• Title/Summary/Keyword: prognostic model

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Survival Analysis for Prognostic Factors of Occupational Low Back Pain (직업성 요통 근로자의 장애기간에 영향을 미치는 요인 연구)

  • Kim, Ji-Yun
    • Research in Community and Public Health Nursing
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    • v.17 no.1
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    • pp.17-25
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    • 2006
  • Purpose: The goals of this research are to find out factors influencing the duration of work-related disability and to present implications for policies to prevent delayed recovery. Method: The subjects of this study were 238 workers who had been proved to be industrial disaster victims for occupational low back pain between January 1 2000 and December 31 2003. Kaplan-Meier method was used to estimate the proportion of duration of disability associated with low back pain, and Cox proportional hazards analysis was used to identify factors predicting it. The model distinguished main symptom variables affecting acute(${\leq}90\;days$) and chronic phase of disability (>90 days). Result: Fifty percent of the workers had not recovered in 408 days. The results of Cox regression show that delayed duration of disability was predicted by diagnosis, pain radiation (in chronic phase), sex, the size and labor union of the workplace, scheduled rest, compensation from the company, and operation. Conclusion: Duration of disability associated with compensated low back pain is influenced not only by factors related to the company and compensation system but also by individual factors. Thus, future efforts to reduce duration of disability may need to take into account all these factors.

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Factors Affecting Survival in Patients with Colorectal Cancer in Shiraz, Iran

  • Zare-Bandamiri, Mohammad;Khanjani, Narges;Jahani, Yunes;Mohammadianpanah, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.159-163
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    • 2016
  • Background: Colorectal cancer (CRC) is the third most common cancer in the world, and the fourth in Iran in both genders. The aim of this study was to find predictive factors for CRC survival. Materials and Methods: Medical records of 570 patients referred to the radiotherapy oncology department of Shiraz Namazi hospital from 2005 to 2010 were retrospectively analysed. Data were collected by reviewing medical records, and by telephone interviews with patients. Survival analysis was performed using the Cox's regression model with survival probability estimated with Kaplan-Meier curve. The log-rank test was used to compare survival between strata. Data was analyzed with Stata 12. Results: The five-year survival rate and the mean survival time after cancer diagnosis were 58.5% and $67{\pm}4months$. On multivariate analysis, age of diagnosis, disease stage and primary tumor site, lymphovascular invasion and type of treatment (in colon cancer) were significant factors for survival. Conclusions: Age of diagnosis and type of treatment (adjuvant therapy in patients with colon cancer) were two modifiable factors related to survival of CRC patients. Therefore earlier diagnosis might help increase survival.

Health prognostics of stator Windings in Water-Cooled Generator using Fick's second law (Fick's second law 를 이용한 수냉식 발전기 고정자 권선의 건전성 예지)

  • Youn, Byeng D.;Jang, Beom-Chan;Kim, Hee-Soo;Bae, Yong-Chae
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2014.10a
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    • pp.533-538
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    • 2014
  • Power generator is one of the most important component of electricity generation system to convert mechanical energy to electrical energy. I t designed robustly to maintain high system reliability during operation time. But unexpected failure of the power generator could happen and it cause huge amount of economic and social loss. To keep it from unexpected failure, health prognostics should be carried out In this research, We developed a health prognostic method of stator windings in power generator with statistical data analysis and degradation modeling against water absorption. We divided whole 42 windings into two groups, absorption suspected group and normal group. We built a degradation model of absorption suspected winding using Fick's second law to predict upcoming absorption data. Through the analysis of data of normal group, we could figure out the distribution of data of normal windings. After that, we can properly predict absorption data of normal windings. With data prediction of two groups, we derived upcoming Directional Mahalanobis Distance (DMD) of absorption suspected winding and time vs DMD curve. Finally we drew the probability distribution of Remaining Useful Life of absorption suspected windings.

