• Journal of Korean Medical Science
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• 제33권48호
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• pp.311.1-311.10
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• 2018

Background: In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. Methods: We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. Results: The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ${\geq}4$ compared to those with lower parity levels. Conclusion: Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.

• 보건행정학회지
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• 제31권4호
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• pp.451-461
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• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• Nutrition Research and Practice
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• 제15권4호
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• pp.528-540
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• 2021

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1-2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008-2009) and V (2010-2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45-86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; 'Diverse', 'Western', 'Traditional', and 'Snacks and beverages'. The 'Western' pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07-2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS: The study findings suggest that the 'Western' dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

• 정보보호학회논문지
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• 제31권4호
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• pp.637-659
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• 2021

2009년 비트코인 블록체인이 처음 생성된 이후 암호화폐 사용자는 꾸준히 증가하고 있다. 하지만 이러한 사용자들의 암호화폐 지갑에 보관된 자산을 노리는 해킹 공격도 증가하고 있다. 따라서 우리는 시중에 나와 있는 암호화폐 지갑들이 안전하게 만들어졌는지를 점검하기 위해 각 지갑에 내재된 위험성을 평가한다. 우리는 위협 모델링을 통해 암호화폐 지갑에 내재된 위협을 식별하고 보안 요구사항을 도출한다. 그리고 도출된 보안 요구사항을 바탕으로 실제 지갑들의 보안성을 분석하고 공격트리와 베이즈 네트워크 등을 활용하여 각 지갑의 위험성을 정량적으로 측정한다. 위험성 평가 결과, 하드웨어 지갑보다 소프트웨어 지갑의 평균적인 위험성이 1.22배 높은 것으로 나타났다. 그리고 하드웨어 지갑 간 비교에서는 secure element를 내장한 Ledger Nano S 지갑보다 범용 MCU를 내장한 Trezor One 지갑의 위험성이 1.11배 높은 것으로 나타났다. 하지만 secure element를 사용하는 것은 암호화폐 지갑의 위험성을 낮추는 데에는 상대적으로 효과가 낮은 것으로 나타났다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.49.1-49.8
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• 2019

Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

• Korean Circulation Journal
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• 제53권11호
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• pp.758-771
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• 2023

Background and Objectives: Paroxysmal atrial fibrillation (AF) is a major potential cause of embolic stroke of undetermined source (ESUS). However, identifying AF remains challenging because it occurs sporadically. Deep learning could be used to identify hidden AF based on the sinus rhythm (SR) electrocardiogram (ECG). We combined known AF risk factors and developed a deep learning algorithm (DLA) for predicting AF to optimize diagnostic performance in ESUS patients. Methods: A DLA was developed to identify AF using SR 12-lead ECG with the database consisting of AF patients and non-AF patients. The accuracy of the DLA was validated in 221 ESUS patients who underwent insertable cardiac monitor (ICM) insertion to identify AF. Results: A total of 44,085 ECGs from 12,666 patient were used for developing the DLA. The internal validation of the DLA revealed 0.862 (95% confidence interval, 0.850-0.873) area under the curve (AUC) in the receiver operating curve analysis. In external validation data from 221 ESUS patients, the diagnostic accuracy of DLA and AUC were 0.811 and 0.827, respectively, and DLA outperformed conventional predictive models, including CHARGE-AF, C2HEST, and HATCH. The combined model, comprising atrial ectopic burden, left atrial diameter and the DLA, showed excellent performance in AF prediction with AUC of 0.906. Conclusions: The DLA accurately identified paroxysmal AF using 12-lead SR ECG in patients with ESUS and outperformed the conventional models. The DLA model along with the traditional AF risk factors could be a useful tool to identify paroxysmal AF in ESUS patients.

