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Evaluation of prolonged pain in preterm infants with pneumothorax using heart rate variability analysis and EDIN (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) scores

  • Buyuktiryaki, Mehmet;Uras, Nurdan;Okur, Nilufer;Oncel, Mehmet Yekta;Simsek, Gulsum Kadioglu;Isik, Sehribanu Ozluer;Oguz, Serife Suna
    • Clinical and Experimental Pediatrics
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    • v.61 no.10
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    • pp.322-326
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    • 2018
  • Purpose: The EDIN scale (${\acute{E}}chelle$ Douleur Inconfort Nouveau-$N{\acute{e}}$, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement due to pneumothorax. Methods: This prospective observational study assessed prolonged pain in preterm infants with a gestational age between 33 and 35 weeks undergoing installation of chest tubes. Prolonged pain was assessed using the EDIN scale and NIPE index. Results: There was a significant correlation between the EDIN scale and NIPE index (r=-0.590, P=0.003). Prolonged pain is significantly more severe in the first 6 hours following chest tube installation (NIPE index: 60 [50-86] vs. 68 [45-89], P<0.002; EDIN score: 8 [7-11] vs. 6 [4-8], P<0.001). Conclusion: Prolonged pain can be accurately assessed with the EDIN scale and NIPE index. However, evaluation with the EDIN scale is time-consuming. The NIPE index can provide instantaneous assessment of prolonged and continuous pain.

MEASURING THE INFLUENCE OF TASK COMPLEXITY ON HUMAN ERROR PROBABILITY: AN EMPIRICAL EVALUATION

  • Podofillini, Luca;Park, Jinkyun;Dang, Vinh N.
    • Nuclear Engineering and Technology
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    • v.45 no.2
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    • pp.151-164
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    • 2013
  • A key input for the assessment of Human Error Probabilities (HEPs) with Human Reliability Analysis (HRA) methods is the evaluation of the factors influencing the human performance (often referred to as Performance Shaping Factors, PSFs). In general, the definition of these factors and the supporting guidance are such that their evaluation involves significant subjectivity. This affects the repeatability of HRA results as well as the collection of HRA data for model construction and verification. In this context, the present paper considers the TAsk COMplexity (TACOM) measure, developed by one of the authors to quantify the complexity of procedure-guided tasks (by the operating crew of nuclear power plants in emergency situations), and evaluates its use to represent (objectively and quantitatively) task complexity issues relevant to HRA methods. In particular, TACOM scores are calculated for five Human Failure Events (HFEs) for which empirical evidence on the HEPs (albeit with large uncertainty) and influencing factors are available - from the International HRA Empirical Study. The empirical evaluation has shown promising results. The TACOM score increases as the empirical HEP of the selected HFEs increases. Except for one case, TACOM scores are well distinguished if related to different difficulty categories (e.g., "easy" vs. "somewhat difficult"), while values corresponding to tasks within the same category are very close. Despite some important limitations related to the small number of HFEs investigated and the large uncertainty in their HEPs, this paper presents one of few attempts to empirically study the effect of a performance shaping factor on the human error probability. This type of study is important to enhance the empirical basis of HRA methods, to make sure that 1) the definitions of the PSFs cover the influences important for HRA (i.e., influencing the error probability), and 2) the quantitative relationships among PSFs and error probability are adequately represented.

Effects of Antihypertensive Drugs on Renal Function and Glomerular Morphology in Chronic Renal Failure Rats (만성신부전 백서에서 항고혈압제의 종류에 따른 신부전의 진행과 사구체의 형태학적 변화)

