Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.
Background: As per guidelines for treating dyslipidemia, the recommended low-density lipoprotein cholesterol (LDL-C) level in extremely high-risk patients, including those with coronary artery diseases is <55 mg/dL. Although this recommendation has been adopted in the guidelines for dyslipidemia in various countries, there is limited evidence of its efficacy in reducing cardiovascular diseases (CVDs), especially among East Asian patients. This study aimed to investigate whether an LDL-C value below 55 mg/dL is associated with decreased risk of CVDs. Methods: Seven clinical trials including 50,970 patients that compared intensive lipid-lowering therapy with less therapy or placebo in patients who had >6 months of follow-up, those with a sample size of ≥150 were selected as the final literature for analysis. Risk ratios (RR) using random effects were represented with 95% confidence intervals (CI) for the reliability of the results. Results: An LDL-C level of <55 mg/dL was related to significantly reduced events of major CVDs (RR: 0.88; 95% CI: 0.80-0.98) and myocardial infarction (RR: 0.81; 95% CI: 0.73-0.90) and a reduced risk of ischemic stroke (RR 0.79; 95% CI 0.69-0.89, mean follow-up=2 years). However, an LDL-C level below 55 mg/dL did not reduce the incidence of CVD in intensive therapy in East Asian patients. Conclusions: A goal LDL-C value below 55 mg/dL was identified to be related to a decreased risk of developing CVD. However, the relation to LDL-C below 55 mg/dL with a decreased risk of CVD was not observed in East Asian patients.
Jun-Young Yang;Ji-Hyeon Park;Seung Joon Choi;Woon Kee Lee
Journal of Gastric Cancer
/
v.24
no.2
/
pp.231-242
/
2024
Purpose: This study aimed to investigate the recurrence patterns in patients who underwent curative surgery for gastric cancer (GC) and analyze their prognostic value for post-recurrence survival (PRS). Materials and Methods: We retrospectively reviewed the medical records of 204 patients who experienced GC recurrence following curative gastrectomy for GC at a single institution between January 2012 and December 2017. Specific recurrence patterns (lymph node, peritoneal, and hematogenous) and their multiplicity were analyzed as prognostic factors of PRS. Results: The median PRS of the 204 patients was 8.3 months (interquartile range [IQR]: 3.2-17.4). For patients with a single recurrence pattern (n=164), the difference in each recurrence pattern did not show a significant prognostic value for PRS (lymph node vs. peritoneal, P=0.343; peritoneal vs. hematogenous, P=0.660; lymph node vs. hematogenous, P=0.822). However, the patients with a single recurrence pattern had significantly longer PRS than those with multiple recurrence patterns (median PRS: 10.2 months [IQR: 3.7-18.7] vs. 3.9 months [IQR: 1.8-10.4]; P=0.037). In the multivariate analysis, multiple recurrence patterns emerged as independent prognostic factors for poor PRS (hazard ratio, 1.553; 95% confidence interval, 1.092-2.208; P=0.014) along with serosal invasion, recurrence within 1 year after gastrectomy, and the absence of post-recurrence chemotherapy. Conclusions: Regardless of the specific recurrence pattern, multiple recurrence patterns emerged as independent prognostic factors for poor PRS compared with a single recurrence pattern.
Tae-Hyung Kim;Sungmin Woo;Sangwon Han;Chong Hyun Suh;Soleen Ghafoor;Hedvig Hricak;Hebert Alberto Vargas
Korean Journal of Radiology
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v.21
no.6
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pp.684-694
/
2020
Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.
Md Shafiqul Islam;Swapnil Roy;Sadia Lena Alfee;Animesh Pal
Nuclear Engineering and Technology
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v.55
no.12
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pp.4617-4627
/
2023
Public perception of benefit over risk is the de facto factor in planning, construction, operation, halting, or phase-out of a nuclear power plant in any country. Even if there are multiple pathways of perceiving risk/benefit among different stakeholders, the perception of nuclear and non-nuclear groups needs to be individually tracked to help understand sectoral influence. Related studies were basically performed between the STEM (Science, Technology, Engineering, and Mathematics) and non-STEM groups. However, there are no such studies between the nuclear and non-nuclear groups. This study investigated the risk-benefit perceptions between the nuclear group (N = 102) and the non-nuclear group (N = 467) using survey data to measure their stake and identify the underlying factors by validating the hypotheses, through descriptive analysis, and structural equation modeling (SEM). Results showed that risk perception is significantly high in the non-nuclear group (as the P-value is > 0.001 to <0.01) while the benefit perception is slightly low in the nuclear group (as the P-value is > 0.01 to <0.05). The non-nuclear group was significantly influenced by risk perception due to a lack of involvement in nuclear activities. Notably, the nuclear group is less interactive in disseminating nuclear energy benefits to the non-nuclear group. Surprisingly, misperceptions and lack of confidence about the benefits of nuclear energy also exist in the nuclear group. The study emphasizes debunking nuclear myths in the nuclear and non-nuclear groups through meaningful interactions and demands effective public awareness-building programs by competent authorities for the growth of the nuclear industry.
