The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial.

Repetitive transcranial magnetic stimulation to the pharyngeal motor cortex has shown beneficial effects on poststroke dysphagia. Previous studies, however, using intermittent theta burst stimulation (iTBS) for dysphagia have targeted the suprahyoid motor cortex. This study aimed to investigate the effects of iTBS to the pharyngeal motor cortex in patients with poststroke dysphagia, using ultrasound and videofluoroscopic swallowing studies (VFSS). A randomized controlled trial was conducted on patients with dysphagia due to a first-time unilateral stroke. Patients who had signs and symptoms of dysphagia and showed aspiration or penetration on VFSS were included. Twenty-eight patients were randomly assigned to either real or sham iTBS groups, and each patient underwent five sessions of iTBS to the ipsilesional pharyngeal motor cortex. Each iTBS session was followed by conventional dysphagia treatment for 30 min. The hyoid-larynx approximation measured by ultrasound, penetration-aspiration scale (PAS) and functional dysphagia scale (FDS) assessed by VFSS were evaluated before and after completion of iTBS. There were no significant differences between the two groups in terms of demographic and clinical characteristics, including age and type of stroke. The hyoid-larynx approximation ratio increased in the real iTBS group and decreased in the sham iTBS group (median values of pre-post differences were 0.27 vs. -0.01, P  < 0.001). The PAS and FDS showed greater improvements in the real iTBS group than in the sham iTBS group (median values of pre-post differences of the PAS were -2.50 vs. 0.00, P  = 0.004; median values of pre-post differences of the FDS were -12.50 vs. -2.50, P  < 0.001). No adverse effects were reported during or after iTBS sessions. Five-session iTBS to the pharyngeal motor cortex combined with conventional treatment led to a significant improvement in poststroke dysphagia in terms of hyoid-larynx approximation which is related to the suprahyoid muscle. Considering the short duration of one iTBS session, this can be an efficient and effective treatment tool for patients with this condition.

Polymer Concentration and Liquid-Liquid Demixing Time Correlation with Porous Structure of Low Dielectric Polyimide in Diffusion-Driven Phase Separation.

Porous polyimide (PI) films are a promising low-k dielectric material for high-frequency data transmission with low signal attenuation. Pores are generated by non-solvent induced phase separation (NIPS) during phase inversion of polymer solution via non-solvent accumulation and solvent diffusion. In this study, aromatic PI was employed as a matrix for NIPS, and the influence of polymer concentration and liquid­liquid demixing time on the morphology of pores in the PI films was investigated. This ensured control over the porous structure of the PI film and provided desirable dielectric properties in a broad frequency range of 100 Hz−30 MHz (1.99 at 30 MHz) and thermal stability (Td5% > 576 °C, Tg > 391 °C). This study addresses the effect of polymer concentration and coagulation time on the morphology and physical properties of PI sponge films and provides guidance on the design and optimization of architectures for polymeric materials requiring pore modification.

Experimental and Digimat-FE Based Representative Volume Element Analysis of Dye-Mixed Colored Resin and Carbon Fiber.

Recently, the automobile industry has demanded weight reduction, so research on materials is being actively conducted. Among this research, carbon fiber-reinforced composite materials are being studied a lot in the automobile industry due to their excellent mechanical properties, chemical resistance, and heat resistance. However, carbon fiber-reinforced composite materials have disadvantages, in that they are not free from color selection, and have weak interfacial bonding strength. In this study, a colored epoxy resin was prepared by mixing epoxy-which is a thermosetting resin according to the pigment concentration (0.1, 0.3, 0.5, 1.0 wt%)-and curing shrinkage. Thermal expansion characteristics were analyzed and the concentration of 0.5 wt% pigment showed the lowest shrinkage and thermal expansion characteristics. In addition, to measure the interfacial shear strength (IFSS) of the carbon fiber and the colored epoxy resin, the IFSS was obtained by performing a microdroplet debonding test, and the strength of the pigment concentration of 0.5 wt% was reduced to a relatively low level. Through these experiments, it was determined that an epoxy resin in which 0.5 wt% pigment is mixed is the optimal condition. Finally, using the composite material modeling software (Digimat 2020.0), the representative volume element (RVE) of the meso-scale was set, and interfacial properties of carbon fibers and colored epoxy resins were analyzed by interworking with general-purpose finite element analysis software (Abaqus CAE).

Postoperative Dysphagia Aortica: Comparison with Other Dysphagia.

