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Kim Y, Ryu J, Jang Y, Kim D, Bang Y, Choi S, Moon J, Kim H, Shin J. 138 Single-cell RNA-seq of dorsal root ganglion reveals neuroinflammatory process in atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yang BY, Blackwood JE, Shin J, Guan S, Gao M, Jorgenson DB, Boehl JE, Sayre MR, Kudenchuk PJ, Rea TD, Kwok H, Johnson NJ. A pilot evaluation of respiratory mechanics during prehospital manual ventilation. Resuscitation 2022; 177:55-62. [PMID: 35690127 DOI: 10.1016/j.resuscitation.2022.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Respiratory mechanics, such as tidal volume (VT) and inspiratory pressures, may affect outcome in hospitalized patients with respiratory failure. Little is known about respiratory mechanics in the prehospital setting. METHODS In this prospective, pilot investigation of patients receiving prehospital advanced airway placement, paramedics applied a device to measure respiratory mechanics. We evaluated tidal volume (VT) per predicted body weight (VTPBW) to determine the proportion of breaths within the lung-protective range of 4-10 mL/kg per PBW overall, according to ventilation bag volume (large versus small) and cardiac arrest status (active CPR, post-ROSC, non-arrest). RESULTS Over 16-months, 7371 post-intubation breaths were measured in 54 patients, 32 patients with cardiac arrest and 22 with other conditions. Paramedics ventilated 19 patients with a small bag and 35 patients with a large bag. Overall, mean VT was 435 mL (95% CI 403, 467); VTPBW was 7.0 mL/kg (95% CI 6.4, 7.6) with 75% within the lung-protective range. Mean VTPBW and peak pressure differed according to arrest status (absolute difference -0.36 mL/kg and 32 cmH2O for active CPR compared to post-ROSC), though not according to bag size. CONCLUSIONS We observed that measuring respiratory mechanics in the prehospital setting was feasible. Tidal volumes were generally delivered within a safe range. Respiratory mechanics varied most significantly with active CPR with lower VTPBW and higher peak pressures, though did not seem to be affected by bag size. Future work might examine the relationship between respiratory mechanics and outcomes, which may identify opportunities to improve clinical outcomes.
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Lee K, Shin J, Lee J, Yoo J, Kim JW. Longitudinal effects of antidepressant treatment on resting state functional connectivity in adolescents with major depressive disorder. Eur Psychiatry 2022. [PMCID: PMC9565871 DOI: 10.1192/j.eurpsy.2022.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Adolescents with major depressive disorder (MDD) often show reduced prefrontal functional connectivity with the subcortical regions than healthy controls (HC) (Tang et al., 2018). However, relatively little is known about longitudinal effects of antidepressant (AD) treatment on resting state functional connectivity (RSFC) in the prefrontal cortex (PFC). Objectives This study aimed to investigate abnormal PFC RSFC in MDD adolescents compared to HC and longitudinal effects of AD on PFC RSFC. Methods
This study included 59 adolescents with MDD and 43 HC. MDD adolescents were treated with escitalopram in an 8 week, open-label trial. The treatment outcome was assessed by Children’s Depression Rating Scale (CDRS-R) and patients showing at least a 40% improvement in CDRS-R scores from baseline to week 8 were defined as “responders”. Functional and T1 images collected before and after treatment were processed using AFNI and Freesurfer. Our seed was the lateral PFC (LPFC, BA46). T-tests and repeated measures ANCOVAs, controlling for age and IQ, were conducted to examine abnormal PFC RSFC and longitudinal effects of AD on LPFC RSFC. Results Relative to HC, MDD showed increased LPFC RSFC with the posterior middle temporal gyrus (pMTG) and superior frontal cortex (SFG) involved in attentional networks. Responders showed greater changes in LPFC RSFC with the MTG and SFG after AD treatment compared to non-responders and HC (Figure 1). ![]()
Conclusions Our finding suggests that reduced LPFC RSFC with the pMTG and SFG reflecting decreased attentional network connectivity may serve as a biomarker to predict AD treatment outcome in adolescents with MDD. Disclosure No significant relationships.
