2D MOFs and Zeolites for Composite Membrane and Gas Separation Applications: A Brief Review.

Commercial membranes have predominantly been fabricated from polymers due to their economic viability and processability. This choice offers significant advantages in energy efficiency, cost-effectiveness, and operational simplicity compared to conventional separation techniques like distillation. However, polymeric membranes inherently exhibit a trade-off between their permeability and selectivity, which is summarized in the Robeson upper bound. To potentially surpass these limitations, mixed-matrix membranes (MMMs) can be an alternative solution, which can be constructed by combining polymers with inorganic additives such as metal-organic frameworks (MOFs) and zeolites. Incorporating high-aspect-ratio fillers like MOF nanosheets and zeolite nanosheets is of significant importance. This incorporation not only enhances the efficiency of separation processes but also reinforces the mechanical robustness of the membranes. We outline synthesis techniques for producing two-dimensional (2D) crystals (including nanocrystals with high aspect ratio) and provide examples of their integration into membranes to customize separation performances. Moreover, we propose a potential trajectory for research in the area of high-aspect-ratio materials-based MMMs, supported by a mathematical-model-based performance prediction.

A 42-year-old patient with renal cell carcinoma presenting as low back pain: A case report.

RATIONALE: Renal cell carcinoma (RCC) is the most common renal neoplasm, accounting for 2.4% of all cancers in Korea. Although the usual clinical manifestations of RCC include flank pain, hematuria, and palpable mass, RCC is generally characterized by a lack of early warning signs and is mostly discovered incidentally in advanced stage. This case report describes a 42-year-old Korean man diagnosed with giant RCC who presented with simple back pain. PATIENT CONCERNS: The clinical manifestation of a 42-year-old Korean man was chronic back pain. DIAGNOSES: Contrast-enhanced computed tomography showed a 19.1-cm sized heterogeneous enhancing mass on the right kidney and tumor thrombosis extending into inferior vena cava. INTERVENTION: Due to the large size of the tumor and extensive tumor thrombosis, the multidisciplinary team decided to administer neoadjuvant chemotherapy and an anticoagulant. Following 12 cycles of treatment with nivolumab and cabozantinib, he underwent a right radical nephrectomy with an adrenalectomy and tumor thrombectomy. OUTCOMES: Treatment was successful and posttreatment he started a cancer rehabilitation program. He was followed-up as an outpatient and no longer complains of back pain. LESSONS: RCC can manifest clinically as back pain, with diagnosis being difficult without appropriate imaging modalities. RCC should be included in the differential diagnosis of patients with low back pain, even at a young age.

Unravelling the main mechanism responsible for nocturnal CO2 uptake by dryland soils.

Soil respiration, or CO2 efflux from soil, is a crucial component of the terrestrial carbon cycle in climate models. Contrastingly, many dryland soils absorb atmospheric CO2 at night, but the exact mechanisms driving this uptake are actively debated. Here we used a mechanistic model with heuristic approaches to unravel the underlying processes of the observed patterns of soil-atmosphere CO2 fluxes. We show that the temperature drop during nighttime is the main driver of CO2 uptake by increasing CO2 solubility and local water pH of a thin water film on soil particle surfaces, providing favourable conditions for carbonate precipitation. Our data demonstrate that the nocturnal inorganic carbon absorption is a common soil process, but often offset by biological CO2 production. The uptake rates can be impacted by different successional stages of biocrusts that consume or produce CO2 and modify the pH of the soil water film, which can be maintained by non-rainfall water inputs, such as pore space condensation. Annual estimates of nocturnal carbon uptake, based on in situ continuous measurements at the soil level in drylands are still very scarce, but fluxes of up to several tens of g C m-2 y-1 have been reported, potentially accounting for a considerable fraction of the global residual terrestrial carbon sink.

Metabolomic changes in culture media with varying passage numbers of pig muscle stem cell culture for cultured meat production.

