Predictive Modeling of Early Neurological Deterioration in Patients with Acute Ischemic Stroke.

BACKGROUND: Ischaemic stroke is the leading cause of death worldwide, and early neurological deterioration(END) occurs in 20%-40% of patients, which is the main cause of severe neurological deficits and disability, and even increased mortality. The occurrence of END is closely related to the poor prognosis of the patients, so it is important to identify the risk factors for the occurrence of END in patients with AIS and target intervention at an early stage factors and targeted intervention is of great significance. METHODS: Up to December 20, 2023, a comprehensive search was conducted across PubMed, Embase, Web of Science, MedLine, and The Cochrane Library for studies focusing on predictive models for END in acute stroke patients. Included studies either developed or validated predictive models. The Prediction Model Risk of Bias Assessment tool was utilized to assess bias in these prediction models. Pooled area under the curve values were calculated using DerSimonian and Laird random-effects model. RESULTS: Nineteen studies, each presenting an original model, were identified. Predominantly constructed through logistic multiple regression, these models demonstrated robust predictive performance (area under the curve ≥0.80). Key predictors of END in acute ischemic stroke patients included blood glucose levels, baseline National Institute of Health Stroke Scale scores, extent of cerebral infarction, and stenosis in the carotid and middle cerebral arteries. DISCUSSION: Clinical practitioners should closely monitor high-frequency predictors of END in patients. However, the varying quality of current models necessitates the selection of models that balance performance with operational simplicity in clinical practice.

Ultra-compact and high-performance suspended aluminum scandium nitride Lamb wave humidity sensor with a graphene oxide layer.

The utilization of Microelectromechanical Systems (MEMS) technology holds great significance for developing compact and high-performance humidity sensors in human healthcare, and the Internet of Things. However, several drawbacks of the current MEMS humidity sensors limit their applications, including their long response time, low sensitivity, relatively large sensing area, and incompatibility with a complementary metal-oxide-semiconductor (CMOS) process. To address these problems, a suspended aluminum scandium nitride (AlScN) Lamb wave humidity sensor utilizing a graphene oxide (GO) layer is firstly designed and fabricated. The theoretical and experimental results both show that the AlScN Lamb wave humidity sensor exhibits high sensing performance. The mass loading sensitivity of the sensor is one order higher than that of the normal surface acoustic wave (SAW) humidity sensor based on an aluminum nitride (AlN) film; thus the AlScN Lamb wave humidity sensor achieves high sensitivity (∼41.2 ppm per % RH) with only an 80 nm-thick GO film. In particular, the as-prepared suspended AlScN Lamb wave sensors are able to respond to the wide relative humidity (0-80% RH) change in 2 s, and the device size is ultra-compact (260 µm × 72 µm). Moreover, the sensor has an excellent linear response in the 0-80% RH range, great repeatability and long-term stability. Therefore, this work brings opportunities for the development of ultra-compact and high-performance humidity sensors.

Analysis of the genetic contribution to thoracic aortic aneurysm or dissection in a prospective cohort of patients with familial and sporadic cases in East China.

BACKGROUND: Thoracic aortic aneurysm or dissections (TAADs) represent a group of life-threatening diseases. Genetic aetiology can affect the age of onset, clinical phenotype, and timing of intervention. We conducted a prospective trial to determine the prevalence of pathogenic variants in TAAD patients and to elucidate the traits related to harbouring the pathogenic variants. One hundred and one unrelated TAAD patients underwent genetic sequencing and analysis for 23 TAAD-associated genes using a targeted PCR and next-generation sequencing-based panel. RESULTS: A total of 47 variants were identified in 52 TAAD patients (51.5%), including 5 pathogenic, 1 likely pathogenic and 41 variants of uncertain significance. The pathogenic or likely pathogenic (P/LP) variants in 4 disease-causing genes were carried by 1 patient with familial and 5 patients with sporadic TAAD (5.9%). In addition to harbouring one variant causing familial TAAD, the FBN1 gene harboured half of the P/LP variants causing sporadic TAAD. Individuals with an age of onset less than 50 years or normotension had a significantly increased genetic risk. CONCLUSIONS: TAAD patients with a younger age at diagnosis or normotension were more likely to carry a P/LP variant; thus, routine genetic testing will be beneficial to a better prognosis through genetically personalized care prior to acute rupture or dissection.

