0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.]]>
Area Under Curve ; Blood Transfusion ; Calibration ; Cesarean Section ; Cohort Studies ; Discrimination (Psychology) ; Early Intervention (Education) ; Erythrocytes ; Female ; Humans ; Logistic Models ; Maternal Age ; Nomograms ; Placenta Previa ; Placenta ; Placentation ; Postpartum Hemorrhage ; Pregnancy ; ROC Curve ; Ultrasonography

Neuroinflammation is an important process underlying a wide variety of neurodegenerative diseases. Carvacrol (CAR) is a phenolic monoterpene commonly used as a food additive due to its antibacterial properties, but it has also been shown to exhibit strong antioxidative, anti-inflammatory, and neuroprotective effects. Here, we sought to investigate the effects of CAR on inflammation in the hippocampus and prefrontal cortex, as well as the molecular mechanisms underlying these effects. In our study, lipopolysaccharide was injected into the lateral ventricle of rats to induce memory impairment and neuroinflammation. Daily administration of CAR (25, 50, and 100 mg/kg) for 21 days improved recognition, discrimination, and memory impairments relative to untreated controls. CAR administration significantly attenuated expression of several inflammatory factors in the brain, including interleukin-1β, tumor necrosis factor-α, and cyclooxygenase-2. In addition, CAR significantly increased expression of brain-derived neurotrophic factor (BDNF) mRNA, and decreased expression of Toll-like receptor 4 (TLR4) mRNA. Taken together, these results show that CAR can improve memory impairment caused by neuroinflammation. This cognitive enhancement is due to the anti-inflammatory effects of CAR medicated by its regulation of BDNF and TLR4. Thus, CAR has significant potential as an inhibitor of memory degeneration in neurodegenerative diseases.
Animals ; Brain ; Brain-Derived Neurotrophic Factor ; Cyclooxygenase 2 ; Cytokines ; Discrimination (Psychology) ; Food Additives ; Hippocampus ; Inflammation ; Lateral Ventricles ; Lipopolysaccharides ; Memory ; Necrosis ; Neurodegenerative Diseases ; Neuroprotective Agents ; Phenol ; Prefrontal Cortex ; Rats ; RNA, Messenger ; Toll-Like Receptor 4

OBJECTIVES: Biosignal data captured by patient monitoring systems could provide key evidence for detecting or predicting critical clinical events; however, noise in these data hinders their use. Because deep learning algorithms can extract features without human annotation, this study hypothesized that they could be used to screen unacceptable electrocardiograms (ECGs) that include noise. To test that, a deep learning-based model for unacceptable ECG screening was developed, and its screening results were compared with the interpretations of a medical expert. METHODS: To develop and apply the screening model, we used a biosignal database comprising 165,142,920 ECG II (10-second lead II electrocardiogram) data gathered between August 31, 2016 and September 30, 2018 from a trauma intensive-care unit. Then, 2,700 and 300 ECGs (ratio of 9:1) were reviewed by a medical expert and used for 9-fold cross-validation (training and validation) and test datasets. A convolutional neural network-based model for unacceptable ECG screening was developed based on the training and validation datasets. The model exhibiting the lowest cross-validation loss was subsequently selected as the final model. Its performance was evaluated through comparison with a test dataset. RESULTS: When the screening results of the proposed model were compared to the test dataset, the area under the receiver operating characteristic curve and the F1-score of the model were 0.93 and 0.80 (sensitivity = 0.88, specificity = 0.89, positive predictive value = 0.74, and negative predictive value = 0.96). CONCLUSIONS: The deep learning-based model developed in this study is capable of detecting and screening unacceptable ECGs efficiently.
Dataset ; Electrocardiography ; Humans ; Learning ; Mass Screening ; Monitoring, Physiologic ; Noise ; ROC Curve ; Sensitivity and Specificity ; Signal Detection, Psychological

Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.
Biomarkers ; Biopsy ; Diagnosis ; Digital Rectal Examination ; Discrimination (Psychology) ; Early Detection of Cancer ; Hematologic Tests ; Humans ; Korea ; Male ; Mass Screening ; Methods ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; United States ; Urinary Retention ; Urinary Tract Infections

discrimination, and identification) scoreRESULTS: Olfactory function improved in 74 of 134 patients (55.2%). Etiology of olfactory disorder, sex, and age had statistically significant influence on the improvement rate of olfactory function, among which etiology of olfactory loss was the most important. However, initial severity and duration of olfactory loss had no statistically significant influence on the improvement rate. The TDI score at three months of olfactory training showed remarkable improvement, primarily because of improvements in the discrimination and identification components.CONCLUSION: The present study showed that olfactory training with intranasal corticosteroid was beneficial to improve olfactory function in patients with olfactory dysfunction, particularly in postviral infection patients.]]>
Adult ; Discrimination (Psychology) ; Fluticasone ; Humans ; Methods ; Odors ; Olfaction Disorders ; Regeneration

discrimination, identification score, and subjective VAS score of olfaction. Olfactory testing was performed before and after training for 4 and 12 weeks.RESULTS: There was no demographic difference between the two groups. After olfactory training, the preference group showed statistically significant improvement in threshold, identification, TDI score, and VAS score. Conversely, there was no significant change of olfactory function in the non-preference group.CONCLUSION: Thus, we conclude that odorants of olfactory training should be applied depending on cultural preferences, and that the preferred odorants of each individual patient will have a greater therapeutic effect on olfactory dysfunction compared to non-preferred odorants.]]>
Discrimination (Psychology) ; Humans ; Methods ; Odors ; Precision Medicine ; Prevalence ; Prospective Studies ; Smell