Selecting the primary cells in an optimal state for cultured meat production is a crucial challenge in commercializing cultured meat. We investigated the metabolomic changes in culture media according to passage numbers for indirectly assessing the state of primary cells. Pig skeletal muscle stem cells (PSCs) harvested from the biceps femoris muscles of 7-d-old crossbred pigs (Landrace × Yorkshire × Duroc, LYD) were used for cell characterization. Fresh media (FM) and spent media (SM) of PSCs during passages 1 to 3 in vitro culture were prepared for metabolomics analysis. SM was collected on the third day of proliferation for each passage of PSCs. Cell characterization analysis revealed that the proliferation rate was highest at passage 2; however, a significant loss of expression of myogenic marker genes was observed at passage 3. Based on metabolomic profiles of culture media, FM and SM groups (SM1, SM2, and SM3) were clearly separated by partial least squares-discriminant analysis. A total of seven differentially abundant metabolites (DAMs) were identified from FM and SM for each passage, based on the following criteria: P < 0.05, fold change > 1.5 or < 0.66, and a variable importance in projection score > 1.5. All seven DAMs and their interconnected metabolites might be primarily used as substrates for energy production and most of them were relatively abundant in SM3. Among the seven DAMs, the three potential biomarkers (γ-glutamyl-L-leucine, cytosine, and ketoleucine), which showed significant changes exclusively in SM3, each had an area under the curve value of 1. Therefore, monitoring the levels of these key metabolites in culture media could serve as a quality control measure for cultured meat production by enabling the indirect detection of suboptimal PSCs based on their proliferation ability.

Toe Grip Strength Is Associated with Improving Gait Function in Patients with Subacute Stroke.

Toe grip strength has recently been suggested to play an essential role in maintaining balance and postural stability for ambulatory function in older populations. This study aimed to investigate its association with improving gait function three months after onset in patients with subacute stroke. This longitudinal cohort study included 98 first-ever stroke patients (67 ± 9 years, 56% female) within one month from the onset who could not ambulate independently. Functional outcome indicators, including toe grip strength, hand grip strength, knee extensor strength, Fugl-Meyer Assessment of Lower Extremity (FMA_LE), and the Postural Assessment Scale for Stroke (PASS), were assessed before and three months after the intervention. We analyzed the correlation between participants' gait function using a 10-meter walk test time and various functional indicators. Then, multiple linear regression analysis was used to investigate whether toe grip strength was related to the improvement of gait function. Correlation analysis revealed a significant positive correlation between the 10MWT time and toe grip strength ratio (affected/unaffected side), with a moderate effect size (r = -0.61, p <0.001). Multiple regression analysis with covariates showed a significant relationship between 10MWT time and toe grip strength ratio (ß = -0.113, p < 0.001), FMA_LE (ß = -1.315, p = 0.004), PASS (ß = -3.275, p <0.001), and age (ß = -0.159, p = 0.004). In conclusion, toe grip strength was an essential factor associated with ambulatory function improvement in subacute stroke patients three months after onset. Additional toe grip muscle strengthening rehabilitation treatment can be expected to help improve the ambulatory function of subacute stroke patients in the future.

Artificial intelligence predicts undiagnosed atrial fibrillation in patients with embolic stroke of undetermined source using sinus rhythm electrocardiograms.

BACKGROUND: Artificial intelligence (AI)-enabled sinus rhythm (SR) electrocardiogram (ECG) interpretation can aid in identifying undiagnosed paroxysmal atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). OBJECTIVE: The purpose of this study was to assess the efficacy of an AI model in identifying AF based on SR ECGs in patients with ESUS. METHODS: A transformer-based vision AI model was developed using 737,815 SR ECGs from patients with and without AF to detect current paroxysmal AF or predict the future development of AF within a 2-year period. Probability of AF was calculated from baseline SR ECGs using this algorithm. Its diagnostic performance was further tested in a cohort of 352 ESUS patients from 4 tertiary hospitals, all of whom were monitored using an insertable cardiac monitor (ICM) for AF surveillance. RESULTS: Over 25.1-month follow-up, AF episodes lasting ≥1 hour were identified in 58 patients (14.4%) using ICMs. In the receiver operating curve (ROC) analysis, the area under the curve for the AI algorithm to identify AF ≥1 hour was 0.806, which improved to 0.880 after integrating the clinical parameters into the model. The AI algorithm exhibited greater accuracy in identifying longer AF episodes (ROC for AF ≥12 hours: 0.837, for AF ≥24 hours: 0.879) and a temporal trend indicating that the AI-based AF risk score increased as the ECG recording approached the AF onset (P for trend <.0001). CONCLUSIONS: Our AI model demonstrated excellent diagnostic performance in predicting AF in patients with ESUS, potentially enhancing patient prognosis through timely intervention and secondary prevention of ischemic stroke in ESUS cohorts.

Risk of Subsequent Primary Cancers in Thyroid Cancer Survivors according to the Dose of Levothyroxine: A Nationwide Cohort Study.

