• Title/Summary/Keyword: Data Heterogeneity

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Comparative Analysis of COVID-19 Infection Prevention Control Guidelines from Seven Countries: Implications on COVID-19 Response and Future Guidelines Development

  • Jeong, Yoolwon;Lee, Sun-Hee
    • Health Policy and Management
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    • v.32 no.3
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    • pp.304-316
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    • 2022
  • Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

Effects of Electrical Stimulation on Patients with Non-Specific Low Back Pain : A Meta-Analysis of Domestic Database (비특이적 만성 허리통증 환자에 대한 전기자극의 효과 : 국내 데이터베이스의 메타분석)

  • Lee, Jeong-Woo;Cho, Sung-Hyoun
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.37-52
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    • 2022
  • Purpose : The purpose of this meta-analysis was to evaluate the effects of electrical stimulation on patients with non-specific low back pain. Methods : Domestic databases were gathered from studies that conducted clinical trials associated with electrical stimulation and its impact on pain of non-specific low back patients. A total of 681 studies were identified, with 12 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, outcome, and study design (PICO-SD). The search outcomes were items associated with low back pain. Cochrane risk of bias 2 (RoB 2) was used to evaluate the quality of 12 randomized controlled trials. Effect sizes (Hedges's g) in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were conducted to analyze the effect according to the sample size and the consistency of the effect size. Results : The following factors had a large overall effect size (Hedges's g=1.28, 95 % CI=.20~2.36) involving electrical stimulation on non-specific low back pain. The subgroup analysis all showed a statistical difference in the types of study design, electrical stimulation, and assessment tool. No statistically significant difference was found in the meta-regression analysis. Publican bias was found in the data. Conclusion : The findings in this study indicate that electrical stimulation interventions have a positive effect on patients with non-specific low back pain. However, due to the low quality of studies and publication bias, the results of our study should be interpreted cautiously.

Add-on Effect of Herbal Bath Combined with Acitretin Treatment in Patients with Psoriasis : Systemic Review and Meta-analysis (건선 환자에서 아시트레틴 치료에 추가한 한방 약욕 효과 : 체계적 문헌 고찰과 메타 분석)

  • Seoyeon Jun;Soojin Park;Jieun Lee;Kyuseok Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.3
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    • pp.74-98
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    • 2023
  • Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I2 =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I2 =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I2 =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

An Analysis of Non-linear Relationship between Local Government Size and Regional Economic Growth: Armey Curve Verification Using AMG Estimation Method (지방정부규모와 지역경제성장 간 비선형관계 분석: AMG 추정법을 이용한 Armey Curve 검증)

  • So-youn Kim;Suyeol Ryu
    • Journal of the Economic Geographical Society of Korea
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    • v.25 no.4
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    • pp.629-640
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    • 2022
  • This study analyzed the relationship between local government size and regional economic growth using regional data from 2002 to 2020. By dividing local government expenditure into social development expenditure and economic development expenditure, economic growth and the inverted U-shaped Armey curve were verified, and the optimal size of local government expenditure was examined. In particular, the AMG estimation method considering the cross-sectional dependence and regional heterogeneity existing in the panel data was utilized. As a result of the analysis, it was found that there was an inverted U-shaped relationship between local fiscal expenditure and regional economic growth. When the proportion of total local fiscal expenditure is 7.63% of GRDP and social development expenditure is 3.45%, it is found that the optimal size of expenditure can maximize the regional economic growth rate. Local governments should increase the effectiveness of public expenditure policies by considering these points.

Prevalence of Senecavirus A in pigs from 2014 to 2020: a global systematic review and meta-analysis

