Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023.

We isolated novel reassortant avian influenza A(H5N6) viruses containing genes from clade 2.3.4.4b H5N1 virus and low pathogenicity avian influenza viruses in carcasses of whooper swans and bean geese in South Korea during December 2023. Neuraminidase gene was from a clade 2.3.4.4b H5N6 virus infecting poultry and humans in China.

Implantable Biosupercapacitor Inspired by the Cellular Redox System.

The carbon nanotube (CNT) yarn supercapacitor has high potential for in vivo energy storage because it can be used in aqueous environments and stitched to inner parts of the body, such as blood vessels. The biocompatibility issue for frequently used pseudocapacitive materials, such as metal oxides, is controversial in the human body. Here, we report an implantable CNT yarn supercapacitor inspired by the cellular redox system. In all living cells, nicotinamide adenine dinucleotide (NAD) is a key redox biomolecule responsible for cellular energy transduction to produce adenosine triphosphate (ATP). Based on this redox system, CNT yarn electrodes were fabricated by inserting a twist in CNT sheets with electrochemically deposited NAD and benzoquinone for redox shuttling. Consequently, the NAD/BQ/CNT yarn electrodes exhibited the maximum area capacitance (55.73 mF cm-2 ) under physiological conditions, such as phosphate-buffered saline and serum. In addition, the yarn electrodes showed a negligible loss of capacitance after 10 000 repeated charge/discharge cycles and deformation tests (bending/knotting). More importantly, NAD/BQ/CNT yarn electrodes implanted into the abdominal cavity of a rat's skin exhibited the stable in vivo electrical performance of a supercapacitor. Therefore, these findings demonstrate a redox biomolecule-applied platform for implantable energy storage devices.

Stretchable Fiber Biofuel Cell by Rewrapping Multiwalled Carbon Nanotube Sheets.

The fiber-type biofuel cell is attractive as an implantable energy source because the fiber can modify various structures and the wound can be stitched like a suture. In addition, in daily life, the biofuel cell is forced by human motion, and stretchability is a critical requirement for real applications. Therefore, we introduce a new type of highly stretchable, stable, soft fiber biofuel cell with microdiameter dimensions as an energy harvester. The completed biofuel cell operated well in fluids similar to human fluids, such as 20 mM phosphate-buffered 0.14 M NaCl solution (39.5 mW/cm2) and human serum (36.6 µW/cm2). The fiber-type biofuel cell can be reversibly stretched up to 100% in tensile direction while producing sustainable electrical power. In addition, the unique rewrapping structure, which traps the enzyme between multiwalled carbon nanotube sheets, enormously enhanced the stability of the biofuel cell when the biofuel cell was repeatedly stretched (the power density retention increased from 63 to 99%) and operated in human serum (the power density retention increased from 29 to 86%). The fiber can be easily woven into various structures, such as McKibben braid yarn, and scaled up by series and parallel connections.

Super-resolution fluorescent materials: an insight into design and bioimaging applications.

Living organisms are generally composed of complex cellular processes which persist only within their native environments. To enhance our understanding of the biological processes lying within complex milieus, various techniques have been developed. Specifically, the emergence of super-resolution microscopy has generated a renaissance in cell biology by redefining the existing dogma towards nanoscale cell dynamics, single synaptic vesicles, and other complex bioprocesses by overcoming the diffraction-imposed resolution barrier that is associated with conventional microscopy techniques. Besides the typical technical reliance on the optical framework and computational algorithm, super-resolution imaging microscopy resorts largely to fluorescent materials with special photophysical properties, including fluorescent proteins, organic fluorophores and nanomaterials. In this tutorial review article, with the emphasis on cell biology, we summarize the recent developments in fluorescent materials being utilized in various super-resolution techniques with successful integration into bio-imaging applications. Fluorescent proteins (FP) applied in super-resolution microscopy will not be covered herein as it has already been well summarized; additionally, we demonstrate the breadth of opportunities offered from a future perspective.

The effects of pelvic diagonal movements and resistance on the lumbar multifidus.

