Evaluation of the COSHH Essentials Model with a Mixture of Organic Chemicals at a Medium-Sized Paint Producer

The Control of Substances Hazardous to Health (COSHH) Essentials model was evaluated using full-shift exposure measurements of five chemical components in a mixture [acetone, ethylbenzene, methyl ethyl ketone, toluene, and xylenes] at a medium-sized plant producing paint materials. Two tasks, batch-making and bucket-washing, were examined. Varying levels of control were already established in both tasks and the average exposures of individual chemicals were considerably lower than the regulatory and advisory 8-h standards. The average exposure fractions using the additive mixture formula were also less than unity (batch-making: 0.25, bucket-washing: 0.56) indicating the mixture of chemicals did not exceed the combined occupational exposure limit (OEL). The paper version of the COSHH Essentials model was used to calculate a predicted exposure range (PER) for each chemical according to different levels of control. The estimated PERs of the tested chemicals for both tasks did not show consistent agreement with exposure measurements when the comparison was made for each control method and this is believed to be because of the considerably different volatilities of the chemicals. Given the combination of health hazard and exposure potential components, the COSHH Essentials model recommended a control approach ‘special advice’ for both tasks, based on the potential reproductive hazard ascribed to toluene. This would not have been the same conclusion if some other chemical had been substituted (for example styrene, which has the same threshold limit value as toluene). Nevertheless, it was special advice, which had led to the combination of hygienic procedures in place at this plant. The probability of the combined exposure fractions exceeding unity was 0.0002 for the batch-making task indicating that the employees performing this task were most likely well protected below the OELs. Although the employees involved in the bucket-washing task had greater potential to exceed the threshold limit value of the mixture (P > 1 = 0.2375), the expected personal exposure after adjusting for the assigned protection factor for the respirators in use would be considerably lower (P > 1 = 0.0161). Thus, our findings suggested that the COSHH essentials model worked reasonably well for the volatile organic chemicals at the plant. However, it was difficult to override the reproductive hazard even though it was meant to be possible in principle. Further, it became apparent that an input of existing controls, which is not possible in the web-based model, may have allowed the model be more widely applicable. The experience of using the web-based COSHH Essentials model generated some suggestions to provide a more user-friendly tool to the model users who do not have expertise in occupational hygiene

Renal transplantation in a patient with Bartter syndrome and glomerulosclerosis

Bartter syndrome (BS) is a clinically and genetically heterogeneous inherited renal tube disorder characterized by renal salt wasting, hypokalemic metabolic alkalosis and normotensive hyperreninemic hyperaldosteronism. There have been several case reports of BS complicated by focal segmental glomerulosclerosis (FSGS). Here, we have reported the case of a BS patient who developed FSGS and subsequent end-stage renal disease (ESRD) and provided a brief literature review. The patient presented with classic BS at 3 months of age and developed proteinuria at 7 years. Renal biopsy performed at 11 years of age revealed a FSGS perihilar variant. Hemodialysis was initiated at 11 years of age, and kidney transplantation was performed at 16 years of age. The post-transplantation course has been uneventful for more than 3 years with complete disappearance of BS without the recurrence of FSGS. Genetic study revealed a homozygous p.Trp(TGG)610Stop(TGA) mutation in the CLCNKB gene. In summary, BS may be complicated by secondary FSGS due to the adaptive response to chronic salt-losing nephropathy, and FSGS may progress to ESRD in some patients. Renal transplantation in patients with BS and ESRD results in complete remission of BS

Long-term outcome of Bartter syndrome in 54 patients: A multicenter study in Korea

IntroductionBartter syndrome (BS) is a rare salt-wasting tubulopathy caused by mutations in genes encoding sodium, potassium, or chloride transporters of the thick ascending limb of the loop of Henle and/or the distal convoluted tubule of the kidney. BS is characterized by polyuria, failure to thrive, hypokalemia, metabolic alkalosis, hyperreninemia, and hyperaldosteronism. Potassium and/or sodium supplements, potassium-sparing diuretics, and nonsteroidal anti-inflammatory drugs can be used to treat BS. While its symptoms and initial management are relatively well known, long-term outcomes and treatments are scarce.MethodsWe retrospectively reviewed 54 Korean patients who were clinically or genetically diagnosed with BS from seven centers in Korea.ResultsAll patients included in this study were clinically or genetically diagnosed with BS at a median age of 5 (range, 0–271) months, and their median follow-up was 8 (range, 0.5–27) years. Genetic diagnosis of BS was confirmed in 39 patients: 4 had SLC12A1 gene mutations, 1 had KCNJ1 gene mutations, 33 had CLCNKB gene mutations, and 1 had BSND mutation. Potassium chloride supplements and potassium-sparing diuretics were administered in 94% and 68% of patients, respectively. The mean dosage of potassium chloride supplements was 5.0 and 2.1 mEq/day/kg for patients younger and older than 18 years, respectively. Nephrocalcinosis was a common finding of BS, and it also improved with age in some patients. At the last follow-up of 8 years after the initial diagnosis, 41% had short stature (height less than 3rd percentile) and impaired kidney function was observed in six patients [chronic kidney disease (CKD) G3, n = 4; CKD G5, n = 2].ConclusionBS patients require a large amount of potassium supplementation along with potassium-sparing agents throughout their lives, but tend to improve with age. Despite management, a significant portion of this population exhibited growth impairment, while 11% developed CKD G3–G5

