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Accuracy of posteroanterior cephalogram landmarks and measurements identification using a cascaded convolutional neural network algorithm: A multicenter study

  • Sung-Hoon Han;Jisup Lim;Jun-Sik Kim;Jin-Hyoung Cho;Mihee Hong;Minji Kim;Su-Jung Kim;Yoon-Ji Kim;Young Ho Kim;Sung-Hoon Lim;Sang Jin Sung;Kyung-Hwa Kang;Seung-Hak Baek;Sung-Kwon Choi;Namkug Kim
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.48-58
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    • 2024
  • Objective: To quantify the effects of midline-related landmark identification on midline deviation measurements in posteroanterior (PA) cephalograms using a cascaded convolutional neural network (CNN). Methods: A total of 2,903 PA cephalogram images obtained from 9 university hospitals were divided into training, internal validation, and test sets (n = 2,150, 376, and 377). As the gold standard, 2 orthodontic professors marked the bilateral landmarks, including the frontozygomatic suture point and latero-orbitale (LO), and the midline landmarks, including the crista galli, anterior nasal spine (ANS), upper dental midpoint (UDM), lower dental midpoint (LDM), and menton (Me). For the test, Examiner-1 and Examiner-2 (3-year and 1-year orthodontic residents) and the Cascaded-CNN models marked the landmarks. After point-to-point errors of landmark identification, the successful detection rate (SDR) and distance and direction of the midline landmark deviation from the midsagittal line (ANS-mid, UDM-mid, LDM-mid, and Me-mid) were measured, and statistical analysis was performed. Results: The cascaded-CNN algorithm showed a clinically acceptable level of point-to-point error (1.26 mm vs. 1.57 mm in Examiner-1 and 1.75 mm in Examiner-2). The average SDR within the 2 mm range was 83.2%, with high accuracy at the LO (right, 96.9%; left, 97.1%), and UDM (96.9%). The absolute measurement errors were less than 1 mm for ANS-mid, UDM-mid, and LDM-mid compared with the gold standard. Conclusions: The cascaded-CNN model may be considered an effective tool for the auto-identification of midline landmarks and quantification of midline deviation in PA cephalograms of adult patients, regardless of variations in the image acquisition method.

Selective Predatory Effect of River Puffer on WSSV-infected Shrimp in Culture of Shrimp with River Puffer under Laboratory Scale (황복과 새우의 복합사육시 황복에 의한 흰반점바이러스(WSSV) 감염 새우의 선택적 포식 효과)

  • Jang, In-Kwon;Cho, Yeong-Rok;Lee, Jae-Yong;Seo, Hyung-Chul;Kim, Bong-Lae;Kim, Jong-Sheek;Kang, Hee-Woong
    • Journal of Aquaculture
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    • v.20 no.4
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    • pp.270-277
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    • 2007
  • White spot syndrome virus (WSSV) which is the most serious threat to cultured shrimp around the world has given enormous economic damages to shrimp culture industry every year since it was found from the shrimp ponds in the west coast of the South Korea in 1993. WSSV has strong infectivity as well as virulence and it can be rapidly transmitted among shrimps in ponds by cannibalism of infected ones. Polyculture of shrimps with carnivorous fish has been applied in commercial shrimp farms to suppress or delay the viral outbreak because the fish may selectively eat the moribund shrimps infected by virus. To determine the selective predatory effect of a carnivorous fish, river puffer Takifugu obscurus on white shrimp Litopenaeus vannamei, polyculture trials in laboratory scale of WSSV-infected and non-infected shrimps with river puffer were conducted in concrete round tanks of $28.26\;m^2$ in surface area as followings: 1) juvenile shrimps (B. W. 0.62 g) with 5 months old puffer (B. W. 11.60 g) cultured for 8 days, and 2) sub-adult shrimps (B. W. 6.84 g) with 16 months old puffer (B. W. 85.82 g) cultured for 5 days in order to know the effects according to size difference of cultured animals. In polyculture of juvenile shrimp with 5 months old puffer, survival rates of infected and non-infected shrimps were 46.0% and 89.1% respectively and in that of sub-adult shrimp with 16 months old puffer those were4% and 48% respectively. The results showed that puffer tends to selectively prey on virus infected shrimps among infected and non-infected ones in a limited space with although there is difference in predatory rate with age and density of animals. Regardless of different densities and ages of animals as well as health condition of shrimps, however, there were low differences in daily biomass of shrimp consumed per kg body weight of puffer. This finding suggests that puffer preys on healthy shrimps when moribund shrimps were not sufficient. Therefore, farmers should consider the total biomass of puffer as well as density and stocking time when they stock puffer into shrimp ponds for polyculture.

