• Korean Journal of Radiology
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• v.22 no.9
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• pp.1481-1489
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• 2021

Objective: To construct a CT-based Fagotti scoring system by analyzing the correlations between laparoscopic findings and CT features in patients with advanced ovarian cancer. Materials and Methods: This retrospective cohort study included patients diagnosed with stage III/IV ovarian cancer who underwent diagnostic laparoscopy and debulking surgery between January 2010 and June 2018. Two radiologists independently reviewed preoperative CT scans and assessed ten CT features known as predictors of suboptimal cytoreduction. Correlation analysis between ten CT features and seven laparoscopic parameters based on the Fagotti scoring system was performed using Spearman's correlation. Variable selection and model construction were performed by logistic regression with the least absolute shrinkage and selection operator method using a predictive index value (PIV) ≥ 8 as an indicator of suboptimal cytoreduction. The final CT-based scoring system was internally validated using 5-fold cross-validation. Results: A total of 157 patients (median age, 56 years; range, 27-79 years) were evaluated. Among 120 (76.4%) patients with a PIV ≥ 8, 105 patients received neoadjuvant chemotherapy followed by interval debulking surgery, and the optimal cytoreduction rate was 90.5% (95 of 105). Among 37 (23.6%) patients with PIV < 8, 29 patients underwent primary debulking surgery, and the optimal cytoreduction rate was 93.1% (27 of 29). CT features showing significant correlations with PIV ≥ 8 were mesenteric involvement, gastro-transverse mesocolon-splenic space involvement, diaphragmatic involvement, and para-aortic lymphadenopathy. The area under the receiver operating curve of the final model for prediction of PIV ≥ 8 was 0.72 (95% confidence interval: 0.62-0.82). Conclusion: Central tumor burden and upper abdominal spread features on preoperative CT were identified as distinct predictive factors for high PIV on diagnostic laparoscopy. The CT-based PIV prediction model might be useful for patient stratification before cytoreduction surgery for advanced ovarian cancer.

• Korean Journal of Radiology
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• v.25 no.1
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• pp.74-85
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• 2024

Objective: Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology associated with venous sinus stenosis. This study aimed to develop a magnetic resonance venography (MRV)-based radiomics model for predicting a high trans-stenotic pressure gradient (TPG) in IIH patients diagnosed with venous sinus stenosis. Materials and Methods: This retrospective study included 105 IIH patients (median age [interquartile range], 35 years [27-42 years]; female:male, 82:23) who underwent MRV and catheter venography complemented by venous manometry. Contrast enhanced-MRV was conducted under 1.5 Tesla system, and the images were reconstructed using a standard algorithm. Shape features were derived from MRV images via the PyRadiomics package and selected by utilizing the least absolute shrinkage and selection operator (LASSO) method. A radiomics score for predicting high TPG (≥ 8 mmHg) in IIH patients was formulated using multivariable logistic regression; its discrimination performance was assessed using the area under the receiver operating characteristic curve (AUROC). A nomogram was constructed by incorporating the radiomics scores and clinical features. Results: Data from 105 patients were randomly divided into two distinct datasets for model training (n = 73; 50 and 23 with and without high TPG, respectively) and testing (n = 32; 22 and 10 with and without high TPG, respectively). Three informative shape features were identified in the training datasets: least axis length, sphericity, and maximum three-dimensional diameter. The radiomics score for predicting high TPG in IIH patients demonstrated an AUROC of 0.906 (95% confidence interval, 0.836-0.976) in the training dataset and 0.877 (95% confidence interval, 0.755-0.999) in the test dataset. The nomogram showed good calibration. Conclusion: Our study presents the feasibility of a novel model for predicting high TPG in IIH patients using radiomics analysis of noninvasive MRV-based shape features. This information may aid clinicians in identifying patients who may benefit from stenting.

