• Title/Summary/Keyword: stage confidence

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Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events

  • Ock, Minsu;Lee, Sang-il;Jo, Min-Woo;Lee, Jin Yong;Kim, Seon-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.5
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    • pp.239-248
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    • 2015
  • Objectives: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. Methods: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. Results: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). Conclusions: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.

Epidemiology and Survival of Hepatocellular Carcinoma in North-east Peninsular Malaysia

  • Norsa'adah, Bachok;Nurhazalini-Zayani, Che Ghazali Che
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6955-6959
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    • 2013
  • The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

Analysis on Science Problem Solving Process of the Elementary Science Gifted Students (초등 과학 영재의 과학 문제 해결 과정 분석)

  • Lim, Cheong-Hwan;Lim, Gui-Sook
    • Journal of Korean Elementary Science Education
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    • v.30 no.2
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    • pp.213-231
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    • 2011
  • The purpose of this study was to investigate knowledge types which the elementary science gifted students would use when solving a science problem, and to examine characteristics and types that were shown in the science problem solving process. For this study, 39 fifth graders and 38 sixth graders from Institute of Education for the Gifted Science Class were sampled in one National University of Education. The results of this study were as follows. First, for science problem solving, the elementary science gifted students used procedural knowledge and declarative knowledge at the same time, and procedural knowledge was more frequently used than declarative knowledge. Second, as for the characteristics in the understanding step of solving science problems, students tend to exactly figure out questions' given conditions and what to seek. In planning and solving stage, most of them used 3~4 different problem solving methods and strategies for solving. In evaluating stage, they mostly re-examined problem solving process for once or twice. Also, they did not correct the answer and had high confidence in their answers. Third, good solvers had used more complete or partially applied procedural knowledge and proper declarative knowledge than poor solvers. In the problem solving process, good solvers had more accurate problem-understanding and successful problem solving strategies. From characteristics shown in the good solvers' problem solving process, it is confirmed that the education program for science gifted students needs both studying on process of acquiring declarative knowledge and studying procedural knowledge for interpreting new situation, solving problem and deducting. In addition, in problem-understanding stage, it is required to develop divided and gradual programs for interpreting and symbolizing the problem, and for increasing the understanding.

The Application Technology of Korean-style R&D in Verification for deploying the Neo-Korean Style Public Building - Focused on the R&D Technologies in Changed Drawings of Neo-Korean Style Public Daycare Center in Sunchang-gun, Korea -

  • Kim, Young-Hoon;Peck, Yoo-Jung;Park, Joon-Young
    • KIEAE Journal
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    • v.15 no.5
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    • pp.35-46
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    • 2015
  • Purpose: This study is to research how New-Hanok R&D technologies of first stage are appearing and adapted to the New-Hanok style public buildings, especially in Daycare Center in Sunchang-gun, Korea. Unlike Hanok houses, public buildings which has special needs for the public and restricted by laws and regulations need not only new system of law incentives but also new components of New-Hnaok R&D technologies used only in Hanok house. Method: For this purpose, we checked the drawings for Daycare Center in Sunchang-gun. The drawings have been changed 6 times for the purpose of adopting New-Hanok R&D technologies of first stage and actual needs for current laws and regulations for public buildings and it reveals not only the possibilities for adapting new technologies in New-Hanok but also meetings the current and public needs for public buildings. Result: The result of this study as follows. Approximately 40-50 percent of New-Hanok R&D technologies in the first stage are adapted in Daycare Center in Sunchang-gun, and this means there are limitations in adapting New-Hanok R&D which are mainly for the Korean style houses. The main reasons are the costs still remaining high and lacking in confidence for using traditional structures and materials still under verification. Some are changed and proposed in another solutions suitable for public buildings as like truss structure system in roof.

