Mitigation of Silicon Contamination in Fuel Cell Gasket Materials through Silica Surface Treatment.

Gaskets and seals are essential components in the operation of proton exchange membrane (PEM) fuel cells and are required for keeping hydrogen and air/oxygen within their individual compartments. The durability of these gaskets and seals is necessary, as it influences not only the lifespan but also the electrochemical efficiency of the PEM fuel cell. In this study, the cause of silicon leaching from silicone gaskets under simulated fuel cell conditions was investigated. Additionally, to reduce silicon leaching, the silica surface was treated with methyltrimethoxysilane, vinyltriethoxysilane, and (3,3,3-trifluoropropyl)trimethoxysilane. Changes in the silica surface chemistry were investigated by scanning electron microscopy, energy dispersive X-ray spectroscopy, thermogravimetric analysis, elemental analysis, X-ray photoelectron spectroscopy, and Fourier transform infrared spectroscopy. Inductively coupled plasma-optical emission spectroscopy analysis revealed that surface-treated silica was highly effective in reducing silicon leaching.

Comparison of virtual reality exercise versus conventional exercise on balance in patients with functional ankle instability: A randomized controlled trial.

BACKGROUND: Recently, a variety of virtual reality (VR)-based interventions have been studied. However, they were only partially applied to physical therapy. OBJECTIVE: The present study investigated the effects of a VR exercise program by comparing the results of VR and conventional exercise on balance in patients with functional ankle instability (FAI). METHODS: Twenty-one participants with symptoms of FAI participated in this study. In the VR training program, the strength and balance exercises were done for 10 minutes each using a program included in the Nintendo Wii Fit Plus for VR intervention. In the conventional program, four ankle strength exercises using the TheraBand and the balance exercises were performed for 10 minutes each. Static and dynamic balance were measured in the overall, anterior-posterior, and medial-lateral directions. RESULTS: Static balance in the VR exercise was significantly lower in the overall direction than in the conventional exercise. Dynamic balance in the virtual reality exercise was significantly lower than in the conventional exercise at level 2, level 4, and level 8 balance in the medial-lateral direction. CONCLUSIONS: This study has shown that VR exercise is more effective in the overall direction (static) and medial-lateral direction (dynamic) of balance than conventional method in patients with FAI.

The efficacy of virtual reality assisted versus traditional rehabilitation intervention on individuals with functional ankle instability: a pilot randomized controlled trial.

PURPOSE: Virtual reality (VR) training, a virtual environment commonly generated by computer systems, may enhance the therapeutic efficacy of functional rehabilitation programmes. The aim of this study was to investigate the efficacy of a VR assisted intervention (VRAI) versus traditional rehabilitation intervention (TRI) on functional ankle instability (FAI). METHODS: A single-blind randomized controlled study was conducted with 10 subjects for each group. The VRAI was conducted with the Nintendo Wii Fit Plus, whilst the TRI was conducted with a series of exercises with theraband. The muscle strength change of the two groups and the difference between pre and post interventions for each group were compared. RESULTS: The VRAI group had less improvement in the muscle strength of all ankle motions than did the TRI group (p > .05). The VRAI group had a greater improvement in muscle strength of plantar flexion than other motions, whilst the TRI group had an improvement in muscle strength of all ankle motions (p < .05). CONCLUSIONS: The effects of VR training for the condition of FAI were not comparable to conventional training. However, VR training may be added to the conventional training programme as an optional for the condition of FAI. Implications for Rehabilitation Functional ankle instability (FAI) is subjective feelings of ankle instability resulting from proprioceptive and neuromuscular deficits in which individuals may experience "giving way" condition of the ankle. Therapeutic applications of virtual reality (VR) may be comparable to traditional rehabilitation interventions (TRI) in the rehabilitation of individuals with FAI. However, there is no definitive evidence for the issue. Integrating low-cost VR into functional rehabilitation programme can provide insight into an issue of whether it can be replaced with traditional therapeutic approaches. Although, the efficacy of VR application on strengthening muscles is unable to compare to traditional strengthening programmes, it may be considered an optional treatment based on the proprioceptive improvements.

Hepatic Alanine Differentiates Nonalcoholic Steatohepatitis From Simple Steatosis in Humans and Mice: A Proton MR Spectroscopy Study With Long Echo Time.

