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Mass transport through nanopores occurs in various natural systems, including the human body. For example, ion transport across nerve cell membranes plays a significant role in neural signal transmission, which can be significantly affected by the electrolyte and temperature conditions. To better understand and control the underlying nanoscopic transport, it is necessary to develop multiphysical transport models as well as validate them using enhanced experimental methods for facile nanopore fabrication and precise nanoscale transport characterization. Here, we report a nanopore-integrated microfluidic platform to characterize ion transport in the presence of electrolyte and temperature gradients; we employ our previous self-assembled particle membrane (SAPM)-integrated microfluidic platform to produce various nanopores with different pore sizes. Subsequently, we quantify pore-size-dependent ionic transport by measuring the short circuit current (SCC) and open circuit voltage (OCV) across various nanopores by manipulating the electrolyte and temperature gradients. We establish three simple theoretical models that heavily depend on pore size, electrolyte concentration, and temperature and subsequently validate them with the experimental results. Finally, we anticipate that the results of this study would help clarify ion transport phenomena at low-temperature conditions, not only providing a fundamental understanding but also enabling practical applications of cryo-anesthesia in the near future.

Jungyul Park,1,2 Sunghyun Jo,1 Hee-Young Choi1,2 1Department of Ophthalmology, School of Medicine, Pusan National University Hospital, Busan, South Korea; 2Biomedical Research Institute, Pusan National University, Busan, South KoreaCorrespondence: Hee-Young Choi, Department of Ophthalmology, School of Medicine, Biomedical Research Institute, Pusan National University, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, Republic of Korea, Tel +82-51-240-7324, Fax +82-51-242-7341, Email hychoi@pusan.ac.krBackground: Detachment of the inferior oblique muscle may be necessary under certain circumstances to repair a large inferomedial orbital fracture involving the orbital strut. This study aimed to evaluate the outcomes of patients who underwent surgeries with and without inferior oblique muscle reattachment after its detachment to repair the orbital wall fractures.Methods: Forty patients who underwent repair of combined floor and medial orbital wall fracture involving the orbital strut at a single tertiary institution between January 2014 and December 2020 were reviewed. Groups 1 and 2 comprised 20 patients each, who underwent surgery with inferior oblique muscle detachment without and with reattachment, respectively, and were followed up for at least 6 months postoperatively. Enophthalmos, Goldmann diplopia test, alignment test, ocular motility test, and orbital inferomedial angle ratio were the outcome measures.Results: Statistically significant improvement was observed in ocular motility, diplopia, and enophthalmos postoperatively at the 1- and 6-month follow-up (p < 0.01). The mean postoperative inferomedial angle ratio (102.28 ± 10.62%) was improved significantly compared with the preoperative inferomedial angle ratio (115.61 ± 4.38%) (p = 0.004) in all patients. After surgery, inferior oblique muscle underaction was observed in seven and six patients in groups 1 and 2, respectively, which was associated with preoperative extraocular movement limitation and strabismus. Two patients showed diplopia in both groups at the last follow-up; they had inferior oblique muscle underaction but no enophthalmos.Conclusion: Orbital fracture repair with or without inferior oblique muscle reattachment was clinically effective and safe; however, patients with preoperative strabismus and extraocular motility limitation should be informed of the increased risk of postoperative complications.Keywords: orbital fracture, inferior oblique muscle, diplopia, strabismus, post-operative complications

Smart contact lenses have the potential to serve as noninvasive healthcare devices or virtual displays. However, their implementation is limited by the lack of suitable power sources for microelectronic devices. This Article demonstrates smart contact lenses with fully embedded glucose fuel cells that are safe, flexible, and durable against deformations. These fuel cells produced stable power throughout the day or during intermittent use after storage for weeks. When the lenses were exposed to 0.05 mM glucose solution, a steady-state maximum power density of 4.4 μW/cm

Purpose: To report a case of traumatic optic neuropathy aggravated by orbital emphysema after an orbital fracture.Case summary: A 19-year-old man with no specific medical history was referred for a right orbital fracture caused by blunt trauma to the supraorbital rim of the right eye. Computed tomography (CT) showed a right orbital fracture involving the inferomedial wall and inferomedial strut. The corrected visual acuity was 0.4 in the right eye (RE) and 1.0 in the left and the intraocular pressure was 15 and 18 mmHg, respectively. Restriction on downgaze, abduction, and an indefinite relative afferent pupillary defect (RAPD) were observed in the RE. Fundus exam was non-specific other than commotio retinae on the temporal side of the macula in the RE. After 12 hours post trauma, the visual acuity of the RE had decreased to light perception. Definite RAPD was observed with optic disc swelling on the fundus photo and optical coherence tomography. Orbital CT showed air shadows, which were not seen on the initial evaluation, adjacent to the optic disc. We diagnosed traumatic optic neuropathy aggravated by orbital emphysema. High-dose intravenous steroid was given for 3 days. Despite a lateral canthotomy and cantholysis to decompress the right orbit, visual acuity did not improve above counting fingers.Conclusions: Increased intraorbital pressure and congestion caused by orbital emphysema may exacerbate traumatic optic neuropathy. Therefore, close observation is required.

