• Title/Summary/Keyword: Randomized response

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Beliefs and Attitudes toward Physician-assisted Suicide among Korean Adults

  • In Cheol, Hwang;Jung Hun, Kang;Won-chul, Kim;Jeanno, Park;Hyun Sook, Kim;DaeKyun, Kim;Kyung Hee, Lee
    • Journal of Hospice and Palliative Care
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    • v.25 no.4
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    • pp.198-203
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    • 2022
  • Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term "hospice and palliative care"; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.

Effectiveness of thaumaturgic distraction in alleviation of anxiety in 4-6-year-old children during inferior alveolar nerve block administration: a randomized controlled trial

  • Payal Kothari;Aditi Mathur;Rashmi Singh Chauhan;Meenakshi Nankar;Sunnypriyatham Tirupathi;Ashrita Suvarna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.3
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    • pp.143-151
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    • 2023
  • Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion: Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

Effects of whey protein supplementation prior to, and following, resistance exercise on body composition and training responses: A randomized double-blind placebo-controlled study

  • Park, Yeram;Park, Hun-Young;Kim, Jisu;Hwang, Hyejung;Jung, Yanghoon;Kreider, Richard;Lim, Kiwon
    • Korean Journal of Exercise Nutrition
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    • v.23 no.2
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    • pp.34-44
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    • 2019
  • [Purpose] The composition of protein supplements, the consumption timing immediately before and after resistance exercise training (RET), and the quantity of protein supplementation may be important factors for the im-provement of muscle mass and function. Although these factors should be considered comprehensively for effective improvement of muscular function in protein supplementation, relatively few studies have focused on this area. Therefore, this study was designed to investigate whether a protein blend supplement before and after resistance exercise for 12 weeks would be effective in increasing muscular function. [Methods] In total, 18 participants were randomly assigned to a placebo (PLA) or protein blend supplement (PRO) group. All subjects followed the same training routine 3 times per week for 12 weeks, taking placebo or protein supplements immediately before and after each exercise session. The protein supplement consisted of 40 g of blend protein, including hydrolyzed whey protein. The RET consisted of lower body (barbell squat, dead lift, seated leg extension, and lying leg curl) and upper body (bench press, barbell rowing, preacher bench biceps curl, and dumbbell shoulder press) exercises. A repetition was defined as three sets of 10-12 times with 80% of one repetition maximum (1RM). [Results] Although the PRO group had a lower protein intake in terms of total food intake than the PLA group, the mean changes in muscle circumference, strength, and exercise volume increased, especially at week 12, compared to the PLA group. [Conclusion] These results suggest that the composition and timing of protein intake are more important than the total amount.

Effects of a new generation of fish protein hydrolysate on performance, intestinal microbiology, and immunity of broiler chickens

  • Amir Hossein Alizadeh-Ghamsari;Amir Reza Shaviklo;Seyyed Abdullah Hosseini
    • Journal of Animal Science and Technology
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    • v.65 no.4
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    • pp.804-817
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    • 2023
  • This study was conducted to evaluate the effects of co-dried fish protein hydrolysate (CFPH) on broilers performance, intestinal microbiology, and cellular immune responses. Five hundred one-day-old (Ross 308) male broilers were allocated to four treatments with five replicates of 25 birds in a completely randomized design. The experimental treatments included four levels of CFPH (0% as the control, 2.5%, 5%, and 7.5%) in the isonitrogenous and isocaloric diets. During the experiment, body weight (BW) and feed intake (FI) were periodically recorded in addition to calculating average daily gain (ADG), feed conversion ratio (FCR), liveability index, and European broiler index (EBI). In addition, cellular immune responses were evaluated at 30 days of age. On day 42, ileal contents were obtained to examine the microbial population. Based on the findings, Dietary supplementation of 5 and 7.5% CFPH increased the percentage of the thigh while decreasing the relative weight of the gizzard compared to the control group. The highest relative length of jejunum was observed in birds receiving 2.5 and 5% CFPH, and its highest relative weight belonged to birds fed with 5% CFPH. The number of coliforms, enterobacters, and total gram-negative bacteria in the intestines of birds receiving CFPH was less than that of the control group. In general, the application of CFPH in broiler nutrition can decrease the level of soybean meal in diet and it can be considered as a new protein supplement in poultry production. It is suggested to study the incorporation of this new supplement in other livestock's diets.

