The objectives of this study were to identify the prevalence of comorbidities of mental and behavioral disorders and to identify the association rules related to comorbidities as a way to improve patient management efficiently. We extracted comorbidities of 20,690 patients (≥19 years old) whose principal diagnosis was a mental disorder from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) between 2006 and 2016. Association rules analysis between comorbid diseases using the Apriori algorithm was used. The prevalence of comorbidities in all patients was 61.98%. The frequent comorbidities of mental and behavioral disorders were analyzed in the order of hypertensive diseases (11.06%), mood disorders (8.34%), diabetes mellitus (7.98%), and diseases of esophagus, stomach, and duodenum (7.04%). Nine major association pathways were analyzed. Significant pathways were analyzed as diabetes mellitus and hypertensive diseases (IS scale = 0.386), hypertensive diseases, and cerebrovascular diseases (IS scale = 0.240). The association pathway of diabetes mellitus and hypertensive diseases was common in subgroups of mental and behavioral disorders, excluding mood disorders and disorders of adult personality and behavior. By monitoring related diseases based on major patterns, it can predict comorbid diseases in advance, improve the efficiency of managing patients with mental and behavioral disorders, and furthermore, it can be used to establish related health policies.
This study explored physical and psychiatric comorbidities of mood disorders using association rule mining. There were 7709 subjects who were patients (19 years old) diagnosed with mood disorders and included in the data collected by the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) between 2006 and 2018. Physical comorbidities (46.17%) were higher than that of psychiatric comorbidities (27.28%). The frequent comorbidities of mood disorders (F30–F39) were hypertensive diseases (I10–I15), neurotic, stress-related and somatoform disorders (F40–F48), diabetes mellitus (E10–E14), and diseases of esophagus, stomach, and duodenum (K20–K31). The bidirectional association path of mood disorders (F30–F39) with hypertensive diseases (I10–I15) and diabetes mellitus (E10–E14) were the strongest. Depressive episodes (F32) and recurrent depressive disorders (F33) revealed strong bidirectional association paths with other degenerative diseases of the nervous system (G30-G32) and organic, including symptomatic and mental disorders (F00–F09). Bipolar affective disorders (F31) revealed strong bidirectional association paths with diabetes mellitus (E10–E14) and hypertensive diseases (I10–I15). It was found that different physical and psychiatric disorders are comorbid according to the sub-classification of mood disorders. Understanding the comorbidity patterns of major comorbidities for each mood disorder can assist mental health providers in treating and managing patients with mood disorders.
Background: Development of an accessible method to routinely evaluate the clonality of strains is needed in microbiology laboratories. We compared the discriminatory power of the Fourier-transform infrared (FTIR) spectroscopy-based IR Biotyper (Bruker Daltonics GmbH, Bremen, Germany) to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), using whole-genome sequencing (WGS) as the reference method.Methods: Eighty-three extended-spectrum β-lactamase-producing Escherichia coli isolates were tested using WGS, MALDI-TOF MS, and IR Biotyper. Simpson's diversity index (SDI), a statistical analysis for testing the homogeneity of a dendrogram, and the adjusted Rand index (aRI) were used to compare the discriminatory ability between typing tests. Results:The SDI (95% confidence interval) was 0.969 (0.952-0.985) for WGS, 0.865 (0.807-0.924) for MALDI-TOF MS, and 0.974 (0.965-0.983) for IR Biotyper. Compared with WGS, IR Biotyper showed compatible diversity, whereas MALDI-TOF MS did not. The concordance and aRI improved from 66.3% to 84.3% and from 0.173 to 0.538, respectively, for IR Biotyper versus MALDI-TOF MS with WGS as the reference method. IR Biotyper showed substantially improved performance in strain typing compared with MALDI-TOF MS.Conclusions: IR Biotyper is useful for diversity analysis with improved discriminatory power over MALDI-TOF MS in comparison with WGS as a reference method. IR Biotyper is an accessible method to evaluate the clonality of strains and could be applied in epidemiological analysis during an outbreak of a health care facility, as well as for research on the transmission of resistant bacteria in community settings.