Ion current rectification (ICR) is the ratio of ion current by forward bias to by backward bias and is a critical indicator of diode performance. In previous studies, many attempts have been continued to improve the performance of this ICR, but there is the intrinsic problem for geometric changes that induce ionic rectification due to their fabrication problem. Additionally, the high ICR could be achieved in the narrow salt concentration range only. Here, we propose a multi-layered bipolar ionic diode based on an asymmetric nanochannel network membrane (NCNM), which is realized by soft lithography and self-assembly of homogenous-sized nanoparticles. Owing to the freely changeable geometry based on soft lithography, the ICR performance can be explored according to the variation of microchannel shape. Interestingly, very stable ICR performance can be achieved using the multi-layered 3D configuration for the bipolar diode in a broad range of salt concentrations (0.1mM ~ 100 mM). This demonstrates the promising potential of multi-layered NCNM for applications in highly concentrated electrolytes, such as biosensors, desalination, or energy harvesting.

DesignRetrospective studyPurposeThe purpose of this retrospective study was to assess the changes in thyroid-stimulating hormone receptor (TSH-R) antibody levels following treatment in patients with moderate-to-severe and active Graves’ orbitopathy (GO) and to investigate the correlation between these antibodies and treatment response.MethodsThe subjects of this study comprised of patients newly diagnosed with moderate-to-severe and active GO within the age range of 19 to 79 years. All participants underwent intravenous methylprednisolone (IVMP) therapy for a duration of 12 weeks. Patients with a clinical activity score (CAS) decrease to or less than 3 and no symptom recurrence for at least 3months after the last dose of IVMP were classified as “Group 1”. Those with a CAS equal to or greater than 4 were classified as “Group 2”. TSH-R antibody levels were measured prior to and following IVMP treatment and treatment response was evaluated after the completion of IVMP therapy. All patients were monitored for a minimum of 6 months post-treatment, with ocular examinations and laboratory tests at the initial visit being included in the analysis.ResultsThe medical records of the 96 patients with GO were retrospectively reviewed. Seventy-five patients (78.1%) were response and 21 (21.9%) were non-responsive to IVMP treatment. A higher TSH-R antibody (TRAb) and thyroid-stimulating antibody (TSAb) following treatment were associated with a high risk of no treatment response (P = 0.017; P = 0.047, respectively). TRAb and TSAb levels before treatment were significantly related to TRAb and TSAb levels after treatment (P < 0.001, respectively). The cut-off values for the prediction of poor treatment response of the TRAb and TSAb before and after treatment were 8.305 IU/L, 5.035 IU/L and 449.5%, 361%, respectively (P = 0.027, P =0.001 and P = 0.136, P = 0.004, respectively).ConclusionIt was observed that elevated levels of TRAb and TSAb prior to IVMP treatment were positively correlated with post-treatment levels of these antibodies. Furthermore, in cases of non-response to IVMP therapy, a diminished decline in both antibodies was observed, and elevated levels of TRAb and TSAb post-treatment were found to be a significant predictor of poor treatment outcome. Measurement of TRAb and TSAb throughout the course of treatment in moderate-to-severe and active cases of GO may offer valuable insights into treatment prognosis and aid in the decision-making process regarding the potential need for increased IVMP dosage or alternative therapeutic strategies.

IntroductionThe primary treatment for active thyroid eye disease (TED) is immunosuppressive therapy with intravenous steroids. In this study, we attempted to predict responsiveness to steroid treatment in TED patients using eXtreme Gradient Boosting (XGBoost). Factors associated with steroid responsiveness were also statistically evaluated.MethodsClinical characteristics and laboratory results of 89 patients with TED who received steroid treatment were retrospectively reviewed. XGBoost was used to explore responsiveness to steroid treatment, and the diagnostic performance was evaluated. Factors contributing to the model output were investigated using the SHapley Additive exPlanation (SHAP), and the treatment response was investigated statistically using SPSS software.ResultsThe eXtra Gradient Boost model showed high performance, with an excellent accuracy of 0.861. Thyroid-stimulating hormone, thyroid-stimulating immunoglobulin (TSI), and low-density lipoprotein (LDL) cholesterol had the highest impact on the model. Multivariate logistic regression analysis showed that less extraocular muscle limitation and high TSI levels were associated with a high risk of poor intravenous methylprednisolone treatment response. As a result of analysis through SHAP, TSH, TSI, and LDL had the highest impact on the XGBoost modelConclusionTSI, extraocular muscle limitation, and LDL cholesterol levels may be useful in predicting steroid treatment response in patients with TED. In terms of machine learning, XGBoost showed relatively robust and reliable results for small datasets. The machine-learning model can assist in decision-making for further treatment of patients with TED.

This study replicated the behavior of intraorbital tissue in patients with thyroid eye disease (TED) based on finite element analysis for general orbital decompression risk evaluation in thyroid eye disease patients. The orbit and intraorbital tissues of thyroid eye disease patients who underwent orbital decompression were modeled as finite element models. The stress was examined at specific locations of the removed orbital wall of a thyroid eye disease patient with undergone orbital decompression, and its variation was analyzed as a function of the shape and dimension (to be removed). As a result, in orbital decompression surgery which removes the orbital wall in a rectangular shape, the stress at the orbital wall decreased as the width and depth of the removed orbital wall increased. In addition, in the case of orbital decompression, it can be seen that the chamfered model compared to the non-chamfered model (a form of general orbital decompression) have the stress reduction rate from 11.08% to 97.88%. It is inferred that if orbital decompression surgery considering the chamfered model is performed on an actual thyroid eye disease patient, it is expected that the damage to the extraocular muscle caused by the removed orbital wall will be reduced.

