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Prognostication for recurrence patterns after curative resection for pancreatic ductal adenocarcinoma

  • Andrew Ang;Athena Michaelides;Claude Chelala;Dayem Ullah;Hemant M. Kocher
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.248-261
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    • 2024
  • Backgrounds/Aims: This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model. Results: Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7). Conclusions: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.

Evaluation of the Measurement Uncertainty from the Standard Operating Procedures(SOP) of the National Environmental Specimen Bank (국가환경시료은행 생태계 대표시료의 채취 및 분석 표준운영절차에 대한 단계별 측정불확도 평가 연구)

  • Lee, Jongchun;Lee, Jangho;Park, Jong-Hyouk;Lee, Eugene;Shim, Kyuyoung;Kim, Taekyu;Han, Areum;Kim, Myungjin
    • Journal of Environmental Impact Assessment
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    • v.24 no.6
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    • pp.607-618
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    • 2015
  • Five years have passed since the first set of environmental samples was taken in 2011 to represent various ecosystems which would help future generations lead back to the past environment. Those samples have been preserved cryogenically in the National Environmental Specimen Bank(NESB) at the National Institute of Environmental Research. Even though there is a strict regulation (SOP, standard operating procedure) that rules over the whole sampling procedure to ensure each sample to represent the sampling area, it has not been put to the test for the validation. The question needs to be answered to clear any doubts on the representativeness and the quality of the samples. In order to address the question and ensure the sampling practice set in the SOP, many steps to the measurement of the sample, that is, from sampling in the field and the chemical analysis in the lab are broken down to evaluate the uncertainty at each level. Of the 8 species currently taken for the cryogenic preservation in the NESB, pine tree samples from two different sites were selected for this study. Duplicate samples were taken from each site according to the sampling protocol followed by the duplicate analyses which were carried out for each discrete sample. The uncertainties were evaluated by Robust ANOVA; two levels of uncertainty, one is the uncertainty from the sampling practice, and the other from the analytical process, were then compiled to give the measurement uncertainty on a measured concentration of the measurand. As a result, it was confirmed that it is the sampling practice not the analytical process that accounts for the most of the measurement uncertainty. Based on the top-down approach for the measurement uncertainty, the efficient way to ensure the representativeness of the sample was to increase the quantity of each discrete sample for the making of a composite sample, than to increase the number of the discrete samples across the site. Furthermore, the cost-effective approach to enhance the confidence level on the measurement can be expected from the efforts to lower the sampling uncertainty, not the analytical uncertainty. To test the representativeness of a composite sample of a sampling area, the variance within the site should be less than the difference from duplicate sampling. For that, a criterion, ${i.e.s^2}_{geochem}$(across the site variance) <${s^2}_{samp}$(variance at the sampling location) was proposed. In light of the criterion, the two representative samples for the two study areas passed the requirement. In contrast, whenever the variance of among the sampling locations (i.e. across the site) is larger than the sampling variance, more sampling increments need to be added within the sampling area until the requirement for the representativeness is achieved.

Self-Efficacy and Self-Control Effects on Purchasing Intention of Annuity Savings Plans: Considering Financial Literacy (금융 유통산업에서의 자기효능감과 자기통제가 연금저축 가입의도와 가입행동에 미치는 영향: 금융이해력에 따른 차이분석)

