Effects and Safety of Wearable Exoskeleton for Robot-Assisted Gait Training: A Retrospective Preliminary Study.

BACKGROUND: Wearable devices for robot-assisted gait training (RAGT) provide overground gait training for the rehabilitation of neurological injuries. We aimed to evaluate the effectiveness and safety of RAGT in patients with a neurologic deficit. METHODS: Twenty-eight patients receiving more than ten sessions of overground RAGT using a joint-torque-assisting wearable exoskeletal robot were retrospectively analyzed in this study. Nineteen patients with brain injury, seven patients with spinal cord injury and two patients with peripheral nerve injury were included. Clinical outcomes, such as the Medical Research Council scale for muscle strength, Berg balance scale, functional ambulation category, trunk control tests, and Fugl-Meyer motor assessment of the lower extremities, were recorded before and after RAGT. Parameters for RAGT and adverse events were also recorded. RESULTS: The Medical Research Council scale scores for muscle strength (36.6 to 37.8), Berg balance scale (24.9 to 32.2), and functional ambulation category (1.8 to 2.7) significantly improved after overground RAGT (p < 0.05). The familiarization process was completed within six sessions of RAGT. Only two mild adverse events were reported. CONCLUSIONS: Overground RAGT using wearable devices can improve muscle strength, balance, and gait function. It is safe in patients with neurologic injury.

Clinical Anatomy of the Puboprostatic Ligament for the Safe Guidance for the Prostate Surgery.

OBJECTIVE: To provide the anatomy of the puboprostatic ligament and related structures to save urogenital competence after prostatectomy. MATERIALS AND METHODS: Pelvic areas of 31 adult cadavers were dissected to figure out the shape, number, and location of the puboprostatic ligaments. RESULTS: The puboprostatic ligament was the most important support structure between the pubic bone and prostate gland. Puboprostatic ligaments were bilaterally single (61.3%), bilaterally double (19.4%), or mixed (19.4%). Ligaments were mostly I-shaped (53.8%). If ligaments had extra attachment to or from the arcuate line, the ligaments were λ-shaped (36.3%), or Y-shaped (8.8%). In one case, the ligament had a central fusion with an irregular shape. I-shaped puboprostatic ligaments were observed more frequently in specimens with double ligaments, while λ-shaped puboprostatic ligaments were observed more frequently in the cases with single ligaments. The average distance between both puboprostatic ligaments was 8.1 mm at the pubic site and 14.2 mm at the prostate site. The distance was narrower when the specimen had double puboprostatic ligaments on both sides. The neurovascular bundle ran beneath the puboprostatic ligament. If the ligament was the λ-shaped type, the neurovascular bundle frequently pierced the lateral band of the ligament. CONCLUSION: Puboprostatic ligaments hold and stabilize the prostate against the pubic bone. It is believed that a pelvis with bilateral, double puboprostatic ligaments would have advantages in urogenital competence. The morphologic data of the shape, multiplicity, and location of the PPLs would help to make a plan to approach the prostate.

Metabolic Changes in Central Poststroke Pain Following Thalamic Intracerebral Hemorrhage: An 18F-FDG PET Study.

PURPOSE: Central poststroke pain (CPSP) is one of the most refractory neuropathic pains following stroke. Injury in the spinothalamic pathway appears crucial for the development of CPSP, but changes in activity in multiple brain regions may also be related. We investigated brain metabolic changes in patients with CPSP following thalamic intracerebral hemorrhage (ICH). METHODS: Forty-three patients with thalamic ICH were examined. Overall brain metabolism was measured with F-FDG PET. Images were analyzed with statistical parametric mapping (SPM12). Patients with CPSP (n = 20) were compared with patients without CPSP (n = 23). In addition, the association between regional brain metabolism and the severity of CPSP was investigated. RESULTS: In comparison to patients in the non-CPSP group, the CPSP group exhibited significant hypometabolism in the ipsilesional precentral, postcentral gyri, and the contralesional cuneus (Puncorrected < 0.001), whereas significant hypermetabolism was found in the medial dorsal nucleus of the contralesional thalamus (Puncorrected < 0.001). In addition, brain metabolism in the ipsilesional Crus I and Crus II of the cerebellum was positively correlated to pain intensity ratings (Puncorrected < 0.001). CONCLUSION: Our findings suggested that an altered state of resting brain metabolism in various brain regions related to sensory processing and cognitive functioning may be involved in the underlying mechanism of CPSP following thalamic ICH.

