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Objective To assess whether performing exercises during hemodialysis reduces the risk of developing intradialytic hypotension and enhances exercise capacity in patients with chronic kidney disease. Methods This study included patients aged ≥18 years undergoing hemodialysis. Participants performed exercises using a portable lower extremity ergometer during hemodialysis sessions for 3 weeks. Data regarding walking distance, knee strength, quality of life, fat-free mass, arterial pressure, blood pressure, heart rate, frequency of intradialytic hypotension, fatigue, and duration of hemodialysis were collected and analyzed. Results Significant improvements in walking distance and knee strength were observed following the implementation of exercise training during hemodialysis. Although there was no significant reduction in the frequency of intradialytic hypotension, a decreasing trend was noted. Other parameters such as quality of life and fatigue did not show significant changes. Conclusion Using a portable ergometer during hemodialysis improved exercise capacity and knee strength in patients with chronic kidney disease. There was a trend toward reduced intradialytic hypotension, suggesting potential cardiovascular benefits. Further research with larger sample sizes is needed to confirm these findings.

Knee osteoarthritis (KOA) is a common degenerative disease in older adults. Natural Eggshell Membrane (NEM) comprises bioactive ingredients known to relieve the symptoms of KOA, such as glycosaminoglycans, and has been shown by preclinical studies to be effective in the treatment of KOA. Participants received either NEM (n = 49) or a placebo product (n = 50). After 12 weeks of NEM intake, the Western Ontario and McMaster Universities Osteoarthritis Index score, visual analog scale pain score, and World Health Organization Quality of Life-BREF score (physical health, social relationship score) significantly improved compared to those in the placebo group (p

Abstract Soft actuators produce the mechanical force needed for the functional movements of soft robots, but they suffer from critical drawbacks since previously reported soft actuators often rely on electrical wires or pneumatic tubes for the power supply, which would limit the potential usage of soft robots in various practical applications. In this article, we review the new types of untethered soft actuators that represent breakthroughs and discuss the future perspective of soft actuators. We discuss the functional materials and innovative strategies that gave rise to untethered soft actuators and deliver our perspective on challenges and opportunities for future-generation soft actuators.

Abstract Within the breath lie numerous health indicators, encompassing respiratory patterns and biomarkers extending beyond respiratory conditions to cardiovascular health. Recently, the emergence of the SARS-CoV-2 pandemic has not only underscored the necessity of on-the-spot breath analysis but has also normalized the use of masks in everyday life. Simultaneously, the rapid evolution of wearable technology has given rise to innovative healthcare monitoring tools, with a specific emphasis on wearable breath sensors. This review explores current research trends in utilizing wearable breathing sensors to detect diverse respiratory biomarkers and monitor respiratory parameters, including airflow, temperature, and humidity. Additionally, it explores diverse applications, ranging from recognizing breathing patterns to swiftly detecting diseases. Integrating the Internet of Things and machine learning technologies into these applications highlights their potential to offer a personalized, accurate, and efficient healthcare solution.

Abstract Adaptive multicolor filters have emerged as key components for ensuring color accuracy and resolution in outdoor visual devices. However, the current state of this technology is still in its infancy and largely reliant on liquid crystal devices that require high voltage and bulky structural designs. Here, we present a multicolor nanofilter consisting of multilayered ‘active’ plasmonic nanocomposites, wherein metallic nanoparticles are embedded within a conductive polymer nanofilm. These nanocomposites are fabricated with a total thickness below 100 nm using a ‘lithography-free’ method at the wafer level, and they inherently exhibit three prominent optical modes, accompanying scattering phenomena that produce distinct dichroic reflection and transmission colors. Here, a pivotal achievement is that all these colors are electrically manipulated with an applied external voltage of less than 1 V with 3.5 s of switching speed, encompassing the entire visible spectrum. Furthermore, this electrically programmable multicolor function enables the effective and dynamic modulation of the color temperature of white light across the warm-to-cool spectrum (3250 K–6250 K). This transformative capability is exceptionally valuable for enhancing the performance of outdoor optical devices that are independent of factors such as the sun’s elevation and prevailing weather conditions.

