Validation and responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in breast cancer patients

PURPOSE

This study aimed to validate the Chemotherapy-Induced Alopecia Distress Scale (CADS) in a diverse English-speaking population and patients with endocrine treatment-induced alopecia (EIA).

OBJECTIVE

Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation.

METHODS

Data from the CHANCE study (NCT02530177), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, 6 months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size.

RESULTS

The CADS exhibited good reliability, with Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively.

CONCLUSION

The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.

Development of the Korean construction job exposure matrix (KoConJEM) based on experts' judgment using the 60 consolidated occupations for construction workers

BACKGROUND

This study was conducted as an effort to develop a Korean construction job exposure matrix (KoConJEM) based on 60 occupations recently consolidated by the construction workers mutual aid association for use by the construction industry.

METHODS

The probability, intensity, and prevalence of exposure to 26 hazardous agents for 60 consolidated occupations were evaluated as binary (Yes/No) or four categories (1 to 4) by 30 industrial hygiene experts. The score for risk was calculated by multiplying the exposure intensity by the prevalence of exposure. Fleiss' kappa for each hazardous agent and occupation was used to determine agreement among the 30 experts. The JEM was expressed on a heatmap and a web-based dashboard to facilitate comparison of factors affecting exposure according to each occupation and hazardous agent.

RESULTS

Awkward posture, heat/cold, heavy lifting, and noise were hazardous agents regarded as exposure is probable by at least one or more experts in all occupations, while exposure to asphalt fumes was considered hazardous in the smallest number of occupations (n = 5). Based on the degree of agreement among experts, more than half of the harmful factors and most occupations showed fair to good results. The highest risk value was 16 for awkward posture for most occupations other than safety officer.

CONCLUSIONS

The KoConJEM provides information on the probability, intensity, and prevalence of exposure to harmful factors, including most occupations employing construction workers; therefore, it may be useful in the conduct of epidemiological studies on assessment of health risk for construction workers.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Validation and Responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in Breast Cancer Patients

Purpose

This study aimed to validate the chemotherapy-induced alopecia distress scale (CADS) in a diverse English-speaking population and patients with endocrine treatment- induced alopecia (EIA).

Objective

Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation.

Methods

Data from the CHANCE study ( NCT02530177 ), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, six months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size.

Results

The CADS exhibited good reliability, with a Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively.

Conclusion

The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.

Association with Combined Occupational Hazards Exposure and Risk of Metabolic Syndrome: A Workers' Health Examination Cohort 2012-2021

Background

This study aimed to evaluate the association between exposure to occupational hazards and the metabolic syndrome. A secondary objective was to analyze the additive and multiplicative effects of exposure to risk factors.

Methods

This retrospective cohort was based on 31,615 health examinees at the Pusan National University Yangsan Hospital in Republic of Korea from 2012-2021. Demographic and behavior-related risk factors were treated as confounding factors, whereas three physical factors, 19 organic solvents and aerosols, and 13 metals and dust were considered occupational risk factors. Time-dependent Cox regression analysis was used to calculate hazard ratios.

Results

The risk of metabolic syndrome was significantly higher in night shift workers (hazard ratio = 1.45: 95% confidence interval = 1.36-1.54) and workers who were exposed to noise (1.15:1.07-1.24). Exposure to some other risk factors was also significantly associated with a higher risk of metabolic syndrome. They were dimethylformamide, acetonitrile, trichloroethylene, xylene, styrene, toluene, dichloromethane, copper, antimony, lead, copper, iron, welding fume, and manganese. Among the 28 significant pairs, 19 exhibited both positive additive and multiplicative effects.

Conclusions

Exposure to single or combined occupational risk factors may increase the risk of developing metabolic syndrome. Working conditions should be monitored and improved to reduce exposure to occupational hazards and prevent the development of the metabolic syndrome.

Incidence rates of injury, musculoskeletal, skin, pulmonary and chronic diseases among construction workers by classification of occupations in South Korea: a 1,027 subject-based cohort of the Korean Construction Worker's Cohort (KCWC)

Background

The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea.

Methods

In a subject-based cohort of the Korean Construction Worker's Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY).

Results

Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers.

Conclusions

This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

Feature extraction of time series data on functional near-infrared spectroscopy and comparison of deep learning performance for classifying patients with Alzheimer's-related mild cognitive impairment: a post-hoc analysis of a diagnostic interventional trial

OBJECTIVE

This study aimed to define a method of classifying patients with mild cognitive impairment caused by Alzheimer's disease by the retrieval of functional near-infrared spectroscopy (fNIRS) signal characteristics obtained during olfactory stimulation and the validation of deep learning findings.

PATIENTS AND METHODS

Participants were recruited for the study from March 02 and August 30, 2021. A total of 78 participants met the criteria for categorization. The Mini-Mental State Examination and the Seoul Neuropsychological Scale were used to distinguish between patients with mild Alzheimer's disease-related cognitive impairment and healthy controls. fNIRS data received during olfactory stimulation were used to create 1,680 time-series sample values. A total of 150 indices with a p-value ≤ 0.1 were used as deep learning features to construct the result values for 120 models accounting for all conceivable combinations of data ratios.

