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Impact of Surveillance Mammography Intervals Less Than One Year on Performance Measures in Women With a Personal History of Breast Cancer

  • Janie M. Lee;Laura E. Ichikawa;Karen J. Wernli;Erin J. A. Bowles;Jennifer M. Specht;Karla Kerlikowske;Diana L. Miglioretti;Kathryn P. Lowry;Anna N. A. Tosteson;Natasha K. Stout;Nehmat Houssami;Tracy Onega;Diana S. M. Buist
    • Korean Journal of Radiology
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    • 제24권8호
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    • pp.729-738
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    • 2023
  • Objective: When multiple surveillance mammograms are performed within an annual interval, the current guidance for oneyear follow-up to determine breast cancer status results in shared follow-up periods in which a single breast cancer diagnosis can be attributed to multiple preceding examinations, posing a challenge for standardized performance assessment. We assessed the impact of using follow-up periods that eliminate the artifactual inflation of second breast cancer diagnoses. Materials and Methods: We evaluated surveillance mammograms from 2007-2016 in women with treated breast cancer linked with tumor registry and pathology outcomes. Second breast cancers included ductal carcinoma in situ or invasive breast cancer diagnosed during one-year follow-up. The cancer detection rate, interval cancer rate, sensitivity, and specificity were compared using different follow-up periods: standard one-year follow-up per the American College of Radiology versus follow-up that was shortened at the next surveillance mammogram if less than one year (truncated follow-up). Performance measures were calculated overall and by indication (screening, evaluation for breast problem, and short interval follow-up). Results: Of 117971 surveillance mammograms, 20% (n = 23533) were followed by another surveillance mammogram within one year. Standard follow-up identified 1597 mammograms that were associated with second breast cancers. With truncated follow-up, the breast cancer status of 179 mammograms (11.2%) was revised, resulting in 1418 mammograms associated with unique second breast cancers. The interval cancer rate decreased with truncated versus standard follow-up (3.6 versus 4.9 per 1000 mammograms, respectively), with a difference (95% confidence interval [CI]) of -1.3 (-1.6, -1.1). The overall sensitivity increased to 70.4% from 63.7%, for the truncated versus standard follow-up, with a difference (95% CI) of 6.6% (5.6%, 7.7%). The specificity remained stable at 98.1%. Conclusion: Truncated follow-up, if less than one year to the next surveillance mammogram, enabled second breast cancers to be associated with a single preceding mammogram and resulted in more accurate estimates of diagnostic performance for national benchmarks.

대한민국의 최근 4년간(2010-2013) 콘택트렌즈 처방 추세 (Contact Lens Prescribing Pattern in Korean During 2010 to 2013)

  • 이종하;이기석;추병선
    • 한국안광학회지
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    • 제19권3호
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    • pp.323-329
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    • 2014
  • 목적: 본 연구는 최근 4년간 대한민국의 안경원에서 판매된 콘택트렌즈를 조사하여 처방되는 추세를 알아보고자 하였다. 방법: 매년 100개의 설문지를 무작위로 전국 안경원에 우편 발송하였다. 각 설문지의 작성은 안경원에서 설문지를 받은 후에 판매된 처음 10건의 콘택트렌즈에 대한 정보를 기재하도록 하였고, 우편이나 이메일로 반송하도록 요청하였다. 결과: 총 400개의 설문지 중에 209개의 설문지가 반송되었고, 훼손이 없고 분석에 적합한 처방건수가 1937건이었다. 콘택트렌즈를 처방 받은 고객들의 평균 나이는 2010년에는 $26.2{\pm}7.0$세, 2011년에는 $26.1{\pm}7.6$세, 2012년에는 $24.7{\pm}.6$세, 2013년에는 $24.8{\pm}7.2$세로 나타났으며, 착용자의 대부분은 여성이었다(75%). 소프트콘택트 렌즈 중에서 실리콘 하이드로겔 렌즈의 비율은 평균 18%를 차지하였고, 디자인별로 분류했을 때, 토릭렌즈의 비율은 평균 17%였으며, 이 비율은 4년간 꾸준히 증가하였다(2010년:10%, 2011년:18%, 2012년:16%, 2013년:22%). 미용렌즈는 29%의 비율을 나타내었다. 일회용 렌즈의 비율은 29%이고, 3~6개월 교체용이 가장 많은 40%로 조사되었다. 결론: 콘택트렌즈 착용자의 대부분이 여성이었으며, 평균나이는 4년간 적은 비율로 차츰 감소하였다. 나이가 어린 여성 착용자가 증가한 것은 미용렌즈의 처방이 갈수록 증가한 것과 연관된다. 또한 미용렌즈의 처방 비율(29%)은 전세계의 미용렌즈 처방 평균(7%)보다 훨씬 높게 나타났다. 이러한 미용렌즈의 성장은 한국의 미용관련 시장의 상승세와 관련 있는 것으로 생각된다.

