• Title/Summary/Keyword: health-risk

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Effects of Patient Safety Motivation and Degree of Patient Safety on Patient Safety Management Activities of Geriatric Hospitals Nurses (노인 요양병원 간호사의 환자 안전동기와 환자안전도가 환자안전관리 활동에 미치는 영향)

  • Ju-Yul Lee;Soon-Ok Kim
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.4
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    • pp.773-785
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    • 2023
  • This study is a descriptive research conducted to identify the factors influencing patient safety management activities of geriatric hospitals nurses and use basic data to prevent patient safety accidents. Subjects were 220 nurses and data were collected by questionnaires from february 1 to 28, 2023. Data were analyzed using t-test, ANOVA, Scheffe's test, Pearson correlation coefficients and Multiple regression analysis using the SPSS 29.0 program. Patient safety motivation was positive correlated with degree of patient safety(r=.41, p<.001), and degree of patient safety was positive correlated with patient safety nursing activity(r=.18, p<.01). Degree of patient safety(𝛽=.21, p<.001) and patient safety guidelines(𝛽=.16, p<.001) were main factors that affect patient safety nursing activity, and its explanatory power was 7.5%(Adj R2=.075, p<.001). For patient safety nursing activity, it is proposed to develop and apply a education program that strengthens practical training for effective coping after safety accidents along with risk prediction training to prevent before safety accidents.

Effect of Stent Placement on Survival in Patients with Malignant Portal Vein Stenosis: A Propensity Score-Matched Study

  • Dong Jae Shim;Jong Woo Kim;Doyoung Kim;Gi-Young Ko;Dong Il Gwon;Ji Hoon Shin;Yun-Jung Yang
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.68-76
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    • 2022
  • Objective: Percutaneous portal vein (PV) stent placement can be an effective treatment for symptoms associated with portal hypertension. This study aimed to evaluate the effect of PV stenting on the overall survival (OS) in patients with malignant PV stenosis. Materials and Methods: Two groups of patients with malignant PV stenosis were compared in this retrospective study involving two institutions. A total of 197 patients who underwent PV stenting between November 2016 and August 2019 were established as the stent group, whereas 29 patients with PV stenosis who were treated conservatively between July 2013 and October 2016 constituted the no-stent group. OS was compared between the two groups before and after propensity score matching (PSM). Risk factors associated with OS were evaluated using the Cox proportional hazards model. Procedure-associated adverse events were also evaluated. Results: The stent group finally included 100 patients (median age, 65 [interquartile range, 58-71] years; 64 male). The no-stent group included 22 patients (69 [61-75] years, 13 male). Stent placement was successful in 95% of attempted cases, and the 1- and 2-year stent occlusion-free survival rate was 56% (95% confidence interval, 45%-69%) and 44% (32%-60%), respectively. The median stent occlusion-free survival time was 176 (interquartile range, 70-440) days. OS was significantly longer in the stent group than in the no-stent group (median 294 vs. 87 days, p < 0.001 before PSM, p = 0.011 after PSM). The 1- and 3-year OS rates before PSM were 40% and 11%, respectively, in the stent group. The 1-year OS rate after PSM was 32% and 5% in the stent and no-stent groups, respectively. Anemia requiring transfusion (n = 2) and acute thrombosis necessitating re-stenting (n = 1) occurred in three patients in the stent group within 1 week. Conclusion: Percutaneous placement of a PV stent may be effective in improving OS in patients with malignant PV stenosis.

Correct Closure of the Left Atrial Appendage Reduces Stagnant Blood Flow and the Risk of Thrombus Formation: A Proof-of-Concept Experimental Study Using 4D Flow Magnetic Resonance Imaging

