Development of a Machine-Learning-Based Tool for Overnight Orthokeratology Lens Fitting.

Purpose: Orthokeratology (ortho-K) is widely used to control myopia. Overnight ortho-K lens fitting with the selection of appropriate parameters is an important technique for achieving successful reductions in myopic refractive error. In this study, we developed a machine-learning model that could select ortho-K lens parameters at an expert level. Methods: Machine-learning models were established to predict the optimal ortho-K parameters, including toric lens option (toric or non-toric), overall diameter (OAD; 10.5 or 11.0 mm), base curve (BC), return zone depth (RZD), landing zone angle (LZA), and lens sagittal depth (LensSag). The analysis included 547 eyes of 297 Korean adolescents with myopia or astigmatism. The dataset was randomly divided into training (80%, n = 437 eyes) and validation (20%, n = 110 eyes) sets at the patient level. The model was trained based on clinical ortho-K lens fitting performed by highly experienced experts and ophthalmic measurements. Results: The final machine-learning models showed accuracies of 92.7% and 86.4% for predicting the toric lens option and OAD, respectively. The mean absolute errors for the BC, RZD, LZA, and LensSag predictions were 0.052 mm, 2.727 µm, 0.118°, and 5.215 µm, respectively. The machine-learning model outperformed the manufacturer's conventional initial lens selector in predicting BC and RZD. Conclusions: We developed an expert-level machine-learning-based model for determining comprehensive ortho-K lens parameters. We also created a web-based application. Translational Relevance: This model may provide more accurate fitting parameters for lenses than those of conventional calculations, thus reducing the need to rely on trial and error.

How Does the Frequency of Eating-Alone among Older People in Korea Affect Their Health and Dietary Behavior?

This study examined the relationship between general population characteristics and diet-related factors pertaining to eating alone for older adults (65 years and older) in Korea. This study used the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2020, and the target population was 7037 Koreans aged 65 years or older who participated in the nutritional survey and health interview. Eating alone variables were classified as follows. Eating together all day means "eating together", eating only one meal a day means "1/day", eating two meals a day alone means "2/day", and "3/day" means eating three meals a day alone. The main results are as follows. The rate of moderate or severe food insecurity was 3.41% in the "eating together" group to 7.86% in the "3/day" group, which was 4.45% higher in the "3/day" group. Fruit + vegetable intake among food intake lowered by about 35 g from 301.2 g in the "eating together" group to 266.2 g in the "3 day" group. In addition, as a result of analyzing the prevalence of depression using the PHQ-9 score, the "3/day" group had a 1.775 to 2.464 times higher risk of depression than the "eating together" group. Finally, EQ-5D variables and quality of life scores were significantly lowered from the "eating together" group to the "3/day" group. Overall, higher frequency of eating alone was associated with food safety, essential food intake, and quality of life. Based on these results, it is thought that a dietary life support program such as the eating together program is necessary to improve the quality of life of the older people who eat alone.

Nutritional Status and Frailty Improvement through Senior-Friendly Diet among Community-Dwelling Older Adults in South Korea.

Considering that Korea's aging population is rapidly increasing, health serves as an indicator of older adults' quality of life, and dietary life directly affects their health. For health maintenance and improvement, preventive healthcare measures including safe food selection and nutritional supply are needed. This study aimed to evaluate the effect of senior-friendly diet on nutrition and health status improvement in older adults receiving community care. A total of 180 older adults were analyzed, with 154 and 26 in the senior-friendly diet intervention group and the general diet group, respectively. Surveys, blood tests, and frailty evaluations were conducted before and after the study. After 5 months of intervention, the blood status, nutrient intake, and frailty level were evaluated. The participants' mean age was 82.7 years, and 89.4% of them were living alone. In both groups, energy, protein, vitamin A, vitamin D, vitamin C, calcium, and magnesium intake were insufficient initially but generally improved after the intervention. Especially in the intervention group, energy, protein, vitamin D, vitamin C, and folic acid intake significantly increased. The frailty level also slightly improved, and the malnutrition rate was reduced. Even after the passage of time, the improvement effect size significantly differed between the groups. Therefore, resolving and supporting meals corresponding to the physiological needs of the older adults has a great impact on improving their quality of life, and such special consideration is a reasonable way to respond to a super-aged society.

Association between serum selenium level and the prevalence of diabetes mellitus in U.S. population.