생산모형(生産模型)을 이용(利用)한 수출(輸出)·수입함수(輸入函數)의 가격탄성치(價格彈性値) 추정(推定) (An Estimation of Price Elasticities of Import Demand and Export Supply Functions Derived from an Integrated Production Model)

  • 이홍구
    • KDI Journal of Economic Policy
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    • 제12권4호
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    • pp.47-69
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    • 1990
  • 수출(輸出) 수입량(輸入量)이 여러 변수(變數)들에 의해서 동시적(同時的)으로 결정(決定)되는 경우 수출(輸出) 수입함수(輸入函數)를 독립적(獨立的)으로 추정(推定)하는 것보다는 이들을 다른 경제활동수준과 함께 동시적(同時的)으로 추정(推定)하는 것이 보다 바람직하다. 본고(本稿)에서는 이에 착안하여 생산모형(生産模型)에 근거한 수출(輸出) 수입함수(輸入函數)의 가격탄성치(價格彈性値)를 추정(推定)하였다. 생산모형(生産模型)에서 수출재(輸出財)는 생산부문(生産部門)의 산출물(産出物)로, 수입재(輸入財)는 투입물(投入物)로 상정(想定)되며 이러한 생산부문(生産部門)을 분석(分析)하고 모형화(模型化)하는 데 GNP함수(函數)가 사용된다. GNP함수(函數)에 약분리성(弱分離性) 제약(制約)이 가해지면 생산모형(生産模型)의 공급(供給) 수요체계(需要體系)에 관한 미시적 정보를 사용하여 이로부터 보다 세분(細分)된 수출(輸出) 수입항목별(輸入項目別) 가격탄성치(價格彈性値)를 도출할 수 있다. 본고(本稿)는 GNP함수(函數)가 약분리성(弱分離性)을 가질 때, 이단계극대화(二段階極大化) 과정(過程)을 통해서 얻을 수 있는 수출공급(輸出供給) 수입수요(輸入需要) 국내공급(國內供給) 노동수요(勞動需要)의 가격탄성치(價格彈性値)와 세분된 수출(輸出) 수입항목(輸入項目)의 가격탄성치(價格彈性値)를 추정하였다. 상부모형(上部模型)의 추정(推定)에서는 국내공급(國內供給)과 수출공급(輸出供給)은 서로 대체관계(代替關係), 수입수요(輸入需要)와 노동수요(勞動需要)는 보완관계(補完關係)에 있으며, 투입요소(投入要素)로서 노동(勞動)과 수입재(輸入財)는 각각 국내공급(國內供給) 및 수출공급(輸出供給)과 서로 보완관계(補完關係)에 있는 것으로 나타났다. 하부모형(下部模型)에서는 세분(細分)된 수출(輸出) 수입항목(輸入項目) 상호간에는 대체(代替) 보완관계(補完關係)가 동시에 나타나는 것으로 추정되었다.

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CHANGES IN WATER USE AND MANAGEMENT OVER TIME AND SIGNIFICANCE FOR AUSTRALIA AND SOUTH-EAST ASIA

