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Wu Y, Rytkin E, Bimrose M, Li S, Choi YS, Lee G, Wang Y, Tang L, Madrid M, Wickerson G, Chang JK, Gu J, Zhang Y, Liu J, Tawfick S, Huang Y, King WP, Efimov IR, Rogers JA. A Sewing Approach to the Fabrication of Eco/bioresorbable Electronics. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2305017. [PMID: 37528504 DOI: 10.1002/smll.202305017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Indexed: 08/03/2023]
Abstract
Eco/bioresorbable electronics represent an emerging class of technology defined by an ability to dissolve or otherwise harmlessly disappear in environmental or biological surroundings after a period of stable operation. The resulting devices provide unique capabilities as temporary biomedical implants, environmental sensors, and related systems. Recent publications report schemes to overcome challenges in fabrication that follow from the low thermostability and/or high chemical reactivity of the eco/bioresorbable constituent materials. Here, this work reports the use of high-speed sewing machines, as the basis for a high-throughput manufacturing technique that addresses many requirements for these applications, without the need for high temperatures or reactive solvents. Results demonstrate that a range of eco/bioresorbable metal wires and polymer threads can be embroidered into complex, user-defined conductive patterns on eco/bioresorbable substrates. Functional electronic components, such as stretchable interconnects and antennas are possible, along with fully integrated systems. Examples of the latter include wirelessly powered light-emitting diodes, radiofrequency identification tags, and temporary cardiac pacemakers. These advances add to a growing range of options in high-throughput, automated fabrication of eco/bioresorbable electronics.
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Lee S, Choi YS, Do SH, Lee W, Lee CH, Lee M, Vojta M, Wang CN, Luetkens H, Guguchia Z, Choi KY. Kondo screening in a Majorana metal. Nat Commun 2023; 14:7405. [PMID: 37974022 PMCID: PMC10654600 DOI: 10.1038/s41467-023-43185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
Kondo impurities provide a nontrivial probe to unravel the character of the excitations of a quantum spin liquid. In the S = 1/2 Kitaev model on the honeycomb lattice, Kondo impurities embedded in the spin-liquid host can be screened by itinerant Majorana fermions via gauge-flux binding. Here, we report experimental signatures of metallic-like Kondo screening at intermediate temperatures in the Kitaev honeycomb material α-RuCl3 with dilute Cr3+ (S = 3/2) impurities. The static magnetic susceptibility, the muon Knight shift, and the muon spin-relaxation rate all feature logarithmic divergences, a hallmark of a metallic Kondo effect. Concurrently, the linear coefficient of the magnetic specific heat is large in the same temperature regime, indicating the presence of a host Majorana metal. This observation opens new avenues for exploring uncharted Kondo physics in insulating quantum magnets.
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Song J, Park J, Lee J, Lee YJ, Cho W, Min C, Kim MS, Rahmati M, Choi YS, Yon DK, Yeo SG. National prevalence and determinants of COVID-19 vaccine hesitancy during the initial phase pandemic. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:8280-8290. [PMID: 37750655 DOI: 10.26355/eurrev_202309_33588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Although previous studies have explored the causes of COVID-19 vaccine hesitancy during the pandemic, there is a lack of generality and reproducibility in these studies. Therefore, we aimed to comprehensively identify the determinants of COVID-19 vaccine hesitancy through a representative nationwide cross-sectional study conducted in South Korea. SUBJECTS AND METHODS We used a nationwide, representative, and large-scale dataset from the 2021 Community Health Survey. By analyzing 193,495 participants, we investigated the nationwide incidence of COVID-19 vaccine hesitancy and the various causes thereof. RESULTS The national prevalence of COVID-19 vaccine hesitancy was 5.7% (95% CI, 5.5-5.8). COVID-19 vaccine hesitancy was associated with an increased incidence of the following factors: (1) demographic factors including early-middle adulthood [vs. late; odds ratio (OR), 1.51; 95% CI, 1.38-1.65] and male sex (vs. female sex; OR, 1.08; 95% CI, 1.01-1.14); (2) physically healthy subjects; (3) lower socio-economic status (vs. high household income; OR, 1.28; 95% CI, 1.19-1.38); (4) having mental illness (vs. normal mental status; OR, 1.25; 95% CI, 1.13-1.38); and (5) unhealthy habits such as current smoking (vs. non-smoking; OR, 1.22; 95% CI, 1.13-1.31); and insufficient physical activity (vs. sufficient; OR, 1.08; 95% CI, 1.01-1.17). Common reasons for vaccine hesitancy were concerns about side effects (41.34%), health problems (24.60%), and inability to select the type of vaccine (14.13%). CONCLUSIONS This representative large-scale nationwide study conducted in South Korea investigated the nationwide prevalence and determinants of vaccine hesitancy. Our results provide useful public health information, especially on novel aspects of vaccination strategies, for policymakers to improve the acceptance of COVID-19 vaccines.
