Analysis of the clinical indications for opiate use in inflammatory bowel disease

( Youran Gao ),( Sundas Khan ),( Meredith Akerman ),( Keith Sultan ) 대한장연구학회 2017 Intestinal Research Vol.15 No.1

Background/Aims: Opiate use for inflammatory bowel disease (IBD), particularly high-dose (HD) use, is associated with increased mortality. It`s assumed that opiate use is directly related to IBD-related complaints, although this hasn`t been well defined. Our goal was to determine the indications for opiate use as a first step in developing strategies to prevent or decrease opiate use. Methods: A retrospective cohort was formed of adults who were diagnosed with IBD and for whom outpatient evaluations from 2009 to 2014 were documented. Opiate use was defined if opiates were prescribed for a minimum of 30 days over a 365-day period. Individual chart notes were then reviewed to determine the clinical indication(s) for low-dose (LD) and HD opiate use. Results: After a search of the electronic records of 1,109,277 patients, 3,226 patients with IBD were found. One hundred four patients were identified as opiate users, including 65 patients with Crohn`s and 39 with ulcerative colitis; a total of 134 indications were available for these patients. IBD-related complaints accounted for 49.25% of the opiate indications, with abdominal pain (23.13%) being the most common. Overall, opiate use for IBD-related complaints (81.40% vs. 50.82%; P =0.0014) and abdominal pain (44.19% vs. 19.67%; P =0.0071) was more common among HD than among LD. Conclusions: Our findings show that most IBD patients using opiates, particularly HD users, used opiates for IBD-related complaints. Future research will need to determine the degree to which these complaints are related to disease activity and to formulate nonopiate pain management strategies for patients with both active and inactive IBD. (Intest Res 2017;15:83-89)

Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review

( Youran Gao ),( Meka Uffenheimer ),( Michael Ashamallah ),( Gregory Grimaldi ),( Arun Swaminath ),( Keith Sultan ) 대한장연구학회 2020 Intestinal Research Vol.18 No.3

Background/Aims: Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn’s disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined. Methods: We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes for IBD. CT and chart review was performed to confirm PI and IBD respectively. A systematic review excluding case reports was performed for PI with IBD for comparison. Results: Of 5,990 patients with a CT abdomen report mentioning PI, we identified 11 cases of PI with IBD, 4 UC, 6 CD, and 1 indeterminate colitis. PI was limited to the small bowel in 5 patients, the right colon in 5, and small bowel and colonic in 1. All 3 mortalities had CD, small intestinal PI and portal/mesenteric venous gas. The systematic literature search identified 9 articles describing 58 patients with IBD and PI. These cases were mostly included in larger cohorts of PI patients without extractable data on presentation or outcomes in the IBD subpopulation. Conclusions: Ours appears to be the first reporting of presentations and outcomes, outside of case reports, for those with PI and IBD. The high mortality for those with CD and PI of the small bowel appears to define a group requiring more than supportive medical care. (Intest Res 2020;18:289- 296)

A Case Report of Intravitreal Dexamethasone Implant with Exudative Retinal Detachment for Ocular Toxocariasis Treatment

Youran Cai,Ye Yang,Xin Zhong 대한기생충학ㆍ열대의학회 2022 The Korean Journal of Parasitology Vol.60 No.2

Toxocariasis is one of the most common geohelminth infections in several parts of the world. We describe a rare case of ocular toxocariasis with secondary exudative retinal detachment treated with albendazole and an intravitreal dexamethasone implant. A 13-year-old boy with counting finger vision was diagnosed with retinal vasculitis and exudative retinal detachment in his right eye. Fundoscopic examination revealed retinal hemorrhage, retinal vasculitis, and exudative retinal detachment. Serological test using serum and intraocular aqueous humor were positive for anti-Toxocara specific IgG antibodies. He received repeated doses of intravitreal dexamethasone implants combined with oral albendazole. A sequential follow-up optical coherence tomography revealed that the retina was successfully reattached. His visual acuity subsequently improved to 20/400.

