Analyzing the incidence of silicosis across various industries in Taiwan: a study of occupational disease surveillance by linking national-based workers' and medicoadministrative databases.

OBJECTIVES: This study aimed to establish an occupational disease surveillance system by identifying high-risk industries for silicosis in Taiwan using a national database linkage approach. METHODS: The study was based on a comprehensive analysis of benefit claims from the National Labor Insurance Research Database and medical records from the National Health Insurance Research Database between 2004 and 2020, providing coverage for more than 88.5% of the workforce and 99.9% of citizens. Silicosis was defined as having received compensation for labor insurance benefits or having received a diagnosis of silicosis (International Classification of Diseases, 10th Revision: J62 or International Classification of Diseases, Ninth Revision: 502). The study used the International Standard Industrial Classification of All Economic Activities for industry-specific classification. Cox proportional hazard models were used to compare the silicosis incidence and risk among each industry and identify high-risk industries for silicosis. RESULTS: This study analyzed 1466 cases of silicosis between 2004 and 2020 and found that 28 industries had incidence rates of over 40 cases per 100,000 workers, indicating more than double the risk of developing silicosis. Of these industries, 14 were considered high risk (relative risk of over four times). Among these, this study identified industries rarely mentioned in the past, such as wholesale of brick, sand, cement, and products, artistic creation, landscape construction, and materials recovery. Stratification by years of work experience reveals those industries such as quarrying of stone, sand, clay, and other mining, construction of buildings, landscape construction, site preparation, foundation and structure construction, building completion and finishing, manufacture of ships, boats, and floating structures, and plumbing, heat, and air conditioning installation display higher hazard ratios for individuals with <10 years of work experience. CONCLUSIONS: The current surveillance system has identified certain industries that are at a higher risk of developing silicosis, which could be used for future occupational epidemiological surveys and targeted preventive measures in these sectors.

Comparison between the effects of deep and moderate neuromuscular blockade during transurethral resection of bladder tumor on endoscopic surgical condition and recovery profile: a prospective, randomized, and controlled trial.

PURPOSE: To compare between deep neuromuscular blockade (NMB) and moderate NMB with respect to endoscopic surgical conditions and recovery profiles in patients with general anesthesia for transurethral resection of bladder (TURB). METHODS: 108 patients undergoing elective TURB were randomized into two groups: the moderate NMB (n = 54) or deep NMB (n = 54) group. After the operation, NMB was reversed with 2 mg/kg sugammadex at a train-of-four (TOF) count of 1 or 2 (moderate NMB group) or with 4 mg/kg sugammadex at post-tetanic count (PTC) of 2 (deep NMB group). Surgeons, who were blinded to the study design, rated the endoscopic surgical condition on a 5-point scale (1 = extremely poor, 2 = poor, 3 = acceptable, 4 = good, 5 = optimal) immediately following the operation. Recovery profiles, including postoperative residual curarization (PORC), respiratory complication, and recovery time, were recorded. RESULTS: No difference was observed between the two groups regarding patients and anesthesia characteristics. There were statistically significant differences in endoscopic surgical conditions between the two groups (P < 0.001). Thirty-eight patients in the deep NMB group (74%) showed optimal surgical conditions, whereas 16 patients in the moderate NMB group (30%) showed optimal endoscopic surgical conditions. No PORC and respiratory complications occurred in both groups, and no difference was found between the two groups in terms of recovery profiles, including recovery time and other adverse events. CONCLUSIONS: Deep NMB and reversal with sugammadex improved the endoscopic surgical condition without complications compared with moderate NMB and reversal with sugammadex in patients undergoing TURB.

Phenotypic features and predictors of the clinical severity of keratoconjunctivitis sicca and salivary gland dysfunction in patients with Sjögren's syndrome: a longitudinal analysis of the Korean Initiative of primary Sjögren's Syndrome (KISS) cohort.