Key Principles of Clinical Validation, Device Approval, and Insurance Coverage Decisions of Artificial Intelligence

  • Seong Ho Park;Jaesoon Choi;Jeong-Sik Byeon
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.442-453
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    • 2021
  • Artificial intelligence (AI) will likely affect various fields of medicine. This article aims to explain the fundamental principles of clinical validation, device approval, and insurance coverage decisions of AI algorithms for medical diagnosis and prediction. Discrimination accuracy of AI algorithms is often evaluated with the Dice similarity coefficient, sensitivity, specificity, and traditional or free-response receiver operating characteristic curves. Calibration accuracy should also be assessed, especially for algorithms that provide probabilities to users. As current AI algorithms have limited generalizability to real-world practice, clinical validation of AI should put it to proper external testing and assisting roles. External testing could adopt diagnostic case-control or diagnostic cohort designs. A diagnostic case-control study evaluates the technical validity/accuracy of AI while the latter tests the clinical validity/accuracy of AI in samples representing target patients in real-world clinical scenarios. Ultimate clinical validation of AI requires evaluations of its impact on patient outcomes, referred to as clinical utility, and for which randomized clinical trials are ideal. Device approval of AI is typically granted with proof of technical validity/accuracy and thus does not intend to directly indicate if AI is beneficial for patient care or if it improves patient outcomes. Neither can it categorically address the issue of limited generalizability of AI. After achieving device approval, it is up to medical professionals to determine if the approved AI algorithms are beneficial for real-world patient care. Insurance coverage decisions generally require a demonstration of clinical utility that the use of AI has improved patient outcomes.

Effectiveness of Electroacupuncture for Managing Urinary Retention Post Lumbar Spine Surgery: a retrospective single-cohort study

  • Phuong Dong Tran;Quoc Dung Nguyen;Thanh Duc Ngo
    • Journal of Pharmacopuncture
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    • v.27 no.2
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    • pp.123-130
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    • 2024
  • Objectives: Post-operative urinary retention (POUR) is a frequent complication following surgical procedures, characterized by an acute inability to void, leading to additional complications and extended hospitalization. Acupuncture has been shown to be effective in facilitating spontaneous urination and alleviating anxiety in patients experiencing poor urination. The present study aims to evaluate the effectiveness of electroacupuncture in the management of POUR in patients who have undergone lumbar spine surgery. Methods: This retrospective study conducted at the National Hospital of Acupuncture in Vietnam and reviewed the medical records of patients over 18 years old who underwent lumbar spine surgery and were diagnosed with POUR between January to December 2019. Electroacupuncture was administered at five specific acupuncture points: Qugu (CV2), Zhongji (CV3), Zhibian (BL54), Pangguanshu (BL28), and Kunlun (BL60). This study monitored key parameters related to the effectiveness of the acupuncture treatment, including the number of acupuncture treatment sessions required until a patient was successfully treated was recorded, with a maximum of three acupuncture treatment sessions per patient, the time elapsed until urination following the treatment (minutes), and urinary bladder volume before and after treatment (mL). Results: The study demonstrated a 93.3% success rate in treating POUR with electroacupuncture. A significant reduction in post-void residual volume was noted, and patients could void within 30 minutes post-treatment. No significant differences in treatment effectiveness were observed across difference genders and age groups. Conclusion: Electroacupuncture proved to be a highly effective treatment for POUR in patients post-lumbar spine surgery, with a rapid response time and substantial reduction in PVR. However, the retrospective nature of the study and single-center focus limit its generalizability. Future research incorporating randomized controlled trials or multi-center observational studies are recommended to validate these findings and explore the potential of acupuncture in POUR management on a broader scale.

Improving Medication Adherence in Isolated Patients With Cognitive Impairment Using Automated Telephone Reminders

  • Moon Jeong Kim;Jeong Yun Song;Jae-won Jang;Seo-Young Lee;Jin Hyeong Jhoo;Gi Hwan Byeon;Yeshin Kim
    • Dementia and Neurocognitive Disorders
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    • v.21 no.4
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    • pp.117-125
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    • 2022
  • Background and Purpose: Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment. Methods: This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer's disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests. Results: Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups. Conclusions: If a patient's compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.

Effect of Various β-1,3-glucan Supplements on the Performance, Blood Parameter, Small Intestinal Microflora and Immune Response in Laying Hens (β-Glucan 제제들이 산란계의 생산성, 혈액 성상과 소장내 미생물 균총 및 면역 체계에 미치는 영향)

  • Park, K.W.;Rhee, A.R.;Lee, I.Y.;Kim, M.K.;Paik, I.K.
    • Korean Journal of Poultry Science
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    • v.35 no.2
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    • pp.183-190
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    • 2008
  • This study was conducted to investigate the effect of feeding diets supplemented with ${\beta}-glucan$ products on the performance, small intestinal microflora and immune response in laying hens. The ${\beta}-glucan$ products used in the experiment were $BetaPolo^{(R)}$ ; soluble ${\beta}-glucan$ of microbial cell wall origin, $HiGlu^{(R)}$ ; microbial cell wall origin, $OGlu^{(R)}$ ; oat origin, $BGlu^{(R)}$ ; barley origin. A total of 720 Hy-Line Brown laying hens of 40wks old were divided into 5 dietary treatments : T1 ; Control( C), T2 ; $BetaPolo^{(R)}$, T3 ; $HiGlu^{(R)}$, T4 ; $OGlu^{(R)}$, T5 ; $BGlu^{(R)}$. Each treatment was replicated 4 times with 36 birds/replicate housed in 2 bird cages, and arranged according to completely randomized block design. Feeding trial lasted 40ds under 16 h lighting regimens. There were significant differences among treatments in hen-house egg production feed intake and feed conversion. HiGlu treatment was significantly higher than OGlu treatments in hen-house egg production. ${\beta}-glucan$ supplemented treatments were lower than the control in feed intake and feed conversion ratio. All ${\beta}-glucan$ supplemented treatments were significantly higher than the control in eggshell strength. Eggshell color and Haugh unit tended to be lower in the supplemented group than the control. IgY concentration was not significantly affected by treatments. At $5^{th}$ week of experiment, however, IgY concentration tended to increase in the supplemented groups. Among the leucocytes parameters, WBC, heterophil, lymphocytes, monocyte and eosinophil concentration were lower in the supplemented groups than those of the control. Among erythrocytes, HCT(hematocrit) and MCV(mean corpuscular volume) were significantly affected by treatment. MCV of supplemented groups were higher than that of the control. Immunoglobulin concentrations in the birds were not significantly different among treatments. However, IgA concentration tended to be low in the supplemented groups than the control. The cfu of small intestinal microflora were not significantly different among treatments, but that of Cl. perfringens tended to be lower than the control. The result of this experiment indicateted that feeding ${\beta}-glucan$ to laying hens improve feed conversion ratio and eggshell strength. Also intestinal microflora and immune responses are modified.

