• Title/Summary/Keyword: Benefit criteria

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Proof-of-concept study of the caninized anti-canine programmed death 1 antibody in dogs with advanced non-oral malignant melanoma solid tumors

  • Masaya Igase;Sakuya Inanaga;Shoma Nishibori;Kazuhito Itamoto;Hiroshi Sunahara;Yuki Nemoto;Kenji Tani;Hiro Horikirizono;Munekazu Nakaichi;Kenji Baba;Satoshi Kambayashi;Masaru Okuda;Yusuke Sakai;Masashi Sakurai;Masahiro Kato;Toshihiro Tsukui;Takuya Mizuno
    • Journal of Veterinary Science
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    • v.25 no.1
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    • pp.15.1-15.15
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    • 2024
  • Background: The anti-programmed death 1 (PD-1) antibody has led to durable clinical responses in a wide variety of human tumors. We have previously developed the caninized anti-canine PD-1 antibody (ca-4F12-E6) and evaluated its therapeutic properties in dogs with advance-staged oral malignant melanoma (OMM), however, their therapeutic effects on other types of canine tumors remain unclear. Objective: The present clinical study was carried out to evaluate the safety profile and clinical efficacy of ca-4F12-E6 in dogs with advanced solid tumors except for OMM. Methods: Thirty-eight dogs with non-OMM solid tumors were enrolled prospectively and treated with ca-4F12-E6 at 3 mg/kg every 2 weeks of each 10-week treatment cycle. Adverse events (AEs) and treatment efficacy were graded based on the criteria established by the Veterinary Cooperative Oncology Group. Results: One dog was withdrawn, and thirty-seven dogs were evaluated for the safety and efficacy of ca-4F12-E6. Treatment-related AEs of any grade occurred in 13 out of 37 cases (35.1%). Two dogs with sterile nodular panniculitis and one with myasthenia gravis and hypothyroidism were suspected of immune-related AEs. In 30 out of 37 dogs that had target tumor lesions, the overall response and clinical benefit rates were 6.9% and 27.6%, respectively. The median progression-free survival and overall survival time were 70 days and 215 days, respectively. Conclusions: The present study demonstrated that ca-4F12-E6 was well-tolerated in non-OMM dogs, with a small number of cases showing objective responses. This provides evidence supporting large-scale clinical trials of anti-PD-1 antibody therapy in dogs.

Medical Students Understanding of The Scope of Plastic Surgery

  • Mohammad K.H.B. Abdulaziz;Mohammad Al-Jamali;Sundus Al-Mazidi;Sarah Albuloushi;Ahmad B. Al-Ali
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.251-257
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    • 2024
  • Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p-values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.

A Study on the Hull-dimension of 89 ton class Stow-net Vessel with Stern-fishing (89톤급 선미식 안강망어선의 선형치수에 관한 연구)

  • Park, Je-Ung;Lee, Hyeon-Sang
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.3
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    • pp.159-165
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    • 1997
  • This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

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Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.78-86
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    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

Short-term Clinical Experience on Interferon gamma-1b Therapy for Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에서 Interferon gamma-1b 치료의 단기 임상경험)

