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Kim J, Kim SC, Kang D, Kim SY, Kwon R, Yon DK, Kim JG. Feature extraction of time series data on functional near-infrared spectroscopy and comparison of deep learning performance for classifying patients with Alzheimer's-related mild cognitive impairment: a post-hoc analysis of a diagnostic interventional trial. Eur Rev Med Pharmacol Sci 2023; 27:6824-6830. [PMID: 37522693 DOI: 10.26355/eurrev_202307_33153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE This study aimed to define a method of classifying patients with mild cognitive impairment caused by Alzheimer's disease by the retrieval of functional near-infrared spectroscopy (fNIRS) signal characteristics obtained during olfactory stimulation and the validation of deep learning findings. PATIENTS AND METHODS Participants were recruited for the study from March 02 and August 30, 2021. A total of 78 participants met the criteria for categorization. The Mini-Mental State Examination and the Seoul Neuropsychological Scale were used to distinguish between patients with mild Alzheimer's disease-related cognitive impairment and healthy controls. fNIRS data received during olfactory stimulation were used to create 1,680 time-series sample values. A total of 150 indices with a p-value ≤ 0.1 were used as deep learning features to construct the result values for 120 models accounting for all conceivable combinations of data ratios. RESULTS For this trial, 78 participants were recruited for the original intervention trial. The average accuracy of the 120 deep-learning models for classifying patients with Alzheimer's-related mild cognitive impairment ranged from 0.78 to 0.90. Sensitivity ranged from 0.88 to 0.96 for the 120 models, while specificity ranged from 0.86 to 0.94. The F1 scores ranged from 0.74 to 0.88. At 0.78 to 0.90, the precision and recall were equivalent. CONCLUSIONS This trial using a deep-learning model found that the representative value extracted from the time series data of each channel could distinguish between healthy people and patients with mild cognitive impairment caused by Alzheimer's disease.
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Affiliation(s)
- J Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea.
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Eum S, Son JW, Min C, Cho W, Kim S, Woo HG, Kwon R, Lee KN, Han KD, Yon DK, Rhee SY. Ethnic and sex differences in the distributions of body mass index and waist circumference among adults: a binationally representative study in South Korea and the United States. Eur Rev Med Pharmacol Sci 2023; 27:1889-1903. [PMID: 36930486 DOI: 10.26355/eurrev_202303_31555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The ethnic and sex differences in the distributions of body mass index (BMI) and waist circumference (WC) among adults are largely unknown. Therefore, we aimed to investigate the percentiles of BMI and WC in groups divided according to age, sex, and ethnicity. PATIENTS AND METHODS We conducted a population-based binational study of adults aged ≥20 years based on data from two sources: US National Health and Nutrition Examination Survey (2015 to 2020) and Korea National Health and Nutrition Examination Survey (2016 to 2019). RESULTS Weight, height, and WC were measured in 13,144 American adults and 30,191 Korean adults. Overall, BMI increased at younger ages and decreased at older ages, which indicates a reversed U-shaped relationship, and differed in terms of age, sex, and ethnicity. Women in the other Hispanic, non-Hispanic white, non-Hispanic black, and "other ethnic groups" showed a common BMI peak at ages 50-54 years. The patterns of WC distribution were similar to those of BMI distribution. CONCLUSIONS In this binational representative study, we found varied distributions of ethnic and sex differences in BMI and WC. Considering the differences in these distributions may help improve individual and personalized treatment strategies.
