Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.
Nienke Miedema;Inger Sierevelt;Tjarco Dirk Willem Alta;Roderick Jan Maximiliaan Vossen;Arthur van Noort
Clinics in Shoulder and Elbow
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v.26
no.2
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pp.175-181
/
2023
Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.
Shazia Afrine;Jasmine Ara Haque;Md Shahed Morshed;Hurjahan Banu;Ahmed Hossain;Muhammad Abul Hasanat
Clinical and Experimental Reproductive Medicine
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v.50
no.3
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pp.200-205
/
2023
Objective: Polycystic ovary (PCO), a diagnostic component of polycystic ovary syndrome (PCOS), requires either an ovarian volume (OV) criterion or a follicle number per ovary (FNPO) criterion. This study investigated the association of OV and FNPO criteria with various manifestations of PCOS. Methods: This cross-sectional study was conducted at a university hospital among 100 patients newly diagnosed with PCOS (according to the revised Rotterdam criteria). Fasting blood samples were collected to measure glucose, total testosterone (TT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), lipid, insulin, and hemoglobin A1c levels. An oral glucose tolerance test was performed. Transabdominal or transvaginal ultrasound of the ovaries was done, depending on patients' marital status. All investigations were conducted in the follicular phase of the menstrual cycle. OV >10 mL and/or FNPO ≥12 indicated PCO. A homeostasis model assessment of insulin resistance (IR) value ≥2.6 indicated IR, and metabolic syndrome (MS) was defined according to the international harmonization criteria. Results: Seventy-six participants fulfilled the OV criterion, 70 fulfilled the FNPO criterion, and 89 overall had PCO. Both maximum OV and mean OV had a significant correlation with TT levels (r=0.239, p=0.017 and r=0.280, p=0.005, respectively) and the LH/FSH ratio (r=0.212, p=0.034 and r=0.200, p=0.047, respectively). Mean OV also had a significant correlation with fasting insulin levels (r=0.210, p=0.036). Multivariate binary logistic regression analysis showed that IR (odds ratio [OR], 9.429; 95% confidence interval [CI], 1.701 to 52.271; p=0.010) and MS (OR, 7.952; 95% CI, 1.821 to 34.731; p=0.006) had significant predictive associations with OV alone, even after adjustment for age and body mass index. Conclusion: OV may be more closely related to the androgenic and metabolic characteristics of PCOS than FNPO.
Ilteris Ahmet Senturk;Erman Senturk;Isil Ustun;Akin Gokcedag;Nilgun Pulur Yildirim;Nilufer Kale Icen
The Korean Journal of Pain
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v.36
no.1
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pp.84-97
/
2023
Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.
Objectives: The purpose of this study was to test the reliability and validity of an assessment tool for dental hygienists' consideration of patients with mild disabilities. Methods: Thirty-seven preliminary questions were compiled through literature review, and thirty-two questions were selected through content validity testing by eight experts. Two hundred and three dental hygienists completed the assessment tool as an online survey. The construct validity, internal consistency, and test-retest reliability of the tool were investigated using the SPSS 26.0 program. The construct validity was assessed using exploratory factor analysis. The internal consistency was assessed using Cronbach's alpha. The intraclass correlation coefficient (ICC) value with 95% confidence intervals was calculated for test-retest reliability. Results: Ten items and four factors were selected through exploratory factor analysis. The internal consistency reliability of the tool was found to be Cronbach's alpha=0.658, and test-retest reliability was found to be ICC=0.812. Conclusions: An assessment tool of care for patients with mild disabilities by dental hygienists is a reliable and valid tool suitable for the job characteristics of dental hygienists. It can be used in clinical practice and research.
Journal of the Korea Society of Computer and Information
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v.28
no.5
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pp.129-153
/
2023
This study was conducted in the context of the Covid-19 pandemic by analyzing a large amount of press report frames regarding the Covid-19 vaccine which is of great public interest, in order to explore the role and direction of trusted media as core elements of crisis communication. The study period lasted for eight months beginning in November 2020 when the development of the Covid-19 vaccine was in progress until June 2021. Set-up as research subjects were the Chosun Ilbo, Joongang Ilbo, Dong-A Ilbo and Hankyoreh according to their public confidence rankings and number of readers.The analysis method used structured topic Modeling (STM) and semantic network analysis. As a result, based on a clear cluster of word structures and a central analysis value, a total of 64 relevant frames, 16 for each news company, were gathered. In the third phase a comparative analysis of the four news companies was carried out to verify the organizational degree of the frames and substantial differences.
