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OBJECTIVE: Previous studies have comprehensively investigated the preva-lence and various potential risk factors for de-lirium among patients with advanced cancer ad-mitted to the acute palliative care unit (APCU). Our objective was to evaluate the comprehen-sive association between delirium and various risk factors among patients with advanced can-cer in an acute palliative care setting using a pa-tient-based multicenter registry cohort.PATIENTS AND METHODS: We performed a multicenter, patient-based registry cohort study collected in South Korea between January 1, 2019, and December 31, 2020. Delirium was identified using a medical record review based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.RESULTS: In total, 2,124 eligible patients with advanced cancer in the APCU met the inclu-sion criteria. There were 127 out of 2,124 pa-tients (prevalence, 6.0%;95% CI, 5.0 to 7.1) with delirium during admission. Delirium in patients with advanced cancer was associated with age >70 years (OR, 1.793;95% CI, 1.246 to 2.581), male sex (OR, 1.675;95% CI, 1.131 to 2.479), no chemotherapy during hospitalization (OR, 2.019;95% CI, 1.236 to 3.298), hearing impairment (OR, 3.566;95% CI, 1.176 to 10.810), underweight (OR, 1.826;95% CI, 1.067 to 3.124), current use of opioid medication (OR, 1.942;95% CI, 1.264 to 2.982), previous history of delirium (OR, 12.497;95% CI, 6.920 to 22.568), and mental illness (OR, 2.333;95% CI, 1.251 to 4.352).CONCLUSIONS: In a large-scale multicenter patient-based registry cohort, delirium was asso-ciated with old age, male sex, no chemotherapy during hospitalization, hearing impairment, un-derweight, current use of opioid medication, and a history of delirium and mental illness. Our find-ings suggest physicians should pay attention to delirium in patients with advanced cancer admit-ted to the APCU with the above risk factors.
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Clinical question What is the role of drug interventions in the treatment and prevention of covid-19? Recommendations The first version on this living guidance focuses on corticosteroids. It contains a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19, and a weak or conditional recommendation against systemic corticosteroids in patients with non-severe covid-19. Corticosteroids are inexpensive and are on the World Health Organisation list of essential medicines. How this guideline was created This guideline reflects an innovative collaboration between the WHO and the MAGIC Evidence Ecosystem Foundation, driven by an urgent need for global collaboration to provide trustworthy and living covid-19 guidance. A standing international panel of content experts, patients, clinicians, and methodologists, free from relevant conflicts of interest, produce recommendations for clinical practice. The panel follows standards, methods, processes, and platforms for trustworthy guideline development using the GRADE approach. We apply an individual patient perspective while considering contextual factors (that is, resources, feasibility, acceptability, equity) for countries and healthcare systems. The evidence A living systematic review and network meta-analysis, supported by a prospective meta-analysis, with data from eight randomised trials (7184 participants) found that systemic corticosteroids probably reduce 28 day mortality in patients with critical covid-19 (moderate certainty evidence;87 fewer deaths per 1000 patients (95% confidence interval 124 fewer to 41 fewer)), and also in those with severe disease (moderate certainty evidence;67 fewer deaths per 1000 patients (100 fewer to 27 fewer)). In contrast, systemic corticosteroids may increase the risk of death in patients without severe covid-19 (low certainty evidence;absolute effect estimate 39 more per 1000 patients, (12 fewer to 107 more)). Systemic corticosteroids probably reduce the need for invasive mechanical ventilation, and harms are likely to be minor (indirect evidence). Understanding the recommendations The panel made a strong recommendation for use of corticosteroids in severe and critical covid-19 because there is a lower risk of death among people treated with systemic corticosteroids (moderate certainty evidence), and they believe that all or almost all fully informed patients with severe and critical covid-19 would choose this treatment. In contrast, the panel concluded that patients with non-severe covid-19 would decline this treatment because they would be unlikely to benefit and may be harmed. Moreover, taking both a public health and a patient perspective, the panel warned that indiscriminate use of any therapy for covid-19 would potentially rapidly deplete global resources and deprive patients who may benefit from it most as potentially lifesaving therapy. Updates This is a living guideline. Work is under way to evaluate other interventions. New recommendations will be published as updates to this guideline. Readers note This is version 1 of the living guideline, published on 4 September (BMJ 2020;370:m3379) version 1. Updates will be labelled as version 2, 3 etc. When citing this article, please cite the version number. Submitted August 28 Accepted August 31Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
