• Title/Summary/Keyword: Multivariate Regression

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Analysis of Treatment Failure after Curative Radiotherapy in Uterine Cervical Carcinoma (자궁경부암에 있어서 방사선치료 후의 치료실패 분석)

  • Chai, Gyu-Young;Kang, Ki-Mun;Lee, Jong-Hak
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.224-229
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    • 2001
  • Purpose : The aim of this study is to analyze the treatment failure patterns and the risk factors for locoregional or distant failure of uterine cervical carcinoma treated with radiation therapy. Materials and methods . A retrospective analysis was undertaken of 154 patients treated with curative radiation therapy in Gyeongsang National University Hospital from April 1989 through December 1997. According to FIGO classification, 12 patients were stage IB, 24 were IIA, 98 were IIB, 1 were IIIA, 17 were IIIB, 2 were IVA. Results : Overall treatment failure rate was $42.1\%$ (65/154), and that of complete responder was $31.5\%$ (41/130). Among 65 failures, 25 failed locoregionally, another 25 failed distantly, and 15 failed locoregionally and distantly. Multivariate analysis confirmed tumor size (>4 cm) as risk factor for locoregional failure, and tumor size (>4 cm), pelvic lymph node involvement as risk factors for distant failure. Conclusion : On the basis of results of our study and recent published data of prospective randomized study for locally advanced uterine cervical carcinoma, we concluded that uterine cervical carcinoma with size more than 4 cm or pelvic lymph node involvement should be treated with concurrent chemoradiation.

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The Role of Pelvic Irradiation after Hysterectomy in Early Stage Cervical Carcinoma with Pelvic Nodal Metastasis (림프절 전이를 동반한 초기 자궁경부암에서 수술 후 방사선치료의 역할)

  • Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.469-475
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    • 1998
  • Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

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Vitamin D Deficiency and Related Factors in Patients at a Hospice (일개 호스피스 병동에서 비타민 D 결핍 현황 및 관련인자)

  • Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.27-33
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    • 2014
  • Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.

Factors Related to Knowledge, Health Belief and Sick Role Behavior to the Coronary Artery Disease among Patients with Coronary Artery Disease (관상동맥질환자의 관상동맥질환에 대한 지식, 건강신념 및 환자역할행위에 관련된 요인)

  • Kang, Young-Ok;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.11
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    • pp.4985-4994
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    • 2011
  • The purpose of this study was to investigate the level of knowledge, health belief and sick role behavior, and the influencing factors on them among the patients with coronary artery disease. The study subjects were 168 patients diagnosed as having coronary artery disease at a university hospital during the period from July 1st, to August 31th, 2010. As a results, Based on the mean scores of knowledge about coronary artery disease according to the general characteristics, they were significantly higher in males than in females(p=0.033). The mean scores of health belief were significantly higher according to age decrease(p=0.043). The mean scores of sick role behaviors were significantly higher in females than in males(p=0.006), with their increasing tendency in the age range from 40's to 60's and decreasing tendency in the age over 70's(p=0.015), the group with religion were significantly higher than the one without(p=0.050). In terms of the mean scores of knowledge and sick role behaviors about coronary artery disease according to the related characteristics, there was a significant difference with the time period elapsed after diagnosed as coronary artery disease, frequency of admissions, perception about the disease, information gathering through mass com. but in terms of those of health belief, there was a not significant difference in all the variables. The significantly influencing factors on degree of knowledge by multivariate regression analysis included degree of perception about a disease, scores of sick role behavior, presence of coronary artery diseases in a family or friends, and the time period elapsed after diagnosed as having coronary artery disease. Those on health belief included age and scores of sick role behavior, and those on sick role behaviors included score of knowledge, perception about a disease, age, BMI, and religion. The results showed a significant difference with their general characteristics or coronary artery disease-related factors.

