• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.211-219
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• 2020

Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

• Physical Therapy Rehabilitation Science
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• 제6권4호
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• pp.176-181
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• 2017

Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.

• 한국기계가공학회지
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• 제19권6호
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• pp.67-72
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• 2020

Life tests are essential in reducing the catastrophic damage caused by the accidents of large machinery such as aircraft and ships. However, life tests are challenging to implement due to the high costs and time required to test the life of large machinery parts. Therefore, it is advantageous and convenient to apply accelerated life test techniques for key components to reduce costs and time. In fact, extensive research has already been conducted on these techniques. However, recently, there have been cases in which an experimental value was applied to the shape parameter of the Weibull distribution used in the reliability test, but the test time was not significantly reduced. Therefore, in this paper, the shape parameters are estimated from the probability density function of the Weibull distribution for the analysis of an accelerated life test for bladder accumulators, which are core components of military helicopters. The test time was derived based on the number of samples and confidence level by substituting it into the test time equation. Next, the accelerated life test time was calculated using the steady-state test time with an acceleration factor obtained from the Arrhenius model. The steady-state life test required approximately 15,000 H, whereas the accelerated life test time for one sample at 100 ℃ was 34% shorter than that of the steady-state life test.

• 보건행정학회지
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• 제14권4호
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• pp.1-20
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• 2004

This study is to examine relationships of several socioeconomic position indicators with mortality risk in a nationwide longitudinal study of South Korea. The Korea Labor & Income Panel Study, conducted on a probability sample of urban South Korean households by Korea Labor Institute, contains date of death information for the decedents which were used to estimate relative risks of mortality and their $95\%$ confidence intervals (CI) with Cox regression analysis. A total of 125 men and women among 8,415 subjects died between 1998 and 2002. Socioeconomic differentials in mortality were observed after adjustment for sex and age. Those with less than 12-year education had 1.90 times $(95\%\;CI=1.25-2.91)$ greater mortality risk than those with 12-year education or more. Greater mortality risks were also found among those with low occupational class and manual occupation. The magnitude of differentials in mortality risks between occupational class were similar in two different approaches to measuring women's occupational class: (1) approach 1 where women, married or not, retain their own occupational class, and (2) approach 2 where married women are assigned their husbands' occupational class. Relative risks of dying among those with low household Income were 1.62 $(95\%\; CI=1.08-2.42)$ compared with the counterparts. Those who reported economic hardship at the time of survey in 1998 had greater risk of mortality $(RR=1.83,\;95\%\;CI=1.21-2.78)$ than those who did not. In conclusion, increased social discourse and policy discussions about these health inequalities are needed in Korean society. Future studies should explore the causes and mechanisms of socioeconomic mortality inequalities.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6819-6822
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• 2014

Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

• 한국의료질향상학회지
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• 제7권2호
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• pp.218-228
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• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.603-606
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• 2013

Background: Ovarian cancer is the second most common malignancy in Pakistani women, accounting for 4% of all cancers in the female population. The aim of this study was to determine sensitivity, specificity, positive and negative predictive values and 95% confidence intervals for ultrasound in characterization of ovarian masses in patients presenting at public and private tertiary care hospitals in Karachi, Pakistan. Materials and Methods: We adopted a cross-sectional analytical study design to retrospectively collect data from January 2009-11 from medical records of two tertiary care hospitals. Using a non-probability purposive sampling technique, we recruited a sample of 86 women aged between 15 and 85 years fulfilling inclusion criteria with histopathologically proven ovarian masses presenting for an ultrasound examination in our radiology departments. Results: Our retrospective data depicted sensitivity and specificity of ultrasound to be 90.7%, 95%CI (0.77, 0.97) and 91.4%, 95%CI (0.76, 0.98) respectively. Positive predictive value was 93%, 95%CI (0.79, 0.98) and negative predictive value was 89%, 95%CI (0.73, 0.96). A total of 78 ovarian masses were detected, out of which 42 were malignant and 36 were benign. Conclusions: Results of our study further reinforce the conclusion that ultrasound should be used as an initial modality of choice in the workup of every woman suspected of having an ovarian mass. It not only results in decreasing the mortality but also avoids unnecessary surgical interventions.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2067-2070
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• 2013