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Clifton DR, Nelson DA, Choi YS, Edgeworth DB, Nelson KJ, Shell D, Deuster PA. Risk factors for musculoskeletal-related occupational disability among US Army soldiers. BMJ Mil Health 2023; 169:327-334. [PMID: 34373349 DOI: 10.1136/bmjmilitary-2021-001900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/25/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Minimising temporary and permanent disability associated with musculoskeletal conditions (MSK-D) is critical to the mission of the US Army. Prior research has identified potentially actionable risk factors for overall military disability and its MSK-D subset, including elevated body mass index, tobacco use and physical fitness. However, prior work does not appear to have addressed the impact of these factors on MSK-D when controlling for a full range of factors that may affect health behaviours, including aptitude scores that may serve as a proxy for health literacy. Identifying risk factors for MSK-D when providing control for all such factors may inform efforts to improve military readiness. METHODS We studied 494 757 enlisted Army soldiers from 2014 to 2017 using a combined medical and administrative database. Leveraging data from the Army's digital 'eProfile' system of duty restriction records, we defined MSK-D as the first restriction associated with musculoskeletal conditions and resulting in the inability to deploy or train. We used multivariable Cox proportional hazards regression to assess the associations between incident MSK-D and selected risk factors including aptitude scores, physical fitness test scores, body mass index and tobacco use. RESULTS Among the subjects, 281 278 (45.14%) experienced MSK-D. In the MSK-D hazards model, the highest effect size was for failing the physical fitness test (adjusted HR=1.63, 95% CI 1.58 to 1.67, p<0.001) compared with scoring ≥290 points. CONCLUSIONS The analysis revealed the strongest associations between physical fitness and MSK-D. Additional efforts are warranted to determine potential mechanisms for the observed associations between selected factors and MSK-D.
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Kim HG, Kim DS, Choi YS, Lee ES, Yoo HJ, Kim DY. High-intensity focused ultrasound therapy versus Coblation for treatment of inferior turbinate hypertrophy: Clinical trial. Clin Exp Otorhinolaryngol 2023; 16:141-147. [PMID: 36791808 DOI: 10.21053/ceo.2022.01312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/12/2023] [Indexed: 02/14/2023] Open
Abstract
Objectives To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) therapy with coblation for the treatment of inferior turbinate hypertrophy (ITH). Methods In this randomized controlled clinical trial, a total of 20 patients underwent inferior turbinate surgery, which consisted of either HIFU or coblation therapy. Efficacy, safety and tolerability were evaluated by subjective symptom scores, acoustic rhinometry, and nasal endoscopy. Results The modified nasal obstruction symptom evaluation (NOSE) score and nasal obstruction visual analog scale (NO-VAS) were significantly decreased in both groups 12 weeks postoperatively. Differences between the evaluation scores of the two patient groups were not significant. On nasal endoscopy, the HIFU patients showed improvements in mucosal swelling sooner than the patients undergoing coblation therapy. Nasal crusting was significantly increased in the patients undergoing coblation over the patients undergoing HIFU therapy, until postoperative week 4. Mucosal preservation was superior in the HIFU patients. Although HIFU was less painful than coblation therapy during the procedure, the difference was not significant (4.9 vs 6.3, p=0.143). The difference between global satisfaction in the two groups was not significant, although satisfaction was slightly greater for the HIFU than the coblation patients (4.6 vs 4.1, p=0.393). Conclusion HIFU provided results similar to those of coblation therapy for patients with nasal obstruction due to ITH, but HIFU therapy caused less discomfort during the procedure. HIFU therapy appears to be a good noninvasive alternative to the current surgical modalities for ITH.
