• Title/Summary/Keyword: Generalized linear mixed model

Search Result 57, Processing Time 0.038 seconds

Blink reflex changes and sensory perception in infraorbital nerve-innervated areas following zygomaticomaxillary complex fractures

  • Park, Young Sook;Choi, Jaehoon;Park, Sang Woo
    • Archives of Plastic Surgery
    • /
    • v.47 no.6
    • /
    • pp.559-566
    • /
    • 2020
  • Background Infraorbital nerve dysfunction is commonly reported after zygomaticomaxillary complex fractures. We evaluated sensory changes in four designated areas (eyelid, nose, zygoma, and lip) innervated by the infraorbital nerve. This evaluation was conducted using the static two-point discrimination test and the vibration threshold test. We assessed the diagnostic significance of the blink reflex in patients with infraorbital nerve dysfunction. Methods This study included 18 patients, all of whom complained of some degree of infraorbital nerve dysfunction preoperatively. A visual analog scale, the infraorbital blink reflex, static two-point discrimination, and the vibration threshold were assessed preoperatively, at 1 month postoperatively (T1), and at a final follow-up that took place at least 4 months postoperatively (T4). The results were analyzed using a multilevel generalized linear mixed model. Results Scores on the visual analog scale significantly improved at T1 and T4. The infraorbital blink reflex significantly improved at T4. Visual analog scale scores improved more rapidly than the infraorbital blink reflex. Two-point discrimination significantly improved in all areas at T4, and the vibration perception threshold significantly improved in the eyelid at T4. Conclusions Recovery of the infraorbital blink reflex reflected the recovery of infraorbital nerve dysfunction. We also determined that the lip tended to recover later than the other areas innervated by the infraorbital nerve.

Socioeconomic Status and Number of Children Among Korean Women: The Healthy Twin Study

  • Kim, Jinseob;Sung, Joohon
    • Journal of Preventive Medicine and Public Health
    • /
    • v.46 no.1
    • /
    • pp.50-60
    • /
    • 2013
  • Objectives: This study aimed to evaluate whether the birth rate is associated with socioeconomic status in the women of the Republic of Korea, where the birth rate is rapidly decreasing. Methods: This study included 732 females from the Healthy Twin Study, a family-twin cohort. The participants were classified into 3 socioeconomic groups according to their average income, education, and occupation. The association between socioeconomic status and number of children was assessed using gamma regression analysis with a generalized linear mixed model, adjusting for the age group, smoking/alcohol status, and family relationships. Results: The group with the highest education level had significantly fewer children compared with the group with the lowest education level (p=0.004). However, no significant associations were found according to household income level. The non-manual labor group had significantly fewer children compared with those working as homemakers (p=0.008). Conclusions: This study aimed to explain the causal relationship between socioeconomic status and number of children. Associations between some socioeconomic status and number of children were found in Korea.

The Effect of the Infant Cardiopulmonary Resuscitation Immediate Remediation for Child Care Teachers (보육교사를 대상으로 한 영아 심폐소생술 현장교정교육의 지속효과)

  • Kim, Il Ok;Shin, Sun Hwa
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.21 no.3
    • /
    • pp.350-360
    • /
    • 2015
  • Purpose: The purpose of this study was to evaluate the effectiveness and retention period of immediate remediation for infant cardiopulmonary resuscitation (CPR) in child care teachers. Methods: This study used a nonequivalent comparison pre- and post-test design to measure knowledge about and confidence in infant CPR and an interrupted time-series design to determine skill performance. The experimental group (n=25) received both immediate remediation and video learning for infant CPR, and the comparison group (n=28) received video learning only. Knowledge and confidence were measured before and after 4 weeks. Their skill performance was tested immediately, and 4 weeks, 8 weeks, 12 weeks, and 24 weeks after intervention. Data analysis consisted of ${\chi}^2$ tests, t-tests, paired t-tests, and a generalized linear mixed model. Results: There were significant increases in knowledge and confidence within the experimental group. Skill performance showed a significant difference according to the group factor (F=10.81, p=.002) and measurement time (F=146.80, p<.001). The experimental group maintained significantly higher skill performance than did the comparison group. Conclusion: These findings support the necessity of immediate remediation education for infant CPR to maintain skill performance. In addition, appropriate renewal time and the improvement of training programs for child care teachers are necessary.