Evolution of Thermoelectric Generators: From Application to Hybridization.

Considerable thermal energy is emitted into the environment from human activities and equipment operation in the course of daily production. Accordingly, the use of thermoelectric generators (TEGs) can attract wide interest, and it shows high potential in reducing energy waste and increasing energy recovery rates. Notably, TEGs have aroused rising attention and been significantly boosted over the past few years, as the energy crisis has worsened. The reason for their progress is that thermoelectric generators can be easily attached to the surface of a heat source, converting heat energy directly into electricity in a stable and continuous manner. In this review, applications in wearable devices, and everyday life are reviewed according to the type of structure of TEGs. Meanwhile, the latest progress of TEGs' hybridization with triboelectric nanogenerator (TENG), piezoelectric nanogenerator (PENG), and photovoltaic effect is introduced. Moreover, prospects and suggestions for subsequent research work are proposed. This review suggests that hybridization of energy harvesting, and flexible high-temperature thermoelectric generators are the future trends.

A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups.

Objective: In this study, the clinical application and efficacy of three different methods for placing and repositioning patients in the lithotomy position over the bed using stirrups were evaluated. Methods: A total of 240 surgical patients who underwent surgery in Chongqing Traditional Chinese Medicine Hospital between July and November 2022 were selected as study participants. Using envelopes, they were randomly divided into three groups of 80 cases each using a randomization method. The groups included the traditional over-bed method, the postural trolley-assisted over-bed method, and the direct over-bed method. Using the Kruskal-Wallis rank-sum test, analysis of variance, and multiple linear regression equations, the placement time, over-bed repositioning time, and total time of the three methods for placing and repositioning in the lithotomy position supported by stirrups were analyzed statistically. In addition, we investigated and examined the satisfaction of nurses and doctors with the aforementioned techniques. Results: The placement time, repositioning time, and total time were significantly higher for the traditional over-bed method than for the postural trolley-assisted over-bed method and the direct over-bed method (both P < 0.01). However, there was no statistically significant difference between the postural trolley-assisted over-bed method and the direct over-bed method (P > 0.05). Nurses and doctors reported significantly higher satisfaction with the postural trolley-assisted over-bed method and the direct over-bed method compared to the traditional over-bed method (both P < 0.01). In addition, nurses were more satisfied with the direct over-bed method than the postural trolley-assisted over-bed method (P < 0.05). Conclusion: The results of this study demonstrate that the direct over-bed method is preferred for positioning and repositioning patients in the lithotomy position with the support of stirrups.

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery.

Background: Acute Stanford type A aortic dissection (STAAD) is a fatal condition requiring urgent surgical intervention. Owing to the complexity of the surgical process, various complications, such as neurological disorders, are common. In this study, we prioritized the reconstruction of aortic arch branches during surgery and investigated the association between prioritizing the branches and the postoperative outcomes of patients with STAAD. Methods: Ninety-seven patients were included in the observational study and underwent total arch replacement and frozen elephant trunk technique between January 2018 and June 2021. Of these, 35 patients underwent the branch-priority technique, and 62 patients underwent the classic technique. By analyzing the perioperative outcomes, we compared the differences between the two techniques. Results: The branch priority group had significantly shorter cardiopulmonary bypass and ventilator times and earlier postoperative wake-up times than the classic group. Additionally, the ICU stay time was shorter, with a significant decrease in neurological complications and 24 h drainage in the branch priority group compared to the classic group. Conclusion: The branch priority technique can effectively provide better brain protection, resulting in earlier awakening of patients after surgery, reduced neurological complications, shorter ventilation time and decreased ICU hospitalization time. Therefore, it is recommended for use in aortic dissection surgeries.

Characterization of Ferroelectric Al0.7Sc0.3N Thin Film on Pt and Mo Electrodes.

