• Title/Summary/Keyword: mortality map

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Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

  • Gjonbrataj, Juarda;Kim, Hyun Jung;Jung, Hye In;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.85-91
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    • 2015
  • Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data

  • Okui, Tasuku
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.5
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    • pp.352-359
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    • 2021
  • Objectives: The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods: Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. Results: The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. Conclusions: Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.

DENSITY DEPENDENT MORTALITY OF INTERMEDIATE PREDATOR CONTROLS CHAOS-CONCLUSION DRAWN FROM A TRI-TROPHIC FOOD CHAIN

  • NATH, BINAYAK;DAS, KRISHNA PADA
    • Journal of the Korean Society for Industrial and Applied Mathematics
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    • v.22 no.3
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    • pp.179-199
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    • 2018
  • The paper explores a tri-trophic food chain model with density dependent mortality of intermediate predator. To analyze this aspect, we have worked out the local stability of different equilibrium points. We have also derived the conditions for global stability of interior equilibrium point and conditions for persistence of model system. To observe the global behaviour of the system, we performed extensive numerical simulations. Our simulation results reveal that chaotic dynamics is produced for increasing value of half-saturation constant. We have also observed trajectory motions around different equilibrium points. It is noticed that chaotic dynamics has been controlled by increasing value of density dependent mortality parameter. So, we conclude that the density dependent mortality parameter can be used to control chaotic dynamics. We also applied basic tools of nonlinear dynamics such as Poincare section and Lyapunov exponent to investigate chaotic behaviour of the system.

Visualization of Regional Mortality Ratios by Major Causes of Death (주요 사망원인에 대한 지역별 사망비율 가시화)

  • Ryu, Wooseok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.05a
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    • pp.149-151
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    • 2018
  • The purpose of this paper is to visualize and to analyze differences of regional mortality rates by major causes of death. We use causes of death statistics from KOSIS and compare regional mortality rates divided by national mortality rates by three causes of death. To do this, we define regional mortality ratio and regional age-standardized mortality ratio, and visualized by choropleth map using R. As a result, In case of neoplasm, there was no significant difference by region. In case of circulatory system, Ulsan, Daegu, Busan and Gyungnam showed relatively high regional age-standardized mortality ratio. In case of respiratory system, the ratios were in order of Gangwon, Sejong, and Chungbuk.

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Improvement of the Environmental Conservation Value Assessment Map (ECVAM) by Complement of the Vegetation Community Stability Item (식생 군집구조 안정성 평가항목 보완을 통한 국토환경성평가지도 개선방안 연구)

  • Jeon, Seong-Woo;Song, Won-Kyong;Lee, Moung-Jin;Kang, Byung-Jin
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.13 no.2
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    • pp.114-123
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    • 2010
  • The Environmental Conservation Value Assessment Map (ECVAM) is a five grade assessment map created with nationally integrated environmental information and environmental values. The map is made through the evaluation of 67 items, including greenbelt area and bio-diversity. The ECVAM assesses the stability of the community using forest maps. However, the existing assessment method is problematic because the assessment grades are evaluated using higher than practical values; in part because it uses even-valued overlay and minimal indicator methods. This study was performed in order to suggest an integrated assessment method that could complement the stability evaluation based on existing methods. Accordingly, this study added forest type information, including whether the forest was natural or artificial, to the overlay method using forest diameter maps and forest density maps. As a result, the proposed ECVAM indicated a drastic grade change. After applying the method in South Korea, Grade I areas decreased 12.1%, from 52.6% to 40.6%, Grade II areas increased 11.9%, from 17.4% to 29.2%, and Grade III areas increased 0.2%, from 17.1% to 17.4%, respectively. From the results of the field survey, we found differences between natural forest and planted forest with regard to the number of mortality, species of shrubs, and vine cover. This means that natural forests are more stable than planted forests. This study suggests an improved assessment methodology to complement the existing EVCAM method. The results are expected to be used in environmental evaluations and forest conservation value assessments in ecology and environmental fields.

Assessing the Health Benefits of the Seoul Air Quality Management Plan Using BenMAP

  • Park, Jeong-Im;Bae, Hyun-Joo
    • Journal of Environmental Health Sciences
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    • v.32 no.6
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    • pp.571-577
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    • 2006
  • Health benefits from implementing air quality control measures were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP). BenMAP developed by US EPA is a GIS-based software tool that estimates the health impacts and associated economic values connected with changes in ambient air pollution. Once a set of BenMAP-required data was collected, the health benefits from implementing Seoul Air Quality Management Plan (SAQMP), an official AQ improvement plan for Seoul Metropolitan Area, was assessed using BenMAP. The PM10 concentrations assuming the SAQMP implemented successfully were predicted with the MM5 (Mesoscale Meteorological model version 5)/CMAQ (Community Multiscale Air Quality) model. A PM 10 exposure related premature mortality function was adopted trom a well-known epidemiology study. Economic valuation functions driven from benefit transfer methods were utilized. Through the SAQMP, PM10 concentrations were estimated to be lowered by $15{\mu}g/m^3\;to\;75{\mu}g/m^3$ depending on air quality modeling grids. 5,569 premature deaths (95% CI $3,264{\sim}7,809$ deaths) could be avoided in the Seoul Metropolitan Area. The economic value of the deaths avoided was estimated to $13.2 billion $(95%\;CI\;$890\;million{\sim}$28.2\;billion)$ using the benefit transfer value. BenMAP could be a useful tool for developing effective air quality improvement policy, enabling the policy makers to anticipate the effects of regulatory changes on people's health and the economy.

