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Lee J, Jeong H, Kang HG, Park J, Choi EY, Lee CS, Byeon SH, Kim M. Rapid Pathogen Detection in Infectious Uveitis Using Nanopore Metagenomic Next-Generation Sequencing: A Preliminary Study. Ocul Immunol Inflamm 2024; 32:463-469. [PMID: 36758246 DOI: 10.1080/09273948.2023.2173243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 12/09/2022] [Accepted: 01/22/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE We establish an accurate and rapid diagnostic method for pathogen detection in infectious uveitis using nanopore metagenomic next-generation sequencing (NGS). METHODS In eight patients with suspected infectious uveitis, we prospectively compared the accuracy and time taken for pathogen identification between conventional diagnostic methods, such as cultures and PCR, and nanopore metagenomic NGS. RESULTS All causative pathogens were identified using nanopore sequencing, while only five of the eight patients were confirmed positive for a specific pathogen using conventional methods. The overall sample-to-answer turnaround time of nanopore sequencing was much shorter than that of conventional methods in the bacterial and fungal infection (mean, 17 h vs. 4d, respectively; P = .028). The pathogens could be detected even when the quantity or quality of DNA was not optimal. CONCLUSION Nanopore metagenomic NGS is a promising diagnostic tool that can rapidly and accurately identify the causative pathogen in infectious uveitis.
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Affiliation(s)
- Junwon Lee
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Han Jeong
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
- Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Jinkyu Park
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Young Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
- Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kang C, Yun D, Yoon H, Hong M, Hwang J, Shin HM, Park S, Cheon S, Han D, Moon KC, Kim HY, Choi EY, Lee EY, Kim MH, Jeong CW, Kwak C, Kim DK, Oh KH, Joo KW, Lee DS, Kim YS, Han SS. Glutamyl-prolyl-tRNA synthetase (EPRS1) drives tubulointerstitial nephritis-induced fibrosis by enhancing T cell proliferation and activity. Kidney Int 2024; 105:997-1019. [PMID: 38320721 DOI: 10.1016/j.kint.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 02/27/2024]
Abstract
Toxin- and drug-induced tubulointerstitial nephritis (TIN), characterized by interstitial infiltration of immune cells, frequently necessitates dialysis for patients due to irreversible fibrosis. However, agents modulating interstitial immune cells are lacking. Here, we addressed whether the housekeeping enzyme glutamyl-prolyl-transfer RNA synthetase 1 (EPRS1), responsible for attaching glutamic acid and proline to transfer RNA, modulates immune cell activity during TIN and whether its pharmacological inhibition abrogates fibrotic transformation. The immunological feature following TIN induction by means of an adenine-mixed diet was infiltration of EPRS1high T cells, particularly proliferating T and γδ T cells. The proliferation capacity of both CD4+ and CD8+ T cells, along with interleukin-17 production of γδ T cells, was higher in the kidneys of TIN-induced Eprs1+/+ mice than in the kidneys of TIN-induced Eprs1+/- mice. This discrepancy contributed to the fibrotic amelioration observed in kidneys of Eprs1+/- mice. TIN-induced fibrosis was also reduced in Rag1-/- mice adoptively transferred with Eprs1+/- T cells compared to the Rag1-/- mice transferred with Eprs1+/+ T cells. The use of an EPRS1-targeting small molecule inhibitor (bersiporocin) under clinical trials to evaluate its therapeutic potential against idiopathic pulmonary fibrosis alleviated immunofibrotic aggravation in TIN. EPRS1 expression was also observed in human kidney tissues and blood-derived T cells, and high expression was associated with worse patient outcomes. Thus, EPRS1 may emerge as a therapeutic target in toxin- and drug-induced TIN, modulating the proliferation and activity of infiltrated T cells.
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Affiliation(s)
- Chaelin Kang
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Donghwan Yun
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Haein Yoon
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Minki Hong
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Juhyeon Hwang
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Mu Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Seokwoo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seongmin Cheon
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Dohyun Han
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea; Transdisciplinary Department of Medicine and Advanced Technology, Seoul National University Hospital, Seoul, Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Young Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Young Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Eun-Young Lee
- Microbiome Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Myung Hee Kim
- Microbiome Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Sup Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Yon Su Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Jeong H, Lee W, Jang SG, Pyo J, Choi EY, Baek SJ, Ock M. Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea. Curr Med Res Opin 2024:1-14. [PMID: 38646669 DOI: 10.1080/03007995.2024.2346334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND To ensure effective patient engagement, patients' efforts, partnerships with healthcare professionals, and the organisation's role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals' perception of patient engagement and compared the findings with that determined for the public in a previous study. METHODS An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher's exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study. RESULTS The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 87% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals' hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as 'medical dispute mediation and arbitration programs', 'fall prevention', and 'infection prevention', there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses' perception being particularly more positive than that of physicians. CONCLUSIONS The healthcare professionals' perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public's perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.
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Affiliation(s)
- Hyeran Jeong
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | | | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Seung Ju Baek
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Lee Y, Yoon B, Son S, Cho E, Kim KB, Choi EY, Kim DE. Inhibition of Immunoproteasome Attenuates NLRP3 Inflammasome Response by Regulating E3 Ubiquitin Ligase TRIM31. Cells 2024; 13:675. [PMID: 38667290 PMCID: PMC11048918 DOI: 10.3390/cells13080675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Excessive secretion of pro-inflammatory cytokines leads to the disruption of intestinal barrier in inflammatory bowel disease (IBD). The inflammatory cytokine tumor necrosis factor alpha (TNFα) induces the assembly of the NLRP3 inflammasome, resulting in the augmented secretion of inflammatory cytokines implicated in the pathogenesis of inflammatory bowel disease (IBD). TNFα has also been known to induce the formation of immunoproteasome (IP), which incorporates immunosubunits LMP2, LMP7, and MECL-1. Inhibition of IP activity using the IP subunit LMP2-specific inhibitor YU102, a peptide epoxyketone, decreased the protein levels of NLRP3 and increased the K48-linked polyubiquitination levels of NLRP3 in TNFα-stimulated intestinal epithelial cells. We observed that inhibition of IP activity caused an increase in the protein level of the ubiquitin E3 ligase, tripartite motif-containing protein 31 (TRIM31). TRIM31 facilitated K48-linked polyubiquitination and proteasomal degradation of NLRP3 with an enhanced interaction between NLRP3 and TRIM31 in intestinal epithelial cells. In addition, IP inhibition using YU102 ameliorated the symptoms of colitis in the model mice inflicted with dextran sodium sulfate (DSS). Administration of YU102 in the DSS-treated colitis model mice caused suppression of the NLRP3 protein levels and accompanied inflammatory cytokine release in the intestinal epithelium. Taken together, we demonstrated that inhibiting IP under inflammatory conditions induces E3 ligase TRIM31-mediated NLRP3 degradation, leading to attenuation of the NLRP3 inflammatory response that triggers disruption of intestinal barrier.
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Affiliation(s)
- Yubin Lee
- Department of Bioscience and Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea; (Y.L.); (B.Y.); (S.S.); (E.C.)
| | - Boran Yoon
- Department of Bioscience and Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea; (Y.L.); (B.Y.); (S.S.); (E.C.)
| | - Sumin Son
- Department of Bioscience and Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea; (Y.L.); (B.Y.); (S.S.); (E.C.)
| | - Eunbin Cho
- Department of Bioscience and Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea; (Y.L.); (B.Y.); (S.S.); (E.C.)
| | - Kyung Bo Kim
- Department of Cellular & Molecular Medicine, Herbert Wertheim College of Medicine, Center for Translational Science at Port St. Lucie, Florida International University, 11350 SW Village Pkwy, Port St. Lucie, FL 34987, USA;
| | - Eun Young Choi
- Department of Cellular & Molecular Medicine, Herbert Wertheim College of Medicine, Center for Translational Science at Port St. Lucie, Florida International University, 11350 SW Village Pkwy, Port St. Lucie, FL 34987, USA;
| | - Dong-Eun Kim
- Department of Bioscience and Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea; (Y.L.); (B.Y.); (S.S.); (E.C.)
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Card NS, Wairagkar M, Iacobacci C, Hou X, Singer-Clark T, Willett FR, Kunz EM, Fan C, Vahdati Nia M, Deo DR, Srinivasan A, Choi EY, Glasser MF, Hochberg LR, Henderson JM, Shahlaie K, Brandman DM, Stavisky SD. An accurate and rapidly calibrating speech neuroprosthesis. medRxiv 2024:2023.12.26.23300110. [PMID: 38645254 PMCID: PMC11030484 DOI: 10.1101/2023.12.26.23300110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Brain-computer interfaces can enable rapid, intuitive communication for people with paralysis by transforming the cortical activity associated with attempted speech into text on a computer screen. Despite recent advances, communication with brain-computer interfaces has been restricted by extensive training data requirements and inaccurate word output. A man in his 40's with ALS with tetraparesis and severe dysarthria (ALSFRS-R = 23) was enrolled into the BrainGate2 clinical trial. He underwent surgical implantation of four microelectrode arrays into his left precentral gyrus, which recorded neural activity from 256 intracortical electrodes. We report a speech neuroprosthesis that decoded his neural activity as he attempted to speak in both prompted and unstructured conversational settings. Decoded words were displayed on a screen, then vocalized using text-to-speech software designed to sound like his pre-ALS voice. On the first day of system use, following 30 minutes of attempted speech training data, the neuroprosthesis achieved 99.6% accuracy with a 50-word vocabulary. On the second day, the size of the possible output vocabulary increased to 125,000 words, and, after 1.4 additional hours of training data, the neuroprosthesis achieved 90.2% accuracy. With further training data, the neuroprosthesis sustained 97.5% accuracy beyond eight months after surgical implantation. The participant has used the neuroprosthesis to communicate in self-paced conversations for over 248 hours. In an individual with ALS and severe dysarthria, an intracortical speech neuroprosthesis reached a level of performance suitable to restore naturalistic communication after a brief training period.