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Ban CY, Shin H, Eum S, Yon H, Lee SW, Choi YS, Shin YH, Shin JU, Koyanagi A, Jacob L, Smith L, Min C, Yeniova AÖ, Kim SY, Lee J, Yeo SG, Kwon R, Koo MJ, Fond G, Boyer L, Acharya KP, Kim S, Woo HG, Park S, Shin JI, Rhee SY, Yon DK. 17-year trends of body mass index, overweight, and obesity among adolescents from 2005 to 2021, including the COVID-19 pandemic: a Korean national representative study. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:1565-1575. [PMID: 36876712 DOI: 10.26355/eurrev_202302_31399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE There is a lack of pediatric studies that have analyzed trends in mean body mass index (BMI) and the prevalence of obesity and overweight over a period that includes the mid-stage of the COVID-19 pandemic. Thus, we aimed to investigate trends in BMI, overweight, and obesity among Korean adolescents from 2005 to 2021, including the COVID-19 pandemic. SUBJECTS AND METHODS We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), which is nationally representative of South Korea. The study included middle- and high-school students between the ages of 12 and 18. We examined trends in mean BMI and prevalence of obesity and/or overweight during the COVID-19 pandemic and compared these to those of pre-pandemic trends in each subgroup by gender, grade, and residential region. RESULTS Data from 1,111,300 adolescents (mean age: 15.04 years) were analyzed. The estimated weighted mean BMI was 20.48 kg/m2 (95% CI, 20.46-20.51) between 2005 and 2007, and this was 21.61 kg/m2 (95% CI, 21.54-21.68) in 2021. The prevalence of overweight and obesity was 13.1% (95% CI, 12.9-13.3%) between 2005 and 2007 and 23.4% (95% CI, 22.8-24.0%) in 2021. The mean BMI and prevalence of obesity and overweight have gradually increased over the past 17 years; however, the extent of change in mean BMI and in the prevalence of obesity and overweight during the pandemic was distinctly less than before. The 17-year trends in the mean BMI, obesity, and overweight exhibited a considerable rise from 2005 to 2021; however, the slope during the COVID-19 pandemic (2020-2021) was significantly less prominent than in the pre-pandemic (2005-2019). CONCLUSIONS These findings enable us to comprehend long-term trends in the mean BMI of Korean adolescents and further emphasize the need for practical prevention measures against youth obesity and overweight.
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Yoon HJ, Lee G, Kim JT, Yoo JY, Luan H, Cheng S, Kang S, Huynh HLT, Kim H, Park J, Kim J, Kwak SS, Ryu H, Kim J, Choi YS, Ahn HY, Choi J, Oh S, Jung YH, Park M, Bai W, Huang Y, Chamorro LP, Park Y, Rogers JA. Biodegradable, three-dimensional colorimetric fliers for environmental monitoring. SCIENCE ADVANCES 2022; 8:eade3201. [PMID: 36563148 PMCID: PMC9788784 DOI: 10.1126/sciadv.ade3201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Recently reported winged microelectronic systems offer passive flight mechanisms as a dispersal strategy for purposes in environmental monitoring, population surveillance, pathogen tracking, and other applications. Initial studies indicate potential for technologies of this type, but advances in structural and responsive materials and in aerodynamically optimized geometries are necessary to improve the functionality and expand the modes of operation. Here, we introduce environmentally degradable materials as the basis of 3D fliers that allow remote, colorimetric assessments of multiple environmental parameters-pH, heavy metal concentrations, and ultraviolet exposure, along with humidity levels and temperature. Experimental and theoretical investigations of the aerodynamics of these systems reveal design considerations that include not only the geometries of the structures but also their mass distributions across a range of bioinspired designs. Preliminary field studies that rely on drones for deployment and for remote colorimetric analysis by machine learning interpretation of digital images illustrate scenarios for practical use.
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Lee G, Ray E, Yoon HJ, Genovese S, Choi YS, Lee MK, Şahin S, Yan Y, Ahn HY, Bandodkar AJ, Kim J, Park M, Ryu H, Kwak SS, Jung YH, Odabas A, Khandpur U, Ray WZ, MacEwan MR, Rogers JA. A bioresorbable peripheral nerve stimulator for electronic pain block. SCIENCE ADVANCES 2022; 8:eabp9169. [PMID: 36197971 PMCID: PMC9534494 DOI: 10.1126/sciadv.abp9169] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/18/2022] [Indexed: 05/31/2023]
Abstract
Local electrical stimulation of peripheral nerves can block the propagation of action potentials, as an attractive alternative to pharmacological agents for the treatment of acute pain. Traditional hardware for such purposes, however, involves interfaces that can damage nerve tissue and, when used for temporary pain relief, that impose costs and risks due to requirements for surgical extraction after a period of need. Here, we introduce a bioresorbable nerve stimulator that enables electrical nerve block and associated pain mitigation without these drawbacks. This platform combines a collection of bioresorbable materials in architectures that support stable blocking with minimal adverse mechanical, electrical, or biochemical effects. Optimized designs ensure that the device disappears harmlessly in the body after a desired period of use. Studies in live animal models illustrate capabilities for complete nerve block and other key features of the technology. In certain clinically relevant scenarios, such approaches may reduce or eliminate the need for use of highly addictive drugs such as opioids.
