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Purpose: Delirium is a common neurocognitive disorder in patients with advanced cancer and is associated with poor clinical outcomes. As a potentially reversible phenomenon, early recognition of delirium by identifying the risk factors demands attention. We aimed to develop a model to predict the occurrence of delirium in hospitalized patients with advanced cancer., Materials and Methods: This retrospective study included patients with advanced cancer admitted to the oncology ward of four tertiary cancer centers in Korea for supportive cares and excluded those discharged due to death. The primary endpoint was occurrence of delirium. Sociodemographic characteristics, clinical characteristics, laboratory findings, and concomitant medication were investigated for associating variables. The predictive model developed using multivariate logistic regression was internally validated by bootstrapping., Results: From January 2019 to December 2020, 2,152 patients were enrolled. The median age of patients was 64 years, and 58.4% were male. A total of 127 patients (5.9%) developed delirium during hospitalization. In multivariate logistic regression, age, body mass index, hearing impairment, previous delirium history, length of hospitalization, chemotherapy during hospitalization, blood urea nitrogen and calcium levels, and concomitant antidepressant use were significantly associated with the occurrence of delirium. The predictive model combining all four categorized variables showed the best performance among the developed models (area under the curve 0.831, sensitivity 80.3%, and specificity 72.0%). The calibration plot showed optimal agreement between predicted and actual probabilities through internal validation of the final model., Conclusion: We proposed a successful predictive model for the risk of delirium in hospitalized patients with advanced cancer.

This study aimed to present a new approach to predict to delirium admitted to the acute palliative care unit. To achieve this, this study employed machine learning model to predict delirium in patients in palliative care and identified the significant features that influenced the model. A multicenter, patient-based registry cohort study in South Korea between January 1, 2019, and December 31, 2020. Delirium was identified by reviewing the medical records based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The study dataset included 165 patients with delirium among 2314 patients with advanced cancer admitted to the acute palliative care unit. Seven machine learning models, including extreme gradient boosting, adaptive boosting, gradient boosting, light gradient boosting, logistic regression, support vector machine, and random forest, were evaluated to predict delirium in patients with advanced cancer admitted to the acute palliative care unit. An ensemble approach was adopted to determine the optimal model. For k-fold cross-validation, the combination of extreme gradient boosting and random forest provided the best performance, achieving the following accuracy metrics: 68.83% sensitivity, 70.85% specificity, 69.84% balanced accuracy, and 74.55% area under the receiver operating characteristic curve. The performance of the isolated testing dataset was also validated, and the machine learning model was successfully deployed on a public website ( http://ai-wm.khu.ac.kr/Delirium/ ) to provide public access to delirium prediction results in patients with advanced cancer. Furthermore, using feature importance analysis, sex was determined to be the top contributor in predicting delirium, followed by a history of delirium, chemotherapy, smoking status, alcohol consumption, and living with family. Based on a large-scale, multicenter, patient-based registry cohort, a machine learning prediction model for delirium in patients with advanced cancer was developed in South Korea. We believe that this model will assist healthcare providers in treating patients with delirium and advanced cancer., (© 2024. The Author(s).)

Objective: We aimed to study the pregnancy outcomes of women exposed to isotretinoin and to identify the factors influencing their decision to request an abortion., Methods: The study prospectively identified 79 women who had been treated for acne with isotretinoin during the periconceptional period, and who were followed up until completion of their pregnancy. Characteristics of exposure and doses were self-reported by participants., Results: Of the 56 participants who decided to continue their pregnancy, there were 11 spontaneous abortions and 44 women who delivered healthy full-term babies of which 19 had been exposed to isotretinoin <1 month before conception or during pregnancy. In a nominal logistic regression analysis including 68 patients who provided adequate information for analysis, exposure to isotretinoin >2 weeks post-conception and pregnancy termination recommended by the first-contact physician were found to be significantly associated with patients' decision to undergo elective abortion: adjusted OR = 9.87 (95% CI 1.18-82.34) and 12.51 (95% CI 2.36-66.29), respectively., Conclusions: Our study reports an elevated rate of babies born without evidence of gross malformation or neurofunctional abnormality even tough exposure occurred during the teratogenic risk period. However, caution is recommended since a substantial risk of congenital malformations has been reported with low doses of isotretinoin and at exposures limited to early pregnancy. We also found that primary-care physicians may influence patients' decision to request pregnancy termination independently of their timing of exposure to isotretinoin.