  • Hwang, Jung Hye;Chung, Man Pyo;Kang, Eun Hae;Kim, Kyung Chan;Lee, Byoung-Hoon;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Lee, Kyung Soo;Han, Joungho;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.619-627
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    • 2004
  • Background : Corticosteroids in combination with cytotoxic drugs are the mainstays of therapy for idiopathic pulmonary fibrosis (IPF). However, there has been no regimen showing any survival benefit. The aim of this study was to describe a short-term clinical experience on interferon gamma-1b (IFN-${\gamma}1b$) therapy for IPF, as an antifibrotic agent. Methods : Medical records of 27 patients who were treated with IFN-${\gamma}1b$ (2 million IU, 3 times a week, subcutaneous injection) were retrospectively reviewed. Treatment response was assessed using ATS/ERS criteria in 17 patients who received IFN-${\gamma}1b$ for more than 6 months. In addition, we compared the efficacy of IFN-${\gamma}1b$ therapy with that of cyclophosphamide${\pm}$prednisolone therapy (n=26). Results : The median age of IFN-${\gamma}$ treated group (M:F=19:8) was 59 years (44-74 years). Compared to the patients who showed a stable response at 6 months (n=12), the deteriorated group (n=5) had worse baseline lung function (FVC, $55.4{\pm}11.3%$ vs. $70.7{\pm}10.9%$, p=0.019; DLco, $50.3{\pm}7.3%$ vs. $76.9{\pm}19.6%$, p=0.014). Lower baseline $PaO_2$ on room air breathing was observed in the deteriorated group ($68.6{\pm}7.8mmHg$ vs. $91.4{\pm}6.6mmHg$ p=0.001). Subcutaneous IFN-${\gamma}1b$ did not show better efficacy than prednisolone. Five patients discontinued IFN-${\gamma}$ because of severe side effects. ARDS developed in one patient, who eventually died. Conclusion : The administration of IFN-${\gamma}1b$ is not desirable for patients diagnosed with IPF with poor lung function. Long-term and large-scaled clinical studies are needed for its efficacy in IPF.

Improvement Plan to Facilitate a Landscape Architectural Promotion Facility and Complex System (조경진흥시설과 조경진흥단지 제도 활성화 방안 연구)

  • Kim, Yong-Gook;Kim, Shin-Sung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.1
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    • pp.9-16
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    • 2018
  • Landscape architecture is an indispensable professional service in building sustainable land and urban environments. The landscape architecture industry is closely related to the promotion of the health and welfare of the people, urban revitalization and residential environment improvement as well as job creation. Despite various public interest values of landscape architecture, the growth engine of the landscape architecture industry, which is supposed to improve the quality of landscape services, has stagnated. In 2015, the Landscape Architecture Promotion Act was enacted to provide a landscape architectural promotion facility and complex system to support revitalization through the integration of the landscape architecture industry. The purpose of this study is to suggest an improvement plan to enhance the effectiveness of the landscape architectural promotion facility and complex system. The results of the analysis are as follows: First, workers and experts in landscape architecture recognized the need for policies and projects to promote the landscape architecture industry. Second, the industrial types suitable for the landscape architectural promotion facility were landscape design, landscape maintenance and management, and landscape construction industry. Meanwhile the industrial types suitable for a landscape architectural promotion complex were landscape trees and landscape facilities production and distribution. Third, the expected effect of the designation of the landscape architectural facility was 'the increase of the business opportunity through the expansion of the network'. On the other hand, that of the landscape architectural promotion complex was 'the activation of various information sharing'. Fourth, 'the size of the local government landscape architecture industry and the capacity to cultivate' was the most important among the designation criteria of the landscape architectural promotion facility. As for that of the landscape architectural promotion complex, the 'feasibility of promotion plan' was the most crucial. Fifth, 'tax benefit and deductible exemption' was considered as a necessary support method for the activation of the landscape architectural promotion facility, and 'maintenance and management fee support' was recognized in the case of the landscape architectural promotion complex.

A Study of Establishing the Plan of Lodging for the Workers of Gaesung Industrial Complex (개성공단 근로자 기숙사 건립 계획 연구)

