• 제목/요약/키워드: multivariate stratification

검색결과 29건 처리시간 0.03초

Risk factors affecting amputation in diabetic foot

  • Lee, Jun Ho;Yoon, Ji Sung;Lee, Hyoung Woo;Won, Kyu Chang;Moon, Jun Sung;Chung, Seung Min;Lee, Yin Young
    • Journal of Yeungnam Medical Science
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    • 제37권4호
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    • pp.314-320
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    • 2020
  • Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561-10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087-5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981-0.999), ulcer size (HR, 1.247; 95% CI, 1.107-1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224-0.73) were associated with risk of amputation. Conclusion: Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

Post-operative Treatment with Cisplatin and Vinorelbine in Chinese Patients with Non-small Cell Lung Cancer: A Clinical Prospective Analysis of 451 Patients

  • Wang, Jing;Liu, Feng;Huang, Deng-Xiao;Jiang, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4505-4510
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    • 2012
  • Purpose: To determine the efficacy of post-operative chemotherapy with cisplatin plus vinorelbine (NP) in Chinese patients with non-small cell lung cancer (NSCLC). Methods: A total of 451 patients with NSCLCs at stages I, II, and IIIA after surgical resection were treated with cisplatin plus vinorelbine for 4 cycles or volunteers observed between January 2002 and November 2004 and were followed for five years. The therapeutic efficacy was evaluated with reference to overall survival (OS) and disease-free survival (DFS), and adverse effects were also recorded. Potential factors affecting the lengths of OS and DFS were analyzed by multivariate analysis. Results: Most patients (86.7%) completed at least 4 cycles of treatment. Patients with chemotherapy survived significantly longer than those in the observation group (p<0.001). The absolute improvements in the 2 and 5-year OS were 3.8% [hazard ratio (HR) =0.674, 95% confidence interval (CI): 0.554-0.820, P<0.0001] and 13.0% (HR=0.732, 95% CI: 0.579-0.926, P=0.009), respectively. The improvement at 4-year DFS was 2.1% (HR=0.327, 95% CI: 0.214-0.500, P<0.0001). Stratification analysis revealed that older age, histological type, pathological degree, but not the gender and smoking status, are independent factors affecting the length of survival in this population. Many patients (63.3%) had grade 1-III tolerable adverse effects, and there was no treatment-related death. Conclusions: Post-operative chemotherapy with NP regimen is effective and tolerable in Chinese patients with NSCLC.

알츠하이머 병의 검출을 위한 ML-SVM, PCA, VBM, GMM을 결합한 융합적 성능 비교 (Convergence performance comparison using combination of ML-SVM, PCA, VBM and GMM for detection of AD)

  • 사우라르 알람;권구락
    • 한국융합학회논문지
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    • 제7권4호
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    • pp.1-7
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    • 2016
  • 구조적 MRI 영상은 여러 단 변량과 다변량 방법을 위해 그레이 메터 (GM), 화이트 메터 (WM), 뇌척수액 (CSF) 세션화 과정을 하고 난후 형태계측학적 특징을 추출하기 위해 사용한다. 새로운 접근 방법은 매우 가벼운 알츠하이머 병에서 가벼운 알츠하이머병의 진단을 위해 적용된다. 간이정신상태검사에 따른 형태계측학적 특징과 가우시안 복합 모델 파라미터를 결합하여 정상인으로부터 알츠하이머 병 환자로 분류하는 방법을 제안한다. 결합한 특징은 주성분 분석 기법을 이용한 고차원의 저주를 제거한 후 다중 커널 SVM 분류기에 공급한다. 제안한 진단 방법의 실험적 결과는 90%이상의 특성도와 고민감도에 따라 다중 커널 SVM을 가진 층화 정확도가 96%까지 최대 산출한다.

Effect of Xeroderma Pigmentosum Complementation Group F Polymorphisms on Gastric Cancer Risk and Associations with H.pylori Infection

  • Zhang, Ji-Shun;Zhang, Chuan;Yan, Xue-Yan;Yuan, Zhi-Fang;Duan, Zhuo-Yang;Gao, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1847-1850
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    • 2013
  • We conducted a hospital case-control study by genotyping four potential functional single nucleotide polymorphisms (SNPs) to assess the association of Xeroderma pigmentosum complementation group F (XPF) with gastric cancer susceptibility, and role of XPF polymorphisms in combination with H.pylori infection in risk definition. A total of 331 patients with gastric cancer and 355 controls were collected. Four SNPs of XPF, rs180067, rs1799801, rs2276466 and rs744154, were genotyped by Taqman real-time PCR method with a 7900 HT sequence detector system. The gastric cancer patients were more likely to have smoking habit, a family history of cancer and H.pylori infection. We did not find any significant difference in the genotype distributions of XPF rs180067, rs1799801, rs2276466 and rs744154 between cases and controls. However, multivariate logistic analysis showed a non-significant decreased risk in patients carrying rs180067 G allele, rs1799801 T allele or rs2276466 T allele genotypes. A non-significant increased risk of gastric cancer was found in individuals carrying the rs744154 GG genotype. Stratification by H.pylori infection and smoking was not significantly different in polymorphisms of XPF rs180067, rs1799801, rs2276466 and rs744154. The four XPF SNPs did not show significant interaction with H.pylori infection and smoking status (P for interaction was 0.35 and 0.18, respectively). Our study indicated that polymorphisms in rs180067, rs1799801, rs2276466 and rs744154 may affect the risk of gastric cancer but further large sample size studies are needed to validate any association.

