Development of an Ultrasonic Doppler Sensor-Based Swallowing Monitoring and Assessment System.

Existing swallowing evaluation methods using X-ray or endoscopy are qualitative. The present study develops a swallowing monitoring and assessment system (SMAS) that is nonintrusive and quantitative. The SMAS comprises an ultrasonic Doppler sensor array, a microphone, and an inertial measurement unit to measure ultrasound signals originating only from swallowing activities. Ultrasound measurements were collected for combinations of two viscosity conditions (water and yogurt) and two volume conditions (3 mL and 9 mL) from 24 healthy participants (14 males and 10 females; age = 30.5 ± 7.6 years) with no history of swallowing disorders and were quantified for 1st peak amplitude, 2nd peak amplitude, peak-to-peak (PP) time interval, duration, energy, and proportion of two or more peaks. The peak amplitudes and energy significantly decreased by viscosity and the PP time interval and duration increased by volume. The correlation between the time measures were higher (r = 0.78) than that of the amplitude measures (r = 0.30), and the energy highly correlated with the 1st peak amplitude (r = 0.86). The proportion of two or more peaks varied from 76.8% to 87.9% by viscosity and volume. Further research is needed to examine the concurrent validity and generalizability of the ultrasonic Doppler sensor-based SMAS.

Analysis of natural finger-press motions for design of trackball buttons.

This study analysed natural press motions of the index, middle and ring fingers for ergonomic design of the positions and surface angles of the left, middle and right trackball buttons. Finger motions of 26 male participants for naturally pressing the trackball buttons were recorded after the participants adjusted the trackball buttons to their preferred locations for comfortable pressing. The natural positions of the finger pulps formed a symmetrically rainbow-shaped reach zone for the fingers. The natural press angles of the fingers' motion trajectories to the vertical reference line ranged from 14.2° to 20.5°, suggesting an 18-degree surface from the horizontal line for the trackball buttons. Regression formulas (adjusted R2 = 0.90 ± 0.07 and mean squared error = 8.55 ± 7.52 mm) were established to estimate the natural positions of finger pulps from hand segment lengths and joint angles for a population having different hand sizes from this study. Relevance to industry.

Classification of Upper Body Shapes Among Korean Male Wheelchair Users to Improve Clothing Fit.

The upper body shape is an important factor to be considered in customized suit jacket design. The present study is intended to identify the lateral upper body shapes of wheelchair users in a sagittal plane. Anthropometric data of 144 Korean male wheelchair users were collected using a tape measure and photography. Three lateral upper body shapes were identified by cluster analysis: convex back with largely protruded abdomen (31%), convex back with flat abdomen (36%), and straight back with moderately protruded abdomen (33%). Discriminant functions were constructed for the three lateral upper body shape groups, and their overall and cross-validated classification accuracies were identified as 94.4% and 89.6%, respectively. The present study found that the wheelchair users have more convex back (67%) and protruded abdomen (64%) shapes than non-wheelchair individuals. The lateral upper body shapes and discriminant functions identified in the study can be applied to a custom production process of suit jacket design for wheelchair users.

Highly luminescent silica-coated CdS/CdSe/CdS nanoparticles with strong chemical robustness and excellent thermal stability.

We present facile synthesis of bright CdS/CdSe/CdS@SiO2 nanoparticles with 72% of quantum yields (QYs) retaining ca 80% of the original QYs. The main innovative point is the utilization of the highly luminescent CdS/CdSe/CdS seed/spherical quantum well/shell (SQW) as silica coating seeds. The significance of inorganic semiconductor shell passivation and structure design of quantum dots (QDs) for obtaining bright QD@SiO2 is demonstrated by applying silica encapsulation via reverse microemulsion method to three kinds of QDs with different structure: CdSe core and 2 nm CdS shell (CdSe/CdS-thin); CdSe core and 6 nm CdS shell (CdSe/CdS-thick); and CdS core, CdSe intermediate shell and 5 nm CdS outer shell (CdS/CdSe/CdS-SQW). Silica encapsulation inevitably results in lower photoluminescence quantum yield (PL QY) than pristine QDs due to formation of surface defects. However, the retaining ratio of pristine QY is different in the three silica coated samples; for example, CdSe/CdS-thin/SiO2 shows the lowest retaining ratio (36%) while the retaining ratio of pristine PL QY in CdSe/CdS-thick/SiO2 and SQW/SiO2 is over 80% and SQW/SiO2 shows the highest resulting PL QY. Thick outermost CdS shell isolates the excitons from the defects at surface, making PL QY relatively insensitive to silica encapsulation. The bright SiO2-coated SQW sample shows robustness against harsh conditions, such as acid etching and thermal annealing. The high luminescence and long-term stability highlights the potential of using the SQW/SiO2 nanoparticles in bio-labeling or display applications.

