• Title/Summary/Keyword: Critical ratio

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Emergent Esophagectomy in Patients with Esophageal Malignancy Is Associated with Higher Rates of Perioperative Complications but No Independent Impact on Short-Term Mortality

  • Yahya Alwatari;Devon C. Freudenberger;Jad Khoraki;Lena Bless;Riley Payne;Walker A. Julliard;Rachit D. Shah;Carlos A. Puig
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.160-168
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    • 2024
  • Background: Data on perioperative outcomes of emergent versus elective resection in esophageal cancer patients requiring esophagectomy are lacking. We investigated whether emergent resection was associated with increased risks of morbidity and mortality. Methods: Data on patients with esophageal malignancy who underwent esophagectomy from 2005 to 2020 were retrospectively analyzed from the American College of Surgeons National Surgical Quality Improvement Program database. Thirty-day complication and mortality rates were compared between emergent esophagectomy (EE) and non-emergent esophagectomy. Logistic regression assessed factors associated with complications and mortality. Results: Of 10,067 patients with malignancy who underwent esophagectomy, 181 (1.8%) had EE, 64% had preoperative systemic inflammatory response syndrome, sepsis, or septic shock, and 44% had bleeding requiring transfusion. The EE group had higher American Society of Anesthesiologists (ASA) class and functional dependency. More transhiatal esophagectomies and diversions were performed in the EE group. After EE, the rates of 30-day mortality (6.1% vs. 2.8%), overall complications (65.2% vs. 44.2%), bleeding, pneumonia, prolonged intubation, and positive margin (17.7% vs. 7.4%) were higher, while that of anastomotic leak was similar. On adjusted logistic regression, older age, lower albumin, higher ASA class, and fragility were associated with increased complications and mortality. McKeown esophagectomy and esophageal diversion were associated with a higher risk of postoperative complications. EE was associated with 30-day postoperative complications (odds ratio, 2.39; 95% confidence interval, 1.66-3.43; p<0.0001). Conclusion: EE was associated with a more than 2-fold increase in complications compared to elective procedures, but no independent increase in short-term mortality. These findings may help guide data-driven critical decision-making for surgery in select cases of complicated esophageal malignancy.

Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey

  • Yusuff Adebayo Adebisi;Don Eliseo Lucero-Prisno III;Jerico B. Ogaya;Victor C. Canezo Jr.;Roland A. Niez;Florante E. Delos Santos;Melchor M. Magramo;Ann Rosanie Yap-Tan;Francis Ann R. Sy;Omar Kasimieh
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.288-297
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    • 2024
  • Objectives: This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). Methods: We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. Results: The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries. Conclusions: The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.

Online Host and Its Impact on Live Streaming Commerce Performance: The Moderating Role of Product Type (온라인 호스트가 라이브 스트리밍 커머스 성과에 미치는 영향: 제품 유형의 조절 역할을 중심으로)

  • Xuanting Jin;Minghao Huang;Dongwon Lee
    • Information Systems Review
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    • v.25 no.1
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    • pp.213-231
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    • 2023
  • With the rapid development of live streaming commerce, online host as an information source plays a critical role in affecting live streaming performance. However, the impact of different product types on the relationship between online hosts and live streaming has been less studied. Based on the elaboration likelihood model (ELM) and information source theory, this study aims to empirically investigate what factors influence the sales of live streaming commerce and how product type moderates the relationship between them. The analysis of 11,422 live streaming commerce data collected for four months from October 10, 2021 to February 10, 2022 shows that, among the factors related to source credibility and attractiveness, multi-channel networks (MCN) and the number of followers positively affect the sales volume of live streaming commerce, whereas the reputation score harms the sales. Moreover, the moderating effect of the product type (i.e., ratio of involvement products) on the relationships is confirmed. The findings enrich the literature on live streaming commerce performance. The limitations and future research directions are also discussed.

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.

Particulate matter concentration effects on attention to environmental issues: a cross-sectional study among residents in Korea's Pohang Industrial Complex

  • Hye-seung Ryu;Jea Chul Ha;Insung Chung;Seonhee Yang;Hyunjoo Kim;Sung-Deuk Choi
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.31.1-31.10
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    • 2023
  • Background: With modernization, air pollution has become increasingly serious, and its effects on health have been revealed. As a result, public interest in environmental pollution has become critical for regulating air pollution. In our study, we aim to evaluate the impact of air pollution levels on public attention to environmental issues and examine whether awareness of the residential environment's impact on health acts as a mediator in this relationship. Methods: We conducted an analysis on 400 individuals surveyed in the preliminary feasibility study on adverse health effects in the Pohang Industrial Complex, to examine the relationship between particulate matter 2.5 (PM2.5) and attention to environmental issues. Logistic regression analysis was performed, and mediation analysis was used to determine whether awareness of the residential environment's impact on health mediated the relationship. Results: The logistic regression analysis results showed that PM2.5 levels were associated with attention to environmental issues (adjusted odds ratio [AOR]: 2.1; 95% confidence interval [CI]: 1.3-3.5; p = 0.003) and awareness of health impacts (AOR: 3.4; 95% CI: 1.6-7.1; p = 0.001). The PM2.5 levels showed 9.9% (95% CI: 5.4-14.0) increase in the prevalence of high attention to environmental issues, of which, only 1.0% (95% CI: 0.2-2.3) were mediated by health impact awareness. In the overall analysis, 10% of the total effect of PM2.5 on attention to environmental issues was mediated by health impact awareness. Conclusions: According to this study's results, there was a correlation between air pollution levels and attention to environmental issues. Awareness of the health impacts of air pollution partially mediated the effect of air pollution levels on attention to environmental issues. In future studies, it is recommended to identify other mediators to further understand this structure.

