Development of a Cranial Suture Traction Therapy Program for Facial Asymmetry Correction Using the New Delphi Technique.

Background and Objectives: We aimed to develop a cranial suture traction therapy program, a non-surgical therapeutic method for facial asymmetry correction. Materials and Methods: Six experts, including rehabilitation medicine specialists, oriental medical doctors, dentistry specialists, five experts, including Master's or doctoral degree holders in skin care and cosmetology with more than 10 years of experience in the field, 4 experts including educators in the field of skin care, a total of 15 people participated in the validation of the development of the cranial suture traction therapy program in stages 1 to 3. Open questions were used in the primary survey. In the second survey, the results of the first survey were summarized and the degree of agreement regarding the questions in each category was presented. In the third survey, the degree of agreement for each item in the questionnaire was analyzed statistically. Results: Most of the questions attained a certain level of consensus by the experts (average of ≥ 4.0). The difference between the mean values was the highest for the third survey at 0.33 and was the lowest between the second and third surveys at 0.47. The results regarding the perceived degree of importance for each point of the evaluation in both the second and third stages of the cranial suture traction therapy program were verified using the content validity ratio. The ratio for the 13 evaluation points was within the range of 0.40-1.00; thus, the Delphi program for cranial suture traction therapy verified that the content was valid. Conclusions: As most questions attained a certain level of consensus by the experts, it can be concluded that these questions are suitable, relevant, and important. The commercialization of the cranial suture traction treatment program will contribute to the correction and prevention of facial dislocations or asymmetry, and the developed treatment will be referred to as cranial suture traction therapy (CSTT).

Complete Genome Sequences of Two Type 3 Porcine Circoviruses, WB17KW and WB20GG, Isolated from Korean Wild Boar.

Porcine circovirus type 3 (PCV3) in domestic pigs was first reported in South Korea in 2017. Here, we report the first complete genome sequences of two PCV3 strains isolated from Korean wild boar, which enhance our understanding about the genetic relatedness of PCV3 in domestic pigs and wild boar.

High-Performance Gas Sensor Using a Large-Area WS2 xSe2-2 x Alloy for Low-Power Operation Wearable Applications.

Two-dimensional (2D) transition-metal dichalcogenides (TMDCs) have attracted considerable attention as promising building blocks for a new generation of gas-sensing devices because of their excellent electrical properties, superior response, flexibility, and low-power consumption. Owing to their large surface-to-volume ratio, various 2D TMDCs, such as MoS2, MoSe2, WS2, and WSe2, have exhibited excellent gas-sensing characteristics. However, exploration toward the enhancement of TMDC gas-sensing performance has not yet been intensively addressed. Here, we synthesized large-area uniform WS2 xSe2-2 x alloys for room-temperature gas sensors. As-synthesized WS2 xSe2-2 x alloys exhibit an elaborative composition control owing to their thermodynamically stable sulfurization process. Further, utilizing uniform WS2 xSe2-2 x alloys over a large area, we demonstrated improved NO2-sensing performance compared to WSe2 on the basis of an electronic sensitization mechanism. The WS0.96Se1.04 alloy gas sensor exhibits 2.4 times enhanced response for NO2 exposure. Further, we demonstrated a low-power wearable NO2-detecting wristband that operates at room temperature. Our results show that the proposed method is a promising strategy to improve 2D TMDC gas sensors and has a potential for applications in advanced gas-sensing devices.

Recovery Improvement for Large-Area Tungsten Diselenide Gas Sensors.

