• Title/Summary/Keyword: mixed outcomes

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An Asian Airline Implementation of Smartphone Collaboration: From Training to Operations (스마트폰을 활용한 항공사의 협업 사례 연구: 훈련 기간과 운영 기간의 차이 분석)

  • Dionne, Dante;Schutz, Douglas M.;Kim, Yong-Young
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.303-313
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    • 2018
  • In order to provide quality services across international airports, airline personnel must rapidly and effectively develop and share knowledge. Combining components of adaptive structuration theory (AST) and media synchronicity theory (MST), a research framework was developed to convey three distinct stages of knowledge sharing. We use the grounded theory research method for the qualitative data collected from audio transcripts of employees learning how to use and work with company issued smartphones with push-to-talk functionalities. Data was collected from 33 operations personnel. The results of the content analysis are recorded for the elements of each of the three concepts of our research framework. During the social interaction stage, the content of the audio conversations shifts mainly from conflict management to task management; for media synchronicity, from quality to quantity; for productive outcomes, from efficiency to commitment. New insights are uncovered from our analysis of data from the field as users advance from learning how to use the mobile devices, to using the devices for managing knowledge for their work in the airline industry.

Clinical analysis and review of literature on pilomatrixoma in pediatric patients

  • Hu, Ju Long;Yoo, Hyokyung;Kwon, Sung Tack;Kim, Sukwha;Chung, Jee Hyeok;Kim, Hyeonwoo;Kim, Jinhyun;Yu, Na Hee;Kim, Byung Jun
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.288-293
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    • 2020
  • Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion: Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.

Provider Variation in Diagnosing Complications of Upper Respiratory Infection in Korean Children (소아 급성상기도감염 합병증 진단의 공급자간 편차)

  • Choi, Hyug-Yong;Park, Jung-Hoo;Yoo, Do-Young;Lim, Myeon-Gil;Kim, Min-Ah;Kim, Nam-Gil;Cho, Hyun-Joo
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.1
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    • pp.181-197
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    • 2013
  • Objectives : This study aimed to assess the differences in treatment behavior by reviewing data of a medical institution that studies treatment behavior in URI and assessing the treatment efficacy in Korea. Methods : We analyzed the behavior of medical customers and providers of upper respiratory infection medications using the NPS published by the Health Insurance Review Assessment Service. We created an operational definition for complications, and confirmed the difference in complication distribution between medical specialties. We also performed a multivariate analysis using a mixed model to elucidate the factors influencing the occurrence of complications. Results : The outcomes of analyzing factors to influence the difference in practice patterns of the diagnosing URI between the physicians are as follows; (1) Analysis of antibiotics prescriptions rate showed significant difference from medical departments (pediatrics; 49.7%, internal medicine; 54.2%, otorhinolaryngology; 69.6%, family medicine; 61.6%, general surgery; 57.5%, p<0.001). Analysis of steroid prescriptions rate showed significant difference from medical departments (pediatrics; 3.8%, internal medicine; 4.5%, otorhinolaryngology; 5.4%, family medicine; 3.0%, general surgery; 11.2%, p<0.001). (2) In patients who visited medical institutes with the common cold, the complication distribution differed according to the medical specialty, which suggests that specific complications arise depending on the particular medical specialty (p<0.001). (3) Moreover, through multivariate analysis, we found that the complication rate is higher in clinics than in hospitals, depending on the institute's size. (p<0.001; odds ratio of 4.67 in clinics than in hospitals, 95% CI 2.66-8.21) Conclusions : We observe a deviation between the behavior of patients diagnosed with URI and medication providers. This may arise from the interaction between providers and consumers, wherein the complications are associated with the choice of outpatient department and the prevention of cutting incentives. These findings suggest that the health policies should be improved to prevent inappropriate medical practice in the treatment of pediatric URI.

A Strategic Study of Pedestrian-Friendly Reconstruction in University Campus Core - Case Study of 'H' University in Gyeonggi-do Province - (대학 캠퍼스코어의 보행친화형 개조전략 연구 - 경기도 H대학교를 사례로 -)

  • Hong, Youn-Soon;Park, Chung-In
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.6
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    • pp.89-100
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    • 2014
  • The Campus Core is centered at the physical, functional and symbolic environment of a university, which is known as the top academic institution, hence it metaphorically represents not only the educational philosophy when institution first opened, but also the transformed values of the time. Today, universities are asked to actively communicate with the local community in terms of function and be remodeled as pedestrian-friendly campuses in terms of physical environment. For this reason, the study comprehends the concept of the campus core in accordance with a pedestrian-friendly environment and suggests a practical plan for campus cores of district national universities based on previous research examination. Since the purpose of the study is to suggest a change in the circulation system centered on vehicle use to transform into a pedestrian-friendly environment through a planned approach while introducing public mixed-use at the same time, the study supports the fact that it is possible to reorganize the strategy of a pedestrian-friendly circulation system and partially revise the land utilization to yield the expected outcomes. Thus, this study will provide valid suggestions for similar maintenance plans while looking back to the meaning and value of today's campus core.

Stabilization of Short Juxta-articular Fractures Using a Circular External Skeletal Fixator System in Dogs (개에서 원형외고정장치를 이용한 관절주위 골절의 안정화)

  • Cheong, Hye-Yeon;Kim, Joo-Ho;Cha, Jae-Gwan;Seol, Jae-Won;Kim, Min-Su;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.523-526
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    • 2014
  • Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.