Background: Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients. Methods: We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy. Results: A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05-1.24 and 1.17- 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence. Conclusion: High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.

A framework for inferring and analyzing pharmacotherapy treatment patterns.

BACKGROUND: To discover pharmacotherapy prescription patterns and their statistical associations with outcomes through a clinical pathway inference framework applied to real-world data. METHODS: We apply machine learning steps in our framework using a 2006 to 2020 cohort of veterans with major depressive disorder (MDD). Outpatient antidepressant pharmacy fills, dispensed inpatient antidepressant medications, emergency department visits, self-harm, and all-cause mortality data were extracted from the Department of Veterans Affairs Corporate Data Warehouse. RESULTS: Our MDD cohort consisted of 252,179 individuals. During the study period there were 98,417 emergency department visits, 1,016 cases of self-harm, and 1,507 deaths from all causes. The top ten prescription patterns accounted for 69.3% of the data for individuals starting antidepressants at the fluoxetine equivalent of 20-39 mg. Additionally, we found associations between outcomes and dosage change. CONCLUSIONS: For 252,179 Veterans who served in Iraq and Afghanistan with subsequent MDD noted in their electronic medical records, we documented and described the major pharmacotherapy prescription patterns implemented by Veterans Health Administration providers. Ten patterns accounted for almost 70% of the data. Associations between antidepressant usage and outcomes in observational data may be confounded. The low numbers of adverse events, especially those associated with all-cause mortality, make our calculations imprecise. Furthermore, our outcomes are also indications for both disease and treatment. Despite these limitations, we demonstrate the usefulness of our framework in providing operational insight into clinical practice, and our results underscore the need for increased monitoring during critical points of treatment.

Synaptic wiring motifs in posterior parietal cortex support decision-making.

The posterior parietal cortex exhibits choice-selective activity during perceptual decision-making tasks1-10. However, it is not known how this selective activity arises from the underlying synaptic connectivity. Here we combined virtual-reality behaviour, two-photon calcium imaging, high-throughput electron microscopy and circuit modelling to analyse how synaptic connectivity between neurons in the posterior parietal cortex relates to their selective activity. We found that excitatory pyramidal neurons preferentially target inhibitory interneurons with the same selectivity. In turn, inhibitory interneurons preferentially target pyramidal neurons with opposite selectivity, forming an opponent inhibition motif. This motif was present even between neurons with activity peaks in different task epochs. We developed neural-circuit models of the computations performed by these motifs, and found that opponent inhibition between neural populations with opposite selectivity amplifies selective inputs, thereby improving the encoding of trial-type information. The models also predict that opponent inhibition between neurons with activity peaks in different task epochs contributes to creating choice-specific sequential activity. These results provide evidence for how synaptic connectivity in cortical circuits supports a learned decision-making task.

An ultrasensitive and broadband transparent ultrasound transducer for ultrasound and photoacoustic imaging in-vivo.

Transparent ultrasound transducers (TUTs) can seamlessly integrate optical and ultrasound components, but acoustic impedance mismatch prohibits existing TUTs from being practical substitutes for conventional opaque ultrasound transducers. Here, we propose a transparent adhesive based on a silicon dioxide-epoxy composite to fabricate matching and backing layers with acoustic impedances of 7.5 and 4-6 MRayl, respectively. By employing these layers, we develop an ultrasensitive, broadband TUT with 63% bandwidth at a single resonance frequency and high optical transparency ( > 80%), comparable to conventional opaque ultrasound transducers. Our TUT maximises both acoustic power and transfer efficiency with maximal spectrum flatness while minimising ringdowns. This enables high contrast and high-definition dual-modal ultrasound and photoacoustic imaging in live animals and humans. Both modalities reach an imaging depth of > 15 mm, with depth-to-resolution ratios exceeding 500 and 370, respectively. This development sets a new standard for TUTs, advancing the possibilities of sensor fusion.

Highly Stretchable Thermoplastic Polyurethane Separators for Li-Ion Batteries Based on Non-Solvent-Induced Phase Separation Method.

