• Journal of Korean Biological Nursing Science
• /
• 제25권1호
• /
• pp.63-72
• /
• 2023

Purpose: This study investigated the knowledge, attitudes, and perceptions of a safe environment, as well as self-reported and observed compliance with the use of personal protective equipment (PPE), among intensive care unit (ICU) nurses. Methods: This study was conducted in October 2021 with 55 nurses working in the medical and surgical ICUs of a general hospital in Seoul. A self-reported questionnaire and an observational tool for compliance with the use of PPE were used to collect data. Results: Except for masks, the observed compliance for all other PPE types was lower than the self-reported compliance. Male nurses showed significantly higher observed compliance than female nurses. Self-reported compliance with PPE use, including "when there is a possibility of contact with objects contaminated with blood or body fluids, mucous membranes, damaged skin, or contaminated skin" (r = .23, p = .015) and "when there is a possibility of contact with blood, body fluids, secretions, or exudates" (r = .27, p = .004) showed significant correlations with knowledge of PPE. In the results for self-reported compliance with PPE use, gown use had a significant correlation with knowledge (r = .24, p < .001) and perceptions of a safe environment (r = .15, p = .016) for PPE, and gloves showed significant correlations with attitudes (r = .14, p = .024) and perceptions of a safe environment (r = .18, p = .003). Conclusion: The observed compliance with PPE use tended to be lower than the self-reported compliance among ICU nurses. It is necessary to develop and apply an effective educational program that can enhance improve actual compliance with PPE use among intensive care unit nurses.

• 한국차세대컴퓨팅학회논문지
• /
• 제13권6호
• /
• pp.66-76
• /
• 2017

본 연구에서는 OMOP(Observational Medical Outcomes Partnership) CDM(Common Data Model) 구축시 개인의료정보를 보호하는 방법을 연구하였다. 제안된 방법은 HIPAA(The Health Insurance Portability and Accountability Act) PHI(Protected Health Information)에 대응되는 데이터가 CDM으로 추출 되는 것을 제한하거나 식별 불능 화 처리 하는 것이다. 하지만 한국의 개인정보보호법 및 의료법에는 민감 정보의 처리 제한에 관한 내용은 존재하나 그 민감 정보가 무엇인지에 관한 명확한 규정은 없어 개인의료정보 보호를 위한 민감 정보 선정에 어려움이 있다. 본 연구에서는 이러한 문제를 해결하기 위해 HIPAA PHI를 개인정보 보호법 제23조 민감 정보의 처리 제한 기준으로 정하고 CDM데이터와 매핑 하였다. 본 연구를 통해 CDM구축 시 발생되는 개인의료 정보 보호문제에 대한 해결 방법을 제시함으로써 국내 CDM구축 확산에 기여할 것으로 예상된다.

• Physical Therapy Rehabilitation Science
• /
• 제12권3호
• /
• pp.222-228
• /
• 2023

Objective: Training-related injuries and attrition put an additional burden on police and military institutions. Preventing and minimizing musculoskeletal injuries is the primary concern of the Abu Dhabi Police. Therefore, this study aimed to evaluate the correlation between functional movement screen, lower-limb strength, Y-balance test, grip strength and vertical jump and the incidence of musculoskeletal injuries among Abu Dhabi police recruits. Design: Observational analytical study. Methods: An observational study was conducted on 400 male police recruits of Abu Dhabi Police Academy. Physical performance was assessed before the 16-weeks basic police training. Spearman's correlation evaluated the correlation between the performance parameters and the outcome measures and logistic regression predicted the risk factors associated with musculoskeletal injuries. Results: 149 (34.4%) participants reported at least one injury during the basic police training. Comparison between injured and non-injured participants showed significant difference in mean right Y-balance, back-leg-chest dynamometer, and vertical jump (p=0.02, p=0.02, and p=0.04, respectively). Spearman's correlation showed a significant negative correlation between risk of injury and back-leg-chest dynamometer and right Y balance (ρ= -0.11, p=0.03). Logistic regression showed that back-leg-chest dynamometer and right Y balance were significant predictors of injury (p =.036 and p=0.037; Odds ratio=0.96; 95% CI (0.92, 0.99) and Odds ratio=0.99; 95% CI (0.98,0.99). Conclusions: Our findings suggest functional movement screen and grip strength may not independently predict injury rates, balance and lower-limb strength needs to be considered in injury prevention strategies to reduce musculoskeletal injuries.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제24권3호
• /
• pp.173-185
• /
• 2024

