• Title/Summary/Keyword: Cumulative effects

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Occupational Exposure to Knee Loading and the Risk of Osteoarthritis of the Knee: A Systematic Review and a Dose-Response Meta-Analysis

  • Verbeek, Jos;Mischke, Christina;Robinson, Rachel;Ijaz, Sharea;Kuijer, Paul;Kievit, Arthur;Ojajarvi, Anneli;Neuvonen, Kaisa
    • Safety and Health at Work
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    • v.8 no.2
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    • pp.130-142
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    • 2017
  • Background: Osteoarthritis of the knee is considered to be related to knee straining activities at work. The objective of this review is to assess the exposure dose-response relation between kneeling or squatting, lifting, and climbing stairs at work, and knee osteoarthritis. Methods: We included cohort and case-control studies. For each study that reported enough data, we calculated the odds ratio (OR) per 5,000 hours of cumulative kneeling and per 100,000 kg of cumulative lifting. We pooled these incremental ORs in a random effects meta-analysis. Results: We included 15 studies (2 cohort and 13 case-control studies) of which nine assessed risks in more than two exposure categories. We considered all but one study at high risk of bias. The incremental OR per 5,000 hours of kneeling was 1.26 (95% confidence interval 1.17-1.35, 5 studies, moderate quality evidence) for a log-linear exposure dose-response model. For lifting, there was no exposure dose-response per 100,000 kg of lifetime lifting (OR 1.00, 95% confidence interval 1.00-1.01). For climbing, an exposure dose-response could not be calculated. Conclusion: There is moderate quality evidence that longer cumulative exposure to kneeling or squatting at work leads to a higher risk of osteoarthritis of the knee. For other exposure, there was no exposure dose-response or there were insufficient data to establish this. More reliable exposure measurements would increase the quality of the evidence.

Radiosurgery for Recurrent Brain Metastases after Whole-Brain Radiotherapy : Factors Affecting Radiation-Induced Neurological Dysfunction

  • Gwak, Ho-Shin;Yoo, Hyung-Jun;Youn, Sang-Min;Lee, Dong-Han;Kim, Mi-Sook;Rhee, Chang-Hun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.275-283
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    • 2009
  • Objective : We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction. Methods : In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was $12.4cm^3$. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria. Results : Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age(<60 years) and tumor volume affected survival rate(p=0.03, each). Acute (${\leq}$1 month) toxicity was observed in 22% of patients, subacute and chronic (>6 months) toxicity occurred in 21 %, respectively. Less acute toxicity was observed with small tumors (<$10cm^3$. p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gy${\times}cm^3$) was a significant predictor of both acute and chronic CNS toxicities. Conclusion: Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.

Prediction of HIV and AIDS Incidence Using a Back-calculation Model in Korea (후향연산 모형 (Back-calculation model)을 이용한 국내 HIV 감염자와 AIDS 환자의 추계)

  • Lee, Ju-Young;Goh, Un-Yeong;Kee, Mee-Kyung;Kim, Jee-Yun;Hwang, Jin-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.1
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    • pp.65-71
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    • 2002
  • Objective : To estimate the status of HIV infection and AIDS incidence using a back-calculation model in Korea. Methods : Back-calculation is a method for estimating the past infection rate using AIDS incidence data. The method has been useful for obtaining short-term projections of AIDS incidence and estimating previous HIV prevalence. If the density of the incubation periods is known, together with the AIDS incidence, we can estimate historical HIV infections and forecast AIDS incidence in any time period up to time t. In this paper, we estimated the number of HIV infections and AIDS incidence according to the distribution of various incubation periods Results : The cumulative numbers of HIV infection from 1991 to 1996 were $708{\sim}1,426$ in Weibull distribution and $918{\sim}1,980$ in Gamma distribution. The projected AIDS incidence in 1997 was $16{\sim}25$ in Weibull distribution and $13{\sim}26$ in Gamma distribution. Conclusions : The estimated cumulative HIV infections from 1991 to 1996 were $1.4{\sim}4.0$ times more than notified cumulative HIV infections. Additionally, the projected AIDS incidence in 1997 was less than the notified AIDS cases. The reason for this underestimation derives from the very low level of HIV prevalence in Korea, further research is required for the distribution of the incubation period of HIV infection in Korea, particularly for the effects of combination treatments.

Association of Fatty Acid Ethyl Esters in Meconium of Neonates with Growth Deficits at Birth: a Prospective, Single-Centre Cohort Study

  • Lee, Hyun-Seung;Kim, Yeon Hee;Kwak, Ho-Seok;Han, Jung-Yeol;Jo, Sun-Jin;Lee, Hae Kook
    • Journal of Korean Medical Science
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    • v.33 no.50
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    • pp.318.1-318.10
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    • 2018
  • Background: In this prospective cohort study, we investigated the association between fatty acid ethyl esters (FAEEs) in meconium as biomarkers of prenatal ethanol exposure and growth deficits, as birth outcomes, that constitute several of the key cardinal features of fetal alcohol syndrome. Methods: A total of 157 meconium samples were collected from enrolled infants within 24 hours of birth, and nine FAEEs were quantified using liquid chromatography/tandem mass spectrometry. The relationships between cumulative concentrations of nine species of FAEEs in meconium and birth parameters of growth (age-sex-specific centiles of head circumference [HC], weight, and length) and respective and combined birth outcomes of growth deficits (HC ${\leq}10th$ centile, weight ${\leq}10th$ centile, and length ${\leq}10th$ centile) were determined. Results: Multivariate logistic regression analysis demonstrated that higher cumulative concentrations of meconium FAEEs correlated with elevated risks for HC and length, both, 10th percentile or less (adjusted odds ratio [aOR], 2.94; 95% confidence interval [CI], 1.12-7.74; P = 0.029) and HC and weight and length, all of them, 10th percentile or less (aOR, 3.27; 95% CI, 1.12-9.59; P = 0.031). Conclusion: The elevated cumulative FAEEs in meconium were associated with combined growth deficits at birth, specifically HC and length, both, 10th percentile or less, which might be correlated with detrimental alcohol effects on fetal brain and bone development, suggesting a plausible alcohol-specific pattern of intrauterine growth restriction.

