• Title/Summary/Keyword: risk evaluation criteria

Search Result 310, Processing Time 0.031 seconds

Effect of Acupuncture on Sciatica in Rat Models: Systematic Review and Meta-analysis (좌골신경통 백서모델에서 침치료의 효과: 체계적 문헌고찰 및 메타분석)

  • Yoon, Ye-Ji;Kim, Soojeon;Cho, Jae-Heung;Kim, Koh-Woon;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.1
    • /
    • pp.79-93
    • /
    • 2020
  • Objectives While sciatic neuropathy is one of the common symptoms which have the lifetime incidence of 13~40%, still there is no consensus about the standardized and the most effective conservative treatment. In addition, the importance of systematic review and meta-analysis of preclinical are growing as they could suggest possible effective treatment strategy for future studies. Therefore, we conducted systematic review and meta-analysis to estimate analgesic effect of acupuncture on sciatica in rat models. Methods Systematic search was conducted for all controlled comparative preclinical trials which assessed analgesic effect of acupuncture in sciatica rat models. Database of PubMed, EMBASE, Web of Science, CNKI and 6 Korean databases were used. The primary outcome was pain, which is evaluated by stimulus behavior tests in rat models. We assessed the methodological quality with Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool. RevMan 5.3 was used for meta-analysis and subgroup analysis was conducted according to treatment site, acupuncture point, treatment period and frequency used in electroacupuncture. Results 14 studies were finally included following our inclusion criteria. The data from meta-analysis indicated that the acupuncture significantly improved the result values of behavior tests for pain evaluation, compared to no-treatment control group in animal models (standardized mean difference=4.43, 95% confidence interval 3.16 to 5.69, Z=6.84, p<0.00001; χ2=68.02, p<0.00001; I2=82%). The results of subgroup analysis indicate that acupuncture treatment of unilateral site, distal acupoints, longer treatment period and applying 2/100 Hz frequency in electroacupuncture could be more effective. Conclusions Systematic review and meta-analysis of animal studies are getting important for the future clinical studies and the improvement of heatlh care. Therefore the results of the study would provide evidence and better design for the forthcoming studies.

Evaluation of Cut-off Values in Acute Acetaminophen Intoxication Following the Revised Guideline of the United Kingdom (개정된 가이드라인에 따른 아세트아미노펜 급성 중독환자 치료 기준의 검증)

  • Park, Sung Jin;Cha, Kyungman;So, Byung Hak;Kim, Hyung Min;Jeoung, Won Jung
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.16 no.2
    • /
    • pp.68-74
    • /
    • 2018
  • Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${\chi}^2$ test for trend, ${\chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

Evaluation of Clinical Outcomes by Therapeutic Dosing Interval of Denosumab (Prolia®) and Calcium-Vitamin D Prescriptions (Denosumab (Prolia®)의 투여 간격 및 칼슘·비타민 D 복합제제 처방 여부에 따른 임상적 결과 평가)

  • Kim, Youkyeong;Kim, Junghyun;Doh, Hyunjeong;Jeong, Young Mi;Lee, Jeonghwa;Lee, Ju-Yeun;Lee, Euni
    • Korean Journal of Clinical Pharmacy
    • /
    • v.32 no.3
    • /
    • pp.185-190
    • /
    • 2022
  • Background: Denosumab (Prolia®) is administered every 6 months for osteoporosis treatment. Co-administration of calcium and vitamin D is required to minimize hypocalcemia risk. We evaluated clinical outcomes based on the administration interval of denosumab and co-prescription with calcium-vitamin D combination products. Methods: A retrospective study was conducted using electronic medical records from 668 patients who started denosumab therapy between January 1 and December 31, 2018, at Seoul National University Bundang Hospital. Clinical outcomes, as measured by changes in T-score, were evaluated by the intervals and concurrent prescriptions with calcium-vitamin D combination products. Results: Of the 668 patients, 333 patients met the eligibility criteria. These patients were divided into two groups based on appropriateness of the administration interval: "Appropriate" (304 patients, 91.3%) and "Inappropriate" (29 patients, 8.3%). T-score changes were significantly higher in the "Appropriate" than in the "Inappropriate" group (0.30±0.44 vs. 0.13±0.37, p=0.048). At the beginning of the treatment, 221 patients (66.4%) were prescribed calcium-vitamin D combination products, but the changes in T-scores were not significantly different by the prescription status of the product (0.29±0.46 vs. 0.28±0.38, p=0.919). Conclusion: T-scores were significantly improved in patients with appropriate administration intervals. No significant changes in T-scores were observed by the prescription status with calcium-vitamin D combination products. For optimal treatment outcomes, prescribers should encourage adherence to the approved prescription information on dosage and administration, and pharmacists should provide medication counseling for patients.