[Purpose] The purpose of this study was to compare the effects of pelvic diagonal movements, made with and without resistance, on the thickness of lumbar multifidus muscles. [Subjects and Methods] Participants in this study were healthy subjects who had no musculoskeletal disorders or lumbar-related pain. Participants were positioned on their side and instructed to lie with their hip flexor at 40 degrees. Ultrasonography was used for measurement, and the values of two calculations were averaged. [Results] The thickness of ipsilateral lumbar multifidus muscles showed a significant difference following the exercise of pelvic diagonal movements. The results of anterior elevation movements and posterior depression movements also demonstrated significant difference. There was no significant difference in lumbar multifidus muscles thickness between movements made with and without resistance. [Conclusion] These findings suggest that pelvic diagonal movements can be an effective method to promote muscular activation of the ipsilateral multifidus. Furthermore, researchers have concluded that resistance is not required during pelvic diagonal movements to selectively activate the core muscles.

Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults.

[Purpose] To date, core muscle activity detected using ultrasonography during prone bridge exercises has not been reported. Here we investigated the effects of core muscle thickness and balance on sling exercise efficacy by shoulder joint angle in healthy individuals. [Subjects and Methods] Forty-three healthy university students were enrolled in this study. Ultrasonography thickness of external oblique, internal oblique, and transversus abdominis during sling workouts was investigated. Muscle thickness was measured on ultrasonography imaging before and after the experiment. Dynamic balance was tested using a functional reaching test. Static balance was tested using a Tetrax Interactive Balance System. [Results] Different muscle thicknesses were observed during the prone bridge exercise with the shoulder flexed at 60°, 90° or 120°. Shoulder flexion at 60° and 90° in the prone bridge exercise with a sling generated the greatest thickness of most transversus abdominis muscles. Shoulder flexion at 120° in the prone bridge exercise with a sling generated the greatest thickness of most external oblique muscles. [Conclusion] The results suggest that the prone bridge exercise with shoulder joint angle is an effective method of increasing global and local muscle strength.

Effects of adjustment of transcranial direct current stimulation on motor function of the upper extremity in stroke patients.

[Purpose] The purpose of this study was to examine the effects of transcranial direct current stimulation (tDCS) applied to the cerebral cortex motor area on the upper extremity functions of hemiplegic patients. [Subjects and Methods] Twenty four Patients with hemiplegia resulting from a stroke were divided into two groups: a tDCS group that received tDCS and physical therapy and a control group that received only physical therapy. A functional evaluation of the two groups was performed, and an electrophysiological evaluation was conducted before and after the experiment. Statistical analyses were performed to verify differences before and after the experiment. All statistical significance levels were set at 0.05. [Results] The results showed that functional evaluation scores for the elbow joint and hand increased after the treatment in both the experimental group and the control group, and the increases were statistically significantly different. [Conclusion] tDCS was effective in improving the upper extremity motor function of stroke patients. Additional research is warranted on the usefulness of tDCS in the rehabilitation of stroke patients in the clinical field.

Effects of fast and slow squat exercises on the muscle activity of the paretic lower extremity in patients with chronic stroke.

[Purpose] The purpose of this study was to investigate the effects of the speed of squat exercises on paretic lower extremity muscle activity in patients with hemiplegia following a stroke. [Subjects and Methods] Ten stroke patients performed fast and slow squat exercises for 2 seconds and 8 seconds, respectively. The muscle activities of the paretic and non-paretic sides of the rectus femoris muscle, the biceps femoris muscle, and the tibialis anterior muscle were assessed and compared using surface electromyography. [Results] The paretic side of the rectus femoris muscle showed statistically significant differences in the fast squat exercise group, which demonstrated the highest muscle activity during the rapid return to the upright position. [Conclusion] The rectus femoris muscle showed the highest muscle activity during the return to the upright position during the fast squat exercise, which indicates that the rectus femoris muscle is highly active during the fast squat exercise.

Effects of visibility and types of the ground surface on the muscle activities of the vastus medialis oblique and vastus lateralis.

[Purpose] The purpose of this study was to compare the effects of visibility and types of ground surface (stable and unstable) during the performance of squats on the muscle activities of the vastus medialis oblique (VMO) and vastus lateralis (VL). [Subjects and Methods] The subjects were 25 healthy adults in their 20s. They performed squats under four conditions: stable ground surface (SGS) with vision-allowed; unstable ground surface (UGS) with vision-allowed; SGS with vision-blocked; and UGS with vision-blocked. The different conditions were performed on different days. Surface electromyogram (EMG) values were recorded. [Results] The most significant difference in the activity of the VMO and VL was observed when the subjects performed squats on the UGS, with their vision blocked. [Conclusion] For the selective activation of the VMO, performing squats on an UGS was effective, and it was more effective when subjects' vision was blocked.

Relationship between somatosensory function and the spinothalamocortical pathway in chronic stroke patients.

