Improving Upper Limb Spasticity in Patients with Stroke by Electroacupuncture Therapy: a Pre- and Post-Treatment Study.

Background: : Post-stroke upper limb spasticity (PS-ULS) causes a decline in the quality of life of patients by reducing their ability to perform normal daily activities. Objectives: : We performed pre- and post-treatment analyses of the changes in stroke patients with ULS following constant electroacupuncture therapy (EAT). Methods: : Thirty patients with PS-ULS underwent 12 sessions of EAT over 4 weeks. After performing acupuncture therapy at four acupoints on the affected arm (LI11, LI10, LI4, and TE5), electrostimulation (60 Hz) was performed for 20 min. The modified Ashworth scale (MAS) and the Fugl-Meyer assessment of the upper extremity (FMA-UE) were measured as the outcome variables. Results: : Following EAT, there was a significant decrease in the elbow MAS score (p < 0.001), a significant decrease in the wrist MAS score (p < 0.01), and a significant increase in the FMA-UE score (p < 0.001). Adverse events related to EAT were not reported. Conclusion: : EAT decreased upper limb spasticity and improved functional recovery at the elbow and wrist. Large-scale and rigorous clinical trials are needed to verify the efficacy of EAT.

Effectiveness of training program combining chakrayoga and meditation.

Background This study was designed to examine the effectiveness of program combining chakrayoga and meditation on the physical health and disease-related factors and psychological factors of people. Methods Ninety-seven subjects (32-83 years old) who had free from prior experiences in meditation programs or Chakrayoga training courses were assigned to either the experimental group (EXP) (45 subjects; 13 male subjects and 32 female subjects; average age of 60.67 years, SD=11.09 years) or the control group (CONT) of remaining subjects (52 subjects; 14 male subjects and 38 female subjects; average age of 61.58 years, SD=9.70 years). Subjects in the EXP participated in the Chakrayoga Meditation Program for twice a week for 2 h during 6 weeks in each session consisted of 1 h of Chakrayoga and 1 h of meditation. The measurements in this study included the mindfulness, stress response, subjective quality of life, medical symptom checklist, difficulty in emotional regulation and objective of life and sense of control. Results Results revealed that participants in the EXP reported significantly more relief of mindfulness, stress response, subjective quality of life and medical symptom checklist than those in the CONT. Conclusions These findings provide evidence that the Chakrayoga Meditation Program can help relieve the physical health and disease-related factors and psychological factors.

Fabrication of Uniform Wrinkled Silica Nanoparticles and Their Application to Abrasives in Chemical Mechanical Planarization.

A simple one-pot method is reported for the fabrication of uniform wrinkled silica nanoparticles (WSNs). Rapid cooling of reactants at the appropriate moment during synthesis allowed the separation of nucleation and growth stages, resulting in uniform particles. The factors affecting particle size and interwrinkle distance were also investigated. WSNs with particle sizes of 65-400 nm, interwrinkle distances of 10-33 nm, and surface areas up to 617 m2 g-1 were fabricated. Furthermore, our results demonstrate the advantages of WSNs over comparable nonporous silica nanospheres and fumed silica-based products as an abrasive material in chemical mechanical planarization processes.

Superfast Room-Temperature Activation of SnO2 Thin Films via Atmospheric Plasma Oxidation and their Application in Planar Perovskite Photovoltaics.

The power conversion efficiency (PCE) of perovskite solar cells (PSCs) has now exceeded 20%; thus, research focus has shifted to establishing the foundations for commercialization. One of the pivotal themes is to curtail the overall fabrication time, to reduce unit cost, and mass-produce PSCs. Additionally, energy dissipation during the thermal annealing (TA) stage must be minimized by realizing a genuine low-temperature (LT) process. Here, tin oxide (SnO2 ) thin films (TFs) are formulated at extremely high speed, within 5 min, under an almost room-temperature environment (<50 °C), using atmospheric Ar/O2 plasma energy (P-SnO2 ) and are applied as an electron transport layer of a "n-i-p"-type planar PSC. Compared with a thermally annealed SnO2 TF (T-SnO2 ), the P-SnO2 TF yields a more even surface but also outstanding electrical conductivity with higher electron mobility and a lower number of charge trap sites, consequently achieving a superior PCE of 19.56% in P-SnO2 -based PSCs. These findings motivate the use of a plasma strategy to fabricate various metal oxide TFs using the sol-gel route.

Comparison of Percutaneous Endoscopic Lumbar Diskectomy and Open Lumbar Microdiskectomy for Recurrent Lumbar Disk Herniation.

