Beyond Frequency Bands: Complementary-Ensemble-Empirical-Mode-Decomposition-Enhanced Microstate Sequence Non-Randomness Analysis for Aiding Diagnosis and Cognitive Prediction of Dementia.

Exploring the spatiotemporal dynamic patterns of multi-channel electroencephalography (EEG) is crucial for interpreting dementia and related cognitive decline. Spatiotemporal patterns of EEG can be described through microstate analysis, which provides a discrete approximation of the continuous electric field patterns generated by the brain cortex. Here, we propose a novel microstate spatiotemporal dynamic indicator, termed the microstate sequence non-randomness index (MSNRI). The essence of the method lies in initially generating a sequence of microstate transition patterns through state space compression of EEG data using microstate analysis. Following this, we assess the non-randomness of these microstate patterns using information-based similarity analysis. The results suggest that this MSNRI metric is a potential marker for distinguishing between health control (HC) and frontotemporal dementia (FTD) (HC vs. FTD: 6.958 vs. 5.756, p < 0.01), as well as between HC and populations with Alzheimer's disease (AD) (HC vs. AD: 6.958 vs. 5.462, p < 0.001). Healthy individuals exhibit more complex macroscopic structures and non-random spatiotemporal patterns of microstates, whereas dementia disorders lead to more random spatiotemporal patterns. Additionally, we extend the proposed method by integrating the Complementary Ensemble Empirical Mode Decomposition (CEEMD) method to explore spatiotemporal dynamic patterns of microstates at specific frequency scales. Moreover, we assessed the effectiveness of this innovative method in predicting cognitive scores. The results demonstrate that the incorporation of CEEMD-enhanced microstate dynamic indicators significantly improved the prediction accuracy of Mini-Mental State Examination (MMSE) scores (R2 = 0.940). The CEEMD-enhanced MSNRI method not only aids in the exploration of large-scale neural changes in populations with dementia but also offers a robust tool for characterizing the dynamics of EEG microstate transitions and their impact on cognitive function.

Association of self-reported and objective sleep disturbance with the spectrum of gastroesophageal reflux disease.

STUDY OBJECTIVES: The relationship between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) is complex. We aimed to determine the association of self-reported and objective sleep parameters with diverse manifestations of the GERD spectrum. METHODS: We prospectively recruited 561 individuals who underwent an electrocardiogram-based cardiopulmonary coupling for OSA screening during a health check-up. All participants received the Reflux Disease Questionnaire and an upper endoscopy to determine the presence of troublesome reflux symptoms and erosive esophagitis (EE). Sleep quality was evaluated by the Pittsburgh Sleep Quality Index and sleep dysfunction was defined as a Pittsburgh Sleep Quality Index score > 5. OSA was defined as a cardiopulmonary coupling-derived apnea-hypopnea index exceeding 15 events/h. Comparisons were made between participants on the GERD spectrum with respect to their various self-reported and objective sleep parameters. RESULTS: Among the 277 patients with GERD (49.4%), 198 (35.3%) had EE. Patients with GERD had higher PSQI scores (6.99 ± 3.97 vs 6.07 ± 3.73, P = .005) and a higher prevalence of sleep dysfunction (60.6% vs 49.6%, P = .009). Patients with EE had a higher prevalence of OSA (42.9% vs 33.9%, P = .034). Along the GERD spectrum, symptomatic patients with EE had the highest PSQI scores and prevalence of sleep dysfunction (70.7%), while asymptomatic patients with EE had the highest prevalence of OSA (44%). CONCLUSIONS: Our findings indicate a high prevalence of sleep dysfunction among individuals with GERD. Furthermore, patients on the GERD spectrum are prone to experiencing a range of self-reported and objective sleep disturbances. CITATION: Hu K-Y, Tseng P-H, Hsu W-C, et al. Association of self-reported and objective sleep disturbance with the spectrum of gastroesophageal reflux disease. J Clin Sleep Med. 2024;20(6):911-920.

Quantifying the accuracy of inter-beat intervals acquired from consumer-grade photoplethysmography wristbands using an electrocardiogram-aided information-based similarity approach.