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

  • Saeyeon Kim;Tak Kyu Oh;In-Ae Song;Young-Tae Jeon
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.84-93
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    • 2024
  • Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

Deep Learning-Based Short-Term Time Series Forecasting Modeling for Palm Oil Price Prediction (팜유 가격 예측을 위한 딥러닝 기반 단기 시계열 예측 모델링)

  • Sungho Bae;Myungsun Kim;Woo-Hyuk Jung;Jihwan Woo
    • Information Systems Review
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    • v.26 no.2
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    • pp.45-57
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    • 2024
  • This study develops a deep learning-based methodology for predicting Crude Palm Oil (CPO) prices. Palm oil is an essential resource across various industries due to its yield and economic efficiency, leading to increased industrial interest in its price volatility. While numerous studies have been conducted on palm oil price prediction, most rely on time series forecasting, which has inherent accuracy limitations. To address the main limitation of traditional methods-the absence of stationarity-this research introduces a novel model that uses the ratio of future prices to current prices as the dependent variable. This approach, inspired by return modeling in stock price predictions, demonstrates superior performance over simple price prediction. Additionally, the methodology incorporates the consideration of lag values of independent variables, a critical factor in multivariate time series forecasting, to eliminate unnecessary noise and enhance the stability of the prediction model. This research not only significantly improves the accuracy of palm oil price prediction but also offers an applicable approach for other economic forecasting issues where time series data is crucial, providing substantial value to the industry.

GPU Based Feature Profile Simulation for Deep Contact Hole Etching in Fluorocarbon Plasma

  • Im, Yeon-Ho;Chang, Won-Seok;Choi, Kwang-Sung;Yu, Dong-Hun;Cho, Deog-Gyun;Yook, Yeong-Geun;Chun, Poo-Reum;Lee, Se-A;Kim, Jin-Tae;Kwon, Deuk-Chul;Yoon, Jung-Sik;Kim3, Dae-Woong;You, Shin-Jae
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.08a
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    • pp.80-81
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    • 2012
  • Recently, one of the critical issues in the etching processes of the nanoscale devices is to achieve ultra-high aspect ratio contact (UHARC) profile without anomalous behaviors such as sidewall bowing, and twisting profile. To achieve this goal, the fluorocarbon plasmas with major advantage of the sidewall passivation have been used commonly with numerous additives to obtain the ideal etch profiles. However, they still suffer from formidable challenges such as tight limits of sidewall bowing and controlling the randomly distorted features in nanoscale etching profile. Furthermore, the absence of the available plasma simulation tools has made it difficult to develop revolutionary technologies to overcome these process limitations, including novel plasma chemistries, and plasma sources. As an effort to address these issues, we performed a fluorocarbon surface kinetic modeling based on the experimental plasma diagnostic data for silicon dioxide etching process under inductively coupled C4F6/Ar/O2 plasmas. For this work, the SiO2 etch rates were investigated with bulk plasma diagnostics tools such as Langmuir probe, cutoff probe and Quadruple Mass Spectrometer (QMS). The surface chemistries of the etched samples were measured by X-ray Photoelectron Spectrometer. To measure plasma parameters, the self-cleaned RF Langmuir probe was used for polymer deposition environment on the probe tip and double-checked by the cutoff probe which was known to be a precise plasma diagnostic tool for the electron density measurement. In addition, neutral and ion fluxes from bulk plasma were monitored with appearance methods using QMS signal. Based on these experimental data, we proposed a phenomenological, and realistic two-layer surface reaction model of SiO2 etch process under the overlying polymer passivation layer, considering material balance of deposition and etching through steady-state fluorocarbon layer. The predicted surface reaction modeling results showed good agreement with the experimental data. With the above studies of plasma surface reaction, we have developed a 3D topography simulator using the multi-layer level set algorithm and new memory saving technique, which is suitable in 3D UHARC etch simulation. Ballistic transports of neutral and ion species inside feature profile was considered by deterministic and Monte Carlo methods, respectively. In case of ultra-high aspect ratio contact hole etching, it is already well-known that the huge computational burden is required for realistic consideration of these ballistic transports. To address this issue, the related computational codes were efficiently parallelized for GPU (Graphic Processing Unit) computing, so that the total computation time could be improved more than few hundred times compared to the serial version. Finally, the 3D topography simulator was integrated with ballistic transport module and etch reaction model. Realistic etch-profile simulations with consideration of the sidewall polymer passivation layer were demonstrated.