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

  • Yoon, Hyung-Suk;Yang, Jae Jeong;Song, Minkyo;Lee, Hwi-Won;Lee, Yunhee;Lee, Kyoung-Mu;Lee, Sang-Ah;Lee, Jong-koo;Kang, Daehee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4705-4710
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    • 2015
  • Background: Though a large proportion of cancer survivors are assumed to be commonly affected by sleep disturbance, few studies have focused on short sleep problems and its correlates among Korean cancer survivors. The purpose of this study was to evaluate the prevalence of short sleep in adult cancer survivors from a nationwide population-based sample and to identify risk factors for short sleep duration. Materials and Methods: Based on the fourth and fifth Korea National Health and Nutrition Examination Surveys (2007-2012), 1,045 cancer survivors and 33,929 non-cancer controls were analyzed. The prevalence of short sleep was compared between these two groups. Associations between short sleep and its correlates were evaluated using multiple logistic regression among cancer survivors: odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated after adjusting for sociodemographic factors, lifestyle factors, psychological conditions, and cancer-related factors. Results: About 8.1% of cancer survivors slept for less than 5 hours per day (6.2% men and 9.3% women), whereas this was the case for only 3.7% of non-cancer controls. Cancer survivors who had the lowest household income level showed a significantly higher likelihood for short sleep (adjusted OR 2.82, 95%CI 1.06-7.54). Self-reported poor health and depressive symptoms were found to be associated with significantly increased likelihood for short sleep in cancer survivors (adjusted OR 3.60, 95%CI 1.40-9.26 and adjusted OR 2.00, 95%CI 1.17-3.42). Gastric cancer survivors had a 3.97-fold increased risk for short sleep (95%CI 1.60-9.90). Conclusions: The prevalence of short sleep occurs at a high rate among the Korean cancer survivors, which may indicate a poorer quality of life and a higher risk of future complications in survivorship. Targeted interventions that can assist cancer survivors to cope with sleep disturbances as well as ensuring psychological stability are warranted to reduce the latent disease burden.

Evaluation of Visual Perception in Smoking Cessation Websites and Construction of Antismoking Website

  • Lee, Yoon-Hyeon;Shin, Soon-Ho
    • Korean Journal of Health Education and Promotion
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    • v.20 no.4
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    • pp.95-109
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    • 2003
  • Tobacco use is the most readily preventable cause of premature death; it is a worldwide problem, with a significant impact on heath and well-being. In order to design an effective tobacco education program, it is important to understand smoking patterns and the underlying factors associated with smoking in different generations such as adults or young people. Despite a general decline in the prevalence of regular smoking among adults, recent surveys commissioned by the Ministry Heath & Welfare for the Republic of Korea have shown no evidence of any decline in smoking rates among young women and adolescents. The Republic of Korea has the highest adult male smoking percentage (65.1%) in the world and smoking in adolescents is still an increasing trend. Smoking in adolescents and young women is especially more dangerous, thus health education of anti-smoking directed at these groups is an important area that will benefit from using internet content that they can easily access. The purpose of this study is the evaluation of visual perception and effectiveness analysis in smoking cessation websites in promoting smoking cessation in adolescents and young women through Internet content. As a result of this project, at first we evaluated the Internet content of cyber smoking cessation programs by the evaluation criteria of web design interface. The Internet site of http://nosmokeguide.or.kr received the most superior evaluation in the domestic Internet content for smoking cessation and the Internet site of the National Center for Tobacco-Free Kids received the most superior evaluation in the foreign Internet content for smoking cessation. This evaluation was surveyed by an expert in Internet content and user. Secondly, we developed the Internet content for cyber smoking cessation program, namely, "Dr. Smoking" that contained several menus and a database regarding anti-smoking designed in accordance with the results of this evaluation. The domain address of Dr. Smoking is http://www.dmosmoking.com and our webpage has assorted kinds of news, information, self-diagnosis, prescription, consulting, a no-smoking mall etc. In conclusion, this project is designed to develop Internet content for the most effective smoking cessation program and to contribute to eliminating smoking from our society. We also will try to develop and upgrade this web-site in order to help a smoker who want to quit smoking and diminish the physical and socioeconomic harm from smoking.m smoking.

