Direct Observation of Particle-To-Particle Variability in Ambient Aerosol pH Using a Novel Analytical Approach Based on Surface-Enhanced Raman Spectroscopy.

The pH of atmospheric aerosols is a key characteristic that profoundly influences their impacts on climate change, human health, and ecosystems. Despite widely performed aerosol pH research, determining the pH levels of individual atmospheric aerosol particles has been a challenge. This study presents a novel analytical technique that utilizes surface-enhanced Raman spectroscopy to assess the pH of individual ambient PM2.5-10 aerosol particles in conjunction with examining their hygroscopic behavior, morphology, and elemental compositions. The results revealed a substantial pH variation among simultaneously collected aerosol particles, ranging from 3.3 to 5.7. This variability is likely related to each particle's unique reaction and aging states. The extensive particle-to-particle pH variability suggests that atmospheric aerosols present at the same time and location can exhibit diverse reactivities, reaction pathways, phase equilibria, and phase separation properties. This pioneering study paves the way for in-depth investigations into particle-to-particle variability, size dependency, and detailed spatial and temporal variations of aerosol pH, thus deepening our understanding of atmospheric chemistry and its environmental implications.

Permanent Anticoagulation Blood-Vessel by Mezzo-Sized Double Re-Entrant Structure.

Having a permanent omniphobicity on the inner surface of the tube can bring enormous advantages, such as reducing resistance and avoiding precipitation during mass transfer. For example, such a tube can prevent blood clotting when delivering blood composed of complex hydrophilic and lipophilic compounds. However, it is very challenging to fabricate micro and nanostructures inside a tube. To overcome these, a wearability and deformation-free structural omniphobic surface is fabricated. The omniphobic surface can repel liquids by its "air-spring" under the structure, regardless of surface tension. Furthermore, it is not lost an omniphobicity under physical deformation like curved or twisted. By using these properties, omniphobic structures on the inner wall of the tube by the "roll-up" method are fabricated. Fabricated omniphobic tubes still repels liquids, even complex liquids like blood. According to the ex vivo blood tests for medical usage, the tube can reduce thrombus formation by 99%, like the heparin-coated tube. So, the surface will soon replace typical coating-based medical surfaces or anticoagulation blood vessels.

A Proteomic Approach to Understand the Clinical Significance of Acute Myeloid Leukemia-Derived Extracellular Vesicles Reflecting Essential Characteristics of Leukemia.

Extracellular vesicle (EV) proteins from acute myeloid leukemia (AML) cell lines were analyzed using mass spectrometry. The analyses identified 2450 proteins, including 461 differentially expressed proteins (290 upregulated and 171 downregulated). CD53 and CD47 were upregulated and were selected as candidate biomarkers. The association between survival of patients with AML and the expression levels of CD53 and CD47 at diagnosis was analyzed using mRNA expression data from The Cancer Genome Atlas database. Patients with higher expression levels showed significantly inferior survival than those with lower expression levels. ELISA results of the expression levels of CD53 and CD47 from EVs in the bone marrow of patients with AML at diagnosis and at the time of complete remission with induction chemotherapy revealed that patients with downregulated CD53 and CD47 expression appeared to relapse less frequently. Network model analysis of EV proteins revealed several upregulated kinases, including LYN, CSNK2A1, SYK, CSK, and PTK2B. The potential cytotoxicity of several clinically applicable drugs that inhibit these kinases was tested in AML cell lines. The drugs lowered the viability of AML cells. The collective data suggest that AML cell-derived EVs could reflect essential leukemia biology.

Extracellular Vesicle Identification Using Label-Free Surface-Enhanced Raman Spectroscopy: Detection and Signal Analysis Strategies.