Voxel-based lesion symptom mapping analysis of depressive mood in patients with isolated cerebellar stroke: A pilot study.

Post-stroke depression (PSD) is the most common neuropsychological sequela of stroke and occurs in approximately one-third of all stroke survivors. However, there are no well-established predictors of PSD. Depression in stroke patients is correlated with unfavorable outcomes. Meta-analyses of the relationship between PSD and lesion location have yielded contradictory results and have not adequately addressed the impact of cerebellar lesions. Furthermore, other brain regions associated with depression in patients with cerebellar stroke remain a matter of debate. For these reasons, this cross-sectional study investigated the relationship between PSD and lesion location in patients with isolated cerebellar stroke. Twenty-four patients in the subacute rehabilitative period following a first-ever isolated cerebellar stroke were enrolled in the study. Depressive mood were evaluated using the Geriatric Depression Scale. Regions of interest were drawn manually on T1-weighted magnetic resonance images using MRIcron software, and data were normalized to a standard brain template in order to examine the neural correlates of depression using voxel-based lesion-symptom mapping analysis. Voxel-wise subtraction and χ (Ayerbe et al., 2014) analyses indicated that damage to the left posterior cerebellar hemisphere was associated with depression. Significant correlations were also found between the severity of depressive symptoms and lesions in lobules VI, VIIb, VIII, Crus I, and Crus II of the left cerebellar hemisphere (Pcorrected = 0.045). Our results suggest that damage to the left posterior cerebellum is associated with increased depressive mood severity in patients with isolated cerebellar stroke.

Enhanced Performance of Polymer Solar Cells Comprising Diketopyrrolopyrrole-Based Regular Terpolymer Bearing Two Different π-Extended Donor Units.

New regular and random diketopyrrolopyrrole (DPP)-based terpolymers (i.e., Reg-PBDPPT and Ran-PBDPPT, respectively) bearing DPP as an electron deficient unit and 2,2'-bithiophene and (E)-1,2-di(thiophen-2-yl)ethene as electron donating units were designed and synthesized, and their performance in photovoltaic cells was investigated precisely. The absorption properties and highest occupied molecular orbital (HOMO) of Reg-PBDPPT were found to be different from those of Ran-PBDPPT. The results of grazing incidence X-ray diffraction experiments revealed that Ran-PBDPPT typically had a predominantly edge-on chain orientation on the substrate, whereas Reg-PBDPPT showed mixed chain orientation both in pristine and thermally annealed films. Although Reg-PBDPPT exhibited a lower degree of edge-on chain orientation on the substrate, the corresponding TFTs showed a high hole mobility of 0.42-0.96 cm(2) V(-1) s(-1) and maintained a high current on/off ratio (>10(6)). A polymer solar cell (PSC) composed of Reg-PBDPPT and PC71BM exhibited power conversion efficiencies (PCE) of 5.24-5.45%, which were higher than those of the Ran-PBDPPT-based PSCs. The enhanced efficiency was supported by an increase in the short circuit current, which is strongly related to the unique internal crystalline morphology and pronounced nanophase segregation behavior in the blend films. These results obviously manifested that this synthetic strategy for regular conjugated terpolymers could be employed to control morphological properties to obtain high-performance PSCs.

High-Performing Thin-Film Transistors in Large Spherulites of Conjugated Polymer Formed by Epitaxial Growth on Removable Organic Crystalline Templates.

Diketopyrrolopyrrole (DPP)-based conjugated polymer PDTDPPQT was synthesized and was used to perform epitaxial polymer crystal growth on removable 1,3,5-trichlorobenzene crystallite templates. A thin-film transistor (TFT) was successfully fabricated in well-grown large spherulites of PDTDPPQT. The charge carrier mobility along the radial direction of the spherulites was measured to be 5.46-12.04 cm(2) V(-1) s(-1), which is significantly higher than that in the direction perpendicular to the radial direction. The dynamic response of charge transport was also investigated by applying a pulsed bias to TFTs loaded with a resistor (∼20 MΩ). The charge-transport behaviors along the radial direction and perpendicular to the radial direction were investigated by static and dynamic experiments through a resistor-loaded (RL) inverter. The RL inverter made of PDTDPPQT-based TFT operates well, maintaining a fairly high switching voltage ratio (Vout(ON)/Vout(OFF)) at a relatively high frequency when the source-drain electrodes are aligned parallel to the radial direction.