Combined Effects of Acidification, Zeolite, and Biochar on Ammonia Emission and Nitrate Leaching from Pig Slurry

  • Sang-Hyun Park;Muchamad Muchlas;Tae-Hwan Kim;Bok-Rye Lee
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.44 no.2
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    • pp.133-139
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    • 2024
  • This study aimed to evaluate the efficiency of combining acidification with adsorbents (zeolite and biochar) to mitigate the environmental impacts of pig slurry, focusing on ammonia (NH3) emission and nitrate (NO3-) leaching. The four treatments were applied: 1) pig slurry (PS) alone as a control, 2) acidified PS (AP), 3) acidified pig slurry with zeolite (APZ), and 4) acidified pig slurry with biochar (APB). The AP mitigates NH3 emission and NO3- leaching compared to PS alone. Acidification reduced the cumulative NH3 emission and its emission factor by 35.9% and 12.5%, respectively. The APZ and APB increased NH4+-N concentration, with the highest level in APB, compared to AP. The NH4+ adsorption capacity of APB (0.90 mg g-1) was higher than that of APZ (0.63 mg g-1). The APB and APZ treatments induced less NH3 emission compared to AP. The cumulative NH3 emission was reduced by 12.2% and 27.6% in APZ and APB, respectively, compared to AP treatment. NO3- leaching began to appear on days 12 and 13, and its peak reached on days 16 and 17, which were later than AP. The cumulative NO3- leaching decreased by 17.7% and 25.0% in APZ and APB, respectively, compared to AP treatment. These results suggest that combining biochar or zeolite with acidified pig slurry is an effective method to mitigate NH3 emission and NO3- leaching, with biochar being particularly effective.

Population Size Estimates for the Use of Humidifier Disinfectants and Experience of Health Effects from Exposure to Humidifier Disinfectants (가습기 살균제 노출 및 건강피해 규모 평가 연구)

  • Lee, Kyoung-Mu;Paek, Domyung;Cheong, Hae-Kwan;Kim, Solwhee;Seo, Jung-Wook;Hong, Young-seob;Kim, Hyeongsu;Lee, Jongwha;Leem, Jonghan;Kim, Pangyi
    • Journal of Environmental Health Sciences
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    • v.45 no.3
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    • pp.273-284
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    • 2019
  • Objective: This study was performed to estimate the number of those who used humidifier disinfectants (HDs) and experienced health effects from exposure to HDs in Korea between 1994 and 2011. Methods: A nationwide interview survey was conducted for the representative sample to identify the proportion of those who used HDs among the general population (n=3,001). Another online survey was conducted for those exposed to HDs to find the proportion of those who experienced health effects among those who were exposed to HDs (n=3,993). Statistics for population size by region and year (1994-2011) were used to estimate the cumulative number of those exposed to HDs and those who experienced health effects. In terms of the proportion of those exposed to HDs, those less than 30 years of age were excluded due to an issue related to information bias. Various approaches for estimation included the capture-recapture method for estimation of those who experienced health effects. Results: The cumulative proportion of those exposed to HDs was 6.7% among the general population, and the proportion of those who experienced health effects among those who were exposed to HDs was 13.9%. Based on these factors, it was estimated that 3.5 to 4.0 million people were exposed to HDs and 350 to 400 thousand experienced health effects at least requiring visiting a hospital. Conclusion: It is suggested that a nationwide representative sample may be essential for population size estimation of those exposed to environmental risk factors and of those who experienced health effects.

Hybridal Method for the Prediction of Wave Instabilities Inherent in High Energy-Density Combustors (2): Cumulative Effects of Pressure Coupled Responses on Cavity Acoustics

  • Lee, Gil-Yong;Yoon, Woong-Sup
    • International Journal of Aeronautical and Space Sciences
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    • v.7 no.2
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    • pp.33-41
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    • 2006
  • Theoretical-numerical approach of combustion instability in a specific rocket engine is conducted with parametric response functions. Fluctuating instantaneous burning rate is assumed to be functionally coupled with acoustic pressures and have a finite or time-varying amplitudes and phase lags. Only when the amplitudes and phases of combustion response function are sufficiently large and small respectively, the triggered unstable waves are amplified.

A Continuation-Ratio Logits Mixed Model for Structured Polytomous Data

  • Choi, Jae-Sung
    • Journal of the Korean Data and Information Science Society
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    • v.17 no.1
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    • pp.187-193
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    • 2006
  • This paper shows how to use continuation-ratio logits for the analysis of structured polytomous data. Here, response categories are considered to have a nested binary structure. Thus, conditionally nested binary random variables can be defined in each step. Two types of factors are considered as independent variables affecting response probabilities. For the purpose of analyzing categorical data with binary nested strutures a continuation-ratio mixed model is suggested. Estimation procedure for the unknown parameters in a suggested model is also discussed in detail by an example.

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