Electrical impulse generation and its conduction within cells or cellular networks are the corner... more Electrical impulse generation and its conduction within cells or cellular networks are the cornerstone of electrophysiology. However, the advancement of the field is limited by sensing accuracy and the scalability of current recording technologies. Here we describe a scalable platform that enables accurate recording of transmembrane potentials in electrogenic cells. The platform employs a three-dimensional high-performance field-effect transistor array for minimally invasive cellular interfacing that produces faithful recordings, as validated by the gold standard patch clamp. Leveraging the high spatial and temporal resolutions of the field-effect transistors, we measured the intracellular signal conduction velocity of a cardiomyocyte to be 0.182 m s−1, which is about five times the intercellular velocity. We also demonstrate intracellular recordings in cardiac muscle tissue constructs and reveal the signal conduction paths. This platform could provide new capabilities in probing the electrical behaviours of single cells and cellular networks, which carries broad implications for understanding cellular physiology, pathology and cell–cell interactions. A three-dimensional field-effect transistor array produced via compressive buckling enables accurate and minimally invasive intra- and intercellular recordings in cells and cellular networks.
Supplemental materials for JAADI-D-21-00063R1, Use of technology for the objective evaluation of ... more Supplemental materials for JAADI-D-21-00063R1, Use of technology for the objective evaluation of scratching behavior: a systematic review. Files included: 1. Search Strategy 2. PRISMA Flow Diagram 3. PRISMA 2020 Systetmatic Review Checklist 4. PRISMA 2020 Abstract Checklist 5. Supplemental Figure 1 displaying the different data outputs from various scratch-detection technologies (actigraphy, smartwatch application, wearable acoustomechanic skin device)
BACKGROUND Norovirus is a contagious disease leading to vomiting and diarrhea. The transmission o... more BACKGROUND Norovirus is a contagious disease leading to vomiting and diarrhea. The transmission of norovirus spreads quickly and easily in various ways. Because effective methods to prevent or treat norovirus have not been discovered, it is important to rapidly recognize and report norovirus outbreaks in the early phase. Internet search has been a useful method for people to access information immediately. With the precise record of Internet search trends, Internet search has been a useful tool to manifest infectious disease outbreaks. OBJECTIVE In this study, we tried to discover the correlation between Internet search terms and norovirus infection. METHODS The Internet search trend data of norovirus were obtained from Google Trends. We used cross-correlation analysis to discover the temporal correlation between norovirus and other terms. We also used multiple linear regression with the stepwise method to recognize the most important predictors of Internet search trends and norovir...
4824 Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin bli... more 4824 Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin blistering disease caused by mutations in the type VII collagen (COL7A1) gene that encodes a major component in anchoring fibrils (Christiano et.al. Nat Gen 1993). Recently, iPSCs have been generated from RDEB patients, which provides promises on gene correction and future autologous Stem Cell Transplantation (SCT) (Itoh/Cairo/Christiano PNAS 2011). Currently, Allogeneic (Allo) SCT remains to be the best treatment for numerous malignant and non-malignant diseases in pediatric patients (Cairo et al BBMT 2008). This has also been supported by the first report on Allo-SCT in seven children with RDEB (Wagner et.al. N Engl J Med 2010). However no distinct anchoring fibrils were observed in the recipient skin. Moreover the functional cell populations are to be characterized. Stem cell populations with pluripotent properties, including unrestricted somatic stem cells (USSCs) have been isolated fro...
