• Title/Summary/Keyword: risk-targeted

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A Study on Developing a Model for Cancer Damage Cost Due to Risk from Benzene in Ulsan Metropolitan City (울산 지역에서 대기중 벤젠으로 인한 암 사망 손실비용 추정 모형에 관한 연구)

  • Lee, Yong-Jin;Kim, Ye-Shin;Shin, Dong-Chun;Shin, Young-Chul
    • Environmental and Resource Economics Review
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    • v.13 no.1
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    • pp.49-82
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    • 2004
  • The study aimed to evaluate cancer damage cost due to risk from benzene inhalation. We performed health risk assessment based on US EPA guideline to estimate annual population risk in Ulsan metropolitan city. Also, we estimated a willingness-to-pay amount for reducing a cancer mortality rate to evaluate a value of statistical life. We combined the annual population risk and the value of statistical life to calculate the cancer damage cost. In the health risk assessment, we applied the benzene unit risk ($2.2{\times}10^{-6}{\sim}7.8{\times}10^{-6}$) in the US EPA'S Integrated Risk Information System to assess the annual population risk. Average concentration of benzene in ambient air is $7.88{\mu}g/m^3$(min: 1.16~max: $23.32{\mu}g/m^3$). We targeted an exposure population of 516,641 persons who aged over 30 years old. Using a Monte-Carlo simulation for uncertainty analysis, we evaluated that the population risk of benzene during ten years in Ulsan city is 2.90 persons (5 percentile: 0.32~95 percentile: 9.11persons). And the monthly average WTP for 5/1,000 cancer mortality reduction during ten years is 14,852 Won(95% C.I: 13,135~16,794 Won) and the implied VSL is 36 million Won(95% C.I: 30~40 million Won). Cancer damage cost due to risk from benzene inhalation during 10 years in Ulsan city is about 104 million Won(5 percentile: 13~95 percentile: 328 million Won). Health benefit cost to reduce a cancer mortality risk of benzene is about 50 million Won is Ulsan metropolitann city. But, it is very important that this cost is not for all health damage cost of cancer mortality in some area. We just recommended a model for evaluating a cancer risk reduction, so we must re-evaluate an integrated application of total VOCs damage cost including benzene.

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Alteration of Trabecular Bone Microarchitecure at Tibial Epiphysis due to Knee Joint Instability by Anterior Cruciate Ligament Rupture: Difference between Medial and Lateral Part (전방십자인대 손상으로 인한 슬관절 불안정성에 따른 경골 골단 해면골 미세구조 변화 : 내방과 외방에서의 해면골 미세구조 패턴 변화)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Kim, Han-Sung;Lim, Do-Hyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.2
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    • pp.78-88
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    • 2012
  • Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

Investigation of Red Cell Antiobody Screening Tests Gyeonggi Areas (경기일부지역의 적혈구 항체선별검사의 실태조사)

  • Kim, Dai-Joong;Sung, Hyun-Ho;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.1
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    • pp.36-40
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    • 2016
  • Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. The discrepancy of RBC antibody screening test occurs when the results of red cell tests do not agree with those of the serum test. In order to select the proper blood units for transfusion, clarification of the cause of discrepancies is essential. The RBC antibody screening test is an easy, quick, and reliable method for detection of clinically significant antibodies. Antibody screening and identification is recommended prior to transfusion to determine whether there is blood group incompatibility. We reported that phenotyping for E, D, M, E+c, and C+e antibody screening test should be extended. Therefore, these results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population. We suggested that its antibody screening be adapted to blood safety interventions. Targeted screening of selected recipients at risk offers less value than universal antibody screening, and more research is needed to determine the real incidence of this national condition.

Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

  • Seo, Munseok;Langabeer, James
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.4
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    • pp.181-187
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    • 2018
  • Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Factors Affecting the Project Performance of Software Development Outsourcing (소프트웨어 개발 아웃소싱 프로젝트 성과에 영향을 미치는 요인)

  • Cho, Dong-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.3
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    • pp.1077-1083
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    • 2012
  • SDO(Software Development Outsourcing) projects have been consistently increasing and expanding but also have many failures. In order to improve SDO performance, the factors affecting SDO performance are investigated in this study. SDO has relational risk as well as performance risk in nature, and the factors affecting the SDO performance caused by these mixed risks are drawn from the prior studies. With field survey targeted client IS personnel who experienced SDO, 214 survey questionnaires are collected and analyzed. Research results show that vendor power, client requirements certainty, goal clarity and goal alignment affect the SDO performance. However, vendor knowledge and client knowledge do not have much effect on SDO performance. The results of this study can be effectively utilized to decrease the failures of SDO and increase the possibility of success.

Pre-vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: a Cross-sectional Study

  • Guettiti, Haifa;Ennaifer, Emna;Attia, Leila;Chelly, Dalenda;Alaya, Nissaf Ben;Aissa, Rim Ben;Laassili, Thalja;Boubaker, Samir
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9361-9365
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    • 2014
  • Background: To estimate the pre-vaccination distribution of human papillomavirus (HPV) types among women from urban Tunis. Materials and Methods: A total of 611 women aged 18-69 years were enrolled in three local gynaecological outpatient departments. All underwent a gynaecological examination with Pap test and dry swab for HPV detection and typing performed by linear array genotyping test (Roche). Cytological examination was conducted on conventional Pap smears. Results: HPV DNA was found in 6.5% of the women; the most frequent HPV types were HPV 16 and HPV 11 at 3.27% and 1.96%, respectively. The second most frequent high risk (HR) HPV type was HPV 58 (0.82%) followed by HPV 18, HPV 31 and HPV 33 found in only 0.33% of women. Single infections with HPV types, targeted by the quadrivalent vaccine (6, 11, 16, and 18), were detected in 3.6 % of the study patients (55% of positive women). HPV infection was found in 3.83% of women with normal cytology and in 47.4% of women with cytological abnormalities. No statistically significant trend in prevalence by age group emerged for any HPV type or for high or low risk types. Conclusions: These data show a relatively low prevalence of HPV infection in women from urban Tunis with a high proportion of HPV16 and HPV58. This should be considered in the upcoming screening programs and vaccination strategy.

Benefits of Metformin Use for Cholangiocarcinoma

  • Kaewpitoon, Soraya J;Loyd, Ryan A;Rujirakul, Ratana;Panpimanmas, Sukij;Matrakool, Likit;Tongtawee, Taweesak;Kootanavanichpong, Nusorn;Kompor, Ponthip;Chavengkun, Wasugree;Kujapun, Jirawoot;Norkaew, Jun;Ponphimai, Sukanya;Padchasuwan, Natnapa;Pholsripradit, Poowadol;Eksanti, Thawatchai;Phatisena, Tanida;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8079-8083
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    • 2016
  • Metformin is an oral anti-hyperglycemic agent, which is the most commonly prescribed medication in the treatment of type-2 diabetes mellitus. It is purportedly associated with a reduced risk for various cancers, mainly exerting anti-proliferation effects on various human cancer cell types, such as pancreas, prostate, breast, stomach and liver. This mini-review highlights the risk and benefit of metformin used for cholangiocarcinoma (CCA) prevention and therapy. The results indicated metformin might be a quite promising strategy CCA prevention and treatment, one mechanism being inhibition of CCA tumor growth by cell cycle arrest in both in vitro and in vivo. The AMPK/mTORC1 pathway in intrahepatic CCA cells is targeted by metformin. Furthermore, metformin inhibited CCA tumor growth via the regulation of Drosha-mediated expression of multiple carcinogenic miRNAs. The use of metformin seems to be safe in patients with cirrhosis, and provides a survival benefit. Once hepatic malignancies are already established, metformin does not offer any therapeutic potential. Clinical trials and epidemiological studies of the benefit of metformin use for CCA should be conducted. To date, whether metformin as a prospective chemotherapeutic for CCA is still questionable and waits further atttention.

