Metabolic Syndrome Prediction Models Using Machine Learning and Sasang Constitution Type.

BACKGROUND: Machine learning may be a useful tool for predicting metabolic syndrome (MetS), and previous studies also suggest that the risk of MetS differs according to Sasang constitution type. The present study investigated the development of MetS prediction models utilizing machine learning methods and whether the incorporation of Sasang constitution type could improve the performance of those prediction models. METHODS: Participants visiting a medical center for a health check-up were recruited in 2005 and 2006. Six kinds of machine learning were utilized (K-nearest neighbor, naive Bayes, random forest, decision tree, multilayer perceptron, and support vector machine), as was conventional logistic regression. Machine learning-derived MetS prediction models with and without the incorporation of Sasang constitution type were compared to investigate whether the former would predict MetS with higher sensitivity. Age, sex, education level, marital status, body mass index, stress, physical activity, alcohol consumption, and smoking were included as potentially predictive factors. RESULTS: A total of 750/2,871 participants had MetS. Among the six types of machine learning methods investigated, multiplayer perceptron and support vector machine exhibited the same performance as the conventional regression method, based on the areas under the receiver operating characteristic curves. The naive-Bayes method exhibited the highest sensitivity (0.49), which was higher than that of the conventional regression method (0.39). The incorporation of Sasang constitution type improved the sensitivity of all of the machine learning methods investigated except for the K-nearest neighbor method. CONCLUSION: Machine learning-derived models may be useful for MetS prediction, and the incorporation of Sasang constitution type may increase the sensitivity of such models.

Association between Resting Energy Expenditure and Heat Pattern in Traditional Medicine.

Many symptoms of heat pattern (HP) in traditional medicine are related to thermoregulation; however, research on the association between energy expenditure characteristics and HP is limited. We aimed to study the association between HP and resting energy expenditure (REE). A total of 109 participants were divided into the HP and non-HP groups based on a self-administered questionnaire and their REE was measured using an indirect calorimeter. Multiple logistic regression models were used to calculate the odds ratio (OR) of HP according to the level of REE. No significant differences in age, anthropometric, and body composition characteristics were observed between the HP and the non-HP groups. The likelihood of having an HP significantly increased with higher REE after adjustment for fat-free mass (OR 1.22 [95% CI 1.03-1.46]) and also after additional adjustment for sex and age (OR 1.21 [95% CI 1.01-1.46]). These results suggest that increased REE could be a biological characteristic of HP. Future studies are necessary to investigate the underlying mechanisms associated with the differing energy expenditure in HP.

Complementary and Alternative Medicine Use in Amyotrophic Lateral Sclerosis Cases in South Korea.

Patients with amyotrophic lateral sclerosis (ALS) sometimes consider complementary and alternative medicine (CAM) because of ineffective treatment. This study investigated the prevalence and utilization pattern of CAM among patients with ALS in South Korea. Participants were recruited through homecare services for mechanical ventilation in South Korea. This study comprised a face-to-face cross-sectional survey with staff members available to address any queries. Fifty-five participants were included; all had used >1 CAM treatment option for ALS symptoms. Dietary treatments were most common, followed by functional food and massages. Most participants had obtained relevant information from family members or friends. The main reason for CAM use was an expectation that symptoms will improve with CAM; most patients were unsure of the effects. CAM use was previously discontinued by the majority of patients because of unsatisfactory effects. The mean expenditure on CAM was 288,385.28 ± 685,265.14 won per month, and the mean duration of CAM use was 11.54 ± 20.09 months. The results indicate that there is a high prevalence of CAM use among ALS patients. Healthcare providers should inquire about CAM use and openly provide accurate CAM information. Further evidence of CAM efficacy is required, as is specific guidance for consulting ALS patients regarding CAM.

Effect of Traditional East Asian Medicinal herbal tea (HT002) on insomnia: a randomized controlled pilot study.

BACKGROUND: Complementary and alternative medicine treatment for insomnia has been sought due to the possible adverse effects of conventional pharmacotherapies. We performed a preliminary evaluation of the feasibility of using, and of the effect of a herbal tea (HT002), based on Traditional East Asian Medicine, in mild-to-moderate insomnia. METHODS: Patients (n = 40) with mild-to-moderate insomnia were randomized to the HT002 (n = 20) or waitlist (n = 20) groups. The HT002 group consumed HT002 twice daily for 4 weeks. Outcomes were assessed using the Insomnia Severity Scale (ISI), Pittsburgh Sleep Quality Index (PSQI), and 12-item Short Form Health Survey (SF-12) at baseline and after 4 and 8 weeks. RESULTS: The ISI score differences from baseline at weeks 4 and 8 were significantly greater in the HT002 than that in the waitlist group (week 4: -4.0 ± 0.8 vs. -0.4 ± 0.8, p < 0.05; week 8: -4.8 ± 0.7 vs. -0.9 ± 0.7, p < 0.05). Changes in PSQI and SF-12 physical component scores in the HT002 group were significantly greater at weeks 4 and 8 (p < 0.05), while SF-12 mental component scores were only significantly larger at 4 weeks (p < 0.05). HT002 was well-tolerated, with only one (5.0%) dropout, and no significant mean liver and renal function test changes post-treatment. CONCLUSION: Our preliminary results suggest that a 4-week treatment with HT002 may reduce the severity of insomnia symptoms and improve the quality of life. Further studies devoid of the limitations of our protocol may provide stronger conclusions. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), KCT0001900.

