• Archives of Plastic Surgery
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• v.50 no.3
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• pp.254-263
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• 2023

Background The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.

• Journal of Korean Academy of Nursing
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• v.53 no.3
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• pp.324-339
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• 2023

Purpose: This study aimed to valuate the reliability and validity of the Korean version of the 5C Psychological Antecedents of Vaccination (K-5C) scale. Methods: The English version of the 5C scale was translated into Korean, following the World Health Organization guidelines. Data were collected from 316 community-dwelling adults. Content validity was evaluated using the content validity index, while construct validity was evaluated through confirmatory factor analysis. Convergent validity was examined by assessing the correlation with vaccination attitude, and concurrent validity was evaluated by examining the association with coronavirus disease 2019 (COVID-19) vaccination status. Internal consistency and test-retest reliability were also evaluated. Results: Content validity results indicated an item-level content validity index ranging from .83 to 1, and scale-level content validity index, averaging method was .95. Confirmatory factor analysis supported the fit of the measurement model, comprising a five-factor structure with a 15-item questionnaire (RMSEA = .05, SRMR = .05, CFI = .97, TLI = .96). Convergent validity was acceptable with a significant correlation between each sub-scale of the 5C scale and vaccination attitude. In concurrent validity evaluation, confidence, constraints, and collective responsibility of the 5C scale were significant independent predictors of the current COVID-19 vaccination status. Cronbach's alpha for each subscale ranged from .78 to .88, and the intraclass correlation coefficient for each subscale ranged from .67 to .89. Conclusion: The Korean version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of vaccination among Korean adults.

• Journal of Technologic Dentistry
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• v.46 no.2
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• pp.36-41
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• 2024

Purpose: This study aimed to generate virtual mandibular left first molar teeth using deep convolutional generative adversarial networks (DCGANs) and analyze their matching accuracy with actual tooth morphology to propose a new paradigm for using medical data. Methods: Occlusal surface images of the mandibular left first molar scanned using a dental model scanner were analyzed using DCGANs. Overall, 100 training sets comprising 50 original and 50 background-removed images were created, thus generating 1,000 virtual teeth. These virtual teeth were classified based on the number of cusps and occlusal surface ratio, and subsequently, were analyzed for consistency by expert dental technicians over three rounds of examination. Statistical analysis was conducted using IBM SPSS Statistics ver. 23.0 (IBM), including intraclass correlation coefficient for intrarater reliability, one-way ANOVA, and Tukey's post-hoc analysis. Results: Virtual mandibular left first molars exhibited high consistency in the occlusal surface ratio but varied in other criteria. Moreover, consistency was the highest in the occlusal buccal lingual criteria at 91.9%, whereas discrepancies were observed most in the occusal buccal cusp criteria at 85.5%. Significant differences were observed among all groups (p<0.05). Conclusion: Based on the classification of the virtually generated left mandibular first molar according to several criteria, DCGANs can generate virtual data highly similar to real data. Thus, subsequent research in the dental field, including the development of improved neural network structures, is necessary.

• Korean Journal of Radiology
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• v.20 no.6
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• pp.880-893
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• 2019

Objective: To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness. Materials and Methods: The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient. Results: The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3-3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7-11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82-0.90) and 0.93 (95% CI, 0.89-0.95), respectively, suggesting good to excellent reliability. Conclusion: 2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

• Safety and Health at Work
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• v.14 no.4
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• pp.358-367
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• 2023

Background: This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace. Methods: This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS₂₂ and AMOS₂₀ software. Results: The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively. Conclusion: This study confirmed that the psychometric features of the 58-item final version of PAWPQSCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.591-600
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• 2006

Purpose: This study assessed the impact of self-reported periodontal health on the oral health-related quality of life among elderly Koreans. Methods: Four hundred twenty one elderly Koreans in Seoul and suburban areas were selected with a cluster (institution) sampling method, and were requested to take oral examinations and finish questionnaires on the Oral Health Impact Profile-14(OHIP-14). and self-reported periodontal health status, such as periodontal symptoms, self-rated periodontal health and periodontal treatment need. As the dependent variable, OHIP-14 showed a positive skewed distribution (skewness: 1.17), we transformed to square-root form to apply parametric analyses. Bivariate analysis by t-test and ANOVA, and multivariate analysis with the two-level regression model accounting clusters were implemented. Results: Mean age of the subjects was 74.6 years and 66.5% were women. Fourteen items of OHIP-14 were summarized to one factor explaining 78.6% of total variance and produced the Chronbach alpha coefficient of 0.92. Results from the multivariate model, adjusting for age, sex, type of institutions, ability to pay, and number of teeth present, showed significantly lower OHIP-14 with reporting less than 3 periodontal symptoms (p(O.OOO1), rating their own periodontal health as above average level (p=O.0144), and thinking they don't need any periodontal treatments in the near future (p=O.0148), than their counterparts. The intraclass-corrrelation estimated by the final model was 0.028. Conclusion: This study demonstrates a significant association between self-reported periodontal health status and the oral health-related quality of life.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.1
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• pp.17-25
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• 2012