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Choi EY, Lee SM, Chun J, Choi YJ, Kim M. CLINICAL CHARACTERISTICS, TREATMENT MODALITIES, AND THEIR ASSOCIATION WITH LONG-TERM VISUAL OUTCOMES IN UVEAL EFFUSION SYNDROME. Retina 2024; 44:642-651. [PMID: 38109673 DOI: 10.1097/iae.0000000000004019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
PURPOSE Uveal effusion syndrome (UES) is a rare eye condition characterized by fluid accumulation in the uveal layer. We investigated its clinical characteristics and treatment modalities and their association with long-term visual outcomes. METHODS This retrospective cohort study included patients with UES treated at two tertiary hospitals between November 2005 and June 2023. Clinical characteristics and treatment outcomes by modality were compared between nanophthalmic Type 1 UES (UES-1) and non-nanophthalmic Type 2 UES (UES-2), and between initial and final visits. Logistic regression analysis was used to identify factors associated with vision loss. RESULTS Twenty-three eyes were included (UES-1, n = 10; UES-2, n = 13). Retinal pigment epithelium mottling was significantly more common in UES-1 than in UES-2 ( P = 0.043); no other between-group differences were observed. Post-treatment, in UES-1, best-corrected visual acuity ( P = 0.028) and central macular thickness ( P = 0.046) significantly decreased; in UES-2, best-corrected visual acuity significantly improved ( P = 0.021), and subfoveal choroidal thickness ( P = 0.048), central subretinal fluid height ( P = 0.011), and central macular thickness ( P = 0.010) significantly decreased. UES-2 was associated with a lower risk of vision loss (odds ratio, 0.024; P = 0.044). No other associated factors were identified. CONCLUSION The UES type was the sole independent prognostic factor for vision loss, whereas treatment modalities had no significant impact on visual outcomes.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Republic of Korea ; and
- Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Min Lee
- Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Republic of Korea ; and
- Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinsuk Chun
- Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Republic of Korea ; and
- Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Je Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Republic of Korea ; and
- Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Republic of Korea ; and
- Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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Choi EY, Cho G, Chang VW. Neighborhood Social Environment and Dementia: The Mediating Role of Social Isolation. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad199. [PMID: 38180790 DOI: 10.1093/geronb/gbad199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVES Despite the potential importance of the neighborhood social environment for cognitive health, the connection between neighborhood characteristics and dementia remains unclear. This study investigated the association between the prospective risk of dementia and three distinct aspects of neighborhood social environment: socioeconomic deprivation, disorder, and social cohesion. We also examined whether objective and subjective aspects of individual-level social isolation may function as mediators. METHODS Leveraging data from the Health and Retirement Study (2006-2018; N = 9,251), we used Cox proportional hazards models to examine the association between time-to-dementia incidence and each neighborhood characteristic, adjusting for covariates and the propensity to self-select into disadvantaged neighborhoods. We used inverse odds weighting to decompose significant total effects of neighborhood characteristics into mediational effects of objective and subjective social isolation. RESULTS The risk of dementia was associated with deprivation and disorder but not low cohesion. In deprived neighborhoods, individuals had an 18% increased risk of developing dementia (cause-specific hazard ratio [CHR] = 1.18, 95% CI: 1.02 to 1.38), and those in disordered areas had a 27% higher risk (CHR = 1.27, 95% CI: 1.03 to 1.59). 20% of the disorder's effects were mediated by subjective social isolation, while the mediational effects of objective isolation were nonsignificant. Deprivation's total effects were not partitioned into mediational effects given its nonsignificant associations with the mediators. DISCUSSION Neighborhood deprivation and disorder may increase middle to older adults' risks of dementia. The disorder may adversely affect cognitive health through increasing loneliness. Our results suggest a clear need for dementia prevention targeting upstream neighborhood contexts, including the improvement of neighborhood conditions to foster social integration among residents.
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Affiliation(s)
- Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Gawon Cho
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Virginia W Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
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Kang Y, Kim D, Lee S, Kim H, Kim T, Cho JA, Lee T, Choi EY. Innate Immune Training Initiates Efferocytosis to Protect against Lung Injury. Adv Sci (Weinh) 2024; 11:e2308978. [PMID: 38279580 PMCID: PMC11005705 DOI: 10.1002/advs.202308978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Indexed: 01/28/2024]
Abstract
Innate immune training involves myelopoiesis, dynamic gene modulation, and functional reprogramming of myeloid cells in response to secondary heterologous challenges. The present study evaluates whether systemic innate immune training can protect tissues from local injury. Systemic pretreatment of mice with β-glucan, a trained immunity agonist, reduces the mortality rate of mice with bleomycin-induced lung injury and fibrosis, as well as decreasing collagen deposition in the lungs. β-Glucan pretreatment induces neutrophil accumulation in the lungs and enhances efferocytosis. Training of mice with β-glucan results in histone modification in both alveolar macrophages (AMs) and neighboring lung epithelial cells. Training also increases the production of RvD1 and soluble mediators by AMs and efferocytes. Efferocytosis increases trained immunity in AMs by stimulating RvD1 release, thus inducing SIRT1 expression in neighboring lung epithelial cells. Elevated epithelial SIRT1 expression is associated with decreased epithelial cell apoptosis after lung injury, attenuating tissue damage. Further, neutrophil depletion dampens the effects of β-glucan on macrophage accumulation, epigenetic modification in lung macrophages, epithelial SIRT1 expression, and injury-mediated fibrosis in the lung. These findings provide mechanistic insights into innate immune training and clues to the potential ability of centrally trained immunity to protect peripheral organs against injury-mediated disorders.
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Affiliation(s)
- Yoon‐Young Kang
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
- Department of MicrobiologyUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
| | - Dong‐Young Kim
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
- Present address:
Institute for Clinical Chemistry and Laboratory MedicineFaculty of MedicineTechnische Universität Dresden01307DresdenGermany
| | - Sang‐Yong Lee
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
- Department of MicrobiologyUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
| | - Hee‐Joong Kim
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
- Department of MicrobiologyUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
| | - Taehawn Kim
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
| | - Jeong A. Cho
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
| | - Taewon Lee
- Division of Applied Mathematical SciencesCollege of Science and TechnologyKorea UniversitySejong30019Republic of Korea
| | - Eun Young Choi
- Department of Biomedical SciencesUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
- Department of MicrobiologyUniversity of Ulsan College of MedicineASAN Medical CenterSeoul05505Republic of Korea
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Kim TW, Kim WY, Park S, Lee SH, Park O, Kim T, Yeo HJ, Jang JH, Cho WH, Huh JW, Lee SM, Chung CR, Lee J, Kim JS, Lim SY, Baek AR, Yoo JW, Kim HC, Choi EY, Park C, Kim TO, Moon DS, Lee SI, Moon JY, Kwon SJ, Seong GM, Jung WJ, Baek MS. Risk Factors for the Mortality of Patients With Coronavirus Disease 2019 Requiring Extracorporeal Membrane Oxygenation in a Non-Centralized Setting: A Nationwide Study. J Korean Med Sci 2024; 39:e75. [PMID: 38442718 PMCID: PMC10911941 DOI: 10.3346/jkms.2024.39.e75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/03/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. METHODS We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan-Meier (KM) method. RESULTS Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010-1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312-7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). CONCLUSION Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.
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Affiliation(s)
- Tae Wan Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Won-Young Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sunghoon Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Su Hwan Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Onyu Park
- BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Taehwa Kim
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye Ju Yeo
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jin Ho Jang
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Woo Hyun Cho
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jin-Won Huh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jongmin Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Soo Kim
- Division of Critical Care Medicine, Department of Hospital Medicine, Inha Collage of Medicine, Incheon, Korea
| | - Sung Yoon Lim
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ae-Rin Baek
- Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jung-Wan Yoo
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Ho Cheol Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Eun Young Choi
- Division of Pulmonology and Allergy, Department of Internal Medicine, College of Medicine, Yeungnam University and Regional Center for Respiratory Diseases, Yeungnam University Medical Center, Daegu, Korea
| | - Chul Park
- Division of Pulmonology and Critical Care Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Tae-Ok Kim
- Division of Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Do Sik Moon
- Department of Pulmonology and Critical Care Medicine, Chosun University Hospital, Gwangju, Korea
| | - Song-I Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jae Young Moon
- Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Sun Jung Kwon
- Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Gil Myeong Seong
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Won Jai Jung
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Moon Seong Baek
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
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Choi EY, Johnson NA, Stinnett S, Rosdahl J, Moya F, Herndon LW. The Effect of Bimatoprost Implant on Glaucoma Patients: An Observational Study. J Glaucoma 2024:00061198-990000000-00346. [PMID: 38506759 DOI: 10.1097/ijg.0000000000002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/20/2024] [Indexed: 03/21/2024]
Abstract
PRCIS In this retrospective study of glaucoma patients receiving the bimatoprost implant at Duke Eye Center, the number of topical intraocular pressure-lowering medications was significantly reduced through 12 months after the implant. PURPOSE To study the effects of the bimatoprost implant on intraocular pressure (IOP) and the need for topical IOP-lowering medications in glaucoma patients in the clinical practice setting. PATIENTS AND METHODS Patients who received the bimatoprost implant at Duke Eye Center from November 2020 to October 2021 were identified. Exclusion criteria included addition of other IOP-lowering medications concurrent with the implant and less than 1 month of follow-up. The change in IOP and number of topical IOP-lowering medications from baseline to months 1, 3, 6, 9, and 12 after the implant was calculated. Subgroup analysis was performed for different glaucoma severities. RESULTS A total of 63 patients and 92 eyes were included (mean age 77.8 ± 10.1 years). Glaucoma severity ranged from mild (11%), moderate (30%), to severe (54%). There was a nonsignificant decrease in IOP at all timepoints. The mean number of topical IOP-lowering medications significantly decreased by 0.81, 0.75, 0.63, 0.70, and 0.67 at month 1, 3, 6, 9, and 12, respectively (all P < 0.001). There was no significant change in the total number of medications including the bimatoprost implant. When divided by glaucoma severity, the reduction in the number of topical medications was significant at 1, 3, and 6 months for mild/moderate disease, and at 1 month for severe disease. During the follow-up period, 19 eyes underwent additional laser or surgical procedures, 68% of which had a history of prior incisional glaucoma surgery. CONCLUSIONS The bimatoprost implant may reduce the need for topical IOP-lowering agents over a 1-year period, especially in mild-to-moderate stage glaucoma. The efficacy of the implant may be more limited in severe glaucoma, and further work is needed to characterize its long-term effects.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Duke University, Durham, NC, USA
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11
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Choi EY, Boisvert CJ, Basuroski ID, Khagi S. Paraneoplastic Optic Neuropathy in a Patient With Glioblastoma. J Neuroophthalmol 2024; 44:e42-e44. [PMID: 36166778 DOI: 10.1097/wno.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology (EYC, CJB), Duke University Medical Center, Durham, North Carolina; Department of Neurology (IDB), University of North Carolina School of Medicine, Chapel Hill, North Carolina; and Department of Medicine (SK), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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Jeong H, Choi EY, Lee W, Jang SG, Pyo J, Ock M. Importance of Quality of Medical Record: Differences in Patient Safety Incident Inquiry Results According to Assessment for Quality of Medical Record. J Patient Saf 2024:01209203-990000000-00193. [PMID: 38446056 DOI: 10.1097/pts.0000000000001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Medical record review is the gold standard method of identifying adverse events. However, the quality of medical records is a critical factor that can affect the accuracy of adverse event detection. Few studies have examined the impact of medical record quality on the identification of adverse events. OBJECTIVES In this study, we analyze whether there were differences in screening criteria and characteristics of adverse events according to the quality of medical records evaluated in the patient safety incident inquiry in Korea. METHODS Patient safety incident inquiry was conducted in 2019 on 7500 patients in Korea to evaluate their screening criteria, adverse events, and preventability. Furthermore, medical records quality judged by reviewers was evaluated on a 4-point scale. The χ2 test was used to examine differences in patient safety incident inquiry results according to medical record quality. RESULTS Cases with inadequate medical records had higher rates of identified screening criteria than those with adequate records (88.8% versus 55.7%). Medical records judged inadequate had a higher rate of confirmed adverse events than those judged adequate. "Drugs, fluids, and blood-related events," "diagnosis-related events," and "patient care-related events" were more frequently identified in cases with inadequate medical records. There was no statistically significant difference in the preventability of adverse events according to the medical record quality. CONCLUSIONS Lower medical record quality was associated with higher rates of identified screening criteria and confirmed adverse events. Patient safety incident inquiry should specify medical record quality evaluation questions more accurately to more clearly estimate the impact of medical record quality.
