Feasibility and outcomes of a community-based, mobile health system-monitored lifestyle intervention in chronic stroke: A pilot study.

BACKGROUND: People with disabilities face challenges in daily life during the COVID-19 pandemic, including limited access to care, exposure to lifestyle-related diseases, and difficulties in regular exercise. Therefore, it is important to establish health safety nets using Information and Communication Technology (ICT) in communities. OBJECTIVE: This study aimed to develop an m-Health-based personalized lifestyle intervention algorithm targeting high-risk groups of lifestyle-related diseases (including hypertension, diabetes, and obesity) among people with hemiplegic disabilities, and to verify its feasibility. METHODS: Six people at a high risk of lifestyle-related diseases participated in an 8-week lifestyle intervention using a wearable device and the S-Health program. The self-health management areas included walking, moderate-intensity exercise, weight, blood pressure, blood sugar, diet, calorie intake, heart rate, sobriety, no smoking. Health, physical, psychological, and social changes were measured before and after the study. RESULTS: The intervention had a positive impact on the participants' health, with statistically significant differences found in fasting blood glucose, highest systolic blood pressure, grip strength, and motor function assessment. Quality of life, health-related quality of life, and self-efficacy improved post-intervention. CONCLUSION: Our findings can be used as preliminary evidence for establishing m-Health-based health safety net systems for people with disabilities who live in communities.

Correction: Lee et al. Improved Optical Efficiency of 850-nm Infrared Light-Emitting Diode with Reflective Transparent Structure. Micromachines 2023, 14, 1586.

In the original publication [...].

Improvement of Near-Infrared Light-Emitting Diodes' Optical Efficiency Using a Broadband Distributed Bragg Reflector with an AlAs Buffer.

This study developed an advanced 850 nm centered distributed Bragg reflector (DBR) (broadband DBR) composed of nanomaterial-based multiple structures to improve the optical efficiency of an 850 nm near-infrared light-emitting diode (NIR-LED). A combined 850 nm centered broadband DBR was fabricated by growing an 800 nm centered ten-pair DBR on a 900 nm centered ten-pair DBR (denoted as a combined DBR). The combined DBR exhibited a slightly wider peak band than conventional DBRs. Furthermore, the peak band width of the combined DBR significantly increased upon using a reflective AlAs buffer layer that reduced the overlapped reflection. The output power (20.5 mW) of NIR-LED chips using the combined DBR with an AlAs buffer layer exceeded that of a conventional 850 nm centered DBR (14.5 mW) by more than 40%. Results indicated that combining the optical conditions of wavelengths and the AlAs buffer layer effectively strengthened the broadband effect of the DBR and increased the optical efficiency of the 850 nm NIR-LED.

Usability of the novel ankle training equipment with spring resistance-based plantar press exercises in the standing position: A focus on chronic stroke patients with hemiplegic gait.

BACKGROUND: To improve gait disability in patients with chronic stroke, ankle muscle strengthening and calf muscle stretching exercises are required. However, currently available ankle training equipment limit ankle exercises based on the position. Recently developed ankle training equipment enables spring resistance-based plantar press exercises to be performed in the standing position with weight support. OBJECTIVE: To conduct a usability test of the ankle training equipment in the standing position by stroke patients with hemiplegic gait and verify its effects on ankle movements. METHODS: The ankle training equipment was applied to five patients with chronic stroke and hemiplegic gait. In the standing position, the patients performed forefoot and rearfoot press exercises in the affected side with a day's interval at 20 repetitions maximum (RM). During the exercises, surface electromyography (sEMG) was used to measure the maximum voluntary isometric contraction (%MVIC) of the leg muscles. The System Usability Scale (SUS) was used to assess the ankle training equipment. Wilcoxon signed-rank test was used to evaluate the differences in muscle activity between the two exercises. RESULTS: Forefoot and rearfoot press exercises increased the %MVIC in the biceps femoris. Additionally, the tibialis anterior and medial gastrocnemius activity was significantly different between the two exercises. The SUS was 78.75% (SD 12.7). CONCLUSION: The usability test of the passive-control foot press trainer (PFPT) that with improvements in the structure and functions for convenience, it could be commercialized. PFPT could be an alternative to the ankle rehabilitation robot that necessitates a sitting position.

Improved Optical Efficiency of 850-nm Infrared Light-Emitting Diode with Reflective Transparent Structure.