Dysphagia can be classified as oropharyngeal or esophageal, and functional or structural deficits of the esophagus can cause esophageal dysphagia. Dysphagia aortica (DA) is defined as dysphagia caused by extrinsic compression of the esophagus by the aorta. The aim of this study was to investigate the characteristics of DA by comparing the findings of videofluoroscopic swallowing studies (VFSS) with those of other dysphagia. Sixty-seven patients with postoperative dysphagia aortica (PDA), dysphagia after brainstem infarction (DBI), dysphagia after anterior cervical discectomy and fusion (DACDF), and subjective swallowing difficulty (SSD) without penetration and/or aspiration, who had undergone VFSS incorporating tests using 5 ml of thin and thick liquids, were included. The clinical data were collected retrospectively. The penetration-aspiration scale, functional dysphagia scale (FDS), esophageal transit time (ETT), and aortic lesion parameters (maximal diameter and distance between the lesion and the apex of the aortic arch) were assessed. The patients with PDA had higher FDS scores than the patients with SSD and lower scores than the patients with DBI did on thin liquids, while the FDS scores on thick liquids were lower in the patients with PDA than in those with DBI or DACDF. The patients with PDA had longer ETT than the other three groups. No correlation was found between the aortic lesion parameters and the VFSS findings. Although PDA has some oropharyngeal symptoms, the esophageal phase was affected mainly by PDA. After an operation on the aorta, VFSS should be considered before resuming oral feeding.

Comparison of straw and cup for liquid swallowing in poststroke patients.

The purposes of this study were to compare poststroke liquid swallowing methods by including a cup and a straw in videofluoroscopic swallowing studies (VFSS) and to test the hypothesis that increased aspiration would be observed with the cup compared to the straw. Eighty-five poststroke patients who had undergone VFSS using a spoon, cup, and straw were included. Penetration-aspiration scale and functional dysphagia scale (FDS) were used for assessment. These scores did not differ significantly between the cup and the straw. Higher FDS scores were found with the cup than with the straw in patients who had penetration/aspiration with both the cup and the straw and with the cup only. However, FDS scores did not differ significantly between the cup and the straw in patients who had penetration/aspiration with the straw only. Although advantages of the straw over the cup were clear, some patients showed penetration/aspiration only with the straw.

Self-Cleaning Polyester Fabric Prepared with TiOF2 and Hexadecyltrimethoxysilane.

In this study, self-cleaning polyester (PET) fabrics were prepared using TiOF2 and hexadecyltrimethoxysilane(HDS) treatment. TiOF2 was synthesized via direct fluorination of a precursor TiO2 at various reaction temperatures. The prepared PET fabrics had superior photocatalytic self-cleaning properties compared with anatase TiO2/HDS-treated PET fabrics under UV and sunlight with 98% decomposition of methylene blue. TiOF2/HDS-treated PET fabrics also had superior superhydrophobic self-cleaning properties compared with anatase TiO2/HDS-treated PET fabrics with a 161° water contact angle and 6° roll-off angle. After the self-cleaning tests of the non-dyed TiOF2/HDS-treated PET fabrics, we prepared dyed TiOF2/HDS-treated PET fabrics to test practical aspects of the treatment method. These PET fabrics were barely stained by tomato ketchup; even when stained, they could be self-cleaned within 4 h. These results suggest that practical self-cleaning PET fabrics with superhydrophobicity and photocatalytic degradation could be prepared using TiOF2/HDS-treatment.

Natural changes of traumatic vertebral compression fractures during the first 6 months in patients visiting for disability certificates: A retrospective observational study.

ABSTRACT: To identify the natural changes of traumatic vertebral compression fractures during the first six months in patients visiting for disability certificates after conservative treatment.Data of patients who visited the rehabilitation medicine department of a university hospital for disability certificates concerning traumatic vertebral compression fractures from 2015 to 2018 were reviewed. Those who visited 180 to 210 days after injuries were included, and those who received invasive procedures for compression fractures were excluded. The anterior and posterior heights, local kyphotic angle of compression fractures, and upper and lower vertebrae on initial and follow-up images were measured and compared. Compression ratio was calculated by vertebral body compression ratio and anterior vertebral body compression percentage. Thoracic and lumbar traumatic fractures were also compared.Among 110 patients, 61 patients met the criteria. After six months, the anterior height of compression fractures decreased more than 4 mm, which implies the development of new compression fractures. The compression ratio and local kyphotic angle increased significantly without affecting the upper and lower vertebrae. Thoracic and lumbar compression fractures showed similar changes.Traumatic vertebral compression fractures change significantly during the first six months. This study could warrant 6 months of waiting for issuance of disability certificates for patients with traumatic vertebral compression fractures.

