• Title/Summary/Keyword: Risk-sensitive

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Clinical characteristics and risk factors for staphylococcal infections in neonatal intensive care unit (신생아 중환자실에서 포도알균 감염에 대한 임상적 고찰과 위험 요인 조사)

  • Chung, Min Kook;Choi, Jeong Ho;Chang, Jin Keun;Chung, Sung Hoon;Bae, Chong Woo;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1287-1295
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    • 2006
  • Purpose : The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society. Methods : This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures. Results : For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown. Conclusion : To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.

Cross-Sectional Relations of Arterial Stiffness and Inflammatory Markers in Korean Adults Aged 50 Years and Older (지역사회 거주 50세 이상 성인의 동맥경직도와 염증반응인자와의 관련성)

  • Ryu, So-Yeon;Shin, Min-Ho;Lee, Young-Hoon;Rhee, Jung-Ae;Choi, Jin-Su;Park, Kyeong-Soo;Nam, Hae-Sung;Jeong, Seul-Ki;Kweon, Sun-Seog
    • Journal of agricultural medicine and community health
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    • v.36 no.2
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    • pp.101-112
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    • 2011
  • Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.

Serum high sensitivity C-reactive protein levels in obese middle school boys (남자 중학생에서 비만과 high sensitiviy C-reactive protein의 관계)

  • Jeong, Jae-Ho;Lim, Jae-Woo;Cheon, Eun-Jeong;Ko, Kyong-Og;Lee, Young-Hyuk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.617-622
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    • 2006
  • Purpose : High-Sensitivity C-reactive protein(hs-CRP) has been recognized as a very useful and sensitive predictor of the future risk of myocardial infarction. But the clinical significance of hs-CRP in children remains uncertain. To confirm the existence of obesity-induced vascular inflammation and the association between metabolic syndromes and elevation of CRP in children, we investigated the relationship among CRP, obesity, blood pressure(BP), and serum lipids in schoolboys. Methods : Twenty-eight obese(BMI $29.61{\pm}3.29kg/m^2$) and 93 non-obese(BMI $18.99{\pm}2.21kg/m^2$) boys aged 14 years were examined. Serum CRP levels was measured by the high sensitive latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dL were adopted to avoid the influence of acute infection. Results : Obese children had significantly higher hs-CRP levels than their non-obese group($0.104{\pm}0.075$ vs. $0.054{\pm}0.005mg/dL$). In the obese group, BMI, systolic blood pressure, diastolic blood pressure, apolipoprotein B, atherogenic index, and triglyceride were significantly higher than in nonobese. The BMI, diastolic blood pressure, apolipoprotein E, atherognic index, and triglyceride showed positive correlation with log CRP by simple regression. Multiple regression analysis indicated that BMI and apolipoprotein E were strongly related to CRP. Conclusion : This study revealed that obese children tended to have higher levels of serum hsCRP, BP elevation and dyslipidemia than the control group and that BMI and apolipoprotein E were strongly related to CRP. These results indicate that obesity related metabolic syndrome can be developed in children.

Robo-Advisor Algorithm with Intelligent View Model (지능형 전망모형을 결합한 로보어드바이저 알고리즘)

