Local Injection of Growth Hormone for Temporomandibular Joint Osteoarthritis.

PURPOSE: Osteoarthritis (OA) of the temporomandibular joint (TMJ) elicits cartilage and subchondral bone defects. Growth hormone (GH) promotes chondrocyte growth. The aim of this study was to evaluate the efficacy of intra-articular injections of GH to treat TMJ-OA. MATERIALS AND METHODS: Monosodium iodoacetate (MIA) was used to induce OA in the TMJs of rats. After confirming the induction of OA, recombinant human GH was injected into the articular cavities of rats. Concentrations of GH and IGF-1 were measured in the blood and synovial fluid, and OA grades of cartilage and subchondral bone degradation were recorded by histological examination and micro-computed tomography. RESULTS: MIA-induced OA in the rat TMJ upregulated insulin-like growth factor-1 (IGF-1) rather than GH levels. GH and IGF-1 concentrations were increased after local injection of GH, compared with controls. Locally injected GH lowered osteoarthritic scores in the cartilage and subchondral bone of the TMJ. CONCLUSION: Intra-articular injection of GH improved OA scores in rat TMJs in both cartilage and subchondral bone of the condyles without affecting condylar bone growth. These results suggest that intra-articular injection of human GH could be a suitable treatment option for TMJ-OA patients in the future.

Organic Light-Emitting Diodes: Pushing Toward the Limits and Beyond.

Organic light-emitting diodes (OLEDs) are established as a mainstream light source for display applications and can now be found in a plethora of consumer electronic devices used daily. This success can be attributed to the rich luminescent properties of organic materials, but efficiency enhancement made over the last few decades has also played a significant role in making OLEDs a practically viable technology. This report summarizes the efforts made so far to improve the external quantum efficiency (EQE) of OLEDs and discusses what should further be done to push toward the ultimate efficiency that can be offered by OLEDs. The study indicates that EQE close to 58% and 80% can be within reach without and with additional light extraction structures, respectively, with an optimal combination of cavity engineering, low-index transport layers, and horizontal dipole orientation. In addition, recent endeavors to identify possible applications of OLEDs beyond displays are presented with emphasis on their potential in wearable healthcare, such as OLED-based pulse oximetry as well as phototherapeutic applications based on body-attachable flexible OLED patches. OLEDs with fabric-like form factors and washable encapsulation strategies are also introduced as technologies essential to the success of OLED-based wearable electronics.

Recent Progress of Fiber Shaped Lighting Devices for Smart Display Applications-A Fibertronic Perspective.

Advances in material science and nanotechnology have fostered the miniaturization of devices. Over the past two decades, the form-factor of these devices has evolved from 3D rigid, volumetric devices through 2D film-based flexible electronics, finally to 1D fiber electronics (fibertronics). In this regard, fibertronic strategies toward wearable applications (e.g., electronic textiles (e-textiles)) have attracted considerable attention thanks to their capability to impart various functions into textiles with retaining textiles' intrinsic properties as well as imperceptible irritation by foreign matters. In recent years, extensive research has been carried out to develop various functional devices in the fiber form. Among various features, lighting and display features are the highly desirable functions in wearable electronics. This article discusses the recent progress of materials, architectural designs, and new fabrication technologies of fiber-shaped lighting devices and the current challenges corresponding to each device's operating mechanism. Moreover, opportunities and applications that the revolutionary convergence between the state-of-the-art fibertronic technology and age-long textile industry will bring in the future are also discussed.

Design of Highly Water Resistant, Impermeable, and Flexible Thin-Film Encapsulation Based on Inorganic/Organic Hybrid Layers.

The lack of a transparent, flexible, and reliable encapsulation layer for organic-based devices makes it difficult to commercialize wearable, transparent, flexible displays. The reliability of organic-based devices sensitive to water vapor and oxygen must be guaranteed through an additional encapsulation layer for the luminance efficiency and lifetime. Especially, one of the major difficulties in current and future OLED applications has been the absence of thin-film encapsulation with superior barrier performance, mechanical flexibility, and water-resistant properties. In this work, we fabricated highly water-resistant, impermeable, and flexible inorganic/organic multilayers with optimized Al2O3 and functional organic layers. The key properties of the fabricated multilayers were compared according to the thickness and functionality of the inorganic and organic layers. Improvement of the barrier performance is mainly attributed to the optimized thickness of the Al2O3 films, and is additionally due to the increased lag time and effective surface planarization effects caused by the use of micrometer-thick organic layers. As a result, the 3-dyad multilayer structure composed of 60 nm-thick Al2O3 layers deposited at 70 °C and 2-µm-thick silane-based inorganic/organic hybrid polymer (silamer) layers with layered silica exhibited the lowest WVTR value of 1.11 × 10-6 g/m2/day in storage conditions of 30 °C/90% relative humidity. In addition, the multibarrier exhibited good mechanical stability through the use of alternating stacks of brittle inorganic and soft organic layers, without showing a large increase in the WVTR after bending tests. In addition, silamer layers improved the environmental stability of the Al2O3 ALD film. The silamer layer coated on the Al2O3 film effectively worked as a protective layer against harsh environments. The effective contact at the interface of Al2O3/silamer makes the barrier structure more impermeable and corrosion-resistant. In this study, we not only demonstrated an optimized multilayer based on functional organic layers but also provided a methodology for designing a wearable encapsulation applicable to wearable organic electronics.