  • Min Jae Cha;Don-Gwan An;Minsoo Kang;Hyue Mee Kim;Sang-Wook Kim;Iksung Cho;Joonhwa Hong;Hyewon Choi;Jee-Hyun Cho;Seung Yong Shin;Simon Song
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.647-659
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    • 2023
  • Objective: The study was conducted to investigate the effect of correct occlusion of the left atrial appendage (LAA) on intracardiac blood flow and thrombus formation in patients with atrial fibrillation (AF) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D)-printed phantoms. Materials and Methods: Three life-sized 3D-printed left atrium (LA) phantoms, including a pre-occlusion (i.e., before the occlusion procedure) model and correctly and incorrectly occluded post-procedural models, were constructed based on cardiac computed tomography images from an 86-year-old male with long-standing persistent AF. A custom-made closed-loop flow circuit was set up, and pulsatile simulated pulmonary venous flow was delivered by a pump. 4D flow MRI was performed using a 3T scanner, and the images were analyzed using MATLAB-based software (R2020b; Mathworks). Flow metrics associated with blood stasis and thrombogenicity, such as the volume of stasis defined by the velocity threshold ($\left|\vec{V}\right|$ < 3 cm/s), surface-and-time-averaged wall shear stress (WSS), and endothelial cell activation potential (ECAP), were analyzed and compared among the three LA phantom models. Results: Different spatial distributions, orientations, and magnitudes of LA flow were directly visualized within the three LA phantoms using 4D flow MRI. The time-averaged volume and its ratio to the corresponding entire volume of LA flow stasis were consistently reduced in the correctly occluded model (70.82 mL and 39.0%, respectively), followed by the incorrectly occluded (73.17 mL and 39.0%, respectively) and pre-occlusion (79.11 mL and 39.7%, respectively) models. The surfaceand-time-averaged WSS and ECAP were also lowest in the correctly occluded model (0.048 Pa and 4.004 Pa-1, respectively), followed by the incorrectly occluded (0.059 Pa and 4.792 Pa-1, respectively) and pre-occlusion (0.072 Pa and 5.861 Pa-1, respectively) models. Conclusion: These findings suggest that a correctly occluded LAA leads to the greatest reduction in LA flow stasis and thrombogenicity, presenting a tentative procedural goal to maximize clinical benefits in patients with AF.

Prediction of Decompensation and Death in Advanced Chronic Liver Disease Using Deep Learning Analysis of Gadoxetic Acid-Enhanced MRI

  • Subin Heo;Seung Soo Lee;So Yeon Kim;Young-Suk Lim;Hyo Jung Park;Jee Seok Yoon;Heung-Il Suk;Yu Sub Sung;Bumwoo Park;Ji Sung Lee
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1269-1280
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    • 2022
  • Objective: This study aimed to evaluate the usefulness of quantitative indices obtained from deep learning analysis of gadoxetic acid-enhanced hepatobiliary phase (HBP) MRI and their longitudinal changes in predicting decompensation and death in patients with advanced chronic liver disease (ACLD). Materials and Methods: We included patients who underwent baseline and 1-year follow-up MRI from a prospective cohort that underwent gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance between November 2011 and August 2012 at a tertiary medical center. Baseline liver condition was categorized as non-ACLD, compensated ACLD, and decompensated ACLD. The liver-to-spleen signal intensity ratio (LS-SIR) and liver-to-spleen volume ratio (LS-VR) were automatically measured on the HBP images using a deep learning algorithm, and their percentage changes at the 1-year follow-up (ΔLS-SIR and ΔLS-VR) were calculated. The associations of the MRI indices with hepatic decompensation and a composite endpoint of liver-related death or transplantation were evaluated using a competing risk analysis with multivariable Fine and Gray regression models, including baseline parameters alone and both baseline and follow-up parameters. Results: Our study included 280 patients (153 male; mean age ± standard deviation, 57 ± 7.95 years) with non-ACLD, compensated ACLD, and decompensated ACLD in 32, 186, and 62 patients, respectively. Patients were followed for 11-117 months (median, 104 months). In patients with compensated ACLD, baseline LS-SIR (sub-distribution hazard ratio [sHR], 0.81; p = 0.034) and LS-VR (sHR, 0.71; p = 0.01) were independently associated with hepatic decompensation. The ΔLS-VR (sHR, 0.54; p = 0.002) was predictive of hepatic decompensation after adjusting for baseline variables. ΔLS-VR was an independent predictor of liver-related death or transplantation in patients with compensated ACLD (sHR, 0.46; p = 0.026) and decompensated ACLD (sHR, 0.61; p = 0.023). Conclusion: MRI indices automatically derived from the deep learning analysis of gadoxetic acid-enhanced HBP MRI can be used as prognostic markers in patients with ACLD.

