• Title/Summary/Keyword: Systematic risk

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The Study of Risk Acceptance Criteria for Railway System (철도시스템의 위험도 허용 기준 개발에 관한 연구)

  • Kim, Young-Sang;Maeng, Hee-Young;Wang, Jong-Bae
    • Proceedings of the KSR Conference
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    • 2008.06a
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    • pp.796-805
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    • 2008
  • Safety Management of Korean railway industry has been rapidly changed into a risk-based approach adopted by developed countries since Railway Safety Act 2004, Rolling Stock Risk Assessment Guidance and its following regulations came into force. The fundamental requirements for the risk-based safety management is to carry out a systematic hazard identification and quantified risk analyses including cost-benefit analyses, but there has been rare a serious discussion over risk acceptance criteria and value of life in order to be able to judge the results of risk analyses and carry out cost-benefit analyses. This study presents the results of a review of risk acceptance criteria and value of life which may be adoped to Korean railway industry through the analyses with comparison of risk accepatnce principles and risk accepatnce criteria which have been already applied to other countries or other railway operators.

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Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review

  • Daniel Feijolo Marconi ;Giovana Siocheta da Silva ;Theodoro Weissheimer;Isadora Ames Silva ;Gabriel Barcelos So;Leonardo Thomasi Jahnke ;Jovito Adiel Skupien ; Marcus Vinicius Reis So ; Ricardo Abreu da Rosa
    • Restorative Dentistry and Endodontics
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    • v.47 no.4
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    • pp.40.1-40.18
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    • 2022
  • Objectives: This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Materials and Methods: Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Results: Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. Conclusions: This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

Influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium instruments: a systematic review

  • Silva, Emmanuel Joao Nogueira Leal;Zanon, Mayara;Hecksher, Fernanda;Belladonna, Felipe Goncalves;de Vasconcelos, Rafaela Andrade;da Silva Fidalgo, Tatiana Kelly
    • Restorative Dentistry and Endodontics
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    • v.45 no.2
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    • pp.25.1-25.12
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    • 2020
  • Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results: From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions: Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.

Effects of garlic intake on cancer: a systematic review of randomized clinical trials and cohort studies

  • Lee, Jounghee;Zhao, Naisi;Fu, Zhuxuan;Choi, Jihee;Lee, Hae-Jeung;Chung, Mei
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.773-788
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    • 2021
  • BACKGROUND/OBJECTIVES: Due to the rapid increase of global cancer incidence and mortality and a high level of interest in cancer prevention, a systematic review of garlic intake and cancer risk is needed. SUBJECTS/METHODS: We implemented a systematic review to examine the effects of varying levels of garlic intake on cancer. We conducted comprehensive literature searches in three electronic databases (MEDLINE, Embase, and Web of Science) for studies published between database inception and July or September of 2018. Two investigators independently screened abstracts and full-texts, extracted data, and assessed risk of bias (RoB). A total of one medium-quality randomized controlled trial (RCT) and 13 cohort studies graded as high RoB were included. RESULTS: The 1-year follow-up results from a RCT showed that a significant decrease in the number and size of colorectal adenomas among participants with colorectal adenomas who received high-dose aged garlic extract (AGE) compared with those who received low-dose AGE (P < 0.05). The results of prospective observational studies provided inconsistent associations of colorectal cancer risk with garlic supplements and garlic intake as food. CONCLUSIONS: In summary, the AGE was effective in reducing the number and magnitude of colorectal adenomas in one RCT, but there were inconsistent associations between garlic intake and colorectal cancer in cohort studies. Therefore, we could not draw a firm conclusion regarding the effects of garlic on cancer, because the current strength of evidence is inadequate due to a lack of number of high-quality RCTs.

Anesthetic efficacy of supplemental intraligamentary injection in human mandibular teeth with irreversible pulpitis: a systematic review and meta-analysis

  • Gupta, Alpa;Wadhwa, Jitesh;Aggarwal, Vivek;Mehta, Namrata;Abraham, Dax;Aneja, Kritika;Singh, Arundeep
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.1-10
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    • 2022
  • Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

Efficacy of Manual Therapy for Knee Meniscus Injuries: A Systematic Review and Meta-Analysis (반월상 연골 손상에 대한 수기치료의 효과: 체계적 고찰 및 메타분석)

  • Seok-Beom Kang;Han-Byeol Park;Woo-Seok Shon;Young-Jun Kim;Chang-Hoon Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.2
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    • pp.17-25
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    • 2022
  • Objectives This study aimed to evaluate the efficacy of manual therapy for knee meniscus injuries. Methods We searched seven electronic databases (MEDLINE, Cochrane Library, CAJ, Wanfang, RISS, ScienceON, and OASIS) to collect randomized controlled trials (RCTs) using the keywords "manual therapy OR chuna OR tuina" and "meniscus injury." Results Eleven RCTs were selected based on the inclusion criteria, and all studies were conducted in China. Five studies were meta-analyzed. The systematic review revealed a positive effect of manual therapy for knee meniscus injury. Low risk of selection, attrition, and reporting bias were demonstrated in all studies. Ten studies had a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for knee meniscus injury. However, this study has several limitations because of the high risk of bias. Further clinical studies and reviews with higher levels of evidence are warranted.

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert;Sergio Augusto Quevedo Miguens Jr;Caroline Solda;Juliana Tomaz Sganzerla;Leandro Azambuja Reichert;Carlos Estrela;Fernando Branco Barletta
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.48.1-48.11
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    • 2020
  • Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

The prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation: a systematic review

  • Letícia Taina de Oliveira Lemes;Carolina Horn Troian-Michel;Theodoro Weissheimer;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • v.49 no.2
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    • pp.22.1-22.12
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    • 2024
  • Objectives: This systematic review addressed the question: "What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?" Materials and Methods: A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%-43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified. Conclusions: With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.

Effect of Home-based Rehabilitation on Balance and Gait Function in Patient With Stroke: A Systematic Review and Meta-analysis

  • Yong-gu Han;Chung-hwi Yi
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.91-103
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    • 2024
  • Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger's regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger's regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.

VULNERABILITY ASSESSMENTS AND RISK MANAGEMENT FOR CRITICAL INFRASTRUCTURES FROM HOMELAND SECURITY VIEWPOINTS

  • Chun Nen Huang;Yao-Chen Kuo
    • International conference on construction engineering and project management
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    • 2009.05a
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    • pp.292-301
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    • 2009
  • The employment of risk management theory in Urban Disaster Management System (UDMS) has become an important trend in recent years. The viewpoint of risk management is mainly a comprehensive risk assessment of various internal and external factors, and a subsequent handling of risks. Through continuous and systematic accumulation and analysis of risk information, disaster prevention and rescue system is established. Taking risk management theory as the foundation, Organization for Economic Cooperation and Development (OECD) has developed a series of UDMS in the mega-cities all over the world. With this system as a common platform, OECD cooperates with different cities to develop disaster prevention and rescue system consisting of vulnerability assessment methods, risk assessment and countermeasures. The paper refers to the urban disaster vulnerability assessment and risk management of OECD and the mega-cities of different advanced and developed countries in the world, and then constructs a preliminarily drafted structure for the vulnerability assessment methods and risk management mechanism in the metropolitan districts of Taiwan.

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