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  • Oxford University Press (OUP)  (8)
  • 2020-2024  (8)
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  • Oxford University Press (OUP)  (8)
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  • 2020-2024  (8)
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  • 1
    Online Resource
    Online Resource
    Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. 12 ( 2021-12-01), p. 1448-1464
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. 12 ( 2021-12-01), p. 1448-1464
    Abstract: This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P  & lt; 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P  & lt; 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P  & lt; 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab336
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2006309-X
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  • 2
    Online Resource
    Online Resource
    0484 Heart Rate Variability and Deep Learning Analysis of Obstructive Sleep Apnea Using ECG from Polysomnography
    Oxford University Press (OUP) ; 2024
    In:  SLEEP Vol. 47, No. Supplement_1 ( 2024-04-20), p. A208-A209
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 47, No. Supplement_1 ( 2024-04-20), p. A208-A209
    Abstract: Previous studies suggested that obstructive sleep apnea (OSA) can affect the autonomic nervous system. Patients with OSA appear to have a higher sympathetic component, a lower parasympathetic component, and greater autonomic nervous system (ANS) imbalance. We compared heart rate variability (HRV) with existing studies and confirmed classification accuracy through deep learning analysis (DLA), using electrocardiogram (ECG) data extracted from polysomnography (PSG). Methods We retrospectively surveyed people who underwent PSG at our hospital from January 2015 to March 2023. The diagnosis of OSA was classified into normal, mild, moderate, and severe based on AHI, and whether arrhythmia was identified during the test was also investigated. HRV analysis performed by frequency domain analysis of the tachogram. For DLA, the tachogram was converted to a Mel-spectrogram and a Convolutional Neuronal Network (CNN) was used to confirm the confusion matrix. Results Of a total of 1,806 PSG, 1,554 cases were selected, excluding 252 cases of arrhythmia. OSA confirmed by PSG was normal in 282 patients, mild in 334, moderate in 293, and severe in 645. When comparing the results of HRV divided into AHI below 15 and above, VLF power (ms2/Hz) was 940.78 ± 763.72 vs 1132.75 ± 1104.50 (p & lt; 0.001), LF power (ms2/Hz) was 719.26 ± 734.71 vs. 724.46 ± 945.26 (p = 0.908), HF power (ms2/Hz) was 763.61 ± 1058.92 vs 595.53 ± 1386.75 (p = 0.011), and LF/HF ratio was 1.27 ± 0.74 vs 1.63 ± 1.02 (p & lt; 0.001). As a result of DLA, the ROC AUC Score was confirmed to be 0.7077 and the F1 Score was 0.67. Conclusion As a result of HRV using ECG from PSG, OSA patients were found to have low HF power and high LF/HF ratio, similar to previous studies. Additionally, if tachogram's DLA accuracy can be improved through preprocessing and deep learning model improvements, it is expected that it can be used as a screening tool in various place. Support (if any) This work was partly supported by Institute of Information & Communications Technology Planning & Evaluation grant funded by the Korea government No.RS_2023_00227552, Development of artificial intelligence video background removal SaaS service using domestic semiconductor 64 TOPS.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsae067.0484
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2056761-3
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  • 3
    Online Resource
    Online Resource
    P1545LOW SOCIOECONAMIC STATUS INCREASES MORTALITY RISK IN KOREAN MAINTENANCE HEMODIALYSIS PATIENTS: A LONGITUDINAL COHORT STUDY USING HEMODIALYSIS QUALITY ASSESSMENT DATA
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: The number of hemodialysis (HD) patients and their medical expenses are growing rapidly in Korea due to entry into aging society and accompanying diseases such as diabetes and hypertension. Whether low socioeconomic status (SES) affect poorer HD survival is controversial with most reports come from the USA. Therefore, this study was performed to evaluate the effect of SES upon mortality in Korean maintenance HD patients using periodic HD quality assessment data. Method The HD quality assessment has been performed periodically by Health Insurance review and Assessment Service (HIRA) since 2001. We used 4th and 5th HD quality assessment data from the year of 2013 and 2015 respectively for collecting demographic and clinical data. The 4th survey was a sample survey while the 5th survey was a complete enumeration survey. We also collected data on patient comorbidity using the diagnosis codes from the health insurance claims database. The mortality data was collected until Dec 2017. As a proxy indicator reflecting SES, we classified subjects as a Medical Aid (MA) recipients (“low” SES) or a National Health Insurance (NHI) beneficiary (“middle/high” SES). We analyzed mortality risk based on SES using Cox proportional hazard model. Results A total of 21,786 HD patients from 4th survey and 35,454 HD patients from 5th survey were included in the analysis. The ratio between NHI beneficiary and MA recipient was 76.7% versus 23.3%. Mean age of the subjects was 59.0 years old in 4th survey and 60.3 years old in 5th survey. The MA recipients were younger and showed higher proportion of male, shorter duration of HD, lower body mass index (BMI), higher systolic and diastolic blood pressures before HD compared to the NHI beneficiary. The NHI beneficiary demonstrated higher proportion of diabetes, hypertension, cerebrovascular accidents, and dementia compared to the MA recipients. Two groups did not differ in dialysis efficiency presented as single pool Kt/V. A total of 7,173 deaths occurred in 2013 participants, while 7,306 deaths occurred in 2015 participants. After adjusting for age, gender, Charlson’s comorbidity index, BMI, presence of atrial fibrillation, serum albumin, and serum creatinine, MA recipients showed significantly higher mortality risk compared to the NHI beneficiary (hazard ratio 1.162; 95% confidence interval 1.092-1.237, p & lt;0.001 in 4th survey and hazard ratio 1.078; 95% confidence interval 1.013-1.146, p=0.017 in 5th survey). Conclusion Low SES independently increased mortality risk in Korean maintenance hemodialysis patients.