Purpose: Recently, a three dimensional approach to hard and soft tissues of the maxillofacial area has been widely used. This study was to evaluate the reproducibility and accuracy of a stereocamera compared to actual measurement methods using a digital caliper and digitizer. Methods: The stereoscopies of 7 head dummies with different sizes and shapes were obtained using a Di3D system (Dimensional Imaging, Glasgow, UK) after marking reference points on facial areas. From the obtained stereoscopy, 10 measurements representing the width, height and depth of each of the facial sections of the dummy were measured twice using a three dimensional reverse engineering software program (RapidForm$^{TM}$ 2006, Inus, Seoul, Korea). The x, y, and z coordinates of each of the three dimensional measurements were obtained and distances between two points were calculated. All procedures were repeated twice. The actual measurement method was performed twice, directly on dummies, using a digital caliper and values were compared with the previously determined values. Results: The results were as follows. In the ANOVA analysis, there were no significant statistical differences among the three measurement methods. In the Bonferroni analysis, with adjustments applied for multiple comparisons, there was no difference between actual measurement methods using a digitizer and a digital caliper. However, there was some difference between using a stereocamera and actual measurement methods using a digitizer and a digital caliper in values of $Ex_{Rt}-Ex_{Lt}$, $En_{Rt}-En_{Lt}$, $Ala_{Rt}-Ala_{Lt}$, $Ch_{Rt}-Ch_{Lt}$, G-Pg', $Ala_{Rt}$-Prn, $Ala_{Rt}$-Prn. The mean value for technical error in measurement (TEM) in Di3D (0.98 mm) was slightly higher than for a digital caliper (0.17 mm) and a digitizer (0.30 mm). In an intraclass correlation coefficient (ICC) there were no significant differences among the three measurement methods, but the Di3D system with the stereocamera showed relatively lower reproducibility compared to actual measurement methods using a digitizer and a digital caliper. Conclusion: These results indicate that some complementary measures may be needed to improve accuracy and reproducibility in the Di3D system with stereocamera.

• Health Policy and Management
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• v.32 no.4
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• pp.347-355
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• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• Journal of Korean Academy of Nursing
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• v.53 no.3
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• pp.295-308
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• 2023

Purpose: This study evaluated the validity and reliability of Shively and colleagues' self-efficacy for HIV disease management skills (HIV-SE) among Korean participants. Methods: The original HIV-SE questionnaire, comprising 34 items, was translated into Korean using a translation and back-translation process. To enhance clarity and eliminate redundancy, the author and expert committee engaged in multiple discussions and integrated two items with similar meanings into a single item. Further, four HIV nurse experts tested content validity. Survey data were collected from 227 individuals diagnosed with HIV from five Korean hospitals. Construct validity was verified through confirmatory factor analysis. Criterion validity was evaluated using Pearson's correlation coefficients with the new general self-efficacy scale. Internal consistency reliability and test-retest were examined for reliability. Results: The Korean version of HIV-SE (K-HIV-SE) comprises 33 items across six domains: "managing depression/mood," "managing medications," "managing symptoms," "communicating with a healthcare provider," "getting support/help," and "managing fatigue." The fitness of the modified model was acceptable (minimum value of the discrepancy function/degree of freedom = 2.49, root mean square error of approximation = .08, goodness-of-fit index = .76, adjusted goodness-of-fit index = .71, Tucker-Lewis index = .84, and comparative fit index = .86). The internal consistency reliability (Cronbach's α = .91) and test-retest reliability (intraclass correlation coefficient = .73) were good. The criterion validity of the K-HIV-SE was .59 (p < .001). Conclusion: This study suggests that the K-HIV-SE is useful for efficiently assessing self-efficacy for HIV disease management.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1110-1122
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• 2023

Purpose This study aimed to assess the variability of transrectal shear wave elastography (SWE) using a designed phantom. Materials and Methods In a phantom, the SWE values were examined by two radiologists using agarose and emulsion silicone of different sizes (1, 2, and 3 cm) and shapes (round, cubic) at three depths (1, 2, and 3 cm), two region of interest (ROI) and locations (central, peripheral) using two ultrasound machines (A, B from different vendors). Variability was evaluated using the coefficient of variation (CV). Results The CVs decreased with increasing phantom size. Significant changes in SWE values included; agarose phantom at 3 cm depth (p < 0.001; machine A), 1 cm depth (p = 0.01; machine B), emulsion silicone at 2 cm depth (p = 0.047, p = 0.020; both machines). The CVs increased with increasing depth. Significant changes in SWE values included; 1 cm agarose (p = 0.037, p = 0.021; both machines) and 2 cm agarose phantom (p = 0.047; machine A). Significant differences in SWE values were observed between the shapes for emulsion silicone phantom (p = 0.032; machines A) and between ROI locations on machine B (p ≤ 0.001). The SWE values differed significantly between the two machines (p < 0.05). The intra-/inter-operator agreements were excellent (intraclass correlation coefficient > 0.9). Conclusion The phantom size, depth, and different machines affected the variability of transrectal SWE.