Cluster Analysis of Inhalant Allergens in South Korea: A Computational Model of Allergic Sensitization.

OBJECTIVES: Sensitization to specific inhalant allergens is a major risk factor for the development of atopic diseases, which impose a major socioeconomic burden and significantly diminish quality of life. However, patterns of inhalant allergic sensitization have yet to be precisely described. Therefore, to enhance the understanding of aeroallergens, we performed a cluster analysis of inhalant allergic sensitization using a computational model. METHODS: Skin prick data were collected from 7,504 individuals. A positive skin prick response was defined as an allergen-to-histamine wheal ratio ≥1. To identify the clustering of inhalant allergic sensitization, we performed computational analysis using the four-parameter unified-Richards model. RESULTS: Hierarchical cluster analysis grouped inhalant allergens into three clusters based on the Davies-Bouldin index (0.528): cluster 1 (Dermatophagoides pteronyssinus and Dermatophagoides farinae), cluster 2 (mugwort, cockroach, oak, birch, cat, and dog), and cluster 3 (Alternaria tenus, ragweed, Candida albicans, Kentucky grass, and meadow grass). Computational modeling revealed that each allergen cluster had a different trajectory over the lifespan. Cluster 1 showed a high level (>50%) of sensitization at an early age (before 19 years), followed by a sharp decrease in sensitization. Cluster 2 showed a moderate level (10%-20%) of sensitization before 29 years of age, followed by a steady decrease in sensitization. However, cluster 3 revealed a low level (<10%) of sensitization at all ages. CONCLUSION: Computational modeling suggests that allergic sensitization consists of three clusters with distinct patterns at different ages. The results of this study will be helpful to allergists in managing patients with atopic diseases.

Recovery of signal loss adopting the residual bootstrap method in fetal heart rate dynamics.

Fetal heart rate (FHR) data obtained from a non-stress test (NST) can be presented in a type of time series, which is accompanied by signal loss due to physical and biological causes. To recover or estimate FHR data, which is subjected to a high rate of signal loss, time series models [second-order autoregressive (AR(2)), first-order autoregressive conditional heteroscedasticity (ARCH(1)) and empirical mode decomposition and vector autoregressive (EMD-VAR)] and the residual bootstrap method were applied. The ARCH(1) model with the residual bootstrap technique was the most accurate [root mean square error (RMSE), 2.065] as it reflects the nonlinearity of the FHR data [mean absolute error (MAE) for approximate entropy (ApEn), 0.081]. As a result, the goal of predicting fetal health and identifying a high-risk pregnancy could be achieved. These trials may be effectively used to save the time and cost of repeating the NST when the fetal diagnosis is impossible owing to a large amount of signal loss.

Estimating time to full uterine cervical dilation using genetic algorithm.

The objectives of this study were to provide new parameters to better understand labor curves, and to provide a model to predict the time to full cervical dilation (CD). We studied labor curves using the retrospective records of 594 nulliparas, including at term, spontaneous labor onset, and singleton vertex deliveries of normal birth weight infants. We redefined the parameters of Friedman's labor curve, and applied a three-parameter model to the labor curve with a logistic model using the genetic algorithm and the Newton-Raphson method to predict the time necessary to reach full CD. The genetic algorithm is more effective than the Newton-Raphson method for modeling labor progress, as demonstrated by its higher accuracy in predicting the time to reach full CD. In addition, we predicted the time (11.4 hours) to reach full CD using the logistic labor curve using the mean parameters (the power of CD = 0.97 cm/hours, a midpoint of the active phase = 7.60 hours, and the initial CD = 2.11 cm). Our new parameters and model can predict the time to reach full CD, which can aid in the forecasting of prolonged labor and the timing of interventions, with the end goal being normal vaginal birth.

Fetal heart rate after vibroacoustic stimulation.