MPC-based Two-stage Rolling Power Dispatch Approach for Wind-integrated Power System

  • Zhai, Junyi;Zhou, Ming;Dong, Shengxiao;Li, Gengyin;Ren, Jianwen
    • Journal of Electrical Engineering and Technology
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    • v.13 no.2
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    • pp.648-658
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    • 2018
  • Regarding the fact that wind power forecast accuracy is gradually improved as time is approaching, this paper proposes a two-stage rolling dispatch approach based on model predictive control (MPC), which contains an intra-day rolling optimal scheme and a real-time rolling base point tracing scheme. The scheduled output of the intra-day rolling scheme is set as the reference output, and the real-time rolling scheme is based on MPC which includes the leading rolling optimization and lagging feedback correction strategy. On the basis of the latest measured thermal unit output feedback, the closed-loop optimization is formed to correct the power deviation timely, making the unit output smoother, thus reducing the costs of power adjustment and promoting wind power accommodation. We adopt chance constraint to describe forecasts uncertainty. Then for reflecting the increasing prediction precision as well as the power dispatcher's rising expected satisfaction degree with reliable system operation, we set the confidence level of reserve constraints at different timescales as the incremental vector. The expectation of up/down reserve shortage is proposed to assess the adequacy of the upward/downward reserve. The studies executed on the modified IEEE RTS system demonstrate the effectiveness of the proposed approach.

Blood Pressure and the Risk of Death From Non-cardiovascular Diseases: A Population-based Cohort Study of Korean Adults

  • Choi, Jeoungbin;Jang, Jieun;An, Yoonsuk;Park, Sue K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.6
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    • pp.298-309
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    • 2018
  • Objectives: The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases. Methods: We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model. Results: Compared to normal levels (SBP <120 or DBP <90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85-89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ${\geq}160mmHg$) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ${\geq}160mmHg$) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively). Conclusions: An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.

The Application of Vacuum-Assisted Closures According to the Texas Staging System in the Treatment of Infective Diabetic Foot Ulcers (감염성 당뇨 족부 궤양 치료에서 Texas 기준 체계에 따른 음압치료 적용)

  • Lim, Seong-An;Choi, Yong-Soo;Jang, Young-Jae;Baek, Sung-Nyun;Bae, An-Na
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.66-70
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    • 2022
  • Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

Prognostic Role of Circulating Tumor Cells in the Pulmonary Vein, Peripheral Blood, and Bone Marrow in Resectable Non-Small Cell Lung Cancer

  • Lee, Jeong Moon;Jung, Woohyun;Yum, Sungwon;Lee, Jeong Hoon;Cho, Sukki
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.214-224
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    • 2022
  • Background: Studies of the prognostic role of circulating tumor cells (CTCs) in early-stage non-small cell lung cancer (NSCLC) are still limited. This study investigated the prognostic power of CTCs from the pulmonary vein (PV), peripheral blood (PB), and bone marrow (BM) for postoperative recurrence in patients who underwent curative resection for NSCLC. Methods: Forty patients who underwent curative resection for NSCLC were enrolled. Before resection, 10-mL samples were obtained of PB from the radial artery, blood from the PV of the lobe containing the tumor, and BM aspirates from the rib. A microfabricated filter was used for CTC enrichment, and immunofluorescence staining was used to identify CTCs. Results: The pathologic stage was stage I in 8 patients (20%), II in 15 (38%), III in 14 (35%), and IV in 3 (8%). The median number of PB-, PV-, and BM-CTCs was 4, 4, and 5, respectively. A time-dependent receiver operating characteristic curve analysis showed that PB-CTCs had excellent predictive value for recurrence-free survival (RFS), with the highest area under the curve at each time point (first, second, and third quartiles of RFS). In a multivariate Cox proportional hazard regression model, PB-CTCs were an independent risk factor for recurrence (hazard ratio, 10.580; 95% confidence interval, 1.637-68.388; p<0.013). Conclusion: The presence of ≥4 PB-CTCs was an independent poor prognostic factor for RFS, and PV-CTCs and PB-CTCs had a positive linear correlation in patients with recurrence.

Attitude Confidence and User Resistance for Purchasing Wearable Devices on Virtual Reality: Based on Virtual Reality Headgears (가상현실 웨어러블 기기의 구매 촉진을 위한 태도 자신감과 사용자 저항 태도: 가상현실 헤드기어를 중심으로)

