• 제목/요약/키워드: evidence base

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Influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium instruments: a systematic review

  • Silva, Emmanuel Joao Nogueira Leal;Zanon, Mayara;Hecksher, Fernanda;Belladonna, Felipe Goncalves;de Vasconcelos, Rafaela Andrade;da Silva Fidalgo, Tatiana Kelly
    • Restorative Dentistry and Endodontics
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    • 제45권2호
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    • pp.25.1-25.12
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    • 2020
  • Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results: From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions: Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.

대한한방부인과학회지(大韓韓方婦人科學會誌) 수재(收載) 논문(論文) 분석(分析) (Analytic Study on Treatises of the Journal of Oriental Obstetrics & Gynecology)

  • 윤영진;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제24권2호
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    • pp.97-103
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    • 2011
  • Objectives: Recently, high attention has been drawn towards evidence based medicine(EBM). However, there is little follow study after Park's analysis research (2002) in the journal of oriental gynecology. Therefore, there is a need to conduct analyzed research on the topic, due to the increasing interest about EBM. Methods: To analyze the treatises of the journal of oriental gynecology, we examined 56 journals published from 1987 to 2010. we followed the way of Park, classifying treatises into bibliographic, experimental and clinical categories. Results: Analytic research, as a part of clinical treatises, increased rapidly from 2001. As a result, it took 53.3% of whole study in general after 2002 and it reached up to 70.0% in 2004. Most part of clinical treatises until 2002 was about case report of patients, but the amount of clinical trial started to increase since 2003. Case report and case series showed dramatic increase after 2001, and clinical trial started to increase after 2003. As a result, 43.8% of the analyzed research was due to clinical trial by 2009. Conclusions: On the base of this research, quality evaluation of clinical treatises using guality assessment tool is needed for EBM in the part of oriental obstetrics & gynecology.

한국 중소벤처기업의 시장지향성과 해외진출성과간 관계에 있어 기업가정신의 조절효과에 관한 연구 (An Empirical Study on Moderating Effects of Entrepreneurship between Market Orientation and Performance Relationship of Korean Venture)

  • 김정포
    • 국제지역연구
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    • 제13권3호
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    • pp.481-500
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    • 2009
  • 본 연구는 해외로 진출한 우리나라 고기술/지식집약산업 중소벤처기업의 시장지향성과 해외진출성과간 관계에 있어 기업가정신의 영향력을 탐색해보고자 하는 것이다. 기존연구들에서는 기업가정신이 시장지향성의 선행요인임과 동시에 해외진출성과에 영향을 미치는 중요 요인으로 제시되고 있으나, 본 연구에서는 기업가정신이 시장지향성의 선행요인으로서의 역할이 아니라 시장지향성과 해외진출성과간의 관계에 긍정적인 영향을 미치는 중요한 조절변수로서의 역할을 수행할 것이라 가정하고 연구를 진행하였다. 또한 보다 세부적으로는 기업가정신을 구성하는 3가지 하위요소 각각도 중요한 조절변수로서의 역할을 수행할 것이라는 가설을 설정하여 계층적 회귀분석 모형을 통한 실증분석을 시도하였다. 한국 해외진출 중소벤처기업 217개의 표본을 이용한 실증분석결과, 기업가정신요인은 시장지향성과 해외진출성과간 관계에 유의한 조절효과를 미치고 있는 것으로 나타났으며, 특히 기업가정신의 하위요인 중 혁신성과 진취성에 유의한 조절효과를 보이고 있는 것으로 나타났다.

Comparative Analysis of COVID-19 Infection Prevention Control Guidelines from Seven Countries: Implications on COVID-19 Response and Future Guidelines Development

  • Jeong, Yoolwon;Lee, Sun-Hee
    • 보건행정학회지
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    • 제32권3호
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    • pp.304-316
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    • 2022
  • Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

뇌졸중 환자의 상지 기능에 기능적 전기 자극이 미치는 영향: 무작위대조군연구에 기초한 체계적 고찰 (Effect of Electrical Stimulation on Upper Extremity Function in Stroke Patients: A Systematic Review Based on Randomized Controlled Trials)

  • 황수진;서연주
    • PNF and Movement
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    • 제20권2호
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    • pp.147-156
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    • 2022
  • Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

질환별 레이저 침의 임상적 효과 평가 : 체계적 문헌고찰 및 메타분석 (Evaluation of the Clinical Effectiveness of Laser Acupuncture for Disease Specific : Systematic Reviews and Meta-analyses)

