• Title/Summary/Keyword: observational

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Ultrasonographic evaluation of pennation angle in canine tibialis cranialis muscle in South Korea: an observational study

  • Jaehwan Kim;Tae Sung Hwang;Hee Chun Lee
    • Korean Journal of Veterinary Research
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    • v.64 no.2
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    • pp.14.1-14.6
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    • 2024
  • In human, ultrasonography is used to measure the pennation angle in various muscles to identify muscle functions such as force production, and to study alterations of the pennation angle during muscle contraction, hypertrophy, and atrophy. However, assessments of the pennation angle have not yet been conducted in dogs. This study aims to assess the normal pennation angle of the tibialis cranialis muscle in dogs using ultrasound and to detect changes in this angle in dogs with muscular atrophy. Sixty-eight healthy dogs were examined to establish normal values, while 12 ataxic and 12 lame dogs with suspected hindlimb muscle atrophy were also included. The pennation angle was measured using ultrasound at the midpoint between the proximal end of the tibia and the malleolus, measuring the angle between the muscle bundle and the deep aponeurosis. To confirm the significance between the 5 breeds and to identify a difference between normal and atrophied muscles, statistical analysis was conducted. The study found no significant difference in pennation angle between breeds, with mean values (± standard deviation) of 4.97° (± 1.88) in neutral, 7.25° (± 2.68) in flexion, and 3.31° (± 1.33) in extension positions. Decrease of the pennation angle was identified in muscle atrophy and the flexion position was determined to be the most appropriate for pennation angle measurement of tibialis cranialis muscle. We recommend considering the pennation angle as a valuable indicator of muscle health in dogs, as it demonstrates significant potential for diagnosing and monitoring muscular conditions.

Association Between Plasma Homocysteine Level and Mortality: A Mendelian Randomization Study

  • Chang Kyun Choi ;Sun-Seog Kweon;Young-Hoon Lee;Hae-Sung Nam;Seong-Woo Choi;Hye-Yeon Kim;Min-Ho Shin
    • Korean Circulation Journal
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    • v.53 no.10
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    • pp.710-719
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    • 2023
  • Background and Objectives: In previous studies, high homocysteine levels were associated with high cardiovascular mortality. However, these results were inconsistent with those of randomized controlled trials. We aimed to evaluate the causal role of homocysteine on allcause and cardiovascular mortality using Mendelian randomization (MR) analysis. Methods: This study included the 10,005 participants in the Namwon Study. In conventional observational analysis, age, sex, survey years, lifestyles, body mass index, comorbidities, and serum folate level were adjusted using multivariate Cox proportional regression. MR using 2-stage least squares regression was used to evaluate the association between genetically predicted plasma homocysteine levels and mortality. Age, sex, and survey years were adjusted for each stage. The methylenetetrahydrofolate reductase (MTHFR) polymorphism was used as an instrumental variable for predicting plasma homocysteine levels. Results: Observed homocysteine levels were positively associated with all-cause (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.26-1.54) and cardiovascular (HR, 1.62; 95% CI, 1.28-2.06) mortality when plasma homocysteine levels doubled. However, these associations were not significant in MR analysis. The HRs of doubling genetically predicted plasma homocysteine levels for all-cause and cardiovascular mortality were 0.99 (95% CI, 0.62-1.57) and 1.76 (95% CI, 0.54-5.77), respectively. Conclusions: This MR analysis did not support a causal role for elevated plasma homocysteine concentrations in premature deaths.

Exploring the variations of the pancreatic ductal system: a systematic review and meta-analysis of observational studies

  • Adil Asghar;Ravi Kant Narayan;Nagavalli Basavanna Pushpa;Apurba Patra;Kumar Satish Ravi;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.57 no.1
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    • pp.31-44
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    • 2024
  • The exocrine part of the pancreas has a duct system called the pancreatic ductal system (PDS). Its mechanism of development is complex, and any reorganization during early embryogenesis can give rise to anatomical variants. The aim of this study is to collect, classify, and analyze published evidence on the importance of anatomical variants of the PDS, addressing gaps in our understanding of such variations. The MEDLINE, Web of Science, Embase, and Google Scholar databases were searched to identify publications relevant to this review. R studio with meta-package was used for data extraction, risk of bias estimation, and statistical analysis. A total of 64 studies out of 1,778 proved suitable for this review and metanalysis. The meta-analysis computed the prevalence of normal variants of the PDS (92% of 10,514 subjects). Type 3 variants and "descending" subtypes of the main pancreatic duct (MPD) predominated in the pooled samples. The mean lengths of the MPD and accessory pancreatic duct (APD) were 16.53 cm and 3.36 cm, respectively. The mean diameters of the MPD at the head and the APD were 3.43 mm and 1.69 mm, respectively. The APD was present in only 41% of samples, and the long type predominated. The pancreatic ductal anatomy is highly variable, and the incorrect identification of variants may be challenging for surgeons during ductal anastomosis with gut, failure to which may often cause ductal obstruction or pseudocysts formation.