  • Choi, Sang-Hee;Kim, Doo-Hwan;Kim, Sang-Yeon;Choi, Eun-Hee
    • Land and Housing Review
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    • v.6 no.2
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    • pp.67-77
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    • 2015
  • Now that it is the current situation that the smooth supply and demand are necessary for 2nd phase of beginning construction and stable development of Gaesung Industrial Complex, this study was willing to offer the planning criteria and model to establish the lodging for the workers in Gaesung Industrial Complex based on the agreement that both South and North Korea agreed in 2007. Regarding the plan, its standard and the alternative were reviewed considering welfare of workers, economic efficiency, technical validity, possibility of agreement and long-term development. The exclusive area per capita was calculated through Labor Standards Act of Korea and status survey of lodging for the workers provided to border line area between China and North Korea and the economic alternative based on one room for 6 persons with the public restroom was compared with that of development type based on one room for 4 persons with indoor restroom. Especially regarding the proposed site, the area with the optimized position was set by considering gradient, accessibility and convenience of development out of the area of Dongchang-ri where was agreed already and the priority of the proposed site that can keep the existing building site and provide was offered. The necessary period for whole construction was set as approximately 36 months. Regarding construction method, RC Rahmen method was selected as the optimized alternative considering the workmanship of manpower of North Korea and conditions of supply and demand of materials and cluster-type vehicle allocation plan based on 4~6 units considering the efficiency of supplying service facilities and convenient facilities along the simultaneous accommodation of 15,000 people was offered. It was analyzed that total business expenses of approximately 80~100 billion Korean Won would required though there were the difference for each alternative in the charged rental way that the development business owner develops by lending the inter-Korea Cooperation Fund and withdraws the rent by the benefit principle. The possibility of withdrawing the rent was analyzed assuming that the period of withdrawing the investment is 30 years. Especially for the operation management after moving, the establishment of the committee of operating the lodging for the workers of Gaesung Industrial Complex (tentative name) was offered with the dualized governance that the constructor takes charge of operational management, collecting fees and management of infrastructure and human resource management is delegated to North Korea.

The Application of Operations Research to Librarianship : Some Research Directions (운영연구(OR)의 도서관응용 -그 몇가지 잠재적응용분야에 대하여-)

  • Choi Sung Jin
    • Journal of the Korean Society for Library and Information Science
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    • v.4
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    • pp.43-71
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    • 1975
  • Operations research has developed rapidly since its origins in World War II. Practitioners of O. R. have contributed to almost every aspect of government and business. More recently, a number of operations researchers have turned their attention to library and information systems, and the author believes that significant research has resulted. It is the purpose of this essay to introduce the library audience to some of these accomplishments, to present some of the author's hypotheses on the subject of library management to which he belives O. R. has great potential, and to suggest some future research directions. Some problem areas in librianship where O. R. may play a part have been discussed and are summarized below. (1) Library location. It is usually necessary to make balance between accessibility and cost In location problems. Many mathematical methods are available for identifying the optimal locations once the balance between these two criteria has been decided. The major difficulties lie in relating cost to size and in taking future change into account when discriminating possible solutions. (2) Planning new facilities. Standard approaches to using mathematical models for simple investment decisions are well established. If the problem is one of choosing the most economical way of achieving a certain objective, one may compare th althenatives by using one of the discounted cash flow techniques. In other situations it may be necessary to use of cost-benefit approach. (3) Allocating library resources. In order to allocate the resources to best advantage the librarian needs to know how the effectiveness of the services he offers depends on the way he puts his resources. The O. R. approach to the problems is to construct a model representing effectiveness as a mathematical function of levels of different inputs(e.g., numbers of people in different jobs, acquisitions of different types, physical resources). (4) Long term planning. Resource allocation problems are generally concerned with up to one and a half years ahead. The longer term certainly offers both greater freedom of action and greater uncertainty. Thus it is difficult to generalize about long term planning problems. In other fields, however, O. R. has made a significant contribution to long range planning and it is likely to have one to make in librarianship as well. (5) Public relations. It is generally accepted that actual and potential users are too ignorant both of the range of library services provided and of how to make use of them. How should services be brought to the attention of potential users? The answer seems to lie in obtaining empirical evidence by controlled experiments in which a group of libraries participated. (6) Acquisition policy. In comparing alternative policies for acquisition of materials one needs to know the implications of each service which depends on the stock. Second is the relative importance to be ascribed to each service for each class of user. By reducing the level of the first, formal models will allow the librarian to concentrate his attention upon the value judgements which will be necessary for the second. (7) Loan policy. The approach to choosing between loan policies is much the same as the previous approach. (8) Manpower planning. For large library systems one should consider constructing models which will permit the skills necessary in the future with predictions of the skills that will be available, so as to allow informed decisions. (9) Management information system for libraries. A great deal of data can be available in libraries as a by-product of all recording activities. It is particularly tempting when procedures are computerized to make summary statistics available as a management information system. The values of information to particular decisions that may have to be taken future is best assessed in terms of a model of the relevant problem. (10) Management gaming. One of the most common uses of a management game is as a means of developing staff's to take decisions. The value of such exercises depends upon the validity of the computerized model. If the model were sufficiently simple to take the form of a mathematical equation, decision-makers would probably able to learn adequately from a graph. More complex situations require simulation models. (11) Diagnostics tools. Libraries are sufficiently complex systems that it would be useful to have available simple means of telling whether performance could be regarded as satisfactory which, if it could not, would also provide pointers to what was wrong. (12) Data banks. It would appear to be worth considering establishing a bank for certain types of data. It certain items on questionnaires were to take a standard form, a greater pool of data would de available for various analysis. (13) Effectiveness measures. The meaning of a library performance measure is not readily interpreted. Each measure must itself be assessed in relation to the corresponding measures for earlier periods of time and a standard measure that may be a corresponding measure in another library, the 'norm', the 'best practice', or user expectations.

