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Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • 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.

A Review of Acupuncture Treatment Methods for Lumbar Herniated Intervertebral Disc

  • Kim, Sung Jin;Jeong, Seong Mok;Lee, Chang Hee;Yoon, Jin-Young;Shim, Sung Eun;Kim, Jeong Hyon;Goo, Bon Hyuk;Park, Yeon Cheol;Baek, Yong-Hyun;Nam, Sang Soo;Seo, Byung-Kwan
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.158-168
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    • 2018
  • The purpose of this study was to review clinical studies of lumbar herniated intervertebral disc (LHIVD) treatment using acupuncture. Online database (PubMed, COCHRANE Library, EMBASE, CNKI, KISS, NDSL, KoreaMed, KMbase, OASIS, and KISTI) searches were conducted in May 2018. Studies that used acupuncture, electroacupuncture or warm needle acupuncture were included, along with participants who had lower back pain and radiating pain of their lower limbs consistent with radiological findings. Animal studies and nonclinical data were excluded. Data on treatment methods, site, time, frequency, period, and scales used were analyzed. There were 69 studies including 38 randomized controlled trials, 14 retrospective observational studies, and 17 clinical case studies. There were 51 acupoints selected for acupuncture treatment of LHIVD. The most frequently treated acupoints were BL23, BL25, BL24, and BL40. The mean treatment time, frequency, and duration were $26.06{\pm}6.70$ mins, $6.29{\pm}1.70$ times/week, and $20.57{\pm}11.04$ days, respectively, in randomized controlled trials (RCT), and $18.62{\pm}4.60$ mins, $11.58{\pm}3.99$ times/week, and $34.43{\pm}17.62$ days, respectively, in case/retrospective studies ($mean{\pm}SD$). This review collates information about acupuncture treatment methods for LHIVD.

Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

A Web-based Simulation Environment based on the Client/Server Architecture for Distance Education: SimDraw (원격교육을 위한 클라이언트/서버구조의 웹 기반 시뮬레이션 환경 : SimDraw)

  • 서현곤;사공봉;김기형
    • Journal of KIISE:Software and Applications
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    • v.30 no.11
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    • pp.1080-1091
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    • 2003
  • Recently, the distance education has been rapidly proliferated with the rapid growth of the Internet and high speed networks. There has been relatively much research with regard to online lecture (teaching and studying) tools for the distance education, compared to the virtual laboratory tools (for self-study and experiments). In this paper, we design and implement a web-based simulation tool, named as SimDraw, for the virtual laboratory in the distance education. To apply the web-based simulation technology into the distance education, some requirements should be met; firstly, the user interface of the simulation should be very easy for students. Secondly, the simulation should be very portable to be run on various computer systems of remote students. Finally, the simulation program on remote computers should be very thin so that students can easily install the program onto their computers. To meet these requirements, SimDraw adopts the client/server architecture; the client program contains only model development and animation functions so that no installation of a client program onto student's system is required, and it can be implemented by a Java applet in Web browsers. The server program supports client programs by offering the functions such as remote compiling, model storing, library management, and user management. For the evaluation of SimDraw, we show the simulation process using the example experimentation of the RIP(Routing Information Protocol) Internet routing protocol.

Related Factors of Problem Behaviors among Students of Multicultural Family in Korea: A Systematic Review (한국 다문화 가정 학생의 문제행동 관련 요인에 관한 체계적 문헌고찰)

  • Chae, Myung-Ock;Kim, Ahrin;Jeon, Hae Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.614-626
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    • 2018
  • This study was conducted to review the literature and examine the factors related to problem behaviors among students of multicultural families in Korea. A systematic review of the literature was conducted using domestic documents retrieved through July 4, 2018 based on online searches of domestic databases (the Research Information Sharing Service, Korean Studies Information Service System and the National Diet Library). A total of 2,084 studies were searched, and 21 studies were used for analysis. The factors related to problem behaviors were related to individual factors (gender, school record, self-esteem, etc.), family factors (family type, parent support, mothers' enculturation stress, etc.) and environmental factors (friend support, teacher support, social support). The variables measured the problem behaviors among students of multicultural families were school life adjustment (10), psychological, social adjustment or maladjustment (4), and emotional problem behavior (3). Overall, the results indicate that social and policy efforts are needed to improve individual, family, and environmental factors based on more specific and consistent theoretical definitions related to problem behaviors among students of multicultural families in Korea.

