• Korean Journal of Radiology
• /
• v.22 no.8
• /
• pp.1369-1378
• /
• 2021

Objective: Few attempts have been made to investigate the prognostic value of dynamic contrast-enhanced (DCE) MRI or dynamic susceptibility contrast (DSC) MRI of non-enhancing, T2-high-signal-intensity (T2-HSI) lesions of glioblastoma multiforme (GBM) in newly diagnosed patients. This study aimed to investigate the prognostic values of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM. Materials and Methods: A total of 76 patients with GBM who underwent preoperative DCE MRI and DSC MRI and standard treatment were retrospectively included. Six months after surgery, the patients were categorized into early progression (n = 15) and non-early progression (n = 61) groups. We extracted and analyzed the permeability and perfusion parameters of both modalities for the non-enhancing, T2-HSI lesions of the tumors. The optimal percentiles of the respective parameters obtained from cumulative histograms were determined using receiver operating characteristic (ROC) curve and univariable Cox regression analyses. The results were compared using multivariable Cox proportional hazards regression analysis of progression-free survival. Results: The 95th percentile value (PV) of Ktrans, mean Ktrans, and median Ve were significant predictors of early progression as identified by the ROC curve analysis (area under the ROC curve [AUC] = 0.704, p = 0.005; AUC = 0.684, p = 0.021; and AUC = 0.670, p = 0.0325, respectively). Univariable Cox regression analysis of the above three parametric values showed that the 95th PV of Ktrans and the mean Ktrans were significant predictors of early progression (hazard ratio [HR] = 1.06, p = 0.009; HR = 1.25, p = 0.017, respectively). Multivariable Cox regression analysis, which also incorporated clinical parameters, revealed that the 95th PV of Ktrans was the sole significant independent predictor of early progression (HR = 1.062, p < 0.009). Conclusion: The 95th PV of Ktrans from the non-enhancing, T2-HSI lesions of GBM is a potential prognostic marker for disease progression.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8365-8370
• /
• 2016

Background: Shammah is a traditional form of snuff dipping tobacco (a smokeless tobacco form) that is commonly used in Yemen. Oral mucosal changes due to the use of shammah can usually be observed in the mucosal surfaces that the product touches. The aim of this study was to determine the association between shammah use and oral leukoplakia-like lesions. Other associated factors were also determined. Materials and Methods: A cross sectional study was conducted on 346 randomly selected adult males. Multi-stage random sampling was used to select the study location. After completing the structured questionnaire interviews, all the participants underwent clinical exanimation for screening of oral leukoplakia-like lesions Clinical features of oral leukoplakia-like lesion were characterized based on the grades of $Ax{\acute{e}}ll$ et al (1976). Univariable logistic regression and multivariable logistic regression were used to assess the potential associated factors. Results: Out of 346 male participants aged 18 years and older, 68 (19.7%) reported being current shammah users. The multivariable analysis revealed that age, non-formal or primary level of education, former shammah user, current shammah user, and frequency of shammah use per day were statistically associated with the presence of oral leukoplakia-like lesions [Adjusted odds ratio (AOR) = 1.03; 95% confidence interval (CI) : 1.01, 1.06; P=0.006], (AOR=8.65; 95% CI: 2.81, 26.57; P=0.001), (AOR=3.65; 95% CI: 1.40, 9.50; P=0.008), (AOR=12.99; 95% CI: 6.34, 26.59; P=0.001), and (AOR=1.17; 95% CI: 1.02, 1.36; P=0.026), respectively. Conclusions: The results revealed oral leukoplakia-like lesions to be significantly associated with shammah use. Therefore, it is important to develop comprehensive shammah prevention programs in Yemen.

• Journal of Preventive Medicine and Public Health
• /
• v.55 no.1
• /
• pp.98-105
• /
• 2022

Objectives: Low back pain (LBP) is a common chronic condition among sedentary workers that causes long-term productivity loss. This study aimed to identify the relationships of individual and occupational factors with LBP among Bangladeshi online professionals. Methods: We conducted a cross-sectional study involving 468 full-time online professionals who usually worked in a sitting position. One-month LBP complaints were assessed using a musculoskeletal subscale of subjective health complaints. The chi-square test was used to measure associations between categorical predictors and LBP, and multivariable logistic regression was conducted to identify the variables significantly associated with LBP. Results: LBP within the last month was reported by 65.6% of participants. Multivariable logistic regression analysis indicated that age >30 years (adjusted odds ratio [aOR], 0.40; 95% confidence interval [CI], 0.23 to 0.70) and being married (aOR, 0.59; 95% CI, 0.36 to 0.97) had significant negative associations with LBP. Significant positive associations were found for spending >50 hours weekly on average working in a sitting position (aOR, 1.61; 95% CI, 1.05 to 2.49), being overweight and obese (aOR, 1.87; 95% CI, 1.16 to 2.99), sleeping on a soft mattress (aOR, 2.01; 95% CI, 1.06 to 3.80), and ex-smoking status (aOR, 3.33; 95% CI, 1.41 to 7.87). Conclusions: A high prevalence of LBP was found among full-time online professionals. Long working hours in a sitting position showed a significant association with developing LBP. Smoking history, body mass index, and sleeping arrangements should also be considered while considering solutions for LBP prevalence among online professionals.

