• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Journal of Biomedical Engineering Research
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• v.31 no.3
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• pp.199-209
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• 2010

The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.537-544
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• 2017

An experimental study was carried out to investigate the characteristics of the propagation distance of a flood wave considering the levee failure speed in a flat inundation area. The Ritter solution for one dimensional flow was considered to formulate the experimental results and a representative form with coefficients of k and m, which consider the three dimensional flow characteristics, was applied. The experiments showed that the propagation velocity of the wave front in the inundation area was influenced by the levee breach speed as well as the initial water level, which is a significant variable representing the flood wave behavior. In addition, coefficients k and m are not constants, but variables that vary with levee breach speed. An empirical formula was also suggested using the experimental results in the form of the relationships between k and m. In this study, a large-scale experiment for flood inundation was carried out to examine the behavior of flooding in the inundated area and the relationships between the levee breach speed and wave-front propagation velocity were suggested based on the experimental results. These research results are expected to be used as the baseline data to draw a flow inundation map, establish an emergency action plan, and verify the two-dimensional numerical model.

• The Journal of the Korea Contents Association
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• v.16 no.5
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• pp.623-637
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• 2016

This study examined the importance of social capital in facilitating older adults' learning and adaptation of information technology as well as alleviating depressive symptoms. At two senior community centers in South Korea, 144 adults aged 60 and older were recruited to participate in 12 week-long technology classes to learn computers, smart phone, and internet skills. At the baseline interviews were conducted to assess their health status, depression, and online social relationships. Online and offline social capital (bonding vs. bridging) was assessed (Williams, 2006). Four-step Hierarchical Linear Regression analysis was conducted to examine the effects of online social relationship on depression. Findings suggested that depressive symptoms were associated with being widowed, being unemployed, and perceiving poor health status. Adding social capital variables in the final step, older adults who perceived less stressors, greater level of subjective health and high online bonding capitals had less depressive symptoms. Only online social bonding was significant in alleviating depression. This final model explained 48% of the variance. Computer/Internet training for older adults need to consider the significant role bonding social capital can play. The findings of this pilot study provided a preliminary base of knowledge about acceptable community-based interventions for older adults.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1672-1683
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• 2012

The purpose of this descriptive survey was to investigate the duration of exclusive breastfeeding practice and its related factors of married immigrant Vietnamese women. And to provide baseline information necessary to develop education programs for the promotion of exclusive breastfeeding practice among them. 125 married immigrant Vietnamese women with a child between 6 months and 60 months old were conveniently recruited in two Multi-cultural Family Support Center in Chungcheong area. Data were collected through interviews using a structured questionnaire of Korean and Vietnamese versions. The data were analyzed using frequencies, t-test, ANOVA, Stepwise multiple regression with SPSS 18.0 program. The results were as follows; 1) The mean duration of exclusive breastfeeding of the subjects was 15.9 weeks. 2) As the infants grows older, the rate of formula feeding and mixed feeding were markedly increased. 3) Stepwise multiple regression analysis indicated that breastfeeding education and family type were significant determinants of the duration of exclusive breastfeeding practice. This model accounted for 30.8% of the duration of exclusive breastfeeding practice. Based on these results, we recommend to develop systematic breastfeeding education program in order to promote the duration of exclusive breastfeeding practice among married immigrant Vietnamese women.

• Fisheries and Aquatic Sciences
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• v.23 no.6
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• pp.16.1-16.10
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• 2020

