• Title/Summary/Keyword: Kaplan-Meier estimation

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기관 내 삽관환자의 의도적 자가발관 위험요인 (Risk Factors for Deliberate Self-extubation)

  • 조영신;여정희
    • 대한간호학회지
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    • 제44권5호
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    • pp.573-580
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    • 2014
  • Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

배전계통 설비의 시변 고장률 추출 (Extraction of Time-varying Failure Rate for Power Distribution System Equipment)

  • 문종필;이희태;김재철;박창호
    • 대한전기학회논문지:전력기술부문A
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    • 제54권11호
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    • pp.548-556
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    • 2005
  • Reliability evaluation of power distribution system is very important to both power utilities and customers. It present the probabilistic number and duration of interruption such as failure rate, SATDI, SAIFI, and CAIDI. However, it has a fatal weakness at reliability index because of accuracy of failure rate. In this paper, the Time-varying Failure Rate(TFR) of power distribution system equipment is extracted from the recorded failure data of KEPCO(Korea Electric Power Corporation) in Korea. For TFR extraction, it is used that the fault data accumulated by KEPCO during 10 years. The TFR is approximated to bathtub curve using the exponential(random failure) and Weibull(aging failure) distribution function. In addition, Kaplan-Meier estimation is applied to TFR extraction because of incomplete failure data of KEPCO. Finally, Probability plot and regression analysis is applied. It is presented that the extracted TFR is more effective and useful than Mean Failure Rate(MfR) through the comparison between TFR and MFR

상급종합병원 입원환자의 낙상 위험요인: 생존분석으로 (Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis)

  • 조영신;이영옥;윤영순
    • 중환자간호학회지
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    • 제12권1호
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    • pp.57-70
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    • 2019
  • Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

Zinc Finger E-box binding Homeobox 1 as Prognostic Biomarker and its Correlation with Infiltrating Immune Cells and Telomerase in Lung Cancer

  • Kim, Hye-Ran;Seo, Choong-Won;Kim, Jongwan
    • 대한의생명과학회지
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    • 제28권1호
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    • pp.9-24
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    • 2022
  • The aim of this study was to identify the expression of zinc finger E-box binding homeobox 1 (ZEB1), its prognostic significance, and correlation between ZEB1 and infiltrating immune cells in lung cancer. Correlation between ZEB1 and telomerase was also analyzed in different types of cancers. RNA sequencing analysis and survival rates of patients were confirmed by Gene Expression Profiling Interactive Analysis (GEPIA). The Kaplan-Meier plotter and PrognoScan databases were used to analyze the prognostic value of ZEB1 in various cancers. The Tumor IMmune Estimation Resource (TIMER) was used to determine the correlation between ZEB1 and infiltrating immune cells. Lower ZEB1 expression was lower in lung cancer and was related to poor prognosis in lung adenocarcinoma (LUAD). ZEB1 expression exhibited a significantly positive correlation with infiltration levels of immune cells in LUAD and lung squamous cell carcinoma. Furthermore, we found that the ZEB1 expression correlated with subunits of telomerase. Our findings suggest ZEB1 as a potential biomarker to be used for prognostic significance and tumor immunology in lung cancer. The correlation between the expression of ZEB1 and telomere-related gene will help in understand the cancer-promoting mechanisms.

SAMD13 as a Novel Prognostic Biomarker and its Correlation with Infiltrating Immune Cells in Hepatocellular Carcinoma

