• Korean Journal of Community Nutrition
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• v.26 no.4
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Maritime Security
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• v.2 no.1
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• pp.1-42
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• 2021

Controversy continues over the offensive nature of China's naval strategy to become a maritime power. Therefore, the purpose of this study is to identify the characteristics of China's naval strategy to become a maritime power by using the three elements of strategy and predict China's military actions in the future. For this purpose, research was conducted by considering the three elements of strategy and the distinct characteristics of naval strategy, and it was found that China's naval strategy was overall aggressive, but there was an imbalance in the pursuit of aggression between each strategic element. Offensive nature was prominent in terms of the methods, but there were limitations in the goals and means, such as the need to cooperate with neighboring countries to become a maritime power and the lack of military technology and operational continuity. The prospects for China's future military actions derived from the imbalance between these strategic elements are as follows. ① The risk of all-out military conflict with the US is low for now. ② China may use its naval power to force or cause limited military clashes against neighboring countries within the first island chain. ③ Accidental military conflicts with the US and neighboring countries may occur over naval confrontation over territorial disputes.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• The Korean Journal of Applied Statistics
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• v.34 no.3
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• pp.375-388
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• 2021

This paper aims to help prevent the spread of COVID-19 by analyzing confirmed cases of COVID-19 in Daejeon. A high volume of visitors, downtown areas, and psychological fatigue with prolonged social distancing were considered as risk factors associated with the spread of COVID-19. We considered the weekly confirmed cases in each administrative district as a response variable. Explanatory variables were the number of passengers getting off at a bus station in each administrative district and the elapsed time since the Korean government had imposed distancing in daily life. We employed a mixed-effects zero-inflated Poisson regression model because the number of cases was repeatedly measured with excess zero-count data. We conducted k-means clustering to identify three groups of administrative districts having different characteristics in terms of the number of bars, the population size, and the distance to the closest college. Considering that the number of confirmed cases might vary depending on districts' characteristics, the clustering information was incorporated as a categorical explanatory variable. We found that Covid-19 was more prevalent as population size increased and a district is downtown. As the number of passengers getting off at a downtown district increased, the confirmed cases significantly increased.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.1
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• pp.520-530
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• 2021

Objectives: This study aimed to identify the effects of music therapy on cognitive function, agitation, anxiety and depression in the elderly with dementia. Method: A comprehensive literature search was performed on PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar and PsycINFO, for the period 2010 to 2019. In the meta-analysis, the standardized mean difference (Hedges' g) and 95% confidence interval were calculated as summary measure, and the random effect model and inverse variance method were applied using the RevMan 5.4 program. A total of 13 studies were included; all were determined to be acceptable, based on the Cochrane collaboration's tool for assessing risk of bias. Results: The effect size (Hedges' g) was 0.31 (95% CI: -0.02, 0.65) for cognition and -0.03 (95% CI: -0.17, 0.11) for agitation behavior as the primary outcomes, and 0.61 (95% CI: -1.17, -0.05) for anxiety and -0.44(95% CI: -0.88, 0.00) for depression as the secondary outcomes. Subgroup analysis by type of music intervention revealed that combined music therapy has a significantly increasing beneficial effect on cognition of dementia patients (g=0.45[95% CI: 0.03, 0.87]). Conclusion: Music therapy was determined to exert beneficial effects in reducing anxiety and depression, and combined music therapy demonstrated improved cognitive functions in elderly patients with dementia.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.135-142
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• 2020

Objectives : To identify the relationship between somatization, stress, depression, anxiety, and psychological symptoms risk for nurses working in the intensive care unit. Create clinical evidence of psychosomatic medicine research and complement the meaning of somatization. Methods : Seventy of the mental health checkups conducted by the National Mental Health Center among the nurses using tools including Perceived Stress scale, Fatigue Severity Scale, Patient Health questionnaire-15, Korean Beck Depression Inventory, Korean Beck Anxiety Inventory, and Symptom Checklist-90-Revision. Results : 12.9% of the patients experienced more than moderate somatization. There was no statistical relationship between somatization and psychological stress perception, but feeling of anxiety and decreased self-confidence were related to the level of somatization. The group with severe somatization experienced more depression and anxiety. The group with high physical fatigue also had no statistical relationship with psychological stress perception, but had an effect on the feeling of tension, stress, or decreased control. Physical fatigue level was increased by experience of depression, not by anxiety. For psychological symptoms the higher the level of somatization, the higher the obsession and hostility was explored. In the linear regression model, stress, depression, and anxiety accounted for 39.3% of somatization and 16.1% of physical fatigue symptoms. Conclusions : We can estimate the decrease in stress cognitive symptoms, accompanying depression and anxiety, compulsion and hostility as characteristics of somatization. The causal relationship between somatization and psychological symptoms cannot be confirmed in this study, but the interrelationships are observed, can be referred to mediation strategies.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.1
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• pp.94-103
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• 2021