The growing interest in wearable and portable devices has stimulated the need for flexible and stretchable lithium-ion batteries (LiBs). A crucial component in these batteries is the separator, which provides a pathway for Li-ion transfer and prevents electrode contact. In a flexible and stretchable LiB, the separator must exhibit stretchability and elasticity akin to its existing counterparts. Here, we developed a non-modified thermoplastic polyurethane (TPU) separator using the non-solvent induced phase separation (NIPS) technique. We compared their performance with commercially available polypropylene (PP) separators. Our results demonstrate that TPU separators exhibit superior elasticity based on repeated stretch/release tests with excellent thermal stability and electrolyte wettability. Furthermore, our findings confirm that TPU separators, even after being repeatedly stretched and released, can function effectively without severe damage in a fabricated coin cell LiB with high oxidative stability, as evidenced by linear sweep voltammetry, like commercially available separators.

Isomerism of Cyclodextrin Tetramer Induced by Alkali Halide Cluster Ions Observed by Ion Mobility Spectrometry-Mass Spectrometry.

Cyclodextrins (CDs) exhibit versatile self-assembly properties due to their hydrophilic and hydrophobic components, with applications such as drug delivery and selective binding. While research on CD self-assembly is extensive, limited studies have explored their aggregation behavior, particularly in interactions with small ionic guests. The present work investigates the structure of ß-CD tetramers aggregated with alkali metal chloride clusters using ion mobility spectrometry-mass spectrometry (IMS-MS). The results revealed that diverse structures emerge in the tetramer depending on the alkali metal cluster size. Notably, the doubly charged tetramer exhibits distinct aggregation trends with specific numbers of MCl clusters for Na+ and K+ ions. After initially adopting a bucket-wheel structure with two internal cations, the structure transforms into a new isomer with a tetrahedral configuration upon cluster addition. The formation of the new isomer structure is closely linked to filling the cavity volume with MCl clusters and ionic interactions, which possibly compensate for the weakened hydrogen bonds between CDs. Theoretical calculations further support the structures, showing well-matched collision cross-section (CCS) values compared with the experimental CCS values. This study highlights the role of alkali metal chloride clusters as potential templates, leading to the formation of novel CD assemblies.

Mechanism Behind the Loss of Fast Charging Capability in Nickel-Rich Cathode Materials.

Fast charging technology for electric vehicles (EVs), offering rapid charging times similar to conventional vehicle refueling, holds promise but faces obstacles owing to kinetic issues within lithium-ion batteries (LIBs). Specifically, the significance of cathode materials in fast charging has grown because Ni-rich cathodes are employed to enhance the energy density of LIBs. Herein, the mechanism behind the loss of fast charging capability of Ni-rich cathodes during extended cycling is investigated through a comparative analysis of Ni-rich cathodes with different microstructures. The results revealed that microcracks and the resultant cathode deterioration significantly compromised the fast charging capability over extended cycling. When thick rocksalt impurity phases form throughout the particles owing to electrolyte infiltration via microcracks, the limited kinetics of Li+ ions create electrochemically unreactive areas under high-current conditions, resulting in the loss of fast charging capability. Hence, preventing microcrack formation by tailoring microstructures is essential to ensure stability in fast charging capability. Understanding the relationship between microcracks and the loss of fast charging capability is essential for developing Ni-rich cathodes that facilitate stable fast charging upon extended cycling, thereby promoting widespread EV adoption.

In-Car Environment Control Using an SSVEP-Based Brain-Computer Interface with Visual Stimuli Presented on Head-Up Display: Performance Comparison with a Button-Press Interface.

Controlling the in-car environment, including temperature and ventilation, is necessary for a comfortable driving experience. However, it often distracts the driver's attention, potentially causing critical car accidents. In the present study, we implemented an in-car environment control system utilizing a brain-computer interface (BCI) based on steady-state visual evoked potential (SSVEP). In the experiment, four visual stimuli were displayed on a laboratory-made head-up display (HUD). This allowed the participants to control the in-car environment by simply staring at a target visual stimulus, i.e., without pressing a button or averting their eyes from the front. The driving performances in two realistic driving tests-obstacle avoidance and car-following tests-were then compared between the manual control condition and SSVEP-BCI control condition using a driving simulator. In the obstacle avoidance driving test, where participants needed to stop the car when obstacles suddenly appeared, the participants showed significantly shorter response time (1.42 ± 0.26 s) in the SSVEP-BCI control condition than in the manual control condition (1.79 ± 0.27 s). No-response rate, defined as the ratio of obstacles that the participants did not react to, was also significantly lower in the SSVEP-BCI control condition (4.6 ± 14.7%) than in the manual control condition (20.5 ± 25.2%). In the car-following driving test, where the participants were instructed to follow a preceding car that runs at a sinusoidally changing speed, the participants showed significantly lower speed difference with the preceding car in the SSVEP-BCI control condition (15.65 ± 7.04 km/h) than in the manual control condition (19.54 ± 11.51 km/h). The in-car environment control system using SSVEP-based BCI showed a possibility that might contribute to safer driving by keeping the driver's focus on the front and thereby enhancing the overall driving performance.

