• Title/Summary/Keyword: risk selection

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Implant selection for successful reverse total shoulder arthroplasty

  • Joo Han Oh;Hyeon Jang Jeong;Yoo-Sun Won
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.93-106
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    • 2023
  • Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.

Comparative Review of Pharmacological Treatment Guidelines for Bipolar Disorder (양극성 장애의 약물치료 가이드라인 비교)

  • Seoyeon Chin;Hyoyoung Kim;Yesul Kim;;Bo-young Kwon;Boyoon Choi;Bobae Lee;Jiye Lee;Chae-Eun Kwon;Yeongdo Mun;Kaveesha Fernando;Ji Hyun Park
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.153-167
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    • 2023
  • Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

Variations in Neural Correlates of Human Decision Making - a Case of Book Recommender Systems

  • Naveen Z. Quazilbash;Zaheeruddin Asif;Saman Rizvi
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.3
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    • pp.775-793
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    • 2023
  • Human decision-making is a complex behavior. A replication of human decision making offers a potential to enhance the capacity of intelligent systems by providing additional user assistance in decision making. By reducing the effort and task complexity on behalf of the user, such replication would improve the overall user experience, and affect the degree of intelligence exhibited by the system. This paper explores individuals' decision-making processes when using recommender systems, and its related outcomes. In this study, human decision-making (HDM) refers to the selection of an item from a given set of options that are shown as recommendations to a user. The goal of our study was to identify IS constructs that contribute towards such decision-making, thereby contributing towards creating a mental model of HDM. This was achieved through recording Electroencephalographic (EEG) readings of subjects while they performed a decision-making activity. Readings from 16 righthanded healthy avid readers reflect that reward, theory of mind, risk, calculation, task intention, emotion, sense of touch, ambiguity and decision making are the primary constructs that users employ while deciding from a given set of recommendations in an online bookstore. In all 10 distinct brain areas were identified. These brain areas that lead to their respective constructs were found to be cingulate gyrus, precentral gyrus, inferior parietal lobule, posterior cingulate, medial frontal gyrus, anterior cingulate, postcentral gyrus, superior frontal gyrus, inferior frontal gyrus, and middle frontal gyrus (also referred to as dorsolateral prefrontal gyrus (DLPFC)). The identified constructs would help in developing a design theory for enhancing user assistance, especially in the context of recommender systems.

The Effect of Program on Emotion of Patients with Schizophrenia: A systematic review of randomized controlled trials (조현병 환자의 정서를 위한 프로그램의 효과: 무작위 대조군 실험연구의 체계적 고찰)

  • Eun-Sol Ju
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.77-86
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    • 2023
  • Purpose : This study systematically assessed 9 emotion-function programs for schizophrenic individuals that have been implemented over the past 10 years in Korea and abroad, with the objective of providing clinical grounds and data for further programs. Methods : This study identified 2,558 studies from among those registered in the RISS, KISS, EMbase, PubMed and Scopus databases from 2013 to September 2023, using 'schizophrenia' AND 'emotion' AND ('program' OR 'therapy') as keywords. Of the 2,558 studies retrieved from electronic databases, 602 duplicate papers were excluded. After this process, 1,915 papers that did not meet the study's inclusion and exclusion criteria were excluded based on their titles and abstracts. Following a review of the texts of the remaining 41 papers, nine papers were finally selected, excluding 32 papers according to the selection and exclusion criteria. Results : Programs for the emotional function of patients with schizophrenia have continued to be researched. The results of an evaluation on the quality of the selected literature confirmed that a majority of the reviewed items were "uncertain", confirming that there was a risk of bias. The interventions for emotions included art, cognitive-behavioral, and physical programs, of which art programs were frequently applied. Most of the interventions were implemented in hospitals. The dependent variables for evaluating emotions included emotional expression, depression, anxiety, and positive emotions, and among them, emotional expression was used most frequently. Accordingly, the Berkeley expressivity questionnaire was commonly used as an evaluation tool. Conclusion : This study is significant for intending to analyze domestic and overseas programs for the emotions of patients with schizophrenia, thereby proposing the direction for planning and applying interventions in clinical settings. In follow-up studies, it will be necessary to develop a protocol that confirms interventions according to the settings and patient characteristics of programs and expands the scope of literature reviews.

Association of added sugar intake with all-cause and cardiovascular disease mortality: a systematic review of cohort studies

  • Song, SuJin;Shim, Jae Eun;Song, YoonJu
    • Nutrition Research and Practice
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    • v.16 no.sup1
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    • pp.21-36
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    • 2022
  • BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

The Comorbidity of Anxiety Disorder in Depressed Patients : A CRESCEND(Clinical Research Center for Depression in Korea) Cohort Study (우울증 환자에서 불안장애의 동반이환 : 우울증 임상연구센터 코호트연구)

  • Sakong, Jeong-Kyu;Lee, Do-Yun;Suh, Ho-Suk;Sung, Hyung-Mo;Kim, Jung-Bum;Jung, Young-Eun;Lee, Min-Soo;Kim, Jae-Min;Jo, Sunjin
    • Mood & Emotion
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    • v.9 no.1
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    • pp.30-36
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    • 2011
  • Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M. I.N.I.-Plus were used during first clinical interview for depression diagnosis.

