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Lack of Health Insurance Increases All Cause and All Cancer Mortality in Adults: An Analysis of National Health and Nutrition Examination Survey (NHANES III) Data

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2259-2263
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    • 2013
  • Background: Public use National Health and Nutrition Examination Survey (NHANES III) and NHANES III linked mortality data were here applied to investigate the association between health insurance coverage and all cause and all cancer mortality in adults. Patients and Methods: NHANES III household adult, laboratory and mortality data were merged. Only patients examined in the mobile examination center (MEC) were included in this study. The sampling weight employed was WTPFEX6, SDPPSU6 being used for the probability sampling unit and SDPSTRA6 to designate the strata for the survey analysis. All cause and all cancer mortalities were used as binary outcomes. The effect of health insurance coverage status on all cause and all cancer mortalities were analyzed with potential socioeconomic, behavioral and health status confounders. Results: There were 2398 sample persons included in this study. The mean age was 40 years and the mean (S.E.) follow up was 171.85 (3.12) person months from the MEC examination. For all cause mortality, the odds ratios (significant p-values) of the covariates were: age, 1.0095 (0.000); no health insurance coverage (using subjects with health insurance), 1.71 (0.092); black race (using non-Hispanic white subjects as the reference group) 1.43, (0.083); Mexican-Americans, 0.60 (0.089); DMPPIR, 0.82, (0.000); and drinking hard liquor, 1.014 (0.007). For all cancer mortality, the odds ratio (significant p-values) of the covariates were: age, 1.0072 (0.00); no health insurance coverage, using with health coverage as the reference group, 2.91 (0.002); black race, using non-Hispanic whites as the reference group, 1.64 (0.047); Mexican Americans, 0.33 (0.008) and smoking, 1.017 (0.118). Conclusion: There was a 70% increase in risk of all cause death and almost 300% of all cancer death for people without any health insurance coverage.

Poor Treatment Outcome of Neuroblastoma and Other Peripheral Nerve Cell Tumors May be Related to Under Usage of Radiotherapy and Socio-Economic Disparity: A US SEER Data Analysis

  • Cheung, Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4587-4592
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    • 2012
  • Purpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) neuroblastoma (NB) and other peripheral nerve cell tumors (PNCT) outcome data. This study found under usage of radiotherapy in these patients. Materials and methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for NB and other PNCT. For the risk modeling, each factor was fitted by a generalized linear model to predict the outcome (soft tissue specific death, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate the modeling errors. Risk of neuroendocrine (other endocrine including thymus as coded in SEER) death was computed for the predictors. Results: There were 5261 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 83.8 (97.6) months. The mean (SD) age was 18 (25) years. About 30.45% of patients were un-staged. The SEER staging has high ROC (SD) area of 0.58 (0.01) among the factors tested. We simplified the 4-layered risk levels (local, regional, distant, un-staged/others) to a simpler 3-tiered model with comparable ROC area of 0.59 (0.01). Less than 50% of PNCT patients received radiotherapy (RT) including the ones with localized disease. This avoidance of RT use occurred in adults and children. Conclusion: The high under-staging rate may have precented patients from selecting definitive radiotherapy (RT) after surgery. Using RT for, especially, adult PNCT patients is a potential way to improve outcome.

A Study on the Preparation of Rare Earth Oxide Powder for Rare Earth Precipitates Recovered from Spent Ni-MH Batteries (폐니켈수소전지로부터 회수된 희토류 침전물의 희토류 산화물 분말 제조에 대한 연구)

  • Kim, Dae-Weon;Ahn, Nak-Kyoon;Shim, Hyun-Woo;Park, Kyung-Soo;Choi, Hee-Lack
    • Journal of Powder Materials
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    • v.25 no.3
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    • pp.213-219
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    • 2018
  • We report a method for preparing rare earth oxides ($Re_xO_y$) from the recycling process for spent Ni-metal hydride (Ni-MH) batteries. This process first involves a leaching of spent Ni-MH powders with sulfuric acid at $90^{\circ}C$, resulting in rare earth precipitates (i.e., $NaRE(SO_4)_2{\cdot}H_2O$, RE = La, Ce, Nd), which are converted into rare earth oxides via two different approaches: i) simple heat treatment in air, and ii) metathesis reaction with NaOH at $70^{\circ}C$. Not only the morphological features but also the crystallographic structures of all products are systematically investigated using field-emission scanning electron microscopy (FESEM) and X-ray diffraction (XRD); their thermal behaviors are also analyzed. In particular, XRD results show that some of the rare earth precipitates are converted into oxide form (such as $La_2O_3$, $Ce_2O_3$, and $Nd_2O_3$) with heat treatment at $1200^{\circ}C$; however, secondary peaks are also observed. On the other hand, rare earth oxides, RExOy can be successfully obtained after metathesis of rare earth precipitates, followed by heat treatment at $1000^{\circ}C$ in air, along with a change of crystallographic structures, i.e., $NaRE(SO_4)_2{\cdot}H_2O{\rightarrow}RE(OH)_3{\rightarrow}RE_xO_y$.

