28 selected for their potential anti-Parkinsonian effects and lack of prior PD-related reporting. CCK8 assays showed significant neuroprotection in SH-SY5Y cells for Omaveloxolone and Cyproheptadine. In the MPTP-induced mouse model, Cyproheptadine inhibited interleukin-6 (IL-6) expression and prevented Tyrosine Hydroxylase (TH) downregulation via the MAPK/NFκB pathway, while Omaveloxolone alleviated TH downregulation, potentially through the Kelch-like ECH-associated protein 1 (KEAP1)-NF-E2-related factor 2 (Nrf2)/antioxidant response element (ARE) pathway. Both drugs preserved dopaminergic neurons and improved neurological deficits in the PD model. Conclusion: This study elucidates potential drug candidates for the treatment of Parkinson's disease through the application of computational repurposing, thereby underscoring its efficacy as a drug discovery strategy.

Harvesting renewable water energy in various formats such as raindrops, waves, and evaporation is one of the key strategies for achieving global carbon neutrality. The recent decade has witnessed rapid advancement of the droplet‐based electricity generator (DEG) with a continuous leap in the instantaneous output power density from 50 W/m2 to several kW/m2. Despite this, further pushing the upper limit of the output performance of DEG is still constrained by low surface charge density and long precharging time. Here, we report a DEG incorporating the Kelvin water dropper (K‐DEG) that can generate an ultrahigh instantaneous power density of 105 W/m2 upon one droplet impinging. In this design, the Kelvin water dropper continuously replenishes the high density of surface charges on DEG, while DEG fully releases these surface charges into electric output. K‐DEG with such a high output can directly light five 6‐W commercial lamps and even charge a cellphone by using falling droplets. Water, as a widely accessible and renewable energy source, holds an immense amount of energy estimated at 60 petawatts (1015 W) per year, several orders of magnitude greater than the global electricity consumption. Although significant progress has been made in harvesting high‐frequency and centralized hydrodynamic energy using electromagnetic generators, efficiently harvesting low‐frequency and decentralized water energy in various forms such as raindrops, river/ocean waves, tides, and even moisture remains a challenge. Here, we develop a droplet‐based electricity generator incorporating the Kelvin water dropper (K‐DEG), in which the Kelvin water dropper can instantly inject abundant charges on the surface of the dielectric layer of DEG as a result of corona discharge, while DEG can fully release these surface charges into electricity generation upon droplet impinging. With this elegant integration of DEG with Kelvin water dropper, K‐DEG can generate an enormously boosted transferred charge of 201 nC and output voltage up to 2000 V from one droplet impinging (100 μL).

Background: To date, few data have been reported on clinical outcomes following interventions in elderly populations with acute basilar artery occlusion. Using data from the Endovascular Treatment for Acute Basilar Artery Occlusion Study (BASILAR), we evaluated the efficacy and safety of intervention and determined predictors of outcomes among elderly patients in China. Methods: Patients from January 2014 to May 2019 were dichotomized into elderly (75 years or older) and nonelderly patients (under 75 years). Pearson’s Chi-square test and multivariate logistic regression were performed to assess 90-day favorable functional outcome (defined as a modified Rankin scale score of 0–3), mortality and symptomatic intracranial hemorrhage between intervention and conservative cohorts in elderly patients. Results: Among the 829 patients in the BASILAR, 182 patients aged 75 years or older were analyzed. These patients were divided into intervention (127 patients) and conservative (55 patients) cohorts. Compared with the conservative cohort, the intervention cohort presented more frequently with a favorable functional outcome (28.3% versus 12.7%; p = 0.023) and with a decreased mortality (54.3% versus 76.4%; p = 0.005). There was no difference in symptomatic intracranial hemorrhage (4.7% versus 0, p = 0.235). Multivariate analysis indicated that intervention was associated with favorable functional outcome (adjusted odds ratio, 0.262; 95% confidence interval, 0.088–0.778, p = 0.016) and lower mortality (adjusted odds ratio, 0.257; 95% confidence interval, 0.109–0.606, p = 0.002). In the intervention cohort, initial National Institutes of Health Stroke Scale (NIHSS) score and occlusion site were associated with functional outcome, and initial NIHSS score and recanalization were associated with mortality. Conclusions: Although the overall outcome following intervention was worse with age, intervention was more effective and safer than conservative treatment for elderly Chinese patients with basilar artery occlusion. Predictors of desirable outcome in elderly patients undergoing intervention included lower initial NIHSS score, occlusion site and successful recanalization. Clinical Trial Registration-URL: http://www.chictr.org. Unique identifier: ChiCTR-1800014759

