The purpose of this study is to assess respirable crystalline silica (RCS) exposure levels in workers who collect and dispose used coal briquette ash (CBA) in sanitation companies that are subcontracted by one medium-sized local government on the collection of municipal household waste (MHW), and to analyze the quartz content in CBA. When the CBA powder that undergone specialized pretreatment in several steps were subjected to mineral identification and quantitative analysis using X-ray diffraction (XRD), it was found that quartz represented 18%, and in addition, mullite, and plagioclase were included. For two CBA collectors, samples were collected by the personal sampling evaluation method. After respirable dust was collected in accordance with the National Institute for Occupational Safety and Health 7500 method, the concentration of quartz was analyzed using XRD. Meanwhile, a portable real-time dust monitor (Sidepak AM520, TSI Inc., USA) was also used to observe the dust exposure level for each time zone and job task. The RCS exposure level of one worker was as high as 0.024 mg/㎥, which was the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLV) level. The other worker also exhibited a concentration of 0.013 mg/㎥, which was more than half of TLV. The Sidepak results revealed that the work of collecting CBA and loading it onto a vehicle was hardly exposed to the dust of a significant level. It was found, however, that the work of transferring the collected CBA to a container through a conveyor belt was exposed to a very high average respirable dust concentration of 2.238 mg/㎥. The results of this study confirmed that quartz, which is crystalline silica and a carcinogen, is contained in CBA, one of municipal household waste (MHW), in high concentration. It was also confirmed that workers are exposed to high RCS concentrations while transferring collected CBA into a container. Although each local government in South Korea handles CBA in different ways, it is imperative to investigate the CBA exposure level of sanitation workers and improve their working conditions.
Implant-assisted removable partial denture (IAPRD) can be considered as a simple and cost-effective treatment approach for an edentulous patient with anatomical or financial limitations. Recently, it was reported that the application of IARPD with implant supported fixed prostheses covered by the National Health Insurance Service (NHIS) were increasing. This case report describes the treatment of maxillary fully edentulous patient with anterior four-implant-supported fixed prosthesis and distal extension IARPD. This treatment approach may be advantageous over maxillary implant overdentures in some circumstances. The patient was satisfied with improved function and esthetics in the anterior area and financial benefit from the NHIS. Further long-term clinical studies are needed to establish clinical validity of the treatment approach described in this case report.
Background: This study investigated the distribution of valve incompetence in patients with chronic venous disease (CVD) and its correlation with the clinical category of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. Methods: In total, 1,386 limbs with clinically suspected CVD were categorized according to the CEAP classification and consecutively underwent duplex ultrasonography between April 2017 and December 2020. Results: There were 362 limbs in male patients and 1,024 limbs in female patients. The limbs were classified as C0s-C1 (608 limbs, 43.8%), C2 (727 limbs, 52.5%), or C3-C6 (51 limbs, 3.7%). The prevalence of saphenous vein incompetence in CEAP C0s-C1 limbs was 43.6%. The saphenofemoral junction (SFJ) was competent in 37% of CEAP C2-C6 limbs. The CEAP C3-C6 category was not correlated with reflux patterns of the saphenous vein system (Cramer's V=0.07), incompetent SFJ (Cramer's V=0.07), deep vein reflux (Cramer's V=0.03), or the distribution of incompetent segments in the great saphenous vein (GSV) (Cramer's V=0.11). Conclusion: Duplex ultrasonography is necessary to formulate a proper treatment plan for limbs categorized as CEAP C0s-C1. The SFJ was competent in more than one-third of CEAP C2-C6 limbs with GSV reflux; as such, flush ligation of the GSV may be unnecessary in these patients. The CEAP C3-C6 category showed no correlations with reflux patterns of the saphenous vein system, SFJ reflux, deep vein reflux, or the distribution of incompetent segments in the GSV.
Journal of the Korea Society of Computer and Information
/
v.27
no.10
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pp.195-202
/
2022
This study explored the effects of Tai Chi on cardiovascular disease(CVD) risk factors among the Korean elderly. 68 elderly were selected and divided into two groups: an experiment group(34 patients) and a control group(34 patients). The experimental group practiced Tai Chi for 60 minutes a day, five times per week for 6 weeks total. The control group continued their routine levels of activity. CVD risk factors evaluated in both groups including body mass index, fasting blood sugar, triglyceride, high density lipoprotein cholesterol(HDL-C), and low density lipoprotein cholesterol(LDL-C). Each factor was measured before and after the 6-week intervention. Results showed that the experimental group had a significant decrease in measurements of body mass index, fasting blood sugar, triglyceride, and LDL-C levels. The experimental group also had an increase HDL-C level. Based on such findings, we believe that Tai Chi exercise program would function as an effective intervention strategy for preventing CVD in the elderly. Therefore, it is recommended that health and medical service personnel should seek to apply Tai Chi intervention as a daily component of elderly care.