Current Status and Needs Assessment for Obesity Prevention and Management Project at Public Health Centers (보건소 비만예방관리 사업 현황 및 요구도 분석)

  • Park, Jiyoung;Im, Mihae;Baek, Seolhyang;Park, Chongwon;Hwang, Gahui;Kim, Wansoo;Oh, Yumi;Cho, A Ra;Jo, Jieun
    • Research in Community and Public Health Nursing
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    • v.32 no.3
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    • pp.368-381
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    • 2021
  • Purpose: The obesity prevention and management program led by public health centers are important in the community. This study aims to identify the current status of obesity prevention and management programs at public health centers and perceptions regarding facilitators and barriers when implementing programs. Methods: This study used a concurrent mixed methods design. A survey was conducted to investigate the current status and infrastructure of the obesity prevention and management program at eighty-three public health centers nationwide. Nine program managers and six local residents with experience in the program were interviewed by using a semi-structured questionnaires. Results: Most of the infrastructure facilities for the program were inadequate, and insufficient budgets and lack of professional staff were identified as barriers. Facilitators included diversification of program delivery methods, operator competence, and visible outcomes and rewards. For the effectiveness of the program, it is vital to have adequate assistants, a sufficient budget, various promotional methods, and connections with various institutions in the community. On this basis, it is acknowledged that the public health center serves as a platform for preventing and managing obesity in the community. Conclusion: It is expected that infrastructure improvements in public health centers and the link with community resources are needed. In addition, there is an urgent need to set standards for obesity prevention and management programs implemented in public health centers to 'resolve regional disparities'.

Prognostic Threshold of Neuroendocrine Differentiation in Gastric Carcinoma: a Clinicopathological Study of 945 Cases

  • Zou, Yi;Chen, Linying;Wang, Xingfu;Chen, Yupeng;Hu, Liwen;Zeng, Saifan;Wang, Pengcheng;Li, Guoping;Huang, Ming;Wang, Liting;He, Shi;Li, Sanyan;Jian, Lihui;Zhang, Sheng
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.121-131
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    • 2019
  • Purpose: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. Materials and Methods: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED ($P_{NED}$) and demographic and clinicopathological parameters. Results: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. $P_{NED}$, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff $P_{NED}$ was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher $P_{NED}$. Tumors with ${\geq}10%$ NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. Conclusions: GC with ${\geq}10%$ NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.

Primary Invasive Mucinous Adenocarcinoma of the Lung: Prognostic Value of CT Imaging Features Combined with Clinical Factors

  • Tingting Wang;Yang Yang;Xinyue Liu;Jiajun Deng;Junqi Wu;Likun Hou;Chunyan Wu;Yunlang She;Xiwen Sun;Dong Xie;Chang Chen
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.652-662
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    • 2021
  • Objective: To investigate the association between CT imaging features and survival outcomes in patients with primary invasive mucinous adenocarcinoma (IMA). Materials and Methods: Preoperative CT image findings were consecutively evaluated in 317 patients with resected IMA from January 2011 to December 2015. The association between CT features and long-term survival were assessed by univariate analysis. The independent prognostic factors were identified by the multivariate Cox regression analyses. The survival comparison of IMA patients was investigated using the Kaplan-Meier method and propensity scores. Furthermore, the prognostic impact of CT features was assessed based on different imaging subtypes, and the results were adjusted using the Bonferroni method. Results: The median follow-up time was 52.8 months; the 5-year disease-free survival (DFS) and overall survival rates of resected IMAs were 68.5% and 77.6%, respectively. The univariate analyses of all IMA patients demonstrated that 15 CT imaging features, in addition to the clinicopathologic characteristics, significantly correlated with the recurrence or death of IMA patients. The multivariable analysis revealed that five of them, including imaging subtype (p = 0.002), spiculation (p < 0.001), tumor density (p = 0.008), air bronchogram (p < 0.001), emphysema (p < 0.001), and location (p = 0.029) were independent prognostic factors. The subgroup analysis demonstrated that pneumonic-type IMA had a significantly worse prognosis than solitary-type IMA. Moreover, for solitary-type IMAs, the most independent CT imaging biomarkers were air bronchogram and emphysema with an adjusted p value less than 0.05; for pneumonic-type IMA, the tumors with mixed consolidation and ground-glass opacity were associated with a longer DFS (adjusted p = 0.012). Conclusion: CT imaging features characteristic of IMA may provide prognostic information and individual risk assessment in addition to the recognized clinical predictors.

Surgical Results and Risk Facor Analysis of the Patients with Single Ventricle Associated with Total Anomalous Pulmonary Venous Connection (총폐정맥연결이상증을 동반한 단심증 환아의 수술결과 및 위험인자 분석)

  • 이정렬;김창영;김홍관;이정상;김용진;노준량
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.862-870
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    • 2002
  • The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs) (한국 뮤코 다당체 침착증 환자에 대한 임상적 고찰)

  • Sohn, Woo Yun;Lee, Jee Hyun;Paik, Kyung Hoon;Kwon, Eun Kyoung;Kim, Ahn Hee;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1132-1138
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    • 2005
  • Purpose : The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. Methods : Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. Results : Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7 : 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. Conclusion : Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.