OBJECTIVE: To establish the appropriateness of transforaminal percutaneous endoscopic lumbar diskectomy (PELD) by comparing it with open lumbar microdiskectomy (OLM) for surgical treatment of recurrent lumbar disk herniation. METHODS: We retrospectively analyzed 83 patients who underwent revision surgery (group A: PELD, 35 cases; group B: OLM, 48 cases) for recurrent lumbar disk herniation between March 2009 and April 2014. All of the patients were followed > 12 months. To evaluate outcomes, we checked the leg and back visual analog scale (VAS), Oswestry Disability Index (ODI), complications, and recurrence for all patients. RESULTS: The mean improvement of VAS for leg was 5.97 ± 0.98 for group A and 5.62 ± 1.42 for group B (p = 0.194). The mean improvement of VAS for back pain was 2.71 ± 1.30 for group A and 2.29 ± 1.41 for group B (p = 0.168). The mean improvement of ODI scores was 28.86 ± 3.93 for group A and 28.00 ± 4.22 for group B (p = 0.350). Total surgery-related complications were none for group A and nine for group B (p = 0.009). Group A had one subject with surgery-related neurologic symptoms and group B had four (p = 0.391). Recurrence occurred in two patients in group A and seven patients in group B (p = 0.291). CONCLUSION: PELD and OLM have favorable clinical outcomes in patients with recurrent lumbar disk herniation, and PELD results in fewer complications compared with OLM. Therefore, PELD may be a better alternative to OLM for patients with recurrent lumbar disk herniation.

Enhanced efficiency and air-stability of NiOX-based perovskite solar cells via PCBM electron transport layer modification with Triton X-100.

We modified phenyl-C61-butyric acid methyl ester (PCBM) for use as a stable, efficient electron transport layer (ETL) in inverted perovskite solar cells (PSCs). PCBM containing a surfactant Triton X-100 acts as the ETL and NiOX nanocrystals act as a hole transport layer (HTL). Atomic force microscopy and scanning electron microscopy images showed that surfactant-modified PCBM (s-PCBM) forms a high-quality, uniform, and dense ETL on the rough perovskite layer. This layer effectively blocks holes and reduces interfacial recombination. Steady-state photoluminescence and electrochemical impedance spectroscopy analyses confirmed that Triton X-100 improved the electron extraction performance of PCBM. When the s-PCBM ETL was used, the average power conversion efficiency increased from 10.76% to 15.68%. This improvement was primarily caused by the increases in the open-circuit voltage and fill factor. s-PCBM-based PSCs also showed good air-stability, retaining 83.8% of their initial performance after 800 h under ambient conditions.

Paintable Carbon-Based Perovskite Solar Cells with Engineered Perovskite/Carbon Interface Using Carbon Nanotubes Dripping Method.

Paintable carbon electrode-based perovskite solar cells (PSCs) are of particular interest due to their material and fabrication process costs, as well as their moisture stability. However, printing the carbon paste on the perovskite layer limits the quality of the interface between the perovskite layer and carbon electrode. Herein, an attempt to enhance the performance of the paintable carbon-based PSCs is made using a modified solvent dripping method that involves dripping of the carbon nanotubes (CNTs), which is dispersed in chlorobenzene solution. This method allows CNTs to penetrate into both the perovskite film and carbon electrode, facilitating fast hole transport between the two layers. Furthermore, this method is results in increased open circuit voltage (Voc ) and fill factor (FF), providing better contact at the perovskite/carbon interfaces. The best devices made with CNT dripping show 13.57% power conversion efficiency and hysteresis-free performance.

High-Density Single-Layer Coating of Gold Nanoparticles onto Multiple Substrates by Using an Intrinsically Disordered Protein of α-Synuclein for Nanoapplications.

Functional graffiti of nanoparticles onto target surface is an important issue in the development of nanodevices. A general strategy has been introduced here to decorate chemically diverse substrates with gold nanoparticles (AuNPs) in the form of a close-packed single layer by using an omni-adhesive protein of α-synuclein (αS) as conjugated with the particles. Since the adsorption was highly sensitive to pH, the amino acid sequence of αS exposed from the conjugates and its conformationally disordered state capable of exhibiting structural plasticity are considered to be responsible for the single-layer coating over diverse surfaces. Merited by the simple solution-based adsorption procedure, the particles have been imprinted to various geometric shapes in 2-D and physically inaccessible surfaces of 3-D objects. The αS-encapsulated AuNPs to form a high-density single-layer coat has been employed in the development of nonvolatile memory, fule-cell, solar-cell, and cell-culture platform, where the outlying αS has played versatile roles such as a dielectric layer for charge retention, a sacrificial layer to expose AuNPs for chemical catalysis, a reaction center for silicification, and biointerface for cell attachment, respectively. Multiple utilizations of the αS-based hybrid NPs, therefore, could offer great versatility to fabricate a variety of NP-integrated advanced materials which would serve as an indispensable component for widespread applications of high-performance nanodevices.

