A Proof of Concept: Optimized Jawbone-Reduction Model for Mandibular Fracture Surgery.

Previous research on computer-assisted jawbone reduction for mandibular fracture surgery has only focused on the relationship between fractured sections disregarding proper dental occlusion with the maxilla. To overcome malocclusion caused by overlooking dental articulation, this study aims to provide a model for jawbone reduction based on dental occlusion. After dental landmarks and fracture sectional features are extracted, the maxilla and two mandible segments are aligned first using the extracted dental landmarks. A swarm-based optimization is subsequently performed by simultaneously observing the fracture section fitting and the dental occlusion condition. The proposed method was evaluated using jawbone data of 12 subjects with simulated and real mandibular fractures. Results showed that the optimized model achieved both accurate jawbone reduction and desired dental occlusion, which may not be possible by existing methods.

Aptasensor-encapsulating semi-permeable proteinosomes for direct target detection in non-treated biofluids.

Detecting biomarkers in biofluids directly without sample treatments makes molecular diagnostics faster and more efficient. Aptasensors, the nucleic acid-based molecular biosensors, can detect a wide range of target molecules, but their susceptibility to degradation and aggregation by nucleases and charged proteins, respectively, limits their direct use in clinical samples. In this work, we demonstrate that when aptasensors are encapsulated in proteinosomes, the protein-based liposome mimics, clinically important small molecules can be sensitively and selectively detected in non-treated specimens, such as 100 % unpurified serum. As serum albumin is used to form the membrane, the nanomeshed proteinosomes become semi-permeable and antifouling, which enables exclusive admission of small molecules while blocking unwanted large proteins. Consequently, the enclosed aptasensors can maintain close-to-optimal performance for target binding, and nucleolytic degradation and electrostatic aggregation are effectively suppressed. Three different structure-switching aptamers specific for estradiol, dopamine, and cocaine, respectively, are demonstrated to fully conserve their high affinities and specificities inside the microcapsules. The shielding effect of proteinosomes is indeed exceptional; the enclosed DNA aptasensors remain completely intact over 18 h in serum and even in an extremely concentrated DNase solution (1 mg/ml, ∼300,000× the serum level). Moreover, the proteinosome-mediated compartmentalization enables independent operation of multiple aptasensors in the same mixture. Hence, simultaneous real-time sensing of two different targets is demonstrated with different operation modes, 'recording' target appearance and 'reporting' target concentration changes. This work is the first demonstration of small-molecule-specific aptasensors operating with optimal performance in serum environments and will find promising applications in molecular diagnostics.

G-Quadruplex-Filtered Selective Ion-to-Ion Current Amplification for Non-Invasive Ion Monitoring in Real Time.

Living cells efflux intracellular ions for maintaining cellular life, so intravital measurements of specific ion signals are of significant importance for studying cellular functions and pharmacokinetics. In this work, de novo synthesis of artificial K+ -selective membrane and its integration with polyelectrolyte hydrogel-based open-junction ionic diode (OJID) is demonstrated, achieving a real-time K+ -selective ion-to-ion current amplification in complex bioenvironments. By mimicking biological K+ channels and nerve impulse transmitters, in-line K+ -binding G-quartets are introduced across freestanding lipid bilayers by G-specific hexylation of monolithic G-quadruplex, and the pre-filtered K+ flow is directly converted to amplified ionic currents by the OJID with a fast response time at 100 ms intervals. By the synergistic combination of charge repulsion, sieving, and ion recognition, the synthetic membrane allows K+ transport exclusively without water leakage; it is 250× and 17× more permeable toward K+ than monovalent anion, Cl- , and polyatomic cation, N-methyl-d-glucamine+ , respectively. The molecular recognition-mediated ion channeling provides a 500% larger signal for K+ as compared to Li+ (0.6× smaller than K+ ) despite the same valence. Using the miniaturized device, non-invasive, direct, and real-time K+ efflux monitoring from living cell spheroids is achieved with minimal crosstalk, specifically in identifying osmotic shock-induced necrosis and drug-antidote dynamics.

The Effect of Omega-3 Enriched Oral Nutrition Supplement on Nutritional Indices and Quality of Life in Gastrointestinal Cancer Patients: A Randomized Clinical Trial.