  • Lee, Yun-Bok;Lee, Phil-Soo;Hwang, Jae-Kwang
    • Journal of Distribution Science
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    • v.13 no.11
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    • pp.69-77
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    • 2015
  • Purpose - Economic status at an early stage of life after one's retirement is often determined by the long-term sacrifice of one's earlier consumption tendencies. In general, the first and foremost way to secure income after retirement is through annuity savings. People sign up for personal annuity savings in order to guarantee a stable economic life upon retirement, and such actions may be heavily influenced by self-efficacy. Confidence in current economic activity is a source of rational decision-making. Inability to achieve self-control can lead to reckless spending and the eventual hindering of proper investment for the future. This paper examines how self-efficacy and self-control affect the intention and action of enrolling in an annuity savings plan in relation to one's level of financial literacy. Research design, data, and methodology - To analyze the proposed model, this study investigates financial consumers over the age of 20. The data were collected from 511 respondents and analyzed with SPSS 21.0 and AMOS 21.0. First, for the one-dimensional test and to measure the convergent validity of each structure, we use the scale purification process. The results of the test and the confirmatory factor analysis ensure the focus of the validity of the single dimension for each structure. In addition, the validity of the measurement was guaranteed from the results of correlation analysis. Results - First, self-efficacy and self-control have positive effects on the purchasing intention of the personal annuity savings plan. Second, purchasing intention positively affects purchasing behavior. Lastly, self-control has a positive effect on purchasing intention among the low financial literacy group, whereas self-efficacy does not have this effect in the high financial literacy one. Conclusions - The time of product benefit is different with age. The younger group would be granted the savings after several decades once they enroll, whereas the older group would wait for a relatively shorter period of time. Therefore, further research should be conducted in order to verify such a difference. However, this study has value through its confirmation that the roles of self-efficacy and self-control play a part in leading to the enrollment in annuity savings plans and by verifying different effects based on levels of financial literacy. Such results suggest a number of implications in a real life setting. First, banks need to put greater emphasis on the stability of annuity savings in general. Second, customers with relatively low levels of financial literacy are able to control their finances through annuity savings, but find self-efficacy difficult due to a lack of financial understanding. Therefore, such customers should be approached from an invest-effectiveness comparison method. Third, customers with high financial literacy tend to put more value in rational economic decision-making and behavior than in self-efficacy. Therefore, such customers should be approached by promoting the reliability of annuity savings and the excellence of the specific bank's annuity savings plan in comparison to those of other financial institutions.

A Study on Estimation of the Course Keeping Ability of a Ship in Confined Waterways Using the MMG Model (MMG 모델을 이용한 제한수로를 운항하는 선박의 침로안정성능 추정에 관한 연구)

  • Kim, Hyunchul;Kim, In-Tae;Kim, Sanghyun;Kwon, Soo Yeon
    • Journal of Navigation and Port Research
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    • v.43 no.6
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    • pp.369-376
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    • 2019
  • Ship hydrodynamics in the confined waterways is challenging. When a ship is maneuvering in confined waterways, the hydrodynamic behavior may vary significantly because of the hydrodynamic interaction between the bottom of the ship hull and the seabed, or so-called shallow water effects. Thus, an accurate prediction of shallow water and bank effects is essential to minimizing the risk of the collision and the grounding of the ships. The hydrodynamic derivatives measured by the virtual captive model test provide a path to predicting the change in ship maneuverability. This paper presents a numerical simulation of captive model tests to predict the maneuverability of a ship in confined waterways. Also, straight and zig-zag simulation were conducted to predict the trajectory of a ship maneuvering in confined waterways. The results showed that the asymmetric flow around a ship induced by vicinity of banks causes pressure differences between the port and starboard sides and the trajectory of a ship maneuvering in confined waterways.

Germination Continuity and Restoration of Salicornia europaea, Halophyte in West-coast of Korea (서해안 염생식물 퉁퉁마디의 발아지속과 복원)

  • Kim, Ki-Hoon;Kang, Nae-Kyu;Song, Uh-Ram;Lee, Eun-Ju
    • Journal of Environmental Science International
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    • v.21 no.2
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    • pp.181-188
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    • 2012
  • Salicornia europaea (glasswort) is succulent, annual, halophytic plant mainly distributed throughout reclaimed land or salt marsh. It has strong tolerance to salt so that it plays the part of the pioneer species in the first succession. According to domestic and foreign studies, S. europaea contains plenty of minerals and antioxidant in the body. Since people take note of an availableness of this plant as health diet, the natural growth sites are threatened. In addition to development of salt marsh and sea shore, imprudent harvest has a bad effect to S. europaea population maintenance. To seek ways to preserve the population of this plant, we carried out the continuity of seed germination and restoration test. Seokmo Island, Daebu Island, Youngjong Island and Sudokwon landfill in Korea are selected sites for research. Result of germination continuity shows that most S. europaea seeds germinate on March but no more after July. However the germination was occurred after that time in the greenhouse. So we concluded that no germination after July is a matter of environmental condition not the number of remaining seeds. Also germination was seldom occurred in the spot where seeds production was not happened. In result of continuity test of seed germination by soil depth, germination was occurred vigorously only in top soil. From these results, we note that most S. europaea germinate in the early spring, and germination is finished by July. And this rapid germination speed makes the number of seeds in soil seed bank rare. If a large number of S. europaea in some area are harvested after July, the number of this species will dramatically decrease in that area the following year. In Seokmo Island, we carried out reintroduction experiment by sowing S. europaea seeds. On the first year, a small number of S. europaea settled and they produced seeds successfully. On April 2010, the second year, we observed many S. europaea in seed sowing sites. And we found out that plowing is more efficient than treatment sea water for settlement of S. europaea.