ABSTRACT An investigation into retrovirus was conducted in six species of bats (Myotis aurascens, Myotis petax, Myotis macrodactylus, Miniopterus fuliginosus, Rhinolophus ferrumequinum, and Pipistrellus abramus) inhabiting South Korea. Exogenous retroviruses (XRVs) were detected in the tissue samples of R. ferrumequinum individuals by PCR assay. Proviruses were identified in all tissue samples through viral quantification using a digital PCR assay per organ (lung, intestine, heart, brain, wing, kidney, and liver), with viral loads varying greatly between each organ. In phylogenetic analysis based on the whole genome, the Korean bat retroviruses and the R. ferrumequinum retrovirus (RfRV) strain formed a new clade distinct from the Gammaretrovirus clade. The phylogenetic results determined these viruses to be RfRV-like viruses. In the Simplot comparison, Korean RfRV-like viruses exhibited relatively strong fluctuated patterns in the latter part of the envelope gene area compared to other gene areas. Several point mutations within this region (6,878–7,774 bp) of these viruses were observed compared to the RfRV sequence. One Korean RfRV-like virus (named Y4b strain) was successfully recovered in the Raw 264.7 cell line, and virus particles replicated in the cells were confirmed by transmission electron microscopy. RfRVs (or RfRV-like viruses) have been spreading since their first discovery in 2012, and the Korean RfRV-like viruses were assumed to be XRVs that evolved from RfRV.IMPORTANCER. ferrumequinum retrovirus (RfRV)-like viruses were identified in greater horseshoe bats in South Korea. These RfRV-like viruses were considered exogenous retroviruses (XRVs) that emerged from RfRV. Varying amounts of provirus detected in different organs suggest ongoing viral activity, replication, and de novo integration in certain organs. Additionally, the successful recovery of the virus in the Raw 264.7 cell line provides strong evidence supporting their status as XRVs. These viruses have now been identified in South Korea and, more recently, in Kenya since RfRV was discovered in China in 2012, indicating that RfRVs (or RfRV-like viruses) have spread worldwide.

Abstract UPF1 and LIN28A are RNA-binding proteins involved in post-transcriptional regulation and stem cell differentiation. Most studies on UPF1 and LIN28A have focused on the molecular mechanisms of differentiated cells and stem cell differentiation, respectively. We reveal that LIN28A directly interacts with UPF1 before UPF1-UPF2 complexing, thereby reducing UPF1 phosphorylation and inhibiting nonsense-mediated mRNA decay (NMD). We identify the interacting domains of UPF1 and LIN28A; moreover, we develop a peptide that impairs UPF1-LIN28A interaction and augments NMD efficiency. Transcriptome analysis of human pluripotent stem cells (hPSCs) confirms that the levels of NMD targets are significantly regulated by both UPF1 and LIN28A. Inhibiting the UPF1-LIN28A interaction using a CPP-conjugated peptide promotes spontaneous differentiation by repressing the pluripotency of hPSCs during proliferation. Furthermore, the UPF1-LIN28A interaction specifically regulates transcripts involved in ectodermal differentiation. Our study reveals that transcriptome regulation via the UPF1-LIN28A interaction in hPSCs determines cell fate.

Abstract This review article explores the transformative advancements in wearable biosignal sensors powered by machine learning, focusing on four notable biosignals: electrocardiogram (ECG), electromyogram (EMG), electroencephalogram (EEG), and photoplethysmogram (PPG). The integration of machine learning with these biosignals has led to remarkable breakthroughs in various medical monitoring and human–machine interface applications. For ECG, machine learning enables automated heartbeat classification and accurate disease detection, improving cardiac healthcare with early diagnosis and personalized interventions. EMG technology, combined with machine learning, facilitates real‐time prediction and classification of human motions, revolutionizing applications in sports medicine, rehabilitation, prosthetics, and virtual reality interfaces. EEG analysis powered by machine learning goes beyond traditional clinical applications, enabling brain activity understanding in psychology, neurology, and human–computer interaction, and holds promise in brain–computer interfaces. PPG, augmented with machine learning, has shown exceptional progress in diagnosing and monitoring cardiovascular and respiratory disorders, offering non‐invasive and accurate healthcare solutions. These integrated technologies, powered by machine learning, open new avenues for medical monitoring and human–machine interaction, shaping the future of healthcare.

