A Pneumatically Controlled Prosthetic Socket for Transfemoral Amputees.

Amputees typically experience changes in residual limb volume in their daily lives. It causes an uncomfortable fit of the socket by applying high pressure on the sensitive area of the residual limb or by loosening the socket. In this study, we developed a transfemoral prosthetic socket for above-the-knee amputees that ensures a good socket fit by maintaining uniform and constant contact pressure despite volume changes in the residual limb. The socket has two air bladders in the posterior femoral region, and the pneumatic controller is located on the tibia of the prosthesis. The pneumatic system aims to minimize unstable fitting of the socket and improve walking performance by inflating or deflating the air bladder. The developed socket autonomously maintains the air pressure inside the prosthetic socket at a steady-state error of 3 mmHg or less by adjusting the amount of air in the air bladder via closed-loop control. In the clinical trial, amputee participants walked on flat and inclined surfaces. The displacement between the residual limb and socket during the gait cycle was reduced by up to 33.4% after air injection into the socket. The inflatable bladder increased the knee flexion angle on the affected side, resulting in increased stride length and gait velocity. The pneumatic socket provides a stable and comfortable walking experience not only when walking on flat ground but also on slopes.

A Prosthetic Socket with Active Volume Compensation for Amputated Lower Limb.

Typically, the actual volume of the residual limb changes over time. This causes the prosthesis to not fit, and then pain and skin disease. In this study, a prosthetic socket was developed to compensate for the volume change of the residual limb. Using an inflatable air bladder, the proposed socket monitors the pressure in the socket and keeps the pressure distribution uniform and constant while walking. The socket has three air bladders on anterior and posterior tibia areas, a latching type 3-way pneumatic valve and a portable control device. In the paper, the mechanical properties of the air bladder were investigated, and the electromagnetic analysis was performed to design the pneumatic valve. The controller is based on a hysteresis control algorithm with a closed loop, which keeps the pressure in the socket close to the initial set point over a long period of time. In experiments, the proposed prosthesis was tested through the gait simulator that can imitate a human's gait cycle. The active volume compensation of the socket was successfully verified during repetitive gait cycle using the weight loads of 50, 70, and 90 kg and the residual limb model with a variety of volumes. It was confirmed that the pressure of the residual limb recovered to the initial state through the active control. The pressure inside the socket had a steady state error of less than 0.75% even if the volume of the residual limb was changed from -7% to +7%.

Integrated, Automated, Fast PCR System for Point-Of-Care Molecular Diagnosis of Bacterial Infection.

We developed an integrated PCR system that performs automated sample preparation and fast polymerase chain reaction (PCR) for application in point-of care (POC) testing. This system is assembled from inexpensive 3D-printing parts, off-the-shelf electronics and motors. Molecular detection requires a series of procedures including sample preparation, amplification, and fluorescence intensity analysis. The system can perform automated DNA sample preparation (extraction, separation and purification) in ≤5 min. The variance of the automated sample preparation was clearly lower than that achieved using manual DNA extraction. Fast thermal ramp cycles were generated by a customized thermocycler designed to automatically transport samples between heating and cooling blocks. Despite the large sample volume (50 µL), rapid two-step PCR amplification completed 40 cycles in ≤13.8 min. Variations in fluorescence intensity were measured by analyzing fluorescence images. As proof of concept of this system, we demonstrated the rapid DNA detection of pathogenic bacteria. We also compared the sensitivity of this system with that of a commercial device during the automated extraction and fast PCR of Salmonella bacteria.

Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses.

INTRODUCTION: Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. METHODS: Trauma patients with survival data between November 2015 and December 2019 were identified using a trauma database. Patients were divided between TAE and non-TAE groups, and a propensity score was developed using multivariate logistic regression. Survival at 28 days was compared between the groups after propensity score matching. RESULTS: Among 881 patients included in this study, 308 (35.0%) were treated with TAE. After propensity score matching, 130 pairs were selected. Survival at 28 days was significantly higher among patients treated with TAE than among those treated without TAE [122 (93.9%) vs. 112 (86.2%); odds ratio = 2.45; 95% CI 1.02-5.86; p = 0.039]. CONCLUSIONS: TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture.