Receiver Operating Characteristic Curve Analysis of SEER Medulloblastoma and Primitive Neuroectodermal Tumor (PNET) Outcome Data: Identification and Optimization of Predictive Models

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6781-6785
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    • 2014
  • Purpose: This study used receiver operating characteristic curves to analyze Surveillance, Epidemiology and End Results (SEER) medulloblastoma (MB) and primitive neuroectodermal tumor (PNET) outcome data. The aim of this study was to identify and optimize predictive outcome models. Materials and Methods: Patients diagnosed from 1973 to 2009 were selected for analysis of socio-economic, staging and treatment factors available in the SEER database for MB and PNET. For the risk modeling, each factor was fitted by a generalized linear model to predict the outcome (brain cancer specific death, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A Monte Carlo algorithm was used to estimate the modeling errors. Results: There were 3,702 patients included in this study. The mean follow up time (S.D.) was 73.7 (86.2) months. Some 40% of the patients were female and the mean (S.D.) age was 16.5 (16.6) years. There were more adult MB/PNET patients listed from SEER data than pediatric and young adult patients. Only 12% of patients were staged. The SEER staging has the highest ROC (S.D.) area of 0.55 (0.05) among the factors tested. We simplified the 3-layered risk levels (local, regional, distant) to a simpler non-metastatic (I and II) versus metastatic (III) model. The ROC area (S.D.) of the 2-tiered model was 0.57 (0.04). Conclusions: ROC analysis optimized the most predictive SEER staging model. The high under staging rate may have prevented patients from selecting definitive radiotherapy after surgery.

Surveying and Optimizing the Predictors for Ependymoma Specific Survival using SEER Data

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.867-870
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    • 2014
  • Purpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) ependymoma data to identify predictive models and potential disparity in outcome. Materials and Methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for ependymoma. For the risk modeling, each factor was fitted by a Generalized Linear Model to predict the outcome ('brain and other nervous systems' specific death in yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate the modeling errors. Risk of ependymoma death was computed for the predictors for comparison. Results: A total of 3,500 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 79.8 (82.3) months. Some 46% of the patients were female. The mean (S.D.) age was 34.4 (22.8) years. Age was the most predictive factor of outcome. Unknown grade demonstrated a 15% risk of cause specific death compared to 9% for grades I and II, and 36% for grades III and IV. A 5-tiered grade model (with a ROC area 0.48) was optimized to a 3-tiered model (with ROC area of 0.53). This ROC area tied for the second with that for surgery. African-American patients had 21.5% risk of death compared with 16.6% for the others. Some 72.7% of patient who did not get RT had cerebellar or spinal ependymoma. Patients undergoing surgery had 16.3% risk of death, as compared to 23.7% among those who did not have surgery. Conclusion: Grading ependymoma may dramatically improve modeling of data. RT is under used for cerebellum and spinal cord ependymoma and it may be a potential way to improve outcome.

