Clinical effectiveness of postoperative prostaglandin E1 administration in reducing flap necrosis following microsurgical reconstruction.

BACKGROUND: Extensive experimental evidence has suggested the potential efficacy of prostaglandin E1 (PGE1) in enhancing flap survival, leading to its widespread empirical use following free flap operation. However, the translation of these experimental findings into clinical benefits remains uncertain. This study aimed to assess the clinical effectiveness of postoperative PGE1 administration on the outcomes of microsurgical reconstruction. METHODS: A retrospective review was conducted for patients who underwent free flap-based reconstruction between September 2020 and November 2022, dividing into two cohorts. For all consecutive cases conducted during the formal half, PGE1 was administered for postoperative 7 days (PGE1 cohort), and for those during the latter, PGE1 was not given (non-PGE1 cohort). The profiles of perfusion-related complications (PRC) were compared between the two cohorts. Further analyses after propensity-score matching were performed. RESULTS: In total, 274 cases were analyzed, consisting of 142 in PGE1 and 132 in non-PGE1 cohort. Baseline characteristics were similar between the two cohorts, except for higher rates of comorbidities and chronic wound-related defects in the PGE1 cohort. Overall PRC developed in 37 cases (13.5%), including 6 (2.1%) total loss and 38 (10.2%) partial necrosis. Compared to the control, the PGE1 cohort exhibited significantly lower rates of overall PRC and partial flap necrosis. This difference remained significant on multivariable analyses. The rate of total flap loss did not differ between the cohorts. Consistent associations were observed in the propensity-score matching analysis. CONCLUSION: Postoperative administration of PGE1 appears to be associated with reduced risks for the development of partial flap necrosis.

Modified Chemoselective Reduction and Consecutive Regioselective Deuteration Reaction Catalyzed by B(C6F5)3.

An efficient chemoselective reduction of isatin derivatives using catalyst B(C6F5)3, benzyldimethylsilane, and H2O is described. Notably, a small amount of water is shown to be a highly effective reaction promoter that decreases the reaction time and temperature for the synthesis of indolin-3-ones. Moreover, using method, excellent deuterium incorporation is achieved via the catalytic α-deuteration of indolin-3-ones using B(C6F5)3 and D2O.

Could we prove the nursing outcomes utilising clinical data warehouse? Effectiveness of pressure ulcer intervention in Korean tertiary hospital.

The use of Clinical Data Warehouse (CDW)  for research and quality improvement has become more frequent in the last 10 years. In this study, we used CDW to determine the effectiveness of pressure ulcer interventions offered by ward nurses and wound care nursing specialists. A retrospective clinical outcomes study that utilise CDW has been carried out. We identified 1415 patients who were evaluated as pressure ulcer risk group from 1 July 2019 to 31 December 2019. Kaplan-Meier survival analyses were used to estimate the time to occurrence of pressure ulcers. We compared the survival curves of each group by applying the log-rank test for significance. The overall median time to occurrence for both groups was 13 days (95% CI range: 11-14 days). The control group showed a longer median time (14 days) to occurrence than the case group (12 days). In the pressure ulcer stage I, the case group showed a longer median time (14 days) to occurrence than the control group (8 days), indicating that the intervention provided by the wound care nursing specialist was effective in stage I, and delayed the occurrence of pressure ulcers. The findings may be used as preliminary data for the utilisation of the CDW in the field of nursing research in the future. Also, facilitating the accessibility of the wound care nursing specialist in the general wards should be effective to decrease the incidence rates.

Strategic Customization of Polymeric Nanocomposites Modified by 2D Titanium Oxide Nanosheet for High-k and Flexible Gate Dielectrics.

