• Title/Summary/Keyword: Multivariate Data

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Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

  • Wittayathorn Pornsiripratharn;Suporn Treepongkaruna;Phatthawit Tangkittithaworn;Niyata Chitrapaz;Chatmanee Lertudomphonwanit;Songpon Getsuwan;Pornthep Tanpowpong;Pat Mahachoklertwattana
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.158-167
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    • 2024
  • Purpose: To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. Methods: A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected. Results: We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males. Conclusion: In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer

  • Tadayuki Takagi;Mitsuru Sugimoto;Hidemichi Imamura;Yosuke Takahata;Yuki Nakajima;Rei Suzuki;Naoki Konno;Hiroyuki Asama;Yuki Sato;Hiroki Irie;Jun Nakamura;Mika Takasumi;Minami Hashimoto;Tsunetaka Kato;Ryoichiro Kobashi;Yuko Hashimoto;Goro Shibukawa;Shigeru Marubashi;Takuto Hikichi;Hiromasa Ohira
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.107-113
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    • 2023
  • Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018-2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions: EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

The structural relationships between organizational ethical, job satisfaction and organizational citizenship behavior of private security guards (민간경비원의 조직윤리, 직무만족 및 조직시민행동의 구조적 관계)

  • Kim, Young-Hyun;Park, Kill-Jun
    • Korean Security Journal
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    • no.42
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    • pp.59-85
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    • 2015
  • The purpose of this study is to establish the structural relationship among organizational ethical climate, job satisfaction, and organizational citizenship behavior. It was intended for the private security guards who work in the security companies in Seoul and Gyeonggi from Jan. 1st, 2014 to Apr. 1st, 2014 to achieve the purpose like this. Purposive sampling was used as the sampling method according to this and sampling of 400 persons was done. However, the samples of 372 persons were finally used in the analysis through the process to check faithless answers, double answers, and abnormal data. The collected data was analyzed according to the purpose of the study by utilizing STATA 13.0 and AMOS 17.0. And for statistic techniques, frequency analysis, descriptive analysis, multivariate normality, confirmatory factor analysis(CFA), Pearson's correlation analysis, and structural equation model analysis were carried out. The conclusion gotten from this study through the data analyses according to the methods and procedure like this is as follow: First, organizational ethical climate has found to have the positive effect on job satisfaction(Non-standard $B=1.427^{***}$). That is, it can be interpreted that organizational ethical climate positively affects superiors, fellow employees, pay, current duties, and chances of promotion. Second, job satisfaction has found not to have the significant effect on organizational citizenship behavior. That is, it can be interpreted that job satisfaction does not affect altruism, conscience, and participation behavior. Third, organizational ethical climate has found to have the positive effect on organizational citizenship behavior (Non-standard $B=.361^{***}$). That is, it can be interpreted that organizational ethical climate positively affects altruism, conscience, and participation behavior. Fourth, the relationship between organizational ethical climate and organizational citizens has found that there is no any indirect effect in the bootstrapping estimation result to establish the indirect effect of job satisfaction. Fifth, the relationship between organizational ethical climate and job satisfaction has found that there are the moderating effects in the analytical result of the moderating effects of person-organization fit. That is, the effects of organizational ethical climate on job satisfaction have found that the groups with higher person-organization fit are more positive than those with lower person-organization fit. Sixth, the relationship between job satisfaction and organizational citizenship behavior has found that there are moderating effects in the analytical result of person-organization fit. That is, the effects of job satisfaction on organizational citizenship behavior have found that the groups with higher person-organization fit are more positive than those with lower person-organization fit.

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Comparison of Models for Stock Price Prediction Based on Keyword Search Volume According to the Social Acceptance of Artificial Intelligence (인공지능의 사회적 수용도에 따른 키워드 검색량 기반 주가예측모형 비교연구)

