• Title/Summary/Keyword: Predictors of weight loss

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Weighted Support Vector Machines with the SCAD Penalty

  • Jung, Kang-Mo
    • Communications for Statistical Applications and Methods
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    • v.20 no.6
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    • pp.481-490
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    • 2013
  • Classification is an important research area as data can be easily obtained even if the number of predictors becomes huge. The support vector machine(SVM) is widely used to classify a subject into a predetermined group because it gives sound theoretical background and better performance than other methods in many applications. The SVM can be viewed as a penalized method with the hinge loss function and penalty functions. Instead of $L_2$ penalty function Fan and Li (2001) proposed the smoothly clipped absolute deviation(SCAD) satisfying good statistical properties. Despite the ability of SVMs, they have drawbacks of non-robustness when there are outliers in the data. We develop a robust SVM method using a weight function with the SCAD penalty function based on the local quadratic approximation. We compare the performance of the proposed SVM with the SVM using the $L_1$ and $L_2$ penalty functions.

Hearing loss screening tool (COBRA score) for newborns in primary care setting

  • Poonual, Watcharapol;Navacharoen, Niramon;Kangsanarak, Jaran;Namwongprom, Sirianong;Saokaew, Surasak
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.353-358
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    • 2017
  • Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

The Associations of Online Health Information Search and eHealth Literacy with Perceived Information Usefulness: Analysis in the Context of Diet and Weight Control (인터넷 건강정보이해능력과 정보탐색 유형별 인지된 정보유용성 분석: 다이어트 및 체중조절 관련 정보탐색을 중심으로)

  • Shim, Minsun;Jo, Heui Sug;Jung, Su Mi
    • Health Policy and Management
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    • v.28 no.2
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    • pp.119-127
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    • 2018
  • Background: This study aimed to examine (1) the patterns of online health information search with respect to seeking and scanning, and (2) how online search, along with eHealth literacy, predicts perceived information usefulness in the context of diet and weight control. Methods: Online survey was conducted with 299 adults from the consumer panel recruited for the purpose of quality assessment of the Korean National Health Information Portal in 2016. We conducted paired sample t-test and multiple logistic regression to address the research questions. Data analysis was performed using IBM SPSS Statistics ver. 24.0 (IBM Corp., Armonk, NY, USA) and SAS ver. 9.3 (SAS Institute Inc., Cary, NC, USA). Results: Of the respondents, 38.8% were 'high seek-high scanners,' 35.8% were 'low seek-low scanners,' 13.0% were 'high seek-low scanners,' and 12.4% were 'low seek-high scanners.' eHealth literacy was a significant, positive predictor of online information scanning (odds ratio [OR], 2.46; 95% confidence interval [CI], 1.41-4.29), but not for online information seeking (OR, 1.75; 95% CI, 1.00-3.05). With respect to perceived usefulness of online information seeking, online seeking (OR, 4.90; 95% CI, 2.19-11.00) and eHealth literacy (OR, 2.30; 95% CI, 1.11-4.75) were significant predictors. Perceived usefulness of online scanning had a significant association with online scanning (OR, 2.38; 95% CI, 1.08-5.22), but not with eHealth literacy. Conclusion: To increase the effectiveness of the health policy for online information search and related outcomes in the context of diet and weight control, it is important to develop education programs promoting eHealth literacy.

Factors Influencing Overactive Bladder Symptom Severity in Community Residents (일 지역 주민의 과민성방광 증상심각도 영향요인)

  • Choi, Eun Hui;Lee, Eun Nam;Cho, Jeong Lim;Jang, Moon Jung
    • Journal of muscle and joint health
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    • v.23 no.1
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    • pp.39-48
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    • 2016
  • Purpose: This study was conducted to determine factors that influence overactive bladder (OAB) symptom severity in community residents. Methods: The participants of the study were 115 adults who participated in the health lectures for patients with OAB between March 1 and June 30, 2013. The overactive bladder-questionnaire (OAB-q) was used to assess the OAB symptom severity. Results: The mean score of OAB symptom severity was 35.48 out of 100. Participants showed the highest score of urgency among OAB symptoms. The significant predictors were the monthly income, operation history of urogynecology, and body mass index accounting for 23% of the variance of OAB symptom severity. The OAB symptom severity was higher in subjects who had lower monthly income, urogynecology operation history and higher BMI (>$25kg/m^2$). Conclusion: The findings of this study demonstrate that it should be considered to recommend weight loss as a component of nursing intervention for alleviating OAB symptom severity in overweight OAB patients.

