Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are ...commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values ...by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents.
A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off.
The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach's alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888-1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887-1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls.
The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Fugl-Meyer assessment (FMA) is the most popular instrument for evaluating upper extremity motor function in stroke patients. However, it is a labor-intensive and time-consuming method. This paper ...proposes a novel automated FMA system to overcome these limitations of the FMA. For automation, we used Kinect v2 and force sensing resistor sensors owing to their convenient installation as compared with body-worn sensors. Based on the linguistic guideline of the FMA, a rule-based binary logic classification algorithm was developed to assign FMA scores using the extracted features obtained from the sensors. The algorithm is appropriate for clinical use, because it is not based on machine learning, which requires additional learning processes with a large amount of clinical data. The proposed system was able to automate 79% of the FMA tests because of optimized sensor selection and the classification algorithm. In clinical trials conducted with nine stroke patients, the proposed system exhibited high scoring accuracy (92%) and time efficiency (85% reduction in clinicians' required time).
Background:
It is challenging to predict retear after arthroscopic rotator cuff repair (ARCR). The usefulness of arthroscopic intraoperative images as predictors of the ARCR prognosis has not been ...analyzed.
Purpose:
To evaluate the usefulness of arthroscopic images for the prediction of retear after ARCR using deep learning (DL) algorithms.
Study Design:
Cohort study (Diagnosis); Level of evidence, 2.
Methods:
In total, 1394 arthroscopic intraoperative images were retrospectively obtained from 580 patients. Repaired tendon integrity was evaluated using magnetic resonance imaging performed within 2 years after surgery. Images obtained immediately after ARCR were included. We used 3 DL architectures to predict retear based on arthroscopic images. Three pretrained DL algorithms (VGG16, DenseNet, and Xception) were used for transfer learning. Training and test sets were split into 8:2. Threefold stratified validation was used to fine-tune the hyperparameters using the training data set. The validation results of each fold were evaluated. The performance of each model in the test set was evaluated in terms of accuracy, area under the receiver operating characteristic curve (AUC), F1-score, sensitivity, and specificity.
Results:
In total, 1138 and 256 arthroscopic images were obtained from 514 patients and 66 patients in the nonretear and retear groups, respectively. The mean validation accuracy of each model was 83% for VGG16, 89% for Xception, and 91% for DenseNet. The accuracy for the test set was 76% for VGG16, 87% for Xception, and 91% for DenseNet. The AUC was highest for DenseNet (0.92); it was 0.83 for VGG16 and 0.91 for Xception. For the test set, the specificity and sensitivity were 0.93 and 0.84 for DenseNet, 0.89 and 0.84 for Xception, and 0.70 and 0.80 for VGG16, respectively.
Conclusion:
The application of DL algorithms to intraoperative arthroscopic images has demonstrated a high level of accuracy in predicting retear occurrences.
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•Cork biochar produced at temperature 600 °C has porous structure.•Conc. H2SO4 activated biochar able to transesterify WCO into biodiesel.•A:O ratio (25:1) at catalyst loading 1.5% ...w/v results in 98% FAME conversion.•Produced biodiesel has CN (50.56), HHV (39.5), ʋ (3.9) and (ρ) 0.87.
In this study, a heterogeneous catalyst prepared by pyrolysis of waste cork (Quercus suber) was used for the transesterification of waste cooking oil (WCO). Physicochemical properties of the synthesized biochar catalyst were studied using BET, SEM, FTIR, and XRD. The experiment results demonstrate that heterogeneous catalyst synthesized at 600 °C showed maximum fatty acids methyl esters (FAMEs) conversion (98%) at alcohol:oil (25:1), catalyst loading (1.5% w/v) and temperature 65 °C. Biodiesel produced from WCO (Canola oil) mainly composed of FAMEs in following order C18:1 > C18:2 > C16:0 > C18:0 > C20:0. Properties of produced biodiesel were analysed as cetane number (CN) 50.56, higher heating value (HHV) 39.5, kinematic viscosity (ʋ) 3.9, and density (ρ) 0.87.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
It is important to ensure consumer acceptance in a smart grid since the ultimate deployment of the smart grid depends on the end users׳ acceptance of smart grid products and services such as smart ...meters and advanced metering services. We examine how residential consumers perceive the smart grid and what factors influence their acceptance of the smart grid through a survey for electricity consumers in Korea. In this study, consumers׳ smart grid acceptance factors, including the perceived risk, were examined with the existing technology acceptance model suggested by Davis. This study has an implication that it has provided theoretical and empirical ground, based on which the policies to promote consumer participation in the deployment of the smart grid can be developed. Since there are few studies on the policies from the perspective of the smart grid users, this study will contribute directly to the development of the strategy to ensure the acceptance of the smart grid.
