• Title/Summary/Keyword: clinical guidance

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Knowledge-guided artificial intelligence technologies for decoding complex multiomics interactions in cells

  • Lee, Dohoon;Kim, Sun
    • Clinical and Experimental Pediatrics
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    • v.65 no.5
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    • pp.239-249
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    • 2022
  • Cells survive and proliferate through complex interactions among diverse molecules across multiomics layers. Conventional experimental approaches for identifying these interactions have built a firm foundation for molecular biology, but their scalability is gradually becoming inadequate compared to the rapid accumulation of multiomics data measured by high-throughput technologies. Therefore, the need for data-driven computational modeling of interactions within cells has been highlighted in recent years. The complexity of multiomics interactions is primarily due to their nonlinearity. That is, their accurate modeling requires intricate conditional dependencies, synergies, or antagonisms between considered genes or proteins, which retard experimental validations. Artificial intelligence (AI) technologies, including deep learning models, are optimal choices for handling complex nonlinear relationships between features that are scalable and produce large amounts of data. Thus, they have great potential for modeling multiomics interactions. Although there exist many AI-driven models for computational biology applications, relatively few explicitly incorporate the prior knowledge within model architectures or training procedures. Such guidance of models by domain knowledge will greatly reduce the amount of data needed to train models and constrain their vast expressive powers to focus on the biologically relevant space. Therefore, it can enhance a model's interpretability, reduce spurious interactions, and prove its validity and utility. Thus, to facilitate further development of knowledge-guided AI technologies for the modeling of multiomics interactions, here we review representative bioinformatics applications of deep learning models for multiomics interactions developed to date by categorizing them by guidance mode.

A Study on the Relationship between Perceived Family Support and Satisfaction of Clinical Practice by Nursing Students (간호학생이 지각한 가족지지와 임상실습만족도와의 관계)

  • Gu, Hye-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.2
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    • pp.205-215
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    • 2008
  • Purpose: This study was to identify the relationship between the degree of family support and the degree of satisfaction in clinical practice by nursing students. Method: This study was designed to measure the level of satisfaction according to the content, guidance, circumstance, hours, and the evaluation of clinical practice. Four hundred sixty-five nursing students from 4 nursing colleges, and 1 baccalaureate program in G area were randomly sampled. An instrument consisting of 64 questions, developed by the researcher and a nursing professor, was used to gather data from March 10 through 31, 2008. The data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson Correlation, using the SPSS 14.0 program. Result: The results were summarized as follows : Family support of nursing students showed a significant difference by religion (t=2.104, p=0.036) and satisfaction of major (F=8.010, p<0.001). The satisfaction degree of clinical practice by nursing students showed a significant difference by university or college (t=2.636, p=0.012), residence type (t=2.098, p=0.036), and satisfaction of major (F=5.779, p=0.003). The relationship between generally perceived family support correlated with the degree of satisfaction in clinical practice of nursing students (r=.199, p<0.001). Conclusion: It was found that a higher degree of satisfaction in clinical practice depends on a higher degree of family support. Therefore, nursing faculty should plan interventions to inspire satisfaction level of clinical practice by family support.

Proposals on Basic Data Based on Comparison of Changes in Clinical Laboratory Technologists' National Examination and Job Definition: Focused on Korea, Japan, and Taiwan (임상병리사국가시험 및 직무의 변천 비교를 중심으로 한 기초자료 제안: 한국, 일본, 대만을 중심으로)

  • Bon-Kyeong KOO;Myung Soo KIM;Yoon Sik KIM;Jun Ho LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.2
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    • pp.71-81
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    • 2023
  • This study examined the transition process of clinical laboratory technologists' national examination and job definition in Korea and compared the differences in the national examination between Korea and neighboring countries, such as Japan and Taiwan. In Korea, the number of questions made for it was 200 (1965), 200 (1977), 300 (1982), 250 (1992), 330 (2006), and 280 (2015). The practice of clinical physiology is important for real-time monitoring, given the characteristics of physiological testing. On the other hand, there are conflicts between other occupations in the working area. Clinical molecular biology needs to be established as a new major subject considering the diagnostic importance of molecular biological tests and the speed of science and technology development. Clinical laboratory operations provide policy and guidance recommendations to technologist staff. The proposed clinical laboratory technologists' national examination comprises major subjects: clinical biochemistry, clinical hematology, clinical transfusionology, clinical immunology, clinical microbiology, clinical molecular biology, clinical histology, clinical cytology, clinical physiology, and clinical laboratory operations. In addition, this study proposes the job definition of clinical laboratory technologists, revising various chemical or physiological testing to biomedical or physiological testing required for medical practice.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