Improvement for Technology Readiness Assessment with Weighting Method for Defense Acquisition Project (가중치 산출방법을 활용한 획득방안 분석단계의 기술성숙도평가 개선방안)

  • Kim, Mi-Seon;Noh, Eun-Young
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.22 no.4
    • /
    • pp.538-544
    • /
    • 2021
  • Technology readiness assessment is a procedure for managing defense project risk factors based on the preemptive identification of technical risks. Under current regulations, technology readiness is determined based on considerations of the ratings of factors itemized on a checklist, whether unsatisfied factors have a fatal impact on the project, and whether countermeasures for unsatisfied factors have been established. However, objective criteria for assessing the impact of unsatisfied factors have not been presented, and thus, at present, the results of technology readiness level determinations are largely subjective. In addition, the importance of questions on the checklist is dependent on individual project characteristics and this is not considered during the assessment process. In this paper, we propose an improved technology readiness assessment procedure that considers the characteristics of each project. Using the proposed procedure, we quantitatively determined the importance of each checklist item using a weighting method. We found the devised procedure improved the reliability and objectivity of technology readiness assessment results. A case analysis of a complex weapons system is presented to demonstrate these improvements.

Decision Making of Seismic Performance Management for the Aged Road Facilities Based on Road-Network and Fragility Curve (취약도곡선을 이용한 도로망기반 노후도로시설물 내진성능관리 의사결정)

  • Kim, Dong-Joo;Choi, Ji-Hae
    • Journal of the Korea institute for structural maintenance and inspection
    • /
    • v.25 no.5
    • /
    • pp.94-101
    • /
    • 2021
  • According to the Facility Management System (FMS) operated by the Korea Authority of Land & Infrastructure Safety, it is expected that the number of aging facilities that have been in use for more than 30 years will increase rapidly to 13.9% in 2019 and 34.5% in 2929, and end up with a social problem. In addition, with the revision of "Common Application of Seismic Design Criteria" by the Ministry of Public Administration and Security in 2017, it is mandatory to re-evaluate all existing road facilities and if necessary seismic reinforcement should be done to minimize the magnitude of earthquake damage and perform normal road functions. The seismic performance management-decision support technology currently used in seismic performance management practice in Korea only determines the earthquake-resistance reinforcement priority based on the qualitative index value for the seismic performance of individual facilities. However with this practice, normal traffic functions cannot be guaranteed. A new seismic performance management decision support technology that can provide various judgment data required for decision making is needed to overcome these shortcomings and better perform seismic performance management from a road network perspective.

Geochemical Occurrence Characteristics of Geogenic Heavy Metals in Korea Evaluated Using Geochemical Map Data (전국 지화학도 자료를 이용한 지질기원 중금속의 지화학적 발생특성)

  • Ahn, Joo Sung;Youm, Seung-Jun;Cho, Yong-Chan;Yim, Gil-Jae;Ji, Sang-Woo;Lee, Jung-Hwa;Lee, Pyeong-Koo;Lee, Jeong-Ho;Shin, Seong-Cheon
    • Economic and Environmental Geology
    • /
    • v.55 no.4
    • /
    • pp.339-352
    • /
    • 2022
  • As environmental criteria items are increased or strengthened, cases of heavy metal contamination by geogenic origin are increasing, and the need to distinguish between natural and anthropogenic origins in soil or groundwater exceeding the standard is increasing. In this study, geochemical occurrences of geogenic heavy metals were identified through statistical processing of the national geochemical map data and evaluation of geochemical characteristics of regions with high geoaccumulation indices. Cobalt, Cr, Cu, Ni, Pb, V, and Zn were targeted for which the national geochemical maps were prepared, and Co, Cr, Ni, and V derived from ultrabasic or ultramafic rocks were classified as factor 1. Copper, Pb and Zn of non-ferrous sulfide origin were classified as factor 2. In particular, enrichment of heavy metals by factor 1 occurs mainly in the serpentine distribution areas of the Chungcheong region, and there is a risk of contamination in neighboring areas. In the case of factor 2, geogenic occurrence is concerned not only in non-ferrous metal mineralization areas such as Taebacksan and Gyeongnam mineralization zones, but also in Au-Ag mineralization areas distributed nationwide.

