• Title/Summary/Keyword: proportional odds

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The Association of Subjective Symptoms of Students and Indoor Air Quality in Private Academic Facilities (학원시설 실내공기질과 이용자의 자각증상에 관한 연구)

  • Jung, Kyung-Sick;Kim, Nam-Soo;Lee, Jong-Dae;HwangBo, Young;Son, Bu-Soon;Lee, Byung-Kook
    • Journal of Environmental Health Sciences
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    • v.35 no.6
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    • pp.468-477
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    • 2009
  • To evaluate the current indoor air quality condition of private academic facilities in Korea and investigate its association with subjective symptoms of student residing at the same academic facilities, air quality monitoring was carried out in total of 20 academic facilities located in Seoul, Daejon and Chungnam from the beginning of January to the end of April, 2009. To assess the air quality condition of academic facilities, 6 air pollutants with temperature and humidity were measured simultaneously inside and outside of academic facilities. The rate of exceeding the Indoor Air Quality (IAQ) guideline concentrations in 6 air pollutants were 5%, 85%, 15%, 5%, 10% and 30% for CO, $CO_2$, PM10, HCHO, TVOCs and TBC, respectively. A questionnaire on 16 subjective symptoms related to indoor air quality was given to 342 students who studied at the 20 academic facilities. The most frequent symptom of students was 'I feel easily tired or sleepy', and this was followed by 'I feel muscular pain or stiffness on shoulder, back and neck'. The association of net difference (subjective symptoms at the academic facility - subjective symptoms of the usual situation) with air pollutants was analyzed using spearman rank correlation. In logistic analysis using proportional odds method, the students whose indoor air concentration of HCHO was ${\geq}60{\mu}g/m^3$ hadsignificant odds of having more subjective symptoms of 'My eyes are dry or feel irritated or itching' (OR=5.026: CI=1.587-15.911), 'I feel easily tired or sleepy' (OR=2.956: CI=1.072-8.152), 'I lose my concentration and I feel my memory is falling' (OR=7.745: CI=1.938-30.955) and 'I feel dizzy' (OR=4.424: CI=1.292-15.149) than those of <$60{\mu}g/m^3$.

The Impact of Surgical versus Transcatheter Aortic Valve Replacement on Postprocedural Acute Kidney Injury in Patients with Chronic Kidney Disease

  • Eun Chae, Kim;Sue Hyun, Kim;Yeiwon, Lee;Suk Ho, Sohn;Jae Woong, Choi;Jeehoon, Kang;Jung Kyu, Han;Kyung Hwan, Kim;Hyo-Soo, Kim;Ho Young, Hwang
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.435-441
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    • 2022
  • Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India

  • Johnson, Avita R.;Jayappa, Rakesh;James, Manisha;Kulnu, Avono;Kovayil, Rajitha;Joseph, Bobby
    • Safety and Health at Work
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    • v.11 no.3
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    • pp.347-352
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    • 2020
  • Background: Low self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city. Methods: This cross-sectional study included a random sample of health-care workers of various cadres - doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom-Melamed Burnout Measure were used as study tools. Results: Among the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress. Conclusions: Health-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36-5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02-6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.

Surgical Outcomes for Native Valve Endocarditis

  • Park, Bong Suk;Lee, Won Yong;Ra, Yong Joon;Lee, Hong Kyu;Gu, Byung Mo;Yang, Jun Tae
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.1-7
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    • 2020
  • Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients' characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1-107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346-0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459-394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353-505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

Application of Pharmacovigilance Methods in Occupational Health Surveillance: Comparison of Seven Disproportionality Metrics