  • 김대진;최병희;김태영;박수강;곽진영
    • 대한의용생체공학회:의공학회지
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    • 제45권2호
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    • pp.81-89
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    • 2024
  • Purpose : This study conducted a systematic review and meta-analysis to evaluate the clinical effectiveness of laser acupuncture for each condition using information from laser acupuncture trials registered on clinicaltrials.gov from January 2013 to June 2023. Methods : We quantitatively and qualitatively analysed the results of 16 clinical trials of laser acupuncture whose research results were confirmed. A risk of bias assessment was also carried out to assess the quality of each clinical trial. Results : A meta-analysis including three clinical trials was conducted to evaluate the comparative effectiveness of laser acupuncture and sham laser acupuncture in reducing pain and found that the laser acupuncture group had a statistically significant reduction in pain compared with the sham laser acupuncture group. In addition, 11 of the 13 trials not included in the meta-analysis showed a positive effect of laser acupuncture. Conclusion : Although laser acupuncture has a long history of clinical use and a lot of research, there is still some scepticism due to the lack of a clear mechanism of action and inconsistent reports of clinical effectiveness. In addition, there is a significant lack of systematic reviews of clinical evidence for major disease specific, and ongoing research is needed to establish an objective evidence base for the clinical effectiveness of laser acupuncture.

Suppressed DNA Repair Mechanisms in Rheumatoid Arthritis

  • Lee, Sang-Heon;Firestein, Gary S
    • IMMUNE NETWORK
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    • 제2권4호
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    • pp.208-216
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    • 2002
  • Background: Reactive oxygen and nitrogen are produced by rheumatoid arthritis (RA) synovial tissue and can induce mutations in key genes. Normally, this process is prevented by a DNA mismatch repair (MMR) system that maintains sequence fidelity. Key members of the MMR system include MutS${\alpha}$ (comprised of hMSH2 and hMSH6), which can sense and repair single base mismatches and 8-oxoguanine, and MutS${\beta}$ (comprised of hMSH2 and hMSH3), which repairs longer insertion/deletion loops. Methods: To provide further evidence of DNA damage, we analyzed synovial tissues for microsatellite instability (MSI). MSI was examined by PCR on genomic DNA of paired synovial tissue and peripheral blood cells (PBC) of RA patients using specific primer sequences for 5 key microsatellites. Results: Surprisingly, abundant MSI was observed in RA synovium compared with osteoarthritis (OA) tissue. Western blot analysis of the same tissues for the expression of MMR proteins demonstrated decreased hMSH6 and increased hMSH3 in RA synovium. To evaluate potential mechanisms of MMR regulation in arthritis, fibroblast-like synoviocytes (FLS) were isolated from synovial tissues and incubated with the nitric oxide donor S-nitroso-N-acetylpenicillamine (SNAP). Western blot analysis demonstrated constitutive expression of hMSH2, 3 and 6 in RA and OA FLS. When FLS were cultured with SNAP, the RA synovial pattern of MMR expression was reproduced (high hMSH3, low hMSH6). Conclusion: Therefore, oxidative stress can relax the DNA MMR system in RA by suppressing hMSH6. Decreased hMSH6 can subsequently interfere with repair of single base mutations, which is the type observed in RA. We propose that oxidative stress not only creates DNA adducts that are potentially mutagenic, but also suppresses the mechanisms that limit the DNA damage.

메타학문인 정보학을 모태학문으로 하는 교과 '정보' (Subject 'Informatics' that Originated from Informatics in a Metascience as Academic base)

  • 안영희;김자미;이원규
    • 컴퓨터교육학회논문지
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    • 제19권3호
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    • pp.1-10
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    • 2016
  • 21세기에 들어서 한국을 포함한 세계 각국은 정보교육에 대한 많은 변화를 시도하였다. 각국의 상황을 고려하여 정보교육의 필요성을 인지하고 실천적 행동으로 옮기고 있다. 본 연구는 다양한 명칭으로 논의되고 있는 정보교육의 모태학문인 정보학에 대해 고찰하기 위한 목적으로 진행되었다. 모태학문에 대한 고찰은 용어에 집중하여 학술논문과 고등교육기관의 학과명, 학술지에서 정보관련 용어의 출현빈도를 중심으로 분석하였다. 분석을 토대로 교과 '정보'는 사회적 변화에 기여하는 정보학을 모태학문으로 하고, 통합된 정보학은 모든 학문의 메타학문임을 제시하였다. 본 연구는 학문적인 측면 뿐 아니라 사회적 필요 측면에서 정보교육를 규명하고, 메타학문을 모태학문으로 하는 정보교육은 초중등 학교에서 필수로 가르쳐야 할 교과임을 시사점을 제공하였다.