  • Hong Sung-Jin;Kim Kyo-Sun;Kim Pyung-Kil;Park Kyung-Hwa;Kim Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.169-177
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    • 2002
  • Purpose: Hypertension accelerates the progression of chronic renal disease, whether it results from, or causes, the renal disease. Therefore, the control of hypertension is one of the important factors that retard the rate of renal deterioration. We compared the effects of different antihypertensive agents on renal function and glomerular morphology In subtotal nephrectomized rats. Materials and methods: After induction of chronic renal failure with 5/6 nephrectomy, the rats were divided into three groups; control group (Group C), enalapril group (Group E), and nicardipine group (Group N). Systolic blood pressure was measured by tail cuff method every 4 weeks until 12 weeks after nephrectomy. At 12 weeks after nephrectomy, all rats were placed in metabolic cages for 24 hour urine collections to measure urinary protein and creatinine excretion. After urine collection and blood sampling for serum creatinine, all rats were sacrificed. The renal tissue was processed for morphometric study with light microscope and electron microscope. Results: 1. The blood pressure of Group C increased progressively, but both enalapril and nicardipine prevented the development of hypertension, and the two drugs were equally effective in maintaining normal blood pressure throughout the study. 2. Twenty-four hour urinary protein excretion was lower in Group E compared to Group C and Group N 3. Mesangial expansion score in both treated groups were significantly lower than the control group. Mean glomerular volume in Group E was significantly reduced compared to Group C and Group N. There was no significant difference in mean glomerular volume between Group C and Group N. 4. There was no significant difference in podocyte structural changes, estimated by filtration slit length density, among control, enalapril and nicardipine treated groups. Conclusion: Control of hypertension with enalapril or nicardipine afforded considerable protection from mesangial expansion in the rat remnant kidney model. But protein excretion and glomerular growth were significantly reduced in Group E compared to Group N. There was no significant difference in podocyte structural changes among the 3 groups.

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Shear bond strengths of aged and non-aged CAD/CAM materials after different surface treatments

  • Kilinc, Hamiyet;Sanal, Fatma Ayse;Turgut, Sedanur
    • The Journal of Advanced Prosthodontics
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    • v.12 no.5
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    • pp.273-282
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    • 2020
  • PURPOSE. To assess shear bond strengths (SBS) of resin composites on aged and non-aged prosthetic materials with various surface treatments. MATERIALS AND METHODS. Cerasmart (CE), Vita Enamic (VE), Vita Mark II (VM), and IPS e.max CAD (EC) blocks were sliced, and rectangular-shaped specimens (14 × 12 × 1.5 mm; N = 352) were obtained. Half of the specimens were aged (5000 thermal cycles) for each material. Non-aged and aged specimens were divided into 4 groups according to the surface treatments (control, air abrasion, etching, and laser irradiation; n = 11) and processed for scanning electron microscopy (SEM). The repair procedure was performed after the surface treatments. SBS values and failure types were determined. Obtained data were statistically analyzed (P≤.05). RESULTS. The material type, surface treatment type, and their interactions were found significant with regard to SBS (P<.001). Aging also had a significant effect on prosthetic material-resin composite bonding (P<.001). SBS values of non-aged specimens ranged from 12.16 to 17.91 MPa, while SBS values of aged specimens ranged from 9.46 to 15.61 MPa. Non-aged VM in combination with acid etching presented the highest score while the control group of aged CE showed the lowest. CONCLUSION. Etching was more effective in achieving durable SBS for VM and EC. Laser irradiation could be considered as an alternative surface treatment method to air abrasion for all tested materials. Aging had significant effect on SBS values generated between tested materials and resin composite.

The Effects of Polydeoxyribonucleotide on the Survival of Random Pattern Skin Flaps in Rats

  • Chung, Kun Il;Kim, Han Koo;Kim, Woo Seob;Bae, Tae Hui
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.181-186
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    • 2013
  • Background Partial or complete necrosis of a skin flap is a common problem. Polydeoxyribonucleotide (PDRN) can be extracted from trout sperm and used as a tissue repair agent. The aim of this study was to investigate whether PDRN could improve the survival of random pattern skin flaps in rats. Methods Twenty-two male Sprague-Dawley rats were randomly divided into two groups: the PDRN treatment group (n=11) and the control group (n=11). Caudally pedicled random pattern skin flaps were elevated on their dorsal skin and resutured. The treatment group received daily intraperitoneal administration of PDRN (8 mg/kg/day), and the control group received fluid vehicle (NaCl 0.9%, 8 mg/kg/day) from day 0 to day 6. On day 7, the flap survival was evaluated and the harvested tissue surrounding the demarcation line of the necrotic area was stained with H&E, anti-rat vascular endothelial cell growth factor (VEGF) antibody, and PECAM-1/CD31 antibody. Results The average necrotic area of the flap in the PDRN group was significantly smaller when compared with that of the control group. Histologic and immunohistochemical evaluation showed that granulation thickness score and VEGF-positive staining cells were marked higher in the PDRN group than in the control group. PECAM-1/CD31-positive microvascular densities were significantly higher in the PDRN group when compared with the control group. Conclusions This study confirms that PDRN improves the survival of random pattern skin flaps in rats. These results may represent a new therapeutic approach to enhancing flap viability and achieving faster wound repair.