Dong‑Jin, Kang;Young‑Joo, Shin;Jin-Kyu, Kang;Jae‑Yong, Jung;Woo-jin, Lee;Tae-Seong, Baek;Boram, Lee
Journal of radiological science and technology
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v.45
no.6
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pp.553-560
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2022
The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.
Eun-Sol Kang;Young-Tae Ahn;Hyo-Jeong Kim;Ji-Soo Hyun;Jin-Young Kang;Yoon-Jae Lee
The Journal of Korean Obstetrics and Gynecology
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v.36
no.2
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pp.55-68
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2023
Objectives: The purpose of this study is to analyze the effectiveness of Guibi-tang that are used for postpartum depression. Methods: We searched on five databases [Korean studies Information Service (KISS), Oriental medicine advanced searching integrated system (OASIS), The Cochrane Library, PubMed, and China national knowledge infrastructure (CNKI)] with keywords for Postpartum depression (English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 8 potentially relevant articles were retrieved for further evaluation. There was evidence that Guibi-tang compared with Western medicine was significantly higher rate in total effect rate (RR 1.20, 95% CI 1.04, 1.39, p=0.01). Also, the combined therapeutic effects of Guibi-tang and Psychological intervention compared with Psychological intervention were statistically significant in total effect rate (RR 1.14, 95% CI 1.05, 1.24, p=0.002). And they showed improvement on scores of HAMD (Hamilton depression scale, HAMD) and SF-36 (36-Item short form health survey, SF-36). Conclusion: Guibi-tang appears to be more effective compared to Western medicine in the treatment of postpartum depression. The combination Guibi-tang and Psychological intervention was more effective than psychological intervention alone treated for postpartum depression. However, since unclear risk of bias, the result of this study should be considered carefully. Further clinical trials should be carried out in order to academical clinical progress regarding treatment of Postpartum Depression.
Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.
Kim, So Sun;Chae, Gye Soon;Kim, Kyeong Nam;Park, Kwang Ok;Moon, Seong Mi
Journal of Korean Clinical Nursing Research
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v.16
no.1
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pp.167-175
/
2010
Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.
Andrew Hirsch;Sophan Chhin;Jianwei Zhang;Michael Premer
Journal of Forest and Environmental Science
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v.39
no.2
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pp.81-95
/
2023
Due to the multiple ecosystem benefits that iconic large, old growth trees provide, forest managers are applying thinning treatments around these legacy trees to improve their vigor and reduce mortality, especially in the face of climate change and other forest health threats. One objectives of this study was to analyze sub-hourly stem fluctuations of legacy ponderosa (Pinus ponderosa Dougl. Ex P. & C. Laws) and sugar pines (Pinus lambertiana Dougl.) in the mixed-conifer forests of the Sierra Nevada in multiple different radius thinning treatments to assess the short-term effects of these treatments. Thinning treatments applied were: R30C0 (9.1 m radius), R30C2 (9.1 m radius leaving 2 competitors), and RD1.2 (radius equaling DBH multiplied by 1 ft/in multiplied by 1.25). The other objective was to assess climatic drivers of hourly stem fluctuations. Using the dendrometeR package, we gathered daily statistics (i.e. daily amplitude) of the stem fluctuations, as well as stem cycle statistics such as duration and magnitude of contraction, expansion, and stem radial increment. We then performed correlation analyses to assess the climatic drivers of stem fluctuations and to determine which radial thinning treatment was most effective at improving growth. We found an important role that mean solar radiation, air temperature, and relative humidity play in stem variations of both species. One of the main findings from a management perspective was that the RD1.2 treatment group allowed both species to contract less on warmer and higher solar radiation days. Furthermore, sugar pine put on more stem radial increment on higher solar radiation days. These findings suggest that the extended radius RD1.2 thinning treatment may be the most effective at releasing legacy sugar and ponderosa pine trees compared to the other forest management treatments applied.
Choi, Ha Eun;Lee, Ji Won;Je, Nam Kyung;Jeong, Kyeong Hye
Korean Journal of Clinical Pharmacy
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v.32
no.1
/
pp.13-19
/
2022
Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.
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