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Optimization of Microalgae-Based Biodiesel Supply Chain Network Under the Uncertainty in Supplying Carbon Dioxide (이산화탄소 원료 공급의 불확실성을 고려한 미세조류 기반 바이오 디젤 공급 네트워크 최적화)

  • Ahn, Yuchan;Kim, Junghwan;Han, Jeehoon
    • Korean Chemical Engineering Research
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    • v.58 no.3
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    • pp.396-407
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    • 2020
  • As fossil fuels are depleted worldwide, alternative resources is required to replace fossil fuels, and biofuels are in the spotlight as alternative resources. Biofuels are produced from biomass, which is a renewable resource to produce biofuels or bio-chemicals. Especially, in order to substitute fossil fuels, the research focusing the biofuel (biodiesel) production based on CO2 and biomass achieves more attention recently. To produce biomass-based biodiesel, the development of a supply chain network is required considering the amounts of feedstocks (ex, CO2 and water) required producing biodiesel, potential locations and capacities of bio-refineries, and transportations of biodiesel produced at biorefineries to demand cities. Although many studies of the biomass-based biodiesel supply chain network are performed, there are few types of research handled the uncertainty in CO2 supply which influences the optimal strategies of microalgae-based biodiesel production. Because CO2, which is used in the production of microalgae-based biodiesel as one of important resources, is captured from the off-gases emitted in power plants, the uncertainty in CO2 supply from power plants has big impacts on the optimal configuration of the biodiesel supply chain network. Therefore, in this study, to handle those issues, we develop the two-stage stochastic model to determine the optimal strategies of the biodiesel supply chain network considering the uncertainty in CO2 supply. The goal of the proposed model is to minimize the expected total cost of the biodiesel supply chain network considering the uncertain CO2 supply as well as satisfy diesel demands at each city. This model conducted a case study satisfying 10% diesel demand in the Republic of Korea. The overall cost of the stochastic model (US$ 12.9/gallon·y) is slightly higher (23%) than that of the deterministic model (US$ 10.5/gallon·y). Fluctuations in CO2 supply (stochastic model) had a significant impact on the optimal strategies of the biodiesel supply network.

A Study Consequence Management System of the Terrorism (테러리즘의 대응관리체제에 관한 고찰 - "9. 11 테러"를 중심으로 -)

  • Kim, Yi-Soo;Ahn, Byung-Soo;Han, Nam-Soo
    • Korean Security Journal
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    • no.7
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    • pp.95-124
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    • 2004
  • It can be said that 'the September 11th Terrorist Attacks' in 2001 were not only the indiscriminate attacks on innocent people but also the whole - political, economical and military - attacks on human life. Also, 'the September 11th Terrorist Attacks' can be regarded as the significant events in the history of world, which were on the peak of the super-terrorism or new-terrorism that had emerged from the 1980s. However, if one would have analysed the developments of terrorism from the 1970s, they could have been foreknown without difficulty. The finding from this study can be summarized as the followings, First, in spite that the USA responsive system against terrorism had been assessed as perfect before 'the September 11th Terrorist Attacks', the fragilities were found in the aspects of the response on the new-terrorism or super-terrorism. The previous responsive system before 'the September 11th Terrorist Attacks' had the following defects as the followings: (1) it was impossible to establish the integrated strategy, because the organizations related to the response against terrorism had not integrated; (2) there were some weakness to collect and diffuse the informations related to terrorism; (3) the security system for the domestic airline service in USA and the responsive system of air defense against terrors on aircraft were very fragile. For these reasons, USA government established the 'Department of Homeland Security' of which the President is the head so that the many organizations related to terrorism were integrated into a single management system. And, it legislated a new act to protect security from terrors, which legalized of the wiretapping in spite of the risk of encroachment upon personal rights, increased the jail terms upon terrorists, froze the bank related to terrorist organization, and could censor e-mails. Second, it seem that Korean responsive system against terrors more fragile than that of USA. One of the reasons is that people have some perception that Korea is a safe zone from terrors, because there were little attacks from international terrorists in Korea. This can be found from the fact that the legal arrangement against terrorism is only the President's instruction No. 47. Under this responsive system against terrorism dependent on only the President's instruction, it is expected that there would be a poor response against terrors due to the lack of unified and integrated responsive agency as like the case of USA before 'the September 11th Terrorist Attacks'. And, where there is no legal countermeasure, it is impossible to expect the binding force on the outside of administrative agencies and the performances to prevent and hinder the terrorist actions can not but be limited. That is to say, the current responsive system can not counteract effectively against the new-terrorism and super-terrorism. Third, although there were some changes in Korean government's policies against terrorism. there still are problems. One of the most important problems is that the new responsive system against terrorism in Korea, different from that of USA, is not a permanent agency but a meeting body that is organized by a commission. This commission is controled by the Prime Minister and the substantial tasks are under the National Intelligence Service. Under this configuration, there can be the lack of strong leadership and control. Additionally, because there is no statute to response against terrorism, it is impossible to prevent and counteract effectively against terrorism. The above summarized suggests that, because the contemporary super-terrorism or new-terrorism makes numerous casualties of unspecified persons and enormous nationwide damages, the thorough prevention against terrorism is the most important challenge, and that the full range of legal and institutional arrangements for the ex post counteraction should be established. In order to do so, it is necessary for the government to make legal and institutional arrangements such as the permanent agency for protection from terrorism in which the related departments cooperates with together and the development of efficient anti-terror programs, and to show its willingness and ability that it can counteract upon any type of domestic and foreign terrorism so that obtain the active supports and confidence from citizens.