This study investigated a reflective transparent structure to improve the optical efficiency of 850 nm infrared light-emitting diodes (IR-LEDs), by effectively enhancing the number of extracted photons emitted from the active region. The reflective transparent structure was fabricated by combining transparent epitaxial and reflective bonding structures. The transparent epitaxial structure was grown by the liquid-phase epitaxy method, which efficiently extracted photons emitted from the active area in IR-LEDs, both in the vertical and horizontal directions. Furthermore, a reflective bonding structure was fabricated using an omnidirectional reflector and a eutectic metal, which efficiently reflected the photons emitted downwards from the active area in an upward direction. To evaluate reflective transparent IR-LED efficiency, a conventional absorbing substrate infrared light-emitting diode (AS IR-LED) and a transparent substrate infrared light-emitting diode (TS IR-LED) were fabricated, and their characteristics were analyzed. Based on the power-current (L-I) evaluation results, the output power (212 mW) of the 850 nm IR-LED with the reflective transparent structure increased by 76% and 26%, relative to those of the AS IR-LED (121 mW) and TS IR-LED (169 mW), respectively. Furthermore, the reflective transparent structure possesses both transparent and reflective properties, as confirmed by photometric and radial theta measurements. Therefore, light photons emitted from the active area of the 850 nm IR-LED were efficiently extracted upward and sideways, because of the reflective transparent structure.

Evaluation of Polycaprolactone Applicability for Manufacturing High-Performance Cellulose Nanocrystal Cement Composites.

This experimental study examined the aplication effect of polycaprolactone (PCL), an organic resin material with excellent elasticity and ductility, on improving the mechanical performance of cellulose nanocrystal (CNC) cement composites. PCL was compared according to its shape, and in the case of Granules, which is the basic shape, interfacial adhesion with cement was not achieved, so a dichloromethane (DCM) solution was used to dissolve and use the Granules form. As a method for bonding PCL to the CNC surface, the CNC surface was modified using 3-aminopropyltriethoxysilane (APTES), and surface silylation was confirmed through Fourier transform infrared spectroscopy (FT-IR) analysis. In order to evaluate the dispersibility according to the application of PCL to the modified CNC, particle size analysis (PSA) and zeta potential analysis were performed according to the PCL mixing ratio. Through the PSA and zeta potential values, the highest dispersion stability was shown at 1 vol.%, the cohesive force of CNC was low, and the dispersion stability was high according to the application of PCL. According to the results of the dispersion stability evaluation, the degree of hydration of the dissolved PCL 1 vol.%, CNC-only specimens, and plain specimens were analyzed. CNC acted as a water channel inside the cement to accelerate hydration in the non-hydrated area, resulting in an increased degree of hydration. However, the incorporation of PCL showed a low degree of hydration, and the analysis of strength characteristics also showed a decrease of approximately 27% compared with that of plain specimens. This was because the bonding with SiO2 was not smooth owing to the solvent, thus affecting internal hydration. In order to investigate the effect of the PCL shape, the compressive and flexural strength characteristics were compared using PCL powder as an additional parameter. The compressive strength and flexural strength were improved by about 54% and 26%, respectively, in the PCL powder 15 wt% specimen compared to the general specimen. Scanning electron microscopy (SEM) analysis confirmed that the filler effect, which made the microporous structure denser, affects the mechanical performance improvement.

Study on P-AlGaAs/Al/Au Ohmic Contact Characteristics for Improving Optoelectronic Response of Infrared Light-Emitting Device.

The Al/Au alloy was investigated to improve the ohmic characteristic and light efficiency of reflective infrared light-emitting diodes (IR-LEDs). The Al/Au alloy, which was fabricated by combining 10% aluminum and 90% gold, led to considerably improved conductivity on the top layer of p-AlGaAs of the reflective IR-LEDs. In the wafer bond process required for fabricating the reflective IR-LED, the Al/Au alloy, which has filled the hole patterns in Si3N4 film, was used for improving the reflectivity of the Ag reflector and was bonded directly to the top layer of p-AlGaAs on the epitaxial wafer. Based on current-voltage measurements, it was found that the Al/Au alloyed material has a distinct ohmic characteristic pertaining to the p-AlGaAs layer compared with those of the Au/Be alloy material. Therefore, the Al/Au alloy may constitute one of the favored approaches for overcoming the insulative reflective structures of reflective IR-LEDs. For a current density of 200 mA, a lower forward voltage (1.56 V) was observed from the wafer bond IR-LED chip made with the Al/Au alloy; this voltage was remarkably lower in value than that of the conventional chip made with the Au/Be metal (2.29 V). A higher output power (182 mW) was observed from the reflective IR-LEDs made with the Al/Au alloy, thus displaying an increase of 64% compared with those made with the Au/Be alloy (111 mW).

