• 제목/요약/키워드: Risk Treatment Method

검색결과 568건 처리시간 0.04초

Performance study of propensity score methods against regression with covariate adjustment

  • Park, Jincheol
    • Journal of the Korean Data and Information Science Society
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    • 제26권1호
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    • pp.217-227
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    • 2015
  • In observational study, handling confounders is a primary issue in measuring treatment effect of interest. Historically, a regression with covariate adjustment (covariate-adjusted regression) has been the typical approach to estimate treatment effect incorporating potential confounders into model. However, ever since the introduction of the propensity score, covariate-adjusted regression has been gradually replaced in medical literatures with various balancing methods based on propensity score. On the other hand, there is only a paucity of researches assessing propensity score methods compared with the covariate-adjusted regression. This paper examined the performance of propensity score methods in estimating risk difference and compare their performance with the covariate-adjusted regression by a Monte Carlo study. The study demonstrated in general the covariate-adjusted regression with variable selection procedure outperformed propensity-score-based methods in terms both of bias and MSE, suggesting that the classical regression method needs to be considered, rather than the propensity score methods, if a performance is a primary concern.

하천수 및 정수공정에서의 비소관리를 위한 대체인자 개발 (Development of Alternative Indicator for Arsenic Management in River Basin and Drinking Water Treatment)

  • 강미아;김광태
    • 한국물환경학회지
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    • 제21권6호
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    • pp.659-663
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    • 2005
  • Many studies have been conducted to develop new technologies for arsenic removal and to reveal the levels of arsenic and other chemicals in rivers, lakes and ground waters. However, there are few studies dealing with such compounds in the total water system of the city, and the way of management of these compounds in the water system. Because the occurrence of these hazardous compounds, which are geological origins, is almost impossible to control, it is very important to manage these compounds in the water system. In this research, it was revealed that the risk of arsenic in the water treatment system of S city in Japan. As a results, the parameters such as Q in river and E260 in drinking water treatment plant is proposed as a new indicator with simple and rapid method for controling arsenic level.

Treatment and Follow-up of Human Papillomavirus Infected Women in a Municipality in Southern Brazil

  • Ruggeri, Joao Batista;Agnolo, Catia Millene Dell;Gravena, Angela Andreia Franca;Demitto, Marcela de Oliveira;Lopes, Tiara Cristina Romeiro;Delatorre, Silvana;Carvalho, Maria Dalva de Barros;Consolaro, Marcia Edilaine Lopes;Pelloso, Sandra Marisa
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6521-6526
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    • 2015
  • Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

Development of a Method for Improving the Electric Field Distribution in Patients Undergoing Tumor-Treating Fields Therapy

  • Sung, Jiwon;Seo, Jaehyeon;Jo, Yunhui;Yoon, Myonggeun;Hwang, Sang-Gu;Kim, Eun Ho
    • Journal of the Korean Physical Society
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    • 제73권10호
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    • pp.1577-1583
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    • 2018
  • Tumor-treating fields therapy involves placing pads onto the patient's skin to create a low- intensity (1 - 3 V/cm), intermediate frequency (100 - 300 kHz), alternating electric field to treat cancerous tumors. This new treatment modality has been approved by the Food and Drug Administration in the USA to treat patients with both newly diagnosed and recurrent glioblastoma. To deliver the prescribed electric field intensity to the tumor while minimizing exposure of organs at risk, we developed an optimization method for the electric field distribution in the body and compared the electric field distribution in the body before and after application of this optimization algorithm. To determine the electric field distribution in the body before optimization, we applied the same electric potential to all pairs of electric pads located on opposite sides of models. We subsequently adjusted the intensity of the electric field to each pair of pads to optimize the electric field distribution in the body, resulting in the prescribed electric field intensity to the tumor while minimizing electric fields at organs at risk. A comparison of the electric field distribution within the body before and after optimization showed that application of the optimization algorithm delivered a therapeutically effective electric field to the tumor while minimizing the average and the maximum field strength applied to organs at risk. Use of this optimization algorithm when planning tumor-treating fields therapy should maintain or increase the intensity of the electric field applied to the tumor while minimizing the intensity of the electric field applied to organs at risk. This would enhance the effectiveness of tumor-treating fields therapy while reducing dangerous side effects.

Outcome of Childhood Acute Lymphoblastic Leukemia Treated Using the Thai National Protocols

  • Seksarn, Panya;Wiangnon, Surapon;Veerakul, Gavivann;Chotsampancharoen, Thirachit;Kanjanapongkul, Somjai;Chainansamit, Su-On
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4609-4614
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    • 2015
  • Background: In recent decades, the prognosis for childhood leukemia has improved, especially for acute lymphoblastic leukemia (ALL). In Thailand, though, the survival rate for ALL is unimpressive. In 2006, standard national protocols for childhood leukemia treatment were implemented. We herein report the outcome of the ALL national protocols and explanations behind discrepancies in outcomes between institutions. Materials and Methods: Between March 2006 and February 2008, 486 children with ALL from 12 institutions were enrolled in the Thai national protocols. There were 3 different protocols based on specific criteria: one each for standard risk, high risk and Burkitt's ALL. We classified participating centers into 4 groups of institutions, namely: medical schools in Bangkok, provincial medical schools, hospitals in Bangkok and provincial hospitals. We also evaluated supportive care, laboratory facilities in participating centers, socioeconomics, and patient compliance. Overall and event-free survival were determined for each group using the Kaplan Meier method. Statistical differences were determined using the log-rank test. Previous outcomes of Thai childhood ALL treatment between 2003 and 2005 served as the historic control. Results: Five-year overall survival of ALL treated using the Thai national protocol was 67.2%; an improvement from the 63.7% of the 12-institute historical control (p-value=0.06). There were discrepancies in event-free survival of ALL between centers in Bangkok and up-country provinces (69.9% vs 51.2%, p-value <0.01). Socioeconomics and patient compliance were key elements in determining the outcome (65.5% vs 47.5%, 59.4% vs 42.9%) (p-value < 0.02). Conclusions: Implementation of standard national protocols for childhood leukemia in Thailand did not significantly improve the outcome of ALL. Factors leading to better outcomes included (a) improvement of treatment compliance (b) prevention of treatment abandonment and (c) financial support to the family.

