Publications by authors named "Jia-Jin Chen"

91 Publications

An Improved Sensing Method of a Robotic Ultrasound System for Real-Time Force and Angle Calibration.

Sensors (Basel) 2021 Apr 22;21(9). Epub 2021 Apr 22.

Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan.

An ultrasonic examination is a clinically universal and safe examination method, and with the development of telemedicine and precision medicine, the robotic ultrasound system (RUS) integrated with a robotic arm and ultrasound imaging system receives increasing attention. As the RUS requires precision and reproducibility, it is important to monitor the real-time calibration of the RUS during examination, especially the angle of the probe for image detection and its force on the surface. Additionally, to speed up the integration of the RUS and the current medical ultrasound system (US), the current RUSs mostly use a self-designed fixture to connect the probe to the arm. If the fixture has inconsistencies, it may cause an operating error. In order to improve its resilience, this study proposed an improved sensing method for real-time force and angle calibration. Based on multichannel pressure sensors, an inertial measurement unit (IMU), and a novel sensing structure, the ultrasonic probe and robotic arm could be simply and rapidly combined, which rendered real-time force and angle calibration at a low cost. The experimental results show that the average success rate of the downforce position identification achieved was 88.2%. The phantom experiment indicated that the method could assist the RUS in the real-time calibration of both force and angle during an examination.
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http://dx.doi.org/10.3390/s21092927DOI Listing
April 2021

Long-Term Outcomes of Acute Kidney Injury After Different Types of Cardiac Surgeries: A Population-Based Study.

J Am Heart Assoc 2021 May 21;10(9):e019718. Epub 2021 Apr 21.

Division of Thoracic and Cardiovascular Surgery Department of Surgery Chang Gung Memorial Hospital Linkou Medical Center Chang Gung University Taoyuan City Taiwan.

Background Dialysis-requiring acute kidney injury (D-AKI) is a major complication of cardiovascular surgery that results in worse prognosis. However, the incidence and impacts of D-AKI in different types of cardiac surgeries have not been fully investigated. Methods and Results Patients admitted for cardiovascular surgery between July 1, 2004, and December 31, 2013, were identified from the National Health Insurance Research Database of Taiwan. The patients were grouped into D-AKI (n=3089) and non-D-AKI (n=42 151) groups. The outcome was all-cause mortality and major adverse kidney event. The long-term outcomes were worse in the D-AKI group than the non-D-AKI group (hazard ratio [HR], 3.89; 95% CI, 3.79-3.99 for major adverse kidney event; HR, 2.89; 95% CI, 2.81-2.98 for all-cause mortality). Patients who underwent aortic surgery had higher risk for D-AKI than other types of surgeries, but they were also more likely to recover. The long-term dialysis rate for the patients who recovered from D-AKI was also lowest in those who underwent aortic surgery. Among all types of cardiac surgeries with D-AKI, patients who had heart valve surgery exhibited the greatest risks of all-cause mortality (HR, 6.04; 95% CI, 5.78-6.32). Conclusions Compared with other heart surgeries, aortic surgery resulted in a higher incidence of D-AKI but better renal recovery, better short-term outcome, and lower incidences of long-term dialysis.
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http://dx.doi.org/10.1161/JAHA.120.019718DOI Listing
May 2021

Using lipocalin as a prognostic biomarker in acute kidney injury.

Expert Rev Mol Diagn 2021 Apr 19:1-10. Epub 2021 Apr 19.

Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.

: Human lipocalin-2, known as neutrophil gelatinase-associated lipocalin (NGAL), is a widely studied biomarker of acute kidney injury (AKI).: NGAL can serve as a predictor of AKI, disease progression, and mortality and can help in differentiating between AKI etiologies. We conducted a systematic review in the PubMed and Medline databases involving the clinical application of NGAL in patients with AKI.: In this review, we explored the usefulness of NGAL for AKI or clinical outcome prediction. The use of urine or blood NGAL levels alone or in combination with a clinical prediction model may facilitate AKI prediction, severity prediction, AKI etiological differentiation, and mortality prediction. For AKI prediction, urine and plasma NGAL levels have an area under the curve (AUC) ranging from 0.71 to 0.90 and from 0.71 to 0.89, respectively, in different populations. The diagnostic performance of NGAL alone for renal replacement therapy or successful discontinuation prediction is suboptimal (AUC range: 0.65-0.81). Sepsis limits the application of NGAL as a clinical predictor, and the prediction performance of NGAL is affected by baseline renal function, timing of sample collection, and underlying comorbidities. The lack of internationally approved reference material also limits the usefulness of NGAL.
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http://dx.doi.org/10.1080/14737159.2021.1917384DOI Listing
April 2021

Risk factors and prognosis assessment for acute kidney injury: The 2020 consensus of the Taiwan AKI Task Force.

J Formos Med Assoc 2021 Mar 8. Epub 2021 Mar 8.

Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan. Electronic address:

Risk and prognostic factors for acute kidney injury (AKI) have been published in various studies across various populations. We aimed to explore recent advancements in and provide updated recommendations on AKI risk stratification and information about local AKI risk factors. The Taiwan Acute Kidney Injury Task Force reviewed relevant recently published literature and reached a consensus after group meetings. Systemic review and group discussion were performed. We conducted a meta-analysis according to the PRISMA statement for evaluating the diagnostic performance of the furosemide stress test. Several risk and susceptibility factors were identified through literature review. Contrast-associated AKI prediction models after coronary angiography were one of the most discussed prediction models we found. The basic approach and evaluation of patients with AKI was also discussed. Our meta-analysis found that the furosemide stress test can be used as a prognostic tool for AKI progression and to identify patients with AKI who are at low risk of renal replacement therapy. Factors associated with de novo chronic kidney injury or renal non-recovery after AKI were identified and summarized. Our review provided practical information about early identification of patients at high risk of AKI or disease progression for Taiwan local clinics.
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http://dx.doi.org/10.1016/j.jfma.2021.02.013DOI Listing
March 2021

Treatment Strategies and Metabolic Pathway Regulation in Urothelial Cell Carcinoma: A Comprehensive Review.

Int J Mol Sci 2020 Nov 26;21(23). Epub 2020 Nov 26.

Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.