OBJECTIVE: Gastrointestinal (GI) cancer patients often experience severe malnutrition during cancer therapies due to gastrointestinal dysfunctions including poor digestion and absorption as well as tumor-associated anorexia. In this study, we performed a randomized clinical trial to determine the efficacy of oral nutrition supplement (ONS) enriched with omega-3 fatty acids on nutritional status, quality of life (QOL), and pro-inflammatory indices. METHODS: Patients diagnosed with GI cancers were recruited and screened for eligibility. A total of 58 patients were randomly allocated to either the control group (n=27) or the experimental group (n=31). The intervention group received 200 ml ONS twice a day while the control group received routine care. Anthropometrics, Patient-Generated Subjective Global Assessment (PG-SGA) score, QOL score and nutrient intake data were collected at baseline, week 4 and week 8. Blood was drawn for biochemical assessments. Nine patients from each group dropped out of the study Forty patients (18 control patients and 22 intervention patients) completed the study. RESULTS: This study showed that ONS intervention improved PG-SGA scores in the intervention group (p<0.01). Scores of physical functioning score and role functioning were declined only in the control group and the difference between week 8 and baseline for role functioning was significant (p<0.001). Fatigue score was steadily decreased in the experiment group, and the differences between week 8 and baseline was significant between two groups (p<0.02). However, no statistically significant improvement in biochemical markers of nutritional status and pro-inflammatory cytokine concentrations were found. These results suggests that ONS intervention for 8 weeks improves PG-SGA scores and QOL scores in patients undergoing cancer therapy.

Postural Difference between the Interventions Reflecting the Concept of Mirror Therapy in Healthy Subjects.

(1) Background: Mirror therapy is one of the promising interventions for the upper limb rehabilitation of stroke patients. Postural asymmetry during mirror therapy was pointed out as a possibility to influence stroke patients' rehabilitation negatively. However, it is still difficult to find studies on the postural changes in mirror therapy concept interventions. This study compared three methods of postural differences as follows: traditional mirror therapy (mirror); displaying the real-time movement of the unaffected side on the screen above the affected side (screen); and playing a pre-recorded movement of the unaffected side on a tablet placed on a movable box where the affected hand is put inside (movable). (2) Methods: to observe a kinematic difference, we recruited 16 healthy volunteers to go through three different interventions (mirror, screen, movable). The motion capture system made observations on the postures before and during interventions, then compared and analyzed. (3) Results: while using the mirror, the sitting posture was observed to become asymmetric, and the following unique posture was observed where the target hand went further from the trunk while performing tasks. In addition, the shoulder of the target side came forward, and the difference between both elbow flexion angles was also observed. On the other hand, the screen or movable device did not cause a significant change in the sitting posture, and no additional postural differences were observed either. (4) Conclusions: mirror therapy showed a tendency to cause lateral flexion opposite the target hand, thus, creating additional postural change. However, developed methods controlled spine tilt, and enabled the keeping of the midline while sitting during the intervention.

On the encoding capacity of human motor adaptation.

Primitive-based models of motor learning suggest that adaptation occurs by tuning the responses of motor primitives. Based on this idea, we consider motor learning as an information encoding procedure, that is, a procedure of encoding a motor skill into primitives. The capacity of encoding is determined by the number of recruited primitives, which depends on how many primitives are "visited" by the movement, and this leads to a rather counterintuitive prediction that faster movement, where a larger number of motor primitives are involved, allows learning more complicated motor skills. Here, we provide a set of experimental results that support this hypothesis. First, we show that learning occurs only with movement, that is, only with nonzero encoding capacity. When participants were asked to counteract a rotating force applied to a robotic handle, they were unable to do so when maintaining a static posture but were able to adapt when making small circular movements. Our second experiment further investigated how adaptation is affected by movement speed. When adapting to a simple (low-information-content) force field, fast (high-capacity) movement did not have an advantage over slow (low-capacity) movement. However, for a complex (high-information-content) force field, the fast movement showed a significant advantage over slow movement. Our final experiment confirmed that the observed benefit of high-speed movement is only weakly affected by mechanical factors. Taken together, our results suggest that the encoding capacity is a genuine limiting factor of human motor adaptation.NEW & NOTEWORTHY We propose a novel concept called "encoding capacity" of motor adaptation, which describes an inherent limiting-factor of our brain's ability to learn new motor skills, just like any other storage system. By reinterpreting the existing primitive-based models of motor learning, we hypothesize that the encoding capacity is determined by the size of the movement, and present a set of experimental evidence suggesting that such limiting effect of encoding capacity does exist in human motor adaptation.

Enhanced Spontaneous Emission of Monolayer MoS2 on Epitaxially Grown Titanium Nitride Epsilon-Near-Zero Thin Films.

