Objectives: This study provides an evaluation of the effectiveness of acupuncture for the treatment of essential tremors (ETs) using randomized controlled trials (RCTs). Methods: Nine databases (PubMed, CINAHL, EMBASE, OASIS, NDSL, CNKI, Wanfang, J-STAGE, and CiNii) and the keywords "Essential tremor", "Benign tremor", "Familial tremor", and "Acupuncture" were used to compile RCTs that used acupuncture to treat ETs. Studies that were not RCTs, such as case studies, reviews, and essays, were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool, and where appropriate, meta-analyses were performed. Results: Initially, 819 studies were found, but 773 were excluded after title and abstract screening. After further screening of the resulting 46 papers, eight RCTs were selected that had been published between 2003 and 2016, and the total effective rate (TER) was used as the primary evaluation method for all eight studies. It was found that the TER was significantly higher in treatment groups (83.33-96.7%) than in control groups (56.5-80.0%), and seven studies included in the meta-analysis showed positive results for acupuncture for ETs (Risk Ratio: 1.43, 95% Confidence Interval: 1.21-1.69, P<0.0001) Confidence Interval. Conclusions: This meta-analysis of clinical trials suggests that acupuncture is effective for treating ET patients; however, further studies are needed or larger populations to prove its effectiveness.
Currently, reflective teaching has been actively studied in terms of teachers' professional development relating to classroom instruction. The present study looked at, using the method of a case study, the differences between a novice and an experienced elementary school mathematics teachers' beliefs demonstrated during their reflective teaching. The findings of the study show that at the intial stage of reflective teaching, the novice teacher identified few errors during class and was not enthusiastic about applying the results of her reflective teaching due to lack of confidence. By contrast, the experienced teacher identified more errors during class than the novice teacher and had fewer reflections due to a sense of confidence. As the teachers' engagement in reflective teaching increased with time, they both felt the need for advice from experts on mathematics teaching and directed their attention to interactions with their students away from teacher-centered instruction. Further, the novice teacher engaged in more teacher-student interactions than the experienced teacher, and the experienced teacher increased the frequency of teaching reflection. Based on the findings, the article suggests a number of implications for the cooperative reflective teaching between novice and experienced teachers and the improvement of classroom instruction.
PURPOSE. To compare the dimensional accuracy of three impression techniques- a separating foil impression, a custom tray impression, and a stock tray impression. MATERIALS AND METHODS. A machined mandibular complete-arch metal model with special modifications served as a master cast. Three different impression techniques (n = 6 in each group) were performed with addition-cured silicon materials: i) putty-wash technique with a prefabricated metal tray (MET) using putty and regular body, ii) single-phase impression with custom tray (CUS) using regular body material, and iii) two-stage technique with stock metal tray (SEP) using putty with a separating foil and regular body material. All impressions were poured with epoxy resin. Six different distances (four intra-abutment and two inter-abutment distances) were gauged on the metal master model and on the casts with a microscope in combination with calibrated measuring software. The differences of the evaluated distances between the reference and the three test groups were calculated and expressed as mean (${\pm}SD$). Additionally, the 95% confidence intervals were calculated and significant differences between the experimental groups were assumed when confidence intervals did not overlap. RESULTS. Dimensional changes compared to reference values varied between -74.01 and $32.57{\mu}m$ (MET), -78.86 and 30.84 (CUS), and between -92.20 and 30.98 (SEP). For the intra-abutment distances, no significant differences among the experimental groups were detected. CUS showed a significantly higher dimensional accuracy for the inter-abutment distances with -0.02 and -0.08 percentage deviation compared to MET and SEP. CONCLUSION. The separation foil technique is a simple alternative to the custom tray technique for single tooth restorations, while limitations may exist for extended restorations with multiple abutment teeth.