Comparative gene expression analysis of stemness between periodontal ligament and umbilical cord tissues in humans.

Background/purpose: Due to their regenerative potential, periodontal ligament (PDL) and umbilical cord (UBC) tissues are an attractive potential mesenchymal stem cells (MSCs) source. This study compared the expression patterns of genes related to stemness between fresh PDL and UBC tissues. Materials and methods: PDL tissues were collected from 38 permanent premolars extracted for orthodontic purposes, and UBC tissues were obtained from three newborns. Each sample was immediately frozen to prevent RNA degradation. cDNA microarray analysis, quantitative real-time polymerase chain reaction (PCR), and immunohistochemical staining were performed. Gene expression patterns associated with dental stemness (DS) and induced pluripotent stemness (iPS) were compared between PDL and UBC tissues. Results: In the cDNA microarray analyses, the expressions of most iPS genes were greater in the PDL than in the UBC. Meanwhile, the expressions of most DS genes were greater in the UBC than in the PDL. Quantitative real-time PCR analyses showed that the expression levels of matrix metallopeptidase 13 (MMP13), ADAM metallopeptidase domain 22 (ADAM22), vascular cell adhesion protein 1 (VCAM1), and kruppel-like factor 4 (KLF4) genes were greater in the PDL than in the UBC, while the expressions of melanoma cell adhesion molecule (MCAM) and activated leukocyte cell adhesion molecule (ALCAM) were greater in the UBC than in the PDL. Conclusion: These results suggest that UBC and PDL tissues showed slightly different expression patterns of genes related to stemness, which warrants further investigation to use these tissues for future regeneration and implantation therapies.

Enhanced Light Output Power on Near-Infrared Light-Emitting Diodes with TITO/Ag Multilayer Reflector.

A titanium-indium tin oxide (TITO) multilayer reflector was investigated to improve the light efficiency of high-power, near-infrared, light-emitting diodes (NIR-LEDs). The TITO/Ag was fabricated by combining a patterned TITO and an omnidirectional reflector (ODR). For fabricating a high-power NIR-LED, the wafer bond process required the TITO reflective structure, which has patterns filled by AlAu contact metal, bonded directly to the Ag reflector deposited on the silicon wafer. Among Ag-based single- and multilayer reflectors, the TITO/Ag showed the highest reflectance (R = 96%), which was favorable for wafer-bonded high-power NIR-LEDs. Therefore, the TITO/Ag reflector enabled the production of wafer-bonded NIR-LED chips that exhibit superior output performance (190 mW) compared with conventional cases using a single Ag reflector.

Balanced Strain Compensation of In0.07GaAs/Al0.2GaAs/GaAsP0.06 for Improving 940 nm Infrared Light-Emitting Diodes.

Optimum strain compensation structures for In0.07GaAs-based MQWs were investigated to obtain a higher output power for infrared lighting-emitting diodes (IR-LEDs) requiring a 940 nm wave-length. A GaAsP0.06 tensile strain material for compensating the compressive strain of In0.07GaAs quantum wells was used as a quantum barrier. To improve upon the excessive unbalance strain condition caused due to the In0.07GaAs quantum well and GaAsP0.06 quantum barrier, a conditioned Al0.2GaAs strain balancing barrier was also investigated. Through subsequent photoluminescence (PL) measurements, it was found that the GaAsP0.06 tensile strain barrier could effectively compensate for the compressive strain of In0.07GaAs quantum wells. Furthermore, the PL intensity of In0.07GaAs/GaAsP0.06 MQWs was observed to be markedly improved by using an Al0.2GaAs strain balancing barrier. A fabricated IR-LED chip, having In0.07GaAs/GaAsP0.06 MQWs with an Al0.2GaAs strain balancing barrier, showed a 60% higher light output power than conventional MQWs. These results subsequently suggest that using GaAsP0.06 and Al0.2GaAs barriers effectively improved unbalanced strain conditions of lattice-mismatched In0.07GaAs based MQWs requiring a 940 nm emitting wavelength.

