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"Tiong, M."
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Sex and Gender Differences in Occupational Hazard Exposures: a Scoping Review of the Recent Literature
2021
Purpose of Review
Comparative research on sex and/or gender differences in occupational hazard exposures is necessary for effective work injury and illness prevention strategies. This scoping review summarizes the peer-reviewed literature from 2009 to 2019 on exposure differences to occupational hazards between men and women, across occupations, and within the same occupation.
Recent Findings
Fifty-eight studies retrieved from eight databases met our inclusion criteria. Of these, 30 studies were found on physical hazards, 38 studies on psychological/psychosocial hazards, 5 studies on biological hazards, and 17 studies on chemical hazards. The majority of studies reported that men were exposed to noise, vibration, medical radiation, physically demanding work, solar radiation, falls, biomechanical risks, chemical hazards, and blood contamination; while women were exposed to wet work, bullying and discrimination, work stress, and biological agents. Within the same occupations, men were more likely to be exposed to physical hazards, with the exception of women in health care occupations and exposure to prolonged standing. Women compared to men in the same occupations were more likely to experience harassment, while men compared to women in the same occupations reported higher work stress. Men reported more exposure to hazardous chemicals in the same occupations as women.
Summary
The review suggests that men and women have different exposures to occupational hazards and that these differences are not solely due to a gendered distribution of the labor force by occupation. Findings may inform prevention efforts seeking to reduce gender inequalities in occupational health. Future research is needed to explain the reasons for sex/gender inequality differences in exposures within the same occupation.
Journal Article
Developing carbon-neutral construction materials using wastes as carbon sink
2021
Developing ecofriendly and low-carbon construction materials is essential to meet the ambitious target of global net zero emission by 2050. The concept of using wastes as carbon sink is taking advantage of alkaline solid wastes, which are rich in calcium or magnesium as a medium for absorbing carbon dioxide (CO2), and allowing manufacturing thermodynamically stable carbonate minerals for construction applications. Today, the major practical and successful applications of CO2 in the construction industry are through accelerated carbonation of granulated aggregates and precast concrete blocks manufactured with different proportions of calcium-rich waste materials. CO2 is also used as an activator in speciality nonhydraulic carbonate-binders or directly injected (in a liquid form) into fresh ready-mix concrete to produce a construction material with higher strength and lower carbon footprint. In addition, accelerated carbonation has become a promising approach to improve the quality of crushed concrete waste, and can be reused in new concrete to attain a sustainable concrete life cycle. In this paper, the progress in academic research of using CO2 in wastes and cement-based products as well as the key advantages and limitations related to the large scale application in the construction industry have been discussed in detail.
Journal Article
An approach to enhance the durability and mechanical properties of Class G cement using nano materials
2019
Maintaining the integrity of the cement used to seal off the injection intervals of sequestrations sites is crucial to confine CO2 for thousands of years. There have been many studies to resolve the issue of cement degradation induced in the presence of CO2, but a very limited success has been reported to the application of the approaches proposed so far. Nano materials have gained the attention of many researchers in the past decade and might be able to resolve the issue of cement degradation given their outstanding performance and proven applications in the civil and polymer industries. In this paper, attempts are made to improve the physical and mechanical characteristics of class G cement using nano glass flakes (NGFs) and multiple-walled carbon nanotubes (MWCNTs). To do this, different cement-nanocomposites were prepared using two mixing techniques and their physical and mechanical changes were evaluated under different curing conditions. Samples with cylindrical shape of were prepared and cured under the temperature of 50°C and atmospheric pressure for 1 days. The results obtained indicated both nanoparticles are neutrally stable and may have a very slight effect on the cement rheology but may significantly increase the strength of the cement. It was concluded that the cement with 0.05 wt.% MWCNTs can provide the best results in terms of rheology, compositional changes and compressive strength.
Journal Article
Stability of the NLS Equation with Viscosity Effect
2011
A nonlinear Schrödinger (NLS) equation with an effect of viscosity is derived from a Korteweg-de Vries (KdV) equation modified with viscosity using the method of multiple time scale. It is well known that the plane-wave solution of the NLS equation exhibits modulational instability phenomenon. In this paper, the modulational instability of the plane-wave solution of the NLS equation modified with viscosity is investigated. The corresponding modulational dispersion relation is expressed as a quadratic equation with complex-valued coefficients. By restricting the modulational wavenumber into the case of narrow-banded spectra, it is observed that a type of dissipation, in this case the effect of viscosity, stabilizes the modulational instability, as confirmed by earlier findings.
