The effects of remdesivir on mortality and the requirement for mechanical ventilation in patients with COVID-19: a systematic review stratified by disease severity

Seungeun Ryoo,Miyoung Choi,Su-Yeon Yu,Young Kyung Yoon,Kyungmin Huh,Eun-Jeong Joo 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.1

Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85–1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77–1.00; 6 studies; I2 = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59–0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilatory support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

사용자 시나리오 도출을 위한 모바일폰 멀티태스킹 태스크 플로우 다이어그램

정승은 (Chung Seungeun ),이신혜 (Lee Shinhae ),이정윤 (Rhee Jeongyoon ),류한영 (Ryoo Hanyoung ) 한국디지털디자인학회 2009 디지털디자인학연구 Vol.9 No.2

본 연구는 모바일 폰에서 멀티태스킹이 이루어지는 다양한 상황의 태스크 시나리오 제작을 효과적으로 지원하기 위한 멀티태스킹 플로우 다이어그램을 제안하고 있다. 이를 위해 먼저 모바일 폰의 기능을 조사하여 멀티태스킹이 이루어 질 수 있는 주요태스크를 도출하였고 도출된 각 태스크 별로 멀티태스킹 니즈에 대한 사용자 조사를 설문으로 진행하였다. 최종적으로 멀티태스킹 니즈가 있는 태스크를 연속적으로 대응시키는 방식으로 정량화 된 11가지 멀티태스킹 플로우 다이어그램을 도출하였다. 또한 도출된 태스크 플로우 다이어그램을 이용하여 디자이너들로 하여금 시나리오를 제작해보게 함으로써 태스크 플로우 다이어그램이 시나리오를 만드는데 있어 실제로 도움을 줄 수 있는지 그 효용성을 확인하였다. 여러 태스크가 동시에 일어날 때 멀티태스킹이 어떠한 과정을 통하여 나타나는가를 체계화하고 시나리오 제작 에 활용하는 일련의 과정은 향후 사용자 중심의 인터페이스 디자인 및 평가의 기반자료로 활용될 것으로 기대 한다. The purpose of this study is to suggest task flow diagrams which represent users' multi-tasking needs in the case they use mobile phones and help designer generate various task scenario effectively. In order to complete the task flow diagrams researchers 1) listed mobile phone's functions which might be included in the task flow of multi-tasking 2) investigated users' multi-tasking needs by conducting a survey and 3) developed 11 multi-tasking task flow diagrams by iteratively connecting one task to another based on the survey results. In addition the usefulness of these task flow diagrams were examined by requesting designers to generate multi-tasking scenarios using them. It is expected that the results of this research in which the detailed procedure of multi-tasking is described might help designers when they design and/or evaluate user interfaces of mobile phones' multi-taskings.

장소 맥락에 따른 로봇 얼굴 디자인에 대한 사용자 인식 차이 ‑ 공공장소와 사적장소를 중심으로

윤지선(Yoon, Jisun),류한영(Ryoo, Han Young),최지원(Choi, Jiwon),정승은(Chung, Seungeun) 인제대학교 디자인연구소 2021 Journal of Integrated Design Research (JIDR) Vol.20 No.1

