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International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando;Alrefaee, Fawaz;Chakrabarty, Anjan;de Leon, Julia C.;Geng, Lanlan;Gong, Sitang;Heine, Ralf G.;Jarvi, Anette;Ngamphaiboon, Jarungchit;Ong, Christina;Rogacion, Jossie M.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.263-275
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    • 2022
  • Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

Assessment of Volatile Organic Compound Reduction Using an Air Purification Facility in an Adhesive Handling Process (접착제 취급 작업장 내 공기정화 설비를 이용한 휘발성 유기화합물 저감 평가)

  • Jaemin Woo;Dongjun Kim;Jihun Shin;Gihong Min;Chaekwan Lee;Wonho Yang
    • Journal of Environmental Health Sciences
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    • v.49 no.2
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    • pp.78-88
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    • 2023
  • Background: Exposure to volatile organic compounds (VOCs) can have acute and chronic health effects on human beings in general and in working environments. In particular, VOCs are often emitted in large quantities in industrial settings. In such circumstances, there is a need to improve the indoor air quality at workplaces. Objectives: The purposes of this study were to verify the effectiveness of air cleaning devices in workplaces and provide alternative solutions for improving working environments. Methods: Personal exposure and area level of VOCs for workers were evaluated in a car-part adhesive process before and after installing an air cleaning device with a TiO2-coated filter. Passive samplers and direct reading instruments were used to collect and analyze the VOCs, and the removal efficiency and improvement of air quality were evaluated. We also calculated the exposure index (EI) to assess the risk level in the workplace. Results: The removal efficiency for VOCs through the installation of the air cleaning device was approximately 26.9~69.0% as determined by the concentration levels before and after installation. The measured substances did not exceed the exposure limits for the work environment and the EI was less than 1. However, carcinogenic substances such as benzene, formaldehyde, carbon tetrachloride, and trichloroethylene were detected. Conclusions: The application of an air cleaning device can be a solution for controlling the indoor air quality in a workplace, particularly in cases where ventilation systems cannot be installed due to process limitations.

The efficacy of different implant surface decontamination methods using spectrophotometric analysis: an in vitro study

  • Roberto Giffi;Davide Pietropaoli;Leonardo Mancini;Francesco Tarallo;Philipp Sahrmann;Enrico Marchetti
    • Journal of Periodontal and Implant Science
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    • v.53 no.4
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    • pp.295-305
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    • 2023
  • Purpose: Various methods have been proposed to achieve the nearly complete decontamination of the surface of implants affected by peri-implantitis. We investigated the in vitro debridement efficiency of multiple decontamination methods (Gracey curettes [GC], glycine air-polishing [G-Air], erythritol air-polishing [E-Air] and titanium brushes [TiB]) using a novel spectrophotometric ink-model in 3 different bone defect settings (30°, 60°, and 90°). Methods: Forty-five dental implants were stained with indelible ink and mounted in resin models, which simulated standardised peri-implantitis defects with different bone defect angulations (30°, 60°, and 90°). After each run of instrumentation, the implants were removed from the resin model, and the ink was dissolved in ethanol (97%). A spectrophotometric analysis was performed to detect colour remnants in order to measure the cumulative uncleaned surface area of the implants. Scanning electron microscopy images were taken to assess micromorphological surface changes. Results: Generally, the 60° bone defects were the easiest to debride, and the 30° defects were the most difficult (ink absorption peak: 0.26±0.04 for 60° defects; 0.32±0.06 for 30° defects; 0.27±0.04 for 90° defects). The most effective debridement method was TiB, independently of the bone defect type (TiB vs. GC: P<0.0001; TiB vs. G-Air: P=0.0017; TiB vs. GE-Air: P=0.0007). GE-Air appeared to be the least efficient method for biofilm debridement. Conclusions: T-brushes seem to be a promising decontamination method compared to the other techniques, whereas G-Air was less aggressive on the implant surface. The use of a spectrophotometric model was shown to be a novel but promising assessment method for in vitro ink studies.

Matching-adjusted Indirect Comparison (MAIC) of Tralokinumab Versus Dupilumab for the Treatment of Moderate to Severe Adult Atopic Dermatitis (트랄로키누맙과 두필루맙의 매칭 조정 간접 비교)