Growth Performance, Humoral Immune Response and Carcass Characteristics of Broiler Chickens Fed Alkali Processed Karanj Cake Incorporated Diet Supplemented with Methionine

  • Panda, K.;Sastry, V.R.B.;Mandal, A.B.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.5
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    • pp.677-681
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    • 2005
  • A study was conducted to see the effect of dietary incorporation of alkali (1.5% NaOH, w/w) processed solvent extracted karanj cake (SKC) supplemented with methionine on growth performance, humoral immune response and carcass characteristics of broiler chickens from 0 to 8 weeks of age. One hundred and twenty, day- old broiler chicks were wing banded, vaccinated against Marek' disease and distributed in a completely randomized design (CRD) into 3 groups of 40 chicks each, which was further replicated to 4 and fed on diet containing soybean meal and those of test groups were fed diets containing alkali (1.5% NaOH) treated SKC partially replacing soybean meal nitrogen of reference diet (12.5%) without or with supplementation of methionine (0.2%). Individual body weight of chicks and replicate-wise feed intakes were recorded at weekly intervals throughout the experimental period. Feed consumption from 1 to 14, 28, 42 and 56 d of age was recorded for each replicate and feed conversion efficiency (weight gain/feed intake) for the respective period was calculated. Mortality was monitored on daily basis. On 28$^{th}$ day of experimental feeding, two birds of each replicate in each dietary group (8 birds/diet) were inoculated with 0.1 ml of a 1.0% suspension of sheep red blood cells (SRBC) and the antibody titre (log 2) was measured after 5 days by the microtitre haemmagglutination procedure. After 42 days of experimental feeding, a retention study of 4 days (43-47 d) duration was conducted on all birds to determine the retention of various nutrients such as DM, N, Ca, P and GE. On 43$^{rd}$ day of experimental feeding, one representative bird from each replicate of a dietary treatment (4/dietary group) was sacrificed, after fasting for two hours with free access to water, through cervical dislocation to observe the weight of dressed carcass, primal cuts (breast, thigh, drumstick, back, neck and wing), giblet (liver, heart and gizzard), abdominal fat and digestive organs. The body weight gain of chicks fed reference diet and those fed diet incorporated with NaOH treated SKC (12.5% replacement) with or without methionine supplementation was comparable during 0 to 4 weeks of age. However, dietary incorporation of alkali processed SKC replacing 12.5% nitrogen moiety of soybean meal resulted in growth retardation, subsequently as evidenced by significantly (p<0.05) lowered body weight gain during 0 to 6 weeks of age in birds fed diet incorporated with alkali processed SKC at 6.43% without methionine as compared to those supplemented with methionine or reference diet. Dietary incorporation of alkali (1.5% NaOH) processed SKC replacing 12.5% of soybean meal nitrogen in the diet of broiler chickens had no adverse effect on feed conversion ratio during all the weeks of experimental feeding. The humoral immune response (HIR) as measured by the antibody titre in response to SRBC inoculation was comparable among all the dietary groups. No significant difference in the intake and retention of DM, N, Ca, P or GE was noted among the chicks fed reference and alkali processed SKC incorporated diets with or without methionine supplementation. None of the carcass traits varied significantly due to dietary variations, except the percent weight of liver and giblet. The percent liver weight was significantly (p<0.05) higher in the birds fed diet incorporated with alkali processed SKC as compared to that in other two groups. Thus solvent extracted karanj cake could be incorporated after alkali (1.5% NaOH, w/w) processing at an enhanced level of 6.43%, replacing 12.5% of soybean meal nitrogen, in the broiler diets up to 4 weeks of age, beyond which the observed growth depression on this diet could be alleviated by 0.2% methionine supplementation.

Radiotherapy Results of Midline Malignant Reticulosis (MMR) (중심선 악성 세망증의 방사선 치료 결과)

  • Yun, Sang-Mo;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.291-297
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    • 1996
  • Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

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