High aspect ratio conjugated polymer nanowires for high performance field-effect transistors and phototransistors.

We synthesized a highly crystalline DPP-based polymer, DPPBTSPE, which contained 1,2-bis(5-(thiophen-2-yl)selenophen-2-yl)ethene as a planar and rigid electron donating group. High- and low-molecular weight (MW) DPPBTSPE fractions were collected by Soxhlet extraction and were employed to investigate their unique charge transport properties in macroscopic films and single crystalline polymer nanowire (SC-PNW), respectively. The low-MW polymer could provide well-isolated and high aspect ratio SC-PNWs, in which the direction of π-π stacking was perpendicular to the wire growing axis. The field effect transistors made of SC-PNWs exhibited remarkably high carrier mobility of 24 cm(2) V(-1) s(-1). In addition, phototransistors (PTs) made of SC-PNW showed very high performance in terms of photoresponsivity (R) and photoswitching ratio (P). The average R of the SC PNW-based PTs were in the range of 160-170 A W(-1) and the maximum R was measured at 1920 A W(-1), which is almost three orders higher than that of thin film-based PT device.

Bis(thienothiophenyl) diketopyrrolopyrrole-based conjugated polymers with various branched alkyl side chains and their applications in thin-film transistors and polymer solar cells.

New thienothiophene-flanked diketopyrrolopyrrole and thiophene-containing π-extended conjugated polymers with various branched alkyl side-chains were successfully synthesized. 2-Octyldodecyl, 2-decyltetradecyl, 2-tetradecylhexadecyl, 2-hexadecyloctadecyl, and 2-octadecyldocosyl groups were selected as the side-chain moieties and were anchored to the N-positions of the thienothiophene-flanked diketopyrrolopyrrole unit. All five polymers were found to be soluble owing to the bulkiness of the side chains. The thin-film transistor based on the 2-tetradecylhexadecyl-substituted polymer showed the highest hole mobility of 1.92 cm2 V(-1) s(-1) due to it having the smallest π-π stacking distance between the polymer chains, which was determined by grazing incidence X-ray diffraction. Bulk heterojunction polymer solar cells incorporating [6,6]-phenyl-C71-butyric acid methyl ester as the n-type molecule and the additive 1,8-diiodooctane (1 vol %) were also constructed from the synthesized polymers without thermal annealing; the device containing the 2-octyldodecyl-substituted polymer exhibited the highest power conversion efficiency of 5.8%. Although all the polymers showed similar physical properties, their device performance was clearly influenced by the sizes of the branched alkyl side-chain groups.

Characterization of Human Gingival Fibroblasts on Zirconia Surfaces Containing Niobium Oxide.

It was indicated that tetragonal zirconia polycrystal (TZP) containing yttria (Y2O3) and niobium oxide (Nb2O5) ((Y,Nb)-TZP) could be an adequate dental material to be used at esthetically important sites. The (Y,Nb)-TZP was also proved to possess its osteogenic potential comparable with those conventional dental implant material, titanium (Ti). The objective of the current study was to characterize cellular response of human gingival fibroblasts (HGFs) to smooth and rough surfaces of the (Y,Nb)-TZP disc, which were obtained by polishing and sandblasting, respectively. Various microscopic, biochemical, and molecular techniques were used to investigate the disc surfaces and cellular responses for the experimental (Y,Nb)-TZP and the comparing Ti groups. Sandblasted rough (Y,Nb)-TZP (Zir-R) discs had the highest surface roughness. HGFs cultured on polished (Y,Nb)-TZP (Zir) showed a rounded cell morphology and light spreading at 6 h after seeding and its proliferation rate significantly increased during seven days of culture compared to other surfaces. The mRNA expressions of type I collagen, integrin α2 and ß1 were significantly stimulated for the Zir group at 24 h after seeding. The current findings, combined with the previous results, indicate that (Y,Nb)-TZP provides appropriate surface condition for osseointegration at the fixture level and for peri-implant mucosal sealing at the abutment level producing a suitable candidate for dental implantation with an expected favorable clinical outcome.