  • Knight, Michael J.
    • 한국지하수토양환경학회:학술대회논문집
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    • 한국지하수토양환경학회 1997년도 추계 국제학술심포지움 논문집
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    • pp.3-31
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    • 1997
  • Water has always played a significant role in the lives of people. In urbanised Rome, with its million people. sophisticated supply systems developed and then fled with the empire. only to be rediscovered later But it was the industrial Revolution commencing in the eighteenth century that ushered in major paradigm shifts In use and altitudes towards water. Rapid and concentrated urbanisation brought problems of expanded demands for drinking supplies, waste management and disease. The strategy of using water from local streams, springs and village wells collapsed under the onslaughts of rising urban demands and pollution due to poor waste disposal practices. Expanding travel (railways. and steamships) aided the spread of disease. In England. public health crises peaks, related to water-borne typhoid and the three major cholera outbreaks occurred in the late eighteenth and early nineteenth century respectively. Technological, engineering and institutional responses were successful in solving the public health problem. it is generally accepted that the putting of water into pipe networks both for a clean drinking supply, as well as using it as a transport medium for removal of human and other wastes, played a significant role in towering death rates due to waterborne diseases such as cholera and typhoid towards the end of the nineteenth century. Today, similar principles apply. A recent World Bank report Indicates that there can be upto 76% reduction in illness when major water and sanitation improvements occur in developing countries. Water management, technology and thinking in Australia were relatively stable in the twentieth century up to the mid to late 1970s. Groundwater sources were investigated and developed for towns and agriculture. Dams were built, and pipe networks extended both for supply and waste water management. The management paradigms in Australia were essentially extensions of European strategies with the minor adaptions due to climate and hydrogeology. During the 1970s and 1980s in Australia, it was realised increasingly that a knowledge of groundwater and hydrogeological processes were critical to pollution prevention, the development of sound waste management and the problems of salinity. Many millions of dollars have been both saved and generated as a consequence. This is especially in relation to domestic waste management and the disposal of aluminium refinery waste in New South Wales. Major institutional changes in public sector water management are occurring in Australia. Upheveals and change have now reached ail states in Australia with various approaches being followed. Market thinking, corporatisation, privatisation, internationalisation, downsizing and environmental pressures are all playing their role in this paradigm shift. One casualty of this turmoil is the progressive erosion of the public sector skillbase and this may become a serious issue should a public health crisis occur such as a water borne disease. Such crises have arisen over recent times. A complete rethink of the urban water cycle is going on right now in Australia both at the State and Federal level. We are on the threshold of significant change in how we use and manage water, both as a supply and a waste transporter in Urban environments especially. Substantial replacement of the pipe system will be needed in 25 to 30 years time and this will cost billions of dollars. The competition for water between imgation needs and environmental requirements in Australia and overseas will continue to be an issue in rural areas. This will be especially heightened by the rising demand for irrigation produced food as the world's population grows. Rapid urbanisation and industrialisation in the emerging S.E Asian countries are currently producing considerable demands for water management skills and Infrastructure development. This trend e expected to grow. There are also severe water shortages in the Middle East to such an extent that wars may be fought over water issues. Environmental public health crises and shortages will help drive the trends.

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Improving Corsican pine somatic embryo maturation: comparison of somatic and zygotic embryo morphology and germination