  • Kim, Hyeong-Suk;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.156-158
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    • 2012
  • Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Endoscopic Balloon Dilatation of Nasopharyngeal Stenosis in a Dog

  • Hwang, Ji-Hye;Kim, Jae-Hoon;Lee, Young-Won;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.33 no.6
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    • pp.372-375
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    • 2016
  • A four-year old, intact male, mixed-breed dog had a history of chronic snoring sound and dyspnea. Based on the results of computed tomography, the patient was diagnosed as nasopharyngeal stenosis. Balloon dilatation in the area of stenosis was performed using a balloon dilator inserted retrograde fashion through the working channel of an endoscope. Clinical signs were relieved but reappeared after 3 weeks. Thirty-four days following the first balloon dilatation treatment, a second procedure was performed; the balloon catheter was inserted in antegrade fashion through the left nostril and was filled with contrast agent under fluoroscopic guidance. Because of the relapse of clinical signs after 6 months, the patient received additional balloon dilatation procedure by the antegrade approach. At the one-year follow-up, the owner said that the clinical signs of nasopharyngeal stenosis had been completely resolved. Balloon dilatation could be a minimally invasive and effective treatment for nasopharyngeal stenosis, although the repetition of the procedure may be required.

Review of Traditional Chinese Medicine Clinical Studies on Tuina Treatment of Children's Autism Spectrum Disorder (소아 자폐스펙트럼 장애의 추나 치료에 대한 중의학 임상 연구 고찰)

  • Park, Jem Ma
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.28-42
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    • 2021
  • Objectives The purpose of this study is to investigate the effect of Tuina treatment for children with Autism Spectrum Disorder (ASD), and to propose guidance to future studies or application in clinical setting. Methods The articles published from year 2000 to May 2021 by China National Knowledge Infrastructure (CNKI) were searched by setting up field as '中醫學', '中藥', '中西醫結合' and by setting up keyword as '小儿自閉症', '儿童自閉症', '自閉症譜系障碍', 'Autism', 'Autism spectrum disorder' that corresponds to participant and '推拿', '導引', '按摩', 'Tuina', 'massage'. Results Nine selected articles were analyzed and summarized by authors and year published, characteristics, diagnostic criteria, treatment methods and contents, treatment duration, evaluation criteria and results of the study. The articles were also reviewed by reported side effects, and evaluated the quality of the study according to Cochrane Handbook's Risk of Bias 2 (RoB 2) assessment of the Randomized Control Trial (RCT) articles. All studies used Tuina treatment to achieve effective results for pediatric autism spectrum disorder. Conclusion Pediatric Tuina treatment (TM) is a non-invasive treatment that does not stimulate patients with unstable ASD but increase patient adherence, and can be safely and simply operated. Therefore, pediatric Tuina treatment is worth utilizing as a clinical basis for further development of ASD treatment.

A Review of Clinical Studies of Chinese Medicine Treatment for Postherpetic Neuralgia - Research using CNKI Database (대상포진 후 신경통의 중의치료 최신 연구 동향 - CNKI 검색을 중심으로)

  • Rho, Yeun Wha;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.2
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    • pp.41-47
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    • 2022
  • Postherpetic neuralgia(PHN) is one of the most common intractable chronic pain syndromes. This review was conducted to investigates the trends in recent clinical studies of PHN in China and to find out the efficacy of Chinese medicine treatment for PHN. Based on CNKI databases, nineteen randomized controlled trials(RCTs) were analyzed. The search focused on the authors, publication year, sample size, age, duration of illness, treatment period, lesion sites, methods, outcome measures, and results of the selected articles. Four studies used herbal medicine. The most frequently used herbs were Angelicae Gigantis Radix(當歸) and Corydalis Tube(玄胡索). Eighteen studies used acupuncture treatment. The most frequently used acupoints were ST36, LR3, LI4. Three studies used moxibustion and 5 studies used cupping treatment. In all nineteen studies, the efficacy of Chinese medicine treatments was confirmed. More varied and scientifically designed clinical studies are required to develop treatments for PHN. The results of current study could be used as guidance for further studies of treatment on PHN.