Organic polymer-based dielectrics with intrinsic mechanical flexibility and good processability are excellent candidates for the dielectric layer of flexible electronics. These polymer films can become even more rigid and electrically robust when modified through cross-linking processes. Moreover, the composites formed by dispersing nanoscale inorganic fillers in a polymer matrix can exhibit further improved polarization property. However, these strategies can be challenging as homogeneous dispersion of nanomaterials in the matrix is difficult to achieve; thus, degradation of electrically insulating properties of nanocomposite layers is often observed. Here, a high-k, pinhole-free, and flexible poly(vinyl alcohol) (PVA)-based nanocomposite dielectric is presented, incorporating 2D TiO2 nanosheets (NSs) for the first time. Despite the attractive dielectric constant, exceptional flexibility, and electrically insulating property of PVA-TiO2 nanocomposites, only few studies on these materials have been reported. The organic/inorganic nanosheet hybrid layer, which reaches an unprecedentedly high dielectric constant of 43.8 (more than four times higher than that of cross-linked PVA), also exhibits an outstanding leakage current density as low as 10-9 A cm-2 . Furthermore, the repeated bending tests for nanocomposite capacitors reveal their capability of operating without any deterioration of their performances even after 1000 iterations of bending cycles at a bending radius of 3 mm.

Myeloid-Derived Suppressor Cells Mediate Inflammation Resolution in Humans and Mice with Autoimmune Uveoretinitis.

Resolution of inflammation is an active process that leads to tissue homeostasis and involves multiple cellular and molecular mechanisms. Myeloid-derived suppressor cells (MDSCs) have recently emerged as important cellular components in the resolution of inflammation because of their activities to suppress T cell activation. In this article, we show that HLA-DR-CD11b+CD33+CD14+ human MDSCs and CD11b+Ly6G-Ly6C+ mouse MDSCs markedly increased in patients and mice during and before the resolution phase of autoimmune uveoretinitis. CD11b+Ly6C+ monocytes isolated from autoimmune uveoretinitis mice were able to suppress T cell proliferation in culture, and adoptive transfer of the cells accelerated the remission of autoimmune uveoretinitis in mice. Alternatively, depletion of CD11b+Ly6C+ monocytes at the resolution phase, but not CD11b+Ly6G+ granulocytes, exacerbated the disease. These findings collectively indicate that monocytic MDSCs serve as regulatory cells mediating the resolution of autoimmune uveoretinitis.

Mesenchymal Stromal Cells Inhibit Inflammatory Lymphangiogenesis in the Cornea by Suppressing Macrophage in a TSG-6-Dependent Manner.

The cornea is a transparent tissue devoid of blood and lymphatic vessels. However, various inflammatory conditions can cause hemangiogenesis and lymphangiogenesis in the cornea, compromising transparency and visual acuity. Mesenchymal stem/stromal cells (MSCs) have therapeutic potentials in a variety of diseases because of anti-inflammatory properties. Herein, we investigated the effects of MSCs on corneal angiogenesis using a model of suture-induced inflammatory corneal neovascularization. Data demonstrated that an intravenous administration of MSCs suppressed corneal inflammation and neovascularization, inhibiting both hemangiogenesis and lymphangiogenesis. MSCs reduced the levels of vascular endothelial growth factor (VEGF)-C, VEGF-D, Tek, MRC1, and MRC2 in the cornea, which are expressed by pro-angiogenic macrophages. Moreover, the number of CD11b+ monocytes/macrophages in the cornea, spleen, peripheral blood, and draining lymph nodes was decreased by MSCs. Depletion of circulating CD11b+ monocytes by blocking antibodies replicated the effects of MSCs. Importantly, knockdown of tumor necrosis factor alpha (TNF-α)-stimulated gene/protein 6 (TSG-6) in MSCs abrogated the effects of MSCs in inhibiting corneal hemangiogenesis and lymphangiogenesis and monocyte/macrophage infiltration. Together, the results suggest that MSCs inhibit inflammatory neovascularization in the cornea by suppressing pro-angiogenic monocyte/macrophage recruitment in a TSG-6-dependent manner.

Glucocorticoids induce corneal allograft tolerance through expansion of monocytic myeloid-derived suppressor cells.