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Affiliation(s)
- Hyeran Jeong
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
| | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | | | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
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13
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Ong KTI, Kwon T, Jang H, Kim M, Lee CS, Byeon SH, Kim SS, Yeo J, Choi EY. Multitask Deep Learning for Joint Detection of Necrotizing Viral and Noninfectious Retinitis From Common Blood and Serology Test Data. Invest Ophthalmol Vis Sci 2024; 65:5. [PMID: 38306107 PMCID: PMC10851173 DOI: 10.1167/iovs.65.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Purpose Necrotizing viral retinitis is a serious eye infection that requires immediate treatment to prevent permanent vision loss. Uncertain clinical suspicion can result in delayed diagnosis, inappropriate administration of corticosteroids, or repeated intraocular sampling. To quickly and accurately distinguish between viral and noninfectious retinitis, we aimed to develop deep learning (DL) models solely using noninvasive blood test data. Methods This cross-sectional study trained DL models using common blood and serology test data from 3080 patients (noninfectious uveitis of the posterior segment [NIU-PS] = 2858, acute retinal necrosis [ARN] = 66, cytomegalovirus [CMV], retinitis = 156). Following the development of separate base DL models for ARN and CMV retinitis, multitask learning (MTL) was employed to enable simultaneous discrimination. Advanced MTL models incorporating adversarial training were used to enhance DL feature extraction from the small, imbalanced data. We evaluated model performance, disease-specific important features, and the causal relationship between DL features and detection results. Results The presented models all achieved excellent detection performances, with the adversarial MTL model achieving the highest receiver operating characteristic curves (0.932 for ARN and 0.982 for CMV retinitis). Significant features for ARN detection included varicella-zoster virus (VZV) immunoglobulin M (IgM), herpes simplex virus immunoglobulin G, and neutrophil count, while for CMV retinitis, they encompassed VZV IgM, CMV IgM, and lymphocyte count. The adversarial MTL model exhibited substantial changes in detection outcomes when the key features were contaminated, indicating stronger causality between DL features and detection results. Conclusions The adversarial MTL model, using blood test data, may serve as a reliable adjunct for the expedited diagnosis of ARN, CMV retinitis, and NIU-PS simultaneously in real clinical settings.
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Affiliation(s)
- Kai Tzu-iunn Ong
- Department of Artificial Intelligence, Yonsei University College of Computing, Seoul, Republic of Korea
| | - Taeyoon Kwon
- Department of Artificial Intelligence, Yonsei University College of Computing, Seoul, Republic of Korea
| | - Harok Jang
- Department of Artificial Intelligence, Yonsei University College of Computing, Seoul, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinyoung Yeo
- Department of Artificial Intelligence, Yonsei University College of Computing, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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14
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Choi EY. Longitudinal Associations of Neighborhood Social Cohesion With Self-Perceptions of Aging and Loneliness. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad148. [PMID: 37804237 DOI: 10.1093/geronb/gbad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVES One's aging experience is structurally embedded in the social aspects of the residential environment. However, it is largely unknown how this upstream contextual factor may shape self-perceptions of aging (SPA) and loneliness, critical aspects of later-life psychological well-being with profound health implications. This study examines the longitudinal association of neighborhood social cohesion with SPA and -loneliness, as well as the potential bidirectional associations between outcomes. METHODS This study used 8-year data from the Health and Retirement Study, with an analytic sample of 9,299 U.S. adults aged 50 or older. Latent growth curve models were implemented to assess the associations of baseline neighborhood social cohesion with trajectories of SPA and loneliness. Path analysis was conducted to examine the longitudinal mediation mechanisms connecting neighborhood social cohesion with SPA and loneliness. RESULTS Respondents from cohesive neighborhoods at baseline started with and maintained more positive initial SPA over time, but their positive perceptions decreased faster over time. Cohesive neighborhoods were associated with lower levels of loneliness over an 8-year study period, but also with slower rates of decline in loneliness. Path analysis revealed that neighborhood social cohesion indirectly affected SPA and loneliness, via bidirectional mechanisms. DISCUSSION This study demonstrates the significant role of environmental factors beyond individual predictors and advocates for the potential of neighborhood environments as a target for interventions to foster positive aging perception and tackle loneliness. Furthermore, it indicates that loneliness and SPA could reciprocally influence each other in the context of neighborhood social cohesion, enriching our understanding of their dynamics.
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Affiliation(s)
- Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
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15
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Schiff ND, Giacino JT, Butson CR, Choi EY, Baker JL, O'Sullivan KP, Janson AP, Bergin M, Bronte-Stewart HM, Chua J, DeGeorge L, Dikmen S, Fogarty A, Gerber LM, Krel M, Maldonado J, Radovan M, Shah SA, Su J, Temkin N, Tourdias T, Victor JD, Waters A, Kolakowsky-Hayner SA, Fins JJ, Machado AG, Rutt BK, Henderson JM. Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study. Nat Med 2023; 29:3162-3174. [PMID: 38049620 DOI: 10.1038/s41591-023-02638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 12/06/2023]
Abstract
Converging evidence indicates that impairments in executive function and information-processing speed limit quality of life and social reentry after moderate-to-severe traumatic brain injury (msTBI). These deficits reflect dysfunction of frontostriatal networks for which the central lateral (CL) nucleus of the thalamus is a critical node. The primary objective of this feasibility study was to test the safety and efficacy of deep brain stimulation within the CL and the associated medial dorsal tegmental (CL/DTTm) tract.Six participants with msTBI, who were between 3 and 18 years post-injury, underwent surgery with electrode placement guided by imaging and subject-specific biophysical modeling to predict activation of the CL/DTTm tract. The primary efficacy measure was improvement in executive control indexed by processing speed on part B of the trail-making test.All six participants were safely implanted. Five participants completed the study and one was withdrawn for protocol non-compliance. Processing speed on part B of the trail-making test improved 15% to 52% from baseline, exceeding the 10% benchmark for improvement in all five cases.CL/DTTm deep brain stimulation can be safely applied and may improve executive control in patients with msTBI who are in the chronic phase of recovery.ClinicalTrials.gov identifier: NCT02881151 .
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Affiliation(s)
- Nicholas D Schiff
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA.
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Christopher R Butson
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
- Norman Fixel Institute for Neurological Diseases Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Eun Young Choi
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Jonathan L Baker
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
| | - Kyle P O'Sullivan
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
| | - Andrew P Janson
- Scientific Computing and Imaging Institute Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Michael Bergin
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | | | - Jason Chua
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Laurel DeGeorge
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
| | - Sureyya Dikmen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Adam Fogarty
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Linda M Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Mark Krel
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Jose Maldonado
- Department of Psychiatry, Stanford University, Stanford, CA, USA
| | - Matthew Radovan
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Jason Su
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Nancy Temkin
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Thomas Tourdias
- Department of Neuroimaging, University of Bordeaux, Nouvelle-Aquitaine, France
| | - Jonathan D Victor
- Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Abigail Waters
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | | | - Joseph J Fins
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Andre G Machado
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brian K Rutt
- Department of Radiology, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Bio-X Program, Stanford University, Stanford, CA, USA
| | - Jaimie M Henderson
- Department of Neurosurgery, Stanford University, Stanford, CA, USA.
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
- Bio-X Program, Stanford University, Stanford, CA, USA.
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Lee SM, Kim KH, Kang HG, Choi EY, Lee J, Kim M. Vascular abnormalities in fellow eyes of patients with unilateral coats' disease. Sci Rep 2023; 13:19380. [PMID: 37938623 PMCID: PMC10632512 DOI: 10.1038/s41598-023-45838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Coats' disease is an idiopathic retinal vascular disorder, known to usually occur unilaterally; however, recent studies have highlighted vascular abnormalities in the fellow unaffected eyes. This retrospective study investigated the peripheral vascular features and macular vascular structure of unaffected fellow eyes in patients with unilateral Coats' disease using multimodal imaging tools. We analysed images of patients, including bilateral ultra-widefield imaging, fluorescein angiography (FA), ultra-widefield FA, or standard fundus photography. Available bilateral optical coherence tomography angiography (OCT-A) images were used for macular vascular structure analysis. OCT-A parameters, including foveal avascular zone (FAZ), perfusion index, and vessel density (VD) in the superficial and deep capillary plexuses (SCP, DCP), were calculated using Image J software. The mean age at diagnosis was 34.5 ± 17.9 years. The mean final best-corrected visual acuity of the affected eyes was logMAR 0.78 ± 0.79, while that of the fellow eyes was logMAR 0.04 ± 0.12. Ten fellow eyes had microaneurysms (47.6%), two had tortuous vessel abnormalities (9.5%), and 11(52.4%) had abnormal vascular findings on FA. Although there was a trend towards larger DCP FAZ (1.201 ± 0.086 vs. 1.072 ± 0.226), and lower DCP VD (8.593 ± 1.583 vs. 10.827 ± 3.392) in the affected eyes as measured by the Cirrus machine, the difference was not statistically significant between affected and fellow eyes when measured using the Zeiss Cirrus machine (P = 0.686, P = 0.343, respectively). However, when measured with the Spectralis machine, DCP FAZ was larger in affected eyes (0.828 ± 0.426 vs. 0.254 ± 0.092, P = 0.002) and DCP VD was lower in affected eyes (6.901 ± 2.634 vs. 17.451 ± 7.207, P = 0.002) compared to the fellow eyes, while other parameters showed no significant variations. These findings indicate that there may be subtle vascular abnormalities primarily located in the peripheral regions of the unaffected fellow eyes in patients with unilateral Coats' disease, while the macular microvasculature remains unaffected.
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Affiliation(s)
- Seung Min Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Kang Hyun Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-gu, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Junwon Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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Choi EY, Kim J, Lee W, Jang SG, Pyo J, Ock M. Comprehensive Measurement of the Burden of Disease due to Adverse Events: A New Analysis of the Cross-Sectional Patient Safety Incident Inquiry. J Korean Med Sci 2023; 38:e337. [PMID: 37935164 PMCID: PMC10627726 DOI: 10.3346/jkms.2023.38.e337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/19/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND A methodology for comprehensively and reasonably measuring the burden of disease due to adverse events has yet to be clearly established. In this study, a new and systematic method for measuring the burden of disease due to adverse events was tested by utilizing the results of a medical record review, which is commonly used as a gold standard. METHODS Using the characteristics of preventable adverse events identified in the 2019 Patient Safety Incidents Inquiry (PSII), conducted to monitor the level of patient safety in Korea accurately, the resulting disability-adjusted life years (DALYs) and economic costs were estimated. DALYs were calculated as the sum of the years lived with a disability for patients who suffered permanent disability, or more, due to preventable adverse events, and the years of life lost due to premature mortality was calculated for patients who died due to preventable adverse events. The economic cost was calculated using the main diagnostic codes of patients who suffered preventable adverse events, identified as prolonged hospitalization in PSII, and the average medical cost by disease category and age group. RESULTS Estimates of DALYs due to preventable adverse events were 1,114.4 DALYs per 100,000 population for the minimum standard and 1,658.5 DALYs per 100,000 population for the maximum standard. Compared to the 2015 Korea Burden of Disease results, the ranking of DALYs due to preventable adverse events was sixth for the minimum standard and third for the maximum standard. The annual medical cost of adverse events in 2016 was estimated to be approximately Korean Republic Won (KRW) 870 billion (700 million US dollars). Medical expenses due to preventable adverse events were calculated to be approximately KRW 150 billion (120 million US dollars) as a minimum standard and approximately KRW 300 billion (240 million US dollars) as a maximum standard. CONCLUSION If this more standard method of systematically calculating the disease burden due to adverse events is used, it will be possible to compare the size of the patient safety problem with that of other diseases. The results of this study indicate that we still need to pay more attention to the issue of patient safety.
