• 제목/요약/키워드: Multivariate Assessment

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Risk and protective factors affecting sensory recovery after breast reconstruction

  • Bae, Jae Young;Shin, Ha Young;Song, Seung Yong;Lee, Dong Won
    • Archives of Plastic Surgery
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    • 제48권1호
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    • pp.26-32
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    • 2021
  • Background Although loss of sensation in patients with breast cancer after mastectomy followed by breast reconstruction is an important factor affecting patients' quality of life, the mechanism of sensory recovery is still unclear. Our study aimed to identify variables that affect sensory recovery, especially pain, in reconstructed breasts. Methods All patients with breast cancer who underwent mastectomy followed by immediate breast reconstruction, including nipple reconstruction or areolar tattooing, were included in this study. Sensation was evaluated in the nipple as an endpoint of sensation recovery of the whole breast. Patients rated pain severity using a 3-point verbal rating scale (VRS): grade 0, no pain; grade 1, mild to moderate pain; and grade 2, severe pain. The VRS was assessed by a single experienced plastic surgeon. Results In the univariate analysis, the odds ratio (OR) for sensation recovery was 0.951 for age (P=0.014), 0.803 for body mass index (P=0.001), 0.996 for breast volume before surgery (P=0.001), 0.998 for specimen weight after mastectomy (P=0.040), and 1.066 for the period between mastectomy and sensory assessment (P=0.003). In the multivariate analysis, the variables that showed a significant effect were age (OR, 0.953; P=0.034), the period between mastectomy and sensory assessment (OR, 1.071; P=0.006), and reconstruction using abdominal tissue instead of prosthetic reconstruction (OR, 0.270; P=0.004). Conclusions Based on our results, it can be inferred that aging has a negative impact on the recovery of sensation, breast sensation improves with time after surgery, and the recovery of sensation is better in prosthetic reconstruction.

행동 시계열 데이터와 k-평균 군집화를 통한 젖소의 일일 행동패턴 검출 (Daily Behavior Pattern Extraction using Time-Series Behavioral Data of Dairy Cows and k-Means Clustering)

  • 이성훈;박기철;박재화
    • 한국소프트웨어감정평가학회 논문지
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    • 제17권1호
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    • pp.83-92
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    • 2021
  • 지난 동안 낙농업계에서는 다양한 센서 기술과 ICT 응용이 도입되어왔으며 축적된 낙농 데이터를 토대로 과학적인 낙농생산관리가 가능해졌다. 그러나 이러한 시도들은 젖소의 출산이나 우유 생산량과 같은 낙농 생산성에 직접적으로 관여하는 요인들에 대해서만 집중적으로 이루어졌으며 이러한 결과에 근본적으로 관여하는 생리학적 혹은 동물심리학적 요인에 대해서는 연구가 더딘 실정이다. 이 논문에서는 이러한 연구의 일환으로서 젖소의 시간별 행동 데이터로부터 일일 행동패턴을 검출하는 기초적인 방안을 제시하였다. k-평균 군집화를 통해 한 젖소의 1594일간 행동을 네 개의 군집으로 구분하였으며 각 군집에 속한 데이터와 군집의 대푯값을 시각화하여 군집 형성의 합리성을 확인하였다. 또한 개체의 일별 군집 변화를 토대로 군집 개수의 적정성을 판단하였다. 이 연구 결과가 향후 젖소의 이상상태나 질병징후의 포착 연구에 기여하기를 기대한다.

Neuropathic pain feature in cancer-induced bone pain: does it matter? a prospective observational study

  • Nantthasorn Zinboonyahgoon;Choopong Luansritisakul
    • The Korean Journal of Pain
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    • 제36권2호
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    • pp.253-267
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    • 2023
  • Background: Cancer-induced bone pain (CIBP) is considered to have both nociceptive and neuropathic components. However, the prevalence, risk factors, and impact of the neuropathic components are yet poorly understood. Methods: We estimate the prevalence of neuropathic pain (NP) features in patients with CIBP at a tertiary care pain clinic setting using the Douleur Neuropathique 4 questionnaire and evaluate their associated factors and their impact after 4 weeks of treatment using the Brief Pain Inventory questionnaire and the Edmonton Symptom Assessment System. Results: A total of 133 patients were recruited. The estimated prevalence of NP was 30.8% (95% confidence interval: 23.6%-39.1%). Initially, the patients with NP had significantly higher average pain scores (6.00 vs. 5.05, P = 0.006), higher total interference scores (5.84 vs. 4.89, P = 0.033), and symptom distress scores (35.88 vs. 26.52, P = 0.002). After 4 weeks of treatment, patients in both groups reported significantly decreased pain intensity and improved quality of life. However, the patients with NP still reported significantly higher average pain (4.61 vs. 3.58, P = 0.048), trending toward higher total interference scores (3.52 vs. 2.99, P = 0.426), and symptom distress scores (23.30 vs. 20.77, P = 0.524). From multivariate analysis, the independent risk factors for NP were younger age, pain in the extremities, and higher average pain scores. Conclusions: NP are common in patients with CIBP. These conditions negatively affect pain intensity and the patient's quality of life before and after treatment.