• Nutrition Research and Practice
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• v.13 no.2
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• pp.150-158
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• 2019

BACKGROUND/OBJECTIVES: Inflammation is known to be a risk factor for metabolic diseases. This study aimed to develop a Food-based Index of Dietary Inflammatory Potential (FBDI) and examine its association with metabolic biomarkers. SUBJECTS/METHODS: This study analyzed the raw data from the 2012-2014 Korean Genome and Epidemiology Study data of 17,771 people. To analyze the relationship between foods consumed by Koreans and inflammation, we conducted a correlation analysis between 51 food groups and hs-CRP levels. The FBDI was developed from 17 food groups selected by multiple regression method. We examined whether FBDI was associated with metabolic markers (waist circumference, blood pressure, fasting glucose, triglyceride, and HDL-cholesterol) in the 6th Korea National Health and Nutrition Examination Survey (KNHANES). We used binary logistic regression analysis to examine the association. RESULTS: The FBDI model included seven of the anti-inflammatory food groups and three of the pro-inflammatory food groups. The FBDI formula was calculated by multiplying the intake of food group by ${\beta}$-coefficients derived from the multiple regression model based on the correlation analysis. The FBDI was significantly associated with waist circumference (P < 0.001), blood pressure (P < 0.001), triglyceride level (P < 0.001), and HDL-cholesterol (P < 0.001) level among adults aged 20-64 years in the KNHANES. The prevalence of metabolic syndrome was 2.618 times higher in the group with the highest FBDI than in the group with the lowest one (95% confidence interval: 1.778-3.856, P for trend < 0.001). CONCLUSIONS: This study established an FBDI reflecting food intake patterns of Koreans, which showed a significant relationship with the prevalence of metabolic syndrome.

• Journal of Preventive Medicine and Public Health
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• v.36 no.1
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• The Journal of Korean Academic Society of Nursing Education
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• v.24 no.3
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• pp.205-213
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• 2018

Purpose: This study was performed to identify factors associated with human papillomavirus vaccination intention among unvaccinated nursing students. Methods: Two hundred-and-five female nursing students from three universities completed self-administered questionnaires including participants' characteristics, human papillomavirus-related knowledge, attitude toward human papillomavirus vaccination, and human papillomavirus-related health beliefs. Multivariate logistic regression analysis was used to determine significant independent predictors of human papillomavirus vaccination intention. Results: Of 205 participants, 134 (65.4%) reported an intention to obtain a vaccination against human papillomavirus. As a result of the analysis of the bivariate relationships, family history of cervix cancer, perceived needs, importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier were significantly related to vaccination intention. A multivariate logistic regression model identified factors of human papillomavirus vaccination intention: higher importance of prevention (Adjusted Odds Ratio [AOR]: 4.20, 95% Confidence Interval [CI]: 1.73~10.19), higher perceived benefit (AOR: 6.94, 95% CI: 2.01~23.98), lower perceived barrier (AOR: 0.39, 95% CI: 0.20~0.73). Conclusion: The results of this study indicated significant factors influencing the intention to obtain human papillomavirus vaccination in unvaccinated nursing students. Also, the importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier in obtaining human papillomavirus vaccination should be taken into account when developing educational programs.

• Journal of Korean society of Dental Hygiene
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• v.21 no.2
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• pp.129-140
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• 2021

Objectives: We sought to evaluate the mitigating effect of using floss and interdental brushes on periodontal health inequality. Methods: This study was based on data acquired from the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII; 2016-2018). We included 11,359 participants aged ≥19 years in the final analysis. Multivariable logistic regression analysis was performed using socioeconomic characteristics, health behavior, health status, and periodontitis status. We analyzed differences in the prevalence of periodontitis according to household income stratified by the use of floss and interdental brush. Results: In the multivariable logistic regression model, the lowest income group had 1.304 (95% confidence interval [CI] 1.08-1.58) odds ratios for periodontitis than the highest income group. In the interdental brush nonusers or floss nonusers, the lowest income group had significantly higher odds of developing periodontitis. However, we found no significant differences in the periodontitis prevalence between the income groups among the interdental brush users. In the 65-year-old or older group, the same result was observed in the interdental brush and floss users. Conclusions: The results suggest that the use of floss and interdental brushes could alleviate periodontal health inequality.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.258-266
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• 2018