Glucocorticoids (GCs) are the most widely used drugs to prevent transplant rejection; however, it is not yet clear how GCs induce immune tolerance in transplantation. Here, we demonstrate that GCs induce tolerance to corneal allografts in mice through expansion of MHC class II- CD11b+ Ly6C+ monocytes in the bone marrow and mobilization of the cells to spleen, draining lymph nodes, and graft site. The GC-induced CD11b+ Ly6C+ monocytes inhibited T cell proliferation in vitro, and adoptive transfer of the cells improved the survival of corneal allografts. Depletion of CD11b+ Ly6C+ cells in mice during GC treatment abrogated the effects of GCs in prevention of immune rejection. Together, the results identify monocytic myeloid-derived suppressor cells as crucial mediators of the GC-induced tolerance in transplantation.

Comparison of the anti-inflammatory effects of induced pluripotent stem cell-derived and bone marrow-derived mesenchymal stromal cells in a murine model of corneal injury.

BACKGROUND AIMS: Mesenchymal stromal cells (MSCs) offer tremendous potential for therapeutic applications for inflammatory diseases. However, tissue-derived MSCs, such as bone marrow-derived MSCs (BM-MSCs), have considerable donor variations and limited expandability. It was recently demonstrated that MSCs derived from induced pluripotent stem cells (iPSC-MSCs) have less pro-tumor potential and greater expandability of homogenous cell population. In this study, we investigated the anti-inflammatory effects and mechanism of iPSC-MSCs in a murine model of chemical and mechanical injury to the cornea and compared the effects with those of BM-MSCs. METHODS: To create an injury, ethanol was applied to the corneal surface in mice, and the corneal epithelium was removed with a blade. Immediately after injury, mice received an intravenous injection of (i) iPSC-MSCs, (ii) BM-MSCs or (iii) vehicle. Clinical, histological and molecular assays were performed in the cornea to evaluate inflammation. RESULTS: We found that corneal opacity was significantly reduced by iPSC-MSCs or BM-MSCs. Histological examination revealed that the swelling and inflammatory infiltration in the cornea were markedly decreased in mice treated with iPSC-MSCs or BM-MSCs. Corneal levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1ß and IL-6 were lower in iPSC-MSC- and BM-MSC-treated mice, compared with vehicle-treated controls. In contrast, iPSC-MSCs with a knockdown of the TNF-α stimulating gene (TSG)-6 did not suppress the levels of inflammatory cytokines and failed to reduce corneal opacity. CONCLUSIONS: Together these data demonstrate that iPSC-MSCs exert therapeutic effects in the cornea by reducing inflammation in part through the expression of TSG-6, and the effects are similar to those seen with BM-MSCs.

Immediate effects of the trunk stabilizing exercise on static balance parameters in double-leg and one-leg stances.

[Purpose] The purpose of this study was to evaluate the immediate effect of stabilizing exercise using the PNF technique on standing balance in one-leg and double-leg stances. [Subjects and Methods] The present study recruited 34 healthy participants from a local university. The Participants performed four balance tests (double-leg stance with and without vision, one-leg stance with and without vision), before and after exercise. The exercise consisted of exercises performed using PNF techniques (stabilizing reversal and rhythmic stabilization), which were applied to facilitate trunk musculature. To examine balance ability, total displacement of the center of pressure was measured during balance tests. [Results] The total anterior-posterior center of pressure displacement was significantly reduced after applying rhythmic stabilization compared before exercise regardless of the balance test conditions. [Conclusion] The present results suggest that trunk stability exercise using rhythmic stabilization could effectively enhance balance ability under one-leg and double-leg conditions.

Patient satisfaction with out-patient rehabilitation therapy: validity and reliability.