Clinical analsysis of 101 cases of open heart surgery (개심술 101 례의 임상적 고찰)

  • Sin, Gi-U;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.147-156
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    • 1983
  • Over a period from May, 1977 to SEptember, 1982, 101 cases ofopen heart surgerywere done under cardiopulmonary bypass. There were 50 male and 51 female patients, and the ages of the patients ranged from 19 months to 48 years. Sixty-nine cases were congenital heart disease and 32 cases were acquired heart disease, which consisted of 30 valvular disease, 1 IVC obstruction, and 1 myxoma. Among the 30 cases of valvular disease, 12 MVR, 4 MVR+TAP, 2 MVT+AVR, 1 MAP, and 11 OMC were done. There were 3 operative deaths (17.5%) in 16 MVR, 1 in 2 MVR+AVR, and 1 in 11 OMC. Operative mortality in 69 congenital heart disease was 13.0% ; 3 deaths (6.7%) in 45 acyanotic and 6(25.0%) in 24 cyanotic cases. The overall mortality for 101 cases was 14.8%; 13.0% for congenital and 18.8% for acquired heart disease.

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Clinical Analysis of 39 Cases of Open Heart Surgery (개심술 39례의 임상적 고찰)

  • Lee, Jae-Seong;Sin, Gi-U;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.711-717
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    • 1985
  • Over a period from July 1984 to June 1985, 39 cases of open heart surgery were done under cardiopulmonary bypass. There were 23 male and 16 female patients, ranging in age from 18 months to 58 years. Thirty cases were valvular disease. The most common of congenital heart disease is VSD. Among the 9 cases of acquired valvular diseae,1 MAP, 5 MVR, 2 MVR+TAP, and 1 MVR+AVR were done. There were 1 operative death[11%] which was done MVR+TAP. Operative mortality in 30 congenital heart disease was 7%; 1 death [5%] in 22 acyanotic and 1[13%] in 8 cyanotic cases. Finally, overall mortality for 39 cases was 8%; 7% for congenital heart disease and 11% for acquired heart disease.

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Regional Differentials in Mortality in Korea, 1990-2000 (사망력 수준의 시ㆍ군별 편차 및 그 변화 추이, 1990∼2000)

  • 김두섭;박효준
    • Korea journal of population studies
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    • v.26 no.1
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    • pp.1-30
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    • 2003
  • This paper attempts to explore the effects of ecological and socioeconomic factors on the level of mortality and the changing trends of such effects during the period of 1990∼2000. For this purpose the population census data and micro-data from the vital statistics for years 1990, 1995 and 2000 were used. As indicators of mortality, the crude death rate(CDR), the standardized death rate(SDR) and the longevity rate were calculated for 170 'Si' s and 'Gun's. Using GIS, this paper first presents the mortality and longevity maps for years 1990, 1995 and 2000. Then ANOVA and regression analyses are carried out in an effort to generalize the effects of ecological and socioeconomic factors on the CDR, the SDR and the longevity rate. When the mortality and longevity maps are examined, three indices of mortality are found to be markedly high in the southwest coastal regions of Cholla-Nam-Do. By contrast, Seoul and Pusan metropolitan areas show substantially low level of mortality and longevity in these indices. It is also found that the regional differentials in the SDR and the longevity rate show a trend of becoming smaller after 1990. The research, however, does not find any linear relationship between the SDR and the longevity rate. The causal mechanisms of the two indices are found to be different. The results of the ANOVA and the regression analysis reveal that the locational factors of both mountainous and farming regions tend to increase the CDR and SDR while both coastal and farming regions disclose a tendency of increasing the longevity rate. The level of statistical significance of these analytical results is found to be weaker when socioeconomic factors such as education, income, marital status, availability of medical care, and sanitary conditions of the region are taken into account. The regional differentials in the mortality level seem to have a clear relationship not only with the socioeconomic factors but also with the age structure influenced by the age selectivity of migration during the past 40 years.

Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum

  • Lee, Gil Jae;Lee, Min A;Yoo, Byungchul;Park, Youngeun;Jang, Myung Jin;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.38-42
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    • 2020
  • Purpose: Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown. Methods: In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy. Results: The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay. Conclusions: PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.