Diagnostic Performance of Photoplethysmography-Based Smartwatch for Obstructive Sleep Apnea

Background and Objectives Considering the prevalence and health effects of obstructive sleep apnea (OSA), early diagnosis and proper treatment are essential. Polysomnography (PSG) has limitations in diagnosing or tracking large-scale OSA patients. Smartwatches (SWs) can be equipped with a photoplethysmograph (PPG) that can indirectly measure heart rate and blood oxygen saturation by detecting the difference of light absorption through blood. The purpose of this study is to compare oxygen saturation parameters of PPG-based SWs with those of PSG to determine the diagnostic accuracy for OSA. Methods After obtaining voluntary consent from patients who were scheduled to undergo PSG in a sleep clinic due to suspected OSA, they were randomly assigned to wear a Galaxy watch4 (GW) or Apple watch7 (AW) on their wrist. The agreement rates between the oxygen saturation parameters of the two SW types and PSG were evaluated. The accuracy, sensitivity, and specificity of the oxygen saturation parameters for diagnosis of OSA (apnea-hypopnea index [AHI] ≥5/h) were compared between the two types of SW. Results A total of 133 patients underwent PSG while wearing an SW. Including duplicates, 109 patients wearing a GW and 69 wearing an AW were included. The diagnostic accuracy of AHI ≥5/h according to oxygen saturation time measured by a GW was less than 90%, the respective sensitivity and specificity were 82.9% and 75.8%. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.807 (p<0.001). Using the lowest oxygen saturation value of GW, the sensitivity was 81.6%, the specificity was 69.7%, and the AUC of the ROC was 0.849 (p<0.001). The diagnostic accuracy of AHI ≥5/h according to the average oxygen saturation of AW, and the sensitivity and specificity were 75.6% and 70.8%, respectively. The AUC of this ROC curve was 0.757 (p<0.001). Using the lowest oxygen saturation value of AW, the sensitivity was 71.1%, the specificity was 62.5%, and the AUC of the ROC was 0.705 (p=0.005). Conclusion This study found that the two types of SW showed considerable accuracy in diagnosing OSA, but the accuracy decreased as the severity of OSA increased

EEG-controlled tele-grasping for undefined objects

This paper presents a teleoperation system of robot grasping for undefined objects based on a real-time EEG (Electroencephalography) measurement and shared autonomy. When grasping an undefined object in an unstructured environment, real-time human decision is necessary since fully autonomous grasping may not handle uncertain situations. The proposed system allows involvement of a wide range of human decisions throughout the entire grasping procedure, including 3D movement of the gripper, selecting proper grasping posture, and adjusting the amount of grip force. These multiple decision-making procedures of the human operator have been implemented with six flickering blocks for steady-state visually evoked potentials (SSVEP) by dividing the grasping task into predefined substeps. Each substep consists of approaching the object, selecting posture and grip force, grasping, transporting to the desired position, and releasing. The graphical user interface (GUI) displays the current substep and simple symbols beside each flickering block for quick understanding. The tele-grasping of various objects by using real-time human decisions of selecting among four possible postures and three levels of grip force has been demonstrated. This system can be adapted to other sequential EEG-controlled teleoperation tasks that require complex human decisions

Controllable synthesis of molybdenum tungsten disulfide alloy for vertically composition-controlled multilayer

The effective synthesis of two-dimensional transition metal dichalcogenides alloy is essential for successful application in electronic and optical devices based on a tunable band gap. Here we show a synthesis process for Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; alloy using sulfurization of super-cycle atomic layer deposition Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;O&lt;inf&gt;y&lt;/inf&gt;. Various spectroscopic and microscopic results indicate that the synthesized Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; alloys have complete mixing of Mo and Watoms and tunable band gap by systematically controlled composition and layer number. Based on this, we synthesize a vertically composition-controlled (VCC) Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; multilayer using five continuous super-cycles with different cycle ratios for each super-cycle. Angle-resolved X-ray photoemission spectroscopy, Raman and ultraviolet-visible spectrophotometer results reveal that a VCC Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; multilayer has different vertical composition and broadband light absorption with strong interlayer coupling within a VCC Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; multilayer. Further, we demonstrate that a VCC Mo&lt;inf&gt;1-x&lt;/inf&gt;W&lt;inf&gt;x&lt;/inf&gt;S&lt;inf&gt;2&lt;/inf&gt; multilayer photodetector generates three to four times greater photocurrent than MoS&lt;inf&gt;2&lt;/inf&gt;-and WS&lt;inf&gt;2&lt;/inf&gt;-based devices, owing to the broadband light absorption. &amp;#169; 2015 Macmillan Publishers Limitedopen1