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Introduction: Obesity has been on the rise in children, adolescents and young adults during the Corona virus disesase-2019 (COVID-19) outbreak. Obesity is known as the main risk factor for a number of diseases including type 2 diabetes mellitus (T2DM) and more than 90 percent of T2DM patients are overweight or obese. Along with the rise in obesity during the COVID-19 pandemic, we investigated the impact of COVD-19 pandemic on type 2 diabetes in children and adolescents. Material(s) and Method(s): A retrospective case analysis of children and adolescents diagnosed with T2DM who visited Korea University Hospital in both 2019 and 2020. We investigated changes in weight and body mass index (BMI)-standard deviation scores (SDS), glycated hemoglobin (HbA1c), diabetic complications, and management from 2019 to 2020. Result(s): The Mean age of patients at study was 15.48 +/- 2.15 years old and the mean disease duration was 2.56 +/- 1.51 years. 70.6 % of patients were obese and the mean BMI-SDS was higher in 2020 than before the COVID-19 pandemic (2.21 +/- 1.25 vs 2.35 +/- 1.43, P=0.044). From 2019 to 2020, HbA1c level has also increased (6.5+/-2.72 mg/dL vs 7.3+/-3.70 mg/dL, P<0.001) and blood pressure (BP), total cholesterol, non-high density lipoprotein (HDL) cholesterol have also significantly increased. Obesity was found to be independent predictor of increased HbA1c in multivariable analysis (95% confidence interval 1.071-50.384, P=0.042). In non-obese subjects, HbA1c level has not significantly increased during the COVID-19 outbreak. In obese subjects, HbA1c and BMI-SDS have increased during the COVID-19 outbreak (6.45+/-2.30 mg/dL vs 7.20+/-3.05 mg/dL, P<0.001, 2.88 +/- 0.75 vs 3.08+/-0.98, P=0.045, respectively). Diastolic BP, total cholesterol were also higher in 2020 compared to 2019 (P=0.037, 0.019 repectively). Conclusion(s): During the COVID-19 outbreak, glycemic control and complications of type 2 DM have deteriorated in children and adolescents. This tendency was prominent in obese patients. Obese type 2 DM patients should be more closely monitored in glycemic control and complications.
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Background. Respiratory virus infections (RVIs) in adult hematopoietic cell transplant (HCT) candidates have been shown to impact posttransplant outcomes;however, there are few studies in pediatric patients. We sought to evaluate the role of specific viruses and the location of viral infection on post HCT outcomes. Methods. We evaluated allogeneic pediatric HCT recipients receiving myeloablative conditioning from 3/2010-3/2018. All patients had a multiplex PCR for RVIs prior to HCT, regardless of symptoms. Delaying HCT was recommended when feasible for RSV, parainfluenza, metapneumovirus, adenovirus, and influenza, but not routinely for human rhinovirus (HRV) and endemic coronaviruses. We utilized Cox proportional hazards models to evaluate progression to lower respiratory disease (LRD) post HCT and linear regression models to evaluated days alive and out of hospital (DAOH) by 100 days post HCT. Results. Of 310 allogeneic HCT recipients receiving myeloablative conditioning, 133 (43%) were positive for a RVI before HCT. Baseline characteristics were notable for differences for age, recipient CMV serostatus, and delayed HCT (Table 1). The most common RVI was HRV (97, 73%) and 81 (61%) patients were symptomatic at the time of detection. Most patients had a URI (92%) and 11 patients had LRD (3 proven, 8 possible). In univariate analysis, HRV as virus type was associated with fewer DAOH and preHCT URI as location of viral infection (with and without symptoms) trended towards fewer DAOH (Figure 1a). When adjusted for age, preHCT lymphocyte count, cell source, and conditioning regimen, both HRV and preHCT URI showed a trend towards fewer DAOH, but no significant association was found (Figure 1b,c). Twenty patients progressed to LRD after HCT with the same preHCT RVI;no factors, including delay of transplant, were associated with reduced progression to LRD. Conclusion. In this single center study, HRV as virus type and URI as location of viral infection before myeloablative allogeneic HCT were associated with increased hospitalization after HCT, but not inmultivariatemodels. Larger multicenter studies are needed to provide timely evaluation and adequate statistical power to definitivelydetermine role of URI versus LRD and the impact of transplant delay and treatment strategies. (Table Presented).