For a long time, cisplatin-based chemotherapy had been viewed as first-line chemotherapy for advanced and metastatic urothelial carcinoma (UC). However, many patients with UC had been classified as cisplatin-ineligible who can only receive alternative chemotherapy with poor treatment response, and the vast majority of the cisplatin-eligible patients eventually progressed, even those with objective response with cisplatin-based chemotherapy initially. By understanding tumor immunology in UC, immune checkpoint inhibitors, targeting on programmed death 1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) pathways, had been proven as first-line treatment for cisplatin-ineligible metastatic UC and as second-line treatment for patients with platinum-refractory metastatic UC by the U.S Food and Drug Administration (FDA). In 2020, JAVEIN bladder 100 further reported that PD-L1 inhibitors showed benefits on prolonged survival and progression-free survival as maintenance therapy. Besides targeting on immune checkpoint, manipulation of the tumor microenvironment by metabolic pathways intervention, including inhibition on tumor glycolysis, lactate accumulation and exogenous glutamine uptake, had been investigated in the past few years. In this comprehensive review, we start by introducing traditional chemotherapy of UC, and then we summarize current evidences supporting the use of immune checkpoint inhibitors and highlight ongoing clinical trials. Lastly, we reviewed the tumor metabolic characteristic and the anti-tumor treatments targeting on metabolic pathways.
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http://dx.doi.org/10.3390/ijms21238993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730311PMC
November 2020

Advanced Chronic Kidney Disease with Low and Very Low GFR: Can a Low-Protein Diet Supplemented with Ketoanalogues Delay Dialysis?

Nutrients 2020 Oct 31;12(11). Epub 2020 Oct 31.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33341, Taiwan.

Background: Previous studies have demonstrated that dietary therapy can delay the initiation of dialysis, but little research has investigated whether patients with very poor renal function would benefit from a dietary therapy.

Methods: This study was performed by using the Chang Gung Research Database (CGRD), which is based on the largest medical system in Taiwan. Patients with estimated glomerular filtration rates (eGFR) < 15 mL/min/1.73 m between 2001 and 2015 with more than 3 months of low-protein diet supplemented with ketoanalogues (sLPD) were extracted (Ketosteril group). We then assigned five patients without any sLPD to match one patient of the Ketosteril group (comparison group). Both groups were followed up for 1 year for the initiation of dialysis and rates of major adverse cardiac and cerebrovascular events (MACCEs).

Results: The Ketosteril group ( = 547), compared with the comparison group ( = 2735), exhibited a lower incidence of new-onset dialysis (40.2% vs. 44.4%, subdistribution hazard ratio (SHR): 0.80, 95% confidence interval (CI): 0.70-0.91) and MACCEs (3.7% vs. 5.9%, HR: 0.61, 95% CI: 0.38-0.97). The beneficial effect of an sLPD did not differ in patients with a baseline eGFR < 5 mL/min/1.73 m.

Conclusion: Even among patients with extremely low eGFR, sLPD treatment can safely delay the need for dialysis.
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http://dx.doi.org/10.3390/nu12113358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694025PMC
October 2020

Mid-term survival of patients with chronic kidney disease after extracorporeal membrane oxygenation.

Interact Cardiovasc Thorac Surg 2020 11;31(5):595-602

Division of Nephrology, Kidney Research Center, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan.

Objectives: Chronic kidney disease (CKD) impairs the elimination of fluids, electrolytes and metabolic wastes, which can affect the outcomes of extracorporeal membrane oxygenation (ECMO) treatment. This study aimed to elucidate the impact of CKD on in-hospital mortality and mid-term survival of adult patients who received ECMO treatment.

Methods: Patients who received first-time ECMO treatment between 1 January 2003 and 31 December 2013 were included. Those with CKD were identified and matched to patients without CKD using a 1:2 ratio and were followed for 3 years. The study outcomes included in-hospital outcomes and the 3-year mortality rate. A subgroup analysis was conducted by comparing the dialytic patients with the non-dialytic CKD patients.

Results: The study comprised 1008 CKD patients and 2016 non-CKD patients after propensity score matching. The CKD patients had higher in-hospital mortality rates [69.5% vs 62.2%; adjusted odds ratio 1.41; 95% confidence interval (CI) 1.15-1.72] than the non-CKD patients. The 3-year mortality rate was 80.4% in the CKD group and 68% in the non-CKD group (adjusted hazard ratio 1.17; 95% CI 1.06-1.28). The subgroup analysis showed that the 3-year mortality rates were 84.5% and 78.4% in the dialytic and non-dialytic patients, respectively. No difference in the 3-year mortality rate was noted between the 2 CKD subgroups (P = 0.111).

Conclusions: CKD was associated with increased risks of in-hospital and mid-term mortalities in patients who received ECMO treatment. Furthermore, no difference in survival was observed between the patients with end-stage renal disease and non-dialytic CKD patients.
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http://dx.doi.org/10.1093/icvts/ivaa168DOI Listing
November 2020

Enhancement of PVDF Sensing Characteristics by Retooling the Near-Field Direct-Write Electrospinning System.

Sensors (Basel) 2020 Aug 28;20(17). Epub 2020 Aug 28.

Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan.

This research aimed to develop a direct-write near-field electrospinning system (DW-NFES) with three-axis positioning of controllable speed, torque and position to produce sizable and high-quality piezoelectric fibers for sensing purposes. Sensor devices with high electrical response signals were developed and tested. To achieve DW-NFES purpose, a servo motor controller was designed to develop a high response rate, accurate positioning, and stable mobile device through the calculation of bandwidth and system time delay. With this retooled system of DW-NFES, controllable and uniform size fibers in terms of diameters, stretching force, and interspaces can be obtained. Sensor devices can be made selectively without a complicated lithography process. The characteristics of this DW-NFES platform were featured by high response rate, accurate positioning, and stable movement to make fibers with high piezoelectric property. In this study, polyvinylidene fluoride (PVDF) was used to explore and enhance their sensing quality through the platform. The parametric study of the process factors on piezoelectric sensing signals mainly included the concentration of electrospinning PVDF solution, high voltage electric field, and collection speed. Finally, the surface morphology and piezoelectric properties of the as-electrospun PVDF fibers were examined by scanning electron microscopy (SEM) and characterized by electrical response measurement techniques. The results showed that the fiber spinning speed of the DW-NFES system could be increased to ~125 from ~20 mm/s and the accuracy precision was improved to ~1 from ~50 μm, compared to conventional step motor system. The fiber diameter reached ~10 μm, and the electrospinning pitch reached to as small as ~10 μm. The piezoelectric output voltage of the electrospun fibers was increased ~28.6% from ~97.2 to ~125 mV; the current was increased ~27.6% from ~163 to ~208 nA, suggesting that the piezoelectric signals can be enhanced significantly by using this retooled system. Finally, an external control module (Arduino-MAGE) was introduced to control the PVDF piezoelectric fiber sensors integrated as a sensing array. The behavior of long-term sedentary patients can be successfully detected by this module system to prevent the patients from the bedsores.
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http://dx.doi.org/10.3390/s20174873DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506575PMC
August 2020