Active Body Pressure Relief System with Time-of-Flight Optical Pressure Sensors for Pressure Ulcer Prevention.

A body pressure relief system was newly developed with optical pressure sensors for pressure ulcer prevention. Unlike a conventional alternating pressure air mattress (APAM), this system automatically regulates air flow into a body supporting mattress with adaptive inflation (or deflation) duration in response to the pressure level in order to reduce skin stress due to prolonged high pressures. The system continuously quantifies the body pressure distribution using time-of-flight (ToF) optical sensors. The proposed pressure sensor, a ToF optical sensor in the air-filled cell, measures changes in surface height of mattress when pressed under body weight, thereby indirectly indicating the interface pressure. Non-contact measurement of optical sensor usually improves the durability and repeatability of the system. The pressure sensor was successfully identified the 4 different-predefined postures, and quantitatively measured the body pressure distribution of them. Duty cycle of switches in solenoid valves was adjusted to 0-50% for pressure relief, which shows that the interface pressure was lower than 32 mmHg for pressure ulcer prevention.

ALKBH5 gene is a novel biomarker that predicts the prognosis of pancreatic cancer: A retrospective multicohort study.

BACKGROUNDS/AIMS: Discovery of new prognostic factors for cases in which the pancreatic cancer scoring and staging system does not result in a clear definition is imperative. We examined the role of Human AlkB homolog H5 (ALKBH5) as a prognostic marker for pancreatic cancer. METHODS: Patient data were extracted from the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). The prognostic value of ALKBH5 was confirmed via analysis of ALKBH5 and other clinical factors, such as age, sex, and stage, using the time-dependent area under the curve (AUC) of Uno's C-index, the AUC value of the receiver operating characteristics (ROC) at three years, the Kaplan-Meier survival curve, and multivariate analysis. RESULTS: ALKBH5 showed excellent prognosis prediction in comparison with existing markers in the two independent cohorts (n=262). Kaplan-Meier survival analysis showed that ALKBH5 expression was positively associated with overall survival (log-rank test, ICGC, p=0.001; TCGA, p=0.01). Notably, comparison of C-index and AUC values in ROC analysis showed that ALKBH5 was associated with high C-index and AUC values compared with other clinical variables (C-index: ICGC, 0.621; TCGA, 0.614 and AUC at three years: ICGC, 0.609; TCGA, 0.558). Multivariate analysis demonstrated thatALKBH5 is an independent prognostic factor (ICGC, p=0.0123; TCGA, p<0.001). CONCLUSIONS: These findings contribute to the study of RNA methylation in pancreatic cancer. We believe that ALKBH5 is a new prognostic marker for pancreatic cancer.

A Sensitive Potentiometric Sensor for Isothermal Amplification-Coupled Detection of Nucleic Acids.

A disposable potentiometric sensor was newly developed for the amplification-coupled detection of nucleic acids. The hydrogen-ion is generally released during isothermal amplification of nucleic acids. The surface potential on the oxide-functionalized electrode of the extended gate was directly measured using full electrical circuits with the commercial metal-oxide semiconductor field-effect transistors (MOSFETs) and ring oscillator components, which resulted in cost-effective, portable and scalable real-time nucleic acid analysis. The current-starved ring oscillator changes surface potential to its frequency depending on the square of the variation in pH with a high signal-to-noise ratio during isothermal amplification. The device achieves a conversion rate of 20.5 kHz/mV and a detection resolution of 200 µV for the surface potential. It is demonstrated that the sensor successfully monitors in real-time isothermal amplification of the extracted nucleic acids from Salmonella pathogenic bacteria. The in situ variations in the frequency of the pH-sensitive sensor were compared with the results of both a conventional optical device and pH-meter during isothermal amplification.

