• Title/Summary/Keyword: randomized and sensitivity analysis

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Helicobacter pylori infection and abdominal pain in children (Helicobacter pylori 감염과 소아 복통)

  • Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.136-143
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    • 2006
  • The relationship between H. pylori(Hp) infection and recurrent abdominal pain(RAP) in children is not clear. Current data in the literature regarding a causal relationship between Hp infection and childhood RAP are conflicting. However, meta-analysis and most of the recently published studies have not supported an association between Hp infection and an increased prevalence of abdominal pain. Most published studies have some problems and have been criticized on methodological grounds. Most of the existing studies have not been designed to include double-blind placebo controls. And, because of the low incidence of Hp infection in children, they have a problem of obtaining sufficient numbers of the Hp infected children. There is also a concern about the heterogeneity of testing methodology in the studies and diagnostic accuracy problems of the non-invasive tests such as low sensitivity of the serology tests and false positive results of the UBT in children. And conflicting results may be explained, in part, by the poor definition of RAP or dyspepsia for the study subjects. To date, no consensus exists for the treatment of Hp-infected children with RAP. Some authors suggest the clinical efficacy of Hp. But others suggest that eradication of Hp is not associated with improvement of RAP. The problem of the most treatment studies is that they had usually no control groups and the number of the subjects was small. In order to make reasonable decisions about treatment of Hp infection in children with RAP, long-term, randomized, double blind, well controlled studies in large numbers of children will be required.

Is dentin biomodification with collagen cross-linking agents effective for improving dentin adhesion? A systematic review and meta-analysis

  • Julianne Coelho Silva;Edson Luiz Cetira Filho;Paulo Goberlanio de Barros Silva;Fabio Wildson Gurgel Costa;Vicente de Paulo Aragao Saboia
    • Restorative Dentistry and Endodontics
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    • v.47 no.2
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    • pp.23.1-23.18
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    • 2022
  • Objectives: The aim of this investigation was to evaluate the effectiveness of collagen cross-linking agents (CCLAs) used in combination with the adhesive technique in restorative procedures. Materials and Methods: In this systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An electronic search was performed using PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and DOSS, up to October 2020. The gray literature was also researched. Only randomized clinical trials were selected. Results: The selection process yielded 3 studies from the 838 retrieved. The addition of CCLAs in the retention of restorations increased the number of events. The postoperative sensitivity scores and marginal adaptation scores showed no significant difference between the CCLA and control groups, and the marginal pigmentation scores showed a significant increase in the CCLA group. There were no caries events in any group throughout the evaluation period. Conclusions: This systematic review showed that there is no clinical efficacy to justify the use of CCLAs in the protocols performed.

Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis

  • Hong, Sung-Bin;Kusnoto, Budi;Kim, Eun-Jeong;BeGole, Ellen A;Hwang, Hyeon-Shik;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.46 no.2
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    • pp.111-126
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    • 2016
  • Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

Clinical Benefits of Self-monitoring of Blood Glucose in Non-insulin Treated Patients with Type 2 Diabetes : A systematic Review and Meta-analysis (제 2형 당뇨 환자에서 자가혈당측정의 임상적 유용성 : 체계적문헌고찰 및 메타분석)

  • Choi, Yoon-Young;Sohn, Hyun-Soon;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.183-192
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    • 2010
  • While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

Damage index based seismic risk generalization for concrete gravity dams considering FFDI