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Alrashidi I, Shin J. Abstract No. 573 Embolization of urinary tract fistulae using an Amplatzer vascular plug and glue. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Shin J, Choi H, Kee S, Shin M, Shin J. M240 Evaluation of utility of BD vacutainer barricor for clinical routine biochemical analytes in hemodialysis patients receiving anticoagulant therapy. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim W, Kim W, Lee H, Park G, Kang S, Youngjin K, Shin J, Won E, Lee S, Kim C, Sookjin J. W084 Assessment of a novel matrix-assisted desorption/ionization time-of-flight mass spectrometry platform, asta microidsys, for identification of various acinetobacter species, compared with bruker maldi biotyper. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Qian J, Akama-Garren E, Shin J, Bang A, Pike L, Grassberger C, Schoenfeld J. Dosimetric Factors Associated With Lymphopenia in Metastatic Cancer Patients Receiving Palliative Radiation and PD-1 Immune Checkpoint Inhibitors. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Xing S, Pursley J, Shin J, Alfonso C, Domal S, Withrow J, Bolch W, Grassberger C, Paganetti H. Dynamic Hepatic Blood Flow Model Shows Greater Impact of Total Treatment Time Than Integral Dose for Assessing Dose to Circulating Lymphocytes. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee Y, Shin J, Park JK, Shin JH, Kim HJ, Park HC, Heo R. Associations between changing patterns of ST-T waves morphologies in rest electrocardiography and cardiovascular risk in an asymptomatic low risk population: a report from Ansan-Ansung cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
While clinical significance of ST-T wave abnormalities (STA) in rest electrocardiography (ECG) on long-term cardiovascular outcomes has been on debate, few studies have been reported on the association between the changes in ST-T waves in rest ECG and cardiovascular outcomes in low risk populations. We investigate the changing patterns of STA in rest ECG and the predictive value of the changes in ST-T wave in rest ECG for cardiovascular events in an asymptomatic general population.
Methods
A longitudinal community-based cohort study was conducted for 12 years. Koreans aged 40–69 years were followed biennially through scheduled revisit for comprehensive assessments. Among 10,030 participants, 6,648 participants who did not have any cardiovascular diseases, angina-related symptoms or pathologic Q waves in rest ECG at baseline were included for analysis. Changes in STAs were defined using the changes between ECG at baseline and that at the first revisit. A major adverse cardiovascular events was defined as a composite of cardiac death, myocardial infarction, clinical diagnosis of coronary artery disease and stroke.
Results
Among 5,924 participants without STA at baseline, only 187 participants (3.2%) developed new STA. Among 724 patients (10.9%) with STA at baseline, 274 patients (37.8%) persistently showed STA at the first revisit. MACEs occurred more frequently in the participants persistently with STA and those with newly-developed STA than in the participants persistently without STA (Figure 1). Multivariate Cox-proportional hazard models showed that a higher risk of MACE was only associated with the persisted STA (HR 1.69; 95% CI 1.10–2.63). In participants with baseline STA, persisted T-wave flattening was associated with a higher risk of MACE, whereas T-wave inversion, either persisted or fluctuated was not associated with a higher risk of MACE, compared with persistent absence of STA (Figure 2). In the participants without baseline STAs, multivariate Cox-proportional hazard model showed that newly-developed T-wave flattening (HR 1.85; 95% CI 0.20–2.84), not T-wave inversion (HR 1.50; 95% CI 0.85–2.65) was associated with a higher risk of MACE. Survival receiver operating curve analysis showed that the changes in STAs had a C-index of 0.538 (95% CI 0.511–0.558), a sensitivity of 13.0% and a specificity of 92.5% and add only a small value to the predictive power of 10-year atherosclerotic cardiovascular diseases risk estimator (C-index without STA changes 0.708 [0.681–0.736] vs. C-index with STA changes 0.721 [0.694–0.748]).
