Screening of sleep apnea based on heart rate variability and long short-term memory

Purpose: Sleep apnea syndrome (SAS) is a prevalent sleep disorder in which apnea and hypopnea occur frequently during sleep and result in increase of the risk of lifestyle-related disease development as well as daytime sleepiness. Although SAS is a common sleep disorder, most patients remain undiagnosed because the gold standard test polysomnography (PSG), is high-cost and unavailable in many hospitals. Thus, an SAS screening system that can be used easily at home is needed. Methods: Apnea during sleep affects changes in the autonomic nervous function, which causes fluctuation of the heart rate. In this study, we propose a new SAS screening method that combines heart rate measurement and long short-term memory (LSTM) which is a type of recurrent neural network (RNN). We analyzed the data of intervals between adjacent R waves (R-R interval; RRI) on the electrocardiogram (ECG) records, and used an LSTM model whose inputs are the RRI data is trained to discriminate the respiratory condition during sleep. Results: The application of the proposed method to clinical data showed that it distinguished between patients with moderate-to-severe SAS with a sensitivity of 100% and specificity of 100%, results which are superior to any other existing SAS screening methods. Conclusion: Since the RRI data can be easily measured by means of wearable heart rate sensors, our method may prove to be useful as an SAS screening system at home

Prevalence and cumulative incidence of autism spectrum disorders and the patterns of co-occurring neurodevelopmental disorders in a total population sample of 5-year-old children.

BackgroundsWhether there is a true increase in autism spectrum disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample has not been fully examined before. Therefore, using a total population sample in Japan, we aimed to estimate the prevalence and cumulative incidence of autism spectrum disorder (ASD) annually, to determine whether there is a true increase in ASD prevalence by estimating the cumulative incidence of ASD annually, and to examine the rates of co-existing neurodevelopmental disorders (NDD).MethodIn this cross-sectional sequential design study, all 5-year-old children in the catchment area underwent the screening annually from the year 2013-2016. Screen-positive children were invited to participate in a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary research team.ResultsCaregivers of 3954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% confidence interval (CI) 2.66-3.76%). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31% (95% CI 1.00-1.62%). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD.LimitationsModest sample size for a total population study.ConclusionsOur findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in children with ASD

Sleep-EEG-based parameters for discriminating fatigue and sleepiness

Sleep quality can be evaluated from the viewpoint of recovery from fatigue and sleepiness; however, it is difficult to investigate sleep quality while distinguishing between the two. The aim of this study is to find biomarkers that can discriminate between daytime fatigue and sleepiness and to assess sleep quality in consideration thereof. We collected answers to questionnaires regarding daytime fatigue and sleepiness, as well as EEG data measured during sleep, from 754 city government employees in a rural area of Japan. The respondents were categorized into four groups in accordance with the severity of fatigue and sleepiness as assessed by the questionnaires: fatigued and sleepy (FS), fatigued, non-sleepy (FO), non-fatigued and sleepy (SO), and non-fatigued and non-sleepy (neither fatigued nor sleepy; NE) groups. EEG data of medial frontal electrodes were obtained with a one-channel portable electroencephalograph, and various sleep parameters such as powers or sleep durations in each stage were compared among the four groups. Statistical tests confirmed significant differences in some derived sleep parameters among the four groups. The Theta Delta power may be a biomarker that can discriminate between fatigue and sleepiness. In addition, the Delta and Theta powers may be associated with sleep quality in terms of recovery from sleepiness and fatigue, respectively. Moreover, high frequency or long duration of mid-arousals may contribute to recovery from fatigue. The results showed that fatigue and sleepiness have different effects on sleep, and multiple sleep parameters derived from EEG are associated with sleep quality

Work Habit-Related Sleep Debt; Insights From Factor Identification Analysis of Actigraphy Data.