Associations of serum 25(OH)D levels with depression and depressed condition in Korean adults: results from KNHANES 2008-2010 (한국 성인의 혈청 25(OH)D 수준과 우울증 및 우울증상 경험과의 연관성: 국민건강영양조사 2008-2010 분석 결과)

  • Koo, Sle;Park, Kyong
    • Journal of Nutrition and Health
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    • v.47 no.2
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    • pp.113-123
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    • 2014
  • Purpose: Vitamin D has been known to play an important role in the central nervous system and brain functions in the human body, and cumulative evidence has shown that vitamin D deficiency might be linked with various mental health conditions. Epidemiologic studies have shown that vitamin D deficiency may be associated with higher risk of depression in the US and European populations. However, limited information is available regarding the association between vitamin D status and depression in the Korean population. The objective of this study was to examine the associations between vitamin D levels and prevalence of depression. Methods: We conducted a cross-sectional analysis using nationally representative data from the 2008-2010 Korean National Health and Nutrition Examination Survey from which serum 25-hydroxyvitamin D concentrations were available. A total of 18,735 adults who had available demographic, dietary, and lifestyle information were included in our analysis. We defined "depression" with a diagnosis by a physician. "Depressed condition" was defined as having feelings of sadness or depression without diagnosis by a physician. Results: The prevalence of depression was 1.63% and 5.43% in Korean men and women, respectively; 12.5% of men and 26.1% of women were defined as the group having depressed conditions. In multivariate logistic regression models, no significant associations were observed between vitamin D status and prevalence of depression or depressed conditions in Korean men and women. Conclusion: We found no association between vitamin D insufficiency and depression/depressed conditions in Korean adults. Future large prospective studies and randomized controlled trials are needed to confirm this relationship.

Reduced Ovarian Cancer Incidence in Women Exposed to Low Dose Ionizing Background Radiation or Radiation to the Ovaries after Treatment for Breast Cancer or Rectosigmoid Cancer

  • Lehrer, Steven;Green, Sheryl;Rosenzweig, Kenneth E
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2979-2982
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    • 2016
  • Background: High dose ionizing radiation can induce ovarian cancer, but the effect of low dose radiation on the development of ovarian cancer has not been extensively studied. We evaluated the effect of low dose radiation and total background radiation, and the radiation delivered to the ovaries during the treatment of rectosigmoid cancer and breast cancer on ovarian cancer incidence. Materials and Methods: Background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States, 2011. Ovarian cancer incidence data are from the Centers for Disease Control and Prevention. Standardized incidence ratios (SIR) of ovarian cancer following breast cancer and rectosigmoid cancer are from Surveillance, Epidemiology, and End Results (SEER) data. Obesity data by US state are from the Centers for Disease Control and Prevention. Mean ages of US state populations are from the United States Census Bureau. Results: We calculated standardized incidence ratios (SIR) from Surveillance, Epidemiology, and End Results (SEER) data, which reveal that in 194,042 cases of breast cancer treated with beam radiation, there were 796 cases of ovarian cancer by 120+ months of treatment (0.41%); in 283, 875 cases of breast cancer not treated with radiation, there were 1,531 cases of ovarian cancer by 120+ months (0.54%). The difference in ovarian cancer incidence in the two groups was significant (p < 0.001, two tailed Fisher exact test). The small dose of scattered ovarian radiation (about 3.09 cGy) from beam radiation to the breast appears to have reduced the risk of ovarian cancer by 24%. In 13,099 cases of rectal or rectosigmoid junction cancer treated with beam radiation in the SEER data, there were 20 cases of ovarian cancer by 120+ months of treatment (0.15%). In 33,305 cases of rectal or rectosigmoid junction cancer not treated with radiation, there were 91 cases of ovarian cancer by 120+ months (0.27%). The difference in ovarian cancer incidence in the two groups was significant (p = 0.017, two tailed Fisher exact test). In other words, the beam radiation to rectum and rectosigmoid that also reached the ovaries reduced the risk of ovarian cancer by 44%. In addition, there was a significant inverse relationship between ovarian cancer in white women and radon background radiation (r = - 0.465. p = 0.002) and total background radiation (r = -0.456, p = 0.002). Because increasing age and obesity are risk factors for ovarian cancer, multivariate linear regression was performed. The inverse relationship between ovarian cancer incidence and radon background was significant (${\beta}=-0.463$, p = 0.002) but unrelated to age (${\beta}=-0.080$, p = 0.570) or obesity (${\beta}=-0.180$, p = 0.208). Conclusions: The reduction of ovarian cancer risk following low dose radiation may be the result of radiation hormesis. Hormesis is a favorable biological response to low toxin exposure. A pollutant or toxin demonstrating hormesis has the opposite effect in small doses as in large doses. In the case of radiation, large doses are carcinogenic. However, lower overall cancer rates are found in U.S. states with high impact radiation. Moreover, there is reduced lung cancer incidence in high radiation background US states where nuclear weapons testing was done. Women at increased risk of ovarian cancer have two choices. They may be closely followed (surveillance) or undergo immediate prophylactic bilateral salpingo-oophorectomy. However, the efficacy of surveillance is questionable. Bilateral salpingo-oophorectomy is considered preferable, although it carries the risk of surgical complications. The data analysis above suggests that low-dose pelvic irradiation might be a good third choice to reduce ovarian cancer risk. Further studies would be worthwhile to establish the lowest optimum radiation dose.