  • Taekyung Kim;Keun Soo Shin;Hyojin Kim;Eugene Kim;Leejung Choi;Dong Hun Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.178-185
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    • 2023
  • Objective: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease. Both tralokinumab and dupilumab have been recommended in the European Guideline for the treatment of adult patients with severe AD. In Korea, dupilumab has been approved for patients with moderate to severe AD, and reimbursed for those with severe AD. Since there is no clinical trial directly comparing tralokinumab and dupilumab, we conducted indirect comparison to assess the clinical usefulness in patients with AD. Methods: We selected clinical trials for indirect comparison through a systematic literature review. Individual patient data were available for the tralokinumab clinical trial, and aggregated data were available for the dupilumab clinical trial. Therefore, we employed the Matching-Adjusted Indirect Comparison (MAIC) method. The treatment efficacy was assessed based on whether patients achieved a 75% reduction on the Eczema Area and Severity Index (EASI 75) after drug administration. Results: The difference in the proportion of patients achieving EASI 75 between tralokinumab and dupilumab was 4.7% (95% CI: -7.9 to 17.3). Considering the non-inferiority margin for the EASI 75 achievement rate is -10%, tralokinumab is deemed non-inferior to dupilumab as the lower bound of the CI for the difference in the EASI 75 achievement rate between tralokinumab and dupilumab was within -10%. Conclusion: We conducted a MAIC analysis comparing tralokinumab and dupilumab based on EASI 75 achievement. The findings of this study show that tralokinumab is non-inferior to dupilumab and can be implemented in Korean clinical settings with a therapeutic position comparable to dupilumab.

Qualitative Study on the Narcotics Information Management System (NIMS) Experience of Doctors and Pharmacists Using Narcotic Analgesics (의료용 마약류 진통제 처방자와 조제자의 마약류통합관리시스템 사용경험에 관한 질적 연구)

  • Jinyi Kim;Young-jeon Shin
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.22-34
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    • 2023
  • Background: With the increasing use of narcotic analgesics, the Ministry of Food and Drug Safety has been operating the National Narcotics Information Management System (NIMS) since 2018 in Korea. Some studies are related to the narcotic analgesics use, but the evaluation studies of system, including NIMS users are insufficient. Objective: This study evaluated the NIMS enforcement process through in-depth interviews on the experience of using NIMS of doctors and pharmacists who prescribe or dispense opioid analgesics. Methods: Participants in this study were selected through purposeful sampling as three doctors and two pharmacists in the metropolitan area. The interviews were conducted from August 27 to October 19, 2022. Each interview was analyzed using a phenomenological method. Results: Six components of this study included "Doctors and pharmacists come across drug abusers", "They respond individually to drug abusers", "They use NIMS tailored to the needs of system managers", "They are concerned about the role of NIMS in practice settings", "They face challenges against drug abusers" and "They find a way to utilize the system to deal with drug abusers." The interviews confirmed that doctors and pharmacists used NIMS little in their work, and they only reported data. Therefore, it might be difficult for doctors and pharmacists to take measures for the safe use of narcotic analgesics. Conclusion: It is likely that adding data-feedback and medication-check function can reduce the abuse of narcotic analgesics. In the future, further studies on the evaluation of the empirical results of NIMS and review of systems in other countries will be required.

Development of Hair Keratin Protein to Accelerate Oral Mucosal Regeneration

  • So-Yeon Kim
    • Journal of dental hygiene science
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    • v.23 no.4
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    • pp.369-377
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    • 2023
  • Background: In this study, we investigated the potential use of keratin for oral tissue regeneration. Keratin is well-known for its effectiveness in skin regeneration by promoting keratinization and enhancing the elasticity and activity of fibroblasts. Because of its structural stability, high storability, biocompatibility, and safety in humans, existing research has predominantly focused on its role in skin wound healing. Herein, we propose using keratin proteins as biocompatible materials for dental applications. Methods: To assess the suitability of alpha-keratin protein as a substrate for cell culture, keratin was extracted from human hair via PEGylation. Viabilities of primary human gingival fibroblasts (HGFs) and human oral keratinocytes (HOKs) were assessed. Fluorescence immunostaining and migration assays were conducted using a fluorescence microscope and confocal laser scanning microscope. Wound healing and migration assays were performed using automated software to analyze the experimental readout and gap closure rate. Results: We confirmed the extraction of alpha-keratin and formation of the PEG-g-keratin complex. Treatment of HGFs with keratin protein at a concentration of 5 mg/ml promoted proliferation and maintained cell viability in the test group compared to the control group. HOKs treated with 5 mg/ml keratin exhibited a slight decrease in cell proliferation and activity after 48 hours compared to the untreated group, followed by an increase after 72 hours. Wound healing and migration assays revealed rapid closure of the area covered by HOKs over time following keratin treatment. Additionally, HOKs exhibited changes in cell morphology and increased the expression of the mesenchymal marker vimentin. Conclusion: Our study demonstrated the potential of hair keratin for soft tissue regeneration, with potential future applications in clinical settings for wound healing.