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa142.P1545
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1465709-0
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  • 4
    Online Resource
    Online Resource
    Effectiveness of A Fourth Dose of COVID-19 mRNA Vaccine in the Elderly Population During the Omicron BA.2 and BA.5 Circulation: A Nationwide Cohort Study in Korea (K-COVE)
    Oxford University Press (OUP) ; 2023
    In:  Open Forum Infectious Diseases Vol. 10, No. 3 ( 2023-03-03)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 10, No. 3 ( 2023-03-03)
    Abstract: We estimate the effectiveness of a fourth dose booster of coronavirus disease 2019 mRNA vaccine in individuals aged ≥60 years during Omicron BA.2 and BA.5 circulation in Korea. The effectiveness against critical infection was 67.7% (95% confidence interval, 50.7%–78.8%) at 31–60 days and 62.1% (95% confidence interval, 45.5%–73.7%) at 61–90 days.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofad109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2757767-3
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  • 5
    Online Resource
    Online Resource
    0902 Comparative Analysis of Sleep Apnea Patients Selected from the Stroke Unit vs Outpatient Clinic
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A397-A398
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A397-A398
    Abstract: To our knowledge, there have been studies actively looking for patients with suspected SA in the Stroke Unit (SU), but most of them were conducted using a portable polysomnography (PSG), and no study has performed Level 1 PSG (L1PSG) to date. We conducted L1PSG to the acute stroke patients selected in the SU, and conducted L1PSG to patients who visited the Neurology Outpatient Clinic (NOC) with subjective SA symptoms at the same time. By comparison, we tried to find out the SA characteristics of acute stroke patients. Methods This study was conducted on patients admitted to SU from April 1, 2021 to October 31, 2022, and patients who visited NOC during the same period and underwent L1PSG. Among patients admitted to the SU, trained night shift nurses selected patients with SA symptoms with a modified mallampati score of 3 or higher. Cases under intracranial pressure control or other interventions were excluded. Outpatients were enrolled in patients who underwent L1PSG by visiting the NOC to examine only SA. The results of the pre-sleep questionnaire and L1PSG were compared. Results Of a total of 829 stroke patients admitted to SU, 31 SU patients received L1PSG, and during the same period, 74 patients received L1PSG for SA testing at NOC. The average age of SU and NOC was 56 and 57 years, and the median BMI was 26.9 and 26.4. In the survey, the ISI (7 vs 12, p=0.04) and PSQI (5 vs 7, p=0.021) scores were statistically significantly higher in NOC patients. As a result of the L1PSG, AHI (38.8 vs 23.1, p=0.027), AHI in Supine (59.3 vs 25.6, p=0.004) and NonREM AHI (36.3 vs 20.9, p=0.027) were statistically significantly higher in SU patients. Conclusion Patients screened SA at SU overlooked their symptom and thought their sleep quality was better than that of NOC patients, but the actual AHI was higher. In particular, acute stroke patients show a large difference in AHI in supine compared to NOC, so lateral position can be recommended when absolute bed rest is needed in situations where SA is suspected in SU. More follow-up studies will be needed. Support (if any)  
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad077.0902
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2056761-3
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  • 6
    Online Resource
    Online Resource
    Metabolic Disorders Are Associated With Drug-Induced Liver Injury During Antituberculosis Treatment: A Multicenter Prospective Observational Cohort Study in Korea
    Oxford University Press (OUP) ; 2023
    In:  Open Forum Infectious Diseases Vol. 10, No. 8 ( 2023-08-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 10, No. 8 ( 2023-08-01)