Classification of a Driver's cognitive workload levels using artificial neural network on ECG signals.

An artificial neural network (ANN) model was developed in the present study to classify the level of a driver's cognitive workload based on electrocardiography (ECG). ECG signals were measured on 15 male participants while they performed a simulated driving task as a primary task with/without an N-back task as a secondary task. Three time-domain ECG measures (mean inter-beat interval (IBI), standard deviation of IBIs, and root mean squared difference of adjacent IBIs) and three frequencydomain ECG measures (power in low frequency, power in high frequency, and ratio of power in low and high frequencies) were calculated. To compensate for individual differences in heart response during the driving tasks, a three-step data processing procedure was performed to ECG signals of each participant: (1) selection of two most sensitive ECG measures, (2) definition of three (low, medium, and high) cognitive workload levels, and (3) normalization of the selected ECG measures. An ANN model was constructed using a feed-forward network and scaled conjugate gradient as a back-propagation learning rule. The accuracy of the ANN classification model was found satisfactory for learning data (95%) and testing data (82%).

The Effects of Age, Gender, and Hand on Force Control Capabilities of Healthy Adults.

OBJECTIVE: The present study examined the effects of age (20s to 70s), gender (male and female), and hand (dominant and nondominant) on force control capabilities (FCCs) in four force control phases (initiation, development, maintenance, and termination). BACKGROUND: Normative data of FCCs by force control phase are needed for various populations in age and gender to identify a type of motor performance reduction and its severity. METHOD: FCCs of 360 participants (30 for each combination of age group and gender) were measured using a finger dynamometer and quantified in terms of initiation time (IT), development time (DT), maintenance error (ME), and termination time (TT). RESULTS: Although gradual increases (1%~28%) by age were shown in IT, DT, and TT, a dramatic increase in ME was observed among participants in their 50s (26%), 60s (68%), and 70s (160%) compared to those in their 20s~40s. The most distinctive interaction effect of age and gender was found in ME out of the four FCC measures. Lastly, hand and its related interactions were not found significant. CONCLUSION: Normative FCC data were established for four age groups (20s~40s, 50s, 60s, and 70s) and gender. APPLICATION: The normative FCC data can be used for evaluating an individual's motor performance, screening patients with brain disorders, and designing input devices triggered and/or operated by the finger.

Directional and spatial motor intentional disorders in patients with right versus left hemisphere strokes.

OBJECTIVE: Motor intentional disorders (MIDs) are characterized by dysfunction in the preparation, initiation, maintenance, and termination of goal-oriented actions. In this study, we investigated (1) whether patients with right hemisphere strokes (RHS) and left hemisphere strokes (LHS) differ in the frequency of delayed action initiation (hypokinesia) and motor impersistence; (2) whether there is a directional or hemispatial component of hypokinesia or motor impersistence; (3) whether there is an association between the presence of hemispatial neglect and tests for MID; and (4) the location of injury associated with MID. METHOD: Thirty-two patients with acute unilateral stroke (21 with RHS and 11 with LHS) and 12 age-matched healthy controls participated in the study. To determine the presence and severity of directional and spatial hypokinesia and impersistence we used a new apparatus, the Directional Movement Tester (DMT). While being tested with the DMT, the participants held a static bar located either in the right or left hemispace using either their right or left hand and upon stimulus onset pushed the bar either leftward or rightward and maintained a given force for 10 sec. RESULTS AND CONCLUSION: The frequency of hypokinesia and impersistence was higher in the RHS group than in the LHS group, but there were no hypokinetic directional or spatial asymmetries. The RHS group did demonstrate left contralesional directional impersistence, but there were no spatial asymmetries of impersistence. Signs of hemispatial neglect were not associated with these measures of MID. Participants with frontal or subcortical lesions were significantly more likely to demonstrate hypokinesia and impersistence than those with posterior lesions.

Histomorphometric analysis of the palatal mucosa associated with periodontal plastic surgery on cadavers.

