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Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

A Study on the Restoration of Stone Railings at Gwanghwamun Woldae in Gyeongbokgung Palace (경복궁 광화문 월대(月臺)의 난간석 복원에 관한 고찰)

  • JEON, Nana
    • Korean Journal of Heritage: History & Science
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    • v.54 no.4
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    • pp.112-131
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    • 2021
  • The Gwanghwamun Gate of the Gyeongbokgung Palace was established in 1866 when Heungseon Daewongun rebuilt the Gyeongbokgung Palace. In Gwanghwamun, a large platform, woldae was established to reveal its hierarchy. The Gwanghwamun Woldae was equipped with stone railings on the left and right sides, fishing routes in the center, and stairs and slopes to the south. The Yongdu Stone was installed on the south side of the slope, which connected to the woldae, to express the path of the king in a formative manner. The Woldae King Road in Gwanghwamun was expanded in 1915 as the Joseon Promotion Conference was held at the Gyeongbokgung Palace and the woldae was destroyed around 1925. Since then, the figure has not been found since the time before the Gwanghwamun Gate. In the Donggureung royal tombs, there are many stones that are not placed in the royal tombs, including voussoir arch stones, Munsojeon Gugi-bi, as well as Nangan-Seokju, Dongja-seok, and Juk-seok, which are elements of the stone railings. These stone railings and Yongdu-seok are seen as stone objects of the Gwanghwamun Woldae, which can be found through the analysis of the style of the times and comparison with modern photographs.

The Effect of Emission Trading System on Air Transport Industry and Airlines' Strategic Responses in Korea (온실가스 배출권거래제(ETS)가 국내 항공사에 미치는 영향 및 항공사들의 전략적 대응방안 연구)

  • Yoon, Han-Young;Lim, Jong-Bin;Park, Kang-Sung;Park, Wan-Kyu;Park, Sung-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.576-586
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    • 2019
  • Airlines need to reduce their greenhouse gas (GHG) emissions because of the Paris Climate Agreement and ICAO CORSIA. This examined the degree of the strategic responses to which the airlines have made and the problems in the emission trading system (ETS). According to the analysis, the total amount of emission all the airlines made in the last three years was 116% more than the emission allowance imposed by the central government resulting in 10.7 billion KRW additional emission expense. Airlines would also face an increased carbon cost due to the implementation of ICAO CORSIA by purchasing an additional paid-in emission allowance in international routes. Although it is effective to retire the old aircraft early and induce the brand-new fuel-efficient aircraft to reduce GHG emissions, it is impractical in the short-term due to the tremendous amount of investment. To reduce the emission, airlines are washing engines, using ultra-light ULD and carts in the cabin, increasing the use of flaps and preventing the use of APU. On the other hand, these are very limited measures for reducing emissions according to the ICAO's mandatory emission target.

The Characteristics of South Korea's New Northern Policy and Cooperation with Eurasia Countries' Initiatives Focused on China, Mongolia and Russia (한국 신(新)북방정책과 유라시아 주요 국가와의 협력방안 모색 - 중국, 몽골, 러시아를 중심으로 -)

  • Song, Min-Geun
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.1-13
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    • 2019
  • The purpose of this study is to examine the main features of South Korea's New Northern Policy and to make some suggestions for cooperation with neighboring countries' initiatives. The New Northern Policy encompasses the whole of Eurasia, but the starting development area would be the border region of the Korean Peninsula. In this viewpoint, this study examines the Belt and Road Initiative of China, the New Eastern Policy of Russia and the Steppe Road Initiative of Mongolia, and presents the characteristics, problems and some implementation strategies of the New Northern Policy. Apart from the future possibilities of the regional cooperations that include North Korea, it would be necessary for South Korea to secure and expand the possible opportunities for "Korea-China-Mongolia-Russia" cooperation. In order to create a close cooperative environment with North Korea in the future, it would also be necessary to build a maritime route, with port development around major border regions on the Korean Peninsula, including Russia, and to develop the port-railway intermodal transportation system with neighboring countries. South Korea need to actively cooperate with neighboring countries to develop the new Eurasia logistics routes would be more favorable to the Korean Peninsula in preparation for the time when the North Korean nuclear issue will be resolved.

