• Title/Summary/Keyword: likelihood interval

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Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease

  • Baek, Jin-Young;Song, Min Seob
    • Clinical and Experimental Pediatrics
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    • v.59 no.2
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    • pp.80-90
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    • 2016
  • Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

A Three Dimensional Study on the Probability of Slope Failure (사면(斜面)의 삼차원(三次元) 파괴확률(破壞確率)에 관한 연구(硏究))

  • Kim, Young Su;Lim, Byuong Zo;Paik, Young Shik
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.3 no.3
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    • pp.95-106
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    • 1983
  • The probability of failure is used to analyze the reliability of three dimensional slope failure, instead of conventional factor of safety. The strength parameters are assumed to be normal variated and beta variated. These are interval estimated under the specified confidence level and maximum likelihood estimation. The pseudonormal and beta random variables are generated using the uniform probability transformation method according to central limit theorem and rejection method. By means of a Monte-Carlo Simulation, the probability of failure is defined as; $$P_f$$=M/N N: Total number of trials M: Total number of failures some of the conclusions derived from the case study include; 1. If the strength parameters are assumed to be normal variated, the relationship between safety factor and the probability of failure is fairly consistent, regardless of the procedures of analysis and dimensions of assumed rupture surfaces. 2. However if the strength parameters are beta variated, general relationship between $F_s$ and $P_f$ is hardly found.

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A Three Dimensional Study on the Probability of Slope Failure(II) (사면(斜面)의 삼차원(三次元) 파괴확률(破壞確率)에 관(關)한 연구(硏究)(II))

  • Kim, Young-Su;Tcha, Hong-Jun;Jung, Sung-Kwan
    • Journal of Industrial Technology
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    • v.3
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    • pp.53-63
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    • 1983
  • The probability of failure is used to analyze the reliability of three dimensional slope failure, instead of conventional factor of safety. The strength parameters are assumed to be normal variated and beta variated. These are interval estimated under the specified confidence level and maximum likelihood estimation. The pseudonormal and beta random variables are generated using the uniform probability transformation method according to central limit theorem and rejection method. By means of a Monte-Carlo Simulation, the probability of failure is defined as; Pf=M/N N : Total number of trials M : Total number of failures Some of the conclusions derived from the case study include; 1. Three dimensional factors of safety are generally much higher than 2-D factors of safety. However situations appear to exist where the 3-D factor of safety can be lower than the 2-D factor of safety. 2. The F3/F2 ratio appears to be quite sensitive to c and ${\phi}$ and to the shape of the 3-D shear surface and the slope but not to be to the unit weight of soil. 3. In cases that strength parameters are assumed to be normal variated and beta variated, the relationships between safety factor and the probability of failure are fairly consistent, regardless of the shape of the 3-D shear surface and the slope. 4. As the c-value is increased, the probability of failure for the same safety factor is increased and as the ${\phi}-value$ is increased, the probability of failure for the same safety factor is decreased.

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Clinical Characteristics of Children Needing Inpatient Treatment after Failed Outpatient Treatment for Fecal Impaction

  • Sinha, Amrita;Mhanna, Maroun;Gulati, Reema
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.196-202
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    • 2018
  • Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

Objective and Subjective Socioeconomic Position and Current Smoking Among Korean Adolescents