Objective. Although inter-beat intervals (IBI) and the derived heart rate variability (HRV) can be acquired through consumer-grade photoplethysmography (PPG) wristbands and have been applied in a variety of physiological and psychophysiological conditions, their accuracy is still unsatisfactory.Approach.In this study, 30 healthy participants concurrently wore two wristbands (E4 and Honor 5) and a gold-standard electrocardiogram (ECG) device under four conditions: resting, deep breathing with a frequency of 0.17 Hz and 0.1 Hz, and mental stress tasks. To quantitatively validate the accuracy of IBI acquired from PPG wristbands, this study proposed to apply an information-based similarity (IBS) approach to quantify the pattern similarity of the underlying dynamical temporal structures embedded in IBI time series simultaneously recorded using PPG wristbands and the ECG system. The occurrence frequency of basic patterns and their rankings were analyzed to calculate the IBS distance from gold-standard IBI, and to further calculate the signal-to-noise ratio (SNR) of the wristband IBI time series.Main results.The accuracies of both HRV and mental state classification were not satisfactory due to the low SNR in the wristband IBI. However, by rejecting data segments of SNR < 25, the Pearson correlation coefficients between the wristbands' HRV and the gold-standard HRV were increased from 0.542 ± 0.235 to 0.922 ± 0.120 for E4 and from 0.596 ± 0.227 to 0.859 ± 0.145 for Honor 5. The average accuracy of four-class mental state classification increased from 77.3% to 81.9% for E4 and from 79.3% to 83.3% for Honor 5.Significance.Consumer-grade PPG wristbands are acceptable for HR and HRV monitoring when removing low SNR segments. The proposed method can be applied for quantifying the accuracies of IBI and HRV indices acquired via any non-ECG system.

Serial assessment and long-term radiographic evaluation of the maxillary sinus after inferior maxillectomy and soft tissue free flap reconstruction in patients with oral cancer.

PURPOSE: This study evaluates serial radiographic changes in the maxillary sinus of patients with oral cancer after an inferior maxillectomy and a soft tissue free flap reconstruction. METHODS: Fifty-six patients were evaluated between Oct 2005 and Mar 2017 from an institutional database. Preoperative and surveillance imaging was reviewed at set time-points. Maxillary sinus scores were allotted based on a modification of the Lund-MacKay staging system. Patients were evaluated for change in sinus score. A univariate (UV) and multivariate (MV) analysis was performed. RESULTS: There were 53.5% T3/T4 category tumors and 68% received adjuvant treatment. Median follow-up was 24.4 months. Preoperative mean sinus score was 0.27 ± 0.44 and postoperative mean sinus score at 24 months was 1.2 ± 1.3 (p = <0.001). On UV analysis advanced T-stage at 12 months (OR 6.7, 95% CI 1.2-50.3, p = 0.01) and 24 months (OR 5.2, 95% CI 1.03-36.8, p = 0.04) was associated with significantly higher sinus score. On MV analysis, advanced T-stage continued to be associated with increased odds for higher sinus score (OR 4.9, 95% CI 1.1-26.8, p = 0.039). CONCLUSION: A mild increase in postoperative sinus score is seen in this cohort of patients. Advanced T-stage is associated with increased odds for higher sinus scores.

[Wearable devices: Perspectives on assessing and monitoring human physiological status].

This review article aims to explore the major challenges that the healthcare system is currently facing and propose a new paradigm shift that harnesses the potential of wearable devices and novel theoretical frameworks on health and disease. Lifestyle-induced diseases currently account for a significant portion of all healthcare spending, with this proportion projected to increase with population aging. Wearable devices have emerged as a key technology for implementing large-scale healthcare systems focused on disease prevention and management. Advancements in miniaturized sensors, system integration, the Internet of Things, artificial intelligence, 5G, and other technologies have enabled wearable devices to perform high-quality measurements comparable to medical devices. Through various physical, chemical, and biological sensors, wearable devices can continuously monitor physiological status information in a non-invasive or minimally invasive way, including electrocardiography, electroencephalography, respiration, blood oxygen, blood pressure, blood glucose, activity, and more. Furthermore, by combining concepts and methods from complex systems and nonlinear dynamics, we developed a novel theory of continuous dynamic physiological signal analysis-dynamical complexity. The results of dynamic signal analyses can provide crucial information for disease prevention, diagnosis, treatment, and management. Wearable devices can also serve as an important bridge connecting doctors and patients by tracking, storing, and sharing patient data with medical institutions, enabling remote or real-time health assessments of patients, and providing a basis for precision medicine and personalized treatment. Wearable devices have a promising future in the healthcare field and will be an important driving force for the transformation of the healthcare system, while also improving the health experience for individuals.

