Bowel management is important in poststroke rehabilitation as constipation is the dominant gastrointestinal problem after stroke. (1-3) The prevalence of constipation in patients with stroke has been reported to range from 22.9% to 60%, (1-4) and the unpleasant symptoms of constipation are often distressing to both patients and their caregivers. It has a negative effect on the patients' quality of life and may limit social activities. (5,6) A proactive approach toward treating constipation in patients with stroke is thus warranted, but few studies have focused on this topic. Furthermore, as the definitions of constipation and study designs varied in the few studies that focused on constipation in poststroke patients, it is difficult to compare their results. (3,4,7) The diagnosis of constipation is also more complex in patients with stroke than in the general population. Patients with stroke may have poor verbal expression or cognition, which may result in undiagnosed or misdiagnosed constipation. To the best of our knowledge, there are no reports in the literature that specifically address the bowel function of patients who have difficulty expressing themselves. In addition, most studies on poststroke constipation were cross-sectional, and did not report information about the clinical course of constipation and the relevant interventions. (4,7) Since multiple factors can contribute to poststroke constipation, identifying these factors will be useful for early diagnosis and treatment. The classification of the severity of poststroke constipation, while not done in any previous study, would also be useful in the management of this condition. Unfortunately, while efforts have been made to identify the risk factors for poststroke constipation, (3,4,7) none have been found for severe constipation. Thus, the aims of this study were to (a) document the incidence of poststroke constipation among patients in a rehabilitation ward, (b) examine the clinical course of poststroke constipation, and (c) identify the factors that are independently associated with general or severe poststroke constipation. M E TH O DS We retrospectively reviewed the charts of all patients who had had an acute stroke and were admitted to the rehabilitation ward of a tertiary hospital over a 12-month period. The study was approved by the Ethics Research Committee of the hospital. Stroke diagnosis and localisation were confirmed using computed tomography or magnetic resonance imaging. Patients with a prior history of constipation before the stroke diagnosis and patients with subarachnoid haemorrhage

Immune cells sense, communicate, and logically integrate a multitude of environmental signals to make important cell-fate decisions and fulfill their effector functions. These processes are initiated and regulated by a diverse array of immune receptors and via their dynamic spatiotemporal organization upon ligand binding. Given the widespread relevance of the immune system to health and disease, there have been significant efforts toward understanding the biophysical principles governing immune receptor signaling and activation, as well as the development of biomaterials which exploit these principles for therapeutic immune engineering. Here, how advances in the field of DNA nanotechnology constitute a growing toolbox for further pursuit of these endeavors is discussed. Key cellular players involved in the induction of immunity against pathogens or diseased cells are first summarized. How the ability to design DNA nanostructures with custom shapes, dynamics, and with site-specific incorporation of diverse guests can be leveraged to manipulate the signaling pathways that regulate these processes is then presented. It is followed by highlighting emerging applications of DNA nanotechnology at the crossroads of immune engineering, such as in vitro reconstitution platforms, vaccines, and adjuvant delivery systems. Finally, outstanding questions that remain for further advancing immune-modulatory DNA nanodevices are outlined.

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