• Radiation Oncology Journal
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• v.36 no.4
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• pp.276-284
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• 2018

Purpose: Traditionally, three-dimensional conformal radiation therapy (3D-CRT) is used for neoadjuvant chemoradiation in locally advanced rectal cancer. Intensity-modulated radiation therapy (IMRT) was later developed for more conformal dose distribution, with the potential for reduced toxicity across many disease sites. We sought to use the National Cancer Database (NCDB) to examine trends and predictors for IMRT use in rectal cancer. Materials and Methods: We queried the NCDB from 2004 to 2015 for patients with rectal adenocarcinoma treated with neoadjuvant concurrent chemoradiation to standard doses followed by surgical resection. Odds ratios were used to determine predictors of IMRT use. Univariable and multivariable Cox regressions were used to determine potential predictors of overall survival (OS). Propensity matching was used to account for any indication bias. Results: Among 21,490 eligible patients, 3,131 were treated with IMRT. IMRT use increased from 1% in 2004 to 22% in 2014. Predictors for IMRT use included increased N stage, higher comorbidity score, more recent year, treatment at an academic facility, increased income, and higher educational level. On propensity-adjusted, multivariable analysis, male gender, increased distance to facility, higher comorbidity score, IMRT technique, government insurance, African-American race, and non-metro location were predictive of worse OS. Of note, the complete response rate at time of surgery was 28% with non-IMRT and 21% with IMRT. Conclusion: IMRT use has steadily increased in the treatment of rectal cancer, but still remains only a fraction of overall treatment technique, more often reserved for higher disease burden.

• Research in Community and Public Health Nursing
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• v.7 no.1
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• pp.170-177
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• 1996

신체의 활력을 측정하는 혈압은 다른 어느 측정치보다 변동이 심하고 정상적으로 변할 수 있는 생리적 현상이어서 정확하게 측정하기란 쉽지 않다. 1mmHg 차이의 혈압일지라도, 특히 큰 집단일 경우, 연구목적에서 그 결과를 크게 왜곡 시킬 수 있다. (Wright & dore, 1970). 혈압 측정에는 직접적 방법과 간접적 방법이 있다. 이 중 간접적 방법은 임상분야와 연구분야에서 실제로 넓게 사용되고 있을 분만 아니라 신체로의 직접적 침투하는 방법도 아니고 가격 또한 비싸지 않다. 그러나, 간접적 측정 방법은 혈압에 영향을 끼치는 많은 요인들인 관찰자 편견, 확장기음의 청취음 선택, 관찰자와 환자 사이의 상호관계 때문에 방법론적으로 문제제기가 되기도 한다. 이런 요인을 최소화하기 위하여 가장 타당도가 높은 측정도구의 선택이 필요하다. 도시지역의(Ease Baltimore) 고혈압을 가진 젊은 흑인 남성(연령별/성별/종속별/거주지역) 중 수축기 혈압이 140mmHg 이고 확장기 혈압이 90mmHg인 사람, 또는 확장기 혈압이 90mmHg인 사람, 또는 혈압하강제를 먹고 있는 사람 200명을 대상으로 훈련받은 community health worker(CHW)에 의해 Random-Zero Sphygmdmanometer(RZS)와 Digit Automatic Device(DAD)로 혈압을 측정하게 하였다. 이 중 36명을 무작위 추출하여 regular Mercury Sphygmdmanometer (RMS)로 혈압을 측정하게 했다. Bland 와 Altman에 의해 제기된 두측정값의 차이에 대한 scattergram(일치도 검증법)과 AAMI(Association for the Advancement of Medical Instrument) 기준, BHS 기준, Central Tendency와 숫자선호도로 검증되었다. AAMI와 BHS 기준에 의하면 확장기 혈압에서 RZS와 DAD의 일치도와 평균을 중심으로 더 넓게 퍼져있어 낮은 일치도를 보였으며 또 DAD와 RMS의 혈압치는 숫자 선호도를 볼 수 있는데 특히 RMS는 더 뚜렷하게 나타났는데 확장기 혈압의 최빈치(30.6)는 100mmHg이었다. 혈압치들이 가장 가까이 "0"점으로 치우쳐져 있었다. RZS의 Central tendency는 DAD와 RMS보다 뚜렷하였다. 결론적으로 RZS는 이 연구목적으로 가장 적절함을 보여준다.

