• Title/Summary/Keyword: Risk based Value Index

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The Effect of Eating Habits and Nutrient Intake on the Physical Growth Indices in Preschool Children (학령 전 아동들의 식습관과 영양소 섭취가 신체발달 지수에 미치는 영향)

  • 최미자;윤진숙
    • Korean Journal of Community Nutrition
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    • v.8 no.1
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    • pp.3-14
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    • 2003
  • The purpose of this study was to estimate the nutrient intake, dietary habits, and body indices among preschool children. The study subjects were 166 kindergarten children, aged 4 to 6 years. A measurement of the weight, height, chest circumference, and head circumference of the children was conducted. The general home environment and factors related to the eating habits of children were collected using a questionnaire that included information about physical activity, outdoor playing time, television watching, family income, and parents education and occupations. Underweight, overweight were defined based on a value of less than 110 and more than 140 on the Rohrer Index, or less than 90 and more than 120 on the weight-length index (WLI). The average Rohrer and WLI for the preschool children were 14.3 $\pm$ 23.2% and 104 $\pm$ 13.5%. Using the WLI, 12.7% of the preschool children were underweight 62.6% were normal, and 24.7% were overweight or obese. On the Rohrer Index, 32.0% of the preschool children were underweight, 34.7% were normal, and 34.1% were overweight or obese. With regard to frequency of regularity of eating breakfast, 2.5% of preschool children skipped breakfast every morning. The risk of being overweight increased in preschool children who had faster eating times. The Rohrer and WLI were negatively related to faster eating times. The average daily energy intake was 1272 Kcal, which corresponded to 79.5% of the Korean RDA. In particular, the average intakes of calcium, iron, and vitamin B$_2$ were much lower than the Korean RDAs for each of those nutrients. Children whose mothers had occupations were at greater risk of decreased nutrient intake than those whose mothers were at home. The data presented in this study confirm that, in preschool children, undernutrition remains the nutritional problem of great concern in Korea, even though Koreans are starting to have worrisome rates of overweight. Therefore, during the early years of life, focus should remain on sustaining Proper growth and development.

Oxygenation Index in the First 24 Hours after the Diagnosis of Acute Respiratory Distress Syndrome as a Surrogate Metric for Risk Stratification in Children

  • Kim, Soo Yeon;Kim, Byuhree;Choi, Sun Ha;Kim, Jong Deok;Sol, In Suk;Kim, Min Jung;Kim, Yoon Hee;Kim, Kyung Won;Sohn, Myung Hyun;Kim, Kyu-Earn
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.222-229
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    • 2018
  • Background: The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS. Methods: Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality. Results: PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001). Conclusions: Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women (중년 여성의 식생활 중심 건강상태 판정 도구의 현장 적용 및 평가)

  • Lee, Hye-Jin;Lee, Kyung-Hea
    • Korean Journal of Community Nutrition
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    • v.23 no.4
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    • pp.277-288
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    • 2018
  • Objectives: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. Methods: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value <0.05 was considered to be statistically significant. Results: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p<0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p<0.001). Conclusions: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

Estimation of Multi-Route Exposure and Aggregated Risk Assessment for Cadmium and Lead (카드뮴과 납의 다경로 노출량 추정 및 통합 위해성 평가)

  • Yu, Changwoo;Kwon, Hoonjeong
    • Journal of Food Hygiene and Safety
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    • v.35 no.6
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    • pp.587-601
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    • 2020
  • Exposure to hazardous substances occurs through multiple pathways. Aggregated risk assessment, which includes all potential exposure pathways to a single toxicant, is necessary to prevent exposure to harmful substances. We aimed to estimate cadmium and lead exposure through various media, such as food, water, air, smoking, cosmetics, and female hygiene products. This study covered 10,733 subjects from the Seventh Korea National Health and Nutrition Examination Survey(2016, 2017). Dietary exposure was estimated using 24-hour recall data. For water and inhalational exposure, regional variations were considered. Water was classified as tap, bottled, and public water. Inhalational exposure was estimated using the '2014 Time Use Survey' based on daily lifestyle and social status. The frequency and volume of cosmetic usage were randomly approximated by sex and age. Post-menarcheal and premenopausal women were assumed to use feminine hygiene products. Non-carcinogenic aggregated risks were estimated using the Aggregate Risk Index from EPAs and the Total Exposure Hazard Index from Korean government guidelines. For carcinogenic risk assessment, excessive cancer risk was estimated. Ingestion, especially food, was the major route for both cadmium and lead exposure. Smoking was also associated with high cadmium exposure. Exposure to lead from cosmetics was remarkable but not critical. In aggregate risk assessments, median cadmium and lead exposure did not exceed the reference value. Sex, age, smoking status, and income affected exposure levels, unlike to regional variations.

Establishment of Navigational Risk Assessment Model Combining Dynamic Ship Domain and Collision Judgement Model (선박동적영역과 충돌위험평가식을 결합한 항해위험성평가모델 전개)

  • Kim, Won-Ouk;Kim, Chang-Je
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.24 no.1
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    • pp.36-42
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    • 2018
  • This paper considers the Marine Traffic Risk Assessment for fixed and moving targets, which threaten officers during a voyage. The Collision Risk Assessment Formula was calculated based on a dynamic ship domain considering the length, speed and maneuvering capability of a vessel. In particular, the Navigation Risk Assessment Model that is used to quantitatively index the effect of a ship's size, speed, etc. has been reviewed and improved using a hybrid combination of a vessel's dynamic area and the Collision Risk Assessment Formula. Accordingly, a new type of Marine Traffic Risk Assessment Model has been suggested giving consideration to the Speed Length Ratio, which was not sufficiently reflected in the existing Risk Assessment Model. The larger the Speed Length Ratio (dimensionless speed), the higher the CJ value. That is, the CJ value is presented well by the Speed Length Ratio. When the Speed Length Ratio is large, states ranging from [Caution], [Warning], [Dangerous] or [Very Dangerous] are presented from a greater distance than when the Speed Length Ratio is small. The results of this study, can be used for route and port development, including dangerous route avoidance, optimum route planning, breakwater width, bridge span, etc. as well as the development of costal navigation safety charts. This research is also applicable for the selection of optimum ship routing and the prevention of collisions for smart ships such as autonomous vessels.

Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.3
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.96-106
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    • 2022
  • Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

A Case of Establishing Robo-advisor Strategy through Parameter Optimization (금융 지표와 파라미터 최적화를 통한 로보어드바이저 전략 도출 사례)

  • Kang, Mincheal;Lim, Gyoo Gun
    • Journal of Information Technology Services
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    • v.19 no.2
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    • pp.109-124
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    • 2020
  • Facing the 4th Industrial Revolution era, researches on artificial intelligence have become active and attempts have been made to apply machine learning in various fields. In the field of finance, Robo Advisor service, which analyze the market, make investment decisions and allocate assets instead of people, are rapidly expanding. The stock price prediction using the machine learning that has been carried out to date is mainly based on the prediction of the market index such as KOSPI, and utilizes technical data that is fundamental index or price derivative index using financial statement. However, most researches have proceeded without any explicit verification of the prediction rate of the learning data. In this study, we conducted an experiment to determine the degree of market prediction ability of basic indicators, technical indicators, and system risk indicators (AR) used in stock price prediction. First, we set the core parameters for each financial indicator and define the objective function reflecting the return and volatility. Then, an experiment was performed to extract the sample from the distribution of each parameter by the Markov chain Monte Carlo (MCMC) method and to find the optimum value to maximize the objective function. Since Robo Advisor is a commodity that trades financial instruments such as stocks and funds, it can not be utilized only by forecasting the market index. The sample for this experiment is data of 17 years of 1,500 stocks that have been listed in Korea for more than 5 years after listing. As a result of the experiment, it was possible to establish a meaningful trading strategy that exceeds the market return. This study can be utilized as a basis for the development of Robo Advisor products in that it includes a large proportion of listed stocks in Korea, rather than an experiment on a single index, and verifies market predictability of various financial indicators.

The Association Between Healthy Beverage Index (HBI) With Metabolic Risk Factors Among Apparently Metabolically Healthy Overweight and Obese Individuals

  • Leila Jahanbazi;Mahdieh Abbasalizad Farhangi;Ayda Zahiri Tousi;Negin Nikrad
    • Clinical Nutrition Research
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    • v.12 no.3
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    • pp.218-228
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    • 2023
  • Recent studies have evaluated the association between specific beverage intake and metabolic risks in adults. However, more evidence is needed to examine the association between the Healthy Beverage Index (HBI) and metabolic factors. Therefore, this study investigated the relationship between HBI and metabolic factors in adults. In this cross-sectional study, 338 overweight and obese individuals living in Tabriz, Iran were selected. Data on beverage consumption, demographics, physical activity, and anthropometric characteristics were evaluated using validated standard protocols. The predefined HBI was calculated based on previous studies. The mean value of HBI index among all of the participants was 59.76 ± 6.51. Those at the higher HBI scores had significantly lower waist circumference, waist-to-hip ratio, fat mass, and weight (p < 0.05). HBI and triglyceride scores also had a significant relationship. It has been shown that at higher HBI scores compared to lower scores, high-density lipoprotein cholesterol levels increase while homeostatic model assessment for insulin resistance, low-density lipoprotein cholesterol, total cholesterol, and blood pressure decrease. HBI scores higher among Iranian adults were associated with a better chance of losing weight and weight loss and a better lipid profile, and lower blood pressure. Therefore, HBI can be a useful and helpful tool for assessing the overall quality of beverages adults consume. However, further studies are warranted to confirm the possible health effects of healthy beverage index.

Risk Assessment of Groundwater and Soil in Sasang Industrial Area in Busan Metropolitan City (부산광역시 사상공단지역의 지하수 및 토양 위해성 평가)

  • Jeon, Hang-Tak;Hamm, Se-Yeong;Cheong, Jae-Yeol;Ryu, Sang-Min;Jang, Seong;Lee, Jeong-Hwan;Lee, Soo-Hyung
    • The Journal of Engineering Geology
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    • v.19 no.3
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    • pp.295-306
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    • 2009
  • The risk assessment of groundwater and soil in Sasang industrial complex in Busan Metropolitan City was carried out in order to estimate risks to human health and the environment. The carcinogenic risk (CR) of receptors to soil and air was not identified. However, the CRs for TCE and PCE were 6.7E-6 and 1.0E-5, respectively. Hazard quotient (HQ) and hazard index (HI) did not appear through air exposure pathways. Yet the HQ and HI of soil were 3.4E-5 and 5E-5, respectively, and lower than the critical value (1.0). On the contrary, HQ and HI with respect to groundwater were calculated as 0.7 (not hazardous) and 1.4 (hazardous). The constituent reduction factor (CRF) for TCE in the study area was determined as 2.5, and thus remediation work is demanded. As a result of sensitivity analysis for 18 exposure factors, eight exposure factors (life time of carcinogens, age, body weight, exposure duration, exposure frequency, dermal exposure frequency, water ingestion rate, and soil ingestion rate) varied with the variation of risk.