The incidence and survival after in-hospital cardiopulmonary cerebral resuscitation in end-stage kidney disease patients: A nationwide population-based study.

PLoS One 2020 28;15(8):e0238029. Epub 2020 Aug 28.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

Background: This study analyzed the survival and protective predictors of in-hospital cardiopulmonary cerebral resuscitation (CPCR) to potentially help physicians create effective treatment plans for End-stage kidney disease (ESKD) patients.

Methods: We extracted the data of 7,116 ESKD patients who received their first in-hospital CPCR after initial dialysis between 2004 and 2012 from the National Health Insurance Research Database. The primary outcome was the survival rate during the first in-hospital CPCR. The secondary outcome was the median post-discharge survival.

Results: From 2004 through 2012, the incidence of in-hospital CPCR decreases from 3.97 to 3.67 events per 1,000 admission days (P for linear trend <0.001). The survival rate for the first in-hospital CPCR did not change significantly across the 9 years (P for trend = 0.244), whereas the median survival of post-discharge survival increased significantly from 3.0 months in 2004 to 6.8 months in 2011 (P for linear trend <0.001). In addition, multivariable analysis identified older age as a risk factor and prior intracardiac defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) implantation as a protective factor for in-hospital death during the first in-hospital CPCR.

Conclusion: The incidence of in-hospital CPCR and the duration post-discharge among ESKD patients improved despite there being no significant difference in the survival rate of ESKD patients after CPCP. Either ICD or CRT-D implantation may be advisable for ESKD patients with a high risk of sudden cardiac death.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238029PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454972PMC
October 2020

Furosemide stress test as a predictive marker of acute kidney injury progression or renal replacement therapy: a systemic review and meta-analysis.

Crit Care 2020 05 7;24(1):202. Epub 2020 May 7.

Department of Nephrology, Chang Gung Memorial Hospital, No 5 Fu-shin Street, Taoyuan City, 333, Taiwan.

Background: The use of the furosemide stress test (FST) as an acute kidney injury (AKI) severity marker has been described in several trials. However, the diagnostic performance of the FST in predicting AKI progression has not yet been fully discussed.

Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, and Cochrane databases up to March 2020. The diagnostic performance of the FST (in terms of sensitivity, specificity, number of events, true positive, false positive) was extracted and evaluated.

Results: We identified eleven trials that enrolled a total of 1366 patients, including 517 patients and 1017 patients for whom the outcomes in terms of AKI stage progression and renal replacement therapy (RRT), respectively, were reported. The pooled sensitivity and specificity results of the FST for AKI progression prediction were 0.81 (95% CI 0.74-0.87) and 0.88 (95% CI 0.82-0.92), respectively. The pooled positive likelihood ratio (LR) was 5.45 (95% CI 3.96-7.50), the pooled negative LR was 0.26 (95% CI 0.19-0.36), and the pooled diagnostic odds ratio (DOR) was 29.69 (95% CI 17.00-51.85). The summary receiver operating characteristics (SROC) with pooled diagnostic accuracy was 0.88. The diagnostic performance of the FST in predicting AKI progression was not affected by different AKI criteria or underlying chronic kidney disease. The pooled sensitivity and specificity results of the FST for RRT prediction were 0.84 (95% CI 0.72-0.91) and 0.77 (95% CI 0.64-0.87), respectively. The pooled positive LR and pooled negative LR were 3.16 (95% CI 2.06-4.86) and 0.25 (95% CI 0.14-0.44), respectively. The pooled diagnostic odds ratio (DOR) was 13.59 (95% CI 5.74-32.17), and SROC with pooled diagnostic accuracy was 0.86. The diagnostic performance of FST for RRT prediction is better in stage 1-2 AKI compared to stage 3 AKI (relative DOR 5.75, 95% CI 2.51-13.33).

Conclusion: The FST is a simple tool for the identification of AKI populations at high risk of AKI progression and the need for RRT, and the diagnostic performance of FST in RRT prediction is better in early AKI population.
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http://dx.doi.org/10.1186/s13054-020-02912-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206785PMC
May 2020

Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study.

Sensors (Basel) 2020 Apr 13;20(8). Epub 2020 Apr 13.

Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

Since there is merit in noninvasive monitoring of muscular oxidative metabolism for near-infrared spectroscopy in a wide range of clinical scenarios, the present study attempted to evaluate the clinical usability for featuring the modulatory strategies of sternocleidomastoid muscular oxygenation using near-infrared spectroscopy in mild nonspecific neck pain patients. The muscular oxygenation variables of the dominant or affected sternocleidomastoid muscles of interest were extracted at 25% of the maximum voluntary isometric contraction from ten patients (5 males and 5 females, 23.6 ± 4.2 years) and asymptomatic individuals (6 males and 4 females, 24.0 ± 5.1 years) using near-infrared spectroscopy. Only a shorter half-deoxygenation time of oxygen saturation during a sternocleidomastoid isometric contraction was noted in patients compared to asymptomatic individuals (10.43 ± 1.79 s vs. 13.82 ± 1.42 s, < 0.001). Even though the lack of statically significant differences in most of the muscular oxygenation variables failed to refine the definite pathogenic mechanisms underlying nonspecific neck pain, the findings of modulatory strategies of faster deoxygenation implied that near-infrared spectroscopy appears to have practical potential to provide relevant physiological information regarding muscular oxidative metabolism and constituted convincing preliminary evidences of the adaptive manipulations rather than pathological responses of oxidative metabolism capacity of sternocleidomastoid muscles in nonspecific neck patients with mild disability.
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http://dx.doi.org/10.3390/s20082197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218888PMC
April 2020

Comparison between watchful waiting strategy and early initiation of renal replacement therapy in the critically ill acute kidney injury population: an updated systematic review and meta-analysis.