  • Ko, Min Jung;Lee, Eun Young;Kim, Kirang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8877-8881
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    • 2014
  • Background: Despite social gradients in adult smoking, the effects of socioeconomic position (SEP) on adolescent smoking is not well understood. This study examined effects of subjective SEP as well as the objective SEP on smoking among Korean adolescents. Materials and Methods: Data were obtained from the 2012 Korea Youth Risk Behavior Web-based Survey, a nationally representative sample of middle and high school students (38,221 boys; 35,965 girls). SEP was assessed by the Family Affluence Scale (FAS) and the self-rated household economic status. Relationships between SEP and smoking were analyzed by multivariate logistic regression. Results: The low perceived SEP for either the high or low FAS grade was related to an elevated likelihood of smoking in both genders. A significantly higher risk of smoking was found in boys of low perceived SEP in middle school (odds ratio [OR] 1.50; 95% confidence interval [CI] 1.28-1.77 for high FAS, OR 1.55; 95% CI 1.21-1.98 for low FAS), and of low perceived SEP and high FAS in high school (OR 1.13; 95% CI 1.02-1.26). Among girls, an elevated risk of smoking was observed in middle school group with low perceived SEP and low FAS (OR 2.01; 95% CI 1.44-2.79) and in the high school group of low perceived SEP, regardless of FAS level (OR 1.34; 95% CI 1.14-1.57 for high FAS, OR 1.31; 95% CI 1.04-1.65 for low FAS). Conclusions: The relationship of subjectively perceived SEP with smoking is as important as objective SEP and more significant in Korean high school adolescents.

Effects of Obesity, Body Image Dissatisfaction and Dietary Habits on the Risk of Disturbed Eating Attitudes among High School Students in Gyunggi Province, Korea (경기지역 일부 남녀 고등학생의 비만도, 체형불만족도 및 식습관이 식사장애 위험도에 미치는 영향)

  • Yim, Kyeong-Sook
    • Korean Journal of Community Nutrition
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    • v.15 no.5
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    • pp.656-669
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    • 2010
  • Rapid shift to western dietary patterns and social drive of thinness would lead to increase the likelihood of developing eating disorders. This study was performed to analyze the associated factors between dietary pattern and self visualization in terms of body shape, which may increase the risk of disturbed eating attitudes among high school students in Korea. A cross-sectional study was conducted from 2009 to 2010 for high school students including both male and female students, from 6 schools in Gyunggi Province, Korea. A total of 766 students self-reported a questionnaire, including weight control practice, perceptions of self body image and ideal body image, dietary habit, and EAT-26 (Eating Attitude Test-26). Logistic regression analysis was used to fine the factors potentially associated with disturbed eating attitudes. Statistical analysis was conducted using SAS program (version 9.1). Results showed that disturbed eating attitudes were found in 8.7% of male high school students, and in 20.8% of female high school students. Experience of body weight control was reported by 56.2% of male students and by 87.3% of female students. According to multiple logistic regression analysis, obesity was independently associated with high risk of disturbed eating attitudes in male students [Odds Ratios (OR) 2.96, 95% Confidence Interval (CI) 0.90-9.71]. Body image dissatisfaction (OR 2.77, 95%CI 1.37-5.62) and extended family type (OR 2.70, 95%CI 1.05-6.90) were independently associated with high risk of disturbed eating attitudes, especially in female students. In conclusion, proper efforts in education for obesity and developing self-esteem to reduce the risks of disturbed eating attitudes should be implemented in high school nutrition program.

Hearing loss screening tool (COBRA score) for newborns in primary care setting

  • Poonual, Watcharapol;Navacharoen, Niramon;Kangsanarak, Jaran;Namwongprom, Sirianong;Saokaew, Surasak
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.353-358
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    • 2017
  • Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

The Impact of Marriage Migrant Women's Korean Language Ability, Self-esteem, and Acculturative Stress on Their Family Health: Focused on Mediating Effects of Marital Adjustment (결혼이주여성의 한국어 능력, 자아존중감, 문화적응 스트레스가 가족건강성에 미치는 영향 - 부부적응의 매개효과를 중심으로)