Diffusion tensor tractography (DTT) allows for identification and evaluation of the spinothalamic tract and its thalamocortical pathway (STP). We attempted to investigate the relationship between tactile sensation and the STP in chronic stroke patients. We measured fractional anisotropy, mean diffusivity, and tract volume of the STP. The tactile sensation score of the affected side in patients with preserved STP integrity was higher compared with that of patients with an interrupted STP. The remaining volume and integrity of the STP in the affected hemisphere were important factors for tactile sensation of the affected side in chronic patients with intracerebral hemorrhage (ICH).

The effects of a warm whirlpool bath on pain and stiffness of patients with chronic stroke induced knee osteoarthritis.

[Purpose] This study set out to investigate the effects of leg immersion in warm water on pain, and stiffness of patients with stroke-induced chronic osteoarthritis. [Subjects] Forty-four patients with chronic stroke were randomly assigned to either the whirlpool group (n=24) or the control group (n=20). [Methods] Subjects in the whirlpool group immersed their legs in a whirlpool bath at 40 °C for 40 minutes 5 times a week for 8 weeks. The control group of patients was instructed to perform activities as usual without using a whirlpool bath. Pre-immersion and post-immersion measurements of the Western Ontario and McMaster University arthritis index (WOMAC)-pain and stiffness indexes were compared to determine the effects of the intervention. The paired t-test was performed to test the significance of differences before and after the experiment. The independent t-test was conducted in order to test the significance of differences between the whirlpool and control groups. Statistical significance was accepted for values of p<0.05. [Results] The WOMAC-pain score, and stiffness index were significantly lower after the intervention. [Conclusion] Immersion of the lower extremities in a whirlpool bath was beneficial for patients with chronic stroke-induced knee osteoarthritis.

The relationship of abdominal muscles balance and body balance.

This study aimed to identify what impact the thickness differences between the leftside and rightside transversus abdominis (TrA), internal obliquus (IO) and external obliquus (EO) have on balance ability in the abdominal drawing-in maneuver (ADIM) and resting postures. [Subjects and Methods] In this study, 41 young adults were asked to adopt a resting posture and to perform ADIM. The thicknesses of the abdominal muscles (TrA, IO, EO) were measured using ultrasound imaging, Then balance ability was measured, so that a comparative analysis could be carried out. [Results] According to the results, the thicknesses of TrA and IO very significantly increased when ADIM was performed. The changes in thickness of the muscles on the left and right sides showed no significant correlations with balance ability. [Conclusion] According to the study results, the difference in thickness between the left and right side muscles in a normal person is small (symmetric), and the differences in the thickness of TrA and IO on the left and right side reduced when the ADIM, which is a re-education method for abdominal muscles was performed. Therefore, we consider that the ADIM should be used in future clinical trials to induce symmetric contraction of the abdominal muscles. Also, the correlation results of muscle balance and body balance can be used as empirical data.

Tissue-engineered vascular graft based on a bioresorbable tubular knit scaffold with flexibility, durability, and suturability for implantation.

The tissue-engineered vascular graft (TEVG) is a technology used to recreate a blood vessel by using vascular cells (endothelial cells and smooth muscle cells) and their scaffolds, and is a promising approach as a clinically feasible alternative for small-diameter blood vessel replacement. Since mechanical damage occurs during/after implantation, it needs flexibility and durability to withstand the mechanical damage to be applied. To achieve this, we applied a bioresorbable polyglycolic acid (PGA) fiber-knitted tubular scaffold for vascular endothelial and smooth muscle cell layers. Similar to the native rat aorta, the knitted tubular scaffold (130 µm-thick PGA fiber) exhibited mechanical performance at 150 mN for up to 40% strain for axial stress and at 90 mN for up to 5% strain for circumferential stress. After co-culturing, a vascular barrier comprised of an inner layer of endothelial cells and an outer layer of smooth muscle cells between tubular knits was observed. Up to 93.6% of the co-cultured cells were retained even after bending 50 times, and the suturability to flow liquid without any leakage in various shapes, such as an L-shape or a Y-shape, was acceptable. Taken together, these results support that the PGA tubular knit plays multifunctional roles, such as a porous three-dimensional matrix to attach and grow the vascular cells, and as a flexible and durable scaffold for the suture. Therefore, we suggest that the bioresorbable PGA tubular knit scaffold is a promising scaffold for TEVGs.

Adverse events of a third dose of BNT162b2 mRNA COVID-19 vaccine among Korean healthcare workers.