AIM: To predict final visual acuity and analyze significant factors influencing open globe injury prognosis. METHODS: Prediction models were built using a supervised classification algorithm from Microsoft Azure Machine Learning Studio. The best algorithm was selected to analyze the predicted final visual acuity. We retrospectively reviewed the data of 171 patients with open globe injury who visited the Pusan National University Hospital between January 2010 and July 2020. We then applied cross-validation, the permutation feature importance method, and the synthetic minority over-sampling technique to enhance tool performance. RESULTS: The two-class boosted decision tree model showed the best predictive performance. The accuracy, precision, recall, F1 score, and area under the receiver operating characteristic curve were 0.925, 0.962, 0.833, 0.893, and 0.971, respectively. To increase the efficiency and efficacy of the prognostic tool, the top 14 features were finally selected using the permutation feature importance method: (listed in the order of importance) retinal detachment, location of laceration, initial visual acuity, iris damage, surgeon, past history, size of the scleral laceration, vitreous hemorrhage, trauma characteristics, age, corneal injury, primary diagnosis, wound location, and lid laceration. CONCLUSION: Here we devise a highly accurate model to predict the final visual acuity of patients with open globe injury. This tool is useful and easily accessible to doctors and patients, reducing the socioeconomic burden. With further multicenter verification using larger datasets and external validation, we expect this model to become useful worldwide.

Purpose: To demonstrate the efficacy of subcutaneous tocilizumab (TCZ-SC) treatment for recalcitrant thyroid eye disease (TED) refractory to intravenous methylprednisolone (MP) and oral methotrexate (MTX).Case summary: (Case 1) A 52-year-old man, smoker, with hyperthyroidism presented with a 3-months history of TED. The initial clinical activity score (CAS) was 5 (total score of 7). High-dose intravenous MP and oral MTX failed to improve the symptoms. He was treated with four doses of 162 mg TCZ-SC at an interval of 2 weeks. Pre-treatment laboratory test results were within normal limits. CAS was reduced to 2 weeks after the final injection, and there were no recurrences during the 6-month follow-up. (Case 2) A 37-year-old woman, non-smoker, with a 3-months history of hyperthyroidism presented with conjunctival injection and upper eyelid erythema. The initial CAS was 4, and thyroid-stimulating immunoglobulin level was raised (475% of normal). The symptoms did not improve with 7.5 g intravenous MP and oral MTX. The patient was treated with 162 mg TCZ-SC. Pre-treatment laboratory test results were within normal limits. CAS was reduced to 1 after the final injection, and there were no recurrences during the 6-months follow-up.Conclusions: TCZ-SC improves symptoms of corticosteroid-resistant TED, and may be a reasonable option in recalcitrant TED cases. However, further studies are required to justify the use of TCZ-SC for TED.

Diffusioosmosis (DO) results from ion transport near charged surfaces in the presence of electrolyte gradients and is critical in nanofluidic systems. However, DO has not yet been comprehensively studied because nanofabrication materials have limitations of low throughput and difficult quantification. Herein, we describe a self-assembled particle membrane (SAPM)-integrated microfluidic platform that can modulate the material properties (e.g., zeta-potential) and transport flux of nanopores. We quantify the effect of the zeta-potential on DO by measuring the electrical signals across three different nanopores/nanochannels of the SAPM. We then empirically quantify the effects of the temperature and ionic strength of the electrolytes on DO and reveal a nonlinear relationship with DO-driven ion transport; the ionic strengths govern the DO- or diffusion-effective ion transport phenomena. Finally, we demonstrate DO-driven electric power generation with enhanced performance as a potential application under optimized experimental conditions.

Purpose: Chondroid syringoma of the skin is a rare subcutaneous tumor and localization in the eyelid and orbital region that has rarely been described. We report a case of chondroid syringoma that involved the sub-brow region and was accompanied by hair loss. Case summary: A 57-year-old women presented with a mass on the lateral side of the left sub-brow region which was observed 25 years earlier. The mass, which recurred 2 months after surgery at another hospital through a skin incision was accompanied by an itching sensation. The mass was not tender or ulcerated but was reddish with superficial blood vessels and had a smooth surface with hair loss at the site of the mass. The mass showed high signal intensity on a T2-weighted magnetic resonance image and a round echogenic nodule with an irregular hypoechoic portion was observed on ultrasonography. A full-thickness excision including the adjacent normal tissue of the sub-brow mass and direct closure were subsequently performed. The pathological diagnosis was chondroid syringoma which was revealed as numerous tubular structures with various lumens in a collagenous stroma. Mucinous and fibrous findings were also observed. No recurrence was detected during the first 2 years after surgery. Conclusions: Chondroid syringoma in the eyelid and sub-brow region is uncommon. Complete resection is required to differentiate it from a malignancy and reduce the possibility of recurrence. Incomplete resection or capsular rupture during removal of the tumor could induce recurrence or a malignant change in the tumor.