RESULTS

For this trial, 78 participants were recruited for the original intervention trial. The average accuracy of the 120 deep-learning models for classifying patients with Alzheimer's-related mild cognitive impairment ranged from 0.78 to 0.90. Sensitivity ranged from 0.88 to 0.96 for the 120 models, while specificity ranged from 0.86 to 0.94. The F1 scores ranged from 0.74 to 0.88. At 0.78 to 0.90, the precision and recall were equivalent.

CONCLUSIONS

This trial using a deep-learning model found that the representative value extracted from the time series data of each channel could distinguish between healthy people and patients with mild cognitive impairment caused by Alzheimer's disease.

Observation of high-energy neutrinos from the Galactic plane

The origin of high-energy cosmic rays, atomic nuclei that continuously impact Earth's atmosphere, is unknown. Because of deflection by interstellar magnetic fields, cosmic rays produced within the Milky Way arrive at Earth from random directions. However, cosmic rays interact with matter near their sources and during propagation, which produces high-energy neutrinos. We searched for neutrino emission using machine learning techniques applied to 10 years of data from the IceCube Neutrino Observatory. By comparing diffuse emission models to a background-only hypothesis, we identified neutrino emission from the Galactic plane at the 4.5σ level of significance. The signal is consistent with diffuse emission of neutrinos from the Milky Way but could also arise from a population of unresolved point sources.

Occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range: a case report

Background

Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment.

Case presentation

A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted.

Conclusions

The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient's atopy and allergic rhinitis may have contributed to the development of occupational asthma.

Problems and suggested improvement plans for occupational health service in Korea

The purpose of this paper was to review the problems relating to Korea's occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%-40%, to 70%-80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

Epidemiology of occupational injuries in construction workers between 2009 and 2018 in South Korea

BACKGROUND

This study aimed to investigate the characteristics of occupational injuries based on fatality, sex, and classification of occupations among construction workers using workers' compensation (WC) insurance data in South Korea.

METHODS

We collected WC insurance data from the Korea Workers' Compensation & Welfare Service for all construction workers between 2009 and 2018. Data from 158,947 accepted claims for occupational injury were extracted, and the demographic features, occupational injury types, and annual trends were analyzed for fatal and nonfatal cases. The annual incidence and mortality trends of occupational injury were estimated using negative binomial regression and Poisson regression models, for injury incidence and mortality respectively.

RESULTS

Among a total of 158,947 occupational injury cases, there were 155,772 (98%) nonfatal injuries and 3175 (2%) fatal injuries. For all occupational injuries, Construction Elementary Workers (6th Korean Standard Classification of Occupations (KSCO) 910; 45.7%) was the most frequent occupation, followed by Construction-Related Technical Workers (6th KSCO 772; 39.2%). The most frequent injury type was a fracture, followed by ruptures or lacerations and contusions. The incidence of all occupational injuries increased from 700.36 per 100,000 persons in 2009 to 1,195.98 per 100,000 persons in 2018. Further, deaths from injuries at work followed a significantly increasing annual trend [mortality rate ratio 1.04 (95% CI: 1.03-1.05)] from 2009 to 2018.

CONCLUSION

The over two-thirds increased incidence of occupational injuries and significantly increasing mortality trends for occupational injuries during the last 10 years indicate the need for aggressive intervention in occupational safety and health management within the Korean construction industry.

Evidence for neutrino emission from the nearby active galaxy NGC 1068

A supermassive black hole, obscured by cosmic dust, powers the nearby active galaxy NGC 1068. Neutrinos, which rarely interact with matter, could provide information on the galaxy’s active core. We searched for neutrino emission from astrophysical objects using data recorded with the IceCube neutrino detector between 2011 and 2020. The positions of 110 known gamma-ray sources were individually searched for neutrino detections above atmospheric and cosmic backgrounds. We found that NGC 1068 has an excess of 79 − 20 + 22 neutrinos at tera–electron volt energies, with a global significance of 4.2σ, which we interpret as associated with the active galaxy. The flux of high-energy neutrinos that we measured from NGC 1068 is more than an order of magnitude higher than the upper limit on emissions of tera–electron volt gamma rays from this source.

Classification of Alzheimer's disease stage using machine learning for left and right oxygenation difference signals in the prefrontal cortex: a patient-level, single-group, diagnostic interventional trial

OBJECTIVE

Recent evidence shows that indicators testing conventional olfactory function have a high degree of similarity to cognitive function tests and the potential to diagnose early-stage Alzheimer's disease (AD). In this study, the efficacy of functional near-infrared spectroscopy time-series data obtained through olfactory stimulation was investigated as an early diagnostic tool for mild cognitive impairment in AD using random forest, a machine learning algorithm.

PATIENTS AND METHODS

We conducted a patient-level, single-group, diagnostic interventional trial using near-infrared signals measured during olfactory stimulation in the prefrontal cortex of 178 older adults ranging from normal to participants with AD as markers to discriminate AD stages. We first divided the participants into normal older adults, AD mild cognitive impairment, and AD groups using dementia diagnostic criteria such as the Mini-Mental State Examination and Seoul Neuropsychological Screening Battery. We compared the left and right oxygenation difference by calculating the relative oxygenation difference from the change in relative oxygen concentration.