[Purpose] The purpose of present study were to develop an out-patient satisfaction questionnaire to be used in health care system, from which the underlying dimensions could be derived and individual patient scores calculated, and to evaluate some of the questionnaire's psychometric properties. [Subjects and Methods] Forty out-patient of local hospital reply both the questionnaire used in previous study and newly designed questionnaire. To identifying validity, the statistical linear relationship between the total score of the primary questionnaire and newly designed questionnaire, which were analyzed. The test-retest reliability has been investigated by using a single measure intra class correlation. [Results] The average satisfaction of the previous questionnaire were significantly correlated with newly designed questionnaire. The intra-lass correlation coefficient of the each items of newly designed questionnaire were strong. Total score of the previous questionnaire had the lowest test-retest reliability, Cronbach' s alpha coefficient for the newly designed questionnaire score showed acceptable inter-item reliability. [Conclusion] The out-patients' satisfaction questionnaire developed in present study, which had appropriate validity, reliability, and acceptability.

Effect of Wearing a Tight Waist Belt on the Sagittal Kinematics of the Pelvis during Sit-to-Stand.

[Purpose] The purpose of the present study was to evaluate the effect of a tight waist belt on the human musculoskeletal system by assessing sagittal pelvic kinematic data during the sit-to-stand (STS) maneuver. [Subjects] Twelve asymptomatic males were recruited and three belt conditions were used during the STS. Sagittal kinematic data of pelvic motion were collected using a 3D motion-capture device [Results] The changes of the anterior pelvic tilt during the STS were significantly greater in the tight waist-belt condition than in the no-belt condition. [Conclusion] The results of this study show that wearing a tight waist belt increases anterior pelvic motion.

Effects of the sustained computer work on upper cervical flexion motion.

[Purpose] The purpose of this study was to evaluate the effect of sustained computer work on cervical flexion, especially the upper cervical region. [Subjects] We recruited 11 sedentary workers who used a computer for at least 4 hours a day. [Methods] Total range of cervical flexion, upper cervical flexion, and their ratio were measured before and after 1 hour of computer work. [Results] The total range of cervical flexion was not significantly different between pre-and post-measurement. However, upper cervical flexion, and the ratio between the upper cervical flexion and total cervical flexion significantly decreased after 1 hour of computer work, compared to pre-measurement. [Conclusion] Sustained computer work affects the range of cervical flexion, especially in the upper cervical region.

Scapulothoracic Muscle Activity during Use of a Wall Slide Device (WSD), a Comparison with the General Wall Push up Plus.

[Purpose] The purpose of this study was to evaluate the effect of the wall slide device on activation of the scapulothoracic musculature. [Subjects] We recruited 15 healthy male subjects. [Methods] The subjects performed the general wall push-up plus (WPUP) and the wall slide with device (WSD) exercises. During the exercises, the muscle activities of the upper and lower trapezius (UT, LT), middle and lower serratus anterior (MSA, LSA), and pectoralis major (PM) were measured. [Results] The normalized muscle activity data of the WSD were significantly higher in UT, MSA and LSA than the WPUP. [Conclusion] Our results suggest that exercise using the WSD can more effectively activate the scapulothoracic musculature than the general WPUP.

Use of Super-thin Superficial Circumflex Iliac Artery Perforator Flap for Reconstruction of Lower Lip Defect.

SUMMARY: Wide local excision remains the main treatment modality for primary lip cancer, which often results in considerable deficits of lip tissue and requires reconstruction using free tissue transfer. Although diverse free flaps, such as radial forearm flap or anterolateral thigh flap, have been used, their application is often limited by their inherent limitations including donor morbidity and flap bulkiness. This report details our experience of lower lip reconstruction using a super-thin superficial circumflex iliac artery perforator (SCIP) free flap.

Development of ultra-high surface area polyaniline-based activated carbon for the removal of volatile organic compounds from industrial effluents.

