• 한국임상약학회지
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• 제34권1호
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• pp.21-29
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• 2024

Background: Daytime sleepiness, a common phenomenon among adolescents focused on academics, has negative effects on aspects such as growth and overall learning. However, research on various drugs and diseases affecting daytime sleepiness is lacking in the reality. Therefore, this study aims to investigate the factors influencing daytime sleepiness in adolescents with daytime sleepiness. Methods: This study was conducted through a survey of 2,432 middle and high school students, aged 14 to 19. The questionnaire consisted of information on socio-demographic characteristics, overall health status, and sleep patterns. The Pediatric Daytime Sleepiness Scale (PDSS), translated into Korean, was used to assess daytime sleepiness. Daytime sleepiness was measured by calculating the total score for each item of the PDSS, and divided into two groups based on the cutoff value of 19, which was the upper quartile. Results: We analyzed a total of 1,770 students including 799 boys and 971 girls. Students with a PDSS score of 19 or higher made up 33.3% of boys and 66.7% of girls. In multivariate analyses, females, smoking, poor self-reported health level, sleep after 12 am, not feeling refreshed in the morning, headache, muscle pain, and scoliosis increased the risk of daytime sleepiness significantly. The AUROC of PDSS, including significant factors in multivariate analyses, was 0.751 (95% CI 0.725~0.776). Conclusions: Daytime sleepiness in adolescents affects growth, academic performance, and emotional stability. Therefore, it is important to manage medications, diseases, and other factors that affect daytime sleepiness on a social level.

• Nutrition Research and Practice
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• 제18권4호
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• pp.534-543
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• 2024

BACKGROUND/OBJECTIVES: Studies on the impact of dietary fiber intake on kidney stones are few, and their results were controversial. This study aimed to explore the association between dietary fiber intake and kidney stones in the nationally representative population of the USA. SUBJECTS/METHODS: This cross-sectional research included 8,588 participants from the National Health and Nutrition Examination Survey, 2011 to 2018. Information regarding dietary fiber intake was obtained from a 24-h recall survey. Participants were categorized into different dietary fiber intake tertiles according to the average of 2 days of dietary recall data. The outcome was self-reported kidney stones. After adjusting for the traditional risk factors, a multivariate logistic regression model was used to examine the association between dietary fiber intake and kidney stones. RESULTS: Eight hundred seventy-two participants had kidney stones. The weighted prevalence (SE) of kidney stones in the lowest tertile, medium tertile, and highest tertile of dietary fiber intake was 11.8% (0.8%), 10.3% (0.8%), and 9.1% (0.8%), respectively. After adjusting for age, sex, race and ethnicity, education level, smoking status, alcohol consumption, physical activity, body mass index, hypertension, diabetes, dyslipidemia, daily water intake, chronic kidney disease stage 3-5, and total energy intake, participants with the highest tertile of fiber intake had a significantly lower risk of kidney stones (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.48-0.95) compared to those in the lowest tertile. Every 5 g/day increment in dietary fiber intake was associated with a significant decrease in risk of kidney stones (OR, 0.90; 95% CI, 0.83-0.98). CONCLUSION: An increase in dietary fiber intake was associated with a lower risk of kidney stones, suggesting adults should be encouraged to maintain an adequate dietary fiber intake to prevent the development of kidney stones. Our results provide evidence to formulate nutrition management strategies for the prevention of kidney stones.

• 대한족부족관절학회지
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• 제28권3호
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• pp.96-101
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• 2024

Purpose: Diabetic foot ulcers and gangrene are major complications of diabetes, often accompanied by peripheral vascular occlusion. Revascularization is performed to restore blood flow and reduce complications such as amputation surgery. Nevertheless, reocclusion, a frequently reported complication after revascularization, often necessitates further lower limb amputations to facilitate rehabilitation and ambulation. This study examined the factors influencing the performance of secondary revascularization procedures in patients with diabetic foot gangrene who even underwent transtibial amputation (TTA) following revascularization. Materials and Methods: A retrospective study was conducted on 36 patients with diabetic foot gangrene who underwent TTA after revascularization from March 2005 to March 2022. The factors influencing restenosis were classified into three categories: revascularization factors, preoperative factors, and intraoperative factors. The revascularization factors were categorized based on whether percutaneous transluminal angioplasty (PTA) or bypass surgery had been performed. Preoperative factors included the patient's age, gender, body mass index (BMI), hypertension, and other relevant factors. Intraoperative factors included surgery duration, blood loss, and transfusion. The study examined the factors influencing secondary revascularization in these three categories. Results: Among the 36 patients in the study, 27.8% (11 patients) underwent secondary revascularization procedures. There was no significant correlation between the performance of secondary revascularization and the type of revascularization procedure, whether PTA or bypass surgery (p>0.05). Similarly, no significant differences were observed in preoperative factors (including age, BMI, smoking status, HbA1c, and underlying diseases) and intraoperative factors (surgery duration, blood loss, and transfusion). On the other hand, regarding gender, all patients who underwent revascularization procedures were male, indicating a statistically significant result (p=0.039). Conclusion: This study suggests that while most clinical variables showed no association with reocclusion, the fact that all patients who underwent secondary revascularization procedures were male indicates that gender may be a significant predictive factor of revascularization.