Photocatalysis, which utilizes solar energy to electrochemically decompose water pollutants into harmless products, has attracted considerable attention to address serious environmental issues. The photocatalytic effect can be enhanced using an external electric field owing to the inhibition of the recombination of photoexcited electrons and holes. However, the typical linear potential bias that induces a small potential drop across a thin photocatalyst film exhibits a limited photocatalytic reaction. Herein, we propose an ion-concentration-polarization-assisted photocatalytic reactor that generates a nonlinear electric field across the microchannel of this system, which enables an 85.5% increase in the reaction rate compared to that achieved using a linear potential, and a high reaction rate constant up to 12.7 min

A higher rectification degree in ionic diodes is required to achieve better performance in applications. Nonetheless, the active geometrical change that is critical for inducing electrical potential asymmetry is difficult to realize in typical ionic diodes because of the intrinsic limitation of the fabrication method. Here, we propose a nanochannel-network-based bipolar diode with a high rectification degree of ∼1600─the highest value realized until now, to the best of our knowledge. Such a high rectification is obtained based on the synergetic effect of the bipolar surface charge and the optimization of the microchannel through experimental studies and multiphysics numerical simulations. It induces ion concentrations at the heterogeneous junction based on the accumulation effect under the forward potential bias. In particular, this proposed molecular concentration occurs in the ohmic region without vortex and instability that is inevitable at the conventional nano-electrokinetic concentration. Combining this accumulation with the horizontally aligned configuration of the nanochannel network membrane (NCNM), a highly sensitive and quantitative mercury ion (Hg

Microscopic visualization of DNA molecules is a simple, intuitive, and powerful method. Nonetheless, DNA-molecule quantification methods that employ microscopic visualization have not been reported so far. In this study, a new quantitative approach is presented that enables the counting of individual DNA molecules that have been rendered visible by fluorescence microscopy. Toward this, a microfluidic device was employed that directed DNA molecules into microchannels and deposited the molecules onto a positively charged surface. This microfluidic device had a vertically tapered channel inlet structure that prevented the accumulation of excess DNA molecules in the channel inlet while creating a tapering flow, thereby ensuring the even distribution of the DNA molecules in the microchannels. The channel heights and the density of positive charges on the surface were optimized for analysis. The linearity of this method with respect to the determination of the concentration of DNA in solutions was subsequently determined. The limit of detection was 0.48 fg/μL, which corresponds to 64 molecules of 7.25 kbp DNA in 1 μL of sample. This quantitative approach was finally used to count two types of plasmids co-transformed in an E. coli cell; a measurement that is typically considered challenging with gel electrophoresis.

In this paper, we report a thin magnetic micropump embedded in contact lens, which is capable of on-demand one-directional drug delivery. The proposed micropump can be actuated by the external magnetic field whenever needed without the need of battery. A micro check valve was integrated with the micropump for one-directional drug delivery from the micropump to the post-lens tear film. With actuation of the external magnetic field, the micro check valve is opened, and on-demand drug release can be realized. On the contrary, without an external magnetic field, the micro check valve is closed, and the undesired drug diffusion can be prevented. Through the control of the strength and the frequency of the magnetic field pulse, on-demand drug release and controlled dose can be realized.

Background To evaluate the risk of general orbital decompression in patients with thyroid eye disease (TED).Methods In this study, we replicated the behavior of intraorbital tissue in patients with TED based on finite element analysis. The orbit and intraorbital tissues of TED patient who underwent orbital decompression were modeled as finite element models. The stress was examined at a specific location of the removed orbital wall of a patient with TED who had undergone orbital decompression, and its variation was investigated and analyzed as a function of the shape and dimension (to be removed).Results In orbital decompression surgery which removes the orbital wall in a rectangular shape, the stress at the orbital wall decreased as the width and depth of the removed orbital wall increased. In addition, the stress of the non-chamfered model (a form of general orbital decompression) was higher than that of the chamfered model. Especially, in the case of orbital decompression, it can be seen that the chamfered model compared to the non-chamfered model have the stress reduction rate from 11.08% to 97.88%.Conclusions It is inferred that if orbital decompression surgery considering the chamfered model is performed on an actual TED patient, it is expected that the damage to the extraocular muscle caused by the removed orbital wall will be reduced.

Various microfluidic devices have overcome many disadvantages common to conventional bioreactor systems by enabling active manipulation of cell-culture conditions, monitoring of cellular responses in high-throughput mode, and extraction of target cells in a relatively rapid and low-cost manner. However, existing microfluidic devices still have limitations, including the complexity of their operation and a lack of availability of dynamic control of the chemical environment. Here, we present a novel microfluidic bioreactor array device capable of not only the stable and dynamic programing of cell-culture environments but also the selective extraction of target cells. This device comprises 64 microchambers in a 16 × 4 array format, and each microchamber is integrated with a robust and nanoporous membrane on one side and an H-shaped entrance on the other. The membrane made of self-assembled particles allowed continuous and sequential delivery of various nutrients containing gene inducers to compartmentalized microbial cells, thereby enabling dynamic cell culturing. Additionally, the H-shaped entrance was used for local and selective blocking of the microchamber by employing UV-curable material, thereby enabling the retrieval of target cells from the device while sequestering nontarget cells in the microchambers. Our results demonstrated that the targeted rare cells could be isolated and separated from a mixture of cells by repeating the extraction procedure. Therefore, we anticipate that this microfluidic bioreactor array device will be widely used for not only screening/extraction but also off-chip postanalyses of various microorganisms.