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Background: In an interim analysis of Asian pts with uHCC in the observational REFINE study of regorafenib (NCT03289273), treatment-emergent adverse events (TEAEs) were consistent with those reported in the global, phase 3 RESORCE trial. Here, we present the final analysis of Asian pts with uHCC in REFINE. Method(s): REFINE is an international, prospective, multicenter study that enrolled pts with uHCC for whom a decision to treat with regorafenib was made by the treating physician prior to enrollment, according to the local health authority approved label. The primary objective is safety, including the incidences of TEAEs and dose modifications due to TEAEs (NCI-CTCAE v4.03). Secondary endpoints include overall survival, progression-free survival, and treatment duration. Result(s): Of the 1005 evaluable pts, 557 (55%) were from Asia (Korea [31%], Japan [26%], Taiwan [24%], China [18%], Thailand [1%]) and 82% were male. At baseline, median age was 65 years (range 21-94) and the most common HCC etiology in Asian pts was hepatitis B (60%) and in non-Asian pts was alcohol use (36%;Table). More Asian pts (71%) had received prior transarterial chemoembolization vs non-Asian pts (42%). The initial daily regorafenib dose was 160/120/80/40 mg in 51%/12%/35%/3% of Asian pts and 42%/9%/45%/4% of non-Asian pts. The median treatment duration was 3.7 months (range 0-34.4) in Asian pts and 3.6 months (range 0-38.9) in non-Asian pts. The most common TEAEs in Asian pts were hand-foot skin reaction (40%), diarrhea (27%), and decreased appetite (17%). TEAEs led to dose modification in 44% of Asian pts. [Formula presented]. Conclusion(s): These final data from REFINE confirm the safety and effectiveness of regorafenib in Asian pts with uHCC from a broad population in real-world practice. Final analyses from REFINE are ongoing and will be presented at the conference. Clinical trial identification: NCT03289273. Editorial acknowledgement: Editorial assistance in the preparation of this manuscript was provided by Matthew Reynolds of OPEN Health Communications (London, UK), with financial support from Bayer. Legal entity responsible for the study: Bayer. Funding(s): Bayer. Disclosure: Y.J. Kim: Financial Interests, Personal, Advisory Role: Bayer, Bristol Myers Squibb, Samil, PharmaKing, Celltrion, Bukwang;Financial Interests, Personal, Invited Speaker: Roche, AbbVie, Eisai, Ipsen, Boston Scientific, Bristol Myers Squibb, BTG, Bayer, MSD, Gilead Sciences, Novo Nordisk, Green Cross Cell, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding: BTG, Bayer, Boston Scientific, AstraZeneca, Gilead Sciences, Samjin, BL&H. M. Kurosaki: Financial Interests, Personal, Speaker's Bureau: Gilead Sciences, AbbVie, Eisai, Chugai, Lilly, Takeda. H.Y. Lim: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Roche, Ipsen. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, Nihon Servier, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Liiy, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. Y. Huang: Financial Interests, Personal, Advisory Role: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Personal, Invited Speaker: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Inte ests, Personal, Speaker's Bureau: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Institutional, Funding: Gilead. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. C. Hsu: Financial Interests, Personal, Speaker's Bureau: Bristol Myers Squibb, Ono Pharmaceutical, Merck Sharp & Dohme, Roche, Eisai;Financial Interests, Institutional, Funding: Ono Pharmaceutical, AstraZeneca, MSD, Merck Serono, Taiho Pharmaceutical, Bristol Myers Squibb, BeiGene, NuCana BioMed, Johnson & Johnson, Roche/Genentech, BeiGene;Financial Interests, Personal, Advisory Role: Ono Pharmaceutical, MSD, Bristol Myers Squibb, Merck Serono, Roche/Genentech. B. Chewaskulyong: Financial Interests, Personal, Advisory Role: Pfizer, STADA;Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Personal, Speaker's Bureau: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Institutional, Funding: Bayer. J. Khan: Financial Interests, Institutional, Full or part-time Employment: Bayer. K. Ozgurdal: Financial Interests, Institutional, Full or part-time Employment: Bayer;Financial Interests, Personal, Stocks/Shares: Bayer. All other authors have declared no conflicts of interest. Copyright © 2022