• Nutrition Research and Practice
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• v.7 no.4
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• pp.315-325
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• 2013

We evaluated folate status of child-bearing age women diagnosed with abnormal pap smear in the US post-folic acid (FA) fortification era and assessed the determinants of NTD-protective and supra-physiologic (SP) concentrations of folate. The distribution of 843 women according to NTD-protective concentrations of RBC folate, plasma folate and SP concentrations of plasma folate were tested in relation to demographic and life-style factors. Logistic regression models specified NTD-protective concentrations of RBC and plasma folate or SP concentrations of plasma folate as dependent variables and demographic and life-style factors as independent predictors of interest. More than 82% reached NTD-protective concentrations of RBC and plasma folate and ~30% reached SP concentrations of plasma folate. FA supplement use was associated with having SP concentrations of plasma folate rather than NTD-protective concentrations of folate. African American (AA) women and smokers were significantly less likely to achieve NTD-protective concentrations of RBC and plasma folate. A large majority of women reached NTD-protective concentrations of folate with the current level of FA fortification without using supplementary FA. Therefore, the remaining disparities in AA women and in smokers should be addressed by targeted individual improvements in folate intake.

• Safety and Health at Work
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• v.7 no.2
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• pp.97-101
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• 2016

Background: Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the "stand your ground laws to promote worker protection." This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. Methods: A structure questionnaire was used to collect data for the study. Three facilities were sampled and 80 nurses and certified nursing assistants participated in the study. Ninety-two percent (n = 74) were female and 8% (n = 6) were male. Approximately 62% were black or African American, approximately 33% were Caucasians, and only 2% were from other ethnicities. Results: We found that 65% of the participants had experienced WPV while 41% believed that management shows little or no concern for their safety. Approximately 23% of respondents believed that reporting supervisor's WPV act is an unsafe action. In addition, 22% of those who reported that they have experienced WPV believed that the work environment is not safe to perform their duties. This significant difference in perception of workplace safety between those who had experienced WPV and those who had not was significant (t = 3.95, df = 158, p < 0.0001). Conclusion: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.

• Clinical and Experimental Pediatrics
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• v.64 no.11
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• pp.575-581
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• 2021

Background: Toxocariasis is a zoonotic parasitic disease caused by Toxocara canis and Toxocara cati in humans. Various types of T. canis are important. Purpose: The current study aimed to investigate the prevalence of Toxocara spp. in pediatrics in the context of a systematic review and meta-analysis. Methods: The MEDLINE (PubMed), Web of Sciences, Embase, Google Scholar, Scopus, and Cumulative Index of Nursing and Allied Health databases were searched to identify peer-reviewed studies published between January 2000 and December 2019 that report the prevalence of Toxocara spp. in pediatrics. The evaluation of articles based on the inclusion and exclusion criteria was performed by 2 researchers individually. Results: The results of 31 relevant studies indicated that the prevalence of Toxocara spp. was 3%-79% in 10,676 cases. The pooled estimate of global prevalence of Toxocara spp. in pediatrics was 30 (95% confidence interval, 22%-37%; I²=99.11%; P=0.00). The prevalence was higher in Asian populations than in European, American, and African populations. Conclusion: Health policymakers should be more attentive to future research and approaches to Toxocara spp. and other zoonotic diseases to improve culture and identify socioeconomically important factors.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2019.04a
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• pp.63-63
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• 2019