RESULTS

A total of 168 participants met the eligibility criteria: 70 (41.6%) had normal cognitive function; 42 (25%) mild cognitive impairment; 21 (12.5%) mild AD; and 35 (20.8%) moderate AD. A random forest machine learning model was developed to predict the AD stage, with an area under the receiver operating characteristic curve of 90.7% for mild cognitive impairment and AD, 90.99% for mild cognitive impairment, and 93.34% for AD only.

CONCLUSIONS

Based on the classification of the oxygenation difference index of the left and right prefrontal cortices during olfactory stimulation through machine learning, we found that it was possible to detect early-stage mild cognitive impairment in AD. Our results highlight the potential for early AD diagnosis using near-infrared signals from the prefrontal cortex obtained upon olfactory stimulation. Moreover, the results showed high similarity to the existing cognitive function tests and high accuracy in AD stage classification.

Search for Unstable Sterile Neutrinos with the IceCube Neutrino Observatory

We present a search for an unstable sterile neutrino by looking for a resonant signal in eight years of atmospheric ν_{μ} data collected from 2011 to 2019 at the IceCube Neutrino Observatory. Both the (stable) three-neutrino and the 3+1 sterile neutrino models are disfavored relative to the unstable sterile neutrino model, though with p values of 2.8% and 0.81%, respectively, we do not observe evidence for 3+1 neutrinos with neutrino decay. The best-fit parameters for the sterile neutrino with decay model from this study are Δm_{41}^{2}=6.7_{-2.5}^{+3.9}  eV^{2}, sin^{2}2θ_{24}=0.33_{-0.17}^{+0.20}, and g^{2}=2.5π±1.5π, where g is the decay-mediating coupling. The preferred regions of the 3+1+decay model from short-baseline oscillation searches are excluded at 90% C.L.

Strong Constraints on Neutrino Nonstandard Interactions from TeV-Scale ν_{μ} Disappearance at IceCube

We report a search for nonstandard neutrino interactions (NSI) using eight years of TeV-scale atmospheric muon neutrino data from the IceCube Neutrino Observatory. By reconstructing incident energies and zenith angles for atmospheric neutrino events, this analysis presents unified confidence intervals for the NSI parameter ε_{μτ}. The best-fit value is consistent with no NSI at a p value of 25.2%. With a 90% confidence interval of -0.0041≤ε_{μτ}≤0.0031 along the real axis and similar strength in the complex plane, this result is the strongest constraint on any NSI parameter from any oscillation channel to date.

Search for Relativistic Magnetic Monopoles with Eight Years of IceCube Data

We present an all-sky 90% confidence level upper limit on the cosmic flux of relativistic magnetic monopoles using 2886 days of IceCube data. The analysis was optimized for monopole speeds between 0.750c and 0.995c, without any explicit restriction on the monopole mass. We constrain the flux of relativistic cosmic magnetic monopoles to a level below 2.0×10^{-19}  cm^{-2} s^{-1} sr^{-1} over the majority of the targeted speed range. This result constitutes the most strict upper limit to date for magnetic monopoles with β≳0.8 and up to β∼0.995 and fills the gap between existing limits on the cosmic flux of nonrelativistic and ultrarelativistic magnetic monopoles.

Exposure to Nickel Oxide Nanoparticles Induces Acute and Chronic Inflammatory Responses in Rat Lungs and Perturbs the Lung Microbiome

Nickel oxide nanoparticles (NiO NPs) are highly redox active nanoparticles. They can cause acute and chronic inflammation in rat lungs. Unlike the gut microbiome, the association between the lung microbiome's role and pulmonary inflammatory response to inhaled nanoparticles remains largely unexplored. We aimed to explore the interaction between the lung microbiome and inflammatory responses in rats exposed to NiO NPs. Thirty female Wistar rats were randomly categorized into control and low- (50 cm2/rat), and high- (150 cm2/rat) dose NiO NPs exposure groups. NiO NPs were intratracheally instilled, and cytological, biochemical, proinflammatory cytokine, and lung microbiome analyses of bronchoalveolar lavage fluid were performed at 1 day and 4 weeks after instillation. NiO NPs caused a neutrophilic and lymphocytic inflammatory response in rat lung. We demonstrated that exposure to NiO NPs can alter the lung microbial composition in rats. In particular, we found that more Burkholderiales are present in the NiO NPs exposure groups than in the control group at 1 day after instillation. Dysbiosis in the lung microbiome is thought to be associated with acute lung inflammation. We also suggested that Burkholderiales may be a key biomarker associated with lung neutrophilic inflammation after NiO NPs exposure.

