• Clinical Endoscopy
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• 제57권4호
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• pp.454-465
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• 2024

Background/Aims: Gastrointestinal bleeding is a significant and potentially lethal event. We aimed to review the efficiency and safety of self-assembling peptides for the treatment and prevention of gastrointestinal tract bleeding. Methods: We conducted a systematic search for studies describing the endoscopic use of self-assembling peptides for treatment or prevention of bleeding in the gastrointestinal tract in a parallel, independent fashion. The primary outcomes were rates of successful initial hemostasis, delayed bleeding, and rebleeding. The secondary outcomes were adverse events and ease and volume of gel used. Results: Seventeen studies were analyzed. Overall success rate of self-assembling peptides in gastrointestinal bleeding was 87.7% (38%-100%), regardless of etiology or associated treatments. Rebleeding rate ranged from 0% to 16.2%, with a mean of 4.7%, and overall delayed bleeding rate was 5% (range, 0%-15.9%). Only three adverse events were reported in a pooled number of 815 patients. The volume of gel used varied (0.43 to 3.7 mL) according to indication and type of bleeding. Conclusions: The limited available data on the use of self-assembling peptides in gastrointestinal endoscopy suggest a high efficiency and good safety profile.

• Clinical Endoscopy
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• 제57권4호
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• pp.476-485
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• 2024

Background/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods: This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results: Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79-0.86) and displayed a moderate discriminatory power. Conclusions: High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권3호
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• pp.275-287
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• 2023

Objective: Flow diverting stents (FDS) are a validated device in the treatment of intracranial aneurysms, allowing for minimally invasive intervention. However, after its approval for use in the United States in 2011, post-market surveillance of adverse events is limited. This study aims to address this critical knowledge gap by analyzing the FDA Manufacturer and User Facility Device Experience (MAUDE) database for patient and device related (PR and DR) reports of adverse events and malfunctions. Methods: Using post-market surveillance data from the MAUDE database, PR and DR reports from January 2012-December 2021 were extracted, compiled, and analyzed with R-Studio version 2021.09.2. PR and DR reports with insufficient information were excluded. Raw information was organized, and further author generated classifications were created for both PR and DR reports. Results: A total of 2203 PR and 4017 DR events were recorded. The most frequently reported PR adverse event categories were cerebrovascular (60%), death (11%), and neurological (8%). The most frequent PR adverse event reports were death (11%), thrombosis/thrombus (9%) cerebral infarction (8%), decreased therapeutic response (7%), stroke/cerebrovascular accident (6%), intracranial hemorrhage (5%), aneurysm (4%), occlusion (4%), headache (4%), neurological deficit/dysfunction (3%). The most frequent DR reports were activation/positioning/separation problems (52%), break (9%), device operates differently than expected (4%), difficult to open or close (4%), material deformation (3%), migration or expulsion of device (3%), detachment of device or device component (2%). Conclusions: Post-market surveillance is important to guide patient counselling and identify adverse events and device problems that were not identified in initial trials. We present frequent reports of several types of cerebrovascular and neurological adverse events as well as the most common device shortcomings that should be explored by manufacturers and future studies. Although inherent limitations to the MAUDE database are present, our results highlight important PR and DR complications that can help optimize patient counseling and device development.

• PNF and Movement
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• 제22권2호
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• pp.257-266
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• 2024

Purpose: The aim of this study was to determine the influence of psychological and other risk factors on the recurrence of nonspecific neck pain. To achieve this, a nationwide cohort provided by the National Health Insurance Service in South Korea, with a three-year follow-up, was used. Methods: The study included patients who did not experience neck pain for the first year but were diagnosed with nonspecific neck pain (ICD-10 code: M54.2) in the second year. The progress of their neck pain recurrence was followed up for the next two years. Medical records, including age, gender, health insurance premium quintile, regional health vulnerability index score, initial onset duration, total hospitalization duration, and secondary diagnosis at onset, were extracted for analysis. Multivariate logistic regression analysis was performed to analyze the recurrence rate and risk factors for nonspecific neck pain recurrence. Results: Among a total of 591,215 patients, 29.2% experienced recurrence within two years. Patients with psychological disorders had a higher recurrence rate (30.6-33.8%) than those without psychological disorders (29.2%). Specifically, mood disorders (OR = 1.16) and stress-related disorders (OR = 1.06) were identified as risk factors for the recurrence of nonspecific neck pain. Older age (OR = 1.16-1.43), being female (OR = 1.17), being employed (OR = 1.23), and using medial aids (OR = 1.41) were also identified as risk factors. Conclusion: This study provides evidence for a high recurrence rate of nonspecific neck pain and highlights the need to consider psychological factors as well as personal factors in comprehensive interventions to prevent recurrent nonspecific neck pain.

