• 제목/요약/키워드: Higher utility

검색결과 522건 처리시간 0.024초

행복결정요인에 대한 문화예술 활동참여의 역할 (The Role of Participation in Arts and Cultural Activities in the Determinants of Happiness)

  • 이학준;허식
    • 문화경제연구
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    • 제21권3호
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    • pp.3-30
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    • 2018
  • 본 연구는 서울시민의 행복결정요인에 있어 문화예술 활동참여의 영향력을 파악하기 위해 "2014 서울서베이"의 원자료를 바탕으로 실증분석을 실시하였다. 분석결과 문화예술 활동에 대한 참여는 개인의 행복과 긍정적인 관계에 있는 것으로 나타났으며, 이는 문화예술에 대한 향유 자체에서 즐거움이 발생하며 향유 과정에서 또한 타인과의 사회적 접촉이 유발되기 때문인 것으로 보인다. 이어 개인의 행복뿐만 아니라 문화예술수요에도 상당한 영향을 미치는 소득수준과 교육수준을 고 저 집단으로 나누어 분석한 결과에서도 전반적으로 유사한 결과를 보였다. 특이한 점은 저소득 저학력 집단은 고소득 고학력 집단에 비해 문화예술소비량이 적은 것으로 나타났으나 문화예술 활동에 대한 참여를 통해 얻는 효용의 크기는 더 큰 것으로 나타났는데, 이는 금전 및 시간적 제약에서 비롯하는 기회비용이 고소득 고학력 집단에 비해 저소득 저학력 집단에서 더 크게 작용한 것으로 사료된다. 또한 저소득 집단의 경우, 문화예술 활동에 대한 지출금액이 일정수준을 초과하면 한계효용이 감소하는 추세를 보이는데 이는 문화예술 활동참여에 있어 저소득 집단에서 금전적 제약이 존재함을 의미한다.

상장 에너지 공기업 경영 안정성 분석: 중위투표자이론의 관점에서 (An Analysis of Operational Stability of the KOSPI-listed Energy Public Enterprise from the Perspective of Median Voter Theory)

  • 김영신
    • 자원ㆍ환경경제연구
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    • 제32권2호
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    • pp.77-105
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    • 2023
  • 본 논문은 상장 에너지 공기업의 경영 안정성에 대해 중위투표자이론의 관점에서 분석한다. 2011~2022년 기간 동안 KOSPI에 상장된 한국가스공사, 한국전력공사, 한국지역난방공사, 한국전력기술(주), 한전KPS(주)의 수익성과 안정성에 대해 분석하고, 일반 국민을 대리할 수 있는 중위투표자의 선호와 관련이 있는지 실증분석을 수행한다. 상장 에너지 공기업의 총자산 수익률, 매출액 영업이익률, 자기자본 순이익률로 대리되는 수익성과 자본 대비 부채비율로 대리되는 안정성을 분석한 결과, 근년 들어 상장 에너지 공기업의 경영 안정성은 악화되는 추세에 있는 것으로 나타났다. 또한 공기업의 경영 안정성이 중위투표자의 선호와 관련이 있음이 실증분석 결과로 나타났다. 중위투표자의 소득이 평균소득보다 낮을수록 공기업의 수익성은 하락하고 부채비율은 증가하는 결과를 보여준다. 본 논문은 중위투표자관점에서 공공·에너지 요금의 지나친 부담은 정부와 정치권의 요금 인상 억제의 유인을 강화시켜 공기업의 수익성은 하락하고 부채는 증가하는 결과를 초래할 수 있음을 시사한다.

The Utility of Contrast Enhanced Ultrasound and Elastography in the Early Detection of Fibro-Stenotic Ileal Strictures in Children with Crohn's Disease

  • Sarah D. Sidhu ;Shelly Joseph;Emily Dunn;Carmen Cuffari
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권4호
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    • pp.193-200
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    • 2023
  • Purpose: Crohn's disease (CD) is a chronic, idiopathic bowel disorder that can progress to partial or complete bowel obstruction. At present, there are no reliable diagnostic tests that can readily distinguish between acute inflammatory, purely fibrotic and mixed inflammatory and fibrotic. Our aim is to study the utility of contrast enhanced ultrasound (CEUS) in combination with shear wave elastography (SWE) to differentiate fibrotic from inflammatory strictures in children with obstructive CD of the terminal ileum. Methods: Twenty-five (19 male) children between 2016-2021 with CD of the terminal ileum were recruited into the study. Among these patients, 22 had CEUS kinetic measurements of tissue perfusion, including wash-in slope (dB/sec), peak intensity (dB), time to peak intensity (sec), area under the curve (AUC) (dB sec), and SWE. In total, 11 patients required surgery due to bowel obstruction. Histopathologic analysis was performed by a pathologist who was blinded to the CEUS and SWE test results. Results: Patients that underwent surgical resection had significantly higher mean area under the curve on CEUS compared to patients responsive to medical therapy (p=0.03). The AUC also correlated with the degree of hypertrophy and the percent fibrosis of the muscularis propria, as determined by histopathologic grading (p<0.01). There was no difference in the mean elastography measurements between these two patient groups. Conclusion: CEUS is a useful radiological technique that can help identify pediatric patients with medically refractory obstructive fibrotic strictures of the terminal ileum that should be considered for early surgical resection.