A Study on the Statistical Continuity of Electrical Construction Cost Index Applied Chain Method (전기공사비지수의 산정방식 변경에 따른 통계연속성 실증분석 연구)

  • Park, Houng-Hee
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.2
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    • pp.46-53
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    • 2015
  • Electrical construction cost index is composed of the cost of albor and material. The producer price index is used to the cost of material. The Bank of Korea restructured the formation method and the basic period of the producer price index in 2013. Because fixed-weighted method can't faithfully reflect industrial structure changes. The weighted value and price index of fixed-weighted method is fixed on the basicp eriod. Electrical construction cost index is changed from fixed-weighted method to chain-weighted method in september 2014, because of these on the need. But the change of organization in formation method changes the weighted value. So there is the need of analysis about the statistical continuity of electrical construction cost index. This study is focused on the time series analysis between fixed-weighted and chain-weighted electrical construction cost index. We uses unit root test, cointegration test, regression analysis of long and short term equation, fitness for the estimation of static forecast as time series analysis. We verify that chain-weighted electrical construction cost index can be replaced to fixed-weighted construction cost index accounting analyses result. So users of it recognize that chain-weighted electrical construction cost index has statistical continuity.

Survival analysis on the business types of small business using Cox's proportional hazard regression model (콕스 비례위험 모형을 이용한 중소기업의 업종별 생존율 및 생존요인 분석)

  • Park, Jin-Kyung;Oh, Kwang-Ho;Kim, Min-Soo
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.2
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    • pp.257-269
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    • 2012
  • Global crisis expedites the change in the environment of industry and puts small size enterprises in danger of mass bankruptcy. Because of this, domestic small size enterprises is an urgent need of restructuring. Based on the small business data registered in the Credit Guarantee Fund, we estimated the survival probability in the context of the survival analysis. We also analyzed the survival time which are distinguished depending on the types of business in the small business. Financial variables were also conducted using COX regression analysis of small businesses by types of business. In terms of types of business wholesale and retail trade industry and services were relatively high in the survival probability than light, heavy, and the construction industries. Especially the construction industry showed the lowest survival probability. In addition, we found that construction industry, the bigger BIS (bank of international settlements capital ratio) and current ratio are, the smaller default-rate is. But the bigger borrowing bond is, the bigger default-rate is. In the light industry, the bigger BIS and ROA (return on assets) are, the smaller a default-rate is. In the wholesale and retail trade industry, the bigger bis and current ratio are, the smaller a default-rate is. In the heavy industry, the bigger BIS, ROA, current ratio are, the smaller default-rate is. Finally, in the services industry, the bigger current ratio is, the smaller a default-rate is.

Security and Trust on Non-Contact Financial Transaction (금융보안과 신뢰가 비대면 금융거래에 미치는 영향)

  • John, Yong-Jean
    • Journal of Digital Convergence
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    • v.19 no.7
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    • pp.147-154
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    • 2021
  • The pandemic age came to us after the COVID19 broke out in the early of 2020, which resulted in many changes in our everyday life. One of the changes is non-contact transactions in economic activities, especially contact-free financial transactions are ever-increasing activities in the pandemic age. In non-contact financial transactions, security and trust are important issues that users are concerned about the most. So the paper examines how security and trust have effects on the attitudes of bank customers who use mobile banking applications on their smartphones. The study conducted factor ananlysis to extract research constructs using survey data gathered during Nobember of 2020 through February of 2021 across the nation. After extracting the constructs, the study checked validity, sampling adequacy, and internal reliability with KMO, Bartlett's test, and Crombach Alpha respectively. To make sure the purpose of the study, I do regression analysis. All factors of attitude had impacts on willingness on both of transactions and purchasing financial products. The results could give guidelines banks which want to attract more customers in open-banking environment through ever-more secure and trusty mobile banking application.