Background: Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods: A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results: In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54±17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion: The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

• 대한한방내과학회지
• /
• 제45권1호
• /
• pp.1-10
• /
• 2024

Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제50권3호
• /
• pp.146-152
• /
• 2024

Objectives: This prospective observational study aimed to assess the clinical outcomes of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer. The study described the frequencies and types of procedures for securing the airway and the duration and types of postoperative ventilatory support. We compared the findings with those of the TRACHY study. Patients and Methods: One hundred patients undergoing oral cavity oncological surgeries were included. Airway assessment included inter-incisor gap, Mallampati class, neck movements, and radiological features. Surgical parameters, postoperative ventilatory support, and complications were documented. Results: The buccal mucosa was the most common cancer site (48.0%), and direct laryngoscopy was deemed difficult in 58.0% of patients. Awake fibreoptic intubation or elective tracheostomy was required in 43.0% of cases. Thirty-three patients were extubated on the table, and 34 patients were successfully managed with a delayed extubation strategy. In comparison with the TRACHY study, variations were observed in demographic parameters, tumour characteristics, and surgical interventions. Our mean TRACHY score was 1.38, and only five patients had a score ≥4. Prophylactic tracheostomy was performed in 2.0% of cases, in contrast to the TRACHY study in which 42.0% of patients underwent the procedure. Conclusion: The study emphasizes the challenges in airway management for oral cavity cancer surgery. While prophylactic tracheostomy may be necessary in specific cases, individualized approaches, including delayed extubation, are preferrable to maximize safety. Our findings contribute to better understanding and managing perioperative challenges in oral cancer patients and highlight the need for personalized strategies. Scoring systems like TRACHY should not be accepted as universally applicable.

• Journal of Yeungnam Medical Science
• /
• 제41권2호
• /
• pp.86-95
• /
• 2024

Background: This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital. Methods: The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders. Results: The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45-4.98), sleep disorders (HR, 2.27; 95% CI, 1.76-2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25-2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09-2.15). Conclusion: This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제24권1호
• /
• pp.67-73
• /
• 2024

Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m³ (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO₂ equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.

• Ocean Systems Engineering
• /
• 제14권1호
• /
• pp.85-99
• /
• 2024

Ocean surface currents have an essential role in the Earth's climate system and significantly impact the marine ecosystem, weather patterns, and human activities. However, predicting ocean surface currents remains challenging due to the complexity and variability of the oceanic processes involved. This review article provides an overview of the current research status, challenges, and opportunities in the prediction of ocean surface currents. We discuss the various observational and modelling approaches used to study ocean surface currents, including satellite remote sensing, in situ measurements, and numerical models. We also highlight the major challenges facing the prediction of ocean surface currents, such as data assimilation, model-observation integration, and the representation of sub-grid scale processes. In this article, we suggest that future research should focus on developing advanced modeling techniques, such as machine learning, and the integration of multiple observational platforms to improve the accuracy and skill of ocean surface current predictions. We also emphasize the need to address the limitations of observing instruments, such as delays in receiving data, versioning errors, missing data, and undocumented data processing techniques. Improving data availability and quality will be essential for enhancing the accuracy of predictions. The future research should focus on developing methods for effective bias correction, a series of data preprocessing procedures, and utilizing combined models and xAI models to incorporate data from various sources. Advancements in predicting ocean surface currents will benefit various applications such as maritime operations, climate studies, and ecosystem management.

• 한국간담췌외과학회지
• /
• 제28권2호
• /
• pp.203-213
• /
• 2024

Backgrounds/Aims: The standard treatment for acute cholecystitis, biliary pancreatitis and intractable biliary colics ("hot gallbladder") is emergency laparoscopic cholecystectomy (LC). This paper aims to identify the prognostic factors and create statistical models to predict the outcomes of emergency LC for "hot gallbladder." Methods: A prospective observational cohort study was conducted on 466 patients having an emergency LC in 17 months. Primary endpoint was "suboptimal treatment," defined as the use of escape strategies due to the impossibility to complete the LC. Secondary endpoints were postoperative morbidity and length of postoperative stay. Results: About 10% of patients had a "suboptimal treatment" predicted by age and low albumin. Postop morbidity was 17.2%, predicted by age, admission day, and male sex. Postoperative length of stay was correlated to age, low albumin, and delayed surgery. Conclusions: Several predictive prognostic factors were found to be related to poor emergency LC outcomes. These can be useful in the decision-making process and to inform patients of risks and benefits of an emergency vs. delayed LC for hot gallbladder.