  • Lee, Ji Hyun;Jin, Su Jin;Ju, Hyeon Jeong;Cho, Yeon Sil
    • Research in Community and Public Health Nursing
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    • v.24 no.1
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    • pp.87-98
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    • 2013
  • Purpose: This study was conducted for the purpose of a structural model analysis of family health of women who came to Korea for being married to Korean men. Methods: The data were collected from 260 immigrant women at multicultural centers located in C and B cities from May 10th to 30th, 2012. The variance analysis on the samples was conducted by using the maximum likelihood minimization function with AMOS 7.0. The fitness was evaluated by means of the SRMR, RMSEA, CFI, and TLI with a 90% confidence interval. Results: First, immigrant women's self-esteem and acculturative stress were found to have significant direct effects on their family health. Second, their self-esteem and acculturative stress have direct effects on their marital adjustment. Third, their marital adjustment was found to have significant direct effects on their family health. Forth, immigrant women's Korean language ability was found not to have significant direct effects on their marital adjustment and family health. Conclusion: In order to enhance the family health of immigrant women, it is necessary to develop and apply nursing programs in consideration of immigrant women's self-esteem, marital adjustment and acculturative stress.

The Impact of Organizational Justice, Empowerment on the Nursing Task Performance of Nurses: Focused on the Mediating Effect of Job Satisfaction and Organizational Commitment (간호사의 조직공정성, 임파워먼트가 간호업무성과에 미치는 영향: 직무만족과 조직몰입의 매개효과를 중심으로)

  • Jun, So Yeun;Rho, Hyung Jin;Lee, Ji Hyun
    • Korean Journal of Occupational Health Nursing
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    • v.23 no.2
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    • pp.55-66
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    • 2014
  • Purpose: The purpose of this study is to analyze the structural model on the Nursing Task Performance of Hospital Nurses. Methods: Data collection was done by the 200 hospital nurses from May 1st to May 20th, 2013 in Seoul city. The sample variance-covariance matrix was analyzed using AMOS 19.0 and the maximum likelihood minimization function. The goodness of fit was evaluated using the SRMR, RMSEA and its 90% confidence interval, CFI, and TLI. Results: First, hospital nurses' organizational justice and empowerment was not found to have a significant direct effect on nursing task performance. Second, organizational justice and empowerment had a direct effect on job satisfaction and organizational commitment. Third, organizational commitment was found to have a significant direct effect on nursing task performance. Forth, hospital nurses' empowerment was found to have a significant direct effect on nursing task performance. Conclusion: Nurses' nursing task performance was influenced by organizational justice, empowerment, and organizational commitment. In order to increase the degree of nursing task performance in hospital nurse, it is necessary to develop the nursing program and its application considering hospital nurses' organizational justice and empowerment and organizational commitment.

A Structural Relationship between the Related Variables of Adolescence's Suicidal Ideation (청소년의 자살생각 관련변인들 간의 인과적 구조분석 : 가족응집성, 가족적응성, 자아존중감, 집단따돌림, 그리고 우울을 중심으로)

  • Moon, Dae-Geun;Lee, Jin-Ju;Lee, Jong-Kak;Koim, Jung-Min;Moon, Soo-Back
    • Korean Journal of Child Studies
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    • v.34 no.3
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    • pp.93-112
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    • 2013
  • The purpose of this study was to investigate the structural relationships between variables related to the Suicidal Ideation of Adolescences. A total of 923 Middle school students residing in Daegu City completed questionnaires which assessed family adaptability, family cohesion, self-esteem, bullying victimhood, depression and suicidal ideation. The sample variance-covariance matrix was analyzed using AMOS 20.0, and a maximum likelihood minimization function. Goodness of fit was evaluated using the SRMS, RMSEA, and its 90% confidence interval, CFI, and TLI. The results were as follows : First, the variables of family adaptability and family cohesion did not have a statistically significant direct impact on adolescence's suicidal ideation, although they may well have an indirect effect on suicidal ideation through self-esteem, bullying victimhood and depression. Second, Self-esteem and bullying victimhood had significant direct effects on depression and suicidal ideation. Moreover, they also had an indirect effect on suicidal ideation through self-esteem. Third, depression had a substantial direct effect on suicidal ideation. Finally, self-esteem did not indicate a direct effect on bullying victimhood.