Methods: Forty-nine individuals with SocAhn and 33 well-matched controls underwent a fMRI session... more Methods: Forty-nine individuals with SocAhn and 33 well-matched controls underwent a fMRI session, during which they were instructed to envision positive or neutral future events in next year in response to the cue words. Each trial was divided into construction phase and elaboration phase. After scanning, participants received an interview to confirm they were able to project themselves into future and rated their experience in future events. Results: Three contrasts were identified to examine the main effect of emotion [Positive-Neutral] and phase [Construction-Elaboration], and their interaction [(Positive_Construction-Neutral_Construction)-(Positive_Elaboration-Neutral_Elaboration)]. One sample t test was conducted on these contrasts in each group and the results demonstrated that, in the control group, a set of regions including the bilateral caudate, bilateral amygdala, the left medial prefrontal (mPFC), and the left inferior parietal lobe were more engaged in envisioning positive future episodes relative to neutral episodes. However, preferential engagement of these regions was not observed in the SocAhn group. Both the SocAhn and control groups exhibited similar brain activation for the phase contrast. In addition, no significant clusters were shown for the interaction contrast in both groups, which may reflect no significant emotion difference in construction and elaboration of future events in these participants. Two sample t test results indicated that compared to controls, individuals with SocAhn exhibited hypo-activation in the right caudate and the right precuneus cortex when envisioning positive future events (relative to neutral events). Subsequent ROI analysis indicated that social interaction in positive future events was correlated with the engagement of bilateral amygdala (left, r = 0.46, p = 0.001; right, r = 0.43, p = 0.003) in the SocAhn group. In the control group, social interaction was correlated with activation of the left mPFC (r = 0.43, p = 0.02). Discussion: The present findings suggest there is reduced engagement of the caudate and the precuneus cortex in individuals with SocAhn when they envision positive future events. In addition, social interaction involved in positive future episodes is related to activation in different regions in individuals with SocAhn and controls.
Author contributions: Yoshioka H involved in overseeing the data collection process and data anal... more Author contributions: Yoshioka H involved in overseeing the data collection process and data analysis following the data collection; Hagiwara S and Takao S accessed to subject identifiable data and analyzed the data; all the authors have read the manuscript and have approved this submission. Institutional review board statement: The research protocol of this retrospective study was in compliance with the Helsinki Declaration, was approved by the institutional review board, and was registered with the University of California Irvine Medical Center.
The study of the healthy brain in elders, especially age-associated alterations in cognition, is ... more The study of the healthy brain in elders, especially age-associated alterations in cognition, is important to understand the deficits created by Alzheimer's disease (AD), which imposes a tremendous burden on individuals, families, and society. Although, the changes in synaptic connectivity and reorganization of brain networks that accompany aging are gradually becoming understood, little is known about how normal aging affects brain interregional synchronization and functional networks when items are held in working memory (WM). According to the classic Sternberg WM paradigm, we recorded multichannel electroencephalography (EEG) from healthy adults (young and senior) in three different conditions, i.e., the resting state, 0-back (control) task, and 2-back task. The phase lag index (PLI) between EEG channels was computed and then weighted and undirected network was constructed based on the PLI matrix. The effects of aging on network topology were examined using a brain connectivity toolbox. The results showed that age-related alteration was more prominent when the 2-back task was engaged, especially in the theta band. For the younger adults, the WM task evoked a significant increase in the clustering coefficient of the beta-band functional connectivity network, which was absent in the older adults. Furthermore, significant correlations were observed between the behavioral performance of WM and EEG metrics in the theta and gamma bands, suggesting the potential use of those measures as biomarkers for the evaluation of cognitive training, for instance. Taken together, our findings shed further light on the underlying mechanism of WM in physiological aging and suggest that different EEG frequencies appear to have distinct functional correlates in cognitive aging. Analysis of interregional synchronization and topological characteristics based on graph theory is thus an appropriate way to explore natural age-related changes in the human brain.
Sleep electroencephalography (EEG) provides an opportunity to study sleep scientifically, whose c... more Sleep electroencephalography (EEG) provides an opportunity to study sleep scientifically, whose chaotic, dynamic, complex, and dissipative nature implies that non-linear approaches could uncover some mechanism of sleep. Based on well-established complexity theories, one hypothesis in sleep medicine is that lower complexity of brain waves at pre-sleep state can facilitate sleep initiation and further improve sleep quality. However, this has never been studied with solid data. In this study, EEG collected from healthy subjects was used to investigate the association between pre-sleep EEG complexity and sleep quality. Multiscale entropy analysis (MSE) was applied to pre-sleep EEG signals recorded immediately after light-off (while subjects were awake) for measuring the complexities of brain dynamics by a proposed index, CI 1−30. Slow wave activity (SWA) in sleep, which is commonly used as an indicator of sleep depth or sleep intensity, was quantified based on two methods, traditional Fast Fourier transform (FFT) and ensemble empirical mode decomposition (EEMD). The associations between wake EEG complexity, sleep latency, and SWA in sleep were evaluated. Our results demonstrated that lower complexity before sleep onset is associated with decreased sleep latency, indicating a potential facilitating role of reduced pre-sleep complexity in the wake-sleep transition. In addition, the proposed EEMD-based method revealed an association between wake complexity and quantified SWA in the beginning of sleep (90 min after sleep onset). Complexity metric could thus be considered as a potential indicator for sleep interventions, and further studies are encouraged to examine the application of EEG complexity before sleep onset in populations with difficulty in sleep initiation. Further studies may also examine the mechanisms of the causal relationships between pre-sleep brain complexity and SWA, or conduct comparisons between normal and pathological conditions.