Conclusions
STAs uncommonly developed while frequently disappeared spontaneously in the asymptomatic general population. Persisted STA and newly developed STA in rest ECG were predictive of future cardiovascular events in the asymptomatic general population. However, the changes in STAs did not significantly improve the predictive value of the conventional risk estimator, when added.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research Foundation of Korea Figure 1Figure 2
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Lee Y, Shin J, Shin JH, Kim HJ, Ryu MH, Park HC, Lim HY, Park JK, Heo R, Kim WH. Simulation and validation for count-based binary decision of target blood pressure achievement in home blood pressure monitoring data analysis for clinical practice. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Home blood pressure monitoring (HBPM) is a useful tool to identify hypertension and to decide whether a patient's blood pressure (BP) is controlled. The use of automatized oscillometric BP measurement devices has become increasingly popular with help of information technology and internet of things to the devices. However, applying HBPM to daily clinical practices is still challenging, because most patients with hypertension are in age groups not familiar to digital devices and internet and high BP criteria using average home BP values are often useless in outpatient clinics without easily accessible average BP calculation tools. Therefore, we developed a simple and straightforward method to interpret HBPM through counts of BP ≥135/85 mmHg.
Methods
We simulated 400 cases of HBPM using a random number generator function in statistical software. The simulated average home systolic BP (SBP) and its standard deviation (SD) were 125±15 mmHg and 12±5 mmHg and the number of HBP readings was 24 times. The simulated diastolic BP (DBP) was randomly selected to 50–75% of the SBP. The validation of the binary interpretation method was conducted using actual HBPM data from 386 subjects in a rural area of South Korea. Receiver operating characteristics curve analysis was conducted, and linear regression and logarithmic models were fitted between the numbers of home BP ≥135/85 mmHg and mean BP. Hypertension was defined with average home BP ≥135/85 mmHg.
Results
In the simulated cohort, hypertension was presented in 197 cases (49.3%). The C-index of the numbers of BP readings ≥135/85 mmHg was 0.994 (95% confidence interval [CI] 0.990–0.998), and ≥12 of 24 BP readings ≥135/85 mmHg showed a sensitivity of 95.4%, a specificity of 95.1% and an accuracy of 95.3% for the diagnosis of hypertension. In validation cohort, the numbers of home BP measurements varied from 8 to 81 times. The validation cohort similarly showed that the C-index of the ratio between the number of high BP readings (≥135/85 mmHg) to the number of BP measurements (R-NHBP/NBP) was 0.985 (95% CI, 0.976–0.994) and the best accuracy was shown at R-NHBP/NBP of ≥0.45. R-NHBP/NBP of ≥0.5 showed a sensitivity of 0.957, a specificity of 0.907 and an accuracy of 0.927. The accuracy of the R-NHBP/NBP of ≥0.5 decreased as SD and the range of SBP increased, whereas it did not change with the number of measurements (Figure 1). R-NHBP/NBP <0.2 predicted normotension and R-NHBP/NBP >0.8 predicted hypertension in 95% confidence. Mean widths of the 95 prediction intervals for the average SBP and DBP were 18.2 mmHg and 12.6 mmHg, respectively (Figure 2).