Abstract In this study, a parametric analysis was conducted for the design of a suggested dual flapping hydrofoil turbine. A Navier–Stokes‐based computational fluid dynamics code was utilized for the analysis while varying the pitch angle, reduced frequency, separation distance, and phase difference. The smallest pitch angle of 60° and the reduced frequency of 0.1 among the given ranges of the parameters were fixed for the first parametric analysis. After an assessment, the 90° front‐lead with the longest distance of 6c and the 90° rear‐lead with the shortest distance of 2c were chosen for further parametric analysis based on a suggested performance indicator and a margin for improvement. It was derived from a subsequent parametric analysis that a 70° pitch angle, 0.12 reduced frequency, and a 4c distance for the 90° front‐lead was the final optimum with 59.48% efficiency and 55.44% fluctuation according to the performance indicator as well as the system length and power balance of dual hydrofoils.

Cardiopulmonary resuscitation (CPR) is a life-saving technique used in emergencies when the heart stops beating, typically involving chest compressions and ventilation. Current adult CPR guidelines do not differentiate based on age beyond infancy and childhood. This oversight increases the risk of fatigue fractures in the elderly due to decreased bone density and changes in thoracic structure. Therefore, this study aimed to investigate the correlation and impact of factors influencing rib fatigue fractures for safer out-of-hospital manual cardiopulmonary resuscitation (OHMCPR) application. Using the finite element analysis (FEA) method, we performed fatigue analysis on rib cage models incorporating chest compression conditions and age-specific trabecular bone properties. Fatigue life analyses were conducted on three age-specific rib cage models, each differentiated by trabecular bone properties, to determine the influence of four explanatory variables (the properties of the trabecular bone (a surrogate for the age of the subject), the site of application of the compression force on the breastbone, the magnitude of applied compression force, and the rate of application of the compression force) on the fatigue life of the model. Additionally, considering the complex interaction of chest compression conditions during actual CPR, we aimed to predict rib fatigue fractures under conditions simulating real-life scenarios by analyzing the sensitivity and interrelation of chest compression conditions on the model’s fatigue life. Time constraints led to the selection of optimal analysis conditions through the use of design of experiments (DOE), specifically orthogonal array testing, followed by the construction of a deep learning-based metamodel. The predicted fatigue life values of the rib cage model, obtained from the metamodel, showed the influence of the four explanatory variables on fatigue life. These results may be used to devise safer CPR guidelines, particularly for the elderly at a high risk of acute cardiac arrest, safeguarding against potential complications like fatigue fractures.

Highlights This article systematically reviews the thermal management wearables with a specific emphasis on materials and strategies to regulate the human body temperature. Thermal management wearables are subdivided into the active and passive thermal managing methods. The strength and weakness of each thermal regulatory wearables are discussed in details from the view point of practical usage in real-life. Abstract Thermal management is essential in our body as it affects various bodily functions, ranging from thermal discomfort to serious organ failures, as an example of the worst-case scenario. There have been extensive studies about wearable materials and devices that augment thermoregulatory functionalities in our body, employing diverse materials and systematic approaches to attaining thermal homeostasis. This paper reviews the recent progress of functional materials and devices that contribute to thermoregulatory wearables, particularly emphasizing the strategic methodology to regulate body temperature. There exist several methods to promote personal thermal management in a wearable form. For instance, we can impede heat transfer using a thermally insulating material with extremely low thermal conductivity or directly cool and heat the skin surface. Thus, we classify many studies into two branches, passive and active thermal management modes, which are further subdivided into specific strategies. Apart from discussing the strategies and their mechanisms, we also identify the weaknesses of each strategy and scrutinize its potential direction that studies should follow to make substantial contributions to future thermal regulatory wearable industries.

