Background/Aims: Recent advances in computer-aided diagnosis (CADx) systems have demonstrated expert-level accuracy in the optical diagnosis of colorectal polyps. High-confidence (HC) diagnoses have been defined as those made within 3 seconds without hesitation, and these systems have been shown to improve diagnostic accuracy. We aimed to evaluate the performance of endoscopists with varying levels of experience in diagnosing colorectal polyps with the assistance of a new CADx system applying the 3-second rule and without artificial intelligence assistance. Methods: In this multicenter ex vivo study, 35 endoscopists assessed 100 polyps (51 adenomas, 39 hyperplastic polyps, 10 sessile serrated lesions) using narrow-band imaging video clips on an online platform. Assessments consisted of individual endoscopist diagnosis and CADx-assisted diagnosis. HC assignments followed the 3-second rule in both phases. Performance metrics included HC accuracy, HC rate, and adherence to the Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) and Simple Optical Diagnosis Accuracy (SODA) thresholds. Results: HC diagnostic accuracy improved from 78.3% (95% confidence interval [CI], 76.6% to 80.0%) to 89.8% (95% CI, 88.6% to 90.9%) with CADx assistance (p<0.001). The proportion of HC predictions increased from 64.2% to 75.4% (p<0.001). Novice endoscopists showed marked improvement with CADx (74.1% vs 88.8%; p<0.001). CADx-assisted diagnoses nearly met SODA and PIVI thresholds under the 3-second rule. Additional analysis demonstrated that CADx assistance significantly improved interobserver agreement and ground truth, particularly for novices (κ=0.37 to κ=0.65; p<0.001). Conclusions Integrating CADx with the 3-second rule significantly enhances the performance of endoscopists in the optical diagnosis of colorectal polyps, with the greatest benefit observed among novice endoscopists.

Platelets contain various growth factors and cytokines. Platelet-derived bioproducts, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and platelet lysate (PL), have been developed and used in clinical practice. PRP and PRF are mainly derived from autologous blood and are used in orthopedics, ophthalmology, skin ulcer treatment, and oral surgery. PL is attracting attention as a substitute for fetal bovine serum in cultures for cell therapy. Research and development on platelet lysate production should be carried out, and transfusion medicine professionals must be involved in the clinical utilization of platelet-derived bioproducts.

Platelets contain various growth factors and cytokines. Platelet-derived bioproducts, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and platelet lysate (PL), have been developed and used in clinical practice. PRP and PRF are mainly derived from autologous blood and are used in orthopedics, ophthalmology, skin ulcer treatment, and oral surgery. PL is attracting attention as a substitute for fetal bovine serum in cultures for cell therapy. Research and development on platelet lysate production should be carried out, and transfusion medicine professionals must be involved in the clinical utilization of platelet-derived bioproducts.

Platelets contain various growth factors and cytokines. Platelet-derived bioproducts, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and platelet lysate (PL), have been developed and used in clinical practice. PRP and PRF are mainly derived from autologous blood and are used in orthopedics, ophthalmology, skin ulcer treatment, and oral surgery. PL is attracting attention as a substitute for fetal bovine serum in cultures for cell therapy. Research and development on platelet lysate production should be carried out, and transfusion medicine professionals must be involved in the clinical utilization of platelet-derived bioproducts.

