OBJECTIVE: In recent years there has been an enormous increase of neuroscience research using the facial expressions of emotion. This has led to a need for ethnically specific facial expressions data, due to differences of facial emotion processing among different ethnicities. METHODS: Fifty professional actors were asked to pose with each of the following facial expressions in turn: happiness, sadness, fear, anger, disgust, surprise, and neutral. A total of 283 facial pictures of 40 actors were selected to be included in the validation study. Facial expression emotion identification was performed in a validation study by 104 healthy raters who provided emotion labeling, valence ratings, and arousal ratings. RESULTS: A total of 259 images of 37 actors were selected for inclusion in the Extended ChaeLee Korean Facial Expressions of Emotions tool, based on the analysis of results. In these images, the actors' mean age was 38+/-11.1 years (range 26-60 years), with 16 (43.2%) males and 21 (56.8%) females. The consistency varied by emotion type, showing the highest for happiness (95.5%) and the lowest for fear (49.0%). The mean scores for the valence ratings ranged from 4.0 (happiness) to 1.9 (sadness, anger, and disgust). The mean scores for the arousal ratings ranged from 3.7 (anger and fear) to 2.5 (neutral). CONCLUSION: We obtained facial expressions from individuals of Korean ethnicity and performed a study to validate them. Our results provide a tool for the affective neurosciences which could be used for the investigation of mechanisms of emotion processing in healthy individuals as well as in patients with various psychiatric disorders.
Anger ; Arousal ; Facial Expression ; Female ; Happiness ; Humans ; Male ; Neurosciences

Objective: Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that can have a significant impact on the quality of life. According to recent studies, some OSAS patients exhibit swallowing abnormalities, such as the premature entry of food into the hypopharynx, and laryngeal penetration. We aimed to evaluate the swallowing function of OSAS patients and compare swallowing-related parameters between OSAS severity groups through a video fluoroscopic swallowing study (VFSS). Methods: Ninety-two participants with a symptom of snoring were enrolled in this retrospective study. Eighty-four participants were diagnosed with OSAS by polysomnography. The subjects were evaluated using the apnea-hypopnea index (AHI) and divided into four groups, namely non-OSAS, mild, moderate, and severe OSAS. Since all patients reported choking symptoms, they underwent VFSS and were evaluated for penetration or aspiration. The temporal parameters evaluated were oral transit time, pharyngeal transit time, and pharyngeal delay time. The movement parameters assessed were the distance, duration, and velocity of laryngeal elevation (LE). Results: Penetration was detected in six OSAS patients, but aspiration was not observed in any patient. Seventy-four patients showed vallecular and pyriform sinus residue, although the amount was not significantly large. There was no significant difference in any of the temporal parameters between the groups except pharyngeal transit time with 10 ml of yogurt. In the Pearson’s correlation and multivariate linear regression analysis, LE distance and LE velocity, both correlated with AHI scores with 5 ml of liquid, 10 ml of liquid, and 10 ml of yogurt, respectively. Conclusion Severe OSAS patients showed longer and faster hyolaryngeal movement while swallowing, which may be a compensatory movement to prevent penetration or aspiration.

Objective: Emergency medical system reform is an important part of the 4th Emergency Medical Care 5-year plan in Korea, published in 2023. However, little is known about the current emergency department (ED) utilization status of local emergency medical agencies (EMAs). We sought to compare the ED utilization code between the emergency medical centers (EMCs) (n=58) and the local EMAs (n=152) based on parameters such as the admission rate or transfer rate in patients with a critical illness. Methods: Consecutive emergency patients registered on the National Emergency Department Information System from January 2022 to December 2022 were included in this study and their records were analyzed. The study included critically ill patients who were defined as having a critical illness code. Results: Among 590,878 (EMC of 450,007; local EMA of 140,871) critical illness code patients, the admission rate was 76.2% for EMCs and 52.9% for local EMAs. Of the critical illness code patients who visited local EMAs, 89.4% were Korean Triage and Acuity Scale (KTAS) grade 3-5 patients. The hospitalization volume of critical illness code patients in the local EMAs was 74,571, mostly major trauma (47.5%) and ischemic stroke (11.5%). If KTAS grade 1 or 2 patients could not be transferred to the local EMAs, the EMCs covered up to 14,989 ED patients and 74,571 admitted patients additionally. Conclusion If the local EMAs maintain their current roles in the areas of major trauma and ischemic stroke, and take charge of the admission of patients with critical illness codes transferred from the EMC after emergency treatment, then the local EMAs can still maintain their functions even after the proposed emergency medical system reform.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.