Sequential Organ Failure Assessment score as a predictor of mortality in ventilated patients with multidrug-resistant bacteremia

오예슬,노지연,이재민,정현성,이광하,이민기 대한중환자의학회 2020 Acute and Critical Care Vol.35 No.3

Background: The occurrence of multidrug-resistant (MDR) bacteremia in ventilated patients may be associated with a high mortality rate. We evaluated whether Sequential Organ Failure Assessment (SOFA) score on the day of bacteremia could predict 90-day mortality in these patients. Methods: Data were obtained retrospectively from 202 patients (male, 60.4%; median age, 64 years) hospitalized at a single university-affiliated tertiary care hospital. All adult patients who had were ventilated and had one of the following six MDR bacteremias between March 2011 and February 2018 were enrolled: methicillin-resistant Staphylococcus aureus, extended- spectrum β-lactamase-producing Gram-negative bacteria (Escherichia coli and Klebsiella pneumonia), carbapenem-resistant Gram-negative rods (Acinetobacter baumannii and Pseudomonas aeruginosa), or vancomycin-resistant Enterococcus faecium. Results: The overall 90-day mortality rate after the day of bacteremia was 59.9%. The areas under the receiver operating characteristic curves for the SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 0.732 (95% confidence interval [CI], 0.666 to 0.792; P<0.001) and 0.662 (95% CI, 0.593 to 0.727; P<0.001), respectively, with no difference between the two (P=0.059). Also, the cutoff value of the SOFA score was 9 (based on Youden’s index). Multivariate Cox regression analysis showed that this cut-off value was significantly associated with higher mortality rate (hazard ratio, 2.886; 95% CI, 1.946 to 4.221; P<0.001). Conclusions: SOFA score measured on the day of bacteremia may be a useful prognostic indicator of 90-day mortality in ventilated patients with MDR bacteremia.

Prognostic factors in patients with pneumonia requiring ventilator care more than four days

오예슬,이광하 대한내과학회 2020 대한내과학회 추계학술대회 Vol.2020 No.1

Comparison of SOI scoring systems for predicting prognosis in ventilated patients with MDRbacteremia

오예슬,이광하 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1

Development of a prognostic scoring system in patients with pneumonia requiring ventilator care for more than 4 days: a single-center observational study

오예슬,강예원,이광하 대한중환자의학회 2021 Acute and Critical Care Vol.36 No.1

Background:The aim of the present study was to develop a prognostic model using demographic characteristics, comorbidities, and clinical variables measured on day 4 of mechanical ventilation (MV) for patients with prolonged acute mechanical ventilation (PAMV; MV for >96 hours). Methods:Data from 437 patients (70.9% male; median age, 68 years) were obtained over a period of 9 years. All patients were diagnosed with pneumonia. Binary logistic regression identified factors predicting mortality at 90 days after the start of MV. A PAMV prognosis score was calculating ß-coefficient values and assigning points to variables. Results:The overall 90-day mortality rate was 47.1%. Five factors (age ≥65 years, body mass index <18.5 kg/m2, hemato-oncologic diseases as comorbidities, requirement for vasopressors on day 4 of MV and requirement for neuromuscular blocking agents on day 4 of MV) were identified as prognostic indicators. Each factor was valued as +1 point, and used to develop a PAMV prognosis score. This score showed acceptable discrimination (area under the receiver operating characteristic curve of 0.695 for mortality, 95% confidence interval 0.650–0.738, p<0.001), and calibration (Hosmer–Lemeshow chi-square=6.331, with df 7 and p=0.502). The cutoff value for predicting mortality based on the maximum Youden index was ≤2 (sensitivity, 87.5%; specificity, 41.3%). For patients with PAMV scores ≤1, 2, 3 and ≥4, the 90-day mortality rates were 29.2%, 45.7%, 67.9%, and 90.9%, respectively (P<0.001). Conclusions:Our study developed a PAMV prognosis score for predicting 90-day mortality. Further research is needed to validate the utility of this score.

Decoupling Memory from Desire: T.S. Eliot’s Journey Towards Detachment

오예슬 한국영어영문학회 2022 영어 영문학 Vol.68 No.1

This paper pivots on T.S. Eliot’s impersonality by focusing on the overarching religiosity in his later writings, or in the case of his earlier works, the lack thereof. Such claim is predicated on the paradox of a glaring absence, which is suggestive of intentional, or at least subconscious avoidance. Although the triad paradigm of attachment, indifference, and detachment is introduced much later in “Little Gidding,” the poet’s immersion in religious philosophy dating back to his college days allows us to discover detachment as prefigurative of Eliot’s formulation of poetic impersonality, thereby facilitating a more holistic reading of his oeuvre. To conceptualize attachment, indifference, and detachment, therefore, I borrow from the thirteenth-century German Dominican mystic Meister Eckhart whose works Eliot first became familiar with at Harvard. Opening with Eliot’s early poems of attachment, I demonstrate how the poet often takes up heterosexual relationships to showcase the poetic consciousness as inextricably caught up in the secular, everyday world. Here, I mainly examine “La Figlia Che Piange.” Because the poem delineates an escape from genuine emotion and functions as an exposé of the male speaker’s irresponsible, egotistic aesthetics, it performs indifference, which I next delve into. In this intermission on “Tradition and the Individual Talent” and The Waste Land, I carry out a quick analysis of indifference and Eliot’s poetic impersonality, which attempts to disentangle it from the traps of human emotion and personality. My understanding of impersonality is as a precursor to detachment, a principle more closely and explicitly articulated in “Burnt Norton” and “Little Gidding.”