Multiple cerebral infarct with cerebral vasculitis in a young patient with ulcerative colitis.

Ulcerative colitis (UC) is a chronic and debilitating disorder, characterized by inflammation of the colonic mucosa. UC can be considered a systemic disorder but UC-related manifestations in the central nervous system (CNS) are quite rare. A 29-year-old man was admitted to the emergency department with repeated generalized tonic-clonic (GTC) type seizures. Based on brain CT, brain metastasis or hemorrhagic infarct was suspected. Diffusion-weighted image of brain MRI showed high signal in the left thalamus and heterogenous enhancement in the right parietal and left frontal lobes. This image indicated a cerebral infarct, but could not completely rule out cerebral metastasis and vasculitis, or any other pathology. However, the brain biopsy revealed multiple thromboemboli with acute inflammation and necrosis. Thus, the patient was diagnosed with multiple cerebral infarcts with cerebral vasculitis, occurring as a complication of UC. In conclusion, CNS manifestations of UC are rare. However, clinicians should consider uncommon diagnoses like vasculitis and thromboembolism in patients with UC presenting with seizures.

Extension of a coronary intramural hematoma after blunt chest trauma.

Coronary artery dissection and intramural hematoma after blunt chest trauma are rare, but life-threatening, complications. Coronary intramural hematoma extension is even rarer. A 31-year-old man was transferred to our hospital for worsening left chest pain during while he was admitted at a nearby hospital due to blunt chest trauma. Bedside echocardiography showed akinesis of the left ventricular apex and anterior wall as well as hypokinesis of the mid-to-basal anteroseptal wall and mid-to-basal lateral and posterior walls of the left ventricle. Computed tomography coronary angiography revealed intramural hematoma in the left main (LM) coronary and proximal left anterior descending (LAD) arteries. Percutaneous coronary intervention, with bare metal stent implantation from the LM coronary artery to the proximal LAD artery, was performed to treat the occlusion caused by the hematoma. After stenting, the hematoma that compressed the LM coronary artery shifted the left circumflex (LCX) artery, and the intramural hematoma developed and extended to the LCX artery. To resolve this occlusion, a drug-eluting stent was successfully implanted in the LCX artery. The patient was discharged without complications. At 2-month follow-up, he remained asymptomatic, with no recurrence of cardiovascular symptoms. Delayed chest pain after trauma should be suspected during coronary dissection, and on treatment, care must be taken to extend the hematoma.

5-Hydroxytryptamine 6 Receptor (5-HT6R)-Mediated Morphological Changes via RhoA-Dependent Pathways.

The 5-HT6R has been considered as an attractive therapeutic target in the brain due to its exclusive expression in the brain. However, the mechanistic linkage between 5-HT6Rs and brain functions remains poorly understood. Here, we examined the effects of 5-HT6R-mediated cell morphological changes using immunocytochemistry, Western blot, and live-cell imaging assays. Our results showed that the activation of 5-HT6Rs caused morphological changes and increased cell surface area in HEK293 cells expressing 5-HT6Rs. Treatment with 5-HT specifically increased RhoA-GTP activity without affecting other Rho family proteins, such as Rac1 and Cdc42. Furthermore, live-cell imaging in hippocampal neurons revealed that activation of 5-HT6Rs using a selective agonist, ST1936, increased the density and size of dendritic protrusions along with the activation of RhoA-GTP activity and that both effects were blocked by pretreatment with a selective 5-HT6R antagonist, SB258585. Taken together, our results show that 5-HT6R plays an important role in the regulation of cell morphology via a RhoA-dependent pathway in mammalian cell lines and primary neurons.

Anxiety symptoms and occupational stress among young Korean female manufacturing workers.