A study on comparison of predictive factors on happiness among male and female aged living alone (남녀 독거노인의 행복감 예측요인 비교 연구)

  • Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.392-402
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    • 2019
  • The purpose of this study is to determine the factors that predict happiness among aged males and females who live alone, and we focused on their satisfaction with their socio-physical environment, their social network, regular participation in social activities, their subjective health status and if they suffer from depression. A total of 2,76 people were the subjects of this study, their average age was 65 years old, they lived alone and all of them were selected from the '2017 Community Health Survey' data. The data was analyzed utilizing the Chi-square test, the Mann-Whitney test and multivariate logistic regression analysis. The subjects were 605 males (21.86%) and 2,163 females (78.14%). For the result of this study, the significant predictive factors of happiness for aged males living alone were monthly income (OR=2.363, 95% CI=1.473-3.791), basic livelihood rights (OR=1.903, 95% CI=1.144-3.167), trusting their neighbors (OR=2.018, 95% CI=1.263-3.225), religious activities (OR=2.098, 95% CI=1.314-3.349), subjective health (OR=2.753, 95% CI=1.217-6.228), and depression (OR=0.852, 95% CI=0.803-0.905). The significant predictive factors of happiness for aged females living alone were income (OR=2.407 95% CI=1.362-4.253), basic livelihood rights (OR=1.350, 95% CI=1.019-1.788), contact with friends (OR=1.879, 95% CI=1.323-2.669), religious activities (OR=1.372, 95% CI=1.124-1.676), recreation/leisure activities (OR=1.608, 95% CI=1.161-2.228), subjective health (OR=5.327, 95% CI=1.347-21.070), and depression (OR=0.864, 95% CI=0.840-0.890). In conclusion, programs to enhance happiness should be developed with considering the characteristics affecting the happiness of aged Korean males and females who live alone.

Comparison of Models for Stock Price Prediction Based on Keyword Search Volume According to the Social Acceptance of Artificial Intelligence (인공지능의 사회적 수용도에 따른 키워드 검색량 기반 주가예측모형 비교연구)

  • Cho, Yujung;Sohn, Kwonsang;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.103-128
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    • 2021
  • Recently, investors' interest and the influence of stock-related information dissemination are being considered as significant factors that explain stock returns and volume. Besides, companies that develop, distribute, or utilize innovative new technologies such as artificial intelligence have a problem that it is difficult to accurately predict a company's future stock returns and volatility due to macro-environment and market uncertainty. Market uncertainty is recognized as an obstacle to the activation and spread of artificial intelligence technology, so research is needed to mitigate this. Hence, the purpose of this study is to propose a machine learning model that predicts the volatility of a company's stock price by using the internet search volume of artificial intelligence-related technology keywords as a measure of the interest of investors. To this end, for predicting the stock market, we using the VAR(Vector Auto Regression) and deep neural network LSTM (Long Short-Term Memory). And the stock price prediction performance using keyword search volume is compared according to the technology's social acceptance stage. In addition, we also conduct the analysis of sub-technology of artificial intelligence technology to examine the change in the search volume of detailed technology keywords according to the technology acceptance stage and the effect of interest in specific technology on the stock market forecast. To this end, in this study, the words artificial intelligence, deep learning, machine learning were selected as keywords. Next, we investigated how many keywords each week appeared in online documents for five years from January 1, 2015, to December 31, 2019. The stock price and transaction volume data of KOSDAQ listed companies were also collected and used for analysis. As a result, we found that the keyword search volume for artificial intelligence technology increased as the social acceptance of artificial intelligence technology increased. In particular, starting from AlphaGo Shock, the keyword search volume for artificial intelligence itself and detailed technologies such as machine learning and deep learning appeared to increase. Also, the keyword search volume for artificial intelligence technology increases as the social acceptance stage progresses. It showed high accuracy, and it was confirmed that the acceptance stages showing the best prediction performance were different for each keyword. As a result of stock price prediction based on keyword search volume for each social acceptance stage of artificial intelligence technologies classified in this study, the awareness stage's prediction accuracy was found to be the highest. The prediction accuracy was different according to the keywords used in the stock price prediction model for each social acceptance stage. Therefore, when constructing a stock price prediction model using technology keywords, it is necessary to consider social acceptance of the technology and sub-technology classification. The results of this study provide the following implications. First, to predict the return on investment for companies based on innovative technology, it is most important to capture the recognition stage in which public interest rapidly increases in social acceptance of the technology. Second, the change in keyword search volume and the accuracy of the prediction model varies according to the social acceptance of technology should be considered in developing a Decision Support System for investment such as the big data-based Robo-advisor recently introduced by the financial sector.