Transmission Dose Estimation Algorithm for in vivo Dosimertry (투과선량을 이용한 생체내 (in vivo) 선량측정을 위한 알고리즘)

  • Yun, Hyong-Geun;Chie, Eui-Kyu;Huh, Soon-Nyung;Lee, Hyoung-Koo;Woo, Hong-Gyun;Shin, Kyo-Chul;Kim, Si-Yong;Ha, Sung-Whan
    • Journal of Radiation Protection and Research
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    • v.27 no.3
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    • pp.147-154
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry of QA purpose. The objective of this study is to develope an algorithm for estimation of tumor dose using measured transmission dose for open radiation field. Materials and Methods : Transmission dose was measured with various field size (FS), phantom thickness (Tp), and phantom chamber distance (PCD) with a acrylic phantom for 6 MV and 10 MV X-ray. Source to chamber distance (SCD) was set to 150 cm. Measurement was conducted with a 0.6 co Farmer type ion chamber. Using measured data and regression analysis, an algorithm was developed lot estimation of expected reading of transmission dose. Accuracy of the algorithm was tested with flat solid phantom with various settings. Results : The algorithm consisted of quadratic function of log(A/P) (where A/P is area-perimeter ratio) and tertiary function of PCD. The algorithm could estimate dose with very high accuracy for open square field, with errors within ${\pm}0.5%$. For elongated radiation field, the errors were limited to ${\pm}1.0%$. Conclusion : The developed algorithm can accurately estimate the transmission dose in open radiation fields with various treatment settings.

The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area (지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로)

  • LIM, Jaebin;Jeong, Kiseong
    • Land and Housing Review
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    • v.12 no.2
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    • pp.47-59
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    • 2021
  • This study aims to review the trends of the population outflows in the metropolitan area of Busan and to investigate the factors that affect population out-migration to the Seoul metropolitan area. The following variables are considered for analysis: traditional population movement variables and quality of life variables, such as population, society, employment, housing, culture, safety, medical care, greenery, education, and childcare. The 'domestic population movement data', provided by the MDIS of the National Statistical Office, was used for this research. Out of the total of 57 million population movement data in the period 2012 - 2017, population outmigration from Busan to the Seoul metropolitan area was extracted. Independent variables were drawn from public data sources in accordance with the temporal and spatial settings of the study. The multiple linear regression model was specified based on the dataset, and the fit of the model was measured by the p-value, and the values of Adjusted R2, Durbin-Watson analysis, and F-statistics. The results of the analysis showed that the variables that have a significant effect on population movement from Busan to the Seoul metropolitan area were as follows: 'single-person households', 'the elderly population', 'the total birth rate', 'the number of companies', 'the number of employees', 'the housing sales price index', 'cultural facilities', and 'the number of students per teacher'. More positive (+) influences of the population out-movement were observed in areas with higher numbers of single-person households, lowers proportions of the elderly, lower numbers of businesses, higher numbers of employees, higher numbers of housing sales, lower numbers of cultural facilities, and lower numbers of students. The findings suggest that policies should enhance the environments such as quality jobs, culture, and welfare that can retain young people within Busan. Improvements in the quality of life and job creation are critical factors that can mitigate the outflows of the Busan residents to the Seoul metropolitan area.

A Study on a Science Laboratory Model for Elementary School (국민학교(國民學校) 과학실험실(料學實驗室) 모형(模型)의 연구개발(硏究開發))

  • Choi, Don-Hyung;Han, Bok-Soo
    • Journal of The Korean Association For Science Education
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    • v.4 no.1
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    • pp.15-25
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    • 1984
  • The purpose of this study is to develop a practical and ideal model of science laboratory enrolled 48-60 students by studying optimal facilities such as laboratory tables and chairs proper to elementary school settings. The science laboratory model was figured out in terms of the following six procedures; (1) Current status as well as problems of science laboratory and its facilities was identified by means of the questionnaires conducted to 201 elementary schools, using stratified cluster sampling tehnique, under the consideration of the school size and the regional characteristics across the country. (2) Collected were the anthropometric data with respect to sitting height, popliteal height, buttock popliteal length, elbow rest height, and back width from the 747 students, 4th-6th grade, in Seoul area. (3) It was measured the work apace necessary for individual student to perform his experiment. (4) Using the data of the process (2), we determined the optimal sizes of laboratory tables and chairs fitted for Korean elementary school students. (5) The optimal area of science laboratory for 48-60 students is determined in terms of the data obtained in (3) for individual work space in addition to the appropriate table size figured out by (4). (6) A practical and ideal model for a science laboratory in elementary school was designed according to the above procedures. For the optimal model of science laboratory, the results of this study can be summarized as follows: The sizes of chair and table are categorized into three groups such as small, medium, and large depending on students' physical outfit. The small size base on the 12.5th percentile point of students' sitting height is used for students of the 0-25th percentile ranks. The medium size base on the 50th percentile point of students' sitting height is used for students of the 26-75th percentile ranks. The large size base on the 87.5th percentile point of students' sitting height is used for students of the 76-100th percentile ranks. (1) Sizes of chairs: The small size is 28cm in width and 33cm in height. The medium size is 31cm in width and 36cm in height. The large size is 35cm in width and 38cm in height. (2) Sizes of laboratory tables: The small size is 120cm in length, 86cm in width, and 60cm in height. The large size is 120cm in length, 86cm in width, and 60cm in height. The large size is 120cm in length, 86cm in width, and 65cm in height. (3) Size of science laboratory: The optimal science laboratory for 48-60 elementary school students, which can install the 12 laboratory tables, is 12m in length and 10m in width.

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The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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