Identifying Latent Profiles in School Adaptation of School Absentee Adolescents and Testing the Effects of Predictive Variables (학교결석 청소년의 학교적응 유형과 예측요인 검증)

  • Kim, Dongha
    • Korean Journal of Social Welfare
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    • v.66 no.3
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    • pp.5-28
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    • 2014
  • School absenteeism, one of the early warning signs of behavioral problems, has been known to be a complex and heterogeneous problem. However, much of the research assumes that school absentee adolescents comprise a homogeneous group. This study explored the heterogeneity of school absentee adolescents, based on school adaptation, to provide a more nuanced understanding of school absenteeism and examined predictive and risk factors associated with each typology of school absentee adolescents. Latent profile analysis was conducted using sample 477 middle school students who were reported absent in the previous year from the 3rd wave of Korean Children and Youth Panel Study. Multinomial logistic regression and ANOVA was also employed to examine the effects of predictive variables. As a result, three profiles were identified: low, middle, and high adaptive group. Group membership was found to be associated deferentially with gender, mental health, parenting neglect, delinquent friends, and delinquent behaviors. These findings propose more specific and targeted interventions designed to meet the needs and risk factors associated with the different typologies of school absentee adolescents.

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Efficacy and Safety of Selumetinib Compared with Current Therapies for Advanced Cancer: a Meta-analysis

  • Shen, Chen-Tian;Qiu, Zhong-Ling;Luo, Quan-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2369-2374
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    • 2014
  • Background and Aim: Selumetinib is a promising and interesting targeted therapy agent as it may reverse radioiodine uptake in patients with radioiodine-refractory differentiated thyroid cancer. We conduct this metaanalysis to compare the efficacy and safety of selumetinib with current therapies in patients with advanced cancer. Methods: An electronic search was conducted using PubMed/ Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity of eligible studies. Results: Six eligible trials involved 601 patients were identified. Compared with current therapies, treatment schedules with selumetinib did not improve progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69-2.24, P = 0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 0.052) though its impact was not statistically significant. Sub-group analysis resulted in significantly improved progression free survival (hazard ratio, 0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema (risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently observed adverse effects associated with selumetinib. Conclusions: Compared with current chemotherapy, selumetinib has modest clinical activity as monotherapy in patients with advanced cancer, but combinations of selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold great promise for cancer treatment. Dermatitis acneiform and peripheral edema are the most frequently observed adverse effects in patients with selumetinib.

Androgen Receptor Expression and its Correlation with Other Risk Factors in Triple Negative Breast Cancers: a Report from Western Iran

  • Payandeh, Mehrdad;Shazad, Babak;Madani, Seyed-Hamid;Ramezani, Mazaher;Sadeghi, Masoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3321-3324
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    • 2016
  • Background: Androgen receptors (ARs) are expressed in more than 70% of breast cancers (BCs) and have been implicated in BC pathogenesis. Some triple negative (TN)BC tumors express AR and may benefit from AR-targeted therapies. The aim of this study was to evaluate survival and the prevalence of AR expression and its correlation with other risk factors in triple negative BCs in women from Western Iran. Materials and Methods: In a retrospective study between 2009-2015, 41 patients with TNBC were referred to the Private Clinic of Oncology, Kermanshah city, Iran. ER, PR and AR-positive expression was defined as ${\geq}10%$ nuclear staining and also HER2 (2+), FISH was performed. Nuclear staining was considered representative for Ki67 and P53. The mean follow-up for the patients was 25 months. In this time, 5 patients died and 4 lost to follow-up were censored from survival analysis. Results: The mean age at diagnosis was 46.9 years (range, 24-71 years) and all patients were female. The OS rates for AR-positive and AR-negative patients were 90% and 85.1%, respectively, and the mean OS was 26.3 and 23.2 months. Therefore, there was no significant difference between the two groups (Hazard ratio: 0.580, 95% CI: 0.086-3.893, P=0.575). Conclusions: In TNBC patients, evaluation of AR status may provide additional information on prognosis and treatment. The results of studies showed that the prevalence AR expression may differ in the world and probably ethnicity can be an influencing factor.