• Title/Summary/Keyword: Rank regression

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Comparison between Early and Late Onset Breast Cancer in Pakistani Women Undergoing Breast Conservative Therapy: is There any Difference?

  • Bhatti, Abu Bakar Hafeez;Jamshed, Aarif;Khan, Amina;Siddiqui, Neelam;Muzaffar, Nargis;Shah, Mazhar Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5331-5336
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    • 2014
  • Background: Early onset breast cancer is associated with poor outcomes but variable results have been reported. It is a significant problem in Pakistani women but remains under reported. Breast conservation plays an important role in surgical management of this younger patient group. The objective of this study was to determine the outcome of breast conservative therapy in patients with early onset breast cancer in our population and compare it with their older counterparts. Materials and Methods: A review of patients with invasive breast cancer who underwent breast conservation surgery at Shaukat Khanum Cancer Hospital from 1997 to 2009 was performed. Patients were divided into two groups i.e. Group I age ${\leq}40$ and Group II >40 years. A total of 401 patients with breast cancer were identified in Group I and 405 patients in Group II. Demographics, histopathological findings and receptor status of the two groups were compared. The Chi square test was used for categorical variables. Outcome was assessed on basis of 10 year locoregional recurrence free survival (LRRFS), disease free survival (DFS) and overall survival (OS). For survival analysis Kaplan Meier curves were used and significance was determined using the Log rank test. Cox regression was applied for multivariate analysis. Results: Median follow up was 4.31 (0.1-15.5) years. Median age at presentation was 34.6 years (17-40) and 51.9 years (41-82) for the two groups. Groups were significantly different from each other with respect to grade, receptor status, tumor stage and use of neoadjuvant therapy. No significant difference was present between the two groups for estimated 10 year LRRFS (86% vs 95%) (p=0.1), DFS (70% vs 70%) (p=0.5) and OS (75% vs 63%) (p=0.1). On multivariate analysis, tumor stage was an independent predictor of LRRFS, DFS and OS. Conclusions: Early onset breast cancer is associated with a distinct biology but does not lead to poorer outcomes in our population.

Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province, Iran

  • Ahmadnia, Zahra;Joukar, Farahnaz;Hasavari, Farideh;Roushan, Zahra Atrkar;Khalili, Malahat
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2035-2040
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    • 2016
  • Background: Several studies have pointed to roles of dietary and food groups in the pathogenesis of breast cancer, but information on dietary patterns among women with breast cancer and their healthy counterparts in Iran is limited. Therefore the present investigation was conducted in Guilan province in 2014-2015. Materials and Methods: In a case-control study, 450 women with breast cancer and one of their relatives (third-rank) were investigated. At first the phone numbers of patients in Razi Hospital in radiotherapy and chemotherapy and oncology centers of Guilan were taken. Data were collected through telephone interviews by the researcher. The questionnaire had two parts comprising demographic clinical and food frequency data including a list of 40 food items. To analyze the variables, Chi-square test and univariate logistic regression models were used. Results: In each group, 225 subjects were investigated. The majority of samples in both groups of experiment and control were consumed than two glasses of milk and dairy products per day. Regarding consumption of meat and its products, 56% of the cancer group had more than three servings per day while 26.7% of the control group had less than 2 servings per day. The majority of subjects had less than six servings of cereal per day. Some 54. 7 % of the cancer and 62.2 % of the control group consumed less than two servings of fruit per day. Consumption of vegetables in experimental and control groups were 52.9% and 76.9% respectively, more than five servings per day. There was a meaningful difference between two groups regarding the consumption of milk and dairy items (OR=0.6,95%CI= 0.4-0.9), meat and its products (OR=0.49,95%CI=0.3-0.7), bread and cereals (OR=0.4,95%CI=0.2-0.8), vegetables (OR=0.5,95%CI= 0.3-0.9). (P-value<0.05). Conclusions: The results of this study emphasize the importance of informing women, particularly those at higher risk of breast cancer, in relation to dietary factors.