•We examine what factors influence electricity consumers׳ smart grid acceptance.•We test the smart grid technology acceptance model including the perceived risk as a main factor.•The importance of consumer education and public relations of the smart grid has been confirmed.•Another shortcut to ensure the acceptance of the smart grid is to mitigate the anxiety about the risk in the use of the smart grid.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Significant progress has been made on the molecular biology of the severe fever with thrombopenia virus (SFTSV); however, many parts of the pathophysiological mechanisms of mortality in SFTS remain ...unclear. In this study, we investigated virologic and immunologic factors for fatal outcomes of patients with SFTS. We prospectively enrolled SFTS patients admitted from July 2015 to October 2020. Plasma samples were subjected to SFTSV RNA RT-PCR, multiplex microbead immunoassay for 17 cytokines, and IFA assay. A total of 44 SFTS patients were enrolled, including 37 (84.1%) survivors and 7 (15.9%) non-survivors. Non-survivors had a 2.5 times higher plasma SFTSV load than survivors at admission (
< 0.001), and the viral load in non-survivors increased progressively during hospitalization. In addition, non-survivors did not develop adequate anti-SFTSV IgG, whereas survivors exhibited anti-SFTSV IgG during hospitalization. IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF were significantly elevated in non-survivors compared to survivors and did not revert to normal ranges during hospitalization (
< 0.05). Severe signs of inflammation such as a high plasma concentration of IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF, poor viral control, and inadequate antibody response during the disease course were associated with mortality in SFTS patients.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The prevalence of cardiocerebrovascular disease (CVD) is continuously increasing, and it is the leading cause of human death. Since it is difficult for physicians to screen thousands of people, ...high-accuracy and interpretable methods need to be presented. We developed four machine learning-based CVD classifiers (i.e., multi-layer perceptron, support vector machine, random forest, and light gradient boosting) based on the Korea National Health and Nutrition Examination Survey. We resampled and rebalanced KNHANES data using complex sampling weights such that the rebalanced dataset mimics a uniformly sampled dataset from overall population. For clear risk factor analysis, we removed multicollinearity and CVD-irrelevant variables using VIF-based filtering and the Boruta algorithm. We applied synthetic minority oversampling technique and random undersampling before ML training. We demonstrated that the proposed classifiers achieved excellent performance with AUCs over 0.853. Using Shapley value-based risk factor analysis, we identified that the most significant risk factors of CVD were age, sex, and the prevalence of hypertension. Additionally, we identified that age, hypertension, and BMI were positively correlated with CVD prevalence, while sex (female), alcohol consumption and, monthly income were negative. The results showed that the feature selection and the class balancing technique effectively improve the interpretability of models.
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Background: Early passive motion exercise has been the standard rehabilitation protocol after rotator cuff repair for preventing postoperative stiffness. However, recent approaches show that longer ...immobilization may enhance tendon healing and quality.
Purpose: To elucidate whether early passive motion exercise affects functional outcome and tendon healing after arthroscopic rotator cuff repair.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: One hundred five consecutive patients who underwent arthroscopic repair for small to medium-sized full-thickness rotator cuff tears were included. Patients with large to massive tears and concomitant stiffness or labral lesions were excluded. Patients were instructed to wear an abduction brace for 4 to 5 weeks after surgery and to start active-assisted shoulder exercise after brace weaning. Fifty-six patients were randomly allocated into group 1: early passive motion exercises were conducted 3 to 4 times per day during the abduction brace-wearing period. Forty-nine patients were allocated into group 2: no passive motion was allowed during the same period. Range of motion (ROM) and visual analog scale (VAS) for pain were measured preoperatively and 3, 6, and 12 months postoperatively. Functional evaluations, including Constant score, Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons (ASES) score, were also evaluated at 6 and 12 months postoperatively. Ultrasonography, magnetic resonance imaging, or computed tomography arthrography was utilized to evaluate postoperative cuff healing.
Results: There were no statistical differences between the 2 groups in ROM or VAS for pain at each time point. Functional evaluations were not statistically different between the 2 groups either. The final functional scores assessed at 12 months for groups 1 and 2 were as follows: Constant score, 69.81 ± 3.43 versus 69.83 ± 6.24 (P = .854); SST, 9.00 ± 2.12 versus 9.00 ± 2.59 (P = .631); and ASES score, 73.29 ± 18.48 versus 82.90 ± 12.35 (P = .216). Detachment of the repaired cuff was identified in 12% of group 1 and 18% of group 2 (P = .429).
Conclusion: Early passive motion exercise after arthroscopic cuff repair did not guarantee early gain of ROM or pain relief but also did not negatively affect cuff healing. We suggest that early passive motion exercise is not mandatory after arthroscopic repair of small to medium-sized full-thickness rotator cuff tears, and postoperative rehabilitation can be modified to ensure patient compliance.
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•One step synthesis of PU–CA–zein-drug loaded nanofibers via electrospinning.•Enhanced blood clotting and excellent platelet activation ability.•Good bactericidal activity against both gram-positive ...and gram-negative bacteria.•Scaffolds showed enhanced cell viability and infiltration.•Applicable to most of the open wounds due to bactericidal activity.
In this study, an antibacterial electrospun nanofibrous scaffolds with diameters around 400–700nm were prepared by physically blending polyurethane (PU) with two biopolymers such as cellulose acetate (CA) and zein. Here, PU was used as the foundation polymer, was blended with CA and zein to achieve desirable properties such as better hydrophilicity, excellent cell attachment, proliferation and blood clotting ability. To prevent common clinical infections, an antimicrobial agent, streptomycin sulfate was incorporated into the electrospun fibers and its antimicrobial ability against the gram negative and gram positive bacteria were examined. The interaction between fibroblasts and the PU–CA and PU–CA–zein-drug scaffolds such as viability, proliferation, and attachment were characterized. PU–CA–zein-drug composite nanoscaffold showed enhanced blood clotting ability in comparison with pristine PU nanofibers. The presence of CA and zein in the nanofiber membrane improved its hydrophilicity, bioactivity and created a moist environment for the wound, which can accelerate wound recovery.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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