Impact of a custom-made 3D printed ergonomic grip for direct laryngoscopy on novice intubation performance in a simulated easy and difficult airway scenario-A manikin study.

Direct laryngoscopy using a Macintosh laryngoscope is the most widely used approach; however, this skill is not easy for novices and trainees. We evaluated the performance of novices using a laryngoscope with a three-dimensional (3D)-printed ergonomic grip on an airway manikin. Forty second-year medical students were enrolled. Endotracheal intubation was attempted using a conventional Macintosh laryngoscope with or without a 3D-printed ergonomic support grip. Primary outcomes were intubation time and overall success rate. Secondary outcomes were number of unsuccessful attempts, first-attempt success rate, airway Cormack-Lehane (CL) grade, and difficulty score. In the easy airway scenario, intubation time, and the overall success rate were similar between two group. CL grade and ease-of-use scores were significantly better for those using the ergonomic support grip (P < 0.05). In the difficult airway scenario, intubation time (49.7±37.5 vs. 35.5±29.2, P = 0.013), the first-attempt success rate (67.5% vs. 90%, P = 0.029), number of attempts (1.4±0.6 vs. 1.1±0.4, P = 0.006), CL grade (2 [2, 2] vs. 2 [1, 1], P = 0.012), and ease-of-use scores (3.5 [2, 4] vs. 4 [3, 5], P = 0.008) were significantly better for those using the ergonomic support grip. Linear mixed model analysis showed that the ergonomic support grip had a favorable effect on CL grade (P<0.001), ease-of-use scores (P<0.001), intubation time (P = 0.015), and number of intubation attempts (P = 0.029). Our custom 3D-printed ergonomic laryngoscope support grip improved several indicators related to the successful endotracheal intubation in the easy and difficult scenario simulated on an airway manikin. This grip may be useful for intubation training and practice.

Robust Channel Allocation with Heterogeneous Requirements for Wireless Mesh Backbone Networks.

When multiple mobile sensors and actuators share a common wireless mesh backbone network of defence systems, the channel allocation mechanism must guarantee the heterogeneous link requirements under conditions of uncertainty. In this paper, a robust channel allocation mechanism is proposed by exploiting partially overlapped channels for directional multi-channel wireless mesh networks. The approach relies on a chance-constrained optimization problem, in which the objective is to minimize the spectrum usage of the network, and the constraints are the signal-to-interference-plus-noise ratio requirements of links with uncertainty. We convert the proposed integer non-linear optimization problem into a mixed-integer convex problem by using efficient transition and approximation. The optimal channel allocation is obtained by solving the proposed optimization problem which adapts to the heterogeneous link and robustness requirements. The simulation results show that the proposed method ensures the heterogeneous link requirements under uncertain conditions while minimizing the spectrum usage of the network.

Incidence of intracranial injury in orbital wall fracture patients not classified as traumatic brain injury.

OBJECTIVE: The detection of intracranial injury in patients with facial injury rather than traumatic brain injury (TBI) remains a challenge for emergency physicians. This study aimed to evaluate the incidence and risk factors of intracranial injury in patients with orbital wall fracture (OWF), who were classified with a chief complaint of facial injury rather than TBI. METHODS: This retrospective case-control study enrolled adult OWF patients (age ≥18 years) who presented at the hospital between January 2004 and March 2016. Patients with definite TBI were excluded because non-contrast head computed tomography (CT) is recommended for such patients. RESULTS: A total of 1220 patients with OWF were finally enrolled. CT of the head was performed on 677 patients, and the incidence of concomitant intracranial injury was found to be 9% (62/677). Patients with definite TBI were excluded. Symptoms raising a suspicion of TBI, such as loss of consciousness, alcohol intoxication, or vomiting, were present in 347 of the patients, with 44 of these patients (13%) showing a concomitant intracranial injury. Of the 330 patients without such symptoms, 18 (6%) demonstrated a concomitant intracranial injury. In OWF patients, superior wall fracture (odds ratio [OR], 4.15; 95% confidence interval [CI], 2.06-8.34; P < 0.001), associated frontal bone fracture (OR, 4.38; 95% CI, 2.08-9.23; P < 0.001), and older age (decades) (OR, 1.03; 95% CI, 1.01-1.04; P = 0.002) were independent risk factors for concomitant intracranial injury. CONCLUSIONS: Emergency physicians should maintain a high degree of suspicion of TBI, even when their primary concern is facial trauma with OWF. Head CT is recommended for OWF patients with a superior OWF, frontal bone fracture, or increased age.