Background/Aims: We investigated how interactions between humans and computer-aided detection (CADe) systems are influenced by the user’s experience and polyp characteristics. Methods: We developed a CADe system using YOLOv4, trained on 16,996 polyp images from 1,914 patients and 1,800 synthesized sessile serrated lesion (SSL) images. The performance of polyp detection with CADe assistance was evaluated using a computerized test module. Eighteen participants were grouped by colonoscopy experience (nurses, fellows, and experts). The value added by CADe based on the histopathology and detection difficulty of polyps were analyzed. Results: The area under the curve for CADe was 0.87 (95% confidence interval [CI], 0.83 to 0.91). CADe assistance increased overall polyp detection accuracy from 69.7% to 77.7% (odds ratio [OR], 1.88; 95% CI, 1.69 to 2.09). However, accuracy decreased when CADe inaccurately detected a polyp (OR, 0.72; 95% CI, 0.58 to 0.87). The impact of CADe assistance was most and least prominent in the nurses (OR, 1.97; 95% CI, 1.71 to 2.27) and the experts (OR, 1.42; 95% CI, 1.15 to 1.74), respectively. Participants demonstrated better sensitivity with CADe assistance, achieving 81.7% for adenomas and 92.4% for easy-to-detect polyps, surpassing the standalone CADe performance of 79.7% and 89.8%, respectively. For SSLs and difficult-to-detect polyps, participants' sensitivities with CADe assistance (66.5% and 71.5%, respectively) were below those of standalone CADe (81.1% and 74.4%). Compared to the other two groups (56.1% and 61.7%), the expert group showed sensitivity closest to that of standalone CADe in detecting SSLs (79.7% vs 81.1%, respectively). Conclusions CADe assistance boosts polyp detection significantly, but its effectiveness depends on the user’s experience, particularly for challenging lesions.

Platelets contain various growth factors and cytokines. Platelet-derived bioproducts, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and platelet lysate (PL), have been developed and used in clinical practice. PRP and PRF are mainly derived from autologous blood and are used in orthopedics, ophthalmology, skin ulcer treatment, and oral surgery. PL is attracting attention as a substitute for fetal bovine serum in cultures for cell therapy. Research and development on platelet lysate production should be carried out, and transfusion medicine professionals must be involved in the clinical utilization of platelet-derived bioproducts.

Background: The decreased use of cord blood units (CBU) due to improvements in haploidentical transplantation is a financial burden for public cord blood banks. Currently, there is no guidance regarding the length of cryopreservation of CBU in Korean public banks. The relative quality of long-term storage CB (LTCB) and short-term storage CB (STCB) needs to be evaluated to establish a storage policy. Methods: Thirty-four and thirty-one units of CB cryopreserved for less than one year and up to 14∼15.5 years, respectively, in the Busan Gyeongnam Public Cord Blood Bank were assessed. The total nucleated cells (TNCs), CD34+ cell counts, and colony-forming units-granulocyte monocyte (CFU-GM) were examined. The cell viabilities were evaluated by Eosin-Y exclusion staining and 7-aminoactinomycin D flow cytometry. The number of stored Korean public CB units from 2000 to 2016 was determined and categorized according to TNCs. Results: The post-thawing viability of the STCBs measured by flow cytometry was consistently higher than that of the LTCBs (TNCs, 62.5% vs 57.3%; MNCs, 93.1% vs 88.9%; CD34+ cells 95.7% vs 94.0%). The CD34+ cell viability was significantly higher in STCB (P=0.03). The CFU-GM after thawing was higher in STCBs (61.5±23.4 vs 49.9±22.8 [0.95 mm 2 ] P=0.05). Of the 48,161 CB units stored until 2016, Dec, 9,493 (19.7%), which were stored until 2006, had been stored for more than 10 years. Conclusion LTCB with a low number of cells (＜0.7×10 9 cells) should be considered to exclude from storage for therapeutic purposes to improve the storage efficiency.

OBJECTIVE: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS).METHODS: Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics.RESULTS: Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%).CONCLUSION: Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies.
Asia ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Education ; Electronic Mail ; Emergencies ; Emergency Service, Hospital ; Epidemiology ; Humans ; Physician Executives ; Taiwan ; Thailand ; Trauma Centers

No abstract available.
Bicuspid* ; Echocardiography*

BACKGROUND AND OBJECTIVES: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician's diagnostic and therapeutic approaches for BPPV. MATERIALS AND METHODS: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. RESULTS: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). CONCLUSION: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.
Surveys and Questionnaires ; Delivery of Health Care ; Dizziness ; Electronic Mail ; Korea ; Otolaryngology ; Otolithic Membrane ; Public Opinion ; Vertigo