Long Term Outcomes and Prognostic Factors of N0 Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

  • Sun, Jian-Da;Chen, Chuang-Zhen;Chen, Jian-Zhou;Li, Dong-Sheng;Chen, Zhi-Jian;Zhou, Ming-Zhen;Li, De-Rui
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2101-2107
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    • 2012
  • Treatment responses of $N_0$ stage nasopharyngeal carcinoma were firstly analyzed comprehensively to evaluate long term outcomes of patients and identify prognostic factors. A total of 610 patients with $N_0$ NPC, undergoing definitive radiotherapy to their primary lesion and prophylactic radiation to upper neck, were reviewed retrospectively. Concomitant chemotherapy was administrated to 65 out of the 610. Survival rates of the patients were calculated using the Kaplan-Meier method and compared by log-rank test. Prognostic factors were identified by the Cox regression model. The study revealed the 5-year and 10-year overall, disease-free, disease-specific, local failure-free, regional failure-free, locoregional failure-free and distant metastasis-free survival rates to be 78.7% and 66.8%, 68.8% and 55.8%, 79.9% and 70.4%, 81.2% and 72.5%, 95.8% and 91.8%, 78.3% and 68.5%, 88.5% and 85.5%, respectively. There were 192 patients experiencing failure (31.5%) after radiotherapy or chemoradiotherapy. Of these, local recurrence, regional relapse and distant metastases as the first event of failure occurred in 100 (100/610, 16.4%), 15(15/610, 2.5%) and 52 (52/610, 8.5%), respectively. Multivariate analysis showed that T stage was the only independent prognostic factor for patients with $N_0$ NPC (P=0.000). Late T stage (P=0.000), male (P=0.039) and anemia (P=0.007) were independently unfavorable factors predicting disease-free survival. After treatment, satisfactory outcome wasgenerally achieved in patients with $N_0$ NPC. Local recurrence represented the predominant mode of treatment failure, while T stage was the only independent prognostic factor for overall survival. Late T stage, male gender, and anemia independently predicted lower possibility of the disease-free survival.

Variance Components and Genetic Parameters for Milk Production and Lactation Pattern in an Ethiopian Multibreed Dairy Cattle Population

  • Gebreyohannes, Gebregziabher;Koonawootrittriron, Skorn;Elzo, Mauricio A.;Suwanasopee, Thanathip
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.9
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    • pp.1237-1246
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    • 2013
  • The objective of this study was to estimate variance components and genetic parameters for lactation milk yield (LY), lactation length (LL), average milk yield per day (YD), initial milk yield (IY), peak milk yield (PY), days to peak (DP) and parameters (ln(a) and c) of the modified incomplete gamma function (MIG) in an Ethiopian multibreed dairy cattle population. The dataset was composed of 5,507 lactation records collected from 1,639 cows in three locations (Bako, Debre Zeit and Holetta) in Ethiopia from 1977 to 2010. Parameters for MIG were obtained from regression analysis of monthly test-day milk data on days in milk. The cows were purebred (Bos indicus) Boran (B) and Horro (H) and their crosses with different fractions of Friesian (F), Jersey (J) and Simmental (S). There were 23 breed groups (B, H, and their crossbreds with F, J, and S) in the population. Fixed and mixed models were used to analyse the data. The fixed model considered herd-year-season, parity and breed group as fixed effects, and residual as random. The single and two-traits mixed animal repeatability models, considered the fixed effects of herd-year-season and parity subclasses, breed as a function of cow H, F, J, and S breed fractions and general heterosis as a function of heterozygosity, and the random additive animal, permanent environment, and residual effects. For the analysis of LY, LL was added as a fixed covariate to all models. Variance components and genetic parameters were estimated using average information restricted maximum likelihood procedures. The results indicated that all traits were affected (p<0.001) by the considered fixed effects. High grade $B{\times}F$ cows (3/16B 13/16F) had the highest least squares means (LSM) for LY ($2,490{\pm}178.9kg$), IY ($10.5{\pm}0.8kg$), PY ($12.7{\pm}0.9kg$), YD ($7.6{\pm}0.55kg$) and LL ($361.4{\pm}31.2d$), while B cows had the lowest LSM values for these traits. The LSM of LY, IY, YD, and PY tended to increase from the first to the fifth parity. Single-trait analyses yielded low heritability ($0.03{\pm}0.03$ and $0.08{\pm}0.02$) and repeatability ($0.14{\pm}0.01$ to $0.24{\pm}0.02$) estimates for LL, DP and parameter c. Medium heritability ($0.21{\pm}0.03$ to $0.33{\pm}0.04$) and repeatability ($0.27{\pm}0.02$ to $0.53{\pm}0.01$) estimates were obtained for LY, IY, PY, YD and ln(a). Genetic correlations between LY, IY, PY, YD, ln(a), and LL ranged from 0.59 to 0.99. Spearman's rank correlations between sire estimated breeding values for LY, LL, IY, PY, YD, ln(a) and c were positive (0.67 to 0.99, p<0.001). These results suggested that selection for IY, PY, YD, or LY would genetically improve lactation milk yield in this Ethiopian dairy cattle population.