The Impact of Drug Interactions with Tyrosine Kinase Inhibitors on Adverse Event Development based on the changes of drug concentration level: Meta-analysis (Tyrosine Kinase 억제제와의 약물 상호작용이 약물 혈중농도 변화에 따라 부작용 발생에 미치는 영향: 메타분석 연구)

  • JinAh Hwang;Heeyoung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.1
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    • pp.71-78
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    • 2024
  • Background: Oral cancer drugs, particularly tyrosine kinase inhibitors (TKIs), are increasingly popular due to their convenience. However, they pose challenges like drug interactions, especially with medications like azole antifungals. While the FDA provides some guidance, more detailed information is needed to manage these interactions effectively. A meta-analysis was conducted to understand the impact of interactions between TKIs and azole antifungals on adverse events during clinical studies. Methods: A meta-analysis followed PRISMA guidelines. Data from PubMed, EMBASE, and references were searched until November 30, 2021. Inclusion criteria encompassed studies on TKI-antifungal interactions in English. Study selection and quality assessment were conducted by two independent investigators. Results: Out of 158 articles, 11 were selected for analysis. Combination therapy showed a slight increase in adverse events but was not statistically significant (OR 1.02, 95% CI 0.49-2.13, p=0.95). AUC and Cmax fold changes did not significantly impact adverse event development. Both itraconazole and ketoconazole showed no significant difference in adverse event development compared to TKI alone. Conclusions: Study finds TKI-DDI not significantly linked to AE increase; azole antifungal types not related to AE. Future DDI research crucial for drug development.

Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy

  • Sun Gyo Lim;Chan Gyoo Kim
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.571-580
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    • 2024
  • Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.

Comparison of Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance During Transcatheter Aortic Valve Replacement

  • Sang-Hyup Lee;Seunguk Oh;Young-Guk Ko;Yong-Joon Lee;Seung-Jun Lee;Sung-Jin Hong;Chul-Min Ahn;Jung-Sun Kim;Byeong-Keuk Kim;Kyu-Yong Ko;Iksung Cho;Chi Young Shim;Geu-Ru Hong;Donghoon Choi;Myeong-Ki Hong
    • Korean Circulation Journal
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    • v.54 no.2
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    • pp.63-75
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    • 2024
  • Background and Objectives: Evidence regarding the efficacy and safety of intracardiac echocardiography (ICE) for guidance during transcatheter aortic valve replacement (TAVR) is limited. This study aimed to compare the clinical efficacy and safety of ICE versus transesophageal echocardiography (TEE) for guiding TAVR. Methods: This prospective cohort study included patients who underwent TAVR from August 18, 2015, to June 31, 2021. Eligible patients were stratified by echocardiographic modality (ICE or TEE) and anesthesia mode (monitored anesthesia care [MAC] or general anesthesia [GA]). Primary outcome was the 1-year composite of all-cause mortality, rehospitalization for cardiovascular cause, or stroke, according to the Valve Academic Research Consortium-3 (VARC-3) definition. Propensity score matching was performed, and study outcomes were analyzed for the matched cohorts. Results: Of the 359 eligible patients, 120 patients were matched for the ICE-MAC and TEEGA groups, respectively. The incidence of primary outcome was similar between matched groups (18.3% vs. 20.0%; adjusted hazard ratio, 0.94; 95% confidence interval [CI], 0.53-1.68; p=0.843). ICE-MAC and TEE-GA also had similar incidences of moderate-to-severe paravalvular regurgitation (PVR) (4.2% vs. 5.0%; adjusted odds ratio, 0.83; 95% CI, 0.23-2.82; p=0.758), new permanent pacemaker implantation, and VARC-3 types 2-4 bleeding. Conclusions: ICE was comparable to TEE for guidance during TAVR for the composite clinical efficacy outcome, with similar incidences of moderate-to-severe PVR, new permanent pacemaker implantation, and major bleeding. These results suggest that ICE could be a safe and effective alternative echocardiographic modality to TEE for guiding TAVR.