Extracellular vesicles (EVs) have been widely investigated as promising biomarkers for the liquid biopsy of diseases, owing to their countless roles in biological systems. Furthermore, with the notable progress of exosome research, the use of label-free surface-enhanced Raman spectroscopy (SERS) to identify and distinguish disease-related EVs has emerged. Even in the absence of specific markers for disease-related EVs, label-free SERS enables the identification of unique patterns of disease-related EVs through their molecular fingerprints. In this review, we describe label-free SERS approaches for disease-related EV pattern identification in terms of substrate design and signal analysis strategies. We first describe the general characteristics of EVs and their SERS signals. We then present recent works on applied plasmonic nanostructures to sensitively detect EVs and notable methods to interpret complex spectral data. This review also discusses current challenges and future prospects of label-free SERS-based disease-related EV pattern identification.

The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain.

Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20-~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (p < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (p < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (p < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (p < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment.

Flexible and Stable Omniphobic Surfaces Based on Biomimetic Repulsive Air-Spring Structures.

In artificial biological circulation systems such as extracorporeal membrane oxygenation, surface wettability is a critical factor in blood clotting problems. Therefore, to prevent blood from clotting, omniphobic surfaces are required to repel both hydrophilic and oleophilic liquids and reduce surface friction. However, most omniphobic surfaces have been fabricated by combining chemical reagent coating and physical structures and/or using rigid materials such as silicon and metal. It is almost impossible for chemicals to be used in the omniphobic surface for biomedical devices due to durability and toxicity. Moreover, a flexible and stable omniphobic surface is difficult to be fabricated by using conventional rigid materials. This study demonstrates a flexible and stable omniphobic surface by mimicking the re-entrant structure of springtail's skin. Our surface consists of a thin nanohole membrane on supporting microstructures. This structure traps air under the membrane, which can repel the liquid on the surface like a spring and increase the contact angle regardless of liquid type. By theoretical wetting model and simulation, we confirm that the omniphobic property is derived from air trapped in the structure. Also, our surface well maintains the omniphobicity under a highly pressurized condition. As a proof of our concept and one of the real-life applications, blood experiments are performed with our flat and curved surfaces and the results including contact angle, advancing/receding angles, and residuals show significant omniphobicity. We hope that our omniphobic surface has a significant impact on blood-contacting biomedical applications.

A comparison of ultrasonography measurement on the abdominal muscle thickness between adolescent idiopathic scoliosis and healthy subjects.

BACKGROUND: Many studies have shown asymmetric behavior of the surface and deep layers of spine muscles in scoliosis patients, compared to normal individuals. However, there is a lack of research on the transversus abdominal (TA) muscle, which plays an important role in trunk stabilization. OBJECTIVE: To assess symmetry in subjects with adolescent idiopathic scoliosis (AIS) by measuring the thickness of abdominal muscles, and to investigate characteristic features through a comparative analysis of the data with healthy aged-matched group. METHODS: Subjects consisted of 33 AIS and 32 healthy subjects of similar ages between 11-28 years old. We measured TA, internal abdominal oblique (IO), and external abdominal oblique (EO) muscles were measured using ultrasonography imaging. Three repeat measurements of the thickness of each muscle were performed during rest and contraction. RESULTS: For the healthy subjects, the intra-class correlation coefficients (ICCs) for the muscle thickness measures ranged from 0.70 to 0.99, standard error of measurement (SEM) was 0.38 cm, and minimal detectable change (MDC) was 1.07 cm. The ICCs for the muscle thickness measures in the AIS group ranged from 0.90 to 0.98, SEM was 0.45 cm, and MDC was 1.24 cm. The symmetry of the two groups was compared, and showed significant difference only in TA in AIS patient group (P< 0.01). CONCLUSIONS: In conclusion, treatment should be focused on exercises that emphasize symmetry, to induce normal action of the TA and structural changes in the spine because AIS induces asymmetry in TA, which plays an important role in trunk stability.

The effects of calcaneal posture on thoracolumbar alignment in a standing position.

[Purpose] Severe calcaneus misalignment is correlated with low back pain, and affects pelvic alignment. However, little has been published with regard to the influence of pronation and supination on trunk alignment. Therefore, the present study aimed to investigate the influence of calcaneal inversion on pelvic and trunk alignment. [Subjects and Methods] A 3-dimensional motion analysis system was used to assess pelvic and trunk alignment in 10 healthy male subjects with unilateral and bilateral calcaneus inversion. [Results] Medial and anterior tilting of the pelvis, and posterior tilting and lateral rotation of the trunk were observed. [Conclusion] Calcaneal inversion induces changes in the alignment of the pelvis and trunk. These changes may induce lumbar lordosis and body misalignment, leading to back pain.

