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Magnetic skyrmioniums—with a composite structure comprising two skyrmions with opposite topological charges, exhibit unique dynamic behaviors that are crucial for technological advancements and have application potential for high-density and nonvolatile memory. This study explores the impact of periodic perpendicular magnetic anisotropy (PMA) and damping gradients on skyrmioniums. Utilizing the object oriented micromagnetic framework for detailed simulations, the effective control and enhancement of the skyrmionium stability and mobility through the periodic modulation of PMA and damping gradients is demonstrated. The results demonstrate the dynamic behavior and stability control of skyrmioniums in periodic PMA/damping gradient nanowires. Moreover, the critical influence of the periodic gradient on the skyrmionium motion and stability is highlighted. The results present new avenues for developing advanced memory technologies, leveraging skyrmionium's unique nonlinear behaviors to improve the device performance and reliability. [ABSTRACT FROM AUTHOR]

Teacher and student perceptions of using technology enhanced learning (TEL) in higher education have received growing attention, particularly during COVID-19, however existing studies are mainly disciplinespecific. This study adopts a holistic cross-disciplinary approach. It compares teacher and student perceptions on defining TEL, promotors and barriers for its use, and solutions offered for better use of TEL in the future. Both qualitative and quantitative data were collected from an Australian university. A total of 75 teachers and 48 students completed an online survey, and of these participants, 24 teachers and 29 students participated in follow-up focus group interviews that included Kahoot! surveys. Quantitative results show that teacher and student perceptions on TEL were generally aligned except that self-reported technology savviness and confidence was rated higher than how students and staff rated each other. Qualitative analyses reveal that both teachers and students identified the main promoters for TEL as being: modern and expected in higher education, while being equalising, efficient, engaging, authentic, collaborative and flexible. The common barriers for using TEL were identified as fear, time, organisational culture, knowledge and technical/support issues, along with the perceived pitfalls of distraction, and superficial student learning. Solutions offered for TEL in the future from staff focused on the institution and a desire for strategic, pedagogical and holistic approaches, while students focussed on the accessibility, flexibility and collaborative potential of TEL. This cross-discipline pre-COVID-19 study of TEL perceptions offered by teachers and students has contributed to knowledge in this area by identifying barriers and solutions for TEL common to all disciplines that have the potential to be applied to whole of institution strategic approaches for the more effective use of TEL in teaching and learning in higher education. Student accessibility to TEL and the development of pedagogically sound digital learning resources bringing together educational developers and discipline experts are of particular relevance during and post-COVID-19.

ObjectiveTo observe the effect of proprioceptive neuromuscular facilitation (PNF) technique combined with kinesio taping on upper limb motor function of patients with stroke.MethodsA total of 67 stroke patients hospitalized in the department of rehabilitation medicine of the First Affiliated Hospital of Anhui Medical University from January 2021 to January 2022 were randomly divided into control group, PNF group and combined group, with 22, 22, 23 cases in each group. During the course of the treatment, 2, 2 and 3 cases dropped out or discontinued respectively. Finally, there were 20 cases included in each group. The control group received conventional physical modality therapy (20 min a time, twice a day, six times a week), comprehensive training of hemiplegic limbs (40 min a time, once a day, five times a week) and occupational therapy (20 min a time, once a day, five days a week), lasting for four weeks. The PNF group received upper limb PNF training on the basis of the control group, including 20 min comprehensive training of hemiplegic limbs and 20 min PNF training, once a day, five times a week, lasting for four weeks. The combined group received kinesio taping on the basis of the PNF group, and the taping was changed once every three days, lasting for four weeks. Before treatment and after treatment for four weeks, Fugl-Meyer motor assessment scale (FMA) was used to evaluate the upper limb motor function; modified Ashworth scale (MAS) was used to evaluate the muscle tone; surface electromyography (sEMG) was used to evaluate integrated electromyography (iEMG) and co-contraction ratio (CR).Results(1) Upper limb motor function: Compared with that before treatment, FMA scores of the PNF group and the combined group increased significantly after treatment, and the differences were statistically significant (PPPP>0.05); there was no significant difference in MAS score in the PNF group and the combined group with the control group after treatment (P>0.05). (3) Surface electromyography: compared with that before treatment, CR in the control group decreased significantly after treatment (PPPPP

Cardiorespiratory fitness is known as the “fifth vital sign” and is closely related to the onset, progression, and prognosis of various common and chronic diseases. As the leading cause of adult mortality and disability in China, stroke often leads to dysfunction such as decreased cardiorespiratory fitness, which affects patients' rehabilitation prognosis and increases their risk of recurrent stroke. In recent years, more and more rehabilitation medical workers have realized the importance of cardiorespiratory fitness in stroke rehabilitation. This article introduces the mechanism of decreased cardiorespiratory fitness in stroke patients, as well as the evaluation and training methods for cardiorespiratory fitness, in order to provide reference for comprehensive rehabilitation of stroke.

Gestational diabetes mellitus (GDM) , gestational hypertension, macrosomia, low birth weight, and premature delivery can directly affect short- and long-term maternal and infant health. Fasting plasma glucose can be obtained conveniently and rapidly during pregnancy. Numerous studies have verified that early- and mild-pregnancy fasting plasma glucose are associated with GDM, large for gestational age, and neonatal birth weight. But there is still some controversy about whether they associate with gestational hypertension and cesarean section. Furthermore, further studies are needed to examine their long-term influence on related diseases of pregnant women and their offspring in childhood and adulthood. This paper gives a summary of recent advances in the associations of early- and mid-pregnancy fasting plasma glucose with pregnancy outcome, providing a reference for future studies that profoundly explore relevant issues.