The present study investigates the factors of "Weekday sleep debt (WSD)" by comparing activity datacollected from persons with and without WSD. Since it has been reported that the amount of sleep debt aswell the difference between the social clock and the biological clock is associated with WSD, specifying thefactors of WSD other than chronotype may contribute to sleep debt prevention. We recruited 324 healthy male employees working at the same company and collected their 1-week wrist actigraphy data and answers to questionnaires. Because 106 participants were excluded due to measurement failure of the actigraphy data, the remaining 218 participants were included in the analysis. All participants were classified into WSD or non-WSD groups, in which persons had WDS if the difference between their weekend sleep duration and the mean weekday sleep duration was more than 120 min. We evaluated multiple measurements derived from the collected actigraphy data and trained a classifier that predicts thepresence of WSD using these measurements. A support vector machine (SVM) was adopted as the classifier. In addition, to evaluate the contribution of each indicator to WSD, permutation feature importance was calculated based on the trained classifier. Our analysis results showed significant importance of the following three out of the tested 32 factors: (1) WSD was significantly related to personswith evening tendency. (2) Daily activity rhythms and sleep were less stable in the WSD group than in thenon-WSD group. (3) A specific day of the week had the highest importance in our data, suggesting thatwork habit contributes to WSD. These findings indicate some WSD factors: evening chronotype, instability of the daily activity rhythm, and differences in work habits on the specific day of the week. Thus, it is necessary to evaluate the rhythms of diurnal activities as well as sleep conditions to identify the WSDfactors. In particular, the diurnal activity rhythm influences WSD. It is suggested that proper management of activity rhythm may contribute to the prevention of sleep debt

Dynamic movement of the Golgi unit and its glycosylation enzyme zones

Harada A., Kunii M., Kurokawa K., et al. Dynamic movement of the Golgi unit and its glycosylation enzyme zones. Nature Communications 15, 4514 (2024); https://doi.org/10.1038/S41467-024-48901-1.Knowledge on the distribution and dynamics of glycosylation enzymes in the Golgi is essential for better understanding this modification. Here, using a combination of CRISPR/Cas9 knockin technology and super-resolution microscopy, we show that the Golgi complex is assembled by a number of small ‘Golgi units’ that have 1-3 μm in diameter. Each Golgi unit contains small domains of glycosylation enzymes which we call ‘zones’. The zones of N- and O-glycosylation enzymes are colocalised. However, they are less colocalised with the zones of a glycosaminoglycan synthesizing enzyme. Golgi units change shapes dynamically and the zones of glycosylation enzymes rapidly move near the rim of the unit. Photobleaching analysis indicates that a glycosaminoglycan synthesizing enzyme moves between units. Depletion of giantin dissociates units and prevents the movement of glycosaminoglycan synthesizing enzymes, which leads to insufficient glycosaminoglycan synthesis. Thus, we show the structure-function relationship of the Golgi and its implications in human pathogenesis

An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital and Seoul National University Hospital

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Abstract Background International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. Methods A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. Results The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. Conclusions Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to encourage doctors to participate in and conduct clinical trials

The Asia‐Pacific Biodiversity Observation Network : 10‐year achievements and new strategies to 2030.

The Asia-Pacific Biodiversity Observation Network (APBON) was launched in 2009, in response to the establishment of the Biodiversity Observation Network under the Group on Earth Observations in 2008. APBON's mission is to increase exchange of knowledge and know-how between institutions and researchers concerning biodiversity science research in the Asia-Pacific (AP) region and thereby contribute to evidence-based decision-making and policy-making. Here we summarize APBON activities and achievements in its first 10 years. We review how APBON has developed networks, facilitated communication for sharing knowledge, and built capacity of researchers and stakeholders through workshops and publications as well as discuss the network plan. Key findings by APBON members include descriptions of species new to science, mapping tropical forest cover change, evaluating impacts of hydropower dams and climate change on fish species diversity in the Mekong, and mapping “Ecologically and Biologically Significant Areas” in the oceans. APBON has also contributed to data collection, sharing, analysis, and synthesis for regional and global biodiversity assessment. A highlight was contributing to the “Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services” regional report. New strategic plans target the development of national-level BONs and interdisciplinary research to address the data and knowledge gaps and increase data accessibility for users and for meeting societal demands. Strengthening networks in AP region and capacity building through APBON meetings will continue. By promoting monitoring and scientific research and facilitating the dialogue with scientists and policymakers, APBON will contribute to the implementation of conservation and sustainable use of biodiversity in the entire AP region.publishedVersio

Resting Heart Rate Variability Is Associated With Subsequent Orthostatic Hypotension: Comparison Between Healthy Older People and Patients With Rapid Eye Movement Sleep Behavior Disorder.