The Effect of Self-help Group Program on Adaptation and Quality of Life of Mastectomy Patients (자조집단 프로그램이 유방절제술 환자의 적응과 삶의 질에 미치는 효과)

  • Park, Young-Shin;Lim, Nan-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.61-71
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    • 1999
  • This quasi-experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up ; 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale(SDS, 1965), and Self-rating Anxiety Scale(SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self-help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention, Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, $X^2$-test, Mann-Whitney U test. Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows ; Hypothesis 1. "The experimental group with the self-help group program will have a higher score on adaptation state than control group." was not supported. But the post test score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2. "The experimental group with the self-help group program will have a higher score on quality of life than control group." was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3. "The higher adaptation state of mastectomy patients, the higher quality, of life." was supported(r=,80, p<.001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing inter vention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further re search on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.

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An Analysis for Urban Competitiveness of Global Cities & 7 Metropolitan Korean Cities using Oxford Economics Data (우리나라 7대 광역시와 세계 770개 도시 경쟁력 비교분석 - Oxford Economics 자료에 근거한 도시경쟁력 -)

  • Cho, Jae Ho
    • Journal of the Korean Regional Science Association
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    • v.33 no.4
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    • pp.3-17
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    • 2017
  • This study ranks by developing an urban competitiveness index of major global cities, including seven cities in Korea using data from the Global Cities Forecast (2013) provided by Oxford Economics. The City competitiveness index is selected from 18 indicators including scale index, ratio index, growth rate index while Gini coefficient is used for distribution index. In order to analyze the relationship between the competitiveness index and the distribution index, we use the LOGIT panel regression model. As a result, the increase in income inequality (Gini coefficient) has a negative effect on the economic growth rate in 5-year time lag shown statistically significant. We have compiled global rankings of 770 city competitiveness based upon 19 indicators by combining the global competitiveness index and the distribution index. The trend of rank shows that 7 Metropolitan Korean Cities are expected to decline substantially over the period. In particular, Seoul ranked $59^{th}$ in 2010 and $74^{th}$ in 2015. Its ranking is expected to be decline to $185^{th}$ in 2030. The declining competitiveness of Korean cities is expected to lead to a weakening of Korea's national competitiveness in the long run. Accordingly, it is imperative to identify problems and seek strategic plans to secure global urban competitiveness.

A Suggested Air Sampling Strategy for Bioaerosols in Daycare Center Settings (어린이활동공간에서의 바이오에어로졸 포집 전략)

  • Jo, JungHeum;Park, Jun-sik;Kim, Sung-Yeon;Kwon, Myung hee;Kim, Ki Youn;Choi, Jeong-Hak;Seo, SungChul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.26 no.3
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    • pp.324-333
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    • 2016
  • Objectives: We aimed to compare the sampling performance of different flow-based impactor samplers for collecting fungal spores and bacteria and to explore the association of the level of bioaerosols with activity patterns of occupants in daycare center settings. Methods: For comparison of sampling performance, two different flow-based samplers (greater than 100 L/min or not) were selected; a low flow-based sampler (one-stage Andersen sampler) and two high flow-based samplers (DUO SAS SUPER 360 sampler, BUCK bio-culture sampler). We collected airborne mold and bacteria in 30 daycare centers with various levels of contaminated air. Three repeat samplings per each sampler were performed. Mold and bacteria were grown for 96 hours at $25{\pm}1^{\circ}C$ and 48 hours at $35{\pm}1^{\circ}C$, respectively. The Andersen and SAS samplers were used for investigating the association between the level of bioaerosols and the activity patterns of occupants in daycares. Particular matters 10($PM_{10}$), temperature, and relative humidity were monitored as well. Samplings were carried out with one-hour interval from 9 to 5 O'clock. For statistical comparisons, Kruskal-Wallis test, Wilcoxon's signed rank test, and multiple regression analysis were carried out. Results: The airborne level of molds by the low flow-based sampler were significantly higher than that of high flow-based samplers (indoor, P=0.037; outdoor, P=0.041). However, no statistical difference was observed in the airborne level of bacteria by each sampler. Also the level of bioaerosols varied by the time, particularly with different activity patterns in daycare centers. The higher level of mold and bacteria were observed in play time in indoor. Similarly, the concentrations of $PM_{10}$ were significantly associated with the level of bioaerosols (P<0.05). Conclusions: Our findings indicate that the flow rate of sampler, rather than total air volume, could be able to affect the results of sampling. Also, the level of airborne mold and bacteria vary behavior patterns of occupants in indoor of daycare settings. Therefore, different samplers with other flow rate may be selected for mold or bacteria sampling, and activity patterns should be considered for bioaerosol sampling as well.