  • Hye-Ran Kim;Choong Won Seo;Jae-Ho Lee;Sang Jun Han;Jongwan Kim
    • 대한의생명과학회지
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    • 제28권4호
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    • pp.260-275
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    • 2022
  • Sterile alpha motif (SAM) domains bind to various proteins, lipids, and RNAs. However, these domains have not yet been analyzed as prognostic biomarkers. In this study, SAM domain containing 13 (SAMD13), a member of the SAM domain, was evaluated to identify a novel prognostic biomarker in various human cancers, including hepatocellular carcinoma (HCC). Moreover, we identified a correlation between SAMD13 expression and immune cell infiltration in HCC. We performed bioinformatics analysis using online databases, such as Tumor Immune Estimation Resource, UALCAN, Kaplan-Meier plotter, LinkedOmics, and Gene Expression Profiling Interactive Analysis2. SAMD13 expression in HCC samples was significantly higher than that in normal liver tissue; additionally, SAMD13 was higher in primary tumors, various stages of cancer and grades of tumor, and status of nodal metastasis. Higher SAMD13 expression was also associated with poorer prognosis. SAMD13 expression positively correlated with CD8+ T cells, CD4+ T cells, B cells, neutrophils, macrophages, and dendritic cells. In the analysis of SAMD13 co-expression networks, positively related genes of SAMD13 were associated with a high hazard ratio in different types of cancer, including HCC. In biological function of SAMD13, SAMD13 mainly include spliceosome, ribosome biogenesis in eukaryote, ribosome, etc. These results suggest that SAMD13 may serve as a novel prognostic biomarker for HCC diagnosis and provide novel insights into tumor immunology in HCC.

임플란트 주위염의 유병률 및 위험요소분석에 관한 후향적 연구 (Prevalence and risk factors of peri-implantitis: A retrospective study)

  • 이새은;김대엽;이종빈;방은경
    • 대한치과보철학회지
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    • 제57권1호
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    • pp.8-17
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    • 2019
  • 목적: 본 연구의 목적은 최근 5년간 식립된 임플란트 증례를 대상으로 임플란트 주위염의 유병률을 조사하고, 질환 발생에 영향을 미칠 수 있는 요소들을 분석, 평가하는 것이다. 대상 및 방법: 2012년 1월 1일부터 2016년 12월 31일까지 이화여자대학교 의과대학 부속 목동병원 치과진료부 치주과에 내원한 환자 중 본원에서 임플란트를 식립하고 보철수복을 시행한 환자 422명(853개 임플란트)에 대한 의료기록과 방사선 사진을 바탕으로 임플란트 주위염의 유병률을 조사하고 임플란트 주위염에 영향을 미칠 수 있는 요소와의 연관성을 분석하였다. 각 위험요소와 임플란트 주위염의 통계적 연관성을 분석하기 위해 일반화추정방정식(generalized estimation equations, GEE)을 사용하여 각 변수들과 임플란트 주위염의 발생 사이 상관관계를 평가하였다. 또한 관찰 기간 중 임플란트 주위염의 누적 유병률은 Kaplan Meier Method를 사용하였다. 결과: 임플란트 주위염의 유병률은 환자 수준에서 7.3% (422명 중 31명), 임플란트 수준에서 5.5% (853개 중 47개)로 나타났다. 성별, 골유도재생술(guided bone regeneration, GBR)여부, 보철물 부하기간이 임플란트 주위염의 발생과 통계적 상관관계를 갖는 것으로 나타났다. 부하기간에 따른 임플란트 주위염의 누적 유병률을 분석한 결과 보철물 장착 후 19개월째 첫 임플란트 주위염이 발생하였고, 이후로 임계점(critical point) 없이 위험도는 시간에 따라 전반적으로 상승하는 양상을 보였다. 결론: 임플란트 주위염의 유병률은 환자수준에서 7.3%, 임플란트 수준에서 5.5%로 나타났으며, 남성, GBR을 시행한 경우, 보철물 부하기간이 길수록 임플란트 주위염의 발생 위험도가 증가한다.

Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience

  • Heera Yoen;Hye Eun Park;Se Hyung Kim;Jeong Hee Yoon;Bo Yun Hur;Jae Seok Bae;Jung Ho Kim;Hyeon Jeong Oh;Joon Koo Han
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1065-1076
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    • 2020
  • Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.