Conclusion
Counting the number of BP ≥135/85 mmHg can provide accurate assessments for the BP levels. R-NHBP/NBP of ≥0.5 is a simple and accurate marker of high BP in HBPM, and R-NHBP/NBP could be a useful tool to assess BP levels in patients practicing HBPM.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Fassett M, Braz J, Castellanos C, Schroeder A, Sadeghi M, Mar D, Zhou C, Shin J, Basbaum A, Ansel K. LB722 IL-31/IL31RA negatively regulate IL-4 production and cutaneous M2-like macrophage accumulation. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Shin J, Walker R, Blackwood J, Chapman F, Crackel J, Kudenchuk P, Rea T. Cerebral Oximetry during Out-of-Hospital Resuscitation: Pilot Study of First Responder Implementation. PREHOSP EMERG CARE 2021; 26:519-523. [PMID: 34191686 DOI: 10.1080/10903127.2021.1948647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Anoxic brain injury is a common mode of death following out-of-hospital cardiac arrest (OHCA). We assessed the course of regional cerebral oxygen saturation (rSO2) at the outset and during first responder resuscitation to understand its relationship with return of spontaneous circulation (ROSC) and functional survival. Methods: We undertook a prospective observational investigation of adult OHCA patients treated by a first-responder EMS agency in King County, WA. Cerebral oximetry was performed using the SenSmart® Model X-100 Universal Oximetry System (Nonin Medical, Inc). We determined cerebral oximetry rSO2 overall and stratified according to ROSC and favorable survival status defined by Cerebral Performance Category (CPC) of 1-2. Results: Among the 59 OHCA cases enrolled, 47% (n = 28) achieved ROSC and 14% (n = 8) survived with CPC 1-2. On average, initial rSO2 cerebral oximetry was 41% and was not different at the outset according to return of spontaneous circulation (ROSC) or survival status. Within 5 minutes of first responder resuscitation, those who would subsequently achieve ROSC had a higher rSO2 than those who would not achieve ROSC (51% vs. 43%, p = 0.03). Among patients who achieved ROSC, those who would survive with CPC 1-2 had a higher rSO2 cerebral oximetry following ROSC than nonsurvivors (74% vs. 60%, p = 0.04 at 5 minutes post ROSC), a difference that was not evident in the minutes prior to ROSC (55% vs. 51% at 3 minutes prior to ROSC, p = 0.5). Conclusion: In this observational study, where first responders applied cerebral oximetry, higher rSO2 during the course of care predicted ROSC among all patients and predicted favorable survival among those who achieved ROSC. Future investigation should evaluate whether and how treatments might modify rSO2 and in turn may influence prognosis.
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Jeong H, Shin J, Jeong JH, Kim KP, Hong SM, Kim YI, Ryu JS, Ryoo BY, Yoo C. Capecitabine plus temozolomide in patients with grade 3 unresectable or metastatic gastroenteropancreatic neuroendocrine neoplasms with Ki-67 index <55%: single-arm phase II study. ESMO Open 2021; 6:100119. [PMID: 33901869 PMCID: PMC8099746 DOI: 10.1016/j.esmoop.2021.100119] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Grade 3 neuroendocrine neoplasms (NENs) of gastroenteropancreatic (GEP) origin with Ki-67 indices <55% do not respond well to platinum-based chemotherapy. The combination of capecitabine and temozolomide (CAPTEM) has shown favorable responses in grade 1-2 NENs, but has rarely been studied in patients with grade 3 NENs. PATIENTS AND METHODS This open-label, single-arm phase II trial included patients with unresectable or metastatic grade 3 NENs of GEP origin with Ki-67 indices <55% enrolled between June 2017 and July 2020. Patients received oral capecitabine 750 mg/m2 twice daily on days 1 to 14 and oral temozolomide 200 mg/m2 once daily on days 10 to 14 every 4 weeks. Histologic findings were centrally reviewed after the completion of enrollment. The primary endpoint was overall response rate, and the secondary endpoints were progression-free survival (PFS), overall survival (OS), and adverse events. RESULTS Of the 30 patients included in the full analysis set, 1 (3.3%) achieved complete response, 8 (26.7%) had partial responses, and 14 (46.7%) had stable disease, making the overall response rate 30.0%. At a median follow-up of 19.2 months, the median PFS was 5.9 months and the median OS was not reached. Patients with well-differentiated NENs showed significantly better median PFS (9.3 months versus 3.5 months, P = 0.005) and median OS (not reached versus 6.2 months, P = 0.004) than patients with poorly differentiated tumors. Expression of O6-methyl-guanine methyltransferase protein did not correlate with clinical outcomes. The most common grade 3-4 adverse events were thrombocytopenia (10%), anemia (6.7%), and nausea (6.7%). CONCLUSIONS CAPTEM was effective and well tolerated in patients with grade 3 GEP-NENs with Ki-67 indices <55%, with superior efficacy outcomes compared with the historical controls receiving platinum-based chemotherapy.
