Background: Innovative Alzheimer's disease drugs received approval in the United States in 2021 and 2023. This study aims to assess the safety and efficacy of these novel treatments, elucidate their mechanisms of action, and compare their impact on cognitive function improvement with approved drugs. Methods: We conducted a comprehensive search of pivotal clinical studies related to Alzheimer's disease treatments in PubMed/Medline, Embase, and the Cochrane Library databases from January 1st, 2020 to December 31st, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 14 studies were included in this systematic review. When compared to the placebo, the new drugs did not exhibit a statistically significant effect on MMSE (Mini-Mental State Examination) (mean difference= -0.04, 95% confidence intervals [CIs]: -0.31, 0.23, N=3662, I2=0%). However, they demonstrated a significant impact on ADAS-cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) (standardized mean difference= -0.15, 95% CIs: -0.2, -0.1, N=6710, I2=17%). When compared to the approved drugs, the new drugs showed a statistically significantly lower effect on MMSE (test for subgroup difference Chi2=23.13, N = 5870, p<0.00001) but showed only a trend of decreased efficacy on ADAS-cog (Chi2=1.16, N = 8670, p=0.28). Conclusion: New drugs yielded diverse clinical endpoint results compared to the placebo, and in comparison to existing approved drugs, they exhibited lower efficacy in improving cognitive function. The safety profile of these new drugs, as reported in clinical trials, was generally well-tolerated.
Seo, Jeewon;Lee, Gyusang;Kim, Kibum;Hyung, Jinseok;Kim, Taehyeon;Koo, Jayong
Journal of Korean Society of Water and Wastewater
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v.33
no.5
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pp.353-366
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2019
This research proposes an optimal flushing operation technique in an effort to prevent secondary water pollutions and accidents in aged pipes, and to improve the cleaning effect of unidirectional flushing. Water flow directions were analyzed using EPANET 2.0, while flushing and air scouring experiments in forward and reverse directions were performed in the field. In 42 experiments, average residual chlorine concentration and turbidity were improved after cleaning compared to before cleaning. It was found that even when the same cleaning method was used, further improvement of cleaning effect was possible by applying air injection and reverse direction cleaning techniques. By means of one-way ANOVA(Analysis of variance), it was also possible to statistically verify the need of actively utilizing air injection and reverse direction cleaning. Based on correlation between turbidity and TSS, the total amount of suspended solids removal was estimated for 874 flushing operations and 194 air scouring operations. The result showed that air scouring used more discharge water than flushing by an average of $4.9m^3$ yet with larger amounts of suspended solids removal by an average of 145.9 g. The result of analysis on turbidity values from 887 flushing operations showed low cleaning effect of unidirectional flushing for the pipes with diameters over 300 mm. In addition, the turbidity values measured during cleaning showed an increasing tendency as pipe age increased. The methodology and results of this research are expected to contribute to the efficient maintenance and improvement of water quality in water distribution networks. Follow-up research involving the measurement of water quality at regular time intervals during cleaning would allow a more accurate comparison of discharge water quality characteristics and cleaning effects between different cleaning methods. To this end, it is considered necessary to develop a standardized manual that can be used in the field and to provide relevant trainings.
Song, Kyung Ja;Yoo, Cheong Suk;Kwon, Eun Ok;Jung, Eun Ja;Shin, Hyeon Ju;Park, Ock Hyang;Ok, Sun Ok;Yu, Mi;Yun, Sun Hee;Lee, Bok Nam;Choi, Jin Ah;Hwang, Jeong Hae;Oh, Hyang Soon
Quality Improvement in Health Care
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v.8
no.1
/
pp.44-55
/
2001
Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.
The Journal of Korean Academy of Sensory Integration
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v.21
no.2
/
pp.69-83
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2023
Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.
