• Korean Circulation Journal
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• v.52 no.3
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• pp.205-217
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• 2022

Background and Objectives: The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear. Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery. Methods: From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes. Results: During a median follow-up of 45 months (interquartile range, 26-65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85-0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI, 0.86-1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70; 95% CI, 1.04-7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m². Conclusions: In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.501-512
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• 2024

Background/Aims: Optimal risk stratification based on simplified geriatric assessment to predict treatment-related toxicity and survival needs to be clarified in older patients with diffuse large B-cell lymphoma (DLBCL). Methods: This multicenter prospective cohort study enrolled newly diagnosed patients with DLBCL (≥ 65 yr) between September 2015 and April 2018. A simplified geriatric assessment was performed at baseline using Activities of Daily Living (ADL), Instrumental ADL (IADL), and Charlson's Comorbidity Index (CCI). The primary endpoint was event-free survival (EFS). Results: The study included 249 patients, the median age was 74 years (range, 65-88), and 125 (50.2%) were female. In multivariable Cox analysis, ADL, IADL, CCI, and age were independent factors for EFS; an integrated geriatric score was derived and the patients stratified into three geriatric categories: fit (n = 162, 65.1%), intermediate-fit (n = 25, 10.0%), and frail (n = 62, 24.9%). The established geriatric model was significantly associated with EFS (fit vs. intermediate-fit, HR 2.61, p < 0.001; fit vs. frail, HR 4.61, p < 0.001) and outperformed each covariate alone or in combination. In 87 intermediate-fit or frail patients, the relative doxorubicin dose intensity (RDDI) ≥ 62.4% was significantly associated with worse EFS (HR, 2.15, 95% CI 1.30-3.53, p = 0.002). It was related with a higher incidence of grade ≥ 3 symptomatic non-hematologic toxicities (63.2% vs. 27.8%, p < 0.001) and earlier treatment discontinuation (34.5% vs. 8.0%, p < 0.001) in patients with RDDI ≥ 62.4% than in those with RDDI < 62.4%. Conclusions: This model integrating simplified geriatric assessment can risk-stratify older patients with DLBCL and identify those who are highly vulnerable to standard dose-intensity chemoimmunotherapy.

• Korean Circulation Journal
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• v.54 no.6
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• pp.325-335
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• 2024

Background and Objectives: The number of sensitized heart failure patients on waiting lists for heart transplantation (HTx) is increasing. Using the Korean Organ Transplantation Registry (KOTRY), a nationwide multicenter database, we investigated the prevalence and clinical impact of calculated panel-reactive antibody (cPRA) in patients undergoing HTx. Methods: We retrospectively reviewed 813 patients who underwent HTx between 2014 and 2021. Patients were grouped according to peak PRA level as group A: patients with cPRA ≤10% (n= 492); group B: patients with cPRA >10%, <50% (n=160); group C patients with cPRA ≥50% (n=161). Post-HTx outcomes were freedom from antibody-mediated rejection (AMR), acute cellular rejection, coronary allograft vasculopathy, and all-cause mortality. Results: The median follow-up duration was 44 (19-72) months. Female sex, re-transplantation, and pre-HTx renal replacement therapy were independently associated with an increased risk of sensitization (cPRA ≥50%). Group C patients were more likely to have longer hospital stays and to use anti-thymocyte globulin as an induction agent compared to groups A and B. Significantly more patients in group C had positive flow cytometric crossmatch and had a higher incidence of preformed donor-specific antibody (DSA) compared to groups A and B. During follow-up, group C had a significantly higher rate of AMR, but the overall survival rate was comparable to that of groups A and B. In a subgroup analysis of group C, post-transplant survival was comparable despite higher preformed DSA in a desensitized group compared to the non-desensitized group. Conclusions: Patients with cPRA ≥50% had significantly higher incidence of preformed DSA and lower freedom from AMR, but post-HTx survival rates were similar to those with cPRA <50%. Our findings suggest that sensitized patients can attain comparable post-transplant survival to non-sensitized patients when treated with optimal desensitization treatment and therapeutic intervention.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.1
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• pp.1-10
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• 2024

Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.

