• Title/Summary/Keyword: Risk Adjustment

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Association of Specific Immunoglobulin E to Staphylococcal Enterotoxin with Airway Hyperresponsiveness in Asthma Patients

  • Kim, Seong Han;Yang, Seo Yeon;You, Jihong;Lee, Sang Bae;You, Jin;Chang, Yoon Soo;Kim, Hyung Jung;Ahn, Chul Min;Byun, Min Kwang;Park, Hye Jung;Park, Jung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.295-301
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    • 2016
  • Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.

Smartphone-based Wavelength Control LED Lighting System according to the Sleep-Wake Cycle of Occupants (재실자의 수면-각성 주기에 따른 스마트폰 기반 파장제어 LED 조명시스템)

  • Kim, Yang-Soo;Kwon, Sook-Youn;Hwang, Jun;Lim, Jae-Hyun
    • Journal of Internet Computing and Services
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    • v.17 no.1
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    • pp.35-45
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    • 2016
  • Melatonin hormone involved in human's circadian rhythm adjustment sensitively responds to light's specific short wavelength ratio. A shift worker's circadian rhythm disturbance and sleep disorder are caused by the existing lighting conditions, whose short wavelength ratio is fixed. The life pattern of a shift worker changes irregularly because of irregular working hours and the same lighting environment; thus, his/her concentration is reduced. For such a reason, negative effects ensue to the detriment of healthy everyday life, including a high risk of accidents or having unsound sleep after leaving work. A smartphone-based wavelength control LED lighting system that targets shift workers and that can easily measure and control lighting suitable for wake-sleep cycle, according to working hours and closing hours, is proposed in this paper. First, after the light characteristics of LED lighting that changes depending on light control ratio are measured through the color sensor installed on the smartphone and the externally-linked Mini-Spectrometer, they are stored in the database. Based on the stored optical characteristics data, the measurement module and light control module are implemented. Lighting is offered using a control ratio having the maximum rate of short wavelength in consideration of the target illuminance, classified according to work type by identifying working hours as time when waking is required for shift workers. After a shift work leaves work, the amount of lighting is varied, using a control ratio having a minimum short wavelength rate so that a shift worker can enter the sleep state naturally.

A Time-Series Study of Ambient Air Pollution in Relation to Daily Mortality in Seoul, 1998∼2001 (서울시 대기오염과 일별 사망의 상관성에 관한 시계열적 연구 (1998∼2001년))

  • Cho, Yong-Sung;Lee, Jong-Tae;Kim, Yoon-Sin;Hong, Seung-Cheol;Kim, Ho;Ha, Eun-Hee;Park, Hye-Sook;Lee, Bo-Eun
    • Journal of Korean Society for Atmospheric Environment
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    • v.19 no.6
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    • pp.625-637
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    • 2003
  • This study was performed to examine the relationship between air pollution exposure and mortality in Seoul for the years of 1998∼2001. Daily counts of death were analyzed by general additive Poisson model, with adjustment for effects of seasonal trend, air temperature, humidity, and day of the week as confounders in a nonparametric approach. Daily death counts were associated with CO (current day),O$_3$ (current day), PM$_{10}$ (current day), NO$_2$ (1 day before), SO$_2$ (1 day before). Increase of 41.71 $\mu\textrm{g}$/㎥ (interquartile range) in PM$_{10}$ was associated with 1.3% (95% CI = 0.7∼1.9%) increase in the daily number of death. $O_3$ concentrations resulted in an increased risk of 1.3% for 23.86 ppb in all-aged mortality [RR = 1.013 (1.004-1.023)1. This effect was greater in children (less than 15 aged) and elderly (more than 65 aged). After ozone level exceeds 25 ppb, the dose-response relationship between mortality and ozone was almost linear. We concluded that Seoul had 1∼5% increase in mortality in association with IQR (interquartile range) in air pollutants. Daily variations in air pollution within the range currently occurring in Seoul might have an adverse effect on daily mortality. These findings also support the hypothesis that air pollution, at levels below the current ambient air quality standards of Korea, is harmful to sensitive subjects, such as children or elderly.rly.

Relationship between White Blood Cell Counts and the Metabolic Syndrome (백혈구 수와 대사증후군과의 관련성)

  • Seo, Hyun-Sook;Yun, Yong-Woon;Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.67-76
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    • 2010
  • Objectives: This study was attempted to identify the relationship between white blood cell counts and the metabolic syndrome. Methods: This study included 394 adults who visited the medical checkup center placed in Gwangju, January 1, 2008 to December 31, 2008. Index of blood test and physical checkup were performed on the study such as triglyceride, HDL-cholesterol, fasting sugar and white blood cell counts. Logistic regression analysis was used to evaluate the association between white blood cell counts, white blood cell differential count and metabolic syndrome with an adjustment age and smoking status. Results: The prevalence rate of metabolic syndrome was 25.3% among males and 13.3% among females, and was particularly high among males in their 40s. The increase in white blood cell counts lead to high prevalence of metabolic syndrome for both males and females. As white blood cell counts increased, the values of body mass index and cardiovascular risk factors were increased significantly. The odds ratio for elevated white blood cell counts increased significantly in the subjects with each components of the metabolic syndrome compared to the subjects without them. The lymphocyte counts in the white blood cell differential counts were higher in patients with metabolic syndrome than in those without. Conclusions: High level of white blood cell counts in normal range can be used as indicator in chronic inflammation. Increased white blood cell counts were significantly associated with metabolic syndrome.

