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

PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS upstaging in preoperative biopsy. Patients were divided into two groups according to the final postoperative pathology. Univariate and multivariate analyses with the chi-square test, Student's t-test, and binary logistic regression method identified new significant variables. The updated nomogram was evaluated with the C-index and Hosmer—Lemeshow goodness of fit test. RESULTS: The area under a receiver operating characteristic curve for comparison with the previous nomogram was 0.48. In postoperative pathology, the pure DCIS and invasive cancer groups comprised 345 and 99 cases, respectively. Approximately 22.3% of patients preoperatively diagnosed with DCIS were upstaged to invasive cancer. Significant variables in the univariate analysis were operation type, human epidermal growth factor receptor 2 overexpression, comedo necrosis, sonographic mass, mammographic mass, preoperative biopsy method, and suspicious microinvasion in preoperative biopsy. In multivariate analysis, operation type, sonographic mass, mammographic mass, and suspicious microinvasion were risk factors for upstaging. The updated model with these variables showed moderate discrimination and was appropriate in the calibration test. CONCLUSION: The previous nomogram did not effectively discriminate upstaging of preoperative DCIS in an independent cohort. An updated version of the nomogram appears to provide more accurate information for predicting preoperative DCIS upstaging.
Biopsy ; Breast Neoplasms ; Breast ; Calibration ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Cohort Studies ; Discrimination (Psychology) ; Humans ; Logistic Models ; Medical Records ; Methods ; Multivariate Analysis ; Necrosis ; Nomograms ; Pathology ; Receptor, Epidermal Growth Factor ; Risk Factors ; ROC Curve ; Ultrasonography

PURPOSE: Identification of lymph node (LN) metastasis in non-small cell lung cancer (NSCLC) is critical for disease staging and selection of therapeutic modalities. Sometimes it is not possible to obtain LN core tissue by endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA), resulting in low diagnostic yield. MATERIALS AND METHODS: In this study, 138 specimens were collected from 108 patients who underwent EBUS-TBNA under the suspicion of LN metastasis of NSCLC. Diagnostic yields of anti-CD45 and anti-methionyl-tRNA synthetase (MRS), immunofluorescent (IF) staining on cytology specimens were compared with those of conventional cytology and positron emission tomography-computed tomography (PET-CT). RESULTS: MRS was strongly expressed in NSCLC cells metastasized to LNs, but weakly expressed in cells at the periphery of the LN germinal center. The majority of cells were CD20 positive, although a few cells were either CD3 or CD14 positive, indicating that CD45 staining is required for discrimination of non-malignant LN constituent cells from NSCLC cells. When the diagnostic efficacy of MRS/CD45 IF staining was evaluated using 138 LN cellular aspirates from 108 patients through EBUS-TBNA, the sensitivity was 76.7% and specificity was 90.8%, whereas those of conventional cytology test were 71.8% and 100.0%, respectively. Combining the results of conventional cytology testing and those of PET-CT showed a sensitivity and specificity of 71.6% and 100%, and the addition of MRS/CD45 dual IF data to this combination increased sensitivity and specificity to 85.1% and 97.8%, respectively. CONCLUSION: MRS/CD45 dual IF staining showed good diagnostic performance and may be a good tool complementing conventional cytology test for determining LN metastasis of NSCLC.
Amino Acyl-tRNA Synthetases ; Carcinoma, Non-Small-Cell Lung ; Complement System Proteins ; Discrimination (Psychology) ; Electrons ; Germinal Center ; Humans ; Ligases ; Lymph Nodes ; Methionine-tRNA Ligase ; Needles ; Neoplasm Metastasis ; Sensitivity and Specificity