Short-term cane use in subacute stroke patients affects the nonparetic upper extremity nerves.

Overuse of the nonparetic upper extremity can lead to entrapment neuropathies in chronic stroke patients. However, little is known about the effects of cane use in subacute stage of stroke. The aim of this study was to investigate the short-term effects of cane use on the upper extremity nerves in subacute stroke patients recovering from a bedridden state. Thirty subacute hemiparetic stroke patients who were initially bedridden participated when they were able to walk with a cane. Symptoms and signs related to the median or ulnar nerves were checked, and nerve conduction studies were performed. The largest cross-sectional area (CSA) of these nerves from the wrist to elbow was measured with ultrasound. After 3 weeks of cane use, electrophysiologic and ultrasonographic reevaluation was performed. Nerve conduction studies and CSA of the nerves at the nonparetic upper extremity showed significant changes, whereas those of the hemiparetic upper extremity did not. Walking with a cane for a short period can induce the enlargement of the median and ulnar nerves at the nonparetic extremity of subacute hemiparetic stroke patients. Attention should be placed on correct cane usage from the beginning of rehabilitation.

Effects of multi-session intermittent theta burst stimulation on central neuropathic pain: A randomized controlled trial.

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is one of the effective treatments for neuropathic pain. Little is known about the effects of multi-session theta burst stimulation, one of the new paradigms of rTMS. OBJECTIVE: The aim of this study was to investigate the effects of multi-session intermittent theta burst stimulation (iTBS) on central neuropathic pain, using evaluation tools specific to neuropathic pain. METHODS: Patients with central neuropathic pain diagnosed using Neuropathic Pain Special Interest Group guidelines were recruited. Thirty patients were randomly assigned to either a real or sham iTBS group. Each patient underwent 5 sessions of iTBS; before and after completion of the 5 sessions, participants were evaluated using the self-completed Leeds assessment of neuropathic symptoms and signs (S-LANSS), the numeric rating scale (NRS), the neuropathic pain symptom inventory (NPSI), and the neuropathic pain scale (NPS). RESULTS: S-LANSS, NRS, NPSI, and 3 of 4 NPS combination scores decreased significantly in the real iTBS group but not in the sham iTBS group. No adverse effects were reported during or after iTBS sessions. CONCLUSIONS: Multi-session iTBS was associated with a significant decrease in neuropathic pain, indicating its effectiveness as a treatment for patients with central neuropathic pain.

The synthesis and spectral properties of a stimuli-responsive D-π-A charge transfer dye.

A new donor-π-acceptor (D-π-A) type isophorone dye was synthesized by the condensation reaction between 2-(3,5,5-trimethylcyclohex-2-enylidene)-malononitrile and indole-3-carboxaldehyde. The chemical structure of the dye was characterized by 1H NMR, EA and MS. A novel, chromogenic, fluorescent dye based on indol as donor unit and isophorone as acceptor unit displayed marked UV-visible absorption changes and highly selective fluorescence quenching in the presence of fluoride ion. The dye also exhibited sizeable colour changes when used as a pH-induced molecular switch and as a detector for volatile organic compounds. The absorption and fluorescent intensity of the dye can be reversibly selected by protonation/deprotonation of the amine moiety via control of intramolecular charge transfer (ICT), leading to a molecular switch with "on" and "off" states.

Evaluation of new 2,2'-dimethyl-5,5'-dipropoxybenzidine- and 3,3'-dipropoxybenzidine-based direct dye analogs for mutagenic activity by use of the Salmonella/mammalian mutagenicity assay.

As part of a continuing study aimed at establishing structure-activity relationships and heuristic principles useful for the design of non-genotoxic azo dyes, a series of new direct dyes based on two non-mutagenic benzidine analogs, 2,2'-dimethyl-5,5'-dipropoxybenzidine and 3,3'-dipropoxybenzidine, were evaluated for mutagenic activity in Salmonella typhimurium strains TA98 and TA100. These strains are widely used for mutagenicity screening and have been shown to detect the mutagenic activity of benzidine analogs. While some toxicity was seen with some dyes at high doses, all of the dyes examined were judged non-mutagenic with and without metabolic activation in the standard Salmonella plate-incorporation assay. The results in the standard test are consistent with the properties of the diamines themselves. However, only one of the dyes was non-mutagenic when a reductive-metabolism pre-incubation assay was used. The results of this study suggest that although benzidine analogs are potential replacements for benzidine, there is a need to understand which mutagenic products are produced when reductive metabolism is present. There is also a need to know whether or not metal complexes of these dyes are mutagenic. Such information will allow the development of new non-mutagenic azo dyes.