Experiences of Institutions Utilization among Homeless Young Men with Mental Health Problems: Inevitable Repeated Usages between Two Facility Systems behind the Deinstitutionalization (정신장애를 가진 노숙 청년의 시설 이용 경험 : 탈시설화의 이면(裏面), 생존을 위한 두 체계의 반복 이용을 중심으로)

  • Kim, Soyoung
    • Korean Journal of Social Welfare Studies
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    • v.48 no.3
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    • pp.83-116
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    • 2017
  • The purpose of this study is to raise the issue of the existing deinstitutionalization debate, considering only the shipment process to these two spaces, and still leaving the inter-facility circulation of vulnerable mental handicapped who are still hanging around the facility. In particular, we sought to supplement the discussion of deinstitutionalization by illuminating the problems of those who have to rely on facilities, as well as the mental health facility system and the homeless facility system. In the case of homeless persons with mental disabilities who repeatedly use the mental health facility system and the homeless facility system, they confirmed the pattern of using the facilities by constantly changing the place to manage the overlapping risk of mental illness and homelessness. Also it is triggered by the voluntary nature of the parties with no resources and resources. This situation appeared to be inevitable in the absence of resources and supportive systems that would actually enable a life in the community. Nevertheless, I asserted that the life of the mentally handicapped, which is circling the facility, is extremely unstable and is not desirable from a welfare point of view.

25-Hydroxyvitamin D level is associated with mortality in patients with critical COVID-19: a prospective observational study in Mexico City

  • Parra-Ortega, Israel;Alcara-Ramirez, Diana Guadalupe;Ronzon-Ronzon, Alma Angelica;Elias-Garcia, Fermin;Mata-Chapol, Jose Agustin;Cervantes-Cote, Alejandro Daniel;Lopez-Martinez, Briceida;Villasis-Keever, Miguel Angel;Zurita-Cruz, Jessie Nallely
    • Nutrition Research and Practice
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    • v.15 no.sup1
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    • pp.32-40
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    • 2021
  • BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.

Socio-demographic Factors Related to Older Adults' Lifelong Education Participation Patterns (인구사회학적 특성에 따른 노인의 평생교육 참여양상 분석: 2017년 노인실태조사 자료를 활용하여)

  • Kim, Young Sek
    • 한국노년학
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    • v.39 no.4
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    • pp.959-976
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    • 2019
  • The purpose of this study was to understand socio-demographic factors related to older adults' participation patterns in lifelong education. For the purpose, this study used the raw data of 2017 Survey of the Living Conditions of the Elderly (SLCE) conducted by The Korea Institute for Health and Social Affairs. From the data of 10,073 older adults, their lifelong education participation, participating program types, participating organizations, and participating frequency were analyzed by their sex, age, educational level, household income, the longest job status, and health status. This study found that female, age of 70-74 and 75-79, educational levels of high school and higher, the longest job status of regular employees and unpaid family workers, and decent health status of older adults more participated in lifelong education. According to lifelong education program types, significant differences were found between education groups of middle school/lower and groups of high school/higher and between 1, 2 quintile income groups and 3, 4, 5 quintile income groups. In relation to the participating organizations, groups of 70 years and older, middle school and higher education level, under 3 quintile income, and poor health tended to participate in lifelong education at the elderly welfare center, senior citizens, and elderly classrooms. In terms of participation frequency, high school and college/higher than 0 year of school education, and regular workers than unpaid family workers were more frequently participated in lifelong education. This study showed the inequality in lifelong education participation according to older adults' demographic characteristics; finally, this study suggested necessary policies and academic discussions for future older adults' lifelong education.

An Effect of Aerobic Exercise on Blood Pressure, Pulse Rate Body Fat, Body Weight, Symptoms of Stress Response -With special reference to the adult woman- (에어로빅 훈련이 체지방, 체중, 혈압, 심박수 및 스트레스 반응에 미치는 영향)

