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Feasibility of a Clinical-Radiomics Model to Predict the Outcomes of Acute Ischemic Stroke

  • Yiran Zhou;Di Wu;Su Yan;Yan Xie;Shun Zhang;Wenzhi Lv;Yuanyuan Qin;Yufei Liu;Chengxia Liu;Jun Lu;Jia Li;Hongquan Zhu;Weiyin Vivian Liu;Huan Liu;Guiling Zhang;Wenzhen Zhu
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.811-820
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    • 2022
  • Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825-0.910) in the training cohort and 0.890 (0.844-0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion: The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

Impact of Collateral Circulation on Futile Endovascular Thrombectomy in Acute Anterior Circulation Ischemic Stroke

  • Yoo Sung Jeon;Hyun Jeong Kim;Hong Gee Roh;Taek-Jun Lee;Jeong Jin Park;Sang Bong Lee;Hyung Jin Lee;Jin Tae Kwak;Ji Sung Lee;Hee Jong Ki
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.31-41
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    • 2024
  • Objective : Collateral circulation is associated with the differential treatment effect of endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to verify the ability of the collateral map to predict futile EVT in patients with acute anterior circulation ischemic stroke. Methods : This secondary analysis of a prospective observational study included data from participants underwent EVT for acute ischemic stroke due to occlusion of the internal carotid artery and/or the middle cerebral artery within 8 hours of symptom onset. Multiple logistic regression analyses were conducted to identify independent predictors of futile recanalization (modified Rankin scale score at 90 days of 4-6 despite of successful reperfusion). Results : In a total of 214 participants, older age (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.56 to 3.67; p<0.001), higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR, 1.12; 95% CI, 1.04 to 1.21; p=0.004), very poor collateral perfusion grade (OR, 35.09; 95% CI, 3.50 to 351.33; p=0.002), longer door-to-puncture time (OR, 1.08; 95% CI, 1.02 to 1.14; p=0.009), and failed reperfusion (OR, 3.73; 95% CI, 1.30 to 10.76; p=0.015) were associated with unfavorable functional outcomes. In 184 participants who achieved successful reperfusion, older age (OR, 2.30; 95% CI, 1.44 to 3.67; p<0.001), higher baseline NIHSS scores (OR, 1.12; 95% CI, 1.03 to 1.22; p=0.006), very poor collateral perfusion grade (OR, 4.96; 95% CI, 1.42 to 17.37; p=0.012), and longer door-to-reperfusion time (OR, 1.09; 95% CI, 1.03 to 1.15; p=0.003) were associated with unfavorable functional outcomes. Conclusion : The assessment of collateral perfusion status using the collateral map can predict futile EVT, which may help select ineligible patients for EVT, thereby potentially reducing the rate of futile EVT.

Simplistic Beam Theory-based Structural Safety Evaluation Method for Block Structure on the A-Carrier (블록 구조물 적치용 지지대의 빔 이론 기반 구조 안전성 평가법)

  • Myung-Su Yi;Joo-Shin Park
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.30 no.4
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    • pp.358-364
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    • 2024
  • Type A carrier structures that support blocks or equipment gradually deform over time with load changes, reducing the area in contact with the block and changing the load pattern from distributed to concentrated during construction work in the shipyard. This phenomenon has the potential to misrepresent actual service loads. In particular, A carriers are often used by small manufacturers, who often do not have specialized engineering capabilities, necessitating the development of a method for easy calculation of carrier safe working load. This study proposes a quick evaluation method for the long-term safe working load of Type A carriers, to predict the plastic deformation and safety issues resulting from changes in load distribution. Based on the results of finite element analysis (beam and shell modeling) of the centralized load, beam-theory was modified to propose a method for determining the distributed load conditions of the A-carrier. In beam modeling, the theoretical value was multiplied by a correction factor of 0.73 for concentrated loads and 0.69 for distributed loads to obtain a safe working load. For shell modeling, a correction factor of 0.75 can be used for concentrated loads and 0.69 for distributed loads. This study can serve as a basis for improving the safety of shipbuilding, enabling quick and effective decisions for determining safe working loads in actual working environments.