Effects of the Use of Beta-Blockers on Chronic Obstructive Pulmonary Disease Associated with Cardiovascular Comorbities: Systematic Review and Meta-analysis

  • Natasha Cordeiro dos Santos;Aquiles Assuncao Camelier;Anne Karine Menezes;Victor Durier Cavalcanti de Almeida;Roberto Rodrigues Bandeira Tosta Maciel;Fernanda Warken Rosa Camelier
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.261-281
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    • 2024
  • Cardiovascular comorbidity is common in individuals with chronic obstructive pulmonary disease (COPD). This factor interferes with pharmacological treatment. The use of β-blockers has been proposed for their known cardioprotective effects. However, due to their adverse reactions, and the risk of causing bronchospasm, there is reluctance to use them. To summarize existing evidence on the effects of β-blocker use in COPD associated with cardiovascular comorbidities in relation to disease severity, exacerbation, and mortality outcomes. EMBASE, Medline, Lilacs, Cochrane Library, and Science Direct databases were used. Observational studies that evaluated the effects of β-blockers on individuals with COPD and cardiovascular comorbidities, and related disease severity, exacerbations, or mortality outcomes were included. Studies that did not present important information about the sample and pharmacological treatment were excluded. Twenty studies were included. Relevance to patient care and clinical practice: The use of β-blockers in individuals with COPD and cardiovascular disease caused positive effects on mortality and exacerbations outcomes, compared with the results of individuals who did not use them. The severity of the disease caused a slight change in forced expiratory volume in 1 second. The odds ratio for mortality was 0.50 (95% confidence interval [CI], 0.39 to 0.63; p<0.00001), and for exacerbations, 0.76 (95% CI, 0.62 to 0.92; p=0.005), being favorable to the group that used β-blockers. Further studies are needed to study the effect of using a specific β-blocker in COPD associated with a specific cardiovascular comorbidity.

Acute abdomen following COVID-19 vaccination: a systematic review

  • Nelson Luis Cahuapaza-Gutierrez;Renzo Pajuelo-Vasquez;Cristina Quiroz-Narvaez;Flavia Rioja-Torres;Maria Quispe-Andahua;Fernando M. Runzer-Colmenares
    • Clinical and Experimental Vaccine Research
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    • v.13 no.1
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    • pp.42-53
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    • 2024
  • Purpose: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following coronavirus disease 2019 (COVID-19) vaccination, to describe the possible association and the clinical and demographic characteristics in detail. Materials and Methods: This study included case report studies and case series that focused on the development of acute abdomen following COVID-19 vaccination. Systematic review studies, literature, letters to the editor, brief comments, and so forth were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Briggs Institute tool was used to assess the risk of bias and the quality of the study. Descriptive data were presented as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified, evaluating 17 patients with acute abdomen associated with COVID-19 vaccination, which included acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2), and colitis (n=2). The COVID-19 vaccine most commonly linked to acute abdomen was Pfizer-BioNTech (messenger RNA), accounting for 64.71% of cases. Acute abdomen predominantly occurred after the first vaccine dose (52.94%). All patients responded objectively to medical (88.34%) and surgical (11.76%) treatment and were discharged within a few weeks. No cases of death were reported. Conclusion: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination. Our study is based on a small sample of patients; therefore, it is recommended to conduct future observational studies to fully elucidate the underlying mechanisms of this association.