Abstract Radiative cooling is a passive cooling technology without any energy consumption, compared to conventional cooling technologies that require power sources and dump waste heat into the surroundings. For decades, many radiative cooling studies have been introduced but its applications are mostly restricted to nighttime use only. Recently, the emergence of photonic technologies to achieves daytime radiative cooling overcome the performance limitations. For example, broadband and selective emissions in mid-IR and high reflectance in the solar spectral range have already been demonstrated. This review article discusses the fundamentals of thermodynamic heat transfer that motivates radiative cooling. Several photonic structures such as multilayer, periodical, random; derived from nature, and associated design procedures were thoroughly discussed. Photonic integration with new functionality significantly enhances the efficiency of radiative cooling technologies such as colored, transparent, and switchable radiative cooling applications has been developed. The commercial applications such as reducing cooling loads in vehicles, increasing the power generation of solar cells, generating electricity, saving water, and personal thermal regulation are also summarized. Lastly, perspectives on radiative cooling and emerging issues with potential solution strategies are discussed.

Abstract Fano resonance, known for its unique asymmetric line shape, has gained significant attention in photonics, particularly in sensing applications. However, it remains difficult to achieve controllable Fano parameters with a simple geometric structure. Here, a novel approach of using a thin‐film optical Fano resonator with a porous layer to generate entire spectral shapes from quasi‐Lorentzian to Lorentzian to Fano is proposed and experimentally demonstrated. The glancing angle deposition technique is utilized to create a polarization‐dependent Fano resonator. By altering the linear polarization between s‐ and p‐polarization, a switchable Fano device between quasi‐Lorentz state and negative Fano state is demonstrated. This change in spectral shape is advantageous for detecting materials with a low‐refractive index. A bio‐particle sensing experiment is conducted that demonstrates an enhanced signal‐to‐noise ratio and prediction accuracy. Finally, the challenge of optimizing the film‐based Fano resonator due to intricate interplay among numerous parameters, including layer thicknesses, porosity, and materials selection, is addressed. The inverse design tool is developed based on a multilayer perceptron model that allows fast computation for all ranges of Fano parameters. The method provides improved accuracy of the mean validation factor (MVF = 0.07, q‐q') compared to the conventional exhaustive enumeration method (MVF = 0.37).

BackgroundArticulation disorder decreases the clarity of language and causes a decrease in children’s learning and social ability. The demand for non–face-to-face treatment is increasing owing to the limited number of therapists and geographical or economic constraints. Non–face-to-face speech therapy programs using serious games have been proposed as an alternative. ObjectiveThe aim of this study is to investigate the efficacy of home therapy on logopedic and phoniatric abilities in children with articulation disorder using the Smart Speech game interface. MethodsThis study is a prospective single-arm clinical trial. Children with articulation disorders, whose Urimal Test of Articulation and Phonology (U-TAP) was –2 SDs or less and the Receptive and Expressive Vocabulary Test score was –1 SD or more, were enrolled. A preliminary evaluation (E0) was conducted to check whether the children had articulation disorders, and for the next 4 weeks, they lived their usual lifestyle without other treatments. Prior to the beginning of the training, a pre-evaluation (E1) was performed, and the children trained at home for ≥30 minutes per day, ≥5 times a week, over 4 weeks (a total of 20 sessions). The Smart Speech program comprised oral exercise training, breathing training, and speech training; the difficulty and type of the training were configured differently according to the participants’ articulation error, exercise, and vocal ability. After the training, postevaluation (E2) was performed using the same method. Finally, 8 weeks later, postevaluation (E3) was performed as a follow-up. A voice evaluation included parameters such as maximum phonation time (MPT), fundamental frequency (F0), jitter, peak air pressure (relative average perturbation), pitch, intensity, and voice onset time. Articulation parameters included a percentage of correct consonants (PCC; U-TAP word-unit PCC, U-TAP sentence-unit PCC, and three-position articulation test) and alternate motion evaluation (diadochokinesis, DDK). Data obtained during each evaluation (E1-E2-E3) were compared. ResultsA total of 13 children with articulation disorders aged 4-10 years were enrolled in the study. In voice parameters, MPT, jitter, and pitch showed significant changes in repeated-measures ANOVA. However, only MPT showed significant changes during E1-E2 (P=.007) and E1-E3 (P=.004) in post hoc tests. Other voice parameters did not show significant changes. In articulation parameters, U-TAP, three-position articulation test (TA), and DDK showed significant changes in repeated-measures ANOVA. In post hoc tests, U-TAP (word, sentence) and TA showed significant changes during E1-E2 (P=.003, .04, and .01) and E1-E3 (P=.001, .03, and .003), and DDK showed significant changes during E1-E2 only (P=.03). ConclusionsHome-based serious games can be considered an alternative treatment method to improve language function. Trial RegistrationClinical Research Information Service KCT0006448; https://cris.nih.go.kr/cris/search/detailSearch.do/20119

