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Prediction of outcome after stroke may help clinicians provide effective management and plan long-term care. We aimed to develop and validate a score for predicting good functional outcome available for hospitals after ischemic stroke using linked data. A total of 22,005 patients with acute ischemic stroke from the Clinical Research Center for Stroke Registry between July 2007 and December 2014 were included in the derivation group. We assessed functional outcomes using a modified Rankin scale (mRS) score at 3 months after ischemic stroke. We identified predictors related to good 3-month outcome (mRS score ≤ 2) and developed a score. External validations (geographic and temporal validations) of the developed model were performed. The prediction model performance was assessed using the area under the receiver operating characteristic curve (AUC) and the calibration test. Stroke severity, sex, stroke mechanism, age, pre-stroke mRS, and thrombolysis/thrombectomy treatment were identified as predictors for 3-month good functional outcomes in the S-SMART score (total 34 points). Patients with higher S-SMART scores had an increased likelihood of a good outcome. The AUC of the prediction score was 0.805 (0.798–0.811) in the derivation group and 0.812 (0.795–0.830) in the geographic validation group for good functional outcome. The AUC of the model was 0.812 (0.771–0.854) for the temporal validation group. Moreover, they had good calibration. The S-SMART score is a valid and useful tool to predict good functional outcome following ischemic stroke. This prediction model may assist in the estimation of outcomes to determine care plans after stroke.

Continuous glucose monitoring (CGM) sensors have led a paradigm shift to painless, continuous, zero-finger pricking measurement in blood glucose monitoring. Recent electrochemical CGM sensors have reached two-week lifespans and no calibration with clinically acceptable accuracy. The system with the recent CGM sensors is identified as an “integrated glucose monitoring system,” which can replace finger-pricking glucose-testing for diabetes treatment decisions. Although such innovation has brought CGM technology closer to realizing the artificial pancreas, discomfort and infection problems have arisen from short lifespans and open wounds. A fully implantable sensor with a longer-term lifespan (90 days) is considered as an alternative CGM sensor with high comfort and low running cost. However, it still has barriers, including surgery for applying and replacing and frequent calibration. If technical refinement is conducted (e.g., stability and reproducibility of sensor fabrication), fully implantable, long-term CGM sensors can open the new era of continuous glucose monitoring.

We propose a simple, fast, height-scalable, and direct way to fabricate highly biocompatible polyethylene glycol diacrylate (PEGDA) microneedles. A needle-shaped distribution of ultraviolet (UV) exposure dose is formed in PEGDA by applying UV light through a rotating prism. A prism makes UV light rays bend, such that the base angle of the prism determines the inclined angle of the light. Thus, the microneedle height can be controlled by varying the base angles of the prism. We experimentally demonstrate the direct height-scalable potential. The microneedle height decreases and the microneedle tip angle increases with increases in the base angle of the prism. These results indicate that the microneedle geometry can be easily controlled by the base angle of a prism without additional microfabrication. In addition, unlike photoresist microneedles, PEGDA does not require any thermal baking, thus enabling well-defined symmetric needle formation with short process time. Therefore, the present method can facilitate PEGDA microneedles to practical applications. [2017-0136]

[Purpose] The purpose of this research was to examine differences in muscle activity between the resting forearm position (RFP) and the straight forearm position (SFP) during upper arm strengthening exercises. [Participants and Methods] In total, 35 healthy college students were randomly sampled (18 males and 17 females). Surface electromyography data were collected from the medial and lateral sides of the biceps and triceps brachii muscles. [Results] The medial muscles showed greater activity during SFP versus RFP, but no difference in overall activation was found between the two positions. [Conclusion] Carrying angle less affected to biceps and triceps brachii muscles activation during upper arm strengthening exercises.

This paper describes a theoretical estimation of the geometry of negative epoxy-resist microneedles prepared via inclined/rotated ultraviolet (UV) lithography based on spatially controlled UV exposure doses. In comparison with other methods based on UV lithography, the present method can create microneedle structures with high scalability. When negative photoresist is exposed to inclined/rotated UV through circular mask patterns, a three-dimensional, needle-shaped distribution of the exposure dose forms in the irradiated region. Controlling the inclination angles and the exposure dose modifies the photo-polymerized portion of the photoresist, thus allowing the variation of the heights and contours of microneedles formed by using the same mask patterns. In an experimental study, the dimensions of the fabricated needles agreed well with the theoretical predictions for varying inclination angles and exposure doses. These results demonstrate that our theoretical approach can provide a simple route for fabricating microneedles with on-demand geometry. The fabricated microneedles can be used as solid microneedles or as a mold master for dissolving microneedles, thus simplifying the microneedle fabrication process. We envision that this method can improve fabrication accuracy and reduce fabrication cost and time, thereby facilitating the practical applications of microneedle-based drug delivery technology.

Diabetes can strike at any age, from childhood to adulthood, and lasts a lifetime. Thus, it is important to find ways to increase the quality of life for diabetic patients through intensive, continuous care of blood glucose concentrations. Glucose biosensors that are implanted under the skin are promising for continuous glucose monitoring because they can constantly read blood glucose concentrations and signal a warning in case of hypo- or hyperglycemia. The demand for subcutaneous glucose biosensors has led to the development of many glucose-sensing principles and sensor designs. This Review covers the effort to develop subcutaneous glucose biosensors, including the glucose-sensing principles, and discusses their current status for in vivo monitoring. In addition, the Review examines the future prospects for intensive diabetes care.