Study on Pretreatment Methods for Calcium Extraction from Cuttle Bone (갑오징어갑으로부터 칼슘의 추출을 위한 전처리 방법의 검토)

  • CHO Moon-Lae;HEU Min-Soo;KIM Jin-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.5
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    • pp.483-487
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    • 2001
  • As a part of basic investigation for utilizing of cuttle bone as a calcium source, we examined on the extraction methods (calcining at $800^{\circ}C$ for 2 hrs, autoclaving at $121^{\circ}C$ for 10 hrs and ultrasonic treatments at $60^{\circ}C$ for 10 hrs) as a pretreatment methods for preparation of calcium-based powder from cuttle bone, The color of calcined calcium-based powder from cuttle bone was white, while that treated by other methods was light yellow. The calcium content in calcined calcium-based powder was $70.5\%$, and revealed high about 2 times compared to those pretreated by other methods. And, calcium solubility in calcined calcium-based powder was improved 22 times compared to raw cuttle bone powder, Among calcining, autoclaving and ultrasonic treatments as a pretreaoent methods for preparation of calcium-based powder from cuttle bone, calcining treatment was superior to other methods on the aspect of color, calcium solubility and purity of calcium-based powder, Judging from X-ray diffraction pattern of calcined calcium-based powder, most of calcium was present as a form of calcium oxide, But, pH of calcined calcium-based powder revealed strong alkali of pH 12.9. This pH value might invoke health risk in using food resource. Therefore, for utilization effectively calcined calcium-based powder from cuttle bone, it requires a suitable treatment such as adjustment of pH to neutral condition.

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Perforation Adjustment of Unit Package for 'Fuji' Apples during Short-term Cold Storage and Export Simulation ('후지' 사과의 단기 저온저장 및 모의수출 과정에서 소포장의 천공도 조절 효과)

  • Kim, Su-Jeong;Park, Youn-Moon;Yoon, Tae-Myung
    • Horticultural Science & Technology
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    • v.32 no.2
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    • pp.184-192
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    • 2014
  • Various types of unit packaging methods were applied for 'Fuji' apples during short-term cold storage and export simulation. Gas tightness of the package was controlled stepwise in the successive two-year experiments using different perforation treatments (none, punch hole, or pinhole) and sealing methods (tie v s. heat seal). Risk of tight packaging and effectiveness of macroperforation on weight loss and quality maintenance were analyzed as related to changes in gas concentration inside the packages. Immediately after harvest, each 5 apple units were packaged in $40{\mu}m$ polypropylene (PP) film bags, stored 4 weeks at $0^{\circ}C$, and then put on the shelf for one week at ambient temperature in the preliminary experiment, In the main experiment, export process was imposed after storage simulating 2 week refrigerated container shipment at $0^{\circ}C$ plus one week local marketing at ambient temperature. Non-perforated film packaging with relatively high gas tightness induced flesh browning caused by carbon dioxide accumulation regardless of the sealing methods. Among perforated film packaging, in contrast, atmospheric modification was partly established only in the pinhole treatment and flesh browning symptom was not observed in all the treatments. Even the punch hole perforated film packaging without gas tightness effectively reduced the weight loss, whereas had slight benefits for quality maintenance. Reduced perforation using pinhole treatment seemed to improve sensory texture, while effects on physicochemical quality were insignificant. Overall results suggest the need of more minute perforation treatments on the packaging film to ensure modified atmosphere effects on quality maintenance.

Association Between Transport Accident Type And Mortality In Elderly Inpatients : Using Korean National Hospital Discharge In-depth Injury Survey Dataset (퇴원손상심층조사자료를 이용한 노인 입원 환자의 운수사고 유형과 사망 사이의 연관성)

  • Ryu, Han-Jun;Kang, Sun-Hee;Boo, Yoo-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.616-624
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    • 2020
  • This study analyzed the association between the type of transport accident and the associated mortality of elderly inpatients. The findings will contribute to the development and establishment of a systematic and effective policy according to the type of transport accident to reduce the mortality of inpatients. The data on elderly inpatients with transport accidents was extracted from the 2013-2017 Korean National Hospital Discharge In-depth Survey dataset. The data was analyzed by descriptive statistics analysis, chi-square tests and multiple logistic regression analysis. After adjustment for sociodemographic, disease, injury and policy factors, the elderly inpatient deaths due to transport accidents were significantly higher for pedestrian accidents (OR: 2.522 95%, CI: 1.291-4.972), bicycle/cart accidents (OR: 2.809, 95% CI: 1.328-5.942) and motorcycle accidents (OR: 2.330, 95% CI: 1.226-4.819) rather than that for car accidents. Likewise, elderly inpatients have a higher risk of death from other types of transport accidents than those caused by car accidents. However, Korean policies related to transport accidents of elderly inpatients are concentrated on car accidents. Effective policy is needed according to the characteristics of each type of transport accident to reduce the transport accident mortality of elderly inpatients.