This study was conducted in Lake Hayq between January and December 2018. The objectives of this study were to determine the growth, condition, sex ratio, fecundity, length at first sexual maturity (L₅₀), and spawning seasons of common carp (Cyprinus carpio). Monthly fish samples of C. carpio were collected using gillnets of stretched mesh sizes of 4, 6, 7, 8, 10, and 13 cm and beach seines of mesh size of 6 cm. Immediately after the fish were captured, total length (TL) and total weight (TW) for each individual were measured in centimeters and grams, respectively, and their relationship was determined using power function. Length at first maturity (L₅₀) was determined for both males and females using the logistic regression model. The spawning season was determined from the frequency of mature gonads and variation of gonadosomatic index (GSI) values of both males and females. Fecundity was analyzed from 67 mature female specimens. The length and weight relationship of C. carpio was TW = 0.015TL^2.93 for females and TW = 0.018TL^2.87 for males that indicate negative allometric growth in both cases. The mean Fulton condition factor (C_F) was 1.23 ± 0.013 for females and 1.21 ± 0.011 for males. The value of C_F in both cases was > 1 that shows both sexes are in good condition. Among the total 1055 C. carpio collected from Lake Hayq, 459 (43.5%) were females and 596 (56.5%) were males. The chi-square test showed that there was a significant deviation between male and female numbers from 1:1 ratio (χ²= 22, df = 11, P > 0.05) within sampling months. The length at first sexual maturity (L₅₀) for females and males were 21.5 and 17.5 cm, respectively. Males mature at smaller sizes than females. The spawning season of C. carpio was extended from February to April, and the peak spawning season for both sexes was in April. The average absolute fecundity was 28,100 ± 17,462. C. carpio is currently the commercially important fish while Nile tilapia fishery has declined in Lake Hayq. Therefore, this baseline data on growth, condition, and reproductive biology of common carp will be essential to understand the status of the population of carp and design appropriate management systems for the fish stock of Lake Hayq, Ethiopia, and adjacent countries.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.145-150
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• 2016

Background: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous $O_2$ saturation, and lactate were measured. Results: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

• Journal of Acupuncture Research
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• v.29 no.5
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• pp.1-16
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• 2012

Objectives : The purpose of this study was to examine the effects of manual acupuncture at the $LI_4$, $ST_{36}$ and $LR_3$ on Electroencephalogram(EEG) of patients with stroke. Methods : 32 channel EEG measurement was carried out in 35 Stroke patients(23 males and 12 females). EEG was measured for 21 minutes(made up of 7 sessions, 1 session means 3 minutes time interval) including 15 minutes(5 sessions) of acupuncture time. Power spectrum analysis was used as a measure of complexity. Statistical analysis was performed using Linear mixed model and DUNNETT's multiple comparison. Results : The results were as follows; 1. EEG amplitude was reduced during acupuncture except electrodes PG1 and PG2. 2. There was a notable change during 6~9 minutes after needling in ${\delta}{\cdot}{\beta}{\cdot}{\gamma}$ wave, and during 6~9 minutes after needling in ${\Theta}{\cdot}{\alpha}$ wave. Overall, during 6~9 minutes after needling. 3. TP8 is a common significant electrode among five wave forms. Conclusions : These results suggest that TP8 could be typical electrodes and change of EEG compared to baseline happens most often during 6~9 minutes after manipulated acupuncture at the $LI_4$, $ST_{36}$ and $LR_3$ of patients with stroke.

• Journal of the Korean Geographical Society
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• v.50 no.3
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• pp.277-287
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• 2015

This paper addresses limitations of land-change modeling application in the context of REDD (Reducing Emissions from Deforestation and forest Degradation). REDD is an international conservation policy that aims to protect forests via carbon credit generation and trading. In REDD, carbon credits are generated only if there is measurable quantied carbon sequestration activities that are additional to business-as-usual (BAU). A "reference level" is defined as simulated baseline carbon emissions for the future under a BAU scenario, and predictive land-change modeling plays an important role in constructing reference levels. It is tested in this research how predictive accuracies of two land-change models, namely Geographic Emission Benchmark (GEB) and GEOMOD, vary with respect to different spatial scales: Xishuangbanna prefecture and Yunnan province. The accuracies are measured by Figure of Merit. In this Chinese case study, it turns out that GEB's better performance is mainly due to quantity (e.g., how many hectares of forest will be converted to agricultural land?) rather than spatial allocation (e.g., where will the conversion happen?). As both quantity and allocation are crucial in REDD reference level setting it appears to be fundamental to systematically analyze accuracies of quantity and allocation independently in pursuit of accurate reference levels.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.143-149
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• 2004

Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.