Average SAR prediction, validation, and evaluation for a compact MR scanner head-sized RF coil

A recently developed compact 3 T (C3T) MRI scanner with high performance gradients [1, 2] has a dedicated radiofrequency (RF) transmit coil that exposes only the head, neck and a small portion of the upper body region during head-first scanning. Due to the unique coil geometry and patient positioning, the established SAR model used for a conventional whole-body scanner cannot be directly translated to the C3T. Here a specific absorption rate (SAR) estimation and validation framework was developed and used to implement a dedicated and accurate SAR prediction model for the C3T. Two different SAR prediction models for the C3T were defined and evaluated: one based on an anatomically derived exposed mass, and one using a fixed anatomical position located caudally to the RF coil to determine the exposed mass. After coil modeling and virtual human body simulation, the designed SAR prediction model was implemented on the C3T and verified with calorimetry and in vivo scan power monitoring. The fixed-demarcation exposed mass model was selected as appropriate exposed mass region to accurately estimate the SAR deposition in the patient on the C3T.

Identification of BRAF p. V600E-Mutant and Wild-Type by MR Imaging in Pleomorphic Xanthoastrocytoma and Anaplastic Pleomorphic Xanthoastrocytoma

BACKGROUND AND PURPOSE

Compared with BRAF p. V600E wild-type pleomorphic xanthoastrocytoma, BRAF p. V600E-mutant pleomorphic xanthoastrocytoma showed a higher survival rate. In this study, we focused on finding preoperative MR imaging differences between BRAF p. V600E mutant and wild-type in pleomorphic xanthoastrocytoma and anaplastic pleomorphic xanthoastrocytoma.

MATERIALS AND METHODS

Twenty-three patients with pathologically confirmed pleomorphic xanthoastrocytoma or anaplastic pleomorphic xanthoastrocytoma in our hospital were retrospectively analyzed from January 2015 to December 2020. They were divided into a BRAF p. V600E-mutant group (including 6 pleomorphic xanthoastrocytomas and 5 anaplastic pleomorphic xanthoastrocytomas) and a wild-type group (including 8 pleomorphic xanthoastrocytomas and 4 anaplastic pleomorphic xanthoastrocytomas). The preoperative MR imaging characteristics of these groups were statistically compared.

RESULTS

The wild-type pleomorphic xanthoastrocytoma group presented with more aggressive conventional and advanced MR imaging features than the mutant pleomorphic xanthoastrocytoma group, including greater mean maximum tumor diameter (3.1 [SD, 0.9] cm versus 1.7 [SD, 0.4 ] cm, P < .05), more frequent heterogeneous contrast enhancement of solid portions (100% versus 0%, P < .001), more obvious peritumoral edema (mean, [2.1 SD, 0.7] cm versus 0.6 [SD, 0.2] cm, P < .01), and lower mean minimum relative ADC (896 [SD, 86] versus 988 [SD, 73], P < .05) and mean relative ADC (1060 [SD, 159] versus 1248 [SD, 116], P < .05) on DWI. However, there was no significant difference in either conventional or advanced MR imaging features between the wild-type anaplastic pleomorphic xanthoastrocytoma group and the mutant anaplastic pleomorphic xanthoastrocytoma group.

CONCLUSIONS

Neurosurgeons should carefully interpret MR images before an operation and select appropriate surgical strategies according to genotype prediction.

Effects of Long Working Hours and Night Work on Subjective Well-Being Depending on Work Creativity and Task Variety, and Occupation: The Role of Working-Time Mismatch, Variability, Shift Work, and Autonomy

This study explored the effects of long working hours (LW) and night work (NW) on subjective well-being and the modifying effects of work creativity and task variety (WCTV) and occupation. In addition, we examined the influence of working time-related variables including working-time mismatch, variability, shift work, and autonomy on the effects of LW and NW. This study used data from the 5th Korean Working Conditions Survey on 50,205 workers. LW and NW were defined as 52–60 h (L1) or >60 h (L2) per week, and 1–10 days (N1) or >10 days (N2) of night work per month. Multiple logistic regression was used to examine the effects of LW and NW and the modifying influences of WCTV and occupation. Differences in ORs of LW and NW caused by working time-related variables were investigated, to determine effect sizes and directions. A high level of WCTV alleviated the risks of LW and NW. White-collar workers were more vulnerable to the risk associated with NW. Regarding working-time related variables, working-time mismatch and variability increased the risks of LW and NW, respectively, while shift work alleviated the risks of NW. In countries where flexible work systems are not well utilized, working-time autonomy might not be associated with the risk of LW or NW. This study showed that it is necessary to comprehensively consider the occupation and task characteristics of individual workers performing LW or NW. Further studies of the modifying effects of working time-related variables on LW and NW are needed.

Activity-Based Exposure Levels and Cancer Risk Assessment Due to Naturally Occurring Asbestos for the Residents Near Abandoned Asbestos Mines in South Korea

This study aims to evaluate the overall asbestos exposure intensity and assess the health risk to residents due to naturally occurring asbestos (NOA) near abandoned asbestos mines in South Korea. Of 38 mines, we found 19 with measured concentrations of NOA. We evaluated the average of airborne NOA concentrations according to the environmental exposure category. When evaluated regionally by dividing into two clusters, the mean concentrations in activity-based sampling (ABS) scenarios exceeded the Korean exposure limit (0.01 f/cc) in both clusters. Moreover, airborne NOA concentrations in agricultural activity (5.49 × 10^-2 f/cc) and daily activity (6.95 × 10^-2 f/cc) had the highest values for clusters A and B, respectively. The excess lifetime cancer risk of one region (cluster A) by the ABS scenarios did not exceed the Korean Ministry of the Environment's criteria for soil purification (1 × 10^-4). However, one of the ABS scenarios-the daily life activity of clusters centered on Chungcheongbuk-do (cluster B)-showed an exposure of 1.08 × 10^-4, greater than the limit (1 × 10^-4). This indicates non negligible health damage to residents living near the abandoned asbestos mines, and it is necessary to continuously monitor and clean up the asbestos contamination.