    Abstract: Drug-induced liver injury (DILI) may lead to the discontinuation of antituberculosis (anti-TB) treatment (ATT). Some studies have suggested that metabolic disorders increase the risk of DILI during ATT. This study aimed to identify risk factors for DILI, particularly metabolic disorders, during ATT. Methods A multicenter prospective observational cohort study to evaluate adverse events during ATT was conducted in Korea from 2019 to 2021. Drug-susceptible patients with TB who had been treated with standard ATT for 6 months were included. The patients were divided into 2 groups depending on the presence of 1 or more metabolic conditions, such as insulin resistance, hypertension, obesity, and dyslipidemia. We monitored ATT-related adverse events, including DILI, and treatment outcomes. The incidence of DILI was compared between individuals with and without metabolic disorders, and related factors were evaluated. Results Of 684 patients, 52 (7.6%) experienced DILI, and 92.9% of them had metabolic disorders. In the multivariable analyses, underlying metabolic disorders (adjusted hazard ratio [aHR], 2.85; 95% CI, 1.01–8.07) and serum albumin & lt;3.5 g/dL (aHR, 2.26; 95% CI, 1.29–3.96) were risk factors for DILI during ATT. In the 1-month landmark analyses, metabolic disorders were linked to an elevated risk of DILI, especially significant alanine aminotransferase elevation. The treatment outcome was not affected by the presence of metabolic disorders. Conclusions Patients with metabolic disorders have an increased risk of ATT-induced liver injury compared with controls. The presence of metabolic disorders and hypoalbuminemia adversely affects the liver in patients with ATT.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofad422
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2757767-3
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  • 7
    Online Resource
    Online Resource
    Modulation of Nogo receptor 1 expression orchestrates myelin-associated infiltration of glioblastoma
    Oxford University Press (OUP) ; 2021
    In:  Brain Vol. 144, No. 2 ( 2021-03-03), p. 636-654
    Details
    In: Brain, Oxford University Press (OUP), Vol. 144, No. 2 ( 2021-03-03), p. 636-654
    Abstract: As the clinical failure of glioblastoma treatment is attributed by multiple components, including myelin-associated infiltration, assessment of the molecular mechanisms underlying such process and identification of the infiltrating cells have been the primary objectives in glioblastoma research. Here, we adopted radiogenomic analysis to screen for functionally relevant genes that orchestrate the process of glioma cell infiltration through myelin and promote glioblastoma aggressiveness. The receptor of the Nogo ligand (NgR1) was selected as the top candidate through Differentially Expressed Genes (DEG) and Gene Ontology (GO) enrichment analysis. Gain and loss of function studies on NgR1 elucidated its underlying molecular importance in suppressing myelin-associated infiltration in vitro and in vivo. The migratory ability of glioblastoma cells on myelin is reversibly modulated by NgR1 during differentiation and dedifferentiation process through deubiquitinating activity of USP1, which inhibits the degradation of ID1 to downregulate NgR1 expression. Furthermore, pimozide, a well-known antipsychotic drug, upregulates NgR1 by post-translational targeting of USP1, which sensitizes glioma stem cells to myelin inhibition and suppresses myelin-associated infiltration in vivo. In primary human glioblastoma, downregulation of NgR1 expression is associated with highly infiltrative characteristics and poor survival. Together, our findings reveal that loss of NgR1 drives myelin-associated infiltration of glioblastoma and suggest that novel therapeutic strategies aimed at reactivating expression of NgR1 will improve the clinical outcome of glioblastoma patients.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    URL: Article
    DOI: 10.1093/brain/awaa408
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    Improving the Prediction of Relapse After Nucleos(t)ide Analogue Discontinuation in Patients With Chronic Hepatitis B
    Oxford University Press (OUP) ; 2021
    In:  Clinical Infectious Diseases Vol. 73, No. 4 ( 2021-08-16), p. e892-e903
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 73, No. 4 ( 2021-08-16), p. e892-e903
    Abstract: Current guidelines recommend rules for stopping nucleos(t)ide analogues (NAs) in patients with chronic hepatitis B (CHB), but off-therapy relapse is still high. This study aimed to identify predictors of off-therapy relapse and improve existing stopping rules. Methods This retrospective study included 488 patients with CHB (262 hepatitis B e antigen [HBeAg]–positive and 226 HBeAg-negative) who discontinued NAs. Posttreatment relapse was investigated. Results During the median follow-up period of 73.3 months, the cumulative 5-year and 10-year virologic relapse (VR) rates were 73.5% and 76.1%, respectively. In HBeAg-positive patients, end-of-therapy hepatitis B surface antigen (HBsAg) levels (hazard ratio [HR], 1.93 [95% confidence interval {CI}, 1.42–2.61] ) and consolidation duration ≥2 years (HR, 0.31 [95% CI: .17–.58]) were independent predictors of VR. Consolidation ≥2 years and low HBsAg levels (≤560 IU/mL) significantly lowered VR rates. In HBeAg-negative patients, only the HBsAg level (HR, 1.61 [95% CI: 1.24–2.11] ) was independently predictive of VR. Cirrhosis was significantly associated with higher VR rates in HBeAg-negative patients with low HBsAg levels (≤800 IU/mL). Combining end-of-therapy HBsAg levels with current stopping rules or consolidation duration further reduced off-therapy relapse, with 2-year VR rates of approximately 15%–25% in HBeAg-positive patients and 35% in HBeAg-negative patients. Conclusions End-of-therapy HBsAg levels, consolidation duration, and cirrhosis are key determinants of off-therapy relapse. Together with low HBsAg levels, extended consolidation therapy for ≥2 years should be ensured, and cirrhotic patients should continue NAs even if low HBsAg levels are achieved. A combination of these parameters will help identify individuals at low risk of relapse and significantly improve the predictive ability of the existing stopping rules.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciab007
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2002229-3
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