  • Sohn, Bong-Jin;Park, Da-Sul;Choi, Jaewon
    • Journal of Intelligence and Information Systems
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    • v.22 no.3
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    • pp.165-183
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    • 2016
  • Over the past decade, there has been a rapid diffusion of technological devices and a rising number of various devices, resulting in an escalation of virtual reality technology. Technological market has rapidly been changed from smartphone to wearable devices based on virtual reality. Virtual reality can make users feel real situation through sensing interaction, voice, motion capture and so on. Facebook.com, Google, Samsung, LG, Sony and so on have investigated developing platform of virtual reality. the pricing of virtual reality devices also had decreased into 30% from their launched period. Thus market infrastructure in virtual reality have rapidly been developed to crease marketplace. However, most consumers recognize that virtual reality is not ease to purchase or use. That could not lead consumers to positive attitude for devices and purchase the related devices in the early market. Through previous studies related to virtual reality, there are few studies focusing on why the devices for virtual reality stayed in early stage in adoption & diffusion context in the market. Almost previous studies considered the reasons of hard adoption for innovative products in the viewpoints of Typology of Innovation Resistance, MIR(Management of Innovation Resistant), UTAUT & UTAUT2. However, product-based antecedents also important to increase user intention to purchase and use products in the technological market. In this study, we focus on user acceptance and resistance for increasing purchase and usage promotions of wearable devices related to virtual reality based on headgear products like Galaxy Gear. Especially, we added a variables like attitude confidence as a dimension for user resistance. The research questions of this study are follows. First, how attitude confidence and innovativeness resistance affect user intention to use? Second, What factors related to content and brand contexts can affect user intention to use? This research collected data from the participants who have experiences using virtual rality headgears aged between 20s to 50s located in South Korea. In order to collect data, this study used a pilot test and through making face-to-face interviews on three specialists, face validity and content validity were evaluated for the questionnaire validity. Cleansing the data, we dropped some outliers and data of irrelevant papers. Totally, 156 responses were used for testing the suggested hypotheses. Through collecting data, demographics and the relationships among variables were analyzed through conducting structural equation modeling by PLS. The data showed that the sex of respondents who have experience using social commerce sites (male=86(55.1%), female=70(44.9%). The ages of respondents are mostly from 20s (74.4%) to 30s (16.7%). 126 respondents (80.8%) have used virtual reality devices. The results of our model estimation are as follows. With the exception of Hypothesis 1 and 7, which deals with the two relationships between brand awareness to attitude confidence, and quality of content to perceived enjoyment, all of our hypotheses were supported. In compliance with our hypotheses, perceived ease of use (H2) and use innovativeness (H3) were supported with its positively influence for the attitude confidence. This finding indicates that the more ease of use and innovativeness for devices increased, the more users' attitude confidence increased. Perceived price (H4), enjoyment (H5), Quantity of contents (H6) significantly increase user resistance. However, perceived price positively affect user innovativeness resistance meanwhile perceived enjoyment and quantity of contents negatively affect user innovativeness resistance. In addition, aesthetic exterior (H6) was also positively associated with perceived price (p<0.01). Also projection quality (H8) can increase perceived enjoyment (p<0.05). Finally, attitude confidence (H10) increased user intention to use virtual reality devices. however user resistance (H11) negatively affect user intention to use virtual reality devices. The findings of this study show that attitude confidence and user innovativeness resistance differently influence customer intention for using virtual reality devices. There are two distinct characteristic of attitude confidence: perceived ease of use and user innovativeness. This study identified the antecedents of different roles of perceived price (aesthetic exterior) and perceived enjoyment (quality of contents & projection quality). The findings indicated that brand awareness and quality of contents for virtual reality is not formed within virtual reality market yet. Therefore, firms should developed brand awareness for their product in the virtual market to increase market share.

Structural Health Monitoring Methodology based on Outlier Analysis using Acceleration of Subway Stations (가속도 응답을 이용한 이상치 해석 기반 역사 구조 건전성 평가 기법 개발)

  • Shin, Jeong-Ryol;An, Tae-Ki;Lee, Chang-Gil;Park, Seung-Hee
    • Proceedings of the KSR Conference
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    • 2011.10a
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    • pp.281-286
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    • 2011
  • Station structures, one of important infrastructures, which have been being operated since the 1970s, are especially vulnerable to even the medium-level earthquake and they could be damaged by long-term internal or external vibrations such as ambient vibrations. Recently, much attention has been paid to real-time monitoring of the fatal defect or long-term deterioration of civil infrastructures to ensure their safety and adequate performance throughout their life span. In this study, a structural health monitoring methodology using acceleration responses is proposed to evaluate the health-state of the station structures and to detect initial damage-stage. A damage index is developed using the acceleration data and it is applied to outlier analysis, one of unsupervised learning based pattern recognition methods. A threshold value for the outlier analysis is determined based on confidence level of the probabilistic distribution of the acceleration data. The probabilistic distribution is selected according to the feature of the collected data.

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