• Title/Summary/Keyword: interval regression model

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Efficacy of Nab-Paclitaxel Plus Gemcitabine and Prognostic Value of Peripheral Neuropathy in Patients with Metastatic Pancreatic Cancer

  • You, Min Su;Ryu, Ji Kon;Choi, Young Hoon;Choi, Jin Ho;Huh, Gunn;Paik, Woo Hyun;Lee, Sang Hyub;Kim, Yong-Tae
    • Gut and Liver
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    • v.12 no.6
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    • pp.728-735
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    • 2018
  • Background/Aims: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating metastatic pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. Methods: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and $1,000mg/m^2$, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan-Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. Results: Patients underwent a mean of $6.7{\pm}4.2$ cycles during $6.3{\pm}4.4$ months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). Conclusions: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.

Development and Validation of 18F-FDG PET/CT-Based Multivariable Clinical Prediction Models for the Identification of Malignancy-Associated Hemophagocytic Lymphohistiocytosis

  • Xu Yang;Xia Lu;Jun Liu;Ying Kan;Wei Wang;Shuxin Zhang;Lei Liu;Jixia Li;Jigang Yang
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.466-478
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    • 2022
  • Objective: 18F-fluorodeoxyglucose (FDG) PET/CT is often used for detecting malignancy in patients with newly diagnosed hemophagocytic lymphohistiocytosis (HLH), with acceptable sensitivity but relatively low specificity. The aim of this study was to improve the diagnostic ability of 18F-FDG PET/CT in identifying malignancy in patients with HLH by combining 18F-FDG PET/CT and clinical parameters. Materials and Methods: Ninety-seven patients (age ≥ 14 years) with secondary HLH were retrospectively reviewed and divided into the derivation (n = 71) and validation (n = 26) cohorts according to admission time. In the derivation cohort, 22 patients had malignancy-associated HLH (M-HLH) and 49 patients had non-malignancy-associated HLH (NM-HLH). Data on pretreatment 18F-FDG PET/CT and laboratory results were collected. The variables were analyzed using the Mann-Whitney U test or Pearson's chi-square test, and a nomogram for predicting M-HLH was constructed using multivariable binary logistic regression. The predictors were also ranked using decision-tree analysis. The nomogram and decision tree were validated in the validation cohort (10 patients with M-HLH and 16 patients with NM-HLH). Results: The ratio of the maximal standardized uptake value (SUVmax) of the lymph nodes to that of the mediastinum, the ratio of the SUVmax of bone lesions or bone marrow to that of the mediastinum, and age were selected for constructing the model. The nomogram showed good performance in predicting M-HLH in the validation cohort, with an area under the receiver operating characteristic curve of 0.875 (95% confidence interval, 0.686-0.971). At an appropriate cutoff value, the sensitivity and specificity for identifying M-HLH were 90% (9/10) and 68.8% (11/16), respectively. The decision tree integrating the same variables showed 70% (7/10) sensitivity and 93.8% (15/16) specificity for identifying M-HLH. In comparison, visual analysis of 18F-FDG PET/CT images demonstrated 100% (10/10) sensitivity and 12.5% (2/16) specificity. Conclusion: 18F-FDG PET/CT may be a practical technique for identifying M-HLH. The model constructed using 18F-FDG PET/CT features and age was able to detect malignancy with better accuracy than visual analysis of 18F-FDG PET/CT images.

Association between Sleep Duration, Dental Caries, and Periodontitis in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2013~2014 (한국 성인에서 수면시간과 영구치 우식증 및 치주질환과의 관련성: 2013~2014 국민건강영양조사)

  • Lee, Da-Hyun;Lee, Young-Hoon
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.38-45
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    • 2017
  • We evaluated the association between sleep duration, dental caries, and periodontitis by using representative nationwide data. We examined 8,356 subjects aged ${\geq}19$ years who participated in the sixth Korea National Health and Nutrition Examination Survey (2013~2014). Sleep duration were grouped into ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours. Presence of dental caries was defined as caries in ${\geq}1$ permanent tooth on dental examination. Periodontal status was assessed by using the community periodontal index (CPI), and a CPI code of ${\geq}3$ was defined as periodontitis. A chi-square test and multiple logistic regression analysis were used to determine statistical significance. Model 1 was adjusted for age and sex, model 2 for household income, educational level, and marital status plus model 1, and model 3 for smoking status, alcohol consumption, blood pressure level, fasting blood glucose level, total cholesterol level, and body mass index plus model 2. The prevalence of dental caries according to sleep duration showed a U-shaped curve of 33.4%, 29.4%, 28.4%, 29.4%, and 31.8% with ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours of sleep, respectively. In the fully adjusted model 3, the risk of developing dental caries was significantly higher with ${\leq}5$ than with 7 hours of sleep (odds ratio, 1.23; 95% confidence interval, 1.06~1.43). The prevalence of periodontitis according to sleep duration showed a U-shaped curve of 34.4%, 28.6%, 28.1%, 31.3%, and 32.5%, respectively. The risk of periodontitis was significantly higher with ${\geq}9$ than with 7 hours of sleep in models 1 and 2, whereas the significant association disappeared in model 3. In a nationally representative sample, sleep duration was significantly associated with dental caries formation and weakly associated with periodontitis. Adequate sleep is required to prevent oral diseases such as dental caries and periodontitis.