OBJECTIVE: The aim was to investigate prevalence and degree of ocular and oral involvement in patients with primary Sjögren's syndrome (PSS). METHOD: We analysed 134 participants from the Korean Initiative of PSS cohort who completed a 2 year follow-up oral and ocular sign test. The severity of keratoconjunctivitis sicca (KCS) was determined with the Schirmer I test value (STV) [abnormal (AB) ≤ 5 mm/5 min; normal (N) > 5 mm/5 min]. Salivary gland dysfunction (SGD) was determined by unstimulated whole salivary (UWS) flow rate [moderate to severe (MS) < 0.1 mL/min; mild (Mi) ≥ 0.1 mL/min]. Subgroups were divided into three groups according to STV and severity of SGD: AB-STV/MS-SGD, AB-STV/Mi-SGD, and N-STV/MS-SGD groups. We analysed the changes in STV and SGD during the follow-up period. RESULTS: Among the 134 participants enrolled in this study, 105 (78%) were placed in the AB-STV/MS-SGD group, 16 (12%) in the AB-STV/Mi-SGD, and 13 (10%) in the N-STV/MS-SGD at the 2 year follow-up. The AB-STV/Mi-SGD group was younger than the other two groups, and had a lower Xerostomia Inventory score and lower level of ß2-microglobulin. Participants in the N-STV/MS-SGD group had less hyperimmunoglobulinaemia, rheumatoid factor (RF), and antinuclear antibodies (ANAs). Patients and those with positive RF or ANA ≥ 1:320 at baseline were more likely to have abnormal STV at the 2 year follow-up. CONCLUSIONS: Patients with PSS and positive RF or ANA ≥ 1:320 at baseline may benefit from regular ophthalmology examinations, even if they do not have KCS at baseline or dry eye symptoms.

Multi-peak Light-emitting Diode Curing Units and Polymerization of 3D-printed Crown and Bridge Resin.

PURPOSE: This study aimed to evaluate the substitutive and additive efficacy of multi-peak light-emitting diode (LED) curing units for post-curing of a three-dimensional- (3D-) printed crown and bridge resin. METHODS: A total of 792 disc- and 180 bar-shaped specimens were printed with a crown and bridge resin (NextDent C&B MFH) and post-cured using two LED curing units (VALO Cordless and Bluephase N G4) in fast and standard modes. Conventional post-curing (LC-3D Print Box, Group PC) was compared with LED-only curing (Groups V1, V2, B1, and B2) and LED-combined curing (Groups PV1, PV2, PB1, and PB2) in terms of microhardness, flexural strength, degree of conversion (DC), and CIE L*a*b* color and translucency parameters. Cytotoxicity of the resin eluates was evaluated using the WST-1 assay. Temperature increases on the resin surface were measured with infrared thermography. Data were statistically analyzed using ANOVA and Kruskal-Wallis tests (α=0.05). RESULTS: The microhardness and flexural strength in Groups V1, V2, B1, and DC in all LED-only groups were lower than in other groups (p<0.05). Larger color disparities existed between Group PC and all LED-only groups than between Group PC and the others (p<0.05). There was no significant difference in cytotoxicity among the groups. The temperature increase was lowest in Groups V1 and PV1 during light curing (p<0.05). CONCLUSIONS: Post-curing by multi-peak LED curing units was not as effective as the conventional post-curing device. Additional post-curing by LED curing units did not improve the material properties.

Differences in omega-3 and fatty acid profiles between patients with endometriosis and those with a functional ovarian cyst.

Endometriosis is a chronic inflammatory gynaecological disease. Problems associated with endometriosis include dysmenorrhoea, dyspareunia and infertility. We evaluated the omega-3 and fatty acid profiles in erythrocytes and tissues in patients with endometriosis (n = 10) or a functional ovarian cyst (n = 12), using a food frequency questionnaire that included questions about 117 food items typical of Korean meals. Erythrocyte levels of 20:5n3 and 22:6n3, the omega-3 index, and n-3 PUFA were significantly higher, and the n-6:n-3 ratio was significantly lower in the endometriosis group than in the functional ovarian cyst group. The functional ovarian cyst group consumed significantly more fruit than the group with endometriosis.

Expression of p53, p27 and Jab1 protein in epithelial ovarian tumors.

