Skin-interfacing wearable biosensors for smart health monitoring of infants and neonates.

Health monitoring of infant patients in intensive care can be especially strenuous for both the patient and their caregiver, as testing setups involve a tangle of electrodes, probes, and catheters that keep the patient bedridden. This has typically involved expensive and imposing machines, to track physiological metrics such as heart rate, respiration rate, temperature, blood oxygen saturation, blood pressure, and ion concentrations. However, in the past couple of decades, research advancements have propelled a world of soft, wearable, and non-invasive systems to supersede current practices. This paper summarizes the latest advancements in neonatal wearable systems and the different approaches to each branch of physiological monitoring, with an emphasis on smart skin-interfaced wearables. Weaknesses and shortfalls are also addressed, with some guidelines provided to help drive the further research needed.

Flexible low-profile external ventricular drain catheter for real-time brain monitoring.

External ventricular drainage is one of the most common neurosurgical procedures in the world for acute hydrocephalus, which must be performed carefully by a neurosurgeon. Although various neuromonitoring external ventricular drain (EVD) catheters have been utilized, they still suffer from rigidity and bulkiness to mitigate post-EVD placement trauma. Here, we introduce a flexible and low-profile smart EVD catheter using a class of technologies with sensitive electrical materials, seamless integration, and flexible mechanics, which serves as a highly soft and minimally invasive device to monitor electrical brain signals. This device reliably captures biopotentials in real time while exhibiting remarkable flexibility and reliability. The seamless integration of its sensory system promises a minimally invasive EVD placement on brain tissue. This work validates the device's distinct characteristics and performances through in vitro experiments and computational analysis. Collectively, this device's exceptional patient- and user-friendly attributes highlight its potential as one of the most practical EVD catheters.

Correction: Hybrid protein microspheres and their responsive release behaviors and inhibitory effects on melanin synthesis.

Correction for 'Hybrid protein microspheres and their responsive release behaviors and inhibitory effects on melanin synthesis' by Ee Taek Hwang et al., Biomater. Sci., 2024, https://doi.org/10.1039/d4bm00106k.

Hybrid protein microspheres and their responsive release behaviors and inhibitory effects on melanin synthesis.

In this study, the formation of protein microspheres through lysosomal enzyme-assisted biomineralized crystallization was demonstrated. Spherical micro-sized hybrid CaCO3 constructs were synthesized and characterized using field-emission scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, and particle size analysis. Additionally, parameters such as the Brunauer-Emmett-Teller surface area and single-point total pore volume, and adsorption/desorption analysis were used to investigate the mesoporous properties, which are advantageous for lysosomal enzyme (LE) loading. A LE can be used as an organic template, not only as a morphological controller but also for entrapping LE during the crystallization pathway. The hybrid protein microspheres accommodated 2.3 mg of LE with a 57% encapsulation efficiency and 5.1 wt% loading. The peroxidase activity of the microspheres was calculated and found to be approximately 0.0238 mM-1 min-1. pH-responsive release of the LE from CaCO3 was observed, suggesting potential biomedical and cosmetic applications in acidic environments. The hybrid LE microsphere treatment significantly alleviated melanin production in a dose-dependent manner and further downregulated the mRNA expression of MITF, tyrosinase, TYRP-1, and TYRP-2. These results indicate skin-whitening effects by inhibiting melanin without inducing cytotoxicity. The data provide the first evidence of the potential use of a LE for obtaining hybrid minerals and the effectiveness of biomineralization-based sustainable delivery of enzyme-based vehicles based on organelle-extract-assisted biomineralization.

Large-scale smart bioreactor with fully integrated wireless multivariate sensors and electronics for long-term in situ monitoring of stem cell culture.

