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Objective There are growing interests on suicide risk screening in clinical settings and classifying high-risk groups of suicide with suicidal ideation is crucial for a more effective suicide preventive intervention. Previous statistical techniques were limited because they tried to predict suicide risk using a simple algorithm. Machine learning differs from the traditional statistical techniques in that it generates the most optimal algorithm from various predictors.Methods We aim to analyze the Personality Assessment Inventory (PAI) profiles of child and adolescent patients who received outpatient psychiatric care using machine learning techniques, such as logistic regression (LR), random forest (RF), artificial neural network (ANN), support vector machine (SVM), and extreme gradient boosting (XGB), to develop and validate a classification model for individuals with high suicide risk.Results We developed prediction models using seven relevant features calculated by Boruta algorithm and subsequently tested all models using the testing dataset. The area under the ROC curve of these models were above 0.9 and the RF model exhibited the best performance.Conclusion Suicide must be assessed based on multiple aspects, and although Personality Assessment Inventory for Adolescent assess an array of domains, further research is needed for predicting high suicide risk groups.

Impacted mandibular third molars (M3M) are associated with the occurrence of distal caries on the adjacent mandibular second molars (DCM2M). In this study, we aimed to develop and validate five machine learning (ML) models designed to predict the occurrence of DCM2Ms due to the proximity with M3Ms and determine the relative importance of predictive variables for DCM2Ms that are important for clinical decision making. A total of 2642 mandibular second molars adjacent to M3Ms were analyzed and DCM2Ms were identified in 322 cases (12.2%). The models were trained using logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting ML methods and were subsequently validated using testing datasets. The performance of the ML models was significantly superior to that of single predictors. The area under the receiver operating characteristic curve of the machine learning models ranged from 0.88 to 0.89. Six features (sex, age, contact point at the cementoenamel junction, angulation of M3Ms, Winter's classification, and Pell and Gregory classification) were identified as relevant predictors. These prediction models could be used to detect patients at a high risk of developing DCM2M and ultimately contribute to caries prevention and treatment decision-making for impacted M3Ms.

Background This study aimed to develop and validate five machine learning models designed to predict actinomycotic osteomyelitis of the jaw. Furthermore, this study determined the relative importance of the predictive variables for actinomycotic osteomyelitis of the jaw, which are crucial for clinical decision-making. Methods A total of 222 patients with osteomyelitis of the jaw were analyzed, and Actinomyces were identified in 70 cases (31.5%). Logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting machine learning methods were used to train the models. The models were subsequently validated using testing datasets. These models were compared with each other and also with single predictors, such as age, using area under the receiver operating characteristic (ROC) curve (AUC). Results The AUC of the machine learning models ranged from 0.81 to 0.88. The performance of the machine learning models, such as random forest, support vector machine and extreme gradient boosting was significantly superior to that of single predictors. Presumed causes, antiresorptive agents, age, malignancy, hypertension, and rheumatoid arthritis were the six features that were identified as relevant predictors. Conclusions This prediction model would improve the overall patient care by enhancing prognosis counseling and informing treatment decisions for high-risk groups of actinomycotic osteomyelitis of the jaw.

Suicide attempts (SAs) in adolescents are difficult to predict although it is a leading cause of death among adolescents. This study aimed to develop and evaluate SA prediction models based on six different machine learning (ML) algorithms for Korean adolescents using data from online surveys.Data were extracted from the 2011-2018 Korea Youth Risk Behavior Survey (KYRBS), an ongoing annual national survey. The participants comprised 468,482 nationally representative adolescents from 400 middle and 400 high schools, aged 12 to 18. The models were trained using several classic ML methods and then tested on internal and external independent datasets; performance metrics were calculated. Data analysis was performed from March 2020 to June 2020.Among the 468,482 adolescents included in the analysis, 15,012 cases (3.2%) were identified as having made an SA. Three features (suicidal ideation, suicide planning, and grade) were identified as the most important predictors. The performance of the six ML models on the internal testing dataset was good, with both the area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) ranging from 0.92 to 0.94. Although the AUROC of all models on the external testing dataset (2018 KYRBS) ranged from 0.93 to 0.95, the AUPRC of the models was approximately 0.5.The developed and validated SA prediction models can be applied to detect high risks of SA. This approach could facilitate early intervention in the suicide crisis and may ultimately contribute to suicide prevention for adolescents.

