• 제목/요약/키워드: Clinical variable

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Bayesian bi-level variable selection for genome-wide survival study

  • Eunjee Lee;Joseph G. Ibrahim;Hongtu Zhu
    • Genomics & Informatics
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    • 제21권3호
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    • pp.28.1-28.13
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    • 2023
  • Mild cognitive impairment (MCI) is a clinical syndrome characterized by the onset and evolution of cognitive impairments, often considered a transitional stage to Alzheimer's disease (AD). The genetic traits of MCI patients who experience a rapid progression to AD can enhance early diagnosis capabilities and facilitate drug discovery for AD. While a genome-wide association study (GWAS) is a standard tool for identifying single nucleotide polymorphisms (SNPs) related to a disease, it fails to detect SNPs with small effect sizes due to stringent control for multiple testing. Additionally, the method does not consider the group structures of SNPs, such as genes or linkage disequilibrium blocks, which can provide valuable insights into the genetic architecture. To address the limitations, we propose a Bayesian bi-level variable selection method that detects SNPs associated with time of conversion from MCI to AD. Our approach integrates group inclusion indicators into an accelerated failure time model to identify important SNP groups. Additionally, we employ data augmentation techniques to impute censored time values using a predictive posterior. We adapt Dirichlet-Laplace shrinkage priors to incorporate the group structure for SNP-level variable selection. In the simulation study, our method outperformed other competing methods regarding variable selection. The analysis of Alzheimer's Disease Neuroimaging Initiative (ADNI) data revealed several genes directly or indirectly related to AD, whereas a classical GWAS did not identify any significant SNPs.

Fast Growing Furious Races for Targeting Fibroblast Growth Factor Receptors

  • Park, Daechan
    • Molecules and Cells
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    • 제45권11호
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    • pp.789-791
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    • 2022
  • Targeting fibroblast growth factor receptors (FGFRs) has been slow compared to other targeted cancer therapies for receptor tyrosine kinases, such as epidermal growth factor receptors. The low efficacy and variable response have limited the growth of FGFR inhibitors in clinical use. Nevertheless, recent systematic and genomic approaches have identified the biological conditions for effectively targeting FGFRs and can accelerate the development of targeted drugs. Under clinical and preclinical trials, the inhibitors started fast growing furious races to target FGFRs. Finally, FGFRs will be more actionable and targetable with more precise and effective drugs at the end of the race, passing the finish line.

의과대학 임상실습에서의 학생평가방법: 과거, 현재 및 제언 (Assessment of Medical Students in Clinical Clerkships)

  • 이상엽;임선주;윤소정;백선용;우재석
    • 의학교육논단
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    • 제15권3호
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    • pp.120-124
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    • 2013
  • The clinical clerkship focuses students on developing their ability to perform comprehensive diagnosis and management of patients with common undifferentiated problems by the integration of knowledge and clinical reasoning. Therefore, the clerkship evaluation system should assess their actual problem solving and professional behavior. However, concern remains that clerkship evaluations are imprecise and highly variable. This review is designed to provide faculty members with concepts, options, and a methodology to actively teach and evaluate the clinical clerkship, as well as offer encouragement and inspiration to medical students. We reviewed past and current clinical clerkship evaluations and discuss several tips to improve clinical excellence such as continuity, transparency of the evaluation process, a faculty development program, practical examination of clinical skills, implementation of a checklist for recording exposure and skills, providing prompt and constructive feedback to students, self-evaluation of professional performance, varying multi-faceted assessment combinations, being outpatient clinic-centered, and having dedicated faculty members who give students one-on-one contact with a preceptor.

진동법에서 가변 특성 비를 이용한 혈압 추정 알고리즘의 개발 (Development of Blood Pressure Estimation Algorithm Using Variable Characteristic Ratios on Oscillometric Method)

  • 신준
    • 대한의용생체공학회:의공학회지
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    • 제30권6호
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    • pp.510-515
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    • 2009
  • In this paper, variable characteristic ratio algorithm based on oscillometric method is proposed to enhance the accuracy of blood pressure measurement. We combined the slope-based approach and fuzzy inference technique to change the characteristic ratios of height-based method. The proposed algorithm was assessed on 255 measurements from 85 subjects and compared with the conventional height-based algorithm. The testing results showed that the developed algorithm achieved an overall grade A for both systolic and diastolic blood pressures according to the BHS protocol. And, mean standard deviation between the observers and the developed algorithm were 5.71mmHg and 6.29mmHg for systolic and diastolic pressures respectively, which also fulfilled the AAMI criteria. In conclusion, this algorithm was successfully developed and recommended for further clinical trials with the wider adult population.

