• International journal of advanced smart convergence
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• 제12권4호
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• pp.434-442
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• 2023

The relationship between acute kidney injury (AKI) prediction and nephrotoxic drugs, or drugs that adversely affect kidney function, is one that has yet to be explored in the critical care setting. One contributing factor to this gap in research is the limited investigation of drug modalities in the intensive care unit (ICU) context, due to the challenges of processing prescription data into the corresponding drug representations and a lack in the comprehensive understanding of these drug representations. This study addresses this gap by proposing a novel approach that leverages patient prescription data as a modality to improve existing models for AKI prediction. We base our research on Electronic Health Record (EHR) data, extracting the relevant patient prescription information and converting it into the selected drug representation for our research, the extended-connectivity fingerprint (ECFP). Furthermore, we adopt a unique multimodal approach, developing machine learning models and 1D Convolutional Neural Networks (CNN) applied to clinical drug representations, establishing a procedure which has not been used by any previous studies predicting AKI. The findings showcase a notable improvement in AKI prediction through the integration of drug embeddings and other patient cohort features. By using drug features represented as ECFP molecular fingerprints along with common cohort features such as demographics and lab test values, we achieved a considerable improvement in model performance for the AKI prediction task over the baseline model which does not include the drug representations as features, indicating that our distinct approach enhances existing baseline techniques and highlights the relevance of drug data in predicting AKI in the ICU setting.

• The Korean journal of internal medicine
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• 제39권2호
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• pp.306-317
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• 2024

Background/Aims: To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM. Methods: This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI). Results: The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67-0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01). Conclusions: Metformin use in patients with TB-DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.

• 한국음향학회지
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• 제18권3호
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• pp.3-9
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• 1999

본 논문에서는 독립단어 음성인식 시스템을 위하여 반음소(anti-phone) 모델링을 이용한 인식 거절(rejection)기능에 대해 기술한다. 음성인식 거절 기능은 음성인식기를 제작할 ？ 정해놓은 인식대상 단어 이외의 단어가 입력되었을 때 그 단어가 인식할 수 없는 단어임을 알려주는 기능이다. 음성인식 거절기능을 구하는 방식은 핵심어 검출(keyword spotting)방식과 발화검증(utterance verification)방식으로 구분된다. 핵심어 검출 방식은 인식 대상 단어 외의 단어를 별도로 모델링하여 하나의 인식대상 단어처럼 사용하는 방식이고, 발화검증 방식은 각 음소마다 그와 유사한 anti-model을 작성한 후 정상적인 음소 모델과 anti-model과의 유사도를 비교하여 결정하는 방식이다. 본 연구에서는 독립단어 음성인식 시스템에 적용될 수 있는 발화 검증 방식에 의해 음성인식 거절 기능을 구현하였다. 특히 유사도를 결정함에 있어서 산술평균, 기하평균, 조화평균을 사용하고 각각을 비교하여, 기하평균을 사용하는 방식이 우수한 성능을 보임을 알 수 있었다. 음성의 신뢰도(confidence score)를 정규화하기 위해서 Sigmoid 함수를 사용하는데 이 함수의 가중치(weight) 상수의 변화에 대해 인식률을 비교함으로써 가장 적절한 가중치 상수값을 결정하였다. 그리고 유사음소집합(cohort set)에 대한 실험에서는 유사음소집합의 크기가 클수록 더 좋은 성능을 보이는 결과를 얻었다. 음성인식 테스트 결과에서는 신뢰도 임계치 값을 구하고 이 값을 사용하여 인식률을 계산하였으며, 거절의 오류까지 포함된 음성인식률은 약 76%였다. 이 연구결과는 현재 한국통신에서 시험 서비스 중인 음성인식 증권정보 안내 시스템에 적용될 예정이다.

• 보건의료산업학회지
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• 제14권1호
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• pp.147-159
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• 2020

Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data. Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling. Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days. Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.145-158
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• 2024

Purpose: Although smoking and alcohol consumption are known risk factors for gastric cancer (GC), studies assessing their effects on early-onset GC are limited. In this nationwide, population-based, prospective cohort study, we assessed the effects of smoking and alcohol consumption on early-onset GC in patients aged <50 years. Materials and Methods: We analyzed data of patients aged 20-39 years who underwent cancer and general health screening in the Korean National Health Screening Program between 2009 and 2012. We calculated the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for GC incidence until December 2020. Results: We enrolled 6,793,699 individuals (men:women=4,077,292:2,716,407) in this cohort. The mean duration of follow-up was 9.4 years. During follow-up, 9,893 cases of GC (men:women=6,304:3,589) were reported. Compared with the aHRs (95% CI) of never-smokers, those of former and current-smokers were 1.121 (1.044-1.205) and 1.282 (1.212-1.355), respectively. Compared with the aHRs (95% CI) of non-consumers, those of low-moderate- and high-risk alcohol consumers were 1.095 (1.046-1.146) and 1.212 (1.113-1.321), respectively. GC risk was the highest in current-smokers and high-risk alcohol consumers (1.447 [1.297-1.615]). Interestingly, alcohol consumption and smoking additively increased the GC risk in men but not in women (P_interaction=0.002). Conclusion: Smoking and alcohol consumption are significant risk factors for early-onset GC in young Koreans. Further studies are needed to investigate sex-based impact of alcohol consumption and smoking on GC incidence in young individuals.