Clinical Utility of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form in the Assessment of Internalizing and Externalizing Disorders in Adolescents: A Preliminary Approach

  • Hye Ji Yun;Eun Hee Park;Hyun Ju Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제34권4호
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    • pp.268-274
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    • 2023
  • Objectives: This study investigated whether the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-ARF) can differentiate between two groups of adolescents, one diagnosed with internalizing disorders and another with externalizing disorders, and examined the clinical utility of the MMPI-A-RF by examining which subscales can significantly discriminate between these two groups. Methods: A total of 105 adolescents aged 13-18 years completed the MMPI-A-RF (53 internalizing disorder and 52 externalizing disorder groups). Independent t-test, chi-square test (χ2), and discriminant analysis were used to examine whether MMPI-A-RF can distinguish between the two groups. Results: Sixteen MMPI-A-RF scales best predicted differences between the groups with internalizing and externalizing disorders. Fourteen scales (Higher-Order Scale [Emotional/Internalizing Dysfunction], Restructured Clinical [RC] Scale [RC demoralization, Somatic Complaints (RC1), and Low Positive Emotions (RC2)], Personality Psychopathology Five Scale [Introversion/Low Positive Emotionality-Revised, Negative Emotionality/Neuroticism-Revised], Somatic/Cognitive Scale [Malaise, Head Pain Complaints, and Gastrointestinal Complaints], Internalizing Scale [Stress/Worry, Self-Doubt], Externalizing Scale [Negative School Attitudes], Interpersonal Scale [Social Avoidance, Shyness]) were associated with the internalizing disorder group, whereas two scales (Externalizing Scale [Conduct Problems, Negative Peer Influence]) were associated with the externalizing disorder group. Conclusion: The MMPI-A-RF can be an efficient assessment tool for a quick diagnosis as it can classify individuals with internalizing and externalizing disorders in clinical settings that lack a variety of assessment tools for children and adolescents.

Potential clinical utility of intraoperative fluid amylase measurement during pancreaticoduodenectomy

  • Kunal Joshi;Manuel Abradelo;David Christopher Bartlett;Nikolaos Chatzizacharias;Bobby Venkata Dasari;John Isaac;Ravi Marudanayagam;Darius Mirza;Keith Roberts;Robert Peter Sutcliffe
    • 한국간담췌외과학회지
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    • 제27권2호
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    • pp.189-194
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    • 2023
  • Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a source of major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve patient outcomes and clinical risk scores may be ombined with postoperative drain fluid amylase (DFA) values to stratify patients. The aim of this pilot study was to etermine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF. Methods: In patients undergoing PD from February to November 2020, intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected. Results: Data were obtained for 52 patients with a median alternative Fistula Risk Score (aFRS) of 9.9. Postoperative complications occurred in 20 (38.5%) patients (five Clavien grade ≥ 3). There were eight POPFs and two patients died (pneumonia/sepsis). There was a significant correlation between IFA and DFA1 (R2 = 0.713; p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high aFRS/IFA) and 0% in lowrisk patients (low aFRS/IFA). Conclusions: IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.

Discriminative Power of Seoul Cognitive Status Test in Differentiating Subjective Cognitive Decline, Amnestic Mild Cognitive Impairment, and Dementia Based on CERAD-K Standards

