• Safety and Health at Work
• /
• 제13권3호
• /
• pp.343-349
• /
• 2022

Background: In the United States, the dairy product manufacturing industry has consistently had higher rates of work-related nonfatal injuries and illnesses compared to the national average for industries in all sectors. The selection and implementation of appropriate safety performance indicators are important aspect of reducing risk within safety management systems. This study examined the leading safety indicators implemented in the dairy product-manufacturing sector (NAICS 3115) and their perceived effectiveness in reducing work-related injuries. Methods: Perceptions were collected from individuals with safety responsibilities in the dairy product manufacturing facilities. OSHA Incident Rate (OIR) and Days away, restricted and transferred (DART) rates from 2013 to 2018 were analyzed. Results: The perceived most effective leading were safety observations, stop work authority, near miss reporting, safety audits, preventative maintenance, safety inspections, safety training attendance, and job hazard analysis/safety analysis, respectively. The 6-year trend analysis showed that those implementing all eight top indicators had a slightly lower rates than those that did not implement all eight. Production focused mentality, poor training, and lack of management commitment were perceived as the leading causes of injuries in this industry. Conclusion: Collecting leading indicators with the unique interest to meet the regulatory requirements and to document the management system without the actual goal of using them as input to improve the system most probably will not lead to an effective reduction of negative safety outcomes. For leading indicators to be effective, they should be properly selected, executed, periodically evaluated and actions are taken when necessary.

• 지역사회간호학회지
• /
• 제33권3호
• /
• pp.340-355
• /
• 2022

Purpose: This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

• Archives of Plastic Surgery
• /
• 제50권3호
• /
• pp.315-324
• /
• 2023

Hemoglobinopathies such as sickle cell disease (SCD) are traditionally considered a relative contraindication to free tissue transfer, due to concerns that erythrocyte sickling will increase the risk of microvascular thrombosis and flap failure. This article describes a case report with the successful use of free tissue transfer in a patient with SCD and provides a systematic literature review on free tissue transfer in SCD. A retrospective chart review was performed of a patient with SCD who underwent free tissue transfer at the authors' institution. A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using the keywords "free tissue transfer," "free flap," or "microsurgery" and "sickle cell" on PubMed, Ovid/Medline, and Scopus. A 29-year-old male with delayed presentation of an electrical burn to the face and scalp underwent wound closure with a free anterolateral thigh flap. Key management principles included red blood cell transfusion to keep hemoglobin S under 30% and hemoglobin greater than 10 g/dL, maintenance of hydration, normothermia, adequate analgesia, and postoperative anticoagulation. Systematic literature review identified 7 articles describing 13 cases of free tissue transfer in 10 patients with SCD, with combined complete free flap success in 10 of the 13 flaps. Free tissue transfer can be successfully performed in patients with SCD. However, evidence on the optimal management of this unique patient population in the perioperative period after free tissue transfer is limited to case reports in the literature.

• Archives of Plastic Surgery
• /
• 제50권1호
• /
• pp.3-9
• /
• 2023

Background In breast reconstruction, synthetic meshes are frequently used to replace acellular dermal matrix (ADM), since ADM is expensive and often leads to complications. However, there is limited evidence that compares the types of substitutes. This study aimed to compare complications between materials via a network meta-analysis. Methods We systematically reviewed studies reporting any type of complication from 2010 to 2021. The primary outcomes were the proportion of infection, seroma, major complications, or contracture. We classified the intervention into four categories: ADM, absorbable mesh, nonabsorbable mesh, and nothing used. We then performed a network meta-analysis between these categories and estimated the odds ratio with random-effect models. Results Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for full-text reading, of which 17 studies were finally included. There was a low risk of bias in the included studies, but only an indirect comparison between absorbable and non-absorbable mesh was possible. Infection was more frequent in ADM but not in the two synthetic mesh groups, namely the absorbable or nonabsorbable types, compared with the nonmesh group. The proportion of seroma in the synthetic mesh group was lower (odds ratio was 0.2 for the absorbable and 0.1 for the nonabsorbable mesh group) than in the ADM group. Proportions of major complications and contractures did not significantly differ between groups. Conclusion Compared with ADM, synthetic meshes have low infection and seroma rates. However, more studies concerning aesthetic outcomes and direct comparisons are needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제26권5호
• /
• pp.231-238
• /
• 2023

Purpose: This systematic review and meta-analysis aimed to compare endoscopy as primary versus secondary prophylaxis to prevent future bleeding in children with esophageal varices. Methods: A systematic literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was conducted using the Scopus, PubMed, and Cochrane databases for relevant studies on the outcome of rebleeding events after endoscopy in primary prophylaxis compared to that in secondary prophylaxis. The following keywords were used: esophageal varices, children, endoscopy, primary prophylaxis and bleeding. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale and statistically analyzed using RevMan 5.4 software. Results: A total of 174 children were included from four eligible articles. All four studies were considered of high-quality based on the Newcastle-Ottawa Quality Assessment Scale. Patients who received primary prophylaxis had 79% lower odds of bleeding than those who received secondary prophylaxis (odds ratio, 0.21; 95% confidence interval [CI], 0.07-0.66; I²=0%, p=0.008). Patients in the primary prophylaxis group underwent fewer endoscopic procedures to eradicate varices than those in the secondary prophylaxis group, with a mean difference of 1.73 (95% CI, 0.91-2.56; I²=62%, p<0.0001). Conclusion: Children with high-risk varices who underwent primary prophylaxis were less likely to experience future bleeding episodes and required fewer endoscopic procedures to eradicate the varices than children who underwent secondary prophylaxis.