Impact of work environment and work-related stress on turnover intention in physical therapists.

[Purpose] This study was conducted to provide basic data for solutions to reduce the turnover rate of physical therapists. It should help create efficient personnel and organization management by exploring the impact of the work environment and work-related stress on turnover intention and analyzing the correlation between them. [Subjects and Methods] A survey was conducted with 236 physical therapists working at medical institutions in the Daejeon and Chungcheong areas. For the analysis on the collected data, correlational and linear regression analyses were conducted using the SPSS 18.0 program and Cronbach's alpha coefficient. [Results] The results showed a statistically significant positive correlation between turnover intention and work-related stress but a statistically significant negative correlation respectively between turnover intention and work environment. Work-related stress (ß=0.415) had a significant positive impact on turnover intention and work environment (ß=-0.387) had a significant negative impact on turnover intention. [Conclusion] To increase satisfaction level with the profession as well as the workplace for physical therapists, improvement of the work environment was the most necessary primary improvement.

The effects of whole body vibration on static balance, spinal curvature, pain, and disability of patients with low back pain.

[Purpose] The purpose of this study was to investigate the impact of whole body vibration (WBV) on static balance, spinal curvature, pain, and the disability of patients with chronic lower back pain. [Subjects and Methods] The subjects were of 40 patients, who were randomly assigned to WBV and control groups. Twenty-five minutes of lumbar stability training and 5 minutes of WBV were conducted for the WBV group, and 30 minutes of lumbar stability training was conducted for the control group. The training was conducted three times per week for a total of 6 weeks. Static balance, spinal curvature, pain, and disability were measured before and after the intervention. [Results] After the intervention, the WBV group showed a significant differences in static balance, spinal curvature, pain, and disability. The control group presented significant differences in pain, and disability. In the comparison of the two groups, the WBV group showed more significant improvements in the fall index and pain. [Conclusion] WBV can be recommended for the improvement of the balance ability and pain of chronic lower back pain patients.

The effects of exercise with TENS on spasticity, balance, and gait in patients with chronic stroke: a randomized controlled trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a useful modality for pain control. TENS has recently been applied to decrease spasticity. The purpose of this study is to determine whether the addition of TENS to an exercise program reduces spasticity and improves balance and gait in chronic stroke patients. MATERIAL AND METHODS: This was a single-blinded, multicenter, randomized controlled trial. Thirty-four ambulatory individuals with chronic stroke participated and were randomly allocated to the TENS or Placebo group. The TENS group performed therapeutic exercise with TENS while the placebo (non-stimulation) TENS group performed therapeutic exercise with placebo TENS. Participants in both groups followed the same 30-min exercise regimen 5 times per week for a period of 6 weeks. Spasticity (modified Ashworth scale), static (balance system), and dynamic balance (timed up and go test), and gait ability (gait analyzer) were measured at 1 week before and 1 week after the intervention. RESULTS: Significant differences were observed between the 2 groups. Spasticity improved by 0.80 points in the TENS group. Anterior-posterior and medial-lateral sway velocity among static balance parameters and dynamic balance showed significant differences between the TENS and Placebo TENS groups (p=.000). Gait speed and cadence were enhanced significantly in the TENS group (p=.000). Step and stride length on the paretic side showed a significant difference in the TENS group (p=.000), while only velocity showed a significant difference in the Placebo TENS group (p=.004). CONCLUSIONS: A combination of therapeutic exercise and TENS may reduce spasticity and improve balance, gait, and functional activity in chronic stroke patients.

The comparison of manual lymph drainage and ultrasound therapy on the leg swelling caused by wearing high heels.