Background Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence. Case presentation A case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence. Conclusion This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

Background: The first outbreak in South Korea originated from a particular church, followed by screening all church members and citizens with any history of potential contacts. This provided a good opportunity to identify the epidemiological and clinical characteristics of inapparent infection. Methods: Only asymptomatic patients at the time of admission were included. We classified them into groups by the difference in their feature of clinical course to perform subgroup-analysis. We collected information on epidemiological and clinical characteristics of enrolled patients. Findings: Among a total of 292 patients in our designated cohort hospital, 160 (54.8%) patients were asymptomatic at admission. 93 (59.2%) were asymptomatic from the confirmation of COVID-19 until discharge from the hospital. Patients who showed symptom after admission showed a significant association with underlying disease prevalence compared to patients who were asymptomatic until the admission (21 [32.8%] vs. 14 [15.1%], respectively; p=0.009). The median time from the date of infection confirmation to two consecutive negative RT-PCR tests was 28 days (IQR, 23.3–33.8). There was no significant difference in the length of this duration between the groups. Interpretation: For effective prevention of COVID-19 spread, it is vital to treat patients exhibiting either asymptomatic or mild symptoms effectively. Early and extensive detection of COVID-19 should be of utmost priority, followed by suitable isolation and treatment measures. We recommend at least two negative RT-PCR test results after treatments before lifting isolation measures. Funding Statement: No funds were received in support of this work. Declaration of Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper. Ethics Approval Statement: This study was approved by the ethics committee of The Armed Forces Medical Command (No. AFMC-20-IRB-021).

Accurate genome-wide detection of somatic mutations with low variant allele frequency (VAF, Somatic mutations of low allele frequencies are often difficult to detect. Here, the authors develop RePlow, a computational method that leverages technical replication for detecting low-level somatic mutations using next-generation sequencing.

Objective To identify whether somatic mutations in SLC35A2 alter N-glycan structures in human brain tissues and cause nonlesional focal epilepsy (NLFE) or mild malformation of cortical development (mMCD). Methods Deep whole exome and targeted sequencing analyses were conducted for matched brain and blood tissues from patients with intractable NLFE and patients with mMCD who are negative for mutations in mTOR pathway genes. Furthermore, tissue glyco-capture and nanoLC/mass spectrometry analysis were performed to examine N-glycosylation in affected brain tissue. Results Six of the 31 (19.3%) study patients exhibited brain-only mutations in SLC35A2 (mostly nonsense and splicing site mutations) encoding a uridine diphosphate (UDP)-galactose transporter. Glycome analysis revealed the presence of an aberrant N-glycan series, including high degrees of N-acetylglucosamine, in brain tissues with SLC35A2 mutations. Conclusion Our study suggests that brain somatic mutations in SLC35A2 cause intractable focal epilepsy with NLFE or mMCD via aberrant N-glycosylation in the affected brain.

【Malformations of cortical development (MCD) cover a broad spectrum of developmental disorders which cause the various clinical manifestations including epilepsy, developmental delay, and intellectual disability. MCD have been clinically classified based on the disruption of developmental processes such as proliferation, migration, and organization. Molecular genetic studies of MCD have improved our understanding of these disorders at a molecular level beyond the clinical classification. These recent advances are resulted from the development of massive parallel sequencing technology, also known as next-generation sequencing (NGS), which has allowed researchers to uncover novel molecular genetic pathways associated with inherited or de novo mutations. Although an increasing number of disease-related genes or genetic variations have been identified, genotype-phenotype correlation is hampered when the biological or pathological functions of identified genetic variations are not fully understood. To elucidate the causality of genetic variations, in vivo disease models that reflect these variations are required. In the current review, we review the use of NGS technology to identify genes involved in MCD, and discuss how the functions of these identified genes can be validated through in vivo disease modeling.】

