Publications by authors named "S B Park"

50,879 Publications

A Vascular Intervention Assist Device Using Bi-Motional Roller Cartridge Structure and Clinical Evaluation.

Biosensors (Basel) 2021 Sep 10;11(9). Epub 2021 Sep 10.

Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

Conventional vascular intervention procedures present issues including X-ray exposure during operation, and an experience-dependent success rate and clinical outcome. This paper presents a novel robotic system using modularized bi-motional roller cartridge assemblies for robotic vascular interventions, specifically percutaneous coronary interventions (PCIs). The patient-side robot manipulates instruments such as the guiding catheter, guidewire, balloon/stent catheter, and diagnostic sensor catheter via commands from the user interface device, which is controlled by the physician. The proposed roller cartridge assembly can accommodate instruments of various sizes with an active clamping mechanism, and implements simultaneous translation and rotation motions. It also implements force feedback in the physician-side system, to effectively monitor the patient-side system's status. The positioning accuracy and precision in using the robotic system showed satisfactory performance in a phantom-based test. It was also confirmed, through animal experiments and a pilot clinical trial, that the system demonstrates feasibility for clinical use.
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http://dx.doi.org/10.3390/bios11090329DOI Listing
September 2021

Randomized trial of oral sulfate solution versus polyethylene glycol-ascorbic acid for bowel cleansing in elderly people.

J Gastroenterol Hepatol 2021 Sep 25. Epub 2021 Sep 25.

Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea.

Background And Aim: The efficacy and safety of the recently introduced low-volume purgatives in elderly people are not well-known. Therefore, in this trial, we aimed to evaluate and compare the efficacy of two low-volume agents, oral sulfate solution (OSS) and 2L polyethylene glycol with ascorbic acid (PEG-Asc), in elderly people.

Methods: A prospective, randomized, single-blinded, multicenter, non-inferiority trial was performed at three university-affiliated hospitals in South Korea. Outpatients aged 65-80 years, who underwent elective colonoscopy, were enrolled. The primary outcome was the rate of adequate bowel preparation assessed using the Boston Bowel Preparation Scale.

Results: A total of 199 subjects were randomized into the OSS (n = 99) or the 2L PEG-Asc (n = 100) group. Of them, 189 subjects were included in the analysis of the primary outcome (OSS 95 vs. PEG-Asc group 94). The proportion of adequate bowel preparation was 89.5% (85/95) in the OSS group and 93.6% (88/94) in the 2L PEG-Asc group. OSS was not inferior to 2L PEG-Asc according to the prespecified non-inferiority margin of -15% (95% confidence interval for the difference, -12.1 to 3.8). Vomiting (11.6% vs. 2.1%) and thirst (24.2% vs. 11.7%) were more common in the OSS group than in the 2L PEG-Asc group.

Conclusions: OSS is an effective low-volume purgative that is non-inferior to 2L PEG-Asc in elderly people. Both the low-volume agents were identified to be well-tolerated and safe in the healthy elderly population.
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http://dx.doi.org/10.1111/jgh.15696DOI Listing
September 2021

A PTEN variant uncouples longevity from impaired fitness in Caenorhabditis elegans with reduced insulin/IGF-1 signaling.

Nat Commun 2021 Sep 24;12(1):5631. Epub 2021 Sep 24.

Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon, 34141, South Korea.