Descriptive Correlational Study on Personality Type using MBTI and lob Satisfaction (MBTI를 활용한 일 병원 간호사의 성격특성과 직무만족도와의 관계연구)

  • Han Ae-Kyung;Won Jong-Soon;Kim Ok-Soo;Park Mi-Kyung;Chang Jung-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.3
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    • pp.404-412
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    • 2005
  • Purpose: This study was done to examine the correlations between personality type and job satisfaction of nurses. Methods: Subjects included three hundred twelve nurses ages from 21 to 55. The Myers-Briggs Type Indicator(MBTI) was administered to determine the personality types of the nurses(n=312). A job satisfaction survey including a demographic and career questionnaire was also used. Data were analyzed using ANOVA. Results: The mean score fur job satisfaction was 113.68 out of 205. The result showed that there was no statistically significant correlation between job satisfaction and information gathering functions, S: Sensing, N: Intuition (t=.667, p=.499), T; Thinking, F; Feeling (t=.822, p=.412). The results, however, indicated that style for gaining energy(I: Introversion, E: Extroversion)(t=2.008, p=.046) and life dealing style(J : Judgement, P : Perception)(t=2.290, p=.023) were significantly correlated with job satisfaction. The extrovert focuses on the outside and get energy through interacting with people and doing things. Judgement type is described as organized, decisive, and orderly. Conclusion: Nurses in the extrovert and judgement types were more satisfied with their Jobs than those in the introvert and perceptive type. Other results support that educational level, marital status, job characteristics, clinical experiences, motivation for nursing, and night duty were correlated with job satisfaction.

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Building Linked Big Data for Stroke in Korea: Linkage of Stroke Registry and National Health Insurance Claims Data

  • Kim, Tae Jung;Lee, Ji Sung;Kim, Ji-Woo;Oh, Mi Sun;Mo, Heejung;Lee, Chan-Hyuk;Jeong, Han-Young;Jung, Keun-Hwa;Lim, Jae-Sung;Ko, Sang-Bae;Yu, Kyung-Ho;Lee, Byung-Chul;Yoon, Byung-Woo
    • Journal of Korean Medical Science
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    • v.33 no.53
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    • pp.343.1-343.8
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    • 2018
  • Background: Linkage of public healthcare data is useful in stroke research because patients may visit different sectors of the health system before, during, and after stroke. Therefore, we aimed to establish high-quality big data on stroke in Korea by linking acute stroke registry and national health claim databases. Methods: Acute stroke patients (n = 65,311) with claim data suitable for linkage were included in the Clinical Research Center for Stroke (CRCS) registry during 2006-2014. We linked the CRCS registry with national health claim databases in the Health Insurance Review and Assessment Service (HIRA). Linkage was performed using 6 common variables: birth date, gender, provider identification, receiving year and number, and statement serial number in the benefit claim statement. For matched records, linkage accuracy was evaluated using differences between hospital visiting date in the CRCS registry and the commencement date for health insurance care in HIRA. Results: Of 65,311 CRCS cases, 64,634 were matched to HIRA cases (match rate, 99.0%). The proportion of true matches was 94.4% (n = 61,017) in the matched data. Among true matches (mean age 66.4 years; men 58.4%), the median National Institutes of Health Stroke Scale score was 3 (interquartile range 1-7). When comparing baseline characteristics between true matches and false matches, no substantial difference was observed for any variable. Conclusion: We could establish big data on stroke by linking CRCS registry and HIRA records, using claims data without personal identifiers. We plan to conduct national stroke research and improve stroke care using the linked big database.

Negative association between high temperature-humidity index and milk performance and quality in Korean dairy system: big data analysis

  • Dongseok Lee;Daekyum Yoo;Hyeran Kim;Jakyeom Seo
    • Journal of Animal Science and Technology
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    • v.65 no.3
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    • pp.588-595
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    • 2023
  • The aim of this study was to investigate the effects of heat stress on milk traits in South Korea using comprehensive data (dairy production and climate). The dataset for this study comprised 1,498,232 test-day records for milk yield, fat- and protein-corrected milk, fat yield, protein yield, milk urea nitrogen (MUN), and somatic cell score (SCS) from 215,276 Holstein cows (primiparous: n = 122,087; multiparous: n = 93,189) in 2,419 South Korean dairy herds. Data were collected from July 2017 to April 2020 through the Dairy Cattle Improvement Program, and merged with meteorological data from 600 automatic weather stations through the Korea Meteorological Administration. The segmented regression model was used to estimate the effects of the temperature-humidity index (THI) on milk traits and elucidate the break point (BP) of the THI. To acquire the least-squares mean of milk traits, the generalized linear model was applied using fixed effects (region, calving year, calving month, parity, days in milk, and THI). For all parameters, the BP of THI was observed; in particular, milk production parameters dramatically decreased after a specific BP of THI (p < 0.05). In contrast, MUN and SCS drastically increased when THI exceeded BP in all cows (p < 0.05) and primiparous cows (p < 0.05), respectively. Dairy cows in South Korea exhibited negative effects on milk traits (decrease in milk performance, increase in MUN, and SCS) when the THI exceeded 70; therefore, detailed feeding management is required to prevent heat stress in dairy cows.