• Clinical Endoscopy
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• 제55권2호
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• pp.256-262
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• 2022

Background/Aims: The diagnosis of intestinal tuberculosis (ITB) is often challenging. Therapeutic anti-tubercular trial (TATT) is sometimes used for the diagnosis of ITB. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT in patients with ITB. Methods: A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 and November 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FC measurement reports. Results: The mean age of the participants was 48.8 years. The final diagnosis of ITB was confirmed in 30 patients based on complete mucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the ITB patients was 170.2 ㎍/g (range, 11.5-646.5). It dropped to 25.4 ㎍/g (range, 11.5-75.3) and then 23.3 ㎍/g (range, 11.5-172.2) after one and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant (p<0.001), and FC levels decreased to below 100 ㎍/g in all patients after one month of TATT. Conclusions: All ITB patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosal healing in the follow-up colonoscopy after 2 months of TATT.

• Steel and Composite Structures
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• 제50권5호
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• pp.515-529
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• 2024

Cold-formed steel (CFS) is a popular choice for construction due to its low cost, durability, sustainability, resistance to high environmental and seismic pressures, and ease of installation. The beam-column connections in residential and medium-rise structures are formed using self-drilling screws that connect two CFS channel sections and a gusset plate. In order to increase the moment capacity of these CFS screwed beam-column connections, stiffeners are often placed on the web area of each single channel. However, there is limited literature on studying the effects of stiffeners on the moment capacity of CFS screwed beam-column connections. Hence, this paper proposes a new test approach for determining the moment capacity of CFS screwed beam-column couplings. This study describes an experimental test programme consisting of eight novel experimental tests. The effect of stiffeners, beam thickness, and gusset plate thickness on the structural behaviour of CFS screwed beam-column connections is investigated. Besides, nonlinear elasto-plastic finite element (FE) models were developed and validated against experimental test data. It found that there was reasonable agreement in terms of moment capacity and failure mode prediction. From the experimental and numerical investigation, it found that the increase in gusset plate or beam thickness and the use of stiffeners have no significant effect on the structural behaviour, moment capacity, or rotational capacity of joints exhibiting the same collapse behaviour; however, the capacity or energy absorption capacities have increased in joints whose failure behaviour varies with increasing thickness or using stiffeners. Besides, the thickness change has little impact on the initial stiffness.

• 대한기관윤리심의기구협의회지
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• 제6권2호
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• pp.38-47
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• 2024

Purpose: The purpose of this study is to compare the efficiency of 2 types of Institutional Review Boards (IRBs) for multicenter research. Methods: The 2 types are joint IRB and local IRB. For this study, we selected multicenter research reviewed and approved by joint or local IRBs between October 2019 and December 2022. We assessed the time it took for each IRB to approve the research based on the number of working days per IRB review case. We then stratified the data according to the number of participating institutions, the type of research, and the type of IRB review. Results: The results of our study show that joint IRB is more efficient than local IRB. The median IRB approval time for joint IRB was 27 days, 73.5% shorter than local IRB (27 days vs. 102 days, respectively, p<0.001). As the number of participating institutions in multicenter research increased, joint IRB reviews became more efficient regarding the required approval time than local IRB reviews. We also found that joint IRB was faster in every administrative step until new research was approved (p<0.005) when compared to local IRB. Conclusion: Our study highlights that a single review through a joint IRB can significantly reduce the time required for IRB approval of multicenter research. This approach can ensure that all participating institutions follow the same review results. Therefore, a single IRB review effectively reduces the burden of IRB for multicenter research.