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Effects of Soil Improvement on the Dependence of Rice Nutrient Contents and Grain Quality (논토양개량이 벼의 양분함량과 쌀 품질과의 관계)

  • Kim, Chang-Bae;Lee, Dong-Hun;Choi, Jyung
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.5
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    • pp.296-305
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    • 2002
  • Rice yield and grain guality were investigated with treatments of silicate fertilizer, straw compost and NPK fertilizer in the paddy soil of silty clay loam from 1975 to 2001. Rice yield of the treatments of silicate fertilizer. $1,500kg\;ha^{-1}$ and straw compost $10,00kg\;ha^{-1}$ were increased by 15%, 10%, respectively, for 27years average yield in comparison with NPK plot. In the plots of NPK+silicate fertilizer $1,500kg\;ha^{-1}$, NPK+silicate fertilizer $2,500kg\;ha^{-1}$, taste value(Toyo instrument) of cooked rice and quality assessment were higher than those in NPK control plot and NPK+straw compost $10,000kg\;ha^{-1}$ plot, but the contents of crude protein, amylose of milled rice grain were lower than those in other treated plots. Nitrogen and phosphorous contents of rice plant were lower, but $SiO_2$ content were higher in the treatment of silicate ferti lizer 1,500, $2,500kg\;ha^{-1}$ than straw compost $10,000kg\;ha^{-1}$ plot. Rice quality assessment was positively correlated with taste value, but it was negatively correlated with crude protein and amylose content of milled rice grain. Ratios of Mg/N, $Mg/N{\cdot}K_2O$, $SiO_2/N$, $SiO_2/P_2O_5$ and $SiO_2/K_2O$ were positively correlated with taste value and quality assessment of rice grain, but negatively correlated with crude protein, amylose and fatty acid content. In soil chemical characteristics related with rice quality after experiment in 2001, soil pH and $SiO_2$ content were positively correlated with taste value and quality assessment of rice grain, but contents of soil $P_2O_5$, ex-K were negatively correlated with them.

The comparative study of anti-allergic and anti-inflammatory effects by fermented red ginseng and red ginseng (홍삼과 발효홍삼의 항염증 작용 및 항알러지 효과 비교)

  • Park, Hye-Jin;Jung, Da-Hye;Joo, Hae-Mi;Kang, Nam-Sung;Jang, Seon-A;Lee, Jae-Geun;Sohn, Eun-Hwa
    • Korean Journal of Plant Resources
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    • v.23 no.5
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    • pp.415-422
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    • 2010
  • Red ginseng(RG, steamed and dried root of Panax ginseng C. A. Meyer, family Araliaceae) and fermented red ginseng(FRG, fermented red ginseng by yeast and lactic acid bacteria) are known to show different pharmacological effects by changed composition of saponins through fermentation. We examined the effects of RG and FRG on $\beta$-hexosaminidase secretion, ICAM-1 expression, the mitogen-induced proliferation of lymphocyte from mice in ex vivo systems and HaCaT cell(keratinocyte) proliferation to compare the anti-allergic and anti-inflammatory effects between both groups. RG groups showed inhibition of $\beta$-hexosaminidase secretion and ICAM-1 expression at $1{\mu}g/ml$, $10{\mu}g/ml$ and the same effects were observed at all concentrations in FRG groups. In our study, RG increased LPS-induced B cell proliferation at $1{\mu}g/ml$ and ConA-induced B cell proliferation at $100\;{\mu}g/ml$ but FRG decreased LPS- and ConA-induced lymphocytes at $100\;{\mu}g/ml$. We showed that FRG increased the proliferation of HaCaT at 1, $10{\mu}g/ml$ but not by RG. These findings suggest that RG and FRG might have anti-inflammatory and anti-allergic effects, which can be needed to proper clinical concentration to applied to various allergic diseases and inflammation.