Weavable and Highly Efficient Organic Light-Emitting Fibers for Wearable Electronics: A Scalable, Low-Temperature Process.

Fiber-based wearable displays, one of the most desirable requisites of electronic textiles (e-textiles), have emerged as a technology for their capability to revolutionize textile and fashion industries in collaboration with the state-of-the-art electronics. Nonetheless, challenges remain for the fibertronic approaches, because fiber-based light-emitting devices suffer from much lower performance than those fabricated on planar substrates. Here, we report weavable and highly efficient fiber-based organic light-emitting diodes (fiber OLEDs) based on a simple, cost-effective and low-temperature solution process. The values obtained for the fiber OLEDs, including efficiency and lifetime, are similar to that of conventional glass-based counterparts, which means that these state-of-the-art, highly efficient solution processed planar OLEDs can be applied to cylindrical shaped fibers without a reduction in performance. The fiber OLEDs withstand tensile strain up to 4.3% at a radius of 3.5 mm and are verified to be weavable into textiles and knitted clothes by hand-weaving demonstrations. Furthermore, to ensure the scalability of the proposed scheme fiber OLEDs with several diameters of 300, 220, 120, and 90 µm, thinner than a human hair, are demonstrated successfully. We believe that this approach, suitable for cost-effective reel-to-reel production, can realize low-cost commercially feasible fiber-based wearable displays in the future.

Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients.

BACKGROUND/AIMS: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization. METHODS: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review. The main outcome was lower extremity amputation (LEA). RESULTS: Among 192 patients who completed follow-up, 113 patients (58.9%) required LEAs. Compared to patients without amputation, baseline levels of white blood cell counts and C-reactive protein were higher in patients with amputation. In addition, bone and joint involvement was more frequently observed in patients with amputation. Multivariable regression analysis revealed that combined infection (odds ratio [OR], 11.39; 95% confidence interval [CI], 2.55 to 50.93; p = 0.001) and bone or joint involvement (OR, 3.74; 95% CI, 1.10 to 12.70; p = 0.035) were significantly associated with an increased risk of LEA. CONCLUSION: The depth of the wound and combined infection of DFU, rather than the extent of the wound, were significant prognostic factors of LEAs in patients with type 2 diabetes.

A mechanically enhanced hybrid nano-stratified barrier with a defect suppression mechanism for highly reliable flexible OLEDs.

Understanding the mechanical behaviors of encapsulation barriers under bending stress is important when fabricating flexible organic light-emitting diodes (FOLEDs). The enhanced mechanical characteristics of a nano-stratified barrier were analyzed based on a defect suppression mechanism, and then experimentally demonstrated. Following the Griffith model, naturally-occurring cracks, which were caused by Zn etching at the interface of the nano-stratified structure, can curb the propagation of defects. Cross-section images after bending tests provided remarkable evidence to support the existence of a defect suppression mechanism. Many visible cracks were found in a single Al2O3 layer, but not in the nano-stratified structure, due to the mechanism. The nano-stratified structure also enhanced the barrier's physical properties by changing the crystalline phase of ZnO. In addition, experimental results demonstrated the effect of the mechanism in various ways. The nano-stratified barrier maintained a low water vapor transmission rate after 1000 iterations of a 1 cm bending radius test. Using this mechanically enhanced hybrid nano-stratified barrier, FOLEDs were successfully encapsulated without losing mechanical or electrical performance. Finally, comparative lifetime measurements were conducted to determine reliability. After 2000 hours of constant current driving and 1000 iterations with a 1 cm bending radius, the FOLEDs retained 52.37% of their initial luminance, which is comparable to glass-lid encapsulation, with 55.96% retention. Herein, we report a mechanically enhanced encapsulation technology for FOLEDs using a nano-stratified structure with a defect suppression mechanism.

Highly Conductive Transparent and Flexible Electrodes Including Double-Stacked Thin Metal Films for Transparent Flexible Electronics.