Purpose: This study analyzes the impact of laparoscopic liver resection on intra-abdominal adhesion. Methods: Patients who underwent salvage liver transplantation after liver resection for hepatocellular carcinoma from January 2012 to October 2017 at our institution were included. Information about the severity of intra-abdominal adhesions was collected from a prospectively maintained database. Intra-abdominal adhesions were graded after the agreement of 2 surgeons who participated in the salvage liver transplantation based on predetermined criteria. Adhesion severity and demographic, operative, and postoperative data were compared between the laparoscopic group and the open group. Multivariate logistic regression was performed to consider potential factors related to severe adhesion during salvage transplantation. Results: Sixty-two patients who underwent salvage liver transplantation after liver resection were included in this study. Among them, 52 patients underwent open surgery, and 10 patients underwent laparoscopy. Adhesion was significantly more severe in the open group than in the laparoscopy group (P = 0.029). A multivariate logistic regression model including potential factors related to severe adhesion showed that laparoscopy (odds ratio, 0.168; 95% confidence interval, 0.029-0.970; P = 0.048) was the only significant factor. Conclusion: Laparoscopic liver resection for hepatocellular carcinoma can minimize intra-abdominal adhesion during salvage liver transplantation.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.468-478
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• 2021

BACKGROUND/OBJECTIVES: This study aimed to analyze the association between dietary omega-3 fatty acid intake and depression in postmenopausal women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI. SUBJECTS/METHODS: The KNHANES is a cross-sectional nationwide health and nutrition survey. Dietary data, including omega-3 fatty acids, were assessed using the 24-h recall method. Depression was evaluated using a survey questionnaire. The association between dietary omega-3 fatty acids and depression was evaluated using multivariate logistic regression analysis. Depression, according to the dietary omega-3 fatty acid intake, was expressed as the odds ratio (OR) with a 95% confidence interval (CI). A total of 4,150 postmenopausal women were included in the analysis. RESULTS: In the fully-adjusted model, the group with the highest dietary omega-3 fatty acid intake significantly showed lower prevalence of depression than the group with the lowest intake (OR, 0.52; 95% CI, 0.33-0.83); a significant linear trend was detected (P for trend = 0.04). According to the dose-response analysis using cubic restricted spline regression, this association was linear and monotonic (P for non-linearity = 0.32). CONCLUSIONS: In this study, the dietary omega-3 fatty acid intake in postmenopausal women was inversely proportional to depression in a dose-response manner. Large cohort studies are needed to verify the causality between omega-3 fatty acids and depression in Korean postmenopausal women.

• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.59-66
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• 2023

Objectives: The aim of this study was to evaluate the effect of body weight status and sleep duration on the discrete-time hazard of menarche in Korean schoolgirls using multiple-point prospective panel data. Methods: The study included 914 girls in the 2010 Korean Children and Youth Panel Study who were in the elementary first-grader panel from 2010 until 2016. We used a Gompertz regression model to estimate the effects of weight status based on age-specific and sex-specific body mass index (BMI) percentile and sleep duration on an early schoolchild's conditional probability of menarche during a given time interval using general health condition and annual household income as covariates. Results: Gompertz regression of time to menarche data collected from the Korean Children and Youth Panel Study 2010 suggested that being overweight or sleeping less than the recommended duration was related to an increased hazard of menarche compared to being average weight and sleeping 9 hours to 11 hours, by 1.63 times and 1.38 times, respectively, while other covariates were fixed. In contrast, being underweight was associated with a 66% lower discrete-time hazard of menarche. Conclusions: Weight status based on BMI percentiles and sleep duration in the early school years affect the hazard of menarche.

• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.339-352
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• 2023

Prediction of the time-related traits of pebble flow inside pebble-bed HTGRs is of great significance for reactor operation and design. In this work, an image-driven approach with the aid of a convolutional neural network (CNN) is proposed to predict the remaining time of initially loaded pebbles and the time interval of paired flow images of the pebble bed. Two types of strategies are put forward: one is adding FC layers to the classic classification CNN models and using regression training, and the other is CNN-based deep expectation (DEX) by regarding the time prediction as a deep classification task followed by softmax expected value refinements. The current dataset is obtained from the discrete element method (DEM) simulations. Results show that the CNN-aided models generally make satisfactory predictions on the remaining time with the determination coefficient larger than 0.99. Among these models, the VGG19+DEX performs the best and its CumScore (proportion of test set with prediction error within 0.5s) can reach 0.939. Besides, the remaining time of additional test sets and new cases can also be well predicted, indicating good generalization ability of the model. In the task of predicting the time interval of image pairs, the VGG19+DEX model has also generated satisfactory results. Particularly, the trained model, with promising generalization ability, has demonstrated great potential in accurately and instantaneously predicting the traits of interest, without the need for additional computational intensive DEM simulations. Nevertheless, the issues of data diversity and model optimization need to be improved to achieve the full potential of the CNN-aided prediction tool.