Complete Chloroplast DNA Sequence from a Korean Endemic Genus, Megaleranthis saniculifolia, and Its Evolutionary Implications

  • Kim, Young-Kyu;Park, Chong-wook;Kim, Ki-Joong
    • Molecules and Cells
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    • 제27권3호
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    • pp.365-381
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    • 2009
  • The chloroplast DNA sequences of Megaleranthis saniculifolia, an endemic and monotypic endangered plant species, were completed in this study (GenBank FJ597983). The genome is 159,924 bp in length. It harbors a pair of IR regions consisting of 26,608 bp each. The lengths of the LSC and SSC regions are 88,326 bp and 18,382 bp, respectively. The structural organizations, gene and intron contents, gene orders, AT contents, codon usages, and transcription units of the Megaleranthis chloroplast genome are similar to those of typical land plant cp DNAs. However, the detailed features of Megaleranthis chloroplast genomes are substantially different from that of Ranunculus, which belongs to the same family, the Ranunculaceae. First, the Megaleranthis cp DNA was 4,797 bp longer than that of Ranunculus due to an expanded IR region into the SSC region and duplicated sequence elements in several spacer regions of the Megaleranthis cp genome. Second, the chloroplast genomes of Megaleranthis and Ranunculus evidence 5.6% sequence divergence in the coding regions, 8.9% sequence divergence in the intron regions, and 18.7% sequence divergence in the intergenic spacer regions, respectively. In both the coding and noncoding regions, average nucleotide substitution rates differed markedly, depending on the genome position. Our data strongly implicate the positional effects of the evolutionary modes of chloroplast genes. The genes evidencing higher levels of base substitutions also have higher incidences of indel mutations and low Ka/Ks ratios. A total of 54 simple sequence repeat loci were identified from the Megaleranthis cp genome. The existence of rich cp SSR loci in the Megaleranthis cp genome provides a rare opportunity to study the population genetic structures of this endangered species. Our phylogenetic trees based on the two independent markers, the nuclear ITS and chloroplast MatK sequences, strongly support the inclusion of the Megaleranthis to the Trollius. Therefore, our molecular trees support Ohwi's original treatment of Megaleranthis saniculifolia to Trollius chosenensis Ohwi.

A Natural Hybrid of Intergeneric Mating between a Female Pungtungia herzi and a Male Pseudorasbora parva (Cypriniformes: Cyprinidae)

  • Kim, Keun-Yong;Ko, Myeong-Hun;Cho, Sung Jang;Kim, Woo-Jin;Son, Min Ho;Bang, In-Chul
    • Fisheries and Aquatic Sciences
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    • 제18권1호
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    • pp.99-107
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    • 2015
  • A natural hybrid of a probable intergeneric mating between the striped shiner Pungtungia herzi and the stone morocco Pseudorasbora parva (Cypriniformes: Cyprinidae) was captured in the Geumho River, a tributary of the Nakdong River basin in Korea. Morphological characters and DNA sequences were analyzed to verify its hybrid state and identify the parentage of its parent species. The hybrid exhibited a phenotypic intermediacy between the two parent species in the number of vertebrae and the mouth shape. Out of 1,488 base pair (bp) positions of the nuclear recombination activating gene 1 gene (rag1), which has a biparental mode of inheritance, 41-bp substitutions were detected between the two parent species, whereas an electropherogram of the hybrid displayed polymorphic double peaks at all of the base positions, along with one additional one, strongly indicating its hybrid state. Meanwhile, sequence comparison of the mitochondrial cytochrome b gene (mt-cyb) (1,140 bp), which has a maternal mode of inheritance, showed only 5-22-bp differences (97.6-99.5% identities) between the hybrid and Pu. herzi, but as many as 158-168-bp differences (85.2-86.1% identities) between the hybrid and Ps. parva, clearly indicating Pu. herzi as the maternal species. Thus, combined analyses of independent data sets (i.e., morphology and nuclear and mitochondrial DNA sequences) offered convincing evidence for the hybrid state of a naturally occurring hybrid resulting from intergeneric mating between a female Pu. herzi and a male Ps. parva.