• Title/Summary/Keyword: Fisher information

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Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

Selective Word Embedding for Sentence Classification by Considering Information Gain and Word Similarity (문장 분류를 위한 정보 이득 및 유사도에 따른 단어 제거와 선택적 단어 임베딩 방안)

  • Lee, Min Seok;Yang, Seok Woo;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.105-122
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    • 2019
  • Dimensionality reduction is one of the methods to handle big data in text mining. For dimensionality reduction, we should consider the density of data, which has a significant influence on the performance of sentence classification. It requires lots of computations for data of higher dimensions. Eventually, it can cause lots of computational cost and overfitting in the model. Thus, the dimension reduction process is necessary to improve the performance of the model. Diverse methods have been proposed from only lessening the noise of data like misspelling or informal text to including semantic and syntactic information. On top of it, the expression and selection of the text features have impacts on the performance of the classifier for sentence classification, which is one of the fields of Natural Language Processing. The common goal of dimension reduction is to find latent space that is representative of raw data from observation space. Existing methods utilize various algorithms for dimensionality reduction, such as feature extraction and feature selection. In addition to these algorithms, word embeddings, learning low-dimensional vector space representations of words, that can capture semantic and syntactic information from data are also utilized. For improving performance, recent studies have suggested methods that the word dictionary is modified according to the positive and negative score of pre-defined words. The basic idea of this study is that similar words have similar vector representations. Once the feature selection algorithm selects the words that are not important, we thought the words that are similar to the selected words also have no impacts on sentence classification. This study proposes two ways to achieve more accurate classification that conduct selective word elimination under specific regulations and construct word embedding based on Word2Vec embedding. To select words having low importance from the text, we use information gain algorithm to measure the importance and cosine similarity to search for similar words. First, we eliminate words that have comparatively low information gain values from the raw text and form word embedding. Second, we select words additionally that are similar to the words that have a low level of information gain values and make word embedding. In the end, these filtered text and word embedding apply to the deep learning models; Convolutional Neural Network and Attention-Based Bidirectional LSTM. This study uses customer reviews on Kindle in Amazon.com, IMDB, and Yelp as datasets, and classify each data using the deep learning models. The reviews got more than five helpful votes, and the ratio of helpful votes was over 70% classified as helpful reviews. Also, Yelp only shows the number of helpful votes. We extracted 100,000 reviews which got more than five helpful votes using a random sampling method among 750,000 reviews. The minimal preprocessing was executed to each dataset, such as removing numbers and special characters from text data. To evaluate the proposed methods, we compared the performances of Word2Vec and GloVe word embeddings, which used all the words. We showed that one of the proposed methods is better than the embeddings with all the words. By removing unimportant words, we can get better performance. However, if we removed too many words, it showed that the performance was lowered. For future research, it is required to consider diverse ways of preprocessing and the in-depth analysis for the co-occurrence of words to measure similarity values among words. Also, we only applied the proposed method with Word2Vec. Other embedding methods such as GloVe, fastText, ELMo can be applied with the proposed methods, and it is possible to identify the possible combinations between word embedding methods and elimination methods.

Degree of Dysmenorrhea and Self-management of Dysmenorrhea in the High-school Girl-student (여고생이 호소하는 월경곤란증 정도 및 대처방안)

  • Kim, Mi-Young;Jung, Moon-Sook;Chung, Kwi-Ae
    • Women's Health Nursing
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    • v.6 no.3
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    • pp.413-426
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    • 2000
  • The purposes of this study is to examine the degree of dysmenorrhea and self-management of dysmenorrhea in high school girls and to provide basic information for health education. This research is the contents of the characteristics and self-management of dysmenorrhea and thereby serve to provide some theoretical grounds for the health education of high school-girl students. The subjects of this study are the 376 girl students of a high school in Taegu. This study was conducted by collecting data from April 3rd to 7th, 2000. The instruments used for this study by the researcher of this study based on Choi, Myung-Ok's (1992) menstrurational symtom scale (8 items) and factors used to dysmenorrhea scale (5 items). Health locus of control is obtained from a review of references by the researcher, Sin Jae Sin (1985) translated Multidimensional health Locus of Control scale (18 items) were made by Wallston & Wallston (1976). The collected data was analysed by mean, percent, Chi-squre test, Fisher's Exact Test using the SPSS (v 6.12) and SAS program. The results of this study were as follows : 1. The characteristics of dysmenorrhea were low abdominal pain, fatigue, back pain, headache, muscle pain, diarrhea, nausea and vomiting. 2. The degree of dysmenorrhea was shown 'a few of discomfort experiment': 73%, late, leaving early and absent for school : 4.0%. 3. By means locus of control, internal health locus of control was shown 79.5% and external health locus of control was shown 20.5%. 4. The self-management of dysmenorrhea was shown 'massaging on the abdomen and bed rest' is 31.9%, 'tolerance' is 53.5%. 5. When the characteristics of dysmenorrhea was compared with demographics, low abdominal pain was significant of the number of siblings (p<.05), the family history (mother's dysmenorrhea)(p<.01) and back pain was significant of the age, family history, low abdominal pain (p<.05, p<.01, p<.01). 6. There was no significant of the locus of control. When the self-management of dysmenorrhea was compared with demographics, the age was significant (p<.05).