Large Grain-Based Hole-Blocking Layer-Free Planar-Type Perovskite Solar Cell with Best Efficiency of 18.20.

There remains tremendous interest in perovskite solar cells (PSCs) in the solar energy field; the certified power conversion efficiency (PCE) now exceeds 20%. Along with research focused on enhancing PCE, studies are also underway concerning PSC commercialization. It is crucial to simplify the fabrication process and reduce the production cost to facilitate commercialization. Herein, we successfully fabricated highly efficient hole-blocking layer (HBL)-free PSCs through vigorously interrupting penetration of hole-transport material (HTM) into fluorine-doped tin oxide by a large grain based-CH3NH3PbI3 (MAPbI3) film, thereby obtaining a PCE of 18.20%. Our results advance the commercialization of PSCs via a simple fabrication system and a low-cost approach in respect of mass production and recyclability.

Structural Preservation Percutaneous Endoscopic Lumbar Interlaminar Discectomy for L5-S1 Herniated Nucleus Pulposus.

Objective. Structures such as ligamentum flavum, annulus, and lamina play an important role in the segmental function. We proposed the surgical technique for achieving the sufficient preservation of segmental structures, in spite of sufficient removal of pathologic disc in the L5-S1 using the ligamentum flavum splitting and sealing technique. Methods. We retrospectively analyzed 80 cases that underwent percutaneous endoscopic lumbar discectomy for L5-S1 herniated nucleus pulposus, using the ligamentum flavum splitting and sealing technique between January 2011 and June 2013. Outcomes were assessed using VAS (leg, back), MacNab's criteria, and the immediate postoperative MRI for all patients. Structural preservation was classified as complete, sufficient, and incomplete. Results. The surgical results are as follows: 65 cases were complete, 15 cases were sufficient, and 0 cases were incomplete. The VAS was decreased at the last follow-up (leg: from 7.91 ± 0.73 to 1.15 ± 0.62; back: from 5.15 ± 0.71 to 1.19 ± 0.75). A favorable outcome (excellent or good outcome by MacNab's criteria) was achieved in 77 patients (96.25%). During the follow-up period, 2 cases (2.5%) of recurrence have occurred. Conclusion. According to the result, we could obtain the favorable clinical and radiological outcomes while simultaneously removing pathologic discs using the ligamentum flavum splitting and annular fissure sealing technique.

Hierarchical mesoporous silica nanoparticles as superb light scattering materials.

A novel approach to enhance the light scattering effect was explored by applying hierarchical silica nanoparticles in DSSCs as scattering layers. The WSN-incorporated cells showed a PCE value of 9.53% and a PCE enhancement of 30.19% compared with those of the reference cells.

Extraction of Clinical Indicators That Are Associated with the Heat/Nonheat and Excess/Deficiency Patterns in Pattern Identifications for Stroke.

The aim of this study is to extract indicators that are associated with the heat/nonheat and excess/deficiency patterns in stroke pattern identification through the large-scale analysis of clinical data. Two experts, who had more than three years of clinical experience with stroke, independently performed the pattern identification. We analyzed indicators of clinical data with two doctors' concurrent diagnoses on the patient's pattern identification. To verify heat/nonheat and excess/deficiency patterns, which are the basic elements of pattern identification, we grouped 960 patients diagnosed as the fire-heat pattern, the Yin deficiency pattern, and the Qi deficiency pattern in to two groups, the heat/nonheat group and the excess/deficiency group. We then extracted significant indicators using univariate and multivariate analysis. As a result of the comparison of 65 indicators, we were able to extract 10 indicators for the heat pattern, 6 for the nonheat pattern, 9 for the excess pattern, and 10 for the deficiency pattern. Extracted indicators in this study can be used for pattern identification in the context of stroke. These are positive indicators from large-scale clinical studies and are greatly expected to be crucial discriminant indicators in individual pattern identification henceforth.

Enhanced Electroresponsive Performance of Double-Shell SiO2/TiO2 Hollow Nanoparticles.