SALM4 suppresses excitatory synapse development by cis-inhibiting trans-synaptic SALM3-LAR adhesion

Synaptic adhesion molecules regulate various aspects of synapse development, function and plasticity. These functions mainly involve trans-synaptic interactions and positive regulations, whereas cis-interactions and negative regulation are less understood. Here we report that SALM4, a member of the SALM/Lrfn family of synaptic adhesion molecules, suppresses excitatory synapse development through cis inhibition of SALM3, another SALM family protein with synaptogenic activity. Salm4-mutant (Salm4) mice show increased excitatory synapse numbers in the hippocampus. SALM4 cis-interacts with SALM3, inhibits trans-synaptic SALM3 interaction with presynaptic LAR family receptor tyrosine phosphatases and suppresses SALM3-dependent presynaptic differentiation. Importantly, deletion of Salm3 in Salm4 mice (Salm3, Salm4) normalizes the increased excitatory synapse number. These results suggest that SALM4 negatively regulates excitatory synapses via cis inhibition of the trans-synaptic SALM3-LAR adhesion. © The Author(s) 2016110101sciescopu

Incidence of Atazanavir-associated Hyperbilirubinemia in Korean HIV Patients: 30 Months Follow-up Results in a Population with Low UDP-glucuronosyltransferase1A1*28 Allele Frequency

Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%, at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3-4) hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency

Overexpression of cathepsin S exacerbates lupus pathogenesis through upregulation TLR7 and IFN-α in transgenic mice

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs. Recent studies suggest relevance between cysteine protease cathepsin S (CTSS) expression and SLE. To investigate the mechanism of CTSS in SLE, CTSS-overexpressing transgenic (TG) mice were generated, and induced lupus-like symptoms. Eight months later, the TG mice spontaneously developed typical SLE symptoms regardless of the inducement. Furthermore, we observed increased toll-like receptor 7 (TLR7) expression with increased monocyte and neutrophil populations in the TG mice. In conclusion, overexpression of CTSS in mice influences TLR7 expression, autoantibodies and IFN-α, which leads to an autoimmune reaction and exacerbates lupus-like symptoms. © 2021, The Author(s).1

Toll-like receptor 2 downregulation and cytokine dysregulation predict mortality in patients with Staphylococcus aureus bacteremia

Background Staphylococcus aureus bacteremia (SAB) presents heterogeneously, owing to the differences in underlying host conditions and immune responses. Although Toll-like receptor 2 (TLR2) is important in recognizing S. aureus, its function during S. aureus infection remains controversial. We aimed to examine the association of TLR2 expression and associated cytokine responses with clinical SAB outcomes. Methods Patients from a prospective SAB cohort at two tertiary-care medical centers were enrolled. Blood was sampled at several timepoints (≤5 d, 6–9 d, 10–13 d, 14–19 d, and ≥ 20 d) after SAB onset. TLR2 mRNA levels were determined via real-time PCR and serum tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-10 levels were analyzed with multiplex-high-sensitivity electrochemiluminescent ELISA. Results TLR2 levels varied among 59 SAB patients. On days 2–5, TLR2 levels were significantly higher in SAB survivors than in healthy controls (p = 0.040) and slightly but not significantly higher than non-survivors (p = 0.120), and SAB patients dying within 7 d had lower TLR2 levels than survivors (P = 0.077) although statistically insignificant. IL-6 and IL-10 levels were significantly higher in non-survivors than in survivors on days 2–5 post-bacteremia (P = 0.010 and P = 0.021, respectively), and those dying within 7 d of SAB (n = 3) displayed significantly higher IL-10/TNF-α ratios than the survivors did (P = 0.007). Conclusion TLR2 downregulation and IL-6 and IL-10 concentrations suggestive of immune dysregulation during early bacteremia may be associated with mortality from SAB. TLR2 expression levels and associated cytokine reactions during early-phase SAB may be potential prognostic factors in SAB, although larger studies are warranted.This study was supported by a research grant (13–2014-002) from Seoul National University Bundang Hospital (Seongnam, South Korea). The funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript

JAZF1 heterozygous knockout mice show altered adipose development and metabolism

Background: Juxtaposed with another zinc finger protein 1 (JAZF1) is associated with metabolic disorders, including type 2 diabetes mellitus (T2DM). Several studies showed that JAZF1 and body fat mass are closely related. We attempted to elucidate the JAZF1 functions on adipose development and related metabolism using in vitro and in vivo models. Results: The JAZF1 expression was precisely regulated during adipocyte differentiation of 3T3-L1 preadipocyte and mouse embryonic fibroblasts (MEFs). Homozygous JAZF1 deletion (JAZF1-KO) resulted in impaired adipocyte differentiation in MEF. The JAZF1 role in adipocyte differentiation was demonstrated by the regulation of PPARγ—a key regulator of adipocyte differentiation. Heterozygous JAZF1 deletion (JAZF1-Het) mice fed a normal diet (ND) or a high-fat diet (HFD) had less adipose tissue mass and impaired glucose homeostasis than the control (JAZF1-Cont) mice. However, other metabolic organs, such as brown adipose tissue and liver, were negligible effect on JAZF1 deficiency. Conclusion: Our findings emphasized the JAZF1 role in adipocyte differentiation and related metabolism through the heterozygous knockout mice. This study provides new insights into the JAZF1 function in adipose development and metabolism, informing strategies for treating obesity and related metabolic disorders. © 2021, The Author(s).1

Developmental toxicity and brain aromatase induction by high genistein concentrations in zebrafish embryos

Genistein is a phytoestrogen found at a high level in soybeans. In vitro and in vivo studies showed that high concentrations of genistein caused toxic effects. This study was designed to test the feasibility of zebrafish embryos for evaluating developmental toxicity and estrogenic potential of high genistein concentrations. The zebrafish embryos at 24 h post-fertilization were exposed to genistein (1 × 10−4 M, 0.5 × 10−4 M, 0.25 × 10−4 M) or vehicle (ethanol, 0.1%) for 60 h. Genistein-treated embryos showed decreased heart rates, retarded hatching times, decreased body length, and increased mortality in a dose-dependent manner. After 0.25 × 10−4 M genistein treatment, malformations of survived embryos such as pericardial edema, yolk sac edema, and spinal kyphosis were also observed. TUNEL assay results showed apoptotic DNA fragments in brain. This study also confirmed the estrogenic potential of genistein by EGFP expression in the brain of the mosaic reporter zebrafish embryos. This study first demonstrated that high concentrations of genistein caused a teratogenic effect on zebrafish embryos and confirmed the estrogenic potential of genistein in mosaic reporter zebrafish embryos

Outbreak investigation of Serratia marcescens neurosurgical site infections associated with a contaminated shaving razors

Abstract Background Surgical site infection (SSI) is the most common healthcare-associated infection. We report an outbreak of neurosurgical site infections caused by Serratia marcescens after craniotomy in a tertiary care hospital. Methods Between August 6 and 21, 2018, five cases of early-onset SSI caused by S. marcescens after craniotomy were recorded in a 1786-bed tertiary care hospital. Cultures were collected from potential environmental sources and healthcare workers. Whole-genome sequencing (WGS) was used to investigate the genetic relationships among S. marcescens isolates. Results The outbreak involved five patients; S. marcescens was isolated from the cerebrospinal fluid, pus, tissue, and blood samples from these patients. S. marcescens was also isolated from shaving razors and brushes. All S. marcescens isolates from the infected patients and razors showed the same resistance patterns on antibiotic-susceptibility tests. WGS revealed close clustering among four of five isolates from the patients and among three of four isolates from the razors. No additional patient developed S. marcescens infection after we stopped using the razors for scalp shaving. Conclusions We report an outbreak of neurosurgical site infections after craniotomy, which was associated with shaving razors contaminated by S. marcescens. Shaving scalps with razors should be avoided to prevent SSI