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A Design of Automated Contingency Management and Case Study for Monopropellant Propulsion System (단일추진시스템의 ACM 설계 및 사례연구)

  • Lee, Young-Jin;Lee, Kwon-Soon;Vachtsevanos, George
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.16 no.2
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    • pp.1-11
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    • 2008
  • Increasing demand for improved reliability and survivability of mission-critical systems is driving the development of health monitoring and Automated Contingency Management (ACM) systems. An ACM system is expected to adapt autonomously to fault conditions with the goal of still achieving mission objectives by allowing some degradation in system performance within permissible limits. ACM performance depends on supporting technologies like sensors and anomaly detection, diagnostic/prognostic and reasoning algorithms. This paper presents the development of a generic prototype test bench software framework for developing and validating ACM systems for advanced propulsion systems called the Propulsion ACM (PACM) Test Bench. The architecture has been implemented for a Monopropellant Propulsion System (MPS) to demonstrate the validity of the approach. A Simulink model of the MPS has been developed along with a fault injection module. It has been shown that the ACM system is capable of mitigating the failures by searching for an optimal strategy. Furthermore, the concepts of Validation and Verification (V&V) of such systems are introduced with relevant examples.

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Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation

  • Kim, Il Han
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.1-12
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    • 2019
  • Despite recent innovation in treatment techniques and subsequently improved outcomes, the majority of glioblastoma (GBL) have relapses, especially in locoregional areas. Local re-irradiation (re-RT) has been established as a feasible option for recurrent GBL of all ages with safety, tolerability, and effectiveness both in survival and quality of life regardless of fractionation schedule. To keep adverse effects under acceptable range, cumulative dose limit in equivalent dose at 2 Gy fractions by the linear-quadratic model at α/β = 2 for normal brain tissue (EQD2) with narrow margin should be observed and single/hypofractionated re-RT should be undertaken very carefully to recurrent tumor with large volume or adjacent to the brainstem. Promising outcome of re-operation (re-Op) plus re-RT (re-Op/RT) need to be validated and result from re-RT with temozolomide/bevacizumab (TMZ/BV) or new strategy is expected. Development of new-concept prognostic scoring or risk group is required to select patients properly and make use of predictive biomarkers such as O(6)-methylguanine-DNA methyltransferase (MGMT) promotor methylation that influence outcomes of re-RT, re-Op/RT, or re-RT with TMZ/BV.

The Effect of Atmospheric Flow Field According to the Urban Roughness Parameter and the Future Development Plan on Urban Area (도심 실제 거칠기 적용과 장래 도심 개발계획에 따른 국지 기상장 변화 수치 모의)

  • Choi, Hyun-Jung;Lee, Hwa-Woon;Kim, Min-Jung
    • Journal of Environmental Science International
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    • v.19 no.6
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    • pp.703-714
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    • 2010
  • In this study, we analyzed the impact of orographic and thermal forcing on the atmospheric flow field over the urban metropolitan areas on urban artificial buildings and future development plan. Several numerical experiments have been undertaken in order to clarify the impacts of the future development plan on urban area by analyzing practical urban ground conditions, we revealed that there were large differences in the meteorological differences in each case. The prognostic meteorological fields over complex areas of Seoul, Korea are generated by the PSU/NCAR mesoscale model(MM5). we carried out a comparative examination on the meteorological fields of topography and land-use that had building information and future development plan. A higher wind speed at daytimes tends to be forecasted when using new topography and land use data that have a high resolution with an appropriate limitation to the mixing height and the nocturnal boundary layer(NCB). During nighttime periods, since radiation cooling development is stronger after development plan, the decreased wind speed is often generated.

Evaluation of the Validity of Risk-Adjustment Model of Acute Stroke Mortality for Comparing Hospital Performance (병원 성과 비교를 위한 급성기 뇌졸중 사망률 위험보정모형의 타당도 평가)

  • Choi, Eun Young;Kim, Seon-Ha;Ock, Minsu;Lee, Hyeon-Jeong;Son, Woo-Seung;Jo, Min-Woo;Lee, Sang-il
    • Health Policy and Management
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    • v.26 no.4
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    • pp.359-372
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    • 2016
  • Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

The Prognostic Value of the Charlson's Comorbidity Index in Patients with Prolonged Acute Mechanical Ventilation: A Single Center Experience