BACKGROUND: The prevalence of anxiety disorders has been increasing in South Korea, with recent studies reporting anxiety disorders as the most common mental disorder among all South Korean females. Anxiety disorders, which are independent risk factors of suicidal ideation and suicide attempts, are significantly correlated with productivity loss, high medical costs, impaired work performance, and frequent worker absence, and thus are potentially serious problems affecting the health of South Korean female workers. In previous studies, anxiety disorders were shown to have a significant correlation with occupational stress. This study seeks to examine the prevalence of anxiety symptoms as well as the relationship between occupational stress and anxiety symptoms among South Korean female manufacturing workers. METHODS: A structured self-reported questionnaire was administered to 1,141 female workers at an electrical appliance manufacturing plant. The questionnaire collected data on general characteristics, health behaviors, sleep quality, job characteristics (shift work, shift work schedule, and job tenure), occupational stress, and anxiety symptoms. Sleep quality was measured using the Pittsburgh Sleep Quality Index, occupational stress with the Korean Occupational Stress Scale-Short Form (KOSS-SF), and anxiety symptoms with the Korean version of the Beck Anxiety Inventory. A chi square test was conducted to determine the distribution differences in anxiety symptoms based on general characteristics, health behaviors, job characteristics, and sleep quality. A linear-by-linear association test was used to determine the distribution differences between anxietysymptoms and the levels of occupational stress. Last, logistic regression analysis was used in order to determine the association between occupational stress and anxiety symptoms. RESULTS: The prevalence of anxiety symptoms was 15.2 %. In the multivariate logistic regression analysis that adjusted for sleep quality and general characteristics, a significantassociation was found for those with anxiety disorders; the odds ratios (OR) were significantly higher the greater the total KOSS-SF score (moderate-risk group OR=2.85, 95 % CI=1.79-4.56; high-risk group OR=5.34, 95 % CI=3.59-7.96). In addition, excluding insufficient job control, all other KOSS-SF subscales were significantly associated with anxiety symptoms, and a relatively high OR was seen in the high-risk group for job demand (OR=3.19, 95 % CI=2.27-4.49), job insecurity (OR=4.52, 95 % CI=2.86-7.13), and occupational culture (OR=4.52, 95 % CI=2.90-7.04). CONCLUSION: There was a significant association between anxiety symptoms and occupational stress stemming from the psychosocial work environment among these South Korean female manufacturing workers. Future longitudinal studies are needed to examine the association between the occupational stress caused by the psychosocial work environment and the incidence of anxiety disorders and anxiety symptoms. Furthermore, intervention programs that aim to address the prevalence of anxiety symptoms and improve the psychosocial work environment, especially for younger female manufacturing workers, are needed.

Direct interaction and functional coupling between human 5-HT6 receptor and the light chain 1 subunit of the microtubule-associated protein 1B (MAP1B-LC1).

Serotonin (5-HT) receptors of type 6 (5-HT6R) play important roles in mood, psychosis, and eating disorders. Recently, a growing number of studies support the use of 5-HT6R-targeting compounds as promising drug candidates for treating cognitive dysfunction associated with Alzheimer's disease. However, the mechanistic linkage between 5-HT6R and such functions remains poorly understood. By using yeast two-hybrid, GST pull-down, and co-immunoprecipitation assays, here we show that human 5-HT6R interacts with the light chain 1 (LC1) subunit of MAP1B protein (MAP1B-LC1), a classical microtubule-associated protein highly expressed in the brain. Functionally, we have found that expression of MAP1B-LC1 regulates serotonin signaling in a receptor subtype-specific manner, specifically controlling the activities of 5-HT6R, but not those of 5-HT4R and 5-HT7R. In addition, we have demonstrated that MAP1B-LC1 increases the surface expression of 5-HT6R and decreases its endocytosis, suggesting that MAP1B-LC1 is involved in the desensitization and trafficking of 5-HT6R via a direct interaction. Together, we suggest that signal transduction pathways downstream of 5-HT6R are regulated by MAP1B, which might play a role in 5-HT6R-mediated signaling in the brain.