• 한국재난정보학회 논문집
• /
• 제19권2호
• /
• pp.432-438
• /
• 2023

연구목적: 생활안전 예방서비스 앱에서 신고되는 이미지를 AI를 사용하여 실시간으로 위험 카테고리를 자동으로 분류하여 사용자에게 편리한 위험신고를 가능하게 하는 것을 목적으로 한다. 연구방법: 인터넷으로 상호연결되는 생활안전 예방서비스 플랫폼, 생활안전 예방서비스 앱, AI 모델 서빙 서버와 sftp 서버로 구성되는 시스템을 통하여 신고된 생활안전 이미지를 실시간으로 자동분류하며, 이때 사용되는 AI모델 생성을 위한 AI 학습 알고리즘도 개발하였다. 연구결과: 이미지를 실시간으로 AI 처리하여 자동으로 분류할 수 있게 되어, 신고자가 생활안전 관련 사항을 보다 편리하게 신고할 수 있게 되었다. 결론: 본 논문에서 제시하는 AI 이미지 자동분류 시스템은 90% 이상의 분류 정확도로 신고 이미지를 실시간으로 자동분류하여 신고자가 간편하게 생활안전 관련 이미지를 신고할 수 있게 되었으며 향후 생활안전 예방서비스 앱의 사용자의 증가에 따라 더욱 빠르고 정확한 AI 모델 개발 및 시스템 처리용량 향상이 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권2호
• /
• pp.61-67
• /
• 2023

This systematic review aimed to analyze the clinicopathological profile and relevant prognostic factors of head and neck rhabdomyosarcoma in pediatric patients. The search was carried out in the electronic search portals PubMed, Lilacs, Embase, Scopus, and Web of Science. The search yielded studies that were then analyzed regarding study topic, data extraction, and risk of bias using the STROBE (Strengthening the Reporting of Observational Studies) guidelines. Finally, three studies were included for qualitative analysis. Most of the cases involved embryonic and alveolar rhabdomyosarcoma. Expression of MYOD1 was highly correlated with diagnosis of spindle cell/sclerosing rhabdomyosarcoma, which appears to have a poor prognosis in children. Furthermore, tumor size <5 cm and absence of metastasis accompanied by complete resection and administration of adjuvant therapies such as chemotherapy and radiotherapy favored a better prognosis.

• 동의신경정신과학회지
• /
• 제33권1호
• /
• pp.49-78
• /
• 2022

Objectives: This study was conducted to evaluate the efficacy of Korean Medicine Therapy (KMT) for the treatment of Chemotherapy-induced Cognitive Impairment (CICI) through systematic review and meta-analysis of randomized controlled trials (RCTs) as proceeding research to further research the efficacy of KMT for CICI patients. Methods: We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The RCTs on the efficacy of KMT for treatment of CICI were searched by structured search strategies in MEDLINE, EMBASE, Cochrane library, CAJD, KISS, NDSL, KoreaMed, and OASIS. The searched RCTs were screened by inclusion and exclusion criteria. We evaluated the quality of the method in the included studies using the Jadad score and Cochran ROB tool. The efficacy outcomes were the Visual Analogue Scale (VAS) and the Clinical total Effective Rate (CER) of CICI. They were analyzed using mean difference for continuous variable or Relative Risk (RR) for Dichotomous variable in the random-effect model. The RevMan 5.3 program was used for meta-analysis. Results: We included 19 RCTs, including 653 participants, in the systematic review and meta-analysis. There were favorable results for the KMT group after the intervention compared with the pharmacotherapy group, physiotherapy group, and combined treatment group. KMT group showed improvement using CER and VAS compared with exercises, but their heterogeneities were slightly significant. KMT was more effective compared to the Rehabilitation program in CER and the subgroup analysis results showed that KMT had a significant difference compared to other therapies in VAS, to Medication therapy in CER. Conclusions: KMT presented reasonable evidence on improving the Clinical total Effective Rate and Visual Analogue Scale in CICI patients. However, further evaluation in future research is required.

• 대한한의학회지
• /
• 제44권2호
• /
• pp.201-201
• /
• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• 대한물리의학회지
• /
• 제18권4호
• /
• pp.109-119
• /
• 2023

PURPOSE: The definition and scope of biofeedback are broad and lack a clear framework. Therefore, efforts are needed to clearly understand the exact range and definition of biofeedback based on the research and development conducted to date. Thus, the purpose of this study was to arrive at the definition and scope of biofeedback through a literature review and analysis of its application methods. METHODS: This study is a systematic literature review conducted to understand the various types and effects of biofeedback. International databases such as Google Scholar and PubMed were used. Domestic databases utilized for keyword searches included the Research Information Sharing Service (RISS) and the National Digital Science Library (NDSL). Quality assessment of the selected studies in the selection process was done using the Cochrane risk of bias, and the research was analyzed according to the population, intervention, control, and outcomes (PICO) format. RESULTS: Studies conducted between 2019 and 2021 were selected, with 4 papers falling under physiological classifications and 7 under biomechanical classifications. The quality assessment results showed that random sequence generation, allocation concealment, performance bias, and reporting bias were unclear. Detection bias was moderate, and attrition bias and other biases were low. Out of the 11 papers, 9 dealt with physical function outcomes, 5 with daily life activities, and 3 with mental functions. CONCLUSION: Physiological biofeedback tended to influence psychological factors more than physical functions, while biomechanical biofeedback tended to have a positive impact on physical functions.