The aim of this study is to evaluate the utility of quantitative apparent diffusion coefficient (... more The aim of this study is to evaluate the utility of quantitative apparent diffusion coefficient (ADC) measurements and normalized ADC ratios in multiparametric MRI for the diagnosis of clinically significant peripheral zone (PZ) prostate cancer particularly among equivocally suspicious prostate lesions. A retrospective analysis of 95 patients with PZ lesions by PI-RADSv2 criteria, and who underwent subsequent MRI-US fusion biopsy, was approved by an institutional review board. Two radiologists independently measured ADC values in regions of interest (ROIs) of PZ lesions and calculated normalized ADC ratio based on ROIs in the bladder lumen. Diagnostic performance was evaluated using ROC. Inter observer variability was assessed using intraclass correlation coefficient (ICC). Mean ADC and normalized ADC ratios for clinically significant and non-clinically significant lesions were 0.763 × 10-3 mm s, 29.8%; and 1.135 × 10-3 mm s, 47.2% (p < 0.001), respectively. Area under the ROC cu...
Schizophrenia has been primarily associated with dopamine dysfunction, and treatments have been d... more Schizophrenia has been primarily associated with dopamine dysfunction, and treatments have been developed that target the dopamine pathway in the central nervous system. However, accumulating evidence has shown that the core pathophysiology of schizophrenia might involve dysfunction in dopaminergic, glutamatergic, serotonergic, and gamma-aminobutyric acid (GABA) signaling, which may lead to aberrant functioning of interneurons that manifest as cognitive, behavioral, and social dysfunction through altered functioning of a broad range of macro-and microcircuits. The interactions between neurotransmitters can be modeled as nodes and edges by using graph theory, and oxidative balance, immune, and glutamatergic systems may represent multiple nodes interlocking at a central hub; imbalance within any of these nodes might affect the entire system. Therefore, this review attempts to address novel treatment targets beyond the dopamine hypothesis, including glutamate, serotonin, acetylcholine, GABA, and inflammatory cytokines. Furthermore, we outline that these treatment targets can be possibly integrated with novel treatment strategies aimed at different symptoms or phases of the illness. We anticipate that reversing anomalous activity in these novel treatment targets or combinations between these strategies might be beneficial in the treatment of schizophrenia.
Migraine is characterized by a series of phases (inter-ictal, pre-ictal, ictal, and post-ictal). ... more Migraine is characterized by a series of phases (inter-ictal, pre-ictal, ictal, and post-ictal). It is of great interest whether resting-state electroencephalography (EEG) is differentiable between these phases. We compared resting-state EEG energy intensity and effective connectivity in different migraine phases using EEG power and coherence analyses in patients with migraine without aura as compared with healthy controls (HCs). EEG power and isolated effective coherence of delta (1-3.5 Hz), theta (4-7.5 Hz), alpha (8-12.5 Hz), and beta (13-30 Hz) bands were calculated in the frontal, central, temporal, parietal, and occipital regions. Fifty patients with episodic migraine (1-5 headache days/month) and 20 HCs completed the study. Patients were classified into inter-ictal, pre-ictal, ictal, and post-ictal phases (n = 22, 12, 8, 8, respectively), using 36-h criteria. Compared to HCs, inter-ictal and ictal patients, but not pre- or post-ictal patients, had lower EEG power and coherenc...