A Study on the Dose Constraints for Occupational Exposure: Focusing on Expert Opinions by Field of Ridiation Industry (직무피폭의 선량제약치에 관한 연구: 분야별 전문가 의견 중심으로)

  • Il Park;Chan Hee Park;Kyu Hwan Jung;Chan Ho Park;Yong Geon Kim;Tae Jin Park
    • Journal of Radiation Industry
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    • v.17 no.1
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    • pp.61-67
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    • 2023
  • A Study on the Introduction of Dose Constraints for Occupational Exposures: Focusing on Experts' Opinions by Field of Radiation Industry. The International Commission on Radiological Protection suggests Justification, Optimization, and Dose Limits as the three principles of radiological protection, among which, as a means of protection optimization, ICRP 103 recommends to set dose constraints. In this study, opinions are collected from experts in each category of radiation industries for stakeholder participation to qualify dose constraints. A guidance and questionnaire for analyzing the dose constraints have been developed for their collection, and opinions were collected from radiation protection experts in selected categories. 20 out of 22 experts, consisted with 91%, have assessed the dose constraints setting is necessary, and 2 experts, consisted with 9%, assessed it is unnecessary. The average of dose constraint presented by experts for RI production institutions is to be the highest level of 15.3 mSv, and light-water reactors (14.6 mSv), non-destructive inspection (14.4 mSv), heavy-water reactor and medical institutes (13.9mSv) is to be above the overall average dose constraint. In case of public institutions, the average dose constraint is to be 8.6mSv, and research institutions (8.8mSv), educational institutions (9.6 mSv), waste disposal sites (9.7 mSv), and general industries (10.6 mSv) are resulted to below the overall average dose constraint. As for the means of setting dose constraints, 8 experts out of 22 suggested setting dose constraints for each specific industry or task. And, 5 experts especially suggest setting dose constraints for the specific groups with relatively high exposure, such as workers with above the record levels. As a countermeasure for workers who exceed the dose constraints, 15 experts out of 22 expressed that the cause analyses for them and preparation for a plan of reducing them are necessary.

A Study on Determining the Priority of Introducing Smart Ports in Korea (국내 스마트 항만 도입 우선순위 도출 연구)

  • Ryu, Won-Hyeong;Nam, Hyung-Sik
    • Journal of Korea Port Economic Association
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    • v.40 no.1
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    • pp.31-59
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    • 2024
  • In June 2016, the term "Fourth Industrial Revolution" was first used at the World Economic Forum in Davos, Switzerland, and it gained worldwide attention. Consequently, the importance of smart ports has increased as the shipping industry has been incorporating various Fourth Industrial Revolution technologies. Currently, major countries around the world are working to achieve digital transformation in the maritime and port industry by establishing comprehensive smart ports. However, the smartification of domestic ports in South Korea is currently limited to a few areas such as Busan, Incheon, and Gwangyang, focusing on port automation. In this context, this study performed keyword analysis to identify key components of smart ports and conducted Analytic Hierarchy Process (AHP) analysis among relevant stakeholders to determine the priorities for the Introduction of smart ports in South Korea. The analysis revealed that universities prioritized automation, intelligenceization, informatization and environmentalization in that order. Research institutes prioritized informatization, intelligenceization, automation and environmentalization. Government agencies prioritized informatization, automation, intelligenceization and environmentalization, while private sector enterprises prioritized automation, intelligenceization, informatization, and environmentalization.

Recent Trends of Immunologic Studies of Herbal Medicine on Rheumatoid Arthritis (류마티스 관절염에 대한 한약의 면역학적 연구동향)

  • Choi, Do-young;Lee, Jae-dong;Back, Yong-hyeon;Lee, Song-shil;Yoo, Myung-chul;Han, Chung-soo;Yang, Hyung-in;Park, Sang-do;Ryu, Mi-hyun;Park, Eun-kyung;Park, Dong-seok
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.177-196
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    • 2004
  • Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

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Application of Oceanic Camp Program for the Enhancement of Inquisitiveness and Affection to Ocean: from 2004 to 2012 (해양에 대한 호기심과 친근감 향상을 위한 해양캠프 프로그램의 적용: 2004~2012년)

  • Park, Kyung-Ae;Woo, Hye-Jin;Kim, Kyung-Ryul;Lee, Soo-Kwang;Chung, Jong-Yul;Cho, Byung-Cheol;Kang, Hyun-Joo
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.18 no.3
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    • pp.142-161
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    • 2013
  • In order to enhance scientific interest and a sense of affinity about ocean, the programs of the oceanic camp 'oceanic summer school' were developed and applied to $4^{th}$ and $9^{th}$-grade elementary and middle school students for 9 years from 2004 to 2012. It was composed of oceanic training for snorkeling, a tour to oceanic institutes and museums near the camp academy place, experimental learning in oceanic-related field, field trips for ocean and earth sciences, and lectures on various subjects of ocean. We developed and implemented 9-kinds of inquiry surveys to evaluate changes in cognitive and affective characteristics, and ocean literacy of students participated at the present oceanic summer camp. Based on the statistical analysis, affective characteristics such as interest, inquisitiveness, passion, and so on, were enhanced. Analysis of ocean literacy revealed that cognitive characteristics of the students were increased by 40%. We presented parents' responses on the programs of oceanic summer school. Some students with less initial interest of ocean have positively changed to make up their minds to be a oceanographer in several years later. In light of this, the summer school can be evaluated to be successfully functioned as a long-term support system for potentially young-talented students in the field of ocean science. This study addresses that long-term implementation of the summer oceanic camp may trigger students with potential talent toward in-depth science in the near future even though it could not bring positive effect immediately. This addresses the necessity of policy supports in order that various programs like the scientific camp should be more constructively developed and executed for next-generation manpower in oceanographic fields.