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Girka OI, Lee KI, Choi YS, Jang SO. Ion beam figuring with focused anode layer thruster. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2022; 93:063304. [PMID: 35778031 DOI: 10.1063/5.0071800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
This work presents the peculiarities of cone ion beam formation with a focused thruster with anode layer (TAL) and its application to silicon carbide (SiC) ion beam figuring. Modeling results of Lorentz E × B force distribution in the discharge gap are presented. 3D particle tracing for keV Ar ions is carried out for the first time in the beam drift region of TAL with magnetic lens. Extracted ion beam full width at half maxima is about 2 mm in the focal plane, where the SiC etching rate reaches 0.5 µm/min. The SiC sputter yields are measured as a function of the Ar ion impact energy and beam incidence angle. The maximum sputter yield of 2.8 atom/ion is observed at 45° of the beam-sample angle for the Si targets. Furthermore, the maximum sputter yield value of 1.7 atom/ion is measured at 30° of the beam-sample angle for the SiC targets. The novelty of present research is in the application of focused TAL keV Ar ion beam to the SiC ion beam figuring.
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Choi YS, Jeong H, Yin RT, Avila R, Pfenniger A, Yoo J, Lee JY, Tzavelis A, Lee YJ, Chen SW, Knight HS, Kim S, Ahn HY, Wickerson G, Vázquez-Guardado A, Higbee-Dempsey E, Russo BA, Napolitano MA, Holleran TJ, Razzak LA, Miniovich AN, Lee G, Geist B, Kim B, Han S, Brennan JA, Aras K, Kwak SS, Kim J, Waters EA, Yang X, Burrell A, Chun KS, Liu C, Wu C, Rwei AY, Spann AN, Banks A, Johnson D, Zhang ZJ, Haney CR, Jin SH, Sahakian AV, Huang Y, Trachiotis GD, Knight BP, Arora RK, Efimov IR, Rogers JA. A transient, closed-loop network of wireless, body-integrated devices for autonomous electrotherapy. Science 2022; 376:1006-1012. [PMID: 35617386 PMCID: PMC9282941 DOI: 10.1126/science.abm1703] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Temporary postoperative cardiac pacing requires devices with percutaneous leads and external wired power and control systems. This hardware introduces risks for infection, limitations on patient mobility, and requirements for surgical extraction procedures. Bioresorbable pacemakers mitigate some of these disadvantages, but they demand pairing with external, wired systems and secondary mechanisms for control. We present a transient closed-loop system that combines a time-synchronized, wireless network of skin-integrated devices with an advanced bioresorbable pacemaker to control cardiac rhythms, track cardiopulmonary status, provide multihaptic feedback, and enable transient operation with minimal patient burden. The result provides a range of autonomous, rate-adaptive cardiac pacing capabilities, as demonstrated in rat, canine, and human heart studies. This work establishes an engineering framework for closed-loop temporary electrotherapy using wirelessly linked, body-integrated bioelectronic devices.
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Oh YS, Kim JH, Xie Z, Cho S, Han H, Jeon SW, Park M, Namkoong M, Avila R, Song Z, Lee SU, Ko K, Lee J, Lee JS, Min WG, Lee BJ, Choi M, Chung HU, Kim J, Han M, Koo J, Choi YS, Kwak SS, Kim SB, Kim J, Choi J, Kang CM, Kim JU, Kwon K, Won SM, Baek JM, Lee Y, Kim SY, Lu W, Vazquez-Guardado A, Jeong H, Ryu H, Lee G, Kim K, Kim S, Kim MS, Choi J, Choi DY, Yang Q, Zhao H, Bai W, Jang H, Yu Y, Lim J, Guo X, Kim BH, Jeon S, Davies C, Banks A, Sung HJ, Huang Y, Park I, Rogers JA. Author Correction: Battery-free, wireless soft sensors for continuous multi-site measurements of pressure and temperature from patients at risk for pressure injuries. Nat Commun 2021; 12:6827. [PMID: 34795252 PMCID: PMC8602244 DOI: 10.1038/s41467-021-26984-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Yang Q, Wei T, Yin RT, Wu M, Xu Y, Koo J, Choi YS, Xie Z, Chen SW, Kandela I, Yao S, Deng Y, Avila R, Liu TL, Bai W, Yang Y, Han M, Zhang Q, Haney CR, Benjamin Lee K, Aras K, Wang T, Seo MH, Luan H, Lee SM, Brikha A, Ghoreishi-Haack N, Tran L, Stepien I, Aird F, Waters EA, Yu X, Banks A, Trachiotis GD, Torkelson JM, Huang Y, Kozorovitskiy Y, Efimov IR, Rogers JA. Photocurable bioresorbable adhesives as functional interfaces between flexible bioelectronic devices and soft biological tissues. NATURE MATERIALS 2021; 20:1559-1570. [PMID: 34326506 PMCID: PMC8551016 DOI: 10.1038/s41563-021-01051-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/11/2021] [Indexed: 05/07/2023]
Abstract
Flexible electronic/optoelectronic systems that can intimately integrate onto the surfaces of vital organ systems have the potential to offer revolutionary diagnostic and therapeutic capabilities relevant to a wide spectrum of diseases and disorders. The critical interfaces between such technologies and living tissues must provide soft mechanical coupling and efficient optical/electrical/chemical exchange. Here, we introduce a functional adhesive bioelectronic-tissue interface material, in the forms of mechanically compliant, electrically conductive, and optically transparent encapsulating coatings, interfacial layers or supporting matrices. These materials strongly bond both to the surfaces of the devices and to those of different internal organs, with stable adhesion for several days to months, in chemistries that can be tailored to bioresorb at controlled rates. Experimental demonstrations in live animal models include device applications that range from battery-free optoelectronic systems for deep-brain optogenetics and subdermal phototherapy to wireless millimetre-scale pacemakers and flexible multielectrode epicardial arrays. These advances have immediate applicability across nearly all types of bioelectronic/optoelectronic system currently used in animal model studies, and they also have the potential for future treatment of life-threatening diseases and disorders in humans.