OBJECTIVE: The study aimed to investigate expression of p53, p27 and Jun activation domain-binding protein 1 (Jab1) proteins in epithelial ovarian tumors and the values of these factors as discriminating markers for the transformation of borderline tumors to cancers. METHODS: Forty-seven cases of paraffin-embedded tissues of epithelial ovarian tumors including 22 cases of benign ovarian tumors, nine cases of borderline tumors, and 16 cases of invasive cancers were used to evaluate expression of p53, p27 and Jab1 proteins by immunohistochemical methods. RESULTS: p53 protein was expressed in 13.6% of the benign tumors, 44.4% of the borderline tumors and 62.5% of the malignant tumors and p27 protein was expressed in 95.5% of the benign tumors, 66.7% of the borderline tumors, and 37.5% of the malignant tumors. Expression of Jab1 protein was observed in 22.7% of the benign tumors, 77.8% of the borderline tumors and 62.5% of the malignant tumors. Expressions of p53, p27 and Jab1 proteins in malignant tumors were all higher than in benign tumors and the expression of p27 protein in malignant tumors was lower than in benign tumors (p < 0.05). Expression of Jab1 protein in borderline tumors was significantly higher than in benign tumors (p < 0.05). CONCLUSIONS: Expression of p53, p27 and Jab1 proteins can be used to discriminate between benign and malignant tumors in epithelial ovarian tumors.

Hysterectomy prevention using the uterine hollow obliterations (HYUNHO) method for placenta previa.

OBJECTIVE: We have invented a method of hysterectomy prevention called the uterine hollow obliteration (HYUNHO) method to preserve the uterus and fertility after treating placenta previa or accreta. METHODS: Eighty patients underwent cesarean section because of placenta previa between January 2003 and December 2009. All patients eligible for the study were evaluated by followup and a telephone questionnaire about fertility, menstruation recovery, and complications. RESULTS: The success rate on preserving the uterus with the HYUNHO method was 96.2%. Three cases required additional procedures, including a cesarean hysterectomy or uterine artery embolization (UAE), two cases underwent a cesarean hysterectomy after delivery, and one case underwent UAE. CONCLUSION: The HYUNHO method is a safe, easy method for placenta previa, although it should be evaluated in a randomized controlled trial.

Observation of a 1/3 magnetization plateau in Pb2Cu10O4(SeO3)4Cl7 arising from (Cu2+)7 clusters of corner-sharing (Cu2+)4 tetrahedra.

A mixed-valence compound Pb2Cu10O4(SeO3)4Cl7 has a complex structure consisting of one nonmagnetic Cu+ (S = 0) ion and four nonequivalent magnetic Cu2+ (S = 1/2) ions. It exhibits antiferromagnetic ordering at TN = 10.2 K. At a temperature below TN, a sequence of spin-flop transition at Bspin-flop = 1.3 T and 1/3 plateau formation at Bspin-flip = 4.4 K is observed in the magnetization curve M(B). The 1/3 magnetization plateau persists at least up to 53.5 T. The spin exchanges of Pb2Cu10O4(SeO3)4Cl7 evaluated by performing energy-mapping analysis based on DFT+U calculations show that the magnetic properties of Pb2Cu10O4(SeO3)4Cl7 are described by the (Cu2+)7 cluster of corner-sharing (Cu2+)4 tetrahedra, and that each (Cu2+)7 cluster has a S = 3/2 spin arrangement in the ground state. The 1/3 magnetization plateau observed for Pb2Cu10O4(SeO3)4Cl7 is explained by the field-induced flip of every second (Cu2+)7 cluster within a unit cell.

Toll-like receptor 4 signalling attenuates experimental allergic conjunctivitis.