Blood Lead Concentration Correlates with All Cause, All Cancer and Lung Cancer Mortality in Adults: A Population Based Study

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3105-3108
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    • 2013
  • Background: This study used National Health and Nutrition Examination Survey III to study the relationship between blood lead concentration and all cause, all cancer and lung cancer mortality in adults. Patients and Methods: Public use National Health and Nutrition Examination Survey (NHANES III) data were used. NHANES III uses stratified, multistage probabilistic methods to sample nationally representative samples. Household adult, laboratory and mortality data were merged. Sample persons who were available to be examined in aMobile Examination Center (MEC) were included in this study. Specialized survey analysis software was used. Results: A total of 3,482 sample participants with complete information for all variables were included in this analysis. For all cause death, the odds ratios (S.E.) for statistically significant variables were body mass index, 1.03 (1.01-1.06); 1.01 (1.01-1.01); blood lead concentration, 1.05 (1.01-1.08); poverty income ratio, 0.823 (0.76-0.89); and drinking hard liquor, 1.01 (1.00-1.02). For all cancer mortality, the odds ratios (S.E.) of the statistically signigicant variables were: age, 1.01 (1.01-1.01); blood lead concentration, 1.07 (1.04-1.12), black race, using non-Hispanic white as reference, 1.69 (1.12-2.56); and smoking, 1.02 (1.01-1.04). For lung cancer mortality, the odds ratios (S.E.) of the statistically significant variables were: age, 1.01(1.01-1.01); blood lead concentration, 1.09 (1.05-1.13); Mexican Americans, using non-Hispanic white as refrence, 0.33 (0.129-0.850); other races, 1.80 (0.53-6.18); and smoking, 1.03 (1.02-1.05). Conclusion: Blood lead concentration correlated with all cause, all cancer, and lung cancer mortality in adults.

Practical Evaluation Technique for Deterioration of Railroad Lines using Track Geometry (철도노선 선형의 실용적 노후도 평가기법 개발)

  • Kim, Hyun Ki;Kim, Sung Jin;Choi, Chan Yong;Hwang, Soo Beom
    • Journal of the Korean Society for Railway
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    • v.17 no.2
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    • pp.106-113
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    • 2014
  • In this study, a practical evaluation technique to detect the deterioration of railroad lines by means of train performance and track geometry measures is suggested. A train that has a specific performance and is running the straight line can make minimum travel time (ideal time). But the actual travel time will be increased by the track geometry and various speed limitations. By comparing these travel times, we can easily define the degree of line deterioration. This method does not require complex vehicle performance measures and/or specifications that exceed those of typical Train Performance Simulations (TPS). For this reason, ease of use is ensured and the results are similar to those obtained by running a TPS for practical evaluations.

Effect of Sr Substitution for RE on Microstructure and Tensile Properties in Mg-Al-RE Casting Alloys

  • Jun, Joong-Hwan
    • Journal of Korea Foundry Society
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    • v.31 no.5
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    • pp.284-287
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    • 2011
  • Microstructures and tensile properties at ambient and elevated temperatures were studied by substituting RE for Sr in Mg-6%Al-(3-X)%RE-X%Sr alloys (X = 0~3). With increasing Sr content, $Al_4Sr$ phase with lamellar morphology was newly introduced at interdendritic regions, with a gradual extinction of needle-shaped $Al_4RE$. The Mg-6%Al-3%Sr alloy shows dendritic grains and interdendritic eutectic phases containing bulky Mg-Al-Sr and lamellar $Al_4Sr$ with more continuous manner. The substitution of Sr for RE provided higher YS, UTS and creep resistance at $175^{\circ}C$, which indicates that Sr would be more beneficial in tensile properties and creep resistance at elevated temperature than RE for the Mg-Al based casting alloys.