  • Cho, Yujung;Sohn, Kwonsang;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.103-128
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    • 2021
  • Recently, investors' interest and the influence of stock-related information dissemination are being considered as significant factors that explain stock returns and volume. Besides, companies that develop, distribute, or utilize innovative new technologies such as artificial intelligence have a problem that it is difficult to accurately predict a company's future stock returns and volatility due to macro-environment and market uncertainty. Market uncertainty is recognized as an obstacle to the activation and spread of artificial intelligence technology, so research is needed to mitigate this. Hence, the purpose of this study is to propose a machine learning model that predicts the volatility of a company's stock price by using the internet search volume of artificial intelligence-related technology keywords as a measure of the interest of investors. To this end, for predicting the stock market, we using the VAR(Vector Auto Regression) and deep neural network LSTM (Long Short-Term Memory). And the stock price prediction performance using keyword search volume is compared according to the technology's social acceptance stage. In addition, we also conduct the analysis of sub-technology of artificial intelligence technology to examine the change in the search volume of detailed technology keywords according to the technology acceptance stage and the effect of interest in specific technology on the stock market forecast. To this end, in this study, the words artificial intelligence, deep learning, machine learning were selected as keywords. Next, we investigated how many keywords each week appeared in online documents for five years from January 1, 2015, to December 31, 2019. The stock price and transaction volume data of KOSDAQ listed companies were also collected and used for analysis. As a result, we found that the keyword search volume for artificial intelligence technology increased as the social acceptance of artificial intelligence technology increased. In particular, starting from AlphaGo Shock, the keyword search volume for artificial intelligence itself and detailed technologies such as machine learning and deep learning appeared to increase. Also, the keyword search volume for artificial intelligence technology increases as the social acceptance stage progresses. It showed high accuracy, and it was confirmed that the acceptance stages showing the best prediction performance were different for each keyword. As a result of stock price prediction based on keyword search volume for each social acceptance stage of artificial intelligence technologies classified in this study, the awareness stage's prediction accuracy was found to be the highest. The prediction accuracy was different according to the keywords used in the stock price prediction model for each social acceptance stage. Therefore, when constructing a stock price prediction model using technology keywords, it is necessary to consider social acceptance of the technology and sub-technology classification. The results of this study provide the following implications. First, to predict the return on investment for companies based on innovative technology, it is most important to capture the recognition stage in which public interest rapidly increases in social acceptance of the technology. Second, the change in keyword search volume and the accuracy of the prediction model varies according to the social acceptance of technology should be considered in developing a Decision Support System for investment such as the big data-based Robo-advisor recently introduced by the financial sector.

Clinical Efficacy of Erdosteine in Patients with Acute or Chronic Bronchitis -A Randomized, Double Blind, Comparative Study vs. Ambroxol- (급.만성 기관지염 환자에서 엘도스$^{(R)}$(Erdosteine)의 임상효과 -염산 암브록솔과의 무작위 이중맹검 비교시험-)

  • Kim, Seok-Chan;Lee, Sang-Hoak;Song, So-Hyang;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1296-1307
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    • 1997
  • Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

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Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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A Study on the Prediction Model of Stock Price Index Trend based on GA-MSVM that Simultaneously Optimizes Feature and Instance Selection (입력변수 및 학습사례 선정을 동시에 최적화하는 GA-MSVM 기반 주가지수 추세 예측 모형에 관한 연구)

  • Lee, Jong-sik;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.23 no.4
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    • pp.147-168
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    • 2017
  • There have been many studies on accurate stock market forecasting in academia for a long time, and now there are also various forecasting models using various techniques. Recently, many attempts have been made to predict the stock index using various machine learning methods including Deep Learning. Although the fundamental analysis and the technical analysis method are used for the analysis of the traditional stock investment transaction, the technical analysis method is more useful for the application of the short-term transaction prediction or statistical and mathematical techniques. Most of the studies that have been conducted using these technical indicators have studied the model of predicting stock prices by binary classification - rising or falling - of stock market fluctuations in the future market (usually next trading day). However, it is also true that this binary classification has many unfavorable aspects in predicting trends, identifying trading signals, or signaling portfolio rebalancing. In this study, we try to predict the stock index by expanding the stock index trend (upward trend, boxed, downward trend) to the multiple classification system in the existing binary index method. In order to solve this multi-classification problem, a technique such as Multinomial Logistic Regression Analysis (MLOGIT), Multiple Discriminant Analysis (MDA) or Artificial Neural Networks (ANN) we propose an optimization model using Genetic Algorithm as a wrapper for improving the performance of this model using Multi-classification Support Vector Machines (MSVM), which has proved to be superior in prediction performance. In particular, the proposed model named GA-MSVM is designed to maximize model performance by optimizing not only the kernel function parameters of MSVM, but also the optimal selection of input variables (feature selection) as well as instance selection. In order to verify the performance of the proposed model, we applied the proposed method to the real data. The results show that the proposed method is more effective than the conventional multivariate SVM, which has been known to show the best prediction performance up to now, as well as existing artificial intelligence / data mining techniques such as MDA, MLOGIT, CBR, and it is confirmed that the prediction performance is better than this. Especially, it has been confirmed that the 'instance selection' plays a very important role in predicting the stock index trend, and it is confirmed that the improvement effect of the model is more important than other factors. To verify the usefulness of GA-MSVM, we applied it to Korea's real KOSPI200 stock index trend forecast. Our research is primarily aimed at predicting trend segments to capture signal acquisition or short-term trend transition points. The experimental data set includes technical indicators such as the price and volatility index (2004 ~ 2017) and macroeconomic data (interest rate, exchange rate, S&P 500, etc.) of KOSPI200 stock index in Korea. Using a variety of statistical methods including one-way ANOVA and stepwise MDA, 15 indicators were selected as candidate independent variables. The dependent variable, trend classification, was classified into three states: 1 (upward trend), 0 (boxed), and -1 (downward trend). 70% of the total data for each class was used for training and the remaining 30% was used for verifying. To verify the performance of the proposed model, several comparative model experiments such as MDA, MLOGIT, CBR, ANN and MSVM were conducted. MSVM has adopted the One-Against-One (OAO) approach, which is known as the most accurate approach among the various MSVM approaches. Although there are some limitations, the final experimental results demonstrate that the proposed model, GA-MSVM, performs at a significantly higher level than all comparative models.