  • Nahar, Tahmina T.;Rahman, Md M.;Kim, Dookie
    • Structural Engineering and Mechanics
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    • v.78 no.1
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    • pp.53-66
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    • 2021
  • The determination of the damage index to reveal the performance level of a structure can constitute the seismic risk generalization approach based on the parametric analysis. This study implemented this concept to one kind of civil engineering structure that is the concrete gravity dam. Different cases of the structure exhibit their individual responses, which constitute different considerations. Therefore, this approach allows the parametric study of concrete as well as soil for evaluating the seismic nature in the generalized case. To ensure that the target algorithm applicable to most of the concrete gravity dams, a very simple procedure has been considered. In order to develop a correlated algorithm (by response surface methodology; RSM) between the ground motion and the structural property, randomized sampling was adopted through a stochastic method called half-fractional central composite design. The responses in the case of fluid-foundation-dam interaction (FFDI) make it more reliable by introducing the foundation as being bounded by infinite elements. To evaluate the seismic generalization of FFDI models, incremental dynamic analysis (IDA) was carried out under the impacts of various earthquake records, which have been selected from the Pacific Earthquake Engineering Research Center data. Here, the displacement-based damage indexed fragility curves have been generated to show the variation in the seismic pattern of the dam. The responses to the sensitivity analysis of the various parameters presented here are the most effective controlling factors for the concrete gravity dam. Finally, to establish the accuracy of the proposed approach, reliable verification was adopted in this study.

Development and Validation of a Simple Index Based on Non-Enhanced CT and Clinical Factors for Prediction of Non-Alcoholic Fatty Liver Disease

  • Yura Ahn;Sung-Cheol Yun;Seung Soo Lee;Jung Hee Son;Sora Jo;Jieun Byun;Yu Sub Sung;Ho Sung Kim;Eun Sil Yu
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.413-421
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    • 2020
  • Objective: A widely applicable, non-invasive screening method for non-alcoholic fatty liver disease (NAFLD) is needed. We aimed to develop and validate an index combining computed tomography (CT) and routine clinical data for screening for NAFLD in a large cohort of adults with pathologically proven NAFLD. Materials and Methods: This retrospective study included 2218 living liver donors who had undergone liver biopsy and CT within a span of 3 days. Donors were randomized 2:1 into development and test cohorts. CTL-S was measured by subtracting splenic attenuation from hepatic attenuation on non-enhanced CT. Multivariable logistic regression analysis of the development cohort was utilized to develop a clinical-CT index predicting pathologically proven NAFLD. The diagnostic performance was evaluated by analyzing the areas under the receiver operating characteristic curve (AUC). The cutoffs for the clinical-CT index were determined for 90% sensitivity and 90% specificity in the development cohort, and their diagnostic performance was evaluated in the test cohort. Results: The clinical-CT index included CTL-S, body mass index, and aspartate transaminase and triglyceride concentrations. In the test cohort, the clinical-CT index (AUC, 0.81) outperformed CTL-S (0.74; p < 0.001) and clinical indices (0.73-0.75; p < 0.001) in diagnosing NAFLD. A cutoff of ≥ 46 had a sensitivity of 89% and a specificity of 41%, whereas a cutoff of ≥ 56.5 had a sensitivity of 57% and a specificity of 89%. Conclusion: The clinical-CT index is more accurate than CTL-S and clinical indices alone for the diagnosis of NAFLD and may be clinically useful in screening for NAFLD.

A Study of Quantitative Analysis of Six Basic Reinforcing-reducing Acupunctural Manipulations in Huang di nei jing(黃帝內經) (${\ll}$황제내경${\gg}$ 6가지 기본 보사수법의 정량적 분석연구)

