• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.637-642
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• 2014

The pathogenesis of hepatocellular carcinoma (HCC) related to habitual betel quid (BQ) chewing is unclear. Risk of HCCis increased with adverse hepatic fibrosis. This study aimed to assess the impact of chronic viral hepatitis on adverse hepatic fibrosis in HCC related to BQ chewing. This hospital-based case-control study enrolled 200 pairs of age- and gender-matched patients with HCC and unrelated healthy controls. Serologic hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), ${\alpha}$-fetoprotein (AFP), and surrogate markers for significant hepatic fibrosis were measured. Information on substance-use habits was obtained with a questionnaire. By analysis of surrogate markers for hepatic fibrosis, the prevalence of significant hepatic fibrosis in patients chewing BQ was between 45.8% and 91.7%, whereas that for patients without BQ chewing was between 18.4% and 57.9%. The difference was significant (P <0.05 for each surrogate marker). Multivariate analysis indicated that cirrhosis with Child-Pugh C (odds ratio (OR) = 3.28; 95% confidence interval (CI), 1.29-8.37), thrombocytopenia (OR = 3.92, 95% CI, 1.77-8.68), AFP >400 mg/L (OR = 2.21, 95% CI, 1.05-4.66) and male gender (OR = 4.06, 95% CI, 1.29-12.77) were independent factors associated with habitual BQ chewing. In conclusion, adverse hepatic fibrosis and severe liver damage play important roles in the pathogenesis of BQ-related HCC, which could be aggravated by chronic hepatitis B and hepatitis C. BQ-cessation programs and prevention of chronic HBV/HCV infection are needed to prevent HCC related to BQ chewing.

• Korean Journal of Radiology
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• v.21 no.8
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• pp.1007-1017
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• 2020

Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitals were retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in the training cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in the validation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, or death. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. A nomogram was constructed based on the combination of clinical and CT features, and its prognostic performance was externally tested in the validation group. The predictive value of the combined model was compared with models built on the clinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohort experienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67-6.71; p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04-0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03-4.48; p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76-0.88), and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82-0.96). The combined model provided the best performance over the clinical or radiological model (p < 0.050). Conclusion: Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverse outcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19.

• Journal of Distribution Science
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• v.11 no.12
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• pp.71-81
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• 2013

Purpose - This study investigated the effects of consumers' selection criteria for environment-friendly agricultural products on purchase intention and the effects of consumers' attitudes and the reliability of environment-friendly agricultural products on purchase intention by using the theory of planned behavior. Subjective norms of variables of behavioral intention, attitudes toward behavior and control of the behavior were used to create selection criteria, consumers' attitudes and reliability of environment-friendly agricultural products. The study investigated the effects of consumers' selection criteria, attitudes, and reliability of environment-friendly agricultural products on purchase intention constructing models and hypotheses of mediation and moderation between selection criteria for agricultural products and purchase intention by consumers' attitudes and reliability. Research design, data, and methodology - The findings were as follows: first, consumers' selection criteria for environment-friendly agricultural products had a significantly affirmative influence upon purchase intention. Health was the most important factor of selection criteria convenience was more important than quality and familiarity was next. Consumers' attitudes and trust had a significant influence on purchase intention. Second, testing showed that consumers' attitude and trust partially mediated selection criteria: sub-factors and purchase intention were important in selection criteria. Third, testing showed that consumers' attitude and trust had a significant moderation effect between selection criteria and purchase intention. In the test of the moderation effect between sub-factors of selection criteria and purchase intention, consumers' attitude had a significantly positive influence upon health, convenience, and familiarity, and had no significant influence upon quality and purchase intention. Consumers' trust had no significant influence upon health, convenience, and quality. Results - The study provided several theoretical implications: first, an empirical analysis was undertaken with selection criteria for environmental-friendly agricultural products, consumers' attitude, and trust to investigate subjective norms, attitude toward behavior and control of behavior based on the theory of planned behavior. Second, this study investigated both the mediation effect and moderation effect of consumers' subjective norms on attitudes toward behavior, the mediating effects of perceived behavior control and changes of behavioral intention depending upon size and direction of the variables. This study also provided several practical implications. Conclusions - First, consumption of environment-friendly agricultural products did not increase despite rapid increase of production therefore, promotion of consumption and distribution was needed considering the supply and demand of the products. Second, definite standards for selection criteria were suggested to build up consumers' attitude and trust. Consumers' attitude could be improved by factors including the brand of environment-friendly agricultural products, consistent quality, solving physiological problems caused by adverse effects of environmental problems, supplementary approaches, treatment of adverse effects by eating food, and the development and supply of products in accordance with changes of lifestyle. Finally, consumers' demand for sub-factors of selection criteria could be much higher than health, convenience, and quality of the products. Therefore, a process was needed that could continuously check consumers' needs for the products. Limitations were described at the end of the study.