Ann Intensive Care 2020 Mar 3;10(1):30. Epub 2020 Mar 3.

Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Background: The optimal timing of renal replacement therapy (RRT) initiation is debatable. Many articles in this field enrolled trials not based on acute kidney injury. The safety of the watchful waiting strategy has not been fully discussed, and late RRT initiation criteria vary across studies. The effect of early RRT initiation in the AKI population with high plasma neutrophil gelatinase-associated lipocalin (NGAL) has not been examined yet.

Methods: In accordance with PRISMA guidelines, the PubMed, Embase, and Cochrane databases were systemically searched for randomized controlled trials (RCTs). Trials not conducted in the AKI population were excluded. Data of study characteristics, primary outcome (all-cause mortality), and related secondary outcomes [mechanical ventilation (MV) days, length of hospital stay, RRT days, and length of ICU stay] were extracted. The outcomes were compared between early and late RRT groups by estimating the pooled odds ratio (OR) for binary outcomes and the weighted mean difference for continuous outcomes. Prospective trials were also examined and analyzed using the same method.

Results: Nine RCTs with 1938 patients were included. Early RRT did not provide a survival benefit (pooled OR, 0.88; 95% confidence interval [CI] 0.62-1.27). However, the early RRT group had significantly fewer MV days (pooled mean difference, - 3.98 days; 95% CI - 7.81 to - 0.15 days). Subgroup analysis showed that RCTs enrolling the surgical population (P = .001) and the AKI population with high plasma NGAL (P = .031) had favorable outcomes regarding RRT days in the early initiation group. Moreover, 6 of 9 RCTs were selected for examining the safety of the watchful waiting strategy, and no significant differences were found in primary and secondary outcomes between the early and late RRT groups.

Conclusions: Overall, early RRT initiation did not provide a survival benefit, but a possible benefit of fewer MV days was detected. Early RRT might also provide the benefit of shorter MV or RRT support in the surgical population and in AKI patients with high plasma NGAL. Depending on the conventional indication for RRT initiation, the watchful waiting strategy is safe on the basis of all primary and secondary outcomes.
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http://dx.doi.org/10.1186/s13613-020-0641-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054512PMC
March 2020

Measurement of Interhemispheric Correlation Coefficient in Rodent Model of Middle Cerebral Artery Occlusion Using Near Infrared Spectroscopy.

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:4205-4208

Near-infrared spectroscopy (NIRS) is a noninvasive brain imaging technique that measures hemodynamics by determining the optical properties of tissue. Clinical potential of NIRS for monitoring cerebral hemodynamics in cerebrovascular diseases, such as stroke, has been studied. However, inconsistencies in measurements among studies, which are believed to be partly due to anatomical variance and diversity in disease presentation, limit the clinical feasibility of NIRS for stroke monitoring. In the present study, bihemispheric frequency-domain NIRS measurements on middle cerebral artery occlusion rats were performed. The discrepancy in interhemispheric synchronicity in hemodynamic oscillation appeared during the early reperfusion stage is related to the size of infarct that developed three days later. These NIRS parameters may have the potential to be early prognostic biomarkers for long-term stroke monitoring in the future translational investigation.
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http://dx.doi.org/10.1109/EMBC.2019.8856584DOI Listing
July 2019

Latent Trajectories of Fluid Balance Are Associated With Outcomes in Cardiac and Aortic Surgery.

Ann Thorac Surg 2020 05 15;109(5):1343-1349. Epub 2019 Nov 15.

Department of Nephrology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Background: Fluid overload is common in critically ill patients and is associated with worse outcomes. The trends in fluid balance have not been investigated previously. This study used trajectory analysis to investigate the impact of fluid balance trends on patients who had undergone cardiac or aortic surgery.

Methods: We analyzed patients who underwent cardiac or aortic surgery between August 2005 and March 2015. We excluded patients who died within the first 72 postoperative hours or received chronic dialysis before the surgery. Trajectories of urine and input-output during the first 3 postoperative days were analyzed using a latent class growth model. The primary outcomes were any stage of acute kidney injury (AKI) by Kidney Disease Improving Global Outcomes definition and de novo dialysis.

Results: The in-hospital mortality was 6.6% (70 of the 1063 patients included). The fluid input-output balance trajectories had better association with the primary outcome than urine output trajectories did. The risk of AKI and de novo dialysis were highest in the group with progressively positive fluid balance adjusted by preoperative body weight (AKI: adjusted odds ratio, 7.10; 95% confidence interval, 2.02-24.93; de novo dialysis: odds ratio, 4.54; 95% confidence interval, 1.12-18.38).

Conclusions: A progressively positive fluid balance is associated with AKI and de novo dialysis in patients undergoing cardiac or aortic surgery.
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http://dx.doi.org/10.1016/j.athoracsur.2019.09.068DOI Listing
May 2020

Digit Force Controls and Corresponding Brain Activities in Finger Pressing Performance: A Comparison Between Older Adults and Young Individuals.

J Aging Phys Act 2020 01 1;28(1):94-103. Epub 2020 Jan 1.

This study aims toward an investigation and comparison of the digital force control and the brain activities of older adults and young groups during digital pressing tasks. A total of 15 young and 15 older adults were asked to perform force ramp tasks at different force levels with a custom pressing system. Near-infrared spectroscopy was used to collect the brain activities in the prefrontal cortex and primary motor area. The results showed that the force independence and hand function of the older adults were worse than that of the young adults. The cortical activations in the older adults were higher than those in the young group during the tasks. A significant hemodynamic between-group response and mild negative correlations between brain activation and force independence ability were found. Older adults showed poor force independence ability and manual dexterity and required additional brain activity to compensate for the degeneration.
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http://dx.doi.org/10.1123/japa.2018-0252DOI Listing
January 2020

Meta-Analysis: Urinary Calprotectin for Discrimination of Intrinsic and Prerenal Acute Kidney Injury.

