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Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3403-3410
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    • 2014
  • Context: Interest exits in whether TNF-alpha antagonists increase the risk of breast cancer and total malignancies in patients with rheumatoid arthritis (RA). Objectives: To analyze the risk of malignancies, especially breast cancer, in patients with RA enrolled in randomized control trials (RCTs). Methods: A systematic literature search for RCTs from 1 January 1998 to 1 July 2013 from online databases, such as PubMed, WILEY, EMBASE, ISI web of knowledge and Cochrane Library was conducted. Studies included RCTs that compared the safety of at least one dose of the five TNF-${\alpha}$ antagonists with placebo or methotrexate (MTX) (or TNF-${\alpha}$ antagonists plus MTX vs placebo plus MTX) in RA patients for more than 24 weeks and imported all the references into document management software EndNote${\times}6$. Two independent reviewers selected studies and extracted the data about study design, patients' characteristics and the type, number of all malignancies. Results: 28 RCTs from 34 records with 11,741 patients were analyzed. Of the total, 97 developed at least one malignancy during the double-blind trials, and breast cancer was observed in 17 patients (17.5% of total malignancies). However, there was no statistically significant increased risk observed in either the per protocol (PP) model (OR 0.65, 95%CI [0.22, 1.93]) or the modified intention to treat (mITT) model (OR 0.75, 95%CI [0.25, 2.21]). There were also no significant trend for increased risk of total malignancies on anti-TNF-${\alpha}$ therapy administered at approved doses in either model (OR, 1.06, 95%CI [0.64, 1.75], and OR, 1.30, 95%CI [0.80, 2.14], respectively). As to the two models, modified intention to treat model analysis led to higher estimation than per protocol model analysis. Conclusions: This study did not find a significantly increased risk of breast cancer and total malignancies in adults RA patients treated with TNF-${\alpha}$ antagonists at approved doses. However, it cannot be ignored that more patients developed malignancies with TNF-${\alpha}$ antagonists therapy compared with patients with placebo or MTX, in spite of the lack of statistical significance, so that more strict clinical trials and long-term follow-up are needed, and both mITT and PP analyses should be used in such safety analyses.

A Study of Effect of Self-Leadership by College Student on Recognition of Opportunity on Establishment of Company and Will of Establishing Company: Centered on Mediated Effect of Entrepreneurship (대학생의 셀프리더십이 창업기회인식과 창업의지에 미치는 영향에 관한 연구: 기업가정신의 매개 효과를 중심으로)

  • Kang, Jae-Hac;Ha, Kyu-Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.4
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    • pp.1-12
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    • 2015
  • Among leadership competence essential for start-up C.E.O, this study was to analyze the effect of self-leadership on recognition of opportunity on establishment of company and will of establishing company through the mediated effect of entrepreneurship. Under the atmosphere of encouraging the establishment of company led by the government, within the college curriculum, along with various education and events, the education about entrepreneurship is actively provided, and in academic fields, studies about entrepreneurship, recognition of opportunity on establishment of company, and will of establishing company are actively performed, while there is almost no study about correlation among self-leadership, recognition of opportunity on establishment of company and will of establishing company. Therefore, in this study, 320 questionnaires filled out by college students from four colleges in Seoul were verified and analyzed. As a result of analysis, at first, the self-leadership showed partially significant effect on entrepreneurship. Second, entrepreneurship showed partially significant effect on recognition of opportunity on establishment of company and will of establishing company. Third, the self-leadership showed partially significant effect on recognition of opportunity on establishment of company and will of establishing company. Fourth, regarded as the core of this study, in between self-leadership and recognition of opportunity on establishment of company, and in between self-leadership and will of establishing company, the mediate effect of entrepreneurship was shown. According to such outcome of study, in the curriculum design of college venture education to increase recognition of opportunity on establishment of company and will of establishing company, the education of entrepreneurship and active trial of self-leadership education are essential.

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Optimization of the Scraper Speed and Improvement of the Refrigerant Path for the Evaporator of the Soft Ice Cream Machine (소프트 아이스크림 제조기 증발기의 스크레이퍼 회전수 최적화 및 냉매 유로 개선)

  • Baek, Seung-Hyuk;Kim, Nae-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.8-14
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    • 2017
  • Improvements in the standard of living and lifestyle have led to increased sales of frozen milk products, such as soft ice cream or slush. These frozen milk products are commonly made in a small refrigeration machine. In a soft ice cream machine, the freezer is composed of a concentric cylinder, where the refrigerant flows in the annul us and the ice cream is made in the cylinder by a rotating scraper. In this study, an optimization and performance evaluation were conducted on a soft ice cream machine having a freezer volume of 2.8 liters. The optimization was focused on the scraper rotation speed and the refrigerant path of the freezer. The measurements included the temperature, pressure and consumed power. At the optimized speed of 124 rpm, ice cream was produced in 6 minutes and 2 seconds, and the COP was 0.90. Through a flow visualization study using air-water, the refrigerant path was improved. The improved design reduced the ice cream making time significantly. The present results may be used for the optimization of other refrigeration cycles, including those of frozen food products.