An Index to Assess Overwork-Related Adverse Effects on Employees Under the Occupational Safety and Health Act in Taiwan

  • Yu-Cheng Lin;Yu-Wen Lin
    • Safety and Health at Work
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    • 제13권4호
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    • pp.401-407
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    • 2022
  • Background: The present study aimed to digitally evaluate the risk of overwork-related adverse effects (OrAEs) among employees from various occupational categories in Taiwan. Methods: Anonymous data of employees from seven companies/factories providing occupational health services were analyzed. The studied population comprised 5505 employees, and the data analyzed included employment duration, working hours, shift work schedules, and health checkup results. The risk for OrAEs was assessed by an index, Karo index (0-4, the larger the value, the higher the risk for OrAEs) obtained using a risk matrix made up of cardiocerebral and occupational risk factors. Karo index values of 3 and 4 were categorized as at high risk for OrAEs (h-OrAEs). Results: The 5505 employees had an average employment duration of 8.5 years and a mean age of 39.4 years. The prevalence rates for h-OrAEs of the seven companies/factories ranged from 3.9% to 34.2%. There were significant differences in prevalence rates for h-OrAEs between employees of retail stores and high-tech manufacturing factories. Multivariate analysis results indicated that workers of high-tech manufacturing factories had significantly higher risk for h-OrAEs compared with retail store workers. Conclusion: In terms of satisfying health risk management and legal requirements in Taiwan, the newly issued Karo index, which covers a wide range of occupational risk factors, can serve as an assessment and a warning tool for managing the risk of OrAEs in workplaces. To reduce risks for h-OrAEs, active and prudent control of cerebrocardiovascular risks and working hours is recommended.

노인장기요양보험 재가서비스 이용량 결정요인 (Determinants of Amount of Service Use in Community-Based Long-term Care for Elders)

  • 이태화;김복남
    • 간호행정학회지
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    • 제18권4호
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    • pp.402-413
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    • 2012
  • Purpose: This study was done to explore factors related to amount of service use for elders with long-term care needs. Methods: A descriptive-correlation design was used. The sample included 259 elders and their primary caregivers who had cared for the elders for at least 6 months. Data on long-term care need assessment, service use and interviews with primary caregivers were analyzed. Results: There was no significant relationship between the sociodemographic characteristics and the amount of services use. Amount of service use differed significantly by Long-term care classification. The mean scores for class 1, 2 and 3 were 22.68, 21.47 and 17.87 days respectively. Primary caregiver relationship with the elders and the number of family-friend helpers were also significant. Multivariate regression analysis showed that gender, marital status, activities of daily living, cognitive impairment, and secondary caregiver support explained 17% of the total variance of service use among these elders (F=3.50, p<.001). Conclusion: The results of this study indicate that critical factors including secondary caregiver support and individual background, and other functional dependencies except for physical function should be considered in accurately predicting the amount of service use for community dwelling elders with long-term care needs.

Mast Cell Concentrations in Peripheral and Central Giant Cell Granulomas: Is there any Angiogenetic Role?

  • Farhadi, Sareh;Shahsavari, Fatemeh;Taleghani, Ferial;Komasi, Elaheh
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.673-676
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    • 2016
  • Background: In the maxillofacial region, giant cell granulomas occur in 2 clinical forms, central and peripheral. Despite histopathological similarity between these 2 forms totally different clinical behaviors have been reported. The present study was undertaken to compare mast cell and vascular concentrations in these pathologic lesions. Materials and Methods: In this cross-sectional descriptive study, 20 pathological samples of central giant cell granuloma (CGCG) and 20 samples of peripheral giant cell granuloma (PGCG) were selected and examined through toluidine blue staining for mast cell assessment and immunohistochemical staining by VEGEF antibody for comparing the number of mast cells. T-test, chi-squared test and backward multivariate linear regression were used for statistical analysis using SPSS 20. Statistical significance was set at P<0.05. Results: This study showed significantly greater VEGF expression and mast cell concentrations in CGCG compared to PGCG cases. Also there was a significant correlation between VEGF expression and the concentration of mast cells. No relation was found between age, sex and site of the lesion and concentration of mast cells or VEGF expression. Conclusions: It is feasible that higher concentrations of mast cells in CGCG versus PGCG samples might lead to more aggressive clinical behavior via vascular proliferation and angiogenesis. However, other biologic mechanisms should be considered in this situation.