Bone Joint Journal Orthopaedic Proceedings Supplement, Mar 1, 2013
Background With the projected 673% increase in total knee arthroplasties (TKA) through the year 2... more Background With the projected 673% increase in total knee arthroplasties (TKA) through the year 2030 in the United States alone, arthrofibrosis will become one of the more commonly encountered challenges in orthopaedic surgery. Methods After obtaining Institutional Review Board approval we retrospectively reviewed the results of 19 patients with a mean age at the time of surgery of 55.4 years (41–83) who underwent arthroscopic lysis of adhesions (ALOA) for arthrofibrosis at a minimum of 3 months after primary total knee arthroplasty by a single surgeon (SJC) at a single institution. All patients underwent a standardized adhesiolysis in the operating room. All patients had a minimum of 6 months follow up. All patients underwent arthroscopic lysis of adhersions for restricted range of motion (ROM) after failing aggressive physical therapy. We defined restriction in ROM as any extension lag >5°, and flexion ≤90°. Eight patients underwent manipulation under anesthesia for ROM less than 90° after ALOA. Results Preoperative ROM was compared to ROM measured at most recent follow up. The mean knee arc of motion improved by 17° (p=0.0402), the mean flexion arc improved from 17° (p=0.0263) and the number of patients with flexion less than or equal to 90° decreased from 13 patients to 6 patients (p=0.0049). There were no patients that required polyethylene exchange, no periprosthetic joint infections or intraoperative fractures and no patients who suffered deep vein thrombosis as a result of the procedure. Conclusion We conclude that arthroscopic lysis of adhesions for treatment of arthrofibrosis after total knee arthroplasty is a safe and effective way to improve post-operative range of motion.
Skull base : official journal of North American Skull Base Society ... [et al.], 2008
Intranasal gliomas are challenging for several reasons. Their diagnosis may not be immediately ob... more Intranasal gliomas are challenging for several reasons. Their diagnosis may not be immediately obvious at presentation. It is important to exclude an intracranial extension, and for this some have suggested a craniotomy. We report a 9-day-old male infant in whom an intranasal glioma that mimicked an encephalocele was successfully excised by endoscopic approach after failure to excise it through a craniotomy. After more than a 5-year follow-up, the patient is still free from the disease. An endoscopic intranasal approach provides a safe and effective method for the management of nasal glioma and does not result in postoperative facial scaring or deformity. Endoscopic techniques provide excellent visualization and are preferable to the classic frontal craniotomy to excluding intracranial extension of nasal glioma.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of rep... more Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established. We explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. We identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists. The PCOS cohort consisted of 5...
Sleep disruption is an important aspect of major depressive disorder but lacks an objective and i... more Sleep disruption is an important aspect of major depressive disorder but lacks an objective and inexpensive means of assessment. We evaluated the utility of electrocardiogram (ECG)‐based cardiopulmonary coupling analysis to quantify physiologic sleep stability in patients with major depression. Relative to controls, unmedicated depressed patients had a reduction in high‐frequency coupling, an index of stable sleep, an increase in low‐frequency coupling, an index of unstable sleep, and an increase in very‐low‐frequency coupling, an index of wakefulness/REM sleep. The medicated depressed group showed a restoration of stable sleep to a level comparable with that of the control group. ECG‐based cardiopulmonary coupling analysis may provide a simple, cost‐efficient point‐of‐care method to quantify sleep quality/stability and to objectively evaluate the severity of insomnia in patients with major depression.
Background: It is unclear whether the loss of physiological complexity during the aging process i... more Background: It is unclear whether the loss of physiological complexity during the aging process is due to genetic variations. The APOE gene has been studied extensively in regard to its relationship with aging-associated medical illness. We hypothesize that diminished physiological complexity, as measured by heart rate variability, is influenced by polymorphisms in the APOE allele among elderly individuals. Methodology/Principal Findings: A total of 102 robust, non-demented, elderly subjects with normal functions of daily activities participated in this study (97 males and 5 females, aged 79.264.4 years, range 72-92 years). Among these individuals, the following two APOE genotypes were represented: e4 non-carriers (n = 87, 85.3%) and e4 carriers (n = 15, 14.7%). Multi-scale entropy (MSE), an analysis used in quantifying complexity for nonlinear time series, was employed to analyze heart-rate dynamics. Reduced physiological complexity, as measured by MSE, was significantly associated with the presence of the APOE e4 allele in healthy elderly subjects, as compared to APOE e4 allele non-carriers (24.665.5 versus 28.965.2, F = 9.429, p = 0.003, respectively). Conclusions/Significance: This finding suggests a role for the APOE gene in the diminished physiological complexity seen in elderly populations.
Yang et al. Reply: The preceding Comment [1] on our recent Letter [2] states that (1) our dissimi... more Yang et al. Reply: The preceding Comment [1] on our recent Letter [2] states that (1) our dissimilarity index does not fulfill essential properties of a distance metric and (2) use of conventional statistics based on heart rate mean and variance are sufficient to obtain the ''essential'' results. While we concur with the first comment, the second point is misleading and needs to be addressed.