Room-temperature photoluminescence enhancement of molybdenum disulfide (MoS2) monolayers on epitaxial titanium nitride (TiN) thin films grown by molecular-beam-epitaxy as well as magnetron-sputtered TiN films is observed by a confocal laser scanning microscope with excitation wavelengths covering the transition of TiN's macroscopic optical properties from dielectric to plasmonic. The photoluminescence enhancement increases as TiN becomes more metallic, and strong enhancement is obtained at the excitation wavelengths equal to or longer than the epsilon-near-zero (ENZ) wavelength of TiN films. A good agreement is observed between measured and calculated enhancements. The enhancement is attributed to the increased excitation field in MoS2 at TiN's ENZ wavelength and interference effects for thick spacers that separate the MoS2 flakes from TiN films in the metallic regime. This study enriches the fundamental understanding of emission properties on ENZ substrates that could be important for the development of advanced nanoscale lasers/light sources, optical/biosensors, and nano-optoelectronic devices.

Erratum: Efficacy of Cereal-based Oral Nutrition Supplement on Nutritional Status, Inflammatory Cytokine Secretion and Quality of Life in Cancer Patients Under Cancer Therapy.

[This corrects the article on p. 55 in vol. 25, PMID: 32266180.].

Efficacy of Cereal-based Oral Nutrition Supplement on Nutritional Status, Inflammatory Cytokine Secretion and Quality of Life in Cancer Patients Under Cancer Therapy.

A rapid increase in cancer incidence accompanied by aging population requires evidence-based supportive cancer care practices. Cancer therapies often accompany adverse events which induce malnutrition and declined quality of life. We conducted an 8-week non-randomized clinical trial to evaluate efficacy of cereal-based oral nutritional supplement (ONS) intervention on nutritional status, quality of life and inflammatory responses in cancer patients undergoing cancer therapy with 5% < weight loss. The study included 34 pateints (24 in control group, 10 in intervention group) with 15 drop-outs. ONS used in this intervention contained 0.5% arabinoxylan-rich fermented rice bran powder and 5.5% black rice powder as active ingredients in a regular cereal-based formula. Results showed that ONS intervention for 8 weeks did not show significant improvement in blood biomarkers of nutritional status or patient-generated subjective global assessment scores. However, 8-week of intervention showed reduced interleukin (IL)-6 and IL-1ß secretion in lipopolysaccharide-stimulated peripheral blood mononuclear cells while IL-12p70 level was increased. For health-related quality of life (HRQoL) indices, emotional functioning and fatigue symptoms were improved after 4 weeks only in the intervention group although no difference was found at week 8. These results suggest that ONS intervention may improve chronic inflammatory status and HRQoL indices (at week 4) in cancer patients receiving treatments.

Two-Week Exclusive Supplementation of Modified Ketogenic Nutrition Drink Reserves Lean Body Mass and Improves Blood Lipid Profile in Obese Adults: A Randomized Clinical Trial.

The ketogenic diet has long been recommended in patients with neurological disorders, and its protective effects on the cardiovascular system are of growing research interest. This study aimed to investigate the effects of two-week of low-calorie ketogenic nutrition drinks in obese adults. Subjects were randomized to consume drinks either a ketone-to-non-ketone ratio of 4:1 (KD 4:1), a drink partially complemented with protein at 1.7:1 (KD 1.7:1), or a balanced nutrition drink (BD). Changes in body weight, body composition, blood lipid profile, and blood ketone bodies were investigated. Blood ketone bodies were induced and maintained in the group that consumed both 4:1 and 1.7:1 ketogenic drinks (p < 0.001). Body weight and body fat mass significantly declined in all groups between 0 and 1 week and between 1 and 2 weeks (p < 0.05), while skeletal muscle mass remained unchanged only in the KD 1.7:1 group (p > 0.05). The blood lipid profile improved, appetite was reduced, and fullness was maintained in the two ketogenic drink groups. This study indicates the possibility for the development of obesity treatments based on ketogenic nutrition drinks even with a moderate ketogenic ratio of 1.7:1, as well as adjuvant therapies based on ketosis induction and maintenance for the treatment of other diseases and health conditions.

Intrahepatic recurrence of single nodular hepatocellular carcinoma after surgical resection: an analysis by segmental distribution.

