The Relationship between Delirium and Statin Use According to Disease Severity in Patients in the Intensive Care Unit

Jun Yong An(Jun Yong An),Jin Young Park(Jin Young Park),Jaehwa Cho(Jaehwa Cho),Hesun Erin Kim(Hesun Erin Kim),Jaesub Park(Jaesub Park),Jooyoung Oh(Jooyoung Oh) 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.1

Objective: The aim of this study was to investigate the association between the use of statins and the occurrence of delirium in a large cohort of patients in the intensive care unit (ICU), considering disease severity and statin properties. Methods: We obtained clinical and demographical information from 3,604 patients admitted to the ICU from January 2013 to April 2020. This included information on daily statin use and delirium state, as assessed by the Confusion Assessment Method for ICU. We used inverse probability of treatment weighting and categorized the patients into four groups based on the Acute Physiology and Chronic Health Evaluation II score (group 1: 0−10 - mild; group 2: 11−20 - mild to moderate; group 3: 21−30 - moderate to severe; group 4: > 30 - severe). We analyzed the association between the use of statin and the occurrence of delirium in each group, while taking into account the properties of statins. Results: Comparisons between statin and non-statin patient groups revealed that only in group 2, patients who were administered statin showed significantly higher occurrence of delirium (p = 0.004, odds ratio [OR] = 1.58) compared to the patients who did not receive statin. Regardless of whether statins were lipophilic (p = 0.036, OR = 1.47) or hydrophilic (p = 0.032, OR = 1.84), the occurrence of delirium was higher only in patients from group 2. Conclusion: The use of statins may be associated with the increases in the risk of delirium occurrence in patients with mild to moderate disease severity, irrespective of statin properties.

Systematic Approach for Analyzing Drug Combination by Using Target-Enzyme Distance

Park, Jaesub,Lee, Sunjae,Kim, Kiseong,Lee, Doheon Korean Society for Bioinformatics 2013 Interdisciplinary Bio Central (IBC) Vol.5 No.2

Recently, the productivity of drug discovery has gradually decreased as the limitations of single-target-based drugs for various and complex diseases become exposed. To overcome these limitations, drug combinations have been proposed, and great efforts have been made to predict efficacious drug combinations by statistical methods using drug databases. However, previous methods which did not take into account biological networks are insufficient for elaborate predictions. Also, increased evidences to support the fact that drug effects are closely related to metabolic enzymes suggested the possibility for a new approach to the study drug combinations. Therefore, in this paper we suggest a novel approach for analyzing drug combinations using a metabolic network in a systematic manner. The influence of a drug on the metabolic network is described using the distance between the drug target and an enzyme. Target-enzyme distances are converted into influence scores, and from these scores we calculated the correlations between drugs. The result shows that the influence score derived from the targetenzyme distance reflects the mechanism of drug action onto the metabolic network properly. In an analysis of the correlation score distribution, efficacious drug combinations tended to have low correlation scores, and this tendency corresponded to the known properties of the drug combinations. These facts suggest that our approach is useful for prediction drug combinations with an advanced understanding of drug mechanisms.

Prediction and early detection of delirium in the intensive care unit by using heart rate variability and machine learning

Oh, Jooyoung,Cho, Dongrae,Park, Jaesub,Na, Se Hee,Kim, Jongin,Heo, Jaeseok,Shin, Cheung Soo,Kim, Jae-Jin,Park, Jin Young,Lee, Boreom IOP 2018 Physiological measurement Vol.39 No.3

<P> <I>Objective</I>: Delirium is an important syndrome found in patients in the intensive care unit (ICU), however, it is usually under-recognized during treatment. This study was performed to investigate whether delirious patients can be successfully distinguished from non-delirious patients by using heart rate variability (HRV) and machine learning. <I>Approach</I>: Electrocardiography data of 140 patients was acquired during daily ICU care, and HRV data were analyzed. Delirium, including its type, severity, and etiologies, was evaluated daily by trained psychiatrists. HRV data and various machine learning algorithms including linear support vector machine (SVM), SVM with radial basis function (RBF) kernels, linear extreme learning machine (ELM), ELM with RBF kernels, linear discriminant analysis, and quadratic discriminant analysis were utilized to distinguish delirium patients from non-delirium patients. <I>Main results</I>: HRV data of 4797 ECGs were included, and 39 patients had delirium at least once during their ICU stay. The maximum classification accuracy was acquired using SVM with RBF kernels. Our prediction method based on HRV with machine learning was comparable to previous delirium prediction models using massive amounts of clinical information. <I>Significance</I>: Our results show that autonomic alterations could be a significant feature of patients with delirium in the ICU, suggesting the potential for the automatic prediction and early detection of delirium based on HRV with machine learning.</P>

An Algorithm for Detecting QPSK Signal Using TDNN

Noh, Sunkuk,Kim, Jaesub,Park, Changkyun CHOSUN UNIVERSITY 1997 Basic Science and Engineering Vol.1 No.2