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Affiliation(s)
- Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Juyoung Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Seung Gyeong Jang
- Department of Nursing, College of Nursing, Inje University, Gimhae, Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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18
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Kwak JJ, Lee KS, Lee J, Kim YJ, Choi EY, Byeon SH, Chang WS, Kim YR, Kim JS, Shin S, Lee ST, Kim SS, Lee CS. Next-Generation Sequencing of Vitreoretinal Lymphoma by Vitreous Liquid Biopsy: Diagnostic Potential and Genotype/Phenotype Correlation. Invest Ophthalmol Vis Sci 2023; 64:27. [PMID: 37975847 PMCID: PMC10664732 DOI: 10.1167/iovs.64.14.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023] Open
Abstract
Purpose To determine the diagnostic potential of next-generation sequencing (NGS) in vitreous samples, analyze genotype-phenotype characteristics, and compare NGS of matched vitreous and brain samples in patients with associated central nervous system lymphoma (CNSL). Methods A total of 32 patients suspected of vitreoretinal lymphoma (VRL) who underwent diagnostic vitrectomy and NGS were included in this retrospective observational case-series. Fresh vitreous specimens from diagnostic vitrectomy of VRL-suspected patients underwent NGS using a custom panel targeting 747 candidate genes for lymphoma. They also underwent malignancy cytology, interleukin (IL)-10/IL-6, immunoglobulin heavy chain (IGH)/immunoglobulin kappa light chain (IGK) monoclonality testing. MYD88 L265P mutation was examined from anterior chamber tap samples. The diagnosis of VRL was made based on typical clinical characteristics for VRL, as well as malignant cytology, IGH/IGK clonality, or IL-10/IL-6 > 1. Sensitivity and specificity of NGS were compared with conventional diagnostic tests. Brain tissues suspected of lymphoma were collected by stereotactic biopsy and underwent NGS. Genetic variations detected in NGS of vitreous and brain tissue specimens were compared. Results The sensitivity values for cytology, IL-10/IL-6 > 1, clonality assays for IGH and IGK, MYD88 L265P detection in anterior chamber tap samples, and vitreous NGS were 0.23, 0.83, 0.68, 0.79, 0.67, and 0.85, with specificity values of 1.00, 0.83, 0.50, 0.25, 0.83, and 0.83, respectively. The sensitivity (0.85) of vitreous NGS was the highest compared to other conventional diagnostic tests for VRL. The most common mutations were MYD88 (91%), CDKN2A (36%), PIM1 (32%), IGLL5 (27%), and ETV6 (23%). Although several gene alterations demonstrated heterogeneity between the brain and eyes, some common mutational profiles were observed in matched vitreous and brain samples. Conclusions Overall, NGS of the vitreous demonstrated high sensitivity among conventional diagnostic tests. VRL and CNSL appeared to have both shared and distinct genetic variations, which may suggest site-specific variations from a common origin.
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Affiliation(s)
- Jay Jiyong Kwak
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Seob Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Junwon Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Joon Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Young Choi
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Won Seok Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Ri Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Saeam Shin
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Tae Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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Choi EY, Lee H, Chang VW. Cumulative exposure to extreme heat and trajectories of cognitive decline among older adults in the USA. J Epidemiol Community Health 2023; 77:728-735. [PMID: 37541774 DOI: 10.1136/jech-2023-220675] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The projected increase in extreme heat days is a growing public health concern. While exposure to extreme heat has been shown to negatively affect mortality and physical health, very little is known about its long-term consequences for late-life cognitive function. We examined whether extreme heat exposure is associated with cognitive decline among older adults and whether this association differs by race/ethnicity and neighbourhood socioeconomic status. METHODS Data were drawn from seven waves of the Health and Retirement Study (2006-2018) merged with historical temperature data. We used growth curve models to assess the role of extreme heat exposure on trajectories of cognitive function among US adults aged 52 years and older. RESULTS We found that high exposure to extreme heat was associated with faster cognitive decline for blacks and residents of poor neighbourhoods, but not for whites, Hispanics or residents of wealthier neighbourhoods. CONCLUSION Extreme heat exposure can disproportionately undermine cognitive health in later life for socially vulnerable populations. Our findings underscore the need for policy actions to identify and support high-risk communities for increasingly warming temperatures.
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Affiliation(s)
- Eun Young Choi
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Haena Lee
- Department of Sociology, Sungkyunkwan University, Seoul, Korea (the Republic of)
| | - Virginia W Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
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Kim CS, Jung MH, Choi EY, Shin DM. Probiotic supplementation has sex-dependent effects on immune responses in association with the gut microbiota in community-dwelling older adults: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Res Pract 2023; 17:883-898. [PMID: 37780220 PMCID: PMC10522805 DOI: 10.4162/nrp.2023.17.5.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/13/2023] [Accepted: 05/19/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES Probiotics have been suggested as potent modulators of age-related disorders in immunological functions, yet little is known about sex-dependent effects of probiotic supplements. Therefore, we aimed to investigate sex-dependent effects of probiotics on profiles of the gut microbiota and peripheral immune cells in healthy older adults. SUBJECTS/METHODS In a randomized, double-blind, placebo-controlled, multicenter trial, healthy elderly individuals ≥ 65 yrs old were administered probiotic capsules (or placebo) for 12 wk. Gut microbiota was analyzed using 16S rRNA gene sequencing and bioinformatic analyses. Peripheral immune cells were profiled using flow cytometry for lymphocytes (natural killer, B, CD4+ T, and CD8+ T cells), dendritic cells, monocytes, and their subpopulations. RESULTS Compared with placebo, phylum Firmicutes was significantly reduced in the probiotic group in women, but not in men. At the genus level, sex-specific responses included reductions in the relative abundances of pro-inflammatory gut microbes, including Catabacter and unclassified_Coriobacteriales, and Burkholderia and unclassified Enterobacteriaceae, in men and women, respectively. Peripheral immune cell profiling analysis revealed that in men, probiotics significantly reduced the proportions of dendritic cells and CD14+ CD16- monocytes; however, these effects were not observed in women. In contrast, the proportion of total CD4+ T cells was significantly reduced in women in the probiotic group. Additionally, serum lipopolysaccharide-binding protein levels showed a decreasing tendency that were positively associated with changes in gut bacteria, including Catabacter (ρ = 0.678, P < 0.05) and Burkholderia (ρ = 0.673, P < 0.05) in men and women, respectively. CONCLUSIONS These results suggest that probiotic supplementation may reduce the incidence of inflammation-related diseases by regulating the profiles of the gut microbiota and peripheral immune cells in healthy elders in a sex-specific manner.
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Affiliation(s)
- Chong-Su Kim
- Department of Food and Nutrition, College of Natural Information Sciences, Dongduk Women's University, Seoul 02748, Korea
| | - Min Ho Jung
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Eun Young Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Dong-Mi Shin
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
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21
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Lee HY, Hao Z, Choi EY. Depression among Korean American immigrants living in rural Alabama: use of social determinants of health framework. Ethn Health 2023; 28:1069-1082. [PMID: 37198142 DOI: 10.1080/13557858.2023.2208314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/24/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVES Depression among Korean American (KA) immigrants in rural Alabama is understudied. This study aims to utilize the social determinants of health (SDOH) framework to explore factors associated with depressive symptoms among KA immigrants living in rural communities of Alabama. DESIGN Data were collected from two sites in rural Alabama from September 2019 to February 2020. Convenience sampling was conducted to recruit study participants from the KA community. A total number of 261 KA immigrants aged 23-75 were included in the study. All measures originally in English were translated into Korean using back-translation to assure comparability and equivalence in the meaning of measures. Multiple linear regression modeling was used to explore the predictors of depression. RESULTS Perceived race discrimination was significantly associated with greater depressive symptoms (β = .180, SE = .534, p < .01). Three SDOH were identified to have significant relationship with depressive symptoms. Participants who could not see a doctor because of cost (β = .247, SE = 1.118, p < .001), had lower level of health literacy (β = -.121, SE = .280, p < .05), and had higher social isolation scores (β = .157, SE = .226, p < .05) tended to have higher scores of depressive symptoms. CONCLUSION Rural-living KA immigrants' depression can be significantly affected by race discrimination and SDOH factors, emphasizing the need for culturally competent interventions and services. Policymakers, federal and local governments, non-governmental organizations, and social workers can make joint efforts to address racial discrimination and improve the mental health services among immigrant populations, especially those living in rural areas.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Zhichao Hao
- College of State Governance, Southwest University, Chongqing city, People's Republic of China
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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22
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Lee HY, Song J, Choi EY. Childhood abuse and opioid prescription use in adulthood: Differences between non-Hispanic Whites and non-Hispanic Blacks in the United States. PLoS One 2023; 18:e0291752. [PMID: 37733706 PMCID: PMC10513245 DOI: 10.1371/journal.pone.0291752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
Despite the rapid rise in opioid prescription medication usage, little research has examined the role of early life adversity, such as childhood abuse, particularly in the context of race, in opioid prescription usage in adulthood. Guided by the life course perspective, the current study investigates whether experiencing childhood abuse increases the risk of opioid prescription use in adulthood and whether this association varies by race. Data were sourced from the second wave of the Midlife in the United States (MIDUS) study (2004-2005). The analytic sample consisted of two groups: non-Hispanic Whites (n = 714) and non-Hispanic Blacks (n = 151). Opioid prescription use was identified from the participants' medication list using the MULTUM Lexicon Drug Database Classification System. Three types of childhood abuse-emotional, physical, and sexual-were assessed via summary scales derived from the Childhood Trauma Questionnaire. The results indicate a significant interaction between childhood physical abuse and race. Among non-Hispanic Whites, higher exposure to physical abuse during childhood was associated with greater odds of opioid prescription use in adulthood, even after adjusting for chronic pain, physical and mental health, and sociodemographic characteristics. However, the association between childhood physical abuse and opioid prescription use in adulthood was non-significant among non-Hispanic Black individuals. These findings underscore the long-term adverse health effects of physical abuse in childhood, particularly for non-Hispanic Whites, and suggest support for developing and implementing tailored intervention strategies.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States of America
| | - Jieun Song
- Institute on Aging, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States of America
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23
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Choi EY, Lee M. Reply to Comment on Intermittent Fasting is Associated with a Decreased Risk of Age-related Macular Degeneration. Am J Ophthalmol 2023; 252:334-335. [PMID: 37031903 DOI: 10.1016/j.ajo.2023.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Minyoung Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea.
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Willett FR, Kunz EM, Fan C, Avansino DT, Wilson GH, Choi EY, Kamdar F, Glasser MF, Hochberg LR, Druckmann S, Shenoy KV, Henderson JM. A high-performance speech neuroprosthesis. Nature 2023; 620:1031-1036. [PMID: 37612500 PMCID: PMC10468393 DOI: 10.1038/s41586-023-06377-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/27/2023] [Indexed: 08/25/2023]
Abstract
Speech brain-computer interfaces (BCIs) have the potential to restore rapid communication to people with paralysis by decoding neural activity evoked by attempted speech into text1,2 or sound3,4. Early demonstrations, although promising, have not yet achieved accuracies sufficiently high for communication of unconstrained sentences from a large vocabulary1-7. Here we demonstrate a speech-to-text BCI that records spiking activity from intracortical microelectrode arrays. Enabled by these high-resolution recordings, our study participant-who can no longer speak intelligibly owing to amyotrophic lateral sclerosis-achieved a 9.1% word error rate on a 50-word vocabulary (2.7 times fewer errors than the previous state-of-the-art speech BCI2) and a 23.8% word error rate on a 125,000-word vocabulary (the first successful demonstration, to our knowledge, of large-vocabulary decoding). Our participant's attempted speech was decoded at 62 words per minute, which is 3.4 times as fast as the previous record8 and begins to approach the speed of natural conversation (160 words per minute9). Finally, we highlight two aspects of the neural code for speech that are encouraging for speech BCIs: spatially intermixed tuning to speech articulators that makes accurate decoding possible from only a small region of cortex, and a detailed articulatory representation of phonemes that persists years after paralysis. These results show a feasible path forward for restoring rapid communication to people with paralysis who can no longer speak.