The Analysis of Bus Traffic Accident to Support Safe Driving for Bus Drivers (버스운전자 안전운행지원을 위한 교통사고 분석 연구)

  • BHIN, Miyoung;SON, Seulki
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.18 no.1
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    • pp.14-26
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    • 2019
  • For bus drivers' safe driving, a policy that analyzes the causes of the drivers' traffic accidents and then assists their safe driving is required. Therefore, the Ministry of Land, Infrastructure and Transport set up its plan to gradually expand the equipping of commercial vehicles with FCWS (Forward Collision Warning System) and LDWS(Lane Departure Warning System), from the driver-supporting ADAS(Advanced Driver Assistance Systems). However, there is not much basic research on the analysis of bus drivers' traffic accidents in Korea. As such, the time is appropriate to research what is the most necessary ADAS for bus drivers going forward to prevent bus accidents. The purpose of this research is to analyze how serious the accidents were in the different bus routes and whether the accidents were repetitive, and to give recommendations on how to support ADAS for buses, as an improvement. A model of ordered logit was used to analyze how serious the accidents were and as a result, vehicle to pedestrian accidents which directly affected individuals were statistically significant in all of the models, and violations of regulations, such as speeding, traffic signal violation and violation of safeguards for passengers, were indicated in common in several models. Therefore, the pedestrian-sensor system and automatic emergency control device for pedestrian should be installed to reduce bus accidents directly affecting persons in the future, and education for drivers and ADAS are to be offered to reduce the violations of regulations.

A Study on Road Safety Evaluation Method for Improvement Project of Two-Lane Road (2차로 시설개량 사업의 도로 안전성 평가방법 연구)

  • Shin, Chul-Ho;Kim, Nakseok
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.39 no.1
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    • pp.105-114
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    • 2019
  • Recently, the paradigm of road policy has been focused on user safety. Recently, the number of road facility improvement project has been continuously increased but the economic feasibility (B/C ratio) is insufficient. Therefore, it is necessary to select a reasonable road improvement project through accurate and objective analysis of the road safety evaluation. In this study, to develop a new road safety evaluation method, data were collected based on the current road safety evaluation method for 75 routes including national roads and provincial ones. Based on the collected data, problems were analyzed and utilized as the basic factors of the new road safety evaluation method. Therefore, in this study, traffic accidents were reflected as a general evaluation item by weighing to solve these problems, and the evaluation items were added from experiences and ideas of the local public officials. For each evaluation item, a reasonable weight was determined through AHP (Analytic Hierarchy Process) questionnaire evaluation with highway experts. In addition, the safety index was determined based on the evaluation criteria for each evaluation item. The criteria for evaluating the danger zone are determined by the overall safety index. Finally, the criteria for selection of road improvement projects based on the overall risk level were derived.

Agent-based Modeling and Analysis of Tactical Reconnaissance Behavior with Manned and Unmanned Vehicles (에이전트 기반 유·무인 수색정찰 전술행위 모델링 및 분석)

  • Kim, Ju Youn;Han, Sang Woo;Pyun, Jai Jeong
    • Journal of the Korea Society for Simulation
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    • v.27 no.4
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    • pp.47-60
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    • 2018
  • Today's unmanned technology, which is being used in various industries, is expected to be able to make autonomous judgements as autonomous technology matures, in the long run aspects. In order to improve the usability of unmanned system in the military field, it is necessary to develop a technique for systematically and quantitatively analyzing the efficiency and effectiveness of the unmanned system by means of a substitute for the tasks performed by humans. In this paper, we propose the method of representing rule-based tactical behavior and modeling manned and unmanned reconnaissance agents that can effectively analyze the path alternatives which is required for the future armored cavalry to establish a reconnaissance mission plan. First, we model the unmanned ground vehicle, small tactical vehicle, and combatant as an agent concept. Next, we implement the proposed agent behavior rules, e.g., maneuver, detection, route determination, and combatant's dismount point selection, by NetLogo. Considering the conditions of maneuver, enemy threat elements, reconnaissance assets, appropriate routes are automatically selected on the operation area. It is expected that it will be useful in analyzing unmanned ground system effects by calculating reconnaissance conducted area, time, and combat contribution ratio on the route.