Allergic conjunctivitis from an allergen-driven T helper type 2 (Th2) response is characterized by conjunctival eosinophilic infiltration. Association between signalling through Toll-like receptor 4 (TLR-4) and adaptive immune responses has been observed in allergic airway disease. We examined whether administration of bacterial lipopolysaccharide (LPS), a prototypic bacterial product that activates immune cells via TLR-4, could affect the development of allergic conjunctivitis and modify the immune response to ovalbumin (OVA) allergen in an experimental allergic conjunctivitis (EAC) model. Mice were challenged with two doses of OVA via conjunctival sac after systemic challenge with OVA in alum. Several indicators for allergy were evaluated in wild-type and TLR-4(-/-) mice with or without adding of different doses of LPS into OVA in alum. Mice challenged with OVA via conjunctival sac following systemic challenge with OVA in alum had severe allergic conjunctivitis. Of interest, LPS administration markedly suppressed immunoglobulin (Ig)E-mediated and eosinophil-dependent conjunctival inflammation. In addition, mice sensitized with OVA plus LPS had less interleukin (IL)-4, IL-5 and eotaxin secretion than mice sensitized with OVA only. The suppression of allergic response by LPS administration was due to Th1 shift. In contrast, the presence of LPS during sensitization with OVA had no effect on severity of allergic conjunctivitis and Th2 responses in TLR4-4(-/-) mice. Our findings demonstrate, for the first time, that LPS suppresses Th2 responses via the TLR-4-dependent pathway in the EAC model.

Effect of nalbuphine hydrochloride on the active phase during first stage of labour: a pilot study.

The aim of this pilot study was to determine whether nalbuphine shortens the duration of the active phase during the first stage of labour in pregnant women. Among 1,619 deliveries, we enrolled 302 pregnant women between March 2003 and August 2005. The case group received a nalbuphine injection (n = 57), while the remaining patients served as a control group (n = 245). The effects of nalbuphine on the length of labour were analysed using a survival analysis (log-rank test). The average duration of the initial active phase was 75 and 160 min for the case and control groups, respectively. The reduced duration of the active phase in the case group occurred regardless of oxytocin infusion (p < 0.01) and was without significant risks.

Effect of Deep Margin Elevation on Interfacial Gap Development of CAD/CAM Inlays after Thermomechanical Cycling.

METHODS AND MATERIALS: Mesio-occlusal-distal cavities were prepared on 12 extracted mandibular molars. The gingival margin of one proximal box was elevated with resin modified glass ionomer (RMGI) by a height of 2 mm (Group E [elevation]), and the margin of the other side served as a control (Group NE [no elevation]). Lithium disilicate computer-aided design and computer-aided manufacturing (CAD/CAM) inlays were fabricated and bonded with a self-adhesive resin cement. An aging process was simulated on the specimens under thermomechanical cycling by using a chewing simulator. Marginal integration was evaluated under scanning electron miscroscopy (SEM) using epoxy resin replicas before and after cycling. Marginal areas were stained with silver nitrate solution, and the volumetric gap was measured at the bonded interfaces using micro-computed tomography (CT) before and after cycling. Statistical analyses were performed using paired t-tests, the Wilcoxon signed rank test, and the Mann-Whitney test (a<0.05). RESULTS: SEM showed marginal discontinuities in Group NE that increased after thermomechanical cycling. Micro-computed tomography exhibited three-dimensional dye-penetrating patterns at the interfaces before and after cycling. Interfacial disintegration was larger in Group NE before cycling (p<0.05). Thermomechanical cycling increased the gaps in both Groups NE and E (p<0.05). The gap increment from thermomechanical cycling was larger in Group NE (p<0.05). CONCLUSIONS: Thermomechanical cycling induced interfacial disintegration at the lithium disilicate CAD/CAM inlays, with deep proximal margins. Margin elevation with RMGI placement reduced the extent of the interfacial gap formation before and after the aging simulation.

A novel model to manage air cargo disruptions caused by global catastrophes such as Covid-19.