  • Song, Seung Eon;Lee, Sang Hee;Jo, Eun-Jung;Eom, Jung Seop;Mok, Jeong Ha;Kim, Mi-Hyun;Kim, Ki Uk;Lee, Min Ki;Lee, Kwangha
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.289-294
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    • 2016
  • Background: The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ${\geq}96$ hours). Methods: We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results: The patients' mean age was $65.1{\pm}14.1$ years and 70.6% were male. The mean ICU and hospital length of stay was $21.9{\pm}19.7$ and $39.4{\pm}39.1$ days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was $2.3{\pm}1.8$, with significant differences between nonsurvivors and survivors ($2.7{\pm}2.1$ vs. $2.1{\pm}1.7$, p<0.05). The area under the curve of receiver-operating-characteristics curve for WIC was 0.593 (95% confidence interval [CI], 0.523-0.661; p<0.05). Based on Kaplan-Meier curves of 60-day survival, WIC ${\geq}5$ had statistically lower survival than WIC <5 (logrank test, p<0.05). In a multivariate Cox proportional hazard model, WIC ${\geq}5$ was associated with poor prognosis (hazard ratio, 1.901; 95% CI, 1.140-3.171; p<0.05). The mortality rate of patients with WIC ${\geq}5$ was 54.2%. Conclusion: Our study showed a WIC score ${\geq}5$ might be helpful in predicting 60-day mortality in PAMV patients.

Clinical Features and Prognostic Factors in Elderly Koreans with Advanced Non-Small-Cell Lung Cancer in a Tertiary Referral Hospital

  • Kim, Seo Woo;Kim, Mi Yeon;Lee, Yoon Pyo;Ryu, Yon Ju;Lee, Seok Jeong;Lee, Jin Hwa;Chang, Jung Hyun;Shim, Sung Shine
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.2
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    • pp.52-58
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    • 2013
  • Background: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Methods: Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. Results: The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <$18.5kg/m^2$. The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Conclusion: Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.

Immunohistochemical Assay for Lymph-Node Micrometastasis in Gastric Cancer and Correlation with Survival Rate (위암에서 림프절 미세전이의 면역조직화학적 방법에 의한 측정 및 생존율과의 상관관계)

  • Moon Chul;Park Kyung-Kyu;Lee Moon Soo;Hur Kyung Yul;Jang Yong Seog;Kim Jae Joon;Lee Min Hyuk;Jin So-Young;Lee Dong Wha
    • Journal of Gastric Cancer
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    • v.2 no.1
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    • pp.5-11
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    • 2002
  • Purpose: The purpose of this study is to identify immunohistochemical evidence of lymph-node micrometastasis in histologic node-negative gastric cancer patients and to evaluate the prognostic significance of lymph-node micrometastasis.Materials and Methods: A retrospective study of 50 gastric cancer patients who underwent curative resections from October 1990 to November 1994 was performed. Two consecutive sections were prepared: one for ordinary hematoxylin and eosin staining, and the other for immunohistochemical staining with Pan cytokeratin antibody (Novocastra, UK). In the univariate analysis, the survival rate was calculated using the Life Table Method, and the multivariate analysis was determined using a Cox Proportional HazardsModel. The statistical analyses of the relationships between the clinicopathologic factors and micrometastases were performed by using a Chi-square test. Results: Of 2522 harvested lymph nodes, 81 ($4.1\%$) nodes and 19 ($38\%$) of 50 patients were identified as having lymphnode micrometastases by using immunohistochemical staining for cytokeratin. The incidence of lymph-node micrometastases was significantly higher in diffuse type carcinomas ($54\%$, P=0.024) and in patients with serosal invasion ($52.2\%$, P=0.05). For patients with lymph-node micrometastases (n=19), the 5-year survival rate was significantly decreased ($73.7\%$, P=0.015). The Lauren's classirication (P=0.021) and the depth of invasion (P=0.035) were shown by multivariate analysis to have a significant relationship with the presence of micrometastases. Multivariate analysis revealed that lymph-node micrometastasis was independently correlated with survival in histologic node-negative gastic cancer patients. Conclusion: The presence of cytokeratin detected lymphnode micrometastases correlates with the worse prognosis for patients with histologic node-negative gastric cancer.

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