Effect of Facet Tropism on the Degeneration of the Cervical Facet Joint and Intervertebral Disc (경추의 후관절 퇴행과 추간판 퇴행에서 후관절 비대칭성의 영향)

  • Chung, Sung Soo;Park, Chan-Ho;Heo, Ki Seong
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.413-418
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    • 2021
  • Purpose: To investigate the effect of facet tropism on the degeneration of facet joint and intervertebral disc in the cervical spine. Materials and Methods: From January 2017 to December 2018, cervical tropism of 100 patients at the C5/6 level was analyzed retrospectively. In computed tomography (CT), the orientation and tropism of the facet joint with respect to the sagittal, coronal, and horizontal planes were measured. Regression of the facet joint in magnetic resonance imaging (MRI) and CT was assessed using a grading system. Intervertebral disc degeneration was assessed and divided into five grades on MRI. For the left and right asymmetry, a difference between two facet angles of less than 7° was classified as the control group, more than 7° was classified as the tropism group. Results: The mean age of the patients was 55.44±12.3 years (31-81 years) in the tropism group and 55.66±10.7 years (32-76 years) in the control group. In the tropism group, 32 were male and 18 were female. In the control group, 24 were male and 26 were female. Facet joint degeneration was identified in 24 patients (48.0%) in the tropism group and 14 patients (28.0%) in the control group, showing a significant difference. Intervertebral disc degeneration was identified in 29 patients (58.0%) in the tropism group and 17 patients (34.0%) in the control group, showing a significant difference. Multivariate revealed, tropism to be a factor that affected the facet joint and intervertebral disc degeneration. Conclusion: Facet joint and intervertebral disc degeneration occurred significantly in the tropism group, and tropism is a factor affecting the degeneration of facet joint and intervertebral disc in the C5/6 level.

Characteristics Associated with Citation Rates of the Journal of Korean Orthopaedic Association (An Analysis of Articles between 2001-2015) (대한정형외과학회지에 발표된 논문들의 피인용 횟수와 연관된 특성(2001년부터 2015년까지의 논문 분석))

  • Bae, Jung Yun;Kwak, Sang Ho;Kang, Sang Woo;Woo, Seung Hun;Ahn, Tae Young;Lee, Sang Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.487-494
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    • 2020
  • Purpose: No attempt has been made to identify the relationship between the study characteristics and citation rates of articles published in the Journal of the Korean Orthopaedic Association (JKOA). This study classified the study characteristics of articles in the JKOA and analyzed the relationship between the study characteristics and citation rates. Materials and Methods: A cohort study was conducted on all articles published from February 2001 to December 2015. Three independent reviewers classified the articles according to the article type, material, time of the study, design, clinical categories, number of authors, and number of cases. The citation numbers of each article by other journals were taken in January 2020. Univariate analyses were conducted to assess the effect of each characteristic, and multivariate linear regression analysis was performed to analyze the overall relationship between the characteristics and the citation rates. Results: A total of 1,640 articles were published from 2001 to 2015, and 724 articles were cited more than once. The articles published in 2009 had the highest average number of citations. Original articles had the highest citation rates, followed in descending order by surgical techniques and reviews, instructional course lectures, and case reports (p<0.001). Among the case reports, articles dealing with general trauma scored significantly higher average citations (mean=1.5, p=0.006). Among the original articles, articles on general orthopedics had the highest citation rates, followed in order by clinical articles and experimental articles. Among the clinical articles, epidemiologic studies (mean=5.0, p<0.001) and studies on the spine (mean=1.7, p<0.001) recorded significantly higher citation rates than the others. Conclusion: Of all the articles published in the JKOA from 2001 to 2015, articles dealing with general trauma had the highest citation rates among case reports. Among the original articles, epidemiologic studies and studies concerning the spine were cited significantly more than others.