  • Bonneterre, Vincent;Bicout, Dominique Joseph;De Gaudemaris, Regis
    • Safety and Health at Work
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    • v.3 no.2
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    • pp.92-100
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    • 2012
  • Objectives: The French National Occupational Diseases Surveillance and Prevention Network (RNV3P) is a French network of occupational disease specialists, which collects, in standardised coded reports, all cases where a physician of any specialty, referred a patient to a university occupational disease centre, to establish the relation between the disease observed and occupational exposures, independently of statutory considerations related to compensation. The objective is to compare the relevance of disproportionality measures, widely used in pharmacovigilance, for the detection of potentially new disease ${\times}$ exposure associations in RNV3P database (by analogy with the detection of potentially new health event ${\times}$ drug associations in the spontaneous reporting databases from pharmacovigilance). Methods: 2001-2009 data from RNV3P are used (81,132 observations leading to 11,627 disease ${\times}$ exposure associations). The structure of RNV3P database is compared with the ones of pharmacovigilance databases. Seven disproportionality metrics are tested and their results, notably in terms of ranking the disease ${\times}$ exposure associations, are compared. Results: RNV3P and pharmacovigilance databases showed similar structure. Frequentist methods (proportional reporting ratio [PRR], reporting odds ratio [ROR]) and a Bayesian one (known as BCPNN for "Bayesian Confidence Propagation Neural Network") show a rather similar behaviour on our data, conversely to other methods (as Poisson). Finally the PRR method was chosen, because more complex methods did not show a greater value with the RNV3P data. Accordingly, a procedure for detecting signals with PRR method, automatic triage for exclusion of associations already known, and then investigating these signals is suggested. Conclusion: This procedure may be seen as a first step of hypothesis generation before launching epidemiological and/or experimental studies.

Efficacy of adjuvant radiotherapy in non-extremity soft tissue sarcoma with moderate chemosensitivity

  • Lee, Eun Mi;Kim, Dong Hyun;Kim, Do Young;Seol, Young Mi;Choi, Young Jin;Kim, Hyojeong
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.325-331
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    • 2018
  • Purpose: Soft tissue sarcoma (STS) is a rare and heterogeneous cancer with over 50 known subtypes. It is difficult to understand the role of adjuvant treatment in STS. We aimed to determine the benefits of adjuvant treatment for a rare STS subset: non-extremity STS with moderate chemosensitivity. Materials and Methods: We reviewed medical records from Pusan National University Hospital and Kosin University Gospel Hospital, which had detailed pathological reports on patients diagnosed between 2006 and 2016. The most important inclusion criterion was resection with curative intent. We grouped STS by chemosensitivity based on reported data and analyzed non-extremity STS with moderate chemosensitivity. Results: We investigated 142 patients with 20 pathological subtypes of STS. Eighty-six patients had extremity STS and 56 had non-extremity STS. Thirty-eight of 56 patients were categorized as having moderate chemosensitivity. Seventeen of 38 patients (44.7%) received adjuvant radiotherapy and 14 (36.8%) received adjuvant chemotherapy. A log-rank test showed longer disease-free survival (DFS) in the adjuvant radiotherapy group than in the group treated without adjuvant radiotherapy (not reached vs. 1.468 years, p = 0.037). Multivariate Cox proportional hazard analysis, with covariates including age, stage, resection margin, adjuvant chemotherapy, and adjuvant radiotherapy, revealed that adjuvant radiotherapy was associated with longer DFS (odds ratio = 0.369, p = 0.045). Overall survival was not correlated with adjuvant radiotherapy. Conclusion: Adjuvant radiotherapy may be associated with longer DFS in patients with non-extremity STS with moderate chemosensitivity.

Weight Loss as a Nonpharmacologic Strategy for Erosive Esophagitis: A 5-Year Follow-up Study

  • Bang, Ki Bae;Park, Jung Ho
    • Gut and Liver
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    • v.12 no.6
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    • pp.633-640
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    • 2018
  • Background/Aims: Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE. Methods: A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution. Results: Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ${\leq}1$, 1-2, and >$2kg/m^2$, respectively. Conclusions: EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