  • Hasom Moon;Eek-Sung Lee;Seunghee Na;Dayeong An;Joon Soo Shin;Duk L. Na;Hyemin Jang
    • 대한치매학회지
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    • 제23권3호
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    • pp.136-145
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    • 2024
  • Background and Purpose: We developed a new digital cognitive assessment called Seoul Cognitive Status Test (SCST), formerly called Inbrain Cognitive Screening Test. The purpose of this study was to validate the clinical utility of the SCST by comparing its scores of those with subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), and dementia diagnosed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Methods: All participants (n=296) who completed the CERAD-K, SCST, and Instrumental Activities of Daily Living tests were included in this study. Total score, cognitive domain scores, and subtest scores of the SCST were compared among the 3 groups (SCD, aMCI, and dementia). Additionally, correlations between SCST and CERAD-K subtests were examined. Results: Cognitive domain scores and total score of the SCST showed significant differences among the three groups, with scores being the highest in the order of SCD, aMCI, and dementia (p<0.001). Most subtests of the SCST also showed higher scores in the order of SCD, aMCI, and dementia (p<0.001). However, SCD and aMCI groups showed no significant differences in scores of the Phonemic Word Fluency Test (p=0.083) or Korean Trail Making Test-Elderly version Part A (p=0.434). Additionally, there was no significant difference in the score of Place Recognition (p=0.274) of the Word-Place Association Test between aMCI and dementia groups. Conclusions: In conclusion, differences in total score, cognitive domain scores, and subtest scores of the SCST among the 3 groups of participants diagnosed using CERAD-K confirm the clinical utility of the SCST for cognitive assessment.

만성 뇌졸중 환자들의 체간 조절 평가의 재현성과 Barthel Index구분을 위한 임상 유용성 (Reproducibility of Trunk Control Assessment and the Clinical Utility of the Distinguishing Barthel Index in Chronic Stroke Patients)

  • 안승헌;박대성
    • 대한물리의학회지
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    • 제19권3호
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    • pp.55-63
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    • 2024
  • PURPOSE: This study examined the test-retest reliability and clinical utility of the Modified Trunk Impairment Scale (mTIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke - Trunk Control (PASS-TC) in patients with chronic stroke. METHODS: Thirty-eight stroke patients were reassessed using the mTIS, TCT, and PASS-TC with a seven-day interval between assessments. The test-retest reliability was evaluated using the intraclass correlation coefficient (ICC2,1), the standard error of measurement (SEM), the minimal detectable change (MDC), and MDC%, as well as Bland-Altman analysis. The relationship between the mTIS, TCT, PASS-TC scores, and the Barthel Index (BI) was also investigated. RESULTS: The test-retest reliability for the mTIS, TCT, and PASS-TC was high, with ICC values ranging from .91 to .94 (95% confidence interval: .83-.97). The MDCs for the mTIS and TCT were 2.35 and 13.9, respectively, while the MDC for the P ASS-TC was 2.54, all below 20% of the maximum possible score, indicating reliable measurement. The optimal mTIS cut-off score for distinguishing between mild (75-95 points) and severe (50-74 points) dependence on the BI was ≥ 9.5, with an accuracy of 79%. Patients with an mTIS score ≥ 9.5 (out of 15) showed an 18-fold higher likelihood of achieving a mild level of functional independence than those with a score < 9.5. CONCLUSION: The mTIS, TCT, and PASS-TC showed high test-retest reliability and no systematic errors in chronic stroke patients. The MDC values were reliable, indicating meaningful change. Among these, the mTIS is a sensitive and a useful tool for predicting functional independence in clinical practice and is straightforward to apply.

Clinical Utility of Haptoglobin in Combination with CEA, NSE and CYFRA21-1 for Diagnosis of Lung Cancer

  • Wang, Bing;He, Yu-Jie;Tian, Ying-Xing;Yang, Rui-Ning;Zhu, Yue-Rong;Qiu, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9611-9614
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    • 2014
  • Purpose: To investigate the clinical value in lung cancer of a combination of four serum tumor markers, haptoglobin (Hp), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) as well as the cytokeratin 19 fragment (CYFRA21-1). Materials and Methods: Serum Hp (with immune-turbidimetric method), CEA, NSE, CYFRA21-1 (with chemiluminescence method) level were assessed in 193 patients with lung cancer, 87 patients with benign lung disease and 150 healthy controls. Differences of expression were compared among groups, and joint effects of these tumor markers for the diagnosis of lung cancer were analyzed. Results: Serum tumor marker levels in patients with lung cancer were obviously higher than those with benign lung disease and normal controls (p<0.01). The sensitivities of Hp, CEA, NSE and CYFRA21-1 were 43.5%, 40.9%, 23.3% and 41.5%, with specificities of 90.7%, 99.2%, 97.9% and 97.9%. Four tumor markers combined together could produce a positive detection rate of 85.0%, significantly higher than that of any single test. With squamous carcinomas, the positive detection rates with Hp and CYFRA21-1 were higher than that of other markers. In the adenocarcinoma case, the positive detection rate of CEA was higher than that of other markers. For small cell carcinomas, the positive detection rate of NSE was highest. The area under receiver operating characteristic curve ($AUC^{ROC}$) of Hp in squamous carcinoma (0.805) was higher than in adenocarcinoma (0.664) and small cell carcinoma (0.665). Conclusions: Hp can be used as a new serum tumor marker for lung cancer. Combination detection of Hp, CEA, NSE and CYFRA21-1 could significantly improve the sensitivity and specificity in diagnosis of lung cancer, and could be useful for pathological typing.