Focal malformations of cortical development (FMCDs), including focal cortical dysplasia (FCD) and hemimegalencephaly (HME), are major etiologies of pediatric intractable epilepsies exhibiting cortical dyslamination. Brain somatic mutations in MTOR have recently been identified as a major genetic cause of FMCDs. However, the molecular mechanism by which these mutations lead to cortical dyslamination remains poorly understood. Here, using patient tissue, genome-edited cells, and mouse models with brain somatic mutations in MTOR, we discovered that disruption of neuronal ciliogenesis by the mutations underlies cortical dyslamination in FMCDs. We found that abnormal accumulation of OFD1 at centriolar satellites due to perturbed autophagy was responsible for the defective neuronal ciliogenesis. Additionally, we found that disrupted neuronal ciliogenesis accounted for cortical dyslamination in FMCDs by compromising Wnt signals essential for neuronal polarization. Altogether, this study describes a molecular mechanism by which brain somatic mutations in MTOR contribute to the pathogenesis of cortical dyslamination in FMCDs.

Accurate genome-wide detection of somatic mutations with low variant allele frequency (VAF

Objective: Bilateral cavernous sinus dural arteriovenous fistula (CSdAVF) is very rare, in even Asian countries. Clinical and radiologic outcomes of treating such fistulas through endovascular embolization are presented herein. Materials and Methods All data were obtained from 220 consecutive patients with CSdAVF who were treated from January 2004 to December 2015. Bilateral CSdAVF was identified in 17 patients (7.7%). The clinical and radiologic outcomes of the fistulas were assessed, with emphasis on the technical aspects of treatment. Results At the time of treatment, 7 and 10 patients presented with bilateral and unilateral symptoms, respectively. In the former cases, four patients had progressed from unilateral to bilateral symptoms. Bilateral fistulas were treated with single-stage transvenous embolization (TVE) in 15 patients, via bilateral IPSs (n=9) and unilateral IPS (n=6). In the other 2 patients with one-sided dominance of shunting, only dominant fistula was treated. Two untreated lesions were found on follow up to have spontaneously resolved after treatment of the dominant contralateral fistula. Of the 34 CSdAVF lesions, complete occlusion was finally achieved in 32 lesions after TVE. Seven patients (41.2%) developed paradoxical worsening of cranial nerve palsy after TVE. During the follow-up period, 4 patients obtained complete recovery whereas the other 3 remained with deficits. Conclusions: With adjustments of endovascular procedures to accommodate distinct anatomical configurations, endovascular treatment for bilateral CSdAVF can achieve excellent angiographic occlusion results. However, paradoxical aggravation of symptoms after TVE may occur frequently in bilateral CSdAVF. In the patients with one-sided dominance of shunt, treatment of only dominant fistula might be an alternative option. Disclosures: J. Lim: None. Y. Cho: None. H. Kang: None. M. Han: None.