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Classification of Gene Data Using Membership Function and Neural Network (소속 함수와 유전자 정보의 신경망을 이용한 유전자 타입의 분류)

  • Yeom, Hae-Young;Kim, Jae-Hyup;Moon, Young-Shik
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.42 no.4 s.304
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    • pp.33-42
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    • 2005
  • This paper proposes a classification method for gene expression data, using membership function and neural network. The gene expression is a process to produce mRNA and protains which generate a living body, and the gene expression data is important to find out the functions and correlations of genes. Such gene expression data can be obtained from DNA 칩 massively and quickly. However, thousands of gene expression data may not be useful until it is well organized. Therefore a classification method is necessary to find the characteristics of gene data acquired from the gene expression. In the proposed method, a set of gene data is extracted according to the fisher's criterion, because we assume that selected gene data is the well-classified data sample. However, the selected gene data does not guarantee well-classified data sample and we calculate feature values using membership function to reduce the influence of outliers in gene data. Feature vectors estimated from the selected feature values are used to train back propagation neural network. The experimental results show that the clustering performance of the proposed method has been improved compared to other existing methods in various gene expression data.

Principal Discriminant Variate (PDV) Method for Classification of Multicollinear Data: Application to Diagnosis of Mastitic Cows Using Near-Infrared Spectra of Plasma Samples

  • Jiang, Jian-Hui;Tsenkova, Roumiana;Yu, Ru-Qin;Ozaki, Yukihiro
    • Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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    • 2001.06a
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    • pp.1244-1244
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    • 2001
  • In linear discriminant analysis there are two important properties concerning the effectiveness of discriminant function modeling. The first is the separability of the discriminant function for different classes. The separability reaches its optimum by maximizing the ratio of between-class to within-class variance. The second is the stability of the discriminant function against noises present in the measurement variables. One can optimize the stability by exploring the discriminant variates in a principal variation subspace, i. e., the directions that account for a majority of the total variation of the data. An unstable discriminant function will exhibit inflated variance in the prediction of future unclassified objects, exposed to a significantly increased risk of erroneous prediction. Therefore, an ideal discriminant function should not only separate different classes with a minimum misclassification rate for the training set, but also possess a good stability such that the prediction variance for unclassified objects can be as small as possible. In other words, an optimal classifier should find a balance between the separability and the stability. This is of special significance for multivariate spectroscopy-based classification where multicollinearity always leads to discriminant directions located in low-spread subspaces. A new regularized discriminant analysis technique, the principal discriminant variate (PDV) method, has been developed for handling effectively multicollinear data commonly encountered in multivariate spectroscopy-based classification. The motivation behind this method is to seek a sequence of discriminant directions that not only optimize the separability between different classes, but also account for a maximized variation present in the data. Three different formulations for the PDV methods are suggested, and an effective computing procedure is proposed for a PDV method. Near-infrared (NIR) spectra of blood plasma samples from mastitic and healthy cows have been used to evaluate the behavior of the PDV method in comparison with principal component analysis (PCA), discriminant partial least squares (DPLS), soft independent modeling of class analogies (SIMCA) and Fisher linear discriminant analysis (FLDA). Results obtained demonstrate that the PDV method exhibits improved stability in prediction without significant loss of separability. The NIR spectra of blood plasma samples from mastitic and healthy cows are clearly discriminated between by the PDV method. Moreover, the proposed method provides superior performance to PCA, DPLS, SIMCA and FLDA, indicating that PDV is a promising tool in discriminant analysis of spectra-characterized samples with only small compositional difference, thereby providing a useful means for spectroscopy-based clinic applications.