A meta-analysis of exposure to particulate matter and adverse birth outcomes

  • Lamichhane, Dirga Kumar;Leem, Jong-Han;Lee, Ji-Young;Kim, Hwan-Cheol
    • Environmental Analysis Health and Toxicology
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    • v.30
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    • pp.11.1-11.19
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    • 2015
  • Objectives The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. Methods We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to $2.5{\mu}m$ and $10.0{\mu}m$ in diameter, $PM_{2.5}$ and $PM_{10}$, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results In random effects meta-analyses, BW as a continuous outcome was negatively associated with $10{\mu}g/m^3$ increase in $PM_{10}$ (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947) and $PM_{2.5}$ (-22.17 g; 95% CI, -37.93 to -6.41 g; Isquared=92.3%, p<0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per $10{\mu}g/m^3$ increase in $PM_{10}$ (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p=0.977) and $PM_{2.5}$ (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p<0.001) exposure during entire pregnancy was observed. Effect size of change in BW per $10{\mu}g/m^3$ increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.

Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data (퇴원손상심층조사 자료를 이용한 의료기관 중증도 보정 사망비 비교)

  • Park, Jong-Ho;Kim, Yoo-Mi;Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1739-1750
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    • 2012
  • This study was to develop the assessment of medical service outcome using administration data through compared with hospital standardized mortality ratios(HSMR) in various hospitals. This study analyzed 63,664 cases of Hospital Discharge Injury Data of 2007 and 2008, provided by Korea Centers for Disease Control and Prevention. We used data mining technique and compared decision tree and logistic regression for developing risk-adjustment model of in-hospital mortality. Our Analysis shows that gender, length of stay, Elixhauser comorbidity index, hospitalization path, and primary diagnosis are main variables which influence mortality ratio. By comparing hospital standardized mortality ratios(HSMR) with standardized variables, we found concrete differences (55.6-201.6) of hospital standardized mortality ratios(HSMR) among hospitals. This proves that there are quality-gaps of medical service among hospitals. This study outcome should be utilized more to achieve the improvement of the quality of medical service.

Effects of the Severe Asian Dust Events on Daily Mortality during the Spring of 2002, in Seoul, Korea (2002년 봄 서울 지역에 발생한 심한 황사가 일별 사망에 미치는 영향)

  • Hwang, Seung-Sik;Kwon, Ho-Jang;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.2
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    • pp.197-202
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    • 2005
  • Objectives: During the spring of 2002, an unprecedented 2 Asian dust events were experienced in Seoul. On those days, the $PM_{10}$ was surprisingly increased, with daily $PM_{10}$ averages exceeding $600\;and\;700{\mu}g/m^3$ on March 21 and April 8, respectively. Accordingly, public concern relating to the possible adverse health effects of these dust events has increased, as the dust arrives in Korea after having flown over heavily industrialized eastern China. We investigated the effects of these Asian dust events on the mortality during the spring of 2002, in Seoul, Korea. Methods: The total number of deaths per day during the spring of 2002 in Seoul was extracted form the mortality records of the National Statistical Office. We constructed 14 Asian dust days (March 17-March 23, April 7-April 13) and 42 control days during the 56 day study period (March 3-April 27) with respect to the days of the week. The daily average numbers of deaths between the Asian dust and control days were analyzed, with adjustment for meteorological variables and pollutants. Results: The daily PM10 average during the Asian dust weeks was $295.2{\mu}g/m^3$, which was significantly higher than during the control days (p<0.001). The daily average number of deaths from all causes during the Asian dust days was 109.9; 65.6 for those aged 65 years and older, 6.7 from respiratory causes (J00-J99) and 25.6 from cardiovascular causes (I00-I99). The estimated percentage increases in the rate of deaths were 2.5% (95% CI=-5.0-10.6) from all causes; 2.2% (95% CI=-7.4-12.8) for those aged 65 years and older, and 36.5% (95% CI=0.7-85.0) from respiratory causes, but with a 6.1% (95% CI=-19.7-9.7) decrease in deaths from cardiovascular causes. Conclusion: The Asian dust events were found to be weakly associated with the risk of death from all causes. However, the association between dust events and deaths from respiratory causes was stronger. This suggests that persons with advanced respiratory diseases may be susceptible to Asian dust events.