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Affiliation(s)
- Francis R Willett
- Howard Hughes Medical Institute at Stanford University, Stanford, CA, USA.
| | - Erin M Kunz
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Chaofei Fan
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Donald T Avansino
- Howard Hughes Medical Institute at Stanford University, Stanford, CA, USA
| | - Guy H Wilson
- Department of Neuroscience, Stanford University, Stanford, CA, USA
| | - Eun Young Choi
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Foram Kamdar
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Matthew F Glasser
- Department of Neuroscience, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Leigh R Hochberg
- VA RR&D Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Providence VA Medical Center, Providence, RI, USA
- School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Shaul Druckmann
- Department of Neurobiology, Stanford University, Stanford, CA, USA
| | - Krishna V Shenoy
- Howard Hughes Medical Institute at Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Department of Neurobiology, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Bio-X Program, Stanford University, Stanford, CA, USA
| | - Jaimie M Henderson
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
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Choi EY, Farina M, Zhao E, Ailshire J. Changes in social lives and loneliness during COVID-19 among older adults: a closer look at the sociodemographic differences. Int Psychogeriatr 2023; 35:305-317. [PMID: 36621851 PMCID: PMC10198802 DOI: 10.1017/s1041610222001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The COVID-19 pandemic greatly impacted the social lives of older adults across several areas, leading to concern about an increase in loneliness. This study examines the associations of structural, functional, and quality aspects of social connection with increased loneliness during COVID-19 and how these associations vary by sociodemographic factors. DESIGN Secondary data analyses on a nationally representative survey of older US adults. SETTING The 2020 Health and Retirement Study (HRS) COVID-19 module. PARTICIPANTS The study sample includes 3,804 adults aged 54 or older. MEASUREMENTS Increased loneliness was based on respondents' self-report on whether they felt lonelier than before the COVID-19 outbreak. RESULTS While 29% felt lonelier after COVID-19, middle-aged adults, women, non-Hispanic Whites, and the most educated were more likely to report increased loneliness. Not having enough in-person contact with people outside the household was associated with increased loneliness (OR = 10.07, p < .001). Receiving emotional support less frequently (OR = 2.28, p < .05) or more frequently (OR = 2.00, p < .001) than before was associated with increased loneliness. Worse quality of family relationships (OR = 1.85, p < .05) and worse friend/neighbor relationships (OR = 1.77, p < .01) were related to feeling lonelier. Significant interactions indicated stronger effects on loneliness of poor-quality family relationships for women and insufficient in-person contact with non-household people for the middle-aged group and non-Hispanic Whites. CONCLUSIONS Our findings show an increase in loneliness during COVID-19 that was partly due to social mitigation efforts, and also uncover how sociodemographic groups were impacted differently, providing implications for recovery and support.
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Affiliation(s)
- Eun Young Choi
- PhD, Postdoctoral Associate, School of Global Public Health, New York University, New York
| | - Matthew Farina
- PhD, Postdoctoral Fellow, Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Erfei Zhao
- MSW, PhD Student, Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Jennifer Ailshire
- PhD, Associate Professor, Leonard Davis School of Gerontology, University of Southern California, Los Angeles
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Hyun DG, Ahn JH, Gil HY, Nam CM, Yun C, Lee JM, Kim JH, Lee DH, Kim KH, Kim DJ, Lee SM, Ryu HG, Hong SK, Kim JB, Choi EY, Baek J, Kim J, Kim EJ, Park TY, Kim JH, Park S, Park CM, Jung WJ, Choi NJ, Jang HJ, Lee SH, Lee YS, Suh GY, Choi WS, Lee KS, Kim HW, Min YG, Lee SJ, Lim CM. The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea. J Korean Med Sci 2023; 38:e141. [PMID: 37191845 DOI: 10.3346/jkms.2023.38.e141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/31/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. METHODS From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation-Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. RESULTS Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death (P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.55-0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% CI, 0.56-0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79-1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65-2.17; P = 0.582). CONCLUSION In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.
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Affiliation(s)
- Dong-Gon Hyun
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee Hwan Ahn
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ha-Yeong Gil
- Medical Research Project Team, IM Medical, Pfizer Korea Pharmaceuticals Limited Company, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Choa Yun
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Myeong Lee
- Division of Acute Care Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jae Hun Kim
- Department of Trauma and Surgical Critical Care and Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Dong-Hyun Lee
- Department of Intensive Care Medicine, Dong-A University Hospital, Busan, Korea
| | - Ki Hoon Kim
- Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Dong Jung Kim
- Department of Thoracic & Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Min Lee
- Department of Critical Care Medicine, Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ho-Geol Ryu
- Department of Critical Care Medicine, Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| | - Suk-Kyung Hong
- Department of Acute Care Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Bum Kim
- Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Eun Young Choi
- Division of Pulmonology and Allergy, Department of Internal Medicine, Regional Center for Respiratory Diseases, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - JongHyun Baek
- Department of Thoracic and Cardiovascular Surgery, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jeoungmin Kim
- Division of Critical Care Medicine, Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jin Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Tae Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Je Hyeong Kim
- Department of Critical Care Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sunghoon Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hwaseong, Korea
| | - Chi-Min Park
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Jai Jung
- Department of Pulmonary, Allergy, and Critical Care Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Nak-Jun Choi
- Division of Acute Care Surgery, Department of Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Hang-Jea Jang
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Su Hwan Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Seok Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Gee Young Suh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo-Sung Choi
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Keu Sung Lee
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Hyung Won Kim
- Division of Acute Care Surgery, Department of Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young-Gi Min
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Seok Jeong Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chae-Man Lim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Abstract
Background and Objectives Self-perceptions of aging (SPA) are associated with health and well-being later in life. Although prior studies have identified individual-level predictors of SPA, the role of neighborhood social context in SPA remains largely unexplored. A neighborhood social environment may act as a critical avenue for older adults to remain healthy and socially active, contributing to their evaluations of how they grow old. The present study aims to fill the previous research gap by examining the relationship between neighborhood social environment and SPA, and how age may moderate this relationship. This study is guided by Bronfenbrenner's Ecology of Human Development theory and Lawton's Ecological Model of Aging, positing that an individual's aging experience is deeply rooted in their residential environment. Research Design and Methods Our sample includes 11,145 adults aged 50+ from the 2014 and 2016 waves of the Health and Retirement Study. We included 4 social and economic aspects of neighborhoods: (1) neighborhood poverty; (2) percentage of older adults; (3) perceived social cohesion; and (4) perceived disorder. Results Multilevel linear regression models showed that respondents in neighborhoods with higher percentages of the older population and with perceptions of high neighborhood disorder reported more negative SPA. Those who perceived their neighborhoods as more socially cohesive reported more positive SPA. Controlling for individual socioeconomic and health status, only neighborhood social cohesion remained significant. We also found significant interaction effects between neighborhood social cohesion and age: The effects of neighborhood cohesion on SPA were stronger in middle age than in old age. Discussion and Implications Our findings provide insights into how neighborhood social context is associated with SPA, suggesting that a socially cohesive neighborhood may be important to promote more favorable perceptions of aging, particularly for middle-aged residents.
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Affiliation(s)
- Eun Young Choi
- School of Global Public Health, New York University, New York, New York, USA
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Elizabeth M Zelinski
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Jennifer Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
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Willett FR, Kunz E, Fan C, Avansino D, Wilson G, Choi EY, Kamdar F, Hochberg LRH, Druckmann S, Shenoy K, Henderson J. A high-performance speech neuroprosthesis. bioRxiv 2023:2023.01.21.524489. [PMID: 36711591 PMCID: PMC9882398 DOI: 10.1101/2023.01.21.524489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Speech brain-computer interfaces (BCIs) have the potential to restore rapid communication to people with paralysis by decoding neural activity evoked by attempted speaking movements into text or sound. Early demonstrations, while promising, have not yet achieved accuracies high enough for communication of unconstrainted sentences from a large vocabulary. Here, we demonstrate the first speech-to-text BCI that records spiking activity from intracortical microelectrode arrays. Enabled by these high-resolution recordings, our study participant, who can no longer speak intelligibly due amyotrophic lateral sclerosis (ALS), achieved a 9.1% word error rate on a 50 word vocabulary (2.7 times fewer errors than the prior state of the art speech BCI2) and a 23.8% word error rate on a 125,000 word vocabulary (the first successful demonstration of large-vocabulary decoding). Our BCI decoded speech at 62 words per minute, which is 3.4 times faster than the prior record for any kind of BCI and begins to approach the speed of natural conversation (160 words per minute). Finally, we highlight two aspects of the neural code for speech that are encouraging for speech BCIs: spatially intermixed tuning to speech articulators that makes accurate decoding possible from only a small region of cortex, and a detailed articulatory representation of phonemes that persists years after paralysis. These results show a feasible path forward for using intracortical speech BCIs to restore rapid communication to people with paralysis who can no longer speak.
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Wang AR, Kuijper FM, Barbosa DAN, Hagan KE, Lee E, Tong E, Choi EY, McNab JA, Bohon C, Halpern CH. Human habit neural circuitry may be perturbed in eating disorders. Sci Transl Med 2023; 15:eabo4919. [PMID: 36989377 DOI: 10.1126/scitranslmed.abo4919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/03/2023] [Indexed: 03/31/2023]
Abstract
Circuit-based mechanisms mediating the development and execution of habitual behaviors involve complex cortical-striatal interactions that have been investigated in animal models and more recently in humans. However, how human brain circuits implicated in habit formation may be perturbed in psychiatric disorders remains unclear. First, we identified the locations of the sensorimotor putamen and associative caudate in the human brain using probabilistic tractography from Human Connectome Project data. We found that multivariate connectivity of the sensorimotor putamen was altered in humans with binge eating disorder and bulimia nervosa and that the degree of alteration correlated with severity of disordered eating behavior. Furthermore, the extent of this circuit aberration correlated with mean diffusivity in the sensorimotor putamen and decreased basal dopamine D2/3 receptor binding potential in the striatum, consistent with previously reported microstructural changes and dopamine signaling mediating habit learning in animal models. Our findings suggest a neural circuit that links habit learning and binge eating behavior in humans, which could, in part, explain the treatment-resistant behavior common to eating disorders and other psychiatric conditions.
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Affiliation(s)
- Allan R Wang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Fiene Marie Kuijper
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
- Université Paris Cité, Paris 75006, France
- Assistance Publique des Hôpitaux de Paris, Paris 75012, France
| | - Daniel A N Barbosa
- Department of Neurosurgery, Perelman School of Medicine, Richards Medical Research Laboratories, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kelsey E Hagan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Eric Lee
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, 94305 USA
| | - Eun Young Choi
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jennifer A McNab
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, 94305 USA
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Casey H Halpern
- Department of Neurosurgery, Perelman School of Medicine, Richards Medical Research Laboratories, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Surgery, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
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Lee SM, Jung JH, Lee J, Choi EY, Shin JY, Kim M. Clinical Features, Long-Term Outcomes, and Prognostic Factors of Eales' Disease in Korean Patients. Ocul Immunol Inflamm 2023:1-7. [PMID: 36897992 DOI: 10.1080/09273948.2023.2183870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
PURPOSE We studied Korean patients with Eales' disease to document clinical features, long-term outcomes, and explore its association with TB, given South Korea's high TB burden. METHODS We retrospectively reviewed medical records of Eales' disease patients for clinical characteristics, long-term outcomes, and its association with TB. RESULTS Among 106 eyes, the average age of diagnosis was 39.28 years, with 82.7% male and 58.7% having unilateral involvement. Patients who underwent vitrectomy showed greater long-term improvement in visual acuity (P = .047), while those with glaucoma filtration surgery showed less improvement (P = .008). Having glaucoma through disease progression was associated with poor visual outcomes (odds ratio=15.556, P < .02). 27 out of 39 patients (69.23%) who underwent IGRA screening tested positive for TB. CONCLUSIONS In Korean patients with Eales' disease, we observed male predominance, unilateral presentation, older age of onset, and a link with TB. Timely diagnosis and management should be considered to maintain good vision in patients with Eales' disease.