Study on Permeability, Optimum Yield and Long-term Stability in Alluvial Well with Filter Layer Change (충적우물에서 필터층 변화에 따른 투수특성, 적정양수량 및 장기적 안정성에 대한 연구)

  • Song, Jae-Yong;Lee, Sang-Moo;Choi, Yong-Soo;Kim, Ki-Joon;Jeong, Gyo-Cheol
    • The Journal of Engineering Geology
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    • v.28 no.1
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    • pp.101-115
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    • 2018
  • This study was carried out to evaluate the effects of various filter conditions on unconfined aquifer (alluvial aquifer). We made model test device which has filter layer, pumping well and observation well which consist of sand layer and gravel layer to test. Step drawdown test and long term pumping tests were carried out using the device. The permeability characteristics of each test group were confirmed and the optimal yield was calculated. As a result of comparing the optimal yield of double filter and single filter in sand, dual-filter SD-300 was valued at 216.8 % higher final optimal yield than single-filter SS-300. Comparing the dual filter SD-300 and the single filter SS-100 with a thin filter layer, dual-filter SD-300 was valued at 709.2% higher final optimal yield than single-filter SS-300. As a result of analysis of optimal yield change over time, It was confirmed that the ratio of optimal yield of single filter and dual filter increase over time. In order to evaluate the long-term change in water intake efficiency, we considered the point at which the initial optimal yield was reduced by 50%. The dual filter SD-300 is about 351.1% higher than SS-300, which is the same thickness filter, and about 579.0% higher than SS-100. From these results, Assuming that the point at which the initial quantity of water intake is reduced to 50% is the well life, double filters are expected to increase their lifespan by about 3.5 times over single filters of the same thickness and by about 5.8 times over typical single filter. These results can be used to design wells to river bank filtration or filtered seawater. In addition, it is possible to clarify the effect of the double filter through the comparison with the future field test results.

Detection of Pyrazinamide Resistance in Mycobacterium Tuberculosis by Sequencing of pncA Gene (pncA 유전자의 염기 서열 결정에 의한 결핵균의 Pyrazinamide 내성 진단)

  • Hwang, Jee-Yoon;Kwak, Kyung-Rok;Park, Hye-Kyung;Lee, Ji-Seok;Park, Sam-Seok;Kim, Yun-Seong;Lee, Jung-Yoo;Chang, Chul-Hun;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.94-105
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    • 2001
  • Background : Examining the biological susceptibility of Mycobacterium tuberculosis to pyrazinamide (PZA) in vitro is very difficult as PZA is inactive under normal culture conditions. The biological susceptibility test, an enzyme assay for Pzase activity, and a genetic test for pncA gene mutations, were performed in order to predict PZA resistance. Methods : 28 cultured clinical isolates of Mycobacterium tuberculosis were tested. The biological susceptibility was performed by the absolute concentration method using Lowenstein-Jensen media. The PZase activity was tested by means of Wayne's method. A 710-bp region includes the entire open reading frame of pncA was amplified and sequenced. Results : All six strains with positive PZase activity exhibited no pncA mutations with one strain showing a false resistance in the biological susceptibility test. Among the 22 strains with no PZase activity, 21 exhibited showed pncA mutations. In the biological susceptibility test, 20 strains were resistant, and one was susceptible, and the other flied to test. The mutation types varied with ten missense, one silent and one nonsense mutation 1 slipped-strand mispairing, and 6 frameshift mutations. Three strains had an adenine to guanine mutation at position -11 upstream of the start codon. Conclusion : The mutation at the pncA promotor region is frequent at -11 upstream position. Automatic sequencing of pncA is a useful tool for rapid and accurate detection of PZA resistant M. tuberculosis, and for demonstrating the epidemiological relatedness of the PZA resistant M. tuberculosis strains.

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