Three-Component Herbal Tea Alleviates Prolonged Fatigue and Improves Sleep Quality: A Randomized Controlled Pilot Study.

INTRODUCTION: Prolonged fatigue is common among adults, yet only a small percentage of affected individuals seek medical attention. Following findings that complementary and alternative medicine can be effective strategies for improving fatigue, we evaluated the effect of an herbal tea regimen on prolonged fatigue. METHODS: In this pilot randomized controlled trial, participants with prolonged fatigue were randomly allocated to either a tea (n = 20) or control (n = 20) group. The tea group consumed herbal tea consisting of Astragali Radix, Angelicae gigantis Radix, and Zizyphi Fructus twice daily for 4 weeks, whereas the control group received no intervention. Outcomes were assessed at baseline and 4 and 8 weeks. The primary outcome was fatigue severity, measured using the Chalder Fatigue Scale. Secondary outcomes included sleep quality, depression symptoms, and quality of life. RESULTS: Among the 40 individuals screened, 35 completed the study. Fatigue severity was significantly lower in the tea group than the control group at 4 weeks, and within the tea group, fatigue severity and sleep quality improved at the 4- and 8-week follow-ups vs. baseline in the tea group. Depression also significantly improved in the tea group at 8 weeks. There were no changes within the control group on any measure. CONCLUSION: The findings suggest that our herbal tea formulation reduces fatigue severity and improves sleep quality in adults with prolonged fatigue.

The Association of Quantitative Facial Color Features with Cold Pattern in Traditional East Asian Medicine.

INTRODUCTION: Facial diagnosis is a major component of the diagnostic method in traditional East Asian medicine. We investigated the association of quantitative facial color features with cold pattern using a fully automated facial color parameterization system. METHODS: The facial color parameters of 64 participants were obtained from digital photographs using an automatic color correction and color parameter calculation system. Cold pattern severity was evaluated using a questionnaire. RESULTS: The a⁎ values of the whole face, lower cheek, and chin were negatively associated with cold pattern score (CPS) (whole face: B = -1.048, P = 0.021; lower cheek: B = -0.494, P = 0.007; chin: B = -0.640, P = 0.031), while b⁎ value of the lower cheek was positively associated with CPS (B = 0.234, P = 0.019). The a⁎ values of the whole face were significantly correlated with specific cold pattern symptoms including cold abdomen (partial ρ = -0.354, P < 0.01) and cold sensation in the body (partial ρ = -0.255, P < 0.05). CONCLUSIONS: a⁎ values of the whole face were negatively associated with CPS, indicating that individuals with increased levels of cold pattern had paler faces. These findings suggest that objective facial diagnosis has utility for pattern identification.

Cold and Spleen-Qi Deficiency Patterns in Korean Medicine Are Associated with Low Resting Metabolic Rate.

Background. Korean medicine (KM) patterns such as cold, heat, deficiency, and excess patterns have been associated with alterations of resting metabolic rate (RMR). However, the association of KM patterns with accurately measured body metabolic rate has not been investigated. Methods. Data on cold (CP), heat (HP), spleen-qi deficiency (SQDP), and kidney deficiency (KDP) patterns were extracted by a factor analysis of symptoms experienced by 954 participants. A multiple regression analysis was conducted to determine the association between KM patterns and RMR measured by an indirect calorimeter. Results. The CP and SQDP scores were higher and the HP score was lower in women. The HP and SQDP scores decreased with age, while KDP scores increased with age. A multiple regression analysis revealed that CP and SQDP scores were negatively associated with RMR independently of gender and age, and the CP remained significantly and negatively associated with RMR even after adjustment for fat-free mass. Conclusions. The underlying pathology of CP and SQDP might be associated with the body's metabolic rate. Further studies are needed to investigate the usefulness of RMR measurement in pattern identification and the association of CP and SQDP with metabolic disorders.

Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

INTRODUCTION: Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. METHODS AND ANALYSIS: Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach. ETHICS AND DISSEMINATION: The results of the study will be disseminated via a peer-reviewed journal and/or conference presentations. TRIAL REGISTRATION NUMBER: PROSPERO CRD42015026757.

Development of a template for the classification of traditional medical knowledge in Korea.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Medical Knowledge (TMK) is a form of Traditional Knowledge associated with medicine that is handed down orally or by written material. There are efforts to document TMK, and make database to conserve Traditional Medicine and facilitate future research to validate traditional use. Despite of these efforts, there is no widely accepted template in data file format that is specific for TMK and, at the same time, helpful for understanding and organizing TMK. AIM OF THE STUDY: We aimed to develop a template to classify TMK. MATERIALS AND METHODS: First, we reviewed books, articles, and health-related classification systems, and used focus group discussion to establish the definition, scope, and constituents of TMK. Second, we developed an initial version of the template to classify TMK, and applied it to TMK data. Third, we revised the template, based on the results of the initial template and input from experts, and applied it to the data. RESULTS: We developed the template for classification of TMK. The constituents of the template were summary, properties, tools/ingredients, indication/preparation/application, and international standard classification. We applied International Patent Classification, International Classification of Diseases (Korea version), and Classification of Korean Traditional Knowledge Resources to provide legal protection of TMK and facilitate academic research. The template provides standard terms for ingredients, preparation, administration route, and procedure method to assess safety and efficacy. CONCLUSIONS: This is the first template that is specialized for TMK for arranging and classifying TMK. The template would have important roles in preserving TMK, and protecting intellectual property. TMK data classified with the template could be used as the preliminary data to screen potential candidates for new pharmaceuticals.