Abstract Stretchable electronics is playing an integral role in fields such as wearable electronics and soft robots. Among soft conductive materials, liquid metal is drawing intense attention as an electrode material due to its liquid nature at room temperature. However, the merits of liquid metal conductor are limited by the presence of substrates or enclosed microchannels from physical disturbances by the underlying substrate when applying it to 3D surface and modifying complex circuit. To overcome this limitation, we develop freestanding patterned liquid metal thin-film conductor (FS-GaIn). FS-GaIn was achieved by introducing metal nanowires to liquid metal and subsequent sequential selective laser processing and etching of directly patterned traces. FS-GaIn can be applied directly to nonflat surface without substrates. When incorporated into electrical circuits, FS-GaIn shows high electrical conductivity, stretchability, and stability. The concept of freestanding liquid metal can open a functionality to the conventional liquid metal electronics.

Abstract Background During prolonged standing, insufficient calf muscle pumping accompanies venous stasis and hypertension in the lower legs, resulting in valve dysfunction, venous wall problems, and sub-sequent inflammation. Compression therapy, which includes medical compression stockings (MCS) and mechanical intermittent pneumatic compression (IPC), is one of the most effective therapeutic interventions for treating chronic venous diseases. This study aimed to compare the therapeutic effect among resting, IPC and MCS alone, and IPC with MCS in long-standing workers (> 8 h daily). Methods This crossover trial was conducted with 39 participants with complaints of leg edema and pain whose work involved standing for more than 8 h daily. Four treatment protocols were established for each visit as follows: protocol A (not wear MCS during work and rest without IPC after work), protocol B (wear MCS during work and rest without IPC after work), protocol C (not wear MCS during work and treat with IPC after work), and protocol D (wear MCS during work and treat with IPC after work). The primary outcome was the visual analogue scale (VAS) score for leg pain. The secondary outcomes were leg volume (mL), circumference (cm), extracellular fluid/total body fluid (ECF/TBF), and extracellular water/total body water (ECW/TBW) through bioelectrical impedance analysis. Outcomes were assessed before work (T0), after work (T1), and 60 min after intervention (T2). Results All four protocols had significantly increased leg pain after work (T0-1) but improved 60 min after intervention (T1-2), particularly protocol C (decreased VAS by 1.9). When leg swelling was compared at T0 and T1, protocols A and C showed significant increases in leg volume and circumference, indicating significant work-induced edema, whereas protocols B and D showed no change or even a decrease. After interventions, leg volume and circumference significantly decreased in protocols A and C, although protocols B and C did not show significant improvement. The ECF/TBF and ECW/TBW of all protocols decreased after interventions. Conclusions Leg pain and edema after prolonged standing (T1-T2) in adults were safely and effectively improved by both IPC alone and IPC with MCS. Although the use of MCS during the workday did not show improvement in leg pain immediately after work (T0-T1), both MCS with resting and MCS with IPC decreased leg pain at T1-T2 and prevented leg edema at T0-T1. Trial registration This trial protocol was registered at the Clinical Research Information Service (KCT0005383, the date of first registration: 08/09/2020).