Heart rhythm complexity analysis in patients with inferior ST-elevation myocardial infarction.

Heart rhythm complexity (HRC), a subtype of heart rate variability (HRV), is an important tool to investigate cardiovascular disease. In this study, we aimed to analyze serial changes in HRV and HRC metrics in patients with inferior ST-elevation myocardial infarction (STEMI) within 1 year postinfarct and explore the association between HRC and postinfarct left ventricular (LV) systolic impairment. We prospectively enrolled 33 inferior STEMI patients and 74 control subjects and analyzed traditional linear HRV and HRC metrics in both groups, including detrended fluctuation analysis (DFA) and multiscale entropy (MSE). We also analyzed follow-up postinfarct echocardiography for 1 year. The STEMI group had significantly lower standard deviation of RR interval (SDNN), and DFAα2 within 7 days postinfarct (acute stage) comparing to control subjects. LF power was consistently higher in STEMI group during follow up. The MSE scale 5 was higher at acute stage comparing to control subjects and had a trend of decrease during 1-year postinfarct. The MSE area under scale 1-5 showed persistently lower than control subjects and progressively decreased during 1-year postinfarct. To predict long-term postinfarct LV systolic impairment, the slope between MSE scale 1 to 5 (slope 1-5) had the best predictive value. MSE slope 1-5 also increased the predictive ability of the linear HRV metrics in both the net reclassification index and integrated discrimination index models. In conclusion, HRC and LV contractility decreased 1 year postinfarct in inferior STEMI patients, and MSE slope 1-5 was a good predictor of postinfarct LV systolic impairment.

Causality Network of Infectious Disease Revealed With Causal Decomposition.

Causal inference in the field of infectious disease attempts to gain insight into the potential causal nature of an association between risk factors and diseases. Simulated causality inference experiments have shown preliminary promise in improving understanding of the transmission of infectious diseases but still lack sufficient quantitative causal inference studies based on real-world data. Here, we investigate the causal interactions between three different infectious diseases and related factors, using causal decomposition analysis, to characterize the nature of infectious disease transmission. We show that the complex interactions between infectious disease and human behavior have a quantifiable impact on transmission efficiency of infectious diseases. Our findings, by shedding light on the underlying transmission mechanism of infectious diseases, suggest that causal inference analysis is a promising approach to determine epidemiological interventions.

Neuroprotective effects of fermented tea in MPTP-induced Parkinson's disease mouse model via MAPK signaling-mediated regulation of inflammation and antioxidant activity.

Parkinson's disease (PD) is a neurodegenerative disorder that is characterized by dopaminergic neuronal damage. In this study, three tea extracts from Hadong, Korea, were evaluated in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced neurotoxicity damage model (C57BL/6 mice) for their therapeutic effects against PD: green tea (GT), semi-fermented tea (SFT), and fermented tea (FT). Theaflavin content in the teas increased but catechin content decreased with the degree of fermentation. In addition, SFT showed the highest theanine and γ-aminobutyric acid contents. SFT at a concentration of 25 µg/mL showed the highest activity in the 2,2-diphenyl-1-picrylhydrazyl radical scavenging assay among all samples. Furthermore, the 2,2'-azino-bis 3-ethylbenzothiazoline-6-sulfonic acid radical scavenging activity of 25 µg/mL SFT was higher than that of l-ascorbic acid. Fermented tea suppressed the expression of inflammatory cytokines, such as interleukin-6, tumor necrosis factor-alpha, inducible nitric oxide synthase, cyclooxygenase-2, and macrophage-1, as well as inhibited overexpression of apoptotic signals, including p-53, cleaved caspase-3, and poly (ADP-ribose) polymerase-1. Moreover, GT, SFT, and FT regulated the MPTP-induced oxidative stress-related factors, including superoxide dismutase, glutathione-S-transferase, and nicotinamide adenine dinucleotide phosphate oxidase 4. Fermented tea also alleviated MPTP-induced behavioral impairment and dopaminergic neuronal damage and reduced α-synuclein levels. These results indicate that fermented tea is effective for the treatment of neuro-inflammatory, neuro-apoptotic, and neuro-oxidative disorders.