• Journal of Service Research and Studies
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• v.14 no.3
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• pp.188-205
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• 2024

The food truck business, which involves selling various types of food from mobile vehicles, has gained significant popularity in urban centers and at events. These food trucks have rapidly expanded due to their relatively low initial investment and high flexibility, attracting customers with unique menus and personalized services. However, as competition increases, the need to manage service quality to boost customer satisfaction and encourage repeat visits has become more critical. Despite this growing importance, there has been limited empirical research on the topic. This study aims to analyze customer experiences with food truck services to gain strategic insights for improving service quality. By applying structural topic modeling to customer review data, the study identified 50 key topics. The process included a comprehensive evaluation of model diagnostics and interpretability to determine the optimal number of topics, ultimately selecting the most relevant ones related to service experiences. The impact of these identified topics on overall customer satisfaction was empirically tested using regression analysis. The results showed that aspects such as "Food Taste," "Friendly Staff," and "Positive Emotion" had a positive influence on customer satisfaction, whereas "Delayed Service," "Negative Emotion," and "Beverage Service" had a negative impact. Based on this analysis, the study proposes concrete methods for food truck operators to systematically analyze customer feedback and use it to drive service improvements and innovation. This research highlights the importance of data-driven decision-making in small business environments like food trucks and contributes to expanding the application of topic modeling in the service industry.

• Journal of Korea Water Resources Association
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• v.57 no.9
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• pp.615-626
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• 2024

To accurately and efficiently monitor soil moisture (SM) across South Korea, this study developed a SM estimation model that integrates the cloud computing platform Google Earth Engine (GEE) and Automated Machine Learning (AutoML). Various spatial information was utilized based on Terra MODIS (Moderate Resolution Imaging Spectroradiometer) and the global precipitation observation satellite GPM (Global Precipitation Measurement) to test optimal input data combinations. The results indicated that GPM-based accumulated dry-days, 5-day antecedent average precipitation, NDVI (Normalized Difference Vegetation Index), the sum of LST (Land Surface Temperature) acquired during nighttime and daytime, soil properties (sand and clay content, bulk density), terrain data (elevation and slope), and seasonal classification had high feature importance. After setting the objective function (Determination of coefficient, R² ; Root Mean Square Error, RMSE; Mean Absolute Percent Error, MAPE) using AutoML for the combination of the aforementioned data, a comparative evaluation of machine learning techniques was conducted. The results revealed that tree-based models exhibited high performance, with Random Forest demonstrating the best performance (R² : 0.72, RMSE: 2.70 vol%, MAPE: 0.14).

• The Journal of Engineering Geology
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• v.34 no.3
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• pp.447-457
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• 2024

This study investigated a cut-slope surface containing Tertiary faults, representing a conical-shaped slope with strike varying from N44°E to NS, N50°W, and finally N70°E. The slope consists mainly of basalt, with discontinuities in the slope including faults, fault zones, fracture zones, shear joints, and extension joints. The type and scale of failure vary with the strike of the slope and the strikes of discontinuities, with plane and wedge failure predominating. Based on face-mapping data, SMR (slope mass rating), rock physical and mechanical properties, analysis of stereonet projections and geological cross-sections, and critical equilibrium analysis, optimal slope stability determination was found to involve the countermeasure method, the slope gradient relief method, the green soil surface treatment method, and a fall prevention measure. After application of the countermeasure method, both dry and wet slope conditions exceeded allowable safety factors. It is expected that the preparation of geological cross-sections of various representative sections perpendicular to the surface of the slope, and the application of corresponding countermeasure methods, will be reasonable tools for three-dimensional analysis of slope stability. If the strike of the slope varies widely, it is necessary to prepare geological cross-sections, and the section used for critical equilibrium analysis must be established as the basic section.