Digital wireless communications (Mobile communications, Satelite communications, PCS, Pager etc) are requested high frequency use-rates, more efficient data transmission with limited signal power, frequency band. AWnd digital modulation signals are used BPSK, QPSK, OQPSK, π/4 QPSK and QAM etc. In this paper, for improve symbol error rates of signal in digital communications, we select the QPSK(quadrature phase shift keying) with good spectrum efficiency in digital modulation methods and suggest an algorithm for detecting QPSK signal with TDNN(time delay neural networks). TDNN is an artificial neural networks that has a single layer perceptron. In the results of simulation using the suggested algorithm for detection, we find that symbol error rates are lowed when the rol-off factor α=1 of raised-cosine filter and we confirm utility of suggested detection algorithm in digital communications.

조현병 환자에서 QTc 간격연장에 관련되는 요인 : 후향적 연구

이정석,박재섭,박선영,Lee, Jung Suk,Park, Jaesub,Park, Sunyoung 한국정신신체의학회 2021 정신신체의학 Vol.29 No.1

연구목적 항정신병약물로 인한 QTc간격연장은 심각한 심실성 부정맥을 초래할 가능성 때문에 주의가 필요한 부작용이다. 하지만 현재까지 국내에서 항정신병약물에 의한 QTc간격연장에 대한 연구는 많지 않았다. 본 연구는 조현병 환자에서 QTc간격연장에 영향을 주는 인구학적 및 임상적 변수를 알아보고자 한다. 방 법 일 병원에 입원치료를 받았던 441명 조현병 환자들의 의무기록을 후향적으로 검토하여 QTc간격과 인구학적 및 임상적 변수들을 파악하였다. QTc간격에 영향을 주는 변수를 알아보기 위해 QTc간격을 종속변수로 하여 위계적 중다회귀분석을 수행하였다. 결 과 평균 QTc간격은 417.2±28.4 ms였다. 위계적 중다회귀분석 결과 항정신병약물 단기작용주사제의 사용이 QTc간격연장의 가장 강한 예측인자였다. 결 론 본 연구는 조현병 환자에서 항정신병약물 단기작용주사제 사용이 QTc간격연장에 영향을 줄 수 있으며 조현병 환자의 치료 시 항정신병약물 단기작용주사제 사용에 보다 주의를 기울여야 함을 시사한다. Objectives : QTc prolongation due to antipsychotics is of major concern because it may lead to fatal ventricular arrhythmia such as torsade de pointes. However, few studies have been conducted on QTc prolongation due to antipsychotics, especially in South Korea. This study aimed to investigate how demographic and clinical variables affect QTc interval in patients with schizophrenia. Methods : By retrospectively reviewing medical records, we assessed QTc interval, demographic data and clinical features of 441 (175 males) patients with schizophrenia who admitted to the psychiatric ward of a general hospital. To explore the predictive factors for QTc interval, hierarchical regression analysis was performed with QTc interval as the dependent variable. Results : The mean QTc interval was 417.2±28.4 ms. In the hierarchical regression analysis, the use of short-acting antipsychotic injection was the strongest predictor of the QTc prolongation. Conclusions : This study demonstrated that the use of short-acting antipsychotic injection may affect QTc prolongation in patients with schizophrenia. This result suggests that more attention should be paid to the use of short-acting antipsychotic injection in the treatment of schizophrenia.

저항성 홀배열이 적용된 볼로미터의 적외선 흡수 특성 변화

김태현 ( Tae Hyun Kim ),오재섭 ( Jaesub Oh ),박종철 ( Jongcheol Park ),김희연 ( Hee Yeoun Kim ),이종권 ( Jong-kwon Lee ) 한국센서학회 2018 센서학회지 Vol.27 No.5

In order to develop a highly sensitive infrared sensor, it is necessary to develop techniques for decreasing the rate of heat absorption and the transition of the absorption wavelength to a longer wavelength, both of which can be induced by decreasing the pixel size of the bolometer. Therefore, in this study, 1 μm hole-arrays with a subwavelength smaller than the incident infrared wavelength were formed on the amorphous silicon-based microbolometer pixels in the absorber, which consisted of a TiN absorption layer, an a-Si resistance layer and a SiNx membrane support layer. We demonstrated that it is possible to reduce the thermal time constant by 16% relative to the hole-patternless bolometer, and that it is possible to shift the absorption peak to a shorter wavelength as well as increase absorption in the 4-8 μm band to compensate for the infrared long-wavelength transition. These results demonstrate the potential for a new approach to improve the performance of high-resolution microbolometers.