• 한국농공학회논문집
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• 제57권4호
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• pp.21-29
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• 2015

Safety of reclaimed wastewater irrigation needs to be evaluated to promote public health. Quantitative microbial and toxic risk assessment was conducted to identify the level of risk for farmland workers who use reclaimed wastewater and groundwater in Jeju island. Microbial risk through inhalation and ingestion exposure was below acceptable level (less than $10^{-3}$) of $7.07{\times}10^{-6}$ for reclaimed wastewater and $9.99{\times}10^{-8}$ for groundwater irrigation worker. Aggregate exposure risk of Ni, As and Cu was most contributable to overall risk in both reclaimed wastewater and groundwater irrigation plot. High cumulative exposure risk was estimated through non-dietary soil ingestion and dermal contact of soil, due to the high concentration of As, Cu and Ni in farmland soil. Overall toxic risk was $2.68{\times}10^{-4}$ for reclaimed water and $2.39{\times}10^{-4}$ for groundwater irrigation, which could not meet acceptable toxic risk level of $10^{-6}$. Further efforts, such as provide personal protective equipments or public health education, need to be implicated to reduce adverse health risk.

• 보건교육건강증진학회지
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• 제29권1호
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• pp.13-25
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• 2012

Objectives: The aim of this study was to measure secular trends in health risk behaviors among middle and high school students in Korea between 2005 and 2009 by using data from the Korea Youth Risk Behavior Web-based Survey(KYRBS). Methods: The analyses were performed using data from the 2005, 2006, 2007, 2008, and 2009 KYRBS, which included a nationally representative sample of middle and high school students. A total of 34 health behavior indices were used for the assessment of secular trends in health risk behaviors. Logistic regression models were used to identify statistically significant secular trends in health risk behaviors, after adjusting for gender and grade. Linear and higher-order time variables were simultaneously entered into the statistical models. Results: There was evidence of small, but statistically significant increasing or decreasing trends in certain health risk behaviors. Secular trends in health risk behaviors varied by gender. Conclusions: This study indicates that between 2005 and 2009, changes in health risk behaviors among Korean adolescents were generally small, but represented statistically significant increases or decreases. Further research should explore why certain health risk behaviors are increasing or decreasing and what types of interventions are most effective.

• 성인간호학회지
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• 제23권4호
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• pp.321-331
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• 2011

Purpose: This study was designed to identify the incidence risk of cardicerebrovascular disease (CVD) among male bus drivers, and to examine and compare the predictors of their health behavior according to the level of CVD incidence risk. Methods: The convenience sample of 222 male bus drivers were recruited from a bus company located in Jeonnam province. Data were collected from self-reported questionnaires and annual medical examination records from 2010. The CVD incidence risk was calculated based on the risk criteria for industrial workers. Results: The 26.6% and 26.1% of the participants were in the moderate and high risk group, respectively. The 72% of the participants were in the precontemplation stage and reported no intention to change their unhealthy lifestyles. Stepwise multiple regression analyses showed that current smoking, excessive alcohol drinking, physical inactivity and lack of knowledge were negative predictors of good health behavior in the normal/low risk group (Adj $R^2$=.443). Heavy alcohol drinking, current smoking, physical inactivity and dyslipidemia were reported by the moderate/high risk group (Adj $R^2$=.427). Conclusion: This study suggested that targeted education and counseling are needed to modify unhealthy lifestyles such as alcohol consumption, smoking and exercise among middle aged male drivers. Especially, dyslipidemia should be managed among those who are at risk for CVD.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.567-574
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• 2018

위험 관리는 1) 체계개발 프로젝트의 비용, 일정 및 목표 성능 달성에 부정적인 영향을 줄 수 있는 위험 요소를 식별하고, 2) 식별된 각 위험 요소에 영향도와 발생 가능성을 부여하고 이를 바탕으로 식별 위험 요소를 관리하는 방법을 의미한다. 위험 요소를 사전에 식별하고 이에 대처함으로써 프로젝트의 비용 및 일정 관리와 목표 성능을 효과적으로 수행하고 달성할 수 있기 때문에 다양한 분야에서 위험 관리를 적용하고 있으며 이에 대한 많은 연구가 현재 진행되고 있다. 본 논문에서는 칼만 필터를 이용한 위험 요소 영향도 추정 방안을 제시한다. 위험 요소 영향도는 위험 발생 시의 손실 비용 및 일정을 변수로 갖는 식으로 표현된다고 가정하였다. 위험 요소 영향도의 참 값과 추정 값 사이의 오차를 줄이기 위한 방안으로서 선형 칼만 필터가 사용되었으며, 결과적으로 이를 통해 위험 관리 절차에 투입되는 자원을 절약할 수 있다. 제시된 위험 요소 영향도 추정 프로세스 검증은 시뮬레이션을 통해 수행되었다.