• Yonsei Medical Journal
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• 제59권9호
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• pp.1115-1122
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• 2018

Purpose: To investigate biomechanical properties of the cornea using a dynamic Scheimpflug analyzer according to age. Materials and Methods: In this prospective, cross-sectional, observational study, participants underwent ophthalmic investigations including corneal biomechanical properties, keratometric values, intraocular pressure (IOP), and manifest refraction spherical equivalent (MRSE). We determined the relationship of biomechanical parameters and ocular/systemic variables (participant's age, MRSE, IOP, and mean keratometric values) by piecewise regression analysis, association of biomechanical parameters with variables by Spearman's correlation and stepwise multiple regression analyses, and reference intervals (RI) by the bootstrap method. Results: This study included 217 eyes of 118 participants (20-81 years of age). Piecewise regression analysis between Corvis-central corneal thickness (CCT) and participant's age revealed that the optimal cut-off value of age was 45 years. No clear breakpoints were detected between the corneal biomechanical parameters and MRSE, IOP, and mean keratometric values. Corneal velocity, deformation amplitude, radius, maximal concave power, Corvis-CCT, and Corvis-IOP exhibited correlations with IOP, regardless of age (all ages, 20-44 years, and over 44 years). With smaller deformation amplitude and corneal velocity as well as increased CorvisIOP and Corvis-CCT, IOP became significantly increased. We provided the results of determination of confidence interval from RI data using bootstrap method in three separate age groups (all ages, 20-44 years, and over 44 years). Conclusion: We demonstrated multiple corneal biomechanical parameters according to age, and reported that the corneal biomechanical parameters are influenced by IOP.

• 가정간호학회지
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• 제28권3호
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• pp.266-275
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• 2021

Purpose: This study was conducted to explore the mediating effect of menopausal symptoms in the relationship between occupational stress and quality of Life in middle-aged working women Method: Data collection was conducted from May 2019 to July 2019. A sample of 130 middle-aged working women was recruited from three cities in Korea. The collected data were analyzed using descriptive statistics, t-tset, ANOVA, Scheffé test, pearson correlation, and a three step regression analysis. The mediating effect was analyzed using PROCESS macro with a 95.0% bias corrected bootstrap confidence interval (5,000 bootstraps resampling). Results: Quality of life had a negative correlation with occupational stress and menopausal symptoms, while there was a positive correlation between occupational stress and menopausal symptoms. Menopausal symptoms showed a direct effect on quality of life through occupational stress as a mediating variable. Conclusion: These results suggest that menopausal symptoms should be considered when developing interventions to improve quality of life through occupational stress control of middle-aged working women

• 지역사회간호학회지
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• 제33권1호
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• pp.43-52
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• 2022

Purpose: This study was to investigate the mediating effects of health concern and depression on the stress and fatigue of COVID-19 self-quarantine. Methods: This was a cross-sectional study. A total of 227 people with COVID-19 self-quarantine experience were recruited during May 2021. Participants were invited to complete self-reported questionnaires that measure stress, health concern, depression, fatigue and demographic information. The data obtained were analyzed using multiple regression and dual mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results: This study analyzed the direct effects of COVID-19 stress on the health concern, depression and fatigue. And COVID-19 stress had indirect effects on their fatigue via health concern and depression. Both health concern and depression had dual mediating effects in the influence of COVID-19 stress on fatigue. In the relationship between COVID-19 stress and fatigue, the mediating effect of depression was significant. Conclusion: Fatigue due to prolonged COVID-19 can be alleviated by managing stress and mediating health concern and depression, and so therefore active nursing intervention is required.