Altered Frequency, Activation, and Clinical Relevance of Circulating Innate and Innate-Like Lymphocytes in Patients With Alcoholic Liver Cirrhosis

  • Ki-Jeong Park;Hye-Mi Jin;Young-Nan Cho;Jae Hyun Yoon;Seung-Jung Kee;Hyo-Sin Kim;Yong-Wook Park
    • IMMUNE NETWORK
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    • v.23 no.3
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    • pp.22.1-22.15
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    • 2023
  • Alcoholic liver cirrhosis (ALC) is caused by chronic alcohol overconsumption and might be linked to dysregulated immune responses in the gut-liver axis. However, there is a lack of comprehensive research on levels and functions of innate lymphocytes including mucosal-associated invariant T (MAIT) cells, NKT cells, and NK (NK) cells in ALC patients. Thus, the aim of this study was to examine the levels and function of these cells, evaluate their clinical relevance, and explore their immunologic roles in the pathogenesis of ALC. Peripheral blood samples from ALC patients (n = 31) and healthy controls (HCs, n = 31) were collected. MAIT cells, NKT cells, NK cells, cytokines, CD69, PD-1, and lymphocyte-activation gene 3 (LAG-3) levels were measured by flow cytometry. Percentages and numbers of circulating MAIT cells, NKT cells, and NK cells were significantly reduced in ALC patients than in HCs. MAIT cell exhibited increased production of IL-17 and expression levels of CD69, PD-1, and LAG-3. NKT cells displayed decreased production of IFN-γ and IL-4. NK cells showed elevated CD69 expression. Absolute MAIT cell levels were positively correlated with lymphocyte count but negatively correlated with C-reactive protein. In addition, NKT cell levels were negatively correlated with hemoglobin levels. Furthermore, log-transformed absolute MAIT cell levels were negatively correlated with the Age, Bilirubin, INR, and Creatinine score. This study demonstrates that circulating MAIT cells, NKT cells, and NK cells are numerically deficient in ALC patients, and the degree of cytokine production and activation status also changed. Besides, some of their deficiencies are related to several clinical parameters. These findings provide important information about immune responses of ALC patients.

Is It Safe to Preserve Left Atrial Appendage During Maze Procedure?

  • Kyungsub Song;Woo Sung Jang;Namhee Park;Yun Seok Kim;Jae Bum Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.566-577
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    • 2023
  • Background and Objectives: The left atrial appendage (LAA) can contribute significantly to LA mechanical contraction. Nevertheless, the preventive effect of LAA occlusion during the maze procedure against cerebral infarction remains controversial. In this study, we compared the surgical, cardiac hemodynamic, and neurologic outcomes between LAA preservation and occlusion performed during the maze procedure. Methods: Between January 2015 and August 2021, 252 patients underwent the maze procedure using cryoablation at our medical center. After excluding patients according to our exclusion criteria (i.e., mechanical prosthesis implantation, preexisting LAA thrombus), LAA was preserved in 113 patients (non-occlusion group) and occluded in 75 patients (occlusion group). Outcomes were compared using propensity score matching (PSM). Results: PSM did not reveal significant intergroup differences in baseline characteristics between the non-occlusion (n=53) and occlusion (n=53) groups. During a median follow-up of 44 months, 2 patients in the non-occlusion group (3.8%) experienced ischemic strokes. There was no significant difference in the rate of freedom from stroke (p=0.19) and major adverse cardiac events (p=0.43) between the 2 groups. Through echocardiography at 1-year follow-up, a statistically significant difference in LA mechanical contraction was observed between the non-occlusion group and occlusion group (24 of 33 [72.7%] vs. 18 of 37 [48.6%], respectively; p=0.04). Conclusions: In this study, preservation of the LAA during the maze procedure resulted in better LA function than LAA occlusion, with similar rates of stroke.