20260 research outputs found
Sort by
Zinc Transporter ZIP13 G289R Variant from Spondylocheirodysplastic Ehlers-Danlos Syndrome Is Associated with Abnormal Hair Quality
No full textLong-Term Outcomes After Fractional Flow Reserve vs Intravascular Ultrasound to Guide PCI: The FLAVOUR Trial Extended Follow-Up
No full textBACKGROUND: The optimal treatment strategy for patients with intermediate coronary stenosis remains uncertain. OBJECTIVES: The aim of this study was to investigate the long-term outcomes of a randomized, open-label, multinational trial comparing fractional flow reserve (FFR)-guided vs intravascular ultrasound (IVUS)-guided treatment strategies. METHODS: Patients aged >/=19 years with de novo intermediate coronary stenosis (40%-70%) and target vessel diameters >/=2.5 mm were randomized 1:1 to FFR- or IVUS-guided treatment across 18 sites in Korea and China. The primary endpoint was a composite of all-cause death, myocardial infarction, and any revascularization occurring after the index procedure. Secondary endpoints included individual components of the primary outcome and per vessel outcomes according to treatment type. Extended follow-up continued through September 2024. RESULTS: Between July 2016 and August 2019, 1,682 patients were assigned to the FFR-guided (n = 838) and IVUS-guided (n = 844) groups. Over a median follow-up period of 6.3 years (Q1-Q3: 5.6-6.9 years), the primary outcome occurred in 339 patients (22.0%), with no statistically significant difference between groups (179 [23.1%] for FFR vs 160 [20.9%] for IVUS; HR: 1.15; 95% CI: 0.93-1.42; P = 0.208). The revascularization rate after the index procedure was higher in the FFR group (113 [14.9%] vs 87 [11.8%]; HR: 1.32; 95% CI: 1.00-1.75; P = 0.049), particularly for target vessel revascularization (72 [9.6%] vs 44 [6.2%]; HR: 1.67; 95% CI: 1.15-2.43; P = 0.007). Landmark analysis at 2 years and per vessel analyses indicated that the higher revascularization rate after the index procedure was driven primarily by late (2-7 years) revascularizations in vessels in which percutaneous coronary intervention (PCI) was initially deferred. Nevertheless, the overall rate of target vessel PCI, including procedures at index and during follow-up, was significantly lower in the FFR group (38.8% vs 60.5%; P < 0.001), with no statistically significant differences in the annual cumulative incidence of death or myocardial infarction between groups. CONCLUSIONS: FFR-guided and IVUS-guided treatment strategies resulted in comparable long-term outcomes, with no significant difference in patient-oriented composite outcomes. Although FFR-guided treatment was associated with a higher incidence of late target vessel revascularization, the overall target vessel PCI rate, accounting for both the index procedure and revascularization during follow-up, remained significantly lower in the FFR-guided treatment group, with comparable rates of hard outcomes between the 2 groups
Comparison of surgery and stereotactic body radiation therapy for clinical stage I NSCLC: a propensity score-matched analysis from a single institution