• 문화기술의 융합
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• 제10권4호
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• pp.367-372
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• 2024

발달장애는 전체 장애인 수 중에 비교적 낮은 수치에 해당되지만 장애의 정도에서 전반적으로 중증 장애로 분류되고 있다. 이러한 발달장애는 초기에 발견이 된다면 적응력과 초기 대응에 의한 치료 효과가 향상될 수 있지만, 대부분의 부모들은 자신의 아이에게서 징후를 발견하지 못하거나 치료시기를 놓치는 경우가 대다수이다. 본 논문에서는 특이적 행동특성을 기반으로 하는 초기 발달장애 징후를 객관적으로 볼 수 없는 부모나 유아기관 관계자들을 위해 발달장애 초기 특이행동 중 손 퍼덕대기(Hand-Flapping)를 인식할 수 있는 발달장애 진단 알고리듬개발의 선행연구를 수행하였다. 인지영역과 손가락을 정확하게 인식하여, 손퍼덕임 수를 정확하게 카운트하는 것을확인할 수 있었다. 빅데이터를 활용한 알고리듬의 고도화 및 기능적 성능 확장을 통해 다양한 행동패턴의 진단이 가능한 알고리듬 연구가 지속적으로 수행 및 확대될 것으로 전망된다.

• Smart Structures and Systems
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• 제33권6호
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• pp.399-414
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• 2024

This study discusses the long-term deformation monitoring and shape sensing of bridge girder surfaces with an automated extraction scheme for point clouds in the Region Of Interest (ROI), invariant to the position of a Light Detection And Ranging system (LiDAR). Advanced smart construction necessitates continuous monitoring of the deformation and shape of bridge girders during the construction phase. An automated scheme is proposed for reconstructing geometric model of ROI in the presence of noisy non-stationary background. The proposed scheme involves (i) denoising irrelevant background point clouds using dimensions from the design model, (ii) extracting the outer boundaries of the bridge girder by transforming and processing the point cloud data in a two-dimensional image space, (iii) extracting topology of pre-defined targets using the modified Otsu method, (iv) registering the point clouds to a common reference frame or design coordinate using extracted predefined targets placed outside ROI, and (v) defining the bounding box in the point clouds using corresponding dimensional information of the bridge girder and abutments from the design model. The surface-fitted reconstructed geometric model in the ROI is superposed consistently over a long period to monitor bridge shape and derive deflection during the construction phase, which is highly correlated. The proposed scheme of combining 2D-3D with the design model overcomes the sensitivity of 3D point cloud registration to initial match, which often leads to a local extremum.

• Journal of Periodontal and Implant Science
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• 제54권4호
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• pp.224-235
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• 2024

Purpose: This systematic review investigated whether drug use is associated with the presence of oral lesions and periodontitis. Methods: A search was performed for studies that analyzed the presence of periodontitis and/or oral lesions in users of crack, cocaine, and/or marijuana in the PubMed, Scopus, and Web of Science databases. Observational studies in English, Spanish, or Portuguese, without limitation of year, age, and sex, were included. Studies that did not evaluate periodontitis and oral lesions according to the eligibility criteria were excluded. Two authors independently performed study selection and data extraction using a standardized form. The risk of bias of studies included in the meta-analysis was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The meta-analysis included studies that investigated the association of drug use with the outcome. Results: The initial search resulted in 9,279 articles, from which 16 studies with 15,434 participants were included in the review and 8 studies were included in the meta-analysis. Most studies that evaluated periodontitis in drug users and non-users found a positive association in users. Most studies that analyzed oral lesions reported a higher prevalence, association, or risk of oral lesions in drug users than in non-users. A critical evaluation identified a need to improve the control and reporting of confounding factors in studies on this topic. An association was found between periodontitis and the use of crack, cocaine, and/or marijuana (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.04-3.27; P=0.04) and between oral lesions and the use of these drugs (OR, 2.13; 95% CI, 1.58-2.86; P<0.001). Conclusions: Drug users are more likely to develop oral lesions and periodontitis than nonusers. However, the results should be interpreted with caution, considering the heterogeneity and quality of the studies included in the analysis.