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She R, Kobayashi K, Kim J, Shin J, Patel K, Goel A, Thibodeau R. Abstract No. 203 Association between chest port catheter tip location at the time of placement and catheter migration resulting in port malfunction. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Song Y, Lim J, Lim T, Im K, Kim N, Nam Y, Jeon Y, Ko H, Park I, Shin J, Cho S. Human mesenchymal stem cells derived from umbilical cord and bone marrow exert immunomodulatory effects in different mechanisms. Cytotherapy 2021. [DOI: 10.1016/s1465324921003455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ducoli L, Agrawal S, Sibler E, Kouno T, Tacconi C, Hon C, Berger S, Müllhaupt D, He Y, Kim J, D’Addio M, Dieterich L, Carninci P, de Hoon M, Shin J, Detmar M. 152 LETR1 is a lymphatic endothelial-specific lncRNA governing cell proliferation and migration through KLF4 and SEMA3C. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Wu A, Plodkowski A, Ginsberg M, Shin J, Laplant Q, Shepherd A, Shaverdian N, Ng V, Yue Y, Gilbo P, Gelblum D, Braunstein L, Gomez D, Rimner A. P02.14 Radiotherapy-Associated CT Imaging as a Potential Screening Tool for COVID-19. J Thorac Oncol 2021. [PMCID: PMC7976875 DOI: 10.1016/j.jtho.2021.01.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Moon M, Shin J, Choi K, Kang J, Rim G, Jo H, Moon S. P62.01 3D Cell Model Development for Optimizing Intrapleural Hyperthermic Chemotherapy in Advanced Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shin J, Kim M, Choi J. Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment. J Nutr Health Aging 2021; 25:938-943. [PMID: 34409975 DOI: 10.1007/s12603-021-1652-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aims to develop a multidimensional frailty assessment tool including physical, psychological, and social frailty and to examine its psychometric property in a clinical setting. METHODS Through a literature review and gathered expert perspectives, the Korean Frailty Scale (KFS, 0-6 points) was developed with six questions about weight loss, self-assessment of health status, energy loss, fatigue, social network, and support. The psychometric property was then validated in community-dwelling older adults using the Korean Frailty and Aging Cohort Survey (2016-2019). Receiver operator characteristic (ROC) analyses determined optimal cutoff scores for frail, pre-frail, and robust. The predictive validity for mortality, hospitalization, fall events, and disability, such as declines in activities of daily living (ADL) and instrumental activities of daily living (IADL) was assessed after adjusting for age, sex, education level, household income, body-mass index, smoking status, alcohol consumption, physical activity, marital status, current employment, and residence. RESULTS The 2,923 participants (mean age: 76.0±3.9 years, female: 52.2%) were categorized into frail (≥3 points, 21.1%), pre-frail (1-2 points, 50.2%) and robust (0 points, 28.7%) groups. Sensitivity (88.3%), specificity (91.6%), and the area under the ROC curve (0.730) for the frail group were sufficient to be accepted as a new frailty scale. The frail group had increased risk of falling (relative risk [RR]: 1.810, 95% confidence interval: 1.354-2.420), mortality (hazard ratio, 6.596, 1.802-24.137), and IADL decline (RR, 1.638, 1.231-2.178). CONCLUSION The KFS is a new multidimensional frailty scale for clinical geriatric assessment that was confirmed as effective for predicting adverse health outcomes in Korean community-dwelling older adults.