Tea plant (Camellia sinensis (L.) O. Kuntze) has been cultivated widely in many developing Asian, African, and South American countries, where it is the most widely consumed beverage in the world next to water. It has critical importance to understand the genetic diversity and population sturcutre for effective collection, conservation, and utilization of tea germplasm. In this study, 410 tea accessions collected from South Korea were analyzed using 21 SSR markers. Among 410 tea accessions, 85.4% (310 accessions) accessions were collected from Jeollanam-do. A total of 286 alleles were observed, and the genetic diversity and evenness were estimated to be averagely 0.79 and 0.61, respectively, across all the tested samples. Using discriminant analysis of principal components, the four clusters were detected in 410 tea accessions. Among them, cluster 1 showed higher frequency of rare alleles (less than 1%) than other clusters. Using calculation of the index of association and rbaD value, each cluster showed a clonal mode of reproduction. The result of AMOVA showed that most of the variation observed was within populations (99%) rather than among populations (1%). Our results might contribute to provide data about genetic diversity for the conservation of tea germplasm and for future breeding programs.

• Korean Journal of Exercise Nutrition
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• v.25 no.4
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• pp.24-37
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• 2021

[Purpose] To determine whether physical activity (PA), primarily the recommended 60 minutes of moderate-to-vigorous PA, is associated with gut bacterial microbiota in 10-year-old children. [Methods] The Block Physical Activity Screener, which provides minutes/day PA variables, was used to determine whether the child met the PA recommendations. 16S rRNA sequencing was performed on stool samples from the children to profile the composition of their gut bacterial microbiota. Differences in alpha diversity metrics (richness, Pielou's evenness, and Faith's phylogenetic diversity) by PA were determined using linear regression, whereas beta diversity (unweighted and weighted UniFrac) relationships were assessed using PERMANOVA. Taxon relative abundance differentials were determined using DESeq2. [Results] The analytic sample included 321 children with both PA and 16S rRNA sequencing data (mean age [SD] =10.2 [0.8] years; 54.2% male; 62.9% African American), where 189 (58.9%) met the PA recommendations. After adjusting for covariates, meeting the PA recommendations as well as minutes/day PA variables were not significantly associated with gut richness, evenness, or diversity (p ≥ 0.19). However, meeting the PA recommendations (weighted UniFrac R² = 0.014, p = 0.001) was significantly associated with distinct gut bacterial composition. These compositional differences were partly characterized by increased abundance of Megamonas and Anaerovorax as well as specific Christensenellaceae_R-7_group taxa in children with higher PA. [Conclusion] Children who met the recommendations of PA had altered gut microbiota compositions. Whether this translates to a reduced risk of obesity or associated metabolic diseases is still unclear.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.61-73
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• 2023

Objectives: Prophylactic vaccines against high-risk human papillomaviruses (HR-HPVs) hold promise to prevent the development of higher grade cervical intraepithelial neoplasia (CIN 2+) and cervical cancer (CC) that develop due to HR-HPV genotypes that are included in HPV vaccines, but women will continue to develop CIN 2+ and CC due to HR-HPV genotypes that are not included in the quadrivalent HPV vaccine (qHPV) and 9-valent HPV vaccine (9VHPV). Thus, the current vaccines are likely to decrease but not entirely prevent the development of CIN 2+ or CC. The purpose of the study was to determine the prevalence and determinants of CIN 2+ that develop due to HR-HPVs not included in vaccines. Methods: Study population consisted of 1476 women tested for 37 HPVs and known to be negative for qHPVs (6/11/16/18, group A, n = 811) or 9VHPVs (6/11/16/18/31/33/45/52/58, group B, n = 331), but positive for other HR-HPVs. Regression models were used to determine the association between plasma concentrations of micronutrients, socio-demographic, lifestyle factors and risk of CIN 2+ due to HR-HPVs that are not included in vaccines. Results: The prevalence of infections with HPV 31, 33, 35 and 58 that contributed to CIN 2+ differed by race. In group A, African American (AA) women and current smokers were more likely to have CIN 2 (OR = 1.76, P = 0.032 and 1.79, P = 0.016, respectively) while in both groups of A and B, those with higher vitamin B12 were less likely to have similar lesions (OR = 0.62, P = 0.036 and 0.45, P = 0.035, respectively). Conclusions: We identified vitamin B12 status and smoking as independent modifiable factors and ethnicity as a factor that needs attention to reduce the risk of developing CIN 2+ in the post vaccination era. Continuation of tailored screening programs combined with non-vaccine-based approaches are needed to manage the residual risk of developing HPV-related CIN 2+ and CC in vaccinated women.