Study on Strain Compensation for Multiple-Quantum Well in Infrared Light-Emitting Diode Using the InxGa1-xP Strain Barrier.

Strain compensation for multiple-quantum wells (MQWs) relative to the efficiency improvement of infrared light-emitting diodes (IR-LEDs) was investigated through the use of an InxGa1-xP strain barrier. The InxGa1-xP barrier, which was inserted between the n-confinement and active regions, developed for the reduction of lattice-mismatched strains in GaAs/AlGaAs and InGaAs/GaAs MQWs. Through photoluminescence, improved intensity was displayed in InGaAs/GaAs MQWs having InxGa1-xP strain barriers, with a significant increase in the intensity observed at the In0.47GaP strain barrier. This result is attributed to strain compensation between the In0.47GaP tensile strain barrier used and the In0.07GaAs compressive strain in MQWs. Through results based on InGaAs/GaAs MQWs, the highest output power of 6 mW was obtained at the In0.47GaP strain barrier, which shows a relative increase of almost 20% as compared to conventional MQWs.

Characteristics of orbital wall fractures in preschool and school-aged children.

OBJECTIVE: This study aimed to evaluate the injury patterns in pediatric patients with an orbital wall fracture (OWF) and to identify the differences in injury patterns between preschool and school-aged patients with OWF who presented to the emergency department. METHODS: We performed a retrospective observational study in the emergency department of a tertiary hospital between January 2004 and March 2014. A total of 177 pediatric patients (<18 years) with OWF who underwent facial bone computed tomography scans with specific discharge codes were included. Patients were categorized into preschool (≤7 years) and school-aged (>7 years) pediatric groups. RESULTS: The inferior wall was the most common fracture site in both the preschool and school-aged pediatric groups (50.0% vs. 64.4%, P=0.15). The male-to-female ratio and the mechanism of injury showed significant differences between the two age groups. Violence was the most common mechanism of injury in the school-aged pediatric group (49.3%), whereas falls from a height caused OWF in approximately half of the patients in the preschool pediatric group (42.9%). Concomitant injuries and facial fractures had a tendency to occur more frequently in the school-aged pediatric group. CONCLUSION: Significant differences according to the sex and mechanisms of injury were identified in preschool and school-aged pediatric patients with OWF.

Patterns and injuries associated with orbital wall fractures in elderly patients who visited the emergency room: a retrospective case-control study.

OBJECTIVES: This study aimed to determine orbital wall fracture (OWF) patterns and associated facial injuries in elderly patients and compare them with those in their younger adult counterparts. DESIGN: A retrospective case-control study. SETTING: An emergency department of a university-affiliated hospital located in an urban area. PARTICIPANTS: A total of 1378 adult patients with OWF diagnosed by CT from 1 January 2004 through 31 March 2014 were enrolled. Patients were categorised into elderly (≥65 years) and non-elderly (<65 years) groups. RESULTS: The elderly group (n=146) had a mean age of 74.0 years compared with 37.5 years in the non-elderly group (n=1232). Slipping was the most common cause of OWF in the elderly group (43.8%, p<0.001), whereas violence was the most common cause in the non-elderly group (37.3%, p<0.001). The lateral orbital wall was the more common site of fracture in the elderly group, and their injuries were more often associated with concurrent facial bone fractures, including the mandible, maxilla and zygoma, compared with the non-elderly group. After adjusting for sex and the mechanism of injury, inclusion in the elderly group was a significant risk factor for fracture of the lateral wall (OR 1.658; 95% CI 1.074 to 2.560) and concomitant facial bone fractures of the maxilla (OR 1.625; 95% CI 1.111 to 2.377) and zygoma (OR 1.670; 95% CI 1.126 to 2.475). CONCLUSIONS: Elderly patients were vulnerable to facial trauma, and concurrent facial bone fracture associated with OWF was more commonly observed in this age group. Therefore, a high index of suspicion and thorough investigation, including CT, for OWF-associated facial bone fractures are important.