  • Kim, Sunwoong
    • Journal of Intelligence and Information Systems
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    • v.25 no.2
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    • pp.39-55
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    • 2019
  • Recently banks and large financial institutions have introduced lots of Robo-Advisor products. Robo-Advisor is a Robot to produce the optimal asset allocation portfolio for investors by using the financial engineering algorithms without any human intervention. Since the first introduction in Wall Street in 2008, the market size has grown to 60 billion dollars and is expected to expand to 2,000 billion dollars by 2020. Since Robo-Advisor algorithms suggest asset allocation output to investors, mathematical or statistical asset allocation strategies are applied. Mean variance optimization model developed by Markowitz is the typical asset allocation model. The model is a simple but quite intuitive portfolio strategy. For example, assets are allocated in order to minimize the risk on the portfolio while maximizing the expected return on the portfolio using optimization techniques. Despite its theoretical background, both academics and practitioners find that the standard mean variance optimization portfolio is very sensitive to the expected returns calculated by past price data. Corner solutions are often found to be allocated only to a few assets. The Black-Litterman Optimization model overcomes these problems by choosing a neutral Capital Asset Pricing Model equilibrium point. Implied equilibrium returns of each asset are derived from equilibrium market portfolio through reverse optimization. The Black-Litterman model uses a Bayesian approach to combine the subjective views on the price forecast of one or more assets with implied equilibrium returns, resulting a new estimates of risk and expected returns. These new estimates can produce optimal portfolio by the well-known Markowitz mean-variance optimization algorithm. If the investor does not have any views on his asset classes, the Black-Litterman optimization model produce the same portfolio as the market portfolio. What if the subjective views are incorrect? A survey on reports of stocks performance recommended by securities analysts show very poor results. Therefore the incorrect views combined with implied equilibrium returns may produce very poor portfolio output to the Black-Litterman model users. This paper suggests an objective investor views model based on Support Vector Machines(SVM), which have showed good performance results in stock price forecasting. SVM is a discriminative classifier defined by a separating hyper plane. The linear, radial basis and polynomial kernel functions are used to learn the hyper planes. Input variables for the SVM are returns, standard deviations, Stochastics %K and price parity degree for each asset class. SVM output returns expected stock price movements and their probabilities, which are used as input variables in the intelligent views model. The stock price movements are categorized by three phases; down, neutral and up. The expected stock returns make P matrix and their probability results are used in Q matrix. Implied equilibrium returns vector is combined with the intelligent views matrix, resulting the Black-Litterman optimal portfolio. For comparisons, Markowitz mean-variance optimization model and risk parity model are used. The value weighted market portfolio and equal weighted market portfolio are used as benchmark indexes. We collect the 8 KOSPI 200 sector indexes from January 2008 to December 2018 including 132 monthly index values. Training period is from 2008 to 2015 and testing period is from 2016 to 2018. Our suggested intelligent view model combined with implied equilibrium returns produced the optimal Black-Litterman portfolio. The out of sample period portfolio showed better performance compared with the well-known Markowitz mean-variance optimization portfolio, risk parity portfolio and market portfolio. The total return from 3 year-period Black-Litterman portfolio records 6.4%, which is the highest value. The maximum draw down is -20.8%, which is also the lowest value. Sharpe Ratio shows the highest value, 0.17. It measures the return to risk ratio. Overall, our suggested view model shows the possibility of replacing subjective analysts's views with objective view model for practitioners to apply the Robo-Advisor asset allocation algorithms in the real trading fields.

The Study on the Marine Eco-toxicity and Ecological Risk of Treated Discharge Water from Ballast Water Management System Using Electrolysis (전기분해원리를 이용한 선박평형수관리장치의 배출수에 대한 해양생태독성 및 해양환경위해성에 관한 연구)

  • Shon, M.B.;Son, M.H.;Lee, J.;Son, Y.J.;Lee, G.H.;Moon, C.H.;Kim, Y.S.
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.16 no.2
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    • pp.88-101
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    • 2013
  • The International Convention for the Control and Management of Ship's Ballast Water and Sediments was adopted at 2004 and then various BWMS (ballast water management system) have been developed. In this study, WET (whole effluent toxicity) test with algae (diatom) Skeletonema costatum as primary producer, invertebrate (rotifera) Brachionus plicatilis as 1st consumer and fish (olive flounder) Paralichthys olivaceus as predator, chemical analysis and ERA (environmental risk assessment) were conducted to assess the unacceptable effect on marine ecosystem by emitting the discharge water treated with AquaStar$^{TM}$ BWMS using electrolysis as main treatment equipment for removing the marine organisms in the ship's ballast water. The most sensitive test organism on discharge water treated with AquaStar$^{TM}$ BWMS was S. costatum that gave the NOEC value of 25.00%, LOEC value of 50.00% and 72hr-$EC_{50}$ value of 69.97% from WET test result for 20 psu salinity treated discharge water. NOEC and LOEC value of B. plicatilis and P. olivaceus exposed at 20 psu salinity treated discharge water were 50.00% and 100.00%, respectively. In the chemical analysis results, total number of substances produced by AquaStar$^{TM}$ BWMS was 18 which were bromate, 7 volatile halogenated organic compounds, 7 halogenated acetic acids, 3 halogenated acetonitriles and chloropicrin. Eighteen substances did not consider as persistence and bioaccumulative chemicals. Uncertainty of toxic property of 18 substances was high. PECs of 18 substances calculated by MAMPEC model were ranged from $4.58{\times}10^{-4}$ to $4.87{\mu}g\;L^{-1}$, PNECs of them were ranged from $1.6{\times}10^{-2}$ to $3.2{\times}10^2{\mu}g\;L^{-1}$. And, the PEC/PNEC ratio of 18 substances did not exceed 1. Therefore, ERA for produced substances indicate that the discharge water treated with AquaStar$^{TM}$ BWMS does not pose unacceptable effect on marine life. And $EC_{50}$ value of S. costatum on discharge water treated by BWMS using the electrolysis had positive correlation with initial TRO concentration, concentration and kind & level of HAAs.