Insulin/IGF-1 signaling (IIS) regulates various physiological aspects in numerous species. In Caenorhabditis elegans, mutations in the daf-2/insulin/IGF-1 receptor dramatically increase lifespan and immunity, but generally impair motility, growth, and reproduction. Whether these pleiotropic effects can be dissociated at a specific step in insulin/IGF-1 signaling pathway remains unknown. Through performing a mutagenesis screen, we identified a missense mutation daf-18(yh1) that alters a cysteine to tyrosine in DAF-18/PTEN phosphatase, which maintained the long lifespan and enhanced immunity, while improving the reduced motility in adult daf-2 mutants. We showed that the daf-18(yh1) mutation decreased the lipid phosphatase activity of DAF-18/PTEN, while retaining a partial protein tyrosine phosphatase activity. We found that daf-18(yh1) maintained the partial activity of DAF-16/FOXO but restricted the detrimental upregulation of SKN-1/NRF2, contributing to beneficial physiological traits in daf-2 mutants. Our work provides important insights into how one evolutionarily conserved component, PTEN, can coordinate animal health and longevity.
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http://dx.doi.org/10.1038/s41467-021-25920-wDOI Listing
September 2021

Evolutionarily informed machine learning enhances the power of predictive gene-to-phenotype relationships.

Nat Commun 2021 Sep 24;12(1):5627. Epub 2021 Sep 24.

Department of Biology, Center for Genomics and Systems Biology, New York University, New York, NY, 10003, USA.

Inferring phenotypic outcomes from genomic features is both a promise and challenge for systems biology. Using gene expression data to predict phenotypic outcomes, and functionally validating the genes with predictive powers are two challenges we address in this study. We applied an evolutionarily informed machine learning approach to predict phenotypes based on transcriptome responses shared both within and across species. Specifically, we exploited the phenotypic diversity in nitrogen use efficiency and evolutionarily conserved transcriptome responses to nitrogen treatments across Arabidopsis accessions and maize varieties. We demonstrate that using evolutionarily conserved nitrogen responsive genes is a biologically principled approach to reduce the feature dimensionality in machine learning that ultimately improved the predictive power of our gene-to-trait models. Further, we functionally validated seven candidate transcription factors with predictive power for NUE outcomes in Arabidopsis and one in maize. Moreover, application of our evolutionarily informed pipeline to other species including rice and mice models underscores its potential to uncover genes affecting any physiological or clinical traits of interest across biology, agriculture, or medicine.
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http://dx.doi.org/10.1038/s41467-021-25893-wDOI Listing
September 2021

Understanding diagnostic processes in emergency departments: a mixed methods case study protocol.

BMJ Open 2021 Sep 24;11(9):e044194. Epub 2021 Sep 24.

Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.

Introduction: Diagnostic processes in the emergency department (ED) involve multiple interactions among individuals who interface with information systems to access and record information. A better understanding of diagnostic processes is needed to mitigate errors. This paper describes a study protocol to map diagnostic processes in the ED as a foundation for developing future error mitigation strategies.

Methods And Analysis: This study of an adult and a paediatric academic ED uses a prospective mixed methods case study design informed by an ED-specific diagnostic decision-making model (the modified ED-National Academies of Sciences, Engineering and Medicine (NASEM) model) and two cognitive theories (dual process theory and distributed cognition). Data sources include audio recordings of patient and care team interactions, electronic health record data, observer field notes and stakeholder interviews. Multiple qualitative analysis methods will be used to explore diagnostic processes in situ, including systems information flow, human-human and human-system interactions and contextual factors influencing cognition. The study has three parts. Part 1 involves prospective field observations of patients with undifferentiated symptoms at high risk for diagnostic error, where each patient is followed throughout the entire care delivery process. Part 2 involves observing individual care team providers over a 4-hour window to capture their diagnostic workflow, team coordination and communication across multiple patients. Part 3 uses interviews with key stakeholders to understand different perspectives on the diagnostic process, as well as perceived strengths and vulnerabilities, in order to enrich the ED-NASEM diagnostic model.

Ethics And Dissemination: The University of Michigan Institutional Review Board approved this study, HUM00156261. This foundational work will help identify strengths and vulnerabilities in diagnostic processes. Further, it will inform the future development and testing of patient, provider and systems-level interventions for mitigating error and improving patient safety in these and other EDs. The work will be disseminated through journal publications and presentations at national and international meetings.
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http://dx.doi.org/10.1136/bmjopen-2020-044194DOI Listing
September 2021
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