One of the major symptoms when women are wearing high heels for a long time is leg swelling. The purpose of this study was to compare the effect of manual lymph drainage with ultrasound therapy. The forty-five healthy women of twenties were participated in this study and divided randomly into three groups; manual lymph drainage group (n=15), ultrasound therapy group (n=15) and control group (n=15). Swelling was measured before wearing the high heels (10 cm-height), after one-hour of wearing the high heels, wearing the high heels of one-hour after the intervention of 15 minutes. Also swelling was calculated by using a tape measure, volumeter and body composition analyzer. Statistical analysis of the comparison between the three groups was performed by one-way ANOVA. Also comparison to the mean value in swelling according to the time was performed by repeated measure ANOVA. As the result of this study, a significant changes have emerged within each of manual lymph drainage, ultrasound therapy and control group (p< 0.05). However, there were no significant differences between each group (p> 0.05). But the mean value of manual lymph drainage group showed the tendency of fast recovering before causing swelling. Therefore, we consider that the clinical treatment of manual lymph drainage and ongoing studies will be made since manual lymph drainage is very effective in releasing the leg swelling caused by wearing high heels and standing for a long time at work.

The effect of transcutaneous electrical nerve stimulation on postural sway on fatigued dorsi-plantar flexor.

The application of transcutaneous electrical nerve stimulation (TENS) enhances muscle weakness and static balance by muscle fatigue. It was said that TENS affects decrease of the postural sway. On the other hand, the applications of TENS to separate dorsi-plantar flexor and the comparison with and without visual input have not been studied. Thus, the aim of this study was to compare the effects of TENS on fatigued dorsi-plantar flexor with and without visual input. 13 healthy adult males and 12 females were recruited and agreed to participate as the subject (mean age 20.5 ± 1.4, total 25) in this study after a preliminary research. This experiment was a single group repeated measurements design in three days. The first day, after exercise-induced fatigue, the standing position was maintained for 30 minutes and then the postural sway was measured on eyes open(EO) and eyes closed(EC). The second, TENS was applied to dorsi flexor in standing position for 30 minutes after conducting exercise-induced fatigue. On the last day, plantar flexor applied by TENS was measured to the postural sway on EO and EC after same exercise-induced fatigue. The visual input was not statistically difference between the groups. However, when compared of dorsi-plantar flexor after applied to TENS without visual input, the postural sway of plantar flexor was lower than the dorsi flexor (p< 0.05). As the result, the application of TENS in GCM clinically decreases the postural sway with visual input it helps to stable posture control and prevent to falling down.

Study on the Usefulness of Sit to Stand Training in Self-directed Treatment of Stroke Patients.

[Purpose] This study sought to determine the usefulness of sit to stand training in self-directed treatment of stroke patients. It examined the effect that sit to stand training has on balance and functional movement depending on the form of support surfaces. [Subjects and Methods] Thirty stroke patients were randomly sampled and divided into an unstable support surface group (15) and stable support surface group (15). In order to identify the effect depending on the form of support surfaces, 15 minutes of support surface training plus + 15 minutes of free gait training was performed. [Results] The results of the unstable support surface training showed that the corresponding sample t-test results were significant for the 7-item 3-point Berg balance scale, timed Up and Go test, and 6-minute walking test. The independent samples t-test, showed that there were significant outcomes in step length on the affected side, and step length on the unaffected side. [Conclusion] In conclusion, the sit to stand training on stable support surfaces was not as effective as the training using unstable support surfaces, but it is a simple and stable exercise with less risk of falls during training. It can also be performed alone by the patient in order to increase endurance and dynamic balance ability. Therefore, it is considered a useful exercise that can be performed alone by the patient outside the treatment room.

Comparison of Gait Aspects According to FES Stimulation Position Applied to Stroke Patients.