The current study applied the random forest algorithm to Korean crime victim survey data collected biennially between 2010 and 2018 to explore the relationship between crime/victim characteristics and the victim's criminal damages. A total of 3,080 cases including gender, age (life cycle stage), type of crime, perpetrator acquisition, repeated victimization, psychological damage (depression, isolation, extreme fear, somatic symptoms, interpersonal problems, moving out to avoid people, suicidal impulses, suicide attempts), and emotional changes after victimization (changes in self-protection confidence, self-esteem, confidence in others, confidence in legal institutions, and respect for Korean legal system/law) were analyzed. Considering the features of data that are difficult to apply traditional statistical techniques, this study implemented random forest algorithms to predict crime and victim characteristics using the victim's criminal damages (psychological damage and emotional change) and selected good predictors using VSURF function in VSURF package for R. As a result of the analysis, it was confirmed that the relationship between the type of crime and depression, extreme fear, somatic symptoms, and interpersonal problems, between perpetrator acquisition and somatic symptoms and interpersonal problems, and between repeated victimization and changes in respect for Korean legal system/law. Gender and life cycle stage (youth/adult/elderly) were found to be related to extreme fear and changes in self-protection confidence, respectively. However, more empirical evidence should be aggregated to explain the results as meaningful. The results of this study suggest that it is necessary to enhance the experts' knowledge and educate them on cases about the relationship between crime/victim characteristics and criminal damage. Strengthening their interview strategy and knowledge about law/rules were also needed to increase the effectiveness of the Korean victim assessment system.
Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.
Background: Stage III colon cancer patients demonstrate diverse clinical outcomes. The aim of this study was to develop a prognostic model in order to better predict their survival. Materials and Methods: From 2004 to 2010, 548 patients were retrospectively analyzed, among whom 328 were defined as the study group and the remaining 220 served as a validation group. Clinico-pathologic features, including age, gender, histological grade, T stage, number of positive lymph nodes, number of harvest lymph nodes, pretreatment carcinoembryonic antigen (CEA) levels and pretreatment neutrophil lymphocyte ratio (NLR), were collected. Kaplan-Meier survival curves were used to detect prognostic factors and multivariate analysis was applied to identify independent examples on which to develop a prognostic model. Finally, the model was further validated with the validation group. Results: Histological grade (p=0.002), T stage (p=0.011), number of positive lymph nodes (p=0.003), number of harvested lymph nodes (p=0.020), CEA (p=0.005), and NLR (p<0.001) were found as prognostic factors while histological grade [RR(relative risk):0.632, 95%CI (Confidence interval) 0.405~0.985, p=0.043], CEA (RR:0.644, 95%CI:0.431~0.964, p=0.033) and NLR (RR:0.384, 95%CI:0.255~0.580, p<0.001) levels were independent. The prognostic model based on these three factors was able to classify patients into high risk, intermediate and low risk groups (p<0.001), both in study and validation groups. Conclusions: Histological grade, pretreatment CEA and NLR levels are independent prognostic factors in stage III colon cancer patients. A prognostic model based on these factors merits attention in future clinical practice.
Lee, Jiyun;Moon, Seok Whan;Choi, Jung Suk;Hyun, Kwanyong;Moon, Young Kyu;Moon, Mi Hyoung
Journal of Chest Surgery
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v.53
no.3
/
pp.93-103
/
2020
Background: Risk assessment for pulmonary resection in patients with early-stage non-small-cell lung cancer (NSCLC) is important for minimizing postoperative morbidity. Depletion of skeletal muscle mass is closely associated with impaired nutritional status and limited physical ability. We evaluated the relationship between skeletal muscle depletion and early postoperative complications in patients with early-stage NSCLC. Methods: Patients who underwent curative lung resection between 2016 and 2018 and who were diagnosed with pathological stage I/II NSCLC were included, and their records were retrospectively analyzed. The psoas volume index (PVI, ㎤/㎥) was calculated based on computed tomography images from routine preoperative positron emission tomography-computed tomography. Early postoperative complications, defined as those occurring within 90 days of surgery, were compared between the lowest sex-specific quartile for PVI and the remaining quartiles. Results: A strong correlation was found between the volume and the cross-sectional area of the psoas muscle (R2=0.816). The overall rate of complications was 57.6% among patients with a low PVI and 32.8% among those with a normal-to-high PVI. The most common complication was prolonged air leak (low PVI, 16.9%; normal-to-high PVI, 9.6%), followed by pneumonia (low PVI, 13.6%; normal-to-high PVI, 7.9%) and recurrent pleural effusion (low PVI, 11.9%; normal-to-high PVI, 6.8%). The predictors of overall complications were low PVI (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.07-4.09; p=0.03), low hemoglobin level (OR, 0.686; 95% CI, 0.54-0.87; p=0.002), and smoking history (OR, 3.93; 95% CI, 2.03-7.58; p<0.001). Conclusion: Low PVI was associated with a higher rate of early postoperative complications in patients with early-stage NSCLC.