Cell spheroid culture can be an effective approach for providing an engineered microenvironment similar to an in vivo environment. Our group had recently developed a method for harvesting uniformly sized multicellular spheroids via self-assembly of micro-scaled cell sheets (μCSs) induced by the expansion of temperature-sensitive hydrogels. However, the μCS assembly process was not fully understood. In this study, we investigated the effects of cell number, pattern shape, and contractile force of cells on spheroid formation from micropatterned (width of square pattern from 100-300 μm) hydrogels. We used human dermal fibroblasts (HDFBs) as a model cell type and cultured them for 24 and 72 h. The self-assembly of μCSs cultured on square micropatterns for 72 h rapidly occurred within 4 min after reducing the temperature from 37 to 4 °C. In addition, the size distribution of spheroids was narrower with μCSs from a 72 h culture. Treatment with a ROCK1 inhibitor disrupted cytoskeletal actin fibers and the corresponding μCSs were not detached from the hydrogel. The assembly of the μCS was also affected by the micropattern shape, and the spheroid harvest efficiency was decreased to 60% when using a circular micropattern, which was explained by the stress direction on the circular versus square micropattern upon hydrogel expansion. Therefore, we confirmed that the factors controlling cell-cell interactions are important for spheroid formation using micropatterned hydrogel systems. Finally, the μCSs with dual layers of HDFBs labeled with DiD and DiO dyes resulted in the formation of spheroids with discretely localized colors within the core and shell, respectively, which suggests an outside-in assembly of detached μCSs. In consideration of these complex environmental factors, our system could be utilized in various applications as a three-dimensional culture system to fabricate cell spheroids.

In this paper, we characterized the behavior of polymer jet from near-field electrospinning onto the inkjet patterned paper with conductive Ag nanoparticles in order to form the controlled three-dimensional nanostructures. Using inkjet patterned paper with conductive ink as a collector, the polymer jet is induced to the pre-patterned shape through the concentrated electric field caused by singularity between the spinneret and the printed patterns. Due to the electric field enhancement of the deposited electrospun fiber, an additionally spun fiber can be stacked on the deposited fibers directly. Therefore, the controlled three-dimensional nano/micro structures can be successfully realized by the proposed method. We characterized the deposition of the electrospun fiber according to the distance between the inkjet printed pattern and the spinneret. In addition, the sharp edged three-dimensional microstructures were fabricated by carrying out the electrospinning on the patterns with various angled edges. A CCD camera was used to observe the behavior of the polymer jet, and the SEM image was analyzed to confirm that the fibers are stacked as desired.

Nanofluid diodes are used for controlling ions with the unidirectional flow and have the potential for increasing sensitivity in sensors. Commonly, nanofluidic diodes are realized by a single-nanochannel form fabricated by a nano process like e-beam. Here, we propose a bipolar ionic diode using a 3D nanochannel network membrane (NCNM) formed by self-assembly of nanoparticles. The diode can control ions in high throughput manner and shows a high ion current rectification (ICR) phenomenon. By exploring the I-V characterization according to geometry change of multi-layered NCNM, finally, we can achieve the maximum ICR up to 1475.45, which is the best performance of our knowledge, and maximize a fluorescence-based sensor performance by concentrating mercury ion at the junction of positive charge region, so that 1nM of mercury can be detected

Background To evaluate the patterns of distribution and clinical manifestations of ocular injuries referred to the level 1 trauma center of Pusan National University Hospital (PNUH) in Korea. Methods We analyzed 254 of 4,287 patients who were referred to the Department of Ophthalmology at the level 1 trauma center of the PNUH, from January 2016 through December 2018. Data on the incidence of ocular injuries, sex, age, monthly and seasonal distribution, day and time of injury, side of injury, cause, residence of patients, referral time to an ophthalmologist and subsequent examination time, final visual acuity (VA), and complications were obtained from medical records and retrospectively reviewed. The patients were grouped according to their main diagnosis using the Birmingham Eye Trauma Terminology System (BETTS) and Ocular Trauma Score (OTS). Results The incidence of ocular injuries with major trauma was higher in men (n = 207, 81.5%), the median age at time of injury was 54 years, and Pusan recorded the most cases. The incidences of ocular injury were 1.47/100,000, 1.57/100,000, 1.48/100,000 in 2016, 2017 and 2018, respectively. The most common cause was by a motorbike accident, followed by a pedestrian traffic accident and falls. According to the BETTS classification, open-globe injuries represented 4% of cases, closed-globe injuries represented 12.6%, and other injuries represented 83.1%. Open-globe injuries were significantly associated with low final VA (P = 0.01). In the OTS, 79.4% of patients received 4 or 5 points and 13.7% of patients received 1 or 2 points. The patients who received 1 or 2 points in the OTS score showed final VA below hand movement (P < 0.001), except for two patients. Lid laceration and low initial VA were highly correlated with poor final VA (P < 0.001). Conclusion This is the first study on the epidemiology and clinical manifestations in trauma patients with ocular injuries at a level 1 trauma center. The incidences of ocular injuries with major trauma were about 1.47–1.57/100,000. BETTS, OTS, lid laceration and initial VA were associated with final VA. We expect our study to provide a basis of data for the evaluation, prevention, and management of ocular injuries in patients with systemic trauma., Graphical Abstract

