• Title/Summary/Keyword: interval regression model

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Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

The Effects of Wearing Protective Devices among Residents and Volunteers Participating in the Cleanup of the Hebei Spirit Oil Spill (허베이스피릿호 유류유출사고 방제작업 참여자의 보호장비착용 효과)

  • Lee, Seung-Min;Ha, Mi-Na;Kim, Eun-Jung;Jeong, Woo-Chul;Hur, Jong-Il;Park, Seok-Gun;Kwon, Ho-Jang;Hong, Yun-Chul;Ha, Eun-Hee;Lee, Jong-Seung;Chung, Bong-Chul;Lee, Jeong-Ae;Im, Ho-Sub;Choi, Ye-Yong;Cho, Yong-Min;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.89-95
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    • 2009
  • Objectives : To assess the protective effects of wearing protective devices among the residents and volunteers who participated in the cleanup of the Hebei Spirit oil spill. Methods : A total of 288 residents and 724 volunteers were surveyed about symptoms, whether they were wearing protective devices and potential confounding variables. The questionnaires were administered from the second to the sixth week following the accident. Spot urine samples were collected and analyzed for metabolites of 4 volatile organic compounds(VOCs), 2 polycyclic aromatic hydrocarbons(PAHs), and 6 heavy metals. The association between the wearing of protective devices and various symptoms was assessed using a multiple logistic regression adjusted for confounding variables. A multiple generalized linear regression model adjusted for the covariates was used to test for a difference in least-square mean concentration of urinary biomarkers between residents who wore protective devices and those who did not. Results : Thirty nine to 98% of the residents and 62-98% of volunteers wore protective devices. Levels of fatigue and fever were higher among residents not wearing masks than among those who did wear masks(odds ratio 4.5; 95% confidence interval 1.23-19.86). Urinary mercury levels were found to be significantly higher among residents not wearing work clothes or boots(p<0.05). Conclusions : Because the survey was not performed during the initial high-exposure period, no significant difference was found in metabolite levels between people who wore protective devices and those who did not, except for mercury, whose biological half-life is more than 6 weeks.

Predictors of breast-feeding discontinuation in some followed-up hospital-delivered mothers (추적조사된 대구시내 일부 병원분만 산모에서 모유수유중단 예측변수)

  • Lee, Choong-Won;Lee, Moo-Sik;Park, Jong-Won;Lee, Mi-Young;Kang, Mi-Joung;Shin, Dong-Hoon;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.845-862
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    • 1995
  • We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

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Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL) (필리핀 결혼이민여성의 한식 섭취실태 및 한식 섭취율에 따른 사회경제학적 요인)

  • Kim, Nayeon;Kang, Minji;Abris, Grace;Provido, Sherlyn Mae P.;Joung, Hyojee;Hong, Sangmo;Yu, Sung Hoon;Lee, Chang Beom;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.23 no.6
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    • pp.475-487
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    • 2018
  • Objectives: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). Methods: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. Results: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18-4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. Conclusions: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.

The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly (농촌지역 노인들의 인지기능 장애와 사망과의 관련성)

  • Sun, Byeong-Hwan;Park, Kyeong-Soo;Na, Baeg-Ju;Park, Yo-Seop;Nam, Hae-Sung;Shin, Jun-Ho;Sohn, Seok-Joon;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.630-642
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    • 1997
  • The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

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Risk Factors Related to Uterine Leiomyoma in Korean Women - A Retrospective Study - (한국인 여성에서 자궁근종 발생에 관여하는 인자들에 대한 연구 - 후향적 연구 -)

  • Hong, D.G.;Chung, M.J.;Kim, B.S.;Lee, J.M.;Cho, Y.L.;Lee, T.H.;Chun, S.S.
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.3
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    • pp.159-170
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    • 2006
  • Objective: The purpose of this study is to find out risk factors related to uterine leiomyoma in Korean women and to compare with the results of previous western studies. Methods: A retrospective analysis was carried out. All the cases of uterine leiomyoma (n=244) were diagnosed surgically or sonographically between Jannuary 1998 and December 2004. Total of 269 controls not having uterine leiomyoma were collected from patients who visited Kyungpook national university hospital for routine gynecologic check-up or treatment of their gynecologic or obstetric diseases other than uterine leiomyoma. Data were collected through review of medical records and interviews and analyzed with $x^2$ and logistic regression model. Results: In multivariate analysis, patient's age (OR 1.070; 95% CI 1.041~1.099), number of artificial abortion (OR 1.182; 95% CI 1.018~1.374) and alcohol drinking (OR 1.865; 95% CI 1.231~2.824) had significantly positive correlation with uterine leiomyoma. The duration of lactation was the only factor which had negative correlation (OR 0.985; 95% CI 0.972~0.998). BMI, parity, age at menarche, the duration and interval of menstruation, caffeine consumption and marital status did not show any correlations. Conclusion: In this study, patient's age, number of artificial abortion, and alcohol drinking were the risk factors of uterine leiomyoma in Korean women and the result was similar to that of western studies. Though we couldn't find out the specific risk factors related to the development of uterine leiomyoma in this study, but it has a great meaning to be the first trial in Korean women. The role of information bias should be carefully evaluated and further multicentered, randomized, controlled prospective studies will be needed to know the possible risk factors among Korean women.