보건계열 대학생의 취업 스트레스에 관한 질적 연구

오예슬,오은환 한국학교・지역보건교육학회 2013 한국학교지역보건교육학회지 Vol.14 No.1

Thomas Hardy’s Re-configuration of Time as a Circle in Poems of 1912-13

오예슬 한국현대영미시학회 2015 현대영미시연구 Vol.21 No.1

Thomas Hardy’s Re-configuration of Time as a Circle in Poems of 1912-13 Ye Sul Oh (Seoul Nat’l Univ.) Thomas Hardy’s first wife, Emma, inspired him the most when she died unexpectedly in November 1912. Through the sequence of elegies entitled Poems of 1912-13, the poet aligns himself with the historic lineage of elegists by inheriting their legacies and at the same time revises its generic conventions to secure his originality. Reading the sequence mainly through textual analysis and also by means of the author’s biography, this paper aims to illuminate how Hardy mourns the dead without relying too much on transcendental entities, those often used in the conventional elegies. Most importantly, it examines how the poet re-imagines the generic conception of elegiac time. Instead of overlapping the cyclical time of nature and the linearity of human life, Hardy blurs the boundaries of the sequential time frame. With this strategy, he creates a more unified perception of time as a kind of circle, which ultimately consolidates both his identities as a natural man and a poet. Reading these elegies while paying close attention to his project to rewrite the elegiac concept of time would reconfirm Hardy as the harbinger of the modern elegy. This, in turn, will enable the reader to turn their eyes towards the dynamic transformation of one of the most enduring genres of English poetry.

ST분절 비상승 심근경색증으로 오인된 호산구육아종성다발혈관염

오예슬 ( Yeseul Oh ),한미연 ( Miyeun Han ),박혜경 ( Hye-kyung Park ),조은정 ( Eun-jung Jo ) 대한천식알레르기학회(구 대한알레르기학회) 2021 Allergy Asthma & Respiratory Disease Vol.9 No.1

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic disease and a potentially life-threatening systemic necrotizing vasculitis predominantly affecting small vessels. Herein, we describe a 47-year-old man with EGPA misdiagnosed as non-ST-segment elevation myocardial infarction. He presented to the Emergency Department with indigestion and diarrhea. He had been diagnosed with asthma and chronic rhinosinusitis 3 years earlier and was taking antibiotics due to worsening sinusitis. In laboratory tests, peripheral blood eosinophils, serum creatinine, and serum troponin were elevated to 4,641 cells/μL, 13.40 ng/mL, and 1.26 ng/mL, respectively. Electrocardiography showed ST-segment depression on the inferior wall, and echocardiography indicated an ischemic insult in the right coronary artery territory. A non-ST-segment elevation myocardial infarction as well as antibiotic-associated diarrhea, eosinophilia and acute kidney injury was initially suspected. However, fever persisted and eosinophilia worsened despite cessation of antibiotics after admission. There was no significant stenosis of the coronary arteries on coronary angiography. Meanwhile, abdominal computed tomography suggested medical renal disease, and magnetic resonance imaging showed late gadolinium enhancement at the mid wall and the subepicardial area in the left ventricle of the heart. As a workup for eosinophilia, serum anti-MPO was measured and turned out to be positive. A kidney biopsy was performed, which yielded membranous nephropathy superimposed on antineutrophil cytoplasmic antibodies-mediated crescent formation. He was diagnosed as EGPA with cardiac and renal involvement, and received systemic steroid, cyclophosphamide, and plasmapheresis. Then, peripheral eosinophil counts and renal function were normalized. He is now in clinical remission even after stopping the use of steroids and immunosuppressive agents. (Allergy Asthma Respir Dis 2021;9:50-55)