New bipolar host materials for realizing blue phosphorescent organic light-emitting diodes with high efficiency at 1000 cd/m2.

New host molecules such as 9-(6-(9H-carbazol-9-yl)pyridin-3-yl)-6-(9H-carbazol-9-yl)-9H-pyrido[2,3-b]indole (pPCB2CZ) and 9-(6-(9H-carbazol-9-yl)pyridin-2-yl)-6-(9H-carbazol-9-yl)-9H-pyrido[2,3-b]indole (mPCB2CZ) were designed and synthesized for blue phosphorescent organic light-emitting diodes (PhOLEDs). The glass transition temperatures of two host molecules were measured higher than 120 °C, and the identical triplet energies were determined to be 2.92 eV for both molecules. The bis(3,5-difluoro-2-(2-pyridyl)phenyl-(2-carboxypyridyl)iridium(III) (FIrpic)-doped mPCB2CZ-based PhOLED exhibited practically useful driving voltage of 4.8 V in a simple organic three layer device configuration which has a smaller number of interfaces in conventional multilayer PhOLEDs. Also, the high quantum efficiency of 23.7% is reported at the practically useful brightness value of 1000 cd/m2.

Template-guided solution-shearing method for enhanced charge carrier mobility in diketopyrrolopyrrole-based polymer field-effect transistors.

Template-guided solution-shearing (TGSS) is used to fabricate field-effect transistors (FETs) composed of micropatterned prisms as active channels. The prisms comprise highly crystalline PTDPP-DTTE, in which diketopyrrolopyrrole (DPP) is flanked by thiophene. The FET has a maximum mobility of approximately 7.43 cm(2) V(-1) s(-1) , which is much higher than the mobility values of the thin-film transistors with solution-sheared or spin-coated films of PTDPP-DTTE annealed at 200 °C.

Comparison of the osteogenic potential of titanium- and modified zirconia-based bioceramics.

Zirconia is now favored over titanium for use in dental implant materials because of its superior aesthetic qualities. However, zirconia is susceptible to degradation at lower temperatures. In order to address this issue, we have developed modified zirconia implants that contain tantalum oxide or niobium oxide. Cells attached as efficiently to the zirconia implants as to titanium-based materials, irrespective of surface roughness. Cell proliferation on the polished surface was higher than that on the rough surfaces, but the converse was true for the osteogenic response. Cells on yttrium (Y)/tantalum (Ta)- and yttrium (Y)/niobium (Nb)-stabilized tetragonal zirconia polycrystals (TZP) discs ((Y, Ta)-TZP and (Y, Nb)-TZP, respectively) had a similar proliferative potential as those grown on anodized titanium. The osteogenic potential of MC3T3-E1 pre-osteoblast cells on (Y, Ta)-TZP and (Y, Nb)-TZP was similar to that of cells grown on rough-surface titanium. These data demonstrate that improved zirconia implants, which are resistant to temperature-induced degradation, retain the desirable clinical properties of structural stability and support of an osteogenic response.

A high-mobility terselenophene and diketopyrrolopyrrole containing copolymer in solution-processed thin film transistors.

A new diketopyrrolopyrrole (DPP)-based π-conjugated copolymer containing terselenophene units has been successfully synthesized. Its hole mobility reaches around 5.0 cm(2) V(-1) s(-1) in thin film transistors made from thermally annealed films. This proves that a longer terselenophene unit induced excellent charge transport properties.

High-efficiency blue phosphorescent organic light-emitting diodes using a carbazole and carboline-based host material.

A novel bipolar host 9-(4-(9H-pyrido[2,3-b]indol-9-yl)phenyl)-9H-3,9'-bicarbazole (pBCb2Cz) was prepared for high efficiency blue phosphorescent organic light-emitting diodes (PhOLEDs), a high triplet energy (ET) material, employing electron-deficient α-carboline. pBCb2Cz (ET = 2.93 eV) was effective as a host material for FIrpic- and FCNIrpic-based blue PhOLEDs, and highest quantum efficiencies of 23.0 and 16.2%, respectively, were achieved.