Effect of Acupotomy Treatment for Lateral Epicondylitis: A Systematic Review and Meta-Analysis (외측상과염의 도침 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Jong Chan Choi;Min Jun Ji;Kyung Jun Ser;Do Young Kwon;Jae Eun Yang;Ji Hyang Gu;Eun Jung Lee;Min Seok Oh
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.34 no.2
    • /
    • pp.101-134
    • /
    • 2024
  • Objectives The purpose of this study is to observe the effectiveness of acupotomy treatment for lateral epicondylitis by comparing it with various control groups. Methods We searched 11 domestic and international databases for systematic reviews and meta-analysis. The subjects were studies published from January 1, 2017 to September 1, 2023, and only randomised controlled trials were included. Results 208 studies were searched, of which 21 studies were finally selected. Among the studies published after 2017, the largest number of studies was published in 2019. The average number of participants per study was 72.28±20.26 and the average age was in the 40s. The most frequent intervention in the study was acupotomy alone, and the treatment most often mentioned as a control group was local nerve block. The most used evaluation tool is efficiency. Acupotomy+manipulation had statistically better effect than that of local nerve block in terms of pain (standard mean difference -1.87, 95% confidence interval, -2.18 to -1.57, p<0.00001) and elbow joint function (standard mean difference 2.25, 95% confidence interval, 1.65 to 2.86, p<0.00001). Conclusions As a result of the meta-analysis, the effect of acupotomy added manual therapy treatment was statistically significant compared to the local nerve block frequently used for lateral epicondylitis. Based on these results, it appears that more research on combination treatments other than acupotomy treatment will be needed. Also, it appears that more large-scale randomized controlled studies that strictly adhere to the standards for reporting interventions in controlled trials of acupuncture, risk of bias 2 criteria will be needed.

A Study on the Influence of Entrepreneurship and Start-Up Competency on Entrepreneurial Satisfaction: Focusing on the Moderating Effect of Flow Experience (창업가정신, 창업역량이 창업만족도에 미치는 영향에 관한 연구: 플로우(Flow)경험의 조절효과를 중심으로)

  • Lee, Sang Hwa;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.10 no.5
    • /
    • pp.137-150
    • /
    • 2015
  • This study investigated the influence of Entrepreneurship, Start-up Competency on Entrepreneurial Satisfaction and the moderating effect of Flow experience. The goal of this investigation is to empirically prove that despite the benefits of educational and financial support, mentoring and consulting which selected applicants received as a part of supporting business for start-up companies provided by national and local government and public organizations, there is a gap between individual entrepreneurs' satisfaction after actual foundation of the company. For the purpose of this investigation, data was collected through a survey with 320 entrepreneurs who were beneficiaries of government's supporting business for start-up companies and have founded their companies less than 5 years ago. For entrepreneurship variables, three factors of innovativeness, proactiveness and risk-taking were reviewed, and also reviewed the three variables network capability, market orientation and marketing capacity as Start-up competency. The collected data was used to perform a multiple regression analysis, and the moderating effect of flow experience was analysed using moderated regression analysis. The result of analysis shows that innovativeness, proactiveness and risk-taking of entrepreneurship positively affected the entrepreneurial satisfaction, and network capability, market orientation and marketing capability also positively affected the entrepreneurial satisfaction. As a result of analysing the moderating effect of flow experience, it appeared that there is a positive moderating effect between entrepreneurship, start-up competency, and the entrepreneurial satisfaction. This result concludes that evaluation items of entrepreneurship and start-up competency as applicant selecting criteria in supporting business for start-up companies, are valid. It is also concluded that start-up supports such as education, funds and consulting are also important, but it is necessary to make changes such as construction of start-up ecosystem and reinforcement of networking support, so that entrepreneurs can have the flow experience themselves in the process after founding a company.