Spatial analysis based on topic modeling using foreign tourist review data: Case of Daegu (외국인 관광객 리뷰데이터를 활용한 토픽모델링 기반의 공간분석: 대구광역시를 사례로)

  • Jung, Ji-Woo;Kim, Seo-Yun;Kim, Hyeon-Yu;Yoon, Ju-Hyeok;Jang, Won-Jun;Kim, Keun-Wook
    • Journal of Digital Convergence
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    • v.19 no.8
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    • pp.33-42
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    • 2021
  • As smartphone-based tourism platforms have become active, policy establishment and service enhancement using review data are being made in various fields. In the case of the preceding studies using tourism review data, most of the studies centered on domestic tourists were conducted, and in the case of foreign tourist studies, studies were conducted only on data collected in some languages and text mining techniques. In this study, 3,515 review data written by foreigners were collected by designating the "Daegu attractions" keyword through the online review site. And LDA-based topic modeling was performed to derive tourism topics. The spatial approach through global and local spatial autocorrelation analysis for each topic can be said to be different from previous studies. As a result of the analysis, it was confirmed that there is a global spatial autocorrelation, and that tourist destinations mainly visited by foreigners are concentrated locally. In addition, hot spots have been drawn around Jung-gu in most of the topics. Based on the analysis results, it is expected to be used as a basic research for spatial analysis based on local government foreign tourism policy establishment and topic modeling. And The limitations of this study were also presented.

Digital Barrier-Free and Psychosocial Support for Students with Disabilities in Distance Learning Environments

  • Kravchenko, Oksana;Koliada, Natalia;Berezivska, Larysa;Dikhtyarenko, Svitlana;Baida, Svitlana;Danylevych, Larysa
    • International Journal of Computer Science & Network Security
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    • v.22 no.8
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    • pp.15-24
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    • 2022
  • The article clarifies the conditions for information, digital and educational accessibility for higher education seekers with disabilities in terms of distance learning caused by quarantine restrictions. It is established that such conditions are regulated by international and Ukrainian legal documents (The Standard Rules on the Equalization of Opportunities for Persons with Disabilities, Convention on the Rights of Persons with Disabilities, Sustainable Development Goals, Law of Ukraine "On Education", Law of Ukraine "On Higher Education", Strategy for the Development of Higher Education in Ukraine 2021-2031, Development Strategy areas of innovation for the period up to 2030, Development strategy of the sphere of innovation activity for the period up to 2030). As a part of information barrierlessness, Higher Education Institutions (HEI) should provide access to information in various formats and using technologies, in particular Braille script, large-type printing, audio description (audio descriptive commenting), sign language interpretation, subtitling, a format suitable for reading by screen access programs, formats of simple speech, easy-to-read formats, means of alternative communication. The experience of Pavlo Tychyna Uman State Pedagogical University is described. In particular, special attention is paid to the study of sign language: in view of this, the initiative group implemented the project "Learning to hear and overcome social isolation together" with the financial support of the British Council in Ukraine. Within the framework of digital accessibility, the official website of the Faculty of Social and Psychological Education has been adapted for the visually impaired in accordance with WCAG 2.0 World Standards. In 2021, Pavlo Tychyna Uman State Pedagogical University implemented the project "Cultural, Recreational and Tourist Cherkasy Region: Inclusive Social 3D Map" funded by the Ukrainian Cultural Foundation; a site with available content for online travel in the region to provide barrier-free access to the historical and cultural heritage of Cherkasy region was created. Educational accessibility is achieved by increasing the number of people with special educational needs, receiving education in inclusive groups; activities of the Center for Social and Educational Integration and Inclusive Rehabilitation Social Tourism "Bez barieriv" ("Without barriers"); implementation of a research topic for financing the Ministry of Education and Science of Ukraine: "Social and psychological rehabilitation of children and youth with special educational needs by means of inclusive tourism"; implementation of the project "Social inclusion of distance educational process"; development of information campaigns to popularize the ideas of accessibility, the need for its implementation, ongoing training programs and competitions, etc.