OBJECTIVE: Selenium seems to be a risk factor for diabetes mellitus (DM) in recent studies, opposite to the previous expectation that it may contribute to prevent DM. The authors aimed to ascertain the relationship between selenium and DM. METHODS: Data were collected from the National Health and Nutrition Examination Survey conducted from 2011 to 2014. A multivariate logistic regression analysis with adjustment for age, sex, race/ethnicity, hypertension, dyslipidemia and body mass index was conducted to evaluate the odds ratio for DM. RESULTS: The total number of subjects was 19,931. Large proportion of subjects were excluded due to young age (< 20 years) and missing data. The data of 3406 participants were analyzed, and a total of 604 had DM. In a multivariate logistic regression model, the increase of 10 µg/L in selenium increased the prevalence of DM by 12% (OR: 1.12; 95% CI: 1.06-1.18). Further analysis with 1:1 propensity score matching data with age and sex showed a similar results (OR: 1.08; 95% CI: 1.01-1.15). In addition, the restricted cubic spline regression showed a dose-dependent relationship between selenium level and DM. Subgroup analysis showed a dose-dependent relationship between selenium level and DM regardless of sex or race/ethnicity CONCLUSIONS: This large population study clearly demonstrates a positive association between selenium level and DM. This finding could have implications for nutritional supplementation in clinical settings.

The Cut-off Values of Surrogate Measures for Insulin Sensitivity in a Healthy Population in Korea according to the Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010.

BACKGROUND: This study aimed to identify the gender-specific characteristics of the surrogate measures of insulin resistance and to establish valid cut-off values for metabolic abnormalities in a representative sample in Korea. METHODS: Data were collected from the datasets of the Korean National Health and Nutrition Examination Survey between 2007 and 2010. The total number of eligible participants was 10,997. We used three measures of insulin resistance: the homeostasis model assessment-insulin resistance (HOMA-IR), McAuley index, and triglyceride and glucose (TyG) index. The estimated cut-off values were determined using the highest score of the Youden index. RESULTS: The area under the curve (AUC) of the HOMA-IR, McAuley index, and TyG index were 0.737 (95% confidence interval [CI], 0.725-0.750), 0.861 (95% CI, 0.853-0.870), and 0.877 (95% CI, 0.868-0.885), respectively. The cut-off values of the HOMA-IR were 2.20 in men, 2.55 in premenopausal women, and 2.03 in postmenopausal women, and those of the McAuley index were 6.4 in men and 6.6 in premenopausal and postmenopausal women. For the TyG index, the cut-off values were 4.76 in men and 4.71 in premenopausal and postmenopausal women. CONCLUSION: In conclusion, the present study provides the valid cut-off values of the indirect surrogate measures of insulin sensitivity. These values may be used as reference for insulin sensitivity in a clinical setting and may provide a simple and supplementary method for identifying populations at risk of insulin resistance.

The influence of physical activity on risk of cardiovascular disease in people who are obese but metabolically healthy.

The metabolic outcomes of metabolically healthy obesity (MHO) remain controversial. The aim of the present study was to determine the effect of physical activity on the cardiovascular disease (CVD) outcomes of MHO. The study included participants who were followed for 10 years and recruited from the Korean Genome and Epidemiology Study (KoGES), a population-based cohort study. Participants with previously recorded CVDs or cancer, or who had received steroids or anticoagulants at baseline were excluded. A total of 8144 participants (3,942 men and 4,202 women) fulfilled inclusion criteria. In a multivariate Cox regression model adjusted for age and sex, MHO participants were not at elevated risk of CVD compared with their metabolically healthy non-obese (MHNO) counterparts (HR, 1.28; 95% CI, 0.96-1.71), although both the non-obese (HR, 1.50; 95% CI, 1.19-1.90) and obese (HR, 1.85; 95% CI, 1.48-2.30) participants with metabolic abnormalities were at elevated risk. However, in the subgroup analysis by physical activity, physically inactive MHO participants had a significantly higher HR for CVD events compared to active MHNO participants (HR, 1.54; 95% CI, 1.03-2.30), while active MHO participants were not at elevated risk (HR, 1.15; 95% CI, 0.70-1.89). Physically inactive MHO participants had significantly increased risk of CVD compared to physically active MHNO participants whereas physically active MHO participants did not.

Relationship Between Plant Food (Fruits, Vegetables, and Kimchi) Consumption and the Prevalence of Rhinitis Among Korean Adults: Based on the 2011 and 2012 Korea National Health and Nutrition Examination Survey Data.

The aim of the current study was to analyze the relationship between plant food (fruits, vegetables, and kimchi) and the prevalence of rhinitis among Korean adults using data from the 2011 and 2012 Korea National Health and Nutrition Examination Survey. A total of 7494 subjects aged from 19 to 64 years participated in a rhinitis morbidity survey, health behavior interview, and 24-h dietary recall test. Individuals with energy intakes less than 500 kcal or more than 5000 kcal were excluded. The results showed that kimchi intake was inversely associated with the prevalence of rhinitis. The prevalence of rhinitis decreased with increasing kimchi consumption. The quintile 4 (range of kimchi intake: 108.0-180.0 g) groups, compared with the reference of quintile 1 (0-23.7 g), showed a decrease of 18.9% (odds ratio [OR] = 0.811, 95% confidence interval [CI] = 0.672-0.979) in Model 4. In conclusion, consumption of kimchi lowers the risk of rhinitis, suggesting that its use should be encouraged among the Korean population.