PURPOSE: The palatal mucosa is a major donor site for connective tissue in the field of periodontal plastic surgery, since it satisfies both the esthetic and functional demands of patients. The purpose of this study was to use histomorphometric analysis to measure the thicknesses of the palatal mucosa and the lamina propria including the epithelium on cadavers. METHODS: Thirty-four hemimaxillae of cadavers were examined (13 male and 4 female, mean age 57.2 years). Each maxilla was processed for histological sectioning and subsequently for histomorphometric analysis. The thicknesses of the palatal mucosa and the lamina propria including the epithelium were measured at three points starting from the alveolar crest, at intervals of 4 mm, with the aid of Adobe Photoshop. RESULTS: The thickness of the palatal mucosa at the alveolar crest and at 4 and 8 mm below the alveolar crest were 2.51 ± 0.83 (mean ± SD), 2.92 ± 0.80, and 3.62 ± 0.99 mm, respectively, and thus increasing from the alveolar crest toward the midpalatal suture. Conversely, the thicknesses of the lamina propria including the epithelium at these same positions were 2.06 ± 0.70, 1.54 ± 0.48, and 1.28 ± 0.46 mm, respectively, thus decreasing toward the midpalatal suture. CONCLUSIONS: The present results indicate that clinicians need to be particularly careful when harvesting palatal mucosa that is destined to be used as autogenous donor material for connective tissue in periodontal plastic surgery.

Gel microstructure regulates proliferation and differentiation of MC3T3-E1 cells encapsulated in alginate beads.

For cell transplantation into damaged tissues, viable cells must be delivered to the defect site in a suitable carrier. However, the hypoxic and nutrient-limited environment in the carrier can induce massive cell death. The aims of this study were to increase the viability and regulate the behavior of osteoprogenitor cells encapsulated in alginate hydrogels through control of the gel microstructure. Cell survivability in alginate beads was improved through the use of α-MEM as the solvent for alginic acid sodium salt, and by CaCl(2) solutions, which supplied additional nutrients for the cells compared to water or buffer. The mesh size and shear modulus of the hydrogel were hypothesized to regulate proliferation and differentiation of osteoprogenitor cells. MC3T3-E1 cells demonstrated enhanced osteoblast differentiation when encapsulated in high-density alginate with smaller mesh size and more rigid mechanical properties, as confirmed by increased alkaline phosphatase activity and osteocalcin secretion. However, MC3T3-E1 cells encapsulated in low-density alginate beads with a larger mesh size and more compliant mechanical properties exhibited increased proliferation. These results demonstrate that the microstructure of alginate hydrogels can regulate the behavior of osteoprogenitor cells, thus suggesting that the tuning the properties of the gel may be a useful approach for enhancing new bone formation.

Dual-purpose bone grafts improve healing and reduce infection.

OBJECTIVE: To determine if a dual-purpose bone graft can regenerate bone and reduce infection in highly contaminated bone critical size defects in rats. METHODS: Biodegradable polyurethane (PUR) scaffolds were loaded with recombinant human bone morphogenetic protein-2 (BMP-2) and vancomycin (Vanc). The release kinetics of the BMP-2 were tuned to take advantage of its mechanism of action (ie, an initial burst to recruit cells and sustained release to induce differentiation of the migrating cells). The Vanc release kinetics were designed to protect the graft from contamination until it is vascularized by having a burst for a week and remaining well over the minimum inhibitory concentration for Staphylococcus aureus for 2 months. The bone regeneration and infection reduction capability of these dual-purpose grafts (PUR+Vanc+BMP-2) were compared with collagen sponges loaded with BMP-2 (collagen+BMP-2) and PUR+BMP-2 in infected critical size rat femoral segmental defects. RESULTS: The dual-delivery approach resulted in substantially more new bone formation and a modest improvement in infection than PUR+BMP-2 and collagen+BMP-2 treatments. CONCLUSIONS: The PUR bone graft is injectable, provides a more sustained release of BMP-2 than the collagen sponge, and can release antibiotics for more than 8 weeks. Thus, the dual-delivery approach may improve patient outcomes of open fractures by protecting the osteoinductive graft from colonization until vascularization occurs. In addition, the more optimal release kinetics of BMP-2 may reduce nonunions and the amount of growth factor required.

A new approach for hydroxyapatite coating on polymeric materials using laser-induced precursor formation and subsequent aging.

A new process, laser-induced precursor formation and subsequent aging in a supersaturated calcium phosphate aqueous solution (CP solution), was applied for coating a hydroxyapatite (HAP) film on a polymeric material, ethylene-vinyl alcohol copolymer (EVOH). Laser irradiation onto EVOH immersed in the CP solution induced the formation of CP precursors, and an HAP film composed of a submicrometer-scale cavernous structure was formed by subsequent aging in a CP solution without laser irradiation. The resulting HAP film coated on EVOH demonstrated excellent structural and chemical uniformity and cell adhesion with the CHO-K1 and BHK-21 cells. This process provides a practical technique for coating HAP onto polymeric materials.

Nanostructured hydroxyapatite/TiO(2) composite coating applied to commercially pure titanium by a co-sputtering technique.