Chi-Yun Back;Dae-Sung Hyun;Sei-Jin Chang;Da-Yee Jeung
Safety and Health at Work
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v.14
no.1
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pp.71-77
/
2023
Background: This study investigated the relationship between trauma exposure and suicidal ideation. Moreover, this study examines the moderating roles of organizational climate on the association between trauma exposure and suicidal ideation in Korean male firefighters. Methods: A total of 15,104 male firefighters who completed a questionnaire were analyzed. The data were obtained using an online self-administered questionnaire from the Firefighter Research on Enhancement of Safety and Health Study. Poisson regression analysis was performed to determine the effects of trauma exposure on suicidal ideation and the moderating effect of organizational climate. Results: The results showed that 389 firefighters (2.6%) responded that they had experienced suicidal ideation. In the final model, trauma exposure was positively related to suicidal ideation (adjusted risk ratio [aRR], 1.076; 95% confidence interval [CI]: 1.051-1.103), and organizational climate was negatively associated with suicidal ideation (aRR, 0.772; 95% CI: 0.739-0.806). Additionally, the interaction term (trauma exposure × organizational climate) was related to suicidal ideation (aRR, 1.016; 95% CI: 1.009-1.023). Conclusions: This study suggests that trauma exposure might play a significant role in developing suicidal ideation and that positive organizational climate moderates the negative effects of trauma exposure on suicidal ideation among firefighters. It is necessary to perform a follow-up study of various intervention strategies to maintain a healthy organizational climate or work environment. Such interventions should promote lasting trust within teams, provide social support and belonging, and nurture job value.
Park, Ji-Hoon;Kim, Hye-Ryung;Chae, Ha-Kyung;Park, Jonghyun;Jeon, Bo-Young;Lyoo, Young S.;Park, Choi-Kyu
Korean Journal of Veterinary Service
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v.45
no.1
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pp.19-30
/
2022
In this study, a simple loop-mediated isothermal amplification (LAMP) combined with visual detection method (vLAMP) assay was developed for the rapid and specific detection of African swine fever virus (ASFV), overcoming the shortcomings of previously described LAMP assays that require additional detection steps or pose a cross-contamination risk. The assay results can be directly detected by the naked eye using hydroxynaphthol blue after incubation for 40 min at 62℃. The assay specifically amplified ASFV DNA and no other viral nucleic acids. The limit of detection of the assay was <50 DNA copies/reaction, which was ten times more sensitive than conventional polymerase chain reaction (cPCR) and comparable to real-time PCR (qPCR). For clinical evaluation, the ASFV detection rate of vLAMP was higher than cPCR and comparable to OIE-recommended qPCR, showing 100% concordance, with a κ value (95% confidence interval) of 1 (1.00~1.00). Considering the advantages of high sensitivity and specificity, no possibility for cross-contamination, and being able to be used as low-cost equipment, the developed vLAMP assay will be a valuable tool for detecting ASFV from clinical samples, even in resource-limited laboratories.
Hanna Jung;Yoonjung Lee;Jung Yeon Kim;Minjin Lee;Soo Young Han;Yumie Rhee;Shinki An;Phill Ja Kim
Korean Medical Education Review
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v.25
no.2
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pp.159-173
/
2023
The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master's degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2-12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients' needs by improving the competency of new nurses and lowering the turnover rate.
Purpose: Gastro esophageal reflux disease (GERD) is a burdensome disease affecting many children. A clinical examination is reported to be unreliable to diagnose GERD in children. This study aimed to investigate the relationship between the Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire (PGSQ) and endoscopic and histopathological findings in children with symptoms suggesting GERD. Changes in the PGSQ score in children with esophagitis as response to one month therapy were recorded as secondary outcome. Methods: This is a prospective cohort study in the pediatric outpatient clinic in an Indonesian tertiary hospital. Children aged 2-17 years old with clinical symptoms suspected of GERD are included in the study. Blinded endoscopic and histopathological examination was performed in all patients before one month proton pump inhibitors (PPI) therapy. The PGSQ information was collected at inclusion and after one month PPI treatment. Results: Fifty-eight subjects were included. Esophagitis was found in 60.9% of subjects according to endoscopy and 58.6% according to histology. There was no significant relationship between the PGSQ score and endoscopic (p=0.781) nor biopsy (p=0.740) examinations. The PGSQ showed a low diagnostic value compared to endoscopy and biopsy (area under the curve [AUC] 0.477, p=0.477, 95% confidence interval [CI] 0.326-0.629 and AUC 0.474, p=0.740 (95% CI 0.321-0.627 respectively). The PGSQ improved significantly post one month of PPI treatment. Conclusion: The PGSQ cannot be used to diagnose esophagitis in children with clinical symptoms suggesting GERD. However, the PGSQ can be used to monitor the treatment response in children with esophagitis.
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