Electrical impulse generation and its conduction within cells or cellular networks are the corner... more Electrical impulse generation and its conduction within cells or cellular networks are the cornerstone of electrophysiology. However, the advancement of the field is limited by sensing accuracy and the scalability of current recording technologies. Here we describe a scalable platform that enables accurate recording of transmembrane potentials in electrogenic cells. The platform employs a three-dimensional high-performance field-effect transistor array for minimally invasive cellular interfacing that produces faithful recordings, as validated by the gold standard patch clamp. Leveraging the high spatial and temporal resolutions of the field-effect transistors, we measured the intracellular signal conduction velocity of a cardiomyocyte to be 0.182 m s−1, which is about five times the intercellular velocity. We also demonstrate intracellular recordings in cardiac muscle tissue constructs and reveal the signal conduction paths. This platform could provide new capabilities in probing the electrical behaviours of single cells and cellular networks, which carries broad implications for understanding cellular physiology, pathology and cell–cell interactions. A three-dimensional field-effect transistor array produced via compressive buckling enables accurate and minimally invasive intra- and intercellular recordings in cells and cellular networks.
Supplemental materials for JAADI-D-21-00063R1, Use of technology for the objective evaluation of ... more Supplemental materials for JAADI-D-21-00063R1, Use of technology for the objective evaluation of scratching behavior: a systematic review. Files included: 1. Search Strategy 2. PRISMA Flow Diagram 3. PRISMA 2020 Systetmatic Review Checklist 4. PRISMA 2020 Abstract Checklist 5. Supplemental Figure 1 displaying the different data outputs from various scratch-detection technologies (actigraphy, smartwatch application, wearable acoustomechanic skin device)
BACKGROUND Norovirus is a contagious disease leading to vomiting and diarrhea. The transmission o... more BACKGROUND Norovirus is a contagious disease leading to vomiting and diarrhea. The transmission of norovirus spreads quickly and easily in various ways. Because effective methods to prevent or treat norovirus have not been discovered, it is important to rapidly recognize and report norovirus outbreaks in the early phase. Internet search has been a useful method for people to access information immediately. With the precise record of Internet search trends, Internet search has been a useful tool to manifest infectious disease outbreaks. OBJECTIVE In this study, we tried to discover the correlation between Internet search terms and norovirus infection. METHODS The Internet search trend data of norovirus were obtained from Google Trends. We used cross-correlation analysis to discover the temporal correlation between norovirus and other terms. We also used multiple linear regression with the stepwise method to recognize the most important predictors of Internet search trends and norovir...
4824 Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin bli... more 4824 Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin blistering disease caused by mutations in the type VII collagen (COL7A1) gene that encodes a major component in anchoring fibrils (Christiano et.al. Nat Gen 1993). Recently, iPSCs have been generated from RDEB patients, which provides promises on gene correction and future autologous Stem Cell Transplantation (SCT) (Itoh/Cairo/Christiano PNAS 2011). Currently, Allogeneic (Allo) SCT remains to be the best treatment for numerous malignant and non-malignant diseases in pediatric patients (Cairo et al BBMT 2008). This has also been supported by the first report on Allo-SCT in seven children with RDEB (Wagner et.al. N Engl J Med 2010). However no distinct anchoring fibrils were observed in the recipient skin. Moreover the functional cell populations are to be characterized. Stem cell populations with pluripotent properties, including unrestricted somatic stem cells (USSCs) have been isolated fro...
Methods: Forty-nine individuals with SocAhn and 33 well-matched controls underwent a fMRI session... more Methods: Forty-nine individuals with SocAhn and 33 well-matched controls underwent a fMRI session, during which they were instructed to envision positive or neutral future events in next year in response to the cue words. Each trial was divided into construction phase and elaboration phase. After scanning, participants received an interview to confirm they were able to project themselves into future and rated their experience in future events. Results: Three contrasts were identified to examine the main effect of emotion [Positive-Neutral] and phase [Construction-Elaboration], and their interaction [(Positive_Construction-Neutral_Construction)-(Positive_Elaboration-Neutral_Elaboration)]. One sample t test was conducted on these contrasts in each group and the results demonstrated that, in the control group, a set of regions including the bilateral caudate, bilateral amygdala, the left medial prefrontal (mPFC), and the left inferior parietal lobe were more engaged in envisioning positive future episodes relative to neutral episodes. However, preferential engagement of these regions was not observed in the SocAhn group. Both the SocAhn and control groups exhibited similar brain activation for the phase contrast. In addition, no significant clusters were shown for the interaction contrast in both groups, which may reflect no significant emotion difference in construction and elaboration of future events in these participants. Two sample t test results indicated that compared to controls, individuals with SocAhn exhibited hypo-activation in the right caudate and the right precuneus cortex when envisioning positive future events (relative to neutral events). Subsequent ROI analysis indicated that social interaction in positive future events was correlated with the engagement of bilateral amygdala (left, r = 0.46, p = 0.001; right, r = 0.43, p = 0.003) in the SocAhn group. In the control group, social interaction was correlated with activation of the left mPFC (r = 0.43, p = 0.02). Discussion: The present findings suggest there is reduced engagement of the caudate and the precuneus cortex in individuals with SocAhn when they envision positive future events. In addition, social interaction involved in positive future episodes is related to activation in different regions in individuals with SocAhn and controls.