Achieving large-scale, cost-effective, and reproducible manufacturing of stem cells with the existing devices is challenging. Traditional single-use cell-bag bioreactors, limited by their rigid and single-point sensors, struggle with accuracy and scalability for high-quality cell manufacturing. Here, we introduce a smart bioreactor system that enables multi-spatial sensing for real-time, wireless culture monitoring. This scalable system includes a low-profile, label-free thin-film sensor array and electronics integrated with a flexible cell bag, allowing for simultaneous assessment of culture properties such as pH, dissolved oxygen, glucose, and temperature, to receive real-time feedback for up to 30 days. The experimental results show the accurate monitoring of time-dynamic and spatial variations of stem cells and myoblast cells with adjustable carriers from a plastic dish to a 2-liter cell bag. These advances open up the broad applicability of the smart sensing system for large-scale, lower-cost, reproducible, and high-quality engineered cell manufacturing for broad clinical use.

Metatarsal sliding osteotomy is effective without altering plantar pressure in Morton's neuroma: Retrospective case series.

BACKGROUND: Various operative methods for the treatment of Morton's neuroma have been discussed, and osteotomy of the metatarsal bone has been reported recently. However, there has been no report of pedobarographic changes after metatarsal osteotomy. Pedobarographic changes of other metatarsal area after the surgery may cause transfer metatarsalgia, and thorough analysis of the pedobarographic data should be performed peri-operatively. The purpose of this study is to investigate the post-operative pedobarographic changes of sliding osteotomy of the 3rd metatarsal bone for treating Morton's neuroma. METHODS: Forty patients (45 feet) who underwent metatarsal sliding osteotomy of the 3rd metatarsal bone for treating Morton's neuroma from November 2013 to December 2021 were retrospectively reviewed. Proximal sliding osteotomy was performed at the proximal 3rd metatarsal bone through dorsal approach. Clinical outcomes were evaluated with American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal Interphalangeal Scale (AOFAS LMIS), Foot Function Index (FFI), and Visual Analogue Scale (VAS). Plain radiograph and pedobarogram were performed to evaluate the radiologic and pedobarographic outcomes. RESULTS: AOFAS score was improved from 52.8 ± 9.0 (18-62) to 88.8 ± 9.8 (78-100) and FFI was improved from 61.8 ± 4.9 (50-70) to 32.2 ± 5.1 (23-42) on average. The 3rd metatarsal bone was shortened by 3.1 ± 0.8 mm and dorsally shifted by 1.5 ± 0.4 mm after the surgery. Plantar intermetatarsal distances between 2nd and 3rd and 3rd and 4th metatarsal heads were significantly increased post-operatively. Average forefoot pressure and maximum pressure of the 2nd to 4th metatarsal head were not significantly changed between pre-operatively and post-operatively. CONCLUSION: Proximal metatarsal sliding osteotomy of the 3rd metatarsal bone shows a satisfactory result in both clinical and pedobarographical evaluations. It could be an effective treatment of permanent indirect decompression of Morton's neuroma with avoiding recurred neuroma, adhesion of tissue, paresthesia, and transfer metatarsalgia.

A Double-Blinded, Randomized, Dose-Comparison Pilot Study to Comparatively Evaluate Efficacy and Safety of Two Doses of Botulinum Toxin Type A Injection for Deltoid Muscle Hypertrophy.

BACKGROUND: Botulinum toxin type A (BTX-A) injection is being widely used off-label for muscular hypertrophy, including deltoid muscle hypertrophy. However, very few studies have evaluated the optimal dosage and its clinical response. OBJECTIVE: This study aimed to assess the efficacy and safety of different doses of Prabotulinum toxin A (PBoNT) for treating deltoid muscle hypertrophy. METHODS: Twelve particiapants with bilateral deltoid muscle hypertrophy were enrolled and randomly received either 16 U or 32 U of PBoNT. In each participant, the same dose was administered to both deltoid muscles. Both participants and evaluators were blinded. Deltoid muscle thickness and upper arm circumference were measured on day 0, and weeks 2, 4, and 12 after the PBoNT injection. RESULTS: Upper arm circumference significantly decreased in both groups; however, deltoid muscle thickness was reduced in the 16 U group only. No major complications were reported in both groups. However, a few minor complications were reported in the 16 U injection group. CONCLUSION: Both 16 U and 32 U of PBoNT intramuscular injections are safe and effective in treating deltoid hypertrophy.

