• Title/Summary/Keyword: Real-world

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Nationwide Trends of Gatekeeper to Invasive Coronary Angiography in Suspected Coronary Artery Disease

  • Min Jae Cha;William D Kim;Hoyoun Won;Jaeeun Joo;Hasung Kim;In-Cheol Kim;Jin Young Kim;Seonhwa Lee;Iksung Cho
    • Korean Circulation Journal
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    • v.52 no.11
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    • pp.814-825
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    • 2022
  • Background and Objectives: Real-world trends in the utility and type of gatekeeping studies in invasive coronary angiography (ICA) requires further investigation. Methods: We identified outpatients who underwent noninvasive cardiac tests or directly ICA for suspected coronary artery disease (CAD) from the nationwide Korea Health Insurance Review and Assessment Service-National Patient Sample database between 2012 and 2018. Results: Among 71,401 patients, the percentage of patients who were evaluated for suspected CAD was 34.7% for treadmill test (TMT), 4.2% for single-photon emission computed tomography (SPECT), 24.2% for coronary computed tomography angiography (CCTA), 1.6% for multiple gatekeepers, and 32.3% for directly ICA without noninvasive studies. The proportion of CCTA as a gatekeeper showed linear increase, (18.6% in 2012 and 28.8% in 2018; p<0.001), while those of TMT, SPECT, and direct ICA have decreased (p<0.001, p=0.03, and p<0.001, respectively). The overall incidence of downstream ICA after gatekeeper was 13.8% (6,662/48,346), and SPECT showed higher ICA rate in pairwise comparison with TMT and CCTA (p<0.001). Patients who performed gatekeepers before ICA showed higher rate of subsequent PCI (34.7% vs. 32.3%; p<0.001) and CABG (3.5% vs. 1.0%; p<0.001), compared to those who directly underwent ICA, and CCTA was associated with higher revascularization rate after ICA in pairwise comparison with TMT and SPECT (p<0.001). Conclusions: Nationwide database demonstrated that CCTA is utilized increasingly as a gatekeeper for ICA and is associated with high revascularization rate after ICA in outpatients with suspected CAD.

Long-term Clinical Outcomes and Prognostic Factors After Endovascular Treatment in Patients With Chronic Limb Threatening Ischemia

  • Jung-Joon Cha;Jong-Youn Kim;Hyoeun Kim;Young-Guk Ko;Donghoon Choi;Jae-Hwan Lee;Chang-Hwan Yoon;In-Ho Chae;Cheol Woong Yu;Seung Whan Lee;Sang-Rok Lee;Seung Hyuk Choi;Yoon Seok Koh;Pil-Ki Min;K-VIS (Korean Vascular Intervention Society) investigators
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.429-440
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    • 2022
  • Background and Objectives: Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in real-world practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors. Methods: From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention). Results: Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471; p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3-4 years. Conclusions: In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.

Predictors of renal relapse in Koreans with lupus nephritis after achieving complete response: a 35-years of experience at a single center

  • Howook Jeon;Jennifer Lee;Su-Jin Moon;Seung-Ki Kwok;Ji Hyeon Ju;Wan-Uk Kim;Sung-Hwan Park
    • The Korean journal of internal medicine
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    • v.39 no.2
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    • pp.347-359
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    • 2024
  • Background/Aims: Renal relapse has known to be a poor prognostic factor in patients with lupus nephritis (LN), but there were few studies that identified the risk factors of renal relapse in real world. We conducted this study based on 35-years of experience at a single center to find out predictors of renal relapse in Korean patients with LN after achieving complete response (CR). Methods: We retrospectively analyzed the clinical, laboratory, pathologic and therapeutic parameters in 296 patients of LN who reached CR. The cumulative risk and the independent risk factors for renal relapse were examined by Kaplan-Meier methods and Cox proportional hazards regression analyses, respectively. Results: The median follow-up period from CR was 123 months. Renal relapse had occurred in 157 patients. Renal relapse occurred in 38.2%, 57.6% and 67.9% of patients within 5-, 10-, and 20-year, respectively. The age at diagnosis of SLE and LN were significantly younger, and the proportions of severe proteinuria and serum hypoalbuminemia were higher in patients with renal relapse. Interestingly, the proportion of receiving cytotoxic maintenance treatment was higher in patients with renal relapse. In Cox proportional hazards regression analyses, only young-age onset of LN (by 10 years, HR = 0.779, p = 0.007) was identified to independent predictor of renal relapse. Conclusions: Young-age onset of LN was only independent predictor and the patients with severe proteinuria and serum hypoalbuminemia also tended to relapse more, despite of sufficient maintenance treatment. Studies on more effective maintenance treatment regimens and duration are needed to reduce renal relapse.