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Affiliation(s)
- S Eum
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Ban CY, Shin H, Eum S, Yon H, Lee SW, Choi YS, Shin YH, Shin JU, Koyanagi A, Jacob L, Smith L, Min C, Yeniova AÖ, Kim SY, Lee J, Yeo SG, Kwon R, Koo MJ, Fond G, Boyer L, Acharya KP, Kim S, Woo HG, Park S, Shin JI, Rhee SY, Yon DK. 17-year trends of body mass index, overweight, and obesity among adolescents from 2005 to 2021, including the COVID-19 pandemic: a Korean national representative study. Eur Rev Med Pharmacol Sci 2023; 27:1565-1575. [PMID: 36876712 DOI: 10.26355/eurrev_202302_31399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE There is a lack of pediatric studies that have analyzed trends in mean body mass index (BMI) and the prevalence of obesity and overweight over a period that includes the mid-stage of the COVID-19 pandemic. Thus, we aimed to investigate trends in BMI, overweight, and obesity among Korean adolescents from 2005 to 2021, including the COVID-19 pandemic. SUBJECTS AND METHODS We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), which is nationally representative of South Korea. The study included middle- and high-school students between the ages of 12 and 18. We examined trends in mean BMI and prevalence of obesity and/or overweight during the COVID-19 pandemic and compared these to those of pre-pandemic trends in each subgroup by gender, grade, and residential region. RESULTS Data from 1,111,300 adolescents (mean age: 15.04 years) were analyzed. The estimated weighted mean BMI was 20.48 kg/m2 (95% CI, 20.46-20.51) between 2005 and 2007, and this was 21.61 kg/m2 (95% CI, 21.54-21.68) in 2021. The prevalence of overweight and obesity was 13.1% (95% CI, 12.9-13.3%) between 2005 and 2007 and 23.4% (95% CI, 22.8-24.0%) in 2021. The mean BMI and prevalence of obesity and overweight have gradually increased over the past 17 years; however, the extent of change in mean BMI and in the prevalence of obesity and overweight during the pandemic was distinctly less than before. The 17-year trends in the mean BMI, obesity, and overweight exhibited a considerable rise from 2005 to 2021; however, the slope during the COVID-19 pandemic (2020-2021) was significantly less prominent than in the pre-pandemic (2005-2019). CONCLUSIONS These findings enable us to comprehend long-term trends in the mean BMI of Korean adolescents and further emphasize the need for practical prevention measures against youth obesity and overweight.
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Affiliation(s)
- C Y Ban
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
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Ogasawara C, Watanabe G, Young K, Kwon R, Conching A, Palmisciano P, Kan P, de Oliveira Sillero R. Laser Interstitial Thermal Therapy for Cerebral Cavernous Malformations: A Systematic Review of Indications, Safety, and Outcomes. World Neurosurg 2022; 166:279-287.e1. [PMID: 35760323 DOI: 10.1016/j.wneu.2022.06.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cerebral cavernous malformations (CCM) in deep eloquent areas present a surgical challenge. Laser interstitial thermal therapy (LITT) may present itself as a safe minimally invasive treatment option. OBJECTIVE To systematically review the indications, safety, and outcomes of LITT for CCM. METHODS Electronic databases were searched from inception to October 7, 2021 for articles with CCM and LITT keywords. Studies describing CCMs treated with LITT were included. RESULTS A total of 32 patients with CCMs in lobar (79%), basal ganglia (12%), and brainstem (9%) locations were treated with LITT. Indications for LITT included drug-resistant seizures (75%), unacceptable surgical risk (22%), recurrent hemorrhage (16%), and early intervention to discontinue antiepileptic drugs (3%). No death or CCM-associated intracranial hemorrhage occurred intraoperatively or postoperatively, and most patients experienced no adverse effects or transient effects that resolved at follow-up (84%). Of those treated for CCM-associated epilepsy, 83% experienced Engel class I seizure freedom and most were class IA (61%). Most patients experienced symptomatic improvement (93%), and a decrease in antiepileptic drugs was reported in more than half of patients (56%), with 28% able to discontinue all antiepilepsy medications after LITT. CONCLUSIONS LITT seems to be a safe treatment for CCMs located in deep eloquent areas and in lesions presenting with medically refractory seizures or recurrent hemorrhages. Randomized studies are needed to further elucidate its efficacy in treating CCM.
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Affiliation(s)
- Christian Ogasawara
- Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA.