연구배경 오늘날 로봇들은 인간의 감성적인 부분까지도 보살필 수 있는 존재로 주목받으며 다양한 서비스 분야에 적용되고 있다. 이러한 서비스 로봇들의 외형을 살펴보면 대부분 인간형 디자인을 적용하고 있으며, 공통적으로 얼굴이 있다는 특징을 지닌다. 로봇에게 있어 얼굴이 중요한 이유는 사용자들이 이들과 상호작용할 때 가장 먼저 마주하게 되는 부분이기 때문이며, 로봇에 대한 첫인상을 결정하는 데 가장 큰 영향을 미치기 때문이다. 또한 인간의 대면 상호작용에 있어 공공장소와 사적장소로 분류되는 장소 맥락은 상호작용의 결과에 주요한 영향을 미치는 요소라 할 수 있는데, 이러한 사실은 인간-로봇의 상호작용의 과정에도 동일하게 적용 가능한 사실로 판단된다. 연구방법 다양한 수준으로 나타나고 있는 인간형 로봇의 얼굴 디자인을 얼마나 인간적으로 느껴지는 지에 따라 분류하였으며, 그 분류를 활용하여 공공장소와 사적장소에서 수준별 로봇의 얼굴들이 호감도와 지각된 유용성에 대해 어떻게 다르게 인식되는지와 특정 수준의 로봇 얼굴 디자인에 대한 인식이 맥락에 따라 차이가 있는지 살펴보았다. 연구결과 수준별 분류 조사 결과 로봇의 얼굴 디자인을 인간적인 정도에 따라 5개의 수준으로 분류할 수 있었으며, 이에 대해 가장 추상적인 디자인부터 가장 인간적인 디자인까지를 수준1에서 수준5로 정의하였다. 장소 맥락에 따라 수준별 로봇의 얼굴에 대한 호감도 인식을 분석한 결과, 공공장소에서는 수준2, 수준4가 호감도가 높은 그룹으로 분류되었고, 사적장소에서는 수준1, 수준2, 수준4가 호감도가 높은 그룹으로 분류되었다. 수준1의 경우 장소 맥락에 따른 호감도의 차이가 통계적으로 유의미하게 나타났다. 장소 맥락에 따라 수준별 로봇의 얼굴에 대한 지각된 유용성 인식을 분석한 결과, 공공장소에서는 수준2, 수준4가 지각된 유용성이 높은 그룹으로 분류되었으며, 수준3과 수준4는 지각된 유용성이 중간인 그룹에도 포함되었다. 사적장소에서는 수준1, 수준2, 수준3, 수준4는 지각된 유용성이 높은 그룹으로 분류되었다. 하지만 로봇의 장소 맥락에 따른 지각된 유용성의 차이는 통계적으로 유의미하지 않았다. 결론 본 연구의 결과를 통해 사용자들은 로봇 얼굴의 인간적인 정도를 판단하는 데에 얼굴형보다 얼굴요소 개수에 영향을 받지만, 공공장소와 사적장소에서의 호감도나 지각된 유용성의 경우 얼굴 요소개수와 상관없이 인상을 좌우하는 얼굴형이나 얼굴 요소 간의 비례 등에 영향을 크게 받는 것을 확인할 수 있었다. 또한 사적장소에서는 공공장소에서와 달리 추상적인 로봇 얼굴 디자인이 거부감을 낮추는 요인으로 작용하여 호감도가 높은 것을 확인할 수 있었고, 지각된 유용성의 경우 장소 맥락에 따른 인식의 차이가 없음을 알 수 있었다. 이는 향후 로봇 얼굴을 디자인할 때 사용자가 로봇을 대면하게 되는 장소와 로봇 얼굴 인상에 대한 고려가 필요함을 시사한다. Background Today’s robot has been recognized as a being to care human emotion, and applied to various service fields. Most service robots have human-like design and a human face in common. Designing a face for a robot is important in human-robot interaction because user faces its face at first, and it has the greatest effect on determining the first impression. Furthermore, the context of a place which can be classified as public and private is a major factor for the outcome of the human’s face-to-face interaction, and this seems to be equally applicable to the process of human-robot interaction. Methods This research categorized human-type robot face designs into various levels of similarity with human face, and explored how robot faces are perceived differently for likeability and perceived usefulness in public place and private place and differences of users’ perception about different levels of robot faces depending on the context of places using levels of robot faces, which were derived from the categorizing research. Result In classification research, designs of robot faces were categorized into 5 different levels. The least human-like face design was defined as level-1, and the most human-like face design was defined as level-5. As a result of analyzing the likeability of the robot face according to the context of the place, level-2 and level-4 were classified as high group in public places, and level-1, level-2, and level-4 were classified as high group in private places, In the case of Level 1, the difference in likeability according to the context of the place was statistically significant. As a result of analyzing the perceived usefulness perception of the robot face according to the context of the place, level-2 and level-4 were classified into groups with high perceived usefulness in public places, and level-3 and level-4 were also included in middle group. In private places, level-1, level-2, level-3, and level-4 were classified as high group. However, the difference in perceived usefulness according to the context of the place of the robot face was not statistically significant. Conclusion Through the results of this study, users are influenced by the number of facial elements rather than the face shape in determining the humanity of the robot"s face. But in the case of likeability and perceived usefulness in public and private places, they are more influenced by the proportionality between facial elements. In addition, we find that in private places, unlike in public places, abstract robot face design serves as a factor in reducing repulsion. This suggests that it is necessary to consider the place where the user faces a robot when designing the robot face in the future.

Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19

Kim Sun Bean,Ryoo Seungeun,Huh Kyungmin,Joo Eun-Jeong,Kim Youn Jeong,Choi Won Suk,Kim Yae-Jean,Yoon Young Kyung,Heo Jung Yeon,Seo Yu Bin,Jeong Su Jin,Park Dong-ah,Yu Su-Yeon,Lee Hyeon-Jeong,Kim Jimin 대한감염학회 2021 Infection and Chemotherapy Vol.53 No.1

Despite the global effort to mitigate the spread, coronavirus disease 2019 (COVID-19) has become a pandemic that took more than 2 million lives. There are numerous ongoing clinical studies aiming to find treatment options and many are being published daily. Some effective treatment options, albeit of variable efficacy, have been discovered. Therefore, it is necessary to develop an evidence-based methodology, to continuously check for new evidence, and to update recommendations accordingly. Here we provide guidelines on pharmaceutical treatment for COVID-19 based on the latest evidence.

Total Knee Replacement After Arthroscopic Meniscectomy in Knee Osteoarthritis: A Nationwide Population-Based Cohort Study

Park Chan Mi,Ryoo Seungeun,Choi Miyoung,이수정,Yoo Jong Jin,김현아 대한의학회 2023 Journal of Korean medical science Vol.38 No.1

Background: Recent studies raise concerns that arthroscopic meniscectomy (AM) for degenerative tear may be detrimental to the maintenance of the joint structure. This study was performed to examine the rate of total knee replacement (TKR) among patients with knee osteoarthritis (OA) who underwent AM for meniscal tears and compare this rate with those who did not. Methods: A retrospective cohort study was conducted using the National Health Insurance Database of South Korea. Among knee OA patients aged 50–79, those who were treated with AM due to meniscal damage from 2007 to 2009 were selected as the AM group while those not treated with AM despite the presence of meniscal damage were selected as control group. Both were matched based on a propensity score and followed-up until the earliest occurrence of: TKR, death, or 10 years. Cox proportional hazards models were used to compare the outcome. Results: A total of 36,974 patients were included in AM groups and non-AM group after 1:1 matching. TKR occurred in 9.62% and 7.64% in AM and non-AM groups with the average duration after meniscectomy of 5.88 ± 2.77 and 5.50 ± 2.94 years, respectively. After adjustment for baseline confounders, the TKR rate in the AM group was calculated to be 25% higher than that in the non-AM group (subdistribution hazard ratio, 1.25; 95% confidence interval, 1.16–1.34). The mortality rate was 5.20%, which did not significantly differ between groups. Conclusion: OA patients who underwent AM for the meniscal injury had higher incidence of TKR up to 10 years of follow-up than the non-operated group. The greater TKR utilization observed in patients undergoing AM merits caution when treating OA patients with meniscal injury.

Arthroscopic Partial Meniscectomy versus Physical Therapy for Degenerative Meniscal Tear: a Systematic Review

Choi Miyoung,Lee Su Jung,Park Chan Mi,Ryoo Seungeun,Kim Sunghyun,Jang Ju Yeon,Kim Hyun Ah 대한의학회 2021 Journal of Korean medical science Vol.36 No.45

Background: Meniscal tears are commonly observed in patients with knee osteoarthritis (OA), however, clinical significance of such lesions detected by magnetic resonance imaging is in many cases unclear. This study aimed to determine the clinical effectiveness of arthroscopic partial meniscectomy (APM) compared with non-operative care in patients with knee OA. Method: We used existing systematic reviews with updates of latest studies. Three randomized controlled studies were selected, where two studies compared the effects of APM plus physical therapy (PT) with PT alone and one compared APM alone and PT alone. While 1 study exclusively included OA patients, 2 studies included 21.1 and 12% of patients with no radiographic OA. Patients with knee locking were unanimously excluded. Results: Upon comparison of APM plus PT and PT alone, there was no significant difference observed in knee function, physical activity, or adverse events. Knee pain was observed to be significantly lower in the APM plus PT group at 6 months, but there was no difference between the two groups at 12 and 24 months. With respect to the comparison between APM alone and PT alone, PT was non-inferior based on the criteria for knee function during 24 months; however, knee pain was significantly reduced in the APM alone group. Conclusions: Our study showed that knee pain was significantly improved in the APM group compared to non-operative care group at 6 months and over 24 months. Our result was based on only 3 randomized controlled trials (RCTs) revealing a significant knowledge gap, hence demanding more high-quality RCTs in OA patients.

Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development

Choi Miyoung,Lee Hyeon-Jeong,Yu Su-Yeon,Kim Jimin,Park Jungeun,Ryoo Seungeun,Kim Inho,Park Dong Ah,Yoon Young Kyung,Joh Joon-Sung,Park Sunghoon,Yun Ki Wook,Choi Chi-Hoon,Kim Jae-Seok,Shin Sue,Kim Hyun 대한의학회 2023 Journal of Korean medical science Vol.38 No.23

Background: In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration. Methods: The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations. Results: An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3–4 months. Conclusion: We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.