A Research on Trust Realization Strategies for Oriental Medical Quality Improvement (한방의료 품질 향상을 위한 신뢰구현 체계구축 연구)

  • Kim, Hyun Ji;Kim, So Youn;Ji, Young Seung;Nam, Seung Kyu;Kim, Jeong Ho;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.31 no.1
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    • pp.75-93
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    • 2014
  • Objectives : This study was designed to establish medical trust realization system by finding factors influential to it using questionnaire. Methods : 277 subjects were participated in this study. After a treatment, we conducted a survey from April 1st to October 31th about medical service perception index, medical trust index, patient satisfaction index, patient reliability index, patient flow degree index, recall intension index, and hospital image index. To evaluate the influence of medical service perception with other 6 indexes, we statistically made regression analysis of the results through the survey. Results : By the results of the analysis, evaluation of hospital image influenced all 6 indexes. The systemicity of treatment process had an effect on 5 indexes except for the flow degree of patients. The humanity of medical team brought out the estimation of 4 indexes except for the patient flow degree and hospital image. The empathic ability of doctor and appropriacy of medical costs hold the next rank influencing 3 indexes. It reached the conclusion that the systemicity of medical team tend to determine the medical trust and patient reliability. The expertise, professional skill of doctor, the fault, commercial application, fame of medical team, the speed of treatment process, the newest and clean medical facility affected each one index. Conclusions : Korean medicine should find a way to consider the mind of patients for improving the medical quality through trust realization system, keeping up with times. As a result of this research, we can find out important causes which influence the trustful medical system. From now on, we should apply this result to actual treatment of psychology customized system. Also, more simple and clear questionnaire was organized through this research, it can be used to forward research to apprehend patient mentality more conveniently.

Prognostic Significance of Lymphatic and Perineural Invasions in Patients with Gastric Cancer Who Have No Lymph Node and Serosal Involvement (장막 침윤과 림프절 전이가 없는 위암에서 림프관 및 신경초 침윤의 의의)

  • Kim Wook;Park Cho Hyun;Park Seung Man;Park Woo Bai;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.1 no.2
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    • pp.77-82
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    • 2001
  • Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

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Associations Between Body Fat Percentage and Fitness among Police Officers: A Statewide Study

  • Violanti, John M.;Ma, Claudia C.;Fekedulegn, Desta;Andrew, Michael E.;Gu, Ja K.;Hartley, Tara A.;Charles, Luenda E.;Burchfiel, Cecil M.
    • Safety and Health at Work
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    • v.8 no.1
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    • pp.36-41
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    • 2017
  • Background: Police work is generally sedentary although there may be situations that require physical endurance and strength, such as foot chases and arresting suspects. Factors such as excessive body fat can impede an officer's physical ability to deal with such occurrences. Our objective was to examine associations between officers' body fat percentage (BF%) and performance on a standardized fitness protocol. Methods: Data were obtained from fitness screening among 1,826 male and 115 female officers in a large US police agency. The screening consisted of a 2.4-km run, push-ups, sit-ups, and sit-and-reach test. Sex-specific body fat percentages were estimated from skinfold thickness measured using calipers. Linear regression models were used to examine unadjusted and adjusted mean scores of fitness tests across BF% tertiles. Results: The prevalence of overall fitness was 4.3 times greater in male officers and 3.6 times greater in female officers having the lowest BF% tertile compared with the highest tertile (30.3% vs 7.1% and 46.0% vs 12.8%, respectively). BF% was linearly and positively associated with the time of 2.4-km run (p < 0.001), and linearly and inversely associated with the number of push-ups (p < 0.001), sit-ups (p < 0.001), and the distance of sit-and-reach (p < 0.001) in men. Similar associations were observed in women with the exception of sit-and-reach (p = 0.122). Associations were independent of age, race/ethnicity, rank, and duty station. Conclusion: Overall, BF% was inversely associated with fitness levels in male and female officers. Future longitudinal studies should be initiated to explore the potentially causal relationship between BF% and fitness in law enforcement officers.