• 한국학교보건학회지
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• 제36권3호
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• pp.113-125
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• 2023

Purpose: The purpose of this study is to develop a model for predicting mental health risk among adolescents based on health behavior information by employing a hybrid machine learning method. Methods: The study analyzed data of 51,850 domestic middle and high school students from 2022 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency. Firstly, mental health risk levels (stress perception, suicidal thoughts, suicide attempts, suicide plans, experiences of sadness and despair, loneliness, and generalized anxiety disorder) were classified using the k-mean unsupervised learning technique. Secondly, demographic factors (family economic status, gender, age), academic performance, physical health (body mass index, moderate-intensity exercise, subjective health perception, oral health perception), daily life habits (sleep time, wake-up time, smartphone use time, difficulty recovering from fatigue), eating habits (consumption of high-caffeine drinks, sweet drinks, late-night snacks), violence victimization, and deviance (drinking, smoking experience) data were input to develop a random forest model predicting mental health risk, using logistic and XGBoosting. The model and its prediction performance were compared. Results: First, the subjects were classified into two mental health groups using k-mean unsupervised learning, with the high mental health risk group constituting 26.45% of the total sample (13,712 adolescents). This mental health risk group included most of the adolescents who had made suicide plans (95.1%) or attempted suicide (96.7%). Second, the predictive performance of the random forest model for classifying mental health risk groups significantly outperformed that of the reference model (AUC=.94). Predictors of high importance were 'difficulty recovering from daytime fatigue' and 'subjective health perception'. Conclusion: Based on an understanding of adolescent health behavior information, it is possible to predict the mental health risk levels of adolescents and make interventions in advance.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.169-175
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• 2024

Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients. Methods: A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined. Results: A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings. Conclusions: Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling. Level of evidence: III.

• Journal of Preventive Medicine and Public Health
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• 제57권4호
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• pp.379-387
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• 2024

Objectives: Mental health issues have become a growing concern worldwide. Research has shown that regular physical activity (PA) can positively affect mental health. This study investigated the associations between PA and mental health problems (MHPs) in middle-aged Indonesians. Methods: The study utilized data from the 2018 Indonesian Basic Health Research Survey and used a cross-sectional approach. The participants included individuals aged 40-60 years who completed the 20-question Self-Reporting Questionnaire. A logistic regression was performed to analyze a sample of 263 930 data points. Results: Nearly 10.4% of the participants suffered from mental health issues. Notably, among those who did not engage in moderate and vigorous PA, a sign of MHPs was found in 12.5% of participants. Those who met World Health Organization standards for PA were less likely to experience MHPs (10.1%). This study found a significant association between PA and mental health. After adjusting for smoking, alcohol consumption, non-communicable diseases, and socio-demographic variables like age, sex, education, occupation, marital status, and residence, the connection between PA and mental health became even stronger (adjusted odds ratio, 0.81; 95% confidence interval, 0.78 to 0.85; p<0.001). Conclusions: Regular PA has been shown to affect mental health positively. Therefore, it is important to improve health education and efforts to raise awareness among middle-aged Indonesians about the importance of PA in maintaining good mental health.

• Clinical Nutrition Research
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• 제11권2호
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• pp.84-97
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• 2022

As the proportion of the elderly population increases rapidly, interest in musculoskeletal health is also emerging. Here, we investigated how antioxidant vitamin intake and musculoskeletal health are related. Adults aged 50 to 80 years with a body mass index (BMI) of 18.5 to 27.0 kg/m² were included. Bone mineral density (BMD), lean mass (LM), appendicular skeletal muscle mass index (ASMI) were measured using dual-energy X-ray absorptiometry (DXA), and the grip strength and knee extension using hand dynamometer. Nutrient intakes were measured using a 24-hour recall questionnaire. A total of 153 adults (44 men and 109 women) participated in this study. A partial correlation analysis showed a significant positive relationship between vitamin E and BMD and between vitamin C and LM/Height. Participants were classified into three groups according to whether their vitamin E and C intake met the recommended intake for Dietary Reference Intakes for Koreans (KDRIs). The prevalence of having low T-score (< -1.0) and low ASMI (< 7.0 for men and < 5.4 for women) was 51.3% and 15.4% in the group with vitamins C and E intakes below KDRIs. After adjusting for sex, smoking status and energy, protein, vitamin D, and calcium intake, the group with vitamins C and E both below the KDRIs displayed a significantly lower BMD at all test sites and LM/Height compared with vitamin C and/or E intake above the KDRIs groups. We conclude that sufficient intake of vitamin E and C is important for maintaining BMD and lean mass in Korean adults over 50 years of age.