• Journal of the Korean Society of Radiology
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• v.18 no.5
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• pp.473-481
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• 2024

As a result of measuring and evaluating 24 units of 10 types of medical ultrasonic equipment in Gwangju using the multipurpose ultrasonic phantom (ATS-539), all 24 units were 100% passed in the non-inspection area, vertical distance measurement, horizontal distance measurement, axial/side resolution, gray tone and dynamic range items. As a result of analyzing the ultrasonic phantom pass rate according to the number of years of use of ultrasonic equipment in Gwangju, this study derived that the service life of ultrasonic equipment is related to the equipment performance. As the coverage for ultrasonic inspection is gradually expanded starting with the upper abdominal ultrasound, it is time to further manage the quality of ultrasonic inspection. Therefore, in addition to the standard guidelines for performance measurement for abdominal inspection, research on equipment phantom measurement methods and standards that can be used in various ultrasonic inspection areas such as the neck and chest, which have recently become increasingly important in clinical practice, should be conducted at the same time. In addition, quality control standards should be legally established to maintain the optimal performance of ultrasonic imaging devices and to secure the appropriateness of images. In addition, ultrasound imaging devices should be classified as special medical equipment, and it is considered that the level of equipment should be consistently maintained through continuous management so that images beneficial to treatment can be obtained.

• Journal of Naturopathy
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• v.13 no.2
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• pp.71-84
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• 2024

Background: This literature review analyzes 25 studies on the effects of keyboard instrument-based music interventions on cognitive function in older adults. The review shows positive impacts on sensory-motor functions and cognitive domains such as working capacity, attention, and memory. Objective: The purpose of this study is to systematically examine the effects of music interventions using keyboard instruments on cognitive function in late adulthood and evaluate their effectiveness. Method: The studies were analyzed based on participants, methods, tools, interventions, and outcomes, selecting relevant articles published between 2000 and 2023 according to PRISMA guidelines. Results: The analysis showed that keyboard music interventions significantly enhanced cognitive function, particularly in areas such as auditory abilities, attention, and working memory. Pre- and post-intervention tests demonstrated that piano playing significantly improved auditory abilities, attention, working memory, hand function, and brain plasticity. Conclusion: Keyboard instrument interventions positively impact cognitive function in older adults, suggesting their potential for preventing cognitive decline and promoting brain health. This study can guide future studies on the long-term effects and development of optimal strategies.

• International conference on construction engineering and project management
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• 2024.07a
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• pp.1285-1285
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• 2024

In process plant construction, the implementation of design automation technologies is pivotal in reducing the timeframes associated with the design phase and in enabling the generation and evaluation of a variety of design alternatives, thereby facilitating the identification of optimal solutions. These technologies can play a crucial role in ensuring the successful delivery of projects. Previous research in the domain of design automation has primarily focused on parametric design in architectural contexts and on the automation of equipment layout and pipe routing within plant engineering, predominantly employing rule-based algorithms. Nevertheless, these studies are constrained by the limited flexibility of their models, which narrows the scope for generating alternative solutions and complicates the process of exploring comprehensive solutions using nonlinear optimization techniques as the number of design and engineering parameters increases. This research introduces a framework for automating plant design through the use of generative neural network models to overcome these challenges. The framework is applicable to the layout problems of process plants, covering the equipment necessary for production processes and the facilities for essential resources and their interconnections. The development of the proposed Neural-network (NN) based Generative Design Model unfolds in four stages: (a) Rule-based Model Development: This initial phase involves the development of rule-based models for layout generation and evaluation, where the generation model produces layouts based on predefined parameters, and the evaluation model assesses these layouts using various performance metrics. (b) Neural Network Model Development: This phase transitions towards neural network models, establishing a NN-based layout generation model utilizing Generative Adversarial Network (GAN)-based methods and a NN-based layout evaluation model. (c) Model Optimization: The third phase is dedicated to optimizing the models through Bayesian Optimization, aiming to extend the exploration space beyond the limitations of rule-based models. (d) Inverse Design Model Development: The concluding phase employs an inverse design method to merge the generative and evaluative networks, resulting in a model that outputs layout designs to meet specific performance objectives. This study aims to augment the efficiency and effectiveness of the design process in process plant construction, transcending the limitations of conventional rule-based approaches and contributing to the achievement of successful project outcomes.