  • Wtpsk, Senarath;Shaw, D.S.;Lee, Kui-Jae;Lee, Wang-Hyu
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2003년도 춘계 학술발표대회
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    • pp.61-62
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    • 2003
  • Clonal propagation of high-value forest trees through somatic embryogenesis (SE) has the potential to rapidly capture the benefits of breeding or genetic engineering programs and to improve raw material uniformity and quality. A major barrier to the commercialization of this technology is the low quality of the resulting embryos. Several factors limit commercialization of SE for Corsican pine, including low initiation rates, low culture survival, culture decline causing low or no embryo production, and inability of somatic embryos to fully mature, resulting in low germination and reduced vigour of somatic seedlings. The objective was to develop a Corsican pine maturation medium that would produce cotyledonary embryos capable of germination. Treatments were arranged in a completely randomized design. Data were analyzed by analysis of variance, and significant differences between treatments determined by multiple range test at P=0.05. Corsican pine (Pinus nigra var. maritima) cultures were initiated on modified !P6 medium. Modifications of the same media were used for culture multiplication and maintenance. Embryogenic cultures were maintained on the same medium semi solidified with 2.5 g/l Gelrite. A maturation medium, capable of promoting the development of Corsican pine somatic embryos that can germinate, is a combination of iP6 modified salts, 2% maltose, 13% polyethylene glycol (PEG), 5 mg!l abscisic acid (ABA), and 2.5 g/l Gelrite. After initiation and once enough tissue developed they were grown in liquid medium. Embryogenic cell suspensions were established by adding 0.951.05 g of 10- to 14-day-old semisolid-grown embryogenic tissue to 9 ml of liquid maintenance media in a 250ml Erlenmeyer flask. Cultures were then incubated in the dark at 2022$^{\circ}$C and rotated at 120 rpm. After 2.53 months on maturation medium, somatic embryos were selected that exhibited normal embryo shape. Ten embryos were placed horizontally on 20 ml of either germination medium ($\frac{2}{1}$strength Murashige and Skoog (1962) salts with 2.5 g/l activated charcoal) or same medium with copper sulphate adjusted to 0.25 mg/1 to compensate for copper adsorption by activated carbon. 2% and 4% maltose was substituted by 7.5% and 13% PEG respectively to improve the yield of the embryos. Substitution of' maltose with PEG was clearly beneficial to embryo development. When 2% of the maltose was replaced with 7.5% PEG, many embryos developed to large bullet-shaped embryos. At latter stages of development most embryos callused and stopped development. A few short, barrel-shaped cotyledonary embryos formed that were covered by callus on the sides and base. When 4% of the maltose was removed and substituted with 13% PEG, the embryos developed further, emerging from the callus and increasing yield slightly. Microscopic examination of the cultures showed differing morphologies, varying from mostly single cells or clumps to well-formed somatic embryos that resembled early zygotic embryos only liquid cultures with organized early-stag. A procedure for converting and acclimating germinants to growth in soil and greenhouse conditions is also tested. Seedling conversion and growth were highly related to the quality of the germinant at the time of planting. Germinants with larger shoots, longer, straighter hypocotyls and longer roots performed best. When mature zygotic embryos germinate the root emerges, before or coincident with the shoot. In contrast, somatic embryos germinate in reverse sequence, with the cotyledons greening first, then shoot emergence and then, much later, if at all, the appearance of the root. Somatic seedlings, produced from the maturation medium, showed 100% survival when planted in a field setting. Somatic seedlings showed normal yearly growth relative to standard seedlings from natural seed.

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충전층 플라즈마 반응기에서 Ni-CeO2/γ-Al2O3 촉매를 이용한 프로페인-합성 가스 건식 개질 (Dry reforming of Propane to Syngas over Ni-CeO2/γ-Al2O3 Catalysts in a Packed-bed Plasma Reactor)

  • 라미아 술타나;Md. 샤히누르 라만;M.S.P. 수드하카란;Md. 목터 호세인;목영선
    • 청정기술
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    • 제25권1호
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    • pp.81-90
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    • 2019
  • 프로페인($C_3H_8$)의 건식 개질($CO_2$ 개질)을 통한 합성 가스($H_2$와 CO 혼합물) 제조를 위해 $Ni-CeO_2/{\gamma}-Al_2O_3$ 촉매가 충진된 유전체 장벽 방전 플라즈마 반응기를 사용하였다. 열 또는 플라즈마에 의해 환원된 $Ni-CeO_2/{\gamma}-Al_2O_3$ 촉매를 사용하여 $C_3H_8/CO_2$ 비율 1/3, 총 유량 $300mL\;min^{-1}$에서 플라즈마-촉매 건식 개질을 수행하였다. 건식 개질에 대한 촉매 활성은 온도범위 $500{\sim}600^{\circ}C$에서 평가되었다. $Ni-CeO_2/{\gamma}-Al_2O_3$ 촉매 제조를 위해 전구물질 수용액(질산니켈, 질산세륨)으로 함침된 ${\gamma}-Al_2O_3$를 공기 분위기에서 소성시킨 후, $H_2/Ar$ 분위기에서 환원시켰다. 촉매 특성 조사에는 X-선 회절분석기(XRD), 투과전자현미경(TEM), 전계 방출 주사전자현미경(FE-SEM), 승온 탈착($H_2-TPD$, $CO_2-TPD$) 및 라만 분광기가 이용되었다. 열로 환원된 촉매와 비교하면 플라즈마 방전하에서 환원된 $Ni-CeO_2/{\gamma}-Al_2O_3$ 촉매가 개질 반응을 통한 합성 가스 생산에서 보다 우수한 촉매 활성을 나타내었다. 또한, 플라즈마로 환원된 $Ni-CeO_2/{\gamma}-Al_2O_3$가 개질 반응의 문제점인 탄소퇴적 관점에서 장기 촉매 안정성을 보여주었다.