• Title/Summary/Keyword: time-critical domains

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A Critical Systematic Review for Inhaled Corticosteroids on Lung Cancer Incidence: Not Yet Concluded Story

  • Suh-Young Lee;Soon Ho Yoon;Hyunsook Hong
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.120-132
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    • 2023
  • Background: To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods: We conducted electronic bibliographic searches on OVID-MEDLINE, EMBASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results: Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I2=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I2=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion: Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.

Comparative Study About Academic Thoughts of Xu Lingtai and Yoshimasu Todo (II) - Analysis of the Cause of Similarities and Differences in their Academic Thoughts - (서영태(徐靈胎)와 길익동동(吉益東洞)의 학술사상 비교 연구 (II) - 학술 사상이 같고 다른 원인에 대한 분석 -)

  • Yoon, Cheol-Ho;Huang, Huang
    • The Journal of Internal Korean Medicine
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    • v.32 no.1
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    • pp.87-99
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    • 2011
  • In the 18th century, Xu Lingtai (徐靈胎) and Yoshimasu Todo (吉益東洞) were medical revolutionaries. They emphasized researches about synthesis of formulae, efficacy of medication and observation and then classification of clinical phenomena, so they assumed a modern scientific character. But, there were clear differences between their academic thoughts. In this paper, we examine the causes of difference in three fields, i.e. traditional culture, viewpoints of talented people and academic personality. The first, difference was due to traditional culture. Chinese medicine has a long history and heavy traditional culture. Yin-Yang (陰陽) theory, Five Phase(五行) theory, Viscera and Bowels (臟腑) theory and Meridian and Collateral (經絡) theory stemmed from everyday practice, and Chinese people learn these theories from experience and observation. From the standpoint of Chinese people, particularly scholarly doctors [儒醫] such as Xu Lingtai, it was easy to debate medical theories. In contrast, Japanese traditional culture didn't have as long a history as China. Thus as a necessity, it was harder to disseminate traditional Chinese medicine theories in Japan. Yoshimasu Todo simplified it by cutting out the superfluous traditional Chinese medicine theory, so at that time it must have been shocking to the Japanese medical world's trends. The second, difference was due to viewpoints of talented experts. From the standpoint of Xu Lingtai, above all, medicine is just a learning, only a kind of technique, even more not a means of living. Xu Lingtai was concerned with the appearance of very talented experts such as 'great man' (偉人), and 'exceptional man' (奇士) who carried out medical research. Instead of cultivating a few talented people, Yoshimasu Todo tried to produce a large number of clinicians quickly who could treat ordinary people. The third was due to personality difference. As Xu Lingtai threw away Confucianism and studied medicine in his youth, although he had a critical attitude, he was always mild-mannered. Yoshimasu Todo always had a clearly critical and rebellious nature. Personality influenced their literary spirit and learning style, so although both advocated reactionism, the academic thought of Xu Lingtai was reformative and mild, while that of Yoshimasu Todo was revolutionary and fierce. Xu Lingtai and Yoshimasu Todo had considerably similar research domains and academic thought, so it is proper for them both to serve as examples for making a comparative study of medical history in China and Japan in 18th century.

Development of a Crew Resource Management Training Program for Reduction of Human Errors in APR-1400 Nuclear Power Plant (국내 원자력발전소 인적오류 저감을 위한 Crew Resource Management 교육훈련체계 개발)