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Wang H, D'Andrea D, Choi YS, Bouricha Y, Wickerson G, Ahn HY, Guo H, Huang Y, Sandhu MS, Jordan SW, Rogers JA, Franz CK. Implantation and Control of Wireless, Battery-free Systems for Peripheral Nerve Interfacing. J Vis Exp 2021. [PMID: 34747395 DOI: 10.3791/63085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Peripheral nerve interfaces are frequently used in experimental neuroscience and regenerative medicine for a wide variety of applications. Such interfaces can be sensors, actuators, or both. Traditional methods of peripheral nerve interfacing must either tether to an external system or rely on battery power that limits the time frame for operation. With recent developments of wireless, battery-free, and fully implantable peripheral nerve interfaces, a new class of devices can offer capabilities that match or exceed those of their wired or battery-powered precursors. This paper describes methods to (i) surgically implant and (ii) wirelessly power and control this system in adult rats. The sciatic and phrenic nerve models were selected as examples to highlight the versatility of this approach. The paper shows how the peripheral nerve interface can evoke compound muscle action potentials (CMAPs), deliver a therapeutic electrical stimulation protocol, and incorporate a conduit for the repair of peripheral nerve injury. Such devices offer expanded treatment options for single-dose or repeated dose therapeutic stimulation and can be adapted to a variety of nerve locations.
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Choi YS, Yin RT, Pfenniger A, Koo J, Avila R, Benjamin Lee K, Chen SW, Lee G, Li G, Qiao Y, Murillo-Berlioz A, Kiss A, Han S, Lee SM, Li C, Xie Z, Chen YY, Burrell A, Geist B, Jeong H, Kim J, Yoon HJ, Banks A, Kang SK, Zhang ZJ, Haney CR, Sahakian AV, Johnson D, Efimova T, Huang Y, Trachiotis GD, Knight BP, Arora RK, Efimov IR, Rogers JA. Fully implantable and bioresorbable cardiac pacemakers without leads or batteries. Nat Biotechnol 2021; 39:1228-1238. [PMID: 34183859 PMCID: PMC9270064 DOI: 10.1038/s41587-021-00948-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 05/06/2021] [Indexed: 12/22/2022]
Abstract
Temporary cardiac pacemakers used in periods of need during surgical recovery involve percutaneous leads and externalized hardware that carry risks of infection, constrain patient mobility and may damage the heart during lead removal. Here we report a leadless, battery-free, fully implantable cardiac pacemaker for postoperative control of cardiac rate and rhythm that undergoes complete dissolution and clearance by natural biological processes after a defined operating timeframe. We show that these devices provide effective pacing of hearts of various sizes in mouse, rat, rabbit, canine and human cardiac models, with tailored geometries and operation timescales, powered by wireless energy transfer. This approach overcomes key disadvantages of traditional temporary pacing devices and may serve as the basis for the next generation of postoperative temporary pacing technology.