Introduction Although aneurysms incompletely occluded after coil embolization are subject to recanalization, complete occlusion may evolve in some aneurysms during follow-up in clinical practice, even though the sac fills with contrast immediately after coiling. Stent usage may augment the progressive thrombosis within coiled aneurysms. We evaluated outcomes of small aneurysms ( Methods Between September 2012 and June 2016, a total of 463 intracranial aneurysms were treated by stent-assisted coil embolization. Of these, 132 small saccular aneurysms displayed filling of the sac by contrast immediately after the coiling. TOF-MRA or conventional angiography were used for postoperative monitoring according to our institutional protocol. Progressive thrombosis was defined as complete occlusion of these aneurysms at the 6-month follow-up. Progressive occlusion rates and related risk factors were assessed using binary logistic regression analysis. Results In 101 (76.5%) of the 132 aneurysms that showed filling of the sac with contrast, complete occlusion was observed on follow-up imaging studies at 6 months. Binary logistic regression analysis demonstrated that progressive occlusion was linked to smaller neck diameter (p=0.003; OR=1.533), hyperlipidemia (p=0.036; OR=3.329) and stent type (p=0.031). LVIS stent is susceptible to progressive thrombosis than Neuroform stent (p=0.008; HR=10.204) or Enterprise stent (p=0.098; HR=3.154). In 57 progressively thrombosed aneurysms with follow-up evaluations ≥12 months (mean, 25.0±10.7 months, median 18 months), 56 aneurysms (98.2%) exhibited stable occlusion, whereas minor recanalization was observed in only one (1.8%) instances, and major recanalization occurred in none. Conclusion In small saccular aneurysms occluded incompletely after stent-assisted coil embolization, aneurysms with smaller neck diameters or hyperlipidemia, and LVIS deployment seem predisposed to progressive intra-aneurysmal thrombosis over the course of time. Disclosures: J. Lim: None. Y. Cho: None. H. Kang: None. M. Han: None.

Motivation: Advances in sequencing technologies have remarkably lowered the detection limit of somatic variants to a low frequency. However, calling mutations at this range is still confounded by many factors including environmental contamination. Vector contamination is a continuously occurring issue and is especially problematic since vector inserts are hardly distinguishable from the sample sequences. Such inserts, which may harbor polymorphisms and engineered functional mutations, can result in calling false variants at corresponding sites. Numerous vector-screening methods have been developed, but none could handle contamination from inserts because they are focusing on vector backbone sequences alone. Results: We developed a novel method—Vecuum—that identifies vector-originated reads and resultant false variants. Since vector inserts are generally constructed from intron-less cDNAs, Vecuum identifies vector-originated reads by inspecting the clipping patterns at exon junctions. False variant calls are further detected based on the biased distribution of mutant alleles to vector-originated reads. Tests on simulated and spike-in experimental data validated that Vecuum could detect 93% of vector contaminants and could remove up to 87% of variant-like false calls with 100% precision. Application to public sequence datasets demonstrated the utility of Vecuum in detecting false variants resulting from various types of external contamination. Availability and Implementation: Java-based implementation of the method is available at http://vecuum.sourceforge.net/ Contact: swkim@yuhs.ac Supplementary information: Supplementary data are available at Bioinformatics online.

In recent years, embedded systems such as cellular phones, Portable Multimedia Player, intelligent appliance, automobile engine control are reshaping the way people live, work, and play. Thereby, services application to guarantee various requirements of users become increasingly sophisticated and complicated, such embedded computing platforms use real-time operating systems (RTOSs) with time determinism. These RTOSs must not only provide predictable services but must also be efficient and small in size. Kernel services should also be deterministic by specifying how long each service call will take to execute. Having this information allows the application designers to better plan their real-time application software so as not to miss the deadline of each task. In this paper, we present the complete generalized real-time scheduling algorithm using multi-dimensional methodology to determine the highest priority in the ready list with 2r levels of priorities in a constant time without additional memory overhead.

The growth of CPU and communication technologies have made an important contribution to the development of the network-based intelligent service robots. Robot software must guarantee the correct execution and safety of the user. To achieve this, it is highly required to research how to guarantee the QoS of the components which organize a robot software. The QoS of robot components aims to execute the component stably by processing the data stream in a correct way. By guaranteeing QoS, we can achieve the intelligence and stability of robots. In this paper, we design and implement the QoS framework to guarantee the QoS of robot components on robot platforms with limited resources. We also measure the response times of QoS requests and present the performance analysis results about it.