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In response to the changes in the Coronavirus disease 2019 (COVID-19) epidemic situation, Ewha Womans University established Ewha Safe Campus (ESC), an on-campus infection outbreak management system, to allow students and faculty members to safely resume face-to face classes in 2022. The COVID-19 testing station, Ewha Safe Station, is the core element of ESC. Symptomatic students and faculty members perform a combo swab self-PCR test or receive a nasopharyngeal swab PCR test from experts to prevent the spread of COVID-19 through early detection and management. ESC is significant in that it detects infection risks and proactively implements preemptive measures in a university. The COVID-19 health response system model at the university level was applied for the first time in South Korea, reaching a milestone in the history of university health in South Korea. In particular, it is highly valuable that the test was free of charge, as it enabled all of the examinees to have easy access to the test through joint cooperation with the Seegene Medical Foundation. This is a successful example of cooperation between schools and private institutions for public health improvement. In the future, the direct and indirect effects of the establishment and implementation of ESC need to be evaluated and confirmed, and areas requiring improvements need to be identified in preparation for another infectious disease outbreak in the future.
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Objectives: Worldwide, the COVID-19 pandemic has resulted in lifestyle disruptions, with lockdowns and curtailed activities. This was acutely felt in Asia from February 2020 onwards. Such drastic changes in lifestyle habits may impact negatively on metabolic related diseases. We explored these changes and their effects in patients with metabolic associated fatty liver disease (MAFLD). Materials and Methods: The data of MAFLD patients who were prospectively enrolled from eleven Asian centres in a longitudinal cohort study were analyzed. The data from 1st January 2019 (pre- COVID-19), were compared with the data from 1st February 2020 onwards (during COVID-19). Patients were stratified by physical activity level and whether they met target recommendation of[ 150 min of moderate/vigorous exercise per week. Results: A total of 229 patients were evaluated. Mean age was 59 ± 9.6 years with 136 (59.4%) males. During the COVID-19 pandemic, 50 (21.8%) patients maintained moderate/vigorous exercise, while 28 (12.2%) and 33 (14.4%) patients started and stopped moderate/vigorous exercising respectively. 118 patients (51.5%) did not participate in moderate/vigorous exercise either before or during the pandemic. Seventy-eight (34.1%) patients achieved[150 min moderate/vigorous exercise per week at the last visit. With the onset of COVID-19, reduction of physical activity of any kind was demonstrated in the majority (65.9%) of patients. There was a reduction of any physical activity including walking amongst those who stopped moderate/vigorous exercise and those without moderate/ vigorous exercise throughout. No significant changes in BMI, waist or hip circumference were observed in any activity level group. In patients who stopped moderate/vigorous exercise, alanine transaminase and aspartate transaminase significantly increased by 18.5% and 14.8% respectively. Conclusion: Stoppage of moderate/vigorous exercise leads to worsening of liver enzymes in patients with MAFLD and may have deleterious effects long term. As we adapt to live with COVID endemicity, novel modified healthy lifestyle habits would be needed to manage MAFLD.