J Clin Med 2019 Jan 10;8(1). Epub 2019 Jan 10.

Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Urinary calprotectin is a novel biomarker that distinguishes between intrinsic or prerenal acute kidney injury (AKI) in different studies. However, these studies were based on different populations and different AKI criteria. We evaluated the diagnostic accuracy of urinary calprotectin and compared its diagnostic performance in different AKI criteria and study populations. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Embase, and the Cochrane database up to September 2018. The diagnostic performance of urinary calprotectin (sensitivity, specificity, predictive ratio, and cutoff point) was extracted and evaluated. This study included six studies with a total of 502 patients. The pooled sensitivity and specificity were 0.90 and 0.93, respectively. The pooled positive likelihood ratio (LR) was 15.15, and the negative LR was 0.11. The symmetric summary receiver operating characteristic (symmetric SROC) with pooled diagnostic accuracy was 0.9667. The relative diagnostic odds ratio (RDOC) of the adult to pediatric population and RDOCs of different acute kidney injury criteria showed no significant difference in their diagnostic accuracy. Urinary calprotectin is a good diagnostic tool for the discrimination of intrinsic and prerenal AKI under careful inspection after exclusion of urinary tract infection and urogenital malignancies. Its performance is not affected by different AKI criteria and adult or pediatric populations.
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http://dx.doi.org/10.3390/jcm8010074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352097PMC
January 2019

Position as Well as Velocity Dependence of Spasticity-Four-Dimensional Characterizations of Catch Angle.

Front Neurol 2018 26;9:863. Epub 2018 Oct 26.

Department of Physical Therapy and Rehabilitation Science, Department of Orthopaedics, University of Maryland, Baltimore, MD, United States.

We investigated the muscle alterations related to spasticity in stroke quantitatively using a portable manual spasticity evaluator. Quantitative neuro-mechanical evaluations under controlled passive elbow stretches in stroke survivors and healthy controls were performed in a research laboratory of a rehabilitation hospital. Twelve stroke survivors and nine healthy controls participated in the study. Spasticity and catch angle were evaluated at 90°/s and 270°/s with the velocities controlled through real-time audiovisual feedback. The elbow range of motion (ROM), stiffness, and energy loss were determined at a slow velocity of 30°/s. Four-dimensional measures including joint position, torque, velocity and torque change rate were analyzed jointly to determine the catch angle. The catch angle was dependent on the stretch velocity and occurred significantly later with increasing velocity ( < 0.001), indicating position dependence of spasticity. The higher resistance felt by the examiner at the higher velocity was also due to more extreme joint position (joint angle) since the spastic joint was moved significantly further to a stiffer elbow position with the higher velocity. Stroke survivors showed smaller ROM ( < 0.001), higher stiffness ( < 0.001), and larger energy loss ( = 0.005). Compared to the controls, stroke survivors showed increased reflex excitability with higher reflex-mediated torque ( < 0.001) and at higher velocities ( = 0.02). Velocity dependence of spasticity is partially due to joint angle position dependence with the joint moved further (to a stiffer position where higher resistance was felt) at a higher velocity. The "4-dimensional characterization" including the joint angle, velocity, torque, and torque change rate provides a systematic tool to characterize catch angle and spasticity quantitatively.
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http://dx.doi.org/10.3389/fneur.2018.00863DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212511PMC
October 2018

Investigations of urethral sphincter activity in mice with bladder hyperalgesia before and after drug administration of gabapentin.

Int Urol Nephrol 2019 Jan 1;51(1):53-59. Epub 2018 Nov 1.

Urology at University of California Irvine, Irvine, CA, USA.

Purpose: This study investigated the effect of gabapentin on lower urinary tract dysfunction focusing on urethral activities and cystitis-induced hyperalgesia in a mouse model of painful bladder syndrome/interstitial cystitis (PBS/IC). The electromyography (EMG) of external urethral sphincter (EUS) was difficult to obtain, but contained useful information to examine the drug effect in mice.

Methods: Female C57BL/6J mice were intraperitoneally (ip) administration with either saline or 200 mg/kg of cyclophosphamide (CYP) 48 h before experimental evaluation. Cystitis mice were treated with administration of gabapentin (25 or 50 mg/kg, ip). Cystometry and EUS EMG were obtained and analyzed during continuous bladder infusion. The visceral pain-related visceromotor reflex (VMR) was recorded in response to isotonic bladder distension.

Results: Cystitis mice showed shorter inter-contraction intervals and increased occurrence of non-voiding contractions during bladder infusion, with increased VMR during isotonic bladder distension, indicating cystitis-induced bladder hyperalgesia. Gabapentin (50 mg/kg) suppressed effects of CYP on cystometry, but not on EUS EMG activity, during bladder infusion. The effect on urodynamic recordings lasted 4 h. VMR was significantly reduced by gabapentin.

Conclusions: The present study showed that CYP-induced cystitis in mice is a model of visceral hyperalgesia affecting detrusor contractions, not urethral activations. The technique of using EUS EMG to evaluate the drug effects on urethral activities is novel and useful for future investigations. Gabapentin can be as a potential treatment for detrusor overactivity and PBS/IC.
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http://dx.doi.org/10.1007/s11255-018-2021-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328313PMC
January 2019

Modulation of motor excitability by cortical optogenetic theta burst stimulation.

PLoS One 2018 30;13(8):e0203333. Epub 2018 Aug 30.

Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.