L-Theanine alleviates MPTP-induced Parkinson's disease by targeting Wnt/ß-catenin signaling mediated by the MAPK signaling pathway.

We evaluated the neuroprotective effect of L-theanine in Parkinson's disease and the underlying mechanism focusing on WNT/ß-catenin signaling mediated by the MAPK pathway. We treated MPTP-induced SH-SY5Y cells with various concentrations of L-theanine (50, 100, 200, and 500 µg/mL), and we also treated Parkinson's model mice with L-theanine. L-theanine treatment effectively reduced the immunohistochemical hallmarks of Parkinson's disease, particularly Lewy bodies and α-synuclein, and increased the number of tyrosine hydroxylase-positive cells. L-theanine also improved the motor dysfunction in MPTP-induced Parkinson's disease model mice as measured by the rotarod test. The levels of several pro-inflammatory mediators that are overexpressed in Parkinson's disease, namely TNF-α, IL-6, COX-2, and MAC-1, were reduced following L-theanine treatment, and the levels of the pro-apoptotic proteins Bcl-2, caspase-3, p53, and PARP-1 were significantly reduced. L-theanine regulated the oxidative stress-related factors SOD-1, GST, and NOX-4 by targeting several proteins related to WNT/ß-catenin signaling, i.e., ß-catenin, WNT-3a, WNT-5a, TCF1/TCF7, and LEF1, via the MAPK pathway (p-JNK, p-ERK, and p-p38). Our results indicate that L-theanine is neuroprotective and has anti-inflammatory effects that could be beneficial for treating Parkinson's disease.

Wearable devices: Perspectives on assessing and monitoring human physiological status / 生物医学工程学杂志

This review article aims to explore the major challenges that the healthcare system is currently facing and propose a new paradigm shift that harnesses the potential of wearable devices and novel theoretical frameworks on health and disease. Lifestyle-induced diseases currently account for a significant portion of all healthcare spending, with this proportion projected to increase with population aging. Wearable devices have emerged as a key technology for implementing large-scale healthcare systems focused on disease prevention and management. Advancements in miniaturized sensors, system integration, the Internet of Things, artificial intelligence, 5G, and other technologies have enabled wearable devices to perform high-quality measurements comparable to medical devices. Through various physical, chemical, and biological sensors, wearable devices can continuously monitor physiological status information in a non-invasive or minimally invasive way, including electrocardiography, electroencephalography, respiration, blood oxygen, blood pressure, blood glucose, activity, and more. Furthermore, by combining concepts and methods from complex systems and nonlinear dynamics, we developed a novel theory of continuous dynamic physiological signal analysis-dynamical complexity. The results of dynamic signal analyses can provide crucial information for disease prevention, diagnosis, treatment, and management. Wearable devices can also serve as an important bridge connecting doctors and patients by tracking, storing, and sharing patient data with medical institutions, enabling remote or real-time health assessments of patients, and providing a basis for precision medicine and personalized treatment. Wearable devices have a promising future in the healthcare field and will be an important driving force for the transformation of the healthcare system, while also improving the health experience for individuals.

Slow wave synchronization and sleep state transitions.

Spontaneous synchronization over large networks is ubiquitous in nature, ranging from inanimate to biological systems. In the human brain, neuronal synchronization and de-synchronization occur during sleep, with the greatest degree of neuronal synchronization during slow wave sleep (SWS). The current sleep classification schema is based on electroencephalography and provides common criteria for clinicians and researchers to describe stages of non-rapid eye movement (NREM) sleep as well as rapid eye movement (REM) sleep. These sleep stage classifications have been based on convenient heuristic criteria, with little consideration of the accompanying normal physiological changes across those same sleep stages. To begin to resolve those inconsistencies, first focusing only on NREM sleep, we propose a simple cluster synchronization model to explain the emergence of SWS in healthy people without sleep disorders. We apply the empirical mode decomposition (EMD) analysis to quantify slow wave activity in electroencephalograms, and provide quantitative evidence to support our model. Based on this synchronization model, NREM sleep can be classified as SWS and non-SWS, such that NREM sleep can be considered as an intrinsically bistable process. Finally, we develop an automated algorithm for SWS classification. We show that this new approach can unify brain wave dynamics and their corresponding physiologic changes.