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Background: Due to the COVID-19 pandemic, Korean men are withdrawing from social interactions and feeling depressed due to financial difficulties. This depression can be reduced through physical activities and use of social media for communication. Therefore, this study aims to examine activities effective in reducing depression by analyzing the differences in physical activities and levels of social media addiction, depending on the level of depression. Methods: A total of 591 Korean males affected by the COVID-19 pandemic participated in the study. Results were extracted by frequency analysis, descriptive statistical analysis, chi-square test, and t-test using SPSS 25.0 (IBM Corp., Armonk, NY, USA). Results: Chi-square test, which analyzed differences in demographic characteristics based on the level of depression, revealed significant differences in monthly average family incomes, levels of participation in physical leisure activities, extent of social media usage and kinds of social media used. Significant differences existed in high-intensity physical activities as well as social media non-addiction and addiction depending on the level of depression. Conclusions: Since COVID-19 is increasing depression in males, government or health-related institutes need to provide spacious areas to engage in physical activities, which may help reduce suicidal ideation and restore mental health in Korean males. Moreover, there is a need to develop diverse health-related social media contents, which can help reduce depression. Thus, it has been thought that places to perform physical activities and sufficient communication with others on social media can prove helpful in managing depression.
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Purpose: This study analyzes the production inducement effect and industrial linkage structure of the land transport industries using input-output analysis. In particular, the focus of research is to confirm the link between the land transport industries and the distribution industry in the industrial linkage structure. Design/methodology/approach: The methodology is used by Input-Output Analysis. The analysis focus is calcu-lated the backward linkage effect (BL) and forward linkage effect (FL) using Input Coefficient and Production Induced Coefficient. The analysis data was applied to Korean time-series data from 2000 to 2014 from the World Input-Output Database (Released November 2016). Findings: In Korea, most domestic transportation needs are land transport, and storage services are also provided in conjunction with this. Therefore, it was found that wholesale and retail businesses (G46, G47) in the distribution industry are widely used as intermediary goods. Without the expansion and development of land transport service networks and courier service facilities in Korea, the current chaos caused by COVID-19 would have intensified. Research limitations/implications: The limitation of the study was that reliable data from the WIOD were used but failed to exclude the passenger sector contained in the land transport industries data. Therefore, it is necessary to secure more pertinent data and industrial classifications embodied in the land transport industries. Furthermore, with additional research direction, we analyze the structure of the forward and backward industries of each country's logistics industry and propose establishing the logistics service supply chain concept. Originality/value: Through this study's results, effective industrial policy establishment will be possible considering industries with high production inducement effect to forward and backward industries by the shipping and land transport industries. This study has a meaningful implication that it provides a foundation for understanding the industrial structure linked to the distribution and land transport industries. © 2022 People and Global Business Association.