Clinical factors affecting the outcome of arthocentesis

  • Andrabi, Syed Wakeel;Malik, Altaf H.;Shah, Ajaz A.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.1
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    • pp.9-14
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    • 2019
  • Objectives: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. Materials and Methods: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (${\leq}25\;years$, >25 and ${\leq}40\;years$, >40 and ${\leq}60\;years$), VAS pain level (${\leq}5$, >5 and ${\leq}7$, >7 and ${\leq}10$), and ROM (<25 and ${\geq}25mm$). Odds ratios (ORs) were used to describe the proportional benefit of each variable the on successful outcome of arthrocentesis. For the OR to be clinically relevant or even clinically noticeable, we assumed that the OR would need to be larger than 2. Results: Mean preoperative pain score was $6.49{\pm}1.560$ and at 6 months postoperative was $0.46{\pm}1.147$ with an average decrease of pain score 6 (P<0.001). The mean preoperactive maximum mouth opening was $26.14{\pm}4.969mm$ and mean maximum mouth opening at 6-month inerval was $38.92{\pm}3.392mm$. The mean increase in the mouth opening was a mean difference of 12.78 mm (P<0.001). Logistic regression showed that the maximum benefit occurred in patients aged <25 years (OR, 12.01; P=0.012), a VAS pain level of >7 (OR, 11.25; P=0.039), and a maximum vertical opening of <25 mm (OR, 7.70; P=0.038). Conclusion: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify "at-benefit" patients early and initiate specific treatment.

Associations between depressed mood with negative health behaviors of Koreans during the COVID-19 pandemic (COVID-19 유행 기간 동안 한국인의 우울한 기분과 부정적인 건강 행동 사이의 연관성)

  • Jung, Suyeon;Lee, Ji-Young;Kim, Heejin
    • Journal of the Korea Convergence Society
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    • v.13 no.4
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    • pp.79-88
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    • 2022
  • The objective of this study was to assess the association of changes in behaviors and depressed mood during the COVID-19 pandemic in Korea. A cross-sectional internet-based survey was conducted, using proportional samples of Korean adults and a logistic regression model was used to assess the association. As a result, negative changes of daily sitting or lying down time, daily walking time, smoking, and alcohol consumption were associated with being more depressed during the COVID-19 pandemic [odds ratios (ORs): 2.23 (95% CI=1.77-2.81), 2.04 (95% CI=1.63-2.56), 2.84 (95% CI=1.51-5.36), and 1.82 (95% CI=1.26-2.63), respectively]. This indicates that strategies to promote positive health behaviors change (increased activities and decreased consumption of smoking and alcohol) could help address psychological distress during the COVID-19 pandemic.

Signal Detection for Adverse Events of Finasteride Using Korea Adverse Event Reporting System (KAERS) Database (의약품이상사례보고시스템 데이터베이스를 이용한 피나스테리드의 약물유해반응 실마리 정보 탐색)

  • Baek, Ji-Won;Yang, Bo Ram;Choi, Subin;Shin, Kwang-Hee
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.4
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    • pp.324-331
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    • 2021
  • To investigate signals of adverse drug reactions of finasteride by using the Korea Adverse Events Reporting System (KAERS) database. This pharmacovigilance was based on the database of the drug-related adverse reactions reported spontaneously to the KAERS from 2013 to 2017. This study was conducted by disproportionality analysis. Data mining analysis was performed to detect signals of finasteride. The signal was defined by three criteria as proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). The signals of finasteride were compared with those of the other drugs; dutasteride (similar mechanism of action), minoxidil (different mechanism but similar indications for alopecia), silodosin (different mechanism but similar indications for BPH). It was examined whether the detected signals exist in drug labels in Korea. The total number of adverse event-drug pairs was reported 2,665,429 from 2013 to 2017, of which 1,426 were associated with finasteride. The number of investigated signals of finasteride was 42. The signals that did not include in the drug label were 29 signals, including mouth dry, hypotension, dysuria etc. The signal of finasteride was similar to that of dutasteride and silodosin but was different to that of minoxidil. Early detection of signals through pharmacovigilance is important to patient safety. We investigated 29 signals of finasteride that do not exist in drug labels in Korea. Further pharmacoepidemiological studies should be needed to evaluate the signal causality with finasteride.