Objectives: The purpose of the study is to investigate the influence of community oral hygiene program on oral hygiene practice behavior in children. Methods: Oral hygiene promotion program was performed in 23 community child centers in Seoul, Incheon and Gyeonggido. The study analyzed the effect of community oral hygiene promotion programs on the oral hygiene practice behavior in children from September to December, 2014. The trained dental hygienists in 23 public health centers and dental hygiene students participated in the oral hygiene promotion program for oral health examination and education for the children. The contents of the program was standardized and instructed to the team members. The individual improvement in children oral hygiene practice was assessed using PHP(patient hygiene performance) index score. Data were analyzed using SPSS 12.0 program. Results: After the program, children who stopped eating confectioneries and those eating once a day increased to 32.12% and 14.24%, respectively. Those eating more than four times a day were still high(32.44%), but it was a lower rate than before the program (p<0.001). The rate of toothbrushing of more than 2 to 3 times a day was 82.75% and it was higher than before the education (p<0.001). The knowledge level of children increased from 18.83% to 66.30%. The oral hygiene practice performance in children was highly improved. Conclusions: The four months duration of oral hygiene program remarkably improved the oral hygiene practice in the children. So the community health centers and welfare centers must cooperate and improve the children oral health promotion by developing the oral health promotion program.
Park, Seong-Hi;Kang, Chang-Bum;Jang, Seon Young;Kim, Bo Yeon
Journal of Korean Academy of Nursing
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v.43
no.3
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pp.420-430
/
2013
Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.
Journal of the Institute of Electronics and Information Engineers
/
v.51
no.12
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pp.46-55
/
2014
PCB design technology for high-speed transmission line has been developed continuously. Adapting to the high capacity of the communication system, switch fabric interface used for backplane is being standardized to accommodate more than 10Gbps serial interface. In this paper, various computer simulations are performed to compare the performance of each transmission line per length according to PCB material, and also to analyze the effect from via stub length and crosstalk, for the purpose of applying 11.5Gbps serial interface as a switch fabric interface in tera-bit switching system. As a result of the simulation, important design issues, such as PCB material of each board supporting 8dB improvement in transmission loss using low loss PCB, maximum available stub length on transmission line via, whether or not to apply the backdrill process to the via, and the clearance of the differential pair between transmission lines, are determined. The most efficient system architecture which could be applied 11.5Gbps serial interface in all switch fabric interfaces is defined from the simulation results.
Purpose: This study was conducted to examine the effectiveness of a self-management program on patients with thyroid cancer, particularly during the time of waiting for surgery after cancer diagnosis. Psychological distress, biological responses of immune cell counts, and quality of life were the variables of this study. Methods: One group pre-post test design was used with the nature of a pilot study. Ten newly diagnosed thyroid cancer patients were recruited through physicians' referrals. After drop out of 4 participants, final data were collected from six participants. Small group technique, a one and half hour-session per week for one month (total 4 sessions, 6 hours) was used. Relaxation techniques, meditation training, and strategies to reduce distress were provided by researchers. Standardized questionnaires and an established bio-assay were used for collection of data. Results: Participants showed significant lowering of psychological distress (p<.05) and improvement in global quality of life (p<.05). Biological responses of immune cell counts did not show statistical significance. Conclusion: The self-management program may reduce psychological distress and improve quality of life of patients with thyroid cancer between the time of diagnosis and surgery. The self-management program would be a valuable approach for patients with an unexpected cancer diagnosis to prepare for their disease experience in a community setting.
Journal of the Korean Society of Hazard Mitigation
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v.5
no.4
s.19
/
pp.59-69
/
2005
Drought is difficult to detect and monitor, but it is easy to interpret through the drought index. The Palmer Drought Severity Index(PDSI), which is most commonly used as one of drought indices, have been widely used, however, the index have limitation as operational tools and triggers for policy responses. Recently, a new index, the Standardized Precipitation Index(SPI), was developed to improve drought detection and monitoring capabilities. The SPI has an improvement over previous indices md has several characteristics including its simplicity and temporal flexibility that allow its application for water resources on all timescales. Keetch-Byram Dought Index(KBDI) was defined as a number representing the net effect of evapotranspiration and precipitation in producing cumulative moisture deficiency in deep duff or upper soil layer. The purpose of this study is to analyze drought in Korea by using PDSI, SPI and KBDI. The result of this study suggests standard drought index by comparing of estimated drought indices. The data are obtained from Korea Meteorological Administration 56 stations over 30 years in each of the 8 sub-basins covering the whole nation. It is found that the PDSI had the advantage to detect the stage of drought resulting from cumulative shortage of rainfall, while SPI and KBDI had the advantage to detect the stage of drought resulting from short-term shortage of rainfall.
Mangkuliguna, Ghea;Glenardi, Glenardi;Natalia, Natalia;Pramono, Laurentius A.
Tuberculosis and Respiratory Diseases
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v.84
no.4
/
pp.299-316
/
2021
Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.
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