Neonatal Immunization with Respiratory Syncytial Virus Glycoprotein Fragment Induces Protective Immunity in the Presence of Maternal Antibodies in Mice

Noh, Youran,Shim, Byoung-Shik,Cheon, In Su,Rho, Semi,Kim, Hee Joo,Choi, Youngjoo,Kang, Chang-Yuil,Chang, Jun,Song, Man Ki,Kim, Jae-Ouk Mary Ann Liebert 2013 Viral immunology Vol.26 No.4

이커머스 유료회원제 가입자/비가입자 주요 이슈 비교: 텍스트마이닝 기법 활용

우유란(Youran Woo),이중정(Choong C. Lee),이소현(So-Hyun Lee) 한국인터넷전자상거래학회 2020 인터넷전자상거래연구 Vol.20 No.2

While the fierce competition in e-commerce market continues to be escalated, more and more e-commerce firms is trying to secure loyal customers through membership marketing. However, as many marketers see the importance of membeship marketing, many firms still don"t clearly understand the unique characteristics of their paid membership customers so that the firms can transform them into loyal customers. Surprisingly, there are very few researches to study the unique characteristics of paid membership customers, that is, investigating how they are different from no-membership customers in terms of the type of service, their interest/ concern, and their expectation in purchasing experience. Therefore, this study explore and compare the key issues between customers with and without paid membership in e-commerce business. The differences in the key issues were derived from text-mining technique(i.e., LDA topic modeling and word frequency analysis) with the customer review data. For the results of the LDA topic modeling, we derived topics of membership, purchased products, events, and payment methods from the customers with paid membership, and membership and purchased products from the customers without paid membership. In addition, for the result of the word frequency analysis, we derived issues of price discount from the customers with paid membership, and purchase/use experience and product information from the customers without paid membership. The result of this study has practical implication that contribute to provide the detailed marketing strategies for each customer group based on the better comparative understanding of paid membership customers over no membership customer group.

청소년들의 체험학습 여행이 지각된 가치와 만족에 미치는 영향: 관여도의 조절효과

루요우란 ( Lu Youran ),윤해진 ( Yoon Hae-jin ) (사)한국마이스관광학회(구 한국컨벤션학회) 2021 MICE관광연구 Vol.21 No.1

The purpose of this study is to explore the key dimensions of perceived value driving satisfaction of educational travel and the influence of travel experience on adolescents’ perception of value and satisfaction. It also examines how involvement moderates the relationship between perceived value and travel experience. A research model was empirically tested with 310 adolescents who participated in educational travels. The results show that travel experiences have positive effects on all dimensions of perceived value and satisfaction. Perceived sacrifices, knowledge, and emotional value also positively affect satisfaction. Moreover, the relationship between experience and two components of perceived value (i.e., knowledge and social) is stronger when the level of involvement is higher. These results provide valuable implications for theory and businesses competing in educational tourism.

Impact of Intersecting Angles on Evacuation Efficiency of Pedestrian Flows in High Volume: A Case Study in Metro Station

Manman Chen,Jinghong Wang,Youran Zhi,Jinhua Sun 대한토목학회 2019 KSCE JOURNAL OF CIVIL ENGINEERING Vol.23 No.5

The intersection of pedestrian flows is a general phenomenon in daily pedestrian traffic and emergency evacuation. However, lacking of effective controls in crowed areas will result in pedestrian deceleration, stopping, and even threats to safety in evacuation. This paper focused on exploring the influence of different intersecting angles on evacuation efficiency of pedestrian flows in high volume. Through establishing a bidirectional pedestrian flow model with different intersecting angles for a busy metro station in China based on the social force model, two factors, namely the impact between pedestrians and the conflict frequency, were firstly proposed and validated as that playing major roles in influencing the evacuation efficiency during the pedestrian intersection. With the case study, it is found that the best intersecting angle is 120 degree and angles between 40 and 80 degree are unfavorable in optimizing the average crowd speed and the crowd density. The results are verified based on the comparative analysis with some existing experimental results. The outcomes of this work can offer some guidelines to control the intersection of pedestrian flows during evacuation and can make contributions to a proposal for the related, optimized design of a structure to increasing the evacuation efficiency of a dense crowd.