Journal Article
Thermoregulation and dehydration in children and youth exercising in extreme heat compared with adults
2025
ObjectiveTo compare hyperthermia and physiological dehydration risk during exercise heat stress between children of different ages and adults and evaluate an existing adult sweat rate calculator in children.Methods68 fit and recreationally active children aged 10–16 years (31 girls), and 24 adults aged 18–40 years (11 females) completed three separate 45 min treadmill walking/running trials at different intensities on different days at 30°C, 40% relative humidity (RH) (WARM) or 40°C, 30% RH (HOT). Exposures were randomised to elicit intensities scaled to (1) fitness, (2) mass and (3) surface area. Core (gastrointestinal (Tgi)) temperature was measured continuously and dehydration determined using body mass changes.ResultsExcept for 60% V̇O2peak in WARM, in which adults exhibited a greater Tgi rise compared with 10–13 years, there was no effect of age on Tgi during exercise (p≥0.176). Physiological rates of dehydration were not affected by age in WARM (p≥0.08) or HOT (p≥0.08). Mean predicted sweat rate error was +0.08 kg/hour (95% CIs: −0.10, +0.25) across WARM and HOT, and 80.5% of variability in sweating was explained by the adult sweat rate calculator.ConclusionsUsing the most comprehensive paediatric exercise heat stress dataset from a single study to date, we show that children aged 10–16 years are at a similar risk of hyperthermia and dehydration as adults during exercise up to 40°C. This supports recent changes to paediatric sport heat policies that were based on limited data. Practitioners can potentially reduce behavioural dehydration risks from inadequate fluid consumption using an existing adult sweat rate calculator for children.
Journal Article
Breadth of immune response, immunogenicity, reactogenicity, and safety for a pentavalent meningococcal ABCWY vaccine in healthy adolescents and young adults: results from a phase 3, randomised, controlled observer-blinded trial
2025
A multicomponent meningococcal serogroups ABCWY vaccine (MenABCWY) could provide broad protection against disease-causing meningococcal strains and simplify the immunisation schedule. The aim of this trial was to confirm the effect of the licensed meningococcal serogroup B (MenB) vaccine, 4CMenB, against diverse MenB strains, and to assess the breadth of immune response against a panel of 110 MenB strains for MenABCWY containing the antigenic components of 4CMenB and licensed serogroups ACWY vaccine, MenACWY-CRM, the non-inferiority of the immune response with MenABCWY versus 4CMenB and MenACWY-CRM, safety, and MenABCWY lot-to-lot consistency.
We conducted a phase 3 randomised, controlled, observer-blinded trial of healthy adolescents and young adults (age 10–25 years) across 114 centres in Australia, Canada, Czechia, Estonia, Finland, Türkiye, and the USA. Exclusion criteria included previous vaccination with a MenB vaccine or (within the last 4 years) MenACWY vaccine. Participants were randomly allocated (5:5:3:3:3:1 ratio) via a central randomisation system using a minimisation procedure to receive 4CMenB at months 0, 2, and 6 (referred to as 4CMenB 0–2–6 hereafter); or 4CMenB at months 0 and 6 (referred to as 4CMenB 0–6 hereafter); or MenABCWY (three groups, each receiving one production lot of the MenACWY-CRM component) at months 0 and 6; or MenACWY-CRM at month 0. Demonstration in the per-protocol set of the consistency of three MenACWY-CRM component lots of the MenABCWY vaccine was a primary objective (demonstrated with two-sided 95% CIs for the ratio of human serum bactericidal antibody [hSBA] geometric mean titres against each serogroup within predefined criteria [0·5–2·0]). The primary endpoints (breadth of immune response) for the MenB component of MenABCWY and 4CMenB were measured using the endogenous complement hSBA (enc-hSBA) assay against a panel of 110 diverse MenB invasive disease strains. For each serum sample, 35 strains from the 110 MenB strain panel were randomly selected for testing. The 4CMenB breadth of immune response data have been published separately. For MenABCWY, breadth of immune response was assessed in two analyses: a test-based analysis of the percentage of samples (tests) without bactericidal serum activity against MenB strains 1 month after two MenABCWY doses versus the percentage after one MenACWY-CRM dose in the per-protocol set, and a responder-based analysis of the percentage of participants (responders) whose sera killed 70% or more strains at 1 month after two MenABCWY doses in the full analysis set. A lower limit of two-sided 95% CI above 65% would demonstrate breadth of immune response. Other primary outcomes included non-inferiority (5% margin) of two MenABCWY doses versus two 4CMenB doses by enc-hSBA assay in the per-protocol set, non-inferiority (10% margin) of two MenABCWY doses versus one MenACWY-CRM dose in MenACWY vaccine-naive participants by traditional hSBA assay in the per-protocol set, and safety in all vaccinated participants. This trial is registered with ClinicalTrials.gov, NCT04502693, and is complete.