• Asian-Australasian Journal of Animal Sciences
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• v.25 no.1
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• pp.22-27
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• 2012

The experiment involved observations of 2,514 Holstein-Friesian cows to determine the effects of environmental factors (cow's age, calving season, weight and sex of calves, housing system) and genetic factors on gestation length in dairy cattle and the correlation between gestation length and other reproductive traits (calving ease, stillbirth rates and placental expulsion). Genetic parameters were estimated based on the sires of calved cows (indirect effect) and the sires of live-born calves (direct effect). The following factors were found to contribute to prolonged gestation: increasing cow's age, male fetuses and growing fetus weight. Optimal gestation length was determined in the range of 275-277 days based on calving ease and stillbirth rates. The heritability of gestation length was estimated at 0.201-0.210 by the direct effect and 0.055-0.073 by the indirect effect. The resulting genetic correlations suggest that the efforts to optimize (prolong) gestation length could exert an adverse influence on the breeding value of bulls by increasing perinatal mortality and calving difficulty. The standard errors of the investigated parameters were relatively high, suggesting that any attempts to modify gestation length for the purpose of improving calving ease and reducing stillbirth rates should be introduced with great caution.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.23 no.1
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• pp.89-96
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• 2020

Adverse impact of Particulate Matters(PM10, PM2.5; PMs) significantly affects daily lives. Major countermeasures for reducing concentration of PMs were focused on emission source without considering spatial difference of PMs concentration. Thus, this study analyzed spatial·temporal distribution of PMs with observation data as well as potential contributing factors on PMs concentration. The annual average concentration of PMs have been decreased while the particulate matter warnings and alerts were significantly increased in 2018. The average concentration of PMs in spring and winter was higher than the other seasons. Also, the spatial distribution of PMs were also showed seasonality while concentration of PMs were higher in Seoul-metropolitan areas in all seasons. Climate variables, emission source, spatial structure and potential PM sinks were selected major factors which could affects on ambient concentrations of PMs. This paper suggest that countermeasures for mitigating PM concentration should consider characteristics of area. Climatic variables(temperature, pressure, wind speed etc.) affects concentrations of PMs. The effects of spatial structure of cities(terrain, ventilation corridor) and biological sinks(green infrastructure, urban forests) on concentration of PMs should be analyzed in further studies. Also, seasonality of PMs concentration should be considered for establishing effective countermeasures to reduce ambient PMs concentration.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.154-160
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• 2019

Objectives: Stillbirth is a common adverse pregnancy outcome that represents a distressing and traumatic event for women and their partners. The aim of this study was to identify factors associated with stillbirth in ever-pregnant women in Nepal. Methods: This study utilized the individual women's dataset from the Nepal Demographic and Health Survey, conducted in 2016. The dependent variable of interest was whether women had at least 1 stillbirth during their lifetime. The associations between independent variables and the dependent variable of the study were analyzed using a multiple logistic regression model. Results: Among 8918 ever-pregnant women aged 15-49 years, 488 had experienced at least 1 stillbirth during their lifetime, representing 5.5% of the total. After adjusting each factor for the confounding effects of other factors, maternal age, maternal education, place of residence, and sub-region remained significantly associated with having experienced stillbirth. Conclusions: Stillbirth continues to be a major problem among women, especially those with higher maternal age, those who are illiterate, and residents of certain geographical regions. To minimize stillbirth in Nepal, plans and policies should be focused on women with low education levels and residents of rural areas, especially in the western mountain and far-western hill regions.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.163-171
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• 2017

Purpose: Although stereotactic ablative body radiotherapy (SABR) is widely used therapeutic technique, predictive factors of radiation pneumonitis (RP) after SABR remain undefined. We aimed to investigate the predictive factors affecting RP in patients with primary or metastatic lung tumors who received SABR. Materials and Methods: From 2012 to 2015, we reviewed 59 patients with 72 primary or metastatic lung tumors treated with SABR, and performed analyses of clinical and dosimetric variables related to symptomatic RP. SABR was delivered as 45-60 Gy in 3-4 fractions, which were over 100 Gy in BED when the ${\alpha}/{\beta}$ value was assumed to be 10. Tumor volume and other various dose volume factors were analyzed using median value as a cutoff value. RP was graded per the Common Terminology Criteria for Adverse Events v4.03. Results: At the median follow-up period of 11 months, symptomatic RP was observed in 13 lesions (12 patients, 18.1%), including grade 2 RP in 11 lesions and grade 3 in 2 lesions. Patients with planning target volume (PTV) of ${\leq}14.35mL$ had significantly lower rates of symptomatic RP when compared to others (8.6% vs. 27%; p = 0.048). Rates of symptomatic RP in patients with internal gross tumor volume (iGTV) >4.21 mL were higher than with ${\leq}4.21mL$ (29.7% vs. 6.1%; p = 0.017). Conclusions: The incidence of symptomatic RP following treatment with SABR was acceptable with grade 2 RP being observed in most patients. iGTV over 4.21 mL and PTV of over 14.35 mL were significant predictive factors related to symptomatic RP.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.1059-1063
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• 2012