Maxillary protraction using customized mini-plates for anchorage in an adolescent girl with skeletal Class III malocclusion

  • Liang, Shuran;Xie, Xianju;Wang, Fan;Chang, Qiao;Wang, Hongmei;Bai, Yuxing
    • 대한치과교정학회지
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    • 제50권5호
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    • pp.346-355
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    • 2020
  • The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized mini-plates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400-500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.

종합병원 간호사의 업무 및 작업자세 분석결과 특징 (Features of Work and Posture Analysis Outputs in General Hospital Nurses)

  • 박정근
    • 한국산업보건학회지
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    • 제29권3호
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    • pp.375-382
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    • 2019
  • Objectives: This study was to examine the features of work and posture analysis outputs in assessment of exposure to musculoskeletal disorder (MSD) risk factors in general hospital nurses. Methods: Work and posture analyses were carried out using observational approaches for nurses at general hospitals across Korea. With development of a taxonomy for assessing exposure to MSD risk factors, nursing tasks were documented in frequency (%time) for 8 hours a day in work analyses. Rapid Entire Body Assessment (REBA) scores were obtained for mode and maximum risk levels, respectively, during posture analyses. Results: A total of 27 nurses were observed while conducting 7 nursing tasks at 6 general hospitals. For both the work analyses and posture analyses, the taxonomy was developed and used. In the work analyses, 'Video display terminal task' and 'Nursing examination/ treatment' were the highest as 25%time for 8 hours a day, followed by 'Patient care' and 'Room rounding' as 13%time in order. In the posture analyses, the mode REBA scores were 2 or less for all nursing tasks while the maximum REBA scores were 7 for upper limbs at 'Room rounding' and 6 for trunk/neck/legs at 'Patient care'. Conclusions: The results showed the study nurses are occasionally at a risk for MSD, a medium level as designated in the REBA risk level, suggesting that it is important to control awkward posture at the nursing tasks such as 'Room rounding' and 'Patient care', in priority, for preventing MSD in the hospital sector including the study general hospitals.

항불안제 사용의 임상지침 (Clinical Guidelines for Anti-anxiety Drug Use)

  • 임기영
    • 생물정신의학
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    • 제1권1호
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    • pp.31-39
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    • 1994
  • Anxiety and anxiety disorders are one of the most common and most serious psychiatric problems. Anti-anxiety drugs are one of the most effective treatment method for these problems. Benzodiazepines have various side-effects and the risk of overuse and abuse. Therefore, physicians should prescribe benzodiazepines carefully. However, they should not be discouraged from prescribing benzodiazepines when they have a knowledge of the pharmacological characteristics of these drugs and there is a clear indication for their use. Generally speaking, problems of benzodiazepine use such as dependence withdrawal symptoms, and cognitive impairment are more likely to occur with high dose, long-term use(more than 4 months), in geriatric patients and patients with a history of alcohol or other sustance abuse. But long-term or high-dose use can be jusified for patients with panic disorder of agoraphobia, and medically-ill patients with persistent anxiety that cannot be otherwise treated. In summary, there cannot be a general prescribing formulation for benzodiazepine use. Physician should always make their decision based on the individual patient's risk/benefit factors.

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수돗물에서 미량유해물질의 체계적 관리방안 연구 (The Systematic Management for Trace Hazard Compounds in Drinking Water)

  • 박선구;임연택
    • 한국물환경학회지
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    • 제21권5호
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    • pp.431-441
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    • 2005
  • The study was carried out to improve and regulate the drinking water quality standard and drinking water quality monitoring substances. For the reliability and safety of finished water, It has been monitored for trace organic and inorganic compounds of 333 in finished water of water treatment plants during 1989 to 2003. As a result of monitoring, 51 compounds were detected from 333 compounds, and it has been regulated the drinking water quality standard of 26 substances and 20 mitoring substance. Improvement and regulation method of the drinking water quality standard was performed by comparing and analyzing with detection concentration, detection frequency, risk assessment and foreign drinking water quality standard.

골다공증 발생요인에 따른 골대사 생화학적 지표의 변동 고찰 (Review of Biochemical Bone Metabolism Markers Change in Osteoporosis Incidence Factors)

  • 이혜자
    • The Journal of Korean Physical Therapy
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    • 제14권4호
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    • pp.412-422
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    • 2002
  • The use of biochemical markers of bone turnover may be particular interest in the investigation of bone disorders with osteoporosis. Serum osteocalcin(OC), total alkaline phosphatase and procollagen C, reflecting bone formation, and urinary pyridinium cross-links excretion, reflecting bone reabsorption have been measured in hyperthyroidism, postmenopause women, after testosterone supplementation, androgen, testosterone and estrogen deficiency, bone mineral density degree, age duration. Bone marks which is reflect to metabolic bone disorders are biochemical indices method to measure enzyme activity about bone formation, bone absorption and bone components in blood or urine. Bone metabolism biochemical marks are correlated with osteophorotic agents and also represent significantly different between bone mineral density and bone biochemical marks. Therefore if we develope and use bone metabolism marks which have higher sensitivity and specificity in bone formation and bone absorption, I think that these bone biochemical marks can have utility in the clinical application to predict osteoporosis risk group, bone loss, bone fracture and response degree to treatment of osteoporosis risk groups.

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