Serum Hepatitis a Antibody Positivity Correlates with Higher Pancreas Cancer Mortality in Adults: Implications for Hepatitis Vaccination in High Risk Areas

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2707-2710
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    • 2013
  • Background: This study used pre-hepatitis A vaccination era data in U.S. to study the relationship between serum hepatitis A antibody positivity with pancreas cancer mortality in adults. Patients and Methods: Public use National Health and Nutrition Examination Survey (NHANES III) data were employed. NHANES III uses complex probabilistic methods to sample nationally representative samples. Household adult laboratory and mortality data were merged. Sample persons who were available to be examined in the Mobile Examination Center (MEC) were included in this study. All results were obtained by using specialized survey software taking into account the primary sampling unit and stratification variables and the weights assigned to the sample persons examined in the MEC. Thus they are representative of the U.S. population. Results: The mean risk (95%CI) of death in the study population for pancreas cancer was 0.0014 (-0.000069 -.0029); their mean age (95%CI) at the mobile examination center (MXPAXTMR) was 473.43 (463.85-482.10); the follow up in months from their medical examination (permth_exm) was 170.12 (164.17-176.07). The odds ratios (S.E.) of the statistically significant univariables were: age, 1.007 (1.005-1.009); serum anti-hepatitis antibody status, 0.038 (0.004-0.376); and drinking hard liquor, 1.014 (1.004-1.023). The coefficients (S.E.) of the statistically significant variables after multivariate analysis were 0.006 (0.002-0.010) for age and -2.528 (-4.945--0.111) for serum anti-hepatitis A antibody negativity (using serum anti-hepatitis A antibody positivity as a reference). Conclusion: Serum hepatitis A antibody positivity correlates with higher pancreas cancer mortality in adults.

영암호 저서동물군집에 미친 하구둑 건설의 영향 (Ecological Impact of the Dyke Construction on the Marine Benthos Community of the Oligohaline Youngam Lake)

  • 임현식;최진우
    • 한국수산과학회지
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    • 제38권3호
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    • pp.172-183
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    • 2005
  • To assess the macrobenthic community of oligohaline Youngam Lake, which is located at the Youngsan Watershed on the southwest part of Korea, macrobenthic fauna were collected at 45 stations during May, 2002. A total of 16 species of macrofauna were recorded with a mean density of 240 individuals per $m^2$ and a mean biomass of 7.07 g wet weight per $m^2$. Major dominant faunal groups were crustacean arthropods in terms of the number of species and abundance, and polychaete annelids in terms of biomass. The mean grain size was $5.7\;{\phi}$ which was dominated by silt fraction. The hydrological environment of the lake was characterised as an oligohaline environment with a mean surface water temperature of $17.8^{\circ}C$ and a mean salinity of 2.08 psu. The major dominant species were amphipods, Corophium sp. ($31\%$) and Jesogammarus sp. ($25\%$). Lowe. values of species diversity (H') with a mean of 0.81 (less than 1.0 from most stations) reflected the overall poor faunal diversity in this area. Multivariate analysis suggested that this benthic faunal community could be divided into four sub-regions such as the area from lake proper to water channel to the south, the stations located at the entrance and northern water channel, the stations near the dike, and the lake proper area. Freshwater and brackish water species which occurred in each station group were corresponded to the oligohaline salinity regime. Bottom hypoxia appeared in the entrance part of the lake between dyke and lake proper on May, which was resulted from stratification from spring season. These facts imply that marine macrobenthos were severely impacted by low salinity and a consequent hypoxia after embankment of the lake due to the restriction of water circulation.

Oxygenation Index in the First 24 Hours after the Diagnosis of Acute Respiratory Distress Syndrome as a Surrogate Metric for Risk Stratification in Children

  • Kim, Soo Yeon;Kim, Byuhree;Choi, Sun Ha;Kim, Jong Deok;Sol, In Suk;Kim, Min Jung;Kim, Yoon Hee;Kim, Kyung Won;Sohn, Myung Hyun;Kim, Kyu-Earn
    • Acute and Critical Care
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    • 제33권4호
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    • pp.222-229
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    • 2018
  • Background: The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS. Methods: Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality. Results: PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001). Conclusions: Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

Prognostication for recurrence patterns after curative resection for pancreatic ductal adenocarcinoma

  • Andrew Ang;Athena Michaelides;Claude Chelala;Dayem Ullah;Hemant M. Kocher
    • 한국간담췌외과학회지
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    • 제28권2호
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    • pp.248-261
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    • 2024
  • Backgrounds/Aims: This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model. Results: Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7). Conclusions: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.