• Journal of Trauma and Injury
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• 제37권3호
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• pp.209-213
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• 2024

Purpose: Trauma patients are at an elevated risk of developing venous thromboembolism (VTE), with the subsequent mortality in patients requiring intensive care unit admission ranging from 25% to 38%. There remains significant variability in clinical practice related to VTE prophylaxis in trauma patients due to the frequent presence of contraindications impacting the timing and consistency of application. This study aimed to assess the effectiveness of the current practice of chemical VTE prophylaxis in trauma patients at a single Australian center. Methods: A prospective review was conducted on patients admitted to the ACT Trauma Service (Canberra, Australia) from July to November 2022. The included patients were 18 years or older, without a direct contraindication to anticoagulation, who received chemical VTE prophylaxis with low-molecular-weight heparin (enoxaparin) for at least three doses and underwent subsequent testing of anti-factor Xa (aFXa) levels. Results: During the study period, 187 patients were admitted, of whom 63 were included in the study. Of these, 47 patients achieved therapeutic levels of anticoagulation as determined by their aFXa levels, while 16 were subtherapeutic. The only statistically significant difference between the two groups was in weight, with patients in the subtherapeutic group weighing an average of 91.9 kg compared to 79.1 kg in the therapeutic group (P<0.05). Conclusions: A fixed-dose enoxaparin regimen was utilized, with limited individualization based on patient factors, such as injuries, comorbidities, and other biological factors. Sixteen patients (25%) had subtherapeutic VTE prophylaxis, as measured by aFXa levels. Higher weight was significantly correlated with inadequate VTE prophylaxis dosing. While age, sex, and smoking status might play important roles in clinical decision-making, weight-based dosing of low-molecular-weight heparin may be more effective in achieving adequate VTE prophylaxis.

• Annals of Occupational and Environmental Medicine
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• 제34권
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• pp.33.1-33.13
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• 2022

Background: Circadian rhythm disturbance caused by shift work has adverse effects on the metabolic homeostasis of the liver. Disruption of the metabolic homeostasis of the liver causes fat accumulation in the liver. The aim of this study was to investigate the correlation between shift work and non-alcoholic fatty liver disease (NAFLD) among male workers in the steel manufacturing industry of Korea. Methods: Based on medical examination data collected in June 2020, 2,511 male subjects from one steel manufacturing company in Korea were selected in total. NAFLD was evaluated using abdominal ultrasound, which was performed by two experienced radiologists. The multinomial logistic regression analysis was performed by adjusting for age, physical activity, smoking history, alcohol consumption, body mass index, waist circumference, blood pressure, blood glucose, lipidemia, liver function test, employment duration, and hepatotoxic materials exposure status. Results: Compared to daytime workers, the odds ratio (OR) of moderate-severe NAFLD in shift workers was 1.449 (95% confidence interval [CI], 1.028-2.043). Compared to daytime workers, the ORs of moderate-severe NAFLD were significantly higher for the group that engaged in total shift work for more than 20 years (OR, 2.285; 95% CI, 1.051-4.970), the group that was not allowed to sleep during night shift work (OR, 1.463; 95% CI, 1.030-2.078), and the group that consumed food during night shift work (OR, 1.580; 95% CI, 1.093-2.284). Conclusions: There was a correlation between shift work and moderate-severe NAFLD in male steel manufacturing workers. There will be a need for more research related to the correlation of shift work with steatohepatitis and cirrhosis in the future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권4호
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• pp.216-221
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• 2024

Objectives: This study aimed to develop and validate a model to predict the need for intensive care unit (ICU) admission in patients with dental infections using an automated machine learning (ML) program called H2O-AutoML. Materials and Methods: Two models were created using only the information available at the initial examination. Model 1 was parameterized with only clinical symptoms and blood tests, excluding contrast-enhanced multi-detector computed tomography (MDCT) images available at the initial visit, whereas model 2 was created with the addition of the MDCT information to the model 1 parameters. Although model 2 was expected to be superior to model 1, we wanted to independently determine this conclusion. A total of 210 patients who visited the Department of Oral and Maxillofacial Surgery at the Dankook University Dental Hospital from March 2013 to August 2023 was included in this study. The patients' demographic characteristics (sex, age, and place of residence), systemic factors (hypertension, diabetes mellitus [DM], kidney disease, liver disease, heart disease, anticoagulation therapy, and osteoporosis), local factors (smoking status, site of infection, postoperative wound infection, dysphagia, odynophagia, and trismus), and factors known from initial blood tests were obtained from their medical charts and retrospectively reviewed. Results: The generalized linear model algorithm provided the best diagnostic accuracy, with an area under the receiver operating characteristic values of 0.8289 in model 1 and 0.8415 in model 2. In both models, the C-reactive protein level was the most important variable, followed by DM. Conclusion: This study provides unprecedented data on the use of ML for successful prediction of ICU admission based on initial examination results. These findings will considerably contribute to the development of the field of dentistry, especially oral and maxillofacial surgery.