No full textBACKGROUND: Lobectomy with mediastinal lymph node dissection is the standard treatment for clinical stage I non-small cell lung cancer (NSCLC). For medically inoperable patients or those unwilling to undergo surgery, stereotactic body radiation therapy (SBRT) has emerged as an alternative. This study aimed to compare the clinical outcomes of SBRT and surgery in patients with stage I NSCLC treated at a single institution. METHODS: We retrospectively reviewed patients diagnosed with clinical stage I NSCLC at Ajou University Hospital from 2016 to 2021. Patients who had prior malignancies or double primary lung cancers were excluded. A total of 214 patients were included, and propensity score matching (PSM) (1:3) was applied to adjust for confounding variables, resulting in 31 patients in the SBRT group and 93 in the surgery group. Clinical outcomes were compared, including overall survival (OS), disease-free survival (DFS), and recurrence patterns. RESULTS: After matching, the 3-year OS was similar between the SBRT and surgery groups (90.0% vs. 90.7%, P=0.90). However, the surgery group showed significantly better 3-year DFS (68.2% vs. 54.4%, P=0.03) and higher locoregional recurrence-free survival (P=0.02). Local recurrence occurred in 19.4% of the SBRT group and 0% of the surgery group (P<0.001), while regional and distant recurrence rates were similar. CONCLUSIONS: In clinical stage I NSCLC, SBRT showed comparable OS and distant recurrence outcomes to surgery, although it was associated with a higher local recurrence rate. For elderly patients or those with high surgical risk, SBRT may be considered an effective alternative
Leveraging technology to help the patient: Combined robotic bronchoscopic biopsy with surgical resection during the same anesthetic event
No full textObjective: Delays from diagnosis to treatment of early-stage lung cancer affect survival, with variable biopsy wait times often requiring diagnostic wedge resection at planned oncologic resection, resulting in a 20% to 25% benign resection rate. We compared 2 approaches to reduce treatment delays in patients with high pretest probability of resectable malignancy. Methods: Patients from 2021 to 2024 with a lung nodule who did not have a previous attempt at diagnosis and had a Mayo Clinic solitary pulmonary nodule malignancy risk score ≥90% were offered a Single Anesthetic robotic bronchoscopy with Biopsy, followed by anatomic Resection, if indicated (SABRR). The control group included contemporaneous patients undergoing traditional surgical wedge resection (WR) for diagnosis, followed by anatomic resection if indicated. All patients with benign diagnoses that did not undergo surgery were followed until their nodule decreased in size or resolved. Results: A total of 138 patients were identified (65 SABRR, 73 WR). There were no differences in clinical characteristics or nodule location between the 2 groups. The mean time from clinic to definitive treatment was 30 ± 21 days in the SABRR group and 32 ± 23 days in the WR group (P = .545). Mean nodule size was larger (2.0 ± 0.9 vs 1.7 ± 0.7, P = .006) and mean operating room time was longer (218 ± 76 minutes vs 113 ± 43 minutes, P < .001) in the SABRR group. There were no differences in postoperative complications or 90-day readmission between groups. Eleven SABRRs were stopped at biopsy alone because of a diagnosis precluding surgical resection. Benign resection rate of 7.6% in the SABRR group was significantly lower than the rate of 21.9% in the WR group (P = .037). All SABRRs that were stopped at biopsy with a benign diagnosis had a decrease in nodule size or repeat benign biopsy within 6 months of their bronchoscopy. Conclusions: Combined robotic bronchoscopy with biopsy and anatomic lung resection under a single period of anesthesia significantly reduces the rate of benign and unnecessary surgery, as well as mitigates delay from diagnosis to surgery
Oral diseases as emerging risk factors for Alzheimer's disease: A scoping review