The Gains To Bidding Firms' Stock Returns From Merger (기업합병의 성과에 영향을 주는 요인에 대한 실증적 연구)

  • Kim, Yong-Kap
    • Management & Information Systems Review
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    • v.23
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    • pp.41-74
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    • 2007
  • In Korea, corporate merger activities were activated since 1980, and nowadays(particuarly since 1986) the changes in domestic and international economic circumstances have made corporate managers have strong interests in merger. Korea and America have different business environments and it is easily conceivable that there exists many differences in motives, methods, and effects of mergers between the two countries. According to recent studies on takeover bids in America, takeover bids have information effects, tax implications, and co-insurance effects, and the form of payment(cash versus securities), the relative size of target and bidder, the leverage effect, Tobin's q, number of bidders(single versus multiple bidder), the time period (before 1968, 1968-1980, 1981 and later), and the target firm reaction (hostile versus friendly) are important determinants of the magnitude of takeover gains and their distribution between targets and bidders at the announcement of takeover bids. This study examines the theory of takeover bids, the status quo and problems of merger in Korea, and then investigates how the announcement of merger are reflected in common stock returns of bidding firms, finally explores empirically the factors influencing abnormal returns of bidding firms' stock price. The hypotheses of this study are as follows ; Shareholders of bidding firms benefit from mergers. And common stock returns of bidding firms at the announcement of takeover bids, shows significant differences according to the condition of the ratio of target size relative to bidding firm, whether the target being a member of the conglomerate to which bidding firm belongs, whether the target being a listed company, the time period(before 1986, 1986, and later), the number of bidding firm's stock in exchange for a stock of the target, whether the merger being a horizontal and vertical merger or a conglomerate merger, and the ratios of debt to equity capital of target and bidding firm. The data analyzed in this study were drawn from public announcements of proposals to acquire a target firm by means of merger. The sample contains all bidding firms which were listed in the stock market and also engaged in successful mergers in the period 1980 through 1992 for which there are daily stock returns. A merger bid was considered successful if it resulted in a completed merger and the target firm disappeared as a separate entity. The final sample contains 113 acquiring firms. The research hypotheses examined in this study are tested by applying an event-type methodology similar to that described in Dodd and Warner. The ordinary-least-squares coefficients of the market-model regression were estimated over the period t=-135 to t=-16 relative to the date of the proposal's initial announcement, t=0. Daily abnormal common stock returns were calculated for each firm i over the interval t=-15 to t=+15. A daily average abnormal return(AR) for each day t was computed. Average cumulative abnormal returns($CART_{T_1,T_2}$) were also derived by summing the $AR_t's$ over various intervals. The expected values of $AR_t$ and $CART_{T_1,T_2}$ are zero in the absence of abnormal performance. The test statistics of $AR_t$ and $CAR_{T_1,T_2}$ are based on the average standardized abnormal return($ASAR_t$) and the average standardized cumulative abnormal return ($ASCAR_{T_1,T_2}$), respectively. Assuming that the individual abnormal returns are normal and independent across t and across securities, the statistics $Z_t$ and $Z_{T_1,T_2}$ which follow a unit-normal distribution(Dodd and Warner), are used to test the hypotheses that the average standardized abnormal returns and the average cumulative standardized abnormal returns equal zero.

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Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer (진행성 비소세포폐암 환자에서 Gefitinib와 Erlotinib의 비교)

  • Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.280-287
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    • 2009
  • Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

Serum Albumin Concentrations and Clinical Disorders by Gestational Ages in Preterm Babies (미숙아에서 재태 연령에 따른 혈청 알부민치와 임상증상과의 관계)

  • Lee, Mia;Yun, Soo;Lim, Baek Keun;Kim, Jong Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.148-153
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    • 2005
  • Purpose : The aim of this study was to determine the reference ranges of serum albumin levels depending on the gestational ages of preterm infants. We also intended to compare the mean serum albumin levels between groups of preterm infants that did not develop clinical disorders later, and groups that did develop clinical disorders such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity, apnea and bronchopulmonary dysplasia. We also examined the significance of serum albumin as a predictor for the development of clinical disorders. Methods : The records of 208 neonates with gestational ages from 23 weeks to 41 weeks were reviewed retrospectively. The mean albumin concentrations with reference ranges by gestational ages were determined. Statistics for each two of group were compared. Logistic regression analysis was used to model odd ratio, and 95 percent confidence interval as a mean of the association between predictors and outcome. Results : Serum albumin levels were at 23-24 weeks gestation was 2.36 g/dL, rising to 3.43 g/dL in full term babies. There were significant mean differences between the clinical groups and control groups for each clinical disorder such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity and apnea in premature babies of 30-36 weeks of gestation. Low serum albumin appeared to be associated with increased risks of clinical disorders. Conclusion : The normal serum albumin levels in preterm infants should be defined according to the gestational ages. Lower albumin levels increase the risks of the later development of clinical disorders, which are common in premature infants.

The Association between Types of Smoking and Periodontal Disease according to the Survey Year Using the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (조사연도에 따른 흡연 유형과 치주질환의 관련성 분석: 제4기, 제5기 국민건강영양조사를 이용하여)

  • Kim, Myoung-Hee;Yoon, Mi-Sook;Lim, Youn-Hee;Lee, Sae-Rom;Kim, So-Yeon;Park, Seon-Ju;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.487-494
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    • 2017
  • There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.