Associations of Reduced Sympathetic Neural Activity and Elevated Baroreflex Sensitivity With Non-Rapid Eye Movement Sleep: Evidence From Electroencephalogram- and Electrocardiogram-Based Sleep Staging.

OBJECTIVE: Autonomic neural controls in sleep regulation have been previously demonstrated; however, whether these alternations can be observed by different sleep staging approaches remains unclear. Two established methods for sleep staging-the standardized visual scoring and the cardiopulmonary coupling (CPC) analysis based on electrocardiogram-were used to explore the cardiovascular profiles of sleep. METHODS: Overnight polysomnography was recorded together with continuous beat-to-beat blood pressure. Cortical activity, heart rate variability, blood pressure variability, and baroreflex sensitivity during sleep stages from 24 nights of sleep were obtained from 15 normotensive participants and analyzed. RESULTS: Non-rapid eye movement sleep (NREM) from visual scoring and restful sleep (RS) of CPC both showed the highest delta power of electroencephalogram (EEG) and lowest beta activity of EEG in comparison with other sleep stages (p < .001); likewise, the lowest total power of heart rate variability and suppressed vascular-sympathetic activity, reflected by low-frequency power of blood pressure variability, as well as a trend in elevated baroreflex sensitivity, were observed in the NREM or RS. This suppressed vascular-sympathetic activity during stable sleep further exhibited a significant correlation with increased slow-wave activity (NREM: r = -0.292 ± 0.34, p = .002; RS: r = -0.209 ± 0.30, p = .010). CONCLUSIONS: Autonomic nervous system is evidently associated with stable sleep, as indicated by the similar findings obtained from sleep stages categorized by standardized visual scoring or CPC analysis. Such association between cardiovascular neural activity and sleep EEGs can be observed regardless of the sleep staging approach followed.

Cervical Radiculopathy: Focus on Factors for Better Surgical Outcomes and Operative Techniques

For patients with cervical radiculopathy, most studies have recommended conservative treatment as the first-line treatment; however, when conventional treatment fails, surgery is considered. A better understanding of the prognosis of cervical radiculopathy is essential to provide accurate information to the patients. If the patients complain of persistent and recurrent arm painumbness not respond to conservative treatment, or exhibit neurologic deficits, surgery is performed using anterior or posterior approaches. Anterior cervical discectomy and fusion (ACDF) has historically been widely used and has proven to be safe and effective. To improve surgical outcomes of ACDF surgery, many studies have been conducted on types of spacers, size/height/position of cages, anterior plating, patients’ factors, surgical techniques, and so forth. Cervical disc replacement (CDR) is designed to reduce the incidence of adjacent segment disease during long-term follow-up by maintaining cervical spine motion postoperatively. Many studies on excellent indications for the CDR, proper type/size/shape/height of the implants, and surgical techniques were performed. Posterior cervical foraminotomy is a safe and effective surgical option to avoid complications associated with anterior approach and fusion surgery. Most recent literature demonstrated that all three surgical techniques for patients with cervical radiculopathy have clear advantages and disadvantages and reveal satisfactory surgical outcomes under a proper selection of patients and application of appropriate surgical methods. For this, it is important to fully understand the factors for better surgical outcomes and to adequately practice the operative techniques for patients with cervical radiculopathy.

Immunomodulatory and anti-inflammatory efficacy of hederagenin-coated maghemite (γ-Fe2O3) nanoparticles in an atopic dermatitis model.