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Kim KJ, Choi J, Shin J, Kim M, Won Won C. Consensus on Components of Frailty Using the Delphi Method: Korean Frailty and Aging Cohort Study. J Nutr Health Aging 2021; 25:242-247. [PMID: 33491040 DOI: 10.1007/s12603-020-1523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The concept of frailty has been suggested to comprise physical, mental, and social phenotypes. However, there is no general consensus about the appropriate components for assessing frailty. OBJECTIVES The purpose of this study was to reach consensus on components of frailty assessment using the Delphi process. METHODS To achieve consensus on the definition of frailty, a modified Delphi method was used. Geriatric and gerontologic experts were selected from various fields. The detailed components of frailty were composed of data from the Korean Frailty and Aging Cohort Study. Establishing consensus and collecting opinions from experts were conducted using a modified Delphi method. RESULTS Overall, nine domains with 14 components of frailty assessment were accepted. There was consensus on the necessity of a broad phenotype including physical, mental, and social frailty. CONCLUSIONS Consensus on the components of a frailty assessment in a clinical setting is achieved through the Delphi process to establish a new tool of frailty assessment.
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Ween MP, Moshensky A, Thredgold L, Bastian NA, Hamon R, Badiei A, Nguyen PT, Herewane K, Jersmann H, Bojanowski CM, Shin J, Reynolds PN, Crotty Alexander LE, Hodge SJ. E-cigarettes and health risks: more to the flavor than just the name. Am J Physiol Lung Cell Mol Physiol 2020; 320:L600-L614. [PMID: 33295836 DOI: 10.1152/ajplung.00370.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The growing interest in regulating flavored E-liquids must incorporate understanding of the "flavoring profile" of each E-liquid-which flavorings (flavoring chemicals) are present and at what concentrations not just focusing on the flavor on the label. We investigated the flavoring profile of 10 different flavored E-liquids. We assessed bronchial epithelial cell viability and apoptosis, phagocytosis of bacteria and apoptotic cells by macrophages after exposure to E-cigarette vapor extract (EVE). We validated our data in normal human bronchial epithelial cells (NHBE) and alveolar macrophages (AM) from healthy donors. We also assessed cytokine release and validated in the saliva from E-cigarette users. Increased necrosis/apoptosis (16.1-64.5% apoptosis) in 16HBE cells was flavor dependent, and NHBEs showed an increased susceptibility to flavors. In THP-1 differentiated macrophages phagocytosis was also flavor dependent, with AM also showing increased susceptibility to flavors. Further, Banana and Chocolate were shown to reduce surface expression of phagocytic target recognition receptors on alveolar macrophages. Banana and Chocolate increased IL-8 secretion by NHBE, whereas all 4 flavors reduced AM IL-1β secretion, which was also reduced in the saliva of E-cigarette users compared with healthy controls. Flavorant profiles of E-liquids varied from simple 2 compound mixtures to complex mixtures containing over a dozen flavorants. E-liquids with high benzene content, complex flavoring profiles, high chemical concentration had the greatest impacts. The Flavorant profile of E-liquids is key to disruption of the airway status quo by increasing bronchial epithelial cell apoptosis, causing alveolar macrophage phagocytic dysfunction, and altering airway cytokines.