  • Xuhua Ran;Zhenru Hu;Jun Wang ;Zhiyuan Yang ;Zhongle Li ;Xiaobo Wen
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.48.1-48.13
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    • 2023
  • Background: Senecavirus A (SVA), a member of the family Picornaviridae, is newly discovered, which causes vesicular lesions, lameness in swine, and even death in neonatal piglets. SVA has rapidly spread worldwide in recent years, especially in Asia. Objectives: We conducted a global meta-analysis and systematic review to determine the status of SVA infection in pigs. Methods: Through PubMed, VIP Chinese Journals Database, China National Knowledge Infrastructure, and Wanfang Data search data from 2014 to July 26, 2020, a total of 34 articles were included in this analysis based on our inclusion criteria. We estimated the pooled prevalence of SVA in pigs by the random effects model. A risk of bias assessment of the studies and subgroup analysis to explain heterogeneity was undertaken. Results: We estimated the SVA prevalence to be 15.90% (1,564/9,839; 95% confidence interval [CI], 44.75-65.89) globally. The prevalence decreased to 11.06% (945/8,542; 95% CI, 28.25-50.64) after 2016. The highest SVA prevalence with the VP1-based RT-PCR and immunohistochemistry assay was 58.52% (594/1,015; 95% CI, 59.90-83.96) and 85.54% (71/83; 95% CI, 76.68-100.00), respectively. Besides, the SVA prevalence in piglet herds was the highest at 71.69% (119/166; 95% CI, 68.61-98.43) (p < 0.05). Moreover, our analysis confirmed that the subgroups, including country, sampling year, sampling position, detected gene, detection method, season, age, and climate, could be the heterogeneous factors associated with SVA prevalence. Conclusions: The results indicated that SVA widely exists in various countries currently. Therefore, more prevention and control policies should be proposed to enhance the management of pig farms and improve breeding conditions and the environment to reduce the spread of SVA.

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

  • Byung-Ho Yoon;Seong Gyun Park;Young Hak Roh
    • Hip & pelvis
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    • v.35 no.4
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    • pp.217-227
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    • 2023
  • Purpose: Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods: We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results: The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P=0.542), nonunion (OR=0.49; CI 0.22-1.10, P=0.085) and deep infection (OR=1.89, CI 0.48-7.46, P=0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P=0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P=0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P=0.130). Conclusion: ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.

Verification of Radiation Therapy Planning Dose Based on Electron Density Correction of CT Number: XiO Experiments (컴퓨터영상의 전자밀도보정에 근거한 치료선량확인: XiO 실험)

  • Choi Tae-Jin;Kim Jin-Hee;Kim Ok-Bae
    • Progress in Medical Physics
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    • v.17 no.2
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    • pp.105-113
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    • 2006
  • This study peformed to confirm the corrected dose In different electron density materials using the superposition/FFT convolution method in radiotherapy Planning system. The experiments of the $K_2HPO_4$ diluted solution for bone substitute, Cork for lung and n-Glucose for soft tissue are very close to effective atomic number of tissue materials. The image data acquisited from the 110 KVp and 130 KVp CT scanner (Siemes, Singo emotions). The electron density was derived from the CT number (H) and adapted to planning system (Xio, CMS) for heterogeneity correction. The heterogeneity tissue phantom used for measurement dose comparison to that of delivered computer planning system. In the results, this investigations showed the CT number is highly affected in photoelectric effect in high Z materials. The electron density in a given energy spectrum showed the relation of first order as a function of H in soft tissue and bone materials, respectively. In our experiments, the ratio of electron density as a function of H was obtained the 0.001026H+1.00 in soft tissue and 0.000304H+1.07 for bone at 130 KVp spectrum and showed 0.000274H+1.10 for bone tissue in low 110 KVp. This experiments of electron density calibrations from CT number used to decide depth and length of photon transportation. The Computed superposition and FFT convolution dose showed very close to measurements within 1.0% discrepancy in homogeneous phantom for 6 and 15 MV X rays, but it showed -5.0% large discrepancy in FFT convolution for bone tissue correction of 6 MV X rays. In this experiments, the evaluated doses showed acceptable discrepancy within -1.2% of average for lung and -2.9% for bone equivalent materials with superposition method in 6 MV X rays. However the FFT convolution method showed more a large discrepancy than superposition in the low electron density medium in 6 and 15 MV X rays. As the CT number depends on energy spectrum of X rays, it should be confirm gradient of function of CT number-electron density regularly.

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An Empirical Study on the Spatial Effect of Distribution Patterns between Small Business and Social-environmental factors (소상공인 점포의 분포와 환경요인의 공간적 영향관계에 관한 실증연구)