We investigated the immunomodulatory and anti-inflammatory efficacy of hederagenin coating on maghemite (γ-Fe2O3) nanoparticles (HM) in atopic dermatitis (AD), as well as the physical and optical properties of maghemite nanoparticles (MP) using SEM, XRD spectroscopy, UV-vis spectra, Raman spectra, and FTIR spectroscopy. Dose-dependent treatment with HM (10, 50, 100, 200 µg/mL) inhibited the expression of Interleukin-2 (IL-2) and Tumor necrosis factor- α (TNF-α) in inflammatory induced HaCaT and Jurkat cells with inflammation caused by TNF/IFN-γ and PMA/A23187. AD model was induced by performing topical application of 2,4-dinitrochlorobenzene (DNCB) and dermatophagoides farinae extract (DFE) for a 31-day period on 8-week-old BALB/c mice. The HM treatments efficiently diminished the AD-like cutaneous lesion induced by DNCB-DFE sensitization in mice. Compared to the AD-only groups, HM treatment considerably attenuated mast cell infiltration and lowered epidermal, and dermal thickness of mice ears skin. In addition, HM treatment prominently alleviated the enlarged size and weight of lymph nodes. Furthermore, HM treatment resulted in a notable reduction in the mRNA expression of Th1 cytokines (TNF-α and IFN-γ), Th2 cytokines (IL-4 and IL-6), Th17 (IL-17), and TSLP. Our data showed that HM provides better AD attenuation compared to MP. Additionally, HM had synergistic effect and act as anti-inflammatory and immunomodulatory agent. Thus, HM shows great potential in AD medication and as a substitution of non-steroid-based medication.

Characteristics and outcome differences in male and female oral cavity cancer patients in Taiwan.

ABSTRACT: Oral cavity squamous cell carcinoma (OSCC) is a leading cause of death in Taiwan. Most of the patients in the literature are male. The risk factors, cancer characteristics, and treatment outcomes were investigated in female patients and compared with male patients in this study.This retrospective study recruited 2046 OSCC patients between 1995 and 2019. The age, tumor subsites, and survival were reviewed and recorded. Overall survival and disease-free survival were the main outcomes.Female patients represented 6.7% of the entire study cohort. Females were diagnosed at an older age and an earlier local stage than male patients (P < .001). Female patients were less exposed to cigarettes, alcohol, and betel-quid (all P < .001). The tongue (55.1%) was the most frequent subsite in females, while the buccal cavity (38.4%) and the tongue (35.3%) were more likely (P < .001) to be associated with the male gender. Female patients in the tongue cancer subgroup presented less frequently with extra-nodal extension compared with male patients (P = .040). No significant differences in recurrence or overall deaths were observed between the genders during the follow-up period.The OSCC male to female ratio in Taiwan was 14:1. Female OSCC occurred more frequently on the tongue, and was diagnosed at an older age and at an earlier tumor stage than in male patients. No survival difference was found between female and male OSCC patients.

HLA-G 14bp Ins/Del Polymorphism in the 3'UTR Region and Acute Rejection in Kidney Transplant Recipients: An Updated Meta-Analysis.

Background and Objectives: Acute kidney injury (AKI) affects the survival rate of kidney transplant organs and patients. Acute rejection (AR) due to AKI may lead to kidney transplantation failure. It is known that there is a relationship between human leukocyte antigen-G (HLA-G), which is involved in immune regulation, and AR in transplant patients. Moreover, 14-bp insertion/deletion polymorphism in the 3' untranslated region (UTR) region of the HLA-G gene is known to affect HLA-G expression. However, its relationship to AR is still controversial. The aim of this study was to investigate whether HLA-G 14-bp insertion/deletion polymorphism contributed to the development of AR in kidney transplant patients using a meta-analysis. Materials and Methods: To perform our meta-analysis, eligible studies about HLA-G 14-bp insertion/deletion polymorphism and AR were searched in electronic databases until 1 June 2021. Finally, a total of 336 patients with AR and 952 patients without AR in relation to kidney transplantation were analyzed from a total of nine studies. Results: In our results, the Del allele and Ins/Del+Del/Del and Del/Del genotypes significantly increased susceptibility of AR in Asian populations [odds ratio (OR) = 2.359, 95% confidence interval (CI) = 1.568-3.550, p = 3.8 × 10-5; OR = 3.357, 95% CI = 1.769-6.370, p = 0.002; OR = 2.750, 95% CI = 1.354-5.587, p = 0.0052 in each model, respectively]. Conclusions: Evidence of the present results indicate that HLA-G 14-bp insertion/deletion polymorphism is associated with susceptibility to AR in the Asian population.