This study aimed to select the pulse sequence providing the optimal MRCP image quality by applying various reduction and denoising level parameters—which could improve image quality and shorten examination time—to BH-2D-SSh TSE, RT- 2D-SENSE TSE, and RT-2D-Compressed SENSE(CS) TSE and then comparing and analyzing the obtained images. This study was carried out using 30 subjects (15 men and 15 women with a mean age of 53 ± 8.76 years) who underwent an MRCP test using 3.0T MRI equipment. These 30 subjects were composed of 20 patients (CHDD: 7; LC: 6; and IPMN: 7) and 10 volunteers without a disease. When the CS technique was used, five reduction values (1.1, 1.2, 1.3, 1.4, and 1.5) were used and four denoising levels (No, Weak, Medium, and Strong) were used. The existing SENSE method was based on a reduction value of 1, and other parameters were set the same. The image data of BH-2D-SSh TSE, RT-2D-SENSE TSE, and RT-CS-2D TSE used for the analysis were acquired in the coronal plane, and the acquired data underwent MIP post-processing for analysis. To compare these techniques, SNR and CNR were measured for six biliary duct images for the purpose of quantitative analysis, and qualitative analysis was performed on the sharpness of the duct, the overall quality of the image, and the motion artifact. The results of the quantitative and standard analyses showed that the RT-2D-CS TSE technique had the highest results for all IPMN, LC, and CHDD diseases (p < 0.05). Moreover, SNR and CNR were the highest when the reduction value was set to 1.3 and the denoising level was set to medium as the CS setting values (p < 0.05). Compared with the conventional RT-2D-SENSE TSE, the test time decreased by 20% and SNR and CNR increased by 14% on average. When conducting RT-2D-CS TSE, we found that it shortened the examination time and improved the image quality compared to the existing RT-2D-SENSE TSE. Unlike previous studies, this study using the RT technique shows that it is a useful MRI Pulse Sequence technique able to replace the BH-2D-SSh TSE and BH-3D-SENSE GRASE techniques, which require the patient to hold their breath during the test.
This study evaluates the clinical usefulness of the images obtained after applying mDixon (O-MAR), CS-SEMAC (SPIR), and STIR techniques to Pig L-Spine Phantom and transplant patients according to the difference in the reduction in metal artifacts and provides the optimal MAR image technique. This study was conducted with Phantom and 30 transplant patients who had an implant on the L-Spine (22 men, 8 women, mean age: 64.2 ± 12.98). All data analyzed were evaluated, using Philips Ingenia 3.0T CX. As pulse sequences, applied to the analysis, mDixon (O-MAR), CS-SEMAC (SPIR), and STIR were used. As the coil used to obtain data, the dStream Head Spine Coil was used. When tested directly applying to the transplant patients in the conditions the same as for the Phantom, as for the MAR effect of T1 and T2 images, the SNR value showed the highest effect on the increase in the signal in T1, T2 CS-SEMAC (SPIR), followed by mDixon (O-MAR) and STIR, which was the same result as the Phantom (p < 0.05). In addition, in the results of the histogram measurement in both of the subjects, Phantom and transplant patients, the count of T1, the T2 Sagittal image was the highest in T1, T2 STIR, followed by T1, T2 mDixon (O-MAR) and T1, and T2 CS-SEMAC (SPIR). As a result of the qualitative analysis, the quality was the best in T2 CS-SEMAC(SPIR) (c), followed by mDixon (O-MAR) (b) and T2 STIR (a). In conclusion, when the MAR effect on the Pig L-spine Phantom and Transplant patients was compared, it was noted that the CS-SEMAC (SPIR) technique was the most excellent in the following order: STIR < mDixon (O-MAR) < CS-SEMAC (SPIR).
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