Antithrombotic Activities of Cheongkookjang and Cheongkookjang Fermented with Green Tea or Mugwort (청국장 및 녹차, 쑥이 첨가된 청국장의 항혈전 활성)

  • Lee, Kyung-Ae;Jang, Jeong-Oak;Yoon, Hye-Kyung;Kim, Moo-Sung
    • Korean Journal of Microbiology
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    • v.43 no.4
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    • pp.298-303
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    • 2007
  • Antithrombotic activities of water extract of cheongkookjang and cheongkookjang fermented with green tea or mugwort were evaluated on some antithrombosis related activities in vitro and thrombotic death inhibition in vivo. Cheongkookjang made of white soybean (Glycine max) or black small soybean (Rhynchosia nulubilis) showed potent antioxidative activities. Addition of green tea or mugwort during cheongkookjang fermentation increased the antioxidative activity, cheongkookjang with green tea showed more drastic increase compared with cheongkookjang with mugwort. Nitrite scavenging effects of the cheongkookjang extracts were prominent but the addition of green tea or mugwort seldom increased the scavenging effects. All the cheongkookjang extracts showed strong inhibitory activities on platelet aggregation. The inhibitory activities of cheongkookjang were increased considerably by addition of green tea or mugwort even with low concentration. Plasmin unit as fibrinolytic activity was not affected considerably by addition of green tea. Addition of mugwort decreased the activity transiently at low concentration ($0.3{\sim}1.0%$) but increased again slowly at higher concentration ($1{\sim}3%$). In vitro thrombotic death inhibition test, the antithrombotic activity of cheongkookjang made of black small bean with green tea was higher by about 1.5 times compared to that without green tea. As results, cheongkookjang might inhibit antithrombosis not only by fibrinolytic action but also by inhibition of platelet aggregation and antioxidative action. The addition of functional materials such as green tea or mugwort could increase the antithrombotic function, even at low concentration.

Evaluation of Food Intake and Diet Quality in High School Students (고등학생의 식품섭취 실태 및 식사의 질 평가)

  • Kim Bok-Ran;Kim Young-Mi
    • Journal of Korean Home Economics Education Association
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    • v.17 no.3 s.37
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    • pp.83-96
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    • 2005
  • To assess the food intake and diet quality of high school students who live in Chuncheon area, a dietary survey using 24-hour recall method was conducted with 318 subjects. $71.4\%$ of total food intake was in the form of plant foods and the rest on the form of animal food. Diet quality was assessed by food group pattern, dietary diversity score(DDS), and dietary variety score(DVS). When counting the major food groups consumed, $37.1\%$ of subjects had a DDS of 3 and $48.4\%$ of subjects had a DDS of 4. When investigating the consumption pattern of the major five food groups, only $14.5\%$ of subjects consumed foods from all five groups. On average, subjects habitually consumed 26.7 different foods daily, with the mean score of diet variety for males (27.3) being significantly higher than for females (25.8) . Correlation coefficients between nutrient adequacy ratio (NAR) and DVS ranged from r=0.39 for vitamin $B_2$ to r=0.61 for phosphorus. NAR also improved as the number or foods or rna groups consumed increased (p<0.001). Associations between the NAR and high level of DVS was more positive than those between the NAR with DDS. When assessing the dietary quality of subjects using DDS and DVS, many people appeared not to have a desirable food intake. Therefore, to lead them to have nutritionally balanced diet, educating students and their parents on nutrients and suggesting guidelines for a desirable diet is considered to be essential so that they can intake from all of major food group and have various foods in their diet.