  • Kim, Yu-Jong;Kim, Eun-Jung;Shin, Kyung-Min;Lee, Eun-Sol;Kim, Kyung-Ho;Kim, Kap-Sung;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.29 no.5
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    • pp.151-158
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    • 2012
  • Objectives : We hypothesized that reinforcing-reducing manipulations produce different effects by quantity of stimulation, and examined whether the difference is statistically significant or not. Methods : The study was conducted to the students of College of Oriental Medicine, Dongguk University. We needled into $ST_{36}$ and applied 6 kinds of basic reinforcing-reducing manipulations in Huang di nei jing by randomized sequence. And we had the students to fill up the questionnaire in form of visual analog scale(VAS). We examined whether significant differences in VAS existed between reinforcing-reducing manipulations(by t-test). And we examined whether significant differences in VDRRT(VAS difference between reinforcing-reducing technique) values existed along the gender, body mass index(BMI), age(by t-test), and psychological sensitivity(by ANOVA). Results : 1. The total stimulation quantity from reducing technique was significantly higher than that from reinforcing technique. Individually VAS values of reducing techniques were significantly higher in rotation, slow-rapid, lift-thrust, respiration and open-close manipulation. 2. The highest stimulation quantity was from rotation manipulation. And the highest VDRRT value was from slow-rapid manipulation. 3. When VDRRT values were analyzed by gender, age, BMI, and psychological sensitivity, VDRRT was significantly different by BMI in rotation manipulation, and by psychological sensitivity in rotation, lift-thrust, and slow-rapid manipulation. Conclusions : We could verify that reinforcing-reducing techniques induce different therapeutic effects by different quantities of stimulations. It suggests that reinforcing-reducing techniques could be applied universally, regardless of gender or age. Further studies are needed to consider control group, or patient groups in characteristic conditions.

Meta Analysis of Symptom Improvement through Eradication of Helicobacter pylori in Patients with Non-ulcer Dyspepsia (비궤양성 소화불량에서 Helicobacter pylori 박멸치료후 증상개선에 대한 메타분석)

  • Ohm, Sang-Hwa;Jeong, Ki-Won;Shin, Won-Chang;Cho, Jong-Rae;Shon, Hye-Suk;Pae, Ki-Taek;Kim, Sung-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.427-434
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    • 1999
  • Objectives: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. Methods: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have peformed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. Results: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results Conclusions: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studios that shows the opposite results there are methodological aspects explaining the heterogeneity.

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Economic Analysis of Growing Ginger (Zingiber officinale) Under Teak (Tectona grandis) Canopy in Southwest Nigeria

  • Oladele, Adekunle Tajudeen;Popoola, Labode
    • Journal of Forest and Environmental Science
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    • v.29 no.2
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    • pp.147-156
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    • 2013
  • Multiple use forestry is capable of generating income for forest based communities through Non-Timber forest products (NTFPs) which provide food, medicine, materials for domestic use and cash income for communities adjoining forest areas in developing countries. This study evaluates the economics of producing ginger rhizomes under teak canopy in a multiple land use system during 2007 and 2008 in even aged teak plantations in Ibadan and Ife, Nigeria. Twelve $6m^2$ sample plots were randomly selected in Completely Randomized Block Design within and outside the plantation. Average ginger rhizome of (50-60 g) were planted on the slightly tilled soil. NPK 15:15:15 was applied at 180 kg/ha on a split unit dose. ANOVA, Profitability, Benefit-Cost (B/C) ratio were used to analyze data. Results showed no significant differences between sites in ginger rhizome yield, (0.089 and 0.718, ${\rho}{\leq}0.05$) in 2007 and 2008 respectively. Average yield were higher outside teak canopy in both sites and treatments, (Ibadan -40.05 g>32.9 g, Ife -67.6 g>25.2 g and Ibadan -41.3 g>31.5 g, Ife -66.8 g>25.0 g) with and without NPK respectively. NPK had no effect on yields within teak plantation, (Ibadan -31.5<32.9 g, Ife -25 g<25.2 g). Ginger rhizome production was viable financially without inorganic fertilizer during second cropping season within and outside plantation (B/C=1.02, 1.09) respectively. Ginger could be raised profitably under teak canopy, however, studies on insolation requirement of ginger under teak canopy and other tree plantations are recommended.

Review on the Objective Effect and Mechanism Studies of Herbal Medicine, Acupuncture and Moxibustion Treatment for Irritable Bowel Syndrome Patients (과민성 대장증후군 환자를 대상으로 수행된 한약 및 침구치료의 객관적 효과와 기전 연구에 대한 문헌고찰)

  • Noh, Hyun Deok;Kim, Min Jeong;Cho, Im Hak;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.5
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    • pp.199-209
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    • 2021
  • The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.