PURPOSE: This study aimed to validate the psychometric properties of the CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble) by using item response theory (IRT) and further examine gender differences in item-level responses.METHODS: This study used the 13(th) (2017) Korea Youth Risk Behavior Survey data conducted by the Korean Centers for Disease and Prevention and analyzed data of 8,568 students who reported drinking alcohol in the previous 30 days. IRT assumptions including unidimensionality, local independence, and monotonicity were tested. A one-factor two-parameter IRT model was fitted for item parameterization (M₂ = 76.92, 20 df, p < .001, root mean square error of approximation = 0.02). Graphics for item characteristic curves and item and test information curves were provided. Differential item functioning (DIF) analysis was evaluated to measure item equivalence between boys and girls.RESULTS: Unidimensionality and local independence were satisfied, and the dominant factor eigenvalue and variance were 2.48 and 41.3% in boys and 2.08 and 34.7% in girls, respectively, and residual correlations in paired items were less than .2. The discrimination parameters were estimated as 1.32–3.59 for boys and 1.30–3.64 for girls. The severity parameters estimated verity as −0.23 to 1.67 for boys and −0.32 to 2.17 for girls. DIF was detected for four of six items, “Car,” “Relax,” “Forget,” and “Family/friends.” However, its impact on the total score was negligible.CONCLUSION: The CRAFFT is a valid and reliable screening tool to identify alcohol use problems for both boys and girls, exhibiting good discrimination, good coverage of severity, and negligible DIF.
Adolescent ; Alcohols ; Discrimination (Psychology) ; Drinking ; Female ; Humans ; Korea ; Mass Screening ; Psychometrics ; Risk-Taking

OBJECTIVE: Despite increased survival in patients with cardiac arrest, it remains difficult to determine patient prognosis at the early stage. This study evaluated the prognosis of cardiac arrest patients using brain injury, inflammation, cardiovascular ischemic events, and coagulation/fibrinolysis markers collected 24, 48, and 72 hours after return of spontaneous circulation (ROSC).METHODS: From January 2011 to December 2016, we retrospectively observed patients who underwent therapeutic hypothermia. Blood samples were collected immediately and 24, 48, and 72 hours after ROSC. Neuron-specific enolase (NSE), S100-B protein, procalcitonin, troponin I, creatine kinase-MB, pro-brain natriuretic protein, D-dimer, fibrin degradation product, antithrombin-III, fibrinogen, and lactate levels were measured. Prognosis was evaluated using Glasgow-Pittsburgh cerebral performance categories and the predictive accuracy of each marker was evaluated. The secondary outcome was whether the presence of multiple markers improved prediction accuracy.RESULTS: A total of 102 patients were included in the study: 39 with good neurologic outcomes and 63 with poor neurologic outcomes. The mean NSE level of good outcomes measured 72 hours after ROSC was 18.50 ng/mL. The area under the curve calculated on receiver operating characteristic analysis was 0.92, which showed the best predictive power among all markers included in the study analysis. The relative integrated discrimination improvement and category-free net reclassification improvement models showed no improvement in prognostic value when combined with all other markers and NSE (72 hours).CONCLUSION: Although biomarker combinations did not improve prognostic accuracy, NSE (72 hours) showed the best predictive power for neurological prognosis in patients who received therapeutic hypothermia.
Biomarkers ; Brain Injuries ; Creatine ; Discrimination (Psychology) ; Fibrin ; Fibrinogen ; Heart Arrest ; Humans ; Hypothermia, Induced ; Inflammation ; Lactic Acid ; Phosphopyruvate Hydratase ; Prognosis ; Retrospective Studies ; ROC Curve ; Troponin I

BACKGROUND: Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function.METHODS: In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year.RESULTS: Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P<0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P<0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P=0.016).CONCLUSION: Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques.
Carotid Artery Diseases ; Carotid Intima-Media Thickness ; Carotid Stenosis ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Discrimination (Psychology) ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Logistic Models ; Prospective Studies ; Risk Factors ; ROC Curve

The infection with Candida spp. for oral cavity is being increasingly reported. However, its variations have not yet been specifically described in periodontitis. The present study was conducted to use an uniplex 26S rRNA-based amplicons to detect and discriminate Candida using only one pair of ribosomal primers. A total of 50 patients with chronic periodontitis was involved in the study. Pure Candida colonies were isolated from 23 patients and genomic DNA was extracted, and PCR was conducted. Direct DNA sequencing followed by comprehensive phylogenetic analyses were performed to confirm the identity of Candida colonies. Results indicated that the ration of Candida-infected patients was 46%, with a high prevalence of C. albicans, followed by remarkably lower ratios of C. parapsilosis, C. glabrata, C. kefyr, and C. dubliniensis respectively. Phylogenetic analyses indicated obvious discrimination amongst the analyzed Candida species as each observed species occupied a distinctive phylogenetic position. The current results reported a simple, efficient, and low-cost detection of five species of Candida without the need for other costly techniques of molecular screening. The current findings may help dentists to easily take a snapshot of the patterns of Candida infection in periodontitis cases to assess the nature and grade of infection.
Candida ; Chronic Periodontitis ; Dentists ; Discrimination (Psychology) ; DNA ; Genes, rRNA ; Humans ; Mass Screening ; Mouth ; Periodontitis ; Polymerase Chain Reaction ; Prevalence ; RNA, Ribosomal ; Sequence Analysis, DNA