Between Aug 14, 2020, and Sept 3, 2021, 3651 participants were enrolled and randomly allocated (900 in the 4CMenB 0–2–6 group and 908 in the 4CMenB 0–6 group, 1666 in the three MenABCWY groups combined, and 177 in the MenACWY-CRM group). All primary objectives for MenABCWY were met. Consistency of immune responses against the three production lots of the MenACWY component of MenABCWY was demonstrated since two-sided 95% CIs for the ratios of hSBA geometric mean titres against serogroups A, C, W, and Y for each pair of lots were within the predefined equivalence criteria. The lot data were pooled for the remainder of MenABCWY endpoints. By enc-hSBA assay, breadth of immune response against the MenB strain panel was 77·9% (95% CI 76·6 to 79·2) in the test-based analysis and 84·1% (81·4 to 86·5; 687 of 817 participants) in the responder-based analysis. Non-inferiority of MenABCWY to 4CMenB was demonstrated by enc-hSBA assay: the difference in percentage of samples with bactericidal serum activity between the MenABCWY group (82·5% [95% CI 82·1 to 83·0]; 21 222 of 25 715) and 4CMenB 0–2 group (83·1% [82·7 to 83·6]; 22 921 of 27 569) was –0·61% (–1·25 to 0·03). Non-inferiority of two-dose MenABCWY to one-dose MenACWY-CRM was demonstrated by traditional hSBA assay, with differences between the MenABCWY group and MenACWY group in percentages of participants with a four-fold rise in hSBA titres of 11·3% (5·9 to 19·0) for serogroup A, 47·2% (38·1 to 56·3) for serogroup C, 35·3% (26·9 to 44·5) for serogroup W, and 27·0% (19·4 to 35·8) for serogroup Y. MenABCWY reactogenicity was mostly of mild or moderate severity and transient, with similar frequencies of adverse events in the MenABCWY and 4CMenB groups and no safety concerns were identified.
This study demonstrates breadth of immune response against a panel of 110 MenB strains for the MenB component of the investigational MenABCWY vaccine, when administered as a 0–6 months schedule to the target population of adolescents and young adults, with predefined criteria for success met for both breadth of immune response endpoints and for non-inferiority versus 4CMenB. This investigational vaccine could provide broad meningococcal serogroup coverage in a simplified immunisation schedule, thus aiding the public health attempt in preventing invasive meningococcal disease due to five Neisseria meningitidis serogroups in adolescents and young adults.
GSK.
Journal Article
Meta-Analysis of the Prognostic Impact of Anemia in Patients Undergoing Percutaneous Coronary Intervention
by
Andreou, Andreas Y.
,
Pradhan, Ashish
,
Myint, Phyo K.
in
Acute coronary syndromes
,
Anemia
,
Anemia - epidemiology
2016
Anemia is common in patients undergoing percutaneous coronary intervention (PCI), and current guidelines fail to offer recommendations for its management. This review aims to examine the relation between baseline anemia and mortality, major adverse cardiovascular events (MACE), and major bleeding in patients undergoing PCI. We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse outcomes in anemic and nonanemic patients who underwent PCI. Data were collected on study design, participant characteristics, definition of anemia, follow-up, and adverse outcomes. Random effects meta-analysis of risk ratios was performed using inverse variance method. A total of 44 studies were included in the review with 230,795 participants. The prevalence of baseline anemia was 26,514 of 170,914 (16%). There was an elevated risk of mortality and MACE with anemia compared with no anemia-pooled risk ratio (RR) 2.39 (2.02 to 2.83), p <0.001 and RR 1.51 (1.34 to 1.71), p <0.001, respectively. The risk of myocardial infarction and bleeding with anemia compared with no anemia was elevated, pooled RR 1.33 (1.07 to 1.65), p = 0.01 and RR 1.97 (1.03 to 3.77), p <0.001, respectively. The risk of mortality per unit incremental decrease in hemoglobin (g/dl) was RR 1.19 (1.09 to 1.30), p <0.001 and the risk of mortality, MACE, and reinfarction per 1 unit incremental decrease in hematocrit (%) was RR 1.07 (1.05 to 1.10), p = 0.04, RR 1.09 (1.08 to 1.10) and RR 1.06 (1.03 to 1.10), respectively. The prevalence of anemia in contemporary cohorts of patients undergoing PCI is significant and is associated with significant increases in postprocedural mortality, MACE, reinfarction, and bleeding. The optimal strategy for the management of anemia in such patients remains uncertain.