In the past decade, aluminum scandium nitride (AlScN) with a high Sc content has shown ferroelectric properties, which provides a new option for CMOS-process-compatible ferroelectric memory, sensors and actuators, as well as tunable devices. In this paper, the ferroelectric properties of Al0.7Sc0.3N grown on different metals were studied. The effect of metal and abnormal orientation grains (AOGs) on ferroelectric properties was observed. A coercive field of approximately 3 MV/cm and a large remanent polarization of more than 100 µC/cm2 were exhibited on the Pt surface. The Al0.7Sc0.3N thin film grown on the Mo metal surface exhibited a large leakage current. We analyzed the leakage current of Al0.7Sc0.3N during polarization with the polarization frequency, and found that the Al0.7Sc0.3N films grown on either Pt or Mo surfaces have large leakage currents at frequencies below 5 kHz. The leakage current decreases significantly as the frequency approaches 10 kHz. The positive up negative down (PUND) measurement was used to obtain the remanent polarization of the films, and it was found that the remanent polarization values were not the same in the positive and negative directions, indicating that the electrode material has an effect on the ferroelectric properties.

Al0.78Sc0.22N Lamb Wave Contour Mode Resonators.

This article presents the lamb wave contour mode resonators (CMRs) based on 22% aluminum scandium nitride (AlScN) thin film with λ of 12-24 [Formula: see text], and operating in [Formula: see text] mode. We report the design, fabrication, and characterization of 500 nm-thick AlScN CMRs, which take advantage of optimized stress control of co-sputtered AlScN thin films and vertical inductively coupled plasma (ICP) etching profile. The experimental results are compared to theoretical predictions by finite element analysis (FEA). All Al 0.78 Sc [Formula: see text] devices show excellent agreement with simulations in piezoelectric coupling using modified AlScN film parameters. The best Al 0.78 Sc [Formula: see text] CMR has achieved an electromechanical coupling coefficient ( kt2) of 5.24% and loaded quality factor ( Q ) of 1219 with an operating frequency at approximately 300 MHz, which exhibits a high Figure-of-Merit (FoM) of 63.88 in piezoelectric microelectromechanical system (MEMS) lamb wave CMR. This article also presents the co-sputtering characteristics of the AlScN thin films under [Formula: see text] gas to achieve low-stress and high-quality piezoelectric materials, and the etching optimization of high concentration Sc doping aluminum nitride (AlN) thin films under Cl2/BCl3/Ar chemistry to obtain record profile angle of 77°, high selectivity of 1:1 with SiO2 hard mask.

Pristine Cu-MOF Induces Mitotic Catastrophe and Alterations of Gene Expression and Cytoskeleton in Ovarian Cancer Cells.

Metals-organic frameworks (MOFs) have been widely explored in biomedicine, mostly in drug delivery, biosensing, and bioimaging due to their large surface area, tunable porosity, readily chemical functionalization, and good biocompatibility. However, the underlining cellular mechanisms controlling the process for MOF cytotoxicity remains almost completely unknown. Here, we demonstrate that pristine Cu-MOF without any loaded drug selectively inhibited ovarian cancer mainly through promoting tubulin polymerization and destroying the cell actin cytoskeleton (F-actin) to trigger the mitotic catastrophe, accompanying by conventional programmed cell death. To our knowledge, this is the first report claiming that mitotic catastrophe may be an explaining mechanism of MOF cytotoxicity. Cu-MOF with an intrinsic protease-like activity also hydrolyzed cellular cytoskeleton proteins (F-actin). The RNA sequencing data indicated the differential expressional mRNA of cell proliferation and actin cytoskeleton (ACTA2, ACTN3, FSCN2, and SCIN) and mitotic spindles (PLK1 and TPX2) related genes. We found that Cu-MOF as a promising candidate in the disruption of cellular cytoskeleton and the change of the gene expression could be actin altering and antimitotic agents against cancer cells, allowing for fundamental biological and biophysical studies of MOFs.

Facile direct synthesis of graphene-wrapped ZnO nanospheres from cyanobacterial cells.

Graphene-based composite materials are versatile but not easily procurable. Cyanobacterial cells, an outgrowth of eutrophic freshwater lake, were simultaneously employed as a template for the growth of ZnO nanoparticles and as a biomass carbon source for graphene sheets, resulting in chlorophyll-containing graphene-wrapped ZnO nanospheres.

