Cerebrospinal fluid (CSF) in the subarachnoid space around the brain drains to lymph nodes in the neck, but the connections and regulation have been challenging to identify^1-24. Here we used fluorescent tracers in Prox1-GFP lymphatic reporter mice to map the pathway of CSF outflow through lymphatics to superficial cervical lymph nodes. CSF entered initial lymphatics in the meninges at the skull base and continued through extracranial periorbital, olfactory, nasopharyngeal and hard palate lymphatics, and then through smooth muscle-covered superficial cervical lymphatics to submandibular lymph nodes. Tracer studies in adult mice revealed that a substantial amount of total CSF outflow to the neck drained to superficial cervical lymph nodes. However, aged mice had fewer lymphatics in the nasal mucosa and hard palate and reduced CSF outflow to cervical lymph nodes. Superficial cervical lymphatics in aged mice had increased endothelial cell expression of Nos3, encoding endothelial nitric oxide synthase (eNOS), but had less eNOS protein and impaired nitric oxide signalling. Manipulation of superficial cervical lymphatics through intact skin by a force-regulated mechanical device doubled CSF outflow and corrected drainage impairment in aged mice. This manipulation increased CSF outflow by compressing superficial cervical lymphatics while having little effect on their normal spontaneous contractions. Overall, the findings highlight the importance of superficial cervical lymphatics for CSF outflow and the potential for reversing CSF drainage impairment by non-invasive mechanical stimulation.

Patients with impaired upper limb and shoulder function need gravity support during their rehabilitation therapy. It could be beneficial to the patient if the gravity support device could also sustain rehabilitation tasks and exercises. Thus in this work we designed a gravity support device with integrated triboelectric nanogenerators (TENGs) for shoulder rehabilitation. The gravity support part of the device was based on origami design. The rehabilitation tasks were based on the popular exercise-gaming approach, with the TENGs acting as self-powered sensors for the gaming task and energy harvesters for the exercise task. The origami was strategically designed with minimal but sufficient folds and a spring based support. The TENGs were also foldable with an output voltage of 35 V p-p . The data acquisition and digitization circuit for gaming was miniaturized on a printed circuit board to fit snugly into the origami structure. The gravity support behavior of the origami was verified using electromyography sensors. Finally a pilot study was conducted with three stroke patients. Their upper-arm range of motion (ROM) was measured without any gravity-support and during the tasks. In the first task the patients played a table-tennis game which required minimal brain-arm coordination effort. In the second task the patients harvested energy by moving their arm as fast as possible. After the tasks, patient feedback was obtained for the effectiveness of the device, and the results suggested that they would be interested in using the device for home-based rehabilitation. Thus this work demonstrated a potential product for tele-rehabilitation which has gained prominence due to the ongoing pandemic. • We demonstrated use of origami structure integrated with triboelectric nanogenerators for shoulder rehabilitation. • The Origami-TENG could provide gravity support for patients with impaired upper-arm motion. • The Origami-TENG could assist with shoulder rehabilitation via exercise-gaming. • Patients were able to play an engaging table-tennis game using Origami-TENG. • Through its energy harvesting capability, patients could use Origami-TENG as an exercise system.

Wearable sensors allow non-invasive monitoring of sweat metabolites, but their reliance on molecular recognition elements limits both physiological coverage and temporal resolution. Here we report an all-flexible chronoepifluidic surface-enhanced Raman spectroscopy (CEP-SERS) patch for label-free and chronometric profiling of sweat metabolites. The CEP-SERS patch integrates plasmonic nanostructures in epifluidic microchannels for chronological sweat sampling and molecular analysis. An ultrathin fluorocarbon nanofilm modulates surface chain mobility to guide low-temperature solid-state dewetting, forming large-area silver nanoislands on a structured flexible substrate. The wearable patch adheres conformally to skin, collects sequential sweat samples, and supports label-free and multiplexed SERS detection of assorted metabolites. Machine learning-assisted quantification of lactate, uric acid, and tyrosine yields robust metabolic profiles in distinct physical activity states. This wearable optofluidic platform refines molecular sweat sensing and expands the potential for individualized phenotyping in proactive and data-driven healthcare.

Registered in Clinical Research Information System of Korea National Institute of Health (KCT0005803).

Muscle synergies, defined as coordinated activations of muscle groups, are thought to simplify motor control by reducing dimensionality and providing a repertoire of adaptable motor solutions. While prior research has investigated synergy adaptation in clinical populations and healthy individuals, most evidence stems from constrained or low-degree-of-freedom (DOF) tasks. A critical gap remains in understanding how synergies are refined in high-DOF, performance-driven contexts that demand full-body coordination. To address this, we examined neuromuscular strategies in professional and amateur golfers performing a 7-iron swing. Electromyographic recordings from 27 muscles, along with kinematic and kinetic data, were analyzed to identify kinematic predictors of clubhead speed and their associated muscle activation patterns. Muscle synergy and clustering analysis of these key muscles revealed two group-invariant synergies, pelvis rotation and plantarflexion, whose peak activation timings were significantly correlated with clubhead speed. A significant subject-specific synergy and a significant amateur-exclusive synergy further highlighted how adaptation involves both individualized tuning and filtering of suboptimal strategies. These findings suggest that expert performance in complex, high-DOF tasks relies on temporal refinement of existing synergies rather than structural reorganization, highlighting the importance of managing, rather than minimizing, motor complexity in the acquisition of advanced motor skills. Furthermore, our approach for identifying neuromuscular patterns linked to performance outcomes provides a foundation for targeted training interventions aimed at enhancing or restoring complex movement patterns.

The study was registered at the Clinical Research Information Service of Korea National Institute of Health (KCT0005803).

Cerebrospinal fluid (CSF) in the subarachnoid space around the brain drains to lymph nodes in the neck, but the connections and regulation have been challenging to identify^1-24. Here we used fluorescent tracers in Prox1-GFP lymphatic reporter mice to map the pathway of CSF outflow through lymphatics to superficial cervical lymph nodes. CSF entered initial lymphatics in the meninges at the skull base and continued through extracranial periorbital, olfactory, nasopharyngeal and hard palate lymphatics, and then through smooth muscle-covered superficial cervical lymphatics to submandibular lymph nodes. Tracer studies in adult mice revealed that a substantial amount of total CSF outflow to the neck drained to superficial cervical lymph nodes. However, aged mice had fewer lymphatics in the nasal mucosa and hard palate and reduced CSF outflow to cervical lymph nodes. Superficial cervical lymphatics in aged mice had increased endothelial cell expression of Nos3, encoding endothelial nitric oxide synthase (eNOS), but had less eNOS protein and impaired nitric oxide signalling. Manipulation of superficial cervical lymphatics through intact skin by a force-regulated mechanical device doubled CSF outflow and corrected drainage impairment in aged mice. This manipulation increased CSF outflow by compressing superficial cervical lymphatics while having little effect on their normal spontaneous contractions. Overall, the findings highlight the importance of superficial cervical lymphatics for CSF outflow and the potential for reversing CSF drainage impairment by non-invasive mechanical stimulation.