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Clinical Study of Chuna Combination Therapy for Patients with Persistent Pain and Dysfunction after Total Knee Arthroplasty (슬관절 전치환술 후 지속 통증 및 기능 장애가 있는 환자에 대한 추나병행치료 임상연구)

  • Lee, Woong-Jin;Lee, Jin-Hyun;Park, Tae-Yong;Park, Jung-Sik;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.123-138
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    • 2022
  • Objectives This study was conducted to evaluate the clinical efficacy and safety of the chuna combination treatment for patients who complain of functional impairment and pain even 3 months after total knee arthroplasty. Methods 24 patients who had 3 months of surgery and who had knee joint pain with a score of 4 or higher on the numerical rating scale (NRS) for more than a week were selected as subjects. The test group received usual care and Chuna treatment and the control group received the administration of drugs as usual care. And then the clinical efficacy and safety were compared and evaluated. Follow-up was performed 1 month after the end of treatment. Results As a result of the analysis, it was confirmed that the primary parameter Korean Western Ontario and McMaster Universities (K-WOMAC) showed statistical significance in the amount of change in visit 2-visit 10 (V2-V10) in the pain domain and in the amount of change in visit 2-follow 1 (V2-FU1) in the functional domain and total score domain. The secondary parameter (NRS, risk of fall, and range of motion) showed a tendency to decrease in the degree of discomfort, but statistical significance could not be confirmed. Conclusions Because this study did not have enough study subjects, it is difficult to use the results as confirmatory evidence. However, it was confirmed that the 4-week Chuna treatment had a significant effect and safety in patients who underwent total knee arthroplasty. Therefore, this study is meaningful as a prior research data to prepare confirmatory evidence in the future.

Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study (양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석)

  • Kim, Soojeong;Kim, So Jeong;Song, Hye Hyun;Lee, Wonhye;Chon, Myong-Wuk;Nam, Yoon Young;Park, Dong Yeon
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.13-22
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    • 2021
  • Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

Updates of Evidence-Based Nursing Practice Guideline for Prevention of Venous Thromboembolism (근거기반 정맥혈전색전증 예방 간호실무지침 개정)

  • Cho, Yong Ae;Eun, Young;Lee, Seon Heui;Jeon, Mi Yang;Jung, Jin Hee;Han, Min Young;Kim, Nari;Huh, Jin Hyung
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.24-41
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    • 2023
  • Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

Effectiveness of Acupuncture for Pain and Depressive Symptoms in Fibromyalgia: Systematic Review and Meta-Analysis (섬유근통의 통증 및 우울증상에 대한 침치료의 효과성: 체계적 문헌고찰 및 메타분석)

  • Hyunwoo Lee;Chan Park;Tae Hoon Bang;Hyung Min Ji;Jong-Woo Kim;Sun-Yong Chung
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.2
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    • pp.95-113
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    • 2023
  • Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

Factors Affecting Consumers' Acceptance of e-Commerce Consumer Credit Service: Multiple Group Path Analysis by Naver Shopping and Coupang (이커머스 후불결제(BNPL) 수용에 영향을 미치는 요인: 네이버쇼핑과 쿠팡 간 다중집단 비교)

  • Kim, Su Jin;Mo, Jeonghoon
    • The Journal of Society for e-Business Studies
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    • v.27 no.2
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    • pp.105-135
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    • 2022
  • As COVID-19 has led to a surge in e-commerce Buy Now Pay Later(BNPL) has become preferred choice among millennials. In Korea Coupang followed by Naver Pay offers a deferred payment, aiming to create customer lock-in effect, save credit card processing fee and lay the groundwork for entering into new financial services. However the literature related to the influential factors of customers' usage intention toward a deferred payment is scarce. For the study, a multi-group analysis was carried out to find differences between Naver shopping and Coupang. The results revealed that the important factors that affect a deferred payment adoption were compatibility, impulsive buying tendency in Naver shopping, whereas compatibility, relative advantage, additional value in Coupang(listed in order of most important). In addition, impulsive buying tendency had a positive effect on adoption intention in Naver shopping and on perceived risk in Coupang. The results imply that Naver shopping need to focus on managing delinquency while Coupang should provide sufficient information on how late fees and credit rating downgrade work and try not to make a deferred payment option stand out. In order to increase adoption rate it is recommendable to narrow down target segment of a deferred payment and expand it to a specialized vertical such as travel.