Effect of Sample Preparations on Prediction of Chemical Composition for Corn Silage by Near Infrared Reflectance Spectroscopy (시료 전처리 방법이 근적외선분광법을 이용한 옥수수 사일리지의 화학적 조성분 평가에 미치는 영향)

  • Park Hyung-Soo;Lee Jong-Kyung;Lee Hyo-Won;Hwang Kyung-Jun;Jung Ha-Yeon;Ko Moon-Suck
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.26 no.1
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    • pp.53-62
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    • 2006
  • Near infrared reflectance spectroscopy (NIRS) has been increasingly used as a rapid, accurate method of evaluating some chemical compositions in forages. Analysis of forage quality by NIRS usually involves dry ground samples. Costs might be reduced if samples could be analyzed without drying or grinding. The objective of this study was to investigate effect of sample preparations and spectral math treatments on prediction ability of chemical composition for corn silage by NIRS. A population of 112 corn silage representing a wide range in chemical parameters were used in this investigation. Samples of com silage were scanned at 2nm intervals over the wavelength range 400-2500nm and the optical data recorded as log l/Reflectance(log l/R) and scanned in overt-dried grinding(ODG), liquid nitrogen grinding(LNG) or intact fresh(IF) condition. Samples were analysed for neutral detergent fiber(NDF), acid detergent fiber(ADF), acid detergent lignin(ADL), crude protein(CP) and crude ash content were expressed on a dry-matter(DM) basis. The spectral data were regressed against a range of chemical parameters using modified partial least squares(MPLS) multivariate analysis in conjunction with four spectral math treatments to reduce the effect of extraneous noise. The optimum calibrations were selected on the basis of minimizing the standard error of cross validation(SECV). The results of this study show that NIRS predicted the chemical parameters with very high degree of accuracy(the correlation coefficient of cross validation$(R^2cv)$ range from $0.70{\sim}0.95$) in ODG. The optimum equations were selected on the basis of minimizing the standard error of prediction(SEP). The Optimum sample preparation methods and spectral math treatment were for ADF, the ODG method using 2,10,5 math treatment(SEP = 0.99, $R^2v=0.93$), and for CP, the ODG method using 1,4,4 math treatment(SEP = 0.29. $R^2v=0.91$).

Association between the Number of Existing Permanent Teeth and Chronic Obstructive Pulmonary Disease (현존자연치아수와 만성폐쇄성폐질환과의 연관성)

  • Shin, Hye-Sun;Ahn, Yong-Soon;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.217-224
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    • 2016
  • The aim of this study was to evaluate whether the number of existing permanent teeth is associated with chronic obstructive pulmonary disease (COPD) in a representative sample of Korean adults. Data from 3,107 subjects who participated in the 2009 Korea National Health and Nutrition Examination Survey were examined. The dependent variable was COPD and the independent variable was the number of existing permanent teeth. Spirometry results were classified into three groups (normal pattern, restrictive pattern, and obstructive pattern) by trained technicians. We used dichotomized COPD variables (no vs. yes). The number of existing permanent teeth was evaluated by oral examination and divided into 3 groups (0~19, 20~27, and 28). Demographic factors (age group and sex group), socioeconomic status (education and income), health behaviors (smoking and drinking), oral health and behavior (frequency of toothbrushing; periodontitis; decayed, missing, filled, permanent teeth index; and denture status), and general health status (body mass index, diabetes mellitus, and hypertension) were included as confounders in the analysis. Bivariate analysis and multivariate logistic regression analyses including confounders were applied, and all analyses considered a complex sampling design. Stratified analysis was performed by smoking status. After controlling for various confounders, there was a significant association between the number of existing permanent teeth and COPD (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.20~3.00 for the 20~27 group; OR, 3.93; 95% CI, 1.75~8.84 for the 0~19 group). The association was more significant in current smokers (OR, 8.90; 95% CI, 2.53~31.33). Our data indicate that the number of existing permanent teeth was independently associated with COPD, especially in current smokers. Further longitudinal research is needed to determine whether oral health promotion plays a role in the improvement of lung function and prevention of COPD.

The Nature of Patient's Disagreement with Doctors among Some Rural Residents (일부 농촌주민에서 의사에 대한 환자의 의견불일치)

  • Lee, Moo-Sik;Cho, Hyong-Won;Kim, Eun-Young;Chun, Byung-Chul;Shin, Dong-Hoon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.315-329
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    • 1999
  • Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

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