Prediction of Forest Fire Danger Rating over the Korean Peninsula with the Digital Forecast Data and Daily Weather Index (DWI) Model (디지털예보자료와 Daily Weather Index (DWI) 모델을 적용한 한반도의 산불발생위험 예측)

  • Won, Myoung-Soo;Lee, Myung-Bo;Lee, Woo-Kyun;Yoon, Suk-Hee
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.14 no.1
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    • pp.1-10
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    • 2012
  • Digital Forecast of the Korea Meteorological Administration (KMA) represents 5 km gridded weather forecast over the Korean Peninsula and the surrounding oceanic regions in Korean territory. Digital Forecast provides 12 weather forecast elements such as three-hour interval temperature, sky condition, wind direction, wind speed, relative humidity, wave height, probability of precipitation, 12 hour accumulated rain and snow, as well as daily minimum and maximum temperatures. These forecast elements are updated every three-hour for the next 48 hours regularly. The objective of this study was to construct Forest Fire Danger Rating Systems on the Korean Peninsula (FFDRS_KORP) based on the daily weather index (DWI) and to improve the accuracy using the digital forecast data. We produced the thematic maps of temperature, humidity, and wind speed over the Korean Peninsula to analyze DWI. To calculate DWI of the Korean Peninsula it was applied forest fire occurrence probability model by logistic regression analysis, i.e. $[1+{\exp}\{-(2.494+(0.004{\times}T_{max})-(0.008{\times}EF))\}]^{-1}$. The result of verification test among the real-time observatory data, digital forecast and RDAPS data showed that predicting values of the digital forecast advanced more than those of RDAPS data. The results of the comparison with the average forest fire danger rating index (sampled at 233 administrative districts) and those with the digital weather showed higher relative accuracy than those with the RDAPS data. The coefficient of determination of forest fire danger rating was shown as $R^2$=0.854. There was a difference of 0.5 between the national mean fire danger rating index (70) with the application of the real-time observatory data and that with the digital forecast (70.5).

LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies (국소 치료 후 잔존 간세포암의 진단을 위한 LI-RADS 치료 반응 알고리즘과 Modified RECIST 기준 간 비교: 비교 연구를 대상으로 한 체계적 문헌고찰과 메타분석)

  • Dong Hwan Kim;Bohyun Kim;Joon-Il Choi;Soon Nam Oh;Sung Eun Rha
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.331-343
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    • 2022
  • Purpose To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT). Materials and Methods Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression. Results For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53). Conclusion The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

Genetic Variations in the HIF1A Gene Modulate Response to Adjuvant Chemotherapy after Surgery in Patients with Colorectal Cancer

  • Zhang, Yi;Wang, Peng;Zhou, Xing-Chun;Bao, Guo-Qiang;Lyu, Zhuo-Ming;Liu, Xiao-Nan;Wan, Shao-Gui;He, Xian-Li;Huang, Qi-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4637-4642
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    • 2014
  • Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

Distribution Characteristics on the Parameters of Vertical Tidal Current Profile at Uldolmok, Jindo, Korea (진도 울돌목의 조류 연직 프로파일 매개변수 분포 특성)

  • Ko, Dong Hui;Park, Jin Soon;Cho, Hong Yeon;Park, Jun Seok;Lee, Gi Seop;Choi, Hyukjin
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.29 no.6
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    • pp.279-285
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    • 2017
  • In general, the power law and logarithmic profile are commonly used as flow vertical velocity profile model. However, since the parameters of profile vary with characteristics of coastal environment, it is necessary to estimate these values from measured data using regression analysis. In this paper, we estimated the power law exponent (n), friction velocity ($u^*$) and roughness length ($z_0$) of logarithmic profile by analyzing measured tidal current data that are averaged at a interval of 30 min. In the results of analysis, power law exponent (n) was estimated to be about 10.75 during flood and about 9.3 during ebb. Meanwhile, $u^*$ of logarithmic profile was estimated to be about 0.084 m/s, 0.105 m/s during flood and ebb, respectively. Also, $z_0$ was estimated to be 0.004 m and 0.006 m, respectively.

Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study

  • Kim, Ji Young;Ko, Young-Jin;Rhee, Chul Woo;Park, Byung-Joo;Kim, Dong-Hyun;Bae, Jong-Myon;Shin, Myung-Hee;Lee, Moo-Song;Li, Zhong Min;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.6
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    • pp.319-328
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    • 2013
  • Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

Performance of a Bayesian Design Compared to Some Optimal Designs for Linear Calibration (선형 캘리브레이션에서 베이지안 실험계획과 기존의 최적실험계획과의 효과비교)

  • 김성철
    • The Korean Journal of Applied Statistics
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    • v.10 no.1
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    • pp.69-84
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    • 1997
  • We consider a linear calibration problem, $y_i = $$\alpha + \beta (x_i - x_0) + \epsilon_i$, $i=1, 2, {\cdot}{\cdot},n$ $y_f = \alpha + \beta (x_f - x_0) + \epsilon, $ where we observe $(x_i, y_i)$'s for the controlled calibration experiments and later we make inference about $x_f$ from a new observation $y_f$. The objective of the calibration design problem is to find the optimal design $x = (x_i, \cdots, x_n$ that gives the best estimates for $x_f$. We compare Kim(1989)'s Bayesian design which minimizes the expected value of the posterior variance of $x_f$ and some optimal designs from literature. Kim suggested the Bayesian optimal design based on the analysis of the characteristics of the expected loss function and numerical must be equal to the prior mean and that the sum of squares be as large as possible. The designs to be compared are (1) Buonaccorsi(1986)'s AV optimal design that minimizes the average asymptotic variance of the classical estimators, (2) D-optimal and A-optimal design for the linear regression model that optimize some functions of $M(x) = \sum x_i x_i'$, and (3) Hunter & Lamboy (1981)'s reference design from their paper. In order to compare the designs which are optimal in some sense, we consider two criteria. First, we compare them by the expected posterior variance criterion and secondly, we perform the Monte Carlo simulation to obtain the HPD intervals and compare the lengths of them. If the prior mean of $x_f$ is at the center of the finite design interval, then the Bayesian, AV optimal, D-optimal and A-optimal designs are indentical and they are equally weighted end-point design. However if the prior mean is not at the center, then they are not expected to be identical.In this case, we demonstrate that the almost Bayesian-optimal design was slightly better than the approximate AV optimal design. We also investigate the effects of the prior variance of the parameters and solution for the case when the number of experiments is odd.

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Nested Case-control Study of Occupational Radiation Exposure and Breast and Esophagus Cancer Risk among Medical Diagnostic X Ray Workers in Jiangsu of China

  • Wang, Fu-Ru;Fang, Qiao-Qiao;Tang, Wei-Ming;Xu, Xiao-San;Mahapatra, Tanmay;Mahapatra, Sanchita;Liu, Yu-Fei;Yu, Ning-Le;Sun, Quan-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4699-4704
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    • 2015
  • Medical diagnostic X-ray workers are one occupational group that expose to the long-term low-dose external radiation over their working lifetime, and they may under risk of different cancers. This study aims to determine the relationship between the occupational X-ray radiation exposure and cancer risk among these workers in Jiangsu, China. We conducted Nested case-control study to investigate the occupational X-ray radiation exposure and cancer risk. Data were collected through self-administered questionnaire, which includes but not limits to demographic data, personal behaviors and family history of cancer. Retrospective dose reconstruction was conducted to estimate the cumulative doses of the x-ray workers. Inferential statistics, t-test and 2 tests were used to compare the differences between each group. We used the logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of cancer by adjusting the age, gender. All 34 breast cancer cases and 45 esophageal cancer cases that detected in a cohort conducted among health workers between 1950~2011 were included in this presented study, and 158 cancer-free controls were selected by frequency-matched (1:2). Our study found that the occupational radiation exposure was associated with a significantly increased cancer risk compared with the control, especially in breast cancer and esophageal cancer (adjusted OR=2.90, 95% CI: 1.19-7.04 for breast cancer; OR=4.19, 95% CI: 1.87-9.38 for esophageal cancer, and OR=3.43, 95% CI: 1.92-6.12 for total cancer, respectively). The occupational X-ray radiation exposure was associated with increasing cancer risk, which indicates that proper intervention and prevention strategies may be needed in order to bring down the occupational cancer risk.