China's 'One Belt and One Road' Initiative and Strategy: Development and Limitations (중국의 '일대일로'(一帶一路) 구상과 전략: 발전과 한계)

  • Heur, Heung-Ho
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.335-347
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    • 2019
  • China's 'One Belt and One Load' initiative is a mega-infrastructure project that connects China and the Eurasian Economies Area by overland and sea routes. Therefore, if it goes smoothly, It will be a new engine for economic development in China and the world, and It is expected to be a factor that will change the structure of the international economy. Especially, the Eurasian continent is likely to develop into the center of the global economy. But China's 'One Belt and One Load' initiative is not only macro and long-term, but also implies complexity, making it hard to be optimistic about development. China's 'One Belt and One Load' initiative is not only strongly promoted as a long-term national development strategy to be completed by 2049, but also strong economic complementarity between China and 'One Belt and One Load' consecutive countries. And many of the successive countries are expecting 'One Belt and One Load' construction. Therefore, there is no possibility at all. In particular, the possibility of development can not be completely ruled out, given the various policies of 'One Belt and One Load' currently being pursued by China. Even if it doesn't go smoothly, the process alone will have significant economic effects on China and neighboring countries, so it will be meaningful. With the help of information technology.

Changes of Time-Distance Accessibility by Year and Day in the Integrated Seoul Metropolitan Public Transportation Network (서울 대도시권 통합 대중 교통망에서 연도별 및 요일별 시간거리 접근도 변화)

  • Park, Jong Soo;Lee, Keumsook
    • Journal of the Economic Geographical Society of Korea
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    • v.21 no.4
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    • pp.335-349
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    • 2018
  • This study analyzes the effect of the changes in traffic environments such as transportation speeds on the time-distance accessibility for the public transportation passengers. To do this, we use passenger transaction databases of the Seoul metropolitan public transportation system: one week for each of the three years (2011, 2013, and 2015). These big data contain the information about time and space on the traffic trajectories of every passenger. In this study, the time-distances of links between subway stations and bus stops of the public transportation system at each time are calculated based on the actual travel time extracted from the traffic-card transaction database. The changes in the time-distance accessibility of the integrated transportation network from the experimental results can be summarized in two aspects. First, the accessibility tends to decline as the year goes by. This is because the transportation network becomes more complicated and then the average moving speed of the vehicles is lowered. Second, the accessibility tends to increase on the weekend in the analysis of accessibility changes by day. This tendency is because the bus speeds on bus routes on the weekend are faster than other days. In order to analyze the accessibility changes, we illustrate graphs of the vehicle speeds and the numbers of passengers by year and day.

A Study on the Yocoanabo (Cave Tombs) of the Baekje Kingdom (백제(百濟) 횡혈묘(橫穴墓)의 특징과 의미에 대하여)

  • Kim, Nakjung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.2
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    • pp.268-291
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    • 2019
  • In this paper, the features and meanings of the Yocoanabo (cave tombs) excavated in the Gongju and Buyeo regions were examined. The creation of the Yocoanabo in the Korean Peninsula was related to the situation in which the powers of the Northern Kyushu (九州) and Yeongsangang (榮山江) River Basin played certain roles and maintained power in the interactions of Wa and Baekje in the late 5th century until the early 6th century. The people buried in the Yocoanabo in the Gongju and Buyeo regions are most closely related to the Buzen (豊前) area in northern Kyushu. They also interacted with the Yeongsangang River Basin communities. The Yocoanabo in Gongju and Buyeo confirms the settlement of the Wa people. There were collective settlements such as the Danjiri (丹芝里) site on the outskirts of Woongjin (熊津). However, most of them were mixed with small local groups located on the main roads connecting Woongjin and Sabi (泗?) through the Geum River and land routes. Unlike the keyhole-shaped tombs of the Youngsangang River Basin, the Yocoanabo was not built until the 7th century. This explains differences in the backgrounds of the two types of graves. The people buried in the Yocoanabo are considered to have settled in the Baekje Kingdom and to have been responsible for practical work in the political and economic negotiations between Baekje and Wa. They came to the Baekje Kingdom collectively in connection with certain historical events. However, it had been presumed that most of the people came individually and dispersed to the local communities of Gonju and Buyeo.