Comparison of Asbestos Victim Relief Available Outside of Conventional Occupational Compensation Schemes

The asbestos victim relief schemes were introduced to resolve the issue of victims of asbestos-related diseases not receiving compensation through conventional legal orders. This article seeks to derive the differences and commonalities of various asbestos victim relief schemes available outside of the conventional occupational compensation system along with a systematic understanding and to propose plans for improvement through a comparative study. After the degree of asbestos exposure, the population, and the period of implementation were corrected, the recognized claims of the total of conventional occupational compensation schemes and the asbestos victim relief schemes could be ranked in the order of South Korea (KOR) (1867, total), France (FRA) (1571), Japan (JPN) (966), KOR (847, asbestosis grade 2,3 excluded), the United Kingdom (GBR) (670), and the Netherlands (NLD) (95). The average amount of compensation per person, in the case of mesothelioma, was higher in the order of FRA (4.60 times), KOR (1.46 times), GBR (1.03 times), and NLD (0.73 times) of the median income per year. The differences between countries were largely caused by the purpose of institutional design and influenced by the level of qualification, the existence of an expiration date, type of disease, type of benefit, level of judgment criteria, the existence of a procedure for appeals, and recognition rate (GBR: 102%, FRA: 84%, NLD: 81%, JPN: 76%, KOR: 73%, and BEL: 54%). Based on this analysis, suggestions could be made regarding the expansion of disease types, benefit types, and the overall review of judgment criteria.

Environmental exposure to asbestos and the risk of lung cancer: a systematic review and meta-analysis

Asbestos is a carcinogen associated with lung cancer, but few studies have examined the increased risk of lung cancer due to environmental asbestos exposure. We performed a systematic review and meta-analysis to evaluate the association between environmental asbestos exposure and lung cancer. We searched for articles on non-occupational or environmental asbestos exposure and lung cancer in PubMed, EMBASE, CINAHL and Web of Science databases. Our review included 15 studies, and except studies on ingestion exposure we performed a meta-analysis for 13 studies with respect to the type of exposure (neighbourhood and domestic/household exposure). Subgroup analyses and meta-regression were also performed. A significant increase in the risk of lung cancer was found for neighbourhood exposure (1.48, 95% CI 1.18 to 1.86), while the risk was not significantly increased for domestic/household exposure (1.04, 95% CI 0.85 to 1.27). With regard to neighbourhood exposure, naturally occurring asbestos and women were both associated with a higher risk of lung cancer; however, such an increase was not significantly greater compared with that associated with other sources of asbestos exposure and men. Although cautious interpretation is needed due to the large degree of heterogeneity and the small number of included studies, our findings imply that living near the source of asbestos increases the risk of lung cancer.

[Short-term effect of sodium zirconium cyclosilicate on potassium lowering in chronic kidney disease patients with hyperkalemia]

Objective: To investigate the efficacy of sodium zirconium cyclosilicate on emergency correction of hyperkalemia in chronic kidney disease patients. Methods: Patients with chronic kidney disease who were admitted to the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from May to June 2020 were selected. Those who had hyperkalemia and took sodium zirconium cyclosilicate powder were finally included. The patient's clinical data and laboratory results were collected. Results: A total of 24 results were included from 21 patients. The age of patients was (48.9±13.5) years old. Fourteen patients were male, and 7 patients were female. After 2 hours of administration, the venous potassium level decreased from (5.85±0.52) mmol/L to (5.15±0.43) mmol/L (P<0.001, n=21), with an average decline of (0.71±0.43) mmol/L. Meanwhile, the arterial potassium level decreased from (5.50±0.40) mmol/L to (4.88±0.33) mmol/L (P<0.001, n=10), with an average decline of (0.62±0.29) mmol/L. Based on the initial venous potassium level, the patients were further divided into three groups. The average potassium decrease in<5.5 mmol/L group (4 patients), 5.5-<6.0 mmol/L group (11 patients) and ≥6.0 mmol/L group (6 patients) was (0.46±0.26) mmol/L, (0.62±0.38) mmol/L and (1.04±0.45) mmol/L, respectively. There was statistically significant difference of potassium reduction among the three groups (P=0.045). Moreover, the extent of potassium reduction was positively correlated with baseline venous potassium level (r=0.603, P=0.004, n=21). The study did not reveal any treatment-related adverse event. Conclusion: Sodium zirconium cyclosilicate powder can rapidly and effectively reduce the serum potassium level in chronic kidney disease patients with hyperkalemia.

eV-Scale Sterile Neutrino Search Using Eight Years of Atmospheric Muon Neutrino Data from the IceCube Neutrino Observatory

The results of a 3+1 sterile neutrino search using eight years of data from the IceCube Neutrino Observatory are presented. A total of 305 735 muon neutrino events are analyzed in reconstructed energy-zenith space to test for signatures of a matter-enhanced oscillation that would occur given a sterile neutrino state with a mass-squared differences between 0.01 and 100  eV^{2}. The best-fit point is found to be at sin^{2}(2θ_{24})=0.10 and Δm_{41}^{2}=4.5  eV^{2}, which is consistent with the no sterile neutrino hypothesis with a p value of 8.0%.