A Clinical Study on the Relationship between Dental Implant and Systemic Disease (치과 임플란트와 전신질환과의 연관성에 관한 임상적 고찰)

  • Yang-Keum Han;Mi-Sook Yoon;Han-Hong Kim
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.25-35
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    • 2023
  • Background: In order to emphasize the importance of clinical dental hygienists-led dental hygiene management processes for those with systemic diseases, we tried to identify systemic diseases affecting dental implants based on clinical data. Methods: In order to identify systemic diseases affecting dental implants, literature review was conducted from March 1 to May 31, 2023, and the search period was for research papers published in domestic and foreign academic journals from January 2000 to December 2020. Domestic databases used for search use RISS, Nuri Media(DBpia), and Korea Academic Information (http://www.papersearch.net ; KISS), while overseas databases searched Pubmed for dental implant failures, implants, systemic diseases, and Dental implant and system disease. Results: The cumulative survival rate of implants averaged 94.3 percent and the failure rate was 5.7 percent. Clinical analysis of systemic diseases related to implants accounted for the highest frequency with 13 (100.0%), followed by 8 (61.5%) studies on high blood pressure and smoking, 7 (53.8%) cardiovascular diseases, and 5 (38.5%). In addition, liver disease, thyroid abnormalities, blood abnormalities, organ transplants and infectious diseases were confirmed. Conclusion: Since unregulated systemic diseases are a risk factor for implant failure, clinical dental hygienists should continue to maintain healthy oral conditions by sharing information with patients during periodic preventive dental hygiene management processes such as dental hygiene assessment.

High-fat diet alters the thermogenic gene expression to β-agonists or 18-carbon fatty acids in adipocytes derived from the white and brown adipose tissue of mice

  • Seonjeong Park;Seung A Ock;Yun Jeong Park;Yoo-Hyun Lee;Chan Yoon Park;Sunhye Shin
    • Journal of Nutrition and Health
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    • v.57 no.2
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    • pp.171-184
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    • 2024
  • Purpose: Although activating thermogenic adipocytes is a promising strategy to reduce the risk of obesity and related metabolic disorders, emerging evidence suggests that it is difficult to induce adipocyte thermogenesis in obesity. Therefore, this study aimed to investigate the regulation of adipocyte thermogenesis in diet-induced obesity. Methods: Adipose progenitor cells were isolated from the white and brown adipose tissues of control diet (CD) or high-fat diet (HFD) fed mice, and fully differentiated white and brown adipocytes were treated with β-agonists or 18-carbon fatty acids for β-adrenergic activation or peroxisome proliferator-activated receptor (PPAR) activation. Results: Compared to the CD-fed mice, the expression of uncoupling protein 1 (Ucp1) was lower in the white adipose tissue of the HFD-fed mice; however, this was not observed in the brown adipose tissue. The expression of peroxisome proliferator-activated receptor gamma (Pparg) was lower in the brown adipose progenitor cells isolated from HFD-fed mice than in those isolated from the CD-fed mice. Norepinephrine (NE) treatment exerted lesser effect on peroxisome proliferator-activated receptor-γ coactivator (Pgc1a) upregulation in white adipocytes derived from HFD-fed mice than those derived from CD-fed mice. Regardless which 18-carbon fatty acids were treated, the expression levels of thermogenic genes including Ucp1, Pgc1a, and positive regulatory domain zinc finger region protein 16 (Prdm16) were higher in the white adipocytes derived from HFD-fed mice. Oleic acid (OLA) and γ-linolenic acid (GLA) upregulated Pgc1a expression in white adipocytes derived from HFD-fed mice. Brown adipocytes derived from HFD-fed mice had higher expression levels of Pgc1a and Prdm16 compared to their counterparts. Conclusion: These results indicate that diet-induced obesity may downregulate brown adipogenesis and NE-induced thermogenesis in white adipocytes. Also, HFD feeding may induce thermogenic gene expression in white and brown primary adipocytes, and OLA and GLA could augment the expression levels.

A Study on the Development of integrated Process Safety Management System based on Artificial Intelligence (AI) (인공지능(AI) 기반 통합 공정안전관리 시스템 개발에 관한 연구)

  • KyungHyun Lee;RackJune Baek;WooSu Kim;HeeJeong Choi
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.1
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    • pp.403-409
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    • 2024
  • In this paper, the guidelines for the design of an Artificial Intelligence(AI) based Integrated Process Safety Management(PSM) system to enhance workplace safety using data from process safety reports submitted by hazardous and risky facility operators in accordance with the Occupational Safety and Health Act is proposed. The system composed of the proposed guidelines is to be implemented separately by individual facility operators and specialized process safety management agencies for single or multiple workplaces. It is structured with key components and stages, including data collection and preprocessing, expansion and segmentation, labeling, and the construction of training datasets. It enables the collection of process operation data and change approval data from various processes, allowing potential fault prediction and maintenance planning through the analysis of all data generated in workplace operations, thereby supporting decision-making during process operation. Moreover, it offers utility and effectiveness in time and cost savings, detection and prediction of various risk factors, including human errors, and continuous model improvement through the use of accurate and reliable training data and specialized datasets. Through this approach, it becomes possible to enhance workplace safety and prevent accidents.