PURPOSE. The aim of this stuldy was to compare the clinical marginal fit of CAD-CAM inlays obtained from intraoral digital impression or addition silicone impression techniques. MATERIALS AND METHODS. The study included 31 inlays for prosthodontics purposes of 31 patients: 15 based on intraoral digital impressions (DI group); and 16 based on a conventional impression technique (CI group). Inlays included occlusal and a non-occlusal surface. Inlays were milled in ceramic. The inlay-teeth interface was replicated by placing each inlay in its corresponding uncemented clinical preparation and taking interface impressions with silicone material from occlusal and free surfaces. Interface analysis was made using white light confocal microscopy (WLCM) (scanning area: 694 × 510 ㎛2) from the impression samples. The gap size and the inlay overextension were measured from the microscopy topographies. For analytical purposes (i.e., 95-%-confidence intervals calculations and P-value calculations), the procedure REGRESS in SUDAAN was used to account for clustering (i.e., multiple measurements). For p-value calculation, the log transformation of the dependent variables was used to normalize the distributions. RESULTS. Marginal fit values for occlusal and free surfaces were affected by the type of impression. There were no differences between surfaces (occlusal vs. free). Gap obtained for DI group was 164 ± 84 ㎛ and that for CI group was 209 ± 104 ㎛, and there were statistical differences between them (p = .041). Mean overextension values were 60 ± 59 ㎛ for DI group and 67 ± 73 ㎛ for CI group, and there were no differences between then (p = .553). CONCLUSION. Digital impression achieved inlays with higher clinical marginal fit and performed better than the conventional silicone materials.
Objective: To evaluate the usefulness of the ventricular volume percentage quantified using three-dimensional (3D) brain computed tomography (CT) data for interpreting serial changes in hydrocephalus. Materials and Methods: Intracranial and ventricular volumes were quantified using the semiautomatic 3D threshold-based segmentation approach for 113 brain CT examinations (age at brain CT examination ≤ 18 years) in 38 patients with hydrocephalus. Changes in ventricular volume percentage were calculated using 75 serial brain CT pairs (time interval 173.6 ± 234.9 days) and compared with the conventional assessment of changes in hydrocephalus (increased, unchanged, or decreased). A cut-off value for the diagnosis of no change in hydrocephalus was calculated using receiver operating characteristic curve analysis. The reproducibility of the volumetric measurements was assessed using the intraclass correlation coefficient on a subset of 20 brain CT examinations. Results: Mean intracranial volume, ventricular volume, and ventricular volume percentage were 1284.6 ± 297.1 cm3, 249.0 ± 150.8 cm3, and 19.9 ± 12.8%, respectively. The volumetric measurements were highly reproducible (intraclass correlation coefficient = 1.0). Serial changes (0.8 ± 0.6%) in ventricular volume percentage in the unchanged group (n = 28) were significantly smaller than those in the increased and decreased groups (6.8 ± 4.3% and 5.6 ± 4.2%, respectively; p = 0.001 and p < 0.001, respectively; n = 11 and n = 36, respectively). The ventricular volume percentage was an excellent parameter for evaluating the degree of hydrocephalus (area under the receiver operating characteristic curve = 0.975; 95% confidence interval, 0.948-1.000; p < 0.001). With a cut-off value of 2.4%, the diagnosis of unchanged hydrocephalus could be made with 83.0% sensitivity and 100.0% specificity. Conclusion: The ventricular volume percentage quantified using 3D brain CT data is useful for interpreting serial changes in hydrocephalus.
Spoken dialog tasks incur many errors including speech recognition errors, understanding errors, and even dialog management errors. These errors create a big gap between the user's intention and the system's understanding, which eventually results in a misinterpretation. To fill in the gap, people in human-to-human dialogs try to clarify the major causes of the misunderstanding to selectively correct them. This paper presents a method of clarification techniques to human-to-machine spoken dialog systems. We viewed the clarification dialog as a two-step problem-Belief confirmation and Clarification strategy establishment. To confirm the belief, we organized the clarification process into three systematic phases. In the belief confirmation phase, we consider the overall dialog system's processes including speech recognition, language understanding and semantic slot and value pairs for clarification dialog management. A clarification expert is developed for establishing clarification dialog strategy. In addition, we proposed a new design of plugging clarification dialog module in a given expert based dialog system. The experiment results demonstrate that the error verifiers effectively catch the word and utterance-level semantic errors and the clarification experts actually increase the dialog success rate and the dialog efficiency.
Proceedings of the Korean Geotechical Society Conference
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2003.03a
/
pp.701-708
/
2003
Recently, piezocone penetration test is frequently conformed in order to estimate the characteristics of soft ground with standard penetration test, generally used in the past. The soil characteristics, such as cone penetration resistance, friction resistence and excessive pore water pressure, can be evaluated continuously through the piezocone penetration test. In Incheon International Airport 2nd phase site preparation, standard penetration test and piezocone penetration test were used in order to increase the confidence for determination of soft ground depth. And the compressible layer was determined by the comparison between the preconsolidation pressure and the designed increase pressure. As the results, the relation between standard penetration test and piezocone penetration test shows q$_{c}$=(1.09~l.63)N at the soft ground, determined by 5/30 N value. And q$_{c}$=(1.21~l.98)N was shown at the point of compressible layer, evaluated by the preconsolidation pressure. These results were applied to determination for the depth of soft ground and to design the improvement for the soft clay.lay.
Social capital is regarded as the alternative plan and the index of healthy society for constructing social tie through solving social problems on the basis of causal relationship between sports, social capital, and healthy society, in order to accomplish sound society. The role of sports to construct healthy society and social capital is emphasized here. To accomplish healthy society amid various social deviations nowadays, the value of sports should be newly recognized and highlighted among the general public. To attain this purpose, organizing sports club as a voluntary association and facilitating its activities, securing confidence for the sports organization and policies, developing and popularizing sports program to form community and civil society should be embodied. The research field of sports sociology should inquire into the most suitable condition in constructing healthy society and social capital, and should make efforts to find out realistic solutions to satisfy this that purpose. To examine this aspect, cooperative research on micro scale and macro scale of trust as social capital interdisciplinary research into the field of psychology and sociology, research on the methodology of the social network, and critical research are required.
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