Pediatric Stroke

  • Jeong, Goun;Lim, Byung Chan;Chae, Jong-Hee
    • Journal of Korean Neurosurgical Society
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    • 제57권6호
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    • pp.396-400
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    • 2015
  • Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors.

폐의 비정형 유암종의 세침흡인 세포학적 소견 - 2예 보고 - (Fine Needle Aspiration Cytology of Atypical Carcinoid Tumor of the Lung - 2 Cases Report -)

  • 이연수;박경신;최영진;강석진;김병기;심상인
    • 대한세포병리학회지
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    • 제8권1호
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    • pp.76-82
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    • 1997
  • Two cases of pulmonary atypical carcinoid tumor were diagnosed by fine needle aspiration cytology. Although the cytologic features of atypical carcinoid tumor have been relatively well described, it is easy to confuse atypical carcinoid tumor with typical carcinoid tumor, small cell carcinoma and adenocarcinoma of the lung. Atypical carcinoid tumor has been recognized as a distinct variant of pulmonary neuroendocrine carcinoma, with characteristic histopathologic and clinical features that separate it from both carcinoid and small cell carelnoma. The distinction of atypical carcinoid tumor from small cell carcinoma has important prognostic and therapeutic implications. The cytologic characteristics of atypical carcinoid tumor included polygonal to fusiform cells with a variable amount of lacy cytoplasm, oval nuclei with coarsely dispersed chromatin and frequent nucleoli, and mild pleomorphism. The malignant cells were arranged either in acinus-like clusterg or in epithelial sheets.

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암 환자의 임상시험 참여 의향과 연관된 요인: 탐색형 서술적 문헌고찰 (Factors associated with willingness to participate in clinical trials for cancer patients: an exploratory narrative review)

  • 김건형;황보연;손경모
    • Journal of Acupuncture Research
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    • 제33권3호
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    • pp.145-152
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    • 2016
  • Objectives : This study aimed to investigate both cancer patients' willingness to participate (WTP) in clinical trials and its associated factors. Methods : We searched MEDLINE (PubMed) for studies that had investigated cancer patients' WTP in clinical trials. Search terms included 'willingness to participate', 'cancer' and 'trial'. Studies published within the last five years up to July 26, 2016 were potentially eligible. Results : Of 44 initial hits, 14 studies (12 quantitative and 2 qualitative) were included. Two out of the 14 studies investigated WTP in an acupuncture trial. Study designs, such as WTP measurement methods, investigation settings, and type of cancer, varied. The proportion of participants with a WTP was widely distributed between the studies (median 48.6 %, range 11.1 % to 88.3 %). Factors associated with WTP included various socio-demographic factors, clinical factors, participants' knowledge/attitudes toward clinical trials, travel distance, information from physicians, and trust toward physicians. Conclusion : WTP and its associated factors were variable across the reviewed studies, which might be due to different research methods and contexts. Whether or not common factors associated with cancer patients' WTP in clinical trials exist remains unclear and thus warrants further research.

Optimal Combination of VNTR Typing for Discrimination of Isolated Mycobacterium tuberculosis in Korea

  • Lee, Jihye;Kang, Heeyoon;Kim, Sarang;Yoo, Heekyung;Kim, Hee Jin;Park, Young Kil
    • Tuberculosis and Respiratory Diseases
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    • 제76권2호
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    • pp.59-65
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    • 2014
  • Background: Variable-number tandem repeat (VNTR) typing is a promising method to discriminate the Mycobacterium tuberculosis isolates in molecular epidemiology. The purpose of this study is to determine the optimal VNTR combinations for discriminating isolated M. tuberculosis strains in Korea. Methods: A total of 317 clinical isolates collected throughout Korea were genotyped by using the IS6110 restriction fragment length polymorphism (RFLP), and then analysed for the number of VNTR copies from 32 VNTR loci. Results: The results of discriminatory power according to diverse combinations were as follows: 25 clusters in 83 strains were yielded from the internationally standardized 15 VNTR loci (Hunter-Gaston discriminatory index [HGDI], 0.9958), 25 clusters in 65 strains by using IS6110 RFLP (HGDI, 0.9977), 14 clusters in 32 strains in 12 hyper-variable VNTR loci (HGDI, 0.9995), 6 clusters in 13 strains in 32 VNTR loci (HDGI, 0.9998), and 7 clusters in 14 strains of both the 12 hyper-variable VNTR and IS6110 RFLP (HDGI, 0.9999). Conclusion: The combination of 12 hyper-variable VNTR typing can be an effective tool for genotyping Korean M. tuberculosis isolates where the Beijing strains are predominant.

간호대학생의 피로와 임상실습 스트레스의 관계에서 의사소통 능력의 매개효과 (Mediating Effect of Communication Skill in the Relationship between Fatigue and Clinical Practice Stress in Nursing Students)

  • 양야기
    • 기본간호학회지
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    • 제25권1호
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    • pp.58-67
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    • 2018
  • Purpose: Fatigue and clinical practice stress can negatively influence nursing students. This study was done to examine of communication skill as mediating effect variable in the relationship between fatigue and stress during clinical practice. Methods: A cross-sectional study design was employed. Research participants were 124 nursing students from G city and J province. Data were collected from December 1, 2016 to January 30, 2017 using self-report questionnaires. Data were analyzed using Baron and Kenny method. Results: Fatigue had a significant negative correlation with communication skill (r=-.28, p=.001). Fatigue had a significant positive correlation with clinical practice stress (r=.39, p<.001). In addition, communication skill had a mediating effect in the relationship between fatigue and clinical practice stress. Conclusion: The findings of this study indicate that communication skill plays an important role in reducing clinical practice stress in nursing students. Therefore, in the field of nursing education, a program to improve the communication ability of nursing students should be developed and applied.

임상간호사의 간호사 윤리강령 인식의 영향 요인; 생명의료 윤리의식, 도덕적 민감성, 비판적사고 성향을 중심으로 (Factors influencing the recognition of clinical nurses' code of ethics; Focusing on consciousness of biomedical ethics, moral sensitivity, and critical thinking deposition)

  • 최영실;김상숙
    • 한국산학기술학회논문지
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    • 제21권12호
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    • pp.660-671
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    • 2020
  • 본 연구는 임상간호사의 생명의료 윤리의식, 도덕적 민감성, 비판적 사고성향 및 간호윤리강령인식 정도를 확인하고, 간호사 윤리강령 인식에 영향을 미치는 요인을 확인하고자 시도된 서술적 조사연구이다. 대상자의 일반적·윤리적특성은 빈도, 백분율, 평균과 표준편차로 산출하였고, 일반적·윤리적 특성에 따른 각 변수별 차이는 SAS 9.4를 이용하여, independent t-test, one-way ANOVA로 분석하였고, 이후 유의한 차이가 발견된 변수는 Scheffé 사후 검정을 이용하여 다중 비교하였다. 각 변수의 점수는 평균과 표준편차, 최소 값과 최대 값을 이용하였고, 변수 별 상관관계는 Pearson correlation coefficient로 분석하였다. 또한 간호사 윤리강령 인식에 영향을 미치는 요인을 파악하기 위하여 multiple regression으로 분석하였다. 대상자의 일반적·윤리적 특성과 변수 간의 상관관계는 모두 유의한 양의 상관관계를 보였다. 마지막으로 간호사 윤리강령 인식에 가장 크게 영향을 미치는 변수는 비판적 사고성향(p<.001)이었고, 다음으로 생명의료 윤리의식(p<.001), 도덕적 민감성(p<.001) 순으로 영향하는 것으로 나타났으며, 이에 대한 설명력은 27.4%이다. 따라서 임상간호사들에게 비판적 사고성향, 생명의료 윤리의식, 도덕적 민감성 등을 향상시킬 수 있는 교육 프로그램을 개발하고, 이를 적용시킴으로써 임상간호사들이 확고한 윤리적 가치관을 가지고 실무에 임할 수 있도록 도움을 주어야 할 것이다.