Journal of Korean Society of Environmental Engineers
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v.28
no.5
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pp.494-500
/
2006
Life Cycle Assessment(LCA) is an environmental assessment tool for evaluating environmental burdens associated with products, processes and activities from the raw material acquisition stage to the end-of-life stage. End-of-life stage as well as other processes requires a reliant database in order to increase the confidence in the LCA results. In this study, the flow of Personal Computer(as PC) in the end-of-life stage was examined and the database of two scenarios has been established, i.e. one is part reuse and the other is no part reuse, in the end-of-life phase of PC. Also, key environmental issues were identified by carrying out LCA on a PC in the end-of-life phase for eight environmental impact categories. The 'ozone layer depletion' contributes the highest environmental impact due to generation of $Cl_2$ gas during the incineration of waste plastics. In addition, the scenario 1(part reuse) is more environmentally sound than the scenario 2(no part reuse) when comparing two scenarios.
Kim, Ye-Hwan;Byun, Young Joon;Kim, Won Tae;Jeong, Pildu;Yan, Chunri;Kang, Ho Won;Kim, Yong-June;Lee, Sang-Cheol;Moon, Sung-Kwon;Choi, Yung-Hyun;Yun, Seok Joong;Kim, Wun-Jae
Journal of Korean Medical Science
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v.33
no.47
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pp.303.1-303.10
/
2018
Background: Cell division cycle 6 (CDC6) is an essential regulator of DNA replication and plays important roles in the activation and maintenance of the checkpoint mechanisms in the cell cycle. CDC6 has been associated with oncogenic activities in human cancers; however, the clinical significance of CDC6 in prostate cancer (PCa) remains unclear. Therefore, we investigated whether the CDC6 mRNA expression level is a diagnostic and prognostic marker in PCa. Methods: The study subjects included 121 PCa patients and 66 age-matched benign prostatic hyperplasia (BPH) patients. CDC6 expression was evaluated using real-time polymerase chain reaction and immunohistochemical (IH) staining, and then compared according to the clinicopathological characteristics of PCa. Results: CDC6 mRNA expression was significantly higher in PCa tissues than in BPH control tissues (P = 0.005). In addition, CDC6 expression was significantly higher in patients with elevated prostate-specific antigen (PSA) levels (> 20 ng/mL), a high Gleason score, and advanced stage than in those with low PSA levels, a low Gleason score, and earlier stage, respectively. Multivariate logistic regression analysis showed that high expression of CDC6 was significantly associated with advanced stage (${\geq}T3b$) (odds ratio [OR], 3.005; confidence interval [CI], 1.212-7.450; P = 0.018) and metastasis (OR, 4.192; CI, 1.079-16.286; P = 0.038). Intense IH staining for CDC6 was significantly associated with a high Gleason score and advanced tumor stage including lymph node metastasis stage (linear-by-linear association, P = 0.044 and P = 0.003, respectively). Conclusion: CDC6 expression is associated with aggressive clinicopathological characteristics in PCa. CDC6 may be a potential diagnostic and prognostic marker in PCa patients.
Park, Jung Ho;Park, Hyoung-Chul;Park, Sung Chan;Oh, Jae Hwan;Kim, Duck-Woo;Kang, Sung-Bum;Heo, Seung Chul;Kim, Min Jung;Park, Ji Won;Jeong, Seung-Yong;Park, Kyu Joo
Annals of Coloproctology
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v.34
no.6
/
pp.286-291
/
2018
Purpose: Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer. Methods: From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary endpoint was the 5-year DFS. Results: The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1-134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19-1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29-2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08-2.15; P < 0.01) and a high (${\geq}0.4$) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63-5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC. Conclusion: Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.
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