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Kim YD, Choi YS, Na HG, Song SY, Bae CH. [MUC4 Silencing Inhibits TGF-β1-induced Epithelial-mesenchymal Transition VIA the ERK1/2 Pathway in Human Airway Epithelial NCI-H292 Cells]. Mol Biol (Mosk) 2021; 55:617-625. [PMID: 34432779 DOI: 10.31857/s0026898421040078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 11/24/2022]
Abstract
MUC4 is a predominant membrane-tethered mucin lubricating and protecting the epithelial surface and playing various biological roles in the renewal and differentiation of epithelial cells, cell signaling, cell adhesion, and carcinogenesis. Interestingly, recent studies have demonstrated that MUC4 expression regulates the epithelial-mesenchymal transition (EMT) of cancer cells in ovarian, pancreatic, and lung cancer. However, the effects of MUC4 expression on EMT in human airway epithelial cells are not yet well known. Here, we describe the effects of transforming growth factor beta 1 (TGF-β1)-induced MUC4 expression on EMT and evaluate its downstream signaling pathway in human airway epithelial cells. In human airway epithelial NCI-H292 cells, exposure to TGF-β1 induced expression of MUC4, CDH2, VIM and SNAI1 genes and encoded by them proteins, MUC4, N-cadherin, vimentin and Snail, and reduced the level of CDH1 and its product, E-cadherin. In MUC4-knockdown cells, TGF-β1-induced expression levels of MUC4, CDH2, VIM and SNAI1 and corresponding proteins were suppressed, but CDH1 and E-cadherin levels were not. In addition, TGF-β1-induced phosphorylation of extracellular signal regulated kinase 1/2 (ERK1/2) was suppressed, but that of Smad2/3, Akt, and p38 was not. The results of this study suggest that MUC4 silencing inhibits TGF-β1 -induced EMT via the ERK1/2 pathway, and a possible role of MUC4 in the induction of EMT in human airway epithelial cells.
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Oh YS, Kim JH, Xie Z, Cho S, Han H, Jeon SW, Park M, Namkoong M, Avila R, Song Z, Lee SU, Ko K, Lee J, Lee JS, Min WG, Lee BJ, Choi M, Chung HU, Kim J, Han M, Koo J, Choi YS, Kwak SS, Kim SB, Kim J, Choi J, Kang CM, Kim JU, Kwon K, Won SM, Baek JM, Lee Y, Kim SY, Lu W, Vazquez-Guardado A, Jeong H, Ryu H, Lee G, Kim K, Kim S, Kim MS, Choi J, Choi DY, Yang Q, Zhao H, Bai W, Jang H, Yu Y, Lim J, Guo X, Kim BH, Jeon S, Davies C, Banks A, Sung HJ, Huang Y, Park I, Rogers JA. Battery-free, wireless soft sensors for continuous multi-site measurements of pressure and temperature from patients at risk for pressure injuries. Nat Commun 2021; 12:5008. [PMID: 34429436 PMCID: PMC8385057 DOI: 10.1038/s41467-021-25324-w] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023] Open
Abstract
Capabilities for continuous monitoring of pressures and temperatures at critical skin interfaces can help to guide care strategies that minimize the potential for pressure injuries in hospitalized patients or in individuals confined to the bed. This paper introduces a soft, skin-mountable class of sensor system for this purpose. The design includes a pressure-responsive element based on membrane deflection and a battery-free, wireless mode of operation capable of multi-site measurements at strategic locations across the body. Such devices yield continuous, simultaneous readings of pressure and temperature in a sequential readout scheme from a pair of primary antennas mounted under the bedding and connected to a wireless reader and a multiplexer located at the bedside. Experimental evaluation of the sensor and the complete system includes benchtop measurements and numerical simulations of the key features. Clinical trials involving two hemiplegic patients and a tetraplegic patient demonstrate the feasibility, functionality and long-term stability of this technology in operating hospital settings.
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Guo H, D'Andrea D, Zhao J, Xu Y, Qiao Z, Janes LE, Murthy NK, Li R, Xie Z, Song Z, Meda R, Koo J, Bai W, Choi YS, Jordan SW, Huang Y, Franz CK, Rogers JA. Advanced Materials in Wireless, Implantable Electrical Stimulators That Offer Rapid Rates of Bioresorption for Peripheral Axon Regeneration. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2102724. [PMID: 36189172 PMCID: PMC9521812 DOI: 10.1002/adfm.202102724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 06/01/2023]
Abstract
Injured peripheral nerves typically exhibit unsatisfactory and incomplete functional outcomes, and there are no clinically approved therapies for improving regeneration. Post-operative electrical stimulation (ES) increases axon regrowth, but practical challenges from the cost of extended operating room time to the risks and pitfalls associated with transcutaneous wire placement have prevented broad clinical adoption. This study presents a possible solution in the form of advanced bioresorbable materials for thin, flexible, wireless implant that provides precisely controlled ES of the injured nerve for a brief time in the immediate post-operative period. Afterward, rapid, complete and safe modes of bioresorption naturally and quickly eliminate all of the constituent materials in their entirety, without the need for surgical extraction. The unusually high rate of bioresorption follows from the use of a unique, bilayer enclosure that combines two distinct formulations of a biocompatible form of polyanhydride as an encapsulating structure, to accelerate the resorption of active components and confine fragments until complete resorption. Results from mouse models of tibial nerve transection with re-anastomosis indicate that this system offers levels of performance and efficacy that match those of conventional wired stimulators, but without the need to extend the operative period or to extract the device hardware.