• 국제물리치료학회지
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• 제1권2호
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• pp.79-90
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• 2010

Breast cancer is the most frequently diagnosed cancer primarily affecting women and negatively impacting the individuals, families, and the health care system. Despite the well-known benefits of exercise for breast cancer survivors, rate of physical activity declines during adjuvant therapy and may not return to pre-diagnosis levels. In addition, low levels of adherence to exercise have been observed in this cohort. The challenge is to identify strategies that are effective in promoting exercise adherence. Several of the studies use social cognitive theory as a theoretical framework to design exercise interventions that encourage adherence. Within and without this framework, they have implemented interventions within the home and gym-based environments. Strategies used to encourage adherence to exercise programs and which are readily implemented in most situations have included distribution of print materials and pedometers, as well as recommendation from the oncologist. Other strategies that may be less feasible have included provision of trainers, gym memberships, regular phone-calls, and psychologist-lead stress management sessions.

• 한국해양학회지
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• 제25권3호
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• pp.131-134
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• 1990

일정한 기간동 한 해역에서 연속적으로 어류플랑크톤 재료를 수집하여 분석함 으로써, 그 시기에 존재하는 어류플랑크톤의 사망률을 추정할 수 있다. 이때 대상 어 종의 자치어군은 조사 해역내에 모두 존재하며, 다른 곳으로 이동되지 않았음을 전제 로 한다. 그러나 해양환경은 대단히 역동적이 기 때문에 플랑크톤들은 한 해역에만 계 속해서 머물러 있지 못하고, 시간이 지남에 따라 그 분포범위가 넓어진다. 본 연구는 kim and Bang(1990)에서 제시된 해양확산계내 자치어의 사망을 추정해에 대한 내용을 보충 설명하기 위해서 준비되었다.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 2003년도 봄 학술발표논문집 Vol.30 No.1 (A)
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• pp.635-637
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• 2003

본 논문에서는 경기도 안성과 안산 지역에 설치된 유전체역학센터에서 조사 지역에 거주하는 45세 이상 69세 이하의 성인을 대상으로 고혈압, 당뇨, 골다공증, 천식, 비만 등 총국민의료비용에서 큰 부분을 차지하는 4-5개의 중요 만성질환을 주요 분석 분야로 진행중에 있는 한국인 유전체 역학조사사업으로부터 산출되는 임상검사 및 역학정보를 입력.관리하는 시스템에 대해 소개하고 있다. 검진 대상자를 접수하는 접수자 및 정보 관리자는 본 시스템을 통해 검진 대상자의 개인식별 정보, 생활습관 정보 등과 같은 설문 정보와 임상 검사 정보를 입력 후 이에 대한 조회, 관리, 집계 현황 출력, 데이터 백업 등을 수행할 수 있다.

• Korean Circulation Journal
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• 제54권3호
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• pp.140-153
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• 2024

Background and Objectives: Although a single-lead electrocardiogram (ECG) patch may provide advantages for detecting arrhythmias in outpatient settings owing to user convenience, its comparative effectiveness for real-time telemonitoring in inpatient settings remains unclear. We aimed to compare a novel telemonitoring system using a single-lead ECG patch with a conventional telemonitoring system in an inpatient setting. Methods: This was a single-center, prospective cohort study. Patients admitted to the cardiology unit for arrhythmia treatment who required a wireless ECG telemonitoring system were enrolled. A single-lead ECG patch and conventional telemetry were applied simultaneously in hospitalized patients for over 24 hours for real-time telemonitoring. The basic ECG parameters, arrhythmia episodes, and signal loss or noise were compared between the 2 systems. Results: Eighty participants (mean age 62±10 years, 76.3% male) were enrolled. The three most common indications for ECG telemonitoring were atrial fibrillation (66.3%), sick sinus syndrome (12.5%), and atrioventricular block (10.0%). The intra-class correlation coefficients for detecting the number of total beats, atrial and ventricular premature complexes, maximal, average, and minimal heart rates, and pauses were all over 0.9 with p values for reliability <0.001. Compared to a conventional system, a novel system demonstrated significantly lower signal noise (median 0.3% [0.1-1.6%] vs. 2.4% [1.4-3.7%], p<0.001) and fewer episodes of signal loss (median 22 [2-53] vs. 64 [22-112] episodes, p=0.002). Conclusions: The novel telemonitoring system using a single-lead ECG patch offers performance comparable to that of a conventional system while significantly reducing signal loss and noise.

• 보건행정학회지
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• 제27권2호
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.