PURPOSE: To evaluate the hepatic metabolic alterations in nonalcoholic fatty liver disease (NAFLD) by using 1 H-MRS (proton magnetic resonance spectroscopy) with long echo time and to test the reproducibility of human study in an animal model. Liver biopsy is the gold standard for diagnosing NAFLD but with practical constraints. 1 H-MRS allows in vivo assessment of hepatocellular metabolism and has shown potential for biochemical differentiation in diffuse liver disease. MATERIALS AND METHODS: In all, 32 subjects (11 patients with nonalcoholic steatohepatitis [NASH], 15 with simple steatosis [SS], and six healthy controls) were studied. For test reproducibility, 36 C57BL/6 mice, including 10 mice with streptozotocin-induced NASH, 15 with SS, and 11 high-fat diet controls, were studied. 1 H-MRS measurements at 3T and 4.7T MRI were performed on a localized voxel of the liver using PRESS sequence. Hepatic alanine (Ala), lactate+triglyceride (Lac+TG), and TG levels were compared between NASH, SS, and control groups using analysis of variance (ANOVA) tests. Diagnostic accuracy was determined by calculating the area under the receiver operating characteristics (ROC) curve. The associations between metabolite levels and pathologic grades or NAFLD activity scores (NAS) were assessed using Pearson's correlation. RESULTS: NASH patients had higher levels of Ala (P < 0.001), Lac+TG (P < 0.001), and TG (P < 0.05) than SS patients or controls. The AUROC curve to distinguish NASH from SS was 1.00 (95% confidence interval [CI] 1.00-1.00) for Ala and 0.782 (95% CI 0.61-0.96) for Lac+TG. Ala and Lac+TG concentrations were positively correlated with steatosis grade (Ala Pearson's r = 0.723; Lac+TG r = 0.446), lobular inflammation (Ala r = 0.513), and NAS (Ala r = 0.743; Lac+TG r = 0.474). CONCLUSION: 1 H-MRS is potentially useful for noninvasive diagnosis of NASH and simple steatosis by hepatic metabolite quantification. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1298-1310.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers.

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

Correlations between the sequelae of stroke and physical activity in Korean adult stroke patients.

[Purpose] The present study investigated a wide range of stroke patients living in South Korea using the Korean Community Health Survey raw data to determine the correlation between stroke and physical activity. [Subjects and Methods] This study used raw data from the 2012 Korean Community Health Survey. The total number of participants was 228,921; of the 4,475 stroke patients who had been diagnosed by a medical doctor or an oriental medical doctor, the data for 4,460 patients, excluding 15 whose amount of physical activity was unclear, were used in the analysis. [Results] The amount of physical activity performed by patients who had sequelae was significantly lower than that performed by patients who no longer had sequelae. Similarly, for the type of sequelae, palsy in the arms and legs, facial palsy, communication disability, swallowing or eating disability, and visual disability were associated with lower physical activity. Furthermore, as the number of sequelae increased, patients performed significantly less physical activity. [Conclusion] The findings suggest that when decisions on national policies and budgets are made, methods for increasing the physical activity of patients with a history of stroke should be considered.

Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability.

[Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost.

Effects of virtual reality programs on balance in functional ankle instability.

[Purpose] The aim of present study was to identify the impact that recent virtual reality training programs used in a variety of fields have had on the ankle's static and dynamic senses of balance among subjects with functional ankle instability. [Subjects and Methods] This study randomly divided research subjects into two groups, a strengthening exercise group (Group I) and a balance exercise group (Group II), with each group consisting of 10 people. A virtual reality program was performed three times a week for four weeks. Exercises from the Nintendo Wii Fit Plus program were applied to each group for twenty minutes along with ten minutes of warming up and wrap-up exercises. [Results] Group II showed a significant decrease of post-intervention static and dynamic balance overall in the anterior-posterior, and mediolateral directions, compared with the pre-intervention test results. In comparison of post-intervention static and dynamic balance between Group I and Group II, a significant decrease was observed overall. [Conclusion] Virtual reality programs improved the static balance and dynamic balance of subjects with functional ankle instability. Virtual reality programs can be used more safely and efficiently if they are implemented under appropriate monitoring by a physiotherapist.

Association between osteoporotic fractures and quality of life based on the Korean Community Health Survey of 2010.

[Purpose] To assess the relationship between fractures and quality of life (QOL) of osteoporosis patients as well as the treatment methods and locations of fractures following osteoporosis diagnosis. [Subjects and Methods] Participants were selected from a cohort consisting of 229,229 subjects who participated in the Korean Community Health Survey. Those who were not diagnosed with osteoporosis by a doctor were excluded from the study (326) and the final analysis included 17,387 previously diagnosed participants with osteoporosis. Multiple linear regression analysis was conducted. [Results] The QOL was significantly lower for subjects receiving treatment for osteoporosis compared to those who had not previously received treatment. Subjects who experienced a fracture similarly had a lower QOL compared to those who did not have a fracture. In addition, the QOL of subjects who experienced a fracture in the pelvis, spine, or wrists was significantly lower compared to those without fractures in these areas. [Conclusion] Better knowledge of osteoporosis leads to early recognition of symptoms and timely treatment. This results in better treatment outcomes and improved QOL for patients. Therefore, the need for physical therapy that is based on research evidence of osteoporosis treatment methods should be presented.

The relationship between fracture and quality of life in Korean adults receiving treatment for osteoporosis based on the 2010 Korean Community Health Survey.