Author contributions: Yoshioka H involved in overseeing the data collection process and data anal... more Author contributions: Yoshioka H involved in overseeing the data collection process and data analysis following the data collection; Hagiwara S and Takao S accessed to subject identifiable data and analyzed the data; all the authors have read the manuscript and have approved this submission. Institutional review board statement: The research protocol of this retrospective study was in compliance with the Helsinki Declaration, was approved by the institutional review board, and was registered with the University of California Irvine Medical Center.
The study of the healthy brain in elders, especially age-associated alterations in cognition, is ... more The study of the healthy brain in elders, especially age-associated alterations in cognition, is important to understand the deficits created by Alzheimer's disease (AD), which imposes a tremendous burden on individuals, families, and society. Although, the changes in synaptic connectivity and reorganization of brain networks that accompany aging are gradually becoming understood, little is known about how normal aging affects brain interregional synchronization and functional networks when items are held in working memory (WM). According to the classic Sternberg WM paradigm, we recorded multichannel electroencephalography (EEG) from healthy adults (young and senior) in three different conditions, i.e., the resting state, 0-back (control) task, and 2-back task. The phase lag index (PLI) between EEG channels was computed and then weighted and undirected network was constructed based on the PLI matrix. The effects of aging on network topology were examined using a brain connectivity toolbox. The results showed that age-related alteration was more prominent when the 2-back task was engaged, especially in the theta band. For the younger adults, the WM task evoked a significant increase in the clustering coefficient of the beta-band functional connectivity network, which was absent in the older adults. Furthermore, significant correlations were observed between the behavioral performance of WM and EEG metrics in the theta and gamma bands, suggesting the potential use of those measures as biomarkers for the evaluation of cognitive training, for instance. Taken together, our findings shed further light on the underlying mechanism of WM in physiological aging and suggest that different EEG frequencies appear to have distinct functional correlates in cognitive aging. Analysis of interregional synchronization and topological characteristics based on graph theory is thus an appropriate way to explore natural age-related changes in the human brain.
Sleep electroencephalography (EEG) provides an opportunity to study sleep scientifically, whose c... more Sleep electroencephalography (EEG) provides an opportunity to study sleep scientifically, whose chaotic, dynamic, complex, and dissipative nature implies that non-linear approaches could uncover some mechanism of sleep. Based on well-established complexity theories, one hypothesis in sleep medicine is that lower complexity of brain waves at pre-sleep state can facilitate sleep initiation and further improve sleep quality. However, this has never been studied with solid data. In this study, EEG collected from healthy subjects was used to investigate the association between pre-sleep EEG complexity and sleep quality. Multiscale entropy analysis (MSE) was applied to pre-sleep EEG signals recorded immediately after light-off (while subjects were awake) for measuring the complexities of brain dynamics by a proposed index, CI 1−30. Slow wave activity (SWA) in sleep, which is commonly used as an indicator of sleep depth or sleep intensity, was quantified based on two methods, traditional Fast Fourier transform (FFT) and ensemble empirical mode decomposition (EEMD). The associations between wake EEG complexity, sleep latency, and SWA in sleep were evaluated. Our results demonstrated that lower complexity before sleep onset is associated with decreased sleep latency, indicating a potential facilitating role of reduced pre-sleep complexity in the wake-sleep transition. In addition, the proposed EEMD-based method revealed an association between wake complexity and quantified SWA in the beginning of sleep (90 min after sleep onset). Complexity metric could thus be considered as a potential indicator for sleep interventions, and further studies are encouraged to examine the application of EEG complexity before sleep onset in populations with difficulty in sleep initiation. Further studies may also examine the mechanisms of the causal relationships between pre-sleep brain complexity and SWA, or conduct comparisons between normal and pathological conditions.