Efficacy and safety of oral palmitoleic acid supplementation for skin barrier improvement: A 12-week, randomized, double-blinded, placebo-controlled study.

Background: Palmitoleic acid (omega-7) has been reported to be effective primarily for metabolic disorders. Recently, it has been reported to help improve quality of life (QoL) by improving skin symptoms. Objective: The aim of this randomized, double-blinded, placebo-controlled clinical study is to evaluate the efficacy and safety of oral palmitoleic acid in improving skin barrier, elasticity, and wrinkle formation in adult women. Methods: In this randomized, double-blind, placebo-controlled clinical study, 90 healthy participants were enrolled and received 500 mg/day palmitoleic acid (intervention) or corn oil without palmitoleic acid (control) for 12 weeks. Skin hydration and transepidermal water loss and skin elasticity, surface roughness, eye wrinkle volume, and wrinkle severity were measured at 6-week intervals to assess the skin barrier function and efficacy in wrinkle improvement, respectively. Results: After 12 weeks, skin hydration and transepidermal water loss significantly improved in the intervention group compared to the control group. Skin elasticity, surface roughness, eye wrinkle volume, wrinkle severity, and participant-assessed clinical improvement score did not significantly improve compared with the control group. Conclusion: Oral palmitoleic acid effectively improves the skin barrier function improvement, which may enhance QoL in aging adults.

The effect of low-intensity cold atmospheric plasma jet on photoaging-induced hyperpigmentation in mouse model.

BACKGROUND: Cold atmospheric plasma (CAP) produces reactive oxygen/nitrogen species (RONS) in the target and can induce cytoprotective effects by activating hormesis-related pathways when its intensity is in the low range. OBJECTIVES: The aim of this study is to evaluate the effect of low-intensified CAP (LICAP) on skin with photoaging-induced hyperpigmentation in an animal model. METHODS: Changes in cell viability and RONS production following LICAP treatment were measured. For the in vivo study, 30 hairless mice underwent antecedent photoaging induction followed by the allocated therapy (i.e., LICAP, topical ascorbic acid (AA), or both). During the first 4 weeks of the treatment period (8 weeks), ultraviolet (UV)-B irradiation was concurrently administered. Visual inspection and measurement of the melanin index (MI) were performed to assess the change in skin pigmentation at Weeks 0, 2, 4, 6, and 8. RESULTS: RONS production increased linearly until the saturation point. Cell viability was not significantly affected by LICAP treatment. At Week 8, MI was significantly decreased in every treatment group compared with the values at Week 0 and Week 4. The treatment effect of the concurrent therapy group was superior to that of the LICAP and AA groups. CONCLUSION: LICAP appears to be a novel modality for photoprotection and pigment reduction in photodamaged skin. LICAP treatment and topical AA application seem to exert a synergistic effect.

Advances in Materials, Sensors, and Integrated Systems for Monitoring Eye Movements.

Eye movements show primary responses that reflect humans' voluntary intention and conscious selection. Because visual perception is one of the fundamental sensory interactions in the brain, eye movements contain critical information regarding physical/psychological health, perception, intention, and preference. With the advancement of wearable device technologies, the performance of monitoring eye tracking has been significantly improved. It also has led to myriad applications for assisting and augmenting human activities. Among them, electrooculograms, measured by skin-mounted electrodes, have been widely used to track eye motions accurately. In addition, eye trackers that detect reflected optical signals offer alternative ways without using wearable sensors. This paper outlines a systematic summary of the latest research on various materials, sensors, and integrated systems for monitoring eye movements and enabling human-machine interfaces. Specifically, we summarize recent developments in soft materials, biocompatible materials, manufacturing methods, sensor functions, systems' performances, and their applications in eye tracking. Finally, we discuss the remaining challenges and suggest research directions for future studies.

Exosomes as novel player in dermatologic field.