The comparison of dexmedetomidine and ketamine for pediatric dental surgery: A meta-analysis of randomized controlled studies.

INTRODUCTION: Dexmedetomidine and ketamine are used for the sedation of pediatric dental surgery. We conduct a systematic review and meta-analysis to compare the sedation of dexmedetomidine and ketamine for pediatric dental surgery. METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of dexmedetomidine versus ketamine on pediatric dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. This meta-analysis is performed using the random-effect model. RESULTS: Four RCTs involving 163 children are included in the meta-analysis. Compared with ketamine for pediatric dental surgery, dexmedetomidine results in comparable sedation level (very low quality, 2 RCTs, n = 40; Std. MD = -0.26; 95% CI = -0.74 to 0.23; P = .31), intraoperative analgesia scores (very low quality, 2 RCTs, n = 98; Std. MD = 0.17; 95% CI = -0.23 to 0.57; P = .40), postoperative analgesia scores (very low quality, 2 RCTs, n = 98; Std. MD = 0.23; 95% CI = -0.17 to 0.62; P = .27), DBP (very low quality, 3 RCTs, n = 123; Std. MD = -0.38; 95% CI = -1.04 to 0.27; P = .25) and SpO2 (very low quality, 3 RCTs, n = 123; Std. MD = 0.24; 95% CI = -0.20 to 0.69; P = .28), but significantly decreases heart rate (very low quality, 3 RCTs, n = 123; Std. MD = -1.51; 95% CI = -2.75 to -0.27; P = .02) and SBP (very low quality, 3 RCTs, n = 123; Std. MD = -0.62; 95% CI = -1.16 to -0.08; P = .02), longer recovery time (very low quality, 3 RCTs, n = 138; Std. MD = 1.74; 95% CI = 0.23 to 3.25; P = .02). CONCLUSIONS: Dexmedetomidine and ketamine have similar sedation, analgesia scores, and hemodynamic balance, but very low quality of the evidence (GRADE) is revealed in this meta-analysis.

The Impact of Parecoxib on Pain Management for Laparoscopic Cholecystectomy: A Meta-analysis of Randomized Controlled Trials.

INTRODUCTION: The efficacy of parecoxib on pain management for laparoscopic cholecystectomy remains controversial. We conducted a systematic review and meta-analysis to explore the impact of parecoxib on pain management after laparoscopic cholecystectomy. MATERIALS AND METHODS: We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library database results through September 2018 for randomized controlled trials to assess the effect of IV parecoxib versus placebo or noting on pain management after laparoscopic cholecystectomy. This meta-analysis was performed using the random-effect model. RESULTS: Seven randomized controlled trials were included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, intravenous parecoxib showed no notable impact on pain scores within 2 hours [mean difference (MD), -0.22; 95% confidence interval (CI), -0.82 to 0.38; P=0.48] and 4 hours (MD, -0.33; 95% CI, -1.04 to 0.38; P=0.36), but showed results of significant decrease in pain scores at 6 hours (MD, -0.82; 95% CI, -1.45 to -0.20; P=0.01), 12 hours (MD, -0.69; 95% CI, -1.23 to -0.15; P=0.01), 24 hours (MD, -0.49; 95% CI, -0.89 to -0.10; P=0.01), and postoperative analgesics need (risk ratio, 0.45; 95% CI, 0.30-0.65; P<0.0001). In addition, no increase in nausea and vomiting is observed after parecoxib use compared with control intervention (risk ratio, 0.89; 95% CI, 0.44-0.76; P=0.76). CONCLUSIONS: Parecoxib can substantially promote postoperative pain relief in patients with laparoscopic cholecystectomy.

One-pot synthesis of CdS/metal-organic framework aerogel composites for efficient visible photocatalytic reduction of aqueous Cr(vi).

Metal-organic framework aerogels (MOAs) embedded with CdS (CdS/MOA(Cr)) synthesized via a facile one-pot solvothermal method have a larger surface area than pristine MOA(Cr) and the post-synthesized composite. CdS/MOA(Cr) exhibited 5 times enhancement in the photocatalytic activity than that of pure CdS for Cr(vi) reduction under visible light without adding any sacrificial agent, due to the larger surface area and photosensitazation of MOA(Cr).