OBJECTIVE: To define reference ranges for fetal heart rate (FHR) parameters after vibroacoustic stimulation (VAS) according to gestational age by determining the relationship between FHR and gestational age using a computerized analysis system. METHODS: Data were analyzed from 3453 women using 10-minute observational recordings during nonstress testing (NST) and VAS testing. FHR parameters were analyzed according to gestational age. RESULTS: All FHR parameters were related to gestational age except for mean baseline FHR, which did not vary significantly with gestational age. All other parameters followed trends similar to the NST results, except for decelerations. CONCLUSION: FHR parameters after VAS differed significantly according to gestational age. The results suggest that the gestational age of the fetus should be considered when interpreting FHR patterns after VAS.

Chaotic indices and canonical ensemble of heart rate patterns in small-for-gestational age fetuses.

AIMS: We studied how linear and nonlinear heart rate dynamics differ between normal fetuses (n=135) and uncomplicated small-for-gestational age (SGA) fetuses (n=65), aged 32-40 weeks' gestation. METHODS: We analyzed each fetal heart rate time series for 20 min. We quantified the complexity (nonlinear dynamics) of each fetal heart rate (FHR) time series by approximate entropy (ApEn) and correlation dimension (CD). The linear dynamics were analyzed by canonical correlation analysis (CCA). RESULTS: The ApEn and CD of the uncomplicated SGA fetuses were significantly lower than that of the normal fetuses in all three gestational periods (32-34, 35-37, 38-40 weeks). Canonical correlation ensemble in SGA fetuses is slightly higher than normal ones in all three gestational periods, especially at 35-37 weeks. CONCLUSIONS: Irregularity and complexity of the heart rate dynamics of SGA fetuses are lower than that of normal ones. Also, canonical ensemble in SGA fetuses is higher than in normal ones, suggesting that the FHR control system has multiple complex interactions. Along with the clear difference between the two groups' non-linear chaotic dynamics in FHR patterns, we clarified the hidden subtle differences in linearity (e.g., canonical ensemble). The decrease in non-linear dynamics may contribute to the increase in linear dynamics. The present statistical methodology can be readily and routinely utilized in obstetrics and gynecologic fields.

Profiling of differentially expressed genes in human stem cells by cDNA microarray.

Stem cells are unique cell populations with the ability to undergo both self-renewal and differentiation, although a wide variety of adult stem cells as well as embryonic stem cells have been identified and stem cell plasticity has recently been reported. To identify genes implicated in the control of the stem cell state as well as the characteristics of each stem cell line, we analyzed the expression profiles of genes in human embryonic, hematopoietic (CD34+ and CD133+), and mesenchymal stem cells using cDNA microarrays, and identified genes that were differentially expressed in specific stem cell populations. In particular we were able to identify potential hESC signature-like genes that encode transcription factors (TFAP2C and MYCN), an RNA binding protein (IMP-3), and a functionally uncharacterized protein (MAGEA4). The overlapping sets of 22 up-regulated and 141 down-regulated genes identified in this study of three human stem cell types may also provide insight into the developmental mechanisms common to all human stem cells. Furthermore, our comprehensive analyses of gene expression profiles in various adult stem cells may help to identify the genetic pathways involved in self-renewal as well as in multi-lineage specific differentiation.

The optimal depth of central venous catheter for infants less than 5 kg.

To avoid fatal complications of central venous catheterization such as cardiac tamponade, the tip of the central venous catheter (CVC) should be placed outside of the cardiac chamber. To suggest a guideline for a proper depth of CVC in infants, we measured the distance from the skin puncture site to the junction between superior vena cava and right atrium (SVC-RA junction) by using transesophageal echocardiography (TEE). Fifty infants less than 5 kg undergoing surgery for congenital heart disease were enrolled in this prospective study. After the induction of general anesthesia, CVC was inserted via the right subclavian vein. After the tip of the CVC was placed at the SVC-RA junction using TEE guidance, the length of the CVC inserted beneath the skin was measured. The measured distance had a high correlation with the patient's height, weight, and age (r = 0.88, 0.76, and 0.64, respectively). In infants smaller than 5 kg, the following guideline can avoid intraatrial placement of the CVC: a depth between 40 and 45 mm for infants 2.0-3.0 kg in weight, 45-50 mm for those 3.0-3.9 kg, and 50-55 mm for those more than 4.0 kg.