PURPOSE: To evaluate predictors of severe or moderate coronary artery disease (CAD) in individuals with zero or very low (<10) coronary artery calcium (CAC) scores. MATERIALS AND METHODS: The 1175 asymptomatic persons with zero or very low (<10) CAC scores were analyzed for CAD stenosis using coronary computed tomography angiography. Moderate and severe CADs were defined as having more than 50% and more than 70% stenosis in any of the major coronary arteries, respectively. Age, gender, body mass index, hypertension, type II diabetes, dyslipidemia, lipid profile, creatinine, and smoking status were evaluated as predictors for moderate and severe CAD. RESULTS: In the study population, moderate and severe CADs were found in 7.5% and 3.3%, respectively. Among evaluated risk factors, age [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02−1.07, p<0.001], current smoking status (OR 3.12, 95% CI 1.82−5.34, p<0.001), and CAC 1−9 (OR 1.80, 95% CI 1.08−3.00, p=0.024) were significantly associated with moderate CAD. Meanwhile, age (OR 1.05, 95% CI 1.02−1.08, p=0.003), low high density lipoprotein (HDL) (OR 0.96, 95% CI 0.93−0.99, p=0.003), and current smoking status (OR 2.34, 95% CI 1.14−5.30, p=0.022) were found to be significantly associated with severe CAD. Improvement of discrimination power for predicting severe CAD was observed when smoking and HDL cholesterol were serially added into the age model. CONCLUSION: Smoking showed significant correlations with moderate or severe CAD, and low HDL cholesterol also proved to be a predictor of severe CAD in asymptomatic individuals with extremely low CAC scores.
Angiography ; Asymptomatic Diseases ; Body Mass Index ; Calcium ; Cholesterol, HDL ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Creatinine ; Discrimination (Psychology) ; Dyslipidemias ; Humans ; Hypertension ; Lipoproteins ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Discrimination is a representative social determinant of health. Presenteeism is defined as presenting to work despite of illness and is an indicator of group health. We investigated the association of discrimination and presenteeism with cardiovascular disease using Korean data. METHODS: This study used the fourth Korea Working Conditions Survey (2014) data of 27,662 wage workers (employees). Presenteeism and discrimination related to age, sex, education, birth region, and employment type were ascertained. Self-reported cardiovascular disease was also assessed using the survey questionnaire. General and occupational characteristics found to be significant in univariate analyses were entered into a multivariate logistic regression analysis of the association of discrimination and presenteeism with cardiovascular disease. We also calculated the odds ratios of multiple discriminations and/or presenteeism for cardiovascular disease. RESULTS: In the univariate analyses, sex, age, education, monthly income, employment type, occupation, hours worked per week, workplace scale, and shift work were significantly associated with cardiovascular disease. A multivariate logistic regression analysis adjusted for general and occupational characteristics showed that discrimination and presenteeism were significantly associated with cardiovascular disease. Finally, the association with cardiovascular disease was strongest when both multiple discriminations and presenteeism were present. CONCLUSIONS: Discrimination and presenteeism are associated with cardiovascular disease, and this association was stronger in the presence of multiple types of discrimination and presenteeism.
Cardiovascular Diseases ; Discrimination (Psychology) ; Education ; Employment ; Korea ; Logistic Models ; Occupations ; Odds Ratio ; Parturition ; Presenteeism ; Salaries and Fringe Benefits

BACKGROUND: The objective of this study is to evaluate the risk of exposure to second hand smoke (SHS) during working hours by job status and occupation. METHODS: Using the 4th Korean Working Conditions Survey (KWCS), 49,674 respondents who answered the question about SHS were studied. A chi-square test was carried out to determine whether there is a significant different in SHS exposure frequency by general and occupational characteristics and experience of discrimination at work and logistic regression analysis was carried out to identify the risk level of SHS exposure by variables. RESULTS: In this study, we found that male workers in their 40s and 50s, workers employed in workplaces with fewer than 50 employees, daily workers, and people working outdoors had a higher rate of exposure to SHS than the others. The top five occupations with the highest SHS exposure were construction and mining-related occupations, metal core-makers-related trade occupations, wood and furniture, musical instrument, and signboard-related trade occupations, transport and machine-related trade occupations, transport and leisure services occupations. The least five exposed occupations were public and enterprise senior officers, legal and administrative professions, education professionals, and health, social welfare, and religion-related occupations. CONCLUSION: Tobacco smoke is a significant occupational hazard. Smoking ban policy in the workplace can be a very effective way to reduce the SHS exposure rate in the workplace and can be more effective if specifically designed by the job status and various occupations.
Discrimination (Psychology) ; Education ; Humans ; Interior Design and Furnishings ; Leisure Activities ; Logistic Models ; Male ; Music ; Occupations ; Smoke ; Smoking ; Social Welfare ; Surveys and Questionnaires ; Tobacco ; Tobacco Smoke Pollution ; Wood

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