• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1077-1082
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• 2016

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.805-810
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• 2013

Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.

• Radiation Oncology Journal
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• v.36 no.4
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• pp.276-284
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• 2018

Purpose: Traditionally, three-dimensional conformal radiation therapy (3D-CRT) is used for neoadjuvant chemoradiation in locally advanced rectal cancer. Intensity-modulated radiation therapy (IMRT) was later developed for more conformal dose distribution, with the potential for reduced toxicity across many disease sites. We sought to use the National Cancer Database (NCDB) to examine trends and predictors for IMRT use in rectal cancer. Materials and Methods: We queried the NCDB from 2004 to 2015 for patients with rectal adenocarcinoma treated with neoadjuvant concurrent chemoradiation to standard doses followed by surgical resection. Odds ratios were used to determine predictors of IMRT use. Univariable and multivariable Cox regressions were used to determine potential predictors of overall survival (OS). Propensity matching was used to account for any indication bias. Results: Among 21,490 eligible patients, 3,131 were treated with IMRT. IMRT use increased from 1% in 2004 to 22% in 2014. Predictors for IMRT use included increased N stage, higher comorbidity score, more recent year, treatment at an academic facility, increased income, and higher educational level. On propensity-adjusted, multivariable analysis, male gender, increased distance to facility, higher comorbidity score, IMRT technique, government insurance, African-American race, and non-metro location were predictive of worse OS. Of note, the complete response rate at time of surgery was 28% with non-IMRT and 21% with IMRT. Conclusion: IMRT use has steadily increased in the treatment of rectal cancer, but still remains only a fraction of overall treatment technique, more often reserved for higher disease burden.

• Journal of agricultural medicine and community health
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• v.44 no.2
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• pp.65-72
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• 2019

This study aimed to identify the prevalence of communicable diseases at household level and associated risk factors among urban slum residents of Rupandehi district of Nepal. A cross-sectional study was carried out among a total of 259 purposively selected households in the urban slum of Butwal sub-metropolitan city, Rupandehi, Nepal between 25 November and 7 December, 2018. Prevalence of communicable diseases in the households within past one year were reported followed by assessment of risk factors associated with prevalence of communicable diseases using multivariable logistic regression analysis. The study result revealed that out of 259 study participants, more than two third (71.8%) reported to have at least any one of the communicable diseases in the household within past one year, and most common (91.9 %) reported to have cold and cough and diarrheal diseases. Final multivariable logistic regression analysis showed that study participants who did not have appropriate lightening in their houses were more likely (aOR 2.75; 95% CI (1.356-5.586)) to have communicable diseases. This study recommends understanding of the existing prevalence of communicable diseases and risk associated with it while designing health promotion activities and appropriate urban planning in Nepal.

• Journal of the Korean Mathematical Society
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• v.49 no.3
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• pp.641-658
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• 2012

The goal of this paper is to develop a nonlinear observer-based control strategy for a multi-variables continuous stirred tank reactor (CSTR). A new robust nonlinear observer is constructed to estimate the whole process state variables. The observer is coupled with a nonlinear controller, designed based on the input-output linearization for controlling the concentration and reactor temperature. The closed loop system is shown to be globally asymptotically stable based on Lyapunov arguments. Finally, computer simulations are developed for showing the performance of the proposed controller.

• Journal of Electrical Engineering and information Science
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• v.2 no.4
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• pp.28-36
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• 1997

In this paper, robust stability analysis for the fuzzy feedback linearization regulator is presented. Well-known Takagi-Sugeno fuzzy model is used as the MISO nonlinear plant model. Uncertainty and disturbance are assumed to be included in the model structure with known bounds. For these structured uncertainty and disturbances, robust stability of the close system is analyzed in both input-output sense and Lyapunov sense. The robust stability conditions are proposed by using multivariable circle criterion and the relationship between input-output stability and Lyapunov stability. The proposed stability analysis is illustrated by a simple example.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.2082-2093
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• 2021