Journal Article
Complete versus culprit lesion-only revascularisation for acute myocardial infarction (Complete Revascularisation Trialists' Collaboration): an individual patient data meta-analysis of randomised trials
by
Ramasundarahettige, Chinthanie
,
Mehta, Shamir R
,
Böhm, Felix
in
Aged
,
Angioplasty
,
Cardiovascular disease
2025
In patients presenting with acute coronary syndromes and multivessel coronary artery disease, the question of whether to undertake a strategy of complete revascularisation in cases in which percutaneous coronary intervention (PCI) is performed routinely on non-culprit lesions (in addition to the culprit lesion) or whether to restrict PCI only to the culprit lesion is a common dilemma. The Complete Revascularisation Trialists' Collaboration aimed to determine, based on the totality of data from randomised trials, the effect of a complete revascularisation strategy on major cardiovascular events and whether it reduces cardiovascular death.
In this individual patient data meta-analysis, trials were included if they enrolled at least 250 patients, compared a complete revascularisation strategy (with PCI) to a culprit lesion-only PCI strategy, and enrolled patients presenting with acute ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction. To ensure that no trials were overlooked, we searched Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomised controlled trials published between 1996 and Sept 15, 2025. The primary outcomes were the composite of cardiovascular death or new myocardial infarction and cardiovascular death alone. Hierarchical testing of cardiovascular death alone was planned contingent on reduction in cardiovascular death or new myocardial infarction based on the prespecified alpha level of 0·04. A one-stage individual patient data meta-analysis was performed using a Cox frailty model. All-cause death was the secondary outcome; non-cardiovascular death and new myocardial infarction were additional outcomes. All analyses included all randomly assigned patients. The meta-analysis was registered in PROSPERO, CRD420251124098.
Six randomised controlled trials involving 8836 individuals were included. The median age was 65·8 years (IQR 57·0–76·0), and 2088 (23·6%) patients were female and 6748 (76·4%) were male. Overall, 7768 (87·9%) patients presented with ST-segment elevation myocardial infarction and 1068 (12·1%) with non-ST-segment elevation myocardial infarction. At a median follow-up of 36·0 months (IQR 30·6–48·0), cardiovascular death or new myocardial infarction occurred in 382 (9·0%) of 4259 patients in the complete revascularisation group compared with 528 (11·5%) of 4577 patients in the culprit lesion-only group (hazard ratio [HR] 0·76 [95% CI 0·67–0·87], p<0·0001). There were 155 (3·6%) cardiovascular deaths in the complete revascularisation group compared with 209 (4·6%) in the culprit lesion-only group (HR 0·76 [95% CI 0·62–0·93], p=0·0091). All-cause death occurred in 308 (7·2%) patients in the complete revascularisation group compared with 370 (8·1%) patients in the culprit lesion-only group (HR 0·85 [95% CI 0·73–0·99], p=0·039). Non-cardiovascular death was similar between the groups (153 [3·6%] in the complete revascularisation group vs 161 [3·5%] in the culprit lesion-only group; HR 0·98 [95% CI 0·78–1·22], p=0·85). Complete revascularisation reduced new myocardial infarctions compared with culprit lesion-only PCI (255 [6·0%] vs 357 [7·8%]; HR 0·76 [95% CI 0·65–0·90], p=0·0011).
In patients presenting with acute myocardial infarction and multivessel disease, complete revascularisation reduced the composite of cardiovascular death or new myocardial infarction as well as cardiovascular death alone compared with a culprit lesion-only PCI strategy. In addition, all-cause death was lower with complete revascularisation. These data provide the strongest and most robust evidence to date that complete revascularisation improves important cardiovascular clinical outcomes.
None.
Journal Article
Stability of the NLS equation with viscosity effect
2018
A nonlinear Schr\"{o}dinger (NLS) equation with an effect of viscosity is derived from a Korteweg-de Vries (KdV) equation modified with viscosity using the method of multiple time-scales. It is well known that the plane-wave solution of the NLS equation exhibits modulational instability phenomenon. In this paper, the modulational instability of the plane-wave solution of the NLS equation modified with viscosity is investigated. The corresponding modulational dispersion relation is expressed as a quadratic equation with complex-valued coefficients. By restricting the modulational wavenumber into the case of narrow-banded spectra, it is observed that a type of dissipation, in this case, the effect of viscosity, stabilizes the modulational instability, as confirmed by earlier findings.
Stability of the NLS Equation with Viscosity Effect
by
Tiong, K. M.
,
Karjanto, N.
2011
A nonlinear Schrödinger (NLS) equation with an effect of viscosity is derived from a Korteweg-de Vries (KdV) equation modified with viscosity using the method of multiple time scale. It is well known that the plane-wave solution of the NLS equation exhibits modulational instability phenomenon. In this paper, the modulational instability of the plane-wave solution of the NLS equation modified with viscosity is investigated. The corresponding modulational dispersion relation is expressed as a quadratic equation with complex-valued coefficients. By restricting the modulational wavenumber into the case of narrow-banded spectra, it is observed that a type of dissipation, in this case the effect of viscosity, stabilizes the modulational instability, as confirmed by earlier findings.
Journal Article