To keep pace with the era of transparent and deformable electronics, electrode functions should be improved. In this paper, an innovative structure is suggested to overcome the trade-off between optical and electrical properties that commonly arises with transparent electrodes. The structure of double-stacked metal films showed high conductivity (<3 Ω/sq) and high transparency (∼90%) simultaneously. A proper space between two metal films led to high transmittance by an optical phenomenon. The principle of parallel connection allowed the electrode to have high conductivity. In situ fabrication was possible because the only materials composing the electrode were silver and WO3, which can be deposited by thermal evaporation. The electrode was flexible enough to withstand 10 000 bending cycles with a 1 mm bending radius. Furthermore, a few µm scale patterning of the electrode was easily implemented by using photolithography, which is widely employed industrially for patterning. Flexible organic light-emitting diodes and a transparent flexible thin-film transistor were successfully fabricated with the proposed electrode. Various practical applications of this electrode to new transparent flexible electronics are expected.

Emphysematous Osteomyelitis due to Escherichia coli.

Emphysematous osteomyelitis, especially that involving the extra-axial skeleton, is an extremely rare presentation but associated with significant morbidity and mortality. Here, we report a case in which a 58-year-old female patient with diabetes mellitus presented with emphysematous osteomyelitis that involved the sternum, clavicle, and pelvic bone and was caused by Escherichia coli via hematogenous spread of urinary tract infection. We successfully treated her with urgent and aggressive surgical drainage with prolonged antibiotics therapy. Early diagnosis and immediate surgical intervention are required for better outcomes in cases of emphysematous osteomyelitis.

Highly stable 2D material (2DM) field-effect transistors (FETs) with wafer-scale multidyad encapsulation.

Field-effect transistors (FETs) composed of 2D materials (2DMs) such as transition-metal dichalcogenide (TMD) materials show unstable electrical characteristics in ambient air due to the high sensitivity of 2DMs to water adsorbates. In this work, in order to demonstrate the long-term retention of electrical characteristics of a TMD FET, a multidyad encapsulation method was applied to a MoS2 FET and thereby its durability was warranted for one month. It was well known that the multidyad encapsulation method was effective to mitigate high sensitivity to ambient air in light-emitting diodes (LEDs) composed of organic materials. However, there was no attempt to check the feasibility of such a multidyad encapsulation method for 2DM FETs. It is timely to investigate the water vapor transmission ratio (WVTR) required for long-term stability of 2DM FETs. The 2DM FETs were fabricated with MoS2 flakes by both an exfoliation method, that is desirable to attain high quality film, and a chemical vapor deposition (CVD) method, that is applicable to fabrication for a large-sized substrate. In order to eliminate other unwanted variables, the MoS2 FETs composed of exfoliated flakes were primarily investigated to assure the effectiveness of the encapsulation method. The encapsulation method uses multiple dyads comprised of a polymer layer by spin coating and an Al2O3 layer deposited by atomic layer deposition (ALD). The proposed method shows wafer-scale uniformity, high transparency, and protective barrier properties against adsorbates (WVTR of 8 × 10-6 g m-2 day-1) over one month.

Chitin Nanofiber Transparent Paper for Flexible Green Electronics.

A transparent paper made of chitin nanofibers (ChNF) is introduced and its utilization as a substrate for flexible organic light-emitting diodes is demonstrated. Given its promising macroscopic properties, biofriendly characteristics, and availability of the raw material, the utilization of the ChNF transparent paper as a structural platform for flexible green electronics is envisaged.

Clinical outcome of kidney transplantation from deceased donors with acute kidney injury by Acute Kidney Injury Network criteria.

PURPOSE: In this study, we investigated the outcome of kidney transplantation (KT) from deceased donors with acute kidney injury (AKI), as defined by the Acute Kidney Injury Network criteria. METHODS: Of 156 deceased donors, kidneys from 43 donors (27.6%) with AKI were transplanted into 57 recipients (AKI group). Another 147 recipients received kidneys from donors without AKI (non-AKI group). We compared the incidence of delayed graft function, allograft function for 1 year after KT, and long-term (5 and 10 years) graft survival rate between the 2 groups. RESULTS: Delayed graft function developed more frequently in the AKI group than in the non-AKI group (42.1% vs 12.2%; P<.05), and allograft function-assessed by the modification of diet in renal disease equation-showed a significantly deteriorating pattern at 2 weeks and 1, 3, and 6 months after KT compared with that in the non-AKI group (P<.05 for comparisons at each time point). However, allograft function at 12 months after KT and the long-term allograft and patient survival rates did not differ between the AKI and non-AKI groups. CONCLUSIONS: In KT from deceased donors, the AKI group that received kidneys with AKI, as defined by the Acute Kidney Injury Network criteria, showed a higher delayed graft function rate and lower allograft function for 6 months after KT but no effect on allograft function 1 year after KT and on long-term allograft survival.