• 경영과정보연구
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• 제35권4호
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• pp.141-153
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• 2016

본 연구는 Bootstrapped Malmquist 지수를 이용하여 국내 의약품산업의 생산성 변화 추이를 측정하고 이러한 변화를 기술효율성 변화와 기술변화 요인으로 분해함으로써 의약품산업의 생산효율성을 제고하기 위한 시사점을 제시하고자 한다. 특히 기존의 연구들과 달리 투입 및 산출요소의 여분을 반영하여 투입최소화와 산출최대화를 측정할 수 있는 투입산출지향 비방사적 Malmquist 지수를 분석에 활용한다. 또한 평활부트스트랩 방법을 적용하여 Malmquist 지수와 그 구성요인의 통계적 신뢰구간을 추정한다. 실증분석을 위해 2005년에서 2014년까지 10개년의 균형패널자료를 수집하였으며, 분석에 사용된 투입요소는 종사자수, 유형자산, 주요생산비를 선정하였고, 생산액을 산출요소로 사용하였다. 분석 결과, 의약품산업의 생산성은 분석기간 동안 하락한 것으로 나타났으며, 이러한 생산성 하락은 기술진보의 둔화에 기인한 것으로 나타났다. 또한 의약품산업의 기술적 효율성은 순수효율성보다는 규모효율성에 보다 많은 영향을 받은 것으로 분석되었다. 따라서 향후 의약품산업의 경쟁력 강화를 위해서는 효율적 R&D 투자와 산업구조의 선진화를 통해 기술혁신역량을 강화하는 정책적 지원이 요구된다.

• 한국임상수의학회지
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• 제24권4호
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• pp.509-513
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• 2007

혈청검사항목의 해석기준으로 사용하는 참고범위는 측정 장비와 병원마다 차이를 보이기 때문에 병원 간 정보를 교환하고 해석하는데 어려움이 많다. 또한 동일한 병원에서도 내원한 환자의 특성을 고려하여 참고범위를 재설정하는 것이 일반모집단의 특성을 제대로 반영한다. 본 연구에서는 강원대학교 수의학부대학 동물병원에서 설정한 혈청화학 검사 항목의 참고범위를 재평가하기 위하여 2005-2006년 동안 본원에 내원한 임상적으로 건강한 개 100두(1-8세, 체중 2.2-5.8 kg)의 혈청검사 일부 항목을 모수 및 비모수적 bootstrap 모의시험으로 분석하였다. 평가항목은 BUN(mg/dl), cholesterol(mg/dl), calcium(mg/dl), aspartate aminotransferase(AST, U/L), alanine aminotransferase(ALT, U/L), alkaline phosphatase(ALP, U/L) 및 total protein(g/dl)으로 Ektachem DT 60 분석기(Johnson & Johnson)로 측정하였다. 칼슘을 제외한 모든 항목이 왜곡이 매우 심한 분포를 보였으며 특히 혈청 효소항목의 outlier는 전체 자료의 5-9%, 기타 항목은 1-2%를 보였다. 각 항목의 분포에 상관없이 모수적 방법에 비하여 비모수적 방법으로 추정한 참고범위가 임상적으로 유용하였으며 추정된 참고범위는 BUN 14.7(7.0-24.2), cholesterol 227.3(120.7-480.8), calcium 10.9(8.1-12.5), AST 25.4(11.8-66.6), ALT 25.5(11.7-68.9), ALP 87.7(31.1-240.8), and total protein 6.8(5.6-8.2)로 나타났다. 이러한 결과는 모집단의 특성을 고려하여 참고범위를 재설정하는데 비모수적 모의시험이 매우 유용하며 특히 측정항목의 분포에 무관하게 사용할 수 있는 장점이 있는 것으로 사료된다.

• Korean Journal of Radiology
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• 제24권5호
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• pp.395-405
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• 2023