A Framework of Test Scenario Development for Issuance of Conditional Driver's Licenses for Elderly Drivers (고령 운전자 조건부 운전면허 발급을 위한 평가 시나리오 개발 프레임워크)

  • Sangsu Kim;Younshik Chung
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.23 no.1
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    • pp.134-145
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    • 2024
  • The purpose of this study was to propose a framework for developing test scenarios for issuance of conditional driver's licenses. The framework was composed of five stages. Initially, we reviewed the literature on traffic crash characteristics in terms of accident frequency and severity regarding the main factors of crashes caused by older drivers. In the second stage, the characteristics of crashes attributed to non-elderly, early elderly, and late elderly drivers were analyzed using data obtained from the Traffic Accident Analysis System (TAAS), and crash types for elderly drivers were derived. In the third stage, black box videos of high-risk crash types were analyzed to derive crash stories that described the circumstances in which crashes occurred. In the fourth step, crash situations were classified by rating the types of crash stories derived to develop various scenarios. Step 5 involved creating a scenario by applying the PEGASUS 5-Layer format, which has recently been used to develop test scenarios for autonomous vehicles. The results of this study are expected to be used as a basis for developing driving ability evaluation scenarios for the issuance of conditional driver's licenses.

Predictors of Participation Restriction in Community-dwelling Persons With Spinal Cord Injury (지역사회 거주 척수장애인의 참여 제약에 영향을 미치는 예측요인)

  • Kim, Yeon-Ju;Park, Ji-Hyuk;Kim, Jung-Ran;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.19-30
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    • 2018
  • Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

Corporate Credit Rating based on Bankruptcy Probability Using AdaBoost Algorithm-based Support Vector Machine (AdaBoost 알고리즘기반 SVM을 이용한 부실 확률분포 기반의 기업신용평가)

  • Shin, Taek-Soo;Hong, Tae-Ho
    • Journal of Intelligence and Information Systems
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    • v.17 no.3
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    • pp.25-41
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    • 2011
  • Recently, support vector machines (SVMs) are being recognized as competitive tools as compared with other data mining techniques for solving pattern recognition or classification decision problems. Furthermore, many researches, in particular, have proved them more powerful than traditional artificial neural networks (ANNs) (Amendolia et al., 2003; Huang et al., 2004, Huang et al., 2005; Tay and Cao, 2001; Min and Lee, 2005; Shin et al., 2005; Kim, 2003).The classification decision, such as a binary or multi-class decision problem, used by any classifier, i.e. data mining techniques is so cost-sensitive particularly in financial classification problems such as the credit ratings that if the credit ratings are misclassified, a terrible economic loss for investors or financial decision makers may happen. Therefore, it is necessary to convert the outputs of the classifier into wellcalibrated posterior probabilities-based multiclass credit ratings according to the bankruptcy probabilities. However, SVMs basically do not provide such probabilities. So it required to use any method to create the probabilities (Platt, 1999; Drish, 2001). This paper applied AdaBoost algorithm-based support vector machines (SVMs) into a bankruptcy prediction as a binary classification problem for the IT companies in Korea and then performed the multi-class credit ratings of the companies by making a normal distribution shape of posterior bankruptcy probabilities from the loss functions extracted from the SVMs. Our proposed approach also showed that their methods can minimize the misclassification problems by adjusting the credit grade interval ranges on condition that each credit grade for credit loan borrowers has its own credit risk, i.e. bankruptcy probability.