Removing volatile organic compounds (VOCs) from aqueous solutions is critical for reducing VOC emissions in the environment. Activated carbons are widely used for removal of VOCs from water. However, they show less application feasibility and low removal due to less surface area. Here, a cost-effective and high surface area activated carbonized polyaniline (ACP) was synthesized to sustainable removal of VOCs from water. The ACP microstructure, surface properties, and pore structure were investigated using Brunauer-Emmett-Teller (BET) theory, Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The specific surface area of ACP6:1 (2988.13 m2/g) was greater than that of commercial activated carbon (PAC) (1094.49 m2/g), indicating that it has excellent VOC adsorption capacity. The effects of pH, initial VOC concentration, time, temperature, and ionic strength were studied. According to kinetic and thermodynamic studies on VOCs adsorption, it is an exothermic and spontaneous process involving rate-limiting kinetics. Adsorption isotherms follow the Freundlich isotherm model, suggesting that the adsorbent surface is heterogeneous with multilayer adsorption and maximum ACP adsorption capacities of 1913.9, 2453.3, 1635.8, and 3327.0 mg/g at 293 K for benzene, toluene, ethylbenzene, and perchloroethylene, respectively, representing a 3- to 5-fold improvement over PAC. ACP is a promising adsorbent with a high adsorption efficiency for VOC removal.

Spectro-Microscopic Perceptions into Oxidation Behavior of Large-Scale Molybdenum Disulfide and its Photoelectrical Correlation.

Despite the encouraging properties and research of 2D MoS2 , an ongoing issue associated with the oxidative instability remains elusive for practical optoelectronic applications. Thus, in-depth understanding of the oxidation behavior of large-scale and homogeneous 2D MoS2 is imperative. Here the structural and chemical transformations of large-area MoS2 multilayers by air-annealing with altered temperature and time via combinatorial spectro-microscopic analyses (Raman spectroscopy, X-ray photoelectron spectroscopy, and atomic force microscopy) are surveyed. The results gave indications pertaining to temperature- and time-dependent oxidation effects: i) heat-driven elimination of redundant residues, ii) internal strain stimulated by the formation of MoO bonds, iii) deterioration of the MoS2 crystallinity, iv) layer thinning, and v) morphological transformation from 2D MoS2 layers to particles. Photoelectrical characterization of the air-annealed MoS2 is implemented to capture the link between the oxidation behavior of MoS2 multilayers and their photoelectrical properties. The photocurrent based on MoS2 air-annealed at 200 °C is assessed to be 4.92 µA, which is 1.73 times higher than that of pristine MoS2 (2.84 µA). The diminution in the photocurrent of the photodetector based on MoS2 air-annealed above 300 °C in terms of the structural, chemical, and electrical conversions induced by the oxidation process is further discussed.

Comparison among low intensity bridge exercises using suspension devices based on muscle activity and subjective difficulty.

BACKGROUND: Recent clinical studies have revealed the advantages of using suspension devices. Although the supine, lateral, and forward leaning bridge exercises are low-intensity exercises with suspension devices, there is a lack of studies directly comparing exercise progression by measuring muscular activity and subjective difficulty. OBJECTIVE: To identify how the variations in the bridge exercise affects trunk muscle activity, the present study investigated changes in neuromuscular activation during low-intensity bridge exercises. We furthermore explored whether the height of the suspension point affects muscle activation and subjective difficulty. METHODS: Nineteen asymptomatic male participants were included. Three bridge exercise positions, supine bridge (SB), lateral bridge (LB), forward leaning (FL), and two exercise angles (15 and 30 degrees) were administered, thereby comparing six bridge exercise conditions with suspension devices. Surface electromyography and subjective difficulty data were collected. RESULTS: The rectus abdominis activity was significantly higher with the LB and FL exercises compared with the SB exercise (p< 0.05). The erector spinae muscle activity was significantly higher with the SB and LB exercises, compared with the FL exercise (p< 0.05). The LB exercise significantly increased the internal oblique muscle activity, compared with other exercise variations (p< 0.05). The inclination angle of the exercise only affected the internal oblique muscle and subjective difficulty, which were significantly higher at 30 degrees compared with 15 degrees (p< 0.05). CONCLUSIONS: Relatively higher inclination angle was not effective in overall activation of the trunk muscles; however, different bridge-type exercises could selectively activate the trunk muscles. The LB and SB exercises could be good options for stimulating the internal oblique abdominis, and the erector spinae muscle, while the FL exercise could minimize the erector spinae activity and activate the abdominal muscles.