This paper presents an autonomous energy harvester based on a textile-based enzymatic biofuel cell, enabling an efficient power management and on-demand usage. The proposed biofuel cell works by an enzymatic reaction with glucose in sweat absorbed by the specially designed textile for sustainable and efficient energy harvesting. The output power of the textile-based biofuel cell has been optimized by changing electrode size and stacking electrodes and corresponding fluidic channels suitable for following power management circuit. The output power level of single electrode is estimated less than 0.5 &mu, W and thus a two-staged power management circuit using intermediate supercapacitor has been presented. As a solution to produce a higher power level, multiple stacks of biofuel cell electrodes have been proposed and thus the textile-based biofuel cell employing serially connected 5 stacks produces a maximal power of 13 &mu, W with an output voltage of 0.88 V when load resistance is 40 k&Omega, A buck-boost converter employing a crystal oscillator directly triggered by DC output voltage of the biofuel cell makes it possible to obtain output voltage of the DC&ndash, DC converter is 6.75 V. The efficiency of the DC&ndash, DC converter is estimated as approximately 50% when the output power of the biofuel cell is tens microwatts. In addition, LT-spice modeling and simulation has been presented to estimate power consumption of each element of the proposed DC&ndash, DC converter circuit and the predicted output voltage has good agreement with measurement result.

Glaucoma is a very common disease after cataracts and is dangerous enough to cause irreversible blindness. However, often the main symptom of glaucoma is difficult to recognize because it may be absent or appear late, so the risk of blindness is greater. Intraocular pressure (IOP) is a well-known primary factor indicating glaucoma. In this study, we demonstrate a smart IOP sensor embedded in a contact lens that works through visual color changes without an external power source such as a battery or RF-based wireless power transfer. A microhydraulic amplification mechanism is adopted to enhance the range of color change from a photonic crystal (PC)-based flexible membrane whose lattice distance between nanostructures varies according to the morphology changes of an eyeball caused by IOP. The performance of the sensor is quantitatively demonstrated using an artificial silicone eye model for in vitro evaluation and a porcine eyeball for ex vivo verification. It has a limit of detection (LOD) of 3.2 and 5.12 mmHg, which was measured and evaluated using a spectrometer and a smartphone camera, respectively. The results prove that our sensor embedded in the contact lens can continuously monitor the IOP change using color change, and a smartphone camera can be used as a quantitative IOP measurement system in a noninvasive manner without an expensive optical spectrometer.

Most materials and devices with structurally switchable color features responsive to external stimuli can actively and flexibly display various colors. However, realizing covert-overt transformation behavior, especially switching between transparent and colored states, is more challenging. A composite laminate of soft poly(dimethylsiloxane) (PDMS) with a rigid SiO2 -nanoparticle (NP) structure pattern is developed as a multidimensional structural color platform. Owing to the similarity in the optical properties of PDMS and SiO2 NPs, this device is fully transparent in the normal state. However, as their mechanical strengths differ considerably, upon compressive loading, a buckling-type instability arises on the surface of the laminate, leading to the generation of 1D or 2D wrinkled patterns in the form of gratings. Finally, an application of the device in which quick response codes are displayed or hidden as covert-overt convertible colored patterns for optical encryption/decryption, showing their remarkable potential for anticounterfeiting applications, is demonstrated.

We introduce a micro-/nanofluidic platform enabling the comprehensive analysis and control of diffusioosmosis (DO)-driven ionic transport through a nanochannel network. The nanochannel network is fabricated in the microfluidic channel by forming a membrane via the self-assembly of nanoparticles (i.e., self-assembled particle membrane, SAPM). This fabrication method allows to use various and different nanoparticles so that it is possible to modulate the material properties of the nanochannel network. Using the platform, we analyze the thermal effect on DO-driven ionic transport with various concentrations of electrolyte solutions with the aid of a temperature switching device (TSD).

In this paper, we propose an intravitreal implantable magnetic micropump integrated with micro check valve capable of on-demand vascular endothelial growth factor receptor (VEGFR)-targeted drug delivery for the treatment of age-related macular degeneration, diabetic retinopathy and other eye pathologies characterized by ocular neoangiogenesis. Precise on-demand drug release is realized by the deflection of the magnetic membrane assembly according to the external magnetic field, and the membrane assembly consists of a thin elastic polydimethylsiloxane (PDMS) membrane and a cylindrical magnetic nanoparticle-PDMS composite block. Additionally, a micro check valve composed of two PDMS layers was integrated into the micropump to realize a diode-like one-directional drug delivery and prevent undesired drug diffusion. For specifically targeting VEGFR and suppression of VEGF-induced proliferation of microvascular endothelial cells, anti-Flt1 gold nanocomplexes are synthesized. In vitro and in vivo experiments and quantitative analysis are carried out in order to verify our proposed concept: precise drug release control according to the external magnetic field, targeting to microvascular endothelial cells, and efficient and on-demand drug delivery from the proposed micropump to the macular area of rabbit's eye.