Semiconducting two-dimensional transition-metal dichalcogenides are considered promising gas-sensing materials because of their large surface-to-volume ratio, excellent electrical conductivity, and susceptible surfaces. However, enhancement of the recovery performance has not yet been intensively explored. In this study, a large-area uniform WSe2 is synthesized for use in a high-performance semiconductor gas sensor. At room temperature, the WSe2 gas sensor shows a significantly high response (4140%) to NO2 compared to the use of NH3, CO2, and acetone. This paper demonstrates improved recovery of the WSe2 gas sensor's NO2-sensing performance by utilizing external thermal energy. In addition, a novel strategy for improving the recovery of the WSe2 gas sensor is realized by reacting NH3 and adsorbed NO2 on the surface of WSe2: the NO2 molecules are spontaneously desorbed, and the recovery time is dramatically decreased (85 min → 43 s). It is expected that the fast recovery of the WSe2 gas sensor achieved here will be used to develop an environmental monitoring system platform.

Use of S-100B, NSE, CRP and ESR to predict neurological outcomes in patients with return of spontaneous circulation and treated with hypothermia.

BACKGROUND: With the introduction of therapeutic hypothermia (TH), the prediction of neurological outcomes in cardiac arrest (CA) survivors is challenging. Early, accurate determination of prognosis by emergency physicians is important to avoid unnecessarily prolonged critical care with a likely poor neurological outcome. METHODS: This prospective observational study included patients with non-traumatic CA and return of spontaneous circulation (ROSC) between March 2009 and May 2012 at a tertiary academic hospital. Unconscious patients with ROSC were treated with mild TH (32°C-34°C) for 24 hours. Blood samples were collected for S-100B, neuron-specific enolase (NSE), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) at 0, 24 and 48 hours post-ROSC. Neurological outcomes were evaluated at hospital discharge and dichotomised as good (cerebral performance category (CPC) 1 or 2) or poor (CPC 3, 4 or 5). RESULTS: Of the 119 patients (68.1% male, 53±15.6 years old) who underwent TH, 46 patients had a good outcome (38.9%). Poor neurological outcomes were predicted using receiver operating characteristic analyses at cut-off values of 0.12 g/L for S-100B at 24 hours post-ROSC (sensitivity, 95.0%; specificity, 75.6%; area under the curve (AUC) 0.916; 95% CI of AUC: 0.846 to 0.961), 31.03 ng/mL for NSE at 48 hours post-ROSC (sensitivity, 83.9%; specificity, 96.9%; AUC 0.929; 95% CI of AUC: 0.836 to 0.979) and 11.2 mg/dL for CRP at 48 hours post-ROSC (sensitivity, 69.4%; specificity, 75.0%; AUC 0.731; 95% CI of AUC: 0.617 to 0.827). ESR was not significant. CONCLUSIONS: Among the biomarkers, S-100B at 24 hours and NSE at 48 hours post-ROSC were highly predictive of neurological outcomes in patients treated with TH after CA.

Outcomes of hanging-induced cardiac arrest patients who underwent therapeutic hypothermia: a multicenter retrospective cohort study.

OBJECTIVES: The aim of this study was to analyze the outcomes of patients with hanging-induced cardiac arrest who underwent therapeutic hypothermia (TH). METHOD: In this multicenter, retrospective registry-based study, discharged patients after out-of-hospital cardiac arrest and treatment with TH were enrolled between June 2007 and March 2013. Several prehospital and hospital variables were examined for an outcome analysis with multivariable logistic regression. RESULTS: A total of 964 patients who had cardiac arrest were enrolled in this study. All patients underwent TH during post-cardiac arrest care after return of spontaneous circulation (ROSC). Of all patients, 105 were assigned to the hanging group and 859 to the non-hanging group. Six patients (6%) with good neurologic outcomes (Cerebral Performance Category 1 or 2) in the hanging group at the time of discharge were found. A shorter time interval between witnessed arrest and ROSC and a Glasgow Coma Scale over 4 after ROSC are statistically significant variables of good neurologic outcomes after hanging-induced cardiac arrest treated with TH. CONCLUSION: A small number of patients who underwent TH after a hanging-induced cardiac arrest provided good neurologic outcomes, and some variables influenced these outcomes.

Use of cold intravenous fluid to induce hypothermia in a comatose child after cardiac arrest due to a lightning strike.