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Shin J, Chocron R, Rea T, Kudenchuk P, McNally B, Eisenberg M. Merits of expanding the Utstein case definition for out of hospital cardiac arrest. Resuscitation 2020; 158:88-93. [PMID: 33220350 DOI: 10.1016/j.resuscitation.2020.10.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/02/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Utstein population is defined by non-traumatic, bystander-witnessed out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation (VF). It is used to compare resuscitation performance across emergency medical services (EMS) systems. We hypothesized a system-specific survival correlation between the current Utstein population and other VF populations defined by unwitnessed VF OHCA and VF OHCA after EMS arrival (EMS-witnessed). Expanding performance metrics to this more comprehensive population would make the Utstein definition more representative of the actual community burden and response to VF OHCA. METHODS We performed a cohort investigation of all non-traumatic, VF OHCA in the Cardiac Arrest Registry to Enhance Survival from 1/1/2013-12/31/2018 among EMS agencies that treated > = 100 VF OHCA. We evaluated sample size and survival with the addition of the new VF populations. We used Pearson coefficient to assess whether there was a correlation of agency-specific survival outcomes between the current Utstein population and unwitnessed and EMS-witnessed VF OHCA. RESULTS A total of 107 EMS agencies treated 38,836 VF arrests: 22,918 current Utstein, 11,297 unwitnessed VF, and 4621 EMS-witnessed VF OHCA. Overall, survival was 29.8% (11,567/38,836): 33.9% (7774/22,918) among current Utstein, 17.2% (1942/11,297) among unwitnessed VF, and 40.1% (1851/4621) among EMS-witnessed VF. For agency-specific survival outcome, the Pearson correlation was 0.52 between the current Utstein population versus combined unwitnessed and EMS-witnessed groups. For survival with Cerebral Performance Category 1-2, the Pearson correlation was 0.61. CONCLUSION Expanding the Utstein population to include unwitnessed and EMS-witnessed VF OHCA achieves a simpler, more inclusive case definition that minimizes variability in case determination and increases the number of survivors and eligible population by ∼50%, while still achieving a distinguishing metric of system-specific performance.
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Oh J, Lee RW, Lee HR, Lee SB, Ju HJ, Park J, Park HR, Park JH, Hann SK, Almurayshid A, Shin J, Kang HY, Bae JM, Oh SH. Classification of facial and truncal segmental vitiligo and its clinical courses including recurrence rate and patterns: a retrospective review of 956 patients. Br J Dermatol 2020; 184:750-753. [PMID: 33131051 DOI: 10.1111/bjd.19661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022]
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Lee Y, Kim H, Shin J, Shin J, Lim Y, Park J, Heo R, Park S, Ihm S, Pyun W. Clinical features and predictors of masked uncontrolled hypertension: from Korean ambulatory blood pressure monitoring (Korabp) registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical characteristics of patients with masked uncontrolled hypertension (MUCH) are poorly defined, and few studies have reported on clinical predictors of MUCH. We investigated demographic, lifestyle, clinical and blood pressure (BP) characteristics in patients with MUCH and proposed a prediction model for MUCH.
Method
We analyzed 2044 subjects taking antihypertensive medication enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, who were categorized into controlled hypertension (n=481, normal office BP, normal 24-hour ABP), pseudo-uncontrolled hypertension (n=131, high office BP, normal 24-hour ABP), MUCH (n=380, normal office BP, high 24-hour ABP), and sustained uncontrolled hypertension (n=1,052; high office BP and high 24-hour ABP).
Result
The prevalence of MUCH increased with office systolic BP (SBP) and diastolic BP (DBP), whereas it was not associated with the numbers of antihypertensive drugs. But in patients with a high office SBP (≥130 mmHg), the prevalence of MUCH increased with decreasing numbers of antihypertensive drugs (interaction p=0.008; Figure 1A). Multiple logistic regression analysis identified high office SBPs and DBPs, prior stroke, dyslipidemia and single anti-hypertensive agent use as independent predictors of MUCH (Table 1). A prediction model using these predictors showed a high diagnostic accuracy (C-index 0.833) and a goodness of fit for the presence of MUCH (Figure 1B).
Conclusion
MUCH is associated with the borderline increase in office BP and the underuse of anti-hypertensive drugs as well as dyslipidemia and prior stroke, which underscores the importance of achieving the optimal BP control level in the high risk patients. The proposed model would accurately predict MUCH in patients with controlled office BP.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Seo K, Park Y, Kim D, Shin J. LIMB GIRDLE MUSCULAR DYSTROPHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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