Using Plant Source as a Buffering Agent to Manipulating Rumen Fermentation in an In vitro Gas Production System

  • Kang, S.;Wanapat, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.10
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    • pp.1424-1436
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    • 2013
  • The objective of this study was to investigate the effect of banana flower powder (BAFLOP) supplementation on gas production kinetics and rumen fermentation efficiency in in vitro incubation with different ratios of roughage to concentrate in swamp buffalo and cattle rumen fluid. Two male, rumen fistulated dairy steers and swamp buffaloes were used as rumen fluid donors. The treatments were arranged according to a $2{\times}2{\times}3$ factorial arrangement in a Completely randomized design by using two ratios of roughage to concentrate (R:C; 75:25 and 25:75) and 3 levels of BAFLOP supplementation (0, 2 and 4% of dietary substrate) into two different kinds of rumen fluid (beef cattle and swamp buffalo). Under this investigation, the results revealed that the rumen ecology was affected by R:C ratio. The pH declined as a result of using high concentrate ratio; however, supplementation of BAFLOP could buffer the pH which led to an improvement of ruminal efficiency. BAFLOP supplementation affected acetic acid (C2) when the proportion of concentrate was increased. However, there were no effect on total volatile fatty acid (TVFA) and butyric acid (C4) by BAFLOP supplementation. The microbial community was affected by BAFLOP supplementation, especially the bacterial population. As revealed by real-time PCR, the populations of F. succinogenes and R. albus were reduced by the high concentrate treatments while that of R. flavafaciens were increased. The populations of three dominant cellulolytic bacteria were enhanced by BAFLOP supplementation, especially on high concentrate diet. BAFLOP supplementation did not influence the ammonia nitrogen ($NH_3$-N) concentration, while R:C did. In addition, the in vitro digestibility was improved by either R:C or BAFLOP supplementation. The BAFLOP supplementation showed an effect on gas production kinetics, except for the gas production rate constant for the insoluble fraction (c), while treatments with high concentrate ratio resulted in the highest values. In addition, BAFLOP tended to increase gas production. Based on this study, it could be concluded that R:C had an effect on rumen ecology both in buffalo and cattle rumen fluid and hence, BAFLOP could be used as a rumen buffering agent for enhancing rumen ecology fed on high concentrate diet. It is recommended that level of BAFLOP supplementation should be at 2 to 4% of total dry matter of substrate. However, in vivo trials should be subsequently conducted to investigate the effect of BAFLOP in high concentrate diets on rumen ecology as well as ruminant production.

Literature Review Nursing Intervention for Developmental Support on Preterm Infants (미숙아의 발달지지를 위한 간호중재에 관한 문헌연구)

  • Kim, Tae-Im;Sim, Mi-Kyung
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.35-55
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    • 2001
  • Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

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A Study on the Ride Film Appearing in Virtual Reality - the focus of Warrior of the Dawn - (가상현실에서 표출된 라이드필름 제작 사례연구 - Warrior of the Dawn 제작사례를 중심 -)

  • Kim, Tae-Hyung;Chung, Jean-Hun
    • Journal of Korea Multimedia Society
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    • v.11 no.9
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    • pp.1204-1212
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    • 2008
  • The vehicle simulation (flight simulator) in 1920's was the first in the virtual reality. With the development of precise optical and electromagnetic equipment, the virtual reality widened its application for other purposes than military one. Based on the realistic display technology, it is more and more common in the various areas such as entertainment, medical profession, learning, film, architectural design, tourism and etc. In 1989, Jaron Ranier was the first to use the terminology 'Virtual Reality'. With this term, all virtual projects could be classified in a single item. But even before the term was used, the virtual reality has been studied up to now. As a part of virtual reality, the human thirst for the impossible thing has led to the development of ride film. The ride film consists of the special technical elements as well as the psychological analysis of human being. The ultimate purpose of virtual reality is engrossment through interaction. Even though the real interaction requires interface, input sensor and reaction ability, the ride film is not an element of the typical interaction. The virtual reality is mostly defined in technical terms now. But in this study, we will analyze the concepts worked out by Professor Michael Haim who is called a philosopher in the cyberspace in aspect of experience-oriented definition. We will analyze the adaptability of virtual reality based on his concepts such as artificial reality/ interaction/ engrossment/ networked world/ remote display/ simulation/ onmon engrossment. And also, we aim to suggest the directions of developing the ride films for perfect engrossment and to draw optimized conclusion thereon. In this viewpoint, we consider that the study of ride film on which there were few case studies will contribute to level up the basic frameworks of IT technology and the digital image.