Evaluation of infrared assisted freeze drying for strawberry snacks: drying kinetics, energy efficiency and quality attributes.

Feasibility of infrared assisted freeze drying (IRAFD) was evaluated for production of the strawberry snacks. Infrared (IR) radiation provided the driving force of ice sublimation during freeze drying (FD). Different IRAFD conditions were tested, including the continuous IRAFD-1.6 kW/m2 and IRAFD-1.6 kW/m2 at different weight reductions (20%, 40%, and 60%). Conventional FD had a total drying time of 691 ± 19 min, whereas continuous IRAFD significantly reduced the drying time to 309 ± 32 min. Continuous IRAFD also reduced the amount of consumed electrical energy by 42% compared to that of FD. A long duration of IR radiation produced a soft texture in the snacks. Drying kinetics were analyzed using various models, including the Page model, exponential model, and Henderson and Pabis model. The Page model provided the best fit to the experimental drying curve. This study showed the potential of IRAFD in producing value-added fruit snacks with good textural quality and efficient use of energy.

Immunomodulatory and Anti-inflammatory Effects of Asiatic Acid in a DNCB-Induced Atopic Dermatitis Animal Model.

We examined the immunomodulatory and anti-inflammatory effects of asiatic acid (AA) in atopic dermatitis (AD). AA treatment (5-20 µg/mL) dose-dependently suppressed the tumor necrosis factor (TNF)-α level and interleukin (IL)-6 protein expression in interferon (IFN)-γ + TNF-α-treated HaCaT cells. The 2,4-dinitrocholrlbenzene (DNCB)-induced AD animal model was developed by administering two AA concentrations (30 and 75 mg/kg/d: AD + AA-L and AD + AA-H groups, respectively) for 18 days. Interestingly, AA treatment decreased AD skin lesions formation and affected other AD characteristics, such as increased ear thickness, lymph node and spleen size, dermal and epidermal thickness, collagen deposition, and mast cell infiltration in dorsal skin. In addition, in the DNCB-induced AD animal model, AA treatment downregulated the mRNA expression level of AD-related cytokines, such as Th1- (TNF-α and IL-1ß and -12) and Th2 (IL-4, -5, -6, -13, and -31)-related cytokines as well as that of cyclooxygenase-2 and CXCL9. Moreover, in the AA treatment group, the protein level of inflammatory cytokines, including COX-2, IL-6, TNF-α, and IL-8, as well as the NF-κB and MAPK signaling pathways, were decreased. Overall, our study confirmed that AA administration inhibited AD skin lesion formation via enhancing immunomodulation and inhibiting inflammation. Thus, AA can be used as palliative medication for regulating AD symptoms.

The Value of Heart Rhythm Complexity in Identifying High-Risk Pulmonary Hypertension Patients.

Pulmonary hypertension (PH) is a fatal disease-even with state-of-the-art medical treatment. Non-invasive clinical tools for risk stratification are still lacking. The aim of this study was to investigate the clinical utility of heart rhythm complexity in risk stratification for PH patients. We prospectively enrolled 54 PH patients, including 20 high-risk patients (group A; defined as WHO functional class IV or class III with severely compromised hemodynamics), and 34 low-risk patients (group B). Both linear and non-linear heart rate variability (HRV) variables, including detrended fluctuation analysis (DFA) and multiscale entropy (MSE), were analyzed. In linear and non-linear HRV analysis, low frequency and high frequency ratio, DFAα1, MSE slope 5, scale 5, and area 6-20 were significantly lower in group A. Among all HRV variables, MSE scale 5 (AUC: 0.758) had the best predictive power to discriminate the two groups. In multivariable analysis, MSE scale 5 (p = 0.010) was the only significantly predictor of severe PH in all HRV variables. In conclusion, the patients with severe PH had worse heart rhythm complexity. MSE parameters, especially scale 5, can help to identify high-risk PH patients.