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The Great Depression in High School Social Science Textbooks : Critiques and Suggestions (대공황에 대한 고등학교 사회과 교과서 서술의 문제점과 개선방안)

  • Kim, Duol
    • KDI Journal of Economic Policy
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    • v.30 no.1
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    • pp.171-209
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    • 2008
  • The Great Depression is one of the most important economic incidents in the twentieth century. A significant and long-lasting impact of this event is the rise of the government intervention to the economy. Under the catastrophic downturn of the economic condition worldwide, people required their government to play an active role for economic recovery, and this $mentalit{\acute{e}}$ prolonged even after the Second World War. Social science textbooks taught at Korean high schools mostly referred to the Great Depression for explaining the reason of government intervention in economy. However, the mainstream view commonly found in the textbooks provides a misleading theological interpretation. It argues that inherent flaws of the market economy causes over-production/under-consumption, and that this mismatch ends up with economic crisis. The chaotic situation was resolved by substitution of the governments for the market, and the New Deal was introduced as the monumental example ('laissez-faire economy ${\rightarrow}$over-production${\rightarrow}$the Great Depression${\rightarrow}$government intervention${\rightarrow}$economic recovery'). Based on economic historians' researches for past three decades, I argue that this mainstream view commits the fallacy of ex-post justification. Unlike what the mainstream view claims, the Great Depression was neither the result of the 'market failure', nor the recovery from the Great Depression but was due to successful government policies. For substantiating this claim, I suggest three points. First, blaming the weakness or instability of the market economy as the cause of the Great Depression is groundless. Unlike what the textbooks describe, the rise of the U.S. stock price during the 1920s cannot be said as a bubble, and there was no sign of under-consumption during the 1920s. On the contrary, a new consensus emerging from the 1980s among economic historians illustrates that the Great Depression was originated from 'the government failure' rather than from the 'market failure'. Policymakers of European countries tried to return to the gold standard regime before the First World War, but discrepancies between this policy and the reality made the world economy vulnerable. Second, the mainstream view identifies the New Deal as Keynesian interventionism and glorifies it for saving the U.S. economy from the crisis. However, this argument is not true. The New Deal was not Keynesian at all. What the U.S. government actually tried was not macroeconomic stabilization but price and quantity control. In addition, New Deal did not brought about economic recovery that people generally believe. Even after the New Deal, industrial production or employment level remained quite low until the late 1930s. Lastly, studies on individual New Deal policies show that they did not work as they were intended. For example, the National Industrial Recovery Act increased unemployment, and the Agricultural Adjustment Act expelled tenants from their land. Third, the mainstream view characterizes the economic order before the Great Depression as laissez-faire, and it tends to attribute all the vice during the Industrial Revolution era to the uncontrolled market economy. However, historical studies show that various economic and social problems of the Industrial Revolution period such as inequality problems, child labor, or environmental problems cannot be simply ascribed to the problems of the market economy. In conclusion, the remedy for all these problems in high school textbooks is not to use the Great Depression as an example showing the weakness of the market economy. The Great Depression should be introduced simply as a historical momentum that had initiated the growth of government intervention. This reform of high school textbooks is imperative for enhancing the right understanding of economy and history.

Technical Efficiency in Korea: Interindustry Determinants and Dynamic Stability (기술적(技術的) 효율성(效率性)의 결정요인(決定要因)과 동태적(動態的) 변화(變化))