The purpose of this study was to identify the association between regular physical activity (PA) types and metabolic syndrome (MetS) in fertile women. Data were obtained from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-3, 2018). The sample consisted of 4,172 fertile women over 19 years of age. The data were analyzed using an independent t-test, χ2 test, and multiple logistic regression analysis for examining the association of regular PA and MetS. The prevalence of MetS in fertile women was 3.1% (n =128), and 1,972 fertile women (47.2%) practiced regular PA. Compared to the non-regular PA group, regular PA resulted in a significantly lower systolic blood pressure (p =.002), lower waist circumference (p <.001), lower fasting blood sugar (p =.007), and higher high-density lipoprotein cholesterol (p <.001). After controlling the confounding variables, multiple logistic regression showed that the regular PA group (odds ratio 0.59, 95% confidence interval 0.35-0.98, p =.040) and the regular muscle-strengthen PA group (odds ratio 0.34, 95% confidence interval 0.14-0.80, p =.013) were associated with a decreased risk of MetS. Therefore, regular PA, including muscle-strengthen PA should be considered to develop effective MetS intervention in fertile women.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.3
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• pp.242-251
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• 2021

This study investigates the effects of availability and accessibility on an individual's risk of developing a gambling problem. A total of 24 off-track betting facilities located in 12 districts of Seoul were examined in an effort to identify any association between their presence and citizens' gambling habits. Study participants included 1,490 online recruits residing in Seoul who participated in gambling activities in the 12 months prior to the study. To examine the differences in addiction rates and gambling frequency, a survey of demographics, gambling addictions, and gambling frequency divided the participants into two groups: those who resided in a district where off-track betting facilities were available, and those who resided elsewhere. Analysis results indicate that gambling frequency and addiction rates were significantly higher among participants residing in a district where off-track betting terminals are available. Additional analysis was performed with participants who mainly gambled on horse racing, with results similar to the previous analysis-significantly higher rates of gambling addiction and frequency were observed among participants residing in close proximity to off-track betting facilities.

• Journal of the Korean Association of Geographic Information Studies
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• v.23 no.4
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• pp.140-155
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• 2020

This study was conducted to identify the location characteristics of infected farms in the areas where livestock diseases were clustered(southern Gyeonggi-do and Chungcheong-do), analyze the probability of disease occurrence in poultry farms, find out the areas corresponding to the conditions, and use them as the basis for prevention of livestock diseases, selection of discriminatory prevention zones, and establishment of prevention strategies and as the basic data for complementary measures. The increase of one poultry farm within a radius of 3-kilometers increases the risk of HPAI infection by 10.9% compared to the previous situation. The increase of 1m in distance from major roads with two lanes or more reduces the probability of HPAI infection by 0.001% compared to the previous situation. If the distance of the poultry farm located with 15 kilometers from a major migratory bird habitat increases by 15 to 30 kilometers, the chance of infection with HPAI is reduced by 46.0%. And if the distance of the same poultry farm increase by more than 30 kilometers, the chances of HPAI infection are reduced by 88.5%. Based on the results of logistic regression, the predicted probability was generated and the actual area of the location condition with 'more than 15 poultry farms within 3km a radius of, within 1km distance from major roads, and within 30km distance from major migratory birds habitat was determined and the infection rate was measured. It is expected that the results of this study will be used as basic data for preparing the data and supplementary measures when the quarantine authorities establish discriminatory quarantine areas and prevention strategies, such as preventive measures for the target areas and farms, or control of vehicles, by identifying the areas where livestock diseases are likely to occur in the region.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.547-557
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• 2020

This study examined the level of depression according to the characteristics of school and family life of female high school students. In particular, this study attempted to identify the relationship between academic stress and the depression levels. The survey conducted a self-administered questionnaire from 438 students at D city in August, 2019. As a result, the distribution of the depression levels among the study subjects was 78.8 % for 「normal」 and 21.2 % for 「depression」, and the distribution of depression was significantly higher in groups with higher academic stress. The academic stress and depression levels showed significant positive correlations. In logistic regression analysis, the risk ratio of 「depression」was significantly higher in groups with higher academic stress than in groups with lower academic stress. According to multiple regression analysis, the factors affecting the level of depression were chosen as significant variables, such as academic achievement, relationship with school fellow, satisfaction with school life, test stress, study stress, and career stress. The above findings suggest that the level of depression in female high school students was related to academic stress and many other variables of school and family life characteristics.