소비자 신념을 공략한 사회적 마케팅의 커뮤니케이션 디자인 분석

오예슬 ( Oh Yeseul ),정정호 ( Jung Jungho ) 전남대학교 예술연구소 2020 藝術論集 Vol.21 No.-

현재 사회가 변화함에 따라 소비트렌드가 바뀌고 있으며 소비자들은 개인의 행복과 만족을 위한 소비활동을 추구하며, 자신의 신념을 소비행위에 반영하고 있다. 이에 본 연구는 기업들의 사회적 책임의 일환으로 소비신념을 공략한 사회적 마케팅을 분석하여 마케팅커뮤니케이션디자인 전략수립의 기초자료로 제안하고자 한다. 본 연구는 소비신념에 대한 이론적 고찰 및 사회적 마케팅에 대한 이해를 바탕으로 국내외 사회적마케팅 사례를 분석하였다. 또한 기업이 마케팅 커뮤니케이션을 실행할 때 소비자의 디즈를 통해 소비자가 실질적으로 원하는 문제를 도출하여 마케팅에 적극적으로 활용하는 방안을 제시할 수 있었다. 연구결과로 소비자의 신념을 공략할 긍정적인 제품과 서비스의 확대, 그리고 기업의 사회 환원의 가치를 전달 할 수 있는 마케팅 전략을 도출하였다. 본 연구를 통해 사회적 기업의 성장을 모색하며 지속적인 사회적기업의 형성과 유지를 위한 건전한 기업 경영의 실현을 제언하고자 한다. At present, consumption trends are changing as society changes, and consumers place consumption activities for individual happiness and satisfaction, and their beliefs are reflected in consumption behavior. Therefore, this study analyzes social marketing targeting consumer beliefs as a part of corporate social responsibility and proposes it as the basic data for establishing marketing communication design strategy. This study analyzed domestic and foreign social marketing cases based on the theoretical consideration of consumption beliefs and understanding of social marketing. In addition, when a company conducts marketing communication, it was possible to suggest a plan to actively use it in marketing by deriving the problem that the consumer actually wants through the consumer's Dizz. As a result of the research, a marketing strategy that can deliver positive product and service expansion to target consumer's beliefs and corporate social return was derived. Through this study, we seek the growth of social enterprises and suggest the realization of sound corporate management for the continuous formation and maintenance of social enterprises.

HRD 관점에서 기업의 스마트 러닝 성공을 위한 탐색적 연구

오예슬 ( Yeseul Oh ),안재영 ( Jaeyoung An ),윤혜정 ( Haejung Yun ) 한국지식경영학회 2023 지식경영연구 Vol.24 No.4

디지털 기술의 발전과 코로나19의 영향으로 기업의 혁신과 조직문화가 변화하고 있으며, HRD(Human Resource Development) 분야에서 스마트 러닝의 중요성이 부각되고 있다. 본 연구에서는 HRD 담당자의 관점에서 스마트 러닝을 구성하는 요인들의 상대적인 중요성을 밝히는 것을 목적으로 하였다. 선행 문헌 검토를 통해 현 상황에 가장 부합하는 스마트 러닝 계층 및 요인을 도출하고, AHP 방법을 활용하여 해당 요인의 상대적 중요도를 파악하였다. 결과적으로 1계층 요인에서는 ‘학습 활동’, ‘교육 활동’, ‘학습 콘텐츠’, ‘평가 방법 및 평가’, ‘학습 시간 및 공간’ 순으로 중요도가 확인되었다. 2계층 전체 요인에서는 ‘교육 전략’, ‘학습 결과’, ‘학습 과업’, ‘학습 목표’, ‘학습 지원’이 상위 5위에 나타나는 요인으로 확인되었다. 본 연구 결과는 스마트 러닝 개념을 재정립하고, 추후 연구를 위한 학술적 프레임워크를 제안한 점에서 의의를 가진다. 또한, 실무적으로는 HRD 담당자들이 스마트 러닝을 개선하고 향상시키기 위해 어떤 요인에 주력해야 하는지에 대한 유용한 정보를 제공하는데 기여할 것으로 기대된다. The advancement of digital technology and the impact of COVID-19 have brought about changes in corporate innovation and organizational culture, thereby highlighting the significance of Smart Learning in the field of HRD (Human Resource Development). This trend has led to an increased interest in personalized Smart Learning among employees due to the growth of hybrid work and the widespread adoption of smart work practices. This study aimed to illuminate the relative importance of the factors that constitute Smart Learning from the perspective of HRD practitioners. Through a review of prior literature, Smart Learning hierarchy and factors most fitting to the current context were identified, and their relative importance was determined using the AHP method. Consequently, in the first-tier factors, importance was confirmed in the order of ‘Learning Activities’, ‘Teaching Activities’, ‘Learning Content’, ‘Assessment and Evaluations’, and ‘Learning Time and Space’. At the second-tier encompassing all factors, ‘Pedagogical Strategy’, ‘Learning Results’, ‘Learning Tasks’, ‘Learning Goal’, and ‘Learning Support’ emerged within the top five factors. These findings are significant in that they redefine the concept of smart learning and propose an academic framework for future research. Additionally, from a practical perspective, it is anticipated that this study will contribute valuable insights for HRD practitioners, aiding them in focusing on which factors to prioritize for enhancing and advancing Smart Learning initiatives.