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Ahn D, Lee GJ, Choi YS, Park JW, Kim JK, Kim EJ, Lee YH. Timing and clinical outcomes of tracheostomy in patients with COVID-19. Br J Surg 2021; 108:e27-e28. [PMID: 33640938 PMCID: PMC7799185 DOI: 10.1093/bjs/znaa064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 01/06/2023]
Abstract
In this retrospective multicentre cohort study that included 27 COVID-19 patients who underwent tracheostomy, the mean time between intubation and tracheostomy was 15.8 days and the negative conversion time of COVID-19 was 43.1 days. Eleven patients (40.7%) died of COVID-19 and the use of percutaneous dilatation tracheostomy was significantly associated with in-hospital death. Timely tracheostomy could be performed in COVID-19 patients, regardless of duration of intubation or positivity of COVID-19 test, with an open surgical tracheostomy as a preferable technique.
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Choi YS, Hsueh YY, Koo J, Yang Q, Avila R, Hu B, Xie Z, Lee G, Ning Z, Liu C, Xu Y, Lee YJ, Zhao W, Fang J, Deng Y, Lee SM, Vázquez-Guardado A, Stepien I, Yan Y, Song JW, Haney C, Oh YS, Liu W, Yoon HJ, Banks A, MacEwan MR, Ameer GA, Ray WZ, Huang Y, Xie T, Franz CK, Li S, Rogers JA. Stretchable, dynamic covalent polymers for soft, long-lived bioresorbable electronic stimulators designed to facilitate neuromuscular regeneration. Nat Commun 2020; 11:5990. [PMID: 33239608 PMCID: PMC7688647 DOI: 10.1038/s41467-020-19660-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022] Open
Abstract
Bioresorbable electronic stimulators are of rapidly growing interest as unusual therapeutic platforms, i.e., bioelectronic medicines, for treating disease states, accelerating wound healing processes and eliminating infections. Here, we present advanced materials that support operation in these systems over clinically relevant timeframes, ultimately bioresorbing harmlessly to benign products without residues, to eliminate the need for surgical extraction. Our findings overcome key challenges of bioresorbable electronic devices by realizing lifetimes that match clinical needs. The devices exploit a bioresorbable dynamic covalent polymer that facilitates tight bonding to itself and other surfaces, as a soft, elastic substrate and encapsulation coating for wireless electronic components. We describe the underlying features and chemical design considerations for this polymer, and the biocompatibility of its constituent materials. In devices with optimized, wireless designs, these polymers enable stable, long-lived operation as distal stimulators in a rat model of peripheral nerve injuries, thereby demonstrating the potential of programmable long-term electrical stimulation for maintaining muscle receptivity and enhancing functional recovery.
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Kim YD, Choi YS, Na HG, Song SY, Bae CH. Ginsenoside Rb1 attenuates LPS-induced MUC5AC expression via the TLR4-mediated ERK1/2 and NF-κB pathway in human airway epithelial NCI-H292 cells. J BIOL REG HOMEOS AG 2020; 34:613-618. [PMID: 32512990 DOI: 10.23812/19-420-l-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Koo J, Kim SB, Choi YS, Xie Z, Bandodkar AJ, Khalifeh J, Yan Y, Kim H, Pezhouh MK, Doty K, Lee G, Chen YY, Lee SM, D’Andrea D, Jung K, Lee K, Li K, Jo S, Wang H, Kim JH, Kim J, Choi SG, Jang WJ, Oh YS, Park I, Kwak SS, Park JH, Hong D, Feng X, Lee CH, Banks A, Leal C, Lee HM, Huang Y, Franz CK, Ray WZ, MacEwan M, Kang SK, Rogers JA. Wirelessly controlled, bioresorbable drug delivery device with active valves that exploit electrochemically triggered crevice corrosion. SCIENCE ADVANCES 2020; 6:eabb1093. [PMID: 32923633 PMCID: PMC7455185 DOI: 10.1126/sciadv.abb1093] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/17/2020] [Indexed: 05/18/2023]
Abstract
Implantable drug release platforms that offer wirelessly programmable control over pharmacokinetics have potential in advanced treatment protocols for hormone imbalances, malignant cancers, diabetic conditions, and others. We present a system with this type of functionality in which the constituent materials undergo complete bioresorption to eliminate device load from the patient after completing the final stage of the release process. Here, bioresorbable polyanhydride reservoirs store drugs in defined reservoirs without leakage until wirelessly triggered valve structures open to allow release. These valves operate through an electrochemical mechanism of geometrically accelerated corrosion induced by passage of electrical current from a wireless, bioresorbable power-harvesting unit. Evaluations in cell cultures demonstrate the efficacy of this technology for the treatment of cancerous tissues by release of the drug doxorubicin. Complete in vivo studies of platforms with multiple, independently controlled release events in live-animal models illustrate capabilities for control of blood glucose levels by timed delivery of insulin.