Objective: This study aimed to develop and validate models using radiomics features on a native T1 map from cardiac magnetic resonance (CMR) to predict left ventricular reverse remodeling (LVRR) in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Data from 274 patients with NIDCM who underwent CMR imaging with T1 mapping at Severance Hospital between April 2012 and December 2018 were retrospectively reviewed. Radiomic features were extracted from the native T1 maps. LVRR was determined using echocardiography performed ≥ 180 days after the CMR. The radiomics score was generated using the least absolute shrinkage and selection operator logistic regression models. Clinical, clinical + late gadolinium enhancement (LGE), clinical + radiomics, and clinical + LGE + radiomics models were built using a logistic regression method to predict LVRR. For internal validation of the result, bootstrap validation with 1000 resampling iterations was performed, and the optimism-corrected area under the receiver operating characteristic curve (AUC) with 95% confidence interval (CI) was computed. Model performance was compared using AUC with the DeLong test and bootstrap. Results: Among 274 patients, 123 (44.9%) were classified as LVRR-positive and 151 (55.1%) as LVRR-negative. The optimism-corrected AUC of the radiomics model in internal validation with bootstrapping was 0.753 (95% CI, 0.698-0.813). The clinical + radiomics model revealed a higher optimism-corrected AUC than that of the clinical + LGE model (0.794 vs. 0.716; difference, 0.078 [99% CI, 0.003-0.151]). The clinical + LGE + radiomics model significantly improved the prediction of LVRR compared with the clinical + LGE model (optimism-corrected AUC of 0.811 vs. 0.716; difference, 0.095 [99% CI, 0.022-0.139]). Conclusion: The radiomic characteristics extracted from a non-enhanced T1 map may improve the prediction of LVRR and offer added value over traditional LGE in patients with NIDCM. Additional external validation research is required.

• 대한간호학회지
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• 제51권4호
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• pp.489-504
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• 2021

Purpose: This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes. Methods: A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results: The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice. Conclusion: Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses' constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

• 대한간호학회지
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• 제52권5호
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• pp.511-521
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• 2022

Purpose: This study aimed to examine the moderating effect of organizational justice on the relationship between self-efficacy and nursing performance among clinical nurses. Methods: In January 2021, a cross-sectional survey was conducted with 224 clinical nurses recruited from a university-affiliated hospital in Suwon, South Korea. Participants completed online-based, self-report structured questionnaires. Collected data were analyzed using multiple regression and a simple model of PROCESS macro with a 95% bias-corrected bootstrap confidence interval. Results: Self-efficacy and organizational justice were found to be significant predictors of nursing performance. These two predictors explained the additional 34.8% variance of nursing performance in the hierarchical regression model, after adjusting the other covariates. In addition, organizational justice moderated the relationship between self-efficacy and nursing performance among the clinical nurses. In particular, at low self-efficacy level, participants with high organizational justice had higher nursing performance compared to those with low organizational justice. Conclusion: Enhancing organizational justice can be used as an organizational strategy for improving the organizational culture in terms of distribution, procedure, and interaction. Ultimately, these efforts will contribute to the improvement of nursing performance through a synergistic effect on organizational justice beyond nurses' individual competency and self-efficacy.

• 대한간호학회지
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• 제52권4호
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• pp.464-475
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• 2022

Purpose: This study aimed to identify the mediating effects of depression amid the influence of fear and social distancing arising from Coronavirus disease 2019 (COVID-19) in Korean women's suicidal ideation. Methods: A descriptive correlation study was conducted. Study participants, recruited by Hankook Research from March 2 to March 5, 2021, included 300 women aged 19 to 49 living in South Korea, and 100 people were randomly allocated and enlisted for each age group out of 700,000 Hankook Research Panels recruited in advance from 17 cities and provinces nationwide. Data were collected through a self-reported questionnaire and analyzed using Pearson's correlation coefficient and Hayes' Process Macro Model 4 with 95% bias-corrected bootstrap confidence interval via SPSS statistics 27.0. Results: Suicidal ideation was significantly correlated with fear of COVID-19 (r = .16, p = .006) and depression (r = .65, p < .001). The mediation effect of depression in the relationship between the fear of COVID-19 and suicidal ideation was found to be significant (B = 0.40, boot 95% CI: 0.21~0.61). However, social distancing did not significantly affect suicidal ideation via depression (B = - 0.79, boot 95% CI: - 1.94~0.26). Conclusion: It is necessary to develop and apply interventions to prevent depression and suicidal behaviors by continuously observing and reducing the negative psychological responses caused by COVID-19.