  • Yoo, Seong-min
    • KDI Journal of Economic Policy
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    • v.12 no.4
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    • pp.21-46
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    • 1990
  • This paper, a sequel to Yoo and Lee (1990), attempts to investigate the interindustry determinants of technical efficiency in Korea's manufacturing industries, and also to conduct an exploratory analysis on the stability of technical efficiency over time. The hypotheses set forth in this paper are most found in the existing literature on technical efficiency. They are, however, revised and shed a new light upon, whenever possible, to accommodate any Korea-specific conditions. The set of regressors used in the cross-sectional analysis are chosen and the hypotheses are posed in such a way that our result can be made comparable to those of similar studies conducted for the U.S. and Japan by Caves and Barton (1990) and Uekusa and Torii (1987), respectively. It is interesting to observe a certain degree of similarity as well as differentiation between the cross-section evidence on Korea's manufacturing industries and that on the U.S. and Japanese industries. As for the similarities, we can find positive and significant effects on technical efficiency of relative size of production and the extent of specialization in production, and negative and significant effect of the variations in capital-labor ratio within industries. The curvature influence of concentration ratio on technical efficiency is also confirmed in the Korean case. There are differences, too. We cannot find any significant effects of capital vintage, R&D and foreign competition on technical efficiency, all of which were shown to be robust determinants of technical efficiency in the U.S. case. We note, however, that the variables measuring capital vintage effect, R&D and the degree of foreign competition in Korean markets are suspected to suffer from serious measurement errors incurred in data collection and/or conversion of industrial classification system into the KSIC (Korea Standard Industrial Classification) system. Thus, we are reluctant to accept the findings on the effects of these variables as definitive conclusions on Korea's industrial organization. Another finding that interests us is that the cross-industry evidence becomes consistently strong when we use the efficiency estimates based on gross output instead of value added, which provides us with an ex post empirical criterion to choose an output measure between the two in estimating the production frontier. We also conduct exploratory analyses on the stability of the estimates of technical efficiency in Korea's manufacturing industries. Though the method of testing stability employed in this paper is never a complete one, we cannot find strong evidence that our efficiency estimates are stable over time. The outcome is both surprising and disappointing. We can also show that the instability of technical efficiency over time is partly explained by the way we constructed our measures of technical efficiency. To the extent that our efficiency estimates depend on the shape of the empirical distribution of plants in the input-output space, any movements of the production frontier over time are not reflected in the estimates, and possibilities exist of associating a higher level of technical efficiency with a downward movement of the production frontier over time, and so on. Thus, we find that efficiency measures that take into account not only the distributional changes, but also the shifts of the production frontier over time, increase the extent of stability, and are more appropriate for use in a dynamic context. The remaining portion of the instability of technical efficiency over time is not explained satisfactorily in this paper, and future research should address this question.

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Studies on the Hydrolysis of Holocellulose with Trichoderma viride Cellulase. (III). Effects of the Optimum Treated Conditions and Reactivation of Residue of Digested Substrates (Cellulase에 의한 목재당화(木材糖化)에 관(関)한 연구(硏究) - (III) 최적(最適) 처리조건(処理條件)과 효소처리(酵素処理) 잔사(殘渣)의 재기질화(再基質化) 효과(效果) -)

  • Min, Du Sik
    • Journal of Korean Society of Forest Science
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    • v.49 no.1
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    • pp.1-5
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    • 1980
  • In this study, enzymatic saccharification of substrates from Alnus hirsuta Ruper (8-14 years). Quercus acutissima Carruthers, Betula platyphylla var. japonica Nera, Populus euramericana Guiner and Platanus orientalis L. were investigated using crude cellulase preparations of Trichoderma viride Pers. ex. Fr. SANK 16374, and conduced on the optimum treated conditions of the cellulase sacchrification and reactivation of residue of digested substrates. The Trichoderma viride cellulase was produced by the submerged culture process and produced in the culture fluid was salted out quantitatively by the use of ammonium sulfate. The method of dilignification from wood (5 species) was treated by the peracetic acid(PA) method. The reducing sugar was determined by the dinitrosalicylic acid (DNS) method. 1. The results of tests carried out for 96 hr. (Figure 1), show conclusively the initial substrates from 5 species ($S_3$) which has been rendered highly reactive form and the mean rate of reducing sugar was 28.3 %. 2. The results of tests carried out for 96 hr., the reactivation of residue of digested substrates (improvement in the quality of the substrate through preheating in air at $190^{\circ}C$. for 45 min. followed by milling was (60 mesh size) at the same substrate level, increased concentrations of cellulase at the same substrate level, and increased concentrations of cellulase increases the rate of hydrolysis considerably. 3. Figure 1. shows conclusively that the residue of digested substrates ($S_1$ dried at $60^{\circ}C$) which has been rendered extremly resistant to cellulase action can be reactivated into a highly reactive form ($S_2$), almost comparable to that of the initial substrates ($S_3$). And the reducing sugar formation did not show statistically significent differences at 5% levels by initial substrates and the residue of digested substrates (preheating in air at $190^{\circ}C$. for 45 min. fallowed by milling was (60 mesh size).

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Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function (호흡기능장애와 관련된 간호진단의 타당도 조사)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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