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Evaluation of Peri-procedural Anticoagulation Drug Therapy undergoing Radiofrequency Ablation in Patients with Atrial Fibrillation (심방세동 환자의 고주파 도자절제술 전.후의 항응고약물요법 사용실태 분석)

  • Kim, Su-Hyun;An, Sung-Shim;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.159-164
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    • 2010
  • Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

Association between Global Cortical Atrophy, Medial Temporal Atrophy, White Matter Hyperintensities and Cognitive Functions in Korean Alzheimer's Disease Patients (알츠하이머병 환자의 전반적 피질 위축, 내측두엽 위축, 백질 고강도 신호와 인지기능의 연관성)

  • Choi, Leen;Joo, Soo-Hyun;Lee, Chang-Uk;Paik, In-Ho
    • Korean Journal of Biological Psychiatry
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    • v.22 no.3
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    • pp.140-148
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    • 2015
  • Objectives The aim of this study is to investigate the correlation between degenerative changes in brain [i.e., global cortical atrophy (GCA), medial temporal atrophy (MTA), white matter hyperintensities (WMH)] and neurocognitive dysfunction in Korean patients with Alzheimer's disease. Methods A total of 62 elderly subjects diagnosed with Alzheimer's disease were included in this study. The degenerative changes in brain MRI were rated with standardized visual rating scales (GCA or global cortical atrophy, MTA or medial temporal atrophy, and Fazekas scales) and the subjects were divided into two groups according to the degree of degeneration for each scale. Cognitive function was evaluated with Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) and several clinical features, including apolipoprotein E ${\varepsilon}4$ status, lipid profile and thyroid hormones, were also examined. Chi-square test and Fisher's exact test were performed to analyze the relationship between the degree of cerebral degeneration and neurocognitive functions. Results Demographic and clinical features, except for the age, did not show any significant difference between the two groups divided according to the degree of cerebral degenerative changes. However, higher degree of GCA was shown to be associated with poorer performance in verbal fluency test, word list recall test, and word list recognition test. Higher degree of MTA was shown to be associated with poorer performance in Mini-Mental State Examination in the Korean Version of CERAD Assessment Packet (MMSE-KC), word list recognition test and construction praxis recall test. Higher degree of white matter hyperintensities was shown to be associated with poorer performance in MMSE-KC. Conclusions Our results suggest that severe brain degeneration shown in MRI is associated with significantly poorer performance in neurocognitive tests in patients with Alzheimer's disease. Moreover, the degree of GCA, MTA and white matter hyperintensities, represented by scores from different visual rating scales, seems to affect certain neurocognitive domains each, which would provide useful information in clinical settings.

Association of Histopathological Markers with Clinico-Pathological Factors in Mexican Women with Breast Cancer

  • Bandala, Cindy;De la Garza-Montano, Paloma;Cortes-Algara, Alfredo;Cruz-Lopez, Jaime;Dominguez-Rubio, Rene;Gonzalez-Lopez, Nelly Judith;Cardenas-Rodriguez, Noemi;Alfaro-Rodriguez, A;Salcedo, M;Floriano-Sanchez, E;Lara-Padilla, Eleazar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8397-8403
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    • 2016
  • Background: Breast cancer (BCa) is the most common malignancy in Mexican women. A set of histopathological markers has been established to guide BCa diagnosis, prognosis and treatment. Nevertheless, in only a few Mexican health services, such as that of the Secretariat of National Defense (SEDENA for its acronym in Spanish), are these markers commonly employed for assessing BCa. The aim of this study was to explore the association of Ki67, TP53, HER2/neu, estrogenic receptors (ERs) and progesterone receptors (PRs) with BCa risk factors. Materials and Methods: Clinical histories provided background patient information. Immunohistochemical (IHC) analysis was conducted on 48 tissue samples from women diagnosed with BCa and treated with radical mastectomy. The Chi square test or Fisher exact test together with the Pearson and Spearman correlation were applied. Results: On average, patients were $58{\pm}10.4$ years old. It was most common to find invasive ductal carcinoma (95.8%), histological grade 3 (45.8%), with a poor Nottingham Prognostic Index (NPI; 80.4%). ERs and PRs were associated with smoking and alcohol consumption, metastasis at diagnosis and Ki67 expression (p<0.05). PR+ was also related to urea and ER+ (p<0.05). Ki67 was associated with TP53 and elevated triglycerides (p<0.05), and HER2/neu with ER+, the number of pregnancies and tumor size (p<0.05). TP53 was also associated with a poor NPI (p<0.05) and CD34 with smoking (p<0.05). The triple negative status (ER-/PR-/HER2/neu-) was related to smoking, alcohol consumption, exposure to biomass, number of pregnancies, metastasis and a poor NPI (p<0.05). Moreover, the luminal B subty was associated with histological type (p=0.007), tumor size (p=0.03) and high cholesterol (p=0.02). Conclusions: Ki67, TP53, HER2/neu, ER and PR proved to be related to several clinical and pathological factors. Hence, it is crucial to determine this IHC profile in women at risk for BCa. Certain associations require further study to understand physiological/biochemical/molecular processes.