South Koreas Soft Power in the Era of the Covid-19 Pandemic: An Analysis of the Expert Survey in Europe

Since the recent outbreak of the Covid-19, South Korea hasdemonstrated successful pandemic management that can beexemplary to other countries. This paper analyzes how SouthKoreas responses to the Covid-19 pandemic has changed theperceptions of the country in Europe. Through a survey conducted with Korea experts in 16 European countries, this paper documents the positive recognition of South Koreas pandemic management by the European public. Part of the positive appraisal can be attributed to South Koreas extensive testing, high technology, and the culture of wearing a face mask, while the opinions were more mixedregarding its comprehensive tracking and tracing strategy due to privacy concerns. Furthermore, the findings of the survey show that Europeans overall perception of South Korea has improved together with its Covid-19 management. This evidence suggests that thecountrys success in pandemic management can be an instrumentof public diplomacy to enhance its soft power, for which thegovernment of South Korea currently invests considerable efforts.We are grateful to the KDI School of Public Policy and Management for providing financial support. We also thank the Korea experts who participated in the survey

Diseño e implementación de un sistema RFID para seguimiento de personas dependientes en el hogar

Este Trabajo Final de Grado se basa en el estudio, diseño, montaje y evaluación de un sistema RFID (Radio Frequency IDentification) para el posicionamiento de personas dependientes dentro de edificios, a fin de proporcionar un servicio a sus habitantes. El primer paso es entender lo que son los sistemas RFID y estudiar casos de uso existentes. Después, se estudia el funcionamiento de los lectores RFID disponibles y las etiquetas (Tags) a rastrear; seguidamente se aprende a configurarlos y se diseña e implementa un programa que pueda establecer una comunicación con los equipos y gestionar los cálculos necesarios lo suficientemente rápido como para realizar un rastreo en tiempo real. Una vez conseguido esto, se busca el método de cálculo de distancias y de coordenadas lo más exacto posible y se corrigen los errores alcanzando la precisión necesaria. Para ello, se realizan continuamente pruebas de rastreo y posicionamiento tanto estáticos como en movimiento.In this final project a RFID (Radio Frequency IDentification) system is studied, designed, implemented and evaluated. The system aims to track and position dependent people in buildings, in order to provide different services to its inhabitants. Firstly, it is needed to understand what RFID systems are, and study real-life use cases. Later, the operation and configuration of the available RFID readers and tags is studied. Once this is accomplished, a computer program is designed and implemented. This computer program must communicate with the RFID equipment and perform the calculations fast enough so that it is possible to track items in real time. Afterwards, errors are corrected and the best formulas for calculating distances and coordinates are found, in order to facilitate the required results and precision. Throughout the process, the system is continuously tested with static and moving tracking and positioning.Catalá Adrama, L. (2015). Diseño e implementación de un sistema RFID para seguimiento de personas dependientes en el hogar. Universitat Politècnica de València. http://hdl.handle.net/10251/55170TFG

Lingual Squamous Cell Carcinoma Surrounded by Granular Cell Tumor

The granular cell tumor (GCT) is an uncommon, benign lesion with a preference for subcutaneous sites. In the head and neck, the tongue is the most common site, followed by the larynx. We experienced a case of a 27-year-old woman with lingual squamous cell carcinoma (SCC) surrounded by GCT. The pathological findings established that the lesion was SCC covered by GCT in the midline of the tongue. The size of the mass was very small, however, so we excised it in a diamond shape. There is an interesting association between GCTs and other malignant neoplasms. However, no causal relationship between GCT and these other carcinomas has been established. Here we report on an SCC coexisting with GCT at the same site as a median tongue lesion and review the literature

Interstitial deletion of 5q33.3q35.1 in a boy with severe mental retardation

Constitutional interstitial deletions of the long arm of chromosome 5 (5q) are quite rare, and the corresponding phenotype is not yet clearly delineated. Severe mental retardation has been described in most patients who present 5q deletions. Specifically, the interstitial deletion of chromosome 5q33.3q35.1, an extremely rare chromosomal aberration, is characterized by mental retardation, developmental delay, and facial dysmorphism. Although the severity of mental retardation varies across cases, it is the most common feature described in patients who present the 5q33.3q35.1 deletion. Here, we report a case of a de novo deletion of 5q33.3q35.1, 46,XY,del(5)(q33.3q35.1) in an 11-year-old boy with mental retardation; to the best of our knowledge this is the first case in Korea to be reported. He was diagnosed with severe mental retardation, developmental delay, facial dysmorphisms, dental anomalies, and epilepsy. Chromosomal microarray analysis using the comparative genomic hybridization array method revealed a 16-Mb-long deletion of 5q33. 3q35.1(156,409,412-172,584,708)x1. Understanding this deletion may help draw a rough phenotypic map of 5q and correlate the phenotypes with specific chromosomal regions. The 5q33.3q35.1 deletion is a rare condition; however, accurate diagnosis of the associated mental retardation is important to ensure proper genetic counseling and to guide patients as part of long-term management

A Patient With Dysphagia due to an Aortic Aneurysm

Dysphagia aortica is difficulty in swallowing caused by extrinsic compression of the esophagus due to an ectatic, tortuous, or aneurysmatic atherosclerotic thoracic aorta. This condition is very uncommon, and it is usually associated with old age, women with short stature, hypertension, and kyphosis. We report herein a case involving a patient with dysphagia who had an aortic aneurysm