Global DNA Methylation Patterns and Gene Expression Associated with Obesity-Susceptibility in Offspring of Pregnant Sprague-Dawley Rats Exposed to BDE-47 and BDE-209 (임신 중 BDE-47 및 BDE-209에 노출된 어미와 새끼 Sprague-Dawley 랫드의 Global DNA 메틸화 양상과 비만 감수성과 연관된 유전자 발현)

  • Park, Byeong-Min;Yoon, Ok-Jin;Lee, Do-Hoon
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.1
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    • pp.28-39
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    • 2017
  • Persistent organic pollutants (POPs) can affect epigenetic mechanisms and obesity development. Polybrominated diphenyl ethers (PBDEs)-widely used to make flames-are one of the important POPs. Prenatal exposure to endocrine disrupting chemicals (EDCs), such as POPs, may affect global DNA methylation in long interspersed nuclear elements (LINE-1), increasing the risk of obesity later in life. Therefore, pregnant Sprague-Dawley (SD) rats were used to elucidate whether BDE-47 and BDE-209 transferred through placenta and breast milk cause epigenetic changes in LINE-1 and increase genetic susceptibility to obesity as obesogen during the developmental periods. Global DNA methylation in LINE-1 and gene expression related to obesity were measured in dams and offspring, using a methylation-sensitive high resolution melting analysis (MS-HRM) and direct bisulfite sequencing and quantitative real time polymerase chain reaction (qPCR), respectively. The results of MS-HRM showed global DNA hypomethylation patterns in LINE-1 of exposed offspring (2 of total 4) at PND 4, but bisulfite sequencing showed no difference in both the exposed and non-exposed groups. Gene expression in dams related to ${\beta}$-oxidation pathway and those related to adipokines showed different patterns between the two groups. On the contrary, gene expressions of offspring showed a similar pattern. Gene expressions related to ${\beta}$-oxidation pathway and obesity were significantly increased when compared with 'at birth', but not $PPAR-{\alpha}$. In conclusion, this study demonstrated the possibility that co-exposure to BDE-47 and BDE-209-via the placenta and breast milk-may affect epigenetic changes and modulate gene expression levels related to obesity.

Clinical Characteristics of Pneumococcal Bacteremia in Adults : The Effect of Penicillin Resistance on the Mortality of Patients with Pneumococcal Bacteremia (폐렴구균 균혈증에서 폐렴구균의 페니실린 내성 여부가 사망률에 미치는 영향)

  • HwangBo, Bin;Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, You-Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.184-194
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    • 1999
  • Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.

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Clinical Features and the Associated Factors of Staphylococcal Scalded Skin Syndrome during the Recent 10 Years (최근 10년간 포도알균 열상 피부 증후군의 발생 양상과 관련인자 분석)