Development of 3-D Stereotactic Localization System and Radiation Measurement for Stereotactic Radiosurgery (방사선수술을 위한 3차원 정위 시스템 및 방사선량 측정 시스템 개발)

  • Suh, Tae-Suk;Suh, Doug-Young;Park, Sung-Hun;Jang, Hong-Seok;Choe, Bo-Young;Yoon, Sei-Chul;Shinn, Kyung-Sub;Bahk, Yong-Whee;Kim, Il-Hwan;Kang, Wee-Sang;Ha, Sung-Whan;Park, Charn-Il
    • Journal of Radiation Protection and Research
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    • v.20 no.1
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    • pp.25-36
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    • 1995
  • The purpose of this research is to develop stereotactic localization and radiation measurement system for the efficient and precise radiosurgery. The algorithm to obtain a 3-D stereotactic coordinates of the target has been developed using a Fisher CT or angio localization. The procedure of stereotactic localization was programmed with PC computer, and consists of three steps: (1) transferring patient images into PC; (2) marking the position of target and reference points of the localizer from the patient image; (3) computing the stereotactic 3-D coordinates of target associated with position information of localizer. Coordinate transformation was quickly done on a real time base. The difference of coordinates computed from between Angio and CT localization method was within 2 mm, which could be generally accepted for the reliability of the localization system developed. We measured dose distribution in small fields of NEC 6 MVX linear accelerator using various detector; ion chamber, film, diode. Specific quantities measured include output factor, percent depth dose (PDD), tissue maximum ratio (TMR), off-axis ratio (OAR). There was small variation of measured data according to the different kinds of detectors used. The overall trends of measured beam data were similar enough to rely on our measurement. The measurement was performed with the use of hand-made spherical water phantom and film for standard arc set-up. We obtained the dose distribution as we expected. In conclusion, PC-based 3-D stereotactic localization system was developed to determine the stereotactic coordinate of the target. A convenient technique for the small field measurement was demonstrated. Those methods will be much helpful for the stereotactic radiosurgery.

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A Study on the Intradermal Skin Test of Antibiotics (항생물질 주사제의 피내반응검사에 대한 조사연구)

  • Yoo Jae-Hee;Shon Young-Hee;Kim Won-Ock
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.319-336
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    • 1997
  • This study was done to identify the reality in doing the intradermal skin test of injectional antibiotics and to serve a basis to the clinical and educational situations. For the study, the survey was done to the staff nurses who are working at one of the selected 39 hospitals in the capital area, from January 6 to Feburary 8 in 1997. The data analysis was done by mean, standard deviation, Fisher's exact test, t-test, ANOVA through running SAS computer program. The results of the study were as follows : 1. The dilution ratio of the antibiotics was mostly 1 : 10 regardless of what kind of antibitics. Making the contrast was done only for the suspended to the antibiotics. Mostly the reaction was detected after 15 to 20 minutes from its diameter of redness and wheals. Most of the respondents answered they do the intradermal skin test only once for the same antibiotics. 2. In the education on the skin test the 66.7% from the respondents had exposed to the education mostly through the new nurses orientation. The 85,4% from them answered the need of the continuous education which had a significant difference in the number of beds(p=.046). The had experiences of detecting positive reactions(98.3%), and of anaphylaxis(49.5%) which had a significant difference in experience(p=.002) and in their age groups(p=.000). 3. The averge score of the confidence on the intradermal skin test was 3.32 form 4-point scale. Also it had a significant difference from the number of beds(p=.010), the year of experiences(p=.016), and their age groups(p=.046). 4. From the general characteristics of respondents, the injection methods had a significant difference in the amounts of injection, whether adopting the contrast pairing, and the repeatable skin tests for the same antibiotics. 5. Only 15 from 39 hospitals had their protocol about the intradermal skin test provided by nursing department which differs in its contents from that provided by the medical information center. From the results of the study, it is suggested that the continuous education on the intradermal skin test and its unified protocol should be provided. Also it is recomended that the drug manufacturer should notice about its anaphylactic cautions and pack its extra skin test use.

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