In this study, needle‐punched quartz fiber felt / fabrics preforms (NQFFPs) with a wide needling densities (NDs) range from 70 to 280 punches/cm2 were manufactured, then the inner correlation among the NDs, mechanical properties and structural failure modes were studied and revealed. Firstly, the effects of NDs on mechanical strengths, which included tensile and interlayer peeling strengths of NQFFPs, were analyzed through experimental methods. Moreover, MATLAB software was applied to fit the NDs‐mechanical strength curves, then best fitting equations were defined to characterize the change rules between NDs and mechanical strengths. Additionally, with NDs increment, tensile strengths decreased from 0.727 to 0.0925 MPa, whereas interlayer peeling strengths increased from 83.46 to 135.04 N/m. Afterwards, the 3D image technology was utilized to capture failure morphologies of NQFFPs at different NDs from tensile and interlayer peeling experiments, which furtherly revealed the failure mechanisms of NQFFPs at different NDs. This work is significant for the engineering manufacturing and application of needle‐punched preforms and the composites. Highlights: Failure structure characteristics of NQFFPs at different NDs were captured.Change rules between NDs and strengths were characterized by math equations.The correlation among NDs, fracture morphologies and strengths was revealed. [ABSTRACT FROM AUTHOR]

Key Points: Question: Is balloon angioplasty plus aggressive medical management superior to aggressive medical management alone for the treatment of severe symptomatic intracranial atherosclerotic stenosis (sICAS)? Finding: In this randomized clinical trial that included 501 patients, the composite outcome of any stroke or death within 30 days or an ischemic stroke or revascularization of the qualifying artery after 30 days through 12 months occurred in 4.4% of patients in the balloon angioplasty group and 13.5% of patients in the aggressive medical management group, a statistically significant difference. Meaning: The findings suggest that balloon angioplasty plus aggressive medical management may be an effective treatment for sICAS, although the risk of stroke or death within 30 days of balloon angioplasty should be considered in clinical practice. Importance: Previous randomized clinical trials did not demonstrate the superiority of endovascular stenting over aggressive medical management for patients with symptomatic intracranial atherosclerotic stenosis (sICAS). However, balloon angioplasty has not been investigated in a randomized clinical trial. Objective: To determine whether balloon angioplasty plus aggressive medical management is superior to aggressive medical management alone for patients with sICAS. Design, Setting, and Participants: A randomized, open-label, blinded end point clinical trial at 31 centers across China. Eligible patients aged 35 to 80 years with sICAS defined as recent transient ischemic attack (<90 days) or ischemic stroke (14-90 days) before enrollment attributed to a 70% to 99% atherosclerotic stenosis of a major intracranial artery receiving treatment with at least 1 antithrombotic drug and/or standard risk factor management were recruited between November 8, 2018, and April 2, 2022 (final follow-up: April 3, 2023). Interventions: Submaximal balloon angioplasty plus aggressive medical management (n = 249) or aggressive medical management alone (n = 252). Aggressive medical management included dual antiplatelet therapy for the first 90 days and risk factor control. Main Outcomes and Measures: The primary outcome was a composite of any stroke or death within 30 days after enrollment or after balloon angioplasty of the qualifying lesion or any ischemic stroke in the qualifying artery territory or revascularization of the qualifying artery after 30 days through 12 months after enrollment. Results: Among 512 randomized patients, 501 were confirmed eligible (mean age, 58.0 years; 158 [31.5%] women) and completed the trial. The incidence of the primary outcome was lower in the balloon angioplasty group than the medical management group (4.4% vs 13.5%; hazard ratio, 0.32 [95% CI, 0.16-0.63]; P <.001). The respective rates of any stroke or all-cause death within 30 days were 3.2% and 1.6%. Beyond 30 days through 1 year after enrollment, the rates of any ischemic stroke in the qualifying artery territory were 0.4% and 7.5%, respectively, and revascularization of the qualifying artery occurred in 1.2% and 8.3%, respectively. The rate of symptomatic intracranial hemorrhage in the balloon angioplasty and medical management groups was 1.2% and 0.4%, respectively. In the balloon angioplasty group, procedural complications occurred in 17.4% of patients and arterial dissection occurred in 14.5% of patients. Conclusions and Relevance: In patients with sICAS, balloon angioplasty plus aggressive medical management, compared with aggressive medical management alone, statistically significantly lowered the risk of a composite outcome of any stroke or death within 30 days or an ischemic stroke or revascularization of the qualifying artery after 30 days through 12 months. The findings suggest that balloon angioplasty plus aggressive medical management may be an effective treatment for sICAS, although the risk of stroke or death within 30 days of balloon angioplasty should be considered in clinical practice. Trial Registration: ClinicalTrials.gov Identifier: NCT03703635 This randomized clinical trial investigates the efficacy of balloon angioplasty plus aggressive medical management vs medical management alone in the treatment of patients with symptomatic intracranial atherosclerotic stenosis. [ABSTRACT FROM AUTHOR]

Understanding the magnetization reversal and temperature characteristics of synthetic antiferromagnets (SAFs) is helpful for optimizing the magnetic properties. In this study, a series of synthetic antiferromagnets with perpendicular magnetic anisotropy are deposited. The four stable magnetic states of the SAF are determined by the mutual alignment of magnetic moments in the layers and are controlled by both the magnetic interlayer exchange interaction and Zeeman energy. First order reversal curves were employed to investigate magnetization reversal behaviors and distinguish between reversible and irreversible components. An innovative approach to enhancing the antiferromagnetic coupling field and thermal stability involves introducing a Ru insertion and increasing the thickness of the adjacent magnetic layer. [ABSTRACT FROM AUTHOR]