Due to the urgency of controlling the coronavirus disease 2019 pandemic, coronavirus disease 2019 messenger ribonucleic acid (mRNA) vaccines have been expeditiously approved and introduced in several countries without sufficient evaluation for adverse events. We analyzed adverse events among Korean healthcare workers who received all 3 doses of the BNT162b2 mRNA vaccine. This survey was conducted among hospital workers of Inha University Hospital who had received the BNT162b2 mRNA vaccine for their first, second, third rounds, and using a diary card. The surveyed adverse events included local (redness, edema, and injection site pain) and systemic (fever, fatigue, headache, chill, myalgia, arthralgia, vomiting, diarrhea, pruritis, and urticaria) side effects and were divided into 5 grades (Grade 0 = none - Grade 4 = critical). Based on adverse events reported at least once after any of the 3 doses, the most common systemic adverse reactions were chills and headache (respectively, 62.6%, 62.4%), followed by myalgia (55.3%), arthralgia (53.4%), fatigue (51.6%), pruritus (38.1%), and fever (36.5%). The frequency and duration of adverse events were significantly greater in women (P < .05) than men. Except for redness, pruritus, urticaria, and most adverse reactions had a higher rate of occurrence after the third dose in subjects who also had reactions with the second dose. However, grade 4 adverse events did occur with the third dose in some patients, even if there were no side effects with the first and second doses. Adverse events experienced with the first and second doses of the BNT162b2 mRNA vaccine in Korean healthcare workers increased the incidence of adverse events at the time of the third dose. On the other hand, grade 4 adverse events could still occur with the third dose even though there were no side effects with the first and second doses.

Comparison of Cefazolin/Metronidazole to Ampicillin/Sulbactam as Preoperative Antibiotics in Colorectal Surgery: A Retrospective, Single-Center Cohort Study.

AIM: The use of prophylactic antibiotics prior to colorectal surgery reduces surgical site infections. Cefazolin and metronidazole are used as a standard regimen. Ampicillin/sulbactam may be an alternative, but current data are limited. We compared the efficacy of ampicillin/sulbactam with cefazolin and metronidazole as prophylactic antibiotics. METHODS: Patients who underwent colorectal surgery at Inha University Hospital between 2010 and 2020 were treated prophylactically with cefazolin and metronidazole or ampicillin/sulbactam, and observed for 30 days following surgery. The primary outcome was surgical site infections. The secondary outcomes were deep/organ infections and the need for drainage. RESULTS: SSIs occurred in 2.6% (17/646) of the ampicillin/sulbactam group, whose rate was not inferior to the occurrence in the group receiving cefazolin and metronidazole (3.8%, 21/556). There was no significant difference between the two groups in the secondary outcomes. CONCLUSIONS: Compared to the cefazolin and metronidazole combination, ampicillin/sulbactam is not inferior as a preoperative prophylactic antibiotic regimen for colorectal surgery.

Comparing the Impact of Upper Body Control and Core Muscle Stabilization Training on Landing Biomechanics in Individuals with Functional Ankle Instability: A Randomized Controlled Trial.

Functional ankle instability (FAI), which is characterized by recurrent ankle sprains and perceived joint instability, arises from various factors contributing to compromised biomechanical control during activities, particularly those involving landing tasks. While current research predominantly addresses lower-extremity and core stabilization interventions for FAI, the contribution of upper body control to landing biomechanics in this population remains insufficiently explored. In this study, 42 participants (19 males, 23 females) with FAI were randomly assigned to either the upper-body control training group (UBCTG) or the core muscle stabilization training group (CMSTG). The groups underwent six-week interventions, with the UBCTG receiving a dynamic core exercise program including upper body control and the CMSTG receiving static core muscle training. Pre- and post-intervention assessments encompassed electromyography of the gastrocnemius, tibialis anterior, and peroneus longus, motion analysis of the lower extremities, and ground reaction force (GRF) readings during a single-leg-jump task. Additionally, dynamic balance was assessed using the Y balance test and self-reported measurements of ankle instability were performed. The results showed similar increases in muscle activation, joint movement, and self-reported ankle instability scores within both groups. However, significant between-group differences were observed in terms of knee flexion angle, dynamic balance, and ankle instability scores, favoring the UBCTG. Although the peak vertical GRF significantly decreased and the time to peak vertical GRF increased in both groups, more changes were noted in the UBCTG. Our results demonstrated that dynamic core exercises with additional upper body control training enhance landing biomechanics, dynamic balance, and stability in individuals with FAI. Consequently, we recommend incorporating shoulder girdle exercises, proprioceptive drills, and balance exercises into dynamic core training.