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Affiliation(s)
- Seung Min Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Jung
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junwon Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joo Youn Shin
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yonginsi, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lee W, Pyo J, Ock M, Jang SG, Choi EY. Nurses' adaptations to changes on a COVID-19 ward in South Korea: A qualitative study. Heliyon 2023; 9:e13926. [PMID: 36845039 PMCID: PMC9941071 DOI: 10.1016/j.heliyon.2023.e13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/08/2022] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Background Elucidating nurses' adaptation to changes in the early stage of an infectious disease epidemic is necessary to promote nurses' coping with and adapting to situations in which new infectious diseases are predicted periodically. Aim To explore nurses' adaptation to changes in COVID-19 wards in South Korea. Methods In-depth interviews were conducted with 20 nurses through purposive sampling from May to August 2020. The collected data were transcribed verbatim, and analysis was performed using conventional content analysis. Findings Three categories emerged from the interviews: (a) Disruption caused by an unforeseen pandemic outbreak, (b) perseverance through the turmoil of changes as a nurse, and (c) transition from feelings of fearfulness to those of accomplishment. While the nurses initially struggled to care for patients with COVID-19, they made conscious efforts to provide emotional nursing and maintain their professionalism. Discussion Nurses caring for patients with COVID-19 have faced a number of challenges but have adapted to new scenarios by endeavoring to fulfil their professional roles. Conclusion To overcome a national disaster situation such as COVID-19, the government and healthcare organizations should prepare strategies to support the efforts of nurses to strengthen their own professionalism.
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Affiliation(s)
- Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | | | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea,Corresponding author. Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea
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Park HS, Kim YJ, Choi EY, Lee SC, Byeon SH, Kim SS, Lee CS. Expanded spectrum of focal scleral nodule: focal scleral nodules can be bifocal. Eye (Lond) 2023; 37:773-778. [PMID: 35414654 PMCID: PMC9998387 DOI: 10.1038/s41433-022-02029-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/15/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To assess multimodal imaging findings of focal scleral nodule (FSN) to evaluate its origin and natural course. METHODS This was a retrospective observational case series and included 14 patients with FSN who underwent multimodal imaging. Clinical information was gathered from patients' medical records. Primary outcome measures were standardized grading of imaging features. RESULTS The mean follow-up duration was 68.8 ± 43.6 months (range, 6-139 months). Most lesions were solitary (92.6%), but one patient had two adjacent lesions (7.1%). Optical coherence tomography revealed that all lesions were confined to the sclera. Lesions showed mostly outer retinal abnormality, with external limiting membrane thinning or absence in 41.6% of lesions and ellipsoid layer absence in 84.6% of lesions. Most lesions showed an absence (69.2%) or thinning (23.1%) of the choroid above the lesion, and the mean choroidal thickness above the lesion for choroids with measurable thickness was 36 ± 75 μm (median, 0; range, 0-265 μm). Of 13 lesions with available follow-up data, only three lesions showed minimal growth over time. CONCLUSIONS This study demonstrates for the first time that bifocal lesions of FSN in the same eye are possible and reaffirms the relative stability of this entity.
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Affiliation(s)
- Hyo Song Park
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Joon Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Young Choi
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Konyang University College of Medicine, Myunggok Medical Research Center, Daejeon, South Korea
| | - Suk Ho Byeon
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Soo Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
| | - Christopher Seungkyu Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
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Shon WJ, Jung MH, Kim Y, Kang GH, Choi EY, Shin DM. Sugar-sweetened beverages exacerbate high-fat diet-induced inflammatory bowel disease by altering the gut microbiome. J Nutr Biochem 2023; 113:109254. [PMID: 36572070 DOI: 10.1016/j.jnutbio.2022.109254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/10/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
High-fat diets (HFDs) and frequent consumption of sugar-sweetened beverages (SSBs) are potential contributors to increasing inflammatory bowel disease (IBD) incidences. While HFDs have been implicated in mild intestinal inflammation, the role of sucrose in SSBs remains unclear. Therefore, we studied the role of SSBs in IBD pathogenesis in a mouse model and humans. C57BL6/J mice were given ad libitum access to a sucrose solution or plain water for 10 weeks, with or without an HFD. Interestingly, sucrose solution consumption alone did not induce gut inflammation in mice; however, when combined with an HFD, it dramatically increased the inflammation score, submucosal edema, and CD45+ cell infiltration. 16S ribosomal RNA gene-sequencing revealed that sucrose solution and HFD co-consumption significantly increased the relative abundance of IBD-related pathogenic bacteria when compared with HFD consumption. RNA sequencing and flow cytometry showed that co-consumption promoted pro-inflammatory cytokine and chemokine synthesis, dendritic-cell expansion, and IFN-γ+TNF-α+CD4+ and CD8+ T-cell activation. Fecal microbiota transplantation from HFD- and sucrose water-fed mice into gut-sterilized mice increased the susceptibility to dextran sulfate sodium-induced colitis in the recipient mice. Consistent herewith, high consumption of SSBs and animal fat-rich diets markedly increased systemic inflammation-associated IBD marker expression in humans. In conclusion, SSBs exacerbate HFD-induced colitis by triggering a shift of the gut microbiome into a pathobiome. Our findings provide new insights for the development of strategies aimed at preventing IBD.
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Affiliation(s)
- Woo-Jeong Shon
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Seoul, Republic of Korea; Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Min Ho Jung
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Younghoon Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Gyeong Hoon Kang
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Environment and Human Interface, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Dong-Mi Shin
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Seoul, Republic of Korea; Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea; Institute on Aging, Seoul National University, Seoul, Republic of Korea.
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Byeon HJ, Lee JH, Lee J, Choi EY, Kim YJ, Lee SC, Lee CS. Therapeutic effect of modified double-dose photodynamic therapy in circumscribed choroidal haemangioma. Br J Ophthalmol 2023; 107:425-429. [PMID: 34580074 DOI: 10.1136/bjophthalmol-2021-319832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/15/2021] [Indexed: 11/04/2022]
Abstract
AIMS To retrospectively compare the therapeutic effect of modified double-dose photodynamic therapy (PDT) with standard-dose PDT in patients with circumscribed choroidal haemangioma (CCH). METHODS Thirty-nine patients with CCH were categorised in two groups by PDT type. The standard-dose group (n=12) was treated with 6 mg/m2 verteporfin and a 689 nm laser for 83 s. The modified double-dose group (n=27) received one vial of verteporfin (15 mg), and the dose was calculated for each patient based on body surface area, then irradiance time was adjusted according to calculated verteporfin dose to achieve a 'double'-dose effect. Treatment outcomes (foveal centre thickness, subretinal fluid, tumour thickness and diameter) were measured at baseline and 1 year post-treatment; subretinal fluid levels were also measured at 1, 3 and 6 months post-treatment. RESULTS No differences in baseline characteristics were found between the two groups. The modified double-dose group showed a greater reduction in tumour thickness (45.3% vs 20.6%, p=0.013) and tumour volume (60.0% vs 30.0%, p=0.006) at 1 year post-treatment. Recurred or non-complete resolution patients in the standard-dose group tended to show much increased subretinal fluid than those in the modified double-dose group at 1-year post-treatment. CONCLUSION Modified double-dose PDT is an effective and safe protocol for symptomatic CCH management, greater tumour regression and potentially better resolution of subretinal fluid compared with standard PDT.
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Affiliation(s)
- Hyeong Ju Byeon
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Hwan Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Junwon Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Young Choi
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Joon Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
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Choi EY. Association of Protein Intake with Handgrip Strength and Its Relation to Strength Exercise in Korean Adults Aged over 60 Years in the KNHANES (2014-18). Nutrients 2023; 15:nu15041014. [PMID: 36839373 PMCID: PMC9960000 DOI: 10.3390/nu15041014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Weak handgrip strength (HGS) is associated with many negative health outcomes in older adults. There is evidence that with strength exercise, high protein intake leads to increased HGS. The goal of this study was to examine the relationship between weak HGS in older adults and dietary protein and it's relation to resistance exercise. Data on 8497 Korean adults aged over 60 years from the Korea National Health and Nutrition Examination Survey (2014-18) were analyzed. Dietary protein intake measured by 24-h recall were categorized as three levels: low (<0.8 g/kg body weight (BW)), adequate (≥0.8 g/kg BW and <1.2 g/kg BW), and high (≥1.2 g/kg BW). Complex sample multiple logistic regression analyses were carried out. The prevalence of weak HGS was 18.3 (0.7)% in men and 28.8 (0.9)% in women. In a multiple logistic regression analysis, low protein intake was significantly associated with higher risk of weak HGS in men, as compared with adequate protein intake, but this relationship was not statistically significant in women. The risk of weak HGS was significantly reduced for both men and women who engaged in strength exercise and increased their dietary protein intake. In this study, based on a representative sample of Koreans aged over 60, men with low protein intake had a higher risk of weak HGS than did men with adequate protein intake. Men and women with a higher protein intake who also engaged in strength exercises had a lower risk of weak HGS. Increasing protein intake and engaging in strength exercises may be an effective way to preserve muscle strength in older men and women.
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Affiliation(s)
- Eun Young Choi
- Department of Family Medicine, School of Medicine, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan City 31116, Chungnam, Republic of Korea
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Choi EY, Pyo J, Park YK, Ock M, Kim S. Development of the Korean Patient Safety Incidents Code Classification System. J Patient Saf 2023; 19:8-14. [PMID: 36538337 PMCID: PMC9788926 DOI: 10.1097/pts.0000000000001083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Attempts to understand patient safety using administrative data in Korea have been rare. This study develops a Korean patient safety incident code classification system and identifies its characteristics to boost diagnosis code usage for assessing patient safety. METHODS Based on existing literature, we selected Korean Standard Classification of Diseases 7 codes for characterizing patient safety incidents using diagnosis codes. We conducted 2 rounds of review to evaluate the codes applicability to different patient safety incidents using the Delphi method. The verified diagnosis codes were then classified by incident type. RESULTS Of the 54,259 Korean Standard Classification of Diseases 7 codes, 4509 were applicable for Korean patients, which were divided into 2435 code groups and 2074 candidate groups. The codes were classified into 6 categories (diagnosis, medication, patient care, operation or procedure, infection related, and other) and then further classified into 35 subcategories. The major categories of patient safety incidents, in the order of frequency, involved medication, fluid and blood related (1719, 38.1%), operation and procedure related (1339, 29.7%), and patient care related (991, 22.0%). Meanwhile, there were only 2 codes related to diagnosis. CONCLUSIONS Our study provides a basis for estimating patient safety incidents using diagnosis codes. We suggest that gradually increasing the utilization and accuracy of the patient safety incident codes will help develop effective patient safety indicators in Korea similar to other countries. Moreover, clinicians are also needed to be aware of using the developed code classification system.
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Affiliation(s)
- Eun Young Choi
- From the College of Nursing, Sungshin Women’s University, Seoul
| | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City
| | | | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City
- Prevention and Management Center, Ulsan University Hospital
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Sukyeong Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
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Pyo J, Lee W, Choi EY, Jang SG, Ock M. Qualitative Research in Healthcare: Necessity and Characteristics. J Prev Med Public Health 2023; 56:12-20. [PMID: 36746418 PMCID: PMC9925284 DOI: 10.3961/jpmph.22.451] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/23/2022] [Indexed: 02/01/2023] Open
Abstract
Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.