Objective: Angiogenesis represents a key element in the pathogenesis of malignancy. There are no robust data on prognostic factors for overall survival (OS) in patients with metastatic colorectal cancer treated with vascular endothelial growth factor (VEGF)-targeted therapy. The present study was conducted to establish a prognostic model for patients using an oxaliplatin-based or irinotecan-based chemotherapy plus bevacizumab in metastatic colorectal cancer. Methods: Baseline characteristics and outcomes on 170 patients treated with FOLFIRI or XELOX plus anti-VEGF therapy-naive metastatic colorectal cancer were collected from three Turkey cancer centers. Cox proportional hazards regression was used to identify independent prognostic factors for OS. Results: The median OS for the whole cohort was 19 months (95% CI, 14.3 to 23.6 months). Three of the seven adverse prognostic factors according to the Anatolian Society of Medical Oncology (ASMO) were independent predictors of short survival: serum lactate dehydrogenase (LDH) greater than the upper limit of normal (ULN; p<0.001); neutrophils greater than the ULN (p<0.0014); and progression free survival (PFS) less than 6 months (p =0.001). Conclusion: Serum LDH and neutrophil levels were the main prognostic factors in predicting survival, followed by PFS. This model validates incorporation of components of the ASMO model into patient care and clinical trials that use VEGF-targeting agents.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.93-98
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• 2009

Objective: Although prophylactic antiepileptic drug (AED) use in patients with aneurysmal subarachnoid hemorrhage (SAH) is a common practice, lack of uniform definitions and guidelines for seizures and AEDs rendered this prescription more habitual instead of evidence-based manner. We herein evaluated the incidence and predictive factors of seizure and complications about AED use. Methods: From July 1999 to June 2007, data of a total of 547 patients with aneurysmal SAH who underwent operative treatments were reviewed. For these, the incidence and risk factors of seizures and epilepsy were assessed, in addition to complications of AEDs. Results: Eighty-three patients (15.2%) had at least one seizure following SAH. Forty-three patients (79%) had onset seizures, 34 (6.2%) had perioperative seizures, and 17 (3.1%) had late epilepsy. Younger age (< 40 years), poor clinical grade, thick hemorrhage, acute hydrocephalus, and rebleeding were related to the occurrence of onset seizures. Cortical infarction and thick hemorrhage were independent risk factors for the occurrence of late epilepsy. Onset seizures were not predictive of late epilepsy. Moreover, adverse drug effects were identified in 128 patients (23.4%) with AEDs. Conclusion: Perioperative seizures are not significant predictors for late epilepsy. Instead, initial amount of SAH and surgery-induced cortical damage should be seriously considered as risk factors for late epilepsy. Because AEDs can not prevent early postoperative seizures (< 1 week) and potentially cause unexpected side effects, long-term use should be readjusted in high-risk patients.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.172-181
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• 2022

Pubertal onset is known to result from reactivation of the hypothalamic-pituitary-gonadal (HPG) axis, which is controlled by complex interactions of genetic and nongenetic factors. Most cases of precocious puberty (PP) are diagnosed as central PP (CPP), defined as premature activation of the HPG axis. The cause of CPP in most girls is not identifiable and, thus, referred to as idiopathic CPP (ICPP), whereas boys are more likely to have an organic lesion in the brain. ICPP has a genetic background, as supported by studies showing that maternal age at menarche is associated with pubertal timing in their offspring. A gain of expression in the kisspeptin gene (KISS1), gain-of-function mutation in the kisspeptin receptor gene (KISS1R), loss-of-function mutation in makorin ring finger protein 3 (MKRN3), and loss-of-function mutations in the delta-like homolog 1 gene (DLK1) have been associated with ICPP. Other genes, such as gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1), lin-28 homolog B (LIN28B), neuropeptide Y (NPYR), tachykinin 3 (TAC3), and tachykinin receptor 3 (TACR3), have been implicated in the progression of ICPP, although their relationships require elucidation. Environmental and socioeconomic factors may also be correlated with ICPP. In the progression of CPP, epigenetic factors such as DNA methylation, histone posttranslational modifications, and non-coding ribonucleic acids may mediate the relationship between genetic and environmental factors. CPP is correlated with short- and long-term adverse health outcomes, which forms the rationale for research focusing on understanding its genetic and nongenetic factors.