Reconstruction of the Korean Asbestos Job Exposure Matrix

Background

A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility.

Methods

We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups.

Results

The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers.

Conclusions

The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Characteristics of the Diffuse Astrophysical Electron and Tau Neutrino Flux with Six Years of IceCube High Energy Cascade Data

We report on the first measurement of the astrophysical neutrino flux using particle showers (cascades) in IceCube data from 2010-2015. Assuming standard oscillations, the astrophysical neutrinos in this dedicated cascade sample are dominated (∼90%) by electron and tau flavors. The flux, observed in the sensitive energy range from 16 TeV to 2.6 PeV, is consistent with a single power-law model as expected from Fermi-type acceleration of high energy particles at astrophysical sources. We find the flux spectral index to be γ=2.53±0.07 and a flux normalization for each neutrino flavor of ϕ_{astro}=1.66_{-0.27}^{+0.25} at E_{0}=100  TeV, in agreement with IceCube's complementary muon neutrino results and with all-neutrino flavor fit results. In the measured energy range we reject spectral indices γ≤2.28 at ≥3σ significance level. Because of high neutrino energy resolution and low atmospheric neutrino backgrounds, this analysis provides the most detailed characterization of the neutrino flux at energies below ∼100  TeV compared to previous IceCube results. Results from fits assuming more complex neutrino flux models suggest a flux softening at high energies and a flux hardening at low energies (p value ≥0.06). The sizable and smooth flux measured below ∼100  TeV remains a puzzle. In order to not violate the isotropic diffuse gamma-ray background as measured by the Fermi Large Area Telescope, it suggests the existence of astrophysical neutrino sources characterized by dense environments which are opaque to gamma rays.

OP0202 STRESS-ACTIVATED MIR-204 GOVERNS SENESCENT PHENOTYPES OF CHONDROCYTES TO PROMOTE OSTEOARTHRITIS DEVELOPMENT

Background:

A progressive loss of cartilage matrix leads to the development of osteoarthritis (OA). Matrix homeostasis is disturbed in OA cartilage as the result of reduced production of cartilage-specific matrix and increased secretion of catabolic mediators by chondrocytes. Chondrocyte senescence is a crucial cellular event contributing to such imbalance in matrix metabolism during OA development.

Objectives:

We sought to identify a previously unknown, senescence-associated signaling pathway in chondrocytes linked to major OA cartilage manifestations such as PG loss and cartilage degeneration.

Methods:

We particularly aimed to screen miRNAs whose inhibition could effectively modulate senescent phenotypes of chondrocytes to treat OA. We investigated the regulatory mechanisms of miR-204 under various stress-eliciting stimuli in primary cultured human and mouse chondrocytes. We examined the in vivo effects of miR-204 overexpression and its antagonism in surgically induced OA mouse models. DMM surgery was used to induce posttraumatic OA in 12-week-old mice. Small RNAs were delivered to mouse knee joints by intra-articular injection. Various OA manifestations including cartilage destruction, subchondral bone sclerosis, osteophyte maturity, and synovial inflammation in mice were histologically inspected.

Results:

We identify miR-204 as a senescence-associated microRNA (miRNA) which is markedly upregulated in OA cartilage. The upregulated miR-204 simultaneously targets multiple components of the sulfated proteoglycan (PG) biosynthesis pathway, effectively shutting down PG anabolism. Ectopic expression of the miR-204 in joints triggers spontaneous cartilage loss and OA development, whereas inhibition of miR-204 ameliorates experimental OA, with concomitant recovery of PG synthesis and suppression of inflammatory senescence-associated secretory phenotype (SASP) factors in cartilage

Conclusion:

we unravel a stress-activated senescence pathway that underlies disrupted matrix homeostasis in OA cartilage.