Prediction of Type 2 Diabetes Remission after Bariatric or Metabolic Surgery

  • Park, Ji Yeon
    • Journal of Obesity & Metabolic Syndrome
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    • v.27 no.4
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    • pp.213-222
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    • 2018
  • Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemotherapy After Total Gastrectomy in Patients With Gastric Cancer

  • Toyota, Kazuhiro;Mori, Masayuki;Hirahara, Satoshi;Yoshioka, Shoko;Kubota, Haruna;Yano, Raita;Kobayashi, Hironori;Hashimoto, Yasushi;Sakashita, Yoshihiro;Yokoyama, Yujiro;Murakami, Yoshiaki;Miyamoto, Katsunari
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.56-66
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    • 2022
  • Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

Prospective Study on Preoperative Evaluation for the Prediction of Mortality and Morbidity after Lung Cancer Resection (폐암절제술후 발생하는 사망 및 합병증의 예측인자 평가에 관한 전향적 연구)

  • Park, Jeong-Woong;Suh, Gee-Young;Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Kim, Kwan-Min;Kim, Jin-Kook;Shim, Young-Mok;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.57-67
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    • 1998
  • Purpose : This study was undertaken to determine the preoperative predictors of mortality and morbidity after lung cancer resection. Method: During the period from October 1, 1995 to August 31, 1996, a prospective study was conducted in 92 lung resection candidates diagnosed as lung cancer. For preoperative predictors of nonpulmonary factors, we considered age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness, and for those of pulmonary factors, smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test. And predicted postoperative(ppo) pulmonary factors such as PPO-$FEV_1$, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}ppo$-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also considered. Results: There were 78 men and 14 women with a median age of 62 years(range 42 to 82) and a mean $FEV_1$ of $2.37\pm0.06L$. Twenty nine patients had a decreased $FEV_1$ less than 2.0L. Pneumonectomy was performed in 26 patients, bilobectomy in 12, lobectomy in 54. Pulmonary complications developed in 10 patients, cardiac complications in 9, other complications(empyema, air leak, bleeding) in 11, and 16 patients were managed in intensive care unit for more than 48hours. Three patients died within 30 days after operation. The ppo-$VO_2$max was less than 10ml/kg/min in these three patients, but its statistical significance could not be determined due to small number of patients. In multivariate analysis, the predictor related to postoperative death was weight loss(p<0.05), and as for pulmonary complications, weight loss, dyspnea scale, ppo-DLco and extent of resection(p<0.05). Conclusions: Based on this study, preoperative nonpulmonary factors such as weight loss and dyspnea scale are more important than the pulmonary factors in the prediction of postoperative mortality and/or morbodity in lung resection candidates, but exercise pulmonary fuction test may be useful Our study suggests that ppo-$VO_2$max value less than 10ml/kg/min is associated with death after lung cancer resection but further studies are needed to validate this result.

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Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective

  • Yap, Ning Yi;Ng, Keng Lim;Ong, Teng Aik;Pailoor, Jayalakshmi;Gobe, Glenda Carolyn;Ooi, Chong Chien;Razack, Azed Hassan;Dublin, Norman;Morais, Christudas;Rajandram, Retnagowri
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7497-7500
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    • 2013
  • Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

Effects of ${\beta}2-Adrenergic$ Receptor Polymorphism on Obesity (베타 2-아드레날린 수용체의 유전자 변이형이 비만도에 미치는 영향)