BACKGROUND: Intrahepatic recurrence is the major cause of management failure after surgical resection of hepatocellular carcinoma (HCC). In the present study, we analysed intrahepatic recurrence by HCC distribution using Couinaud's liver segments. METHODS: Recurrence proximity levels were defined with respect to primary tumour locations from Level LR (locoregional) to Level IV. Initial and recurrent tumours were compared with segmental distribution of their locations, and recurrence proximity levels were compared with initial tumour locations and disease-free survival. RESULTS: Eighty-five (58.2%) of 146 patients with single nodular HCC experienced intrahepatic recurrence after surgical resection with a mean disease-free survival of 20.8 ± 21.1 months. Segmental distributions of initial and recurrent tumour locations were not significantly different (P > 0.05), and both were similar to the normal segmental volume distribution except segments S5, S6 and S8. Recurrences in proximity levels LR to IV were 11.1%, 34.9%, 25.4%, 21.4%, and 7.1%, respectively, and this distribution agreed well with theoretical proximity level distribution (P > 0.05). Disease-free survivals for different recurrence levels were not different (P = 0.530). CONCLUSION: Intrahepatic recurrences after surgical resection of single nodular HCC occurred evenly in the remnant liver, and the timing was independent of the proximity between initial and recurrent tumours. Prevention was found to be proportional to the amount of liver segments removed. Surgical plans should take this into consideration.

Room-Temperature, Ambient-Pressure Chemical Synthesis of Amine-Functionalized Hierarchical Carbon-Sulfur Composites for Lithium-Sulfur Battery Cathodes.

Recently, the achievement of newly designed carbon-sulfur composite materials has attracted a tremendous amount of attention as high-performance cathode materials for lithium-sulfur batteries. To date, sulfur materials have been generally synthesized by a sublimation technique in sealed containers. This is a well-developed technique for the synthesizing of well-ordered sulfur materials, but it is limited when used to scale up synthetic procedures for practical applications. In this study, we suggest an easily scalable, room-temperature/ambient-pressure chemical pathway for the synthesis of highly functioning cathode materials using electrostatically assembled, amine-terminated carbon materials. It is demonstrated that stable cycling performance outcomes are achievable with a capacity of 730 mAhg-1 at a current density of 1 C with good cycling stability by a virtue of the characteristic chemical/physical properties (a high conductivity for efficient charge conduction and the presence of a number of amine groups that can interact with sulfur atoms during electrochemical reactions) of composite materials. The critical roles of conductive carbon moieties and amine functional groups inside composite materials are clarified with combinatorial analyses by X-ray photoelectron spectroscopy, cyclic voltammetry, and electrochemical impedance spectroscopy.

Kinematic analysis of head, trunk, and pelvic motion during mirror therapy for stroke patients.

[Purpose] The purpose of this study was to investigate mirror therapy (MT) condition by analyzing kinematic parameters according to mirror size and angle. [Subjects and Methods] Three hemiparesis stroke patients and five healthy adults participated in this cross-sectional study. Kinematic parameters during the MT were collected over a total of 5 trials for each subject (3 mirror angles × 3 mirror sizes). Center of pressure (COP) excursion data was collected by force plate, and other kinematic parameters by infra-red cameras. [Results] The larger the size and smaller the angle, the overall dependent variables decreased in all participants. Particularly, when virtual reality reflection equipment (VRRE) was used, the value of the flexion and the lateral tilt was the closest to the midline compared to all other independent variables. Moreover, it showed tendency of moving towards the affected side. Based on the results, MT for stroke patients has a disadvantage of shifting weight and leaning towards the unaffected side during therapy. [Conclusion] Therefore, it seems to be more effective in terms of clinics to apply VRRE to make up for the weak parts and provide more elaborate visual feedback.

The Efficacy of Oral Nutritional Intervention in Malnourished Cancer Patients: a Systemic Review.

Cancer is currently a leading cause of deaths worldwide and the number of new cases is growing rapidly in both, developed and developing countries. Nutritional management during and after cancer treatment affects treatment efficacy and patient quality of life (QOL). This review systemically examined the effect of oral nutritional interventions on nutritional and clinical outcomes in cancer patients. We especially focused on outcomes such as nutritional status indices, immune-associated biochemical markers, and QOL assessments to provide insights on the applicability of different outcomes. A total of 28 papers were selected for systematic review. The nutritional composition of oral nutritional supplements (ONS), outcome measures, and efficacy of the oral nutritional interventions were summarized and discussed. Most ONS contain 1 or more functional components in addition to basic nutrients. Each study used various outcome measures and significant efficacy was observed for a limited number of measures. Nutritional status indices, QOL measures, and the duration of hospital stay improved in about 40% of the studies. One or more markers of immune function and inflammatory responses were improved by ONS in 65% of the selected studies. These results suggest that appropriate use of ONS may be an ideal way to improve treatment efficacy; however, additional intervention trials are required to confirm these findings.