We report a case in which mild hypothermia was induced successfully using a cold intravenous fluid infusion in a 12-year-old boy who was comatose following 21 min of cardiac arrest caused by a lightning strike.

Regulated hypothermia reduces brain oxidative stress after hypoxic-ischemia.

UNLABELLED: Regulated hypothermia produces a decrease in core temperature by lowering the brain's temperature set-point while maintaining thermoregulation at that lower set point. In contrast, forced hypothermia lowers core temperature by overwhelming the body's capacity to thermoregulate, but does not change the set-point. Regulated hypothermia has been shown to be cerebral protective in hibernating mammals. The effect of regulated hypothermia on the brain during reperfusion from hypoxic-ischemia has not been well studied. We induced regulated hypothermia with a neurotensin analogue (NT77) to determine whether it could reduce oxidative stress in the brain during reperfusion from asphyxial cardiac arrest (ACA) in rats. Mild hypothermia (32-34 degrees C) was induced by brief (4 h) external cooling (BC), NT77 or prolonged external cooling (24 h) (PC) 30 min after resuscitation from 8 min of ACA in rats. Malondialdehyde (MDA) levels in the brain were measured during reperfusion to quantitate oxidative stress. RESULTS: MDA levels in the hippocampus were elevated at 16 h of normothermic reperfusion versus 48 h with BC reperfusion. There was no increase in hippocampal MDA levels in the NT77 and PC groups at 24-72 h of reperfusion. Regulated hypothermia induced by NT77 reduced oxidative stress in the hippocampus during reperfusion from hypoxic-ischemia in comparison to forced brief external cooling of the same duration. In addition, the duration of external cooling after resuscitation also alters oxidative stress in the brain during reperfusion.

Neurotensin-induced hypothermia improves neurologic outcome after hypoxic-ischemia.

OBJECTIVE: External cooling is commonly used to force induction of mild hypothermia but requires equipment, has a slow onset of action, and must be prolonged to provide permanent neurologic benefits after hypoxic-ischemia. It is unknown whether the method for inducing mild hypothermia affects neurologic outcome after near-drowning. The objective of the study was to induce mild hypothermia with neurotensin analog NT77 or external cooling in a rat model of near-drowning. We hypothesize that NT77 would be more effective for improving neurologic outcome than external cooling of the same duration. DESIGN: Rats were randomized to a normothermic control, neurotensin-induced hypothermia, brief external cooling, or prolonged external cooling group after asphyxial cardiac arrest. SETTING: Laboratory investigation. SUBJECTS: Forty-eight rats. INTERVENTIONS: Mild hypothermia was induced by external cooling for 4 hrs (brief external cooling) or 24 hrs (prolonged external cooling) or by neurotensin-induced hypothermia administration 30 mins after asphyxial cardiac arrest in rats. MEASUREMENTS: Outcome was assessed by a neurologic deficit score, the Morris water maze, and CA1 hippocampus histology 15 days after resuscitation. MAIN RESULTS: Neurologic deficit score at 72 hrs after asphyxial cardiac arrest was lower with neurotensin-induced hypothermia (score, 0) and prolonged external cooling (score, 0) vs. normothermic control (score, 20) and brief external cooling (score, 18; p <.05). Latency time in the Morris water maze 15 days after asphyxial cardiac arrest was decreased with neurotensin-induced hypothermia (14+/-11 secs) and prolonged external cooling (18+/-9 secs) vs. normothermic control (74+/-17 secs) and brief external cooling (78+/-18 secs, p <.05). There was less ischemic neuronal damage with neurotensin-induced hypothermia (28+/-24%) and prolonged external cooling (21+/-14%) vs. normothermic control (61+/-32%) and brief external cooling (51+/-32%). CONCLUSIONS: Neurotensin-induced hypothermia improved neurologic outcome after asphyxial cardiac arrest in rats vs. brief external cooling but was comparable to prolonged external cooling.