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Enhanced conflict monitoring via a short-duration, video-assisted deep breathing in healthy young adults: an event-related potential approach through the Go/NoGo paradigm

Cheng KS, Chang YF, Han RPS, Lee PF

PeerJ, 2017;5:e3857.
PMID: 29018605 DOI: 10.7717/peerj.3857

OBJECTIVES: Practitioners of mindfulness are reported to have greater cognitive control especially in conflict monitoring, response inhibition and sustained attention. However, due to the various existing methods in each mindfulness practices and also, the high commitment factor, a barrier still exists for an individual to pick up the practices. Therefore, the effect of short duration deep breathing on the cognitive control is investigated here.
METHODS: Short duration guided deep breathing videos consisting of 5, 7 and 9 min respectively were created and used on subjects training. The effect on cognitive control was assessed using a Go/NoGo task along with event-related potential (ERP) measurements at Fz, Cz, and Pz.
RESULTS: From the study, the significant outcome showed at the follow-up session in which participants engaged for 5 min deep breathing group showed a profound NoGo N2 amplitude increment as compared to the control group, indicating an enhanced conflict monitoring ability. An inverse relationship between the NoGo N2 amplitude and the breathing duration is observed as well at the follow-up session.
CONCLUSION: These results indicated the possibility of performing short duration deep breathing guided by a video to achieve an enhanced conflict monitoring as an alternative to other mindfulness practices and 5 min is found to be the optimum practice duration.
SIGNIFICANT: This study is the first to establish a relationship between deep breathing and conflict monitoring through ERP. The study population of young adults taken from the same environment reduces the variance in ERP results due to age and environment.
LIMITATION: A larger sample size would provide a greater statistical power. A longer duration of deep breathing should be investigated to further clarify the relationship between the practice duration and the NoGo N2 amplitude. The result can be split by gender and analyzed separately due to the different brain structure of males and females.
Fulltext Classification of Dementia Severity in Taiwan Based on History-Based Clinical Diagnosis System

Chang YF, Loi WY, Chiu PY, Huang HN

Am J Alzheimers Dis Other Demen, 2020;35:1533317520970788.
PMID: 33176431 DOI: 10.1177/1533317520970788

BACKGROUND/AIMS: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale.
METHODS: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level.
RESULT: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients.
CONCLUSION: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.
The point-of-care Bilistick method has very short turn-around-time and high accuracy at lower cutoff levels to predict laboratory-measured TSB

Boo NY, Chang YF, Leong YX, Tok ZY, Hooi LC, Chee SC, et al.

Pediatr Res, 2019 08;86(2):216-220.
PMID: 30696987 DOI: 10.1038/s41390-019-0304-0

BACKGROUND: This study aimed to determine the accuracy of a point-of-care Bilistick method for measuring total serum bilirubin (TSB) and its turn-around-time (TAT) against hospital laboratory methods.
METHODS: This prospective study was carried out on 561 term-gestation jaundiced neonates in two Malaysian hospitals. Venous blood sample was collected from each neonate for contemporary measurement of TSB by hospital laboratories and Bilistick. TAT was the time interval between specimen collection and TSB result reported by each method.
RESULTS: The mean laboratory-measured TSB was 194.85 (±2.844) µmol/L and Bilistick TSB was 169.37 (±2.706) µmol/L. Pearson's correlation coefficient was: r = 0.901 (p
Complete activation of autophagic process attenuates liver injury and improves survival in septic mice

Lin CW, Lo S, Perng DS, Wu DB, Lee PH, Chang YF, et al.

Shock, 2014 Mar;41(3):241-9.
PMID: 24365881 DOI: 10.1097/SHK.0000000000000111

The accumulation of autophagosomes in the terminal step of the autophagic process has recently emerged as a potentially maladaptive process in the septic heart and lung. However, the role of autophagy in the septic liver has not been ascertained. This study was investigated by first examining the entire sequence of the autophagic process in the liver of septic mice. Second, a novel pharmacotherapeutic approach was utilized to treat sepsis with autophagy enhancer/inhibitor. Sepsis was induced by cecal ligation and puncture (CLP). C57BL/6 mice received autophagy enhancer carbamazepine (CBZ), autophagy inhibitor 3-methyladenine (inhibition of autophagosomal formation), or chloroquine (impairment of autophagosomal clearance). We found that the whole autophagic process was activated at 4 h after CLP; however, it did not proceed to completion during the 4- to 24-h time period, as indicated by accumulated autophagosomes and decreased autophagic flux. Carbamazepine, which induced complete activation of the autophagic process, improved CLP survival. This protective effect was also associated with decreased cell death, inflammatory responses, and hepatic injury. However, disruption of autophagosomal clearance with chloroquine abolished the above protective effects in CBZ-treated CLP mice. 3-Methyladenine, which resulted in inhibition of the autophagosomal formation, did not show any above beneficial effects in CLP mice. Impaired autophagosome-lysome fusion resulting in incomplete activation of autophagy may contribute to sepsis-induced liver injury. Treatment with CBZ may serve a protective role in the septic liver, possibly through the effect of complete activation of autophagic process.
Consensus of official position of IOF/ISCD FRAX initiatives in Asia-Pacific region

Wu CH, McCloskey EV, Lee JK, Itabashi A, Prince R, Yu W, et al.