Effects of Neuromuscular Electrical Stimulation on Muscle Wasting with Cancer Patient: A Systematic Review (신경근전기자극치료가 암 환자의 근육 손실에 미치는 영향: 체계적 문헌고찰)

  • Eun Soo Park;Jong Hee Kim;Soo Dam Kim;Dong Hyun Kim;Eun Jung Lee;Min Seok Oh;Hwa Seung Yoo
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.15-29
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    • 2023
  • Objectives The purpose of this study is to systematically review the effects of Neuromuscular Electrical Stimulation treatment on muscle wasting in cancer patients. Methods Randomized controlled trials (RCTs) were searched from seven online databases (PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service. The selected RCTs were evaluated for methodological quality through the Cochrane RoB. Results A total of 126 articles were identified, and 4 randomized controlled trials were selected for systematic review. In one study, it was found that there were statistically significant improvements in the Health-Related Quality of Life (FACTH&N total score, p<0.001). Additionally, significant effects were observed in measurements that represented the size of the quadriceps muscle (cross-sectional area of Vastus lateralis and Rectus femoris, p=0.004), maximum muscle strength, the twitch response of resistance muscles, and voluntary activation (p<0.001). However, no significant differences were observed between the intervention and control groups in terms of quadriceps muscle strength in two other studies (p>0.05). Lastly, while one study showed no significant differences in muscle fiber characteristics between the two groups, it did report significant improvements in measurements related to mitochondria within muscle tissue and muscle strength in the intervention group (p<0.05). Conclusions Neuromuscular electrical stimulation can be a method used to improve muscle strength in muscle wasting of cancer patients, but it is difficult to see its effects as significant compared to other treatments.

A Narrative Literature Review on the Neural Substrates of Cognitive Reserve: Focusing on the Resting-state Functional Magnetic Resonance Imaging Studies (인지예비능의 신경적 기질에 대한 서술적 문헌고찰 연구 : 휴지기 기능적 자기공명영상 연구를 중심으로)

  • Hyeonsang Shin;Woohyun Seong;Bo-in Kwon;Yeonju Woo;Joo-Hee Kim;Dong Hyuk Lee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.38 no.1
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    • pp.1-9
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    • 2024
  • Cognitive reserve (CR) is a concept that can explain the discrepancies between the pathologic burden of the disease and clinical manifestations. It refers to the individual susceptibility to age-related brain changes and pathologies related to Alzheimer's disease, thus recognized as a factor affecting the trajectories of the disease. The purpose of this study was to explore the current states of clinical studies on neural substrates of CR in Alzheimer's disease using functional magnetic resonance imaging. We searched for clinical studies on CR using fMRI in the Pubmed, Cochrane library, RISS, KISS and ScienceON on August 14, 2023. Once the online search was finished, studies were selected manually by the inclusion criteria. Finally, we analyzed the characteristics of selected articles and reviewed the neural substrates of CR. Total thirty-four studies were included in this study. As surrogate markers of CR, not only education and occupational complexity, but also composite score and questionnaire-based method, which cover various areas of life, were mainly used. The most utilized methods in resting-state fMRI were independent component analysis, seed-based analysis, and graph theory analysis. Through the analysis, we demonstrated that neuroimaging techniques could capture the neural substrates associated with cognitive reserve. Moreover, functional connectivity of brain regions centered on prefrontal and parietal cortex and network areas such as default mode network showed a significant correlation with CR, which indicated a significant association with cognitive performance. CR may induce differential effects according to the disease status. We hope that this perspective on cognitive reserve would be helpful when conducting clinical researches on the mechanisms of traditional Korean medicine for Alzheimer's disease in the future.

