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Quality of Life among Breast Cancer Patients In Malaysia

  • Ganesh, Sri;Lye, Munn-Sann;Lau, Fen Nee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1677-1684
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    • 2016
  • Background: Among the factors reported to determine the quality of life of breast cancer patients are socio-demographic background, clinical stage, type of treatment received, and the duration since diagnosis. Objective: The objective of this study was to determine the quality of life (QOL) scores among breast cancer patients at a Malaysian public hospital. Materials and Methods: This cross-sectional study of breast cancer patients was conducted between March to June 2013. QOL scores were determined using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23). Both the QLQ-C30 and QLQ-BR23 assess items from functional and symptom scales. The QLQ-C30 in addition also measures the Global Health Status (GHS). Systematic random sampling was used to recruit patients. Results: 223 breast cancer patients were recruited with a response rate of 92.1%. The mean age of the patients was 52.4 years (95% CI = 51.0, 53.7, SD=10.3). Majority of respondents are Malays (60.5%), followed by Chinese (19.3%), Indians (18.4%), and others (1.8%). More than 50% of respondents are at stage III and stage IV of malignancy. The mean Global Health Status was 65.7 (SD = 21.4). From the QLQ-C30, the mean score in the functioning scale was highest for 'cognitive functioning' (84.1, SD=18.0), while the mean score in the symptom scale was highest for 'financial difficulties' (40.1, SD=31.6). From the QLQ-BR23, the mean score for functioning scale was highest for 'body image' (80.0, SD=24.6) while the mean score in the symptom scale was highest for 'upset by hair loss' (36.2, SD=29.4). Two significant predictors for Global Health Status were age and employment. The predictors explained 10.6% of the variation of global health status ($R^2=0.106$). Conclusions: Age and employment were found to be significant predictors for Global Health Status (GHS). The Quality of Life among breast cancer patients reflected by the GHS improves as age and employment increases.

Depression and the Risk of Breast Cancer: A Meta-Analysis of Cohort Studies

  • Sun, Hui-Lian;Dong, Xiao-Xin;Cong, Ying-Jie;Gan, Yong;Deng, Jian;Cao, Shi-Yi;Lu, Zu-Xun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3233-3239
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    • 2015
  • Background: Whether depression causes increased risk of the development of breast cancer has long been debated. We conducted an updated meta-analysis of cohort studies to assess the association between depression and risk of breast cancer. Materials and Methods: Relevant literature was searched from Medline, Embase, Web of Science (up to April 2014) as well as manual searches of reference lists of selected publications. Cohort studies on the association between depression and breast cancer were included. Data abstraction and quality assessment were conducted independently by two authors. Random-effect model was used to compute the pooled risk estimate. Visual inspection of a funnel plot, Begg rank correlation test and Egger linear regression test were used to evaluate the publication bias. Results: We identified eleven cohort studies (182,241 participants, 2,353 cases) with a follow-up duration ranging from 5 to 38 years. The pooled adjusted RR was 1.13(95% CI: 0.94 to 1.36; $I^2=67.2%$, p=0.001). The association between the risk of breast cancer and depression was consistent across subgroups. Visual inspection of funnel plot and Begg's and Egger's tests indicated no evidence of publication bias. Regarding limitations, a one-time assessment of depression with no measure of duration weakens the test of hypothesis. In addition, 8 different scales were used for the measurement of depression, potentially adding to the multiple conceptual problems concerned with the definition of depression. Conclusions: Available epidemiological evidence is insufficient to support a positive association between depression and breast cancer.

Bayesian Method for Modeling Male Breast Cancer Survival Data

  • Khan, Hafiz Mohammad Rafiqullah;Saxena, Anshul;Rana, Sagar;Ahmed, Nasar Uddin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.663-669
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    • 2014
  • Background: With recent progress in health science administration, a huge amount of data has been collected from thousands of subjects. Statistical and computational techniques are very necessary to understand such data and to make valid scientific conclusions. The purpose of this paper was to develop a statistical probability model and to predict future survival times for male breast cancer patients who were diagnosed in the USA during 1973-2009. Materials and Methods: A random sample of 500 male patients was selected from the Surveillance Epidemiology and End Results (SEER) database. The survival times for the male patients were used to derive the statistical probability model. To measure the goodness of fit tests, the model building criterions: Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC) were employed. A novel Bayesian method was used to derive the posterior density function for the parameters and the predictive inference for future survival times from the exponentiated Weibull model, assuming that the observed breast cancer survival data follow such type of model. The Markov chain Monte Carlo method was used to determine the inference for the parameters. Results: The summary results of certain demographic and socio-economic variables are reported. It was found that the exponentiated Weibull model fits the male survival data. Statistical inferences of the posterior parameters are presented. Mean predictive survival times, 95% predictive intervals, predictive skewness and kurtosis were obtained. Conclusions: The findings will hopefully be useful in treatment planning, healthcare resource allocation, and may motivate future research on breast cancer related survival issues.