• Journal of Preventive Medicine and Public Health
• /
• v.55 no.3
• /
• pp.297-306
• /
• 2022

Objectives: The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran. Methods: This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality. Results: The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model. Conclusions: The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.4
• /
• pp.349-357
• /
• 2022

Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

• Korean Journal of Radiology
• /
• v.22 no.3
• /
• pp.415-424
• /
• 2021

Objective: To determine whether noncontrast computed tomography (NCCT) models based on multivariable, radiomics features, and machine learning (ML) algorithms could further improve the discrimination of early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively reviewed 261 patients with sICH who underwent initial NCCT within 6 hours of ictus and follow-up CT within 24 hours after initial NCCT, between April 2011 and March 2019. The clinical characteristics, imaging signs and radiomics features extracted from the initial NCCT images were used to construct models to discriminate early HE. A clinical-radiologic model was constructed using a multivariate logistic regression (LR) analysis. Radiomics models, a radiomics-radiologic model, and a combined model were constructed in the training cohort (n = 182) and independently verified in the validation cohort (n = 79). Receiver operating characteristic analysis and the area under the curve (AUC) were used to evaluate the discriminative power. Results: The AUC of the clinical-radiologic model for discriminating early HE was 0.766. The AUCs of the radiomics model for discriminating early HE built using the LR algorithm in the training and validation cohorts were 0.926 and 0.850, respectively. The AUCs of the radiomics-radiologic model in the training and validation cohorts were 0.946 and 0.867, respectively. The AUCs of the combined model in the training and validation cohorts were 0.960 and 0.867, respectively. Conclusion: NCCT models based on multivariable, radiomics features and ML algorithm could improve the discrimination of early HE. The combined model was the best recommended model to identify sICH patients at risk of early HE.

• Journal of muscle and joint health
• /
• v.22 no.2
• /
• pp.57-66
• /
• 2015

Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

• Journal of muscle and joint health
• /
• v.24 no.2
• /
• pp.67-76
• /
• 2017

Purpose: The purpose of this study was to evaluate preoperative nutritional status in elderly patients with orthopedic surgery and identify related factors for malnutrition risk. Methods: This study enrolled 337 patient's medical record who underwent orthopedic surgery in hospital between January and December 2015. Data was collected retrospectively. Nutritional status was evaluated by using the Nutritional Risk Screening 2002. Multivariable logistic regression analysis was used to identify independent related factors for malnutrition risk. Results: Malnutrition risk developed in 58 patients (17.2%). Logistic regression analysis identified low physical activity, visual impairment, depression, sleep disorder, low serum calcium level, and low serum albumin level as related factors. Conclusion: Orthopedic surgery in elderly patients was associated with high risk of preoperative malnutrition. The results of this study suggest that evaluating the nutritional status and related factors should be done with preoperative status of elderly patients. At the same time, interventions for nutritional care should be adjusted to meet the nutritional needs of individuals and decrease the risk of malnutrition.

• Journal of Preventive Medicine and Public Health
• /
• v.56 no.4
• /
• pp.338-347
• /
• 2023

Objectives: Young children's feeding characteristics can play an important role in eating habits and health during later childhood. This study was conducted to examine the associations of feeding characteristics with dietary patterns and obesity in children. Methods: This study utilized data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2017. In total, 802 toddlers were included, with information on their demographic characteristics, feeding practices and duration, and 24-hour recall obtained from their parents. Feeding characteristics were categorized into feeding type, duration of total breastfeeding, duration of total formula feeding, duration of exclusive breastfeeding, and age when starting formula feeding. Dietary patterns were identified based on factor loadings for the food groups for 3 major factors, with "vegetables & traditional," "fish & carbohydrates," and "sweet & fat" patterns. Overweight/obesity was defined as ≥85th percentile in body mass index based on the 2017 Korean National Growth charts for children and adolescents. Multiple regression analysis was conducted to examine associations between feeding characteristics and dietary patterns. The association between dietary patterns and obesity was analyzed using multivariable logistic regression analysis. Results: The early introduction of formula feeding was inversely associated with the "vegetables & traditional" pattern (β=-0.18; 95% confidence interval [CI], -0.34 to -0.02). A higher "vegetables & traditional" intake was associated with a lower risk of obesity (odds ratio, 0.48; 95% CI, 0.24 to 0.95). Conclusions: Feeding characteristics are associated with dietary patterns in later childhood, and dietary patterns were shown to have a potential protective association against obesity.

• Research in Community and Public Health Nursing
• /
• v.28 no.4
• /
• pp.375-385
• /
• 2017

Purpose: This study aims to examine the relationships among social discrimination, subjective health, and personal satisfaction based on the country of origin. Methods: The analysis was based on 16,958 immigrants who participated in the National Survey of Multicultural Family 2015 in Korea. This study conducted stratified cross-analysis of social discrimination for the differences in subjective health and personal satisfaction. Multivariate-adjusted odds ratios and 95% confidence intervals for the relationships among social discrimination, subjective health, and personal satisfaction were examined with multivariable logistic regression. Results: There were differences in experience of social discrimination, subjective health status, and personal satisfaction according to the country of origin. Groups without the experience of social discrimination had better subjective health and personal satisfaction than the other groups. Conclusion: This study demonstrates that a discrimination prevention program needs to be developed based on a cultural approach.