  • Kim, Sa-Kil;Byun, Seong-Nam;Lee, Dhong-Hoon;Jeong, Choong-Heui
    • Journal of the Ergonomics Society of Korea
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    • v.28 no.1
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    • pp.37-51
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    • 2009
  • The nuclear power industry in the world has recognized the importance of integrating non-technical and team skills training with the technical training given to its control room operators to reduce human errors since the Three Mile Island and Chernobyl accidents. The Nuclear power plant (NPP) industry in Korea has been also making efforts to reduce the human errors which largely have contributed to 120 nuclear reactor trips from the year 2001 to 2006. The Crew Resource Management (CRM) training was one of the efforts to reduce the human errors in the nuclear power industry. The CRM was developed as a response to new insights into the causes of aircraft accidents which followed from the introduction of flight recorders and cockpit voice recorders into modern jet aircraft. The CRM first became widely used in the commercial airline industry, but military aviation, shipboard crews, medical and surgical teams, offshore oil crews, and other high-consequence, high-risk, time-critical industry teams soon followed. This study aims to develop a CRM training program that helps to improve plant performance by reducing the number of reactor trips caused by the operators' errors in Korean NPP. The program is; firstly, based on the work we conducted to develop a human factors training from the applications to the Nuclear Power Plant; secondly, based on a number of guidelines from the current practicable literature; thirdly, focused on team skills, such as leadership, situational awareness, teamwork, and communication, which have been widely known to be critical for improving the operational performance and reducing human errors in Korean NPPs; lastly, similar to the event-based training approach that many researchers have applied in other domains: aircraft, medical operations, railroads, and offshore oilrigs. We conducted an experiment to test effectiveness of the CRM training program in a condition of simulated control room also. We found that the program made the operators' attitudes and behaviors be improved positively from the experimental results. The more implications of the finding were discussed further in detail.

A Study about the Direction and Responsibility of the National Intelligence Agency to the Cyber Security Issues (사이버 안보에 대한 국가정보기구의 책무와 방향성에 대한 고찰)

  • Han, Hee-Won
    • Korean Security Journal
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    • no.39
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    • pp.319-353
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    • 2014
  • Cyber-based technologies are now ubiquitous around the glob and are emerging as an "instrument of power" in societies, and are becoming more available to a country's opponents, who may use it to attack, degrade, and disrupt communications and the flow of information. The globe-spanning range of cyberspace and no national borders will challenge legal systems and complicate a nation's ability to deter threats and respond to contingencies. Through cyberspace, competitive powers will target industry, academia, government, as well as the military in the air, land, maritime, and space domains of our nations. Enemies in cyberspace will include both states and non-states and will range from the unsophisticated amateur to highly trained professional hackers. In much the same way that airpower transformed the battlefield of World War II, cyberspace has fractured the physical barriers that shield a nation from attacks on its commerce and communication. Cyberthreats to the infrastructure and other assets are a growing concern to policymakers. In 2013 Cyberwarfare was, for the first time, considered a larger threat than Al Qaeda or terrorism, by many U.S. intelligence officials. The new United States military strategy makes explicit that a cyberattack is casus belli just as a traditional act of war. The Economist describes cyberspace as "the fifth domain of warfare and writes that China, Russia, Israel and North Korea. Iran are boasting of having the world's second-largest cyber-army. Entities posing a significant threat to the cybersecurity of critical infrastructure assets include cyberterrorists, cyberspies, cyberthieves, cyberwarriors, and cyberhacktivists. These malefactors may access cyber-based technologies in order to deny service, steal or manipulate data, or use a device to launch an attack against itself or another piece of equipment. However because the Internet offers near-total anonymity, it is difficult to discern the identity, the motives, and the location of an intruder. The scope and enormity of the threats are not just focused to private industry but also to the country's heavily networked critical infrastructure. There are many ongoing efforts in government and industry that focus on making computers, the Internet, and related technologies more secure. As the national intelligence institution's effort, cyber counter-intelligence is measures to identify, penetrate, or neutralize foreign operations that use cyber means as the primary tradecraft methodology, as well as foreign intelligence service collection efforts that use traditional methods to gauge cyber capabilities and intentions. However one of the hardest issues in cyber counterintelligence is the problem of "Attribution". Unlike conventional warfare, figuring out who is behind an attack can be very difficult, even though the Defense Secretary Leon Panetta has claimed that the United States has the capability to trace attacks back to their sources and hold the attackers "accountable". Considering all these cyber security problems, this paper examines closely cyber security issues through the lessons from that of U.S experience. For that purpose I review the arising cyber security issues considering changing global security environments in the 21st century and their implications to the reshaping the government system. For that purpose this study mainly deals with and emphasis the cyber security issues as one of the growing national security threats. This article also reviews what our intelligence and security Agencies should do among the transforming cyber space. At any rate, despite of all hot debates about the various legality and human rights issues derived from the cyber space and intelligence service activity, the national security should be secured. Therefore, this paper suggests that one of the most important and immediate step is to understanding the legal ideology of national security and national intelligence.

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