Development of a Geographic Information System(GIS)-Based Optimal Site System for Developing the Extreme Cold Region (공간정보(GIS) 기반 극한지 자원 개발 최적 위치 선정 시스템 개발)

  • Sewon Kim;Byungyun Yang;YoungSeok Kim
    • Journal of the Korean Geosynthetics Society
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    • v.22 no.4
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    • pp.63-71
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    • 2023
  • The extreme cold regions, including the South and North Poles, are rich in resources, but there are many constraints on resource development projects due to difficult access and a construction environment that is completely different from that of Korea. In recent years, global warming has increased the demand for the construction of resource exploitation plants. For resource development construction activities, a preliminary site analysis is required to minimize the risk of project implementation. In this study, the factors were analyzed to be considered in construction activities in extreme cold and optimal location selection system based on Geographic information system(GIS) has been developed. As a result of applying the development system to Alberta, Canada, where oil sand development is actively underway, it was confirmed that the results were consistent with the currently operating oil sand mining area.

Definition, Scope, and Applications of Physiotherapy Biofeedback: Systematic Reviews (물리치료 바이오피드백의 정의 및 범위와 활용법: 체계적 문헌고찰 )

  • Jong-Seon Oh;Kyung-Jin Lee;Seong-Gil Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.4
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    • pp.109-119
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    • 2023
  • PURPOSE: The definition and scope of biofeedback are broad and lack a clear framework. Therefore, efforts are needed to clearly understand the exact range and definition of biofeedback based on the research and development conducted to date. Thus, the purpose of this study was to arrive at the definition and scope of biofeedback through a literature review and analysis of its application methods. METHODS: This study is a systematic literature review conducted to understand the various types and effects of biofeedback. International databases such as Google Scholar and PubMed were used. Domestic databases utilized for keyword searches included the Research Information Sharing Service (RISS) and the National Digital Science Library (NDSL). Quality assessment of the selected studies in the selection process was done using the Cochrane risk of bias, and the research was analyzed according to the population, intervention, control, and outcomes (PICO) format. RESULTS: Studies conducted between 2019 and 2021 were selected, with 4 papers falling under physiological classifications and 7 under biomechanical classifications. The quality assessment results showed that random sequence generation, allocation concealment, performance bias, and reporting bias were unclear. Detection bias was moderate, and attrition bias and other biases were low. Out of the 11 papers, 9 dealt with physical function outcomes, 5 with daily life activities, and 3 with mental functions. CONCLUSION: Physiological biofeedback tended to influence psychological factors more than physical functions, while biomechanical biofeedback tended to have a positive impact on physical functions.

Applicability of Daoyin Exercise with Therapeutic Exercise for Shoulder Pain: A Systematic Review and Meta-analysis (치료적 운동을 포함한 도인운동의 어깨 통증에 대한 적용 가능성 탐색: 체계적 문헌고찰 및 메타 분석)

  • Hyeonsun Park;Sanghyeon Park;Jiho Lee;Seohyun Park;Dongho Keum
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.79-93
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    • 2023
  • Objectives The purpose of this study is to investigate therapeutic exercise and to provide the evidence of daoyin exercise for shoulder pain. Methods Electronic databases including PubMed, EMBASE, China National Knowledge Infrastructure, Science ON, Oriental Medicine Advanced Searching Integrated System were searched up to October 2022. We selected randomized controlled trials. The quality of studies was assessed by Cochrane risk of bias tool. Meta-analysis were perfomed by Review Manager software. Results Eighteen randomized controlled trials were collected in accordance with the selection and exclusion criteria. Among the 18 trials, 7 trials used strengthening exercise, 4 trials used stablilization exercise, 5 trials used both types of intervention, and 2 trials used daoyin exercise. The study characteristics, results and method of intervention were analyzed. Meta-analysis showed that therapeutic exercise appeared to more effective than no treatment group for shoulder pain (standardized mean difference=-1.18, 95% confidence interval=-1.44 to 0.91, Z=8.82, p<0.00001; chi2=2.71, p=0.61; I2=0%). Conclusions All of 18 selected studies reported the effectiveness of therapeutic exercise for shoulder pain. Combining strengthening and stablilization exercise is considered the most efficient way for shoulder pain. Based on this study, well-designed studies should be performed to be evidence of the use of daoyin exercise for shoulder pain.

A Study on the Improvement of Selection Method of Safety Distance for Worker in Hydrogen Refueling Station (수소 충전 시설 내 근로자를 위한 안전거리 선정 방법 개선에 관한 연구)

  • Hyo-Ryeol Lee
    • Journal of the Korean Institute of Gas
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    • v.27 no.4
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    • pp.78-84
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    • 2023
  • Recently, the world's countries are tightening regulations on CO2 and air pollutants emission to solve them. In addition, eco friendly vehicles is increasing to replace automobiles in internal combustion engine. The government is supporting the expansion of hydrogen refueling infrastructure according to the hydrogen economy road map. In particular, refueling station is important to secure the safety that supplies high-pressure hydrogen with a wide LFL range. This paper is on guidelines for the determination safety distances to ensure worker safety from accident as jet fire. The safety distance is set according to the procedure of the EIGA doc 075/21. For accident frequency is upper 3.5E-05 per annum, safety distance is decided via consequence analysis where the risk of harm is below individual harm exposure threshold.