The relationship between depressive symptoms among female workers and job stress and sleep quality.

OBJECTIVE: Recently, workers' mental health has become important focus in the field of occupational health management. Depression is a psychiatric illness with a high prevalence. The association between job stress and depressive symptoms has been demonstrated in many studies. Recently, studies about the association between sleep quality and depressive symptoms have been reported, but there has been no large-scaled study in Korean female workers. Therefore, this study was designed to investigate the relationship between job stress and sleep quality, and depressive symptoms in female workers. METHODS: From Mar 2011 to Aug 2011, 4,833 female workers in the manufacturing, finance, and service fields at 16 workplaces in Yeungnam province participated in this study, conducted in combination with a worksite-based health checkup initiated by the National Health Insurance Service (NHIS). In this study, a questionnaire survey was carried out using the Korean Occupational Stress Scale-Short Form(KOSS-SF), Pittsburgh Sleep Quality Index(PSQI) and Center for Epidemiological Studies-Depression Scale(CES-D). The collected data was entered in the system and analyzed using the PASW (version 18.0) program. A correlation analysis, cross analysis, multivariate logistic regression analysis, and hierarchical multiple regression analysis were conducted. RESULTS: Among the 4,883 subjects, 978 subjects (20.0%) were in the depression group. Job stress(OR=3.58, 95% CI=3.06-4.21) and sleep quality(OR=3.81, 95% CI=3.18-4.56) were strongly associated with depressive symptoms. Hierarchical multiple regression analysis revealed that job stress displayed explanatory powers of 15.6% on depression while sleep quality displayed explanatory powers of 16.2%, showing that job stress and sleep quality had a closer relationship with depressive symptoms, compared to the other factors. The multivariate logistic regression analysis yielded odds ratios between the 7 subscales of job stress and depressive symptoms in the range of 1.30-2.72 and the odds ratio for the lack of reward was the highest(OR=2.72, 95% CI=2.32-3.19). In the partial correlation analysis between each of the 7 subscales of sleep quality (PSQI) and depressive symptoms, the correlation coefficient of subjective sleep quality and daytime dysfunction were 0.352 and 0.362, respectively. CONCLUSION: This study showed that the depressive symptoms of female workers are closely related to their job stress and sleep quality. In particular, the lack of reward and subjective sleep factors are the greatest contributors to depression. In the future, a large-scale study should be performed to augment the current study and to reflect all age groups in a balanced manner. The findings on job stress, sleep, and depression can be utilized as source data to establish standards for mental health management of the ever increasing numbers of female members of the workplace.

A CMOS label-free DNA sensor using electrostatic induction of molecular charges.

This paper reports a label-free biosensor for the detection of DNA hybridization. The proposed biosensor measures the surface potential on oligonucleotide modified electrodes using a direct charge accumulation method. The sensor directly and repeatedly measures the charges induced in the working electrode, which correspond to intrinsic negative charges in immobilized molecules. The sensor achieves an improved signal-to-noise ratio (SNR), through the oversampling effect of accumulation for charges and the differential architecture. The sensor also shows stable, robust, and reproducible measurement independent of slight changes in the reference voltage, unlike previous ion-sensitive field effect transistors (ISFETs), providing the benefits of choosing a wide variety of reference electrode materials. The proposed device is integrated with working electrodes, a reference electrode and readout circuits into one package via a 0.35 µm complementary metal-oxide-semiconductor (CMOS) process. The sensor achieves a detectable range of 88.3 dB and a detection limit of 36 µV for surface potential. It is demonstrated that the sensor successfully achieves specific detection of oligonucleotide sequences derived from the H5N1 avian influenza virus. The experiments show a limit of detection of 100 pM and include a single-base mismatch test in 18-mer oligonucleotides.

An autonomous CMOS hysteretic sensor for the detection of desorption-free DNA hybridization.