  • YOO, Mu-Sang;CHOI, Don-Jeong
    • Journal of the Korean Association of Geographic Information Studies
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    • v.22 no.1
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    • pp.1-18
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    • 2019
  • This research measured and visualized the spatial dependency and the spatial heterogeneity of the small business in Cheonan-si, Asan-si with $100m{\times}100m$ grids based on global and local spatial autocorrelation. First, we confirmed positive spatial autocorrelation of small business in the research area using Moran's I Index, which is ESDA(Exploratory Spatial Data Analysis). And then, through Getis-Ord $GI{\ast}$, one kind of LISA(Local Indicators of Spatial Association), local patterns of spatial autocorrelation were visualized. These verified that Spatial Regression Model is valid for the location factor analysis on small business commercial buildings. Next, GWR(Geographically Weighted Regression) was used to analyze the spatial relations between the distribution of small business, hourly mobile traffic-based floating population, land use attributes index, residence, commercial building, road networks, and the node of traffic networks. Final six variables were applied and the accessibility to bus stops, afternoon time floating population, and evening time floating population were excluded due to multicollinearity. By this, we demonstrated that GWR is statistically improved compared to OLS. We visualized the spatial influence of the individual variables using the regression coefficients and local coefficients of determinant of the six variables. This research applied the measured population information in a practical way. Reflecting the dynamic information of the urban people using the commercial area. It is different from other studies that performed commercial analysis. Finally, this research has a differentiated advantage over the existing commercial area analysis in that it employed hourly changing commercial service population data and it applied spatial statistical models to micro spatial units. This research proposed new framework for the commercial analysis area analysis.

Environmental Equity Analysis of Fine Dust in Daegu Using MGWR and KT Sensor Data (다중 스케일 지리가중회귀 모형과 KT 측정기 자료를 활용한 대구시 미세먼지에 대한 환경적 형평성 분석)

  • Euna CHO;Byong-Woon JUN
    • Journal of the Korean Association of Geographic Information Studies
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    • v.26 no.4
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    • pp.218-236
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    • 2023
  • This study attempted to analyze the environmental equity of fine dust(PM10) in Daegu using MGWR(Multi-scale Geographically Weighted Regression) and KT(Korea Telecom Corporation) sensor data. Existing national monitoring network data for measuring fine dust are collected at a small number of ground-based stations that are sparsely distributed in a large area. To complement these drawbacks, KT sensor data with a large number of IoT(Internet of Things) stations densely distributed were used in this study. The MGWR model was used to deal with spatial heterogeneity and multi-scale contextual effects in the spatial relationships between fine dust concentration and socioeconomic variables. Results indicate that there existed an environmental inequity by land value and foreigner ratio in the spatial distribution of fine dust in Daegu metropolitan city. Also, the MGWR model showed better the explanatory power than Ordinary Least Square(OLS) and Geographically Weighted Regression(GWR) models in explaining the spatial relationships between the concentration of fine dust and socioeconomic variables. This study demonstrated the potential of KT sensor data as a supplement to the existing national monitoring network data for measuring fine dust.

Dose-Response Relationship of Avian Influenza Virus Based on Feeding Trials in Humans and Chickens (조류인플루엔자 바이러스의 양-반응 모형)

  • Pak, Son-Il;Lee, Jae-Yong;Jeon, Jong-Min
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.101-107
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    • 2011
  • This study aimed to determine dose-response (DR) curve of avian influenza (AI) virus to predict the probability of illness or adverse health effects that may result from exposure to a pathogenic microorganism in a quantitative microbial risk assessment. To determine the parametric DR relationship of several strains of AI virus, 7 feeding trial data sets challenging humans (5 sets) and chickens (2 sets) for strains of H3N2 (4 sets), H5N1 (2 sets) and H1N1 (1 set) from the published literatures. Except for one data set (study with intra-tracheal inoculation for data set no. 6), all were obtained from the studies with intranasal inoculation. The data were analyzed using three types of DR model as the basis of heterogeneity in infectivity of AI strains in humans and chickens: exponential, beta-binomial and beta-Poisson. We fitted to the data using maximum likelihood estimation to get the parameter estimates of each model. The alpha and beta values of the beta-Poisson DR model ranged 0.06-0.19 and 1.7-48.8, respectively for H3N2 strain. Corresponding values for H5N1 ranged 0.464-0.563 and 97.3-99.4, respectively. For H1N1 the parameter values were 0.103 and 12.7, respectively. Using the exponential model, r (infectivity parameter) ranged from $1.6{\times}10^{-8}$ to $1.2{\times}10^{-5}$ for H3N2 and from $7.5{\times}10^{-3}$ to $4.0{\times}10^{-2}$ for H5N1, while the value was $1.6{\times}10^{-8}$ for H1N1. The beta-Poisson DR model provided the best fit to five of 7 data sets tested, and the estimated parameter values in betabinomial model were very close to those of beta-Poisson. Our study indicated that beta-binomial or beta-Poisson model could be the choice for DR modeling of AI, even though DR relationship varied depending on the virus strains studied, as indicated in prior studies. Further DR modeling should be conducted to quantify the differences among AI virus strains.