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Background: In the setting of septic shock, an increase in sympathetic tone results in increased heart rate and contractility as well as decreased left ventricular (LV) end diastolic volume;these compensatory mechanisms can result in LV obstruction. Separately, following an MI, varying degrees of hypokinesis may result from infarcted myocardium. Case: A 75-year-old woman with COVID-19, acute respiratory distress syndrome, and septic shock was found to have a dynamic LV mid-cavitary obstruction on transthoracic echocardiogram (TTE). Three days later, the patient suffered a proximal left anterior descending STEMI and underwent percutaneous coronary intervention with drug-eluting stents. Follow-up TTE revealed mid-anterior and apical hypokinesis, with compensatory basal hyperkinesis and new systolic anterior motion of the mitral valve, resulting in an LV outflow tract (LVOT) obstruction, further exacerbated by underlying basal septal hypertrophy. A dynamic shift of the level of LV obstruction, from mid-cavitary to the outflow tract, was identified. Decision-making: Hemodynamic optimization in the setting of LVOT obstruction complicated by ischemic cardiomyopathy and distributive shock focused on supporting preload and afterload, while avoiding inotropic therapy. Conclusion: Prior case reports have demonstrated dynamic LV obstruction as a compensatory response to septic shock or as a sequelae of MI. However, this case highlights a rare presentation of shifting levels of obstruction. [Formula presented]
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Advanced metering infrastructure (AMI) is an integrated system of smart meters, communication networks, and data management systems. The AMI allows the automatic and remote measurement and monitoring of energy consumption. It also provides important information for the management of peak demand and energy consumption and costs. Pohang University of Science Technology (POSTECH) has developed its own AMI and an IT platform called Open Innovation Big Data Center (OIBC) to store and share various data collected in the campus. In this work, we describe the AMI and the OIBC platform equipped with various sensors and systems for measuring, storing, calling, and monitoring data. Data are collected from seven buildings with different characteristics. We installed 266 sensors at the buildings, including 188 EnerTalk and Biz, 18 plugin, and 60 high-sampling sensors. The sensors collect electricity consumption data in real time, and users can visualize and download the data through the OIBC platform. In this work, we present analysis results of the collected data. The results show that the amounts of electricity consumed by campus buildings are different depending on various factors, including building size, occupant type and their behaviors, and building use. We also compare the amounts of electricity consumed before and after the COVID-19 outbreak. The information extracted can be used to improve the satisfaction of students and faculty as well as the efficiency of electricity management. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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With the changing workplace landscape evident from the recent remote working arrangement, owing to the disruption caused by COVID-19 pandemic, the pace of adopting integrated services with AI has accelerated. In the insurance industry, there has been a gradual increase in business cases and research, with the introduction of AI technology in areas such as detection of unfair claims, claims adjusting, and insurance acceptance. In this study, an insurance underwriting model for accepting/rejecting new applicants was developed to reduce these discrepancies, based on underwriters, as well as enable faster processing. The data of Prudential Life Insurance from Kaggle was utilized to develop the insurance underwriting model. Among the feature selection methods, the filter-based and embedded methods were comparatively evaluated, and a Regularized Random Forest from the embedded methods was finally selected. For the insurance underwriting model, seven classification algorithms were applied for model optimization, and using the ensemble voting, the result of models with excellent classification performance with a recall score of 0.8 or higher was finally predicted by voting to ensure derivation of reliable results.
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Purpose: To demonstrate the effects of epiretinal membrane (ERM) and epiretinal proliferation on surgical outcomes for full-thickness macular hole. Methods: Nested case-control study with propensity score matching. Patients operated on for full-thickness macular hole between January 2011 and March 2020 were enrolled. The primary outcome was failure of the macular hole closure, and the secondary outcome was unfavorable hole closure (V or l type closure) at 6 months after the surgery. Results: Five hundred and thirty-four eyes of 534 patients met the inclusion criteria. After 1:1 propensity score matching (127 pairs), patients demonstrating ERM were more likely to have a failure of hole closure (adjusted odds ratio, 2.71;95% confidence interval, 1.19-6.14) and unfavorable hole closure (adjusted odds ratio, 2.07;95% confidence interval, 1.16-3.71). Epiretinal membrane spanning the hole margin (hole marginal ERM) greatly increased the likelihood of unfavorable hole closure (adjusted odds ratio, 2.13;95% confidence interval, 1.12-4.07). Patients with hole marginal-ERM + epiretinal proliferation were more likely to have a failure of hole closure (38.4%) compared with those with no ERM (11.8%). Conclusion: Patients with ERM had a higher risk for adverse surgical outcomes for full-thickness macular hole closure. The location of the ERM relative to the macular hole and the presence of epiretinal proliferation might affect the surgical outcomes for full-thickness macular hole closure.