A Legal Study on the Certificate System for Light Sports Aircraft Repairman (경량항공기 정비사 자격증명제도에 관한 법적 고찰)

  • Kim, Woong-Yi;Shin, Dai-Won;Lee, Gi-Myung
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.1
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    • pp.175-204
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    • 2018
  • Recently, the aviation leisure business has been legislated, and related industries have become active base with increasing the light sports aircraft within the legislation system. However, in the light sports aircraft safety problem, it is often mentioned that the flight is in violation of the regulations, the lack of safety consciousness of the operator and lack of ability, and the personal operators have a risk of accident of light aircraft such as insufficient safety management and poor maintenance. At present, the maintenance of light sports aircraft is carried out by the A & P mechanic in accordance with the relevant laws and regulations, but it is difficult to say that it is equipped with qualification and expertise. It is not a legal issue to undertake light sports aircraft maintenance work on the regulation system. However, the problem of reliability and appropriateness is constantly being raised because airplanes, light sports aircraft, and ultra-light vehicle are classified and serviced in a legal method. Although legal and institutional frameworks for light sports aircraft are separated, much of it is stipulated in the aviation law provisions. Light sports aircraft maintenance work also follows the current aircraft maintenance system. In the United States, Europe, and Australia where General Aviation developed, legal and institutional devices related to maintenance of light aircraft were introduced, and specialized maintenance tasks are covered in the light aircraft mechanics system. As a result of analysis of domestic and foreign laws and regulations, it is necessary to introduce the qualification system for maintenance of light aircraft. In advanced aviation countries such as the United States, Europe, and Australia, a light sports aircraft repairman system is installed to perform safety management. This is to cope with changes in the operating environment of the new light sports aircraft. This study does not suggest the need for a light aircraft repairman system. From the viewpoint of the legal system, the examination of the relevant laws and regulations revealed that the supplementary part of the system is necessary. It is also require that the necessity of introduction is raised in comparison with overseas cases. Based on these results, it is necessary to introduce the system into the light aircraft repairman system, and suggestions for how to improve it are suggested.

The Characteristics of Child and Adolescent Suicide Attempters Admitted to a University Hospital (일 대학병원에 자살 시도 후 입원한 소아청소년들의 특성)

  • Bang, Yeon-Sik;Lee, Jinhee;Min, Seongho;Ahn, Joung-Sook;Park, Ki-Chang;Kim, Min-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.135-144
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    • 2018
  • Objectives : The purpose of this study was to identify the differences of demographic and clinical characteristics between child-adolescents who received medical inpatient care and non-hospitalized adolescents after suicide attempts. Methods : The study included 35 child-adolescents who were hospitalized (Admission group) and 114 child-adolescents who were not hospitalized (Non-Admission group) as a result of a suicide attempt from 2009 to 2015. We compared sociodemographic, clinical, and suicide attempt-related characteristics through a chi-square test and logistic regression analysis to evaluate the differences between the two groups. Results : Child-adolescents of this study most commonly attempted suicide by poisoning, and for motivation of interpersonal problems. Admission group had significantly fewer attempts through injury by sharp objects (${\chi}^2=4.374$, p=0.037) and attempted suicide with a higher chance of actually dying when compared to Risk-Rescue Rating Scale (t=1.981, p=0.049). In addition, Admission group had relatively common motivation for academic problems (${\chi}^2=12.082$, p=0.001) and less motivation for interpersonal difficulties. (${\chi}^2=9.869$, p=0.002) Psychiatric diagnosis at the time of visiting the emergency department showed higher rates of depression in the admission group than Non-Admission group (${\chi}^2=8.649$, p=0.003). The results of logistic regression showed that depression affects hospitalization (OR=2.783, 95% CI 1.092-7.089, p=0.032). Conclusions : This study is meaningful in that it revealed the social and clinical characteristics of all child-adolescents who were hospitalized at a university hospital after attempting suicide. This study identified differences in motivation, methods, and psychiatric diagnosis of hospitalized adolescents and those who were not. Therefore, the results may help adolescent suicide attempters to get a discriminatory approach based on their admission.