Emoticon by Emotions: The Development of an Emoticon Recommendation System Based on Consumer Emotions (Emoticon by Emotions: 소비자 감성 기반 이모티콘 추천 시스템 개발)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.227-252
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    • 2018
  • The evolution of instant communication has mirrored the development of the Internet and messenger applications are among the most representative manifestations of instant communication technologies. In messenger applications, senders use emoticons to supplement the emotions conveyed in the text of their messages. The fact that communication via messenger applications is not face-to-face makes it difficult for senders to communicate their emotions to message recipients. Emoticons have long been used as symbols that indicate the moods of speakers. However, at present, emoticon-use is evolving into a means of conveying the psychological states of consumers who want to express individual characteristics and personality quirks while communicating their emotions to others. The fact that companies like KakaoTalk, Line, Apple, etc. have begun conducting emoticon business and sales of related content are expected to gradually increase testifies to the significance of this phenomenon. Nevertheless, despite the development of emoticons themselves and the growth of the emoticon market, no suitable emoticon recommendation system has yet been developed. Even KakaoTalk, a messenger application that commands more than 90% of domestic market share in South Korea, just grouped in to popularity, most recent, or brief category. This means consumers face the inconvenience of constantly scrolling around to locate the emoticons they want. The creation of an emoticon recommendation system would improve consumer convenience and satisfaction and increase the sales revenue of companies the sell emoticons. To recommend appropriate emoticons, it is necessary to quantify the emotions that the consumer sees and emotions. Such quantification will enable us to analyze the characteristics and emotions felt by consumers who used similar emoticons, which, in turn, will facilitate our emoticon recommendations for consumers. One way to quantify emoticons use is metadata-ization. Metadata-ization is a means of structuring or organizing unstructured and semi-structured data to extract meaning. By structuring unstructured emoticon data through metadata-ization, we can easily classify emoticons based on the emotions consumers want to express. To determine emoticons' precise emotions, we had to consider sub-detail expressions-not only the seven common emotional adjectives but also the metaphorical expressions that appear only in South Korean proved by previous studies related to emotion focusing on the emoticon's characteristics. We therefore collected the sub-detail expressions of emotion based on the "Shape", "Color" and "Adumbration". Moreover, to design a highly accurate recommendation system, we considered both emotion-technical indexes and emoticon-emotional indexes. We then identified 14 features of emoticon-technical indexes and selected 36 emotional adjectives. The 36 emotional adjectives consisted of contrasting adjectives, which we reduced to 18, and we measured the 18 emotional adjectives using 40 emoticon sets randomly selected from the top-ranked emoticons in the KakaoTalk shop. We surveyed 277 consumers in their mid-twenties who had experience purchasing emoticons; we recruited them online and asked them to evaluate five different emoticon sets. After data acquisition, we conducted a factor analysis of emoticon-emotional factors. We extracted four factors that we named "Comic", Softness", "Modernity" and "Transparency". We analyzed both the relationship between indexes and consumer attitude and the relationship between emoticon-technical indexes and emoticon-emotional factors. Through this process, we confirmed that the emoticon-technical indexes did not directly affect consumer attitudes but had a mediating effect on consumer attitudes through emoticon-emotional factors. The results of the analysis revealed the mechanism consumers use to evaluate emoticons; the results also showed that consumers' emoticon-technical indexes affected emoticon-emotional factors and that the emoticon-emotional factors affected consumer satisfaction. We therefore designed the emoticon recommendation system using only four emoticon-emotional factors; we created a recommendation method to calculate the Euclidean distance from each factors' emotion. In an attempt to increase the accuracy of the emoticon recommendation system, we compared the emotional patterns of selected emoticons with the recommended emoticons. The emotional patterns corresponded in principle. We verified the emoticon recommendation system by testing prediction accuracy; the predictions were 81.02% accurate in the first result, 76.64% accurate in the second, and 81.63% accurate in the third. This study developed a methodology that can be used in various fields academically and practically. We expect that the novel emoticon recommendation system we designed will increase emoticon sales for companies who conduct business in this domain and make consumer experiences more convenient. In addition, this study served as an important first step in the development of an intelligent emoticon recommendation system. The emotional factors proposed in this study could be collected in an emotional library that could serve as an emotion index for evaluation when new emoticons are released. Moreover, by combining the accumulated emotional library with company sales data, sales information, and consumer data, companies could develop hybrid recommendation systems that would bolster convenience for consumers and serve as intellectual assets that companies could strategically deploy.