The double-shell SiO2/TiO2 hollow nanoparticles (DS HNPs) are successfully fabricated and adopted as dispersing materials for electrorheological (ER) fluids to investigate an influence of shell structure on ER properties. The DS HNPs-based ER fluid exhibits outstanding ER performance which is 4.1-fold higher compared to that of single shell SiO2/TiO2 hollow nanoparticles (SS HNPs)-based ER fluid. The significantly improved ER property of DS HNPs-based ER fluid is ascribed to the enhanced interfacial polarization. In addition, the ER activities of DS HNPs-based ER fluids are examined depending on the particle diameter. The yield stress of DS HNPs-based ER fluids increases up to 302.4 kPa under an electric field of 3 kV mm(-1) by reducing the particle size, which is remarkable performance enough to promise sufficient probability for practical and industrial applications. The enhanced ER performance of the smaller DS HNPs is attributed to the increased surface area of large pores (30-35 nm) within the shells, resulting in a large achievable polarizability determined by dielectric constants. Furthermore, the antisedimentation property is analyzed in order to offer an additional insight into the effect of particle size on the ER fluids.

Combined Interlaminar and Paraisthmic Approach for Co-existing Intracanal and Foraminal Lesion.

OBJECTIVE: Stenosis or herniated nucleus pulposus (HNP) occupying lumbar intracanal and foraminal area is an important cause of double radicular symptoms. Using the combined interlaminar and paraisthmic approach, we performed decompression surgery in patients with co-existing intracanal and foraminal lesions. The objective of this study is to describe usefulness and outcome of combined interlaminar and paraisthmic approach surgery and to analysis the cause of poor outcome. METHODS: Between Apr 2009 and Apr 2014, 78 patients (42 males and 36 females) with intracanal and foraminal lesions were enrolled in this study. Patients with a vacuum disc, spondylolisthesis, instability or an isthmic defect on the preoperative dynamic view radiograph were excluded from this study. All patients underwent surgery through a combined approach for discectomy and decompression. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. RESULTS: The results were excellent in 53 patients, good in 9, fair in 6 and poor in 10 during the follow-up. The outcome of the combined approach was excellent to fair in 87% (68 of 78) patients in our study. In the poor outcome group, three patients complained of early-onset relapsed pain (<1 month) and another seven patients complained of delayed-onset pain (>3 months). CONCLUSION: Combined approach for both intracanal and foraminal area lesions may be useful if selectively performed on patients whose facet joint is relatively intact, and that it is worthy of consideration as an alternative to fusion surgery; however, further studies are needed.

Multifunctional Ag-decorated porous TiO2 nanofibers in dye-sensitized solar cells: efficient light harvesting, light scattering, and electrolyte contact.

Designing the photoanode structure in dye-sensitized solar cells (DSSCs) is vital to realizing enhanced power conversion efficiency (PCE). Herein, novel multifunctional silver-decorated porous titanium dioxide nanofibers (Ag/pTiO2 NFs) made by simple electrospinning, etching, and chemical reduction processes are introduced. The Ag/pTiO2 NFs with a high surface area of 163 m(2) g(-1) provided sufficient dye adsorption for light harvesting. Moreover, the approximately 200 nm diameter and rough surface of the Ag/pTiO2 NFs offered enough light scattering, and the enlarged interpores among the NFs in the photoanode also permitted electrolyte circulation. Ag nanoparticles (NPs) were well dispersed on the surface of the TiO2 NFs, which prevented aggregation of the Ag NPs after calcination. Furthermore, a localized surface plasmon resonance effect by the Ag NPs served to increase the light absorption at visible wavelengths. The surface area and amount of Ag NPs was optimized. The PCE of pTiO2 NF-based DSSCs was 27 % higher (from 6.2 to 7.9 %) than for pure TiO2 NFs, whereas the PCE of Ag/pTiO2 NF-based DSSCs increased by about 12 % (from 7.9 to 8.8 %). Thus, the PCE of the multifunctional pTiO2 NFs was improved by 42 %, that is, from 6.2 to 8.8 %.

Fabrication of SiO2/TiO2 double-shelled hollow nanospheres with controllable size via sol-gel reaction and sonication-mediated etching.