Cardiovascular risk may be increased in women with unexplained infertility

  • Verit, Fatma Ferda;Zeyrek, Fadile Yildiz;Zebitay, Ali Galip;Akyol, Hurkan
    • Clinical and Experimental Reproductive Medicine
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    • 제44권1호
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    • pp.28-32
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    • 2017
  • Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.

Implicit Treatment of Technical Specification and Thermal Hydraulic Parameter Uncertainties in Gaussian Process Model to Estimate Safety Margin

  • Fynan, Douglas A.;Ahn, Kwang-Il
    • Nuclear Engineering and Technology
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    • 제48권3호
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    • pp.684-701
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    • 2016
  • The Gaussian process model (GPM) is a flexible surrogate model that can be used for nonparametric regression for multivariate problems. A unique feature of the GPM is that a prediction variance is automatically provided with the regression function. In this paper, we estimate the safety margin of a nuclear power plant by performing regression on the output of best-estimate simulations of a large-break loss-of-coolant accident with sampling of safety system configuration, sequence timing, technical specifications, and thermal hydraulic parameter uncertainties. The key aspect of our approach is that the GPM regression is only performed on the dominant input variables, the safety injection flow rate and the delay time for AC powered pumps to start representing sequence timing uncertainty, providing a predictive model for the peak clad temperature during a reflood phase. Other uncertainties are interpreted as contributors to the measurement noise of the code output and are implicitly treated in the GPM in the noise variance term, providing local uncertainty bounds for the peak clad temperature. We discuss the applicability of the foregoing method to reduce the use of conservative assumptions in best estimate plus uncertainty (BEPU) and Level 1 probabilistic safety assessment (PSA) success criteria definitions while dealing with a large number of uncertainties.

청소년이 인지하는 부모양육행동과 흡연 및 음주와의 관련성 (The Relationship between Smoking, Alcohol Drinking, and Parenting Behavior Perceived by Adolescents)

  • 노윤호;김은주
    • 보건교육건강증진학회지
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    • 제30권2호
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    • pp.71-82
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    • 2013
  • Objectives: The purpose of this study was to analysis the health behaviors differences of adolescents depending on whether parenting behavior perceived by adolescents. Methods: The data which is used in this study was extracted from the 2011 second korean adolescents' penal data collected by the National Youth Policy Institute. Multivariate logistic regression analysis was performed in order to find how degree parents relationship factors are associated with adolescents' health behavior after adjusting sex, smoking(alcohol drinking) friends, and other significant variables. The data was processed by SAS 9.1. Results: Respondent's general characteristics such as smoking(alcohol drinking)friends, parents' job were positively relative to smoking and alcohol drinking experience. Also Parents's affection and experience of being abused from parents were significantly associated with smoking(alcohol drinking) experience. Conclusions: Negative vertical attitude for children is important for the health risk behaviors of adolescents. To increase effectiveness of the health policy for the adolescents in korea, it is important to adapt new strategy to include the positive empowerment of adolescents' social networks except for smoking(alcohol drinking)friends and policy support to turn negative vertical attitude for children into positive attitude for children.

정신분열병 입원 환자에서의 대사 증후군 유병률 연구 (The Prevalence of Metabolic Syndrome in Inpatients with Schizophrenia)

  • 노재우;조연수;조애화
    • 생물정신의학
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    • 제18권1호
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    • pp.46-54
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    • 2011
  • Objectives : The objective of this study is to assess the prevalence and risk factors of metabolic syndrome (MS) among inpatients with schizophrenia, and to compare with general population. Methods : Nine hundreds seventy inpatients were included to assess the prevalence of MS from two mental hospitals in Yong-in city. Assessment of MS was performed based on modified American Heart Association criteria with abdominal obesity threshold of 90cm for men, 85cm for women. Comparative analysis was performed using age- and gender matched sample from Korea Health and Nutritional Examination Survey III. For evaluating risk factors, analysis included 766 inpatients taking consistent medications at least for 30 days. Results : The prevalence of MS of inpatients with schizophrenia was 26.2%, in females it was 33.2%, compared to 20.2% in males(p < 0.001). Compared to general population, the prevalence of MS was significantly lower in male and higher in female patients. In terms of criteria prevalence, who met abdominal circumference criterion were more prevalent in patient group(p < 0.001). After multivariate analysis, female gender and old age remained as risk factors of MS. Conclusions : The prevalence of MS of inpatients with schizophrenia was 26.2% and significantly low compared to general population. Female gender and old age were risk factors of MS.