References:

[1]O. H. Jeon, C. Kim, R.-M. Laberge, M. Demaria, S. Rathod, A. P. Vasserot, J. W. Chung, D. H. Kim, Y. Poon, N. David, D. J. Baker, J. M. van Deursen, J. Campisi, J. H. Elisseeff, Local clearance of senescent cells attenuates the development of post-traumatic osteoarthritis and creates a pro-regenerative environment. Nat. Med. 23, 775–781 (2017)

Disclosure of Interests:

None declared

Time-Integrated Neutrino Source Searches with 10 Years of IceCube Data

This Letter presents the results from pointlike neutrino source searches using ten years of IceCube data collected between April 6, 2008 and July 10, 2018. We evaluate the significance of an astrophysical signal from a pointlike source looking for an excess of clustered neutrino events with energies typically above ∼1  TeV among the background of atmospheric muons and neutrinos. We perform a full-sky scan, a search within a selected source catalog, a catalog population study, and three stacked Galactic catalog searches. The most significant point in the northern hemisphere from scanning the sky is coincident with the Seyfert II galaxy NGC 1068, which was included in the source catalog search. The excess at the coordinates of NGC 1068 is inconsistent with background expectations at the level of 2.9σ after accounting for statistical trials from the entire catalog. The combination of this result along with excesses observed at the coordinates of three other sources, including TXS 0506+056, suggests that, collectively, correlations with sources in the northern catalog are inconsistent with background at 3.3σ significance. The southern catalog is consistent with background. These results, all based on searches for a cumulative neutrino signal integrated over the 10 years of available data, motivate further study of these and similar sources, including time-dependent analyses, multimessenger correlations, and the possibility of stronger evidence with coming upgrades to the detector.

Erythropoietin Protects Retina Against Ceramide 2-Induced Damage in Rat

BACKGROUND

Ceramide plays critical roles in cell proliferation, senescence and apoptosis, and is implicated in neurodegenerative diseases, etc. To clarify if ceramide plays some roles in retinal diseases, we established in vivo and in vitro retinal injury models with ceramide 2 (C2) treatment. In addition, Erythropoietin (EPO), which showed protective effects on retinal cells and blood-retinal barrier (BRB), was also tested for its protection and possible mechanism(s) in these models.

METHODS

Male Sprague-Dawley rats were divided into four groups, i.e., normal control, vehicle control, C2 treatment, and C2+EPO treatment. After intravitreal injection, the rats were examined for eye fundus, electroretinogram, histological study, and immunostaining, etc. In vitro, retinal neuronal cell line (R28) and the primary human retinal microvascular endothelial cells (HRMECs) were treated with C2, cell viability assay, transendothelial electrical resistance (TEER) and BRB-related molecules were studied to test the protective effect of EPO.

RESULTS

Intravitreal C2-treatment caused significant vision loss in rats, as reflected by reduced b-wave amplitude, increased TUNEL positive cells and GFAP immunostaining in retina. Another major retinal injury observed was BRB breakdown following C2- treatment. Such C2-induced injuries were further confirmed by in vitro study. When HRMECs were treated with C2, the TEER was significantly reduced. The mechanisms for C2 to induce such injuries might be through evidently increased expressions of the related molecules like plasmalemma vesicle-associated protein (PLVAP or PV-1), ecto- 5'-nucleotidase (CD73) and intercellular adhesion molecule-1 (ICAM-1), as observed in C2-treated R28 cells. All these injuries induced by C2 were significantly prevented by EPO both in vivo and in vitro, and its protective mechanisms here might be, in addition to neuroprotective, closely related to its maintenance of BRB integrity, through reducing the expressions of PV-1, CD73 and ICAM-1.

CONCLUSION

C2 could induce severe retinal injury, and such injuries could be effectively prevented by EPO treatment.

Association between Heavy Metals, Bisphenol A, Volatile Organic Compounds and Phthalates and Metabolic Syndrome

The incidence of metabolic syndrome (MetS), which causes heart disease and stroke, has increased significantly worldwide. Although many studies have revealed the relationship between heavy metals (cadmium, mercury, and lead), the sum of metabolites of di(2-ethylhexyl) phthalate (DEHP), and MetS, the results remain inconsistent. No study has reported the association between various volatile organic compounds (VOCs) and phthalate metabolites with MetS. This cross-sectional study of a representative sample of adult South Koreans aimed to evaluate the relationship between heavy metals, VOC metabolites, phthalate metabolites, bisphenol A and MetS after adjusting for demographic variables. Data from the Korean National Environmental Health Survey II (2012–2014) (n = 5251) were used in the analysis. Multiple logistic regression analysis was performed for MetS with log-transformed hazardous material quartiles after covariate adjustment. Urine muconic acid (MuA) and mono- (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) levels were significantly associated with MetS after adjusting for confounders (odds ratio: 1.34 and 1.39, respectively). Urine MuA and MEHHP levels were significantly associated with MetS. Because of the rarity of this study, which investigated the relationship between each VOC and phthalate metabolite with MetS and the strict definition of all indirect measures of MetS components, further research is needed.

Recent results from the KASCADE-Grande data analysis

KASCADE, together with its extension KASCADE-Grande measured individual air showers of cosmic rays in the primary energy range of 100 TeV to 1 EeV. The data collection was fully completed at the end of 2013 and the experiment was dismantled. However, the data analysis is still in progress. Recently, we published a new result on upper limits to the flux of ultra-high energy gamma rays, which set constraints on some fundamental astrophysical models. We also use the data to investigate the validity of the new hadronic interactions models like SIBYLL version 2.3c or EPOS-LHC. In addition, we updated and improved the webbased platform of the KASCADE Cosmic Ray Data Centre (KCDC), where now the data from KASCADE and KASCADE-Grande of more than 20 years measurements is available, including corresponding Monte-Carlo simulated events based on three different hadronic interaction models. In this contribution, recent results from KASCADE-Grande and the update of KCDC is briefly discussed.