The outbreak of the COVID-19 pandemic has drastically disrupted the air cargo industry. This disruption has taken many directions, one of which is the demand imbalance which occurs due to the sudden change in the cargo capacity, as well as demand. Therefore, the random change leads to excessive demand in some routes (hot-selling routes), while some other routes suffer from a big shortage of demand (underutilized routes). Routes are substitutable when there are several adjacent airports in the Origin & Destination (O&D) market. In this market, demand imbalance between substitutable routes occurs because of the above reasons. To tackle the demand imbalance problem, a novel model is introduced to estimate the quantity combinations which maintains the balance between underutilized and hot-selling routes. This model is a variant of the classic Cournot model which captures different quantity scenarios in the form of the best response for each route compared to the other. We then cultivate the model by integrating the Puppet Cournot game with the quantity discount policy. The quantity discount policy is an incentive which motivates the freight forwarders to increase their orders in the underutilized routes. After conducting numerical experiments, the results reveal that the profit can increase up to 25% by using the quantity discount. However, the quantity discount model is only applicable when the profit increase in the hot-selling route is greater than the profit decrease in the underutilized route.

The nanostructure effect on the adhesion and growth rates of epithelial cells with well-defined nanoporous alumina substrates.

We systematically analyzed the adhesion and the proliferation of cells on various nanoporous alumina surfaces to understand the effects of nanostructured surfaces on cell behavior. Various nanoporous surfaces were fabricated using the anodizing method and characterized by atomic force microscopy and scanning electron microscopy. The adhesion rate and proliferation rate of cells as functions of pore size and depth were statistically investigated using a colorimetric method. The adhesion rate of cells was not affected by the depth of the nanoporous surface whereas the proliferation of cells dramatically increased when the aspect ratio of the nanopore was near unity. This phenomenon was further verified by comparing the change in roughness of the cytoplasmic layer of cells adhered on a nanoporous surface with that of a bare nanoporous surface. The proliferation of cells was also influenced by the pore size of the nanoporous surface because the nanostructure could control the interaction between extracellular matrix (ECM) molecules and the surface. In conclusion, the nanostructured surfaces affected cell adhesion and proliferation by increasing the surface area to which the cells could adhere, and the interactions between small ECM molecules were influenced by the sufficiently small structures of the nanosurface.

Efficacy of assessment in fetal behaviour by four dimensional ultrasonography.

This study was conducted to examine the behaviour and facial expressions of the fetus after birth by 4-dimensional (4-D) ultrasonography, and the association of the biophysical profile (BPP) with the Doppler scale. A total of 40 singleton pregnancies were included. All 4-D ultrasonographies were performed using the Accuvix XQ (Medison Co. Ltd, Seoul, Republic of Korea). The BPP and Doppler were performed on gravidas using 2-D ultrasonography. We recorded the newborn while awake no later than 48 h after delivery. The most frequent movement in fetuses and newborn was yawning and isolated arm movements, respectively. Sucking, swallowing (r = 0.78) and isolated limb movements (r = 0.72) in fetuses as observed by 4-D ultrasonography had a relationship with isolated limb movements in the newborn. Because of the limitation of ultrasonography, an overall comparison could not be made. There was a high correlation between sucking, swallowing, and isolated limb movements in fetuses and newborn.

Ytterbium-doped fibre femtosecond laser offers robust operation with deep and precise microsurgery of C. elegans neurons.

Laser microsurgery is a powerful tool for neurobiology, used to ablate cells and sever neurites in-vivo. We compare a relatively new laser source to two well-established designs. Rare-earth-doped mode-locked fibre lasers that produce high power pulses recently gained popularity for industrial uses. Such systems are manufactured to high standards of robustness and low maintenance requirements typical of solid-state lasers. We demonstrate that an Ytterbium-doped fibre femtosecond laser is comparable in precision to a Ti:Sapphire femtosecond laser (1-2 micrometres), but with added operational reliability. Due to the lower pulse energy required to ablate, it is more precise than a solid-state nanosecond laser. Due to reduced scattering of near infrared light, it can lesion deeper (more than 100 micrometres) in tissue. These advantages are not specific to the model system ablated for our demonstration, namely neurites in the nematode C. elegans, but are applicable to other systems and transparent tissue where a precise micron-resolution dissection is required.

Dendritic-tree anatomy codes form-vision physiology in tadpole retina.

In tadpole frog retina, the development of four classes of visual form detectors matched the growth of four types of ganglion cell dendritic trees. From this correlation of electrophysiology and anatomy we concluded that the structure of retinal ganglion cell dendritic trees provides the code for detection of visual shapes.