Prognostic Value of an Immune Long Non-Coding RNA Signature in Liver Hepatocellular Carcinoma

  • Rui Kong;Nan Wang;Chun li Zhou;Jie Lu
    • Journal of Microbiology and Biotechnology
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    • 제34권4호
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    • pp.958-968
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    • 2024
  • In recent years, there has been a growing recognition of the important role that long non-coding RNAs (lncRNAs) play in the immunological process of hepatocellular carcinoma (LIHC). An increasing number of studies have shown that certain lncRNAs hold great potential as viable options for diagnosis and treatment in clinical practice. The primary objective of our investigation was to devise an immune lncRNA profile to explore the significance of immune-associated lncRNAs in the accurate diagnosis and prognosis of LIHC. Gene expression profiles of LIHC samples obtained from TCGA database were screened for immune-related genes. The optimal immune-related lncRNA signature was built via correlational analysis, univariate and multivariate Cox analysis. Then, the Kaplan-Meier plot, ROC curve, clinical analysis, gene set enrichment analysis, and principal component analysis were performed to evaluate the capability of the immune lncRNA signature as a prognostic indicator. Six long non-coding RNAs were identified via correlation analysis and Cox regression analysis considering their interactions with immune genes. Subsequently, tumor samples were categorized into two distinct risk groups based on different clinical outcomes. Stratification analysis indicated that the prognostic ability of this signature acted as an independent factor. The Kaplan-Meier method was employed to conduct survival analysis, results showed a significant difference between the two risk groups. The predictive performance of this signature was validated by principal component analysis (PCA). Additionally, data obtained from gene set enrichment analysis (GSEA) revealed several potential biological processes in which these biomarkers may be involved. To summarize, this study demonstrated that this six-lncRNA signature could be identified as a potential factor that can independently predict the prognosis of LIHC patients.

해수유통 중인 간척담수호 화성호에서 식물플랑크톤의 군집과 적응전략에 대한 수문학적 영향 (The Effect of Hydrology on Phytoplankton Assemblages and Its Adaptive Strategies in Lake Hwaseong, Estuarine Reservoir with Seawater Exchange, Korea)

  • 송태윤;유만호;이인호;강의태;김미옥;최중기
    • 생태와환경
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    • 제47권2호
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    • pp.71-81
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    • 2014
  • 해수유통 중인 화성호에서 수문학적 변동이 식물플랑크톤 군집과 적응전략에 미치는 영향을 파악하기 위하여 2012년 5월부터 10월까지 7회에 걸쳐 식물플랑크톤 종조성, 생물량, 환경변수를 조사하였다. 수문학적 이벤트 (해수유통, 강수량)는 화성호의 급격한 염분변동 (2.9~29.1 psu)과 함께 영양염, 투명도를 조절하였다. 식물플랑크톤 종조성은 매 조사마다 강 (class) 수준에서 급격히 변하였고, 클로로필-a는 $9.7{\sim}104.1{\mu}g\;L^{-1}$의 범위로 6월에 낮고 9월에 높았다. 다변량 분석결과, 식물플랑크톤 천이는 4개의 시기로 구분되었다. Phase I (5~6월)은 해수유통이 빈번한 고염-중온 시기로, 작은 크기의 Gymnodinium sp., Heterosigma akashiwo이 우점하였다. Phase II (7월, 9월)에는 집중호우와 바람의 영향으로 Cylindrotheca closterium가 우점하였고, Phase III (8월)에는 저염-고온 시기로 Oscillatoria spp.가 우점하였으며, Phase IV (10월)는 해수유통이 다시 증가하고 수온이 급감하면서 작은 편모조류인 unid. cryptomonad가 우점하였다. 화성호 식물플랑크톤 군집은 형태적, 생리적 특성에 따라 구분되는 세가지 적응전략, 즉 C (colonist-invasives), S (stress-tolerants), R (ruderals)전략에 따라 구분되었다. Phase I와 IV의 우점종은 CR-전략종으로써, 약한 성층조건을 선호하는 작은 크기의 기회종이였고, Phase II와 III의 우점종은 R-전략종으로써, 유입하천수의 교란에 적응된 중간 크기의 종이다. 이 결과는 향후 해수유통차단에 의한 성층강화가 현재의 식물플랑크톤 군집을 더 작은 편모조류의 극우점으로 변화시킬 수 있음을 보여주었다. 결론적으로 화성호의 수문학적 이벤트(해수유통, 강수량)는 염분, 영양염, 성층환경 교란을 조절함으로써 식물플랑크톤의 천이와 대발생을 이끄는 중요한 요인임을 제시한다.