Background:Orthostatic hypotension (OH) caused by autonomic dysfunction is a common symptom in older people and patients with idiopathic rapid eye movement sleep behavior disorder (iRBD). The orthostatic challenge test is a standard autonomic function test that measures a decrease of blood pressure during a postural change from supine to standing positions. Although previous studies have reported that changes in heart rate variability (HRV) are associated with autonomic dysfunction, no study has investigated the relationship between HRV before standing and the occurrence of OH in an orthostatic challenge test. This study aims to examine the connection between HRV in the supine position and the occurrence of OH in an orthostatic challenge test.Methods:We measured the electrocardiograms of patients with iRBD and healthy older people during an orthostatic challenge test, in which the supine and standing positions were held for 15 min, respectively. The subjects were divided into three groups: healthy controls (HC), OH-negative iRBD [OH (–) iRBD], and OH-positive iRBD [OH (+) iRBD]. HRV measured in the supine position during the test were calculated by time-domain analysis and Poincaré plots to evaluate the autonomic dysfunction.Results:Forty-two HC, 12 OH (–) iRBD, and nine OH (+) iRBD subjects were included. HRV indices in the OH (–) and the OH (+) iRBD groups were significantly smaller than those in the HC group. The multivariate logistic regression analysis for OH identification for the iRBD groups showed the model whose inputs were the HRV indices, i.e., standard deviation 2 (SD2) and the percentage of adjacent intervals that varied by more than 50 ms (pNN50), had a receiver operating characteristic curve with area under the curve of 0.840, the sensitivity to OH (+) of 1.000, and the specificity to OH (–) of 0.583 (p = 0.023).Conclusions:This study showed the possibility that short-term HRV indices in the supine position would predict subsequent OH in iRBD patients. Our results are of clinical importance in terms of showing the possibility that OH can be predicted using only HRV in the supine position without an orthostatic challenge test, which would improve the efficiency and safety of testing

The present status related to substance abuse and future intervention in Niigata Prefecture

A symposium related to substance abuse in Niigata Prefecture was held in 2010, in which a questionnaire was distributed to 42 participants. The result showed that 38.1 percent of them have met illegal drug users at work. Furthermore, about three quarters of the participants (76.2%) believed it was important to expand measures against illigal drug abuse. Especially important issues concerned; substance abuse prevention for adolescents (78.6%), family intervention(78.6%), rehabilitation service(76.2%), and medical services (71.4%). It seemed that most professionals feel a deep need to enhance treatment and support for substance abusers and their families in addition to substance abuse prevention for adolescents.新潟県内において、薬物問題に関する理解を深めることを目的としたシンポジウムを開催し、参加者のうち42名を対象としたアンケート調査を実施した。調査の結果、38.1％が「患者、利用者、生徒など、職業上関わった人の中に違法薬物の使用経験者がいた（いる）」と回答するなど、薬物問題の身近さが示唆された。また、県内で今後薬物乱用・依存症対策の充実をはかることの重要性については、76.2％が「極めて重要である」と回答した。今後充実すべき対策としては、「青少年に対する薬物乱用予防教育」（78.6％）、「薬物乱用者をもつ家族に対する相談支援」（78.6％）、「薬物乱用者の社会復帰支援」（76.2％）、「薬物乱用者に対する医療」（71.4％）などが多く、関係者の多くが、青少年に対する予防教育の充実に加え、薬物依存症者及びその家族に対する医療・支援を充実させることの重要性を強く感じていることがうかがえた

3-D Object Recognition Based on Integration of Range Image and Gray-scale Image

In this paper, we propose a practical object recognition system which consists of two functional modules. The first is object extraction module using a range image, and the second is a precise position measurement module using a grayscale intensity image. Both high-reliability and high-accuracy can be achieved by effective image integration. We also propose an idea of stereo vision with random-dot pattern projection as an effective way to obtain a range image