In this paper, we apply a support vector machine(SVM) that incorporates an optimized nonlinear decision rule over different sets of feature vectors to improve the performance of statistical model-based voice activity detection(VAD). Conventional method performs VAD through setting up statistical models for each case of speech absence and presence assumption and comparing the geometric mean of the likelihood ratio (LR) for the individual frequency band extracted from input signal with the given threshold. We propose a novel VAD technique based on SVM by treating the LRs computed in each frequency bin as the elements of feature vector to minimize classification error probability instead of the conventional decision rule using geometric mean. As a result of experiments, the performance of SVM-based VAD using the proposed feature has shown better results compared with those of reported VADs in various noise environments.
Mesenchymal stem cells (MSCs) are effective in treating autoimmune diseases and managing various conditions, such as engraftment of allogeneic islets. Additionally, autologous and HLA-matched allogeneic MSCs can aid in the engraftment of human allogeneic kidneys with or without low doses of tacrolimus, respectively. However, HLA alloantigens are problematic because cell therapy uses more HLA-mismatched allogeneic cells than autologous for convenience and standardization. In particular, HLA-mismatched MSCs showed increased Ag-specific T/B cells and reduced viability faster than HLA-matched MSCs. In CRISPR/Cas9-based cell therapy, Cas9 induce T cell activation in the recipient's immune system. Interestingly, despite their immunogenicity being limited to the cells with foreign Ags, the accumulation of HLA alloantigen-sensitized T/B cells may lead to allograft rejection, suggesting that alloantigens may have a greater scope of adverse effects than foreign Ags. To avoid alloantigen recognition, the β2-microglobulin knockout (B2MKO) system, eliminating class-I MHC, was able to avoid rejection by alloreactive CD8 T cells compared to controls. Moreover, universal donor cells in which both B2M and Class II MHC transactivator (CIITA) were knocked out was more effective in avoiding immune rejection than single KO. However, B2MKO and CIITA KO system remain to be controlled and validated for adverse effects such as the development of tumorigenicity due to deficient Ag recognition by CD8 T and CD4 T cells, respectively. Overall, better HLA-matching or depletion of HLA alloantigens prior to cell therapy can reduce repetitive transplantation through the long-term survival of allogeneic cell therapy, which may be especially important for patients seeking allogeneic transplantation.
James Morris;Lee Hoggett;Sophie Rogers;John Ranson;Andrew Sloan
Hip & pelvis
/
v.35
no.4
/
pp.228-232
/
2023
Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.
Kim Hye Yeon;Kim Tae Hwan;Han Ju Hui;Bang Mi Ran;Chang Gyu Tae;Lee Jin Yong;Kim Hyo In;Lee Donghun;Lee Sun Haeng
The Journal of Pediatrics of Korean Medicine
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v.38
no.3
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pp.66-96
/
2024
Objectives This study aimed to establish a foundation for research on Korean medicine for epilepsy by analyzing its etiology, syndrome differentiation, and the use of herbal medicines. Methods Articles were extracted from five databases in Korea, Japan, and China: the Oriental Medicine Advanced Searching Integrated System (OASIS), Citation Information by the National Institute of Informatics (CiNii), Chinese National Knowledge Infrastructure (CNKI), Wangfang Database, and Chinese Scientific Journal Database (VIP). The etiology, syndrome differentiation, and herbal medicines used for epilepsy were investigated. Results A total of 64 articles were selected, including seven clinical studies, 16 case reports, and 41 reviews. Epilepsy is a complex disease with various etiologies, and among the five viscera, syndrome differentiation mainly involved the liver, spleen, and kidney, with pathological factors that included phlegm, wind, and blood stasis. Frequently used herbal medicines included Modified Jeongganhwan, Sihogyejitang, Yukgunjatang, and Sihogayonggolmoryotang. Conclusions This study analyzed epilepsy's etiology, syndrome differentiation, and herbal treatments. Further evidence is needed to better understand the efficacy and safety of Korean herbal medicine for treating epilepsy.
Park, Jin-Woo;Jahaggirdar, Shamarao;Cho, Yung-Eun;Park, Kyoung-Soo;Lee, Seo-Hyun;Park, Kyung-Seok
The Korean Journal of Pesticide Science
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v.14
no.4
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pp.407-414
/
2010
Bacillus subtilis strains isolated from different regions of Korea were screened for their plant growth promotion and induced systemic resistance (ISR) in tomato and red-pepper. The plant growth promotion on red-pepper and tomato revealed maximum plant height (22.73 cm) on red pepper treated with B. subtilis strain JE 21-1 and 30.18cm in case of tomato treated with B. subtilis strain JE 8-1. There was also significant improvement in root and shoot dry weight in both the plants. The strain JE 21-1 showed better promise for all growth parameters in red-pepper and tomato when compared to other strains and positive check BTH. Different strains screened in square plate method also revealed maximum plant height and leaf width, and suppressed anthracnose on red pepper in case of strain JE 21-1 at $10^6$ and $10^7$ cells/ml when compared to other strains. In all the bacterial inoculations the population was significantly high when compared to untreated check. In plant growth promotion with respect to fruit length and weight, fruit length was maximal in treating with JE 9-4 and ES 2-2, while fruit weight was maximal in treating with JE 3-6, ES4-2, ES2-2 and JE 21-2 on red pepper. In case of tomato, comparatively better fruit weight was in JE 21-1, ES 3-3 and JE 10-2 when compared to BTH and untreated control. The soft rot disease caused by Pectobacterium carotovorum SCCI was completely suppressed in case of transgenic tobacco harboring GUS gene related to PR1a and increased the level of salicylic acid significantly in combined application of JE 9-4 on par with BTH. Thus, this study clarified some potential Bacillus subtilis strains for plant growth promotion and ISR in red-pepper and tomato.