Low-Noise Amplifier with Bypass for 5G New Radio Frequency n77 Band and n79 Band in Radio Frequency Silicon on Insulator Complementary Metal-Oxide Semiconductor Technology.

This paper presents the design of a low-noise amplifier (LNA) with a bypass mode for the n77/79 bands in 5G New Radio (NR). The proposed LNA integrates internal matching networks for both input and output, combining two LNAs for the n77 and n79 bands into a single chip. Additionally, a bypass mode is integrated to accommodate the flexible operation of the receiving system in response to varying input signal levels. For each frequency band, we designed a low-noise amplifier for the n77 band to expand the bandwidth to 900 MHz (3.3 GHz to 4.2 GHz) using resistive-capacitance (RC) feedback and series inductive-peaking techniques. For the n79 band, only the RC feedback technique was employed to optimize the performance of the LNA for its 600 MHz bandwidth (4.4 GHz to 5.0 GHz). Because wideband techniques can lead to a trade-off between gain and noise, causing potential degradation in noise performance, appropriate bandwidth design becomes crucial. The designed n77 band low-noise amplifier achieved a simulated gain of 22.6 dB and a noise figure of 1.7 dB. Similarly, the n79 band exhibited a gain of 21.1 dB and a noise figure of 1.5 dB with a current consumption of 10 mA at a 1.2 supply voltage. The bypass mode was designed with S21 of -3.7 dB and -5.0 dB for n77 and n79, respectively.

Perioperative Management of Patients with Cardiac Implantable Electronic Devices.

The use of cardiac implantable electronic devices (CIEDs) has increased significantly in recent years. Consequently, more patients with CIEDs will undergo surgery during their lifetime, and thus the involvement of anesthesiologists in the perioperative management of CIEDs is increasing. With ongoing advancements in technology, many types of CIEDs have been developed, including permanent pacemakers, leadless pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy-pacemakers/defibrillators, and implantable loop recorders. The functioning of CIEDs exposed to an electromagnetic field can be affected by electromagnetic interference, potential sources of which can be found in the operating room. Thus, to prevent potential adverse events caused by electromagnetic interference in the operating room, anesthesiologists must have knowledge of CIEDs and be able to identify each type. This review focuses on the perioperative management of patients with CIEDs, including indications for CIED implantation to determine the baseline cardiovascular status of patients; concerns associated with CIEDs before and during surgery; perioperative management of CIEDs, including magnet application and device reprogramming; and additional perioperative provisions for patients with CIEDs. As issues such as variations in programming capabilities and responses to magnet application according to device can be challenging, this review provides essential information for the safe perioperative management of patients with CIEDs.

Haze-Suppressed Wideband Light Shutter from Near Ultraviolet to Infrared Rays Utilizing Electrophoretic Carbon Black Particles.

Carbon black (CB) particles that can absorb from near ultraviolet to infrared rays are well dispersed into an isotropic dielectric liquid and their optical properties can be kept even under exposure to sunlight over a long time. The shutter which controls the position of CB particles by electrophoretic force can be applied to switchable light shutters for windows in buildings and automobiles for the purpose of energy savings. Here, a wideband light shutter with three terminal electrodes is proposed, exhibiting excellent dark (transmittance ≈1.4%) and transparent state (transmittance >60%). The device operates at a low field intensity of about 1 V µm-1 to obtain transparent state and its wide temperature range operation from -50 to 120 °C is confirmed while conventional liquid crystal-based shutter cannot perform such levels due to a limited temperature range in the nematic phase. In addition, haze is minimized in a transparent state by adopting an insulation layer over electrodes and a solution is found to keep a transparent state without applying power. It is believed that the proposed broadband shutter with fast response time could open a new chapter in switchable windows owing to its low power consumption and working in a wide temperature range.

Radiographic and computed tomographic evaluation of tracheal diameter and length in kittens.