Exosomes are nano-sized extracellular vesicles released by the majority of the cell types. Exosomes play a major role in intercellular communication via transferring cargoes between cells and altering specific functions of the target cells. The interest in the biological activities of exosomes has been increasing and their therapeutic role has already been demonstrated in various diseases. Recently, there is growing evidence that stem cell-derived exosomes (including mesenchymal stem cell, umbilical cord-derived mesenchymal cell, adipose-derived stem cell, and pluripotent stem cell) can also be used in a variety of skin conditions due to their regenerative and anti-inflammatory capacity. In this paper, we will provide a brief overview of recent studies on practical applications of exosomes in several dermatologic conditions and their potential mechanisms. By elucidating the different mechanisms and therapeutic roles of exosomes in various disease conditions, we hope dermatologists and other clinicians to establish better strategies for disease treatment with further research.

A randomized, participant- and evaluator-blinded, matched-pair prospective study to compare the safety and efficacy between polycaprolactone-based fillers in the correction of nasolabial folds.

Polycaprolactone (PCL)-based fillers are widely used for skin rejuvenation and wrinkle reduction. The objective of this study is to compare the efficacy and safety of newly developed PCL-based fillers (SYB filler®; SF-01) and widely used existing PCL-based fillers (Ellansé-M®) for correction of moderate-to-severe nasolabial folds. In a randomized, participant-and evaluator-blinded, matched-pair, prospective study, participants were randomized for injections of SF-01 or Ellansé-M® in both nasolabial folds. Efficacy was evaluated using the Wrinkle Severity Rating Scale (WSRS), Global Esthetic Improvement Scale (GAIS), and a three-dimensional (3D) scanner. All adverse events (AEs) were examined and reported. At month 12, both SF-01-and Ellansé-M®-treated groups showed statistically significant improvements in the WSRS, GAIS, and 3D scanner scores compared to baseline. The difference in changes in WSRS scores at month 12 between the two groups was 0.08 ± 0.34 compared to baseline. The upper limit of the 95.0% confidence interval was 0.0031, which was lower than the predefined margin for non-inferiority (0.35). All AEs were injection site-related (swelling, pain, and erythema) and disappeared within 30 min after the procedure. SF-01 was non-inferior to Ellansé-M® and demonstrated favorable efficacy and safety at 12 months after correcting moderate-to-severe nasolabial folds.

Retroreflection-based optical biosensing: From concept to applications.

Optical biochemical assays that utilize traditional optical signaling labels, such as fluorophores and fluorescent nanoparticles, have been extensively applied in the development of optical biosensors. However, traditional optical-label-based analytical approaches require expensive and sophisticated optical instruments; thus, the application of traditional optical-label-based biochemical assays to optical biosensors in point-of-care testing (POCT) concepts that require cost-effectiveness and user-friendliness remains challenging. Retroreflection-based optical biosensing technology that utilizes micro-sized retroreflectors as an optical signaling label is being studied as a promising technological alternative to overcome the drawbacks of conventional optical-label-based biosensors. Retroreflection is an optical phenomenon whereby light rays strike a specific surface, a retroreflector, and are redirected to the light source along the inverse direction of the incident light. Biosensors that involve the retroreflection principle and retroreflector-type optical label offer distinctive advantages, such as the cost-effective simplification of optical instrument configuration, highly flexible applicability to various biochemical assays, and high analytical capability; therefore, their further applications toward the biosensing platform for POCT is highly promising. This review introduces the fundamentals of retroreflection and summarizes recent research achievements of retroreflection-based optical biosensor development from the perspective of how retroreflectors can be coupled and utilized with the optical biosensing principle as optical signal labels. The expected future applications of retroreflection-based optical biosensor technology is also discussed.

Retroreflection-based sandwich type affinity sensing of isothermal gene amplification products for foodborne pathogen detection.