The purpose of this study was to find out a suitable resin to remove $NO_3-N$ from groundwater. Four different commercial resins differentiated by type, porosity and nitrate selectivity were used to compare the performance of nitrate removal. Gel type, Type 2 anion exchange resin was preferable when anion concentration of raw water was low. But efficiency of this resin decreased as flow rate increased. However, macroporous type resins were not affected by increasing flow rate. Macroporous resins were preferable when anion concentrations in raw water were high and high flow rate was proposed. And the general type resin showed better efficiency when sulfate concentrations were low. However the nitrate selective resin had better efficiency in treating raw water of high sulfate concentration. From the results, it may be drawn that nitrate selective resins are preferable to general type when a sulfate concentration in groundwater is over 50mg/l.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.7
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pp.3057-3064
/
2012
In this study, we have tried to identify the relationship between the patient's health belief and the implementation of functional movement rehabilitation and ability to perform ADL in stroke patient, and have done this study to use this as evidence in treating stroke patients in clinical trials by providing a basis data of stroke patients' successful rehabilitation program. We targeted stroke patients who were diagnosed with stroke and are hospitalized in D hospital in J City, Jeollabuk-do, South Korea. More over, we distributed a total of 150 questionnaires to patients who understand the purpose of the research and agreed to participate. We were able to collect 132questionnaires at the end. However, 11 had insufficient data so we only analyzed and evaluated 121 of the said questionnaires. We did frequency analysis to understand the general characteristics by using SPSS for Windows(ver.12.0) program and we used Pearson's Correlation Coefficient and regression analysis to know the relationship between the patient's health beliefs and the implementation of rehabilitation and ability to perform ADL in stroke patients. The results of this study shows that patients with higher perceived sensitivity, perceived benefit and perceived severity equates to an implementation of the rehabilitation better, however patients with a lower perceived disability equates an implementation of functional movement rehabilitation better than those with a higher perceived disability.
The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.
Background: The advantages of Rapid Arc plans versus Intensity modulated radiotherapy plans for Carcinoma left breast were analyzed. Materials and Methods: In this study 20 Post mastectomy carcinoma left breast patients were analyzed. Both Intensity modulated Radiotherapy and Rapid Arc plans were generated for these patients. IMRT plans with 7 beams in an arc fashion and VMAT plans with two semi arcs were made to achieve 95% dose coverage to 100% volume. The plans were evaluated using Dose volume Histograms. Results: The mean Conformity and Homogeneity index in VMAT is found to be 1.05 and 0.065 respectively whereas in IMRT it was 1.07 and 0.069. The 20% volume of Heart received a mean dose of 960cGy in VMAT and 1300cGy in IMRT. The mean dose was 1236cGy in VMAT and 1870cGy in IMRT. The ipsilateral Lung received 3395cGy to 5% volume and 1840cGy to 20% volume on an average and the mean dose was 1205cGy in VMAT, while the same were found to be 3525cGy, 2012cGy and 1435cGy respectively in IMRT. The Contralateral Lung received a mean dose of 505cGy in VMAT and 553cGy in IMRT. The mean Monitor units in VMAT were 512MU and 1170MU in IMRT. The NTID in VMAT is $108.8{\times}10^5Gycm^3$ and $110.1{\times}10^5Gycm^3$ in IMRT. Conclusions: The target coverage, homogeneity and Conformity index were better in VMAT plans. The Ipsilateral Lung and heart dose were very less in VMAT plans. The Contralateral Lung dose and the Normal Tissue Integral Dose were also lesser in VMAT plans however the difference is not very appreciable. The MU in VMAT plans is almost 50% that of the IMRT plans which results in the reduction of treatment time. On the whole VMAT proves to be a better modality for treating Ca. Left Breast Patients.
Park, Hae-Jin;Kim, Mi-Hwa;Chun, Mi-Son;Oh, Young-Teak;Suh, Tae-Suk
Progress in Medical Physics
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v.21
no.2
/
pp.183-191
/
2010
In this study, the patient with localized prostate cancer who had previously been treated at Ajou University Hospital was randomly selected since March, 2009. we performed IMRT and 2RA plans and the same dose objectives were used for CTVs, PTVs, rectum, bladder, and femoral head of the respective plans. Arc optimizations and dose calculations were performed using Eclipse versions 8.6. In this paper, we evaluated the performance of IMRT and RA plans to investigate the clinical effect of RA for prostate cancer case. In our comparison of treatment techniques, RA was found to be superior to IMRT being better dose conformity of target volume. As for the rectum and bladder, RA was better than IMRT at decreasing the volume irradiated. RA has the ability to avoid critical organs selectively through applied same dose constraints while maximally treating the target dose. Therefore, this result suggests that there should be less rectal toxicity with RA compared with IMRT, with no compromise in tumor margin. These findings, which show more favorable rectal, bladder, and femoral head DVHs with RA, imply that should not result in excess risk of toxicity when this technique is used. Many experiences with RA have shown not only dosimetric advantage, but also improved clinical toxicity when comparing with IMRT. The main drawbacks of RA are the more complex and time-consuming treatment planning process and the need for more exact physics quality assurance (QA).
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