The aim of this study is to evaluate the utility of quantitative apparent diffusion coefficient (... more The aim of this study is to evaluate the utility of quantitative apparent diffusion coefficient (ADC) measurements and normalized ADC ratios in multiparametric MRI for the diagnosis of clinically significant peripheral zone (PZ) prostate cancer particularly among equivocally suspicious prostate lesions. A retrospective analysis of 95 patients with PZ lesions by PI-RADSv2 criteria, and who underwent subsequent MRI-US fusion biopsy, was approved by an institutional review board. Two radiologists independently measured ADC values in regions of interest (ROIs) of PZ lesions and calculated normalized ADC ratio based on ROIs in the bladder lumen. Diagnostic performance was evaluated using ROC. Inter observer variability was assessed using intraclass correlation coefficient (ICC). Mean ADC and normalized ADC ratios for clinically significant and non-clinically significant lesions were 0.763 × 10-3 mm s, 29.8%; and 1.135 × 10-3 mm s, 47.2% (p < 0.001), respectively. Area under the ROC cu...
Schizophrenia has been primarily associated with dopamine dysfunction, and treatments have been d... more Schizophrenia has been primarily associated with dopamine dysfunction, and treatments have been developed that target the dopamine pathway in the central nervous system. However, accumulating evidence has shown that the core pathophysiology of schizophrenia might involve dysfunction in dopaminergic, glutamatergic, serotonergic, and gamma-aminobutyric acid (GABA) signaling, which may lead to aberrant functioning of interneurons that manifest as cognitive, behavioral, and social dysfunction through altered functioning of a broad range of macro-and microcircuits. The interactions between neurotransmitters can be modeled as nodes and edges by using graph theory, and oxidative balance, immune, and glutamatergic systems may represent multiple nodes interlocking at a central hub; imbalance within any of these nodes might affect the entire system. Therefore, this review attempts to address novel treatment targets beyond the dopamine hypothesis, including glutamate, serotonin, acetylcholine, GABA, and inflammatory cytokines. Furthermore, we outline that these treatment targets can be possibly integrated with novel treatment strategies aimed at different symptoms or phases of the illness. We anticipate that reversing anomalous activity in these novel treatment targets or combinations between these strategies might be beneficial in the treatment of schizophrenia.
Migraine is characterized by a series of phases (inter-ictal, pre-ictal, ictal, and post-ictal). ... more Migraine is characterized by a series of phases (inter-ictal, pre-ictal, ictal, and post-ictal). It is of great interest whether resting-state electroencephalography (EEG) is differentiable between these phases. We compared resting-state EEG energy intensity and effective connectivity in different migraine phases using EEG power and coherence analyses in patients with migraine without aura as compared with healthy controls (HCs). EEG power and isolated effective coherence of delta (1-3.5 Hz), theta (4-7.5 Hz), alpha (8-12.5 Hz), and beta (13-30 Hz) bands were calculated in the frontal, central, temporal, parietal, and occipital regions. Fifty patients with episodic migraine (1-5 headache days/month) and 20 HCs completed the study. Patients were classified into inter-ictal, pre-ictal, ictal, and post-ictal phases (n = 22, 12, 8, 8, respectively), using 36-h criteria. Compared to HCs, inter-ictal and ictal patients, but not pre- or post-ictal patients, had lower EEG power and coherenc...