[Purpose] This study sought to identify the gait aspects according to the FES stimulation position in stroke patients during gait training. [Subjects and Methods] To perform gait analysis, ten stroke patients were grouped based on 4 types of gait conditions: gait without FES stimulation (non-FES), gait with FES stimulation on the tibialis anterior (Ta), gait with FES stimulation on the tibialis anterior and quadriceps (TaQ), and gait with FES stimulation on the tibialis anterior and gluteus medius (TaGm). [Results] Based on repeated measures analysis of variance of measurements of gait aspects comprised of gait speed, gait cycle, and step length according to the FES stimulation position, the FES stimulation significantly affected gait aspects. [Conclusion] In conclusion, stimulating the tibialis anterior and quadriceps and stimulating the tibialis anterior and gluteus medius are much more effective than stimulating only the tibialis anterior during gait training in stroke patients using FES.

The effect of repetitive passive and active movements on proprioception ability in forearm supination.

[Purpose] This study was conducted in order to investigate the effect of repetitive passive movement and repetitive active movement on proprioception in forearm supination. [Subjects] This study had a cross-sectional design. Twenty-three right-handed healthy subjects were recruited. All subjects randomly received both repetitive passive movement and repetitive active movement (repetitive passive/active movement at 120°/s with 60 repetitions over a 0-80° range). Active and passive joint repositioning of all subjects was measured using the error score for position sense, both before and after repositioning intervention. [Results] In the repetitive passive movement test, there was a statistically significant decrease in the pre- versus post-repositioning error scores in the active and passive angle examinations. In the repetitive active movement test, there was a statistically significant increase in pre- versus post-repositioning error scores in the active and passive angle examinations. In the comparison of position sense, there was a statistically significant decrease in both active and passive angle repositioning error scores in repetitive passive movement versus repetitive active movement. [Conclusion] Repetitive passive movement improved the proprioception results for forearm supination, compared to repetitive active movement. Results of this study indicate that repetitive passive movement can be recommended to clinicians for rehabilitation therapy as it provides greater proprioception benefits.

The relationship of abdominal muscles balance and body balance.

This study aimed to identify what impact the thickness differences between the leftside and rightside transversus abdominis (TrA), internal obliquus (IO) and external obliquus (EO) have on balance ability in the abdominal drawing-in maneuver (ADIM) and resting postures. [Subjects and Methods] In this study, 41 young adults were asked to adopt a resting posture and to perform ADIM. The thicknesses of the abdominal muscles (TrA, IO, EO) were measured using ultrasound imaging, Then balance ability was measured, so that a comparative analysis could be carried out. [Results] According to the results, the thicknesses of TrA and IO very significantly increased when ADIM was performed. The changes in thickness of the muscles on the left and right sides showed no significant correlations with balance ability. [Conclusion] According to the study results, the difference in thickness between the left and right side muscles in a normal person is small (symmetric), and the differences in the thickness of TrA and IO on the left and right side reduced when the ADIM, which is a re-education method for abdominal muscles was performed. Therefore, we consider that the ADIM should be used in future clinical trials to induce symmetric contraction of the abdominal muscles. Also, the correlation results of muscle balance and body balance can be used as empirical data.

Comparison of the changes in thickness of the abdominal wall muscles of stroke patients according to the duration of their illness as observed using ultrasonographic images.

[Purpose] This study was conducted in order to investigate the importance of trunk muscle strength in stroke patients. By comparing the thicknesses of the abdominal wall muscles through ultrasonography, relative to the duration of illness, the results of the objective data were applied. [Methods] Thirty stroke patients were divided into three groups including an acute phase group participating in the study within 1 month after the onset of a stroke (n=10), a subacute phase group participating less than 6 months (n=10) after a stroke, and a chronic phase group participating more than 6 months (n=10) after suffering a stroke. The thicknesses of the transversus abdominis muscles (TrA), internal oblique muscle (IO), and the external oblique muscle (EO) were measured at rest and during abdominal draw-in maneuver (ADIM) in a supine hook-lying position, and their differences were compared. [Results] The results showed that, in comparison of the thicknesses of the paretic and nonparetic sides, the TrA of the subacute phase and chronic phase groups showed significant differences. In addition, the IO of the subacute phase group and the EO of the chronic phase groups also showed significant differences. [Conclusion] According to the duration of illness in stroke patients, the abdominal wall muscles become noticeably infirm and asymmetric. By improving their symmetry, the functions of the trunk muscles can be recovered.