Size-controllable double-shell SiO2/TiO2 hollow nanoparticles (DS HNPs) were fabricated using a simple sol-gel reaction and sonication-mediated etching. The size of the DS HNPs was controlled using SiO2 core templates of various sizes. Moreover, monodisperse DS HNPs were produced on a large scale (10 g per 1 batch) using the sol-gel method. The surface area and porosity of intrashell and inner-cavity pores were measured by Brunauer-Emmett-Teller analysis. As a result, 240 nm DS HNPs (240 DS HNPs) exhibited the highest surface area of 497 m(2) g(-1) and a high porosity. Additionally, DS HNPs showed excellent light-scattering ability as a scattering layer in dye-sensitized solar cells due to their structural properties, such as a composite, double-shell, hollow structure, as well as intrashell and inner cavity pores. The DSSCs incorporating 240 DS HNPs demonstrated an 18.3% enhanced power conversion efficiency (PCE) compared to TiO2 nanoparticles.

A Study of Tongue and Pulse Diagnosis in Traditional Korean Medicine for Stroke Patients Based on Quantification Theory Type II.

In traditional Korean medicine (TKM), pattern identification (PI) diagnosis is important for treating diseases. The aim of this study was to comprehensively investigate the relationship between the PI type and tongue diagnosis or pulse diagnosis variables. The study included 1,879 stroke patients who were admitted to 12 oriental medical university hospitals from June 2006 through March 2009. The status of the pulse and tongue was examined in each patient. Additionally, to investigate relatively important indicators related to specialist PI, the quantification theory type II analysis was performed regarding the PI type. In the first axis quantification of the external criteria, the Qi-deficiency and the Yin-deficiency patterns were located in the negative direction, while the dampness-phlegm (DP) and fire-heat patterns were located in the positive direction. The explanatory variable with the greatest impact on the assessment was a fine pulse. In the second axis quantification, the external criteria were divided into either the DP or non-DP patterns. The slippery pulse exhibited the greatest effect on the division. This study attempted to build a model using a statistical method to objectively quantify PI and various indicators that constitute the unique diagnosis system of TKM. These results should assist the development of future diagnostic standards in stroke PI.

Interobserver reliability of tongue diagnosis using traditional korean medicine for stroke patients.

Observation of the tongue, also known as tongue diagnosis, is an important procedure in diagnosis by inspection in Traditional Korean medicine (TKM). We investigated the reliability of TKM tongue diagnosis in stroke patients by evaluating interobserver reliability regarding tongue indicators as part of the project named the Fundamental Study for the Standardization and Objectification of Pattern Identification in TKM for Stroke (SOPI-Stroke). A total of 658 patients with stroke admitted to 9 oriental medical university hospitals participated. Each patient was independently seen by two experts from the same department for an examination of the status of the tongue. Interobserver agreement about subjects regarding pattern identification with the same opinion between the raters (n = 451) was generally high, ranging from "moderate" to "excellent". Interobserver agreement was nearly perfect for certain signs of special tongue appearance (mirror, spotted, and bluish purple), poor for one of the tongue colors (pale) and moderate for others. Clinicians displayed measurable agreement regarding tongue indicators via both observation and pattern identification consistency. However, interobserver reliability regarding tongue color and fur quality was relatively low. Therefore, it is necessary to improve objectivity and reproducibility of tongue diagnosis through the development of detail-oriented criteria and enhanced training of clinicians.

Developing indicators of pattern identification in patients with stroke using traditional Korean medicine.

BACKGROUND: The traditional Korean medical diagnoses employ pattern identification (PI), a diagnostic system that entails the comprehensive analysis of symptoms and signs. The PI needs to be standardized due to its ambiguity. Therefore, this study was performed to establish standard indicators of the PI for stroke through the traditional Korean medical literature, expert consensus and a clinical field test. METHODS: We sorted out stroke patterns with an expert committee organized by the Korean Institute of Oriental Medicine. The expert committee composed a document for a standardized pattern of identification for stroke based on the traditional Korean medical literature, and we evaluated the clinical significance of the document through a field test. RESULTS: We established five stroke patterns from the traditional Korean medical literature and extracted 117 indicators required for diagnosis. The indicators were evaluated by a field test and verified by the expert committee. CONCLUSIONS: This study sought to develop indicators of PI based on the traditional Korean medical literature. This process contributed to the standardization of traditional Korean medical diagnoses.

First Report of Sclerotium Rot on Cymbidium Orchids Caused by Sclerotium rolfsii in Korea.

Sclerotium rot was found on Cymbidium orchids at Seosan-si, Chungcheongnam-do, Korea, in July, 2010. Symptoms occurred on low leaves, which turned yellowish, after which the entire plant wilted. Severely infected plants were blighted and eventually died. White mycelial mats and sclerotia appeared on pseudobulbs. Based on the mycological characteristics and pathogenicity, the causal fungus was identified as Sclerotium rolfsii. This is the first report of new Sclerotium rot on Cymbidium spp. caused by S. rolfsii in Korea.