This paper describes a sensor for label-free, fully electrical detection of DNA hybridization based on capacitive changes in the electrode-electrolyte interface. The sensor measures capacitive changes in real time according to a charging-discharging principle that is limited by the hysteresis window. In addition, a novel autonomous searching technique, which exclusively monitors desorption-free hybridized electrodes among electrode arrays, enhances the performance of the sensor compared with conventional capacitive measurement. The sensor system achieves a detection range of 80 dB. The integrated circuit sensor is fabricated with a 0.35 µm CMOS process. The proposed sensor offers rapid, robust and inexpensive measurement of capacitance with highly integrated detection circuitry. It also facilitates quantitative evaluations of molecular densities on a chip with distinctive impedance variations by monitoring desorption-free hybridized electrodes. Our electrical biosensor has great potential for use with bio analytical tools and point-of-care diagnosis.

An electronic DNA sensor chip using integrated capacitive read-out circuit.

This paper presents fully integrated label-free DNA recognition circuit based on capacitance measurement. A CMOS-based DNA sensor is implemented for the electrical detection of DNA hybridization. The proposed architecture detects the difference of capacitance through the integration of current mismatch of capacitance between reference electrodes functionalized with only single-stranded DNA and sensing electrodes bound with complementary DNA strands specifically. In addition, to minimize the effects of parallel resistance between electrodes and DNA layers, the compensation technique of leakage current through the use of constant current charging and discharging is implemented in the proposed detection circuit. The chip was fabricated in 0.35um 4-metal 2-poly CMOS process, and 16 × 8 sensing electrode arrays were fabricated by post-processing steps.

One-chip electronic detection of DNA hybridization using precision impedance-based CMOS array sensor.

This paper describes a label-free and fully electronic detection method of DNA hybridization, which is achieved through the use of a 16×8 microarray sensor in conjunction with a new type of impedance spectroscopy constructed with standard complementary metal-oxide-semiconductor (CMOS) technology. The impedance-based method is based on changes in the reactive capacitance and the charge-transfer resistance after hybridization with complementary DNA targets. In previously published label-free techniques, the measured capacitance presented unstable capacitive properties due to the parallel resistance that is not infinite and can cause a leakage by discharging the charge on the capacitor. This paper presents an impedance extraction method that uses excitation by triangular wave voltage, which enables a reliable measurement of both C and R producing a highly sensitive sensor with a stable operation independent of external variables. The system was fabricated in an industrial 0.35-µm 4-metal 2-poly CMOS process, integrating working electrodes and readout electronics into one chip. The integrated readout, which uses a parasitic insensitive integrator, achieves an enlarged detection range and improved noise performance. The maximum average relative variations of C and R are 31.5% and 68.6%, respectively, after hybridization with a 1 µM target DNA. The proposed sensor allows quantitative evaluation of the molecule densities on the chip with distinguishable variation in the impedance. This fully electronic microsystem has great potential for use with bioanalytical tools and point-of-care diagnosis.

Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants.

PURPOSE: The purpose of this study was to evaluate the effect of collagen matrix with apically positioned flap (APF) on the width of keratinized gingiva, comparing to the results of APF only and APF combined with free gingival graft (FGG) at the second implant surgery. METHODS: Nine patients were selected from those who had received treatments at the Department of Periodontics, Chosun University Dental Hospital, Gwangju, Korea. We performed APF, APF combined with FGG, and APF combined with collagen matrix coverage respectively. Clinical evaluation of keratinized gingival was performed by measuring the distance from the gingival crest to the mucogingival junction at the mid-buccal point, using a periodontal probe before and after the surgery. RESULTS: The ratio of an increase was 0.3, 0.6, and 0.6 for the three subjects in the APF cases, 3, 5, and 7 for the three in the APF combined with FGG case, and 1.5, 0.5, and 3 for the three in the APF combined with collagen matrix coverage case. CONCLUSIONS: This study suggests that the collagen matrix when used as a soft tissue substitute with the aim of increasing the width of keratinized tissue or mucosa, was as effective and predictable as the FGG.