Numerous methods have been reported for the fabrication of 3D multi-cellular spheroids and their use in stem cell culture. Current methods typically relying on the self-assembly of trypsinized, suspended stem cells, however, show limitations with respect to cell viability, throughput, and accurate recapitulation of the natural microenvironment. In this study, we developed a new system for engineering cell spheroids by self-assembly of micro-scale monolayer of stem cells. We prepared synthetic hydrogels with the surface of chemically formed micropatterns (squares/circles with width/diameter of 200 μm) on which mesenchymal stem cells isolated from human nasal turbinate tissue (hTMSCs) were selectively attached and formed a monolayer. The hydrogel is capable of thermally controlled expansion. As the temperature was decreased from 37 to 4 °C, the cell layer detached rapidly (10 min) and assembled to form spheroids with consistent size (∼100 μm) and high viability (90%). Spheroidization was significantly delayed and occurred with reduced efficiency on circle patterns compared to square patterns. Multi-physics mapping supported that delamination of the micro-scale monolayer may be affected by stress concentrated at the corners of the square pattern. In contrast, stress was distributed symmetrically along the boundary of the circle pattern. In addition, treatment of the micro-scale monolayer with a ROCK inhibitor significantly retarded spheroidization, highlighting the importance of contraction mediated by actin stress fibers for the stable generation of spheroidal stem cell structures. Spheroids prepared from the assembly of monolayers showed higher expression, both on the mRNA and protein levels, of ECM proteins (fibronectin and laminin) and stemness markers (Oct4, Sox2, and Nanog) compared to spheroids prepared from low-attachment plates, in which trypsinized single cells are assembled. The hTMSC spheroids also presented enhanced expression levels of markers related to tri-lineage (osteogenic, chondrogenic and adipogenic) differentiation. The changes in microcellular environments and functionalities were double-confirmed by using adipose derived mesenchymal stem cells (ADSCs). This spheroid engineering technique may have versatile applications in regenerative medicine for functionally improved 3D culture and therapeutic cell delivery.

In this study, a new strategy for improving the radionuclide bio-decontamination (RBD) activity of microalgae by screening a better strain with high potential for biomineral production has been proposed. A noninvasive dielectrophoresis (DEP)-based microalgae screening microplatform has been used to select the highly capable microalgae in RBD. Microalgae (Chlorella vulgaris KMMCC9) with a high degree of competence in strontium (Sr) removal were successfully segregated against Chlorella vulgaris KCTC AG10002 that has relatively weak Sr removal activity under an AC electric field. C. vulgaris KMMCC9 with higher Sr biomineral competence (HSC) was also successfully segregated against others with lower Sr biomineral competence (LSC). Furthermore, after the screening and large-scale cultivation of C. vulgaris KMMCC9 with HSC, the microalgae showed highly effective Sr bio-decontamination in both non-radioactive and radioactive Sr contaminated water compared to wild-type (WT).

Although rapid advances have been made in micro/nano-scale devices, there is still a lack of clean and sustainable power source for them. Here we propose a high voltage nanofluidic energy generator inspired by electrical eel using ion-concentration gradients, which converts Gibbs free energy into electricity without any pollutants. The high voltage can be induced by alternatively multi-stacking cation and anion-exchange nanochannel network membranes (CE-NCNMs and AE-NCNMs) in a confined microscale space. These membranes were constructed by in situ self-assembled nanoparticles with hydroxyl and amine groups, respectively. The multiple stacks of CE-NCNMs & AE-NCNMs were successfully realized by precisely guiding the nanodrops with the suspended positively or negatively charged nanoparticles into the desired positions in the multilayered microchannel platform. The performance of the proposed nanofluidic energy generator was quantitatively investigated by changing nanoparticle species, intermembrane distance (IMD), and environmental temperature. Interestingly, we found that our optimized IMD (~80 µm) is very similar to the inter-cell membrane distance of electrocytes in natural electric eels and the diffusion potential of a single full cell at this IMD (~138 mV) is also similar to the net potential across a single electrocyte (~150 mV). This optimized IMD is verified through not only electrical measurement but also by fluorescent tracing and numerical analysis using multiphysics simulation. The high voltage of up to 1 V achieved by stacking 20 full cells is, to the authors’ knowledge, the highest value yet obtained by microfluidic systems harnessing ion-concentration gradients.

It is necessary to develop low-end sensors to detect volatile organic compounds (VOCs), which are harmful to human body in real life as well as industrial environment. However, conventional colorimetric-based sensors have shown shortcomings in terms of response time, sensitivity and selectivity. To overcome the difficulties, this study proposes a novel method for highly sensitive photonic crystal (PC) based VOC sensor by increasing the intimal distance between nanoparticles. Silicon liquid is used to change the initial interdistance by chemical swelling, and it is fixed by replacing the swollen space with premixed PDMS. As a result, more color change (handgap shift) occurs as the initial interparticle distance increases, and the performance improved up to 24.0 %.

In this study, we proposed a wearable textile-based glucose fuel cell using moisture management fabrics (MMF). MMF is composed of polyester with modified cross-sectional shapes for quick water absorbing and wicking, so naturally continuous flow with high flow rate can be induced, which results in improved and long-term power generation. The proposed fuel cell is fully composed of textile materials including MMF, carbon cloth treated with Prussian blue (PB) and glucose oxidase (GOD), and conductive thread. Owing to low-cost and scalable fabrication process, it can be easily integrated into clothes to utilize human body fluid to generate energy for wearable devices.

International audience; This paper presents electrical characterization and power management circuit of textile-based enzymatic biofuel cell. Firstly, static electrical characteristics (open circuit voltage, short circuit current, and maximum power) of the enzymatic biofuel cell have been investigated by imposing a voltage across the biofuel cell and measuring corresponding output current. Output power of the biofuel cell has been characterized as a function of load resistance, while a glucose solution of 100 mM is fed from one end of the textile-based biofuel cell. Two-step approach based on supercapacitor and DC-DC converter has been proposed and tested as power management of the proposed biofuel cell.

