• 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.

• Journal of the Korea institute for structural maintenance and inspection
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• v.27 no.3
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• pp.30-37
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• 2023

The PSCB girder bridge is a closed cross-section in which the top and bottom flanges and the web are integrated, and the structural characteristics are generally different from the bridges in which the girder and the floor plate are separated, so a maintenance plan that reflects the characteristics of the PSCB girder bridge is required. As a result of analyzing damage types by collecting detailed safety diagnosis reports of highway PSCB girder bridges, most of the deterioration and damage occurring during use is concentrated on the top flange. In particular, cracks in the bridge direction on the underside of the top flange occurred in about 70 % of the PSCB girder bridges to be analyzed, and these cracks were judged to be caused by indirect loads such as heat of hydration and drying shrinkage rather than structural cracks caused by external loads. In order to improve durability and reduce maintenance costs of PSCB girder bridges in use, it is necessary to control restraint drying shrinkage cracks from the design stage. Therefore, in this paper, the cracks caused by drying shrinkage under restraint, which is the main cause of cracks under the flanges of the top part of the PSCB girder bridge, were directly calculated using the Gilbert Model, and the influencing factors such as the amount of reinforcing bars, diameter and spacing of reinforcing bars were analyzed. As a result of the analysis, it was found that the crack width caused by restraint drying shrinkage exceeded the allowable crack width of 0.2 mm for reinforcing bars with a reinforcing bar ratio of 0.01 or less based on the H16 reinforcing bar and a reinforcing bar with a diameter greater than H19 based on the reinforcing bar ratio of 0.01. Finally, based on the results of the crack width review, a method for controlling the crack width of the top flange of the PSCB girder bridge was proposed.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.53-62
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• 2016

Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were 'home program', 'home intervention', 'compliance', 'adherence', 'vestibular rehabilitation', 'motion sickness', and 'motion sensitivity'. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (${\kappa}$=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients' HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.16 no.4
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• pp.180-195
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• 2011

A balanced trophic model for Sinjido marine ecosystem was constructed using ECOPATH model and data obtained 1994 in the region. The model integrates available information on biomass and food spectrum, and analyses ecosystem properties, dynamics of the main species populations and the key trophic pathways of the system, and then compares these results with those of other marine environments. The model comprises 17 groups of benthic algae, phytoplankton, zooplankton, gastropoda, polychaeta, bivalvia, echinodermata, crustacean, cephalopoda, goby, flatfish, rays and skates, croaker, blenny, conger, flatheads, and detritus. The model shows trophic levels of 1.0~4.0 from primary producers and detritus to top predator as flathead group. The model estimates total biomass(B) of 0.1 $kgWW/m^2$, total net primary production(PP) of 1.6 $kgWW/m^2/yr$, total system throughput(TST) of 3.4 $kgWW/m^2/yr$ and TST's components of consumption 7%, exports 43%, respiratory flows 4% and flows into detritus 46%. The model also calculates PP/TR of 0.012, PP/B of 0.015, omnivory index(OI) of 0.12, Fin's cycling index(FCI) of 0.7%, Fin's mean path length(MPL) of2.11, ascendancy(A) of 4.1 $kgWW/m^2/yr$ bits, development capacity(C) of 8.2 $kgWW/m^2/yr$ bits and A/C of 51%. In particular this study focuses the analysis of mixed trophic impacts and describes the indirect impact of a groupb upon another through mediating one based on 4 types. A large proportion of total export in TST means higher exchange rate in the study region than in semi enclosed basins, which seems by strong tidal currents along the channels between islands, called Sinjido, Choyakdo and Saengildo. Among ecosystem theory and cycling indices, B, TST, PP/TR, FCI, MPL and OI are shown low, indicating the system is not fully mature according to Odum's theory. Additionally, high A/C reveals the maximum capacity of the region is small. To sum up, the study region has high exports of trophic flow and low capacity to develop, and reaches a development stage in the moment. This is a pilot research applied to the Sinjido in terms of trophic flow and food web system such that it may be helpful for comparison and management of the ecosystem in the future.