MC(Mission Computer) performs important function in avionics system which tactic data processing, image processing and managing navigation system etc. In general, the fault of SPOF(Single Point Of Failure) in unity system can lead to failure of whole system. It can cause a failure of a mission and also can threaten to the life of the pilot. So, in this paper, we design the HA(Hight-availability) system so that dealing with the failure. And we use HA software like Heartbeat, Fake, DRBD and Bonding to manage HA system. Also we analyze the performance of HA system using the FDT(Fault Detection Time) for fast fault detection and MTTR(Mean Time To Repair) for mission continuity.

Focal cortical dysplasia type II (FCDII) is a sporadic developmental malformation of the cerebral cortex characterized by dysmorphic neurons, dyslamination and medically refractory epilepsy. It has been hypothesized that FCD is caused by somatic mutations in affected regions. Here, we used deep whole-exome sequencing (read depth, 412-668×) validated by site-specific amplicon sequencing (100-347,499×) in paired brain-blood DNA from four subjects with FCDII and uncovered a de novo brain somatic mutation, mechanistic target of rapamycin (MTOR) c.7280T>C (p.Leu2427Pro) in two subjects. Deep sequencing of the MTOR gene in an additional 73 subjects with FCDII using hybrid capture and PCR amplicon sequencing identified eight different somatic missense mutations found in multiple brain tissue samples of ten subjects. The identified mutations accounted for 15.6% of all subjects with FCDII studied (12 of 77). The identified mutations induced the hyperactivation of mTOR kinase. Focal cortical expression of mutant MTOR by in utero electroporation in mice was sufficient to disrupt neuronal migration and cause spontaneous seizures and cytomegalic neurons. Inhibition of mTOR with rapamycin suppressed cytomegalic neurons and epileptic seizures. This study provides, to our knowledge, the first evidence that brain somatic activating mutations in MTOR cause FCD and identifies mTOR as a treatment target for intractable epilepsy in FCD.

Focal cortical dysplasia type II (FCDII) is a focal malformation of the developing cerebral cortex and the major cause of intractable epilepsy. However, since the molecular genetic etiology of FCD has remained enigmatic, the effective therapeutic target for this condition has remained poorly understood. Our recent study on FCD utilizing various deep sequencing platforms identified somatic mutations in MTOR (existing as low as 1% allelic frequency) only in the affected brain tissues. We observed that these mutations induced hyperactivation of the mTOR kinase. In addition, focal cortical expression of mutant MTOR using in utero electroporation in mice, recapitulated the neuropathological features of FCDII, such as migration defect, cytomegalic neuron and spontaneous seizures. Furthermore, seizures and dysmorphic neurons were rescued by the administration of mTOR inhibitor, rapamycin. This study provides the first evidence that brain somatic activating mutations in MTOR cause FCD, and suggests the potential drug target for intractable epilepsy in FCD patients. [BMB Reports 2016; 49(2): 71-72].

A wearable computer is a computer that is subsumed into the personal space of the user, controlled by the user, and is always on and always accessible. Therefore, among the most salient aspect of wearable computers should be small form factor and long battery lifetime. In this paper, we have designed and implemented a low-power real-time operating system (called “eRTOS”) specialized for wearable computers. eRTOS has about 9KB footprint and is equipped with low-power techniques composed of the dynamic power management and the device power management. Experimental results with wearable applications show that we can save energy up to 47 % using the proposed low-power techniques.

J Korean Assoc Oral Maxillofac Surg 2012;38:50-4) According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

J Korean Assoc Oral Maxillofac Surg 2012;38:360-5) The simultaneous surgical correction of bilateral cleft lip and nasal deformity has become a more common surgical technique that has greatly changed conventional strategies for secondary nasal correction. Mulliken has been known as one of the earliest proponents for the synchronous repair of bilateral cleft lip and nasal deformity, and he emphasized the responsibility of the treating surgeon to evaluate nasolabial growth by comparing anthropometric measurements with age-matched normal patients. Good outcomes from this surgical method have been reported in clinical cases worldwide. Herein, we describe the management of two cases of bilateral cleft repair, following the principles and methods established by Mulliken. We also provide a relevant review of the literature.