A Survey of Ecological Knowledge and Information for Climate Change Adaptation in Korea - Focused on the Risk Assessment and Adaptation Strategy to Climate Change - (기후변화 적응정책 관련 생태계 지식정보 수요와 활용도 증진 방향 - 생태계 기후변화 리스크 평가 및 적응대책을 중심으로 -)

  • Yeo, Inae;Hong, Seungbum
    • Journal of Environmental Impact Assessment
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    • v.29 no.1
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    • pp.26-36
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    • 2020
  • This study aimed at investigating present research and knowledge-base on climate change adaptation in ecosystem sector and analyzed the current status of basic information on ecosystem that functions as evidence-base of climate change adaptation to deduce the suggestions for the future development for knowledge and information in biodiversity. In this perspective, a questionary survey titled as "the ecological knowledge-base and information needs for climate change adaptation" with the researchers who were engaged with adaptation studies for biodiversity in the ecosystem related-research institutes including national and 17 regional local governments-affiliated agencies in Korea. The results are as follows; current status of utilizing ecological information which supports climate change adaptation strategy, future needs for adaptation knowledge and ecological information, and activation of utilizing ecological information. The majority of respondents (90.7%) replied that the ecological information has high relevance when conducting research on climate change adaptation. However, only half of all respondents (53.2%) agreed with the real viability of current information to the adaptation research. Particularly, urgent priority for researchers was deduced as intensifying knowledge-base and constructing related information on 'ecosystem change from climate change (productivity, community structure, food chain, phenology, range distribution, and number of individuals) with the overall improvement of information contents and its quality. The respondents emphasized with the necessity of conducting field surveys of local ecosystem and constructing ecosystem inventories, advancing monitoring designs for climate change in ecosystem, and case studies for regional ecosystem changes with the guidance or guidelines for monitoring ecosystem change to enhance the quality of adaptation research and produce related information. In terms of activation for ecological information usage, national and local adaptation network should be working based on the integrated ecological platform necessary to support exchanges of knowledge and information and to expand ecosystem types in time and spatial dimension.

Analysis on the Difference in Perception Between Policy Providers and Users on the Factors that Activate the Innovation Cluster: Focusing on the Case of Daedeok Innopolis using AHP (혁신클러스터 활성화 요인에 대한 정책공급자와 수요자의 인식차이 분석: 대덕연구개발특구 사례에 대한 AHP 조사를 중심으로)

  • Park, Hwogeun;Bae, Kwanpy
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.3
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    • pp.105-119
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    • 2021
  • The innovation cluster is formed by cooperation and networking among a number of actors, including companies, universities, research institutes, government and other supporting organizations, but the main subject of innovation in the venture ecosystem, which can be said to be the core of the innovation cluster, is the enterprise. Therefore, enterprises in innovation cluster can be seen as a major user of the innovation cluster policy. In order for the policy to be executed smoothly, policy acceptance is important. However, existing research on policy prioritization tends to be centered on policy providers, so it is necessary to check them from the perspective of policy users. Accordingly, this study conducted discussions from a two-way perspective to establish the correct policy direction through a balanced perspective between a policy provider-centered top-down perspective and a policy user's bottom-up perspective. First, the factors for activating the innovation cluster (three factors in the first level and 14 factors in the second level) were derived through prior research and expert interviews. After that, the importance of the factors for activating the innovation cluster was analyzed using AHP (Analytic Hierarchy Process) for the policy provider group and the user group in the Daedeok Innopolis, a representative case of innovation cluster policy. As a result of analyzing the importance of the innovation cluster activation factors from the perspectives of policy providers and users, some similarities were also seen, but overall differences in mutual perception were found. It was found that the policy provider group focused on innovation creation factors, while the policy user group viewed innovation creation, clusters, and industrial location factors from a more balanced perspective. This study is meaningful in that it deals with both perspectives in a balanced way by expanding the targets from the existing policy provider-centered research to policy users. In addition, practical contributions exist in the aspect of providing basic data so that policies can be carried out based on corporate needs in fostering innovation clusters.

The Reserch on Actual Condition of Crime of Arson Which Occurs in Korea and Its Countermeasures (방화범죄의 실태와 그 대책 - 관심도와 동기의 다양화에 대한 대응 -)

  • Choi, Jong-Tae
    • Korean Security Journal
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    • no.1
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    • pp.371-408
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    • 1997
  • This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

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