Background Intima-media thickness (IMT) and small dense low-density lipoprotein cholesterol (sdLDL-C) have been reported to be related to atherosclerosis and stroke. This study is trying to explore the association between IMT and sdLDL-C in Chinese acute ischaemic stroke (AIS) subjects. Methods This study enrolled total 368 consecutive AIS patients and 165 non-AIS controls from November 2016 to February 2019. Mean IMT and carotid plaques were measured by using carotid ultrasonography method. Blood glucose and lipid parameters were measured by using an automatic biochemical instrument. SdLDL-C was detected by using the Lipoprint LDL system. IMT > 1.0 mm was defined as increased IMT. Plaque stability based on the nature of the echo was determined by ultrasound examination. Risk factors for IMT were identified by using multivariate logistic regression analysis. A logistic regression model was established to predict AIS risk. Python software (Version 3.6) was used for the statistical analysis of all data. Results The carotid IMT, proportion of plaques, and the sdLDL-C, triglycerides (TG) and glucose levels were obviously higher in AIS patients than those in controls. SdLDL-C level in the IMT thickening group was higher than that in the normal IMT group. SdLDL-C and total cholesterol (TC) were risk factors for IMT, while sdLDL-C was an independent risk factor. The IMT value of the unstable plaque group was markedly higher than that of the stable plaque group. The predictive value of IMT for AIS was better than that of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) but not as good as that of sdLDL-C. A logistic regression model was established to predict AIS risk. Additionally, carotid IMT and sdLDL-C were closely related to AIS severity and outcomes. Conclusions SdLDL-C and TC were risk factors for increased IMT, while sdLDL-C was an independent risk factor. A prediction model based on IMT and other variables was established to screen the population with high AIS risk.

BACKGROUND: The long-term outcomes of acute large vessel occlusion in anterior circulation treated by endovascular treatment remains to be determined. The aim of this study was to assess the 5-year outcomes of patients with LVO who underwent EVT. METHODS: This study was an observational, nationwide registry of consecutive patients with acute LVO who received EVT in 28 comprehensive stroke centers in China. The primary outcome was the proportion of favorable outcome (mRS 0–2) at 5 years. Secondary outcomes included proportions of patients with excellent outcome (mRS 0–1), all-cause mortality and risk of stroke recurrence at 5 years. RESULTS: A total of 807 patients were included into the study and had 90-day follow-up data, 657 patients had 5-year follow-up data. At 90 days, 218 (27.0%) had an excellent outcome, 349 (43.2%) had a favorable functional outcome. 199 (24.7%) died. At 5 years, 190 (28.9%) had an excellent outcome, 261 (39.7%) had a favorable functional outcome, 317 (48.2%) died and 129 (28.2%) had stroke recurrence. Among available 269 patients who achieved functional independence at 90 days, 208 (77.3%) maintained favorable outcome, 19 (7.1%) had disability (mRS 3–5) and 42 (15.6%) died at 5 years. Furthermore, among available 189 patients with mRS 3-5 at 90 days, 53 (28.0%) patients achieved favorable functional outcome, 60 (31.7%) patients maintained unfavorable functional outcome and 76 (40.2%) patients died within 5 years. Multivariate analyses identified that younger age (odds ratio [OR]: 0.96; 95% CI, 0.93–0.99; P=0.009), lower mRS at 90 days (OR: 0.15; 95% CI, 0.10–0.23; P<0.001) and absence of stroke recurrence (OR: 0.001; 95% CI, 0.000–0.006; P<0.001) were significantly associated with favorable outcome at 5 years. Advanced age (OR: 1.06, 95% CI, 1.04–1.08; P<0.001), higher mRS at 90 days (OR: 0.84; 95% CI, 0.73–0.98; P=0.021) and atrial fibrillation (OR: 1.63; 95% CI, 1.02–2.60; P=0.04) were independent factors for stroke recurrence. CONCLUSIONS: Our results indicated that the beneficial effect of EVT in patients with acute LVO can be sustained during the course of at least 5 years. Reducing the risk of stroke recurrence by anticoagulation for atrial fibrillation may be a crucial strategy to improve long-term outcome.

Strain hardening has a significant influence on the contact behavior of rough surfaces. In this study, an asperity contact load model accounting for strain hardening is built with continuous and monotonic properties at the critical point. Furthermore, the asperity contact model is extended to a whole rough surface by integrating asperity interactions and a three-dimensional fractal contact model of rough surfaces that considers strain hardening is established. The contact characteristic of the proposed model is evaluated and compared to those of existing fractal contact models and experimental results. Then, the influences of the real contact area, strain hardening exponent, fractal surface parameters, and material properties on the contact load are investigated. The results of the proposed model are more consistent than those of the existing fractal models with respect to experimental data. The contact load decreases as the strain hardening exponent increases. The contact load depends sensitively on the fractal dimension and exhibits nonmonotonic characteristics. This model increases the depth of insights needed for forecasting of the contact characteristics of engineering structures.