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Affiliation(s)
- Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan, Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Eun Young Choi
- College of Nursing, Sungshin Women’s University, Seoul, Korea
| | | | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan, Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Jang JG, Lee KH, Chung JH, Shin KC, Choi EY, Jin HJ, Ahn JH. Assessment of Inhaler Satisfaction and Determinants of High Satisfaction Among Korean COPD Patients. J Korean Med Sci 2022; 37:e327. [PMID: 36631025 PMCID: PMC9705204 DOI: 10.3346/jkms.2022.37.e327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/15/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) recommend considering patient preference when choosing an inhaler device. However, few studies have assessed both inhaler satisfaction and factors associated with high inhaler satisfaction. Therefore, we assessed inhaler satisfaction and determinants of high satisfaction in Korean COPD patients. METHODS COPD patients were prospectively enrolled from January 2018 to November 2019. The 308 inhalers used by the 261 participants in this study included dry powder inhalers (Turbuhaler, Breezhaler, Ellipta, Diskus, and Genuair), a soft mist inhaler (Respimat), and pressurized metered dose inhalers (pMDIs). Inhaler satisfaction was assessed by the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire. High inhaler satisfaction was defined as an FSI-10 ≥ 43. RESULTS Among 261 COPD patients, 163 (62.5%) were highly satisfied with their inhaler device. The rates of high inhaler satisfaction for Turbuhaler, Breezhaler, Ellipta, Diskus, Genuair, Respimat, and pMDI usage were 40.0%, 67.2%, 66.7%, 50.0%, 55.6%, 63.4%, and 45.0%, respectively (P = 0.215). In univariate analyses, higher body mass index, non-current smoker, GOLD grades I and II, a modified Medical Research Council (mMRC) score < 2, lower inhaler puff burden, once daily usage of inhaler, and good inhaler adherence were associated with high inhaler satisfaction. In multivariate analyses, an mMRC score < 2, and good inhaler adherence were independently associated with high inhaler satisfaction. CONCLUSION High inhaler satisfaction was associated with dyspnea symptom and good inhaler adherence in COPD patients. Effective strategies are needed including appropriate inhaler device selection, consideration of patient preference, and repeated inhaler education to improve patient satisfaction of inhalers.
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Affiliation(s)
- Jong Geol Jang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kwan Ho Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jin Hong Chung
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kyeong-Cheol Shin
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Eun Young Choi
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Hyun Jung Jin
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - June Hong Ahn
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea.
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Choi EY, Tian L, Su JH, Radovan MT, Tourdias T, Tran TT, Trelle AN, Mormino E, Wagner AD, Rutt BK. Thalamic nuclei atrophy at high and heterogenous rates during cognitively unimpaired human aging. Neuroimage 2022; 262:119584. [PMID: 36007822 PMCID: PMC9787236 DOI: 10.1016/j.neuroimage.2022.119584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 02/02/2023] Open
Abstract
The thalamus is a central integration structure in the brain, receiving and distributing information among the cerebral cortex, subcortical structures, and the peripheral nervous system. Prior studies clearly show that the thalamus atrophies in cognitively unimpaired aging. However, the thalamus is comprised of multiple nuclei involved in a wide range of functions, and the age-related atrophy of individual thalamic nuclei remains unknown. Using a recently developed automated method of identifying thalamic nuclei (3T or 7T MRI with white-matter-nulled MPRAGE contrast and THOMAS segmentation) and a cross-sectional design, we evaluated the age-related atrophy rate for 10 thalamic nuclei (AV, CM, VA, VLA, VLP, VPL, pulvinar, LGN, MGN, MD) and an epithalamic nucleus (habenula). We also used T1-weighted images with the FreeSurfer SAMSEG segmentation method to identify and measure age-related atrophy for 11 extra-thalamic structures (cerebral cortex, cerebral white matter, cerebellar cortex, cerebellar white matter, amygdala, hippocampus, caudate, putamen, nucleus accumbens, pallidum, and lateral ventricle). In 198 cognitively unimpaired participants with ages spanning 20-88 years, we found that the whole thalamus atrophied at a rate of 0.45% per year, and that thalamic nuclei had widely varying age-related atrophy rates, ranging from 0.06% to 1.18% per year. A functional grouping analysis revealed that the thalamic nuclei involved in cognitive (AV, MD; 0.53% atrophy per year), visual (LGN, pulvinar; 0.62% atrophy per year), and auditory/vestibular (MGN; 0.64% atrophy per year) functions atrophied at significantly higher rates than those involved in motor (VA, VLA, VLP, and CM; 0.37% atrophy per year) and somatosensory (VPL; 0.32% atrophy per year) functions. A proximity-to-CSF analysis showed that the group of thalamic nuclei situated immediately adjacent to CSF atrophied at a significantly greater atrophy rate (0.59% atrophy per year) than that of the group of nuclei located farther from CSF (0.36% atrophy per year), supporting a growing hypothesis that CSF-mediated factors contribute to neurodegeneration. We did not find any significant hemispheric differences in these rates of change for thalamic nuclei. Only the CM thalamic nucleus showed a sex-specific difference in atrophy rates, atrophying at a greater rate in male versus female participants. Roughly half of the thalamic nuclei showed greater atrophy than all extra-thalamic structures examined (0% to 0.54% per year). These results show the value of white-matter-nulled MPRAGE imaging and THOMAS segmentation for measuring distinct thalamic nuclei and for characterizing the high and heterogeneous atrophy rates of the thalamus and its nuclei across the adult lifespan. Collectively, these methods and results advance our understanding of the role of thalamic substructures in neurocognitive and disease-related changes that occur with aging.
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Affiliation(s)
- Eun Young Choi
- Department of Neurosurgery, Stanford University, 300 Pasteur Drive, MC5327, Stanford, CA 94305, USA
| | - Lu Tian
- Department of Biomedical Data Science, 1265 Welch Road, MC5464, Stanford, CA 94305, USA
| | - Jason H. Su
- Department of Radiology, Stanford University, 300 Pasteur Drive, MC5488, Stanford, CA 94305, USA,Department of Electrical Engineering, Stanford University, 350 Jane Stanford Way, MC9505, Stanford, CA 94305, USA
| | - Matthew T. Radovan
- Department of Computer Science, Stanford University, 353 Jane Stanford Way, MC9025, Stanford, CA 94305, USA
| | - Thomas Tourdias
- Department of Neuroradiology, Bordeaux University Hospital, Bordeaux, France,INSERM U1215, Neurocentre Magendie, University of Bordeaux, France
| | - Tammy T. Tran
- Department of Psychology, Stanford University, Building 420, MC2130, Stanford, CA 94305, USA
| | - Alexandra N. Trelle
- Department of Psychology, Stanford University, Building 420, MC2130, Stanford, CA 94305, USA
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford, University, 300 Pasteur Drive, MC5235, Stanford, CA 94305, USA,Wu Tsai Neurosciences Institute, Stanford University, 290 Jane Stanford Way, Stanford, CA 94305, USA
| | - Anthony D. Wagner
- Department of Psychology, Stanford University, Building 420, MC2130, Stanford, CA 94305, USA,Wu Tsai Neurosciences Institute, Stanford University, 290 Jane Stanford Way, Stanford, CA 94305, USA
| | - Brian K. Rutt
- Department of Radiology, Stanford University, 300 Pasteur Drive, MC5488, Stanford, CA 94305, USA,Wu Tsai Neurosciences Institute, Stanford University, 290 Jane Stanford Way, Stanford, CA 94305, USA,Corresponding author. (B.K. Rutt)
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Lee CH, Lee H, Lee SM, Choi EY, Lee J, Kim M. Clinical and Multimodal Imaging Features of Choroidal Nevi in the Korean Population. J Clin Med 2022; 11:jcm11226666. [PMID: 36431143 PMCID: PMC9698851 DOI: 10.3390/jcm11226666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022] Open
Abstract
Choroidal nevus is a precursor of choroidal melanoma. Multimodal imaging has become vital in predicting the malignant transformation of choroidal nevi. This single-center, retrospective study analyzed clinical characteristics and multimodal imaging findings of 168 choroidal nevi (164 patients) of the Korean population. The mean age at presentation was 50 ± 15 (range, 13−85) (women, n = 88 [53.7%]). Choroidal nevi (melanotic, n = 164 [97.6%]; postequatorial, n = 160 [95.2%]) were densely located between the optic disc and foveola (65.5%). The mean maximum linear basal diameter on fundus photography and thickness on optical coherence tomography were 2.97 ± 1.51 mm and 521 ± 297 μm, respectively. On ultrasonography, the mean thickness was 0.87 ± 0.60 mm. Choroidal nevi in women were associated with a higher maximum linear basal diameter (3.23 ± 1.65 vs. 2.68 ± 1.21 mm; p = 0.033) and age at diagnosis (52 ± 14 vs. 47 ± 16 years; p = 0.046) than those in men. Choroidal nevi with associated subretinal fluid (23.2%) presented with larger basal diameter (p = 0.049) and thickness on B-scan and optical coherence tomography (p < 0.001), but a younger age at diagnosis (p < 0.001) than those of dry nevi. This multimodal imaging study of choroidal nevi revealed some distinct characteristics, including topographic distribution, sex-related differences, and a younger age at diagnosis of nevi with fluid.
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Affiliation(s)
| | | | | | | | | | - Min Kim
- Correspondence: ; Tel.: +82-2-2019-3440
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Lee DH, Cho H, Choi EY, Kim M. Clinical features and long-term treatment outcome of posterior scleritis. Ann Transl Med 2022; 10:1162-1162. [PMID: 36467362 PMCID: PMC9708463 DOI: 10.21037/atm-22-721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
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Choi EY, Kim M, Lee CS, Byeon SH, Kim SS, Lee M. Intermittent Fasting Is Associated With a Decreased Risk of Age-Related Macular Degeneration. Am J Ophthalmol 2022; 243:1-9. [PMID: 35809657 DOI: 10.1016/j.ajo.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate the association between intermittent fasting and age-related macular degeneration (AMD) in the general older adult population. DESIGN A cross-sectional study using a population-based, government-led survey data, Korean National Health and Nutrition Examination Survey (KNHANES). METHODS A total of 4504 individuals aged ≥55 years with comprehensive data including meal frequency and fundus photography were selected using the KNHANES 2015-2018 database. Participants were divided into 2 groups based on breakfast frequency per week; intermittent fasting (nearly 0 time/week) and nonfasting (5-7 times/week) groups. Multiple logistic regression analysis was performed to determine the risk factors for AMD identified by fundus photography. RESULTS AMD was identified in 25.1% of total participants. The intermittent fasting group had a decreased risk of AMD compared with the nonfasting group (adjusted odds ratio [aOR] 0.413, 95% CI 0.203-0.841), especially in individuals with a younger age (<70 years, aOR 0.357, 95% CI 0.153-0.833), obesity (aOR 0.663, 95% CI 0.424-1.037), and urban residence (aOR 0.437, 95% CI 0.248-0.769). Increased age (aOR 1.058, 95% CI 1.041-1.076) and serum high-density lipoprotein levels (aOR 1.011, 95% CI 1.002-1.021) were also independent risk factors for AMD. CONCLUSIONS Using the population-based survey data, we demonstrated that intermittent fasting by skipping breakfast was significantly associated with a reduced risk of AMD in a representative older adult population, especially in individuals with age <70 years, obesity, and urban residence.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Institute of Vision Research (E.Y.C., M.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Institute of Vision Research (E.Y.C., M.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minyoung Lee
- Department of Internal Medicine (M.L.), Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research (M.L.), Yonsei University College of Medicine, Seoul, Republic of Korea.