This paper presents active micromechanical motion amplifiers, inspired from the amplification principle of outer hair cells in cochlea, achieving the displacement amplification using the mechanical resonance modulated by variable stiffness springs. The proposed active micromechanical motion amplifiers modulate the resonant carrier motion using the variable stiffness springs whose stiffness changes depending on the input motion. We have designed, fabricated, and characterized two types of the amplifiers A and B, each having the variable stiffness spring designed to obtain different displacement gains. In the experimental study, we characterized the ratio of output stiffness change to input motion as 1.82 N/m/μm and 0.636 N/m/μm for the variable stiffness springs A and B, respectively. The displacement gains of the amplifiers A and B were measured as different values of 5.62 and 2.62, respectively. Therefore, we experimentally verified that the displacement gain of the proposed active micromechanical motion amplifier can be adjusted by the variable stiffness spring design. The present micromechanical motion amplifiers are capable to amplify the displacement based on the active amplification mechanism, thus having the potential to be used in high-sensitivity microsensors.

We present a micromechanical active amplifier, inspired from the principle of the outer hair cells in cochlea, amplifying both displacement and force. The present micromechanical active amplifier modulates the resonant carrier motion using the variable stiffness spring whose stiffness changes proportionally to the input motion. We design, fabricate, and characterize two types of the amplifiers A and B, each having the variable stiffness spring fur the maximum displacement gain and force gain, respectively. In the experimental study, the amplifier A shows the displacement gain of 5.62, which is 2.15 times larger than that of the amplifier 3. The amplifier B shows the force gain of 10.0, resulting in 1.26 times larger value compared to that of the amplifier A. We experimentally verify that the haircell-inspired micromechanical amplifiers are capable to amplify both displacement and force.

This paper describes preliminary results of a method to regulate the shapes of a single bacterial cell by confining the cell into a micro chamber. The cell wall of Escherichia coli determines the rod-shape (0.5 μm in width, 2 μm in length) of the bacteria and protects from outer stress. We removed its cell wall by enzyme treatment and confined the cell into cross-shaped microchambers formed on the surface of 2% agar contained the growth media. We believe that our method could contribute to the comprehensive understanding of the shape regulation mechanism of E. coli. This paper focuses on the fabrication of cross-shaped microchambers formed on agar and confinement of the bacteria into the microchambers.

Microenvironmental biophysical stimuli influence diverse cellular functions, such as directional motility and stem cell differentiation. Previously, researchers have tuned the linear stiffness of microposts to investigate cell mechanobiological processes and direct cellular behavior; however, microposts suffer from an inherent, yet critical drawback - regulation of micropost stiffness is fundamentally limited to “biaxial” control. To overcome this issue, here we utilize three-dimensional (3D) direct-write laser lithography processes to fabricate arrays of microscale springs (μSprings). By adjusting the geometric characteristics of individual μSprings, the x-, y-, and z-axis stiffness of the cellular substrate can be customized at the microscale. COMSOL simulations were performed to characterize the theoretical “triaxial” stiffness associated with a variety of μSpring designs. Endothelial cells seeded on μSpring arrays were found to successfully deform the μSprings via cell-generated forces. By enabling user-control over the triaxial stiffness of discrete, microscale substrate features, the presented μSpring methodology could offer a powerful platform for cellular studies and applications in fields including tissue engineering, biomaterials, and regenerative medicine.

Fluorescent microbeads hold great promise for in vivo continuous glucose monitoring with wireless transdermal transmission and long-lasting activity. The full potential of fluorescent microbeads has yet to be realized due to insufficient intensity for transdermal transmission and material toxicity. This paper illustrates the highly-sensitive, biostable, long-lasting, and injectable fluorescent microbeads for in vivo continuous glucose monitoring. We synthesized a fluorescent monomer composed of glucose-recognition sites, a fluorogenic site, spacers, and polymerization sites. The spacers are designed to be long and hydrophilic for increasing opportunities to bind glucose molecules; consequently, the fluorescent monomers enable high-intensive responsiveness to glucose. We then fabricated injectable-sized fluorescent polyacrylamide hydrogel beads with high uniformity and high throughput. We found that our fluorescent beads provide sufficient intensity to transdermally monitor glucose concentrations in vivo. The fluorescence intensity successfully traced the blood glucose concentration fluctuation, indicating our method has potential uses in highly-sensitive and minimally invasive continuous blood glucose monitoring.

We present a micromechanical active amplifier, inspired from the principle of the outer hair cells in cochlea, amplifying both displacement and force. The present micromechanical active amplifier modulates the resonant carrier motion using the variable stiffness spring whose stiffness changes proportionally to the input motion. We design, fabricate, and characterize two types of the amplifiers A and B, each having the variable stiffness spring for the maximum displacement gain and force gain, respectively. In the experimental study, the amplifier A shows the displacement gain of 5.62, which is 2.15 times larger than that of the amplifier B. The amplifier B shows the force gain of 10.0, resulting in 1.26 times larger value compared to that of the amplifier A. We experimentally verify that the haircell- inspired micromechanical amplifiers are capable to amplify both displacement and force.

We present micromechanical active amplifiers using carrier motion in the mechanical resonance, thereby performing the amplification of displacement, force, and energy. The carrier motion is modulated by variable stiffness springs whose stiffness change is proportional to input motion. We design, fabricate, and test two types of the amplifiers A and B, including two different variable stiffness springs A and B, which are designed to increase output stiffness variation and output-to-input stiffness ratio, respectively. The displacement gain of amplifier A is 5.62, which is 2.15 times larger than that of the amplifier B. The force gain of the amplifier B is 10.0, which is 1.26 times larger than that of the amplifier A. We experimentally verify that the present devices are able to amplify both displacement and force simultaneously, showing potential applications of high-sensitive sensing and high-force/long-range actuation.