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Optimization of the Refrigerant Charge and the Expansion Valve Opening for the Soft Ice Cream Machine Using R-404A (R-404A를 사용하는 소프트 아이스크림 제조기의 냉매 충전량 및 팽창 밸브 개도 최적화)

  • Kim, Nae-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.728-734
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    • 2016
  • The improvements of living and lifestyle have led to the increased sales of frozen milk products, such as soft ice cream or slush. These frozen milk products are commonly made in small refrigeration machines. R-502, which has long been used as the refrigerant in soft ice cream machines, is being replaced with R-404A due to the ozone layer depletion issue. In this study, an optimization and performance evaluation were conducted on a soft ice cream machine with a freezer volume of 2.8 liters. The optimization focused on the appropriate refrigerant charge and expansion valve opening. Under the optimized conditions, ice cream was produced in 10 minutes and 5 seconds, and the COP was 0.57. The performance tests included ice cream sales with no interval, ice cream sales with 30 second intervals and under extreme outdoor conditions. The results showed that 20 sales were possible with no interval, and infinite sales could be made with 30 seconds intervals. Ice cream sales were also possible under summer or winter outdoor conditions. The present results may be used for the design of food refrigeration machines as well as to optimize other refrigeration cycles.

On the Method of Applying COTS through Restriction Analysis in Weapon Systems Development (무기체계개발에서 제약사항 분석을 통한 상용부품(COTS) 적용 방안 연구)

  • Lee, Tae-Hyung;Lee, Jae-Chon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1896-1902
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    • 2013
  • As a concept that commercial parts are applied to weapon systems, Commercial Off-The-Shelf(COTS) was not well-received at a time when defense technology led commercial technology. However, the exponential growth of IT and the rapid expansion of commercial industry have made possible to make the cost low through mass production system within a short period, and the benefit of cost and schedule has been highlighted, triggering commercial parts to be applied to weapon systems. In order for commercial technology to be used in defense weapon systems, its performance in an extremely restricted condition of combat environment should be guaranteed. Generally, commercial parts have fundamental limitation in that the design and production requirements for commercial parts are different from those for the military. Therefore, it is required to confirm that commercial parts can be used for weapon systems through the approach of system engineering. This study presents the process tailored to characteristics of marine defense system and the method of analyzing its restricted condition in order to apply COTS to marine defense system. The study classifies the restricted conditions into general and special environments, suggests detailed process, and suggests useful tools to select appropriate items adapted to these restricted conditions in the commercial market. Lastly, as a case study for COTS applied to marine defense system, the study finds out the analysis results of application of COTS and restricted conditions of the warship electric system.

An Analysis of Flood Damage Influence by Urban Spatial Factors (도시공간적 요인에 의한 침수피해의 영향 분석)

  • Park, Kiyong;Oh, Hoo;Jeon, Won-Sik;Lee, Eui Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.238-250
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    • 2020
  • This study investigated the long-term measures to minimize flood damage in the event of flooding in urban areas. The relationship between urban spatial factors and the impact of flood damage was analyzed, focusing on non-structural measures. The urban spatial factors were categorized into three parts: open space, disaster prevention facilities, and urbanization sectors. Multiple regression analysis was used to investigate how urban spatial factors influence flood damage. As a result of the analysis, the crucial factors, such as the reduced green areas and parks included in the open space sectors, resulted in an increased flood damage potential. The posterior factors, such as the population density and GRDP included in the urbanization sector concurrently led to an increase in the flood damage potential. Therefore, to better adapt to climate change, it is necessary to establish urban spatial plans strategically, such as green areas and parks. Meanwhile, the population density and GRDP are also the main factors causing flood damage. Therefore, when used appropriately in terms of resilience, it will serve as adaptations and recovery.

Effect of p-Phenylenediamine to Rat Skin (p-Phenylenediamine이 흰쥐의 피부 조직에 미치는 영향)

  • Lee, SangHee;Cho, HyunGug;Lee, Sang-Il
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1330-1335
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    • 2005
  • Red brownish p-pheylenediamine (PPD) has been widely used hair dye for women. The dye was known to cause systemic anaphylaxis, dermatitis and bladder cancer. But the effect of PPD toxicity with oxygen free radical has not been studied. This study investigated the degree of skin injury by PPD. PPD ($2.5\%$ PPD in $2\%\;NH_{4}OH$) was applied to the rat skin ($25 mg/16.5\;cm^2$) 3 or 5 times every other day. Histopathological findings demonstrated the proliferation of epithelial cells and the increased keratinization by PPD. The activities of glucose 6-phosphatase (G6Pase) was decreased and acid phosphatase (ACP) was increased in PPD-applied rat skin. Groups in which PPD was applied 5 times were more damaged than groups applied 3 times. To examine the relationship between tissue damage and oxygen free radicals, effect of PPD on xanthine oxidase (XO) activity was measured and XO activity was more significantly increased in the group treated with PPD 5 times than 3 times. However, reduced glutathione (GSH) content, and the activities of catalase (CAT), super-oxide dismutase (SOD) and glutathione S -transferase (GST) were more decreased in PPD-applied groups than in controls. Even though the activities of XOD was not changed in the group treated with PPD 3 times, the decreased activities of oxygen free radical system and the damaged skin tissue were observed. This result might be caused by the production of toxic PPD metabolites in rat skin. In conclusion, topical PPD application led to skin injury in a dose-dependent manner, probably due to the generation rate of oxygen free radical.