Herpes Simplex Virus type 1 (HSV-1) antibodies are found in up to 90 percent of the general population. About 30% of patients who have been exposed to HSV-1 develop recurrent infections, and this degree is continually increasing. In addition, resistance to all major anti-herpetic drugs such as acyclovir (ACV) has been increasingly reported. These observations underscore the importance of discovering new therapeutic tools for the treatment of HSV-1 infections. Bifidobacterium spp. has been studied in various fields including antibacterial and anticancer effect, but the antiviral activity was studied very little. The aim of this study was to test the antiviral activity of Bifidobacterium spp. against HSV-1. The Bifidobacterium adolescentis SPM 0214 used in this study through the screening of 23 Bifidobacterium spp. by plaque assay was assessed the cell viability assay in Vero cells. We also measured the plaque reduction assay and yield reduction assay after B. adolescentis SPM 0214 treatment at concentrations ranging between 10 and 10⁴ μg/mL. The B. adolescentis SPM 0214 was not toxic to Vero cells, and the inhibition of plaque and yield formation was obviously increased compared to those of the control (no additive). Therefore, these results indicate that antiviral activity of B. adolescentis SPM 0214 against HSV-1.

Objective: Dental caries is the main common infectious disease in the human oral cavity. Streptococcus mutans and Streptococcus sobrinus were reported to be the most important etiological factors in human dental caries. Thus, we examined the inhibitory effects of Bifidobacterium spp. cells and culture supernatants against S. mutans and S. sobrinus, including Streptococcus gordonii, and Aggregatibacter actinomycetemcomitans, which is associated with periodontal disease., Methods: Mutans streptococci or A. actinomycetemcomitans and lactic acid bacteria (LAB) were mixed in 1:1 ratio and then incubated for 90 min at 37°C. After the incubation, the viability of mutans streptococci or A. actinomycetemcomitans was determined by plate count technique. We also investigated the morphological changes of S. mutans treated with LAB using scanning electron microscopy (SEM)., Results: In vitro viability of S. mutans, S. sobrinus, S. gordonii, and A. actinomycetemcomitans was affected by human intestinal LAB identified as Bifidobacterium adolescentis SPM1005 and Bifidobacterium longum SPM1207. Especially, B. adolescentis SPM1005 cells at 1.0 × 10(8) CFU had a strong growth-inhibiting effect against S. mutans and induced a 64% loss of its viability (p<0.05). In addition, swollen and disrupted S. mutans were observed after incubation with B. adolescentis SPM1005. However, the culture supernatant of this strain did not show such inhibitory activity., Conclusion: B. adolescentis SPM1005 cells decreased the growth of S. mutans, which is a risk factor for dental caries. Therefore, we suggest that this Bifidobacterium strain may be a useful probiotic microorganism for prevention of dental caries that does not have adverse effects., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

We have previously reported that live Bifidobacterium longum SPM1207, a strain isolated from healthy adult Koreans, significantly reduced serum cholesterol in broth and rat. We here examined the effect of oral administration of sonication-killed B. longum SPM1207 on serum cholesterol in rats in order to investigate whether this killed strain could be utilized as a potent probiotics for human and animals. Dietary treatments consisted of 3 treatment groups of 24 rats each randomly assigned to either normal diet, high cholesterol diet and saline (HCS), or high cholesterol diet and sonication-killed B. longum SPM1207 (HCKB) for 3 weeks. Although HDL-cholesterol levels in the serum were not significantly (p > 0.05) different between HCKB rats and HCS rats, total and LDL-cholesterol levels in the serum were significantly (p < 0.05) less increased in HCKB (total: 177.71 mg/dL, LDL-: 60.50 mg/dL) rats when compared to HCS (total: 237.17 mg/dL, LDL-: 71.50 mg/dL) rats. AI was significantly (p < 0.05) lower in HCKB (4.95 mg/dL) rats when compared to HCS (9.22 mg/dL) rats. Body weight increase and relative liver weight were significantly (p < 0.05) lower in HCKB rats when compared to HCS rats. Over the time, high cholesterol diet caused dry feces accompanied by decreased fecal water content (66.00 to 61.94%) but sonication-killed B. longum SPM1207 administration increased fecal water content (71.58 to 74.25%). The results in the current study provide evidence that the sonication-killed cells of B. logum SPM1207 isolated from healthy adult Koreans have a greater potential to be used as a cholesterol-lowering agent. Furthermore, the current study suggest that this killed specific strain may play role in part in blocking the body weight increase and relieving or eliminating constipation.