Bone Joint Journal Orthopaedic Proceedings Supplement, Mar 1, 2013
Background With the projected 673% increase in total knee arthroplasties (TKA) through the year 2... more Background With the projected 673% increase in total knee arthroplasties (TKA) through the year 2030 in the United States alone, arthrofibrosis will become one of the more commonly encountered challenges in orthopaedic surgery. Methods After obtaining Institutional Review Board approval we retrospectively reviewed the results of 19 patients with a mean age at the time of surgery of 55.4 years (41–83) who underwent arthroscopic lysis of adhesions (ALOA) for arthrofibrosis at a minimum of 3 months after primary total knee arthroplasty by a single surgeon (SJC) at a single institution. All patients underwent a standardized adhesiolysis in the operating room. All patients had a minimum of 6 months follow up. All patients underwent arthroscopic lysis of adhersions for restricted range of motion (ROM) after failing aggressive physical therapy. We defined restriction in ROM as any extension lag >5°, and flexion ≤90°. Eight patients underwent manipulation under anesthesia for ROM less than 90° after ALOA. Results Preoperative ROM was compared to ROM measured at most recent follow up. The mean knee arc of motion improved by 17° (p=0.0402), the mean flexion arc improved from 17° (p=0.0263) and the number of patients with flexion less than or equal to 90° decreased from 13 patients to 6 patients (p=0.0049). There were no patients that required polyethylene exchange, no periprosthetic joint infections or intraoperative fractures and no patients who suffered deep vein thrombosis as a result of the procedure. Conclusion We conclude that arthroscopic lysis of adhesions for treatment of arthrofibrosis after total knee arthroplasty is a safe and effective way to improve post-operative range of motion.
Skull base : official journal of North American Skull Base Society ... [et al.], 2008
Intranasal gliomas are challenging for several reasons. Their diagnosis may not be immediately ob... more Intranasal gliomas are challenging for several reasons. Their diagnosis may not be immediately obvious at presentation. It is important to exclude an intracranial extension, and for this some have suggested a craniotomy. We report a 9-day-old male infant in whom an intranasal glioma that mimicked an encephalocele was successfully excised by endoscopic approach after failure to excise it through a craniotomy. After more than a 5-year follow-up, the patient is still free from the disease. An endoscopic intranasal approach provides a safe and effective method for the management of nasal glioma and does not result in postoperative facial scaring or deformity. Endoscopic techniques provide excellent visualization and are preferable to the classic frontal craniotomy to excluding intracranial extension of nasal glioma.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of rep... more Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established. We explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. We identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists. The PCOS cohort consisted of 5...
Sleep disruption is an important aspect of major depressive disorder but lacks an objective and i... more Sleep disruption is an important aspect of major depressive disorder but lacks an objective and inexpensive means of assessment. We evaluated the utility of electrocardiogram (ECG)‐based cardiopulmonary coupling analysis to quantify physiologic sleep stability in patients with major depression. Relative to controls, unmedicated depressed patients had a reduction in high‐frequency coupling, an index of stable sleep, an increase in low‐frequency coupling, an index of unstable sleep, and an increase in very‐low‐frequency coupling, an index of wakefulness/REM sleep. The medicated depressed group showed a restoration of stable sleep to a level comparable with that of the control group. ECG‐based cardiopulmonary coupling analysis may provide a simple, cost‐efficient point‐of‐care method to quantify sleep quality/stability and to objectively evaluate the severity of insomnia in patients with major depression.
Background: It is unclear whether the loss of physiological complexity during the aging process i... more Background: It is unclear whether the loss of physiological complexity during the aging process is due to genetic variations. The APOE gene has been studied extensively in regard to its relationship with aging-associated medical illness. We hypothesize that diminished physiological complexity, as measured by heart rate variability, is influenced by polymorphisms in the APOE allele among elderly individuals. Methodology/Principal Findings: A total of 102 robust, non-demented, elderly subjects with normal functions of daily activities participated in this study (97 males and 5 females, aged 79.264.4 years, range 72-92 years). Among these individuals, the following two APOE genotypes were represented: e4 non-carriers (n = 87, 85.3%) and e4 carriers (n = 15, 14.7%). Multi-scale entropy (MSE), an analysis used in quantifying complexity for nonlinear time series, was employed to analyze heart-rate dynamics. Reduced physiological complexity, as measured by MSE, was significantly associated with the presence of the APOE e4 allele in healthy elderly subjects, as compared to APOE e4 allele non-carriers (24.665.5 versus 28.965.2, F = 9.429, p = 0.003, respectively). Conclusions/Significance: This finding suggests a role for the APOE gene in the diminished physiological complexity seen in elderly populations.
Yang et al. Reply: The preceding Comment [1] on our recent Letter [2] states that (1) our dissimi... more Yang et al. Reply: The preceding Comment [1] on our recent Letter [2] states that (1) our dissimilarity index does not fulfill essential properties of a distance metric and (2) use of conventional statistics based on heart rate mean and variance are sufficient to obtain the ''essential'' results. While we concur with the first comment, the second point is misleading and needs to be addressed.
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Papers by Albert Yang