Objective: We conducted a systematic review and meta-analysis of the tissue adequacy and complication rates of percutaneous transthoracic needle biopsy (PTNB) for molecular analysis in patients with non-small cell lung cancer (NSCLC). Materials and Methods: We performed a literature search of the OVID-MEDLINE and Embase databases to identify original studies on the tissue adequacy and complication rates of PTNB for molecular analysis in patients with NSCLC published between January 2005 and January 2020. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic estimates of the outcomes. To explore heterogeneity across the studies, univariable and multivariable metaregression analyses were performed. Results: A total of 21 studies with 2232 biopsies (initial biopsy, 8 studies; rebiopsy after therapy, 13 studies) were included. The pooled rates of tissue adequacy and complications were 89.3% (95% confidence interval [CI]: 85.6%-92.6%; I² = 0.81) and 17.3% (95% CI: 12.1%-23.1%; I² = 0.89), respectively. These rates were 93.5% and 22.2% for the initial biopsies and 86.2% and 16.8% for the rebiopsies, respectively. Severe complications, including pneumothorax requiring chest tube placement and massive hemoptysis, occurred in 0.7% of the cases (95% CI: 0%-2.2%; I² = 0.67). Multivariable meta-regression analysis showed that the tissue adequacy rate was not significantly lower in studies on rebiopsies (p = 0.058). The complication rate was significantly higher in studies that preferentially included older adults (p = 0.001). Conclusion: PTNB demonstrated an average tissue adequacy rate of 89.3% for molecular analysis in patients with NSCLC, with a complication rate of 17.3%. PTNB is a generally safe and effective diagnostic procedure for obtaining tissue samples for molecular analysis in NSCLC. Rebiopsy may be performed actively with an acceptable risk of complications if clinically required.

• Research in Community and Public Health Nursing
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• v.28 no.4
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• pp.375-385
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• 2017

Purpose: This study aims to examine the relationships among social discrimination, subjective health, and personal satisfaction based on the country of origin. Methods: The analysis was based on 16,958 immigrants who participated in the National Survey of Multicultural Family 2015 in Korea. This study conducted stratified cross-analysis of social discrimination for the differences in subjective health and personal satisfaction. Multivariate-adjusted odds ratios and 95% confidence intervals for the relationships among social discrimination, subjective health, and personal satisfaction were examined with multivariable logistic regression. Results: There were differences in experience of social discrimination, subjective health status, and personal satisfaction according to the country of origin. Groups without the experience of social discrimination had better subjective health and personal satisfaction than the other groups. Conclusion: This study demonstrates that a discrimination prevention program needs to be developed based on a cultural approach.

• Water Engineering Research
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• v.2 no.3
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• pp.171-178
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• 2001

There are three methods for analyzing flow and pressure distribution in looped water distribution networks (the loop method, the node method, the element method) taking into consideration hydraulic parameters chosen as unknown. For all these methods the non-linear system of equations can be solved by iterative procedures. The paper presents a different approach to this problem by using the method of variational formulations for hydraulic analysis of water distribution networks. This method has the advantage that it uses a specialized optimization algorithm which minimizes directly an objective multivariable function without constraints, implemented in a computer program. The paper compares developed method to the classic Hardy-Cross method. This shows the good performance of the new method.

• Steel and Composite Structures
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• v.24 no.3
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• pp.369-382
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• 2017

This study investigates the reliability of the performance levels of moment resisting steel frames subjected to lateral loads such as wind and earthquake. The reliability assessment has been performed with respect to three performance levels: serviceability, damageability, and ultimate limit states. A four-story moment resisting frame is used as a typical example. In the reliability assessment the uncertainties in the loadings and in the capacity of the frame have been considered. The wind and earthquake loads are assumed to have lognormal distribution, and the frame resistance is assumed to have a normal distribution. In order to obtain an appropriate limit state function a linear relation between the loading and the deflection is formed. For the reliability analysis an algorithm has been developed for determination of limit state functions and iterations of the first order reliability method (FORM) procedure. By the method presented herein the multivariable analysis of a complicated reliability problem is reduced to an S-R problem. The procedure for iterations has been tested by a known problem for the purpose of avoiding convergence problems. The reliability indices for many cases have been obtained and also the effects of the coefficient of variation of load and resistance have been investigated.