OBJECTIVE: To measure the tracheal diameter and length in kittens using radiography and CT and to evaluate the concordance between measurements obtained with these 2 modalities. ANIMALS: 15 kittens with an estimated age of 12 weeks and mean body weight of 1.49 kg. METHODS: Radiographic and CT images were retrospectively evaluated to measure tracheal lengths and diameters. Tracheal diameters were measured at 5 different sites (A [at the level of the C2-3 intervertebral disk space], B [at the level of the C4-5 intervertebral disk space], C [at the cranial end of the manubrium sterni], D [at the level of the second rib], and E [1 cm cranial to the carina]) along the trachea. The cross-sectional area and transverse and vertical diameter ratios were calculated for each measurement site. RESULTS: The cross-sectional area was largest at site A and decreased from site C to site E. Based on the vertical diameter ratio, the tracheal shape was most circular at sites A and E, whereas from sites B to D, it was elliptical. The vertical diameters of the trachea on radiography and CT did not differ statistically significantly. However, the tracheal length measured on radiography was approximately 6 mm longer than that measured on CT (P < .05). CLINICAL RELEVANCE: Using the first rib as an anatomical reference, the placement of a cuffed endotracheal tube is recommended in kittens. In emergency situations, regression equations based on body weight may be helpful in predicting tracheal diameters.

Association between Vitamin D and Short-Term Functional Outcomes in Acute Ischemic Stroke.

Vitamin D (Vit D) affects musculoskeletal performance and central nervous system neuroprotection. We aimed to investigate the association between serum Vit D levels and short-term functional outcomes in patients with acute ischemic stroke. This study involved patients with acute ischemic stroke confirmed on brain MRI. The National Institutes of Health Stroke Scale (NIHSS) was used to assess initial stroke severity upon admission. We evaluated the functional outcomes using the Berg Balance Scale (BBS), Manual Function Test (MFT), Korean Mini-Mental State Examination (K-MMSE), Korean version of the modified Barthel Index (K-MBI) within three weeks from the onset of stroke, and modified Rankin Scale (mRS) score at discharge. Overall, 192 patients were finally included and divided into three groups: Vit D sufficient (n = 28), insufficient (n = 49), and deficient (n = 115). Multivariate analysis showed that the Vit D deficient group presented with a higher risk of initially severe stroke (p = 0.025) and poor functional outcomes on the BBS (p = 0.048), MFT (p = 0.017), K-MMSE (p = 0.001), K-MBI (p = 0.003), and mRS (p = 0.032) compared to the Vit D sufficient group. Vit D deficiency may be associated with severe initial stroke and poor short-term post-stroke functional outcomes.

Three-Dimensional Magnetic Rehabilitation, Robot-Enhanced Hand-Motor Recovery after Subacute Stroke: A Randomized Controlled Trial.

We developed an end-effector-type rehabilitation robot that can uses electro- and permanent magnets to generate a three-way magnetic field to assist hand movements and perform rehabilitation therapy. This study aimed to investigate the therapeutic effect of a rehabilitation program using a three-dimensional (3D) magnetic force-based hand rehabilitation robot on the motor function recovery of the paralyzed hands of patients with stroke. This was a double-blind randomized controlled trial in which 36 patients with subacute stroke were assigned to intervention and control groups of 18 patients each. The intervention group received 30 min of rehabilitation therapy per day for a month using a 3D magnetic force-driven hand rehabilitation robot, whereas the control group received 30 min of conventional occupational therapy to restore upper-limb function. The patients underwent three behavioral assessments at three time points: before starting treatment (T0), after 1 month of treatment (T1), and at the follow-up 1-month after treatment completion (T2). The primary outcome measure was the Wolf Motor Function Test (WMFT), and secondary outcome measures included the Fugl-Meyer Assessment of the Upper Limb (FMA_U), Modified Barthel Index (MBI), and European Quality of Life Five Dimensions (EQ-5D) questionnaire. No participant safety issues were reported during the intervention. Analysis using repeated measures analysis of variance showed significant interaction effects between time and group for both the WMFT score (p = 0.012) and time (p = 0.010). In post hoc analysis, the WMFT scores and time improved significantly more in the patients who received robotic rehabilitation at T1 than in the controls (p = 0.018 and p = 0.012). At T2, we also consistently found improvements in both the WMFT scores and times for the intervention group that were superior to those in the control group (p = 0.024 and p = 0.018, respectively). Similar results were observed for FMA_U, MBI, and EQ-5D. Rehabilitation using the 3D hand-rehabilitation robot effectively restored hand function in the patients with subacute stroke, contributing to improvement in daily independence and quality of life.