Quantity Estimation Method for High-Performance Insulated Wall Panels with Complex Details Using BIM Family Libraries (BIM의 패밀리 라이브러리를 이용한 복잡한 상세를 갖는 고단열 벽체 판넬의 물량 산출 방법)

  • Mun, Ju-Hyun
    • Journal of the Korea Institute of Building Construction
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    • v.24 no.4
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    • pp.447-458
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    • 2024
  • This study investigates the effectiveness of Building Information Modeling(BIM) software, specifically SketchUp and Revit, in reducing errors during quantity take-off(QTO) for complex building elements. While 3D modeling offers advantages, existing software may not fully account for manufacturing discrepancies, such as variations in concrete cover thickness and reinforcing bar radius. To address this limitation, this research proposes a BIM-based QTO method for high-insulation wall panels with intricate details. The method utilizes a BIM family library, focusing on key parameters like concrete cover thickness and inner radius of shear reinforcement. A case study compared the cross-sectional details of a wall panel modeled in Revit with the actual manufactured specimen. The analysis revealed a 12% reduction in modeled concrete cover thickness and a 1.27 times larger modeled inner radius of the shear bar compared to the real-world values. The proposed method incorporates these manufacturing variations into the Revit model of the high-insulation wall panel. Software like Navisworks facilitates the identification and correction of any material interferences arising from these adjustments. Furthermore, the method employs a unit wall concept(1m2) to account for the volume of various materials, including insulation and splice sleeves at joints. This allows for the identification of a similar existing family within the BIM library(e.g., "Double RC wall with embedded insulation") that reflects the actual material quantities used in the wall panel. By incorporating these manufacturing-induced variations, the proposed method offers a more accurate QTO process for complex high-insulation wall panels. The "Double RC wall with embedded insulation" family within the Revit program serves as a valuable tool for material quantity estimation in such scenarios.

Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry

  • Ji Woong Roh;Sanghoon Shin;Young-Guk Ko;Nak-Hoon Son;Chul-Min Ahn;Pil-Ki Min;Jae-Hwan Lee;Chang-Hwan Yoon;Cheol Woong Yu;Seung Whan Lee;Sang-Rok Lee;Seung Hyuk Choi;In-Ho Chae;Donghoon Choi
    • Korean Circulation Journal
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    • v.52 no.7
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    • pp.529-540
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    • 2022
  • Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12-2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03-8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26-2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28-7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19-7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25-3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07-3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

Agricultural Applicability of AI based Image Generation (AI 기반 이미지 생성 기술의 농업 적용 가능성)

  • Seungri Yoon;Yeyeong Lee;Eunkyu Jung;Tae In Ahn
    • Journal of Bio-Environment Control
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    • v.33 no.2
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    • pp.120-128
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    • 2024
  • Since ChatGPT was released in 2022, the generative artificial intelligence (AI) industry has seen massive growth and is expected to bring significant innovations to cognitive tasks. AI-based image generation, in particular, is leading major changes in the digital world. This study investigates the technical foundations of Midjourney, Stable Diffusion, and Firefly-three notable AI image generation tools-and compares their effectiveness by examining the images they produce. The results show that these AI tools can generate realistic images of tomatoes, strawberries, paprikas, and cucumbers, typical crops grown in greenhouse. Especially, Firefly stood out for its ability to produce very realistic images of greenhouse-grown crops. However, all tools struggled to fully capture the environmental context of greenhouses where these crops grow. The process of refining prompts and using reference images has proven effective in accurately generating images of strawberry fruits and their cultivation systems. In the case of generating cucumber images, the AI tools produced images very close to real ones, with no significant differences found in their evaluation scores. This study demonstrates how AI-based image generation technology can be applied in agriculture, suggesting a bright future for its use in this field.

Atmospheric Disturbance Simulation in Adaptive Optics: from Theory to Practice (적응광학에서의 대기 외란 모사: 이론에서 실제 적용까지)

  • Jun Ho Lee;Ji Hyun Pak;Ji Yong Joo;Seok Gi Han;Yongsuk Jung;Youngsoo Kim
    • Korean Journal of Optics and Photonics
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    • v.35 no.5
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    • pp.199-209
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    • 2024
  • Predicting the performance of adaptive optics systems is a crucial step in their design and analysis. First-order prediction methods, based primarily on several assumptions and scaling laws, are commonly used. These methods must account for various parameters and error sources, such as the intensity and profile of atmospheric turbulence, fitting errors based on the resolution of the wavefront sensor and deformable mirror, wavefront-sensor noise propagated through the wavefront-reconstruction algorithm, servo lag due to the finite bandwidth of the control loop, and anisoplanatism caused by the arrangement of natural and laser guide stars. However, since first-order performance-prediction methods based on certain assumptions can sometimes yield results that deviate from real-world performance, evaluation through computational simulations and closed-loop tests on a testbed is necessary. Additionally, an atmospheric simulator is required for closed-loop testing, which must adequately simulate the spatial and temporal characteristics of atmospheric disturbances. This paper aims to present an overview of the theory of atmospheric disturbance simulators, as well as their implementation in computational simulation and hardware.

Development and Feasibility Assessment of Mobile Application-Based Digital Therapeutics for Postoperative Supportive Care in Gastric Cancer Patients Following Gastrectomy

  • Ji-Hyeon Park;Hyuk-Joon Lee;JeeSun Kim;Yo-Seok Cho;Sunjoo Lee;Seongmin Park;Hwinyeong Choe;Eunhwa Song;Youngran Kim;Seong-Ho Kong;Do Joong Park;Byung-Ho Nam;Han-Kwang Yang
    • Journal of Gastric Cancer
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    • v.24 no.4
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    • pp.420-435
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    • 2024
  • Purpose: This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy. Materials and Method: The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient's body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice. Results: At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0-3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5-24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI. Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight. Conclusions: The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition.