Effects of Augmented Reality Game-Based Cognitive-Motor Training on Restricted and Repetitive Behaviors and Executive Function in Patients with Autism Spectrum Disorder.

Restricted and repetitive behaviors (RRBs) and executive dysfunction are widely acknowledged as core features and hallmarks in patients with autism spectrum disorder (ASD). This study aimed to investigate the effects of augmented reality (AR) using motivational games with cognitive-motor exercises on RRBs, executive function (EF), attention, and reaction time in patients with ASD. Twenty-four patients (range from 6 to 18 years) diagnosed with ASD were recruited from local social welfare centers and randomly allocated to the AR game-based cognitive-motor training group (study group) or the conventional cognitive training group (control group). Both groups completed 30 min training sessions, twice a week for four weeks. Outcome measures were conducted before and after the intervention. As a result, improvements were observed in all the subscales of the RRBs in the study group except for self-injurious and ritualistic behavior. Significant improvements were observed in EF and reaction time in the study group, which was significantly higher compared to the control group. With the present findings, we can suggest that cognitive-motor training using AR game-based content generates positive effects on improving executive function reaction time and accuracy of responses and has a limited effect on RRBs in patients with ASD. This can be proposed as a complementary intervention associated with individualized daily management.

Effects of Augmented Reality-Based Dual-Task Program on Physical Ability by Cognitive Stage with Developmental Disabilities.

People diagnosed with developmental disabilities are less likely to participate in physical activities even if they are provided opportunities. This study aimed to examine the effects of dual-task exercise-based augmented reality (AR) on muscle strength, muscle endurance, balance ability, and flexibility among people with developmental disabilities. Twenty-seven patients with developmental disabilities were included in the study. The intervention was based on an AR-based rehabilitation program and lasted for 8 weeks. The results showed a statistically significant improvement in muscle strength, muscle endurance, balance ability, and flexibility after the intervention (p < 0.05). The AR-based dual-task program increased interest and motivation in the high-cognitive-stage groups, while less interest and motivation were observed in the low-cognitive-stage groups. Our results suggest that an AR-based dual-task program can be an effective method to improve physical ability in patients with high cognitive levels.

Biomimetic cell-actuated artificial muscle with nanofibrous bundles.

Biohybrid artificial muscle produced by integrating living muscle cells and their scaffolds with free movement in vivo is promising for advanced biomedical applications, including cell-based microrobotic systems and therapeutic drug delivery systems. Herein, we provide a biohybrid artificial muscle constructed by integrating living muscle cells and their scaffolds, inspired by bundled myofilaments in skeletal muscle. First, a bundled biohybrid artificial muscle was fabricated by the integration of skeletal muscle cells and hydrophilic polyurethane (HPU)/carbon nanotube (CNT) nanofibers into a fiber shape similar to that of natural skeletal muscle. The HPU/CNT nanofibers provided a stretchable basic backbone of the 3-dimensional fiber structure, which is similar to actin-myosin scaffolds. The incorporated skeletal muscle fibers contribute to the actuation of biohybrid artificial muscle. In fact, electrical field stimulation reversibly leads to the contraction of biohybrid artificial muscle. Therefore, the current development of cell-actuated artificial muscle provides great potential for energy delivery systems as actuators for implantable medibot movement and drug delivery systems. Moreover, the innervation of the biohybrid artificial muscle with motor neurons is of great interest for human-machine interfaces.

Pediatric cervical chordoma: report of two cases and a review of the current literature.

INTRODUCTION: The majority of chordomas occur between the fifth and seventh decades of life and are thus extremely rare in children, which account for less than 5% of all spinal chordoma cases. CASE REPORT: We report on the development of this rare condition in two boys aged 7 and 10 years. One patient presented with a palpable neck mass and dysphagia, while the other presented with posterior neck pain. Radiological studies revealed an extensive mass in the cervical vertebrae and paravertebral soft tissue of both patients. The tumors were subtotally removed in an attempt to improve the success of adjuvant proton beam radiotherapy. Pathological examination, which included immunohistochemical staining, revealed chordoma of the cervical spine in both patients. CONCLUSION: Although en bloc resection is the ideal modality for treatment of chordoma, such a procedure is often associated with a significant risk of surgical morbidity due to the tumor location. Therefore, piecemeal resection followed by postoperative adjuvant radiotherapy, including proton radiotherapy or radiosurgery, should be considered in such cases.