Pharmacoacupuncture for the Treatment of Frozen Shoulder: protocol for a systematic review and meta-analysis

  • Ji-Ho Lee;Hyeon-Sun Park;Sang-Hyeon Park;Dong-Ho Keum;Seo-Hyun Park
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.14-20
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    • 2024
  • Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.

Assessment of the toxic effects of dichlofluanid using survival and relative growth rate on brown alga Undaria pinnatifida (미역(Undaria pinnatifida) 배우체의 생존 및 상대성장률을 이용한 dichlofluanid의 독성영향 평가)

  • Un-Ki Hwang;Yun-Ho Park;Bo-Ram Sim;Ju-Wook Lee
    • Korean Journal of Environmental Biology
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    • v.41 no.4
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    • pp.427-438
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    • 2023
  • Biocide dichlofluanid breaks down quickly and accumulates easily in sediment, potentially causing a persistent impact on various marine organisms. We analyzed the potential toxicity of dichlofluanid on major aquaculture species in Korea, Undaria pinnatifida. Female gametophytes of U. pinnatifida were exposed to dichlofluanid at concentrations of 0, 1, 2, 4, 8, 16, and 32 mg L-1, and their survival and relative growth rate were analyzed. The no observed effect concentration(NOEC), lowest observed effect concentration (LOEC), and median lethal concentration (LC50) for female gametophyte survival were determined as 1, 2, and 10.82 (95% CI: 8.87-13.23) mg L-1, respectively. The NOEC, LOEC, and median effective concentration (EC50) for relative growth rate were 1, 2, and 6.58 (95% CI: 6.03-7.17) mg L-1, respectively. Female gametophytes of U. pinnatifida were expected to experience toxic effects at concentrations above 2 mg L-1 of dichlofluanid. These research findings are expected to serve as important reference data for evaluating the toxicity effects of U. pinnatifida in its early life stages when exposed to dichlofluanid.

Comparison of the Awareness and Knowledge of Scrub Typhus between Case and Control Groups (쯔쯔가무시증 환자군과 대조군의 인지도와 지식 비교)

  • Lee, Kwan;Park, Byeong-Chan;Lim, Hyun-Sul;Kweon, Sun-Seog;Choi, Jin-Su;Kim, Jang-Rak;Kim, Keon-Yeop;Ryu, So-Yeon
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.1-11
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    • 2012
  • Objectives: To survey the awareness of patient to scrub typhus to provide data for education and communication concerning scrub typhus. Methods: Patients with scrub typhus (case group, n=299) and people without scrub typhus within the previous 2 years (control group, n=598) were matched for age (within 5 years), gender, and occupation (farmer or non-farmer). The participants were recruited from 15 study areas between October and December 2006. Results: The awareness rate of scrub typhus was 75.1%, and was significantly higher than in the case group (79.4% vs. 66.6%, respectively; p<0.01). The major routes of awareness were from 'past history of scrub typhus in family members or neighbors' (54.9%), 'television' (28.3%), and their past history of scrub typhus (5.5%). The average correct rate of scrub typhus was 48.4%, and the correct response rate of cases was significantly higher than controls (p<0.01). Especially, the correct rate of etiology, incubation period, route of transmission, and acquired immunity was <40%. Through conditional logistic regression test, the factor significantly associated with awareness in case group was age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.98). And the factors associated with awareness in control group were female (OR, 1.56; 95% CI, 1.03-2.36) age (OR, 0.98; 95% CI, 0.96-0.99), family history of scrub typhus (OR, 10.18; 95% CI, 1.37-75.99), history of receiving prevention education (OR, 8.47; 95% CI, 1.14-63.00). Conclusions: The rate of awareness was relatively low in study population. Thus, effective working guidelines and educational program to prevent scrub typhus must be developed, and publicity activities about the prevention of scrub typhus are needed for high-risk groups.