Generalized Linear Mixed Model for Multivariate Multilevel Binomial Data (다변량 다수준 이항자료에 대한 일반화선형혼합모형)

  • Lim, Hwa-Kyung;Song, Seuck-Heun;Song, Ju-Won;Cheon, Soo-Young
    • The Korean Journal of Applied Statistics
    • /
    • v.21 no.6
    • /
    • pp.923-932
    • /
    • 2008
  • We are likely to face complex multivariate data which can be characterized by having a non-trivial correlation structure. For instance, omitted covariates may simultaneously affect more than one count in clustered data; hence, the modeling of the correlation structure is important for the efficiency of the estimator and the computation of correct standard errors, i.e., valid inference. A standard way to insert dependence among counts is to assume that they share some common unobservable variables. For this assumption, we fitted correlated random effect models considering multilevel model. Estimation was carried out by adopting the semiparametric approach through a finite mixture EM algorithm without parametric assumptions upon the random coefficients distribution.

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea

  • Jongmin Oh;Youn-Hee Lim;Changwoo Han;Dong-Wook Lee;Jisun Myung;Yun-Chul Hong;Soontae Kim;Hyun-Joo Bae
    • Journal of Preventive Medicine and Public Health
    • /
    • v.57 no.2
    • /
    • pp.185-196
    • /
    • 2024
  • Objectives: Excess mortality associated with long-term exposure to fine particulate matter (PM2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM2.5 by considering the potential non-linear concentration-response relationship in Korea. Methods: Daily cause-specific mortality rates and PM2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM2.5 concentrations below 15 ㎍/m3. Overall deaths attributable to short-term PM2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM2.5 exposure. Results: Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM2.5. The estimated number of all-cause excess deaths due to short-term PM2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472). Conclusions: Our findings indicate an association between short-term PM2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM2.5.

Multivariate Meta-Analysis Methods of Comparing the Sensitivity and Specificity of Two Diagnostic Tests (두 진단검사의 비교에 대한 민감도와 특이도의 다변량 메타분석법)

  • Nam, Seon-Young;Song, Hae-Hiang
    • Communications for Statistical Applications and Methods
    • /
    • v.18 no.1
    • /
    • pp.57-69
    • /
    • 2011
  • Researchers are continuously trying to find innovative diagnostic tests and published articles are accumulating at an enormous rate in many medical fields. Meta-analysis enables previously published study results to be reviewed and summarized; therefore, an objective assessment of diagnostic tests can be done with a meta-analysis of sensitivities and specificities. Data obtained by applying two diagnostic tests to a well-defined group of diseased patients produce a pair of sensitivity and by applying the same medical tests to a group of non-diseased subjects produce a pair of specificity. The statistical tests in the meta-analysis need to consider the correlatedness of the results from two diagnostic tests applied to the same diseased and non-diseased subjects. The associations between two diagnostic test results are often found to be unequal for the diseased and non-diseased subjects. In this paper, multivariate meta-analytic methods are studied by taking into account the different associations between correlated variables. On the basis of Monte Carlo simulations, we evaluate the performance of the multivariate meta-analysis methods proposed in this paper.

Blood Triglycerides Levels and Dietary Carbohydrate Indices in Healthy Koreans

  • Min, Hye Sook;Kang, Ji Yeon;Sung, Joohon;Kim, Mi Kyung
    • Journal of Preventive Medicine and Public Health
    • /
    • v.49 no.3
    • /
    • pp.153-164
    • /
    • 2016
  • Objectives: Previous studies have obtained conflicting findings regarding possible associations between indices measuring carbohydrate intake and dyslipidemia, which is an established risk factor of coronary heart disease. In the present study, we examined crosssectional associations between carbohydrate indices, including the dietary glycemic index (GI), glycemic load (GL), total amount of carbohydrates, and the percentage of energy from carbohydrates, and a range of blood lipid parameters. Methods: This study included 1530 participants (554 men and 976 women) from 246 families within the Healthy Twin Study. We analyzed the associations using a generalized linear mixed model to control for familial relationships. Results: Levels of the Apo B were inversely associated with dietary GI, GL, and the amount of carbohydrate intake for men, but these relationships were not significant when fat-adjusted values of the carbohydrate indices were used. Triglyceride levels were positively associated with dietary GI and GL in women, and this pattern was more notable in overweight participants (body mass index [BMI] ${\geq}25kg/m^2$). However, total, low-density lipoprotein and high-density lipoprotein cholesterol levels were not significantly related with carbohydrate intake overall. Conclusions: Of the blood lipid parameters we investigated, only triglyceride levels were positively related with dietary carbohydrate indices among women participants in the Healthy Twin Study, with an interactive role observed for BMI. However, these associations were not observed in men, suggesting that the association between blood lipid levels and carbohydrate intake depends on the type of lipid, specific carbohydrate indices, gender, and BMI.