  • Park, Chan Hee;Na, Se Rin;Cho, Hyung Min;Yoo, Eun Jung;Jung, Kwon;Kim, Eun Young;Kim, Yong Wook;Kim, Kyoung Sim
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.152-161
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    • 2008
  • Purpose : Staphylococcal scalded skin syndrome (4S) is uncommon, but reports of 4S are on the increase during the recent years. The purpose of this study is to determine the clinical features and associated factors of 4S during the recent 10 years. Methods : We retrospectively reviewed the medical records and microbiologic results of 63 patients (27 neonates and 36 children) from January 1998 to December 2007. Results : Since 2003, the incidence of 4S has increased. The mean age of the patients was 16.3 months and the gender ratio was 1:1. The clinical types of 4S were 38 cases of the abortive type (60%), 19 cases of the intermediate type (30%) and 6 cases of the generalized type (10%). The culture results were 36 cases of Methicillin resistant S. aureus (MRSA), 4 cases of Methicillin sensitive S. aureus and 17 cases of no growth. The patients were treated with semi-synthetic penicillin. For the 9 patients who had MRSA isolated and who didn't improve with penicillin, they were treated with vancomycin instead of penicillin. All the patients had no complications. 4S abruptly increased in 2005, and especially in neonates, due to an MRSA outbreak at a local nursery room. The associated factors of 4S in neonates were hospitalization (27 cases), including nursery infection in 2005 (18 cases) and dermatitis (1 case). There was an unknown origin for some children, and the suggested factors for their infection were community acquired infection (24 cases), atopic dermatitis (9 cases) and hospitalization (3 cases). Conclusion : 4S has recently been increasing. The major associated factors of 4S are a history of hospitalization, an outbreak in a nursery room, atopic dermatitis and community acquired infection.

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Effect of Salicylic Acid and Abscisic Acid on Drought Stress of Waxy Corn (찰옥수수 한발 스트레스에 대한 살리실산과 앱시식산의 처리 효과)

  • Seo, Youngho;Park, Kijin;Chang, Eunha;Ryu, Sihwan;Park, Jongyeol;Kim, Kyunghi
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.59 no.1
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    • pp.54-58
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    • 2014
  • Climate change may result in greater risk of yield reduction of waxy corn due to drought stress and maize is one of the sensitive crops to the soil moisture shortage. While irrigation is the most effective practice to reduce the drought damage, farmers are unable to apply water due to limited water resource and irrigating facilities. The study was conducted to investigate the application effect of salicylic acid and abscisic acid on reducing drought stress of waxy corn (Zea mays L.). Drought stress was imposed by withholding irrigation from 9 days before anthesis to 14 days after anthesis. Salicylic acid or abscisic acid was applied on tasseling date at concentration of 0.5 mM and 0.1 mM, respectively. Drought stress increased anthesis-silking interval (ASI) by 3.0~3.3 days and decreased plant height, ear length, ear diameter, number of rows in ear, and yield by 47~51 cm, 4.6~5.0 cm, 4.4~5.3 mm, 1.5~2.0, and 2.4~2.5 Mg/ha, respectively. Application of salicylic acid and abscisic acid did not significantly reduced the drought injuries of waxy corn. Pretreatment of the plant growth regulators before water deficit stress or divided application at low concentration may be required to obtain the reduction effect on drought stress of waxy corn.

Calibration Kit for 4-Port Horizontal/Vertical Probing (4-포트 수평/수직 겸용 프로브용 교정키트)

  • Kim, Taeho;Kim, Jonghyeon;Kim, Sungjun;Kim, Kwangho;Pu, Bo;Nah, Wansoo
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.25 no.5
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    • pp.559-575
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    • 2014
  • In this paper, we propose a horizontal/vertical calibration kit for calibrating a vector network analyzer(VNA) to measure the vertical connector pin. If the conventional calibration kit is used, we should change the arm for a probe or need an assistant device and it takes a long time. In addition there is a risk of precision degradation caused by the position change of the probe tip sensitive to the surroundings. We suggest a 4-port vertical calibration kit to make up for the aforementioned shortcomings. The calibration kit was manufactured for the SOLT calibration method. 'Short', 'Open', and 'Load' are available in the horizontal plane, 'Thru' is available not only in the horizontal plane on the two planes of a PCB, but in the vertical plane between the two planes according to the positions of the probes. We complemented the conventional calibration kit to make a vertical calibration kit to be used for the vertical measurement method. We compared and analysed their reflection/transfer characteristics of the SOLT calibration standards of the proposed calibration kit and conventional one, we get a ${\pm}0.1$ dB differences of transfer characteristics in the range from 300 kHz to 8.5 GHz. In order to demonstrate usefulness, and we performed a case study for horizontal and vertical cases, and compared the results of the proposed calibration kit and conventional one.