We propose a portable, non-powered, long-term working suction pump with a high flow rate for microfluidic devices. The pump is driven by a superabsorbent polymer enclosed in a housing with porous fins to accelerate water absorption. We experimentally demonstrate that the pump creates an outstanding flow rate of more than 80 μl min-1 and an absorption volume of ∼20 ml. We address the key design principles underlying the outstanding performance of the pump. As an exemplary application, we constructed a portable power generator by combining the hydrogel pump with a reverse electrodialysis (RED) device. This portable system, powered only by KCl solutions with different ion concentrations, exhibited an output density of ∼70 μW cm-2 for more than an hour. The proposed versatile hydrogel pump could provide a breakthrough for developing various portable microfluidic systems.

The target is selected according to the purpose of the test. If it is necessary to test in accommodative environment, a small accommodating target should be used. And a large target or a light source may be used if the accommodation is to be eliminated. In the case of infants, a target that can induce the interest of the infant is used. Cover test can only be performed on patients who have enough visual acuity and concentration ability to look at the target. In addition, the results are inaccurate even when there is an abnormal retinal correspondence and extrafoveal fixation. The eye level of the examinee should be the same as the patient and be careful not to occlude the target by the examiner. Since the head position of the patient may affect the rest position, examination is required at the right head position.

In this paper, we propose an ultra-thin magnetic micropump capable of on-demand drug delivery for ocular diseases. The proposed ultra-thin magnetic micropump is less than $500\ \mu m$ thick and can be easily embedded in contact lens or periocular implant. Precise on-demand drug release was realized by the deflection of the magnetic membrane assembly according to the external magnetic field, and the membrane assembly consists of a thin elastic PDMS membrane and a cylindrical magnetic nanoparticle-PDMS composite block. Additionally, micro check valve composed of two PDMS layers was integrated into the micropump to realize one-directional drug delivery and prevent undesired drug diffusion.

When examining the position of the eyelids, it is essential to check the position of the eyebrows. Measuring the extent of proptosis and the difference between the two eyes can be used to differentiate between diseases causing proptosis. The unilateral proptosis indicates an intraorbital disease, while bilateral proptosis indicates a systemic disease. When the cause of epiphora is examined by slit lamp examination, digital compression of the lacrimal sac, fluorescein retention test, lacrimal duct irrigation, probing, dacryocystography, and dacryoscintigraphy.

Large DNA molecules have been utilized as a model system to investigate polymer physics. However, DNA visualization via intercalating dyes has generated equivocal results due to dye-induced structural deformation, particularly unwanted unwinding of the double helix. Thus, the contour length increases and the persistence length changes so unpredictably that there has been a controversy. In this paper, we used TAMRA-polypyrrole to stain single DNA molecules. Since this staining did not change the contour length of B-form DNA, we utilized TAMRA-polypyrrole stained DNA as a tool to measure the persistence length by changing the ionic strength. Then, we investigated DNA stretching in nanochannels by varying the ionic strength from 0.06 mM to 47 mM to evaluate several polymer physics theories proposed by Odijk, de Gennes and recent papers to deal with these regimes.

Wearable electronics have been extensively studied owing to their capability of undertaking continuous multi-task for daily needs. Meanwhile, lightweight, flexible, and wearable power sources that enable high-power and sustainable energy conversion from ambient resources (e.g. bodily fluids) have attracted attention. We propose a wearable and flexible textile-based biofuel cell using moisture management fabric (MMF) widely used in sportswear as a transport layer for sustainable and high-power energy harvesting. The reduction of PB-modified cathode is driven by the oxidation of glucose catalyzed by GOD-modified anode, and this enables a single-compartment structure where MMF acts as biofuel transport media. MMF made of polyester can naturally induce a continuous, high-speed flow which facilitates molecule transport for efficient chemical reactions without an additional pump. The resulting highly efficient power generation in MMF is explored and verified by comparing it with those of cotton and paper. Additionally, multi-stack biofuel cell in both parallel and series was successfully realized, and the open circuit voltage and maximum power reached 1.08 V and 80.2 μW, respectively. Integrated into a bandage and sportswear, a six-stack biofuel cell was able to generate sufficient electrical power from human sweat and turn on a sports watch directly. Owing to low-cost and scalable fabrication process, the proposed biofuel cell has great potential to be systematically integrated into clothes, and generate sufficient and sustainable electrical power for wearable electronics using biofuel (e.g. glucose, lactase) from various bodily fluids, like sweat and urine.

We report studies into the effects of electrolyte membrane characteristics on power generation in glucose fuel cells. Commercially available perfluo-rosulfonate ionomer membranes of various thicknesses were characterized by quantitatively measuring and analyzing electrical power generation. Characterization suggested that thinner Nafion® membranes could lead to improved performance (higher peak power, lower ohmic loss, and lower activation loss) over thicker membranes, however extremely thin membranes gave low performance due to their lack of stability, stemming from fabrication failure. The dependency on fuel concentration was also identified and a glucose concentration of 1 M gave the best performance. Finally, the prepared ion-exchange polymer composite membrane (formed by sorbing a Nafion® membrane into a polycarbonate track-etched (PCTE) membrane) was tested, and it was observed that cell performance was remarkably improved when membrane porosity was considered quantitatively. Our study is expected to be useful in the design of biofuel cells that can be utilized in low-concentration environments, such as living or-ganisms.