Statistical Applications for the Prediction of White Hispanic Breast Cancer Survival

  • Khan, Hafiz Mohammad Rafiqullah;Saxena, Anshul;Gabbidon, Kemesha;Ross, Elizabeth;Shrestha, Alice
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5571-5575
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    • 2014
  • Background: The ability to predict the survival time of breast cancer patients is important because of the potential high morbidity and mortality associated with the disease. To develop a predictive inference for determining the survival of breast cancer patients, we applied a novel Bayesian method. In this paper, we propose the development of a databased statistical probability model and application of the Bayesian method to predict future survival times for White Hispanic female breast cancer patients, diagnosed in the US during 1973-2009. Materials and Methods: A stratified random sample of White Hispanic female patient survival data was selected from the Surveillance Epidemiology and End Results (SEER) database to derive statistical probability models. Four were considered to identify the best-fit model. We used three standard model-building criteria, which included Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC) to measure the goodness of fit. Furthermore, the Bayesian method was used to derive future survival inferences for survival times. Results: The highest number of White Hispanic female breast cancer patients in this sample was from New Mexico and the lowest from Hawaii. The mean (SD) age at diagnosis (years) was 58.2 (14.2). The mean (SD) of survival time (months) for White Hispanic females was 72.7 (32.2). We found that the exponentiated Weibull model best fit the survival times compared to other widely known statistical probability models. The predictive inference for future survival times is presented using the Bayesian method. Conclusions: The findings are significant for treatment planning and health-care cost allocation. They should also contribute to further research on breast cancer survival issues.

Identification of dietary patterns in urban population of Argentina: study on diet-obesity relation in population-based prevalence study

  • Pou, Sonia Alejandra;del Pilar Diaz, Maria;De La Quintana, Ana Gabriela;Forte, Carla Antonella;Aballay, Laura Rosana
    • Nutrition Research and Practice
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    • v.10 no.6
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    • pp.616-622
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    • 2016
  • BACKGROUND/OBJECTIVES: In Argentina, obesity prevalence rose from 14.6% in 2005 to 20.8% in 2013. Although the number of studies on noncommunicable diseases and dietary patterns as a unique dietary exposure measure has increased, information on this topic remains scarce in developing countries. This is the first population-based study investigating the association between diet and obesity using a dietary pattern approach in Argentina. We aimed (a) to identify current dietary patterns of the population of $C{\acute{o}}rdoba$ city, (b) to investigate its association with obesity prevalence, and (c) to identify and describe dietary patterns from the subgroup of people with obesity. SUBJECTS/METHODS: The $C{\acute{o}}rdoba$ Obesity and Diet Study (CODIES) was conducted in $C{\acute{o}}rdoba$ city by using a random sample of n = 4,327 subjects between 2005 and 2012. Empirically derived dietary patterns were identified through principal component factor analysis. A multiple logistic regression analysis was used to investigate the association of dietary patterns with obesity. RESULTS: Four dietary patterns were identified, called "Starchy-Sugar", "Prudent", "Western", and "Sugary drinks". High scores for the "Western" pattern (with strongest factor loading on meats/eggs, processed meats, and alcohol) showed a positive association with obesity (OR: 1.33, 95% CI: 1.06-1.67, for third versus first tertile of factor score). "Meats/Cheeses" and "Snacks/Alcohol" patterns emerged in people with obesity. CONCLUSIONS: The findings suggest that high adherence to the "Western" pattern promoted obesity in this urban population. In addition, people with obesity showed characteristic dietary patterns that differ from those identified in the overall population.

Development of The Irregular Radial Pulse Detection Algorithm Based on Statistical Learning Model (통계적 학습 모형에 기반한 불규칙 맥파 검출 알고리즘 개발)

  • Bae, Jang-Han;Jang, Jun-Su;Ku, Boncho
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.185-194
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    • 2020
  • Arrhythmia is basically diagnosed with the electrocardiogram (ECG) signal, however, ECG is difficult to measure and it requires expert help in analyzing the signal. On the other hand, the radial pulse can be measured with easy and uncomplicated way in daily life, and could be suitable bio-signal for the recent untact paradigm and extensible signal for diagnosis of Korean medicine based on pulse pattern. In this study, we developed an irregular radial pulse detection algorithm based on a learning model and considered its applicability as arrhythmia screening. A total of 1432 pulse waves including irregular pulse data were used in the experiment. Three data sets were prepared with minimal preprocessing to avoid the heuristic feature extraction. As classification algorithms, elastic net logistic regression, random forest, and extreme gradient boosting were applied to each data set and the irregular pulse detection performances were estimated using area under the receiver operating characteristic curve based on a 10-fold cross-validation. The extreme gradient boosting method showed the superior performance than others and found that the classification accuracy reached 99.7%. The results confirmed that the proposed algorithm could be used for arrhythmia screening. To make a fusion technology integrating western and Korean medicine, arrhythmia subtype classification from the perspective of Korean medicine will be needed for future research.