Comparison of Food Supply Status of Korean(Chosun) and Taiwan Prisoners under the Period of Japanese Rule with That of French and German Prisoners in 1920~1930′s (일제하(1920~30연대) 조선과 대만 그리고 프랑스와 독일 수형인의 식품공급상황 비교)

  • 허채옥
    • Journal of the East Asian Society of Dietary Life
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    • v.13 no.4
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    • pp.267-283
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    • 2003
  • This study reviewed the prisoners' dietary lift status under the world panics and Japanese food shortage based on the data of the 1920~1930's prisons' main dish supplies in Chosun, Shinchu boys' prison in Taiwan, Franue correction center in France and Moabit detention house in Germany. 1. The status of main dish food supply of Chosun prisons in 1920~1930's was as follows: 1) Meals were provided with 12 rates depending on the working activities. There were big differences in energy supply between 1$^{st}$ rate of 6045.0 ㎉ in the Mockpo prison and 12$^{th}$ rate of 1855.8 ㎉ in the Masan prison in accordance with the grain supply ratio and the diet rates. 2) The average ratio of energy provided with protein, fat and carbohydrate(PFC ratio) was 20.0: 20.2: 59.8. The supplies of protein and fat were relatively high because main dish was mostly composed of soybean. The soybean was used in 20 ~60% of main dish in prisons except Gaesung. 3) It was estimated that PFC ratio(8.3: 8.1 : 83.6) in Gaesung boys' prison was not appropriate for growing boys because the soybean supply was low. 2. The overall comparison of nutrition supply of prisons in Chosun, Taiwan, France and Germany was as follows: 1) The daily supplies of energy in Keongsung prison was 3966.5 ㎉, of which the PFC ratio was 18.9: 16.6: 64.5. This showed that the PFC ratio seemed to be balanced, even though the total amount of energy is too high and the ratios of protein and fat were somewhat high and somewhat low, respectively. 2) The main dish of the Taiwan boys' prison was provided with 6 rates and the side dish in the from of weekly cycle menu. The energy intakes from 1$^{st}$ rate of 2862.9 ㎉ to 6$^{th}$ rate of 1388.9 ㎉ were not quite enough for growing boys. It was estimated that the amounts of protein and fat taken were small but the quality was not that bad because animal protein such as protein small fish and fried tofu were supplied. 3) In the French Frenue correction center and the German Moabit detention house, the daily total amounts of energy were 2771.3 ㎉ and 2678.7 ㎉, respectively, which was estimated as appropriate compared with standard energy amount of 3000 ㎉ at that time and the current energy RDA of 2500 ㎉ for adult. The ratio of PFC was 16.2: 12.0: 71.8 in Frenue correction center and 12.4: 14.3: 73.3 in Moabit detention house, which showed that the amount of fat was slightly lacked. From this study, it was suggested that the prisons in Chosun and Taiwan under the Japanese rule and European prisons after the world panic were making an efforts to supply prisoners the appropriate amount of energy. The only question remains is that this data may be from only the food supply plan not from the data the prisoners took in real.eal.

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Analysis of the Effects of Teaching Method Using Ball-and-Stick Models in the Middle School (중학교에서 공-막대 모형을 이용한 수업의 효과 분석)

  • Jin, Hee-Ja;Park, Kwang-Seo;Kim, Dong-Jin;Kim, Kyong-Mee;Park, Kuk-Tae
    • Journal of the Korean Chemical Society
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    • v.48 no.1
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    • pp.77-84
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    • 2004
  • The purpose of this study was to analyze the controversial points in the concepts of materials in the science textbook of middle school and to provide alternatives of teaching method. For this study, units in connected textbooks were analyzed and the teaching method using ball-and-stick models was developed. The subjects were 130 second graders from a middle school in Seoul, Korea. It aimed to compare the effectiveness of using ball-and-stick models for lesson with the one of traditional lessons, in learning concepts concerning materials by cognitive levels and to investigate the difference of scientific concept formation about concepts concerning materials by their cognitive levels between experimental group and control group by using concept formation questionnaires. Before the instructions, a short-version GALT was administered. After instructions, the posttest of concepts and attitude test connected with science subject were administered, and 10 months later, the posttest of concepts was administered to analyze the long-term memory effects. According to the results, the experimental group using the ball-and-stick models had significantly higher scores at conceptual understanding and long-term memory effects than the control group and improved the attitude relevant to science subject, and also had affirmative effects in attitude for science and science work. When analyzing the results according to the cognitive level, the long-term memory effects was high in the concrete operational stage students. From the results of this study, middle school students that are more concrete operational stage and transitional stage than formal operational stage elevates interesting in studying by using ball-and-stick models and making material form concretely. It would be effective in helping the students develope the correct concepts by connecting real world as materials and the particle world as atom.