No full textThis scoping review examined current evidence on the relationship between oral diseases and Alzheimer's disease (AD). Systematic searches were conducted in PubMed, Scopus, Web of Science, Google Scholar, and KMbase for studies published from 1990 to December 2024, using terms of Alzheimer's disease, dementia, oral health, periodontal disease, dental caries, and tooth loss. Human and validated animal studies investigating microbiological, immunological, inflammatory, genetic, or functional links between oral health and AD were included. Of 1328 records, 841 remained after duplicates were removed, and 98 were reviewed in full; 45 met inclusion criteria. Findings were organized into four themes: general associations; periodontal disease and AD, including inflammation, amyloid-β pathways, and APOE4-related susceptibility; dental caries; and tooth loss with prosthetic rehabilitation. Evidence indicates that chronic oral diseases, especially periodontitis and tooth loss, are associated with increased risk of AD and its progression through mechanisms involving systemic inflammation, microbial translocation, amyloidogenic processes, genetic predisposition, and impaired masticatory function. Appropriate prosthetic rehabilitation may help reduce dementia risk by restoring chewing function and supporting nutrition. While causality has yet to be established, maintaining oral health throughout life may be a practical, cost-effective component of strategies to promote cognitive health in older adults
Effects of an Empowerment Program on Promoting Self-reliance Among Low-income Welfare Recipients in Korea: A Repeated-measures Design
No full textPURPOSE: This study examined the effectiveness of an empowerment program based on reality therapy in helping low-income welfare recipients become self-reliant. METHODS: This study used a repeated-measures design with a control group. Sixty-four participants were selected through convenience sampling from among welfare recipients who accessed self-sufficiency services at local self-sufficiency centers. The empowerment program consisted of eight sessions. The outcome variables were self-sufficiency motivation, self-esteem, and empowerment. Data were collected at baseline, immediately after intervention, and 4 weeks after intervention, and were analyzed using the independent t-test, chi(2) test, or Fisher's exact test, and generalized estimating equations (GEE). RESULTS: GEE revealed significant group x time interaction effects on self-sufficiency motivation, self-esteem, and empowerment, after adjusting the baseline scores for the three outcome variables. CONCLUSION: The developed empowerment program significantly improved self-sufficiency motivation, self-esteem, and empowerment among welfare recipients who accessed self-sufficiency services at local self-sufficiency centers. This study provides direction for the development of psychosocial empowerment programs to help welfare recipients become self-reliant. Future research should focus on the long-term effects of this empowerment program. TRIAL REGISTRATION: This study was retrospectively registered with the Clinical Research Information Service of Korea (https://cris.nih.go.kr) under the registration number KCT0009782 on September 10, 2024
Trends and Determinants of Smart Device Usage Among Children for Six Years: Latent Trajectory Classes Using a Growth Mixture Model