Quality of Early Depression Management and Long-Term Medical Use: Aspect of Quality Indicators for Outpatients with Depression

Lim Hyun Ho,Lee Jae Kwang,Park Sunyoung,Chang Jhin Goo,Oh Jooyoung,Park Jaesub,Song Jungeun 대한우울조울병학회 2023 우울조울병 Vol.21 No.3

Background: Depression is a global mental health concern that negatively affects individuals’ health and increases medical costs. This study aimed to assess whether early depression management is cost-beneficial and effective from the perspective of quality indicators. Methods: Data of patients newly diagnosed with depressive disorder between 2012 and 2014 as well as follow-up data until 2020 were extracted from the National Health Insurance Service database. Hospitalization, emergency room visits, and annual medical expenses were set as dependent variables to estimate the effect of depression and information on medical expenditures. Six quality indicators developed by the Health Insurance Review and Assessment Service comprised independent variables. Results: In total, 465,766 patients were included in this study. Patients who met the quality indicators were more likely to be hospitalized with a psychiatric diagnosis. Furthermore, patients who met the quality indicator of revisiting within 3 weeks of their first visit had greater psychiatric and overall expenses during the early treatment phase; however, the overall expenses gradually decreased over time. Conclusion: High-quality initial treatment for depression can be cost-effective in the long term; however, further studies are needed to discern its immediate clinical effects.

Delirium characteristics and outcomes in medical and surgical lnpatients: A subgroup analysis

Kim, Sungmin,Kim, Jae-Jin,Oh, Jooyoung,Park, Jaesub,Park, Jin Young Elsevier 2018 Journal of critical care Vol.43 No.-

<P><B>Abstract</B></P> <P><B>Purpose</B></P> <P>Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes.</P> <P><B>Materials and methods</B></P> <P>Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients.</P> <P><B>Results</B></P> <P>Postoperative delirium developing as a secondary complication following surgery was found to be of significantly longer duration and associated with greater length of hospitalization compared with postoperative delirium attributable to surgery and delirium in medical patients. Medical patients with delirium had lower delirium recovery rates at discharge compared with surgical patients.</P> <P><B>Conclusions</B></P> <P>The findings that patient type and timing of postoperative delirium are associated with differential delirium outcomes suggest that targeted screening and intervention approaches may be needed. Medical patients were more likely to be discharged before recovery from delirium compared with surgical patients. Differences in underlying chronic medical conditions may account for the observed differences in discharge condition between medical and surgical patients with delirium.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Delirium is a commonly observed condition following surgical intervention. </LI> <LI> Previous research on postoperative delirium focused on vulnerable populations. </LI> <LI> We explored delirium progression between medical and surgical patient populations. </LI> <LI> Delirium duration, delirium recovery, and length of hospital stay were measured. </LI> </UL> </P>

하단거주공간 확보를 위한 카울크로스바 구조에 대한 연구

이민경(Minkyeong Lee),유영진(Youngjin Yoo),최재섭(Jaesub Choi),이관보(Kwanbo Lee),박창길(Changgil Park) 한국자동차공학회 2023 한국자동차공학회 학술대회 및 전시회 Vol.2023 No.11

Effect of drug compliance on health care costs in newly-diagnosed dementia: Analysis of nationwide population-based data

Oh, Seung-Taek,Han, Kyu-Tae,Choi, Won-Jung,Park, Jaesub Elsevier 2019 Journal of Psychiatric Research Vol.118 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>The cost-effectiveness of both cholinesterase inhibitors and memantine by delaying nursing home placement has been supported by numerous studies. The importance of sustained pharmacological treatment in dementia has been relatively less recognized by public health policies compared to early diagnosis. We investigated the effect of the drug (donepezil, rivastigmine, galantamine, and memantine) compliance on the health care costs in newly-diagnosed dementia.</P> <P><B>Methods</B></P> <P>National Health Insurance Service (NHIS) database which covers the entire population of South Korea was used for analysis. Health care expenditure of patients newly-diagnosed with dementia in between 2012 and 2014 was investigated for 3–5 years. For drug compliance, we used Medication Possession Ratio (MPR) that indicates the percentage of time a patient has access to medication. Multivariate linear regression analysis including generalized estimated equation and gamma distribution was used for statistical analysis.</P> <P><B>Results</B></P> <P>We identified 252,594 patients who were both prescribed with cognitive enhancers and newly diagnosed with dementia. When initial MPR increased 20%, total health care costs decreased 8.4% (RR = 0.916, 95%; CI 0.914 to 0.916). Same relationship was shown with medical costs related to dementia, admission to a general hospital, and emergency room visits. When MPR increased 20% compared to the previous year, the total health care costs, admission to a general hospital, emergency room visits, and admission to a nursing hospital decreased.</P> <P><B>Conclusions</B></P> <P>This population-based retrospective cohort study provides evidence that patients newly-diagnosed with dementia who showed higher initial drug compliance or maintained antidementia drugs (Cholinesterase inhibitors and memantine) would benefit in total health-care costs.</P>