Safety and immunogenicity of different booster vaccination schemes for COVID-19 used in El Salvador

  • Xochitl Sandoval;Rhina Dominguez;Delmy Recinos;Susana Zelaya;Patricia Cativo;Guillermo Horacio Docena
    • Clinical and Experimental Vaccine Research
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    • v.13 no.1
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    • pp.35-41
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    • 2024
  • Purpose: The effectiveness of coronavirus disease 2019 (COVID-19) vaccination schemes and the combination of vaccines of various platforms for administering booster doses is still being studied since it will depend on the population's response to vaccines. We aimed to evaluate the safety, protection, and immunogenicity of the Salvadorean population's third dose booster COVID-19 vaccine and the potential benefit of homologous vs. heterologous regimens. Materials and Methods: This is an analytical observational cohort study in a population aged 18 to 65 years that was primarily vaccinated with AstraZeneca, Sinovac, or Pfizer/BioNTech. Volunteers were recruited (n=223) and followed up for 3 months after receiving the 3rd vaccine (BNT162b2) as a booster. Adverse reactions were monitored, serum anti-spike immunoglobulin G (IgG) was assessed by chemiluminescence, and a polymerase chain reaction was carried out when subjects developed clinical signs. Results: The cohorts finally included 199 participants, and we observed only mild adverse effects in all cohorts. A significant increase in specific IgG levels was found after the booster dose in all cohorts. The heterologous scheme with Sinovac showed the greatest increase in antibody titer, and a decrease was observed in all participants after 3 months. During the follow-up period, 30 participants showed symptomatology compatible with COVID-19, but only four were laboratory-confirmed and they showed mild clinical signs. Conclusion: These findings indicate that the booster doses used were safe and promoted an immediate increase in immunogenicity, which decreased over time. The heterologous regimen showed stronger immunogenicity compared to the messenger RNA-based homologous scheme.

Risk of Atrial Fibrillation and Adverse Outcomes in Patients With Cardiac Implantable Electronic Devices

  • So-Ryoung Lee;Ji Hyun Lee;Eue-Keun Choi;Eun-Kyung Jung;So-Jeong You;Seil Oh;Gregory YH Lip
    • Korean Circulation Journal
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    • v.54 no.1
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    • pp.13-27
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    • 2024
  • Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009-2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8-11.4-fold), admission for HF (2.6-10.5-fold), hospitalization for any cause (2.4-2.7-fold), all-cause death (4.1-5.0-fold), and composite outcomes (3.4-5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.

Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea

  • Jung Wan Choe;Jong Jin Hyun;Seong-Jin Son;Seung-Hak Lee
    • Clinical Endoscopy
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    • v.57 no.4
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    • pp.476-485
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    • 2024
  • Background/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods: This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results: Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79-0.86) and displayed a moderate discriminatory power. Conclusions: High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

A Case Study of Environmental Design from a Viewpoint of Hybrid and Features of User Experience (하이브리드와 이용자체험 특성으로 본 환경설계의 사례연구)

  • Jang, Il-Young;Kim, Jin-Seon
    • Archives of design research
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    • v.19 no.1 s.63
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    • pp.201-214
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    • 2006
  • Modern society is an age of vagueness and confusion. In addition, vagueness, complexity and variety are seen throughout art including modern philosophy, literature, and environmental design. A phenomenon like this shows that modern society has integrated different components as an organic relationship frequently crossing the boundary of fields. This feature can be regarded as hybrid related with accepting contradictory components and binding them into one under relationship between part and whole. As new design concept, presented are attitude to accept the two instead of attitude to select one of the alternatives, abundance instead of dearness, and ambiguity instead of simplicity. This principle has a crucial influence on creative design providing opposing contradiction and several alternative plans as non-deterministic form not completed one and, above all, useful information in mutual dependence and mutual relationship. When it comes to hybrid, therefore, a strategy is needed to consider layer of several fields getting out of standardizing space into a single space. As an event of this situation and concept, space experience means behaving freely based on experience of users' body. It can be known that this experience brings about users' more dynamic experience in comparison with the experience of seeing environmental design from a viewpoint of visual ism on the existing simplicity. Such a practical experience is subjective, synesthetic, and non-observational one. Therefore, hybrid has brought active users to the stage, which is distinguished from synesthesia felt through body's experience, not through observational attitude and visual space which achieve former balance and harmony with non-determination. That's because hybrid creatures are turning to a product resulted from creative imagination instead of from reappearance which makes text visualized. Such experience performed by user's active participation collapses the boundary between special elite-centered art and daily life and it is the present progressive form showing creation process of future events and new esthetic experience.

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Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer (동병하치 확산을 위한 전략적 방향과 이행방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.