No full textBACKGROUND: This study investigated the patterns and determinants of smart device usage among children over a period of six years, utilizing latent trajectory class analysis with a growth mixture model (GMM) to identify risk groups based on their screen time trajectories. METHODS: The Kids Cohort for Understanding of internet addiction Risk factors in Early childhood provided data from six waves of surveys conducted from 2018 to 2023, with a final sample size of 313 participants (mostly mothers) who completed all assessments. We used a GMM to analyze six-year patterns of children's smart device usage. Subgroups were identified based on screen time trajectories using GMM, and the impact of sex, age, parental education, family income, and child behavior checklist (CBCL) scores on group membership was assessed with multinomial logistic regression. RESULTS: Three distinct risk groups were identified: a low-risk group (69.86%) with minimal and stable screen time, a mid-risk group (21.92%) with moderate and occasionally increased screen time, and a high-risk group (8.22%) with consistently high and increasing screen time. Factors such as older age of the child, higher early CBCL scores, lower maternal educational levels, and lower economic status were significantly associated with a higher risk of excessive screen time. CONCLUSION: This study highlights the significant variations in children's smart device usage patterns influenced by behavioral and socioeconomic factors. The findings suggest the need for targeted interventions that address the specific needs and risks associated with different screen-time trajectories. Effective strategies should consider both individual and familial factors to promote healthier digital habits among children
구강 건강 상태와 정신건강(우울감 및 스트레스) 간의 연관성: 국민건강영양조사 제9기(2022-2023)를 중심으로
No full textMasterⅠ. 서론 1
Ⅱ. 이론적 배경 3
A. 구강건강의 개념과 주요 평가 요소 3
B. 스트레스 및 우울감의 개념과 영향 4
C. 구강건강과 정신건강 간 관련성 5
D. 국민건강영양조사의 활용 현황과 본 연구의 접근 방식 6
Ⅲ. 연구 방법 7
A. 연구 대상 7
B. 연구 도구 7
1. 자연치아 수, 저작 불편감, 구강건강에 대한 주관적 인식을 통해 파악한 성인의 구강건강 상태 7
2. 스트레스 인지 정도와 최근 2주 이상 지속된 우울감 경험을 통해 측정한 정신건강 수준 8
3. 인구사회학적 및 건강행태 9
C. 통계 분석 방법 11
Ⅳ. 결과 13
A. 통계 분석 결과 13
1. 연구대상자의 인구사회학적 및 건강 관련 특성 13
2. 인구사회학적, 건강 관련 특성에 따른 구강건강 및 정신건강 비교 15
3. 구강건강이 정신건강에 미치는 영향 25
Ⅴ. 고찰 32
Ⅵ. 결론 35
참고문헌 36
ABSTRACT 3
치과위생사의 노출사고실태와 감염관리교육 및 관리체계에 대한 연구
No full textMasterⅠ. 서론 1
A. 연구배경 및 필요성 1
B. 이론적 배경 3
C. 연구 목적 4
Ⅱ. 연구대상 및 방법 5
A. 연구 디자인 5
B. 연구 대상자 6
C. 연구 방법 7
D. 통계분석 방법 7
Ⅲ. 결과 8
A. 인구사회학적 요인 특성 8
B. 치과위생사의 노출사고 (ET1~ET4) 유형별 경험 현황 10
C. 연구대상자의 치과 감염관리 교육 요인 특성 12
D. 연구대상자의 치과관리체계 현황 14
E. 감염관리 교육 및 근무지 내 감염관리체계 현황에 따른 노출사고 경험 차이 16
(1) 감염관리 교육 및 근무지 내 감염관리체계 현황과 ET1 16
(2) 감염관리 교육 및 근무지 내 감염관리체계 현황과 ET2 19
(3) 감염관리 교육 및 근무지 내 감염관리체계 현황과 ET3 22
(4) 감염관리 교육 및 근무지 내 감염관리체계 현황과 ET4 25
F. 치과감염관리교육 및 감염관리체계와 응급대처인지도의 연관성 28
(1) 치과감염관리교육 및 감염관리체계와 응급대처 전체 인지도 28
(2) 치과감염관리교육 및 감염관리체계와 응급대처 인지도1 32
(3) 치과감염관리교육 및 감염관리체계와 응급대처 인지도2 34
(4) 치과감염관리교육 및 감염관리체계와 응급대처 인지도3 36
(5) 치과감염관리교육 및 감염관리체계와 응급대처 인지도4 38
(6) 치과감염관리교육 및 감염관리체계와 응급대처 인지도5 40
(7) 치과감염관리교육 및 감염관리체계와 응급대처 인지도6 42
(8) 치과감염관리교육 및 감염관리체계와 응급대처 인지도7 44
Ⅳ. 고찰 46
Ⅴ. 결론 50
참고문헌 52
부록 55
ABSTRACT 5
임상 치과위생사의 주 4일 근무와 이직의도 간의 관계 분석 : 직무만족도, 조직몰입, 의사소통을 중심으로
No full textMasterⅠ. 서론 1
A. 연구 배경 1
1. 치과위생사 인력 부족 1
2. 치과위생사의 비활동 이유와 6개월 이내 이직을 하고자 하는 이유 2
3. 치과위생사의 일-가정 양립을 위한 제도로서 주 4일제 3
B. 연구의 필요성 4
1. 주 4일제의 부정적인 영향 4
2. 의료기관 종별과 직종에 따른 직무 차이 4
C. 연구의 목적 5
Ⅱ. 이론적 배경 6
A. 주 4일제 6
1. 주 4일제 해외 사례 6
2. 국내의 주 4일제 도입 및 적용 사례 7
B. 직무만족도 7
C. 조직몰입 7
D. 의사소통 8
E. 이직의도 8
Ⅲ. 연구대상 및 방법 9
A. 연구대상 및 윤리적 고려 9
B. 연구 도구 9
1. 일반적 특성 및 근무 특성 9
2. 주 4일제와 주 5일제 직무만족도 10
3. 조직몰입 10
4. 의사소통 10
5. 이직의도 10
C. 분석 방법 11
Ⅳ. 결과 12
A. 연구대상자의 일반적 특성 12
B. 연구대상자의 근무 특성 14
C. 연구대상자의 직무만족도 및 조직몰입, 의사소통, 이직의도의 상관관계 15
D. 연구대상자의 일반적 특성에 따른 직무만족도 및 조직몰입, 의사소통, 이직의도 17
E. 연구대상자의 근무 특성에 따른 직무만족도 및 조직몰입, 의사소통, 이직의도 20
F. 차이분석 22
G. 회귀분석 25
Ⅴ. 고찰 33
Ⅵ. 결론 35
Ⅶ. 참고문헌 37
부록 39
ABSTRACT 4