CaNb2O6:RE3+(RE=Eu, Sm) 적주황색 형광체의 합성과 발광 특성

  • Jeong, Un-Hwan;Jo, Sin-Ho
    • Proceedings of the Korean Vacuum Society Conference
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    • 2013.08a
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    • pp.165-165
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    • 2013
  • 희토류 발광 물질은 4f 껍질에 위치하는 전자의 독특한 특성 때문에 발광 소자와 디스플레이에 그 응용성을 확장하고 있다. 본 연구에서는 고효율의 적색과 주황색 형광체를 합성하기 위하여 모체 격자 CaNb2O6에 희토류 이온인 유로퓸과 사마륨을 치환 고용하여 최적의 합성 조건을 조사하였다. Ca1-1.5xNb2O6:REx3+ (RE=Eu, Sm) 형광체 분말 시료는 고상반응법을 사용하여 활성제 이온인 Eu3+와 Sm3+의 농도비를 0, 0.01, 0.05, 0.10, 0.15, 0.20 mol 로 변화시키면서 합성하였다. 초기 물질 CaO, Nb2O5, Eu2O3와 Sm2O3을 화학 적량으로 측정하고, 400 rpm의 속도로 24시간 밀링 작업을 수행한 후에, 건조기 $60^{\circ}C$에서 28시간 건조하고, 시료를 막자 사발에서 갈아 세라믹 도가니에 담아 튜브형 전기로에서 분당 $5^{\circ}C$의 비율로 승온시켜 $500^{\circ}C$에서 5시간 동안 하소와 $1,100^{\circ}C$에서 6시간 소결하여 합성하였다. Eu3+가 도핑된 경우에, 발광 스펙트럼은 Eu3+ 이온의 농도비에 관계없이 강한 적색 발광 스펙트럼이 616 nm에서 관측되었다. 이외에도, 596 nm와 708 nm에서 상대적으로 발광 세기가 약한 주황색 발광과 적색 발광 신호가 검출되었으며, 541 nm에서는 매우 약한 녹색스펙트럼이 관측되었다. Eu3+ 이온의 농도비에 0.01 mol에서 0.15 mol로 증가함에 따라 주발광 신호의 세기는 점점 증가하였으며, 0.15 mol에서 최대 발광 세기를 나타내었다. Eu3+ 이온의 농도비가 0.20 mol 로 더욱 증가함에 따라 주 피크의 세기는 농도 소강 현상에 의하여 현저히 감소함을 보였다. 한편, 주된 흡광 스펙트럼은 279 nm에서 나타났는데, 이것은 전하전달밴드 신호이다. Sm3+가 도핑된 형광체 분말의 발광 스펙트럼은 모든 시료의 경우에 613 nm에서 강한 적주황색 발광 스펙트럼이 관측되었고, 상대적으로 세기가 약한 570 nm와 660 nm에 피크를 갖는 황색과 적색 발광 스펙트럼이 발생하였다. 흡광과 발광 스펙트럼의 최대 세기는 0.05 mol에서 나타났으며, Sm3+ 이온의 농도비가 더욱 증가함에 따라 흡광과 발광 세기는 급격하게 감소하였다.

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Epidemiological Studies on Respiratory Infection in Adullt Rabbits (성토의 호흡기 감염증에 관한 역학적 연구)

  • Son Dong-Soo;Kim Yong-Hwan
    • Journal of Veterinary Clinics
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    • v.4 no.1
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    • pp.409-421
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    • 1987
  • For the epidemiological studies of the respiratory infection from 1,918 heads of adult rabbits from January 1980 to December 1985 at an integrated farm, the causative agents were. Isolated samples 92 from of lungs and nasal discharges, and identified by serological and non-serololgical tests, the loss rates by the infection were also investigatyed, and the antimicrobial sensitivities of the isolates were determined. The results obtained were as fellows : 1. The loss rate by respiratory infection was 11.9% among 1,819 heads which raised and 41.7% among 518 heads which lost by diseases, and the rate increased annually. 2. The loss rate of rabbits in Spring (45.0%), Summer (45.5%) and Winter (53.5%) showed significantly higher (P < 0.01) than that in Autumn(29.1%). 3. The loss rate of Rex (56.3%) showed significantly higher (P<0.05) than New Zealand White (40.7%) and Californian (42.0% ). 4. P. multocida.(37.9%), B. brouchiseptica (16.0%), E. coli (10.6%) and so forth were isolated from 92 samples of lungs and nasal discharges. 5. Sixty fours trains of P. multocida were typed by serological or non-serological tests and their all serotypes were A type (62 strains) except 2 strains of untypable. 6. In antimicrobial sensitivity test for 64 isolates of P. multocida, all the strains tested were highly sensitive to chloramphenicol(95.3%), colistin (95.3%), gentamicin (92.2%), kanamycin (90.6%), neomycin (82.8%) and tetracycline (81.3%), but exhibited low sensitivity to streptomycin (26.6%), and all strains were resistant to lincomycin. 7 Twenty seven isolates of B. brouchiseptica showed higher sensitivity to cephalothin (100%), erythromycin (100% ), gentamicin (100%). trimethoprim+sulfamethoxazole (100%), chloramphenicol(88.9%), kanamycin(88.9%), neomycin (88.9%) and colistin (85.2%), but lower sensitivity to nitrofurantoin (18.5%), penicillin(18.5%). streptomycin(18.5%) and ampicillin (14.8%), and all strains were resistant to lincomycin.

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