• Journal of English Language & Literature
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• v.55 no.5
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• pp.907-936
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• 2009

Quite arguably, W. E. B. Du Bois is the first figure in the history of black nationalism who engaged most persistently and systematically with the dominant ideology of racism and white supremacy. It is not too much to say that, by contending with the Eurocentric but taken-for-granted concept of the 'Negro' in the turn of the century, Du bois has laid the theoretical and ideological cornerstone of postcolonialism today. But his concept of race varied over time and was even contradictory in the same writings. The early Du Bois defined race as something historically made rather than biologically given and determined. Yet he didn't utterly deny the significance of physical traits and skin color in constructing racial identity. His notion of the 'Negro' was not unambiguous, either. While drawing on the 'soul' of 'black folk' to undermine the Eurocentric dichotomy of white/mind and black/body, Du Bois argued that there is some kind of 'spiritual' differences between whites and blacks, differences that are essentially inherent and hereditary in the 'Negro.' Such essentialist notion of race and the 'Negro' was on the wane in the later Du Bois, especially after his encounter with Marxism. He came to think of race merely as a discourse of racism that can be subverted and even appropriated for anti-racist practices. Following the Marxist assumption that 'the color line' is a class conflict on the international level, Du Bois contended that the 'Negro' is an outcome of slavery which is in turn a subsystem of Western capitalism. He also argued that, since the 'Negro' is not a biological essence but a sociocultural formation, the identity of the 'Negro' can and must be reconstructed according to historical change. For Du Bois, therefore, the resistance against colonialism and capitalism became a resistance against racism. This is why his Pan-African movement shifted its gear from the American program in the initial phase to a truly 'Afrocentric' and socialist one.

• Journal of English Language & Literature
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• v.58 no.1
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• pp.21-42
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• 2012

Gloria Naylor's second novel Linden Hills (1985) explores the issues of self-exploration, empowerment, history, and memory by delineating the communal and familial tragedies and the distortion of values prevalent in a prosperous African-American urban community called Linden Hills. Drawing upon the Freud's concept of "primal scene" and "family romance," this paper aims to focus upon the Nedeed family, the founder of Linden Hills, and investigate the compelling traumatogenic force within the family, which is inseparably intertwined with the inversion of values and moral corruption permeating the entire community. The "primal crime" committed by the Nedeed ancestors serves to preserve and perpetuate a tyrannical rule by ruthless patriarchs who reign by underhanded strategies of purposefully neglecting and abusing others, including their own wives. The imprisonment, by Luther Nedeed, of his wife Willa in the family morgue epitomizes the long legacy running in the family-the oppression and burial of the pre-Oedipal, maternal history. Willa's accidental encounter, at the nadir of the family estate and her personal despair, with the faded records of the forgotten and abused Nedeed women exposes the violence-ridden ground of the family's primal scene and the absurdity of family romance the Nedeeds pursued. As the several lines of poem composed by Willie, Willa's male double, show, the hidden, forgotten history of the Nedeed women, in a sense, is the real, which cannot be assimilated to the social symbolic governed by the inhumane patriarchy of the Nedeed family and the success-oriented Linden Hills society. By portraying a catastrophic downfall of the Nedeed family and the futile outcome of its family romance, the ending of Linden Hills conveys implicitly that the contingent symbolic order and its oppressive control, however solid and invincible they may seem, can be toppled down by the real, its nameless forgotten Other.