  • PDF

Key Methodologies to Effective Site-specific Accessment in Contaminated Soils : A Review (오염토양의 효과적 현장조사에 대한 주요 방법론의 검토)

  • Chung, Doug-Young
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.32 no.4
    • /
    • pp.383-397
    • /
    • 1999
  • For sites to be investigated, the results of such an investigation can be used in determining foals for cleanup, quantifying risks, determining acceptable and unacceptable risk, and developing cleanup plans t hat do not cause unnecessary delays in the redevelopment and reuse of the property. To do this, it is essential that an appropriately detailed study of the site be performed to identify the cause, nature, and extent of contamination and the possible threats to the environment or to any people living or working nearby through the analysis of samples of soil and soil gas, groundwater, surface water, and sediment. The migration pathways of contaminants also are examined during this phase. Key aspects of cost-effective site assessment to help standardize and accelerate the evaluation of contaminated soils at sites are to provide a simple step-by-step methodology for environmental science/engineering professionals to calculate risk-based, site-specific soil levels for contaminants in soil. Its use may significantly reduce the time it takes to complete soil investigations and cleanup actions at some sites, as well as improve the consistency of these actions across the nation. To achieve the effective site assessment, it requires the criteria for choosing the type of standard and setting the magnitude of the standard come from different sources, depending on many factors including the nature of the contamination. A general scheme for site-specific assessment consists of sequential Phase I, II, and III, which is defined by workplan and soil screening levels. Phase I are conducted to identify and confirm a site's recognized environmental conditions resulting from past actions. If a Phase 1 identifies potential hazardous substances, a Phase II is usually conducted to confirm the absence, or presence and extent, of contamination. Phase II involve the collection and analysis of samples. And Phase III is to remediate the contaminated soils determined by Phase I and Phase II. However, important factors in determining whether a assessment standard is site-specific and suitable are (1) the spatial extent of the sampling and the size of the sample area; (2) the number of samples taken: (3) the strategy of taking samples: and (4) the way the data are analyzed. Although selected methods are recommended, application of quantitative methods is directed by users having prior training or experience for the dynamic site investigation process.

  • PDF

A Comparative Evaluation of Dosal Usefulness in Total Scalp Irradiation according to Treatment Plans and Methods (총 두피 방사선치료 시 치료계획 방법에 따른 선량적 유용성 비교 평가)

  • Park byeal nim;Jung dong min;Kwon yong jae;Cho yong wan;Kim se young;Park kwang soon;Park ryeong hwang;Baek jong geol
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.34
    • /
    • pp.43-50
    • /
    • 2022
  • Objective: The purpose of this study is to choose a treatment plan and equipment to maximize tangential irradiation to protect the normal brain tissues as much as possible during total scalp irradiation. Subjects and Methods: After zoning the total scalp of a phantom and selecting a target area for treatment, the study made a Helical TomoTherapy(HT) plan, a Helical TomoTherapy with a Complete Block(HTCB) plan, and a Volumetric Modulated Arc Therapy(VMAT) plan. All of these plans made sure that the volume of a treatment plan with 95% of a prescription dose(40 Gy) would not exceed 95% of the entire volume and that Dmax would not be more than 110% of the prescription dose. The therapy plans compared doses among organs at risk of damage including the brain. Doses in the brain tissues were assessed based on the volumetric criteria for normal tissues in Emami et al. Results: HT, HTCB, and VMAT had a dose of 21.68 Gy, 13.75 Gy, and 20.89 Gy, respectively, in brain tissues at D33%, a dose of 7.06 Gy, 3.21 Gy, and 7.84 Gy, respectively, at D67%, and a dose of 3.14 Gy, 1.75 Gy, and 3.84 Gy, respectively, at D100%. They recorded a Dmean of 16.64 Gy, 11.78 Gy, and 16.64 Gy, respectively. These results show that the overall dose was low in the HTCB plan. When the volume of a low dose was calculated based on 5 Gy, they recorded 87%, 49%, and 96%, respectively, in V5Gy. In addition, the maximum dose in the remaining organ(brain stem, hippocampus, and both lenses) except for the optic pathway was the lowest in HTCB Conclusion: The findings demonstrate that TomoTherapy with a complete block minimized a dose in organs at risk of damage including the brain and hippocampus on both sides and accordingly reduced the probability of side effects such as radiation-induced brain injuries and a resulting decrease in neurocognitive functions. In addition to total scalp irradiation, if additional studies on ring targets treated in various areas are conducted to establish the benefits of tangential irradiation, it is believed that TomoTherapy using Complete Block can be used to maximize tangential irradiation in treatment planning.