Loop-mediated isothermal amplification (LAMP) is an outstanding method for molecular diagnostics, as the rapid, specific, and sensitive amplification of target genes is possible. However, it is necessary to measure fluorescence in the quantitative analysis of LAMP products, so a sophisticated optical setup is required. This study tried to develop a novel sensing method that can quantify target analytes with simple equipment, such as nonspectroscopic white light and a CMOS camera. To achieve this, a retroreflective Janus particle (RJP) as a probe and specially designed loop primers, fluorescein isothiocyanate (FITC)- and biotin-modified loop primers, were introduced into the LAMP system. By performing LAMP in the presence of designed primers, double-stranded amplicons possessing FITC and biotin labels at each end are generated in proportion to the quantity of the target pathogen. Using the anti-FITC antibody-modified sensing surface and streptavidin-conjugated RJP probes, the amplicons can be captured in sandwich-configuration and detected under nonspectroscopic conditions composed of white light and a camera. To confirm the feasibility of the sensing system, the invA gene of Salmonella was selected as the target. It was possible to quantitatively analyze the Salmonella concentration from 0 to 106 colony-forming units, sufficiently covering the required detection range. In addition, quantitative analyses of pathogens in contaminated food sources, including milk and chicken meat, were successfully conducted with a limit of detection of 10 CFU.

Wash-free operation of smartphone-integrated optical immunosensor using retroreflective microparticles.

Herein, we introduce a smartphone-integrated immunosensor based on non-spectroscopic optical detection. Sedimentation of the retroreflector and gentle inversion of the microfluidic chip was chosen as biosensing principles to ensure minimal human involvement. To realize this, wash-free immunosensing was implemented on a polymeric microfluidic chip device fabricated for light signal penetration in retroreflection signal acquisition. Applying a transparent chip and passive modulation of retroreflectors enabled the minimization of human error during sensing. In addition, a retroreflection-detectable optical gadget was constructed for integration with the commercial smartphone. The gadget had an optical chamber that induced retroreflection by integration with a smartphone. When the micro-sized reflector, named the retroreflective Janus microparticle, reacted on the sensing surface, the incident light was retroreflected towards the image sensor and quantified by a smartphone-installed Android application package. The developed application package features include time-lapse image capture performed by manipulating LED flash and camera modules, and quantification of retroreflected signal counts by image processing of time-lapse images. With this platform, the user could independently commence optical signal processing without a complicated optical setup and running software on a PC, and sensitive and reproducible immunosensing results could be obtained. The applicability test for creatine kinase-myocardial band detection from the buffer to serum was conducted and presented a calibration curve of 0-1000 ng/mL within 1 h. With the developed system, we believe that the applicability of the platform in bioanalytical detection can be expanded.

Biomineralized separation, concentration, and evaluation of the effectiveness of Schisandra chinensis fruit extract.

Here, we detail the biomineralization-assisted separation and concentration of crude food extract and an evaluation of its effectiveness. Schisandra chinensis fruit extract was used as a model plant extract. Hybrid grape-like mineral was assembled by calcium carbonate mineralization. The hybrid particles of S. chinensis mineral were fully characterized using field emission scanning electron microscopy, X-ray diffraction, thermogravimetric analysis, and particle size analysis. Data including the Brunauer-Emmett-Teller surface area, single point total pore volume, and adsorption/desorption analysis of pore size were also investigated. Organic molecules, including lipids such as palmitic acid, stearic acid, and linolenic acid in the Schisandra chinensis fruit, affect the formation of complex structures involving the CaCO3 mineralization pathway by inhibiting crystallization. However, the cosmetic active primary components were entrapped in a similar proportion in the preserved extract, and were efficiently separated without additional filtering and concentration steps for purification. In addition, the hybrid mineral was enriched (10.5 times) in Gomisin N, a representative component of S. chinensis fruit, relative to its concentration in the initial extract samples. The hybrid mineral inhibited both intracellular and extracellular melanin production and increased the 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity. The data provide the first evidence of the potential use of fruit extract for obtaining hybrid minerals and the effectiveness of the biomineralization-based separation and concentration strategy.

Nonspectroscopic Migratory Cell Monitoring Method Using Retroreflective Janus Microparticles.