Intermittent theta burst stimulation (iTBS) and continuous theta burst stimulation (cTBS) are protocols used in repetitive transcranial magnetic stimulation (rTMS) or cortical electrical stimulation (CES) to facilitate or suppress corticospinal excitability. However, rTMS and CES excite all types of neuron in the target cortex probed by the coil or electrode, making it difficult to differentiate the effect of TBS on specific neural circuits involved in motor plasticity. In this study, TBS protocols were converted into an optogenetic model to achieve focalized and cell-type-specific cortical modulation. Light-sensitive channelrhodopsin-2 (ChR2) was expressed in the glutamatergic neuron in the primary motor cortex (M1) driven by the CaMKIIα promoter. A custom-made optrode comprising an optical fiber and a metal cannula electrode was fabricated to achieve optogenetic stimulation and simultaneous local field potential (LFP) recording. Single-pulse CES was delivered into M1 to elicit motor-evoked potential (MEP), which served as an indicator of motor excitability, before and after TBS intervention. Results show that both CES-iTBS and optogenetic iTBS (Opto-iTBS) can potentiate MEP activity. However, CES-cTBS suppressed MEP activity whereas Opto-cTBS enhanced it. This discrepancy may have resulted from the different neural networks targeted by the two TBS modalities, with CES-cTBS exciting all types of neuron and Opto-cTBS targeting excitatory neuron specifically. The results support the idea that intra-cortical networks determine the variation of TBS-induced neuroplasticity. This study shows that focalized and cell-type-specific brain stimulation using the optogenetic approach is viable and can be extended for further exploration of neuroplasticity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203333PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117070PMC
February 2019

Near Infrared Spectroscopy Study of Cortical Excitability During Electrical Stimulation-Assisted Cycling for Neurorehabilitation of Stroke Patients.

IEEE Trans Neural Syst Rehabil Eng 2018 06;26(6):1292-1300

In addition to generating functional limb movement via electrical stimulation, other research proposed lower intensity stimulation for stroke patients from proprioceptive and neuro-biofeedback aspects. This paper investigates the effects of different intensity levels of electrical stimulation during passive cycling on cortical activation using multichannel near infrared spectroscopy (NIRS) covering premotor cortex, supplementary motor area, sensorimotor cortex (SMC), and secondary sensory cortex (S2) regions. Sixteen subjects, including nine stroke patients and seven normal subjects, were instructed to perform passive cycling driven by an ergometer at a pace of 50 rpm under conditions without electrical stimulation (NES) and with low-intensity electrical stimulation (LES) at 10 mA and high-intensity electrical stimulation (HES) at 30 mA. Changes in oxyhemoglobin in different brain regions and the derived interhemispheric correlation coefficient (IHCC) representing the symmetry in response of two hemispheres were evaluated to observe cortical activation and cerebral autoregulation. Our results showed that cortical activation of normal subjects exhibited overall deactivations in HES compared with that under LES and NES. In stroke patients, bilateral S2 activated significantly greater under LES compared with those under NES and HES. The IHCC of the normal group displayed a significant higher value in SMC compared with that of the stroke group. This paper utilized noninvasive NIRS to observe hemodynamic changes and bilateral autoregulation symmetry from IHCC suggesting that passive cycling with LES could better facilitate cortical activation compared with that obtained with NES or HES. The results of this paper could provide general guidelines to simplify the settings of electrical stimulation-assisted-passive cycling in clinical use.
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http://dx.doi.org/10.1109/TNSRE.2018.2829804DOI Listing
June 2018

Bilateral changes in afterhyperpolarization duration of spinal motoneurones in post-stroke patients.

PLoS One 2018 16;13(1):e0189845. Epub 2018 Jan 16.

Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.

This paper extends the observations presented in the previously published work on the afterhyperpolarization (AHP) duration changes in motoneurones (MNs) on the paretic (more affected) side of 11 post-stroke patients by the same analysis on the non-paretic (less-affected) side. The estimated AHP duration for patients' MNs supplying more-affected muscles was significantly longer than control values and the elongation decreased with patient age and disorder duration. For MNs supplying less-affected muscles, dependency of AHP duration on age was closer to the control data, but the scatter was substantially bigger. However, the AHP duration estimate of less-affected MNs tended to be longer than that of controls in the short time elapsed since the stroke, and shorter than controls in the long time. Our results thus suggest that the spinal MNs on both sides respond to the cerebral stroke rapidly with prolongation of AHP duration, which tends to normalize with time, in line with functional recovery. This suggestion is in concert with the published research on post-stroke changes in brain hemispheres. To our knowledge, these dependencies have never been investigated before. Since the number of our data was limited, the observed trends should be verified in a larger sample of patients and such a verification could take into account the suggestions for data analysis that we provide in this paper. Our data are in line with the earlier published research on MN firing characteristics post-stroke and support the conclusion that the MUs of the muscles at the non-paretic side are also affected and cannot be considered a suitable control for the MUs on the paretic side.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189845PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770035PMC
January 2018

The Significance of Impulsive Error in Children With ADHD.

Clin EEG Neurosci 2018 Sep 21;49(5):295-301. Epub 2017 Nov 21.

1 Institute of Allied Health Science, National Cheng Kung University, Taiwan.

A deficit of inhibition ability is a neuropsychological problem in children with attention deficit hyperactivity disorder (ADHD). We investigated whether in children who made impulsive error (IE), less error-related negativity (ERN) would correlate with poorer executive attention functions (EAFs). Ninety children (49 with ADHD and 41 without ADHD) were investigated by a 4-minute simple reaction time task and simultaneous electroencephalogram. When they made IE, the ERN in response-locked event-related potential (ERP) was defined as error awareness. The average area under curve of ERN in the control group with IEs was used as the proper criterion for regrouping the children with ADHD into 2 groups: ADHD children with enough ERN (ADHD-enough ERN) and those with less ERN (ADHD-less ERN). EAFs from Comprehensive Nonverbal Attention Test were used as objective indices, and behavioral questionnaires were used as subjective indices and statistically analyzed within ADHD groups. Forty-eight percent of the children made IEs. ADHD(n = 31, 63%) was significantly more than in the control group (n = 12, 29%; P < .001). The ADHD group had significantly less ERN than did the control group while making IE, especially at frontal and central electrodes ( P < .01). Both ADHD-less ERN and ADHD-enough ERN groups had poorer subjective EAFs on questionnaires. Only the ADHD-less ERN group had significant poorer objective EAFs on the Comprehensive Nonverbal Attention Test than did the ADHD without IE. We conclude that investigating the IE and ERN of IE in children with ADHD might help to differentiate subtypes of ADHD with different neuropsychological abilities, and the possibility that ADHD-less ERN children might be confirmed a meaningful subgroup that needs close follow-up, treatments different from standard, or both.
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http://dx.doi.org/10.1177/1550059417742297DOI Listing
September 2018

Distinct Somatic Discrimination Reflected by Laser-Evoked Potentials Using Scalp EEG Leads.

J Med Biol Eng 2016;36(4):460-469. Epub 2016 Aug 11.