Novel polymer nanowire crystals of diketopyrrolopyrrole-based copolymer with excellent charge transport properties.

The first demonstration of polymer nanowire (PNW) crystals based on a diketopyrrolopyrrole-based copolymer (i.e., PDTTDPP), and their application to field-effect transistors (FETs) is reported. Remarkably, transmission electron microscopy and selected area electron diffraction analyses of the PNW reveal its single-crystalline (SC) nature. FETs fabricated of a SC PNW exhibit a maximal charge carrier mobility of ≈7.00 cm(2) V(-1) s(-1) , which is almost one order of magnitude higher than that of the thin-film transistors made of the same polymer (PDTTDPP).

High-performance low-bandgap conjugated polymers bearing diethynylanthracene units for thin-film transistors.

Novel donor-acceptor π-conjugated copolymers, P(DPP-BDT) and P(DPP-ANT), were synthesized in 87-89% yield. Thin-film transistors (TFTs) made from the thermally annealed film of P(DPP-ANT) exhibited much better performance (e.g., µmax = 1.90 cm(2) V(-1) s(-1), Ion/off ≈ 10(6)) than those made from the thermally annealed film of P(DPP-BDT).

Dramatic enhancement of carrier mobility via effective secondary structural arrangement resulting from the substituents in a porphyrin transistor.

OFET devices based on single-crystals of two different porphyrin derivatives display excellent mobilities of 2.57 and 0.48 cm(2) V(-1) s(-1). Although they generate similar J-aggregations, the dramatic enhancement of mobility obtained using porphyrin 1 is due to the well-confined secondary structural arrangement caused by substituents on the porphyrin ring.

A novel tellurophene-containing conjugated polymer with a dithiophenyl diketopyrrolopyrrole unit for use in organic thin film transistors.

A new tellurophene-based π-conjugated polymer, PDTDPPTe, was synthesized. PDTDPPTe exhibits a smaller optical band gap (E(g)(opt) = 1.25 eV) than thiophene-based PDTDPPT (E(g)(opt) = 1.30 eV). Thin-film transistors comprising PDTDPPTe displayed outstanding performance (µ(max) = 1.78 cm(2) V(-1) s(-1), I(on)/I(off) = 10(5-6)).

J-aggregation induced low bandgap anthracene-based conjugated molecule for solution-processed solar cells.

A new anthracene-based X-shaped conjugated molecule, HBTATHT, was synthesized. Thin film transistors based on unannealed HBTATHT showed a carrier mobility of 0.15 cm(2) V(-1) s(-1) (I(on/off) = 7.9 × 10(6)). Further, a solution processed solar cell made of HBTATHT exhibited promising power conversion efficiencies of 4.84% and 4.70% with PC(61)BM (1:0.8 wt ratio) and PC(71)BM (1:0.6 wt ratio), respectively.

Treatment of chronic akinetic mutism with atomoxetine: subtraction analysis of brain f-18 fluorodeoxyglucose positron emission tomographic images before and after medication: a case report.

Akinetic mutism is a rare, complex neuropathologic disorder. The pharmaceutical treatment of akinetic mutism typically includes dopaminergic agents, but the resulting therapeutic effects are often unsatisfactory, and it remains unclear whether late treatment using these medications is effective. We present a case study of a 53-year-old male patient who developed akinetic mutism for a period of 7 months after a subarachnoid hemorrhage. The hemorrhage was caused by a ruptured aneurysm in the right anterior communicating artery, followed by a secondary infarction in the territory of the right anterior cerebral artery. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images revealed decreased glucose metabolism in both frontal lobes. Treatment with atomoxetine, a selective norepinephrine reuptake inhibitor, for a period of 8 weeks led to a clinically significant improvement in the patient's cognitive function and activities of daily living. A subtraction brain positron emission tomographic analysis after atomoxetine medication revealed increased cerebral glucose metabolism in both the premotor and visual association cortices. Thus, we suggest that atomoxetine can be a useful therapeutic option in the treatment of chronic akinetic mutism.