Establishment of feline in-house reference intervals for hematologic and biochemical parameters and potential age-related differences.

Reference intervals (RIs) are one of the essential elements in the procedure of disease diagnosis. This is especially true for feline species in which RI is less available than in canine species. RIs are affected by biological, geographical and instrumental factors, yet published RIs with incomplete background are popularly used. Inappropriate interpretations of RIs may affect classification of disease and subsequent treatment. In this study, we demonstrated the step-by-step establishment of feline RIs following the American Society for Veterinary Clinical Pathology (ASVCP) reference interval guideline. A total of 51 parameters were examined, including 20 hematology and 31 biochemistry parameters, and the results were compared to one local RI and two foreign RIs. Overall, about 29% (10/35) of tested parameters were different form local RIs and 60% (30/50) were different from the two foreign RIs, highlighting geographical variations. A higher upper reference limit (URL) in red blood cell count (RBC), hematocrit (Hct), Hemoglobin (Hgb), albumin, creatinine and lower URL in potassium and white blood cell count (WBC) were identified, which may impact the interpretation. In addition, statistical analysis of age and gender were factored separately and indicated that 10 parameters were significantly higher in the adult group. For the impact of gender, percentage of basophil and total iron-binding capacity (TIBC) were lower in female and male cats, respectively. In conclusion, we have demonstrated that it is desirable to establish in-house RIs or RIs of local sources. An age specific RI for the geriatric feline population is advisable for better diagnosis and monitoring the disease.

Steroid-Refractory Autoimmune Myocarditis after Pembrolizumab Therapy: Failure of Equine Anti-Thymocyte Globulin to Prevent Heart Failure.

While immune checkpoint inhibitors (ICIs) are improving outcomes for many cancers, they can have severe adverse effects. Though cardiac immune-related adverse effects (irAEs) are rare, they have considerable morbidity and mortality. Prior case studies have demonstrated successful treatment of ICI induced autoimmune myocarditis with a variety of immunosuppressive regimens. This case describes steroid-refractory autoimmune myocarditis after treatment with pembrolizumab. Treatment with equine anti-thymocyte globulin, a regimen previously documented to reverse ICI induced autoimmune myocarditis, temporarily improved clinical status and cardiac biomarkers, however eventually failed to prevent progression to heart failure and cardiovascular death. This case highlights the importance of early stress-dose steroids, identifies troponin as a potential marker of treatment response, and underscores the value of collaboration between oncology and cardiology for optimal management.

A novel transverse expression domain in the mouse cerebellum revealed by a neurofilament-associated antigen.

The mammalian cerebellum is composed of a highly reproducible array of transverse zones, each of which is subdivided into parasagittal stripes. By using a combination of Purkinje cell antigenic markers and afferent tracing, four transverse zones have been identified: the anterior zone (AZ: approximately lobules I-V), the central zone (CZ: approximately lobules VI-VII), the posterior zone (PZ: approximately lobules VIII-dorsal IX) and the nodular zone (NZ: approximately ventral lobule IX+lobule X). Neurofilament-associated antigen (NAA) is an epitope recognized by a monoclonal antibody, which is expressed strongly in association with neurofilaments. During perinatal cerebellar development, anti-NAA immunocytochemistry reveals novel features of cerebellar organization. In particular, the CZ is reproducibly subdivided into anterior and posterior components. Between embryonic day 17 and postnatal day 7 NAA immunoreactivity is expressed selectively by a parallel fiber bundle that is restricted to lobule VII, thereby distinguishing the CZ anterior (lobules VIa, b) from the CZ posterior (lobule VII). The novel restriction boundary at lobule VII/VIII, which is also reflected in the morphology of the external granular layer and aligns with a gap in the developing Purkinje cell layer, precedes the morphological appearance of the posterior superior fissure between lobules VIb and VII. In addition, afferent axons to the CZ terminate in an array of parasagittal stripes that is probably a specific climbing fiber projection. Thus, the transverse zone architecture of the mouse cerebellum is more complex than had previously been appreciated.