  • Kim, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.6 no.1
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    • pp.98-113
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    • 1995
  • The purpose of this study were two fold : first, to determine the effect of aerobic exercise on BP, pulse rate, body fat, body weight, symptoms of sterss response: and secondly, to apply the aerobic exercise on nursing practice in the healthy or ill subjects. In an attempt to investigate the physiological and psychological effect of exercise, a quasi -experiment, non-equivalent control group pre-test & post-test design was planned. Experiments were carried out from July 4, through August 30, 1994 with 37 subjects conveniently sampled from K & Y sports center located in Taejon. The 37 research subjects were assigned to experimental(16 subjects) and control(21 subjects) groups. Aerobic exercise was carried out for experimental group from three times to five times a week for 6 weeks in aerobic center. Data were analyzed with t-test, mean, per centage of change using SAS program. Results were obtained as follows: 1) Systolic blood pressure (M=123.75mmHg, % of change=1.12%) and diastolic blood pressure (M=74.38mmHg, % of change=5.79%) was increased on that of experimental group after 6 weeks experiment. But there was no significant difference between experimental group and control group. 2) Body weight was decreased on that of experimental group(M=56.54Kg, % of change=-1.60%) and that of control group(M=52.05, % of change=-0.99%) after 6 weeks. But there was no significant difference between experimental group and control group. 3) Body fat was decreased on that of experimental group(M=30.53%, % of change=-3.60%) and that of control group (M=28.75%, % of change=-3.52%) after 6 weeks. There was no significant difference between experimental group and control group. 4) Pulse rate was decreased on that of experimental group(M=69.19회/min, % of change -8.43%) and that of control group(M=76.0회/min, % change -0.07%) after 6weeks. There was significant difference(t=-2.621, P<0.05) between experimental group and control group. 5) Symptoms of stress response were decreased on that of experimental group(M=0.97) and that of control group(M=1.15) after 6 weeks. There was no significant difference between experimental group and control group. Therefore, adherence to aerobic exercise for 6 week seem to be affected mainly pulse rate of subjects. A futher study is necessary to determine the difference in the effect of variety exercise, programs, to study over 6 weeks, to produce professional educational program for exercise speciality nurses.

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Feasibility of Bilateral Crossing C7 Intralaminar Screws : A Cadaveric Study

  • Baek, Tae-Hyun;Kim, Ilsup;Hong, Jae-Taek;Kim, Daniel H.;Shin, Dongsuk;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.5-10
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    • 2014
  • Objective : When the pedicle screw insertion technique is failed or not applicable, C7 intralaminar screw insertion method has been used as an alternative or salvage fixation method recently. However, profound understanding of anatomy is required for safe application of the bilaterally crossing laminar screw at C7 in clinic. In this cadaveric study, we evaluated the anatomic feasibility of the bilateral crossing intralaminar screw insertion and especially focused on determination of proper screw entry point. Methods : The C7 vertebrae from 18 adult specimens were studied. Morphometric measurements of the mid-laminar height, the minimum laminar thickness, the maximal screw length, and spino-laminar angle were performed and cross-sectioned vertically at the screw entry point (spino-laminar junction). The sectioned surface was equally divided into 3 parts and maximal thickness and surface area of the parts were measured. All measurements were obtained bilaterally. Results : The mean mid-laminar height was 13.7 mm, mean minimal laminar thickness was 6.6 mm, mean maximal screw length was 24.6 mm, and mean spinolaminar angle was $50.8{\pm}4.7^{\circ}$. Based on the measured laminar thickness, the feasibility of 3.5 mm diameter intralaminar screw application was 83.3% (30 sides laminae out of total 36) when assuming a tolerance of 1 mm on each side. Cross-sectional measurement results showed that the mean maximal thickness of upper, middle, and lower thirds was 5.0 mm, 7.5 mm, and 7.3 mm, respectively, and mean surface area for each part was $21.2mm^2$, $46.8mm^2$, and $34.7mm^2$, respectively. Fourteen (38.9%) sides of laminae would be feasible for 3.5 mm intralaminar screw insertion when upper thirds of C7 spino-laminar junction is the screw entry point. In case of middle and lower thirds of C7 spino-laminar junction, 32 (88.9%) and 28 (77.8%) sides of laminae were feasible for 3.5 mm screw insertion, respectively. Conclusion : The vertical cross-sectioned area of middle thirds at C7 spinolaminar junction was the largest area and 3.5 mm screw can be accommodated with 77.8 % of feasibility when lower thirds were the screw entry point. Thus, selection of middle and lower thirds for each side of screw entry point in spino-laminar junction would be the safest way to place bilateral crossing laminar screw within the entire lamina. This anatomic study result will help surgeons to place the screw safely and accurately.

The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

  • Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.169-178
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    • 2017
  • Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.