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The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

Balance of Power and the Relative Military Capacity - Empirical Analysis and Implication to North East Asia - (세력균형(power balance)에서의 군사력 수준과 동북아시아에 주는 함의)

  • Kim, Myung-soo
    • Strategy21
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    • s.38
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    • pp.112-162
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    • 2015
  • This study began to confirm or review the balance of power theory by applying scientific methods through experiential cases. Though there are several kinds of national power, this study supposes military power as a crucial power when it comes to war and peace. This research covered balance and imbalance through comparing relative military power between nations or nations' group. Comparison of relative military power can be achieved by statistically processing the values of which has been converted into the standard variables in same domain, then calculating the values of nation's power which has been synthesized different experiential factors. In addition, the criteria of experiential experiment is highly dedicated to European countries, USA, Japan prior to 1st and 2nd World War, as well as USA, Soviet Union and North East Asia during Cold War era. In addition, the balance of power theory has been redefined to review the action of the state upon the changes of power as mentioned in the theory. To begin with, the redefined theory states that relative level of military power between nations defines the consistency of peace and balance of power. If military power is enough to be on the range of level required to keep the power in equilibrium, peace and balance can be achieved. The opposite would unbalance the military power, causing conflicts. While the relative military level between nations change, nations seek to establish 'nations group' via military cooperation such as alliance, which also shift relative military power between nations group as well. Thus, in order to achieve balance of power, a nation seeks to strengthen its military power(self-help), while pursuing military cooperation(or alliance). This changes relative military power between nations group also. In other words, if there exists balance of power between nations, there is balance of power between nations group as well. In this theory, WWI and II broke out due to the imbalance of military force between nations and nations group, and reviewed that due to the balance of military force during the Cold War, peace was maintained. WWI was resulted from imbalance of military cooperation between two powerful states group and WWII was occurred because of the imbalance among the states. Peace was maintained from cooperation of military power and balance among the states during the Cold War. Imbalance among continental states is more threatening than maritime states and balance of power made by army force and naval force also is feasible. Also the outcomes of two variables are found military power balanced ratio of military power for balance is 67% when variable ratio of balance is 100% and standard value for balance is 0.86. Military power exists in a form of range. The range is what unstabilized the international system causing nations to supplement their military powers. These results made possible the calculation and comparison between state's military power. How balance of power inflicted war and peace has been studied through scientific reviews. Military conflict is highly possible upon already unbalanced military powers of North East Asian countries, if the US draws its power back to America. China and Japan are constantly building up their military force. On the other hand, Korean military force is inferior so in accordance to change of international situation state's survival could be threatened and it is difficult to achieve drastic increase in military force like Germany did. Especially constructing naval force demands lots of time; however but has benefit that naval force can overcome imbalance between continental states and maritime states.