The change in Geriatric Nutritional Risk Index is associated with mortality in patients who start hemodialysis: Korean Renal Data Registry, 2016-2018.

Malnutrition is common in patients undergoing hemodialysis (HD) and is associated with mortality. This study aimed to investigate the association between changes in nutrition status measured by the Geriatric Nutritional Risk Index (GNRI) and all-cause mortality in patients who started HD. A nationwide retrospective cohort study was conducted based on the Korean Renal Data System database. Patients who started HD from January 2016 to December 2018, and were eligible for GNRI and GNRI trend were included. GNRI trend was a longitudinal change of GNRI, assessed by random slope in a mixed-effect model. Positive and negative random slopes in each patient were assigned to positive and negative GNRI trends. A total of 2313 patients were included and median follow-up period was 3.1 (2.6-3.7) years. GNRI values decreased over time (estimate - 1.212, 95% confidence interval (CI) - 1.116-0.692) and positive GNRI trend was associated with survival benefit (hazard ratio 0.55, 95% CI 0.36-0.84) after multivariate adjustment. These findings show that serial GNRI assessment, besides GNRI, is a useful prognostic factor for mortality in patients who start HD.

Effects of Two Foot-Ankle Interventions on Foot Structure, Function, and Balance Ability in Obese People with Pes Planus.

Obese people are prone to foot deformities such as flat feet. Foot management programs are important to prevent them. This study investigated the effects of two foot-ankle interventions on balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus for four weeks. The experiment was designed as a randomized controlled trial. Twenty-four participants who met the inclusion criteria were selected, and they were randomly assigned to either a short foot group (SFG) or proprioceptive neuromuscular facilitation group (PNFG) according to foot-ankle intervention. Two interventions were commenced three times a week for 20 min over four weeks. The tests were conducted at two intervals: pre-intervention and at four weeks. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the navicular drop test, balance test, and the four-way ankle strength test. Two groups showed significant differences in balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions between pre-test and post-test (p < 0.05). PNFG had significantly higher dorsiflexor and invertor strength than SFG (p < 0.05). SF and PNF interventions were effective to improve balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus. Additionally, PNF intervention is more beneficial in increasing the dorsiflexor and invertor strength compared to SF intervention.

A three-week intervention emphasized diagonal eccentric contraction on balance and joint position sense and ankle strength in subjects with ankle instability: A randomized controlled trial.

BACKGROUND: Problems related to ankle instability, decreased proprioceptive sensation, altered static and dynamic balance abilities are suggested as major representative factors that contribute to the recurrence of ankle sprains. OBJECTIVE: To assess the effect of a three-week intervention (intervention emphasizing diagonal eccentric contraction (IEDEC) and intervention of general exercise (IGE)) on static and dynamic balance abilities, ankle strength and joint position sense at pre- and post-intervention, and at two- and three-week post-intervention. METHODS: Twenty-five participants with ankle instability, including a history of ankle sprain and recurrent episodes of giving way, were enrolled in the study. They were randomly classified into the IEDEC group (n= 12) and the IGE group (n= 13). Dynamic balance was examined using the Y Balance Test, four-way ankle strength was measured, and the static balance was evaluated using the total displacement of the center of pressure (COP). To identify the joint position error, eversion and inversion of the ankle angle were measured. RESULTS: The results revealed significant increases in ankle dynamic stability and strength at two and three weeks post-intervention (p< 0.05). Similarly, the total displacement of the COP differed significantly over time, with a higher COP during the initial measurement than at two and three weeks intervention (p< 0.05) General balance training with IEDEC can improve position sense during ankle inversion (p< 0.05). CONCLUSION: General balance training with IEDEC improved the position sense of the inversion. Combined therapeutic intervention, such as with the manual technique, could be a beneficial approach to maximize the treatment effects.