J Clin Densitom, 2014 Jan-Mar;17(1):150-5.
PMID: 23916756 DOI: 10.1016/j.jocd.2013.06.002

The fracture risk assessment tool (FRAX(®)) has been developed for the identification of individuals with high risk of fracture in whom treatment to prevent fractures would be appropriate. FRAX models are not yet available for all countries or ethnicities, but surrogate models can be used within regions with similar fracture risk. The International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) are nonprofit multidisciplinary international professional organizations. Their visions are to advance the awareness, education, prevention, and treatment of osteoporosis. In November 2010, the IOF/ISCD FRAX initiative was held in Bucharest, bringing together international experts to review and create evidence-based official positions guiding clinicians for the practical use of FRAX. A consensus meeting of the Asia-Pacific (AP) Panel of the ISCD recently reviewed the most current Official Positions of the Joint Official Positions of ISCD and IOF on FRAX in view of the different population characteristics and health standards in the AP regions. The reviewed position statements included not only the key spectrum of positions but also unique concerns in AP regions.
Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region

Chan DD, Chang LY, Akesson KE, Mitchell P, Chen CH, Lewiecki EM, et al.

Arch Osteoporos, 2018 05 12;13(1):59.
PMID: 29754189 DOI: 10.1007/s11657-018-0463-3

The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region.
PURPOSE: To review and generate consensus on best practices of fracture liaison service (FLS) in the Asia-Pacific (AP) region.
METHODS: In October 2017, the Taiwanese Osteoporosis Association (TOA) invited experts from the AP region (n = 23), the Capture the Fracture Steering Committee (n = 2), and the USA (n = 1) to join the AP region FLS Consensus Meeting in Taipei. After two rounds of consensus generation, the recommendations on the 13 Best Practice Framework (BPF) standards were reported and reviewed by the attendees. Experts unable to attend the on-site meeting reviewed the draft, made suggestions, and approved the final version.
RESULTS: Because the number of FLSs in the region is rapidly increasing, experts agreed that it was timely to establish consensus on benchmark quality standards for FLSs in the region. They also agreed that the 13 BPF standards and the 3 levels of standards were generally applicable, but that some clarifications were necessary. They suggested, for example, that patient and family education be incorporated into the current standards and that communication with the public to promote FLSs be increased.
CONCLUSIONS: The consensus on the 13 BPF standards reviewed in this meeting was that they were generally applicable and required only a few advanced clarifications to increase the quality of FLSs in the region.
Correction to: Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region

Chan DD, Chang LY, Akesson KE, Mitchell P, Chen CH, Lewiecki EM, et al.

Arch Osteoporos, 2018 07 03;13(1):73.
PMID: 29971507 DOI: 10.1007/s11657-018-0485-x

In this article the name of the sixth author, E. Michael Lewiecki was rendered incorrectly. The publisher regrets this error and apologizes for the inconvenience caused.
Fulltext Asia-pacific consensus on osteoporotic fracture prevention in postmenopausal women with low bone mass or osteoporosis but no fragility fractures

Huang CF, Chen JF, Reid IR, Chan WP, Ebeling PR, Langdahl B, et al.

J Formos Med Assoc, 2023;122 Suppl 1:S14-S20.
PMID: 36775679 DOI: 10.1016/j.jfma.2023.01.013

Postmenopausal women are at significant risk for osteoporotic fractures due to their rapid bone loss. Half of all postmenopausal women will get an osteoporosis-related fracture over their lifetime, with 25% developing a spine deformity and 15% developing a hip fracture. By 2050, more than half of all osteoporotic fractures will occur in Asia, with postmenopausal women being the most susceptible. Early management can halt or even reverse the progression of osteoporosis. Consequently, on October 31, 2020, the Taiwanese Osteoporosis Association hosted the Asia-Pacific (AP) Postmenopausal Osteoporotic Fracture Prevention (POFP) consensus meeting, which was supported by the Asian Federation of Osteoporosis Societies (AFOS) and the Asia Pacific Osteoporosis Foundation (APOF). International and domestic experts developed ten applicable statements for the prevention of osteoporotic fractures in postmenopausal women with low bone mass or osteoporosis but no fragility fractures in the AP region. The experts advocated, for example, that postmenopausal women with a high fracture risk be reimbursed for pharmaceutical therapy to prevent osteoporotic fractures. More clinical experience and data are required to modify intervention tactics.
Fulltext Consensus Statement on the Use of Bone Turnover Markers for Short-Term Monitoring of Osteoporosis Treatment in the Asia-Pacific Region

Wu CH, Chang YF, Chen CH, Lewiecki EM, Wüster C, Reid I, et al.

J Clin Densitom, 2021;24(1):3-13.
PMID: 31010789 DOI: 10.1016/j.jocd.2019.03.004

Osteoporosis is a major health issue. By 2050, a greater than 2-fold increase in patients number with hip fractures will occur in Asia representing 50% of all hip fractures worldwide. For the Asia-Pacific (AP) region, more efforts on controlling osteoporosis and the subsequent fractures are crucial. Bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) is commonly used to diagnose osteoporosis and monitor osteoporosis treatment. However, the inconvenience, cost, limited availability of DXA and the delay in detection of BMD changes after treatment initiation support an important role for bone turnover markers (BTMs), as short-term tools to monitor therapy. With regards to low adherence rates of medical treatment of osteoporosis, the experts reached consensus on the use of BTMs for both raising awareness and short-term monitoring of osteoporosis treatment in the AP region. The experts endorse the use of BTMs, especially serum C-terminal telopeptide of type 1 collagen (CTX) and serum procollagen type 1 N propeptide (P1NP), as short-term monitoring tools to help clinicians assess the responses to osteoporosis therapies and appropriately adjust treatment regimens earlier than BMD. Either the absolute values or the degree of change from baseline in BTMs can be used to monitor the potential efficacy of osteoporosis therapies. The use of BTMs can be incorporated in osteoporosis care programs, such as fracture liaison service (FLS), to improve patient adherence and treatment outcomes. Encouraging sufficient reimbursement from health care systems may facilitate widespread use of BTMs in clinical practice in the AP region.