Department of Psychology, National Cheng Kung University, 1 University Road, Tai-nan, 701 Taiwan ; Mind Research and Imaging Center, National Cheng Kung University, Tai-nan, 701 Taiwan.

Discrimination is an important function in pain processing of the somatic cortex. The involvement of the somatic cortex has been studied using equivalent dipole analysis and neuroimaging, but the results are inconsistent. Scalp electroencephalography (EEG) can reflect functional changes of particular brain regions underneath a lead. However, the responses of EEG leads close to the somatic cortex in response to pain have not been systematically evaluated. The present study applied CO laser stimulation to the dorsum of the left hand. Laser-evoked potentials (LEPs) of C4, T3, and T4 leads and pain ratings in response to four stimulus intensities were analyzed. LEPs started earlier at the C4 and T4 leads. The onset latency and peak latency of LEPs for C4 and T4 leads were the same. Only 10 of 22 subjects (45 %) presented equivalent current dipoles within the primary somatosensory or motor cortices. LEP amplitudes of these leads increased as stimulation intensity increased. The stimulus-response pattern of the C4 lead was highly correlated with pain rating. In contrast, an S-shaped stimulus-response curve was obtained for the T3 and T4 leads. The present study provides supporting evidence that particular scalp channels are able to reflect the functional characteristics of their underlying cortical areas. Our data strengthen the clinical application of somatic-cortex-related leads for pain discrimination.
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http://dx.doi.org/10.1007/s40846-016-0159-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016541PMC
August 2016

Photo-thermal therapy of bladder cancer with Anti-EGFR antibody conjugated gold nanoparticles.

Front Biosci (Landmark Ed) 2016 06 1;21:1211-21. Epub 2016 Jun 1.

Institute of BioMedical Engineering, National Cheng Kung University, Tainan, Taiwan.

The aim of this study was to enhance the effectiveness of photo thermal therapy (PTT) in the targeting of superficial bladder cancers using a green light laser in conjunction with gold nanoparticles (GNPs) conjugated to antibody fragments (anti-EGFR). GNPs conjugated with anti-EGFR-antibody fragments were used as probes in the targeting of tumor cells and then exposed to a green laser (532nm), resulting in the production of sufficient thermal energy to kill urothelial carcinomas both in vitro and in vivo. Nanoparticles conjugated with antibody fragments are capable of damaging cancer cells even at relatively very low energy levels, while non-conjugated nanoparticles would require an energy level of 3 times under the same conditions. The lower energy required by the nanoparticles allows this method to destroy cancerous cells while preserving normal cells when applied in vivo. Nanoparticles conjugated with antibody fragments (anti-EGFR) require less than half the energy of non-conjugated nanoparticles to kill cancer cells. In an orthotopic bladder cancer model, the group treated using PTT presented significant differences in tumor development.
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http://dx.doi.org/10.2741/4451DOI Listing
June 2016

Neurofeedback training of EEG alpha rhythm enhances episodic and working memory.

Hum Brain Mapp 2016 07 1;37(7):2662-75. Epub 2016 Apr 1.

Department of Psychology, National Cheng Kung University, Tainan, Taiwan.

Neurofeedback training (NFT) of the alpha rhythm has been used for several decades but is still controversial in regards to its trainability and effects on working memory. Alpha rhythm of the frontoparietal region are associated with either the intelligence or memory of healthy subjects and are also related to pathological states. In this study, alpha NFT effects on memory performances were explored. Fifty healthy participants were recruited and randomly assigned into a group receiving a 8-12-Hz amplitude (Alpha) or a group receiving a random 4-Hz amplitude from the range of 7 to 20 Hz (Ctrl). Three NFT sessions per week were conducted for 4 weeks. Working memory was assessed by both a backward digit span task and an operation span task, and episodic memory was assessed using a word pair task. Four questionnaires were used to assess anxiety, depression, insomnia, and cognitive function. The Ctrl group had no change in alpha amplitude and duration. In contrast, the Alpha group showed a progressive significant increase in the alpha amplitude and total alpha duration of the frontoparietal region. Accuracies of both working and episodic memories were significantly improved in a large proportion of participants of the Alpha group, particularly for those with remarkable alpha-amplitude increases. Scores of four questionnaires fell in a normal range before and after NFT. The current study provided supporting evidence for alpha trainability within a small session number compared with that of therapy. The findings suggested the enhancement of working and episodic memory through alpha NFT. Hum Brain Mapp 37:2662-2675, 2016. © 2016 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/hbm.23201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6867560PMC
July 2016

Harmine Hydrochloride Triggers G2 Phase Arrest and Apoptosis in MGC-803 Cells and SMMC-7721 Cells by Upregulating p21, Activating Caspase-8/Bid, and Downregulating ERK/Bad Pathway.

Phytother Res 2016 Jan 9;30(1):31-40. Epub 2015 Nov 9.

Department of Biochemistry, Medical College, Jinan University, Guangzhou, 510630, China.

This study aimed to investigate the effects of harmine hydrochloride (HMH) on digestive tumor cells in vitro and its molecular mechanism. MTT assays showed that HMH inhibited the proliferation of some human cancer cell lines and had no obvious inhibitory effects on human LO2 cells. Flow cytometry assays showed that HMH trigged G2 phase arrest in MGC-803 cells and SMMC-7721 cells, while the expression of cyclin A, cyclin B, p21, Myt1, and p-cdc2 (Tyr15) was upregulated. Flow cytometry assays also showed that the percentages of apoptotic cells were increased, the mitochondrial transmembrane potential (ΔΨm) decreased, and the cleavage of caspase-9, caspase-3, and poly (Adenosine diphosphate ribose) polymerase (PARP) were observed, the expression of Bad increased, phospho-Bad (S112) decreased, pro-caspase-8 was cleaved, and Bid (22 kDa) was cleaved. The expression of p-ERK decreased in both cells. In conclusion, these results demonstrated that HMH upregulates the expression of p21, activates Myt1 and inhibits cdc2 by phospho-cdc2 (Y15), and triggers G2 phase arrest in both MGC-803 cells and SMMC-7721 cells. It can also activate the mitochondria-related cell apoptosis pathway through the caspase-8/Bid pathway, inhibiting the ERK/Bad pathway and promoting apoptosis in both of these two cell types.
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http://dx.doi.org/10.1002/ptr.5497DOI Listing
January 2016

Review: Application of Nanoparticles in Urothelial Cancer of the Urinary Bladder.