We demonstrate an approach for the coating of nanostructured hydroxyapatite(HAP)/TiO(2) composite on commercially pure Ti (CP-Ti) by a co-sputtering process. HAP/TiO(2) composite film was obtained by controlling the processing pressure. It was observed that decomposition of HAP into CaO was easily induced during sputtering at 0.53 Pa, a typical sputtering condition for film deposition. However, HAP/TiO(2) composite film was obtained with the sputtering pressure of 2.67 Pa. The Ca/P ratio was nearly maintained at 1.66 by sputter deposition at 2.67 Pa. We further confirmed by analysis of plasma spectral emission that the variation of the hydroxyl (OH) radical present was due to the Ar pressure during sputtering. It has been shown that HAP coatings are dependent on the processing pressure, which the hydroxyl radical requires in order to create HAP.

In vivo behavior and mechanical stability of surface-modified titanium implants by plasma spray coating and chemical treatments.

The geometric design and chemical compositions of an implant surface may have an important part in affecting early implant stabilization and influencing tissue healing. In this study, in vivo behavior and mechanical stability in implants of three surface designs, which were smooth surface (SS), rough titanium (Ti) surface by plasma spray coating (PSC), and alkali- and heat-treated (AHT) Ti surface after plasma spray coating, were compared by histological and mechanical analyses. Surface morphologies of the implants were observed by optical microscopy and scanning electron microscopy. Chemical compositional surface changes were investigated by energy dispersive spectroscopy. The implants were inserted transversely in a dog thighbone and evaluated at 4 weeks of healing. At 4 weeks of healing after implantation in bone, the healing tissue was more extensively integrated with an AHT implant than with the implants of smooth (SS) and/or rough Ti surfaces (PSC). The bone bonding strength (pull-out force) between living bone and implant was observed by a universal testing machine. At 4 weeks' healing after implant placement in bone, the pull-out forces of the SS, PSC, and AHT implants were 235 (+/-34.25), 710 (+/-142.25), and 823 (+/-152.22) N, respectively. Histological and mechanical data demonstrate that appropriate surface design selection can improve early bone growth and induce an acceleration of the healing response, thereby improving the potential for implant osseointegration.

XPS study of bioactive graded layer in Ti-In-Nb-Ta alloy prepared by alkali and heat treatments.

Ti and Ti-based alloys have been widely used for the biomedical applications due to their superiorities of biocompatibility, mechanical properties and corrosion resistance. However, there has been the limiting factor for these metals to show the low affinity to the living bone. Most of commercially used Ti alloys have harmful alloying elements such as Al, V, etc. The purposes of this study are design of new Ti alloy having the good mechanical properties and corrosion resistivity without harmful alloying elements and to improve the bone-bonding ability between Ti-based alloy and living bone through the chemically activated process (alkali treatment) and thermally activated one (heat treatment). Mechanical properties of the Ti-In-Nb-Ta alloy were observed by tensile test (Instron model 8511). Corrosion potential and corrosion rate were investigated using a Potentiostate machine (EG&G, Princeton Applied Model 273, Boston, USA) with saline solution (9% NaCl) without dissolved oxygen at 37 degrees C. After alkali and heat treatments, the effects of the pre-treatments on the bonding property were evaluated by in vitro test. In this study, the surface changing behavior, which is apatite formation, of newly designed Ti-In-Nb-Ta alloy without harmful alloying elements was investigated through analyzing its surface by using X-ray photoelectron spectroscopy after surface activation treatments (alkali and heat treatments) and after subsequent soaking in the simulated body fluid.

Surface modification by alkali and heat treatments in titanium alloys.

Pure titanium and titanium alloys are normally used for orthopedic and dental prostheses. Nevertheless, their chemical, biological, and mechanical properties still can be improved by the development of new preparation technologies. This has been the limiting factor for these metals to show low affinity to living bone. The purpose of this study is to improve the bone-bonding ability between titanium alloys and living bone through a chemically activated process and a thermally activated one. Two kinds of titanium alloys, a newly designed Ti-In-Nb-Ta alloy and a commercially available Ti-6Al-4V ELI alloy, were used in this study. In this study, surface modification of the titanium alloys by alkali and heat treatments (AHT), alkali treated in 5.0M NaOH solution, and heat treated in vacuum furnace at 600 degrees C, is reported. After AHT, the effects of the AHT on the bone integration property were evaluated in vitro. Surface morphologies of AHT were observed by optical microscopy (OM) and scanning electron microscopy (SEM). Chemical compositional surface changes were investigated by X-ray diffractometry (XRD), energy dispersive spectroscopy (EDS), and auger electron spectroscopy (AES). Titanium alloys with surface modification by AHT showed improved bioactive behavior, and the Ti-In-Nb-Ta alloy had better bioactivity than the Ti-6Al-4V ELI alloy in vitro.