Background/Aim: Stomach cancer is the second most common cause of death from all malignant tumors in the world (third in men, fifth in women), with a strong decreasing trend in most developed countries. The aim of this descriptive epidemiological study was to analyze mortality of stomach cancer in Serbia, excluding the Province of Kosovo, in the 1991-2009 period. Materials and Methods: In data analysis, we used mortality rates which were standardized directly using those of the world population as a standard. In order to analyze the mortality trend from stomach cancer, linear trend and regression analysis were used. Confidence intervals (CIs) for the average age-adjusted and age-specific mortality rates were assessed with 95% level of probability. Mortality data were derived from the data file of the Statistical Office of the Republic of Serbia. Results: During the 1991-2009 period, a significant downward trend in mortality of stomach cancer was recorded in Serbia (y=9.78 - 0.13x, p=0.000; average annual percent change was -6.3 (95%CI, -7.8 to - 4.8). During the same period, a significant decrease in mortality trend was found both in male (y=14.13 - 0.20x; p=0.000; % change was -7.7 (95%CI, -10.9 to -4.5) and female populations (y=6.27 - 0.08x; p=0.000; % change was - 4.4 (95%CI, -5.3 to -3.6). Conclusion: Decreasing trends in mortality from stomach cancer in Serbia are similar to those in most developed countries.

• Computers and Concrete
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• 제3권1호
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• pp.1-15
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• 2006

The seismic safety of reinforced concrete containment building can be evaluated by probabilistic analysis considering randomness of earthquake, which is more rational than deterministic analysis. In the safety assessment of earthquake-resistant structures by the deterministic theory, it is not easy to consider the effects of random variables but the reliability theory and random vibration theory are useful to assess the seismic safety with considering random effects. The reliability assessment of reinforced concrete containment building subjected to earthquake load includes the structural analysis considering random variables such as load, resistance and analysis method, the definition of limit states and the reliability analysis. The reliability analysis procedure requires much time and labor and also needs to get the high confidence in results. In this study, random vibration analysis of containment building is performed with random variables as earthquake load, concrete compressive strength, modal damping ratio. The seismic responses of critical elements of structure are approximated at the most probable failure point by the response surface method. The response surface method helps to figure out the quantitative characteristics of structural response variability. And the limit state is defined as the failure surface of concrete under multi-axial stress, finally the limit state probability of failure can be obtained simply by first-order second moment method. The reliability analysis for the multiaxial strength limit state and the uniaxial strength limit state is performed and the results are compared with each other. This study concludes that the multiaxial failure criterion is a likely limit state to predict concrete failure strength under combined state of stresses and the reliability analysis results are compatible with the fact that the maximum compressive strength of concrete under biaxial compression state increases.

• 한국인터넷방송통신학회논문지
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• 제15권5호
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• pp.113-118
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• 2015

이동 무선망은 통신기반 설치가 필요 없는 빠르고 쉬운 망 구성 등의 장점으로 미래의 통신망으로 많은 주목을 받고 있다. 이동 무선망에서 임의의 두 노드간의 통신 경로는 노드의 이동성으로 인해 어떤 링크에서는 전송 범위($r_0$)를 벗어나 경로 붕괴가 일어나고 통신이 불가능하게 된다. 모든 노드 쌍의 경로 붕괴 시간의 모음인 총 경로붕괴 시간 집합(${\bigcup}T_i$)은 이동 무선망의 동적인 연결 상태를 측정하는 좋은 척도가 될 수 있다. 본 논문에서는 총 경로붕괴 시간의 확률 밀도함수는 지수함수로 근사화 될 수 있음을 보이고 실험 데이터를 통해서 확인하였다. 경로붕괴 시간에 대한 통계적 특성을 알면 이동 무선망에서의 노드 간 지연, 패킷 손실률 등에 대한 정량적 예측을 할 수 있고 시뮬레이션 결과에 대한 확신을 더해 주게 된다.