Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.
Purpose: This study intended to analyze the validity of clinical effectiveness data of clinical trials testing systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent. Material and Methods: Among 5 clinical trials claimed as proof of clinical effectiveness on the Web site of the manufacturer of this chemotherapeutic agent, a review of 4 clinical trials, written in either Korean or English, was conducted. Data were extracted from studies for the following variables: year of publication, age, sample size, follow-up period, combination with contemporary periodontal treatments, randomization, randomization check, blinded measurement, and statistical test type. Results: The study subjects' age intervals were too diverse to decide a common target population to generalize the findings. No study stated clearly the rationale for the sample size determination. Follow-up period to observe the start of clinical effectiveness was inconsistent and decided without any rationale of pathophysiological latent period. Randomization to make the comparisons on the same start line was performed but failed in a study. Randomization effect was not checked in 4 studies. Performance of blinded measurement of clinical outcomes to prevent bias was unclear in 2 studies. Type of statistical test was inappropriate in 3 studies. Conclusions: Based on the analysis of the validity of data on clinical and demographic variables, the four available clinical trials have not demonstrated compelling evidence of therapeutic effectiveness of systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent to improve prognosis of periodontal disease either with the contemporary periodontal treatment or without it.
Masoud, Hossam Hosny;El-Zorkany, Mahmoud Mohamed;Ahmed, Azza Anwar;Assal, Hebatallah Hany
Tuberculosis and Respiratory Diseases
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제84권1호
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pp.67-73
/
2021
Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of PEL after the aspiration of 500 mL of fluid was done with "PEL 0.5" (cm H2O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The PEL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The PEL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of PEL 0.5 >14.5 cm H2O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: PEL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.
The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.
Seo Young Shin;Yong Kwon Chae;Ko Eun Lee;Mi Sun Kim;Ok Hyung Nam;Hyo-seol Lee;Sung Chul Choi
대한소아치과학회지
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제51권1호
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pp.55-65
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2024
This study aimed to assess the accuracy of tooth widths, intermolar widths, and arch lengths acquired through two intraoral scanners, including iTero Element Plus Series (Align Technology, Santa Clara, CA, USA) and Trios 4 (3Shape, Copenhagen, Denmark), specifically on mixed dentition. A total of 30 subjects were divided into 2 groups, each undergoing both alginate impressions and intraoral scanning using either the iTero or Trios scanner. The plaster models were measured with a caliper, while the digital models were measured virtually. In the iTero group, all tooth width measurements exhibited differences compared to the plaster values, except for maxillary left lateral incisors (p = 0.179), mandibular right (p = 0.285), and left (p = 0.073) central incisors. The Trios group did not display significant differences in any of the tooth width measurements. Intermolar width comparisons for both groups indicated differences, except for mandibular primary canine to primary canine values (p = 0.426) in the iTero group. Regarding arch length, the mandibular anterior, maxillary right, and left arch lengths in the iTero group demonstrated larger caliper values than those of iTero. Conversely, in the Trios group, all parameters showed smaller caliper values, especially in upper anterior, maxillary right, mandibular right, and mandibular left arch lengths with significance (p = 0.027, 0.007, 0.003, and 0.047, respectively). Despite the differences between the two groups, digital models might be clinically suitable alternatives for plaster models. Pediatric dentists should carefully assess these differences, as a comprehensive evaluation would result in precise orthodontic treatment planning and favorable outcomes for young patients with mixed dentition.
Purposes: The Common Data Model(CDM) is very important for multi-institutional research. There are various domestic and international CDM construction cases to actively utilize it. In order to construct a CDM, different terms from each institution must be mapped to standard terms. Therefore, we intend to derive the importance and major issues of terminology mapping and propose a solution in CDM construction. Methodology/Approach: This study conducted terminology mapping between Electronic Health Record(EHR) and MOA CDM for constructing Medical Record Observation & Assessment for Drug Safety(MOA) CDM at Dankook University Hospital in 2022. In the process of terminology mapping, a CDM standard terminology process and method were developed and terminology mapping was performed by applying this. The constructions of CDM mapping terms proceeded in the order of diagnosis, drug, measurement, and treatment_procedure. Findings: We developed mapping guideline for CDM construction and used this for mapping. A total of 670,993 EHR data from Dankook University Hospital(January 1, 2013 to December 31, 2021) were mapped. In the case of diagnosis terminology, 19,413 were completely mapped. Drug terminology mapped 92.1% of 2,795. Measurement terminology mapped 94.5% of 7,254 cases. Treatment and procedure were mapped to 2,181 cases, which are the number of mapping targets. Practical Implications: This study found the importance of constructing MOA CDM for drug side effect monitoring and developed terminology mapping guideline. Our results would be useful for all future researchers who are conducting terminology mapping when constructing CDM.