Serial venous lactate measurement following gastrointestinal surgery in horses

  • Smanik, Lauren E.;Moser, Darla K.;Rothers, Kris P.;Hackett, Eileen S.
    • Journal of Veterinary Science
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    • 제23권5호
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    • pp.66.1-66.8
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    • 2022
  • Background: Prospective clinical study of blood lactate concentration in horses undergoing colic surgery is needed to determine utility in outcome prediction. Objectives: To evaluate venous lactate measurements in horses following colic surgery, including immediately after anesthetic recovery and daily throughout hospitalization, as well as to determine if lactate concentrations were significantly higher in horses that developed postoperative complications or did not survive to hospital discharge. Methods: Horses > 1 year of age undergoing surgery for colic and recovered from general anesthesia were sampled. A portable lactate meter was used to measure venous samples collected immediately following anesthetic recovery and daily throughout hospitalization. Complications arising during hospitalization and survival to hospital discharge were recorded. Results: Fifty one horses were enrolled, ranging in age from 2 to 29 years. Lactate concentration immediately following anesthetic recovery was higher in horses that developed complications during hospitalization (p = 0.046). The odds of developing complications postoperatively were doubled for horses with a venous lactate concentration > 5 mmol/L. Lactate measurements in non-survivors were significantly higher compared to survivors by 96 h postoperatively (p < 0.006). Conclusions: Higher venous lactate concentrations in the postoperative colic period were associated with an increased risk of complications and death. Results suggest horses with higher venous lactate measurements in recovery are more likely to have postoperative complications, with the odds of developing complications doubled for horses with a venous lactate > 5 mmol/L. Evaluation of venous lactate could provide information on prognosis in the postoperative period for horses with surgical colic.

베일리영유아발달검사 제3판(Bayley-III)의 미국 규준 적용의 문제: 미숙아 집단을 대상으로 (The Clinical Utility of Korean Bayley Scales of Infant and Toddler Development-III - Focusing on using of the US norm -)

  • 임유진;방희정;이순행
    • 한국심리학회지ㆍ일반
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    • 제36권1호
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    • pp.81-107
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    • 2017
  • 베일리영유아발달검사 제3판(Bayley-III)의 미국 규준이 영유아의 발달수행을 과대추정하고 발달지연율을 과소추정 한다는 논란이 있어서, 본 연구는 발달지연의 고위험군인 미숙아를 대상으로 미국 규준 적용시 Bayley-III의 임상적 유용성을 살펴보고자 하였다. 본 연구는 생후 1개월부터 24개월(교정원령)의 미숙아(재태기간 37주 미만)와 만삭아 93명을 대상으로 Bayley-III와 한국형베일리영유아발달검사 2판(K-BSID-II)을 실시하였다. 연구결과는 다음과 같다. 첫째, 미숙아/만삭아 각 93명을 대상으로 혼합설계 분산분석을 실시한 결과 재태기간(경증미숙아, 중증미숙아, 극중증미숙아, 만삭아)에 따른 Bayley-III의 발달지수 및 척도점수 간에 유의미한 차이가 있었다. 특히 경증미숙아 집단 내에서는 발달영역(인지, 언어, 운동)에 따라 유의미한 차이가 있는 것으로 나타냈다. 둘째, Bayley-III와 K-BSID-II을 모두 실시한 미숙아(n=79)를 대상으로 환산점수 평균 간의 차이를 살펴본 결과, Bayley-III의 발달지수는 K-BSID-II의 발달지수에 비해 유의미하게 높은 것으로 나타났으며 발달지연률은 크게 감소하는 것으로 나타났다. 마지막으로 ROC 분석을 통해 발달지연 변별에 대한 Bayley-III의 민감도와 특이도를 분석하고 Bayley-III의 임상적 절단점을 탐색한 결과, Bayley-III의 하위 척도 모두 우수한 수준의 변별정확도를 나타냈으나, 미국 규준 적용시 절단점은 더 높게 나타났다. 본 연구는 미국 규준을 사용하여 Bayley-III를 임상 현장에 적용할 때 점수 해석의 주의를 알리는 실증적인 자료로서, 한국 규준 마련시 표집 문제와 관련된 논의를 제공하였다.