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Choi EY, Park YK, Ock M. Comparison of low-salt preference trends and regional variations between patients with major non-communicable diseases and the general population. PLoS One 2022; 17:e0276655. [PMID: 36282856 PMCID: PMC9595509 DOI: 10.1371/journal.pone.0276655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
Background We compared low-salt preference between patients with major chronic diseases, also known as non-communicable diseases (hereinafter referred to as ‘“major NCD patients’”), and the general population. Methods We used data extracted from the Korea Community Health Survey Community during the period of 2008–2019. We evaluated the low-salt preference of 13 major NCD patients by year and region to analyse recent changes in low-salt preference trends, using joinpoint regression. Results A greater majority of major NCD patients had a higher low-salt preference than general population; however, the overall trend was not significantly significant. The low-salt preference rate (Type III) was highest among patients with diabetes (15.6%), followed by hypertension (14.1%) and dyslipidaemia (13.4%), with the general population displaying the lowest rate (11.3%). The rates of adherence to a low-salt diet and fried food without soy sauce gradually increased until 2013 and then declined. The rate of adherence to not adding salt and soy sauce at the table gradually increased and maintained a high rate of adherence until 2019, except for patients with some diseases. Regional variations in low-salt preference tended to be greater in patients with major NCDs than general population. Conclusion There is a need to improve the low-salt diet behaviour of not only major NCD patients, but also the general population. Various low-salt diet programs need to be promoted, such as education on a low-salt diet, certification for low-salt restaurants, and sodium tax. Moreover, it is necessary to continuously monitor the low-salt preferences of major NCD patients.
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Affiliation(s)
- Eun Young Choi
- College of Nursing, Sungshin Women’s University, Seoul, Republic of Korea
| | - Young-Kwon Park
- Prevention and Management Center, Ulsan Regional Cardiocerebrovascular Disease Center, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Minsu Ock
- Prevention and Management Center, Ulsan Regional Cardiocerebrovascular Disease Center, Ulsan University Hospital, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
- * E-mail:
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Kim K, Seo J, Cho I, Choi EY, Hong GR, Ha JW, Rim SJ, Shim CY. Characteristics and clinical implications of premature summation of early and late diastolic filling in patients without tachycardia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Backgrounds
The summation of early (E) and late diastolic filling (A) on mitral inflow Doppler even in the absence of tachycardia is often found during assessments of left ventricular (LV) diastolic function. We evaluated the echocardiographic characteristics and clinical implications of premature E-A summation.
Methods
We identified 1,014 subjects who showed E-A summation and normal LV ejection fraction between January 2019 and June 2021 in two tertiary hospitals. Among these, 105 (10.4%) subjects showed premature E-A summation at heart rates less than 100 beats per minute (bpm). The conventional echocardiographic parameters and LV global longitudinal strain (GLS) were compared with 1:1 age, sex, and heart rate matched controls without E-A summation.
Results
The premature E-A summation group had a heart rate of 96.4±3.7 bpm. Only 4 (3.8%) subjects were classified as having LV diastolic dysfunction according to the current guidelines. That group showed prolonged isovolumic relaxation time (107.2±25.3 vs. 61.6±15.6 msec, p<0.001), increased Tei index (0.76±0.19 vs. 0.48±0.10, p<0.001), lower LVEF (63.8±7.0 vs. 67.3±5.6%, p<0.001) and lower absolute LV GLS (|LV GLS|) (17.0±4.2 vs. 19.7±3.3%, p<0.001) than controls. As the E-A summation occurred at lower heart rate, the |LV GLS| was also lower (p for trend=0.002).
Conclusions
The premature E-A summation at heart rates less than 100 bpm is associated with subclinical LV dysfunction. Time-based indices and LV GLS are helpful for evaluating this easily overlooked population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Kim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J Seo
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - I Cho
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - E Y Choi
- Gangnam Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - G R Hong
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J W Ha
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - S J Rim
- Gangnam Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - C Y Shim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
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Jang Y, Choi EY, Wu B, Dong X, Kim MT. Linguistic Adaptation and Cognitive Function in Older Chinese and Korean Immigrants in the United States: A Cross-Sectional Study. J Aging Health 2022; 34:951-960. [PMID: 35387521 PMCID: PMC9950789 DOI: 10.1177/08982643221083107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To examine the cross-sectional association of linguistic adaptation with cognitive function, as well as its interactions with sociodemographic and health profiles in older Chinese and Korean immigrants in the U.S. METHODS Using harmonized data (N = 5063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we examined between- and within-group differences in the role of linguistic adaptation (English use in older Chinese Americans and English proficiency in older Korean Americans) in cognitive function. RESULTS The positive association between linguistic adaptation and cognitive function was common in both groups. We also found that the relationship was pronounced among subgroups with the underlying linguistic and cognitive vulnerabilities (i.e., the very old, women, those with low education, and newly immigrated individuals). DISCUSSION Findings show the importance of linguistic adaptation in older immigrants' cognitive health and suggest a need for targeted interventions for high-risk groups.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Jersey, NJ, USA
| | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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Hyun DG, Lee SY, Ahn JH, Huh JW, Hong SB, Koh Y, Lim CM, Oh DK, Suh GY, Jeon K, Ko RE, Cho YJ, Lee YJ, Lim SY, Park S, Heo J, Lee JM, Kim KC, Lee YJ, Chang Y, Jeon K, Lee SM, Hong SK, Cho WH, Kwak SH, Lee HB, Ahn JJ, Seong GM, Lee SI, Park S, Park TS, Lee SH, Choi EY, Moon JY. Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study. Crit Care 2022; 26:280. [PMID: 36114545 PMCID: PMC9482246 DOI: 10.1186/s13054-022-04149-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear. We aimed to determine the effect of the RRT’s operating hours on in-hospital mortality in inpatient patients with sepsis. Methods We conducted a nationwide cohort study of adult patients with hospital-onset sepsis prospectively collected from the Korean Sepsis Alliance (KSA) Database from 16 tertiary referral or university-affiliated hospitals in South Korea between September of 2019 and February of 2020. RRT was implemented in 11 hospitals, of which 5 (45.5%) operated 24-h RRT (all-day RRT) and the remaining 6 (54.5%) had part-day RRT (non-all-day RRT). The primary outcome was in-hospital mortality between the two groups. Results Of the 405 patients with hospital-onset sepsis, 206 (50.9%) were admitted to hospitals operating all-day RRT, whereas 199 (49.1%) were hospitalized in hospitals with non-all-day RRT. A total of 73 of the 206 patients in the all-day group (35.4%) and 85 of the 199 patients in the non-all-day group (42.7%) died in the hospital (P = 0.133). After adjustments for co-variables, the implementation of all-day RRT was associated with a significant reduction in in-hospital mortality (adjusted odds ratio 0.57; 95% confidence interval 0.35–0.93; P = 0.024). Conclusions In comparison with non-all-day RRTs, the availability of all-day RRTs was associated with reduced in-hospital mortality among patients with hospital-onset sepsis. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04149-z.
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Oh SN, Choi EY, Choi JB, Han EJ, Woo DG, Park JK. The role of the eco–corridor for the walking beetles in Chupungryeong, Korea. Journal of Asia-Pacific Biodiversity 2022. [DOI: 10.1016/j.japb.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Alan D Proia
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.,Department of Pathology, Duke University Medical Center, Durham, North Carolina.,Department of Pathology, Campbell University Jerry M. Wallace School of Osteopathic Medicine, Lillington, North Carolina
| | - Kyle Kirkland
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.,Marr Eye Center, College Station, Texas
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Jang Y, Park J, Choi EY, Cho YJ, Park NS, Chiriboga DA. Social isolation in Asian Americans: risks associated with socio-demographic, health, and immigration factors. Ethn Health 2022; 27:1428-1441. [PMID: 33550840 DOI: 10.1080/13557858.2021.1881765] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The present study examined the factors associated with social isolation in Asian Americans. Three types of social isolation (social isolation from family, social isolation from friends, and overall social isolation), identified by the Lubben Social Network Scale-6, were examined with a sample of Asian Americans representing diverse ethnic groups (Chinese, Asian Indian, Korean, Vietnamese, Filipino, and other Asians) and a broad age range (18-98). DESIGN Using data from the 2015 Asian American Quality of Life Survey (N = 2609), logistic regression models examined how each type of social isolation was predicted by sociodemographic (age, gender, ethnic origin, marital status, education, and perceived financial status), health-related (chronic medical conditions and self-rated health), and immigration-related (proportion of life in the United States and English proficiency) variables. RESULTS The percentage of the sample that fell into the category of social isolation from family, social isolation from friends, and overall isolation ranged from 18.2% to 19.3%. At 36% in the friend category and 33% in the overall category, the Vietnamese sample showed a heightened risk of social isolation. Regression analyses indicated that, for both family and friend categories, individuals who were in the middle-aged group (40-59 years old) and who had limited English proficiency demonstrated higher odds of being isolated. Reflecting relational differences in family and friend networks, the risk associated with unmarried status was specific to social isolation from family, whereas having unmet financial needs was only associated with social isolation from friends. CONCLUSIONS The study findings expand our understanding of the multiple domains of social isolation in an understudied population and emphasize the importance of developing prevention and intervention programs to foster social connectedness among Asian Americans. Our findings on risk factors and ethnic variations help identify the groups to be prioritized in intervention efforts and suggest ways to approach them.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
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Kim J, Choi EY, Lee W, Oh HM, Pyo J, Ock M, Kim SY, Lee SI. Feasibility of Capturing Adverse Events From Insurance Claims Data Using International Classification of Diseases, Tenth Revision, Codes Coupled to Present on Admission Indicators. J Patient Saf 2022; 18:404-409. [PMID: 35948289 PMCID: PMC9329045 DOI: 10.1097/pts.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the feasibility of using administrative data to screen adverse events in Korea. METHODS We used a diagnosis-related groups claims data set and the information of the checklist of healthcare quality improvement (a part of the value incentive program) to verify adverse events in fiscal year 2018. Adverse events were identified using patient safety indicator (PSI) clusters and a present on admission indicator (POA). The PSIs consisted of 19 clusters representing subcategories of adverse events, such as hospital-acquired infection. Among the adverse events identified using PSI clusters, "POA = N," which means not present at the time of admission, was only deemed as the case in the final stage. We compared the agreement on the occurrence of adverse events from claims data with a reference standard data set (i.e., checklist of healthcare quality improvement) and presented them by PSI cluster and institution. RESULTS The cases of global PSI for any adverse event numbered 27,320 (2.32%) among all diagnostic codes in 2018. In terms of institutional distribution, considerable variation was observed throughout the clusters. For example, only 13.2% of institutions (n = 387) reported any global PSI for any adverse event throughout the whole year. The agreement between the reference standard and the claims data was poor, in the range of 2.2% to 10.8%, in 3 types of adverse events. The current claims data system (i.e., diagnostic codes coupled to POA indicators) failed to capture a large majority of adverse events identified using the reference standard. CONCLUSIONS Our results imply that the coding status of International Classification of Diseases, Tenth Revision, codes and POA indicators should be refined before using them as quality indicators.
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Affiliation(s)
- Juyoung Kim
- From the Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul
| | - Eun Young Choi
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
- Department of Nursing, Graduate School of Chung-Ang University
| | - Won Lee
- Department of Nursing, Chung-Ang University
| | - Hae Mi Oh
- Asian Institute for Bioethics and Health Law, Yonsei University
| | - Jeehee Pyo
- From the Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Minsu Ock
- From the Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - So Yoon Kim
- Division of Medical Law and Bioethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-il Lee
- From the Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul
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