Kunal Joshi;Manuel Abradelo;David Christopher Bartlett;Nikolaos Chatzizacharias;Bobby Venkata Dasari;John Isaac;Ravi Marudanayagam;Darius Mirza;Keith Roberts;Robert Peter Sutcliffe
한국간담췌외과학회지
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제27권2호
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pp.189-194
/
2023
Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a source of major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve patient outcomes and clinical risk scores may be ombined with postoperative drain fluid amylase (DFA) values to stratify patients. The aim of this pilot study was to etermine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF. Methods: In patients undergoing PD from February to November 2020, intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected. Results: Data were obtained for 52 patients with a median alternative Fistula Risk Score (aFRS) of 9.9. Postoperative complications occurred in 20 (38.5%) patients (five Clavien grade ≥ 3). There were eight POPFs and two patients died (pneumonia/sepsis). There was a significant correlation between IFA and DFA1 (R2 = 0.713; p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high aFRS/IFA) and 0% in lowrisk patients (low aFRS/IFA). Conclusions: IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.
In the early industrial age which with high intensity of machine and labor, using financial measurement index was good enough to tie in company's mechanization and philosophy of management and been in efficiency. But being comply with "New Economic age," a new economic environment is full of knowledge and information, the enterprise competition had changed from tangible assets, plants to intangible innovation ability of knowledge. As recognizing the new tendency by enterprise, they value gradually the growth and influence from learning. Practice of organization learning not only needs firm structure and be in coordination with both hardware and software, but also needs an affect measurement model to offer enterprise to estimate learning performance. It's a good instrument of financial performance measure mold in the past years, But it's for measuring the past, couldn't formulate enterprise trend to future, hard to estimate investment for future, such as development of products, organization learning, knowledge management etc, as which intangible assets and knowledge ability just the key factors of being win around competition environment in the future. In 1992, Kaplan and Norton brought up Balance Scorecard (BSC) on Harvard Business Review, as an instrument helping enterprise to measure performance, which is being considered to be a most influence management instrument. It added non-financial index such as customer, internal process and learning growth besides traditional financial index, as offering enterprise an index to measure and manage intangible assets and intellectual property. As being aware of organization learning is hard to be ignored in the new economic age, this research is based on learning and growth of BSC, and citing one national material company try to let the most difficult measurement performance of organization learning, to be estimate through BSC, analyze of factor and individual case, to discuss the company how to make the related strategy and vision of organization learning to develop learning and growth of the structure of BSC, subject the matter of out put factors to be discussed, and measure the outcomes as a result of research. The research affect offers (1) the base implement procedure of carrying out BSC; (2) the reference of formulating measurement index while enterprise using BSC to estimate performance of organization learning; (3) the possibility bottleneck maybe forcing while carrying out BSC, to be an improvement or preventive for enterprise.
NAUSHAD, Mohammad;FARIDI, Mohammad Rishad;FAISAL, Shaha
The Journal of Asian Finance, Economics and Business
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제7권6호
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pp.297-304
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2020
This paper applies the Data Envelopment Analysis (DEA) to compute the managerial efficiency of 30 insurance companies listed on the Saudi stock exchange for the duration of four years from 2015 to 2018. The companies taken as a sample of study included both conventional and Takaful insurance companies. The insurance sector of KSA is one of the largest sectors in the country, contributing a substantial percentage in the non-oil economy. Efficiency measurement and evaluation will provide a venue to introspect and benchmark frontiers to the sector. In the present study, we have utilized the basic Banker Charnes Cooper and Charnes Copper Rhodes models of DEA. Two inputs, namely, general & administrative expenses and policy & acquisition costs, and two outputs (Net premium earned and Investment Income & other incomes) were taken for efficiency calculations. The final outcomes of the study reveal that a good number of insurance companies operating in KSA are found to be efficient on managerial efficiency scale. Three firms remain the leader on the frontier of the managerial efficiency. And no company found with zero (0) efficiency or a negative efficiency. It is expected that the outcome of the study will provide benchmarks to managers and a road map to further improvement.
The multiple acupuncture techniques have been used to relieve the pain of lateral ankle sprain. Recently, early functional rehabilitation is emphasized in rehabilitative concepts using active ROM, facilitated proprioception, alphabet exercise and so forth. Similarly, in oriental rehabilition medicine, traditional movement technique called "Dong-Ki" has been used to relieve pain of ankle sprain. So we used "Dong-Ki" technique with SSP(silver spike point) electrotherapy transformed from alphabet exercise and evaluated the effects in method of randomized controlled trials. Methods : 27 outpatients with lateral ankle sprains were randomized into two groups : 15 samples and 12 controls. Sample group was treated with "Dong-Ki" technique(writing his name with foot) with SSP electrotherapy to relieve pain during additionally. "Dong-KI". Outcomes were measured by 10cm VAS and ankle circumference(cm). Results : In terms of VAS, Sample group had inclination of pain relieving but not significantly meaningful. In terms of ankle circumference measurement, Sample group showed significantly improved.
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