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Kwak S, Choi YS, Na HG, Bae CH, Song SY, Kim YD. Fipronil upregulates inflammatory cytokines and MUC5AC expression in human nasal epithelial cells. Rhinology 2020; 58:66-73. [PMID: 31680128 DOI: 10.4193/rhin19.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Airway inflammation and excessive mucin production are pathophysiological characteristics of airway diseases. Fipronil, a pesticide, is being extensively used in agriculture and veterinary medicine worldwide. However, this compound impairs immune function in non-target organisms. The present study aimed to evaluate the effect of fipronil on pro-inflammatory cytokine and mucus production and signalling pathways in human primary nasal METHODOLOGY: The effect of fipronil on pro-inflammatory cytokine and MUC5AC expression and the signalling pathway of fipronil were investigated using real-time PCR, enzyme immunoassays, immunofluorescence, and immunoblot analysis with specific inhibitors and small interfering RNA. RESULTS Fipronil treatment increased pro-inflammatory cytokine interleukin (IL)-1beta, IL-6, IL-8, and MUC5AC expression in human primary nasal epithelial cells. It also induced phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) mitogenactivated protein kinase (MAPK), p38 MAPK, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB). MAPK and NF-kB inhibitor treatment significantly inhibited increases in IL-1beta, IL-6, IL-8, and MUC5AC expression. Ex vivo data confirmed that fipronil-induced MUC5AC expression occurs through ERK1/2, p38, and NF-kB signalling pathways in nasal inferior turbinate tissue. CONCLUSIONS Fipronil induced pro-inflammatory cytokine IL-1beta, IL-6, IL-8, and MUC5AC expression via ERK1/2 MAPK, p38 MAPK, and NF-kB in human primary nasal epithelial cells.
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Choi YS, Kim SK, Smith M, Williams F, Vickers ME, Elliott JA, Kar-Narayan S. Unprecedented dipole alignment in α-phase nylon-11 nanowires for high-performance energy-harvesting applications. SCIENCE ADVANCES 2020; 6:eaay5065. [PMID: 32577503 PMCID: PMC7286685 DOI: 10.1126/sciadv.aay5065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
Dipole alignment in ferroelectric polymers is routinely exploited for applications in charge-based applications. Here, we present the first experimental realization of ideally ordered dipole alignment in α-phase nylon-11 nanowires. This is an unprecedented discovery as dipole alignment is typically only ever achieved in ferroelectric polymers using an applied electric field, whereas here, we achieve dipole alignment in as-fabricated nanowires of 'non-ferroelectric' α-phase nylon-11, an overlooked polymorph of nylon proposed 30 years ago but never practically realized. We show that the strong hydrogen bonding in α-phase nylon-11 serves to enhance the molecular ordering, resulting in exceptional intensity and thermal stability of surface potential. This discovery has profound implications for the field of triboelectric energy harvesting, as the presence of an enhanced surface potential leads to higher mechanical energy harvesting performance. Our approach therefore paves the way towards achieving robust, high-performance mechanical energy harvesters based on this unusual ordered phase of nylon-11.
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Do SH, Lee CH, Kihara T, Choi YS, Yoon S, Kim K, Cheong H, Chen WT, Chou F, Nojiri H, Choi KY. Randomly Hopping Majorana Fermions in the Diluted Kitaev System α-Ru_{0.8}Ir_{0.2}Cl_{3}. PHYSICAL REVIEW LETTERS 2020; 124:047204. [PMID: 32058744 DOI: 10.1103/physrevlett.124.047204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/09/2019] [Indexed: 06/10/2023]
Abstract
dc and ac magnetic susceptibility, magnetization, specific heat, and Raman scattering measurements are combined to probe low-lying spin excitations in α-Ru_{1-x}Ir_{x}Cl_{3} (x≈0.2), which realizes a disordered spin liquid. At intermediate energies (ℏω>3 meV), Raman spectroscopy evidences linearly ω-dependent Majorana-like excitations, obeying Fermi statistics. This points to robustness of a Kitaev paramagnetic state under spin vacancies. At low energies below 3 meV, we observe power-law dependences and quantum-critical-like scalings of the thermodynamic quantities, implying the presence of a weakly divergent low-energy density of states. This scaling phenomenology is interpreted in terms of the random hoppings of Majorana fermions. Our results demonstrate an emergent hierarchy of spin excitations in a diluted Kitaev honeycomb system subject to spin vacancies and bond randomness.
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Kim DH, Kim JH, Oh YW, Seo BH, Suh HS, Choi YS. Scleredema adultorum of Buschke treated by extracorporeal shock wave therapy. J Eur Acad Dermatol Venereol 2019; 34:e133-e135. [PMID: 31733081 DOI: 10.1111/jdv.16086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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