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Monoclonal Antibody against leucocyte CD11b(MAb 1B6) increase the early mortality rate in Spraque Dawley with E. coli pneumonia (백혈구 CD11b에 대한 단 클론 항체 (MAb 1B6)는 Spraque Dawley의 E. coli 폐렴의 조기 사망률을 증가시킨다)

  • Kim, Hyung Jung;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.579-589
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    • 1996
  • Background : Activation of neutrophil is critical for the clearance of microorganisms and toxic host mediators during sepsis. Unfortunately the activated neutrophil and its toxic byproducts can produce tissue injury and organ dysfunction. The leucocyte CD11/18 adhesion complex regulates neutrophil-endothelial cell adhesion, the first step in neutrophil migration to sites of injection and inflammation. To investigate the potential of neutrophil inhibition as a treatment strategy for sepsis, we evaluated the effects of monoclonal antibody against CD11b (MAb 1B6) in rats intrabronchial challenged with Escherichia coli. Methods : Animals were randomly assigned to receive monoclonal antibody against CD11b (1 mg/kg, sc) and bovine serum albumin(BSA, 1 mg/kg, sc) 6 hr before, at 0 and 6 hr after intrabronchial challenge of $20x10^9$ CFU/kg E. coli 0111. Animals were randomized to treat either 24, 60 or 90% oxygen after bacterial challenge and begining 4 hr after inoculation, all animals were received 100 mg/kg ceftriaxone qd for 3 days. Peripheral and alveolar neutrophil(by bronchoalveolar lavage) counts and lung injury parameters such as alveolar-arte rial $PO_2$ difference, wet to dry lung weight ratio and protein concentration of alveolar fluid were measured in survived rats at 12 hr and 96 hr. Results : Monoclonal antibody against CD11b decreased circulating and alveolar neutrophil especially more in 12 hr than in 96 hr The lung injury parameters of antibody-treated animals were not different from those of BSA-treated animals. but It was meaningless due to small number of survived animals. The early(6 hr) mortality rate was significantly increased in antibody-treated group(51%) compared to BSA-treated group(31%) (P=0.02) but late(from 12 hr to 72 hr) mortality rate was not different in antibody-treated group(44%) from BSA-treated group(36%) (P =0.089). Conclusion : Leucocyte CD11b/18 adhesion molecule is known to regulate neutrophil migration to the site of infection and inflammation. The monoclonal antibody against CD11b decreased alveolar neutrophil in rats with pulmonary sepsis and increased early mortality rate. Therefore, we can speculate that monoclonal antibody against CD11b blocks of alveolar recruitment of neutrophils, impairs host defense mechanism and increases early mortality rate of pulmonary sepsis in rat.

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Effects of Attenuation and Scatter Corrections in Cat Brain PET Images Using microPET R4 Scanner (MicroPET R4 스캐너에서 획득한 고양이 뇌 PET 영상의 감쇠 및 산란보정 효과)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Jong-Jin;Lee, Byeong-Il;Park, Min-Hyun;Lee, Hyo-Jeong;Oh, Seung-Ha;Kim, Kyeong-Min;Cheon, Gi-Jeong;Lim, Sang-Moo;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.1
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    • pp.40-47
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    • 2006
  • Purpose: The aim of this study was to examine the effects of attenuation correction (AC) and scatter correction (SC) on the quantification of PET count rates. Materials and Methods: To assess the effects of AC and SC $^{18}F$-FDG PET images of phantom and cat brain were acquired using microPET R4 scanner. Thirty-minute transmission images using $^{68}Ge$ source and emission images after injection of FDG were acquired. PET images were reconstructed using 2D OSEM. AC and SC were applied. Regional count rates were measured using ROIs drawn on cerebral cortex including frontal, parietal, and latral temporal lobes and deep gray matter including head of caudate nucleus, putamen and thalamus for pre- and post-AC and SC images. The count rates were then normalized with the injected dose per body weight. To assess the effects of AC, count ratio of "deep gray matter/cerebral cortex" was calculated. To assess the effects of SC, ROIs were also drawn on the gray matter (GM) and white matter (WM), and contrast between them ((GM-WM)/GM was measured. Results: After the AC, count ratio of "deep gray matter/cerebral cortex" was increased by $17{\pm}7%$. After the SC, contrast was also increased by $12{\pm}3%$. Conclusion: Relative count of deep gray matter and contrast between gray and white matters were increased after AC and SC, suggesting that the AC would be critical for the quantitative analysis of cat brain PET data.