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Background: To aim of this clinical outcome observational study was to assess the evaluate the effect of self-acupressure on the improvement of anxiety for caregivers during COVID-19 lockdown in Malaysia. Methods: The goal of this work was to self-acupressure for caregivers during COVID-19. All the participants (N = 50) enrolled in this study were staying in one of the wellness care centers. The participants were randomly allocated to one of the two groups;25 participants were involved in the selfacupressure group and 25 participants were involved in the nonacupressure group. Hamilton Anxiety Rating Scale and personal well-being (using the four Office for National Statistics personal well-being questions, ONS-4) were used to assess measurement. Data were collected at baseline and after four weeks of treatment. Results: Hamilton Anxiety Rating Scale (7.10±0.15), anxiety score in well-being ONS-4 (3.34 ± 0.38) were significantly lower;the happiness score in well-being ONS-4 (8.82 ± 0.86) was significantly higher in the self-acupressure the group compared with the non-acupressure group in the after four week's assessments. Discussion: Self-acupressure had an effect on nonacupressure in participants during the COVID-19 pandemic. But, satisfaction with life and worthwhile in the well-being was better in both of the groups, which proved the participants became more relaxed. Acupressure seems to be effective in providing relief of anxiety among caregivers during the COVID-19 pandemic.
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Background and objective: The whole world is suffering extensive damage from COVID-19, and even the world of sports cannot escape this situation. Preventive behavior against COVID-19 is crucial to minimizing this damage. Therefore, this study analyzed data examining preventive behaviors of all Korean professional basketball players, providing empirical evidence of the relationship between preventive health behavior and Big-5 factors depending on socio-demographic variables. Material and methods: Using an online survey, data were collected from 106 players registered with the Korean Basketball League in the 2019-2020 season. Results: Married players and those with more years of experience were more thorough in managing injuries and preventing infections. Among the Big-5 personality traits, conscientiousness had a significant effect on COVID-19 prevention and health management behavior. Players low on neuroticism demonstrated higher performance in terms of injury management behavior. Conclusions: These results provide critical insight regarding the preventive health behavior of professional sports players. The findings can serve as basic data for enhancing COVID-19 preventive behavior of male basketball players, and as a reference for a decrease in damage in professional sports leagues from COVID-19 and normal management and maintenance.
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Purpose: As China experienced a crisis due to Covid-19, the global supply chain collapsed and affected the world. Therefore, it is time for a change in port operational efficiency, increasing in importance with changes in the global supply chain. This study analyzed Shanghai Port's efficiency, the world's largest port and representative hub port in Northeast Asia, by looking at the relationship between facility factors and cargo throughput to present hub port development's timely implications. Research design, data and methodology: This study applied the Charnes, Cooper, and Rhodes (CCR) and Banker, Chames, and Cooper (BCC) models of the data development analysis (DEA) to construct an analysis from the input-oriented and output-oriented perspectives. Results: As a result, Yidong Container Terminal can be considered the most optimized in facilities and operation processes. Yidong and Shengdong Container Terminal should maintain current operating levels, while Pudong Container Terminal should review facility investments. Also, Zhendong, Huong, Mingdong, and Guandong Container Terminal should be reviewed to increase cargo throughput or to adjust current input variables in the current state. Conclusions: Therefore, the utilization of the container terminal input variables should be reviewed, and the factors of inefficiency should be improved. Moreover, the strategic focus of container terminal operations should be on increasing annual cargo throughput. © Copyright: The Author(s) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://Creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Forum papers are thought-provoking opinion pieces or essays founded in fact, sometimes containing speculation, on a civil engineering topic of general interest and relevance to the readership of the journal. The views expressed in this Forum article do not necessarily reflect the views of ASCE or the Editorial Board of the journal.