  • Kim, Kil-Soo;Oh, Hyun-Hee;Choi, Sun-Mi;Yang, Hyun-Sung;Bae, Jung-Hwan;Yoon, Yoo-Sik
    • Journal of Korean Medicine for Obesity Research
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    • v.3 no.1
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    • pp.7-16
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    • 2003
  • Objectives : The lipolytic effects of catecholamines in adipose tissue are mediated by members of adrenergic receptors. This study was conducted to examine the effects of ${\beta}2-AR$ Gln27Glu (Q27E) polymorphism on obesity indices and risk among obesity clinic patients. Methods : 532 subjects, 38 men and 494 women, who attended a weight loss program in a local obesity clinic were analyzed. Height, weight, BMI, WHR and obesity index were measured or calculated. Body composition was measured by bio-impedance analysis. Genotype of ${\beta}2-AR$ polymorphism in codon 27 was analyzed by PCR-RFLP method. Serum concentrations of fasting glucose, total and HDL cholesterol, and triglyceride were determined by autobiochemical analyzer. Results: The Genotype distributions of ${\beta}2-AR$ gene were QQ type 81.3%, QE type 17.9% and EE type 8%. Therefore, the frequency of E allele of ${\beta}2-AR$ gene was 0.170 in the total subjects. The frequency of the ${\beta}2-AR$ variant genotype(QE+EE) was significantly higher in obese group($BMI{\geqq}25$) compared with non-obese group(p=0.027). Weight was significantly higher in variant(QE+EE) type compared with normal(QQ) type in total subjects(p=0.001), male(p=0.022) and female(p=0.013). BMI, obesity index and WHR were also significantly higher in QE+EE type. Body fat man was significantly higher in QE+EE type in total subjects(p=0.005) and female(p=0.027). When forward stepwise regression analysis was used to create a model of risk predictors of obesity($BMI{\geqq}25$), QE+EE type of ${\beta}2-AR$ gene was found to be a significant risk factor for obesity (p=0.042, ORs 1.597). Conclusions: QE+EE genotype of ${\beta}2-AR$ was associated with increased obesity indices and might be a significant risk factor for obesity.

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Dosimetric and Clinical Predictors of Acute Esophagitis in Lung Cancer Patients in Turkey Treated with Radiotherapy

  • Etiz, Durmus;Bayman, Evrim;Akcay, Melek;Sahin, Bilgehan;Bal, Cengiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4223-4228
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    • 2013
  • Background: The purpose of this study was to determine the clinical and dosimetric factors associated with acute esophagitis (AE) in lung cancer patients treated with conformal radiotherapy (RT) in Turkey. Materials and Methods: In this retrospective review 104 lung cancer patients were examined. Esophagitis grades were verified weekly during treatment, and at 1 week, and 1 and 2 months afterwards. The clinical parameters included patient age, gender, tumor pathology, number of chemotherapy treatments before RT, concurrent chemotherapy, radiation dose, tumor response to RT, tumor localization, interruption of RT, weight loss, tumor and nodal stage and tumor volume. The following dosimetric parameters were analyzed for correlation of AE: The maximum ($D_{max}$) and mean ($D_{mean}$) doses delivered to the esophagus, the percentage of esophagus volume receiving ${\geq}10$ Gy ($V_{10}$), ${\geq}20$ Gy ($V_{20}$), ${\geq}30$ Gy ($V_{30}$), ${\geq}35$ Gy ($V_{35}$), ${\geq}40$ Gy ($V_{40}$), ${\geq}45$ Gy ($V_{45}$), ${\geq}50$ Gy ($V_{50}$) and ${\geq}60$ Gy ($V_{60}$). Results: Fifty-five patients (52.9%) developed AE. Maximum grades of AE were recorded: Grade 1 in 51 patients (49%), and Grade 2 in 4 patients (3.8%). Clinical factors had no statistically significant influence on the incidence of AE. In terms of dosimetric findings, correlation analyses demonstrated a significant association between AE and $D_{max}$ (>5117 cGy), $D_{mean}$ (>1487 cGy) and $V_{10-60}$ (percentage of volume receiving >10 to 60 Gy). The most significant relationship between RT and esophagitis were in $D_{max}$ (>5117 cGy) (p=0.002) and percentage of esophageal volume receiving >30 Gy ($V_{30}$ >31%) (p=0.008) in the logistic regression analysis. Conclusions: The maximum dose esophagus greater than 5117 cGy and approximately one third (31%) of the esophageal volume receiving >30 Gy was the most statistically significant predictive factor associated with esophagitis due to RT.