This study aims to suggest a simple migratory cell monitoring method in the Transwell system by utilizing retroreflective Janus microparticles (RJPs) as an optical probe. The RJP could be internalized on cells without compromising the cell viability and can be registered as bright spots within the cell body by inducing retroreflection from nonspectroscopic light sources. Conventional optical probes (e.g., fluorophores, chromogens, and nanoparticles) have been extensively studied and applied across diverse platforms (e.g., Boyden chamber, wound closing, and microfluidic chips) for understanding in vitro kinetic cell behavior. However, the complexities of running such platforms and setting up analytical instruments are limiting. In this regard, we aimed to demonstrate a modified Transwell migration assay by introducing the retroreflection principle to the cell quantification procedures that ensure a simplified optical setup, assure easy signal acquisition, and are compatible with conventional platforms. To demonstrate retroreflection as a signaling principle, a half-metal-coated silica particle that can induce interior retroreflection was synthesized. Because the RJPs can concentrate incident light and reflect it back to the light source, retroreflection was distinctively recognizable and enabled sensitive visualization. To verify the applicability of the developed migration assay, cell quantification during the incremental progress of macrophage migration, and cell quantification under gradients of chemoattractant monocyte protein-1, was accomplished by obtaining phagocytosed RJP-mediated retroreflection signals. Considering that conventional assays are designed as endpoint measurements, we anticipate the proposed retroreflection-based cell quantification technique to be a promising solution, bypassing current limitations.

Time-resolved fluorescence resonance energy transfer-based lateral flow immunoassay using a raspberry-type europium particle and a single membrane for the detection of cardiac troponin I.

Herein, we report a novel lateral flow immunoassay (LFIA) system for detecting cardiac troponin I (cTnI) in serum using the time-resolved fluorescence resonance energy transfer (TR-FRET) technique and the fusion 5 membrane. The fusion 5 membrane is used as a strip for LFIA, and it is constructed without additional matrices (such as a sample or conjugation pad). Although this strategy for constructing the LFIA strip is quite simple and cost-effective, LFIA is still not suitable for the analysis of biomarkers that require high sensitivity, such as cTnI. Therefore, the highly sensitive TR-FRET technique is integrated with a fusion 5 membrane-based LFIA strip. To accomplish this, a microparticle covered with europium chelate-contained silica nanoparticles is synthesized as a raspberry-type particle and used as a fluorescence donor. A gold nanorod (GNR) is used as a fluorescence acceptor particle. In the TR-FRET-based LFIA system, the competitive immunoassay should be performed to satisfy the condition required for the FRET phenomenon to occur. Therefore, the fluorescence signal is proportional to the cTnI concentration, ensuring a quantitative analysis of cTnI can be accomplished by measuring the fluorescence signal between the raspberry-type europium particles and GNR. Using the developed TR-FRET-based LFIA system, sensitive detection of cTnI is successfully achieved with a limit of detection of 97 pg/mL in human serum. Moreover, because the result can be obtained using one matrix (the fusion 5 membrane), the developed LFIA system can be employed in cTnI diagnosis with a simple manufacturing process.

Wash-free non-spectroscopic optical immunoassay by controlling retroreflective microparticle movement in a microfluidic chip.

Here, we proposed a retroreflective optical immunoassay platform by introducing the intrinsic sedimentation characteristics of a micro-retroreflector, namely retroreflective Janus particles (RJPs), wherein the sediment-based passive movement of RJPs minimised the random errors due to human involvement and resulted in a simple procedure that does not require the washing step, to follow the concept of point-of-care testing. The transparent sensing interface and the sedimentation property of RJPs were combined to develop a practical retroreflective immunoassay platform. For the sensing surface, transparent silanized poly(methyl methacrylate) was applied to the inverted focusing method. In the retroreflection phenomenon, as the incident light returns to its source by the retroreflector, efficient design of the retroreflective optical path between the light source and retroreflector can be crucial in signal registration. While preparing the RJP-bound transparent substrate on the microfluidic channel, the signal could be achieved more efficiently by directly focusing on the sensing interface, and not via the fluidic channels. To integrate this to build an immunoassay protocol, the sedimentation property of RJPs was employed for microfluidic chip inversion-based particle movement control, which was utilised for both luring and separating RJPs on the sensing surface, resulting in a wash-free immunoassay without any human involvement. To ensure accurate analysis, a time-lapse imaging-based image processing was conducted to eliminate the non-specific signals. To validate the applicability of the proposed immunoassay platform, quantification of acute cardiac infarction marker creatine kinase-MB was performed.