A Data-driven Approach to Estimate the Probability of Pedestrian Flow Congestion at Transportation Bottlenecks

Jinghong Wang,Manman Chen,Wenyu Yan,Youran Zhi,Zhirong Wang 대한토목학회 2019 KSCE JOURNAL OF CIVIL ENGINEERING Vol.23 No.1

In public gathering places, pedestrian flow congestion may happen in transportation bottlenecks. Limitations exist in the conventional judgment of congestion by considering the crowd density or the walking speed merely. In this paper, a data-driven mathematical approach based on Kernel Density Estimation (KDE) to analyze the probability of pedestrian flow congestion is proposed, which comprehensively considers the walking speed, the crowd density and the flow rate when pedestrians walk towards possible bottlenecks. With the case study of Nanjing metro station during rush hours, the advantages of non-parametric KDE compared with traditional parametric normal distribution estimation are analyzed and the optimal bandwidth for KDE is also discussed. The case study shows that the proposed method can obtain a more reliable quantitative assessment of congestion risk, as it overcomes the limitation of parametric estimation that relies on experience, and also avoids biased assessment of congestion that merely concerns single parameter of pedestrian flow. Finally, an assessment framework for dynamic congestion risk at bottlenecks is suggested. With this framework, the change of congestion situations of a monitored region can be mastered through data-driven approach, and thus the transformation of normal flowing to congestion of the crowd can be quantified through probabilistic analysis.

Investigation of the Probability of a Safe Evacuation to Succeed in Subway Fire Emergencies Based on Bayesian Theory

Jinghong Wang,Wenyu Yan,Han Xu,Youran Zhi,Zhirong Wang,Juncheng Jiang 대한토목학회 2018 KSCE Journal of Civil Engineering Vol.22 No.3

Emergency evacuation in subway fires is one of the hot issues in public safety. Based on Bayesian theory, a dynamic evacuation risk analysis model considering both psychological and behavioral responses of evacuees was proposed in this contribution. A subway fire scene was modeled using the Event Tree Analysis (ETA) according to the questionnaire survey at Nanjing Xinjiekou station. In this fire scenario, three control events (the fire alarm, the exhaust system and the evacuation route) were related to fire evacuation control and two control events (active escape and passive escape), which were specifically defined, were related to personnel characteristics. Subsequently, the probability of the final state of each scene was calculated by Monte Carlo simulation. Combined with the statistics of accidents and safe evacuation of subway fire cases from 1976 to 2013, the posterior probability distribution of safety evacuation was obtained after real-time dynamic updating of its precursor probability through Bayesian theory. Results show that the posterior probability of safety evacuation to succeed is around 0.8. This indicates that there is still a probability of 0.2 resulting in injury or fatalities in subway accidents even though most passengers are safely evacuated. It also suggests that utilization of 0.2 as the safety threshold would be an appropriate choice.

Evacuation of Nursing Home Based on Massmotion: Effect of the Distribution of Dependent Elderly

Jia Li,Jinghong Wang,Bowei Jin,Yan Wang,Youran Zhi,Zhirong Wang 대한토목학회 2020 KSCE Journal of Civil Engineering Vol.24 No.4

As dramatically increased elderly population, China is entering a society of deep aging. Due to the decline of physical functions, the elderly move slowly and have difficulty in escape. Hence, enough attention should be paid on pedestrian crowds’ evacuation in a nursing home. This paper takes Chinese old-age care institutions as the research object. Using the Massmotion based on the social force to establish the evacuation model and setting the parameters according to the movement characteristics of the elderly, this paper studied the influence of the dependent elderly on evacuation efficiency when they are distributed to the higher floors of the nursing home in different proportions. The results show that the evacuation time is significantly prolonged with the increase of the proportion of dependent elderly, and there is a controllable critical value for the proportion of dependent elderly. Aspeed-up phenomenon is observed when the old man enters the landing from the stairway, and meanwhile, with the increase of the proportion of dependent elderly, the acceleration position is gradually advanced, while the instantaneous speed declines. The results of this study can provide references in properly arranging the distribution of elderly accommodation and safe evacuation of the aged care institutions.