Study of themuon content of high-energy air showers with KASCADE-Grande

In this work, we report measurements on the muon content (Eth > 230 MeV) of extensive air showers (EAS) induced by cosmic rays with primary energy from 10 PeV up to 1 EeV performed with the KASCADE-Grande experiment. The measurements are confronted with SIBYLL 2.3. The results are focused on the dependence of the total muon number and the lateral density distribution of muons in EAS on the zenith angle and the total number of charged particles in the shower. We also present updated results of a detailed study of the attenuation length of shower muons, which reveal a deviation between the measured data and the predictions of the post-LHC hadronic interaction models SIBYLL 2.3, QGSJET-II-04 and EPOS-LHC.

Summary of the main results of the KASCADE and KASCADE-Grande experiments

The KASCADE and KASCADE-Grande experiments operated in KIT-Campus North, Karlsruhe (Germany) from 1993 to 2012. The two experiments studied primary cosmic rays in the energy range from 1014 eV to 1018 eV, investigating the change of slope of the spectrum detected at 2 - 4 × 1015 eV, the so called knee. We briefly review the performance of the experiments and then the main results obtained in the operation of both experiments: the test of hadronic interaction models, the all particle primary spectrum, the elemental composition of primary cosmic rays (with the first claim of a knee-like feature of the heavy primaries spectrum) and the search for large scale anisotropies.

Ovarian cancer in a former asbestos textile factory worker: a case report

Background

The International Agency for Research on Cancer (IARC) defined that asbestos is a group 1 substance that causes lung cancer, mesothelioma (pleura and peritoneum), laryngeal cancer, and ovarian cancer in humans. Many studies on lung cancer, and mesothelioma caused by asbestos exposure have been conducted, but there was no case report of ovarian cancer due to asbestos exposure in Korea. We describe a case of ovarian cancer caused by asbestos exposure in a worker who worked at an asbestos textile factory for 3 years and 7 months in the late 1970s.

Case presentation

A 57-year-old woman visited the hospital because she had difficulty urinating. Ovarian cancer was suspected in radiologic examination, and exploratory laparotomy was performed. She was diagnosed with epithelial ovarian cancer. The patient did not undergo postoperative chemotherapy and recovered. She joined the asbestos factory in March 1976 and engaged in asbestos textile twisting and spinning for 1 year, 2 years and 7 months respectively. In addition, she lived near the asbestos factory for more than 20 years. There was no other specificity or family history.

Conclusion

Considering the patient’s occupational and environmental history, it is estimated that she had been exposed to asbestos significantly, so we determined that ovarian cancer in the patient is highly correlated with the occupational exposure of asbestos and environmental exposure is a possible cause as well. Social devices are needed to prevent further exposure to asbestos. It is also necessary to recognize that ovarian cancer can occur in workers who have previously been exposed to asbestos, and the education and social compensation for those workers are needed.

Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease's Association with Work

The aim of this research was to identify the differences in the incidence of symptomatic cervical and lumbar disc herniation according to age, sex, and national health insurance eligibility. We evaluated the hospital documents of patients who received medical treatment for symptomatic cervical and lumbar disc herniation between 2004 and 2010 and excluded those who claimed to have expenses at oriental medical clinics or pharmacies. Furthermore, any duplicate documents from the labor force population aged 20⁻69 years were excluded from the analysis. The results showed that the number of individuals diagnosed with symptomatic cervical and lumbar disc herniation increased with age, and the incidence of these diseases was higher in women than in men. Additionally, the incidence differed depending on the subject's qualification for health insurance. The incidence of lumbar disc herniation showed differences depending on the degree of the lumbar burden. The present study findings may help determine whether lumbar disc herniation is associated with tasks performed at the patient's workplace. Further research is needed to classify the risk of lumbar disk herniation in the workplace into detailed categories such as types of business, types of occupation, and lumbar compression force.

Monitoring and Simulating Environmental Asbestos Dispersion from a Textile Factory

Although workplace asbestos concentrations (AC) have been reported several times, the past environmental AC are relatively poorly studied. Due to the harmful effects of the asbestos industry, production has moved from early industrialized countries (Japan), to late industrialized countries (Korea), and finally to industrializing countries (Indonesia). The purpose of this study was to determine current occupational exposure levels and evaluate neighborhood environmental exposure levels in an Indonesian asbestos textile factory through collaboration among three generation of industrialized countries. Asbestos concentrations were measured inside and outside of the factory and compared with simulated data. ACs in the factory were similar to those of 1980s and 1990s levels in the Korean factory that transferred the machines. Environmental ACs were dispersed according to wind direction. There were no significant differences between monitored and simulated data, and correlation coefficients between downwind, upwind, and middle wind directions were high, with some statistical significance. This study can be used to estimate past environmental ACs to understand the causality of asbestos related diseases. Because of the small sample size and specific weather conditions, a large-scale study of various asbestos exposure sources, including asbestos cement factories, shipyards, and mines, and various atmospheric conditions is required.