| | - Gina Watanabe
- Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Kurtis Young
- Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Royce Kwon
- Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Andie Conching
- Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Paolo Palmisciano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Peter Kan
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA
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Kwon R, Koutsogiannaki S, Staffa SJ, Yuki K. The Outcomes of Pediatric Hematopoietic Stem Cell Transplantation Recipients Requiring Intensive Care Unit Admission- A Single Center Experience. Transl Perioper Pain Med 2019; 6:75-80. [PMID: 31304194 PMCID: PMC6625789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although the outcome of pediatric hematopoietic stem cell transplantation (HSCT) has significantly improved, it remains to be associated with high mortality. Identifying patients at high risk of mortality may potentially help to triage clinical management. The primary objective of this study is to evaluate risk factors associated with mortality of patients who received HSCT and admitted to ICU using pediatric sequential organ failure assessment (pSOFA), one of pediatric severity scoring systems in intensive care unit (ICU). METHODS We performed retrospective review of electronic medical records of pediatric patients who received HSCT and were admitted to ICU in our institution between January 2010 and June 2018. Incidence of mortality was obtained, and risk factors associated with the mortality were examined using univariate and multivariable analyses. RESULTS The mortality rate of pediatric HSCT patients who were admitted to ICU as a whole was 27.9%. Patients were divided into three groups based on the number of HSCT required and timing of ICU admission. Patients who received first HSCT and admitted to ICU during the same hospital stay were the majority of the study population (Group A). d(pSOFA), which was defined as the difference between maximum pSOFA and admission pSOFA, greater than and equal to 7 best predicted mortality of Group A (the area under the ROC curve 0.850; 95% CI: 0.733-0.966). Univariate and multivariable analyses showed that an increase in neurologic and cardiovascular sub scores were independently associated with higher mortality (odds ratio (OR) 2.27; 95% CI: 1.32-3.93, and OR 2.69; 95% CI: 1.21-5.99, respectively). DISCUSSION In our single center study, pediatric HSCT patients who were admitted to ICU demonstrated a high mortality. Risk factor analysis demonstrated that patients with the progression of neurologic and cardiovascular injuries probed by pSOFA scoring system during their ICU stay were strongly associated with mortality.
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Affiliation(s)
- Royce Kwon
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, Massachusetts, USA,Tufts University Faculty of Medicine, Boston, Massachusetts, USA
| | - Sophia Koutsogiannaki
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, Massachusetts, USA,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Steven J. Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, Massachusetts, USA,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Koichi Yuki
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children’s Hospital, Boston, Massachusetts, USA,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
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Chau VM, Engeln JT, Axelrath S, Khatter SJ, Kwon R, Melton MA, Reinsvold MC, Staley VM, To J, Tanabe KJ, Wojcik R. Beyond the Chief Complaint: Our Patients' Worries. J Med Humanit 2017; 38:541-547. [PMID: 28975579 DOI: 10.1007/s10912-017-9479-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Fourth-year medical students at the University of Colorado School of Medicine distributed cards to patients in the emergency department asking, "What Worries You Most?" The patients' responses provided insight about their most pressing concerns, often unrelated to their "chief complaints."
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Affiliation(s)
- V M Chau
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA.
| | - J T Engeln
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - S Axelrath
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - S J Khatter
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - R Kwon
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Melton
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - M C Reinsvold
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - V M Staley
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - J To
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - K J Tanabe
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
| | - R Wojcik
- Gold Humanism Honor Society, Class of 2017, University of Colorado School of Medicine, Aurora, CO, USA
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Saeki N, Kwon R, Migita T, Fukuda H, Hamada H, Kawamoto M. Electroconvulsive therapy using rocuronium and sugammadex in patient with neuroleptic malignant syndrome. Anaesth Intensive Care 2011; 39:762-763. [PMID: 21823397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Steinberg M, Knapp H, Khan D, Huang D, Kwon R, Streeter O, Forge N, Fremont A. Patient-Centered Satisfaction and Well Being Assessment in a Lay Patient Navigator Program for an Underserved Radiation Oncology Patient Population. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Khan D, Huang D, Kwon R, Streeter O, Steinberg M. Evolution of a Novel Radiation Oncology Cancer Disparities Research Program in an Indigent Los Angeles Community. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Our institutional experience using the Peacock system for intensity-modulated radiation therapy (IMRT) is summarized. Over 100 patients were treated using this system, which is fitted to a Clinac 600C linac. Both cranial and extracranial lesions have been treated using this modality. Immobilization is achieved either with the Talon system for cranial sites or an Aquaplast cast. Target volumes up to 500 cm3 have been treated. Multiple lesions (up to 3) were treated in one setup. The range of dose/fractionation schemes used was 15 Gy/1 fx (radiosurgical treatment) - 80 Gy/40 fx. Dose validation studies were carried out using film and ion chamber dosimetry in a specially designed phantom. Optimal dose distributions were attainable using inverse treatment planning for IMRT delivery. These were found to encompass the target volumes accurately using dose validation phantom studies. Immobilization methods used were accurate to within 1 mm, as evidenced by daily portal films. IMRT using the Peacock system offers the advantage of delivery of conformal therapy to high doses safely and accurately. This provides the opportunity for dose escalation studies, retreatment of previously treated tumors, as well as treating multiple targets in one setup. The system may be fitted to a conventional linac without major modifications.
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Affiliation(s)
- M Al-Ghazi
- Department of Radiation Oncology, University of California, Irvine, Orange, USA.
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