Prevalence and Associated Risk Factors of Toxocara vitulorum Infections in Buffalo and Cattle Calves in Three Provinces of Central Cambodia

  • Dorny, Pierre;Devleesschauwer, Brecht;Stoliaroff, Valerie;Sothy, Meas;Chea, Rortana;Chea, Bunthon;Sourloing, Hor;Samuth, Sum;Kong, Seth;Nguong, Koemseang;Sorn, San;Holl, Davun;Vercruysse, Jozef
    • Parasites, Hosts and Diseases
    • /
    • v.53 no.2
    • /
    • pp.197-200
    • /
    • 2015
  • The prevalence and associated risk factors of Toxocara vitulorum infection in buffalo and cattle calves was studied in 3 provinces in central Cambodia. Fecal samples were collected from 517 calves between the age of 1-15 weeks and processed for nematode egg counts by a modified McMaster method. A total of 64 calves were found to excrete T. vitulorum eggs in their feces (12.4%; 95% exact CI: 9.7-15.5). The mean fecal egg count was 2,798 EPG (SD=16,351; range=0-224,400). A multivariable generalized linear mixed model showed higher odds of T. vitulorum infection for buffalo versus cattle, for animals aged 4-8 weeks versus younger and older ones, and for animals with strongyle infection. There was no association with fecal consistency. Farmers should be aware of the potential impact of T. vitulorum, and treat their calves at the age of 2-3 weeks with anthelmintics such as benzimidazoles or pyrantel.

Changes in bisphenol A concentrations in urine according to sealant filling in children (치면열구전색 전후의 어린이 소변 내 Bisphenol-A의 농도 변화)

  • Shin, Ah Ra;Kim, Ji-Hye;Jeon, Eun Suk;Jung, Yun-Sook;Song, Keun-Bae;Choi, Youn-Hee
    • Journal of Korean Academy of Oral Health
    • /
    • v.41 no.4
    • /
    • pp.231-236
    • /
    • 2017
  • Objectives: The objectives of this study were to investigate the changes in bisphenol A (BPA) concentrations in urine from before to after sealant filling and the relationship between BPA and the number of teeth with sealed surfaces. Methods: Thirty-one children aged 6 and 7 years from three elementary schools in Daegu city who did not have any sealant and resin filling were selected as subjects. Urine samples were collected before and after sealant filling until 24 hours, with informed consent from their caregivers. The BPA concentration in all the collected urine samples was analyzed at Seegene Medical. Statistical analysis was performed using the Friedman test, Scheirer-Ray-Hope test, and the repeated-measures generalized linear mixed model of SPSS version 22.0. Results: The BPA concentrations increased from $3.49-{\mu}g/g$ creatinine before to $4.91-{\mu}g/g$ creatinine 2-3 hours later and to $4.15-{\mu}g/g$ creatinine after 24 hours. The more teeth with sealed surfaces, the higher the BPA concentration in children, but the difference was not statistically significant (P>0.05). Conclusions: The BPA concentrations were highest at 2-3 hours after sealant filling and decreased at 24 hours. Exposure to the sealant appears to have a meaningful correlation with the concentration of BPA in the urine of children.

Association between Weekend Admission and In-hospital Mortality among Cardiovascular Patients in Korea

  • Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
    • Health Policy and Management
    • /
    • v.29 no.2
    • /
    • pp.237-244
    • /
    • 2019
  • Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.