[Purpose] The purpose of this study was to investigate the relationship between fracture and quality of life in Korean adults receiving treatment for osteoporosis based on the 2010 Korean Community Health Survey (KCHS). [Subjects and Methods] This study utilized the raw data of the 2010 KCHS. In the survey, osteoporosis was assessed in 228,903 subjects, excluding 326 for whom there was insufficient data. There were 17,387 subjects with osteoporosis confirmed by a doctor's diagnosis and 9,419 of them were being treated for osteoporosis at the time of the survey. [Results] Among the patients being treated, those with fractures had a significantly lower QOL than patients who did not experience fractures. The lower QOL scores were caused by hip, vertebral and wrist fractures, and in all cases, QOL was significantly lower. Greater numbers of fractures significantly lowered QOL scores compared to participants without fractures. [Conclusion] Fractures in patients receiving treatment for osteoporosis have a direct impact on QOL. Among the different types of fractures, hip fractures resulted in the lowest scores. Therefore, to avoid additional fractures caused by inappropriate management of osteoporosis, we suggest that there is a need to improve fall related self-efficacy and prevention programs.

The relationship between stroke patients' socio-economic conditions and their quality of life: the 2010 Korean community health survey.

[Purpose] The relationship between stroke patients' socio-economic conditions and quality of life (QOL) using the 2010 Korean Community Health Survey (KCHS) statistics was examined. [Subjects and Methods] A total of 4,604 stroke patients were analyzed. Socio-economic conditions were sex, age, educational level, monthly household income, occupation, residential area, and living with family. [Results] The results show a statistically significant lower QOL for men than for women, for those aged 75 years or over compared to individuals between 19 years and 64 years, and for elementary (or lower) or middle school graduates compared to higher education graduates. QOL was also significant lower among patients whose household income was KRW4 million (US$3,746.72) or less a month. Finally, QOL was significantly lower for patients without an occupation compared to those with an occupation, for patients in rural areas compared to urban areas, and for patients who did not live with family compared to those who lived with family. [Conclusion] We showed the importance of the relationships between socio-economic conditions and QOL of stroke patient.

The relationship between stroke and quality of life in Korean adults: based on the 2010 Korean community health survey.

[Purpose] The purpose of this study was to investigate the status of stroke in the Republic of Korea and its relationship with QOL based on standardized data. [Subjects and Methods] This study utilized raw data from the 2010 KCHS. In total, 229,229 individuals participated in the 2010 survey. The final analysis identified 4,604 individuals who had been diagnosed by a doctor with stroke. To identify the correlation between the aftereffect-related characteristics of stroke patients and QOL, a multiple linear regression analysis was performed. [Results] Participants experiencing aftereffects had a statistically significantly lower QOL than participants who had not experienced aftereffects. Regarding the types of aftereffects, participants experiencing palsy in the arms and legs, facial palsy, communication disabilities, swallowing or eating disabilities, and visual disabilities had a statistically significantly lower QOL than participants without aftereffects. The QOL of participants with one, two, three, four, or five aftereffects was statistically significantly less than that of participants without aftereffects [Conclusion] Stroke directly influences QOL and the number of types of aftereffects experienced by patients. Therefore, it is highly important that physical therapists seek to end the occurrence of one or more types of aftereffects in stroke patients.

Factors Related to Stages of Exercise Behavior Change among University Students Based on the Transtheoretical Model.

[Purpose] The purpose of this study was to identify the distribution of stages of change in the exercise behavior of university students the transtheoretical model. [Subjects and Methods] Study subjects at four universities in G city were surveyed. A total of 1,000 questionnaires were distributed, and 959 responses were analyzed. The collected data was analyzed using descriptive statistics and multiple logistic regression analysis. [Results] Factors that contributed to the transition from the pre-contemplation stage to the contemplation stage included change-experimental processes (C-EP) and change-behavioral processes (C-BP). Factors that contributed to the transition from the contemplation stage to the preparation stage were C-BP and decisional decisional balance-cons (DB-C). Self-efficacy was the factor that contributed to the transition from the preparation stage to the action stage. However, there was no factor that contributed to the transition from the action stage to the maintenance stage. [Conclusion] When exercise behavior change is low, strategies such as giving one-to-one training, having the subjects read relevant books, and providing information are needed. When exercise behavior change is high, it is necessary to heighten self-efficacy by having subjects select and freely conduct appropriate kinds of exercises.

Effectiveness of sling exercise for chronic low back pain: a systematic review.

[Purpose] This study investigated effects of sling exercise for patients with chronic low back pain. [Methods] We reviewed all relevant papers indexed in PubMed, SCOPUS, and the Cochrane Registered Trials. Eligible trials were randomized controlled trials that compared sling exercise with any type of treatment. We extracted data on muscle thickness, muscle activation, pain, and disability, and assessed the methodological quality of the data. Seven studies met our inclusion criteria. [Results] When sling exercise had an impact on activation of the trunk muscles, increasing the trunk muscle thickness, and the reduction in pain and disability had been assessed shortly after the final exercise session, it was more effective than general exercise at activating trunk muscles, but not more effective at increasing trunk muscle thickness and improving pain and disability than general exercise. [Conclusion] As sling therapy studies are based on a small number of trials, we cannot draw conclusions about the therapeutic effects of sling exercise. When segmental stabilizing exercise and individually designed programs are added to sling exercise, it increases the effectiveness of sling exercise at improving low back pain. This should be the focus of future studies.

Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?

[Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises.