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No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

  • Sohn, Sang Kyun;Moon, Joon Ho;Lee, In Hee;Ahn, Jae Sook;Kim, Hyeoung Joon;Chung, Joo Seop;Shin, Ho Jin;Park, Sung Woo;Lee, Won Sik;Lee, Sang Min;Kim, Hawk;Lee, Ho Sup;Kim, Yang Soo;Cho, Yoon Young;Bae, Sung Hwa;Lee, Ji Hyun;Kim, Sung Hyun;Song, Ik Chan;Kwon, Ji Hyun;Lee, Yoo Jin
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1194-1202
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    • 2018
  • Background/Aims: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were $53.1%{\pm}10.7%$ for allo-HCT with HMA, $75%{\pm}21.7%$ for allo-HCT without HMA, $17.3%{\pm}3.6%$ for HMA, and $20.8%{\pm}6.9%$ for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ${\geq}65years$ (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS. Conclusions: For the H/VH risk group, very poor cytogenetic risk, age ${\geq}65years$, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.

Factors Influencing Driving ability and Its Measurements in Older Driver: A Systematic Review (고령자의 운전능력 영향요인 및 측정도구에 대한 체계적 문헌고찰)

  • Woo, Ye-Shin;Shin, Ga-In;Park, Sang-Mi;Park, Hae Yean
    • 한국노년학
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    • v.38 no.1
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    • pp.225-241
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    • 2018
  • Self-driving is meaningful activity for older persons because it enlarges the range of activity and provides opportunities for social participation. Driving is a complex activity that requires integration of physical, cognitive and sensory functions and is influenced by human and psychological factors. Age related functional deterioration affects the driving ability of older drivers. The purpose of this study is to investigate the factors affecting the risk of accidents and driving cessation of elderly drivers through systematic literature review. MEDLINE, EMBASE, Cochrane Library, KoreaMed, Pubmed were used for searching articles published from 2007 to 2017. 'aged', 'aging', 'automobile driving', 'age factors' were used as search terms and 18 articles were finally selected for analysis among 1,458 articles. In result of the study, the most significant effect showed in the physical domain, the driving habit and the performance function. The most frequent used tools evaluated driving habit and the cognitive function. In demographic characteristics, there was a correlation with the driving discontinue according to sex and age. This study emphasizes the necessity of preparing measures for safety driving with elderly. In addition, it suggests the necessity of systematically services such as individual education programs based on various driving cessation related factors of the elderly.

A Comparative Study on the Effects of Location Factors on Sales by Restaurant Type (입지요인이 음식업 업종별 매출액에 미치는 영향 비교연구)

  • Noh, Eun Bin;Lee, Sang Kyeong
    • Korea Real Estate Review
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    • v.28 no.4
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    • pp.37-51
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    • 2018
  • The purpose of this paper is to analyze the effects of location factors on sales by restaurant type in the six districts of Seoul (Jongno-gu, Jung-gu, Yeongdeungpo-gu, Gangnam-gu, Seocho-gu, and Songpa-gu). Ordinary least squares (OLS) regression model is selected for four restaurant types whose spatial autocorrelation is not identified, spatial lag model (SLM) is only selected for seafood restaurant, and spatial error model (SEM) is selected for nine other restaurant types. The floating population and the workers of surrounding businesses have generally positive effects on the sales of restaurants. The floating population elasticity of the sales of restaurants are found to be in the descending order of Oriental food, pub, Western food, and traditional food restaurant, and the elasticity of the workers of surrounding businesses are in the descending order of bakery, Oriental food, and Western food restaurant. The spatial multiplier effects are in the descending order of Oriental food, pub, and Western food restaurant. There is a statistically significant sales gap between roast meat, pub, and bakery in Gangnam-gu and those in five other districts. The results of this research can help in starting a restaurant in that they can provide information on the suitability of location by restaurant type.

Development of the Competency Model of Specialized Vocational High School Teachers as Admission Officers (특성화고 미래인재전형 담당교사들의 역량모델 연구)

  • Doo, Min Young;Woo, BeoDle;Shin, Chang Ho
    • Journal of vocational education research
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    • v.37 no.3
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    • pp.47-63
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    • 2018
  • The purpose of this study is to develop the competency model of specialized vocational school teachers as admission officers. Whereas professional admission officers deal with a variety of admission activities in universities, teachers are responsible for admission duties in specialized high schools in Korea. Therefore, it is necessary to identify the core competencies required for teachers responsible for admission duties in specialized high school settings. In order to develop a competency model, factor analysis was completed for the survey results of 191 teachers who teach in specialized vocational high schools in Seoul, Korea. For evaluating validity of the competency model, the responses from those who had high experiences in admission duties and the average teachers were compared. As a result, this study identified a total of 14 competencies in three competency areas. The competencies required for specialized high school teachers include responsibilities for admission officers, ethics for evaluators, communication skills, teamwork, understandings of admissions process for specialized vocational high school, developing evaluation criteria, generating interview questions, increasing interrater reliability, interview skills, simultaneous evaluation of interviewees, quantification of evaluation results, synthesis of evaluation results, and decision making skills.

The School Curriculum Organization and Teacher's Perceptions about Test Subjects in Vocational Education Division of the College Scholastic Ability Test Based in the 2015 Revised National Curriculum (2015 개정 교육과정 적용에 따른 수능 직업탐구영역 시험과목의 학교 교육과정 편성과 교사의 인식)

  • Hahm, Seung-Yeon
    • Journal of vocational education research
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    • v.37 no.4
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    • pp.1-22
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    • 2018
  • The study tried to investigate the school curriculum organization and teacher's perceptions about test subjects in vocational education division of the college scholastic ability test based in the 2015 revised national curriculum. This study asked vocational teachers to fill in basic questionnaire that consists of 9 relevant and subjective items for the school curriculum organization and test subjects in vocational education division of the college scholastic ability test based in the 2015 revised national curriculum. For this, the survey was conducted 58 schools of 92 schools in technical specialized high schools, meister high schools and vocational high schools about test subjects of 2015 revised national curriculum. As a result, the 'Successful career life' subject was 53.5%, the most organized in the first grade. 'test course 1' was 55.2% and 'test course 2' was 72.4% the most organized in the first grade. The Opinions on the test courses were the highest in the two subjects in the same series as the present. The teacher's perceptions showed that the current test subjects in vocational education division of the college scholastic ability test are valid. The most important factor affecting difficulty was 'The Ministry Education's policy' in vocational education division of the college scholastic ability test.

Extraction of Surface-Active Substances from Defatted Rice Bran by Supercritical Carbon Dioxide (초임계 CO2유체 추출법을 이용한 탈지미강 중 표면활성물질 추출의 최적화)

  • Lee, Hyong-Ju;Lee, Eui-Suk;Hong, Soon-Taek
    • Food Engineering Progress
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    • v.15 no.2
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    • pp.175-181
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    • 2011
  • By using supercritical carbon dioxide fluid, an attempt was made to extract surface-active substances from defatted rice bran. Extraction was carried out according to D-optimal design and results were analyzed by response surface methodology to establish optimum condition. It was found that pressure, temperature and co-solvent (ethanol) influenced in a different extent on the extraction efficiency (i.e., yield and interfacial tension) of surface-active substances. Among them, co-solvent was found to be a major influencing factor, where maximum yield (2.62%) was observed at the highest content (250 g). In addition, it also affected most on the interfacial tension at the oil-water interface but in this case the lowest interfacial tension value (9.51 mN/m) was found when added lowest (50 g). In conclusion, it was estimated that the optimum extraction condition was to be pressure 350bar, temperature $62^{\circ}C$ and co-solvent content 50 g in this study, where extraction yield was 0.69% and interfacial tension to be 10.1 mN/m.

Nitrogen Leaching and Balance of Soils Grown with Cabbage in Weighing Lysimeter (중량식 라이시미터에서 배추 재배에 따른 질소 용탈과 수지)

  • Lee, Ye Jin;Ok, Jung Hun;Lee, Seul Bi;Sung, Jwa Kyung;Song, Yo Sung;Lee, Deog Bae
    • Korean Journal of Environmental Agriculture
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    • v.37 no.3
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    • pp.166-171
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    • 2018
  • BACKGROUND: Nitrogen leaching depends on the drainage pattern and nitrate content, and those are influenced by soil hydraulic properties and fertility. The purpose of this study was to confirm how soil texture contributed to leaching and balance of nitrogen, as well as to drainage. METHODS AND RESULTS: This study was performed using undisturbed weighing lysimeters which were piled up with clay loam (Songjung series) and sandy loam (Sanju series) soils in National Institute of Agricultural Science experimental field. Chinese cabbage was cultivated from August 30 to October 31, 2017. The application rates of N, $P_2O_5$, and $K_2O$ were 21.5, 7.8, and $15.0kg\;10a^{-1}$, respectively, and irrigation was supplied at -33 kPa in 30 cm soil depth. Drainage in clay loam was not noticeable, although it was increased by rainfall in early September. By contrast, the trend of drainage in sandy loam was strongly dependent upon rainfall pattern. Owing to different drainage patterns between both soil textures, nitrogen leaching was 5-fold higher in sandy loam than in clay loam. Nitrogen use efficiencies in clay loam and sandy loam were represented as 43% and 52%, respectively. CONCLUSION: The pattern of drainage and nitrogen leaching were greatly depended on clay content in soil. From this study, we carefully suggest that soil texture should be considered as an incidental factor to estimate nitrogen balance.

Techno-Economic Analysis of Reversible Solid Oxide Fuel Cell System Couple with Waste Steam (폐스팀을 이용한 가역 고체산화물 연료전지의 기술적 경제적 해석)

  • GIAP, VAN-TIEN;LEE, YOUNG DUK;KIM, YOUNG SANG;AHN, KOOK YOUNG
    • Transactions of the Korean hydrogen and new energy society
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    • v.30 no.1
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    • pp.21-28
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    • 2019
  • Reversible solid oxide fuel cell (ReSOC) system was integrated with waste steam for electrical energy storage in distributed energy storage application. Waste steam was utilized as external heat in SOEC mode for higher hydrogen production efficiency. Three system configurations were analyzed to evaluate techno-economic performance. The first system is a simple configuration to minimize the cost of balance of plant. The second system is the more complicated configuration with heat recovery steam generator (HRSG). The third system is featured with HRSG and fuel recirculation by blower. Lumped models were used for system performance analyses. The ReSOC stack was characterized by applying area specific resistance value at fixed operating pressure and temperature. In economical assessment, the levelized costs of energy storage (LCOS) were calculated for three system configurations based on capital investment. The system lifetime was assumed 20 years with ReSOC stack replaced every 5 years, inflation rate of 2%, and capacity factor of 80%. The results showed that the exergy round-trip efficiency of system 1, 2, 3 were 47.9%, 48.8%, and 52.8% respectively. The high round-trip efficiency of third system compared to others is attributed to the remarkable reduction in steam requirement and hydrogen compression power owning to fuel recirculation. The result from economic calculation showed that the LCOS values of system 1, 2, 3 were 3.46 ¢/kWh, 3.43 ¢/kWh, and 3.14 ¢/kWh, respectively. Even though the systems 2 and 3 have expensive HRSG, they showed higher round-trip efficiencies and significant reduction in boiler and hydrogen compressor cost.

Preoperative Risk Factors for Pathologic N2 Metastasis in Positron Emission Tomography-Computed Tomography-Diagnosed N0-1 Non-Small Cell Lung Cancer

  • Yoon, Tae-hong;Lee, Chul-ho;Park, Ki-sung;Bae, Chi-hoon;Cho, Jun-Woo;Jang, Jae-seok
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.221-226
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    • 2019
  • Background: Accurate mediastinal lymph node staging is vital for the optimal therapy and prognostication of patients with lung cancer. This study aimed to determine the preoperative risk factors for pN2 disease, as well as its incidence and long-term outcomes, in patients with clinical N0-1 non-small cell lung cancer. Methods: We retrospectively analyzed patients who were treated surgically for primary non-small cell lung cancer from November 2005 to December 2014. Patients staged as clinical N0-1 via chest computed tomography (CT) and positron emission tomography (PET)-CT were divided into two groups (pN0-1 and pN2) and compared. Results: In a univariate analysis, the significant preoperative risk factors for pN2 included a large tumor size (p=0.083), high maximum standard uptake value on PET (p<0.001), and central location of the tumor (p<0.001). In a multivariate analysis, central location of the tumor (p<0.001) remained a significant preoperative risk factor for pN2 status. The 5-year overall survival rates were 75% and 22.9% in the pN0-1 and pN2 groups, respectively, and 50% and 78.2% in the patients with centrally located and peripherally located tumors, respectively. In a Cox proportional hazard model, central location of the tumor increased the risk of death by 3.4-fold (p<0.001). Conclusion: More invasive procedures should be considered when preoperative risk factors are identified in order to improve the efficacy of diagnostic and therapeutic plans and, consequently, the patient's prognosis.

Factors Influencing the Fear of Falling among Community-dwelling Elderly in Korea (지역사회 재가노인의 낙상 두려움 예측요인)

  • Park, Nan Ju;Shin, Yong Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.6
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    • pp.278-287
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    • 2019
  • This study was conducted to identify the predictors influencing fear of falling in community-dewelling elderly. A secondary data analysis was performed using data of 65 years or older elderly who participating in the 2014 Korean Elderly Survey(Jun. 11th ~ Sep. 4th 2014). Multivariated logistic regression analysis was used to identify the risk factors of fear of falling. 81.5% of the elderly had fear of falling. There were significant factors, sex(OR=2.87, p<.001), education(OR=1.73, p<.001), presence of cohabiting spouse(OR=1.19, p<.001), experience of falling(OR=6.35, p<.001), arthritis(OR=1.83, p<.001), depression(OR=2.25, p<.001), cognitive deficit (OR=1.24, p<.001), instrumental activities of daily living (OR=1.98, p<.001), exercise(OR=1.29, p<.001) and the number of chronic diseases(over 3: OR=2.53, p<.001, 1~2: OR=1.73, p<.001), predicting fear of falling in community-dwelling elderly. Fear of falling was associated with multifactorial condition, and arthritis was an important factor in chronic disease. This study will provide fundamental information on programming and a policy proposal related to fear of falling.