Effect of Shoulder External Rotation on EMG Activity of the Scapular Upward Rotators during Arm Elevation (어깨관절 가쪽돌림이 팔을 올리는 동안 어깨뼈 위쪽돌림근의 근활성도에 미치는 영향)

  • Jung, Do-Young;Weon, Jong-Hyuck
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.4
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    • pp.113-121
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    • 2015
  • PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.

The Study on the Urinary Iodine Excretion of Koreans Living in Rural Areas

  • Lee, Jun-Ho;Min, Byung-Woon
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.3
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    • pp.105-112
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    • 2011
  • More accurate evaluation of iodine consumption of Koreans can be made by measuring the urinary iodine excretion of people living in representative areas. The data about average iodine excretions by region, sex and age were gathered in order to suggest as a factor the criteria on the progress or prognosis of thyroid disease patients. This study was conducted on 3,000 subjects (2,000 Younggwang-gun residents and 1,000 Muan-gun residents) between July 2004 and August 2005. The data sampling was done based on stratified random sampling and the data were analyzed according to age (the subjects were divided into age groups, five years each) and sex of the subjects. Of the 3,000 subjects, a total of 1,592 people (1,174 in Younggwang-gun and 418 in Muan-gun) participated in this study, which used ISE (iodine ion selective electrode) to measure the concentration of iodine in urine. The 1,592 subjects are composed of 732 males and 860 females. The average urinary iodine excretion was $3.10{\pm}1.75mg/L$ (0.31~15.2 mg/L). The average iodine excretion of males was $3.09{\pm}1.61mg/L$ (0.42~15.2 mg/L) while it was $3.11{\pm}1.86mg/L$ (0.31~12.5 mg/L) among females, which represents no significant difference between males and females. However, the values were significantly higher than those of Europeans and Americans. There were statistically significant differences among the regions. When the data were analyzed according to age, females in their 40s were found to have a little less urinary iodine excretion and males had less and less iodine excretion as they get older. These results are deemed to have a statistically significant difference. This study was conducted on a large number of people (N=1,592) for the first time in Korea. If the data collected through this study can be regarded as the average urinary iodine excretion of Koreans, it is possible to conclude that the average iodine consumptions of Koreans are a lot more than Europeans and Americans. Thus, the effect of much iodine consumption should be studied further.

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Functional Neuroimaging of General Fluid Intelligencein Prodigies

  • Lee, Kun-Ho
    • Proceedings of the Korean Society for the Gifted Conference
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    • 2003.05a
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    • pp.137-138
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    • 2003
  • Understanding how and why people differ is a fundamental, if distant, goal of research efforts to bridge psychological and biological levels of analysis. General fluid intelligence (gF) is a major dimension of individual differences and refers to reasoning and novel problemsolving ability. A conceptual integration of evidence from cognitive (behavioral) and anatomical studies suggeststhat gF should covary with both task performance and neural activity in specific brain systems when specific cognitive demands are present, with the neural activity mediating the relation between gF and performance. Direct investigation of this possibility will be a critical step toward a mechanistic model of human intelligence. In turn, a mechanistic model might suggest ways to enhance gF through targeted behavioral or neurobiological intervent ions, We formed two different groups as subjects based on their scholarly attainments. Each group consists of 20 volunteers(aged 16-17 years, right-handed males) from the National Gifted School and a local high school respectively. To test whether individual differences in general intelligence are mediated at a neural level, we first assessed intellectual characteristics in 40 subjects using standard intelligence tests (Raven's Advanced Progressive Matrices, Wechsler Adult Intelligence Scale, Torrance Tests of Creative Thinking) administered outside of the MR scanner. We then used functional magnetic resonance imaging (fMRl) to measure task-related brain activity as participants performed three different kinds of computerized reasoning tasks that were intended to activate the relevant neural systems. To examine the difference of neural activity according to discrepancy in general intelligence, we compared the brain activity of both extreme groups (each, n=10) of the participants based on the standard intelligence test scores. In contrast to the common expectation, there was no significant difference of brain region involved in high-g tasks between both groups. Random effect analysis exhibited that lateral prefrontal, anterior cingulate and parietal cortex are associated with gF. Despite very different task contents in the three high-g-low-g contrasts, recruitment of multiple regions is markedly similar in each case, However, on the task with high 9F correlations, the Prodigy group, (intelligence rank: >99%) showed higher task-related neural activity in several brain regions. These results suggest that the relationship between gF and brain activity should be stronger under high-g conditions than low-g conditions.

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Three-dimensional Analysis of the Spine using Formetric 4D according to Upper Limb Movement and Resistance Application (상지의 움직임과 저항 적용에 따른 Formetric 4D를 이용한 척추의 3차원적 분석)

  • Kim, Hyun-Jin;Shin, Won-Seob
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.3
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    • pp.69-77
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    • 2020
  • PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.