J Med Biol Eng 2015;35(4):419-427. Epub 2015 Aug 11.

Institute of Biomedical Engineering, National Cheng Kung University, 1 University Road, Tainan, 701 Taiwan.

Bladder cancer is a common malignancy of the urinary tract, which generally develops in the epithelial lining of the urinary bladder. The specific course of treatment depends on the stage of bladder cancer; however, therapeutic strategies typically involve intravesical drug delivery to reduce toxicity and increase therapeutic effects. Recently, metallic, polymeric, lipid, and protein nanoparticles have been introduced to aid in the treatment of bladder cancer. Nanoparticles are also commonly used as pharmaceutical carriers to improve interactions between drugs and the urothelium. In this review, we classify the characteristics of bladder cancer and discuss the types of nanoparticles used in various treatment modalities. Finally we summarize the potential applications and benefits of various nanoparticles in intravesical therapy.
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http://dx.doi.org/10.1007/s40846-015-0060-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551548PMC
August 2015

Assessments of Muscle Oxygenation and Cortical Activity Using Functional Near-infrared Spectroscopy in Healthy Adults During Hybrid Activation.

IEEE Trans Neural Syst Rehabil Eng 2016 Jan 12;24(1):1-9. Epub 2015 May 12.

Hybrid activation (HA), patterned electrical stimulation (ES) superimposed on attempted voluntary movement in close synchrony, can augment muscle force output. It has been proposed for limb function restoration and neuromodulation. Limited studies have been performed to investigate the influences of HA on muscle oxygenation and brain cortical activity. The present study investigates muscle oxygenation and cortical activity during isometric knee extension tasks with voluntary contraction (VOL) only, ES only, and with HA at three stimulation intensities, namely 10 mA (HA-I), 30 mA (HA-II), and 50 mA (HA-III). A frequency-domain near-infrared spectroscopy system was employed to assess the muscle oxygenation in the vastus lateralis as well as the cortical activity from the bilateral sensorimotor cortices (SMCs), premotor cortices (PMCs), and supplementary motor areas (SMAs). Our results show that the increased ES contribution during HA significantly increased O2 demand in working muscle, implying that the intervention of ES accelerates the muscle metabolism during muscle contraction. For cortical activation, ES only had a similar cortical activation pattern to that during VOL but with lower activation in SMCs, PMCs, and SMAs. Augmented sensorimotor activation was observed during the HA-II condition. The enhanced level of cortical activation during HA was not only affected by the ES contribution within HA but also related to the functional specificity of cortical areas. Our results suggest that HA can effectively enhance the muscle oxygen demand as well as the activation of cortical regions, and that the ES contribution within HA is a key factor.
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http://dx.doi.org/10.1109/TNSRE.2015.2429655DOI Listing
January 2016

Electroencephalogram valid rate in simple reaction time task as an easy index of children's attention functions.

Pediatr Int 2015 Oct 19;57(5):930-5. Epub 2015 Aug 19.

Spring Sun Psychiatric Clinic, Tainan, Taiwan.

Background: Electroencephalogram (EEG) signal artifacts occur often in children, but an EEG valid rate (VR), constructed by excluding the artifacts, might be meaningful to evaluate children's neuropsychological functions. The aim of this study was to develop an easy screening index, the EEGVR, and to investigate attention function in children using this index.

Methods: The EEG was carried out during a 4 min simple reaction time (SRT) task as standard procedure in 50 children, consisting of 26 with attention-deficit-hyperactivity disorder (ADHD; mean age, 9.8 years; range, 8-11.3 years) and 24 without (mean age, 10.1 years; range, 7.8-12 years). An easy index was derived from the valid rate (VR) of EEG using area under the receiver operating characteristic curve. The index was applied to regroup the 50 children into high VR (HVR) and low VR (LVR) groups, while the Comprehensive Non-verbal Attention Test (CNAT) and four behavioral questionnaires were compared between the two groups in order to investigate the validity of this index.

Results: The EEGVR at 75% was optimal to identify HVR and LVR (sensitivity, 0.769; specificity, 0.792). The LVR group had significantly lower scores on both CNAT and the behavioral questionnaires, although the demographic variables and full-scale intelligence quotient (FSIQ) were similar between the two groups.

Conclusions: The EEGVR in an SRT task might be an easy and effective index to screen the attention function of children, and could consequently contribute to the early diagnosis of ADHD.
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http://dx.doi.org/10.1111/ped.12668DOI Listing
October 2015

Gold nanotheranostics: photothermal therapy and imaging of Mucin 7 conjugated antibody nanoparticles for urothelial cancer.

Biomed Res Int 2015 5;2015:813632. Epub 2015 Mar 5.

Institute of Biomedical Engineering, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.

Objective: To kill urothelial cancer cells while preserving healthy cells, this study used photothermal therapy (PTT). PTT techniques target urothelial cancer cells using gold nanoparticles (GNPs) and a green light laser.

Materials And Methods: The GNPs were conjugated with anti-Mucin 7 antibodies, which acted as a probe for targeting tumor cells. Conjugated GNPs were exposed to a green light laser (532 nm) with sufficient thermal energy to kill the transitional cell carcinomas (TCCs).

Results: According to our results, nanoparticles conjugated with Mucin 7 antibodies damaged all types of cancer cells (MBT2, T24, 9202, and 8301) at relatively low energy levels (i.e., 500 laser shots at 10 W/cm(2) in power, 1.6 Hz in frequency, and 300 ms in duration). Nonconjugated nanoparticles required 30 W/cm(2) or more to achieve the same effect. Cell damage was directly related to irradiation time and applied laser energy.

Conclusions: The minimally invasive PTT procedure combined with Mucin 7 targeted GNPs is able to kill cancer cells and preserve healthy cells. The success of this treatment technique can likely be attributed to the lower amount of energy required to kill targeted cancer cells compared with that required to kill nontargeted cancer cells. Our in vitro pilot study yielded promising results; however, additional animal studies are required to confirm these findings.
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http://dx.doi.org/10.1155/2015/813632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365326PMC
December 2015